NCLEX-RN Pharmacology Neurological
System Practice Questions
20 Original NGN-Style MCQs with
Detailed Rationales
ATI Pharmacology Made Easy Nursing
Exam Prep Study Guide
Question 1
Clinical Scenario
A 27-year-old woman is admitted after experiencing two
generalized tonic-clonic seizures within the past 24 hours. She
has a history of epilepsy and reports missing several doses of
her prescribed levetiracetam during the previous week because
she "felt fine." Vital signs are stable. The provider renews her
levetiracetam prescription and the nurse begins discharge
teaching.
Question Stem
Which statement by the client indicates the need for additional
teaching?
,A. "I should continue taking my medication even if I have not
had a seizure recently."
B. "If I become pregnant, I should notify my healthcare provider
promptly."
C. "I can stop taking levetiracetam once I have been seizure-free
for a few months."
D. "I should avoid activities like driving until my provider says it
is safe."
Correct Answer
Correct Answer: C. "I can stop taking levetiracetam once I have
been seizure-free for a few months."
Detailed Rationale
Levetiracetam is an antiseizure medication that helps stabilize
abnormal neuronal activity, reducing seizure frequency. Abrupt
discontinuation or self-discontinuation after a seizure-free
period can significantly increase the risk of seizure recurrence
and, in some cases, status epilepticus. Medication changes
should only occur under healthcare provider supervision, often
with gradual tapering if discontinuation is appropriate.
Option A is correct patient understanding because antiseizure
medications should be taken consistently, even when seizures
are controlled. Missing doses is a common cause of
breakthrough seizures.
,Option B is also correct because pregnancy planning requires
provider involvement. Although levetiracetam has a relatively
favorable pregnancy safety profile compared with some older
antiepileptic drugs, therapy should be individualized and
prenatal folic acid supplementation is often recommended.
Option D reflects appropriate safety precautions. Driving
restrictions vary by jurisdiction, and patients should follow
provider recommendations and applicable laws before
resuming driving.
Nurses should reinforce medication adherence, discuss
common adverse effects such as dizziness, somnolence,
irritability, and mood changes, and instruct patients not to
discontinue therapy without medical guidance. Monitoring for
behavioral changes and suicidal ideation is also an important
nursing responsibility with many antiseizure medications.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of adherence to antiseizure
medications.
• Identify appropriate patient teaching for levetiracetam
therapy.
• Recognize risks associated with abrupt medication
discontinuation.
, Medication Safety Focus
Medication adherence
Question 2
Clinical Scenario
A 71-year-old man with Parkinson disease takes
carbidopa/levodopa three times daily. During morning
assessment, the nurse notes increasing rigidity, slow shuffling
gait, and resting tremor. The patient states he skipped breakfast
because he planned to eat a large steak immediately after
taking his medication.
Question Stem
Which nursing teaching is the priority?
A. Take the medication with a large high-protein meal.
B. Avoid all foods containing vitamin C.
C. High-protein meals may reduce levodopa absorption and
effectiveness.
D. Double the next dose if symptoms continue.
Correct Answer
Correct Answer: C. High-protein meals may reduce levodopa
absorption and effectiveness.
System Practice Questions
20 Original NGN-Style MCQs with
Detailed Rationales
ATI Pharmacology Made Easy Nursing
Exam Prep Study Guide
Question 1
Clinical Scenario
A 27-year-old woman is admitted after experiencing two
generalized tonic-clonic seizures within the past 24 hours. She
has a history of epilepsy and reports missing several doses of
her prescribed levetiracetam during the previous week because
she "felt fine." Vital signs are stable. The provider renews her
levetiracetam prescription and the nurse begins discharge
teaching.
Question Stem
Which statement by the client indicates the need for additional
teaching?
,A. "I should continue taking my medication even if I have not
had a seizure recently."
B. "If I become pregnant, I should notify my healthcare provider
promptly."
C. "I can stop taking levetiracetam once I have been seizure-free
for a few months."
D. "I should avoid activities like driving until my provider says it
is safe."
Correct Answer
Correct Answer: C. "I can stop taking levetiracetam once I have
been seizure-free for a few months."
Detailed Rationale
Levetiracetam is an antiseizure medication that helps stabilize
abnormal neuronal activity, reducing seizure frequency. Abrupt
discontinuation or self-discontinuation after a seizure-free
period can significantly increase the risk of seizure recurrence
and, in some cases, status epilepticus. Medication changes
should only occur under healthcare provider supervision, often
with gradual tapering if discontinuation is appropriate.
Option A is correct patient understanding because antiseizure
medications should be taken consistently, even when seizures
are controlled. Missing doses is a common cause of
breakthrough seizures.
,Option B is also correct because pregnancy planning requires
provider involvement. Although levetiracetam has a relatively
favorable pregnancy safety profile compared with some older
antiepileptic drugs, therapy should be individualized and
prenatal folic acid supplementation is often recommended.
Option D reflects appropriate safety precautions. Driving
restrictions vary by jurisdiction, and patients should follow
provider recommendations and applicable laws before
resuming driving.
Nurses should reinforce medication adherence, discuss
common adverse effects such as dizziness, somnolence,
irritability, and mood changes, and instruct patients not to
discontinue therapy without medical guidance. Monitoring for
behavioral changes and suicidal ideation is also an important
nursing responsibility with many antiseizure medications.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of adherence to antiseizure
medications.
• Identify appropriate patient teaching for levetiracetam
therapy.
• Recognize risks associated with abrupt medication
discontinuation.
, Medication Safety Focus
Medication adherence
Question 2
Clinical Scenario
A 71-year-old man with Parkinson disease takes
carbidopa/levodopa three times daily. During morning
assessment, the nurse notes increasing rigidity, slow shuffling
gait, and resting tremor. The patient states he skipped breakfast
because he planned to eat a large steak immediately after
taking his medication.
Question Stem
Which nursing teaching is the priority?
A. Take the medication with a large high-protein meal.
B. Avoid all foods containing vitamin C.
C. High-protein meals may reduce levodopa absorption and
effectiveness.
D. Double the next dose if symptoms continue.
Correct Answer
Correct Answer: C. High-protein meals may reduce levodopa
absorption and effectiveness.
