Exam 2 Maryville NURS 663
Megadeck QUESTIONS WITH
COMPLETE SOLUTIONS
Course
NURS 663
1. A patient presents with sudden unilateral facial drooping that began 30 minutes ago. What
is the nurse practitioner's priority action?
A. Prescribe oral corticosteroids
B. Activate the stroke protocol and arrange immediate neuroimaging
C. Schedule outpatient neurology follow-up
D. Observe the patient for 24 hours
Answer: B. Activate the stroke protocol and arrange immediate neuroimaging
Solution:
Acute unilateral facial weakness may indicate an ischemic stroke. Rapid evaluation with a non-
contrast CT scan or MRI is essential to determine eligibility for reperfusion therapy.
2. Which finding is most characteristic of Parkinson disease?
A. Intention tremor
B. Resting tremor with bradykinesia
C. Hyperreflexia
D. Spastic paralysis
Answer: B. Resting tremor with bradykinesia
Solution:
Parkinson disease is characterized by resting tremor, bradykinesia, rigidity, and postural
instability due to degeneration of dopaminergic neurons.
3. Which medication is considered first-line therapy for newly diagnosed Parkinson disease
with significant motor symptoms?
,A. Levodopa/carbidopa
B. Diazepam
C. Phenytoin
D. Prednisone
Answer: A. Levodopa/carbidopa
Solution:
Levodopa is converted to dopamine in the brain, while carbidopa reduces peripheral
metabolism, improving effectiveness and decreasing adverse effects.
4. Which symptom is most suggestive of bacterial meningitis?
A. Gradual headache over several weeks
B. Fever, neck stiffness, and altered mental status
C. Chronic low back pain
D. Isolated dizziness
Answer: B. Fever, neck stiffness, and altered mental status
Solution:
The classic triad of bacterial meningitis consists of fever, nuchal rigidity, and altered mental
status. Immediate antibiotics should not be delayed.
5. Which cranial nerve is responsible for facial muscle movement?
A. CN III
B. CN V
C. CN VII
D. CN XII
Answer: C. CN VII
Solution:
The facial nerve (CN VII) controls muscles of facial expression and contributes to taste sensation
from the anterior two-thirds of the tongue.
,6. Which assessment finding is most concerning in a patient with increased intracranial
pressure?
A. Mild headache
B. Bradycardia with hypertension
C. Temperature of 99°F (37.2°C)
D. Pulse rate of 92 beats/min
Answer: B. Bradycardia with hypertension
Solution:
Bradycardia, hypertension, and irregular respirations (Cushing triad) suggest dangerously
elevated intracranial pressure and possible brain herniation.
7. Which diagnostic test best confirms multiple sclerosis?
A. Chest radiograph
B. MRI of the brain and spinal cord
C. Colonoscopy
D. Echocardiogram
Answer: B. MRI of the brain and spinal cord
Solution:
MRI demonstrates demyelinating plaques and is the imaging study of choice for diagnosing
multiple sclerosis.
8. Which medication is commonly prescribed for acute migraine attacks?
A. Sumatriptan
B. Amoxicillin
C. Metformin
D. Digoxin
Answer: A. Sumatriptan
, Solution:
Triptans are serotonin receptor agonists that relieve migraine headaches by causing cranial
vasoconstriction and reducing neurogenic inflammation.
9. Which patient should NOT receive a triptan medication?
A. Patient with seasonal allergies
B. Patient with coronary artery disease
C. Patient with tension headache
D. Patient with sinusitis
Answer: B. Patient with coronary artery disease
Solution:
Triptans are contraindicated in patients with coronary artery disease because they can cause
coronary vasoconstriction.
10. Which seizure type involves brief episodes of impaired awareness without convulsions?
A. Tonic-clonic seizure
B. Absence seizure
C. Focal motor seizure
D. Myoclonic seizure
Answer: B. Absence seizure
Solution:
Absence seizures involve brief lapses in consciousness, typically lasting only a few seconds,
without postictal confusion.
11. Which medication is commonly used as first-line treatment for generalized tonic-clonic
seizures?
A. Levetiracetam
B. Ibuprofen
Megadeck QUESTIONS WITH
COMPLETE SOLUTIONS
Course
NURS 663
1. A patient presents with sudden unilateral facial drooping that began 30 minutes ago. What
is the nurse practitioner's priority action?
A. Prescribe oral corticosteroids
B. Activate the stroke protocol and arrange immediate neuroimaging
C. Schedule outpatient neurology follow-up
D. Observe the patient for 24 hours
Answer: B. Activate the stroke protocol and arrange immediate neuroimaging
Solution:
Acute unilateral facial weakness may indicate an ischemic stroke. Rapid evaluation with a non-
contrast CT scan or MRI is essential to determine eligibility for reperfusion therapy.
2. Which finding is most characteristic of Parkinson disease?
A. Intention tremor
B. Resting tremor with bradykinesia
C. Hyperreflexia
D. Spastic paralysis
Answer: B. Resting tremor with bradykinesia
Solution:
Parkinson disease is characterized by resting tremor, bradykinesia, rigidity, and postural
instability due to degeneration of dopaminergic neurons.
3. Which medication is considered first-line therapy for newly diagnosed Parkinson disease
with significant motor symptoms?
,A. Levodopa/carbidopa
B. Diazepam
C. Phenytoin
D. Prednisone
Answer: A. Levodopa/carbidopa
Solution:
Levodopa is converted to dopamine in the brain, while carbidopa reduces peripheral
metabolism, improving effectiveness and decreasing adverse effects.
4. Which symptom is most suggestive of bacterial meningitis?
A. Gradual headache over several weeks
B. Fever, neck stiffness, and altered mental status
C. Chronic low back pain
D. Isolated dizziness
Answer: B. Fever, neck stiffness, and altered mental status
Solution:
The classic triad of bacterial meningitis consists of fever, nuchal rigidity, and altered mental
status. Immediate antibiotics should not be delayed.
5. Which cranial nerve is responsible for facial muscle movement?
A. CN III
B. CN V
C. CN VII
D. CN XII
Answer: C. CN VII
Solution:
The facial nerve (CN VII) controls muscles of facial expression and contributes to taste sensation
from the anterior two-thirds of the tongue.
,6. Which assessment finding is most concerning in a patient with increased intracranial
pressure?
A. Mild headache
B. Bradycardia with hypertension
C. Temperature of 99°F (37.2°C)
D. Pulse rate of 92 beats/min
Answer: B. Bradycardia with hypertension
Solution:
Bradycardia, hypertension, and irregular respirations (Cushing triad) suggest dangerously
elevated intracranial pressure and possible brain herniation.
7. Which diagnostic test best confirms multiple sclerosis?
A. Chest radiograph
B. MRI of the brain and spinal cord
C. Colonoscopy
D. Echocardiogram
Answer: B. MRI of the brain and spinal cord
Solution:
MRI demonstrates demyelinating plaques and is the imaging study of choice for diagnosing
multiple sclerosis.
8. Which medication is commonly prescribed for acute migraine attacks?
A. Sumatriptan
B. Amoxicillin
C. Metformin
D. Digoxin
Answer: A. Sumatriptan
, Solution:
Triptans are serotonin receptor agonists that relieve migraine headaches by causing cranial
vasoconstriction and reducing neurogenic inflammation.
9. Which patient should NOT receive a triptan medication?
A. Patient with seasonal allergies
B. Patient with coronary artery disease
C. Patient with tension headache
D. Patient with sinusitis
Answer: B. Patient with coronary artery disease
Solution:
Triptans are contraindicated in patients with coronary artery disease because they can cause
coronary vasoconstriction.
10. Which seizure type involves brief episodes of impaired awareness without convulsions?
A. Tonic-clonic seizure
B. Absence seizure
C. Focal motor seizure
D. Myoclonic seizure
Answer: B. Absence seizure
Solution:
Absence seizures involve brief lapses in consciousness, typically lasting only a few seconds,
without postictal confusion.
11. Which medication is commonly used as first-line treatment for generalized tonic-clonic
seizures?
A. Levetiracetam
B. Ibuprofen
