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ATI Medical-Surgical Neurological &
Neurosensory Practice Exam 2026 | 100
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A nurse is assessing a client who has increased intracranial pressure (ICP).
Which finding should the nurse recognize as an early manifestation?
A. Bradycardia
B. Widened pulse pressure
C. Change in level of consciousness
D. Fixed and dilated pupils
Answer: Change in level of consciousness
Rationale: A change in level of consciousness is often one of the earliest and
most sensitive indicators of increasing ICP. Bradycardia, widened pulse pressure,
and abnormal respirations are later findings associated with Cushing's triad.
2. A nurse is caring for a client with a head injury. Which position should the
nurse use to help reduce intracranial pressure?
A. Flat with the neck flexed
B. Head elevated approximately 30° with the neck midline
C. Trendelenburg position
D. High-Fowler's position with the neck flexed
,Answer: Head elevated approximately 30° with the neck midline
Rationale: Elevating the head about 30° and maintaining the neck in a neutral
position promotes venous drainage from the brain and can help decrease ICP.
3. A client with a traumatic brain injury develops Cushing's triad. Which
findings should the nurse expect?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, widened pulse pressure, and irregular respirations
C. Hypertension, tachycardia, and regular respirations
D. Hypotension, bradycardia, and apnea
Answer: Bradycardia, widened pulse pressure, and irregular respirations
Rationale: Cushing's triad is a late sign of increased ICP and consists of
hypertension with widened pulse pressure, bradycardia, and irregular
respirations.
4. A nurse is assessing a client after a head injury. Which finding requires
immediate intervention?
A. Mild headache
B. Restlessness and increasing confusion
C. Bruising around the eyes
D. Nausea after eating
Answer: Restlessness and increasing confusion
Rationale: Restlessness and increasing confusion can indicate worsening
cerebral edema or increased ICP and require immediate assessment and
intervention.
5. A client has a Glasgow Coma Scale (GCS) score of 7. How should the nurse
interpret this finding?
A. Mild neurological impairment
B. Moderate neurological impairment
,C. Severe neurological impairment
D. Normal neurological function
Answer: Severe neurological impairment
Rationale: A GCS score of 8 or less indicates severe neurological impairment and
may indicate the need for airway protection.
6. A nurse is caring for a client who has a stroke. Which finding is most
characteristic of an ischemic stroke?
A. Ruptured cerebral aneurysm
B. Thrombus or embolus obstructing cerebral blood flow
C. Blood accumulating between the dura and arachnoid
D. Bleeding into the subarachnoid space
Answer: Thrombus or embolus obstructing cerebral blood flow
Rationale: An ischemic stroke occurs when cerebral blood flow is interrupted by
a thrombus or embolus.
7. A client arrives in the emergency department with manifestations of an
acute ischemic stroke. Which diagnostic test is typically performed first to
distinguish ischemic from hemorrhagic stroke?
A. Electroencephalogram
B. Noncontrast CT scan of the head
C. Carotid ultrasound
D. Lumbar puncture
Answer: Noncontrast CT scan of the head
Rationale: A noncontrast CT scan is commonly performed rapidly to identify
intracranial bleeding and help determine whether thrombolytic therapy is
appropriate.
8. A nurse is assessing a client who experienced a left-sided stroke. Which
manifestation should the nurse expect?
, A. Left-sided neglect
B. Right-sided weakness
C. Left visual-field loss only
D. Right-sided neglect only
Answer: Right-sided weakness
Rationale: The cerebral hemispheres generally control the opposite side of the
body. A left-sided stroke commonly causes right-sided weakness or paralysis.
9. A nurse is caring for a client with dysphagia following a stroke. Which action
should the nurse take before offering oral fluids?
A. Place the client supine
B. Assess the client's swallowing ability
C. Encourage the client to drink rapidly
D. Give thin liquids first
Answer: Assess the client's swallowing ability
Rationale: Dysphagia places stroke clients at risk for aspiration. Swallowing
ability should be assessed before oral intake is initiated.
10.A client with a stroke has difficulty communicating but appears to
understand spoken language. Which condition does this finding suggest?
A. Expressive aphasia
B. Receptive aphasia
C. Dysphagia
D. Dysarthria
Answer: Expressive aphasia
Rationale: Expressive aphasia involves difficulty producing language while
comprehension may remain relatively intact.
11.A client has expressive aphasia after a stroke. Which nursing intervention is
appropriate?
ATI Medical-Surgical Neurological &
Neurosensory Practice Exam 2026 | 100
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A nurse is assessing a client who has increased intracranial pressure (ICP).
Which finding should the nurse recognize as an early manifestation?
A. Bradycardia
B. Widened pulse pressure
C. Change in level of consciousness
D. Fixed and dilated pupils
Answer: Change in level of consciousness
Rationale: A change in level of consciousness is often one of the earliest and
most sensitive indicators of increasing ICP. Bradycardia, widened pulse pressure,
and abnormal respirations are later findings associated with Cushing's triad.
2. A nurse is caring for a client with a head injury. Which position should the
nurse use to help reduce intracranial pressure?
A. Flat with the neck flexed
B. Head elevated approximately 30° with the neck midline
C. Trendelenburg position
D. High-Fowler's position with the neck flexed
,Answer: Head elevated approximately 30° with the neck midline
Rationale: Elevating the head about 30° and maintaining the neck in a neutral
position promotes venous drainage from the brain and can help decrease ICP.
3. A client with a traumatic brain injury develops Cushing's triad. Which
findings should the nurse expect?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, widened pulse pressure, and irregular respirations
C. Hypertension, tachycardia, and regular respirations
D. Hypotension, bradycardia, and apnea
Answer: Bradycardia, widened pulse pressure, and irregular respirations
Rationale: Cushing's triad is a late sign of increased ICP and consists of
hypertension with widened pulse pressure, bradycardia, and irregular
respirations.
4. A nurse is assessing a client after a head injury. Which finding requires
immediate intervention?
A. Mild headache
B. Restlessness and increasing confusion
C. Bruising around the eyes
D. Nausea after eating
Answer: Restlessness and increasing confusion
Rationale: Restlessness and increasing confusion can indicate worsening
cerebral edema or increased ICP and require immediate assessment and
intervention.
5. A client has a Glasgow Coma Scale (GCS) score of 7. How should the nurse
interpret this finding?
A. Mild neurological impairment
B. Moderate neurological impairment
,C. Severe neurological impairment
D. Normal neurological function
Answer: Severe neurological impairment
Rationale: A GCS score of 8 or less indicates severe neurological impairment and
may indicate the need for airway protection.
6. A nurse is caring for a client who has a stroke. Which finding is most
characteristic of an ischemic stroke?
A. Ruptured cerebral aneurysm
B. Thrombus or embolus obstructing cerebral blood flow
C. Blood accumulating between the dura and arachnoid
D. Bleeding into the subarachnoid space
Answer: Thrombus or embolus obstructing cerebral blood flow
Rationale: An ischemic stroke occurs when cerebral blood flow is interrupted by
a thrombus or embolus.
7. A client arrives in the emergency department with manifestations of an
acute ischemic stroke. Which diagnostic test is typically performed first to
distinguish ischemic from hemorrhagic stroke?
A. Electroencephalogram
B. Noncontrast CT scan of the head
C. Carotid ultrasound
D. Lumbar puncture
Answer: Noncontrast CT scan of the head
Rationale: A noncontrast CT scan is commonly performed rapidly to identify
intracranial bleeding and help determine whether thrombolytic therapy is
appropriate.
8. A nurse is assessing a client who experienced a left-sided stroke. Which
manifestation should the nurse expect?
, A. Left-sided neglect
B. Right-sided weakness
C. Left visual-field loss only
D. Right-sided neglect only
Answer: Right-sided weakness
Rationale: The cerebral hemispheres generally control the opposite side of the
body. A left-sided stroke commonly causes right-sided weakness or paralysis.
9. A nurse is caring for a client with dysphagia following a stroke. Which action
should the nurse take before offering oral fluids?
A. Place the client supine
B. Assess the client's swallowing ability
C. Encourage the client to drink rapidly
D. Give thin liquids first
Answer: Assess the client's swallowing ability
Rationale: Dysphagia places stroke clients at risk for aspiration. Swallowing
ability should be assessed before oral intake is initiated.
10.A client with a stroke has difficulty communicating but appears to
understand spoken language. Which condition does this finding suggest?
A. Expressive aphasia
B. Receptive aphasia
C. Dysphagia
D. Dysarthria
Answer: Expressive aphasia
Rationale: Expressive aphasia involves difficulty producing language while
comprehension may remain relatively intact.
11.A client has expressive aphasia after a stroke. Which nursing intervention is
appropriate?
