WEST VIRGINIA UNIVERSITY NSG 101 NEURO QUESTIONS AND
ANSWERS | COMPLETE NEUROLOGY NURSING STUDY GUIDE
2026/2027
NSG 101
2026/2027
EXAM HUB
EXAM HUB
,2. Admission vital signs for a brain-injured patient are blood pressure 128/68, pulse 110, and respirations
26. Which set of vital signs, if taken 1 hour after admission, will be of most concern to the nurse?
a. Blood pressure 154/68, pulse 56, respirations 12
b. Blood pressure 134/72, pulse 90, respirations 32
c. Blood pressure 148/78, pulse 112, respirations 28
d. Blood pressure 110/70, pulse 120, respirations
30 ANS: A
Systolic hypertension with widening pulse pressure, bradycardia, and respiratory changes represent
Cushings triad. These findings indicate that the intracranial pressure (ICP) has increased, and brain
herniation may be imminent unless immediate action is taken to reduce ICP. The other vital signs
may indicate the need for changes in treatment, but they are not indicative of an immediately life-
threatening process.
3. When a brain-injured patient responds to nail bed pressure with internal rotation, adduction,
and flexion of the arms, the nurse reports the response as
a. flexion withdrawal.
b. localization of pain.
c. decorticate posturing.
d. decerebrate posturing.
ANS: C
Internal rotation, adduction, and flexion of the arms in an unconscious patient is documented as
decorticate posturing. Extension of the arms and legs is decerebrate posturing. Because the flexion
is generalized, it does not indicate localization of pain or flexion withdrawal.
4. The nurse has administered prescribed IV mannitol (Osmitrol) to an unconscious patient.
Which parameter should the nurse monitor to determine the medications effectiveness?
a. Blood pressure
b. Oxygen saturation
c. Intracranial pressure
d. Hemoglobin and
hematocrit ANS: C
Mannitol is an osmotic diuretic and will reduce cerebral edema and intracranial pressure. It may initially
reduce hematocrit and increase blood pressure, but these are not the best parameters for evaluation of
,the effectiveness of the drug. Oxygen saturation will not directly improve as a result of mannitol
administration.
5. A 46-year-old patient with a head injury opens the eyes to verbal stimulation, curses when
stimulated, and does not respond to a verbal command to move but attempts to push away a painful
stimulus. The nurse records the patients Glasgow Coma Scale score as
a. 9.
b. 11.
c. 13.
d. 15.
ANS: B
The patient has a score of 3 for eye opening, 3 for best verbal response, and 5 for best motor response.
7. A 41-year-old patient who is unconscious has a nursing diagnosis of ineffective cerebral tissue
perfusion related to cerebral tissue swelling. Which nursing intervention will be included in the plan
of care?
a. Encourage coughing and deep breathing.
b. Position the patient with knees and hips flexed.
c. Keep the head of the bed elevated to 30 degrees.
d. Cluster nursing interventions to provide rest
periods. ANS: C
The patient with increased intracranial pressure (ICP) should be maintained in the head-up position to
help reduce ICP. Extreme flexion of the hips and knees increases abdominal pressure, which increases
ICP. Because the stimulation associated with nursing interventions increases ICP, clustering
interventions will progressively elevate ICP. Coughing increases intrathoracic pressure and ICP.
8. A 20-year-old male patient is admitted with a head injury after a collision while playing football.
After noting that the patient has developed clear nasal drainage, which action should the nurse take?
a. Have the patient gently blow the nose.
b. Check the drainage for glucose content.
c. Teach the patient that rhinorrhea is expected after a head injury.
, d. Obtain a specimen of the fluid to send for culture and
sensitivity. ANS: B
Clear nasal drainage in a patient with a head injury suggests a dural tear and cerebrospinal fluid (CSF)
leakage. If the drainage is CSF, it will test positive for glucose. Fluid leaking from the nose will have normal nasal
flora, so culture and sensitivity will not be useful. Blowing the nose is avoided to prevent CSF leakage.
9. Which action will the emergency department nurse anticipate for a patient diagnosed with
a concussion who did not lose consciousness?
a. Coordinate the transfer of the patient to the operating room.
b. Provide discharge instructions about monitoring neurologic status.
c. Transport the patient to radiology for magnetic resonance imaging (MRI).
d. Arrange to admit the patient to the neurologic unit for 24 hours of
observation. ANS: B
A patient with a minor head trauma is usually discharged with instructions about neurologic monitoring
and the need to return if neurologic status deteriorates. MRI, hospital admission, or surgery are not usually
indicated in a patient with a concussion.
10. A 23-year-old patient who is suspected of having an epidural hematoma is admitted to
the emergency department. Which action will the nurse plan to take?
a. Administer IV furosemide (Lasix).
b. Prepare the patient for craniotomy.
c. Initiate high-dose barbiturate therapy.
d. Type and crossmatch for blood
transfusion. ANS: B
The principal treatment for epidural hematoma is rapid surgery to remove the hematoma and prevent
herniation. If intracranial pressure (ICP) is elevated after surgery, furosemide or high-dose barbiturate therapy
may be needed, but these will not be of benefit unless the hematoma is removed. Minimal blood
loss occurs with head injuries, and transfusion is usually not necessary.
ANSWERS | COMPLETE NEUROLOGY NURSING STUDY GUIDE
2026/2027
NSG 101
2026/2027
EXAM HUB
EXAM HUB
,2. Admission vital signs for a brain-injured patient are blood pressure 128/68, pulse 110, and respirations
26. Which set of vital signs, if taken 1 hour after admission, will be of most concern to the nurse?
a. Blood pressure 154/68, pulse 56, respirations 12
b. Blood pressure 134/72, pulse 90, respirations 32
c. Blood pressure 148/78, pulse 112, respirations 28
d. Blood pressure 110/70, pulse 120, respirations
30 ANS: A
Systolic hypertension with widening pulse pressure, bradycardia, and respiratory changes represent
Cushings triad. These findings indicate that the intracranial pressure (ICP) has increased, and brain
herniation may be imminent unless immediate action is taken to reduce ICP. The other vital signs
may indicate the need for changes in treatment, but they are not indicative of an immediately life-
threatening process.
3. When a brain-injured patient responds to nail bed pressure with internal rotation, adduction,
and flexion of the arms, the nurse reports the response as
a. flexion withdrawal.
b. localization of pain.
c. decorticate posturing.
d. decerebrate posturing.
ANS: C
Internal rotation, adduction, and flexion of the arms in an unconscious patient is documented as
decorticate posturing. Extension of the arms and legs is decerebrate posturing. Because the flexion
is generalized, it does not indicate localization of pain or flexion withdrawal.
4. The nurse has administered prescribed IV mannitol (Osmitrol) to an unconscious patient.
Which parameter should the nurse monitor to determine the medications effectiveness?
a. Blood pressure
b. Oxygen saturation
c. Intracranial pressure
d. Hemoglobin and
hematocrit ANS: C
Mannitol is an osmotic diuretic and will reduce cerebral edema and intracranial pressure. It may initially
reduce hematocrit and increase blood pressure, but these are not the best parameters for evaluation of
,the effectiveness of the drug. Oxygen saturation will not directly improve as a result of mannitol
administration.
5. A 46-year-old patient with a head injury opens the eyes to verbal stimulation, curses when
stimulated, and does not respond to a verbal command to move but attempts to push away a painful
stimulus. The nurse records the patients Glasgow Coma Scale score as
a. 9.
b. 11.
c. 13.
d. 15.
ANS: B
The patient has a score of 3 for eye opening, 3 for best verbal response, and 5 for best motor response.
7. A 41-year-old patient who is unconscious has a nursing diagnosis of ineffective cerebral tissue
perfusion related to cerebral tissue swelling. Which nursing intervention will be included in the plan
of care?
a. Encourage coughing and deep breathing.
b. Position the patient with knees and hips flexed.
c. Keep the head of the bed elevated to 30 degrees.
d. Cluster nursing interventions to provide rest
periods. ANS: C
The patient with increased intracranial pressure (ICP) should be maintained in the head-up position to
help reduce ICP. Extreme flexion of the hips and knees increases abdominal pressure, which increases
ICP. Because the stimulation associated with nursing interventions increases ICP, clustering
interventions will progressively elevate ICP. Coughing increases intrathoracic pressure and ICP.
8. A 20-year-old male patient is admitted with a head injury after a collision while playing football.
After noting that the patient has developed clear nasal drainage, which action should the nurse take?
a. Have the patient gently blow the nose.
b. Check the drainage for glucose content.
c. Teach the patient that rhinorrhea is expected after a head injury.
, d. Obtain a specimen of the fluid to send for culture and
sensitivity. ANS: B
Clear nasal drainage in a patient with a head injury suggests a dural tear and cerebrospinal fluid (CSF)
leakage. If the drainage is CSF, it will test positive for glucose. Fluid leaking from the nose will have normal nasal
flora, so culture and sensitivity will not be useful. Blowing the nose is avoided to prevent CSF leakage.
9. Which action will the emergency department nurse anticipate for a patient diagnosed with
a concussion who did not lose consciousness?
a. Coordinate the transfer of the patient to the operating room.
b. Provide discharge instructions about monitoring neurologic status.
c. Transport the patient to radiology for magnetic resonance imaging (MRI).
d. Arrange to admit the patient to the neurologic unit for 24 hours of
observation. ANS: B
A patient with a minor head trauma is usually discharged with instructions about neurologic monitoring
and the need to return if neurologic status deteriorates. MRI, hospital admission, or surgery are not usually
indicated in a patient with a concussion.
10. A 23-year-old patient who is suspected of having an epidural hematoma is admitted to
the emergency department. Which action will the nurse plan to take?
a. Administer IV furosemide (Lasix).
b. Prepare the patient for craniotomy.
c. Initiate high-dose barbiturate therapy.
d. Type and crossmatch for blood
transfusion. ANS: B
The principal treatment for epidural hematoma is rapid surgery to remove the hematoma and prevent
herniation. If intracranial pressure (ICP) is elevated after surgery, furosemide or high-dose barbiturate therapy
may be needed, but these will not be of benefit unless the hematoma is removed. Minimal blood
loss occurs with head injuries, and transfusion is usually not necessary.
