Neurological Nursing Exam Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
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1. A nurse is assessing a patient who has suddenly developed facial drooping,
weakness of the right arm, and difficulty speaking. Which action is the
priority?
A. Give the patient oral fluids
B. Determine the exact time the symptoms began
C. Place the patient in a supine position
D. Administer a prescribed sedative
Answer: B. Determine the exact time the symptoms began
Rationale: The exact time that neurological symptoms began is critical when an
acute stroke is suspected because eligibility for time-sensitive reperfusion therapies
depends on the onset or last-known-well time. The nurse should rapidly activate the
stroke response, assess airway and vital signs, check blood glucose as indicated,
and prepare the patient for urgent neurological evaluation and brain imaging.
2. A patient with a suspected ischemic stroke has difficulty swallowing. Which
nursing intervention is most appropriate before giving food, fluids, or oral
medications?
A. Offer a small amount of water
B. Place the patient in a high-Fowler position and begin feeding
C. Keep the patient NPO until a swallowing assessment is completed
D. Give thickened fluids immediately
Answer: C. Keep the patient NPO until a swallowing assessment is completed
,Rationale: Dysphagia is common after stroke and can result in aspiration,
pneumonia, and inadequate nutrition. Oral intake should be withheld until
swallowing ability has been appropriately assessed. Depending on the setting, a
trained clinician or speech-language professional may perform a formal swallowing
evaluation.
3. A patient with increased intracranial pressure is being monitored in the
neurological intensive care unit. Which finding requires immediate nursing
attention?
A. Mild headache
B. Restlessness after repositioning
C. A sudden decrease in level of consciousness
D. Mild nausea after medication administration
Answer: C. A sudden decrease in level of consciousness
Rationale: A sudden decline in consciousness may indicate worsening cerebral
edema, increasing intracranial pressure, hemorrhage, or impending brain
herniation. Neurological deterioration requires immediate assessment and
notification of the appropriate healthcare team. Changes in consciousness can be
among the earliest important indicators of neurological deterioration.
4. Which assessment finding is most consistent with increased intracranial
pressure?
A. Bradycardia with hypotension only
B. Decreased level of consciousness with changes in pupillary response
C. Increased appetite
D. Bilateral ankle edema
Answer: B. Decreased level of consciousness with changes in pupillary response
Rationale: Increased intracranial pressure can impair cerebral perfusion and
compress cranial nerves. Changes in consciousness and pupillary abnormalities are
important neurological warning signs. Advanced intracranial hypertension may
,produce Cushing responses, including hypertension with widened pulse pressure,
bradycardia, and abnormal respirations.
5. A nurse is caring for a patient after a craniotomy. Which assessment finding
should be reported immediately?
A. Incisional discomfort rated 3/10
B. Mild fatigue
C. New unequal pupils
D. Decreased appetite
Answer: C. New unequal pupils
Rationale: New anisocoria or a significant change in pupil size or reactivity can
indicate neurological deterioration, increased intracranial pressure, cranial nerve
compression, or herniation. A postoperative neurological patient requires frequent
neurological assessments so that subtle changes can be recognized promptly.
6. A patient with a traumatic brain injury becomes increasingly restless. Which
nursing action is most appropriate initially?
A. Apply physical restraints immediately
B. Administer a sedative without assessment
C. Assess neurological status, oxygenation, pain, and other potential causes of
agitation
D. Encourage the patient to walk independently
Answer: C. Assess neurological status, oxygenation, pain, and other potential
causes of agitation
Rationale: Restlessness may be an early manifestation of hypoxia, increased
intracranial pressure, pain, medication effects, metabolic disturbances, or
neurological deterioration. The nurse should first assess for reversible causes while
maintaining patient safety. Sudden behavioral changes in a neurological patient
should never automatically be attributed to anxiety.
7. Which Glasgow Coma Scale component evaluates the patient's ability to
respond verbally?
, A. Eye opening
B. Motor response
C. Verbal response
D. Pupillary response
Answer: C. Verbal response
Rationale: The Glasgow Coma Scale evaluates eye opening, verbal response, and
motor response. The three components are scored separately and combined to
provide an overall assessment of consciousness. Pupillary response is clinically
important but is not one of the three original GCS components.
8. A patient opens the eyes spontaneously, is confused when answering
questions, and obeys commands. Which GCS score is correct?
A. 11
B. 12
C. 14
D. 15
Answer: C. 14
Rationale: Spontaneous eye opening scores 4 points, confused verbal responses
score 4 points, and obeying commands scores 6 points. The total is 14. A change
from a patient's previous GCS should be considered clinically significant, particularly
after head injury.
9. Which patient is at greatest risk for increased intracranial pressure?
A. Patient with an uncomplicated ankle fracture
B. Patient with mild seasonal allergies
C. Patient with cerebral edema following a severe head injury
D. Patient with controlled hypertension
Answer: C. Patient with cerebral edema following a severe head injury
Rationale: Cerebral edema increases the volume within the fixed cranial
compartment and can elevate intracranial pressure. Severe traumatic brain injury is
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A nurse is assessing a patient who has suddenly developed facial drooping,
weakness of the right arm, and difficulty speaking. Which action is the
priority?
A. Give the patient oral fluids
B. Determine the exact time the symptoms began
C. Place the patient in a supine position
D. Administer a prescribed sedative
Answer: B. Determine the exact time the symptoms began
Rationale: The exact time that neurological symptoms began is critical when an
acute stroke is suspected because eligibility for time-sensitive reperfusion therapies
depends on the onset or last-known-well time. The nurse should rapidly activate the
stroke response, assess airway and vital signs, check blood glucose as indicated,
and prepare the patient for urgent neurological evaluation and brain imaging.
2. A patient with a suspected ischemic stroke has difficulty swallowing. Which
nursing intervention is most appropriate before giving food, fluids, or oral
medications?
A. Offer a small amount of water
B. Place the patient in a high-Fowler position and begin feeding
C. Keep the patient NPO until a swallowing assessment is completed
D. Give thickened fluids immediately
Answer: C. Keep the patient NPO until a swallowing assessment is completed
,Rationale: Dysphagia is common after stroke and can result in aspiration,
pneumonia, and inadequate nutrition. Oral intake should be withheld until
swallowing ability has been appropriately assessed. Depending on the setting, a
trained clinician or speech-language professional may perform a formal swallowing
evaluation.
3. A patient with increased intracranial pressure is being monitored in the
neurological intensive care unit. Which finding requires immediate nursing
attention?
A. Mild headache
B. Restlessness after repositioning
C. A sudden decrease in level of consciousness
D. Mild nausea after medication administration
Answer: C. A sudden decrease in level of consciousness
Rationale: A sudden decline in consciousness may indicate worsening cerebral
edema, increasing intracranial pressure, hemorrhage, or impending brain
herniation. Neurological deterioration requires immediate assessment and
notification of the appropriate healthcare team. Changes in consciousness can be
among the earliest important indicators of neurological deterioration.
4. Which assessment finding is most consistent with increased intracranial
pressure?
A. Bradycardia with hypotension only
B. Decreased level of consciousness with changes in pupillary response
C. Increased appetite
D. Bilateral ankle edema
Answer: B. Decreased level of consciousness with changes in pupillary response
Rationale: Increased intracranial pressure can impair cerebral perfusion and
compress cranial nerves. Changes in consciousness and pupillary abnormalities are
important neurological warning signs. Advanced intracranial hypertension may
,produce Cushing responses, including hypertension with widened pulse pressure,
bradycardia, and abnormal respirations.
5. A nurse is caring for a patient after a craniotomy. Which assessment finding
should be reported immediately?
A. Incisional discomfort rated 3/10
B. Mild fatigue
C. New unequal pupils
D. Decreased appetite
Answer: C. New unequal pupils
Rationale: New anisocoria or a significant change in pupil size or reactivity can
indicate neurological deterioration, increased intracranial pressure, cranial nerve
compression, or herniation. A postoperative neurological patient requires frequent
neurological assessments so that subtle changes can be recognized promptly.
6. A patient with a traumatic brain injury becomes increasingly restless. Which
nursing action is most appropriate initially?
A. Apply physical restraints immediately
B. Administer a sedative without assessment
C. Assess neurological status, oxygenation, pain, and other potential causes of
agitation
D. Encourage the patient to walk independently
Answer: C. Assess neurological status, oxygenation, pain, and other potential
causes of agitation
Rationale: Restlessness may be an early manifestation of hypoxia, increased
intracranial pressure, pain, medication effects, metabolic disturbances, or
neurological deterioration. The nurse should first assess for reversible causes while
maintaining patient safety. Sudden behavioral changes in a neurological patient
should never automatically be attributed to anxiety.
7. Which Glasgow Coma Scale component evaluates the patient's ability to
respond verbally?
, A. Eye opening
B. Motor response
C. Verbal response
D. Pupillary response
Answer: C. Verbal response
Rationale: The Glasgow Coma Scale evaluates eye opening, verbal response, and
motor response. The three components are scored separately and combined to
provide an overall assessment of consciousness. Pupillary response is clinically
important but is not one of the three original GCS components.
8. A patient opens the eyes spontaneously, is confused when answering
questions, and obeys commands. Which GCS score is correct?
A. 11
B. 12
C. 14
D. 15
Answer: C. 14
Rationale: Spontaneous eye opening scores 4 points, confused verbal responses
score 4 points, and obeying commands scores 6 points. The total is 14. A change
from a patient's previous GCS should be considered clinically significant, particularly
after head injury.
9. Which patient is at greatest risk for increased intracranial pressure?
A. Patient with an uncomplicated ankle fracture
B. Patient with mild seasonal allergies
C. Patient with cerebral edema following a severe head injury
D. Patient with controlled hypertension
Answer: C. Patient with cerebral edema following a severe head injury
Rationale: Cerebral edema increases the volume within the fixed cranial
compartment and can elevate intracranial pressure. Severe traumatic brain injury is
