Newest NUR 378 EXAM 3 questions verified with correct answers plus rationales
2026/2027 version
1. A patient suddenly develops facial drooping, unilateral arm weakness, and difficulty
speaking. What is the priority nursing action?
A. Give the patient oral fluids
B. Activate the stroke/emergency response process
C. Place the patient in Trendelenburg position
D. Allow the patient to rest and reassess later
Correct Answer: B
Rationale: Sudden focal neurologic deficits are classic warning signs of acute stroke. Rapid
assessment and treatment are essential because cerebral tissue is highly time-sensitive.
2. A patient with an acute ischemic stroke develops difficulty swallowing. What is the
priority intervention before oral medications or food are given?
A. Perform a swallowing assessment
B. Give water to test swallowing
C. Place food at the bedside
D. Encourage rapid eating
Correct Answer: A
Rationale: Dysphagia is common after stroke and increases the risk of aspiration. Oral intake
should be withheld until swallowing safety has been evaluated.
3. A patient with increased intracranial pressure becomes progressively less responsive.
What is the nurse's priority?
A. Encourage ambulation
B. Perform urgent neurologic assessment and notify the appropriate provider
C. Place the patient flat
D. Give oral fluids
Correct Answer: B
Rationale: Declining level of consciousness can indicate worsening intracranial pressure and
possible cerebral herniation. Immediate neurologic assessment and intervention are required.
,4. A patient with a spinal cord injury suddenly develops severe hypertension, headache,
flushing above the injury, and bradycardia. What complication should the nurse suspect?
A. Autonomic dysreflexia
B. Hypovolemic shock
C. Septic shock
D. Pulmonary embolism
Correct Answer: A
Rationale: Autonomic dysreflexia can occur with spinal cord injuries above the T6 level. A
noxious stimulus, commonly bladder or bowel distention, triggers an uncontrolled sympathetic
response.
5. A patient with autonomic dysreflexia has a distended bladder. What is an appropriate
immediate intervention?
A. Identify and remove the triggering stimulus, beginning with bladder assessment
B. Encourage the patient to remain supine
C. Restrict all fluids
D. Delay intervention until symptoms resolve
Correct Answer: A
Rationale: The priority in autonomic dysreflexia is to remove the precipitating stimulus. Bladder
distention is a common trigger.
6. A patient with Parkinson disease has difficulty initiating movement. Which finding is
characteristic of the disease?
A. Bradykinesia
B. Hyperactive movement
C. Severe muscle hypertrophy
D. Increased reflexes in every case
Correct Answer: A
Rationale: Parkinson disease commonly causes bradykinesia, rigidity, resting tremor, and
postural instability.
,7. A patient with Parkinson disease is at increased risk for falls. Which intervention is most
appropriate?
A. Maintain a safe environment and encourage appropriate assistive devices
B. Encourage walking without assistance
C. Remove all mobility aids
D. Keep the patient on strict bed rest indefinitely
Correct Answer: A
Rationale: Motor impairment and postural instability increase fall risk. Environmental safety
and appropriate mobility support are important.
8. A patient with multiple sclerosis reports worsening weakness after prolonged exposure
to heat. What should the nurse teach?
A. Avoid excessive heat and allow adequate rest
B. Exercise continuously in hot environments
C. Restrict all physical activity permanently
D. Increase environmental temperature
Correct Answer: A
Rationale: Heat can temporarily worsen neurologic symptoms in multiple sclerosis. Energy
conservation and temperature management can help reduce symptom exacerbation.
9. A patient with myasthenia gravis develops increasing difficulty swallowing and
breathing. What is the priority concern?
A. Respiratory compromise
B. Mild dehydration
C. Constipation
D. Skin breakdown
Correct Answer: A
Rationale: Myasthenia gravis can impair respiratory and bulbar muscles. Difficulty breathing or
swallowing may indicate a potentially life-threatening exacerbation.
, 10. A patient with a seizure disorder begins having a generalized tonic-clonic seizure. What
is the priority nursing action?
A. Protect the patient from injury and maintain airway safety
B. Restrain the patient's extremities
C. Insert an object into the mouth
D. Give oral medication immediately
Correct Answer: A
Rationale: During a seizure, the priority is patient safety and airway protection. The patient
should not be restrained and nothing should be placed in the mouth.
11. A patient has a seizure lasting several minutes without regaining consciousness. What
condition should the nurse suspect?
A. Status epilepticus
B. Migraine
C. Syncope
D. Normal postictal behavior
Correct Answer: A
Rationale: Prolonged or recurrent seizure activity without adequate recovery is status
epilepticus and requires emergency treatment.
12. A patient is confused and sleepy after a generalized seizure. What phase is most likely
occurring?
A. Postictal phase
B. Aura
C. Prodromal phase only
D. Interictal phase
Correct Answer: A
Rationale: The postictal period follows a seizure and may include confusion, fatigue, headache,
and somnolence.
2026/2027 version
1. A patient suddenly develops facial drooping, unilateral arm weakness, and difficulty
speaking. What is the priority nursing action?
A. Give the patient oral fluids
B. Activate the stroke/emergency response process
C. Place the patient in Trendelenburg position
D. Allow the patient to rest and reassess later
Correct Answer: B
Rationale: Sudden focal neurologic deficits are classic warning signs of acute stroke. Rapid
assessment and treatment are essential because cerebral tissue is highly time-sensitive.
2. A patient with an acute ischemic stroke develops difficulty swallowing. What is the
priority intervention before oral medications or food are given?
A. Perform a swallowing assessment
B. Give water to test swallowing
C. Place food at the bedside
D. Encourage rapid eating
Correct Answer: A
Rationale: Dysphagia is common after stroke and increases the risk of aspiration. Oral intake
should be withheld until swallowing safety has been evaluated.
3. A patient with increased intracranial pressure becomes progressively less responsive.
What is the nurse's priority?
A. Encourage ambulation
B. Perform urgent neurologic assessment and notify the appropriate provider
C. Place the patient flat
D. Give oral fluids
Correct Answer: B
Rationale: Declining level of consciousness can indicate worsening intracranial pressure and
possible cerebral herniation. Immediate neurologic assessment and intervention are required.
,4. A patient with a spinal cord injury suddenly develops severe hypertension, headache,
flushing above the injury, and bradycardia. What complication should the nurse suspect?
A. Autonomic dysreflexia
B. Hypovolemic shock
C. Septic shock
D. Pulmonary embolism
Correct Answer: A
Rationale: Autonomic dysreflexia can occur with spinal cord injuries above the T6 level. A
noxious stimulus, commonly bladder or bowel distention, triggers an uncontrolled sympathetic
response.
5. A patient with autonomic dysreflexia has a distended bladder. What is an appropriate
immediate intervention?
A. Identify and remove the triggering stimulus, beginning with bladder assessment
B. Encourage the patient to remain supine
C. Restrict all fluids
D. Delay intervention until symptoms resolve
Correct Answer: A
Rationale: The priority in autonomic dysreflexia is to remove the precipitating stimulus. Bladder
distention is a common trigger.
6. A patient with Parkinson disease has difficulty initiating movement. Which finding is
characteristic of the disease?
A. Bradykinesia
B. Hyperactive movement
C. Severe muscle hypertrophy
D. Increased reflexes in every case
Correct Answer: A
Rationale: Parkinson disease commonly causes bradykinesia, rigidity, resting tremor, and
postural instability.
,7. A patient with Parkinson disease is at increased risk for falls. Which intervention is most
appropriate?
A. Maintain a safe environment and encourage appropriate assistive devices
B. Encourage walking without assistance
C. Remove all mobility aids
D. Keep the patient on strict bed rest indefinitely
Correct Answer: A
Rationale: Motor impairment and postural instability increase fall risk. Environmental safety
and appropriate mobility support are important.
8. A patient with multiple sclerosis reports worsening weakness after prolonged exposure
to heat. What should the nurse teach?
A. Avoid excessive heat and allow adequate rest
B. Exercise continuously in hot environments
C. Restrict all physical activity permanently
D. Increase environmental temperature
Correct Answer: A
Rationale: Heat can temporarily worsen neurologic symptoms in multiple sclerosis. Energy
conservation and temperature management can help reduce symptom exacerbation.
9. A patient with myasthenia gravis develops increasing difficulty swallowing and
breathing. What is the priority concern?
A. Respiratory compromise
B. Mild dehydration
C. Constipation
D. Skin breakdown
Correct Answer: A
Rationale: Myasthenia gravis can impair respiratory and bulbar muscles. Difficulty breathing or
swallowing may indicate a potentially life-threatening exacerbation.
, 10. A patient with a seizure disorder begins having a generalized tonic-clonic seizure. What
is the priority nursing action?
A. Protect the patient from injury and maintain airway safety
B. Restrain the patient's extremities
C. Insert an object into the mouth
D. Give oral medication immediately
Correct Answer: A
Rationale: During a seizure, the priority is patient safety and airway protection. The patient
should not be restrained and nothing should be placed in the mouth.
11. A patient has a seizure lasting several minutes without regaining consciousness. What
condition should the nurse suspect?
A. Status epilepticus
B. Migraine
C. Syncope
D. Normal postictal behavior
Correct Answer: A
Rationale: Prolonged or recurrent seizure activity without adequate recovery is status
epilepticus and requires emergency treatment.
12. A patient is confused and sleepy after a generalized seizure. What phase is most likely
occurring?
A. Postictal phase
B. Aura
C. Prodromal phase only
D. Interictal phase
Correct Answer: A
Rationale: The postictal period follows a seizure and may include confusion, fatigue, headache,
and somnolence.
