HESI PN NEUROLOGICAL NURSING ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
Question 1
A practical nurse is caring for a client who has sustained a traumatic brain injury
and is now exhibiting decorticate posturing. The nurse should recognize that this
finding indicates injury to which area of the brain?
A. Brainstem
B. Cerebral cortex
C. Cerebellum
D. Spinal cord
Correct Answer: B
Rationale: Decorticate posturing involves flexion of the arms, wrists, and fingers
with adduction of the upper extremities and extension of the lower extremities.
This occurs with lesions of the cerebral cortex or lesions that interrupt the
corticospinal tracts above the brainstem.
,Question 2
A client with increased intracranial pressure is being monitored. Which vital sign
change should the practical nurse identify as a late sign of increasing intracranial
pressure?
A. Tachycardia and hypotension
B. Bradycardia and widening pulse pressure
C. Tachypnea and hypertension
D. Bradycardia and hypotension
Correct Answer: B
Rationale: Cushing’s triad, which includes bradycardia, widening pulse pressure,
and irregular respirations, is a late sign of increased intracranial pressure. It
indicates brainstem compression and is a medical emergency requiring
immediate intervention.
Question 3
The practical nurse is assessing a client who had a cerebrovascular accident
involving the left hemisphere. Which neurological deficit should the nurse
anticipate?
A. Left-sided hemiplegia
B. Right-sided hemiplegia and aphasia
C. Visual spatial deficits
D. Impulsive behavior
Correct Answer: B
Rationale: A left hemisphere stroke results in motor deficits on the right side of
the body, as well as language deficits such as aphasia because the speech
centers are located in the left hemisphere for most individuals.
Question 4
A client with a diagnosis of myasthenia gravis is prescribed pyridostigmine. The
practical nurse should monitor the client for which sign of cholinergic crisis?
A. Dry mouth and constipation
B. Muscle weakness and excessive salivation
C. Hypertension and tachycardia
D. Urinary retention and blurred vision
,Correct Answer: B
Rationale: Cholinergic crisis occurs with excessive anticholinesterase medication,
leading to overstimulation at the neuromuscular junction. Symptoms include
muscle weakness, excessive salivation, lacrimation, diarrhea, and bradycardia.
Question 5
A practical nurse is caring for a client who is experiencing a tonic-clonic seizure.
Which action should the nurse take first?
A. Restrain the client’s arms and legs
B. Insert a padded tongue blade into the mouth
C. Position the client on the side and protect the head
D. Obtain intravenous access
Correct Answer: C
Rationale: During a seizure the priority is to maintain a patent airway and
prevent injury. Positioning the client on the side allows secretions to drain and
reduces the risk of aspiration, while protecting the head prevents trauma.
Question 6
A client with a spinal cord injury at T4 reports a severe headache and is noted to
have profuse diaphoresis and flushing above the level of injury. Blood pressure is
210/110 mmHg. Which intervention should the practical nurse implement first?
A. Place the client flat in bed
B. Elevate the head of the bed to a sitting position
C. Administer an analgesic
D. Notify the healthcare provider after assessing for bladder distention
Correct Answer: B
Rationale: The client is experiencing autonomic dysreflexia, a life-threatening
emergency. The first intervention is to elevate the head of the bed to lower
blood pressure, then identify and remove the triggering stimulus such as bladder
distention or fecal impaction.
Question 7
The practical nurse is performing a neurological assessment on a client using the
Glasgow Coma Scale. The client opens eyes to verbal command, gives confused
verbal responses, and localizes pain. What is the client’s Glasgow Coma Scale
score?
, A. 9
B. 11
C. 13
D. 15
Correct Answer: B
Rationale: Eye opening to verbal command scores 3, confused verbal response
scores 4, and localizing pain scores 4 for a total of 11. The Glasgow Coma Scale
ranges from 3 to 15 with lower scores indicating more severe neurological
impairment.
Question 8
A client with Guillain-Barré syndrome is admitted to the medical-surgical unit.
Which assessment finding should the practical nurse report immediately?
A. Ascending muscle weakness
B. Decreased deep tendon reflexes
C. Difficulty speaking and swallowing
D. Paresthesia of the lower extremities
Correct Answer: C
Rationale: Difficulty speaking and swallowing indicates involvement of the
cranial nerves and potential respiratory compromise. This is a medical
emergency requiring immediate intervention to maintain airway and prevent
aspiration.
Question 9
A practical nurse is caring for a client who has undergone a lumbar puncture.
Which instruction should the nurse provide to prevent a post-procedure
headache?
A. Ambulate frequently to promote cerebrospinal fluid circulation
B. Remain flat in bed for several hours as prescribed
C. Limit fluid intake to reduce cerebrospinal fluid pressure
D. Sit upright in a chair to reduce pressure at the puncture site
Correct Answer: B
Rationale: Lying flat after a lumbar puncture reduces cerebrospinal fluid leakage
from the puncture site and decreases the risk of post-dural puncture headache.
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
Question 1
A practical nurse is caring for a client who has sustained a traumatic brain injury
and is now exhibiting decorticate posturing. The nurse should recognize that this
finding indicates injury to which area of the brain?
A. Brainstem
B. Cerebral cortex
C. Cerebellum
D. Spinal cord
Correct Answer: B
Rationale: Decorticate posturing involves flexion of the arms, wrists, and fingers
with adduction of the upper extremities and extension of the lower extremities.
This occurs with lesions of the cerebral cortex or lesions that interrupt the
corticospinal tracts above the brainstem.
,Question 2
A client with increased intracranial pressure is being monitored. Which vital sign
change should the practical nurse identify as a late sign of increasing intracranial
pressure?
A. Tachycardia and hypotension
B. Bradycardia and widening pulse pressure
C. Tachypnea and hypertension
D. Bradycardia and hypotension
Correct Answer: B
Rationale: Cushing’s triad, which includes bradycardia, widening pulse pressure,
and irregular respirations, is a late sign of increased intracranial pressure. It
indicates brainstem compression and is a medical emergency requiring
immediate intervention.
Question 3
The practical nurse is assessing a client who had a cerebrovascular accident
involving the left hemisphere. Which neurological deficit should the nurse
anticipate?
A. Left-sided hemiplegia
B. Right-sided hemiplegia and aphasia
C. Visual spatial deficits
D. Impulsive behavior
Correct Answer: B
Rationale: A left hemisphere stroke results in motor deficits on the right side of
the body, as well as language deficits such as aphasia because the speech
centers are located in the left hemisphere for most individuals.
Question 4
A client with a diagnosis of myasthenia gravis is prescribed pyridostigmine. The
practical nurse should monitor the client for which sign of cholinergic crisis?
A. Dry mouth and constipation
B. Muscle weakness and excessive salivation
C. Hypertension and tachycardia
D. Urinary retention and blurred vision
,Correct Answer: B
Rationale: Cholinergic crisis occurs with excessive anticholinesterase medication,
leading to overstimulation at the neuromuscular junction. Symptoms include
muscle weakness, excessive salivation, lacrimation, diarrhea, and bradycardia.
Question 5
A practical nurse is caring for a client who is experiencing a tonic-clonic seizure.
Which action should the nurse take first?
A. Restrain the client’s arms and legs
B. Insert a padded tongue blade into the mouth
C. Position the client on the side and protect the head
D. Obtain intravenous access
Correct Answer: C
Rationale: During a seizure the priority is to maintain a patent airway and
prevent injury. Positioning the client on the side allows secretions to drain and
reduces the risk of aspiration, while protecting the head prevents trauma.
Question 6
A client with a spinal cord injury at T4 reports a severe headache and is noted to
have profuse diaphoresis and flushing above the level of injury. Blood pressure is
210/110 mmHg. Which intervention should the practical nurse implement first?
A. Place the client flat in bed
B. Elevate the head of the bed to a sitting position
C. Administer an analgesic
D. Notify the healthcare provider after assessing for bladder distention
Correct Answer: B
Rationale: The client is experiencing autonomic dysreflexia, a life-threatening
emergency. The first intervention is to elevate the head of the bed to lower
blood pressure, then identify and remove the triggering stimulus such as bladder
distention or fecal impaction.
Question 7
The practical nurse is performing a neurological assessment on a client using the
Glasgow Coma Scale. The client opens eyes to verbal command, gives confused
verbal responses, and localizes pain. What is the client’s Glasgow Coma Scale
score?
, A. 9
B. 11
C. 13
D. 15
Correct Answer: B
Rationale: Eye opening to verbal command scores 3, confused verbal response
scores 4, and localizing pain scores 4 for a total of 11. The Glasgow Coma Scale
ranges from 3 to 15 with lower scores indicating more severe neurological
impairment.
Question 8
A client with Guillain-Barré syndrome is admitted to the medical-surgical unit.
Which assessment finding should the practical nurse report immediately?
A. Ascending muscle weakness
B. Decreased deep tendon reflexes
C. Difficulty speaking and swallowing
D. Paresthesia of the lower extremities
Correct Answer: C
Rationale: Difficulty speaking and swallowing indicates involvement of the
cranial nerves and potential respiratory compromise. This is a medical
emergency requiring immediate intervention to maintain airway and prevent
aspiration.
Question 9
A practical nurse is caring for a client who has undergone a lumbar puncture.
Which instruction should the nurse provide to prevent a post-procedure
headache?
A. Ambulate frequently to promote cerebrospinal fluid circulation
B. Remain flat in bed for several hours as prescribed
C. Limit fluid intake to reduce cerebrospinal fluid pressure
D. Sit upright in a chair to reduce pressure at the puncture site
Correct Answer: B
Rationale: Lying flat after a lumbar puncture reduces cerebrospinal fluid leakage
from the puncture site and decreases the risk of post-dural puncture headache.
