PREMIUM STUDY GUIDE
ACE YOUR 2026/2027 NEURO NCLEX CERTIFICATION EXAM:
COMPREHENSIVE QUESTIONS AND ANSWERS GRADED A+
● 1) A client with a subdural hematoma becomes restless and confused,
with dilation of the ipsilateral pupil. The physician orders mannitol for
which of the following reasons?
1. To reduce intraocular pressure
2. To prevent acute tubular necrosis
3. To promote osmotic diuresis to decrease ICP
4. To draw water into the vascular system to increase blood pressure.
Answer: 3
Mannitol promotes osmotic diuresis by increasing the pressure gradient,
drawing fluid from intracellular to intravascular spaces. Although
mannitol is used for all the reasons described, the reduction of ICP in
this client is a concern.
● 2) A client with subdural hematoma was given mannitol to decrease
intracranial pressure (ICP). Which of the following results would best
show the mannitol was effective? 1. Urine output increases
2. Pupils are 8 mm and nonreactive
3. Systolic blood pressure remains at 150 mm Hg
4. BUN and creatinine levels return to normal. Answer: 1
1
,PREMIUM STUDY GUIDE
Mannitol promotes osmotic diuresis by increasing the pressure gradient
in the renal tubes. Fixed and dilated pupils are symptoms of increased
ICP or cranial nerve damage. No information is given about abnormal
BUN and creatinine levels or that mannitol is being given for renal
dysfunction or blood pressure maintenance.
● 3) Which of the following values is considered normal for ICP?
1. 0 to 15 mm Hg
2. 25 mm Hg
3. 35 to 45 mm Hg 4. 120/80 mm Hg. Answer: 1
Normal ICP is 0-15 mm Hg.
● 4) Which of the following symptoms may occur with a phenytoin level
of 32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion
3. Tonic-clonic seizure
4. Urinary incontinence. Answer: 1. A therapeutic phenytoin level is 10
to 20 mg/dl. A level of 32 mg/dl indicates toxicity. Symptoms of
toxicity include confusion and ataxia. Phenytoin doesn't cause
hyponatremia, seizure, or urinary incontinence. Incontinence may
occur during or after a seizure.
● 5) Which of the following signs and symptoms of increased ICP after
head trauma would appear first?
2
,PREMIUM STUDY GUIDE
1. Bradycardia
2. Large amounts of very dilute urine
3. Restlessness and confusion
4. Widened pulse pressure. Answer: 3
The earliest symptom of elevated ICP is a change in mental status.
Bradycardia, widened pulse pressure, and bradypnea occur later. The
client may void large amounts of very dilute urine if there's damage to
the posterior pituitary.
● 6) Problems with memory and learning would relate to which of the
following lobes?
1. Frontal
2. Occipital
3. Parietal
4. Temporal. Answer: 4
The temporal lobe functions to regulate memory and learning problems
because of the integration of the hippocampus. The frontal lobe
primarily functions to regulate thinking, planning, and judgment. The
occipital lobe functions regulate vision. The parietal lobe primarily
functions with sensory function.
● 7) While cooking, your client couldn't feel the temperature of a hot
oven. Which lobe could be dysfunctional?
1. Frontal
3
, PREMIUM STUDY GUIDE
2. Occipital
3. Parietal
4. Temporal. Answer: 3 The parietal lobe regulates sensory function,
which would include the ability to sense hot or cold objects. The
frontal lobe regulates thinking, planning, and judgment, and the
occipital lobe is primarily responsible for vision function. The
temporal lobe regulates memory.
● 8) The nurse is assessing the motor function of an unconscious client.
The nurse would plan to use which of the following to test the client's
peripheral response to pain?
1. Sternal rub
2. Pressure on the orbital rim
3. Squeezing the sternocleidomastoid muscle
4. Nail bed pressure. Answer: 4
Motor testing on the unconscious client can be done only by testing
response to painful stimuli. Nailbed pressure tests a basic peripheral
response. Cerebral responses to pain are testing using sternal rub,
placing upward pressure on the orbital rim, or squeezing the clavicle or
sternocleidomastoid muscle.
● 10) The client is having a lumbar puncture performed. The nurse
would plan to place the client in which position for the procedure?
1. Side-lying, with legs pulled up and head bent down onto the chest
2. Side-lying, with a pillow under the hip
4
ACE YOUR 2026/2027 NEURO NCLEX CERTIFICATION EXAM:
COMPREHENSIVE QUESTIONS AND ANSWERS GRADED A+
● 1) A client with a subdural hematoma becomes restless and confused,
with dilation of the ipsilateral pupil. The physician orders mannitol for
which of the following reasons?
1. To reduce intraocular pressure
2. To prevent acute tubular necrosis
3. To promote osmotic diuresis to decrease ICP
4. To draw water into the vascular system to increase blood pressure.
Answer: 3
Mannitol promotes osmotic diuresis by increasing the pressure gradient,
drawing fluid from intracellular to intravascular spaces. Although
mannitol is used for all the reasons described, the reduction of ICP in
this client is a concern.
● 2) A client with subdural hematoma was given mannitol to decrease
intracranial pressure (ICP). Which of the following results would best
show the mannitol was effective? 1. Urine output increases
2. Pupils are 8 mm and nonreactive
3. Systolic blood pressure remains at 150 mm Hg
4. BUN and creatinine levels return to normal. Answer: 1
1
,PREMIUM STUDY GUIDE
Mannitol promotes osmotic diuresis by increasing the pressure gradient
in the renal tubes. Fixed and dilated pupils are symptoms of increased
ICP or cranial nerve damage. No information is given about abnormal
BUN and creatinine levels or that mannitol is being given for renal
dysfunction or blood pressure maintenance.
● 3) Which of the following values is considered normal for ICP?
1. 0 to 15 mm Hg
2. 25 mm Hg
3. 35 to 45 mm Hg 4. 120/80 mm Hg. Answer: 1
Normal ICP is 0-15 mm Hg.
● 4) Which of the following symptoms may occur with a phenytoin level
of 32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion
3. Tonic-clonic seizure
4. Urinary incontinence. Answer: 1. A therapeutic phenytoin level is 10
to 20 mg/dl. A level of 32 mg/dl indicates toxicity. Symptoms of
toxicity include confusion and ataxia. Phenytoin doesn't cause
hyponatremia, seizure, or urinary incontinence. Incontinence may
occur during or after a seizure.
● 5) Which of the following signs and symptoms of increased ICP after
head trauma would appear first?
2
,PREMIUM STUDY GUIDE
1. Bradycardia
2. Large amounts of very dilute urine
3. Restlessness and confusion
4. Widened pulse pressure. Answer: 3
The earliest symptom of elevated ICP is a change in mental status.
Bradycardia, widened pulse pressure, and bradypnea occur later. The
client may void large amounts of very dilute urine if there's damage to
the posterior pituitary.
● 6) Problems with memory and learning would relate to which of the
following lobes?
1. Frontal
2. Occipital
3. Parietal
4. Temporal. Answer: 4
The temporal lobe functions to regulate memory and learning problems
because of the integration of the hippocampus. The frontal lobe
primarily functions to regulate thinking, planning, and judgment. The
occipital lobe functions regulate vision. The parietal lobe primarily
functions with sensory function.
● 7) While cooking, your client couldn't feel the temperature of a hot
oven. Which lobe could be dysfunctional?
1. Frontal
3
, PREMIUM STUDY GUIDE
2. Occipital
3. Parietal
4. Temporal. Answer: 3 The parietal lobe regulates sensory function,
which would include the ability to sense hot or cold objects. The
frontal lobe regulates thinking, planning, and judgment, and the
occipital lobe is primarily responsible for vision function. The
temporal lobe regulates memory.
● 8) The nurse is assessing the motor function of an unconscious client.
The nurse would plan to use which of the following to test the client's
peripheral response to pain?
1. Sternal rub
2. Pressure on the orbital rim
3. Squeezing the sternocleidomastoid muscle
4. Nail bed pressure. Answer: 4
Motor testing on the unconscious client can be done only by testing
response to painful stimuli. Nailbed pressure tests a basic peripheral
response. Cerebral responses to pain are testing using sternal rub,
placing upward pressure on the orbital rim, or squeezing the clavicle or
sternocleidomastoid muscle.
● 10) The client is having a lumbar puncture performed. The nurse
would plan to place the client in which position for the procedure?
1. Side-lying, with legs pulled up and head bent down onto the chest
2. Side-lying, with a pillow under the hip
4
