Neurological System NCLEX Questions Ch 66
Neurological System NCLEX Questions: Ch 66
Study online at https://quizlet.com/_2q8mw3
1. The nurse is assessing the motor function of an un- 2. Nail Bed Pressure
conscious client. The nurse should plan to use which
technique to test the client's peripheral response to
pain?
1. Sternal rub
2. Nail Bed Pressure
3. Pressure on orbital rim
4. Squeezing of the sternocleidomastoid muscle
2. The nurse is caring for the client with increased in- 2. Increasing temperature,
tracranial pressure. The nurse would note which trend decreasing pulse, de-
in VS if the intracranial pressure is rising? creasing respirations, in-
creasing BP
1. Increasing temperature, increasing pulse, increas-
ing respirations, decreasing BP
2. Increasing temperature, decreasing pulse, decreas-
ing respirations, increasing BP
3. Decreasing temperature, decreasing pulse, increas-
ing respirations, decreasing BP
4. Decreasing temperature, increasing pulse, decreas-
ing respirations, increasing BP
3. A client recovering from a head injury is participating 4. Exhaling during reposi-
in care. The nurse determines that the client under- tioning
stands measures to prevent elevations in intracranial
pressure if the nurse observes the client doing the
activity?
1. Blowing the nose
2. Isometric exercises
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, Neurological System NCLEX Questions Ch 66
Neurological System NCLEX Questions: Ch 66
Study online at https://quizlet.com/_2q8mw3
3. Coughing vigorously
4. Exhaling during repositioning
4. A client has clear liquid leaking from the nose following 4. Fluid separates into
a basilar skull fracture. Which finding would alert the concentric rings and tests
nurse that cerebrospinal fluid is present? positive for glucose.
1. Fluid is clear and tests negative for glucose.
2. Fluid is grossly bloody in appearance and has a pH
of 6.
3. Fluid clumps together on the dressing and has a pH
of 7.
4. Fluid separates into concentric rings and tests posi-
tive for glucose.
5. A client with a spinal chord injury is prone to experi- 4. Limiting bladder
encing autonomic dysreflexia. The nurse should avoid catheterization to once
which measure to minimize the risk of occurrence? ever 12 hours
1. Strict adherence to a bowel retraining program
2 Keeping the linen wrinkle-free under the client
3. Preventing unnecessary pressure on the lower
limbs
4. Limiting bladder catheterization to once ever 12
hours
6. The nurse is evaluating the neurological signs of a 3. Flaccid paralysis
client in spinal shock following spinal chord injury.
Which observation indicates that spinal shock per-
sists?
1. Hyperreflexia
2. Positive reflexes
2/8
actualstudy Page 2 of 8
Neurological System NCLEX Questions: Ch 66
Study online at https://quizlet.com/_2q8mw3
1. The nurse is assessing the motor function of an un- 2. Nail Bed Pressure
conscious client. The nurse should plan to use which
technique to test the client's peripheral response to
pain?
1. Sternal rub
2. Nail Bed Pressure
3. Pressure on orbital rim
4. Squeezing of the sternocleidomastoid muscle
2. The nurse is caring for the client with increased in- 2. Increasing temperature,
tracranial pressure. The nurse would note which trend decreasing pulse, de-
in VS if the intracranial pressure is rising? creasing respirations, in-
creasing BP
1. Increasing temperature, increasing pulse, increas-
ing respirations, decreasing BP
2. Increasing temperature, decreasing pulse, decreas-
ing respirations, increasing BP
3. Decreasing temperature, decreasing pulse, increas-
ing respirations, decreasing BP
4. Decreasing temperature, increasing pulse, decreas-
ing respirations, increasing BP
3. A client recovering from a head injury is participating 4. Exhaling during reposi-
in care. The nurse determines that the client under- tioning
stands measures to prevent elevations in intracranial
pressure if the nurse observes the client doing the
activity?
1. Blowing the nose
2. Isometric exercises
1/8
actualstudy Page 1 of 8
, Neurological System NCLEX Questions Ch 66
Neurological System NCLEX Questions: Ch 66
Study online at https://quizlet.com/_2q8mw3
3. Coughing vigorously
4. Exhaling during repositioning
4. A client has clear liquid leaking from the nose following 4. Fluid separates into
a basilar skull fracture. Which finding would alert the concentric rings and tests
nurse that cerebrospinal fluid is present? positive for glucose.
1. Fluid is clear and tests negative for glucose.
2. Fluid is grossly bloody in appearance and has a pH
of 6.
3. Fluid clumps together on the dressing and has a pH
of 7.
4. Fluid separates into concentric rings and tests posi-
tive for glucose.
5. A client with a spinal chord injury is prone to experi- 4. Limiting bladder
encing autonomic dysreflexia. The nurse should avoid catheterization to once
which measure to minimize the risk of occurrence? ever 12 hours
1. Strict adherence to a bowel retraining program
2 Keeping the linen wrinkle-free under the client
3. Preventing unnecessary pressure on the lower
limbs
4. Limiting bladder catheterization to once ever 12
hours
6. The nurse is evaluating the neurological signs of a 3. Flaccid paralysis
client in spinal shock following spinal chord injury.
Which observation indicates that spinal shock per-
sists?
1. Hyperreflexia
2. Positive reflexes
2/8
actualstudy Page 2 of 8
