EXAM 2
Stroke, Seizures, and Acute Neurological Care
75 Multiple-Choice Questions • Correct Answers Highlighted • Brief Rationales
Instructions: Choose the single best answer for each question. The correct option is highlighted in yellow, followed by a brief
rationale.
Study resource: Original practice questions based on the working assumption that NR-252 covers Adult Health II /
medical-surgical nursing. This is not an official Chamberlain exam; verify topics against your current syllabus.
1. Clinical review: A client with spinal cord injury has weak cough and shallow breathing. Which finding or action best fits this
situation?
A. Delay assessment until morning
B. Assess respiratory function and prepare for airway support
C. Focus only on bowel function
D. Offer a large meal
Rationale: High spinal injuries can impair respiratory muscles and cough effectiveness.
2. Complication prevention: A seizure has continued for 5 minutes. Which complication or risk should the nurse address
first?
A. Ask the client to stand
B. Treat as a medical emergency and activate emergency response
C. Offer oral fluids
D. Wait another 10 minutes
Rationale: A prolonged seizure may be status epilepticus and needs urgent treatment.
3. Client scenario: A client taking phenytoin reports swollen, bleeding gums. Which instruction should the nurse reinforce?
A. Avoid brushing the teeth
B. Stop the medication abruptly
C. Reinforce meticulous oral hygiene and routine dental care
D. Double the next dose
Rationale: Phenytoin can cause gingival overgrowth; oral care reduces complications.
4. At the bedside, a client with spinal cord injury has a distended bladder and autonomic dysreflexia. What should the nurse
do next?
A. Clamp the catheter
B. Check catheter patency and relieve bladder distention per protocol
C. Apply abdominal pressure without assessment
D. Encourage the client to hold urine
Rationale: Bladder problems are common triggers and should be corrected promptly.
, 5. During care: A client with spinal cord injury has a distended bladder and autonomic dysreflexia. Which nursing response is
most appropriate?
A. Apply abdominal pressure without assessment
B. Clamp the catheter
C. Check catheter patency and relieve bladder distention per protocol
D. Encourage the client to hold urine
Rationale: Bladder problems are common triggers and should be corrected promptly.
6. Client scenario: A client is postictal after a seizure. Which instruction should the nurse reinforce?
A. Leave the client alone to sleep
B. Assess airway, breathing, oxygenation, and level of consciousness
C. Immediately give a full meal
D. Assume new confusion is intentional
Rationale: Postictal care prioritizes airway and recovery monitoring.
7. During care: A client taking antiseizure medication asks whether it can be stopped after months without seizures. Which
nursing response is most appropriate?
A. Take it only when an aura occurs
B. Do not stop abruptly; consult the prescriber for any taper
C. Stop today if seizure-free
D. Skip doses on workdays
Rationale: Abrupt withdrawal can precipitate seizures.
8. Complication prevention: A client with a high spinal cord injury develops hypotension and bradycardia. Which complication
or risk should the nurse address first?
A. Give oral fluids as the sole treatment
B. Sit the client up and leave
C. Assume hypovolemic shock is the only possibility
D. Suspect neurogenic shock and notify the emergency team
Rationale: Loss of sympathetic tone can cause hypotension and bradycardia after high cord injury.
9. Safety check: A client with spinal cord injury reports pounding headache and has severe hypertension and flushing. Which
action best promotes client safety?
A. Suspect autonomic dysreflexia; sit upright and identify/remove the trigger
B. Lay flat and elevate legs
C. Give food and wait
D. Ignore the blood pressure
Rationale: Autonomic dysreflexia is an emergency; bladder distention is a common trigger.
10. Teaching and care planning: A seizure has continued for 5 minutes. Which statement shows the best understanding of
care?
A. Wait another 10 minutes
B. Ask the client to stand
C. Offer oral fluids
D. Treat as a medical emergency and activate emergency response
Rationale: A prolonged seizure may be status epilepticus and needs urgent treatment.
Stroke, Seizures, and Acute Neurological Care
75 Multiple-Choice Questions • Correct Answers Highlighted • Brief Rationales
Instructions: Choose the single best answer for each question. The correct option is highlighted in yellow, followed by a brief
rationale.
Study resource: Original practice questions based on the working assumption that NR-252 covers Adult Health II /
medical-surgical nursing. This is not an official Chamberlain exam; verify topics against your current syllabus.
1. Clinical review: A client with spinal cord injury has weak cough and shallow breathing. Which finding or action best fits this
situation?
A. Delay assessment until morning
B. Assess respiratory function and prepare for airway support
C. Focus only on bowel function
D. Offer a large meal
Rationale: High spinal injuries can impair respiratory muscles and cough effectiveness.
2. Complication prevention: A seizure has continued for 5 minutes. Which complication or risk should the nurse address
first?
A. Ask the client to stand
B. Treat as a medical emergency and activate emergency response
C. Offer oral fluids
D. Wait another 10 minutes
Rationale: A prolonged seizure may be status epilepticus and needs urgent treatment.
3. Client scenario: A client taking phenytoin reports swollen, bleeding gums. Which instruction should the nurse reinforce?
A. Avoid brushing the teeth
B. Stop the medication abruptly
C. Reinforce meticulous oral hygiene and routine dental care
D. Double the next dose
Rationale: Phenytoin can cause gingival overgrowth; oral care reduces complications.
4. At the bedside, a client with spinal cord injury has a distended bladder and autonomic dysreflexia. What should the nurse
do next?
A. Clamp the catheter
B. Check catheter patency and relieve bladder distention per protocol
C. Apply abdominal pressure without assessment
D. Encourage the client to hold urine
Rationale: Bladder problems are common triggers and should be corrected promptly.
, 5. During care: A client with spinal cord injury has a distended bladder and autonomic dysreflexia. Which nursing response is
most appropriate?
A. Apply abdominal pressure without assessment
B. Clamp the catheter
C. Check catheter patency and relieve bladder distention per protocol
D. Encourage the client to hold urine
Rationale: Bladder problems are common triggers and should be corrected promptly.
6. Client scenario: A client is postictal after a seizure. Which instruction should the nurse reinforce?
A. Leave the client alone to sleep
B. Assess airway, breathing, oxygenation, and level of consciousness
C. Immediately give a full meal
D. Assume new confusion is intentional
Rationale: Postictal care prioritizes airway and recovery monitoring.
7. During care: A client taking antiseizure medication asks whether it can be stopped after months without seizures. Which
nursing response is most appropriate?
A. Take it only when an aura occurs
B. Do not stop abruptly; consult the prescriber for any taper
C. Stop today if seizure-free
D. Skip doses on workdays
Rationale: Abrupt withdrawal can precipitate seizures.
8. Complication prevention: A client with a high spinal cord injury develops hypotension and bradycardia. Which complication
or risk should the nurse address first?
A. Give oral fluids as the sole treatment
B. Sit the client up and leave
C. Assume hypovolemic shock is the only possibility
D. Suspect neurogenic shock and notify the emergency team
Rationale: Loss of sympathetic tone can cause hypotension and bradycardia after high cord injury.
9. Safety check: A client with spinal cord injury reports pounding headache and has severe hypertension and flushing. Which
action best promotes client safety?
A. Suspect autonomic dysreflexia; sit upright and identify/remove the trigger
B. Lay flat and elevate legs
C. Give food and wait
D. Ignore the blood pressure
Rationale: Autonomic dysreflexia is an emergency; bladder distention is a common trigger.
10. Teaching and care planning: A seizure has continued for 5 minutes. Which statement shows the best understanding of
care?
A. Wait another 10 minutes
B. Ask the client to stand
C. Offer oral fluids
D. Treat as a medical emergency and activate emergency response
Rationale: A prolonged seizure may be status epilepticus and needs urgent treatment.
