Adult Neuro NCLEX Exam QUESTIONS WITH COMPLETE SOLUTIONS Latest Updated 2024 (GRADED A+)

Adult Neuro NCLEX Exam QUESTIONS WITH COMPLETE SOLUTIONS Latest Updated 2024 (GRADED A+) cause of botulism Correct Answer: Improperly canned foods Block acetylcholine cause muscle paralysis; descending flaccid paralysis (face downward), dysphasia, constipation Occur if small infant (1) eat honey, raw wild honey Cause of Giardia Correct Answer: Contaminated water Cause of E-coil Correct Answer: Water and food ingestion that is contaminated by feces- HAND WASHING Multiple Sclerosis (MS) Correct Answer: Chronic, autoimmune disease, progressive Demyelination of cranial nerve and spinal cord (CNS) system Period of remission and exacerbation S/s: spasticity and incoordination, muscle weakness, and fatigue Care: No cure, reduce symptoms. Steroid. Immunosuppressant like interferon Assistive device, walking with feet apart, ROM, strengthening exercise, and stretching, balance rest with exercise, avoid increase duration; dehydration and extreme temp-stressor cause exacerbation; self-catch as spastic bladder Guillian-Barre syndrome Correct Answer: Acute, autoimmune attack in the PNS cause ascending muscle weakness and absent DTR, ARDS-life threatening complication (inability to cough, shallow breath, difficulty breathing, hypoxia), inability to lift head or eye brows MONITOR RESPIRATORY STATUS IS MOST IMPORTANT FVC golden standard for assessing ventilation- decline mean respiratory arrest require ET intubation ALSO sth important is that they cause impaired mobility, increase risk for DVT, paralytic illeus, and even severe ANS-causing that headache and flushing TX: respiratory support, plasmaphresis, IVIG Tonic Correct Answer: Body stiffening Clonic Correct Answer: Muscle jerking Atomic Correct Answer: Loss of muscle tone Supraglottic swallow Correct Answer: Technique that allows them to have voluntary control over vocal cords to protect themselves from aspiration CN IX _______ decrease risk of Ad Correct Answer: Smoking cessation, avoid excessive alcohol intake, exercise reg, and participate in mental activities Frontal lobe Correct Answer: Related to knowledge thing Broca aphasia or expressive aphasia: inability to express words- after TIA or stroke Executive function and personality Behavioral change Temporal Correct Answer: Auditory and past experience Wernickle aphasia- receptive aphasia Report a _________________ is a priority for GCS even if it is only change by ___ Correct Answer: negative trends 1 Initial (means acute) phase of suspected stroke Correct Answer: CT scan, baseline neuro assessment, and prepare tpA Medulla oblongata Correct Answer: Rate and depth of respiration Parietal lobe Correct Answer: Sensory problems-touch Occipital lobe Correct Answer: Visual problems- coup-counter coup Straining or Valsalva maneuver Correct Answer: Holding breathing when bearing down Contraindicated for pt with increased ICP, head injury, stroke, pt with anything can increase abdominal and thoracic pressure- glaucoma, eye surgery, cirrhosis-portal HTN, abdominal surgery, heart disease like MI Spinal immobilization Correct Answer: NSAIDS Neurological examination Significant traumatic mechanism of injury Alertness-pt maybe disoriented Intoxication Distracting injury-sth else distract pt from spinal pain Spinal examination: tenderness over spine or neck pain on movement may be present Transferring stroke pt from bed to chair Correct Answer: Wear non-skid shoesfirst step Bed and wheelchair brakes are locked Transfer belt Transfer pt toward the stronger side. If pt is weak on the left, ask the pt to pivot on the right Never bending at the waist Always keep the leg wide for stability Pivot on the foot distal to the chair What is the risk factors for stroke? WHAT is the most important one that you can change? Correct Answer: DM, high cholesterol, HTN, smoking, obesity And the biggest thing you can change is HTN-take med as precscribed Cerebellum has two functions Correct Answer: coordination of voluntary movement, and maintenance of balance and posture Test for cerebellum function Correct Answer: gait testing-watching normal gait then gait on heel-to-toe (tandem), on toes, and on heels Finger taping Correct Answer: each finger to the hand's thumb Rapid alternating movement Correct Answer: supination and pronation Finger to nose Correct Answer: pt touch HCP's finger and then touch their own nose Heel-to-shin Correct Answer: run each heel down each shin while in supine position Sensory test Correct Answer: ifentify the number 8 traced on the palm-fine touch (graphesthesia). Other tests like identifying object in the hand (stereognosis) and two point discrimination CN I-III Correct Answer: smells or vision (three O) CN IV Correct Answer: trochlea- eyes and motor CN V, VII, IX Correct Answer: trigeminal, facial, and glossopharyngeal- most commonly ask cranial nerves CN IX Correct Answer: glosso is tongue and pharyngeal is pharynx: assess gag reflex- freaking out about it because it concerns AIRWAY. Sensory posterior taste .Test: swallowing water CN VII Correct Answer: facial nerve-unilateral paralysis- bell's palsy or facial nerve palsy. S/s: decreased nasolabial folds, drooping mouth (asymmetrical). Nursing care: can't close their eyes- so we worry about corneal abrasion- keep it lubricate and close it for them or put a patch for them, don't let them dry out-same with the mouth- at risk for dental caries Cn V Correct Answer: trigeminal-temporal region, 3 branches, one go to eye, 1 cheek, 1 down the jawline. sensory-face, motor: chewing. So these patients are extremely sensitive to touch and temperature. So if a pt has a problem with this, extremely sensitive to touch and temperature (feel like a knife stabbing a patients). Tx: carbamazepine- side effect: SJS and agranulocytosis-sepsis risk-presentation: muscle cramps, hypokalemia, cold, pale peripheral edema, HF, UTI, sore throat,...) (clozapine can also cause agranulocytosis as well) Cn VI Correct Answer: abducens: motor, eyes Cn VIII Correct Answer: sensory, hearing, and balance CN X Correct Answer: Vagus sensory: throat; motor: swallowing, speech, cardiac innervation (slow down) Cn XI Correct Answer: motor: throat, neck muscles, upper back accessory test: shrugging the shoulder against resistance CN XII Correct Answer: hypoglossal motor-tongue Posturing Correct Answer: decorticate and decerebrate decorticate (flexion) Correct Answer: ARMS to the core of the body (middle). decerebrate Correct Answer: extension: EXTENDED. The arms are going to be extended rather than flexed. decerebrate _________________than decorticate Correct Answer: worse Deep tendons reflexes Correct Answer: biceps, tricep, brachioradial, quadricep Superficial reflex Correct Answer: plantar, abdominal, Babinski GCS score Correct Answer: eye opening (4), verbal response (5), motor response (6) (score ranging from 3-15) Lumbar puncture Correct Answer: insert the needle in the supraarchnoid space for CSF analysis Preop lumbar puncture Correct Answer: Preop: IPE Informed consent Empty bladder and bowel Position-on the side with knee pull toward the chest and chin tucked downward • Post-op Correct Answer: SEEM o Sim position-lie flat on the side for at least 4 hours. Prone or supine is to prevent headache. HEADACHE IS EXPECTED o Site: redness, swelling, clear drainage o Encourage fluid o Extremities movement o Monitor complication Computed tomography (CT) scan Correct Answer: Pre-op • Informed consent • Allergy to iodine, contrast dye, or shellfish • Assess BUN, creatine • Lie still and flat Post-op: • Increase fluid to clear the dye • Assess dye infection site • Assess allergic reaction Cerebral arteriography- dye Correct Answer: Preop • Informed consent • Allergy • BUN,creatine • NPO 4-6 hours • Mark distal peripheral pulses Correct Answer: • It is normal to feel warm face during procedure Correct Answer: Post-op Correct Answer: • Monitor LOC, sensory or motor deficit, bleeding and hematoma Correct Answer: • Movement restriction Correct Answer: 8-12 hours • Check that pulse Correct Answer: Electroencephalogram (EEG) Correct Answer: noninvasive-gan may cai electrode tren dau for seizure, hea injuries, tumor, degenerative diseases, metabolic disturbances, or brain death • DON'T see any informed consent for this Correct Answer: • Depression, stimulant, and antiseizure medication are not given prior EEG Correct Answer: • Avoid caffeine 8 hours before Correct Answer: • Wash hair to free of oil, spray, and conditioners Correct Answer: • Verify if test is done awake, asleep, or sleep-deprived Correct Answer: MRI Correct Answer: • No metal thingy Correct Answer: • Assess for claustrophobia Correct Answer: • Informed consent Correct Answer: III. Disorder Correct Answer: Head injury Correct Answer: Concussion Correct Answer: temporary loss of neuro function with no damage S/s Correct Answer: Brief disruption of consciousness, amnesia and headache Worsening is when visual problems, weakness and humbling on one side of the body, worsening headache and vomit, sleepiness or confusion-after 1-2 days so you need to monitor closely avoid strenuous activities-rest and light diet Correct Answer: Contusion Correct Answer: brain bi damage, loss of consciousness and confused DAI Correct Answer: diffuse axonal injury: shearing and tearing force Basilar skull fracture Correct Answer: Bleeding nose and ears (otorrhea, rhinorrhea), racoon eyes-periorbital edema and ecchymosis, and battle's sign Correct Answer: postauricular ecchymosis Hematoma Correct Answer: Correct Answer: Epidural Correct Answer: brief loss of consciousness, followed by lucid interval, then rapid deterioration Tx Correct Answer: burr hole and placement of drain to relieve increased ICP Subdural Correct Answer: Acute Correct Answer: develop over 24-48 hours, change in LOC, pupillary changes, and hemiparesis Subacute Correct Answer: develop from 48 hours to 2 wks Chronic Correct Answer: frequently in elderly Tx Correct Answer: surgical evacuation and burr hole and drain placement Increased ICP Correct Answer: • Factors increased ICP Correct Answer: hypercapnia, extreme temperature- too hot or too cold, shivering, lousy places • When pt has concussion, you check if they have s/s of increased ICP Correct Answer: • s/s Correct Answer: o Early signs such as restlessness, confusion, drowsiness, lethargy, or stupor; motor and sensory changes Correct Answer: o Headache, diplopia, irritability Correct Answer: o Worsening headache or stiff neck, unrelieved with OTC meds Correct Answer: o Visual change like blurring, slurred speech, difficulty walking-motor change, seizure Correct Answer: o N/V often projectile Correct Answer: o Pupillary changes Correct Answer: dilated, unequal, nonreactive(i psi lateral pupil dilation) o Change in vital signs Correct Answer: Cushing's triad Correct Answer: HTN with widening pulse pressure, bradycardia, and irregular breathing (Cheyne-Stokes respirations) Ineffective thermoregulation Correct Answer: • Nursing care Correct Answer: o HOB 30-45 Correct Answer: o Keep client's head in neutral position Correct Answer: o Avoid coughing, sneezing, straining, and suctioning Correct Answer: o Administer oxygen to increase the supply to brain Correct Answer: o Strict I & O, restrict fluids to prevent increased cerebral edema Correct Answer: o Decrease environmental stimuli Correct Answer: o Neuro examination for pt at risk of increased ICP must be done by HCP/ nurses and not family members Correct Answer: o Medication Correct Answer: Avoids opiates and sedatives unless ventilated. Correct Answer: Mannitol- decrease cerebral edema and steroids Correct Answer: Hyperthermia Correct Answer: increase cerebral oxygen demand • S/s Correct Answer: o Temperature elevation, shivering Correct Answer: o Hypoxia Correct Answer: • Nursing care Correct Answer: o Hypothermia blanket and cool sponge bath Correct Answer: o ECG for tachycardia and dysrhythmias Correct Answer: o Dehydration s/s Correct Answer: o Prevent shivering Correct Answer: o Med Correct Answer: Benzodiazepine Correct Answer: Chlorpromazine Correct Answer: disorder Correct Answer: • Generalized seizure Correct Answer: o Tonic-clonic Correct Answer: o Absence Correct Answer: