NCM 118 SEMI (NURSESLAB) 2025/26
QUESTIONS WITH COMPLETE SOLUTIONS.
1 of 85
Term
An 18-year-old client is admitted with a closed head injury sustained
in a MVA. His intracranial pressure (ICP) shows an upward trend.
Which intervention should the nurse perform first?
A. Reposition the client to avoid neck flexion.
B.Administer 1 g Mannitol IV as ordered.
C. Increase the ventilator's respiratory rate to 20 breaths/minute.
D.Administer 100 mg of pentobarbital IV as ordered.
Give this one a try later!
, D. Raise the head of the bed A. Reposition the client to
immediately to 90 avoid neck flexion.
degrees.
B. Check the fluid for dextrose C. "Wake him every hour and
with a dipstick. assess his orientation to person,
time, and place."
Don't know?
2 of 85
Term
A 30-year-old was admitted to the progressive care unit with a C5
fracture from a motorcycle accident. Which of the following
assessments would take priority?
A. Bladder distension
B. Neurological deficit
C. Pulse ox readings
D.The client's feelings about the injury
Give this one a try later!
A. Urine output increases. B. Hypertension and bradycardia
C. Neurogenic shock C. Pulse ox readings
Don't know?
,3 of 85
Term
A female client has a neurological deficit involving the limbic
system. Specific to this type of deficit, the nurse would document
which of the following information related to the client's behavior.
A. Is disoriented to person, place, and time.
B.Affect is flat, with periods of emotional lability.
C. Cannot recall what was eaten for breakfast today.
D.Demonstrate inability to add and subtract; does not know who
is the president.
Give this one a try later!
D. Treatment of spasticity B.Check the fluid for dextrose with
associated with spinal cord a dipstick.
lesions.
B. Affect is flat, with periods B. Intracranial pressure (ICP) is
of emotional lability. increased.
Don't know?
4 of 85
Term
Regular oral hygiene is an essential intervention for the client who
has had a stroke. Which of the following nursing measures is
inappropriate when providing oral hygiene?
, A. Placing the client on the back with a small pillow under the head.
B.Keeping portable suctioning equipment at the bedside.
C. Opening the client's mouth with a padded tongue blade.
D.Cleaning the client's mouth and teeth with a toothbrush.
Give this one a try later!
B. Support the joint where the B. Limiting bladder
tendon is being tested. catheterization to once every 12
hours
A. Placing the client on the
back with a small pillow D. Raise the head of the
under the head. bed immediately to 90
degrees.
Don't know?
5 of 85
Term
The nurse is planning care for the client in spinal shock. Which of the
following actions would be least helpful in minimizing the effects of
vasodilation below the level of the injury?
A. Monitoring vital signs before and during position changes.
B.Using vasopressor medications as prescribed.
C. Moving the client quickly as one unit.
D.Applying Teds or compression stockings.
Give this one a try later!
QUESTIONS WITH COMPLETE SOLUTIONS.
1 of 85
Term
An 18-year-old client is admitted with a closed head injury sustained
in a MVA. His intracranial pressure (ICP) shows an upward trend.
Which intervention should the nurse perform first?
A. Reposition the client to avoid neck flexion.
B.Administer 1 g Mannitol IV as ordered.
C. Increase the ventilator's respiratory rate to 20 breaths/minute.
D.Administer 100 mg of pentobarbital IV as ordered.
Give this one a try later!
, D. Raise the head of the bed A. Reposition the client to
immediately to 90 avoid neck flexion.
degrees.
B. Check the fluid for dextrose C. "Wake him every hour and
with a dipstick. assess his orientation to person,
time, and place."
Don't know?
2 of 85
Term
A 30-year-old was admitted to the progressive care unit with a C5
fracture from a motorcycle accident. Which of the following
assessments would take priority?
A. Bladder distension
B. Neurological deficit
C. Pulse ox readings
D.The client's feelings about the injury
Give this one a try later!
A. Urine output increases. B. Hypertension and bradycardia
C. Neurogenic shock C. Pulse ox readings
Don't know?
,3 of 85
Term
A female client has a neurological deficit involving the limbic
system. Specific to this type of deficit, the nurse would document
which of the following information related to the client's behavior.
A. Is disoriented to person, place, and time.
B.Affect is flat, with periods of emotional lability.
C. Cannot recall what was eaten for breakfast today.
D.Demonstrate inability to add and subtract; does not know who
is the president.
Give this one a try later!
D. Treatment of spasticity B.Check the fluid for dextrose with
associated with spinal cord a dipstick.
lesions.
B. Affect is flat, with periods B. Intracranial pressure (ICP) is
of emotional lability. increased.
Don't know?
4 of 85
Term
Regular oral hygiene is an essential intervention for the client who
has had a stroke. Which of the following nursing measures is
inappropriate when providing oral hygiene?
, A. Placing the client on the back with a small pillow under the head.
B.Keeping portable suctioning equipment at the bedside.
C. Opening the client's mouth with a padded tongue blade.
D.Cleaning the client's mouth and teeth with a toothbrush.
Give this one a try later!
B. Support the joint where the B. Limiting bladder
tendon is being tested. catheterization to once every 12
hours
A. Placing the client on the
back with a small pillow D. Raise the head of the
under the head. bed immediately to 90
degrees.
Don't know?
5 of 85
Term
The nurse is planning care for the client in spinal shock. Which of the
following actions would be least helpful in minimizing the effects of
vasodilation below the level of the injury?
A. Monitoring vital signs before and during position changes.
B.Using vasopressor medications as prescribed.
C. Moving the client quickly as one unit.
D.Applying Teds or compression stockings.
Give this one a try later!
