NSG 4100 Exam 4 Final Exam
Practice Questions and well
verified answers real exam
2026
Module: Neurological Conditions (Increased ICP, Head Injury, CVA)
1. A nurse is caring for a client with a head injury. Which assessment finding would the nurse
recognize as an early sign of increased intracranial pressure (ICP)?
a) Kussmaul breathing
b) Projectile vomiting
c) Weakness in one extremity
d) Papilledema
Answer: c) Weakness in one extremity
2. A client is admitted to the neurological ICU following an acute head injury resulting in cerebral
edema. What priority medication does the nurse expect to administer?
a) Furosemide (Lasix)
b) Mannitol (Osmitrol)
c) Hydrochlorothiazide (HydroDIURIL)
d) Spironolactone (Aldactone)
Answer: b) Mannitol (Osmitrol)
3. A client with a head injury has been increasingly agitated. What is the nurse's best intervention for
preventing injury?
a) Restrain the client as ordered.
b) Pad the side rails of the client's bed.
c) Administer opioids PRN as ordered.
d) Arrange for family to stay with the client.
Answer: b) Pad the side rails of the client's bed.
4. The nurse is admitting a client with a severe migraine headache and a history of acute coronary
syndrome. Which medication order would the nurse question?
,a) Rizatriptan (Maxalt)
b) Sumatriptan succinate (Imitrex)
c) Naratriptan (Amerge)
d) Zolmitriptan (Zomig)
Answer: b) Sumatriptan succinate (Imitrex)
5. A client who has been on long-term phenytoin (Dilantin) therapy is admitted. Due to the adverse
effects of this medication, the nurse should prioritize which intervention in the plan of care?
a) Monitoring of pulse oximetry
b) Administration of thorough oral hygiene
c) Fluid restriction as ordered
d) Administration of a low-protein diet
Answer: b) Administration of thorough oral hygiene
6. An 82-year-old man is admitted for observation after a fall. Due to his age, the nurse knows he is at
increased risk for what complication?
a) Skull fracture
b) Stroke
c) Hematoma
d) Embolus
Answer: c) Hematoma
7. A client with a head injury has been producing a large amount of urine for the past 3 hours and is
becoming tachycardic and hypotensive. The nurse knows this client needs to be monitored for which
condition?
a) Diabetes Mellitus (DM)
b) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
c) Diabetes Insipidus (DI)
d) Cushing's syndrome
Answer: c) Diabetes Insipidus (DI)
8. The nurse is assessing a client post-craniotomy. A urine output of 1500 mL for two consecutive
hours suggests which complication?
a) SIADH
b) Diabetes insipidus
c) Adrenal crisis
d) Cushing's triad
Answer: b) Diabetes insipidus
9. Following a craniotomy, the nurse identifies a diagnosis of deficient fluid volume related to fluid
restriction and osmotic diuretic use. What is an appropriate intervention?
a) Maintain NPO status.
b) Monitor serum electrolytes.
c) Monitor arterial blood gas (ABG) values.
d) Change the client's position as indicated.
Answer: b) Monitor serum electrolytes.
, 10. The critical care nurse is caring for a client with a head injury who, on morning rounds, is
responsive to painful stimulus and assumes decorticate posturing. Two hours later, which data would
warrant immediate intervention?
a) The client has purposeful movement when the nurse rubs the sternum.
b) The client extends the upper and lower extremities in response to painful stimuli.
c) The client is aimlessly thrashing in the bed.
d) The client is now localizing to painful stimuli.
Answer: b) The client extends the upper and lower extremities in response to painful stimuli.
(Decerebrate posturing indicates worsening)
11. A client with a pituitary tumor has developed SIADH. Which intervention should the nurse
implement?
a) Administer vasopressin IV.
b) Assess for dehydration and monitor blood glucose.
c) Assess for nausea/vomiting and weigh daily.
d) Monitor potassium level and encourage fluid intake.
Answer: c) Assess for nausea/vomiting and weigh daily.
12. A client is to have a transsphenoidal hypophysectomy. The nurse should instruct the client that
the surgery will be performed through an incision in the:
a) Nose
b) Upper gingival mucosa in the space between the upper gum and lip
c) Back of the mouth
d) Sinus channel below the right eye
Answer: b) Upper gingival mucosa in the space between the upper gum and lip
Module: Spinal Cord Injury (SCI)
13. A client with a C5 spinal cord injury is tetraplegic. After being moved out of the ICU, the client
complains of a severe throbbing headache. What should the nurse do first?
a) Administer analgesia.
b) Lower the head of the bed to improve perfusion.
c) Check the client's indwelling urinary catheter for kinks to ensure patency.
d) Reassure the client that headaches are expected.
Answer: c) Check the client's indwelling urinary catheter for kinks to ensure patency. (This addresses a
potential cause of autonomic dysreflexia)
14. A client is admitted to the neurologic ICU with a spinal cord injury. When assessing the client, the
nurse notes a sudden depression of reflex activity below the level of injury. What should the nurse
suspect?
a) Spinal shock
b) Hypovolemia
c) Epidural hemorrhage
d) Hypertensive emergency
Answer: a) Spinal shock
Practice Questions and well
verified answers real exam
2026
Module: Neurological Conditions (Increased ICP, Head Injury, CVA)
1. A nurse is caring for a client with a head injury. Which assessment finding would the nurse
recognize as an early sign of increased intracranial pressure (ICP)?
a) Kussmaul breathing
b) Projectile vomiting
c) Weakness in one extremity
d) Papilledema
Answer: c) Weakness in one extremity
2. A client is admitted to the neurological ICU following an acute head injury resulting in cerebral
edema. What priority medication does the nurse expect to administer?
a) Furosemide (Lasix)
b) Mannitol (Osmitrol)
c) Hydrochlorothiazide (HydroDIURIL)
d) Spironolactone (Aldactone)
Answer: b) Mannitol (Osmitrol)
3. A client with a head injury has been increasingly agitated. What is the nurse's best intervention for
preventing injury?
a) Restrain the client as ordered.
b) Pad the side rails of the client's bed.
c) Administer opioids PRN as ordered.
d) Arrange for family to stay with the client.
Answer: b) Pad the side rails of the client's bed.
4. The nurse is admitting a client with a severe migraine headache and a history of acute coronary
syndrome. Which medication order would the nurse question?
,a) Rizatriptan (Maxalt)
b) Sumatriptan succinate (Imitrex)
c) Naratriptan (Amerge)
d) Zolmitriptan (Zomig)
Answer: b) Sumatriptan succinate (Imitrex)
5. A client who has been on long-term phenytoin (Dilantin) therapy is admitted. Due to the adverse
effects of this medication, the nurse should prioritize which intervention in the plan of care?
a) Monitoring of pulse oximetry
b) Administration of thorough oral hygiene
c) Fluid restriction as ordered
d) Administration of a low-protein diet
Answer: b) Administration of thorough oral hygiene
6. An 82-year-old man is admitted for observation after a fall. Due to his age, the nurse knows he is at
increased risk for what complication?
a) Skull fracture
b) Stroke
c) Hematoma
d) Embolus
Answer: c) Hematoma
7. A client with a head injury has been producing a large amount of urine for the past 3 hours and is
becoming tachycardic and hypotensive. The nurse knows this client needs to be monitored for which
condition?
a) Diabetes Mellitus (DM)
b) Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
c) Diabetes Insipidus (DI)
d) Cushing's syndrome
Answer: c) Diabetes Insipidus (DI)
8. The nurse is assessing a client post-craniotomy. A urine output of 1500 mL for two consecutive
hours suggests which complication?
a) SIADH
b) Diabetes insipidus
c) Adrenal crisis
d) Cushing's triad
Answer: b) Diabetes insipidus
9. Following a craniotomy, the nurse identifies a diagnosis of deficient fluid volume related to fluid
restriction and osmotic diuretic use. What is an appropriate intervention?
a) Maintain NPO status.
b) Monitor serum electrolytes.
c) Monitor arterial blood gas (ABG) values.
d) Change the client's position as indicated.
Answer: b) Monitor serum electrolytes.
, 10. The critical care nurse is caring for a client with a head injury who, on morning rounds, is
responsive to painful stimulus and assumes decorticate posturing. Two hours later, which data would
warrant immediate intervention?
a) The client has purposeful movement when the nurse rubs the sternum.
b) The client extends the upper and lower extremities in response to painful stimuli.
c) The client is aimlessly thrashing in the bed.
d) The client is now localizing to painful stimuli.
Answer: b) The client extends the upper and lower extremities in response to painful stimuli.
(Decerebrate posturing indicates worsening)
11. A client with a pituitary tumor has developed SIADH. Which intervention should the nurse
implement?
a) Administer vasopressin IV.
b) Assess for dehydration and monitor blood glucose.
c) Assess for nausea/vomiting and weigh daily.
d) Monitor potassium level and encourage fluid intake.
Answer: c) Assess for nausea/vomiting and weigh daily.
12. A client is to have a transsphenoidal hypophysectomy. The nurse should instruct the client that
the surgery will be performed through an incision in the:
a) Nose
b) Upper gingival mucosa in the space between the upper gum and lip
c) Back of the mouth
d) Sinus channel below the right eye
Answer: b) Upper gingival mucosa in the space between the upper gum and lip
Module: Spinal Cord Injury (SCI)
13. A client with a C5 spinal cord injury is tetraplegic. After being moved out of the ICU, the client
complains of a severe throbbing headache. What should the nurse do first?
a) Administer analgesia.
b) Lower the head of the bed to improve perfusion.
c) Check the client's indwelling urinary catheter for kinks to ensure patency.
d) Reassure the client that headaches are expected.
Answer: c) Check the client's indwelling urinary catheter for kinks to ensure patency. (This addresses a
potential cause of autonomic dysreflexia)
14. A client is admitted to the neurologic ICU with a spinal cord injury. When assessing the client, the
nurse notes a sudden depression of reflex activity below the level of injury. What should the nurse
suspect?
a) Spinal shock
b) Hypovolemia
c) Epidural hemorrhage
d) Hypertensive emergency
Answer: a) Spinal shock
