NSG NEUROLOGICAL NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Neurological Assessment and Glasgow Coma Scale*
*- Stroke Management and Ischemic/Hemorrhagic Stroke Care*
*- Increased Intracranial Pressure (ICP) Recognition and Intervention*
*- Seizure Disorders and Epilepsy Management*
*- Traumatic Brain Injury and Spinal Cord Injury Care*
*- Neurological Pharmacology and Medication Safety*
*- Meningitis, Encephalitis, and CNS Infections*
*- Neurodegenerative Disorders (Alzheimer's, Parkinson's, MS, ALS)*
- Ethics, Legal Compliance, and Professional Standards in Neuro Nursing
*- Critical Thinking and Clinical Decision-Making in Neuro Emergencies*
Introduction
This comprehensive neurological nursing assessment evaluates essential knowledge and clinical judgment required for safe, effective practice in
neurological care settings. The exam assesses competency in neurological assessment techniques, recognition of neurological emergencies, stroke
management, seizure care, intracranial pressure monitoring, traumatic brain injury protocols, pharmacological interventions, and management
of neurodegenerative conditions. Questions use multiple-choice and scenario-based formats that emphasize real-world application, critical
thinking, and evidence-based decision-making. Candidates will demonstrate mastery of foundational theory, applied professional knowledge,
regulatory and legal compliance, ethical standards, and prioritization skills essential for neurological nursing practice. This assessment prepares
nurses for certification examinations and clinical practice excellence.
Section One: Questions 1–100
Question 1
A patient with a suspected stroke arrives at the emergency department. The nurse notes the patient's last known well time was 2 hours ago. Which
diagnostic test should the nurse anticipate being performed FIRST to determine eligibility for thrombolytic therapy?
A. Magnetic resonance imaging (MRI)
B. Computed tomography (CT) scan without contrast
C. Cerebral angiography
D. Lumbar puncture
🟢 Correct answer: B
,🔴 RATIONALE: A non-contrast CT scan is the priority initial diagnostic test to differentiate between ischemic and hemorrhagic stroke before
administering thrombolytics, as thrombolytics are contraindicated in hemorrhagic stroke. MRI, angiography, and lumbar puncture are not first-line
for acute stroke clearance.
Question 2
The nurse is assessing a patient's neurological status using the Glasgow Coma Scale (GCS). The patient opens eyes to speech, is confused in
conversation, and localizes pain. What is the patient's total GCS score?
A. 10
B. 11
C. 12
D. 13
🟢 Correct answer: C
🔴 RATIONALE: Eye opening to speech = 3 points, confused verbal response = 4 points, localizing pain = 5 points. Total = 3 + 4 + 5 = 12. A GCS of 8
or less indicates coma.
Question 3
A patient with increased intracranial pressure (ICP) is exhibiting Cushing's triad. Which set of vital signs represents Cushing's triad?
A. Hypotension, tachycardia, irregular respirations
B. Hypertension with widening pulse pressure, bradycardia, irregular respirations
C. Hypertension, tachycardia, regular respirations
D. Hypotension, bradycardia, apnea
🟢 Correct answer: B
🔴 RATIONALE: Cushing's triad consists of systolic hypertension with widening pulse pressure, bradycardia, and irregular respirations, indicating
increased ICP and possible brain herniation. This is a late sign of increased ICP requiring immediate intervention.
Question 4
During a tonic-clonic seizure, which nursing intervention is the PRIORITY?
,A. Insert an oral airway device
B. Restrain the patient's limbs to prevent injury
C. Protect the patient's head and turn them to the side
D. Administer benzodiazepines intramuscularly
🟢 Correct answer: C
🔴 RATIONALE: The priority during a seizure is patient safety—protect the head and turn to the side to prevent aspiration and injury. Never restrain
limbs or insert anything in the mouth as this causes harm.
Question 5
A nurse is caring for a patient with a head injury. How frequently should the nurse initially assess the Glasgow Coma Scale (GCS)?
A. Every 4 hours
B. Every 1 hour
C. Every 15 minutes
D. Every 30 minutes
🟢 Correct answer: C
🔴 RATIONALE: For acute head injury, GCS should be assessed every 15 minutes initially to promptly detect neurological changes indicating rising
ICP or deterioration. After stabilization, frequency decreases to every hour, then every 4 hours.
Question 6
Which finding in a patient with a spinal cord injury at T4 indicates autonomic dysreflexia?
A. Hypotension and tachycardia
B. Severe headache and hypertension
C. Flushing below the level of injury
D. Decreased urine output
🟢 Correct answer: B
🔴 RATIONALE: Autonomic dysreflexia presents with severe headache, hypertension, bradycardia, and flushing above the level of injury, typically
triggered by noxious stimuli below the injury level in spinal cord injuries at T6 or higher.
, Question 7
A patient with Alzheimer's disease is in the moderate stage. Which nursing intervention is MOST appropriate for managing wandering behavior?
A. Restrain the patient in bed at night
B. Install safety locks on all outside doors
C. Administer sedatives regularly
D. Confront the patient when they attempt to walk
🟢 Correct answer: B
🔴 RATIONALE: Safety locks on doors prevent wandering while maintaining patient dignity. Restraints and sedatives are inappropriate and violate
ethical standards; confrontation increases agitation in Alzheimer's patients.
Question 8
Which medication is the FIRST-LINE treatment for terminating an active status epilepticus seizure?
A. Phenytoin
B. Levetiracetam
C. Lorazepam
D. Valproic acid
🟢 Correct answer: C
🔴 RATIONALE: Benzodiazepines (lorazepam or diazepam) are first-line for status epilepticus to rapidly terminate seizures. Phenytoin,
levetiracetam, and valproic acid are second-line agents if benzodiazepines fail.
Question 9
A patient with bacterial meningitis is admitted. Which precaution should the nurse implement FIRST?
A. Contact precautions
B. Airborne precautions
C. Droplet precautions
D. Standard precautions only
🟢 Correct answer: C
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Neurological Assessment and Glasgow Coma Scale*
*- Stroke Management and Ischemic/Hemorrhagic Stroke Care*
*- Increased Intracranial Pressure (ICP) Recognition and Intervention*
*- Seizure Disorders and Epilepsy Management*
*- Traumatic Brain Injury and Spinal Cord Injury Care*
*- Neurological Pharmacology and Medication Safety*
*- Meningitis, Encephalitis, and CNS Infections*
*- Neurodegenerative Disorders (Alzheimer's, Parkinson's, MS, ALS)*
- Ethics, Legal Compliance, and Professional Standards in Neuro Nursing
*- Critical Thinking and Clinical Decision-Making in Neuro Emergencies*
Introduction
This comprehensive neurological nursing assessment evaluates essential knowledge and clinical judgment required for safe, effective practice in
neurological care settings. The exam assesses competency in neurological assessment techniques, recognition of neurological emergencies, stroke
management, seizure care, intracranial pressure monitoring, traumatic brain injury protocols, pharmacological interventions, and management
of neurodegenerative conditions. Questions use multiple-choice and scenario-based formats that emphasize real-world application, critical
thinking, and evidence-based decision-making. Candidates will demonstrate mastery of foundational theory, applied professional knowledge,
regulatory and legal compliance, ethical standards, and prioritization skills essential for neurological nursing practice. This assessment prepares
nurses for certification examinations and clinical practice excellence.
Section One: Questions 1–100
Question 1
A patient with a suspected stroke arrives at the emergency department. The nurse notes the patient's last known well time was 2 hours ago. Which
diagnostic test should the nurse anticipate being performed FIRST to determine eligibility for thrombolytic therapy?
A. Magnetic resonance imaging (MRI)
B. Computed tomography (CT) scan without contrast
C. Cerebral angiography
D. Lumbar puncture
🟢 Correct answer: B
,🔴 RATIONALE: A non-contrast CT scan is the priority initial diagnostic test to differentiate between ischemic and hemorrhagic stroke before
administering thrombolytics, as thrombolytics are contraindicated in hemorrhagic stroke. MRI, angiography, and lumbar puncture are not first-line
for acute stroke clearance.
Question 2
The nurse is assessing a patient's neurological status using the Glasgow Coma Scale (GCS). The patient opens eyes to speech, is confused in
conversation, and localizes pain. What is the patient's total GCS score?
A. 10
B. 11
C. 12
D. 13
🟢 Correct answer: C
🔴 RATIONALE: Eye opening to speech = 3 points, confused verbal response = 4 points, localizing pain = 5 points. Total = 3 + 4 + 5 = 12. A GCS of 8
or less indicates coma.
Question 3
A patient with increased intracranial pressure (ICP) is exhibiting Cushing's triad. Which set of vital signs represents Cushing's triad?
A. Hypotension, tachycardia, irregular respirations
B. Hypertension with widening pulse pressure, bradycardia, irregular respirations
C. Hypertension, tachycardia, regular respirations
D. Hypotension, bradycardia, apnea
🟢 Correct answer: B
🔴 RATIONALE: Cushing's triad consists of systolic hypertension with widening pulse pressure, bradycardia, and irregular respirations, indicating
increased ICP and possible brain herniation. This is a late sign of increased ICP requiring immediate intervention.
Question 4
During a tonic-clonic seizure, which nursing intervention is the PRIORITY?
,A. Insert an oral airway device
B. Restrain the patient's limbs to prevent injury
C. Protect the patient's head and turn them to the side
D. Administer benzodiazepines intramuscularly
🟢 Correct answer: C
🔴 RATIONALE: The priority during a seizure is patient safety—protect the head and turn to the side to prevent aspiration and injury. Never restrain
limbs or insert anything in the mouth as this causes harm.
Question 5
A nurse is caring for a patient with a head injury. How frequently should the nurse initially assess the Glasgow Coma Scale (GCS)?
A. Every 4 hours
B. Every 1 hour
C. Every 15 minutes
D. Every 30 minutes
🟢 Correct answer: C
🔴 RATIONALE: For acute head injury, GCS should be assessed every 15 minutes initially to promptly detect neurological changes indicating rising
ICP or deterioration. After stabilization, frequency decreases to every hour, then every 4 hours.
Question 6
Which finding in a patient with a spinal cord injury at T4 indicates autonomic dysreflexia?
A. Hypotension and tachycardia
B. Severe headache and hypertension
C. Flushing below the level of injury
D. Decreased urine output
🟢 Correct answer: B
🔴 RATIONALE: Autonomic dysreflexia presents with severe headache, hypertension, bradycardia, and flushing above the level of injury, typically
triggered by noxious stimuli below the injury level in spinal cord injuries at T6 or higher.
, Question 7
A patient with Alzheimer's disease is in the moderate stage. Which nursing intervention is MOST appropriate for managing wandering behavior?
A. Restrain the patient in bed at night
B. Install safety locks on all outside doors
C. Administer sedatives regularly
D. Confront the patient when they attempt to walk
🟢 Correct answer: B
🔴 RATIONALE: Safety locks on doors prevent wandering while maintaining patient dignity. Restraints and sedatives are inappropriate and violate
ethical standards; confrontation increases agitation in Alzheimer's patients.
Question 8
Which medication is the FIRST-LINE treatment for terminating an active status epilepticus seizure?
A. Phenytoin
B. Levetiracetam
C. Lorazepam
D. Valproic acid
🟢 Correct answer: C
🔴 RATIONALE: Benzodiazepines (lorazepam or diazepam) are first-line for status epilepticus to rapidly terminate seizures. Phenytoin,
levetiracetam, and valproic acid are second-line agents if benzodiazepines fail.
Question 9
A patient with bacterial meningitis is admitted. Which precaution should the nurse implement FIRST?
A. Contact precautions
B. Airborne precautions
C. Droplet precautions
D. Standard precautions only
🟢 Correct answer: C
