KAPLAN NEUROLOGICAL NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Intracranial Pressure Management & Monitoring
Stroke Assessment & Intervention (Ischemic & Hemorrhagic)
Seizure Disorders & Epilepsy Management
Traumatic Brain Injury (TBI) Care
Spinal Cord Injury & Neurogenic Shock
Neurological Pharmacology & Medication Safety
Peripheral Neurological Disorders (MS, Parkinson's, ALS)
Cranial Neurological Assessment & Diagnostic Testing
Ethics & Legal Compliance in Neuro Nursing
Critical Decision-Making in Acute Neurological Emergencies
Introduction
This comprehensive assessment evaluates critical neurological nursing competencies essential for safe, effective patient care. The exam measures
Mastery of neurological assessment techniques, intervention priorities, and clinical decision-making in acute and chronic neurological conditions.
Through multiple-choice and scenario-based questions, candidates demonstrate applied knowledge in intracranial pressure management, stroke
care, seizure management, traumatic brain injury, spinal cord injuries, and neurological pharmacology. The assessment emphasizes real-world
application, prioritizing critical thinking, ethical decision-making, and regulatory compliance. Success requires integrating foundational theory
with professional standards to navigate complex neurological emergencies and optimize patient outcomes across diverse clinical settings.
Question 1
A patient with a suspected subarachnoid hemorrhage has an intracranial pressure (ICP) of 24 mmHg. Which intervention should the nurse
implement first?
,A. Administer IV mannitol as ordered
B. Elevate the head of bed to 30 degrees
C. Administer IV sedation to reduce agitation
D. Obtain a repeat CT scan immediately
🟢 Correct answer: B
🔴 Explanation: Elevating the head of bed to 30 degrees is the first, least invasive intervention to decrease ICP by promoting venous drainage.
Mannitol and sedation are subsequent interventions if ICP remains elevated. CT scan is not the immediate nursing priority.
Question 2
Which finding in a patient with a right-sided cerebral stroke indicates the need for immediate airway protection?
A. Slurred speech and facial droop
B. Decreased gag reflex and oxygen saturation of 88%
C. Right arm weakness and confusion
D. Hypertension with a BP of 180/100
🟢 Correct answer: B
🔴 Explanation: A decreased gag reflex combined with hypoxia (O2 sat 88%) indicates airway compromise and aspiration risk, requiring immediate
airway protection. Slurred speech and weakness are expected stroke symptoms but not immediate airway threats.
Question 3
A patient with Parkinson's disease is prescribed trihexyphenidyl. Which teaching point is most important for the nurse to include?
A. Take the medication with food to reduce nausea
B. Avoid sudden position changes to prevent orthostatic hypotension
C. Report any window-turning or tremor worsening immediately
D. Stay hydrated and avoid prolonged exposure to heat
,🟢 Correct answer: D
🔴 Explanation: Trihexyphenidyl is an anticholinergic that causes decreased sweating and can lead to hyperthermia. Patients must stay hydrated and
avoid heat exposure. Orthostatic hypotension is more associated with antihypertensives and Parkinson's medications like dopamine agonists.
Question 4
During a tonic-clonic seizure, which action by the nurse is priority?
A. Insert an oral airway device
B. Restrain the patient's limbs gently
C. Turn the patient to the side
D. Administer IV lorazepam immediately
🟢 Correct answer: C
🔴 Explanation: Turning the patient to the side (recovery position) prevents aspiration and maintains airway patency during the seizure. Restraints
are contraindicated. Oral airways should not be inserted during active seizure. IV medication is given after ensuring airway safety.
Question 5
A patient with a spinal cord injury at T4 level develops hypertension (190/100), headache, and bradycardia. What is the most likely diagnosis?
A. Neurogenic shock
B. Autonomic dysreflexia
C. Spinal shock
D. Pulmonary embolism
🟢 Correct answer: B
, 🔴 Explanation: Autonomic dysreflexia occurs in injuries above T6 and presents with severe hypertension, headache, and bradycardia due to
uncontrolled sympathetic response. Neurogenic shock presents with hypotension and bradycardia. Spinal shock is temporary loss of function below
injury.
Question 6
Which assessment finding is most concerning in a patient 2 hours post-craniotomy for tumor removal?
A. Drainage of 50 mL serous fluid from the incision
B. Urine output of 250 mL over 2 hours
C. CSF drainage of 15 mL clear fluid from the dressing
D. Pulse oximetry of 94% on 2L oxygen
🟢 Correct answer: C
🔴 Explanation: CSF leakage (clear fluid) from the dressing indicates a breach in the surgical site and risk for infection (meningitis). This requires
immediate intervention. Serous drainage is expected. Urine output is adequate. O2 sat is acceptable.
Question 7
A patient with multiple sclerosis (MS) is experiencing fatigue. Which intervention is most appropriate?
A. Encourage daily vigorous exercise
B. Schedule rest periods throughout the day
C. Administer stimulants as prescribed
D. Limit fluid intake to reduce bathroom trips
🟢 Correct answer: B
🔴 Explanation: Fatigue in MS is debilitating; scheduling rest periods helps conserve energy. Vigorous exercise worsens fatigue. Stimulants may be
used but rest is first-line. Fluid restriction is contraindicated.
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Intracranial Pressure Management & Monitoring
Stroke Assessment & Intervention (Ischemic & Hemorrhagic)
Seizure Disorders & Epilepsy Management
Traumatic Brain Injury (TBI) Care
Spinal Cord Injury & Neurogenic Shock
Neurological Pharmacology & Medication Safety
Peripheral Neurological Disorders (MS, Parkinson's, ALS)
Cranial Neurological Assessment & Diagnostic Testing
Ethics & Legal Compliance in Neuro Nursing
Critical Decision-Making in Acute Neurological Emergencies
Introduction
This comprehensive assessment evaluates critical neurological nursing competencies essential for safe, effective patient care. The exam measures
Mastery of neurological assessment techniques, intervention priorities, and clinical decision-making in acute and chronic neurological conditions.
Through multiple-choice and scenario-based questions, candidates demonstrate applied knowledge in intracranial pressure management, stroke
care, seizure management, traumatic brain injury, spinal cord injuries, and neurological pharmacology. The assessment emphasizes real-world
application, prioritizing critical thinking, ethical decision-making, and regulatory compliance. Success requires integrating foundational theory
with professional standards to navigate complex neurological emergencies and optimize patient outcomes across diverse clinical settings.
Question 1
A patient with a suspected subarachnoid hemorrhage has an intracranial pressure (ICP) of 24 mmHg. Which intervention should the nurse
implement first?
,A. Administer IV mannitol as ordered
B. Elevate the head of bed to 30 degrees
C. Administer IV sedation to reduce agitation
D. Obtain a repeat CT scan immediately
🟢 Correct answer: B
🔴 Explanation: Elevating the head of bed to 30 degrees is the first, least invasive intervention to decrease ICP by promoting venous drainage.
Mannitol and sedation are subsequent interventions if ICP remains elevated. CT scan is not the immediate nursing priority.
Question 2
Which finding in a patient with a right-sided cerebral stroke indicates the need for immediate airway protection?
A. Slurred speech and facial droop
B. Decreased gag reflex and oxygen saturation of 88%
C. Right arm weakness and confusion
D. Hypertension with a BP of 180/100
🟢 Correct answer: B
🔴 Explanation: A decreased gag reflex combined with hypoxia (O2 sat 88%) indicates airway compromise and aspiration risk, requiring immediate
airway protection. Slurred speech and weakness are expected stroke symptoms but not immediate airway threats.
Question 3
A patient with Parkinson's disease is prescribed trihexyphenidyl. Which teaching point is most important for the nurse to include?
A. Take the medication with food to reduce nausea
B. Avoid sudden position changes to prevent orthostatic hypotension
C. Report any window-turning or tremor worsening immediately
D. Stay hydrated and avoid prolonged exposure to heat
,🟢 Correct answer: D
🔴 Explanation: Trihexyphenidyl is an anticholinergic that causes decreased sweating and can lead to hyperthermia. Patients must stay hydrated and
avoid heat exposure. Orthostatic hypotension is more associated with antihypertensives and Parkinson's medications like dopamine agonists.
Question 4
During a tonic-clonic seizure, which action by the nurse is priority?
A. Insert an oral airway device
B. Restrain the patient's limbs gently
C. Turn the patient to the side
D. Administer IV lorazepam immediately
🟢 Correct answer: C
🔴 Explanation: Turning the patient to the side (recovery position) prevents aspiration and maintains airway patency during the seizure. Restraints
are contraindicated. Oral airways should not be inserted during active seizure. IV medication is given after ensuring airway safety.
Question 5
A patient with a spinal cord injury at T4 level develops hypertension (190/100), headache, and bradycardia. What is the most likely diagnosis?
A. Neurogenic shock
B. Autonomic dysreflexia
C. Spinal shock
D. Pulmonary embolism
🟢 Correct answer: B
, 🔴 Explanation: Autonomic dysreflexia occurs in injuries above T6 and presents with severe hypertension, headache, and bradycardia due to
uncontrolled sympathetic response. Neurogenic shock presents with hypotension and bradycardia. Spinal shock is temporary loss of function below
injury.
Question 6
Which assessment finding is most concerning in a patient 2 hours post-craniotomy for tumor removal?
A. Drainage of 50 mL serous fluid from the incision
B. Urine output of 250 mL over 2 hours
C. CSF drainage of 15 mL clear fluid from the dressing
D. Pulse oximetry of 94% on 2L oxygen
🟢 Correct answer: C
🔴 Explanation: CSF leakage (clear fluid) from the dressing indicates a breach in the surgical site and risk for infection (meningitis). This requires
immediate intervention. Serous drainage is expected. Urine output is adequate. O2 sat is acceptable.
Question 7
A patient with multiple sclerosis (MS) is experiencing fatigue. Which intervention is most appropriate?
A. Encourage daily vigorous exercise
B. Schedule rest periods throughout the day
C. Administer stimulants as prescribed
D. Limit fluid intake to reduce bathroom trips
🟢 Correct answer: B
🔴 Explanation: Fatigue in MS is debilitating; scheduling rest periods helps conserve energy. Vigorous exercise worsens fatigue. Stimulants may be
used but rest is first-line. Fluid restriction is contraindicated.
