NUR265 Exam 4 Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
SECTION 1: NEUROLOGICAL DISORDERS (Questions 1–18)
Q1: A 68-year-old male is brought to the emergency department with sudden onset of
right-sided weakness and inability to speak. His wife states symptoms began 45
minutes ago. Which action is the nurse's priority?
A. Obtain a 12-lead ECG to rule out cardiac arrhythmia
B. Prepare the patient for a non-contrast CT scan of the head
C. Insert a nasogastric tube for enteral feeding
D. Administer aspirin 325 mg orally immediately
Correct Answer: B
Rationale: Correct because a non-contrast CT scan is the first action to rule out
hemorrhagic stroke before administering thrombolytic therapy such as tPA. Guidelines
recommend imaging within 25 minutes of arrival to differentiate ischemic from
hemorrhagic stroke.
Q2: A patient diagnosed with a left hemispheric stroke presents with right-sided
weakness and difficulty producing speech while comprehension remains intact. The
nurse documents this as which type of aphasia?
,A. Global aphasia
B. Wernicke's aphasia
C. Broca's aphasia
D. Conduction aphasia
Correct Answer: C
Rationale: Correct because Broca's (expressive) aphasia is characterized by difficulty
speaking with intact comprehension, which matches this patient's presentation. This
matches NUR 265 curriculum on left hemispheric stroke manifestations.
Q3: A patient with a right hemispheric stroke is consistently ignoring food on the left
side of the tray and bumping into objects on the left. The nurse recognizes this as which
deficit?
A. Apraxia
B. Agnosia
C. Left-sided neglect
D. Homonymous hemianopsia
Correct Answer: C
Rationale: Correct because right hemispheric stroke commonly causes left-sided
neglect and spatial-perceptual deficits, leading the patient to ignore stimuli on the
affected side. The priority nursing intervention is to approach from the unaffected side
and place items within the patient's visual field.
, Q4: A patient is receiving tissue plasminogen activator (tPA) for an acute ischemic
stroke. Thirty minutes into the infusion, the patient reports a sudden severe headache
and begins vomiting. What is the nurse's immediate action?
A. Slow the tPA infusion and notify the physician
B. Stop the tPA infusion immediately and notify the physician
C. Administer an antiemetic and continue the infusion
D. Increase the infusion rate to complete therapy faster
Correct Answer: B
Rationale: Correct because sudden severe headache and vomiting during tPA
administration indicate possible intracranial hemorrhage, which is a life-threatening
complication. The priority action is to stop tPA immediately and alert the physician for
emergent evaluation.
Q5: A patient with a stroke has been diagnosed with homonymous hemianopsia. Which
nursing intervention is most appropriate?
A. Patch the affected eye to improve vision
B. Approach the patient from the unaffected side and place objects within the intact
visual field
C. Encourage the patient to turn their head toward the affected side
D. Administer corticosteroids to reduce optic nerve inflammation
Correct Answer: B
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
SECTION 1: NEUROLOGICAL DISORDERS (Questions 1–18)
Q1: A 68-year-old male is brought to the emergency department with sudden onset of
right-sided weakness and inability to speak. His wife states symptoms began 45
minutes ago. Which action is the nurse's priority?
A. Obtain a 12-lead ECG to rule out cardiac arrhythmia
B. Prepare the patient for a non-contrast CT scan of the head
C. Insert a nasogastric tube for enteral feeding
D. Administer aspirin 325 mg orally immediately
Correct Answer: B
Rationale: Correct because a non-contrast CT scan is the first action to rule out
hemorrhagic stroke before administering thrombolytic therapy such as tPA. Guidelines
recommend imaging within 25 minutes of arrival to differentiate ischemic from
hemorrhagic stroke.
Q2: A patient diagnosed with a left hemispheric stroke presents with right-sided
weakness and difficulty producing speech while comprehension remains intact. The
nurse documents this as which type of aphasia?
,A. Global aphasia
B. Wernicke's aphasia
C. Broca's aphasia
D. Conduction aphasia
Correct Answer: C
Rationale: Correct because Broca's (expressive) aphasia is characterized by difficulty
speaking with intact comprehension, which matches this patient's presentation. This
matches NUR 265 curriculum on left hemispheric stroke manifestations.
Q3: A patient with a right hemispheric stroke is consistently ignoring food on the left
side of the tray and bumping into objects on the left. The nurse recognizes this as which
deficit?
A. Apraxia
B. Agnosia
C. Left-sided neglect
D. Homonymous hemianopsia
Correct Answer: C
Rationale: Correct because right hemispheric stroke commonly causes left-sided
neglect and spatial-perceptual deficits, leading the patient to ignore stimuli on the
affected side. The priority nursing intervention is to approach from the unaffected side
and place items within the patient's visual field.
, Q4: A patient is receiving tissue plasminogen activator (tPA) for an acute ischemic
stroke. Thirty minutes into the infusion, the patient reports a sudden severe headache
and begins vomiting. What is the nurse's immediate action?
A. Slow the tPA infusion and notify the physician
B. Stop the tPA infusion immediately and notify the physician
C. Administer an antiemetic and continue the infusion
D. Increase the infusion rate to complete therapy faster
Correct Answer: B
Rationale: Correct because sudden severe headache and vomiting during tPA
administration indicate possible intracranial hemorrhage, which is a life-threatening
complication. The priority action is to stop tPA immediately and alert the physician for
emergent evaluation.
Q5: A patient with a stroke has been diagnosed with homonymous hemianopsia. Which
nursing intervention is most appropriate?
A. Patch the affected eye to improve vision
B. Approach the patient from the unaffected side and place objects within the intact
visual field
C. Encourage the patient to turn their head toward the affected side
D. Administer corticosteroids to reduce optic nerve inflammation
Correct Answer: B
