NCLEX-RN Pharmacology Neurological System
Part 2 Test Bank |
20 NGN-Style MCQs with Rationales & Clinical
Judgment Focus
Question 1
Clinical Scenario
A 24-year-old woman with newly diagnosed generalized tonic-
clonic seizures is prescribed levetiracetam. She asks the nurse
how the medication will help control her condition.
Question Stem
Which explanation by the nurse is most appropriate?
A. "The medication increases glucose delivery to the brain."
B. "The medication helps reduce abnormal electrical activity in
the brain."
C. "The medication stimulates dopamine production."
D. "The medication improves blood flow to cerebral arteries."
Correct Answer
,Correct Answer: B. "The medication helps reduce abnormal
electrical activity in the brain."
Detailed Rationale
Levetiracetam is an antiepileptic medication that works by
modulating neurotransmitter release and reducing excessive
neuronal firing. The therapeutic goal is seizure prevention
through stabilization of abnormal electrical activity within the
central nervous system. Patients should understand that the
medication controls seizures but does not cure epilepsy.
Option A is incorrect because levetiracetam does not affect
glucose transport. Option C is incorrect because dopamine
stimulation is associated with Parkinson disease therapies
rather than seizure management. Option D is incorrect because
cerebral blood flow is not the primary mechanism of action.
Nurses should emphasize adherence because abrupt
discontinuation may precipitate seizures. Patients should be
instructed to report mood changes, depression, or suicidal
ideation, which may occur with antiepileptic therapy.
Monitoring includes seizure frequency, medication adherence,
and adverse effects such as dizziness and fatigue.
Learning Objective
After completing this question, the learner should be able to:
• Describe the therapeutic action of levetiracetam.
, • Explain seizure-control mechanisms of antiepileptic drugs.
• Educate patients regarding medication adherence.
• Identify common adverse effects of antiepileptic therapy.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 72-year-old man with Parkinson disease takes
carbidopa/levodopa. During a clinic visit, he reports improved
mobility but occasional dizziness when standing.
Question Stem
Which nursing intervention is most appropriate?
A. Encourage rapid position changes.
B. Restrict fluid intake.
C. Teach the client to rise slowly from sitting or lying positions.
D. Hold future doses of carbidopa/levodopa.
Correct Answer
Correct Answer: C. Teach the client to rise slowly from sitting
or lying positions.
, Detailed Rationale
Orthostatic hypotension is a common adverse effect of
dopaminergic medications such as carbidopa/levodopa.
Teaching the patient to change positions gradually reduces fall
risk and promotes safety. This intervention addresses the
underlying cause while allowing continued therapeutic benefit.
Option A increases fall risk. Option B may worsen hypotension
through dehydration. Option D is inappropriate because mild
orthostatic symptoms generally do not warrant discontinuation
without provider evaluation.
Nurses should assess blood pressure changes, fall history, and
medication timing. Patients should be encouraged to maintain
hydration and use assistive devices if needed. Older adults are
particularly vulnerable to injury from medication-induced
hypotension.
Learning Objective
• Recognize orthostatic hypotension associated with
Parkinson medications.
• Implement nursing interventions to prevent falls.
• Educate patients regarding safe position changes.
• Evaluate medication-related safety risks in older adults.
Medication Safety Focus
Part 2 Test Bank |
20 NGN-Style MCQs with Rationales & Clinical
Judgment Focus
Question 1
Clinical Scenario
A 24-year-old woman with newly diagnosed generalized tonic-
clonic seizures is prescribed levetiracetam. She asks the nurse
how the medication will help control her condition.
Question Stem
Which explanation by the nurse is most appropriate?
A. "The medication increases glucose delivery to the brain."
B. "The medication helps reduce abnormal electrical activity in
the brain."
C. "The medication stimulates dopamine production."
D. "The medication improves blood flow to cerebral arteries."
Correct Answer
,Correct Answer: B. "The medication helps reduce abnormal
electrical activity in the brain."
Detailed Rationale
Levetiracetam is an antiepileptic medication that works by
modulating neurotransmitter release and reducing excessive
neuronal firing. The therapeutic goal is seizure prevention
through stabilization of abnormal electrical activity within the
central nervous system. Patients should understand that the
medication controls seizures but does not cure epilepsy.
Option A is incorrect because levetiracetam does not affect
glucose transport. Option C is incorrect because dopamine
stimulation is associated with Parkinson disease therapies
rather than seizure management. Option D is incorrect because
cerebral blood flow is not the primary mechanism of action.
Nurses should emphasize adherence because abrupt
discontinuation may precipitate seizures. Patients should be
instructed to report mood changes, depression, or suicidal
ideation, which may occur with antiepileptic therapy.
Monitoring includes seizure frequency, medication adherence,
and adverse effects such as dizziness and fatigue.
Learning Objective
After completing this question, the learner should be able to:
• Describe the therapeutic action of levetiracetam.
, • Explain seizure-control mechanisms of antiepileptic drugs.
• Educate patients regarding medication adherence.
• Identify common adverse effects of antiepileptic therapy.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 72-year-old man with Parkinson disease takes
carbidopa/levodopa. During a clinic visit, he reports improved
mobility but occasional dizziness when standing.
Question Stem
Which nursing intervention is most appropriate?
A. Encourage rapid position changes.
B. Restrict fluid intake.
C. Teach the client to rise slowly from sitting or lying positions.
D. Hold future doses of carbidopa/levodopa.
Correct Answer
Correct Answer: C. Teach the client to rise slowly from sitting
or lying positions.
, Detailed Rationale
Orthostatic hypotension is a common adverse effect of
dopaminergic medications such as carbidopa/levodopa.
Teaching the patient to change positions gradually reduces fall
risk and promotes safety. This intervention addresses the
underlying cause while allowing continued therapeutic benefit.
Option A increases fall risk. Option B may worsen hypotension
through dehydration. Option D is inappropriate because mild
orthostatic symptoms generally do not warrant discontinuation
without provider evaluation.
Nurses should assess blood pressure changes, fall history, and
medication timing. Patients should be encouraged to maintain
hydration and use assistive devices if needed. Older adults are
particularly vulnerable to injury from medication-induced
hypotension.
Learning Objective
• Recognize orthostatic hypotension associated with
Parkinson medications.
• Implement nursing interventions to prevent falls.
• Educate patients regarding safe position changes.
• Evaluate medication-related safety risks in older adults.
Medication Safety Focus
