NCLEX-RN Pharmacology Neurological
System Part 1 Exam Questions &
Rationales
20 Practice MCQs
NGN Clinical Judgment
ATI-Style Nursing Exam Prep
Question 1 (Easy)
Clinical Scenario
A 24-year-old woman is admitted after experiencing two
generalized tonic-clonic seizures within 24 hours. She is
prescribed levetiracetam 500 mg orally twice daily. During
morning medication administration, she tells the nurse, "I think
I'll stop taking this medicine once I feel better because I don't
like taking pills."
Question Stem
Which response by the nurse is most appropriate?
,A. "You may stop the medication if you remain seizure-free for
one week."
B. "You should discontinue the medication if it causes mild
fatigue."
C. "Do not stop taking this medication abruptly because it may
increase your risk of seizures."
D. "You only need to take the medication when you feel a
seizure coming."
Correct Answer
Correct Answer: C. Do not stop taking this medication abruptly
because it may increase your risk of seizures.
Detailed Rationale
Levetiracetam is an antiepileptic medication that helps stabilize
abnormal electrical activity in the brain. Abrupt discontinuation
of most antiseizure medications significantly increases the risk
of breakthrough seizures and, in some cases, status epilepticus,
a neurological emergency. Even if seizures appear well
controlled, therapy should only be discontinued gradually under
the supervision of the healthcare provider.
Option A is incorrect because seizure-free status for one week
is not sufficient to discontinue therapy. The decision depends
on seizure type, duration of seizure control, EEG findings, and
provider evaluation.
,Option B is incorrect because mild fatigue is a common early
adverse effect and usually improves with time. Patients should
not independently stop therapy because of mild side effects.
Option D is incorrect because levetiracetam is not an "as-
needed" medication. Maintaining consistent serum drug
concentrations through regular dosing is essential for seizure
prevention.
Nurses should reinforce medication adherence, emphasize
taking doses at the same time each day, and instruct patients to
notify the provider before making any medication changes.
Patients should also be monitored for behavioral changes,
including irritability, depression, or suicidal ideation.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of adherence to antiepileptic
therapy.
• Identify risks associated with abrupt medication
discontinuation.
• Provide patient education regarding seizure medication
administration.
Medication Safety Focus
Patient Education
, Question 2 (Moderate)
Clinical Scenario
A 71-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. Two weeks later, he reports
improved mobility but complains of dizziness when standing.
His blood pressure is 132/78 mm Hg while sitting and 102/64
mm Hg when standing.
Question Stem
Which nursing intervention is the priority?
A. Encourage the patient to rise slowly from sitting or lying
positions.
B. Instruct the patient to increase dietary protein intake.
C. Hold the medication until the next provider visit.
D. Recommend taking the medication only at bedtime.
Correct Answer
Correct Answer: A. Encourage the patient to rise slowly from
sitting or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective medication for
improving motor symptoms of Parkinson disease. One common
System Part 1 Exam Questions &
Rationales
20 Practice MCQs
NGN Clinical Judgment
ATI-Style Nursing Exam Prep
Question 1 (Easy)
Clinical Scenario
A 24-year-old woman is admitted after experiencing two
generalized tonic-clonic seizures within 24 hours. She is
prescribed levetiracetam 500 mg orally twice daily. During
morning medication administration, she tells the nurse, "I think
I'll stop taking this medicine once I feel better because I don't
like taking pills."
Question Stem
Which response by the nurse is most appropriate?
,A. "You may stop the medication if you remain seizure-free for
one week."
B. "You should discontinue the medication if it causes mild
fatigue."
C. "Do not stop taking this medication abruptly because it may
increase your risk of seizures."
D. "You only need to take the medication when you feel a
seizure coming."
Correct Answer
Correct Answer: C. Do not stop taking this medication abruptly
because it may increase your risk of seizures.
Detailed Rationale
Levetiracetam is an antiepileptic medication that helps stabilize
abnormal electrical activity in the brain. Abrupt discontinuation
of most antiseizure medications significantly increases the risk
of breakthrough seizures and, in some cases, status epilepticus,
a neurological emergency. Even if seizures appear well
controlled, therapy should only be discontinued gradually under
the supervision of the healthcare provider.
Option A is incorrect because seizure-free status for one week
is not sufficient to discontinue therapy. The decision depends
on seizure type, duration of seizure control, EEG findings, and
provider evaluation.
,Option B is incorrect because mild fatigue is a common early
adverse effect and usually improves with time. Patients should
not independently stop therapy because of mild side effects.
Option D is incorrect because levetiracetam is not an "as-
needed" medication. Maintaining consistent serum drug
concentrations through regular dosing is essential for seizure
prevention.
Nurses should reinforce medication adherence, emphasize
taking doses at the same time each day, and instruct patients to
notify the provider before making any medication changes.
Patients should also be monitored for behavioral changes,
including irritability, depression, or suicidal ideation.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of adherence to antiepileptic
therapy.
• Identify risks associated with abrupt medication
discontinuation.
• Provide patient education regarding seizure medication
administration.
Medication Safety Focus
Patient Education
, Question 2 (Moderate)
Clinical Scenario
A 71-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. Two weeks later, he reports
improved mobility but complains of dizziness when standing.
His blood pressure is 132/78 mm Hg while sitting and 102/64
mm Hg when standing.
Question Stem
Which nursing intervention is the priority?
A. Encourage the patient to rise slowly from sitting or lying
positions.
B. Instruct the patient to increase dietary protein intake.
C. Hold the medication until the next provider visit.
D. Recommend taking the medication only at bedtime.
Correct Answer
Correct Answer: A. Encourage the patient to rise slowly from
sitting or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective medication for
improving motor symptoms of Parkinson disease. One common
