NU 185 Med-Surg II Exam 1:
Neurological & Musculoskeletal
Nursing – 200 NCLEX Questions &
Answers with Rationales Latest
2026-2027[Most Recent] /Instant
Download PDF
1. The nurse is teaching a group of clients about common seizure
triggers. Which of the following should the nurse include? (Select all
that apply)
• A. Sleep deprivation
• B. Alcohol use
• C. High fever
• D. Daily exercise
• E. Hypoglycemia
Correct Answers: A, B, C, E
Rationale: Sleep deprivation, alcohol, fever, and low blood sugar are all
common triggers that can lower the seizure threshold. Moderate daily
exercise is not a trigger and can be beneficial for overall health.
2. The nurse is preparing a client for an EEG. Which instruction
should the nurse include?
• A. "Avoid washing your hair the morning of the test."
• B. "Avoid caffeine for at least 8 hours before the test."
• C. "Take all seizure medications as prescribed the day of the test."
• D. "The test will involve minor shocks to stimulate brain activity."
Correct Answer: B
,Rationale: Caffeine is a stimulant that can affect brain wave activity;
clients should avoid it for 6-8 hours before an EEG. Hair should be clean
and free of oils. Some medications may be withheld, so the client should
follow specific provider instructions. An EEG is painless and does not
involve electrical shocks.
3. A patient is receiving phenytoin for seizure control. Which
assessment finding requires immediate intervention?
• A. Mild drowsiness
• B. Swollen, bleeding gums
• C. Skin rash
• D. Occasional headache
Correct Answer: C
Rationale: A skin rash can be an early sign of a severe, life-threatening
hypersensitivity reaction like Stevens-Johnson syndrome. This finding
requires immediate intervention and notification of the healthcare
provider. Swollen gums (gingival hyperplasia) is a known side effect of
phenytoin but is not immediately life-threatening.
4. Which of the following medications is a barbiturate used for
seizure control?
• A. Carbamazepine
• B. Topiramate
• C. Phenobarbital
• D. Valproic acid
Correct Answer: C
Rationale: Phenobarbital is a barbiturate that has been used for long-
term seizure control. Carbamazepine and Valproic acid are
anticonvulsants, while Topiramate is a newer antiseizure medication with
various mechanisms of action.
5. The nurse is teaching a client about levetiracetam (Keppra).
Which statement by the client indicates a need for further teaching?
• A. "This medication may make me feel dizzy or drowsy."
, • B. "I can stop this medication if I haven't had a seizure in a month."
• C. "I will take this medication at the same time every day."
• D. "If I feel very depressed or agitated, I should tell my provider."
Correct Answer: B
Rationale: Stopping an anticonvulsant abruptly can lead to
breakthrough seizures or status epilepticus. The client should be taught
to never stop the medication without consulting their provider, even if
they feel better and are seizure-free
Seizure Disorders
6. A client is experiencing status epilepticus. What is the priority
nursing action?
• A. Administer IV phenytoin
• B. Restrain the patient to prevent injury
• C. Insert an oral airway
• D. Turn the client to the side and administer IV lorazepam
o Rationale: The first-line treatment for status epilepticus is IV
lorazepam or diazepam. Positioning the client on their side
helps protect the airway and prevent aspiration.
7. Which of the following side effects should the nurse monitor for
in a patient receiving valproic acid (Depakene)?
• A. Gingival hyperplasia
• B. Hepatotoxicity
• C. Hypokalemia
• D. Bradycardia
o Rationale: Valproic acid carries a significant risk of liver
toxicity. Liver function tests should be monitored routinely.
8. Which actions should the nurse take while a client is actively
seizing? (Select all that apply)
• A. Loosen restrictive clothing
• B. Place a padded tongue blade in the mouth
, • C. Turn the patient on their side
• D. Restrain the arms and legs
• E. Monitor the duration of the seizure
o Rationale: Loosen clothing, turn the patient to their side to
protect the airway, and note the seizure duration. Never
restrain a seizing patient or insert anything into their mouth.
9. Which of the following anticonvulsants is classified as a
benzodiazepine?
• A. Phenytoin
• B. Diazepam
• C. Topiramate
• D. Valproic acid
o Rationale: Diazepam (Valium) is a benzodiazepine
commonly used in acute seizure settings.
10. A client with refractory seizures is scheduled for vagus nerve
stimulator (VNS) implantation. Which statement by the client
indicates understanding of the procedure?
• A. "This device will permanently stop my seizures."
• B. "The stimulator will deliver electrical impulses to my brain
through my carotid artery."
• C. "I will still need to take my seizure medications even with
the stimulator."
• D. "The device is only active during nighttime while I sleep."
o Rationale: VNS reduces seizure frequency but does not
eliminate the need for medications.
11. A nurse is caring for a pediatric client newly prescribed a
ketogenic diet for seizure management. What is the priority
teaching point for the parents?
• A. "This diet includes lots of fruits and vegetables."
• B. "This diet limits carbohydrates and increases fats."
• C. "This diet should be high in protein and dairy."
• D. "This diet is safe without medical supervision."
Neurological & Musculoskeletal
Nursing – 200 NCLEX Questions &
Answers with Rationales Latest
2026-2027[Most Recent] /Instant
Download PDF
1. The nurse is teaching a group of clients about common seizure
triggers. Which of the following should the nurse include? (Select all
that apply)
• A. Sleep deprivation
• B. Alcohol use
• C. High fever
• D. Daily exercise
• E. Hypoglycemia
Correct Answers: A, B, C, E
Rationale: Sleep deprivation, alcohol, fever, and low blood sugar are all
common triggers that can lower the seizure threshold. Moderate daily
exercise is not a trigger and can be beneficial for overall health.
2. The nurse is preparing a client for an EEG. Which instruction
should the nurse include?
• A. "Avoid washing your hair the morning of the test."
• B. "Avoid caffeine for at least 8 hours before the test."
• C. "Take all seizure medications as prescribed the day of the test."
• D. "The test will involve minor shocks to stimulate brain activity."
Correct Answer: B
,Rationale: Caffeine is a stimulant that can affect brain wave activity;
clients should avoid it for 6-8 hours before an EEG. Hair should be clean
and free of oils. Some medications may be withheld, so the client should
follow specific provider instructions. An EEG is painless and does not
involve electrical shocks.
3. A patient is receiving phenytoin for seizure control. Which
assessment finding requires immediate intervention?
• A. Mild drowsiness
• B. Swollen, bleeding gums
• C. Skin rash
• D. Occasional headache
Correct Answer: C
Rationale: A skin rash can be an early sign of a severe, life-threatening
hypersensitivity reaction like Stevens-Johnson syndrome. This finding
requires immediate intervention and notification of the healthcare
provider. Swollen gums (gingival hyperplasia) is a known side effect of
phenytoin but is not immediately life-threatening.
4. Which of the following medications is a barbiturate used for
seizure control?
• A. Carbamazepine
• B. Topiramate
• C. Phenobarbital
• D. Valproic acid
Correct Answer: C
Rationale: Phenobarbital is a barbiturate that has been used for long-
term seizure control. Carbamazepine and Valproic acid are
anticonvulsants, while Topiramate is a newer antiseizure medication with
various mechanisms of action.
5. The nurse is teaching a client about levetiracetam (Keppra).
Which statement by the client indicates a need for further teaching?
• A. "This medication may make me feel dizzy or drowsy."
, • B. "I can stop this medication if I haven't had a seizure in a month."
• C. "I will take this medication at the same time every day."
• D. "If I feel very depressed or agitated, I should tell my provider."
Correct Answer: B
Rationale: Stopping an anticonvulsant abruptly can lead to
breakthrough seizures or status epilepticus. The client should be taught
to never stop the medication without consulting their provider, even if
they feel better and are seizure-free
Seizure Disorders
6. A client is experiencing status epilepticus. What is the priority
nursing action?
• A. Administer IV phenytoin
• B. Restrain the patient to prevent injury
• C. Insert an oral airway
• D. Turn the client to the side and administer IV lorazepam
o Rationale: The first-line treatment for status epilepticus is IV
lorazepam or diazepam. Positioning the client on their side
helps protect the airway and prevent aspiration.
7. Which of the following side effects should the nurse monitor for
in a patient receiving valproic acid (Depakene)?
• A. Gingival hyperplasia
• B. Hepatotoxicity
• C. Hypokalemia
• D. Bradycardia
o Rationale: Valproic acid carries a significant risk of liver
toxicity. Liver function tests should be monitored routinely.
8. Which actions should the nurse take while a client is actively
seizing? (Select all that apply)
• A. Loosen restrictive clothing
• B. Place a padded tongue blade in the mouth
, • C. Turn the patient on their side
• D. Restrain the arms and legs
• E. Monitor the duration of the seizure
o Rationale: Loosen clothing, turn the patient to their side to
protect the airway, and note the seizure duration. Never
restrain a seizing patient or insert anything into their mouth.
9. Which of the following anticonvulsants is classified as a
benzodiazepine?
• A. Phenytoin
• B. Diazepam
• C. Topiramate
• D. Valproic acid
o Rationale: Diazepam (Valium) is a benzodiazepine
commonly used in acute seizure settings.
10. A client with refractory seizures is scheduled for vagus nerve
stimulator (VNS) implantation. Which statement by the client
indicates understanding of the procedure?
• A. "This device will permanently stop my seizures."
• B. "The stimulator will deliver electrical impulses to my brain
through my carotid artery."
• C. "I will still need to take my seizure medications even with
the stimulator."
• D. "The device is only active during nighttime while I sleep."
o Rationale: VNS reduces seizure frequency but does not
eliminate the need for medications.
11. A nurse is caring for a pediatric client newly prescribed a
ketogenic diet for seizure management. What is the priority
teaching point for the parents?
• A. "This diet includes lots of fruits and vegetables."
• B. "This diet limits carbohydrates and increases fats."
• C. "This diet should be high in protein and dairy."
• D. "This diet is safe without medical supervision."
