NUR 2755 MDC 4 NEUROGICAL NURSING EXAM 1 – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
Neurological Assessment and Diagnostic Testing
Cerebrovascular Disorders and Stroke Management
Traumatic Brain Injury and Spinal Cord Injury
Seizure Disorders and Antiepileptic Pharmacotherapy
Neurodegenerative Diseases (Alzheimer's, Parkinson's, ALS)
Intracranial Regulation and Increased Intracranial Pressure (ICP)
Pain Management in Neurological Conditions
Ethical and Legal Issues in Neurological Nursing
Introduction
This comprehensive examination is designed to evaluate the advanced knowledge
and critical thinking skills essential for proficient neurological nursing practice. It
assesses a nurse's ability to synthesize complex patient data, apply foundational
neuroanatomy and physiology, and implement evidence-based interventions across
a spectrum of neurological conditions. The exam utilizes multiple-choice and
scenario-based questions to simulate real-world clinical decision-making,
emphasizing the application of theoretical knowledge to patient care, from acute
management to rehabilitation and ethical considerations. Success requires a deep
understanding of pathophysiology, pharmacological principles, and the ability to
prioritize care in dynamic and often life-threatening situations.
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SECTION ONE: QUESTIONS 1 – 50
════════════════════════════════════
,1. A patient presents with a sudden onset of severe headache, nausea,
photophobia, and nuchal rigidity. Which diagnostic test is the primary method
to confirm the suspected diagnosis?
A. Computed tomography (CT) scan of the head without contrast
B. Lumbar puncture with cerebrospinal fluid (CSF) analysis
C. Magnetic resonance imaging (MRI) of the brain
D. Cerebral angiography
🟢 Correct Answer: B. Lumbar puncture with cerebrospinal fluid (CSF) analysis
🔴 Explanation: The patient's signs and symptoms are classic for subarachnoid
hemorrhage or meningitis. While a CT scan is often the initial imaging study, a
lumbar puncture with CSF analysis is the definitive test for diagnosing both
conditions. In subarachnoid hemorrhage, xanthochromia (yellowish CSF) is a key
finding, and in meningitis, elevated white blood cell counts and abnormal
glucose/protein levels are present.
2. A nurse is assessing a patient with a suspected stroke using the FAST
mnemonic. Which assessment finding is MOST indicative of a stroke when
using this tool?
A. Sudden onset of severe chest pain radiating to the left arm
B. Facial drooping on one side and arm drift on the same side
C. Sudden onset of a productive cough with green sputum
D. Bilateral lower extremity edema and shortness of breath
🟢 Correct Answer: B. Facial drooping on one side and arm drift on the same side
🔴 Explanation: FAST stands for Face, Arms, Speech, and Time. Facial drooping
and unilateral arm drift are classic findings of a stroke. Other sudden symptoms
like confusion, trouble speaking, or difficulty walking are also signs. The other
,options describe symptoms of other medical emergencies (MI, pneumonia, heart
failure).
3. A patient with a severe traumatic brain injury (TBI) has an intracranial
pressure (ICP) monitor in place. The ICP reading is 22 mmHg. Which nursing
intervention is a priority?
A. Administer 0.9% normal saline bolus
B. Position the patient in a flat, supine position
C. Elevate the head of the bed to 30-45 degrees
D. Encourage the patient to take deep breaths
🟢 Correct Answer: C. Elevate the head of the bed to 30-45 degrees
🔴 Explanation: Normal ICP is 5-15 mmHg. A reading of 22 mmHg indicates
elevated ICP. Elevating the head of the bed to 30-45 degrees promotes venous
drainage from the brain, which helps to lower ICP. Other interventions to reduce
ICP include maintaining a quiet environment, preventing hyperthermia and
hypoxia, and administering sedatives as ordered.
4. What is the primary mechanism of action of tissue plasminogen activator
(tPA) when used in the treatment of acute ischemic stroke?
A. Prevents platelet aggregation
B. Dissolves the thrombus obstructing cerebral blood flow
C. Vasodilates cerebral arteries
D. Reduces cerebral edema
🟢 Correct Answer: B. Dissolves the thrombus obstructing cerebral blood flow
🔴 Explanation: tPA is a thrombolytic agent. Its primary action is to convert
plasminogen to plasmin, which then breaks down the fibrin matrix of a clot
(thrombus) that is causing the blockage in a cerebral artery. Its administration
aims to restore blood flow and salvage viable brain tissue.
, 5. A patient is prescribed levetiracetam (Keppra) for seizure control. Which
adverse effect is of MOST concern and should be reported to the healthcare
provider immediately?
A. Dizziness
B. Somnolence
C. Behavioral changes, such as aggression or psychosis
D. Mild gastrointestinal upset
🟢 Correct Answer: C. Behavioral changes, such as aggression or psychosis
🔴 Explanation: While dizziness and somnolence are common adverse effects of
levetiracetam, behavioral changes like aggression, hostility, or psychotic
symptoms are serious and require immediate medical attention. The medication
may need to be adjusted or discontinued.
6. A patient with Parkinson's disease is experiencing "on-off" phenomena
related to their carbidopa-levodopa therapy. Which nursing intervention is
most appropriate?
A. Administer the medication with a high-protein meal to enhance absorption
B. Advise the patient to take the medication only when symptoms are severe
C. Document the timing and duration of these fluctuations to assist in medication
timing adjustments
D. Encourage the patient to lie down immediately after taking the medication
🟢 Correct Answer: C. Document the timing and duration of these fluctuations to
assist in medication timing adjustments
🔴 Explanation: "On-off" phenomena are unpredictable fluctuations in motor
response where the patient swings between mobility ("on") and immobility ("off").
Careful documentation of these fluctuations helps the healthcare provider adjust
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
Neurological Assessment and Diagnostic Testing
Cerebrovascular Disorders and Stroke Management
Traumatic Brain Injury and Spinal Cord Injury
Seizure Disorders and Antiepileptic Pharmacotherapy
Neurodegenerative Diseases (Alzheimer's, Parkinson's, ALS)
Intracranial Regulation and Increased Intracranial Pressure (ICP)
Pain Management in Neurological Conditions
Ethical and Legal Issues in Neurological Nursing
Introduction
This comprehensive examination is designed to evaluate the advanced knowledge
and critical thinking skills essential for proficient neurological nursing practice. It
assesses a nurse's ability to synthesize complex patient data, apply foundational
neuroanatomy and physiology, and implement evidence-based interventions across
a spectrum of neurological conditions. The exam utilizes multiple-choice and
scenario-based questions to simulate real-world clinical decision-making,
emphasizing the application of theoretical knowledge to patient care, from acute
management to rehabilitation and ethical considerations. Success requires a deep
understanding of pathophysiology, pharmacological principles, and the ability to
prioritize care in dynamic and often life-threatening situations.
════════════════════════════════════
SECTION ONE: QUESTIONS 1 – 50
════════════════════════════════════
,1. A patient presents with a sudden onset of severe headache, nausea,
photophobia, and nuchal rigidity. Which diagnostic test is the primary method
to confirm the suspected diagnosis?
A. Computed tomography (CT) scan of the head without contrast
B. Lumbar puncture with cerebrospinal fluid (CSF) analysis
C. Magnetic resonance imaging (MRI) of the brain
D. Cerebral angiography
🟢 Correct Answer: B. Lumbar puncture with cerebrospinal fluid (CSF) analysis
🔴 Explanation: The patient's signs and symptoms are classic for subarachnoid
hemorrhage or meningitis. While a CT scan is often the initial imaging study, a
lumbar puncture with CSF analysis is the definitive test for diagnosing both
conditions. In subarachnoid hemorrhage, xanthochromia (yellowish CSF) is a key
finding, and in meningitis, elevated white blood cell counts and abnormal
glucose/protein levels are present.
2. A nurse is assessing a patient with a suspected stroke using the FAST
mnemonic. Which assessment finding is MOST indicative of a stroke when
using this tool?
A. Sudden onset of severe chest pain radiating to the left arm
B. Facial drooping on one side and arm drift on the same side
C. Sudden onset of a productive cough with green sputum
D. Bilateral lower extremity edema and shortness of breath
🟢 Correct Answer: B. Facial drooping on one side and arm drift on the same side
🔴 Explanation: FAST stands for Face, Arms, Speech, and Time. Facial drooping
and unilateral arm drift are classic findings of a stroke. Other sudden symptoms
like confusion, trouble speaking, or difficulty walking are also signs. The other
,options describe symptoms of other medical emergencies (MI, pneumonia, heart
failure).
3. A patient with a severe traumatic brain injury (TBI) has an intracranial
pressure (ICP) monitor in place. The ICP reading is 22 mmHg. Which nursing
intervention is a priority?
A. Administer 0.9% normal saline bolus
B. Position the patient in a flat, supine position
C. Elevate the head of the bed to 30-45 degrees
D. Encourage the patient to take deep breaths
🟢 Correct Answer: C. Elevate the head of the bed to 30-45 degrees
🔴 Explanation: Normal ICP is 5-15 mmHg. A reading of 22 mmHg indicates
elevated ICP. Elevating the head of the bed to 30-45 degrees promotes venous
drainage from the brain, which helps to lower ICP. Other interventions to reduce
ICP include maintaining a quiet environment, preventing hyperthermia and
hypoxia, and administering sedatives as ordered.
4. What is the primary mechanism of action of tissue plasminogen activator
(tPA) when used in the treatment of acute ischemic stroke?
A. Prevents platelet aggregation
B. Dissolves the thrombus obstructing cerebral blood flow
C. Vasodilates cerebral arteries
D. Reduces cerebral edema
🟢 Correct Answer: B. Dissolves the thrombus obstructing cerebral blood flow
🔴 Explanation: tPA is a thrombolytic agent. Its primary action is to convert
plasminogen to plasmin, which then breaks down the fibrin matrix of a clot
(thrombus) that is causing the blockage in a cerebral artery. Its administration
aims to restore blood flow and salvage viable brain tissue.
, 5. A patient is prescribed levetiracetam (Keppra) for seizure control. Which
adverse effect is of MOST concern and should be reported to the healthcare
provider immediately?
A. Dizziness
B. Somnolence
C. Behavioral changes, such as aggression or psychosis
D. Mild gastrointestinal upset
🟢 Correct Answer: C. Behavioral changes, such as aggression or psychosis
🔴 Explanation: While dizziness and somnolence are common adverse effects of
levetiracetam, behavioral changes like aggression, hostility, or psychotic
symptoms are serious and require immediate medical attention. The medication
may need to be adjusted or discontinued.
6. A patient with Parkinson's disease is experiencing "on-off" phenomena
related to their carbidopa-levodopa therapy. Which nursing intervention is
most appropriate?
A. Administer the medication with a high-protein meal to enhance absorption
B. Advise the patient to take the medication only when symptoms are severe
C. Document the timing and duration of these fluctuations to assist in medication
timing adjustments
D. Encourage the patient to lie down immediately after taking the medication
🟢 Correct Answer: C. Document the timing and duration of these fluctuations to
assist in medication timing adjustments
🔴 Explanation: "On-off" phenomena are unpredictable fluctuations in motor
response where the patient swings between mobility ("on") and immobility ("off").
Careful documentation of these fluctuations helps the healthcare provider adjust
