Neurology Nursing Revision Notes –
Complete Exam 13 with Verified Answers
(2026 Edition)
Question 1: A client is admitted with a suspected stroke. The nurse performs a rapid
assessment using the FAST mnemonic. Which finding would indicate a stroke?
A) Facial drooping, arm weakness, and speech difficulty
B) Sudden onset of severe headache and nausea
C) Transient loss of vision in one eye
D) Dizziness and ataxia
Answer: A) Facial drooping, arm weakness, and speech difficulty
Rationale: The FAST mnemonic (Face, Arm, Speech, Time) is used to rapidly assess for stroke.
Facial drooping, arm weakness (unilateral), and speech difficulty are classic signs of stroke.
Sudden severe headache, transient vision loss, dizziness, and ataxia can also occur but are less
specific. The nurse should activate the stroke team immediately if any of these signs are present.
Question 2: A client with a suspected stroke arrives at the emergency department. Which
diagnostic test should the nurse prioritize?
A) Non-contrast computed tomography (CT) scan of the head
B) Magnetic resonance imaging (MRI) of the brain
C) Carotid ultrasound
D) Electroencephalogram (EEG)
Answer: A) Non-contrast computed tomography (CT) scan of the head
Rationale: A non-contrast CT scan of the head is the initial imaging test of choice for suspected
stroke. It can quickly differentiate between ischemic and hemorrhagic stroke, which is critical for
determining treatment (thrombolytics for ischemic stroke, surgical intervention for hemorrhagic
stroke). MRI may provide more detailed imaging but takes longer and is not as readily available
in the emergency setting.
Question 3: A client is diagnosed with an ischemic stroke 2 hours after symptom onset. Which
treatment should the nurse anticipate?
,A) Tissue plasminogen activator (tPA)
B) Heparin infusion
C) Aspirin
D) Surgical intervention
Answer: A) Tissue plasminogen activator (tPA)
Rationale: tPA is the gold standard treatment for acute ischemic stroke and should be
administered within 3-4.5 hours of symptom onset. It works by dissolving the clot causing the
stroke. The nurse should assess for contraindications (e.g., bleeding disorders, recent surgery)
and monitor for signs of bleeding during and after infusion. Heparin and aspirin are used for
stroke prevention, not acute treatment.
Question 4: A client with a hemorrhagic stroke is at risk for increased intracranial pressure
(ICP). Which intervention should the nurse implement to reduce ICP?
A) Elevate the head of the bed to 30 degrees
B) Position the client in a flat, supine position
C) Encourage deep breathing and coughing
D) Administer sedatives to decrease metabolic demand
Answer: A) Elevate the head of the bed to 30 degrees
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage and helps
reduce ICP. The nurse should also avoid hip flexion and extreme neck rotation, maintain a quiet
environment, and minimize suctioning. Sedatives may be used but can mask neurological
changes and should be used cautiously. Deep breathing and coughing can increase ICP and
should be avoided.
Question 5: A client with a seizure disorder is prescribed phenytoin. Which side effect should
the nurse monitor for?
A) Gingival hyperplasia
B) Hepatotoxicity
C) Nystagmus
D) All of the above
Answer: D) All of the above
Rationale: Phenytoin is associated with multiple side effects: gingival hyperplasia (overgrowth
of gum tissue), hepatotoxicity (elevated liver enzymes), and nystagmus (horizontal eye
,movement) at therapeutic levels. The nurse should also monitor for ataxia, drowsiness, and skin
rashes. The client should be taught about proper oral hygiene to minimize gingival hyperplasia.
Question 6: A client with Parkinson's disease is prescribed levodopa-carbidopa. Which finding
indicates the medication is effective?
A) Decreased tremors and improved mobility
B) Increased dyskinesias
C) Decreased appetite
D) Increased rigidity
Answer: A) Decreased tremors and improved mobility
Rationale: Levodopa-carbidopa increases dopamine levels in the brain, reducing Parkinsonian
symptoms including tremors, rigidity, and bradykinesia. Dyskinesias are a side effect of long-
term levodopa therapy, not a sign of effectiveness. Decreased appetite and increased rigidity
indicate worsening symptoms or side effects. The nurse should monitor for "wearing off" effects
and dose adjustments.
Question 7: A client with multiple sclerosis (MS) is prescribed interferon beta. Which finding
indicates the medication is effective?
A) Decreased frequency of relapses
B) Increased frequency of relapses
C) Worsening of symptoms
D) Progression of disability
Answer: A) Decreased frequency of relapses
Rationale: Interferon beta is a disease-modifying therapy that reduces the frequency of relapses
in MS. Effectiveness is demonstrated by a decreased relapse rate, slowed progression of
disability, and reduced MRI lesion activity. The nurse should monitor for side effects, including
flu-like symptoms, injection site reactions, and liver enzyme elevation.
Question 8: A client with a brain tumor develops increased intracranial pressure (ICP). Which
sign indicates worsening ICP?
A) Cushing's triad (hypertension, bradycardia, irregular respirations)
B) Hypotension and tachycardia
C) Pupils equal and reactive to light
D) Decreased level of consciousness
, Answer: A) Cushing's triad (hypertension, bradycardia, irregular respirations)
Rationale: Cushing's triad is a classic sign of increased ICP and indicates brainstem compression.
Other signs include altered level of consciousness, pupillary changes (unequal, sluggish), and
headache. The nurse should monitor ICP continuously, position the client appropriately, and
prepare for interventions such as mannitol, hyperventilation, or surgical decompression.
Question 9: A client with a suspected transient ischemic attack (TIA) reports transient
numbness and weakness in the right arm that resolved within 1 hour. Which action should the
nurse take?
A) Reassure the client that the symptoms are harmless
B) Discharge the client with follow-up instructions
C) Obtain a complete history and prepare for diagnostic testing
D) Administer aspirin and send the client home
Answer: C) Obtain a complete history and prepare for diagnostic testing
Rationale: A TIA is a "warning stroke" and significantly increases the risk of a subsequent stroke.
The nurse should obtain a complete history, perform a thorough neurological assessment, and
prepare for diagnostic testing (carotid ultrasound, echocardiogram, CT/MRI). The client should
be educated about risk factors and signs of stroke. Aspirin may be prescribed but is not the only
intervention.
Question 10: A client with a seizure disorder is receiving valproic acid. Which laboratory value
should the nurse monitor closely?
A) Serum valproic acid level
B) Serum potassium level
C) Serum calcium level
D) Serum sodium level
Answer: A) Serum valproic acid level
Rationale: Valproic acid has a therapeutic range (50-100 mcg/mL) and requires close monitoring
of serum levels to prevent toxicity. Signs of toxicity include nausea, vomiting, tremor, and
confusion. The nurse should also monitor liver function tests (hepatotoxicity), platelet count
(thrombocytopenia), and ammonia levels (hyperammonemia).
Question 11: A client with a stroke has left-sided hemiplegia. Which nursing intervention is
most important?
Complete Exam 13 with Verified Answers
(2026 Edition)
Question 1: A client is admitted with a suspected stroke. The nurse performs a rapid
assessment using the FAST mnemonic. Which finding would indicate a stroke?
A) Facial drooping, arm weakness, and speech difficulty
B) Sudden onset of severe headache and nausea
C) Transient loss of vision in one eye
D) Dizziness and ataxia
Answer: A) Facial drooping, arm weakness, and speech difficulty
Rationale: The FAST mnemonic (Face, Arm, Speech, Time) is used to rapidly assess for stroke.
Facial drooping, arm weakness (unilateral), and speech difficulty are classic signs of stroke.
Sudden severe headache, transient vision loss, dizziness, and ataxia can also occur but are less
specific. The nurse should activate the stroke team immediately if any of these signs are present.
Question 2: A client with a suspected stroke arrives at the emergency department. Which
diagnostic test should the nurse prioritize?
A) Non-contrast computed tomography (CT) scan of the head
B) Magnetic resonance imaging (MRI) of the brain
C) Carotid ultrasound
D) Electroencephalogram (EEG)
Answer: A) Non-contrast computed tomography (CT) scan of the head
Rationale: A non-contrast CT scan of the head is the initial imaging test of choice for suspected
stroke. It can quickly differentiate between ischemic and hemorrhagic stroke, which is critical for
determining treatment (thrombolytics for ischemic stroke, surgical intervention for hemorrhagic
stroke). MRI may provide more detailed imaging but takes longer and is not as readily available
in the emergency setting.
Question 3: A client is diagnosed with an ischemic stroke 2 hours after symptom onset. Which
treatment should the nurse anticipate?
,A) Tissue plasminogen activator (tPA)
B) Heparin infusion
C) Aspirin
D) Surgical intervention
Answer: A) Tissue plasminogen activator (tPA)
Rationale: tPA is the gold standard treatment for acute ischemic stroke and should be
administered within 3-4.5 hours of symptom onset. It works by dissolving the clot causing the
stroke. The nurse should assess for contraindications (e.g., bleeding disorders, recent surgery)
and monitor for signs of bleeding during and after infusion. Heparin and aspirin are used for
stroke prevention, not acute treatment.
Question 4: A client with a hemorrhagic stroke is at risk for increased intracranial pressure
(ICP). Which intervention should the nurse implement to reduce ICP?
A) Elevate the head of the bed to 30 degrees
B) Position the client in a flat, supine position
C) Encourage deep breathing and coughing
D) Administer sedatives to decrease metabolic demand
Answer: A) Elevate the head of the bed to 30 degrees
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage and helps
reduce ICP. The nurse should also avoid hip flexion and extreme neck rotation, maintain a quiet
environment, and minimize suctioning. Sedatives may be used but can mask neurological
changes and should be used cautiously. Deep breathing and coughing can increase ICP and
should be avoided.
Question 5: A client with a seizure disorder is prescribed phenytoin. Which side effect should
the nurse monitor for?
A) Gingival hyperplasia
B) Hepatotoxicity
C) Nystagmus
D) All of the above
Answer: D) All of the above
Rationale: Phenytoin is associated with multiple side effects: gingival hyperplasia (overgrowth
of gum tissue), hepatotoxicity (elevated liver enzymes), and nystagmus (horizontal eye
,movement) at therapeutic levels. The nurse should also monitor for ataxia, drowsiness, and skin
rashes. The client should be taught about proper oral hygiene to minimize gingival hyperplasia.
Question 6: A client with Parkinson's disease is prescribed levodopa-carbidopa. Which finding
indicates the medication is effective?
A) Decreased tremors and improved mobility
B) Increased dyskinesias
C) Decreased appetite
D) Increased rigidity
Answer: A) Decreased tremors and improved mobility
Rationale: Levodopa-carbidopa increases dopamine levels in the brain, reducing Parkinsonian
symptoms including tremors, rigidity, and bradykinesia. Dyskinesias are a side effect of long-
term levodopa therapy, not a sign of effectiveness. Decreased appetite and increased rigidity
indicate worsening symptoms or side effects. The nurse should monitor for "wearing off" effects
and dose adjustments.
Question 7: A client with multiple sclerosis (MS) is prescribed interferon beta. Which finding
indicates the medication is effective?
A) Decreased frequency of relapses
B) Increased frequency of relapses
C) Worsening of symptoms
D) Progression of disability
Answer: A) Decreased frequency of relapses
Rationale: Interferon beta is a disease-modifying therapy that reduces the frequency of relapses
in MS. Effectiveness is demonstrated by a decreased relapse rate, slowed progression of
disability, and reduced MRI lesion activity. The nurse should monitor for side effects, including
flu-like symptoms, injection site reactions, and liver enzyme elevation.
Question 8: A client with a brain tumor develops increased intracranial pressure (ICP). Which
sign indicates worsening ICP?
A) Cushing's triad (hypertension, bradycardia, irregular respirations)
B) Hypotension and tachycardia
C) Pupils equal and reactive to light
D) Decreased level of consciousness
, Answer: A) Cushing's triad (hypertension, bradycardia, irregular respirations)
Rationale: Cushing's triad is a classic sign of increased ICP and indicates brainstem compression.
Other signs include altered level of consciousness, pupillary changes (unequal, sluggish), and
headache. The nurse should monitor ICP continuously, position the client appropriately, and
prepare for interventions such as mannitol, hyperventilation, or surgical decompression.
Question 9: A client with a suspected transient ischemic attack (TIA) reports transient
numbness and weakness in the right arm that resolved within 1 hour. Which action should the
nurse take?
A) Reassure the client that the symptoms are harmless
B) Discharge the client with follow-up instructions
C) Obtain a complete history and prepare for diagnostic testing
D) Administer aspirin and send the client home
Answer: C) Obtain a complete history and prepare for diagnostic testing
Rationale: A TIA is a "warning stroke" and significantly increases the risk of a subsequent stroke.
The nurse should obtain a complete history, perform a thorough neurological assessment, and
prepare for diagnostic testing (carotid ultrasound, echocardiogram, CT/MRI). The client should
be educated about risk factors and signs of stroke. Aspirin may be prescribed but is not the only
intervention.
Question 10: A client with a seizure disorder is receiving valproic acid. Which laboratory value
should the nurse monitor closely?
A) Serum valproic acid level
B) Serum potassium level
C) Serum calcium level
D) Serum sodium level
Answer: A) Serum valproic acid level
Rationale: Valproic acid has a therapeutic range (50-100 mcg/mL) and requires close monitoring
of serum levels to prevent toxicity. Signs of toxicity include nausea, vomiting, tremor, and
confusion. The nurse should also monitor liver function tests (hepatotoxicity), platelet count
(thrombocytopenia), and ammonia levels (hyperammonemia).
Question 11: A client with a stroke has left-sided hemiplegia. Which nursing intervention is
most important?
