Nursing 354 Neurological Emergencies
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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Question 1
A patient suddenly develops facial drooping, right-sided weakness, and difficulty
speaking. Which action should the nurse take first?
A. Administer aspirin
B. Obtain a detailed neurological history
C. Activate the stroke response and determine the time symptoms began
D. Place the patient in Trendelenburg position
Answer: C. Activate the stroke response and determine the time symptoms
began
Rationale: Rapid recognition and determination of the last-known-well time are
essential because acute stroke therapies are time dependent.
Question 2
Which finding is most characteristic of increased intracranial pressure (ICP)?
,A. Hypotension and tachycardia
B. Decreased level of consciousness
C. Increased bowel sounds
D. Bilateral peripheral edema
Answer: B. Decreased level of consciousness
Rationale: A declining level of consciousness is an important early indicator of
neurological deterioration and increased ICP.
Question 3
A patient with suspected ischemic stroke is being evaluated for thrombolytic
therapy. Which diagnostic study is most important initially?
A. Electroencephalogram
B. Lumbar puncture
C. Carotid ultrasound
D. Noncontrast computed tomography of the head
Answer: D. Noncontrast computed tomography of the head
Rationale: Noncontrast head CT rapidly distinguishes intracranial hemorrhage
from ischemic stroke and helps determine eligibility for thrombolytic treatment.
Question 4
Which assessment finding is most concerning in a patient with a head injury?
A. Mild headache
B. Nausea after medication administration
C. Progressive decrease in level of consciousness
D. Small superficial scalp abrasion
Answer: C. Progressive decrease in level of consciousness
,Rationale: A worsening level of consciousness can indicate increasing ICP,
cerebral edema, hemorrhage, or other serious intracranial complications.
Question 5
A patient is actively experiencing a generalized tonic-clonic seizure. What is the
nurse's priority?
A. Restrain the patient's extremities
B. Insert an oral airway
C. Give the patient water
D. Protect the patient from injury and maintain airway safety
Answer: D. Protect the patient from injury and maintain airway safety
Rationale: During a seizure, the nurse should protect the patient from injury,
maintain airway safety, and avoid restraining the patient or placing objects in
the mouth.
Question 6
Which finding is commonly associated with Cushing triad in a patient with
increased ICP?
A. Tachycardia, hypotension, and fever
B. Hypertension, bradycardia, and irregular respirations
C. Hypotension, tachypnea, and bradycardia
D. Hypertension, tachycardia, and hyperventilation
Answer: B. Hypertension, bradycardia, and irregular respirations
Rationale: Cushing triad is a late and serious sign of increased ICP consisting of
hypertension with widened pulse pressure, bradycardia, and abnormal
respirations.
, Question 7
A patient with suspected bacterial meningitis is admitted. Which intervention is
appropriate?
A. Place the patient in a positive-pressure room
B. Use standard precautions only
C. Initiate appropriate droplet precautions
D. Encourage unrestricted visitors
Answer: C. Initiate appropriate droplet precautions
Rationale: Suspected bacterial meningitis requires droplet precautions according
to infection-control recommendations, particularly during the initial period of
appropriate antimicrobial therapy.
Question 8
Which symptom is particularly concerning for subarachnoid hemorrhage?
A. Gradual mild headache over several weeks
B. Sudden severe headache with abrupt onset
C. Chronic tension headache
D. Mild headache relieved by rest
Answer: B. Sudden severe headache with abrupt onset
Rationale: Subarachnoid hemorrhage classically presents with a sudden, severe
headache often described as a "thunderclap" headache.
Question 9
A patient with suspected stroke has difficulty swallowing. What should the nurse
do before giving oral medications?
A. Give medications with applesauce
B. Offer small sips of water
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Question 1
A patient suddenly develops facial drooping, right-sided weakness, and difficulty
speaking. Which action should the nurse take first?
A. Administer aspirin
B. Obtain a detailed neurological history
C. Activate the stroke response and determine the time symptoms began
D. Place the patient in Trendelenburg position
Answer: C. Activate the stroke response and determine the time symptoms
began
Rationale: Rapid recognition and determination of the last-known-well time are
essential because acute stroke therapies are time dependent.
Question 2
Which finding is most characteristic of increased intracranial pressure (ICP)?
,A. Hypotension and tachycardia
B. Decreased level of consciousness
C. Increased bowel sounds
D. Bilateral peripheral edema
Answer: B. Decreased level of consciousness
Rationale: A declining level of consciousness is an important early indicator of
neurological deterioration and increased ICP.
Question 3
A patient with suspected ischemic stroke is being evaluated for thrombolytic
therapy. Which diagnostic study is most important initially?
A. Electroencephalogram
B. Lumbar puncture
C. Carotid ultrasound
D. Noncontrast computed tomography of the head
Answer: D. Noncontrast computed tomography of the head
Rationale: Noncontrast head CT rapidly distinguishes intracranial hemorrhage
from ischemic stroke and helps determine eligibility for thrombolytic treatment.
Question 4
Which assessment finding is most concerning in a patient with a head injury?
A. Mild headache
B. Nausea after medication administration
C. Progressive decrease in level of consciousness
D. Small superficial scalp abrasion
Answer: C. Progressive decrease in level of consciousness
,Rationale: A worsening level of consciousness can indicate increasing ICP,
cerebral edema, hemorrhage, or other serious intracranial complications.
Question 5
A patient is actively experiencing a generalized tonic-clonic seizure. What is the
nurse's priority?
A. Restrain the patient's extremities
B. Insert an oral airway
C. Give the patient water
D. Protect the patient from injury and maintain airway safety
Answer: D. Protect the patient from injury and maintain airway safety
Rationale: During a seizure, the nurse should protect the patient from injury,
maintain airway safety, and avoid restraining the patient or placing objects in
the mouth.
Question 6
Which finding is commonly associated with Cushing triad in a patient with
increased ICP?
A. Tachycardia, hypotension, and fever
B. Hypertension, bradycardia, and irregular respirations
C. Hypotension, tachypnea, and bradycardia
D. Hypertension, tachycardia, and hyperventilation
Answer: B. Hypertension, bradycardia, and irregular respirations
Rationale: Cushing triad is a late and serious sign of increased ICP consisting of
hypertension with widened pulse pressure, bradycardia, and abnormal
respirations.
, Question 7
A patient with suspected bacterial meningitis is admitted. Which intervention is
appropriate?
A. Place the patient in a positive-pressure room
B. Use standard precautions only
C. Initiate appropriate droplet precautions
D. Encourage unrestricted visitors
Answer: C. Initiate appropriate droplet precautions
Rationale: Suspected bacterial meningitis requires droplet precautions according
to infection-control recommendations, particularly during the initial period of
appropriate antimicrobial therapy.
Question 8
Which symptom is particularly concerning for subarachnoid hemorrhage?
A. Gradual mild headache over several weeks
B. Sudden severe headache with abrupt onset
C. Chronic tension headache
D. Mild headache relieved by rest
Answer: B. Sudden severe headache with abrupt onset
Rationale: Subarachnoid hemorrhage classically presents with a sudden, severe
headache often described as a "thunderclap" headache.
Question 9
A patient with suspected stroke has difficulty swallowing. What should the nurse
do before giving oral medications?
A. Give medications with applesauce
B. Offer small sips of water
