Neurological Assessment Exam Master
Practice Test Bank | Multiple Choice Questions
& Detailed Clinical Rationales [2026/2027]
A 39-year-old patient with a suspected herniated intervertebral disc is scheduled for a
myelogram. Which information is most important for the nurse to communicate to the health
care provider before the procedure?
a. The patient is anxious about the test.
b. The patient has an allergy to shellfish.
c. The patient has back pain when lying flat.
d. The patient drank apple juice 4 hours earlier.
Accurate Answer: b.
Iodine-containing contrast medium is injected into the subarachnoid space during a myelogram.
The health care provider may need to modify the postmyelogram orders to prevent back pain,
but this can be done after the procedure. Clear liquids are usually considered safe up to 4 hours
before a diagnostic or surgical procedure. The patients anxiety should be addressed, but this is
not as important as the iodine allergy.
A 27-year-old patient is hospitalized with new onset of Guillain-Barr syndrome. The most
essential assessment for the nurse to carry out is
a. determining level of consciousness.
b. checking strength of the extremities.
c. observing respiratory rate and effort.
d. monitoring the cardiac rate and rhythm.
Accurate Answer: c.
,The most serious complication of Guillain-Barr syndrome is respiratory failure, and the nurse
should monitor respiratory function continuously. The other assessments will also be included
in nursing care, but they are not as important as respiratory assessment.
A 46-year-old patient with a head injury opens the eyes to verbal stimulation, curses when
stimulated, and does not respond to a verbal command to move but attempts to push away a
painful stimulus. The nurse records the patients Glasgow Coma Scale score as
a. 9.
b. 11.
c. 13.
d. 15.
Accurate Answer: b.
The patient has a score of 3 for eye opening, 3 for best verbal response, and 5 for best motor
response.
An unconscious 39-year-old male patient is admitted to the emergency department (ED) with a
head injury. The patients spouse and teenage children stay at the patients side and ask many
questions about the treatment being given. What action is best for the nurse to take?
a. Ask the family to stay in the waiting room until the initial assessment is completed.
b. Allow the family to stay with the patient and briefly explain all procedures to them.
c. Refer the family members to the hospital counseling service to deal with their anxiety.
d. Call the familys pastor or spiritual advisor to take them to the chapel while care is given.
Accurate Answer: b.
The need for information about the diagnosis and care is very high in family members of acutely
ill patients. The nurse should allow the family to observe care and explain the procedures unless
they interfere with emergent care needs. A pastor or counseling service can offer some support,
,but research supports information as being more effective. Asking the family to stay in the
waiting room will increase their anxiety.
A 41-year-old patient who is unconscious has a nursing diagnosis of ineffective cerebral tissue
perfusion related to cerebral tissue swelling. Which nursing intervention will be included in the
plan of care?
a. Encourage coughing and deep breathing.
b. Position the patient with knees and hips flexed.
c. Keep the head of the bed elevated to 30 degrees.
d. Cluster nursing interventions to provide rest periods.
Accurate Answer: c.
The patient with increased intracranial pressure (ICP) should be maintained in the head-up
position to help reduce ICP. Extreme flexion of the hips and knees increases abdominal
pressure, which increases ICP. Because the stimulation associated with nursing interventions
increases ICP, clustering interventions will progressively elevate ICP.
A 20-year-old male patient is admitted with a head injury after a collision while playing football.
After noting that the patient has developed clear nasal drainage, which action should the nurse
take?
a. Have the patient gently blow the nose.
b. Check the drainage for glucose content.
c. Teach the patient that rhinorrhea is expected after a head injury.
d. Obtain a specimen of the fluid to send for culture and sensitivity.
Accurate Answer: b.
Clear nasal drainage in a patient with a head injury suggests a dural tear and cerebrospinal fluid
(CSF) leakage. If the drainage is CSF, it will test positive for glucose. Fluid leaking from the nose
, will have normal nasal flora, so culture and sensitivity will not be useful. Blowing the nose is
avoided to prevent CSF leakage.
Which action will the emergency department nurse anticipate for a patient diagnosed with a
concussion who did not lose consciousness?
a. Coordinate the transfer of the patient to the operating room.
b. Provide discharge instructions about monitoring neurologic status.
c. Transport the patient to radiology for magnetic resonance imaging (MRI).
d. Arrange to admit the patient to the neurologic unit for 24 hours of observation.
Accurate Answer: b.
A patient with a minor head trauma is usually discharged with instructions about neurologic
monitoring and the need to return if neurologic status deteriorates. MRI, hospital admission, or
surgery are not usually indicated in a patient with a concussion.
When admitting an acutely confused 20-year-old patient with a head injury, which action should
the nurse take?
a. Ask family members about the patients health history.
b. Ask leading questions to assist in obtaining health data.
c. Wait until the patient is better oriented to ask questions.
d. Obtain only the physiologic neurologic assessment data.
Accurate Answer: a.
When admitting a patient who is likely to be a poor historian, the nurse should obtain health
history information from others who have knowledge about the patients health. Waiting until
the patient is oriented or obtaining only physiologic data will result in incomplete assessment
Practice Test Bank | Multiple Choice Questions
& Detailed Clinical Rationales [2026/2027]
A 39-year-old patient with a suspected herniated intervertebral disc is scheduled for a
myelogram. Which information is most important for the nurse to communicate to the health
care provider before the procedure?
a. The patient is anxious about the test.
b. The patient has an allergy to shellfish.
c. The patient has back pain when lying flat.
d. The patient drank apple juice 4 hours earlier.
Accurate Answer: b.
Iodine-containing contrast medium is injected into the subarachnoid space during a myelogram.
The health care provider may need to modify the postmyelogram orders to prevent back pain,
but this can be done after the procedure. Clear liquids are usually considered safe up to 4 hours
before a diagnostic or surgical procedure. The patients anxiety should be addressed, but this is
not as important as the iodine allergy.
A 27-year-old patient is hospitalized with new onset of Guillain-Barr syndrome. The most
essential assessment for the nurse to carry out is
a. determining level of consciousness.
b. checking strength of the extremities.
c. observing respiratory rate and effort.
d. monitoring the cardiac rate and rhythm.
Accurate Answer: c.
,The most serious complication of Guillain-Barr syndrome is respiratory failure, and the nurse
should monitor respiratory function continuously. The other assessments will also be included
in nursing care, but they are not as important as respiratory assessment.
A 46-year-old patient with a head injury opens the eyes to verbal stimulation, curses when
stimulated, and does not respond to a verbal command to move but attempts to push away a
painful stimulus. The nurse records the patients Glasgow Coma Scale score as
a. 9.
b. 11.
c. 13.
d. 15.
Accurate Answer: b.
The patient has a score of 3 for eye opening, 3 for best verbal response, and 5 for best motor
response.
An unconscious 39-year-old male patient is admitted to the emergency department (ED) with a
head injury. The patients spouse and teenage children stay at the patients side and ask many
questions about the treatment being given. What action is best for the nurse to take?
a. Ask the family to stay in the waiting room until the initial assessment is completed.
b. Allow the family to stay with the patient and briefly explain all procedures to them.
c. Refer the family members to the hospital counseling service to deal with their anxiety.
d. Call the familys pastor or spiritual advisor to take them to the chapel while care is given.
Accurate Answer: b.
The need for information about the diagnosis and care is very high in family members of acutely
ill patients. The nurse should allow the family to observe care and explain the procedures unless
they interfere with emergent care needs. A pastor or counseling service can offer some support,
,but research supports information as being more effective. Asking the family to stay in the
waiting room will increase their anxiety.
A 41-year-old patient who is unconscious has a nursing diagnosis of ineffective cerebral tissue
perfusion related to cerebral tissue swelling. Which nursing intervention will be included in the
plan of care?
a. Encourage coughing and deep breathing.
b. Position the patient with knees and hips flexed.
c. Keep the head of the bed elevated to 30 degrees.
d. Cluster nursing interventions to provide rest periods.
Accurate Answer: c.
The patient with increased intracranial pressure (ICP) should be maintained in the head-up
position to help reduce ICP. Extreme flexion of the hips and knees increases abdominal
pressure, which increases ICP. Because the stimulation associated with nursing interventions
increases ICP, clustering interventions will progressively elevate ICP.
A 20-year-old male patient is admitted with a head injury after a collision while playing football.
After noting that the patient has developed clear nasal drainage, which action should the nurse
take?
a. Have the patient gently blow the nose.
b. Check the drainage for glucose content.
c. Teach the patient that rhinorrhea is expected after a head injury.
d. Obtain a specimen of the fluid to send for culture and sensitivity.
Accurate Answer: b.
Clear nasal drainage in a patient with a head injury suggests a dural tear and cerebrospinal fluid
(CSF) leakage. If the drainage is CSF, it will test positive for glucose. Fluid leaking from the nose
, will have normal nasal flora, so culture and sensitivity will not be useful. Blowing the nose is
avoided to prevent CSF leakage.
Which action will the emergency department nurse anticipate for a patient diagnosed with a
concussion who did not lose consciousness?
a. Coordinate the transfer of the patient to the operating room.
b. Provide discharge instructions about monitoring neurologic status.
c. Transport the patient to radiology for magnetic resonance imaging (MRI).
d. Arrange to admit the patient to the neurologic unit for 24 hours of observation.
Accurate Answer: b.
A patient with a minor head trauma is usually discharged with instructions about neurologic
monitoring and the need to return if neurologic status deteriorates. MRI, hospital admission, or
surgery are not usually indicated in a patient with a concussion.
When admitting an acutely confused 20-year-old patient with a head injury, which action should
the nurse take?
a. Ask family members about the patients health history.
b. Ask leading questions to assist in obtaining health data.
c. Wait until the patient is better oriented to ask questions.
d. Obtain only the physiologic neurologic assessment data.
Accurate Answer: a.
When admitting a patient who is likely to be a poor historian, the nurse should obtain health
history information from others who have knowledge about the patients health. Waiting until
the patient is oriented or obtaining only physiologic data will result in incomplete assessment
