Galen College of Nursing NSG 3250 Adult
Health I Exam 3 Study Guide: Neurologic,
Musculoskeletal & Sensory Disorders Review
and Rationales (2026/2027)
1. A client with a stroke has left-sided neglect. Which nursing intervention is most appropriate?
A) Place all items on the right side
B) Approach from the left and remind the client to scan left
C) Restrain the right arm
D) Keep the room dark
Answer: B
Rationale: Encourage attention to the neglected side with cues and placement of items on the affected
side.
2. A client with a new onset of slurred speech and facial droop arrives 1 hour after symptom onset.
What is the priority action?
A) Administer aspirin
B) Activate stroke protocol and prepare for CT
C) Give oxygen
D) Place supine
Answer: B
Rationale: Acute stroke requires rapid CT to rule out hemorrhage before thrombolytics.
3. A client with a head injury has a Glasgow Coma Scale score of 8. Which action is priority?
A) Notify neurosurgeon
B) Assess airway and breathing
C) Prepare for CT
D) Administer mannitol
,Answer: B
Rationale: GCS ≤8 indicates severe injury; airway protection is the first priority.
4. A client with ICP has a CPP of 55 mmHg. Which action should the nurse take?
A) Lower HOB
B) Elevate HOB to 30 degrees and notify provider
C) Increase fluids rapidly
D) Administer epinephrine
Answer: B
Rationale: CPP <60 indicates inadequate cerebral perfusion; elevate HOB and notify.
5. A client with a seizure disorder is in status epilepticus. Which medication is first-line?
A) Oral phenytoin
B) IV lorazepam
C) IV levetiracetam
D) IM haloperidol
Answer: B
Rationale: Benzodiazepines are first-line for status epilepticus to stop seizure activity.
6. A client with meningitis has photophobia and neck stiffness. Which precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard only
Answer: B
Rationale: Meningococcal meningitis requires droplet precautions until 24 hours of antibiotics.
,7. A client with Parkinson’s disease is prescribed carbidopa-levodopa. Which instruction is correct?
A) Take with high-protein meal
B) Take 30 minutes before meals
C) Stop if tremor improves
D) Take at bedtime only
Answer: B
Rationale: Protein competes with levodopa absorption; take on empty stomach.
8. A client with myasthenia gravis reports difficulty swallowing and drooling. Which action is
priority?
A) Offer oral fluids
B) Assess airway and notify provider
C) Administer pyridostigmine
D) Place supine
Answer: B
Rationale: Dysphagia and drooling indicate myasthenic crisis and aspiration risk.
9. A client with Guillain-Barré syndrome is admitted. Which assessment is most important?
A) Pain level
B) Vital capacity and respiratory effort
C) Skin color
D) Bowel sounds
Answer: B
Rationale: Ascending paralysis can cause respiratory failure; monitor vital capacity.
10. A client with Alzheimer’s disease is confused and wanders. Which intervention is best?
A) Restrain in bed
B) Provide a safe environment and redirection
, C) Give sedative
D) Darken room
Answer: B
Rationale: Least restrictive measures first; reorient and redirect.
11. A client with a lumbar puncture is post-procedure. Which instruction is correct?
A) Ambulate immediately
B) Lie flat for several hours
C) Sit upright
D) Drink caffeine only
Answer: B
Rationale: Flat positioning reduces post-LP headache risk.
12. A client with a brain tumor has a seizure. Which action is first?
A) Restrain arms
B) Protect head and move furniture
C) Insert oral airway
D) Give oral meds
Answer: B
Rationale: During seizure, protect from injury; do not restrain or insert objects in mouth.
13. A client with a spinal cord injury at T6 has severe headache and hypertension. What is priority?
A) Give antihypertensive
B) Sit up and check bladder distention
C) Lay flat
D) Apply ice
Answer: B
Rationale: Autonomic dysreflexia triggered by bladder/bowel; remove stimulus.
Health I Exam 3 Study Guide: Neurologic,
Musculoskeletal & Sensory Disorders Review
and Rationales (2026/2027)
1. A client with a stroke has left-sided neglect. Which nursing intervention is most appropriate?
A) Place all items on the right side
B) Approach from the left and remind the client to scan left
C) Restrain the right arm
D) Keep the room dark
Answer: B
Rationale: Encourage attention to the neglected side with cues and placement of items on the affected
side.
2. A client with a new onset of slurred speech and facial droop arrives 1 hour after symptom onset.
What is the priority action?
A) Administer aspirin
B) Activate stroke protocol and prepare for CT
C) Give oxygen
D) Place supine
Answer: B
Rationale: Acute stroke requires rapid CT to rule out hemorrhage before thrombolytics.
3. A client with a head injury has a Glasgow Coma Scale score of 8. Which action is priority?
A) Notify neurosurgeon
B) Assess airway and breathing
C) Prepare for CT
D) Administer mannitol
,Answer: B
Rationale: GCS ≤8 indicates severe injury; airway protection is the first priority.
4. A client with ICP has a CPP of 55 mmHg. Which action should the nurse take?
A) Lower HOB
B) Elevate HOB to 30 degrees and notify provider
C) Increase fluids rapidly
D) Administer epinephrine
Answer: B
Rationale: CPP <60 indicates inadequate cerebral perfusion; elevate HOB and notify.
5. A client with a seizure disorder is in status epilepticus. Which medication is first-line?
A) Oral phenytoin
B) IV lorazepam
C) IV levetiracetam
D) IM haloperidol
Answer: B
Rationale: Benzodiazepines are first-line for status epilepticus to stop seizure activity.
6. A client with meningitis has photophobia and neck stiffness. Which precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard only
Answer: B
Rationale: Meningococcal meningitis requires droplet precautions until 24 hours of antibiotics.
,7. A client with Parkinson’s disease is prescribed carbidopa-levodopa. Which instruction is correct?
A) Take with high-protein meal
B) Take 30 minutes before meals
C) Stop if tremor improves
D) Take at bedtime only
Answer: B
Rationale: Protein competes with levodopa absorption; take on empty stomach.
8. A client with myasthenia gravis reports difficulty swallowing and drooling. Which action is
priority?
A) Offer oral fluids
B) Assess airway and notify provider
C) Administer pyridostigmine
D) Place supine
Answer: B
Rationale: Dysphagia and drooling indicate myasthenic crisis and aspiration risk.
9. A client with Guillain-Barré syndrome is admitted. Which assessment is most important?
A) Pain level
B) Vital capacity and respiratory effort
C) Skin color
D) Bowel sounds
Answer: B
Rationale: Ascending paralysis can cause respiratory failure; monitor vital capacity.
10. A client with Alzheimer’s disease is confused and wanders. Which intervention is best?
A) Restrain in bed
B) Provide a safe environment and redirection
, C) Give sedative
D) Darken room
Answer: B
Rationale: Least restrictive measures first; reorient and redirect.
11. A client with a lumbar puncture is post-procedure. Which instruction is correct?
A) Ambulate immediately
B) Lie flat for several hours
C) Sit upright
D) Drink caffeine only
Answer: B
Rationale: Flat positioning reduces post-LP headache risk.
12. A client with a brain tumor has a seizure. Which action is first?
A) Restrain arms
B) Protect head and move furniture
C) Insert oral airway
D) Give oral meds
Answer: B
Rationale: During seizure, protect from injury; do not restrain or insert objects in mouth.
13. A client with a spinal cord injury at T6 has severe headache and hypertension. What is priority?
A) Give antihypertensive
B) Sit up and check bladder distention
C) Lay flat
D) Apply ice
Answer: B
Rationale: Autonomic dysreflexia triggered by bladder/bowel; remove stimulus.
