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MEDICAL-SURGICAL NURSING WITH NEUROLOGICAL FOCUS UPDATED
EXAM COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS LATEST
EDITION 2026
Medical-Surgical Nursing with Neurological Focus — Exam Questions with Rationales
Summarized 10-Point Exam Coverage
1. Neurological Assessment & Diagnostic Testing — LOC, GCS, cranial nerves, ICP
monitoring, and neuro diagnostics.
2. Neurological Disorders — stroke, seizures, TBI, spinal cord injury, meningitis, and
Guillain-Barré.
3. Cardiovascular Disorders — heart failure, MI, dysrhythmias, hypertension, and vascular
disorders.
4. Respiratory Disorders — COPD, pneumonia, PE, ARDS, and mechanical ventilation.
5. Endocrine Disorders — diabetes, DKA, thyroid, adrenal, and SIADH/DI.
6. Renal & Urinary Disorders — AKI, CKD, dialysis, and UTIs.
7. Gastrointestinal Disorders — GI bleeding, cirrhosis, pancreatitis, and bowel obstruction.
8. Musculoskeletal & Integumentary — fractures, joint replacement, burns, and pressure
injuries.
9. Hematologic & Oncologic — anemia, thrombocytopenia, neutropenia, and transfusion
reactions.
10. Perioperative & Emergency Nursing — preoperative care, postoperative complications,
shock, and sepsis.
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SECTION 1: NEUROLOGICAL ASSESSMENT & DIAGNOSTIC TESTING (Questions 1–30)
Q1. A nurse is assessing a client's level of consciousness using the Glasgow Coma Scale. Which
score indicates severe neurological impairment?
A) 15
B) 12
C) 8
D) 3
Correct Answer: C) 8
Rationale: A GCS score of 8 or less indicates severe neurological impairment and coma. Scores
range from 3 (deep coma) to 15 (fully alert).
Q2. A nurse is assessing a client's pupillary response. Which finding requires immediate
intervention?
A) Pupils equal and reactive to light
B) Pupils constricted and reactive
C) Pupils fixed and dilated
D) Pupils equal and round
Correct Answer: C) Pupils fixed and dilated
Rationale: Fixed and dilated pupils indicate a neurological emergency, such as increased
intracranial pressure or brainstem herniation.
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Q3. A nurse is assessing a client's cranial nerves. Which cranial nerve is responsible for facial
movement?
A) CN I
B) CN V
C) CN VII
D) CN X
Correct Answer: C) CN VII
Rationale: CN VII (facial nerve) is responsible for facial movement. CN I is olfactory, CN V is
trigeminal, and CN X is vagus.
Q4. A nurse is assessing a client's cranial nerves. Which cranial nerve is responsible for
hearing?
A) CN II
B) CN VIII
C) CN X
D) CN XII
Correct Answer: B) CN VIII
Rationale: CN VIII (vestibulocochlear nerve) is responsible for hearing and balance.
Q5. A nurse is preparing a client for a lumbar puncture. Which position should the nurse place
the client in?
A) Supine
B) Prone
C) Lateral recumbent with knees drawn to chest
D) High-Fowler's
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Correct Answer: C) Lateral recumbent with knees drawn to chest
Rationale: The lateral recumbent position with knees drawn to the chest (fetal position) widens
the spaces between vertebrae, facilitating needle insertion.
Q6. A nurse is caring for a client following a lumbar puncture. Which finding requires
immediate intervention?
A) Headache relieved by lying flat
B) Clear fluid leaking from the puncture site
C) Mild back discomfort
D) Blood pressure 110/70 mm Hg
Correct Answer: B) Clear fluid leaking from the puncture site
Rationale: Clear fluid leaking from the puncture site indicates cerebrospinal fluid (CSF) leak,
which requires immediate intervention.
Q7. A nurse is assessing a client's deep tendon reflexes. Which finding is normal?
A) 0+
B) 1+
C) 2+
D) 4+
Correct Answer: C) 2+
Rationale: 2+ is a normal deep tendon reflex response. 0+ indicates absent reflexes, 1+ is
diminished, and 4+ is hyperactive (clonus).
Q8. A nurse is assessing a client's coordination. Which test is used to assess coordination?
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MEDICAL-SURGICAL NURSING WITH NEUROLOGICAL FOCUS UPDATED
EXAM COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS LATEST
EDITION 2026
Medical-Surgical Nursing with Neurological Focus — Exam Questions with Rationales
Summarized 10-Point Exam Coverage
1. Neurological Assessment & Diagnostic Testing — LOC, GCS, cranial nerves, ICP
monitoring, and neuro diagnostics.
2. Neurological Disorders — stroke, seizures, TBI, spinal cord injury, meningitis, and
Guillain-Barré.
3. Cardiovascular Disorders — heart failure, MI, dysrhythmias, hypertension, and vascular
disorders.
4. Respiratory Disorders — COPD, pneumonia, PE, ARDS, and mechanical ventilation.
5. Endocrine Disorders — diabetes, DKA, thyroid, adrenal, and SIADH/DI.
6. Renal & Urinary Disorders — AKI, CKD, dialysis, and UTIs.
7. Gastrointestinal Disorders — GI bleeding, cirrhosis, pancreatitis, and bowel obstruction.
8. Musculoskeletal & Integumentary — fractures, joint replacement, burns, and pressure
injuries.
9. Hematologic & Oncologic — anemia, thrombocytopenia, neutropenia, and transfusion
reactions.
10. Perioperative & Emergency Nursing — preoperative care, postoperative complications,
shock, and sepsis.
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,Page 2 of 112
SECTION 1: NEUROLOGICAL ASSESSMENT & DIAGNOSTIC TESTING (Questions 1–30)
Q1. A nurse is assessing a client's level of consciousness using the Glasgow Coma Scale. Which
score indicates severe neurological impairment?
A) 15
B) 12
C) 8
D) 3
Correct Answer: C) 8
Rationale: A GCS score of 8 or less indicates severe neurological impairment and coma. Scores
range from 3 (deep coma) to 15 (fully alert).
Q2. A nurse is assessing a client's pupillary response. Which finding requires immediate
intervention?
A) Pupils equal and reactive to light
B) Pupils constricted and reactive
C) Pupils fixed and dilated
D) Pupils equal and round
Correct Answer: C) Pupils fixed and dilated
Rationale: Fixed and dilated pupils indicate a neurological emergency, such as increased
intracranial pressure or brainstem herniation.
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,Page 3 of 112
Q3. A nurse is assessing a client's cranial nerves. Which cranial nerve is responsible for facial
movement?
A) CN I
B) CN V
C) CN VII
D) CN X
Correct Answer: C) CN VII
Rationale: CN VII (facial nerve) is responsible for facial movement. CN I is olfactory, CN V is
trigeminal, and CN X is vagus.
Q4. A nurse is assessing a client's cranial nerves. Which cranial nerve is responsible for
hearing?
A) CN II
B) CN VIII
C) CN X
D) CN XII
Correct Answer: B) CN VIII
Rationale: CN VIII (vestibulocochlear nerve) is responsible for hearing and balance.
Q5. A nurse is preparing a client for a lumbar puncture. Which position should the nurse place
the client in?
A) Supine
B) Prone
C) Lateral recumbent with knees drawn to chest
D) High-Fowler's
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Correct Answer: C) Lateral recumbent with knees drawn to chest
Rationale: The lateral recumbent position with knees drawn to the chest (fetal position) widens
the spaces between vertebrae, facilitating needle insertion.
Q6. A nurse is caring for a client following a lumbar puncture. Which finding requires
immediate intervention?
A) Headache relieved by lying flat
B) Clear fluid leaking from the puncture site
C) Mild back discomfort
D) Blood pressure 110/70 mm Hg
Correct Answer: B) Clear fluid leaking from the puncture site
Rationale: Clear fluid leaking from the puncture site indicates cerebrospinal fluid (CSF) leak,
which requires immediate intervention.
Q7. A nurse is assessing a client's deep tendon reflexes. Which finding is normal?
A) 0+
B) 1+
C) 2+
D) 4+
Correct Answer: C) 2+
Rationale: 2+ is a normal deep tendon reflex response. 0+ indicates absent reflexes, 1+ is
diminished, and 4+ is hyperactive (clonus).
Q8. A nurse is assessing a client's coordination. Which test is used to assess coordination?
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