Adult Health Nursing I – Neurological, Renal &
Endocrine Disorders Questions
Question 1: A patient suddenly develops facial drooping, right-arm weakness, and
slurred speech. What should the nurse do first?
A. Give oral fluids
B. Determine when symptoms began and activate the stroke response
C. Encourage the patient to walk
D. Wait to see whether symptoms resolve
Correct Answer: B. Determine when symptoms began and activate the stroke
response.
Rationale: Sudden facial drooping, unilateral weakness, and speech difficulty
strongly suggest acute stroke. The time of symptom onset determines eligibility for
time-sensitive treatment. The nurse should activate the stroke protocol, assess
airway and glucose, maintain safety, and prepare the patient for urgent neurologic
imaging.
Question 2
Question 2: A patient with a left-hemisphere stroke has expressive aphasia. Which
communication strategy is most appropriate?
A. Speak loudly and rapidly
B. Ask several questions at once
,C. Use short statements and allow time for responses
D. Complete every sentence for the patient
Correct Answer: C. Use short statements and allow time for responses.
Rationale: Expressive aphasia impairs the ability to produce language, although
comprehension may be preserved. Short statements, simple questions, visual cues,
patience, and alternative communication methods support effective interaction. The
nurse should not assume that impaired speech indicates impaired intelligence or
understanding.
Question 3
Question 3: A patient with an acute stroke coughs while drinking water. What
should the nurse do?
A. Continue offering thin liquids
B. Keep the patient NPO and request a swallowing evaluation
C. Give liquids through a straw
D. Place the patient flat after drinking
Correct Answer: B. Keep the patient NPO and request a swallowing evaluation.
Rationale: Coughing during swallowing suggests impaired airway protection and
aspiration risk. The patient should remain NPO until a qualified swallowing
evaluation is completed. Recommendations may include altered food textures,
upright positioning, small bites, supervised feeding, and aspiration precautions.
Question 4
Question 4: Which finding is most suggestive of increased intracranial pressure?
,A. Improved orientation
B. Decreasing level of consciousness and unequal pupils
C. Increased appetite
D. Clear speech and steady gait
Correct Answer: B. Decreasing level of consciousness and unequal pupils.
Rationale: Decreasing consciousness and unequal pupils may indicate
compression of brain tissue and cranial nerves from rising intracranial pressure.
Other warning signs include headache, vomiting, seizures, abnormal posturing, and
Cushing’s triad. Immediate neurologic assessment and provider notification are
required.
Question 5
Question 5: Which position is generally appropriate for a patient with increased
intracranial pressure?
A. Head of bed elevated with the neck in neutral alignment
B. Flat with the neck sharply flexed
C. Trendelenburg position
D. Prone with the head rotated
Correct Answer: A. Head of bed elevated with the neck in neutral alignment.
Rationale: Elevating the head and maintaining neutral neck alignment promotes
cerebral venous drainage and may help reduce intracranial pressure. The nurse
should avoid neck rotation, excessive hip flexion, straining, coughing when
possible, and unnecessary stimulation.
Question 6
, Question 6: A patient with a head injury becomes increasingly drowsy and
develops projectile vomiting. What should the nurse do first?
A. Allow the patient to sleep
B. Perform an urgent neurologic assessment and notify the provider
C. Offer oral fluids
D. Place the patient in Trendelenburg position
Correct Answer: B. Perform an urgent neurologic assessment and notify the
provider.
Rationale: Increasing drowsiness and projectile vomiting may indicate rising
intracranial pressure. The nurse should assess airway, breathing, pupils, motor
responses, and level of consciousness, maintain head alignment, and notify the
provider immediately for urgent evaluation.
Question 7
Question 7: Which intervention is appropriate during an active generalized tonic-
clonic seizure?
A. Restrain the patient’s limbs
B. Insert a padded object into the mouth
C. Protect the patient from injury and turn the patient to the side
D. Force oral medication into the mouth
Correct Answer: C. Protect the patient from injury and turn the patient to the side.
Rationale: During a seizure, the nurse should protect the patient from injury, move
nearby hazards, support the head, loosen restrictive clothing, and maintain airway
Endocrine Disorders Questions
Question 1: A patient suddenly develops facial drooping, right-arm weakness, and
slurred speech. What should the nurse do first?
A. Give oral fluids
B. Determine when symptoms began and activate the stroke response
C. Encourage the patient to walk
D. Wait to see whether symptoms resolve
Correct Answer: B. Determine when symptoms began and activate the stroke
response.
Rationale: Sudden facial drooping, unilateral weakness, and speech difficulty
strongly suggest acute stroke. The time of symptom onset determines eligibility for
time-sensitive treatment. The nurse should activate the stroke protocol, assess
airway and glucose, maintain safety, and prepare the patient for urgent neurologic
imaging.
Question 2
Question 2: A patient with a left-hemisphere stroke has expressive aphasia. Which
communication strategy is most appropriate?
A. Speak loudly and rapidly
B. Ask several questions at once
,C. Use short statements and allow time for responses
D. Complete every sentence for the patient
Correct Answer: C. Use short statements and allow time for responses.
Rationale: Expressive aphasia impairs the ability to produce language, although
comprehension may be preserved. Short statements, simple questions, visual cues,
patience, and alternative communication methods support effective interaction. The
nurse should not assume that impaired speech indicates impaired intelligence or
understanding.
Question 3
Question 3: A patient with an acute stroke coughs while drinking water. What
should the nurse do?
A. Continue offering thin liquids
B. Keep the patient NPO and request a swallowing evaluation
C. Give liquids through a straw
D. Place the patient flat after drinking
Correct Answer: B. Keep the patient NPO and request a swallowing evaluation.
Rationale: Coughing during swallowing suggests impaired airway protection and
aspiration risk. The patient should remain NPO until a qualified swallowing
evaluation is completed. Recommendations may include altered food textures,
upright positioning, small bites, supervised feeding, and aspiration precautions.
Question 4
Question 4: Which finding is most suggestive of increased intracranial pressure?
,A. Improved orientation
B. Decreasing level of consciousness and unequal pupils
C. Increased appetite
D. Clear speech and steady gait
Correct Answer: B. Decreasing level of consciousness and unequal pupils.
Rationale: Decreasing consciousness and unequal pupils may indicate
compression of brain tissue and cranial nerves from rising intracranial pressure.
Other warning signs include headache, vomiting, seizures, abnormal posturing, and
Cushing’s triad. Immediate neurologic assessment and provider notification are
required.
Question 5
Question 5: Which position is generally appropriate for a patient with increased
intracranial pressure?
A. Head of bed elevated with the neck in neutral alignment
B. Flat with the neck sharply flexed
C. Trendelenburg position
D. Prone with the head rotated
Correct Answer: A. Head of bed elevated with the neck in neutral alignment.
Rationale: Elevating the head and maintaining neutral neck alignment promotes
cerebral venous drainage and may help reduce intracranial pressure. The nurse
should avoid neck rotation, excessive hip flexion, straining, coughing when
possible, and unnecessary stimulation.
Question 6
, Question 6: A patient with a head injury becomes increasingly drowsy and
develops projectile vomiting. What should the nurse do first?
A. Allow the patient to sleep
B. Perform an urgent neurologic assessment and notify the provider
C. Offer oral fluids
D. Place the patient in Trendelenburg position
Correct Answer: B. Perform an urgent neurologic assessment and notify the
provider.
Rationale: Increasing drowsiness and projectile vomiting may indicate rising
intracranial pressure. The nurse should assess airway, breathing, pupils, motor
responses, and level of consciousness, maintain head alignment, and notify the
provider immediately for urgent evaluation.
Question 7
Question 7: Which intervention is appropriate during an active generalized tonic-
clonic seizure?
A. Restrain the patient’s limbs
B. Insert a padded object into the mouth
C. Protect the patient from injury and turn the patient to the side
D. Force oral medication into the mouth
Correct Answer: C. Protect the patient from injury and turn the patient to the side.
Rationale: During a seizure, the nurse should protect the patient from injury, move
nearby hazards, support the head, loosen restrictive clothing, and maintain airway
