NCLEX RN Neurological Disorders
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a suspected stroke suddenly develops facial drooping and
weakness of the right arm. What is the nurse’s priority action?
A. Give the client oral aspirin
B. Place the client in Trendelenburg position
C. Determine the exact time the symptoms began
D. Encourage the client to ambulate
Answer: C. Determine the exact time the symptoms began
Rationale: The time of symptom onset is critical because eligibility for time-
sensitive reperfusion therapies depends on when the stroke symptoms began.
2. Which finding is most characteristic of increased intracranial pressure
(ICP)?
A. Bradycardia with widening pulse pressure
B. Hypotension with tachycardia
C. Increased urine output
D. Hyperactive bowel sounds
Answer: A. Bradycardia with widening pulse pressure
Rationale: Bradycardia, widened pulse pressure, and abnormal respirations
are components of Cushing triad, a late sign of increased ICP.
,3. A client with a head injury becomes increasingly confused and develops
unequal pupils. What should the nurse do first?
A. Reassure the client
B. Notify the healthcare provider immediately
C. Offer oral fluids
D. Place the client in a supine position
Answer: B. Notify the healthcare provider immediately
Rationale: New confusion and unequal pupils can indicate neurological
deterioration and possible brain herniation, requiring immediate
intervention.
4. A client is admitted with bacterial meningitis. Which intervention is the
priority?
A. Initiate droplet precautions
B. Encourage bright lighting
C. Restrict all fluids
D. Place the client in a high-Fowler position
Answer: A. Initiate droplet precautions
Rationale: Bacterial meningitis can be transmitted through respiratory
secretions. Droplet precautions are required initially, along with prompt
antimicrobial therapy.
5. Which assessment finding is commonly associated with meningitis?
A. Nuchal rigidity
B. Painless hematuria
C. Hypoactive bowel sounds
D. Peripheral edema
Answer: A. Nuchal rigidity
Rationale: Neck stiffness or nuchal rigidity is a classic manifestation of
meningeal irritation and commonly occurs with meningitis.
,6. A client with a seizure is actively convulsing. Which action should the nurse
take?
A. Restrain the client’s extremities
B. Insert a tongue blade into the mouth
C. Protect the client from injury and maintain airway safety
D. Give the client oral medication
Answer: C. Protect the client from injury and maintain airway safety
Rationale: During a seizure, the nurse should protect the client from injury,
maintain airway safety, and avoid restraining the client or placing objects in
the mouth.
7. Which medication is commonly used to terminate an ongoing prolonged
seizure?
A. Lorazepam
B. Acetaminophen
C. Furosemide
D. Warfarin
Answer: A. Lorazepam
Rationale: Benzodiazepines such as lorazepam are commonly used as first-
line emergency treatment for prolonged seizures or status epilepticus.
8. Which statement by a client taking phenytoin indicates a need for further
teaching?
A. “I will maintain good oral hygiene.”
B. “I should not stop this medication suddenly.”
C. “I will have my healthcare provider monitor my drug levels when indicated.”
D. “I can stop taking the medication once I have had no seizures for a week.”
Answer: D. “I can stop taking the medication once I have had no seizures for a
week.”
, Rationale: Antiseizure medications should not be discontinued abruptly
because sudden withdrawal can precipitate seizures or status epilepticus.
9. Which adverse effect is associated with long-term phenytoin therapy?
A. Gingival hyperplasia
B. Severe hypoglycemia
C. Urinary retention
D. Cataracts
Answer: A. Gingival hyperplasia
Rationale: Phenytoin can cause gingival hyperplasia. Good oral hygiene and
regular dental care are important.
10. A client with Parkinson disease is prescribed levodopa-carbidopa. Which
outcome indicates therapeutic effectiveness?
A. Increased muscle rigidity
B. Improved ability to perform voluntary movements
C. Increased tremors
D. Increased difficulty initiating movement
Answer: B. Improved ability to perform voluntary movements
Rationale: Levodopa-carbidopa helps replenish dopamine activity in the brain
and reduces motor manifestations such as rigidity and bradykinesia.
11. Which finding is commonly associated with Parkinson disease?
A. Resting tremor
B. Flaccid paralysis
C. Hyperactive reflexes only
D. Sudden complete loss of consciousness
Answer: A. Resting tremor
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a suspected stroke suddenly develops facial drooping and
weakness of the right arm. What is the nurse’s priority action?
A. Give the client oral aspirin
B. Place the client in Trendelenburg position
C. Determine the exact time the symptoms began
D. Encourage the client to ambulate
Answer: C. Determine the exact time the symptoms began
Rationale: The time of symptom onset is critical because eligibility for time-
sensitive reperfusion therapies depends on when the stroke symptoms began.
2. Which finding is most characteristic of increased intracranial pressure
(ICP)?
A. Bradycardia with widening pulse pressure
B. Hypotension with tachycardia
C. Increased urine output
D. Hyperactive bowel sounds
Answer: A. Bradycardia with widening pulse pressure
Rationale: Bradycardia, widened pulse pressure, and abnormal respirations
are components of Cushing triad, a late sign of increased ICP.
,3. A client with a head injury becomes increasingly confused and develops
unequal pupils. What should the nurse do first?
A. Reassure the client
B. Notify the healthcare provider immediately
C. Offer oral fluids
D. Place the client in a supine position
Answer: B. Notify the healthcare provider immediately
Rationale: New confusion and unequal pupils can indicate neurological
deterioration and possible brain herniation, requiring immediate
intervention.
4. A client is admitted with bacterial meningitis. Which intervention is the
priority?
A. Initiate droplet precautions
B. Encourage bright lighting
C. Restrict all fluids
D. Place the client in a high-Fowler position
Answer: A. Initiate droplet precautions
Rationale: Bacterial meningitis can be transmitted through respiratory
secretions. Droplet precautions are required initially, along with prompt
antimicrobial therapy.
5. Which assessment finding is commonly associated with meningitis?
A. Nuchal rigidity
B. Painless hematuria
C. Hypoactive bowel sounds
D. Peripheral edema
Answer: A. Nuchal rigidity
Rationale: Neck stiffness or nuchal rigidity is a classic manifestation of
meningeal irritation and commonly occurs with meningitis.
,6. A client with a seizure is actively convulsing. Which action should the nurse
take?
A. Restrain the client’s extremities
B. Insert a tongue blade into the mouth
C. Protect the client from injury and maintain airway safety
D. Give the client oral medication
Answer: C. Protect the client from injury and maintain airway safety
Rationale: During a seizure, the nurse should protect the client from injury,
maintain airway safety, and avoid restraining the client or placing objects in
the mouth.
7. Which medication is commonly used to terminate an ongoing prolonged
seizure?
A. Lorazepam
B. Acetaminophen
C. Furosemide
D. Warfarin
Answer: A. Lorazepam
Rationale: Benzodiazepines such as lorazepam are commonly used as first-
line emergency treatment for prolonged seizures or status epilepticus.
8. Which statement by a client taking phenytoin indicates a need for further
teaching?
A. “I will maintain good oral hygiene.”
B. “I should not stop this medication suddenly.”
C. “I will have my healthcare provider monitor my drug levels when indicated.”
D. “I can stop taking the medication once I have had no seizures for a week.”
Answer: D. “I can stop taking the medication once I have had no seizures for a
week.”
, Rationale: Antiseizure medications should not be discontinued abruptly
because sudden withdrawal can precipitate seizures or status epilepticus.
9. Which adverse effect is associated with long-term phenytoin therapy?
A. Gingival hyperplasia
B. Severe hypoglycemia
C. Urinary retention
D. Cataracts
Answer: A. Gingival hyperplasia
Rationale: Phenytoin can cause gingival hyperplasia. Good oral hygiene and
regular dental care are important.
10. A client with Parkinson disease is prescribed levodopa-carbidopa. Which
outcome indicates therapeutic effectiveness?
A. Increased muscle rigidity
B. Improved ability to perform voluntary movements
C. Increased tremors
D. Increased difficulty initiating movement
Answer: B. Improved ability to perform voluntary movements
Rationale: Levodopa-carbidopa helps replenish dopamine activity in the brain
and reduces motor manifestations such as rigidity and bradykinesia.
11. Which finding is commonly associated with Parkinson disease?
A. Resting tremor
B. Flaccid paralysis
C. Hyperactive reflexes only
D. Sudden complete loss of consciousness
Answer: A. Resting tremor
