1
Neurological Disorders NCLEX Practice Test Bank:
Comprehensive Question Review on Stroke, Seizures, and
Cerebrovascular Accidents (CVA) for Nursing Students and
NCLEX Success
Why Choose This Test Bank?
● Authored and compiled by a Registered Nurse with expertise in neurology
and NCLEX preparation
● Focus on trending exam topics and recent updates to ensure relevance
● Easy-to-understand language with step-by-step rationales to support learners
at all levels
● Trusted resource for self-study, group review, or classroom use
Compiled by:
Registered Nurse Expert, Mental Health & Neurology
Nursing Tutor
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Neurological Disorders NCLEX Practice Test Bank: Comprehensive Question
Review on Stroke, Seizures, and Cerebrovascular Accidents (CVA) for
Nursing Students and NCLEX Success
1. A patient is brought to the emergency department experiencing sudden right-sided
weakness and facial drooping. What is the nurse’s priority action?
A. Administer aspirin immediately
B. Prepare for a CT scan
C. Provide reassurance to the patient
D. Assess blood glucose levels
The answer is B
Explanation
In a patient presenting with sudden unilateral weakness and facial drooping, stroke must be
suspected. The priority is to rule out hemorrhagic stroke before initiating treatment, especially if
thrombolytic therapy is being considered. A non-contrast CT scan of the head is essential to
differentiate between ischemic and hemorrhagic stroke. Administering aspirin without this
imaging could worsen bleeding if it is a hemorrhagic stroke. While other actions like assessing
glucose and providing reassurance are important, they are not the immediate priority. Rapid
imaging ensures safe, timely intervention and minimizes long-term neurological damage.
2. Which of the following is a classic symptom of a left hemisphere stroke?
A. Impulsivity and poor judgment
B. Spatial-perceptual deficits
C. Expressive aphasia
D. Denial of deficits
The answer is C
Explanation
Left hemisphere strokes commonly affect language centers in the brain, particularly Broca’s and
Wernicke’s areas, resulting in expressive and/or receptive aphasia. Patients may have difficulty
speaking or understanding language. In contrast, right hemisphere strokes often cause
spatial-perceptual deficits, impulsivity, and neglect of the left side of the body. Denial of deficits
(anosognosia) is also more typical of right-sided strokes. Understanding which hemisphere is
affected helps tailor patient education, communication strategies, and rehabilitation approaches
for optimal recovery outcomes.
, 3
3. A nurse is teaching a patient with epilepsy about seizure precautions. Which
instruction is most important to include?
A. Take medication only when seizures occur
B. Avoid alcohol and sleep deprivation
C. Wear tight clothing to prevent injury during seizures
D. Engage in strenuous activities to strengthen neurons
The answer is B
Explanation
Seizures can be triggered by various factors, including alcohol intake and sleep deprivation,
which lower the seizure threshold. Patient education should emphasize avoiding these triggers to
reduce the likelihood of seizures. Antiepileptic medications must be taken consistently, not just
during seizures. Wearing tight clothing may restrict breathing during a seizure and is not
protective. Strenuous activities do not prevent seizures and may increase risk if unsupervised.
Preventing triggers and adhering to treatment are central to epilepsy management and improving
patient safety.
4. Which of the following medications is administered during the acute phase of an
ischemic stroke to restore perfusion?
A. Heparin
B. tPA (alteplase)
C. Warfarin
D. Aspirin
The answer is B
Explanation
Tissue plasminogen activator (tPA), such as alteplase, is used to dissolve clots in acute ischemic
stroke cases. It must be administered within a specific time window (usually 3 to 4.5 hours)
from symptom onset after confirming no hemorrhage via CT scan. Heparin and warfarin are
anticoagulants, useful for prevention but not suitable for acute clot resolution. Aspirin is
commonly used post-stroke or when tPA is contraindicated. Administering tPA improves
outcomes by restoring blood flow and reducing the extent of brain injury, but timing and
contraindications must be carefully evaluated.
5. What is the most appropriate nursing intervention during a generalized tonic-clonic
seizure?
A. Restrain the patient to prevent injury
B. Place a tongue blade in the patient’s mouth
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C. Turn the patient onto their side
D. Hold the patient in a sitting position
The answer is C
Explanation
During a tonic-clonic seizure, it is crucial to turn the patient onto their side to maintain an
open airway and prevent aspiration. Restraining the patient or inserting objects like a tongue
blade into the mouth is dangerous and can cause injury. Holding the patient in a sitting position is
not safe, as it increases the risk of falling or airway obstruction. Seizure safety focuses on
ensuring the patient is in a safe environment, minimizing injury, and preserving respiratory
function until the seizure ends.
6. A patient reports experiencing an “aura” before having a seizure. What does this
indicate?
A. It is a warning sign of an impending seizure
B. It is a postictal symptom
C. It suggests the seizure has already occurred
D. It indicates seizure medications are working
The answer is A
Explanation
An aura is a perceptual disturbance (e.g., visual, olfactory, or sensory) that occurs before a
seizure and serves as a warning sign. It allows patients to take precautions, such as lying down
or notifying someone. It is associated primarily with focal (partial) seizures. It is not a postictal
symptom, which occurs after the seizure, nor does it indicate effective medication use.
Understanding auras helps patients prepare and provides important diagnostic information to the
healthcare team about seizure type and origin.
7. What lab result should the nurse monitor in a patient taking phenytoin (Dilantin)?
A. White blood cell count
B. Sodium level
C. Serum drug level
D. BUN and creatinine
The answer is C
Neurological Disorders NCLEX Practice Test Bank:
Comprehensive Question Review on Stroke, Seizures, and
Cerebrovascular Accidents (CVA) for Nursing Students and
NCLEX Success
Why Choose This Test Bank?
● Authored and compiled by a Registered Nurse with expertise in neurology
and NCLEX preparation
● Focus on trending exam topics and recent updates to ensure relevance
● Easy-to-understand language with step-by-step rationales to support learners
at all levels
● Trusted resource for self-study, group review, or classroom use
Compiled by:
Registered Nurse Expert, Mental Health & Neurology
Nursing Tutor
, 2
Neurological Disorders NCLEX Practice Test Bank: Comprehensive Question
Review on Stroke, Seizures, and Cerebrovascular Accidents (CVA) for
Nursing Students and NCLEX Success
1. A patient is brought to the emergency department experiencing sudden right-sided
weakness and facial drooping. What is the nurse’s priority action?
A. Administer aspirin immediately
B. Prepare for a CT scan
C. Provide reassurance to the patient
D. Assess blood glucose levels
The answer is B
Explanation
In a patient presenting with sudden unilateral weakness and facial drooping, stroke must be
suspected. The priority is to rule out hemorrhagic stroke before initiating treatment, especially if
thrombolytic therapy is being considered. A non-contrast CT scan of the head is essential to
differentiate between ischemic and hemorrhagic stroke. Administering aspirin without this
imaging could worsen bleeding if it is a hemorrhagic stroke. While other actions like assessing
glucose and providing reassurance are important, they are not the immediate priority. Rapid
imaging ensures safe, timely intervention and minimizes long-term neurological damage.
2. Which of the following is a classic symptom of a left hemisphere stroke?
A. Impulsivity and poor judgment
B. Spatial-perceptual deficits
C. Expressive aphasia
D. Denial of deficits
The answer is C
Explanation
Left hemisphere strokes commonly affect language centers in the brain, particularly Broca’s and
Wernicke’s areas, resulting in expressive and/or receptive aphasia. Patients may have difficulty
speaking or understanding language. In contrast, right hemisphere strokes often cause
spatial-perceptual deficits, impulsivity, and neglect of the left side of the body. Denial of deficits
(anosognosia) is also more typical of right-sided strokes. Understanding which hemisphere is
affected helps tailor patient education, communication strategies, and rehabilitation approaches
for optimal recovery outcomes.
, 3
3. A nurse is teaching a patient with epilepsy about seizure precautions. Which
instruction is most important to include?
A. Take medication only when seizures occur
B. Avoid alcohol and sleep deprivation
C. Wear tight clothing to prevent injury during seizures
D. Engage in strenuous activities to strengthen neurons
The answer is B
Explanation
Seizures can be triggered by various factors, including alcohol intake and sleep deprivation,
which lower the seizure threshold. Patient education should emphasize avoiding these triggers to
reduce the likelihood of seizures. Antiepileptic medications must be taken consistently, not just
during seizures. Wearing tight clothing may restrict breathing during a seizure and is not
protective. Strenuous activities do not prevent seizures and may increase risk if unsupervised.
Preventing triggers and adhering to treatment are central to epilepsy management and improving
patient safety.
4. Which of the following medications is administered during the acute phase of an
ischemic stroke to restore perfusion?
A. Heparin
B. tPA (alteplase)
C. Warfarin
D. Aspirin
The answer is B
Explanation
Tissue plasminogen activator (tPA), such as alteplase, is used to dissolve clots in acute ischemic
stroke cases. It must be administered within a specific time window (usually 3 to 4.5 hours)
from symptom onset after confirming no hemorrhage via CT scan. Heparin and warfarin are
anticoagulants, useful for prevention but not suitable for acute clot resolution. Aspirin is
commonly used post-stroke or when tPA is contraindicated. Administering tPA improves
outcomes by restoring blood flow and reducing the extent of brain injury, but timing and
contraindications must be carefully evaluated.
5. What is the most appropriate nursing intervention during a generalized tonic-clonic
seizure?
A. Restrain the patient to prevent injury
B. Place a tongue blade in the patient’s mouth
, 4
C. Turn the patient onto their side
D. Hold the patient in a sitting position
The answer is C
Explanation
During a tonic-clonic seizure, it is crucial to turn the patient onto their side to maintain an
open airway and prevent aspiration. Restraining the patient or inserting objects like a tongue
blade into the mouth is dangerous and can cause injury. Holding the patient in a sitting position is
not safe, as it increases the risk of falling or airway obstruction. Seizure safety focuses on
ensuring the patient is in a safe environment, minimizing injury, and preserving respiratory
function until the seizure ends.
6. A patient reports experiencing an “aura” before having a seizure. What does this
indicate?
A. It is a warning sign of an impending seizure
B. It is a postictal symptom
C. It suggests the seizure has already occurred
D. It indicates seizure medications are working
The answer is A
Explanation
An aura is a perceptual disturbance (e.g., visual, olfactory, or sensory) that occurs before a
seizure and serves as a warning sign. It allows patients to take precautions, such as lying down
or notifying someone. It is associated primarily with focal (partial) seizures. It is not a postictal
symptom, which occurs after the seizure, nor does it indicate effective medication use.
Understanding auras helps patients prepare and provides important diagnostic information to the
healthcare team about seizure type and origin.
7. What lab result should the nurse monitor in a patient taking phenytoin (Dilantin)?
A. White blood cell count
B. Sodium level
C. Serum drug level
D. BUN and creatinine
The answer is C
