NUR 146 NEURO UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED SUCCESS
WITH DETAILED RATIONALES
A nurse caring for an unconscious client should first:
A. Insert an NG tube
B. Record intake and output
C. Ensure a patent airway
D. Administer pain medication
– Rationale: Airway is always the first priority in an unconscious client to prevent hypoxia.
During a generalized seizure, the nurse’s most appropriate action is to:
A. Restrain the client’s limbs firmly
B. Insert an oral airway forcefully
C. Loosen restrictive clothing and clear the area
D. Place the client in high Fowler’s position
– Rationale: Loosening clothing and protecting from injury prevents harm without restraining.
A client on long-term phenytoin (Dilantin) therapy requires:
A. Low-protein diet
B. Strict fluid restriction
C. Thorough daily oral hygiene
D. Frequent pulse oximetry
– Rationale: Phenytoin causes gingival hyperplasia; meticulous oral care prevents gum overgrowth.
To assess level of consciousness after head trauma, the nurse uses the:
A. Monro-Kellie hypothesis
B. Glasgow Coma Scale
C. Cranial nerve exam
D. Mental status exam
– Rationale: GCS provides standardized scoring of eye, verbal, and motor responses.
Nuchal rigidity and photophobia in a client with a ventriculostomy suggest:
A. Encephalitis
B. CSF leak
C. Meningitis
D. Catheter occlusion
– Rationale: Stiff neck and light sensitivity are classic meningitis signs, risk with external drain.
To halt status epilepticus immediately, the nurse anticipates IV:
A. Phenobarbital
B. Diazepam (Valium)
,ESTUDYR
C. Oral lorazepam
D. Phenytoin drip
– Rationale: IV benzodiazepines act rapidly to terminate prolonged seizures.
When teaching a migraine client about alcohol, the nurse explains that alcohol:
A. Alters hormones
B. Causes vasodilation of cerebral vessels
C. Excites CNS neurotransmitters
D. Depletes endorphins
– Rationale: Alcohol-induced vasodilation can trigger or worsen migraine headaches.
A head-injured client develops diabetes insipidus; nursing priority is:
A. Monitor BP continuously
B. Check ABGs
C. Vigilant monitoring of fluid balance
D. Airway patency
– Rationale: DI causes massive diuresis, risking dehydration and electrolyte imbalance.
Post-craniotomy, a urine output of 1,500 mL/hour for two hours suggests:
A. Cushing syndrome
B. SIADH
C. Adrenal crisis
D. Diabetes insipidus
– Rationale: Excessive dilute urine is hallmark of DI from ADH deficiency.
Documenting an alcohol-withdrawal seizure, the nurse should note the client’s:
A. Ability to follow commands
B. Success of restraints
C. Postictal self-report
D. Activities immediately before the seizure
– Rationale: Precipitating events help identify triggers and guide future prevention.
A seizure with initial rigidity followed by alternating contraction and relaxation is:
A. Absence seizure
B. Focal seizure
C. Generalized tonic-clonic seizure
D. Myoclonic seizure
– Rationale: Tonic-clonic (formerly grand mal) features stiffening then rhythmic jerking.
Primary intervention for SIADH is:
A. Platelet transfusion
B. FFP infusion
C. Fluid restriction
, ESTUDYR
D. Electrolyte restriction
– Rationale: Restricting fluids raises serum sodium by reducing free water retention.
A client with ICP elevation should be positioned at:
A. Flat supine
B. Trendelenburg
C. Prone
D. Head of bed 30° with head midline
– Rationale: Elevation and neutral head reduce venous pressure and lower ICP.
If a ventriculostomy transducer is misleveled, ICP readings will be:
A. Unchanged
B. Inaccurate
C. Always too high
D. Always too low
– Rationale: Proper leveling at the foramen of Monro is vital for accurate pressure measurement.
Mannitol administration for high ICP requires monitoring of:
A. AST/ALT
B. Serum osmolality
C. Coagulation profile
D. Blood glucose
– Rationale: Osmotic diuretic can cause hyperosmolarity and acute dehydration.
A late sign of rising ICP is:
A. Restlessness
B. Vomiting
C. Cushing’s triad (hypertension, bradycardia, irregular respirations)
D. Headache
– Rationale: Cushing’s triad indicates imminent brain herniation.
Seizure precautions at bedside include all except:
A. Oxygen
B. Suction setup
C. Oral airway
D. Restraints
– Rationale: Restraints increase injury risk; padded side rails are preferred.
When performing neuro checks, the nurse assesses pupil response to:
A. A loud clap
B. Bright light
C. Sweet smell
D. Gentle touch
– Rationale: Pupillary light reflex evaluates cranial nerves II and III, brainstem function.