NCLEX Nervous System – Batch 1
(Questions 1–10)
Question 1
A patient with a head injury has a Glasgow Coma Scale
(GCS) score of 8. Which action should the nurse take
first?
A. Place the patient in a side-lying position
B. Notify the healthcare provider immediately
C. Assess pupillary response to light
D. Administer prescribed analgesics
Answer: B
Rationale: GCS ≤ 8 indicates severe brain injury; prompt
provider notification is critical to prevent deterioration.
Question 2
A patient with Parkinson’s disease is prescribed levodopa-
carbidopa. Which teaching point is essential?
A. Take medication with high-protein meals
B. Rise slowly from sitting or lying positions
C. Avoid green leafy vegetables
D. Stop taking if tremors improve
Answer: B
Rationale: Orthostatic hypotension is common; patients
should rise slowly to prevent falls.
Question 3
Which assessment finding indicates increased intracranial
,pressure (ICP)?
A. Bradycardia, irregular respirations, widened pulse
pressure
B. Tachycardia, hypotension, dilated pupils
C. Bounding pulses, fever, hyperactive reflexes
D. Hypotension, tachypnea, pinpoint pupils
Answer: A
Rationale: Cushing’s triad (bradycardia, irregular
respirations, widened pulse pressure) is a late sign of
increased ICP.
Question 4
A patient with a suspected stroke suddenly has right-
sided facial droop and slurred speech. Which action
should the nurse take first?
A. Administer aspirin
B. Notify the healthcare provider immediately
C. Obtain an MRI
D. Position patient supine
Answer: B
Rationale: Rapid intervention is essential; early
thrombolytic therapy can reduce disability if ischemic
stroke is confirmed.
Question 5
A patient with multiple sclerosis complains of new
numbness and tingling in the extremities. Which
intervention is most appropriate?
A. Encourage heavy exercise
B. Assess for triggers and implement energy conservation
,C. Increase protein intake
D. Administer high-dose steroids without order
Answer: B
Rationale: Fatigue and environmental factors can
exacerbate MS symptoms; energy conservation helps
prevent worsening.
Question 6
Which patient is at highest risk for developing Guillain-
Barré syndrome?
A. Recent history of viral infection
B. Long-term diabetes
C. Chronic hypertension
D. Osteoarthritis
Answer: A
Rationale: GBS often follows viral or bacterial infections,
leading to autoimmune demyelination.
Question 7
A patient with a tonic-clonic seizure is in the postictal
phase. Which action is priority?
A. Place suction at bedside
B. Assess airway and oxygen saturation
C. Insert oral airway immediately
D. Encourage patient to ambulate
Answer: B
Rationale: Airway management and oxygenation are top
priorities post-seizure.
, Question 8
Which cranial nerve is assessed by asking the patient to
shrug shoulders against resistance?
A. CN III
B. CN V
C. CN XI
D. CN VII
Answer: C
Rationale: CN XI (spinal accessory) controls the
trapezius and sternocleidomastoid muscles.
Question 9
A patient with bacterial meningitis has nuchal rigidity and
fever. Which precaution is essential?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions only
Answer: A
Rationale: Bacterial meningitis is transmitted via
respiratory droplets.
Question 10 (SATA)
Which interventions help reduce the risk of secondary
injury in a patient with head trauma?
A. Elevate head of bed 30°
B. Maintain midline head position
C. Limit fluid intake to 500 mL/day
D. Avoid suctioning when possible
E. Monitor neurologic status frequently
(Questions 1–10)
Question 1
A patient with a head injury has a Glasgow Coma Scale
(GCS) score of 8. Which action should the nurse take
first?
A. Place the patient in a side-lying position
B. Notify the healthcare provider immediately
C. Assess pupillary response to light
D. Administer prescribed analgesics
Answer: B
Rationale: GCS ≤ 8 indicates severe brain injury; prompt
provider notification is critical to prevent deterioration.
Question 2
A patient with Parkinson’s disease is prescribed levodopa-
carbidopa. Which teaching point is essential?
A. Take medication with high-protein meals
B. Rise slowly from sitting or lying positions
C. Avoid green leafy vegetables
D. Stop taking if tremors improve
Answer: B
Rationale: Orthostatic hypotension is common; patients
should rise slowly to prevent falls.
Question 3
Which assessment finding indicates increased intracranial
,pressure (ICP)?
A. Bradycardia, irregular respirations, widened pulse
pressure
B. Tachycardia, hypotension, dilated pupils
C. Bounding pulses, fever, hyperactive reflexes
D. Hypotension, tachypnea, pinpoint pupils
Answer: A
Rationale: Cushing’s triad (bradycardia, irregular
respirations, widened pulse pressure) is a late sign of
increased ICP.
Question 4
A patient with a suspected stroke suddenly has right-
sided facial droop and slurred speech. Which action
should the nurse take first?
A. Administer aspirin
B. Notify the healthcare provider immediately
C. Obtain an MRI
D. Position patient supine
Answer: B
Rationale: Rapid intervention is essential; early
thrombolytic therapy can reduce disability if ischemic
stroke is confirmed.
Question 5
A patient with multiple sclerosis complains of new
numbness and tingling in the extremities. Which
intervention is most appropriate?
A. Encourage heavy exercise
B. Assess for triggers and implement energy conservation
,C. Increase protein intake
D. Administer high-dose steroids without order
Answer: B
Rationale: Fatigue and environmental factors can
exacerbate MS symptoms; energy conservation helps
prevent worsening.
Question 6
Which patient is at highest risk for developing Guillain-
Barré syndrome?
A. Recent history of viral infection
B. Long-term diabetes
C. Chronic hypertension
D. Osteoarthritis
Answer: A
Rationale: GBS often follows viral or bacterial infections,
leading to autoimmune demyelination.
Question 7
A patient with a tonic-clonic seizure is in the postictal
phase. Which action is priority?
A. Place suction at bedside
B. Assess airway and oxygen saturation
C. Insert oral airway immediately
D. Encourage patient to ambulate
Answer: B
Rationale: Airway management and oxygenation are top
priorities post-seizure.
, Question 8
Which cranial nerve is assessed by asking the patient to
shrug shoulders against resistance?
A. CN III
B. CN V
C. CN XI
D. CN VII
Answer: C
Rationale: CN XI (spinal accessory) controls the
trapezius and sternocleidomastoid muscles.
Question 9
A patient with bacterial meningitis has nuchal rigidity and
fever. Which precaution is essential?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions only
Answer: A
Rationale: Bacterial meningitis is transmitted via
respiratory droplets.
Question 10 (SATA)
Which interventions help reduce the risk of secondary
injury in a patient with head trauma?
A. Elevate head of bed 30°
B. Maintain midline head position
C. Limit fluid intake to 500 mL/day
D. Avoid suctioning when possible
E. Monitor neurologic status frequently
