NEURO MED-SURG — APPLICATION & ANALYSIS QUESTIONS
Priority | Clinical Judgment | NCLEX-Style
STROKE — PRIORITY ASSESSMENT
A patient arrives in the ED with sudden right-sided weakness and slurred speech that began 1 hour ago.
Which assessment is the highest priority?
A. Blood glucose level
B. NIH Stroke Scale
C. Non-contrast CT of the head
D. Vital signs
t-PA DECISION MAKING
A patient with suspected ischemic stroke is being evaluated for alteplase (t-PA). Which finding would
immediately contraindicate administration?
A. Blood pressure of 178/96 mmHg
B. History of ischemic stroke 3 years ago
C. Evidence of intracranial bleeding on CT
D. Onset of symptoms 2 hours ago
HEMORRHAGIC STROKE — NURSING PRIORITY
A patient with a hemorrhagic stroke suddenly becomes restless, has a widening pulse pressure, and
decreasing level of consciousness. What is the priority nursing action?
A. Administer prescribed antihypertensives
B. Lower the head of the bed
C. Notify the provider immediately
D. Administer antiplatelet therapy
INCREASED ICP — INTERVENTION
Which nursing intervention is most appropriate to reduce increased intracranial pressure?
A. Frequent suctioning
B. Hyperventilation
C. Head of bed elevated 30 degrees with neutral alignment
D. Flexing the hips and knees
, SEIZURE — DURING EVENT
A hospitalized patient begins having a tonic-clonic seizure. What is the priority nursing action?
A. Insert an oral airway
B. Turn the patient onto their side
C. Restrain the patient’s extremities
D. Administer phenobarbital immediately
STATUS EPILEPTICUS — MEDICATION
A patient is experiencing continuous seizure activity lasting longer than 5 minutes. Which medication
should the nurse expect to administer first?
A. Levetiracetam
B. Phenobarbital
C. Lorazepam
D. Carbamazepine
POST-SEIZURE — ASSESSMENT
After a seizure ends, which assessment is most important?
A. Pain level
B. Level of consciousness
C. Blood pressure
D. Bowel sounds
PARKINSON’S — SAFETY
A patient with Parkinson’s disease has difficulty initiating movement and shuffling gait. Which nursing
intervention is highest priority?
A. Encourage bed rest
B. Provide high-protein meals
C. Implement fall-prevention strategies
D. Limit physical activity
PARKINSON’S MEDS — TEACHING
Which statement by a patient taking levodopa-carbidopa indicates correct understanding?
A. “I should stop the medication if I feel better.”
B. “I should take the medication at the same time every day.”
Priority | Clinical Judgment | NCLEX-Style
STROKE — PRIORITY ASSESSMENT
A patient arrives in the ED with sudden right-sided weakness and slurred speech that began 1 hour ago.
Which assessment is the highest priority?
A. Blood glucose level
B. NIH Stroke Scale
C. Non-contrast CT of the head
D. Vital signs
t-PA DECISION MAKING
A patient with suspected ischemic stroke is being evaluated for alteplase (t-PA). Which finding would
immediately contraindicate administration?
A. Blood pressure of 178/96 mmHg
B. History of ischemic stroke 3 years ago
C. Evidence of intracranial bleeding on CT
D. Onset of symptoms 2 hours ago
HEMORRHAGIC STROKE — NURSING PRIORITY
A patient with a hemorrhagic stroke suddenly becomes restless, has a widening pulse pressure, and
decreasing level of consciousness. What is the priority nursing action?
A. Administer prescribed antihypertensives
B. Lower the head of the bed
C. Notify the provider immediately
D. Administer antiplatelet therapy
INCREASED ICP — INTERVENTION
Which nursing intervention is most appropriate to reduce increased intracranial pressure?
A. Frequent suctioning
B. Hyperventilation
C. Head of bed elevated 30 degrees with neutral alignment
D. Flexing the hips and knees
, SEIZURE — DURING EVENT
A hospitalized patient begins having a tonic-clonic seizure. What is the priority nursing action?
A. Insert an oral airway
B. Turn the patient onto their side
C. Restrain the patient’s extremities
D. Administer phenobarbital immediately
STATUS EPILEPTICUS — MEDICATION
A patient is experiencing continuous seizure activity lasting longer than 5 minutes. Which medication
should the nurse expect to administer first?
A. Levetiracetam
B. Phenobarbital
C. Lorazepam
D. Carbamazepine
POST-SEIZURE — ASSESSMENT
After a seizure ends, which assessment is most important?
A. Pain level
B. Level of consciousness
C. Blood pressure
D. Bowel sounds
PARKINSON’S — SAFETY
A patient with Parkinson’s disease has difficulty initiating movement and shuffling gait. Which nursing
intervention is highest priority?
A. Encourage bed rest
B. Provide high-protein meals
C. Implement fall-prevention strategies
D. Limit physical activity
PARKINSON’S MEDS — TEACHING
Which statement by a patient taking levodopa-carbidopa indicates correct understanding?
A. “I should stop the medication if I feel better.”
B. “I should take the medication at the same time every day.”
