NR547 Midterm Exam Practice
Questions & [Verified Answers], Plus
Explained Rationales|2027 Latest
Update| Instant Download PDF
1. A nurse is assessing a patient who reports sudden onset of
unilateral weakness, facial drooping, and difficulty speaking.
Which action should the nurse prioritize?
A. Administer an oral antihypertensive medication
B. Place the patient in a supine position and reassess in 30 minutes
C. Activate the stroke response and determine the time the symptoms
began
D. Encourage the patient to ambulate to assess gait
Rationale: The sudden onset of focal neurologic deficits is highly
concerning for acute stroke. Rapid activation of the stroke response
and identification of the last-known-well time are essential because
time-sensitive interventions may be available.
2. A patient with suspected increased intracranial pressure develops
a declining level of consciousness. Which additional finding would
most strongly support this concern?
A. Increased appetite
B. Changes in pupillary response and motor function
C. Increased bowel sounds
D. Warm, flushed skin
Rationale: Changes in consciousness, pupils, and motor responses are
important indicators of neurologic deterioration and can occur with
1|Page
,increasing intracranial pressure. Frequent neurologic assessment is
therefore essential.
3. A patient with a traumatic brain injury is being monitored for
increased intracranial pressure. Which intervention is
appropriate?
A. Keep the patient's neck flexed
B. Place the patient in Trendelenburg position
C. Encourage frequent coughing
D. Maintain the head and neck in neutral alignment
Rationale: Neutral head and neck alignment promotes venous
drainage from the brain and can help limit increases in intracranial
pressure. Flexion, extreme rotation, coughing, and Trendelenburg
positioning may impair drainage or increase pressure.
4. A patient with Parkinson disease is experiencing bradykinesia and
rigidity. Which intervention is most appropriate?
A. Encourage complete bed rest
B. Allow additional time for movement and activities
C. Discourage assistive devices
D. Limit physical activity permanently
Rationale: Bradykinesia makes movement slower and more difficult.
Allowing adequate time, using appropriate assistive devices, and
encouraging safe activity can promote independence and reduce
complications of immobility.
5. A patient with multiple sclerosis reports worsening fatigue. Which
nursing intervention is appropriate?
A. Encourage strenuous exercise throughout the day
B. Schedule all activities consecutively
2|Page
,C. Plan activities with regular rest periods
D. Restrict all physical activity
Rationale: Fatigue is common in multiple sclerosis. Energy
conservation strategies, including scheduled rest periods and
prioritizing activities, can help patients maintain function without
excessive exhaustion.
6. A patient with a spinal cord injury develops sudden hypertension,
severe headache, and diaphoresis. What should the nurse
suspect?
A. Hypoglycemia
B. Septic shock
C. Autonomic dysreflexia
D. Pulmonary embolism
Rationale: Autonomic dysreflexia can occur after spinal cord injury,
particularly with injuries above T6. Sudden hypertension, headache,
sweating, and flushing above the injury level are characteristic
findings and require prompt intervention.
7. A patient experiencing a generalized tonic-clonic seizure is actively
convulsing. What is the priority nursing intervention?
A. Insert an oral airway
B. Restrain the patient's extremities
C. Give the patient water
D. Protect the patient from injury and maintain airway safety
Rationale: During a seizure, the priority is maintaining safety and
airway protection. The nurse should not restrain the patient or place
objects in the mouth. After the seizure, positioning and assessment of
breathing are important.
3|Page
, 8. A patient is prescribed levodopa-carbidopa for Parkinson disease.
Which response indicates that the medication is producing the
intended therapeutic effect?
A. Increased rigidity
B. Increased resting tremor
C. Improved ability to initiate and perform movement
D. Increased difficulty swallowing
Rationale: Levodopa is converted to dopamine in the brain, while
carbidopa reduces peripheral conversion. The combination can
improve motor manifestations such as rigidity and bradykinesia.
9. A patient with a suspected spinal cord injury arrives in the
emergency department. Which nursing action is most
appropriate?
A. Encourage the patient to sit upright
B. Ask the patient to walk
C. Maintain spinal alignment and immobilization as indicated
D. Flex the patient's neck to assess range of motion
Rationale: Spinal movement can worsen an unstable spinal injury.
Maintaining appropriate spinal alignment and immobilization until
the spine is adequately evaluated helps prevent secondary neurologic
injury.
10. A patient with a brain injury becomes increasingly restless
and confused. What should the nurse do first?
A. Document the behavior and reassess the next shift
B. Administer a sedative without further assessment
C. Perform a focused neurologic assessment and notify the
appropriate provider of deterioration
D. Encourage the patient to sleep
4|Page
Questions & [Verified Answers], Plus
Explained Rationales|2027 Latest
Update| Instant Download PDF
1. A nurse is assessing a patient who reports sudden onset of
unilateral weakness, facial drooping, and difficulty speaking.
Which action should the nurse prioritize?
A. Administer an oral antihypertensive medication
B. Place the patient in a supine position and reassess in 30 minutes
C. Activate the stroke response and determine the time the symptoms
began
D. Encourage the patient to ambulate to assess gait
Rationale: The sudden onset of focal neurologic deficits is highly
concerning for acute stroke. Rapid activation of the stroke response
and identification of the last-known-well time are essential because
time-sensitive interventions may be available.
2. A patient with suspected increased intracranial pressure develops
a declining level of consciousness. Which additional finding would
most strongly support this concern?
A. Increased appetite
B. Changes in pupillary response and motor function
C. Increased bowel sounds
D. Warm, flushed skin
Rationale: Changes in consciousness, pupils, and motor responses are
important indicators of neurologic deterioration and can occur with
1|Page
,increasing intracranial pressure. Frequent neurologic assessment is
therefore essential.
3. A patient with a traumatic brain injury is being monitored for
increased intracranial pressure. Which intervention is
appropriate?
A. Keep the patient's neck flexed
B. Place the patient in Trendelenburg position
C. Encourage frequent coughing
D. Maintain the head and neck in neutral alignment
Rationale: Neutral head and neck alignment promotes venous
drainage from the brain and can help limit increases in intracranial
pressure. Flexion, extreme rotation, coughing, and Trendelenburg
positioning may impair drainage or increase pressure.
4. A patient with Parkinson disease is experiencing bradykinesia and
rigidity. Which intervention is most appropriate?
A. Encourage complete bed rest
B. Allow additional time for movement and activities
C. Discourage assistive devices
D. Limit physical activity permanently
Rationale: Bradykinesia makes movement slower and more difficult.
Allowing adequate time, using appropriate assistive devices, and
encouraging safe activity can promote independence and reduce
complications of immobility.
5. A patient with multiple sclerosis reports worsening fatigue. Which
nursing intervention is appropriate?
A. Encourage strenuous exercise throughout the day
B. Schedule all activities consecutively
2|Page
,C. Plan activities with regular rest periods
D. Restrict all physical activity
Rationale: Fatigue is common in multiple sclerosis. Energy
conservation strategies, including scheduled rest periods and
prioritizing activities, can help patients maintain function without
excessive exhaustion.
6. A patient with a spinal cord injury develops sudden hypertension,
severe headache, and diaphoresis. What should the nurse
suspect?
A. Hypoglycemia
B. Septic shock
C. Autonomic dysreflexia
D. Pulmonary embolism
Rationale: Autonomic dysreflexia can occur after spinal cord injury,
particularly with injuries above T6. Sudden hypertension, headache,
sweating, and flushing above the injury level are characteristic
findings and require prompt intervention.
7. A patient experiencing a generalized tonic-clonic seizure is actively
convulsing. What is the priority nursing intervention?
A. Insert an oral airway
B. Restrain the patient's extremities
C. Give the patient water
D. Protect the patient from injury and maintain airway safety
Rationale: During a seizure, the priority is maintaining safety and
airway protection. The nurse should not restrain the patient or place
objects in the mouth. After the seizure, positioning and assessment of
breathing are important.
3|Page
, 8. A patient is prescribed levodopa-carbidopa for Parkinson disease.
Which response indicates that the medication is producing the
intended therapeutic effect?
A. Increased rigidity
B. Increased resting tremor
C. Improved ability to initiate and perform movement
D. Increased difficulty swallowing
Rationale: Levodopa is converted to dopamine in the brain, while
carbidopa reduces peripheral conversion. The combination can
improve motor manifestations such as rigidity and bradykinesia.
9. A patient with a suspected spinal cord injury arrives in the
emergency department. Which nursing action is most
appropriate?
A. Encourage the patient to sit upright
B. Ask the patient to walk
C. Maintain spinal alignment and immobilization as indicated
D. Flex the patient's neck to assess range of motion
Rationale: Spinal movement can worsen an unstable spinal injury.
Maintaining appropriate spinal alignment and immobilization until
the spine is adequately evaluated helps prevent secondary neurologic
injury.
10. A patient with a brain injury becomes increasingly restless
and confused. What should the nurse do first?
A. Document the behavior and reassess the next shift
B. Administer a sedative without further assessment
C. Perform a focused neurologic assessment and notify the
appropriate provider of deterioration
D. Encourage the patient to sleep
4|Page
