N172 Exam 4: Comprehensive Practice Questions and Correct Answers with Detailed Rationales |
Latest Update 2026/2027 | Complete Exam Review and Study Guide
Section 1: Neurological System Assessment and Disorders
Question 1
A nurse is assessing a patient's level of consciousness. Which finding is the earliest indicator
of a decline in neurological status?
A) Changes in level of consciousness
B) Pupillary changes
C) Vital sign changes
D) Motor changes
Answer
Answer: A
Rationale
** A change in the level of consciousness (e.g., confusion, restlessness, lethargy) is often the earliest
and most sensitive indicator of neurological deterioration.
Question 2
Which finding indicates increased intracranial pressure (ICP)?
A) Bradycardia and hypotension
B) Tachycardia and hypertension
C) Hypertension, bradycardia, and irregular respirations (Cushing's triad)
D) Hypotension and tachypnea
Answer
Answer: C
Rationale
** Cushing's triad (hypertension, bradycardia, and irregular respirations) is a late and ominous sign of
increased intracranial pressure.
,Question 3
A patient with a suspected stroke has sudden facial droop and arm weakness. What is the
priority action?
A) Activate the stroke pathway and establish last-known-well time
B) Administer aspirin immediately
C) Encourage ambulation
D) Give oral fluids
Answer
Answer: A
Rationale
** Sudden focal neurologic deficits require immediate activation of the stroke emergency pathway for
potential thrombolysis.
Question 4
Which finding indicates autonomic dysreflexia in a patient with a spinal cord injury?
A) Severe hypertension and bradycardia
B) Hypotension and tachycardia
C) Polyuria
D) Constipation
Answer
Answer: A
Rationale
** Autonomic dysreflexia is a life-threatening emergency causing severe hypertension, bradycardia,
and headache, often triggered by bladder or bowel distention.
Question 5
A patient with a new diagnosis of Parkinson's disease is likely to have:
A) Tremor, rigidity, and bradykinesia
B) Hyperreflexia
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,C) Spasticity
D) Polyuria
Answer
Answer: A
Rationale
** Parkinson's disease is characterized by resting tremor, rigidity, bradykinesia, and postural instability.
Question 6
Which instruction is essential for a patient taking levodopa-carbidopa?
A) Take with a high-protein meal
B) Report dark urine
C) Avoid sudden discontinuation
D) Take at bedtime only
Answer
Answer: C
Rationale
** Abrupt discontinuation can cause a parkinsonian crisis. Dark urine is a harmless side effect.
Question 7
A patient with a head injury is admitted for observation. Which finding requires immediate
notification?
A) Decreasing level of consciousness
B) Mild headache
C) Nausea
D) Dizziness
Answer
Answer: A
3
, Rationale
** A decreasing LOC is the earliest and most critical sign of worsening intracranial pressure.
Question 8
Which intervention helps prevent contractures in a patient with a spinal cord injury?
A) Range-of-motion exercises and proper positioning
B) Bed rest
C) Restrict fluids
D) Avoid movement
Answer
Answer: A
Rationale
** ROM exercises and proper positioning maintain joint mobility and prevent contractures.
Question 9
A patient with a new diagnosis of multiple sclerosis is likely to have:
A) Fatigue, vision changes, and weakness
B) Hypertension and bradycardia
C) Polyuria and polydipsia
D) Weight gain
Answer
Answer: A
Rationale
** MS causes demyelination, leading to fatigue, visual disturbances, weakness, and sensory changes.
Question 10
Which finding indicates meningitis?
A) Nuchal rigidity and photophobia
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Latest Update 2026/2027 | Complete Exam Review and Study Guide
Section 1: Neurological System Assessment and Disorders
Question 1
A nurse is assessing a patient's level of consciousness. Which finding is the earliest indicator
of a decline in neurological status?
A) Changes in level of consciousness
B) Pupillary changes
C) Vital sign changes
D) Motor changes
Answer
Answer: A
Rationale
** A change in the level of consciousness (e.g., confusion, restlessness, lethargy) is often the earliest
and most sensitive indicator of neurological deterioration.
Question 2
Which finding indicates increased intracranial pressure (ICP)?
A) Bradycardia and hypotension
B) Tachycardia and hypertension
C) Hypertension, bradycardia, and irregular respirations (Cushing's triad)
D) Hypotension and tachypnea
Answer
Answer: C
Rationale
** Cushing's triad (hypertension, bradycardia, and irregular respirations) is a late and ominous sign of
increased intracranial pressure.
,Question 3
A patient with a suspected stroke has sudden facial droop and arm weakness. What is the
priority action?
A) Activate the stroke pathway and establish last-known-well time
B) Administer aspirin immediately
C) Encourage ambulation
D) Give oral fluids
Answer
Answer: A
Rationale
** Sudden focal neurologic deficits require immediate activation of the stroke emergency pathway for
potential thrombolysis.
Question 4
Which finding indicates autonomic dysreflexia in a patient with a spinal cord injury?
A) Severe hypertension and bradycardia
B) Hypotension and tachycardia
C) Polyuria
D) Constipation
Answer
Answer: A
Rationale
** Autonomic dysreflexia is a life-threatening emergency causing severe hypertension, bradycardia,
and headache, often triggered by bladder or bowel distention.
Question 5
A patient with a new diagnosis of Parkinson's disease is likely to have:
A) Tremor, rigidity, and bradykinesia
B) Hyperreflexia
2
,C) Spasticity
D) Polyuria
Answer
Answer: A
Rationale
** Parkinson's disease is characterized by resting tremor, rigidity, bradykinesia, and postural instability.
Question 6
Which instruction is essential for a patient taking levodopa-carbidopa?
A) Take with a high-protein meal
B) Report dark urine
C) Avoid sudden discontinuation
D) Take at bedtime only
Answer
Answer: C
Rationale
** Abrupt discontinuation can cause a parkinsonian crisis. Dark urine is a harmless side effect.
Question 7
A patient with a head injury is admitted for observation. Which finding requires immediate
notification?
A) Decreasing level of consciousness
B) Mild headache
C) Nausea
D) Dizziness
Answer
Answer: A
3
, Rationale
** A decreasing LOC is the earliest and most critical sign of worsening intracranial pressure.
Question 8
Which intervention helps prevent contractures in a patient with a spinal cord injury?
A) Range-of-motion exercises and proper positioning
B) Bed rest
C) Restrict fluids
D) Avoid movement
Answer
Answer: A
Rationale
** ROM exercises and proper positioning maintain joint mobility and prevent contractures.
Question 9
A patient with a new diagnosis of multiple sclerosis is likely to have:
A) Fatigue, vision changes, and weakness
B) Hypertension and bradycardia
C) Polyuria and polydipsia
D) Weight gain
Answer
Answer: A
Rationale
** MS causes demyelination, leading to fatigue, visual disturbances, weakness, and sensory changes.
Question 10
Which finding indicates meningitis?
A) Nuchal rigidity and photophobia
4
