MED SURG Exam 4 STUDY GUIDE 2026 COMPLETE
QUESTIONS WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS <RECENT VERSION>
Multiple Choice & Case-Based Questions: Medical-Surgical Nursing (Neurological & Sensory
Systems)
1. A patient with a suspected stroke arrives in the Emergency Department. Which diagnostic
test is the priority to determine eligibility for thrombolytic therapy?
A. Lumbar Puncture
B. Electroencephalogram (EEG)
C. Non-contrast CT scan of the head
D. Magnetic Resonance Imaging (MRI)
2. The nurse is assessing a patient for meningeal irritation. Which finding is a positive Kernig's
sign?
A. Pain and resistance when flexing the patient's neck.
B. Flexion of the hips and knees when the neck is flexed.
C. Inability to fully extend the leg at the knee when the hip is flexed.
D. Nuchal rigidity and photophobia.
3. A patient with Guillain-Barré Syndrome is concerned about progression. The nurse
understands that the greatest priority for this patient is monitoring:
A. Level of consciousness.
B. Respiratory muscle strength and vital capacity.
C. Deep tendon reflexes.
D. Bowel and bladder function.
4. Which statement by a patient taking carbidopa-levodopa for Parkinson's disease indicates
an understanding of the medication teaching?
A. "I will take this medication with a high-protein breakfast."
B. "I may suddenly fall asleep without warning during daily activities."
C. "If I miss a dose, I should double the next dose."
D. "This medication will cure my disease."
5. The nurse is caring for a patient with a history of simple partial seizures. Which clinical
manifestation should the nurse expect to observe?
A. A brief loss of consciousness with blank staring.
,B. Jerking movements that begin in one foot and march up the leg.
C. A sudden loss of muscle tone and collapse.
D. Full body tonic-clonic movements with incontinence.
6. A patient is scheduled for a lumbar puncture. Post-procedure, the priority nursing action is
to:
A. Encourage fluid intake.
B. Keep the patient in a prone position.
C. Apply pressure to the puncture site for 10 minutes.
D. Administer prophylactic antibiotics.
7. Which patient is at the highest risk for a hemorrhagic stroke?
A. A 45-year-old with uncontrolled hypertension and an arteriovenous malformation (AVM).
B. A 68-year-old with atrial fibrillation.
C. A 72-year-old with diabetes mellitus and hyperlipidemia.
D. A 55-year-old who smokes and is obese.
8. The classic triad of symptoms for normal pressure hydrocephalus (NPH) is:
A. Headache, vomiting, and papilledema.
B. Dementia, gait disturbance, and urinary incontinence.
C. Fever, nuchal rigidity, and photophobia.
D. Tremor at rest, rigidity, and bradykinesia.
9. When assessing cranial nerve III (Oculomotor), the nurse should:
A. Check visual acuity with a Snellen chart.
B. Assess gag reflex and swallowing.
C. Check pupillary constriction and eye movement.
D. Assess hearing with a whisper test.
10. A patient with myasthenia gravis is experiencing sudden onset of severe muscle weakness,
diplopia, and difficulty breathing. The nurse suspects a myasthenic crisis. The initial action
should be to:
A. Administer the next scheduled dose of pyridostigmine.
B. Prepare for endotracheal intubation and mechanical ventilation.
C. Administer IV corticosteroids immediately.
D. Instruct the patient to perform pursed-lip breathing.
11. Which medication is used to treat status epilepticus?
A. Oral phenytoin
,B. IV lorazepam
C. IM levetiracetam
D. Rectal diazepam (for a single seizure at home)
12. The Glasgow Coma Scale (GCS) assesses which three parameters?
A. Pupil reaction, motor strength, verbal response
B. Eye opening, verbal response, motor response
C. Orientation, memory, calculation
D. Level of consciousness, vital signs, reflexes
13. A patient with Bell's Palsy asks what they can expect. The nurse's best response is:
A. "You will likely have permanent facial deformity."
B. "This is a sign that you are at high risk for a future stroke."
C. "Most patients recover completely within 3-6 weeks."
D. "You will need immediate surgical decompression of the facial nerve."
14. The primary goal in the immediate management of a patient with a spinal cord injury is:
A. Preventing spinal shock.
B. Achieving spinal stabilization and preventing further injury.
C. Initiating aggressive physical therapy.
D. Managing neurogenic pain.
15. Autonomic dysreflexia is a medical emergency for patients with spinal cord injuries above
which level?
A. T1
B. T6
C. L1
D. S2
16. Which finding in a patient with a traumatic brain injury (TBI) indicates increasing
intracranial pressure (ICP)?
A. Increased urinary output.
B. Narrowing pulse pressure. (Note: Actually, widening pulse pressure is a classic sign. This
question tests recognition of incorrect data).
C. Cushing's Triad: Hypertension, bradycardia, irregular respirations.
D. Bilateral dilated and sluggish pupils.
17. A patient with trigeminal neuralgia would describe their pain as:
A. A constant, dull ache over the entire face.
B. Electric shock-like, severe, and triggered by touching the face.
, C. A deep, burning pain following a dermatomal pattern.
D. A pressure sensation behind the eye.
18. The nurse is teaching a patient with macular degeneration. Which statement indicates a
need for further teaching?
A. "I will use bright lighting and reduce glare in my home."
B. "I will use an Amsler grid to monitor for distortion weekly." (This is correct self-care,
indicating understanding, not a need for further teaching. The question is flawed, but in an
exam, the "need for further teaching" format is common. A correct response would be: "Central
vision is primarily affected, but peripheral vision is usually preserved.")
C. "I know there's no treatment for my dry form of the disease." (Incorrect; there are now some
interventions)
D. "I should take a specific AREDS-formula vitamin supplement as my doctor recommends."
19. For a patient experiencing an acute episode of Ménière's disease, the nurse should
anticipate administering:
A. An osmotic diuretic and antiemetic.
B. A thrombolytic agent.
C. An intravenous antibiotic.
D. A corticosteroid taper.
20. The most common cause of bacterial meningitis in adults is:
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Listeria monocytogenes
21. Which instruction is crucial for a patient being discharged on phenytoin?
A. Report any incidence of a sore throat or fever immediately. (Sign of hematologic
toxicity)
B. Take the medication on an empty stomach for best absorption.
C. Limit fluid intake to prevent edema.
D. Stop the medication if you develop gingival hyperplasia.
22. A patient with a cataract would most commonly report:
A. Sudden, painless loss of vision.
B. Seeing halos around lights at night.
C. Cloudy, blurry vision and glare.
D. Loss of peripheral vision.
QUESTIONS WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS <RECENT VERSION>
Multiple Choice & Case-Based Questions: Medical-Surgical Nursing (Neurological & Sensory
Systems)
1. A patient with a suspected stroke arrives in the Emergency Department. Which diagnostic
test is the priority to determine eligibility for thrombolytic therapy?
A. Lumbar Puncture
B. Electroencephalogram (EEG)
C. Non-contrast CT scan of the head
D. Magnetic Resonance Imaging (MRI)
2. The nurse is assessing a patient for meningeal irritation. Which finding is a positive Kernig's
sign?
A. Pain and resistance when flexing the patient's neck.
B. Flexion of the hips and knees when the neck is flexed.
C. Inability to fully extend the leg at the knee when the hip is flexed.
D. Nuchal rigidity and photophobia.
3. A patient with Guillain-Barré Syndrome is concerned about progression. The nurse
understands that the greatest priority for this patient is monitoring:
A. Level of consciousness.
B. Respiratory muscle strength and vital capacity.
C. Deep tendon reflexes.
D. Bowel and bladder function.
4. Which statement by a patient taking carbidopa-levodopa for Parkinson's disease indicates
an understanding of the medication teaching?
A. "I will take this medication with a high-protein breakfast."
B. "I may suddenly fall asleep without warning during daily activities."
C. "If I miss a dose, I should double the next dose."
D. "This medication will cure my disease."
5. The nurse is caring for a patient with a history of simple partial seizures. Which clinical
manifestation should the nurse expect to observe?
A. A brief loss of consciousness with blank staring.
,B. Jerking movements that begin in one foot and march up the leg.
C. A sudden loss of muscle tone and collapse.
D. Full body tonic-clonic movements with incontinence.
6. A patient is scheduled for a lumbar puncture. Post-procedure, the priority nursing action is
to:
A. Encourage fluid intake.
B. Keep the patient in a prone position.
C. Apply pressure to the puncture site for 10 minutes.
D. Administer prophylactic antibiotics.
7. Which patient is at the highest risk for a hemorrhagic stroke?
A. A 45-year-old with uncontrolled hypertension and an arteriovenous malformation (AVM).
B. A 68-year-old with atrial fibrillation.
C. A 72-year-old with diabetes mellitus and hyperlipidemia.
D. A 55-year-old who smokes and is obese.
8. The classic triad of symptoms for normal pressure hydrocephalus (NPH) is:
A. Headache, vomiting, and papilledema.
B. Dementia, gait disturbance, and urinary incontinence.
C. Fever, nuchal rigidity, and photophobia.
D. Tremor at rest, rigidity, and bradykinesia.
9. When assessing cranial nerve III (Oculomotor), the nurse should:
A. Check visual acuity with a Snellen chart.
B. Assess gag reflex and swallowing.
C. Check pupillary constriction and eye movement.
D. Assess hearing with a whisper test.
10. A patient with myasthenia gravis is experiencing sudden onset of severe muscle weakness,
diplopia, and difficulty breathing. The nurse suspects a myasthenic crisis. The initial action
should be to:
A. Administer the next scheduled dose of pyridostigmine.
B. Prepare for endotracheal intubation and mechanical ventilation.
C. Administer IV corticosteroids immediately.
D. Instruct the patient to perform pursed-lip breathing.
11. Which medication is used to treat status epilepticus?
A. Oral phenytoin
,B. IV lorazepam
C. IM levetiracetam
D. Rectal diazepam (for a single seizure at home)
12. The Glasgow Coma Scale (GCS) assesses which three parameters?
A. Pupil reaction, motor strength, verbal response
B. Eye opening, verbal response, motor response
C. Orientation, memory, calculation
D. Level of consciousness, vital signs, reflexes
13. A patient with Bell's Palsy asks what they can expect. The nurse's best response is:
A. "You will likely have permanent facial deformity."
B. "This is a sign that you are at high risk for a future stroke."
C. "Most patients recover completely within 3-6 weeks."
D. "You will need immediate surgical decompression of the facial nerve."
14. The primary goal in the immediate management of a patient with a spinal cord injury is:
A. Preventing spinal shock.
B. Achieving spinal stabilization and preventing further injury.
C. Initiating aggressive physical therapy.
D. Managing neurogenic pain.
15. Autonomic dysreflexia is a medical emergency for patients with spinal cord injuries above
which level?
A. T1
B. T6
C. L1
D. S2
16. Which finding in a patient with a traumatic brain injury (TBI) indicates increasing
intracranial pressure (ICP)?
A. Increased urinary output.
B. Narrowing pulse pressure. (Note: Actually, widening pulse pressure is a classic sign. This
question tests recognition of incorrect data).
C. Cushing's Triad: Hypertension, bradycardia, irregular respirations.
D. Bilateral dilated and sluggish pupils.
17. A patient with trigeminal neuralgia would describe their pain as:
A. A constant, dull ache over the entire face.
B. Electric shock-like, severe, and triggered by touching the face.
, C. A deep, burning pain following a dermatomal pattern.
D. A pressure sensation behind the eye.
18. The nurse is teaching a patient with macular degeneration. Which statement indicates a
need for further teaching?
A. "I will use bright lighting and reduce glare in my home."
B. "I will use an Amsler grid to monitor for distortion weekly." (This is correct self-care,
indicating understanding, not a need for further teaching. The question is flawed, but in an
exam, the "need for further teaching" format is common. A correct response would be: "Central
vision is primarily affected, but peripheral vision is usually preserved.")
C. "I know there's no treatment for my dry form of the disease." (Incorrect; there are now some
interventions)
D. "I should take a specific AREDS-formula vitamin supplement as my doctor recommends."
19. For a patient experiencing an acute episode of Ménière's disease, the nurse should
anticipate administering:
A. An osmotic diuretic and antiemetic.
B. A thrombolytic agent.
C. An intravenous antibiotic.
D. A corticosteroid taper.
20. The most common cause of bacterial meningitis in adults is:
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Listeria monocytogenes
21. Which instruction is crucial for a patient being discharged on phenytoin?
A. Report any incidence of a sore throat or fever immediately. (Sign of hematologic
toxicity)
B. Take the medication on an empty stomach for best absorption.
C. Limit fluid intake to prevent edema.
D. Stop the medication if you develop gingival hyperplasia.
22. A patient with a cataract would most commonly report:
A. Sudden, painless loss of vision.
B. Seeing halos around lights at night.
C. Cloudy, blurry vision and glare.
D. Loss of peripheral vision.
