Neurological Disorders NCLEX Questions 16-20

This 5-item Neurological Disorders NCLEX Questions cover topics about Degenerative Diseases.

16. A client has a neurological deficit involving the limbic system. Which assessment finding is specific to this type of deficit?

a) Is disoriented to person, place, and time
b) Affect is flat, with periods of emotional lability
c) Cannot recall what was eaten for breakfast today
d) Demonstrates inability to add and subtract; does not know who is the president of the United States

17. The nurse is planning to institute seizure precautions for a client who is being admitted from the emergency department. Which measures should the nurse include in planning for the client’s safety? Select all that apply.

a) Padding the side rails of the bed
b) Placing an airway at the bedside
c) Placing the bed in the high position
d) Putting a padded tongue blade at the head of the bed
e) Placing oxygen and suction equipment at the bedside
f) Having intravenous equipment ready for insertion of an intravenous catheter

18. Neurological Disorders NCLEX Questions about the nurse who is evaluating the status of a client who had a craniotomy 3 days ago. Which assessment finding would indicate that the client is developing meningitis as a complication of surgery?

a) A negative Kernig sign
b) Absence of nuchal rigidity
c) A positive Brudzinski sign
d) A Glasgow Coma Scale score of 15

19. The nurse has completed discharge instructions for a client with application of a halo device. Which action indicates that the client needs further clarification of the instructions?

a) Uses a straw for drinking.
b) Drives only during the daytime.
c) Uses caution because the device alters balance.
d) Washes the skin daily under the lamb’s wool liner of the vest.

20. The nurse is admitting a client with Guillain-BarrĂ© syndrome to the nursing unit. The client has ascending paralysis to the level of the waist. Knowing the complications of the disorder, the nurse should bring which most essential items into the client’s room?

a) Nebulizer and pulse oximeter
b) Blood pressure cuff and flashlight
c) Flashlight and incentive spirometer
d) Electrocardiographic monitoring electrodes and intubation tray






Neurological Disorders NCLEX Questions
Answers and Rationale

16) B
- Rationale: The limbic system is responsible for feelings (affect) and emotions. Calculation ability and knowledge of current events relate to function of the frontal lobe. The cerebral hemispheres, with specific regional functions, control orientation. Recall of recent events is controlled by the hippocampus.

- Test-Taking Strategy: Focus on the subject, neurological deficit of the limbic system. Recall that the limbic system is responsible for feelings and emotions to direct you to the correct option. 

17) A, B, E, F
- Neurological Disorders NCLEX Questions Rationale: Seizure precautions may vary from agency to agency, but they generally have some common features. Usually, an airway, oxygen, and suctioning equipment are kept available at the bedside. The side rails of the bed are padded, and the bed is kept in the lowest position. The client has an intravenous access in place to have a readily accessible route if anticonvulsant medications must be administered. The use of padded tongue blades is highly controversial, and they should not be kept at the bedside. Forcing a tongue blade into the mouth during a seizure more likely will harm the client who bites down during seizure activity. Risks include blocking the airway from improper placement, chipping the client’s teeth, and subsequent risk of aspirating tooth fragments. If the client has an aura before the seizure, it may give the nurse enough time to place an oral airway before seizure activity begins.

- Test-Taking Strategy: Focus on the subject, seizure precautions. Evaluate this question from the perspective of causing possible harm. No harm can come to the client from any of the options except for placing the bed in the high position and using a tongue blade.

18) C
- Rationale: Signs of meningeal irritation compatible with meningitis include nuchal rigidity, a positive Brudzinski sign, and positive Kernig sign. Nuchal rigidity is characterized by a stiff neck and soreness, which is especially noticeable when the neck is flexed. Kernig’s sign is positive when the client feels pain and spasm of the hamstring muscles when the leg is fully flexed at the knee and hip. Brudzinski’s sign is positive when the client flexes the hips and knees in response to the nurse gently flexing the head and neck onto the chest. A Glasgow Coma Scale score of 15 is a perfect score and indicates that the client is awake and alert, with no neurological deficits.

- Neurological Disorders NCLEX Questions Test-Taking Strategy: Focus on the subject, a client’s diagnosis of meningitis. You can eliminate options A, B, and D because they are comparable or alike and are normal findings. 

19) B
- Rationale: The halo device alters balance and can cause fatigue because of its weight. The client should cleanse the skin daily under the vest to protect the skin from ulceration and should avoid the use of powder or lotions. The liner should be changed if odor becomes a problem. The client should have food cut into small pieces to facilitate chewing and use a straw for drinking. Pin care is done as instructed. The client cannot drive at all because the device impairs the range of vision.

- Test-Taking Strategy: Note the strategic words needs further clarification. These words indicate a negative event query and ask you to select an option that is incorrect. Visualize this device to answer correctly. The inability to turn the head without turning the torso would contraindicate driving. 

20) D
- Rationale: The client with Guillain-Barré syndrome is at risk for respiratory failure because of ascending paralysis. An intubation tray should be available for use. Another complication of this syndrome is cardiac dysrhythmias, which necessitates the use of electrocardiographic monitoring. Because the client is immobilized, the nurse should assess for deep vein thrombosis and pulmonary embolism routinely. Although items in the incorrect options may be used in care, they are not the most essential items from the options provided.

- Test-Taking Strategy: Note the strategic words most essential. With an ascending paralysis, the client is at risk for involvement of respiratory muscles and subsequent respiratory failure. The correct option is the only one that includes an intubation tray, which would be needed if the client’s status deteriorated to needing intubation and mechanical ventilation. This option most directly addresses the airway.


After you reviewed your answers through its rationale, you can go to the next page to continue your review: 

Neurological Disorders NCLEX Questions 21-25

Or go back to the first page:

Neurological Disorders NCLEX Questions 11-15

This 5-item Neurological Disorders NCLEX Questions covering topics about Spinal Cord Injury and Stroke. Answer this quiz and soar high on your NCLEX!

 11. The nurse is evaluating the neurological signs of a client in spinal shock following spinal cord injury. Which observation indicates that spinal shock persists?

a) Hyperreflexia
b) Positive reflexes
c) Flaccid paralysis
d) Reflex emptying of the bladder

12. The nurse is caring for a client who begins to experience seizure activity while in bed. Which action by the nurse is contraindicated?

a) Loosening restrictive clothing
b) Restraining the client’s limbs
c) Removing the pillow and raising padded side rails
d) Positioning the client to the side, if possible, with the head flexed forward

13. Neurological Disorders NCLEX Questions about the nurse who is assigned to care for a client with complete right-sided hemiparesis. Which characteristics are associated with this condition? Select all that apply.

a) The client is aphasic.
b) The client has weakness in the face and tongue.
c) The client has weakness on the right side of the body.
d) The client has complete bilateral paralysis of the arms and legs.
e) The client has lost the ability to move the right arm but is able to walk independently.
f) The client has lost the ability to ambulate independently but is able to feed and bathe himself or herself without assistance.

14. The nurse has instructed the family of a client with stroke (brain attack) who has homonymous hemianopsia about measures to help the client overcome the deficit. Which statement suggests that the family understands the measures to use when caring for the client?

a) “We need to discourage him from wearing eyeglasses.”
b) “We need to place objects in his impaired field of vision.”
c) “We need to approach him from the impaired field of vision.”
d) “We need to remind him to turn his head to scan the lost visual field.”

15. The nurse is assessing the adaptation of a client to changes in functional status after a stroke (brain attack). Which observation indicates to the nurse that the client is adapting most successfully?

a) Gets angry with family if they interrupt a task
b) Experiences bouts of depression and irritability
c) Has difficulty with using modified feeding utensils
d) Consistently uses adaptive equipment in dressing self




Neurological Disorders NCLEX Questions
Answers and Rationale

11) C
- Rationale: Resolution of spinal shock is occurring when there is return of reflexes (especially flexors to noxious cutaneous stimuli), a state of hyperreflexia rather than flaccidity, and reflex emptying of the bladder.

- Test-Taking Strategy: Recall that spinal shock is characterized by the loss of movement of skeletal muscles, loss of bowel or bladder wall function, and depressed reflex action. Return of any of these indicates that spinal shock is beginning to resolve. Note that options A, B and D are comparable or alike, indicating the presence of reflexes.

12) B
- Neurological Disorders NCLEX Questions Rationale: Nursing actions during a seizure include providing for privacy, loosening restrictive clothing, removing the pillow and raising padded side rails in the bed, and placing the client on one side with the head flexed forward, if possible, to allow the tongue to fall forward and facilitate drainage. The limbs are never restrained because the strong muscle contractions could cause the client harm. If the client is not in bed when seizure activity begins, the nurse lowers the client to the floor, if possible, protects the head from injury, and moves furniture that may injure the client.

- Test-Taking Strategy: Focus on the subject, action contraindicated during a seizure. Evaluate this question from the perspective of causing possible harm. No harm can come to the client from any of the options except for restraining the limbs. Remember, avoid restraints.

13) A, B, C
- Rationale: Hemiparesis is a weakness of one side of the body that may occur after a stroke. It involves weakness of the face and tongue, arm, and leg on one side. These clients are also aphasic: unable to discriminate words and letters. They are generally very cautious and get anxious when attempting a new task. Complete bilateral paralysis does not occur in hemiparesis. The client with right-sided hemiparesis has weakness of the right arm and leg and needs assistance with feeding, bathing, and ambulating.

- Neurological Disorders NCLEX Questions Test-Taking Strategy: Focus on the subject, right-sided hemiparesis. Recalling that hemiparesis indicates weakness and focusing on the subject will direct you to the correct option.

14) D
- Rationale: Homonymous hemianopsia is loss of half of the visual field. The client with homonymous hemianopsia should have objects placed in the intact field of vision, and the nurse also should approach the client from the intact side. The nurse instructs the client to scan the environment to overcome the visual deficit and does client teaching from within the intact field of vision. The nurse encourages the use of personal eyeglasses, if they are available.

- Test-Taking Strategy: Focus on the subject, homonymous hemianopsia. Eliminate options B and C first because they are comparable or alike. Recalling the definition of homonymous hemianopsia will direct you easily to the correct option.

15) D
- Rationale: Clients are evaluated as coping successfully with lifestyle changes after a brain attack (stroke) if they make appropriate lifestyle alterations, use the assistance of others, and have appropriate social interactions. Options A and B are not adaptive behaviors; option C indicates a not yet successful attempt to adapt.

- Test-Taking Strategy: Note the strategic word most and focus on the subject, indications that a client who has had a stroke is adapting most successfully. Options A and B are behaviors that may be expected in the client with a brain attack (stroke), but they are not adaptive responses. Instead, they are a result of the insult to the brain. Options C and D indicate that the client is trying to adapt, but the correct option has the best outcome.


After you reviewed your answers through its rationale, you can go to the next page to continue your review: 


Or go back to the first page: