Nervous System | Neurological Disorders NCLEX Quiz 50
All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.
- 1.
A client admitted to the hospital with a subarachnoid hemorrhage has complaints of severe headache. nuchal rigidity. and projectile vomiting. The nurse knows lumbar puncture (LP) would be contraindicated in this client in which of the following circumstances?
- A.
Vomiting continues
- B.
Intracranial pressure (ICP) is increased
- C.
The client needs mechanical ventilation
- D.
Blood is anticipated in the cerebrospinal fluid (CSF)
Correct Answer
B. Intracranial pressure (ICP) is increasedExplanation
Sudden removal of CSF results in pressures lower in the lumbar area than the brain and favors herniation of the brain; therefore. LP is contraindicated with increased ICP.Option A: Vomiting may be caused by reasons other than increased ICP; therefore. LP isn’t strictly contraindicated.Option C: An LP may be performed on clients needing mechanical ventilation.Option D: Blood in the CSF is diagnostic for subarachnoid hemorrhage and was obtained before signs and symptoms of ICP.Rate this question:
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- 2.
A client with a subdural hematoma becomes restless and confused. with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons?
- A.
To reduce intraocular pressure
- B.
To prevent acute tubular necrosis
- C.
To promote osmotic diuresis to decrease ICP
- D.
To draw water into the vascular system to increase blood pressure
Correct Answer
C. To promote osmotic diuresis to decrease ICPExplanation
Mannitol promotes osmotic diuresis by increasing the pressure gradient. drawing fluid from intracellular to intravascular spaces. Although mannitol is used for all the reasons described. the reduction of ICP in this client is a concern.Rate this question:
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- 3.
A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would best show the mannitol was effective?
- A.
Urine output increases
- B.
Pupils are 8 mm and nonreactive
- C.
Systolic blood pressure remains at 150 mm Hg
- D.
BUN and creatinine levels return to normal
Correct Answer
A. Urine output increasesExplanation
Mannitol promotes osmotic diuresis by increasing the pressure gradient in the renal tubes.Option B: Fixed and dilated pupils are symptoms of increased ICP or cranial nerve damage.Options C and D: No information is given about abnormal BUN and creatinine levels or that mannitol is being given for renal dysfunction or blood pressure maintenance.Rate this question:
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- 4.
Which of the following values is considered normal for ICP?
- A.
0 to 15 mm Hg
- B.
25 mm Hg
- C.
35 to 45 mm Hg
- D.
120/80 mm Hg
Correct Answer
A. 0 to 15 mm HgExplanation
Normal ICP is 0-15 mm Hg.Rate this question:
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- 5.
Which of the following symptoms may occur with a phenytoin level of 32 mg/dl?
- A.
Ataxia and confusion
- B.
Sodium depletion
- C.
Tonic-clonic seizure
- D.
Urinary incontinence
Correct Answer
A. Ataxia and confusionExplanation
A therapeutic phenytoin level is 10 to 20 mg/dl. A level of 32 mg/dl indicates toxicity. Symptoms of toxicity include confusion and ataxia.Options B. C. and D: Phenytoin doesn’t cause hyponatremia. seizure. or urinary incontinence. Incontinence may occur during or after a seizure.Rate this question:
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- 6.
Which of the following signs and symptoms of increased ICP after head trauma would appear first?
- A.
Bradycardia
- B.
Large amounts of very dilute urine
- C.
Restlessness and confusion
- D.
Widened pulse pressure
Correct Answer
C. Restlessness and confusionExplanation
The earliest symptom of elevated ICP is a change in mental status.Option A and D: Bradycardia. widened pulse pressure. and bradypnea occur later.Option B: The client may void large amounts of very dilute urine if there’s damage to the posterior pituitary.Rate this question:
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- 7.
Problems with memory and learning would relate to which of the following lobes?
- A.
Frontal
- B.
Occipital
- C.
Parietal
- D.
Temporal
Correct Answer
D. TemporalExplanation
The temporal lobe functions to regulate memory and learning problems because of the integration of the hippocampus.Option A: The frontal lobe primarily functions to regulate thinking. planning. and judgment.Option B: The occipital lobe functions regulate vision.Option C: The parietal lobe primarily functions with sensory function.Rate this question:
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- 8.
While cooking. your client couldn’t feel the temperature of a hot oven. Which lobe could be dysfunctional?
- A.
Frontal
- B.
Occipital
- C.
Parietal
- D.
Temporal
Correct Answer
C. ParietalExplanation
The parietal lobe regulates sensory function. which would include the ability to sense hot or cold objects.Option A: The frontal lobe regulates thinking. planning. and judgment.Option B: The occipital lobe is primarily responsible for vision function.Option D: The temporal lobe regulates memory.Rate this question:
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- 9.
The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the client’s peripheral response to pain?
- A.
Sternal rub
- B.
Pressure on the orbital rim
- C.
Squeezing the sternocleidomastoid muscle
- D.
Nail bed pressure
Correct Answer
D. Nail bed pressureExplanation
Motor testing on the unconscious client can be done only by testing response to painful stimuli. Nail Bed pressure tests a basic peripheral response.Options A. B. and C: Cerebral responses to pain are testing using sternal rub. placing upward pressure on the orbital rim. or squeezing the clavicle or sternocleidomastoid muscle.Rate this question:
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- 10.
The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure?
- A.
Side-lying. with legs pulled up and head bent down onto the chest
- B.
Side-lying. with a pillow under the hip
- C.
Prone. in a slight Trendelenburg’s position
- D.
Prone. with a pillow under the abdomen.
Correct Answer
A. Side-lying. with legs pulled up and head bent down onto the chestExplanation
The client undergoing lumbar puncture is positioned lying on the side. with the legs pulled up to the abdomen. and with the head bent down onto the chest. This position helps to open the spaces between the vertebrae.Rate this question:
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Aug 22, 2023Quiz Edited by
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Sep 29, 2017Quiz Created by
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