NEURO

CVA 5 items:
1. A post CVA client with right sided paralysis is admitted to the medical-intensive unit.
Upon assessment, she is awake and alert but has difficulty speaking because of
impairment of facial muscles involved with production of speech. When documenting
the clients speech, the nurse notes that the client has
A. Seimantic aphasia
B. Receptive aphasia
C. Dysarthria
D. Dysphagia
2. Which nursing intervention has been found to be the most effective means of
preventing plantar flexion in a client who has had a CVA with residual paralysis?
A. Place the clients feet against a firm footboard
B. Reposition the client every 2 hours
C. Have the client wear ankle high tennis shoes at intervals all throughout the
day
D. Massage the clients feet and ankles regularly
3. An adult client with hemiplegia and right hemianopia expresses concern about how to
operate the vacuum cleaner and washing machine at home. Which of the following
nursing diagnoses is appropriate for this client?
A. High risk for injury related to right sided weakness
B. Impaired home maintenance management related to paralysis and visual
impairment
C.
Altered health management related to altered mobility and sensory
perception
D. Hygiene and self-care deficit related to inability to keep the house clean
4. During recovery from CVA, a client is given nothing by mouth to help prevent
aspiration. To determine if the client is ready for a liquid diet, the nurse assesses the
clients swallowing ability once each shift. This assessment evaluates
A. Cranial nerves I and II
B. Cranial nerves III and V
C. Cranial nerves VI and VIII
D. Cranial nerves IX and X
5. A client is experiencing mood swings after a CVA and often has episodes of
tearfulness that are distressing to the family. Which is the best technique for the
nurse to instruct family members to try when the client experiences a crying
episode?
A. Sit quietly with the client until the episode is over
B. Ignore the behavior
C. Attempt to divert the clients attention
D. Tell the client that this behavior is unacceptable
Parkinsons 5 items:

6. Which nursing diagnosis takes highest priority for a client with parkinsons crisis?
A. Altered nutrition less than body requirements
B. Ineffective airway clearance
C. Altered urinary elimination
D. Risk for injury
7. The nurse is developing a teaching plan for a client newly diagnosed with parkinsons
disease. Which of the following topics that the nurse plans to discuss is the most
important?
A. Maintaining balanced nutritional diet
B. Enhancing the immune system
C. Maintaining a safe environment
D. Engaging in diversional activities
8. A client with parkinsons disease asks the nurse to explain to his nephew what the
doctor said the pallidotomy would do. What is the nurses best response? The main
goal for the client after pallidotomy is improved
A. Functional ability
B. Emotional stress
C. Alertness
D. Appetite
9. A client with parkinsons disease needs a long time to complete her morning hygiene,
but she becomes annoyed when the nurse offers assistance and refuses all help.
Which statement is the nurses best response in this situation?
A. Tell the client firmly that she needs assistance and help her with her care
B. Praise the client for her desire to be independent and give her extra time and
encouragement
C. Tell the client that she is being unrealistic about her abilities and must accept
the fact that she needs help
D. Suggest to the client that if she insists on self-care, she should modify her
routine
10. In planning care for the client with advanced parkinsons disease, which activity is
most likely to be effective in alleviating fatigue?
A. Getting him to bed on time
B. Avoiding high carbohydrate foods
C. Collaborating with him when scheduling activities
D. Providing for morning and afternoon naps while he is in the hospital
Multiple sclerosis 5 items:
11. A client has had multiple sclerosis for 15 years and received various drug therapies.
What is the primary reason why the nurse has found it difficult to evaluate the
effectiveness of the drugs that the client has used? Clients with MS
A. Exhibit tolerance to many drugs
B. Experiences spontaneous remissions from time to time
C. Require multiple drugs simultaneously
D. Endure long periods of exacerbations before the illness responds to a
particular drug
12. Which of the following is inappropriate for the nurse to include in the discharge plan
for a client with MS who has an impaired peripheral sensation?

A.
B.
C.
D.
13. Which
A.
B.
C.
D.

Carefully test the temperature of bath water

Avoid kitchen activities because of the risk of injury
Avoid hot water bottles and heating pads
Inspect the skin daily for injury or pressure points
of the following is an inappropriate outcome to establish with a client with MS?
The client will develop joint mobility
The client will develop muscle strength
The client will develop cognition
The client will develop mood elevation

14. The daughter of a client with multiple sclerosis asks the nurse what she can do at
home to help her mother. Which of the following measures would be most beneficial?
A. Psychotherapy
B. Regular exercise
C. Weekly visits by another person with MS
D. Day care for the granddaughter
15. The nurse is preparing a client with MS for discharge from the hospital to home.
Which of the following instructions is appropriate?
A. You will need to accept the necessity for a quiet and inactive lifestyle
B. Keep active, use stress reduction strategies and avoid fatigue
C. Follow good health habits to change the course of the disease
D. Practice to use the mechanical aids that you will need when future
disabilities arise
Head Injury 5 items:
16. The nurse is caring for a confused client who sustained a head injury resulting in
subdural hematoma. The clients blood pressure is 100/60 mm Hg and he is
unresponsive. Select the most effective position for the client as the nurse transports
him to the operating room
A. Semi-fowlers position
B. Trendelenberg
C. High-fowlers
D. Supine
17. The nurse is performing a mental status examination on a client diagnosed with
subdural hematoma. This test assesses which of the following?
A. Cerebral function
B. Intellectual function
C. Cerebellar function
D. Sensory function
18. When caring for a client with head trauma, the nurse notes a small amount of clear,
watery fluid oozing from the clients nose. What should the nurse do?
A. Test the nasal drainage for glucose
B. Look for a halo sign after the drainage dries
C. Have the client blow the nose
D. Keep the client in supine position

19. A client is at risk for increased intracranial pressure. Which of the following would be
the priority of the nurse to monitor?
A. Unequal pupil size
B. Decreasing systolic BP
C. Tachycardia
D. Decreasing body temperature
20. The client has signs of increased ICP. Which of the following is an early indicator of
deterioration in the clients condition?
A. Widening pulse pressure
B. Decrease pulse rate
C. Dilated fixed pressure
D. Decrease in the level of consciousness
21. While monitoring a client after craniotomy, the nurse notes that the clients urine
specific gravity is decreasing and is currently 1.005. The nurse understand that this is
due to
a.
b.
c.
d.

Fast infusion rate of IV fluids.

Overproduction of vasopressin by the hypothalamus.
Rapid renal excretion in response to hydration.
Hyposecretion of antidiuretic hormone in the body.

22. A client with T4 injury develops facial flushing and a BP of 206/110. After elevating the
head of the bed, which action should the nurse perform next?
a.
b.
c.
d.

Informing the physician immediately

Palpating the bladder for distention
Administering emergency antihypertensive drug
Slowing the IV infusion

23. A client is admitted in the unit due to a motor vehicular accident the other day. As the
nurse visits the client today she noticed that the client is talking to her friend and was
attentive. Which of the following questions is appropriate for the nurse to ask?
a.
b.
c.
d.

Do you experience headache?

Is your vision blurred?
Are you having difficulty concentrating?
Do you easily get tired?

24. A client was admitted with Bells palsy. What will be the nursing consideration for this
patient?
a.
b.
c.
d.

Avoid sunlight
Manually close eyelid
Avoid frequent oral care
Nothing by mouth

25. The nurse doing the assessment for the patient with Bells palsy knows that the CN
affected is:
a. CN 7
b. CN 8
c. CN 6
d. CN 5

26. The nurse is caring for Parkinsons client. Which of the following does she need to
intervene?
a.
b.
c.
d.

Rock back and forth to initiate movements

Using tap water to thin the liquid food
Position to prone without a pillow
Hold hands behind the back when standing

27. The nurse is preparing her discharge plan for a patient with Parkinsons. Which is the
correct teaching to aid in ambulation?
a. Tell the patient to start by rocking back and forth
b. Walk by starting with the left foot followed by the right
c. Exercise walking everyday
d. Provide crutches to aid in ambulation
Rationale: A. Rocking back and forth initiates movement. P. 2174 Black

28. A patient sustained a fall with C6 injury experiencing diaphoresis and piloerection. What
should the nurse asses next?
a. weakness and LOC
b. urinary distention and fecal impaction
c. respiratory rate and depth
d. quadriplegia

29. A patient with C4 injury was placed under the care of the nurse. What should the nurse
report to the physician?
a.
b.
c.
d.

tingling of fingers
experiencing pain at the shoulders
stuffy nose
constricted pupils

30. A patient has been newly admitted and suspected of having Multiple Sclerosis. Which of
the following questions should the nurse ask to support the diagnosis?
a. Do you have headaches?
b. Do you have problems with urination?
c. Does your tremors decrease with activity?
d. Do you have problems with increased sensitivity?
31. The nurse obtains a history from the father of a six-year-old boy with a history of
epilepsy admitted with uncontrolled seizures. It is MOST important for the nurse to ask which
of the following questions?
1. "What part of the body was affected by the seizure?"
2. "What is the family history of seizure disorders?"
3. "What was your son doing before the seizure?"
4. "How long has it been since his last episode of seizures?"

32. The home care nurse is visiting an infant who had a myelomeningocele repair. The
home care nurse determines that the parents are accepting of their infant if which of the
following is observed?
1. The parents state that the infant will outgrow this problem in time.
2. The parents ask a neighbor to perform bladder expression.
3. The parents measure the head circumference daily.
4. The parents relate that they believe the child will walk in one year.

33. The nurse is caring for a four-year-old child with a closed head injury. The nurse would
be reassured by which of the following observations?
1. The child is able to state his name when asked who he is.
2. The child reaches for a stuffed animal brought from home.
3. The child maintains himself in opisthotonos.
4. The child withdraws from mildly painful stimuli.
34. The nurse is performing teaching on a client with Bell's palsy. It is MOST important for
the nurse to include which of the following instructions?
1. Use artificial tears 4 times per day.
2. Wear sunglasses at all times.
3. Avoid sudden movements of the head.
4. Change the pillowcase daily.

35.
An 8-year-old boy is brought to the physician's office by his mother. The mother is
concerned because the boy has a fever, vomited twice, and slept all day yesterday with the
curtains closed. The boy complains of headache, nausea, and has a temperature of 103F
(39.3C). The nurse observes the boy has a petechial rash on the trunk of his body.
Which of the following assessments would be MOST important for the nurse to perform?
1. Grasp the child's hands and ask him to squeeze the nurse's hands.
2. Stroke the plantar surface of the child's foot with a reflex hammer.
3. Gently flex the child's head and neck onto the chest.