Neuro NCLEX CERTIFICATION PAPER 2026
FULL SOLUTION GRADED A+
● 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?
1. To reduce intraocular pressure
2. To prevent acute tubular necrosis
3. To promote osmotic diuresis to decrease ICP
4. To draw water into the vascular system to increase blood pressure.
Answer: 3
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.
● 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?
1. Urine output increases
2. Pupils are 8 mm and nonreactive
3. Systolic blood pressure remains at 150 mm Hg
4. BUN and creatinine levels return to normal. Answer: 1
, Mannitol promotes osmotic diuresis by increasing the pressure gradient
in the renal tubes. Fixed and dilated pupils are symptoms of increased
ICP or cranial nerve damage. No information is given about abnormal
BUN and creatinine levels or that mannitol is being given for renal
dysfunction or blood pressure maintenance.
● 4) Which of the following values is considered normal for ICP?
1. 0 to 15 mm Hg
2. 25 mm Hg
3. 35 to 45 mm Hg
4. 120/80 mm Hg. Answer: 1
Normal ICP is 0-15 mm Hg.
● 5) Which of the following symptoms may occur with a phenytoin
level of 32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion
3. Tonic-clonic seizure
4. Urinary incontinence. Answer: 1. 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. Phenytoin doesn't cause hyponatremia,
seizure, or urinary incontinence. Incontinence may occur during or after
a seizure.
FULL SOLUTION GRADED A+
● 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?
1. To reduce intraocular pressure
2. To prevent acute tubular necrosis
3. To promote osmotic diuresis to decrease ICP
4. To draw water into the vascular system to increase blood pressure.
Answer: 3
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.
● 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?
1. Urine output increases
2. Pupils are 8 mm and nonreactive
3. Systolic blood pressure remains at 150 mm Hg
4. BUN and creatinine levels return to normal. Answer: 1
, Mannitol promotes osmotic diuresis by increasing the pressure gradient
in the renal tubes. Fixed and dilated pupils are symptoms of increased
ICP or cranial nerve damage. No information is given about abnormal
BUN and creatinine levels or that mannitol is being given for renal
dysfunction or blood pressure maintenance.
● 4) Which of the following values is considered normal for ICP?
1. 0 to 15 mm Hg
2. 25 mm Hg
3. 35 to 45 mm Hg
4. 120/80 mm Hg. Answer: 1
Normal ICP is 0-15 mm Hg.
● 5) Which of the following symptoms may occur with a phenytoin
level of 32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion
3. Tonic-clonic seizure
4. Urinary incontinence. Answer: 1. 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. Phenytoin doesn't cause hyponatremia,
seizure, or urinary incontinence. Incontinence may occur during or after
a seizure.
