Neuro NCLEX Test Questions with Answers Rated A
A patient comes to the emergency department imme- a.) Transient ischemic stroke
diately after experiencing numbness of the face and an
inability to speak, but while the patient awaits examina- Rationale:
tion, the symptoms disappear and the patient request The patient has probably experienced a transient ischemic
discharge. The nurse stresses that it is important for the attack (TIA), which is a sign of progressive cerebral vascu-
patient to be evaluated primarily because the patient has lar disease- (A TIA is a temporary focal loss of neurologic
probably experienced a; function caused by ischemia of an area of the brain, usual-
ly lasting only about 3 hours. TIAs may be due to microem-
a.) Transient ischemic attack boli from heart disease or carotid or cerebral thrombi
b.) Ischemic stroke and are a warning of progressive disease. Evaluation is
c.) Hemorrhagic stroke necessary to determine the cause of the neurologic deficit
d.) MI and provide prophylactic treatment if possible.)
Aspirin is ordered for a patient who is admitted with a
possible stroke. Which information obtained during the
c. The patient states, "My symptoms started with a terrible
admission assessment indicates that the nurse should
headache."
consult with the health care provider before giving the
aspirin? Rationale:
A sudden onset headache is typical of a subarachnoid he-
a. The patient has dysphasia.
morrhage, and aspirin is contraindicated. Atrial fibrillation,
b. The patient has atrial fibrillation.
dysphasia, and transient ischemic attack (TIA) are not con-
c. The patient states, "My symptoms started with a terrible
traindications to aspirin use, so the nurse can administer
headache."
the aspirin.
d. The patient has a history of brief episodes of right-sided
hemiplegia.
A patient with a stroke experiences right-sided arm and
d. Diflculty in understanding commands
leg paralysis and facial drooping on the right side. When
admitting the patient, which clinical manifestation will the Rationale:
nurse expect to find? Right-sided paralysis indicates a left-brain stroke, which
will lead to diflculty with comprehension and use of lan-
a. Impulsive behavior
guage. The left-side reflexes are likely to be intact. Impul-
b. Right-sided neglect
, Neuro NCLEX Test Questions with Answers Rated A
c. Hyperactive left-sided reflexes sive behavior and neglect are more likely with a right-side
d. Diflculty in understanding commands stroke.
A patient with a history of several transient ischemic at- d. tissue plasminogen activator (tPA) infusion.
tacks (TIAs) arrives in the emergency department with
hemiparesis and dysarthria that started 2 hours previous- Rationale:
ly. The nurse anticipates the need to prepare the patient The patient's history and clinical manifestations suggest
for an acute ischemic stroke and a patient who is seen with-
in 4.5 hours of stroke onset is likely to receive tPA (af-
a. surgical endarterectomy. ter screening with a CT scan). Heparin administration in
b. transluminal angioplasty. the emergency phase is not indicated. Emergent carotid
c. intravenous heparin administration. transluminal angioplasty or endarterectomy is not indicat-
d. tissue plasminogen activator (tPA) infusion. ed for the patient who is having an acute ischemic stroke.
When caring for a patient with left-sided homonymous
c. Place objects needed for activities of daily living on the
hemianopsia resulting from a stroke, which intervention
patient's right side.
should the nurse include in the plan of care during the
acute period of the stroke? Rationale:
During the acute period, the nurse should place objects
a. Apply an eye patch to the left eye.
on the patient's unattected side. Since there is a visual
b. Approach the patient from the left side.
defect in the left half of each eye, an eye patch is not
c. Place objects needed for activities of daily living on the
appropriate. The patient should be approached from the
patient's right side.
right side. The visual deficit may not resolve, although the
d. Reassure the patient that the visual deficit will resolve
patient can learn to compensate for the defect.
as the stroke progresses.
A 32-year-old patient has a stroke resulting from a rup- a. Applying intermittent pneumatic compression stock-
tured aneurysm and subarachnoid hemorrhage. Which ings
intervention will be included in the care plan?
Rationale:
a. Applying intermittent pneumatic compression stock- The patient with a subarachnoid hemorrhage usually has
ings minimal activity to prevent cerebral vasospasm or further
b. Assisting to dangle on edge of bed and assess for bleeding and is at risk for venous thromboemboism (VTE).
dizziness Activities such as coughing and sitting up that might in-
A patient comes to the emergency department imme- a.) Transient ischemic stroke
diately after experiencing numbness of the face and an
inability to speak, but while the patient awaits examina- Rationale:
tion, the symptoms disappear and the patient request The patient has probably experienced a transient ischemic
discharge. The nurse stresses that it is important for the attack (TIA), which is a sign of progressive cerebral vascu-
patient to be evaluated primarily because the patient has lar disease- (A TIA is a temporary focal loss of neurologic
probably experienced a; function caused by ischemia of an area of the brain, usual-
ly lasting only about 3 hours. TIAs may be due to microem-
a.) Transient ischemic attack boli from heart disease or carotid or cerebral thrombi
b.) Ischemic stroke and are a warning of progressive disease. Evaluation is
c.) Hemorrhagic stroke necessary to determine the cause of the neurologic deficit
d.) MI and provide prophylactic treatment if possible.)
Aspirin is ordered for a patient who is admitted with a
possible stroke. Which information obtained during the
c. The patient states, "My symptoms started with a terrible
admission assessment indicates that the nurse should
headache."
consult with the health care provider before giving the
aspirin? Rationale:
A sudden onset headache is typical of a subarachnoid he-
a. The patient has dysphasia.
morrhage, and aspirin is contraindicated. Atrial fibrillation,
b. The patient has atrial fibrillation.
dysphasia, and transient ischemic attack (TIA) are not con-
c. The patient states, "My symptoms started with a terrible
traindications to aspirin use, so the nurse can administer
headache."
the aspirin.
d. The patient has a history of brief episodes of right-sided
hemiplegia.
A patient with a stroke experiences right-sided arm and
d. Diflculty in understanding commands
leg paralysis and facial drooping on the right side. When
admitting the patient, which clinical manifestation will the Rationale:
nurse expect to find? Right-sided paralysis indicates a left-brain stroke, which
will lead to diflculty with comprehension and use of lan-
a. Impulsive behavior
guage. The left-side reflexes are likely to be intact. Impul-
b. Right-sided neglect
, Neuro NCLEX Test Questions with Answers Rated A
c. Hyperactive left-sided reflexes sive behavior and neglect are more likely with a right-side
d. Diflculty in understanding commands stroke.
A patient with a history of several transient ischemic at- d. tissue plasminogen activator (tPA) infusion.
tacks (TIAs) arrives in the emergency department with
hemiparesis and dysarthria that started 2 hours previous- Rationale:
ly. The nurse anticipates the need to prepare the patient The patient's history and clinical manifestations suggest
for an acute ischemic stroke and a patient who is seen with-
in 4.5 hours of stroke onset is likely to receive tPA (af-
a. surgical endarterectomy. ter screening with a CT scan). Heparin administration in
b. transluminal angioplasty. the emergency phase is not indicated. Emergent carotid
c. intravenous heparin administration. transluminal angioplasty or endarterectomy is not indicat-
d. tissue plasminogen activator (tPA) infusion. ed for the patient who is having an acute ischemic stroke.
When caring for a patient with left-sided homonymous
c. Place objects needed for activities of daily living on the
hemianopsia resulting from a stroke, which intervention
patient's right side.
should the nurse include in the plan of care during the
acute period of the stroke? Rationale:
During the acute period, the nurse should place objects
a. Apply an eye patch to the left eye.
on the patient's unattected side. Since there is a visual
b. Approach the patient from the left side.
defect in the left half of each eye, an eye patch is not
c. Place objects needed for activities of daily living on the
appropriate. The patient should be approached from the
patient's right side.
right side. The visual deficit may not resolve, although the
d. Reassure the patient that the visual deficit will resolve
patient can learn to compensate for the defect.
as the stroke progresses.
A 32-year-old patient has a stroke resulting from a rup- a. Applying intermittent pneumatic compression stock-
tured aneurysm and subarachnoid hemorrhage. Which ings
intervention will be included in the care plan?
Rationale:
a. Applying intermittent pneumatic compression stock- The patient with a subarachnoid hemorrhage usually has
ings minimal activity to prevent cerebral vasospasm or further
b. Assisting to dangle on edge of bed and assess for bleeding and is at risk for venous thromboemboism (VTE).
dizziness Activities such as coughing and sitting up that might in-
