NR 324 Neurological Disorders Practice Exam 2026 |Chamberlain
College
1. Which assessment finding is a classic sign of the ‘Cushing’s Triad’ associated
with increased intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Tachycardia, hypertension, and kussmaul respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
Answer: D
Rationale: Cushing’s Triad consists of bradycardia, hypertension (specifically a widening
pulse pressure), and irregular or altered respirations. It is a late sign of increased ICP and
brainstem compression.
2. The nurse is caring for a patient with increased ICP. Which medication is most
commonly used to reduce cerebral edema by pulling fluid from the brain tissue
into the blood vessels?
A. Furosemide
B. Mannitol
C. Hydrochlorothiazide
D. Spironolactone
Answer: B
Rationale: Mannitol is an osmotic diuretic that increases the osmotic pressure of the
glomerular filtrate, which inhibits reabsorption of water and electrolytes, specifically
reducing cerebral edema in patients with high ICP.
,3. A patient arrives in the Emergency Department with symptoms of a stroke.
What is the priority diagnostic test to determine if the stroke is ischemic or
hemorrhagic?
A. Non-contrast Computed Tomography (CT) scan
B. Magnetic Resonance Imaging (MRI)
C. Carotid Ultrasound
D. Electroencephalogram (EEG)
Answer: A
Rationale: A non-contrast CT scan is the priority to quickly rule out a hemorrhagic stroke
before initiating fibrinolytic therapy for an ischemic stroke.
4. For a patient who has suffered a stroke, the window of time for administering
tissue plasminogen activator (tPA) is typically within how many hours of
symptom onset?
A. 1 to 2 hours
B. 6 to 8 hours
C. 12 hours
D. 3 to 4.5 hours
Answer: D
Rationale: The standard window for intravenous tPA administration in ischemic stroke is
3 to 4.5 hours from the time the patient was last known well.
5. The nurse observes a patient having a tonic-clonic seizure. What is the
priority nursing action?
A. Place a padded tongue blade in the patient’s mouth
B. Restrain the patient’s limbs to prevent injury
C. Turn the patient onto their side and protect the head
D. Administer oral anticonvulsants immediately
Answer: C
, Rationale: Safety is the priority. Turning the patient to the side prevents aspiration, and
protecting the head prevents trauma. Nothing should be placed in the mouth and restraints
should never be used.
6. Which Glasgow Coma Scale (GCS) score would indicate the need for
immediate intubation due to inability to maintain a patent airway?
A. 15
B. 8
C. 12
D. 10
Answer: B
Rationale: A GCS score of 8 or less typically indicates a severe brain injury where the
patient cannot protect their own airway, necessitating intubation (‘Less than 8, intubate’).
7. A patient with a right-sided stroke is most likely to exhibit which of the
following characteristics?
A. Impulsivity and impaired judgment
B. Aphasia and language deficits
C. Slow, cautious behavior
D. Depression and anxiety regarding physical deficits
Answer: A
Rationale: Patients with right-brain damage tend to be impulsive, move quickly, and have
a lack of awareness of their deficits. Left-brain damage is associated with language deficits
and cautious behavior.
College
1. Which assessment finding is a classic sign of the ‘Cushing’s Triad’ associated
with increased intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Tachycardia, hypertension, and kussmaul respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
Answer: D
Rationale: Cushing’s Triad consists of bradycardia, hypertension (specifically a widening
pulse pressure), and irregular or altered respirations. It is a late sign of increased ICP and
brainstem compression.
2. The nurse is caring for a patient with increased ICP. Which medication is most
commonly used to reduce cerebral edema by pulling fluid from the brain tissue
into the blood vessels?
A. Furosemide
B. Mannitol
C. Hydrochlorothiazide
D. Spironolactone
Answer: B
Rationale: Mannitol is an osmotic diuretic that increases the osmotic pressure of the
glomerular filtrate, which inhibits reabsorption of water and electrolytes, specifically
reducing cerebral edema in patients with high ICP.
,3. A patient arrives in the Emergency Department with symptoms of a stroke.
What is the priority diagnostic test to determine if the stroke is ischemic or
hemorrhagic?
A. Non-contrast Computed Tomography (CT) scan
B. Magnetic Resonance Imaging (MRI)
C. Carotid Ultrasound
D. Electroencephalogram (EEG)
Answer: A
Rationale: A non-contrast CT scan is the priority to quickly rule out a hemorrhagic stroke
before initiating fibrinolytic therapy for an ischemic stroke.
4. For a patient who has suffered a stroke, the window of time for administering
tissue plasminogen activator (tPA) is typically within how many hours of
symptom onset?
A. 1 to 2 hours
B. 6 to 8 hours
C. 12 hours
D. 3 to 4.5 hours
Answer: D
Rationale: The standard window for intravenous tPA administration in ischemic stroke is
3 to 4.5 hours from the time the patient was last known well.
5. The nurse observes a patient having a tonic-clonic seizure. What is the
priority nursing action?
A. Place a padded tongue blade in the patient’s mouth
B. Restrain the patient’s limbs to prevent injury
C. Turn the patient onto their side and protect the head
D. Administer oral anticonvulsants immediately
Answer: C
, Rationale: Safety is the priority. Turning the patient to the side prevents aspiration, and
protecting the head prevents trauma. Nothing should be placed in the mouth and restraints
should never be used.
6. Which Glasgow Coma Scale (GCS) score would indicate the need for
immediate intubation due to inability to maintain a patent airway?
A. 15
B. 8
C. 12
D. 10
Answer: B
Rationale: A GCS score of 8 or less typically indicates a severe brain injury where the
patient cannot protect their own airway, necessitating intubation (‘Less than 8, intubate’).
7. A patient with a right-sided stroke is most likely to exhibit which of the
following characteristics?
A. Impulsivity and impaired judgment
B. Aphasia and language deficits
C. Slow, cautious behavior
D. Depression and anxiety regarding physical deficits
Answer: A
Rationale: Patients with right-brain damage tend to be impulsive, move quickly, and have
a lack of awareness of their deficits. Left-brain damage is associated with language deficits
and cautious behavior.
