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Question 1
A patient is admitted with suspected increased intracranial pressure (ICP). Which early
sign is most concerning?
A. Bradycardia
B. Decreased level of consciousness
C. Fixed and dilated pupils
D. Cushing’s triad
Answer: B
Rationale: The earliest and most sensitive indicator of increased intracranial pressure is
a change in level of consciousness. Neurological status declines before vital sign
changes or pupillary abnormalities occur. Bradycardia, hypertension, and abnormal
respirations (Cushing’s triad) are late signs indicating brainstem compression.
Question 2
Which position is most appropriate for a patient with elevated intracranial pressure?
A. Flat with legs elevated
B. Prone position
C. Head elevated at 30 degrees
D. Trendelenburg position
Answer: C
,Rationale: Elevating the head to 30 degrees promotes venous drainage from the brain
and reduces intracranial pressure. Flat or Trendelenburg positions increase venous
congestion and ICP.
Question 3
A patient with a stroke presents with right-sided weakness and aphasia. Which area of
the brain is most likely affected?
A. Occipital lobe
B. Left hemisphere
C. Cerebellum
D. Brainstem
Answer: B
Rationale: The left hemisphere controls language in most individuals and the right side
of the body. Aphasia and right-sided weakness indicate left cerebral involvement.
Question 4
Which medication is the priority in acute ischemic stroke management?
A. Heparin
B. Alteplase
C. Aspirin
D. Warfarin
Answer: B
Rationale: Alteplase is a thrombolytic used to dissolve clots in ischemic stroke if
administered within the appropriate time window. Anticoagulants are not first-line in
acute management.
Question 5
A patient with meningitis should be placed on which type of precautions?
,A. Contact
B. Droplet
C. Airborne
D. Protective isolation
Answer: B
Rationale: Meningitis is transmitted via respiratory droplets, requiring droplet
precautions including mask use within close proximity.
Question 6
Which assessment finding suggests worsening intracranial pressure?
A. Increased appetite
B. Decreased blood pressure
C. Sluggish pupillary response
D. Hyperactive bowel sounds
Answer: C
Rationale: Sluggish or unequal pupillary response indicates increasing neurological
compromise and rising intracranial pressure.
Question 7
A patient with Parkinson’s disease is most likely to exhibit which symptom?
A. Sudden loss of vision
B. Resting tremor
C. Flaccid paralysis
D. Severe headache
Answer: B
, Rationale: Parkinson’s disease is characterized by resting tremor, rigidity, bradykinesia,
and postural instability.
Question 8
Which instruction is most appropriate for a patient taking levodopa?
A. Take with high-protein meals
B. Stop medication when symptoms improve
C. Avoid high-protein foods near dosing time
D. Take only at bedtime
Answer: C
Rationale: High-protein meals can interfere with absorption of levodopa, reducing
effectiveness.
Question 9
Which finding is most consistent with a cerebellar stroke?
A. Aphasia
B. Memory loss
C. Ataxia
D. Hemiplegia
Answer: C
Rationale: The cerebellum controls coordination and balance; damage results in ataxia.
Question 10
What is the priority nursing action for a patient experiencing a seizure?
A. Insert oral airway
B. Restrain the patient
C. Protect airway and prevent injury