PNR 205 EXAM 3 Actual Exam Complete
Questions and Answers Detailed Rationales Pass
Guaranteed - A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Neurological Disorders & Nursing Care | Q1 – Q10
Section 2 | Musculoskeletal Disorders & Mobility | Q11 – Q20
Section 3 | Endocrine Disorders & Metabolic Management | Q21 – Q30
Section 4 | Sensory Disorders (Eye, Ear, Skin) | Q31 – Q40
Section 5 | Multisystem Disorders & Complex Care | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: NEUROLOGICAL DISORDERS & NURSING CARE Q1 – Q10
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Question 1 of 50
A 72-year-old client is admitted with left-sided weakness and slurred speech that began
2 hours ago. The CT scan shows no hemorrhage. Blood pressure is 178/96 mmHg. The
client is alert and follows commands.
A. Administer aspirin 325 mg immediately to prevent clot extension
B. Lower the blood pressure to 140/90 mmHg with IV labetalol
C. Prepare for possible thrombolytic therapy after screening for contraindications ✓
CORRECT
D. Start heparin infusion and monitor for 24 hours
Correct Answer: C
Rationale: Ischemic stroke within the thrombolytic window requires rapid screening for
contraindications before administering tissue plasminogen activator. Aspirin is delayed
,until 24 hours after tPA or immediately if tPA is not given, and aggressive blood
pressure lowering can worsen cerebral perfusion. Heparin is not standard for acute
ischemic stroke and increases hemorrhage risk.
Question 2 of 50
A 28-year-old client is admitted after a motorcycle accident with a Glasgow Coma Scale
score of 8. The client opens eyes to pain, makes incomprehensible sounds, and
withdraws from painful stimuli. An intracranial pressure monitor is inserted showing
readings of 22 mmHg.
A. Place the client in Trendelenburg position to improve cerebral perfusion
B. Maintain the head of bed at 30 degrees with head in midline position ✓ CORRECT
C. Perform endotracheal suctioning every 30 minutes to prevent pneumonia
D. Administer mannitol and restrict fluids to 500 mL per day
Correct Answer: B
Rationale: Elevating the head of bed to 30 degrees with the head in a neutral midline
position promotes jugular venous drainage and reduces intracranial pressure.
Trendelenburg position increases ICP significantly, and frequent suctioning causes
transient ICP spikes. Mannitol may be used for acute ICP crises but fluid restriction is
inappropriate because hypovolemia reduces cerebral perfusion.
Question 3 of 50
A 45-year-old client with multiple sclerosis is admitted with an exacerbation
characterized by leg weakness, urinary urgency, and double vision. The provider orders
methylprednisolone 500 mg IV daily for 3 days. The client asks why the room must be
kept cool.
A. Cool temperatures prevent the IV medication from degrading
B. Heat exposure worsens nerve conduction in demyelinated axons ✓ CORRECT
C. The air conditioning reduces humidity to prevent urinary tract infections
,D. A cool room promotes better sleep and healing
Correct Answer: B
Rationale: The Uhthoff phenomenon causes temporary worsening of MS symptoms
when body temperature rises because heat slows conduction in demyelinated nerves.
Maintaining a cool environment prevents this pseudo-exacerbation during acute
treatment. While sleep is important, the specific rationale for cooling relates directly to
MS pathophysiology rather than general comfort.
Question 4 of 50
A 68-year-old client with Parkinson's disease reports increasing tremor and difficulty
initiating movement in the morning before taking medications. The client takes
carbidopa-levodopa four times daily and eats a high-protein breakfast.
A. Take the medication with breakfast so protein aids absorption
B. Take the medication 30 minutes before or 1 hour after meals ✓ CORRECT
C. Switch to a protein shake because liquids absorb faster
D. Increase the morning dose on days when tremor is worse
Correct Answer: B
Rationale: Dietary protein competes with levodopa for absorption across the blood-brain
barrier, so taking medication away from high-protein meals maximizes therapeutic
effectiveness. Protein shakes contain amino acids that cause the same competition,
and clients should never self-adjust dopaminergic medications because sudden
changes can cause dyskinesias or neuroleptic malignant syndrome.
Question 5 of 50
A 34-year-old client had a witnessed generalized tonic-clonic seizure lasting 4 minutes.
The seizure has stopped, and the client is drowsy with slow, irregular respirations.
Which nursing action is the priority?
, A. Insert an oropharyngeal airway to maintain the airway
B. Turn the client onto the side and suction the mouth as needed ✓ CORRECT
C. Restrain the client's arms to prevent injury during the post-ictal phase
D. Start oxygen at 4 L/min via nasal cannula and obtain a chest x-ray
Correct Answer: B
Rationale: Turning the client onto the side uses gravity to drain oral secretions and
prevents aspiration during the post-ictal phase when airway reflexes are depressed.
Oropharyngeal airways should not be forced into the mouth of a semiconscious client
because they can trigger vomiting or laryngospasm. Restraints cause injury and are
never used during seizures.
Question 6 of 50
A 22-year-old client sustained a T4 spinal cord injury in a diving accident. The client is
hypotensive at 82/48 mmHg, bradycardic at 46 bpm, and has warm, dry skin. Which
intervention should the nurse prepare?
A. Atropine 0.5 mg IV push for symptomatic bradycardia ✓ CORRECT
B. Epinephrine 1 mg IV push every 3 to 5 minutes
C. Trendelenburg position and high-flow oxygen
D. Norepinephrine infusion to maintain systolic pressure above 100 mmHg
Correct Answer: A
Rationale: Neurogenic shock from high thoracic cord injury causes unopposed vagal
tone and bradycardia, which often responds to atropine to increase heart rate and
improve cardiac output. Epinephrine is for cardiac arrest, Trendelenburg increases
venous pooling in paralyzed lower extremities, and norepinephrine may be used for
persistent hypotension but does not address the primary bradycardia.
Question 7 of 50
Questions and Answers Detailed Rationales Pass
Guaranteed - A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Neurological Disorders & Nursing Care | Q1 – Q10
Section 2 | Musculoskeletal Disorders & Mobility | Q11 – Q20
Section 3 | Endocrine Disorders & Metabolic Management | Q21 – Q30
Section 4 | Sensory Disorders (Eye, Ear, Skin) | Q31 – Q40
Section 5 | Multisystem Disorders & Complex Care | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: NEUROLOGICAL DISORDERS & NURSING CARE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old client is admitted with left-sided weakness and slurred speech that began
2 hours ago. The CT scan shows no hemorrhage. Blood pressure is 178/96 mmHg. The
client is alert and follows commands.
A. Administer aspirin 325 mg immediately to prevent clot extension
B. Lower the blood pressure to 140/90 mmHg with IV labetalol
C. Prepare for possible thrombolytic therapy after screening for contraindications ✓
CORRECT
D. Start heparin infusion and monitor for 24 hours
Correct Answer: C
Rationale: Ischemic stroke within the thrombolytic window requires rapid screening for
contraindications before administering tissue plasminogen activator. Aspirin is delayed
,until 24 hours after tPA or immediately if tPA is not given, and aggressive blood
pressure lowering can worsen cerebral perfusion. Heparin is not standard for acute
ischemic stroke and increases hemorrhage risk.
Question 2 of 50
A 28-year-old client is admitted after a motorcycle accident with a Glasgow Coma Scale
score of 8. The client opens eyes to pain, makes incomprehensible sounds, and
withdraws from painful stimuli. An intracranial pressure monitor is inserted showing
readings of 22 mmHg.
A. Place the client in Trendelenburg position to improve cerebral perfusion
B. Maintain the head of bed at 30 degrees with head in midline position ✓ CORRECT
C. Perform endotracheal suctioning every 30 minutes to prevent pneumonia
D. Administer mannitol and restrict fluids to 500 mL per day
Correct Answer: B
Rationale: Elevating the head of bed to 30 degrees with the head in a neutral midline
position promotes jugular venous drainage and reduces intracranial pressure.
Trendelenburg position increases ICP significantly, and frequent suctioning causes
transient ICP spikes. Mannitol may be used for acute ICP crises but fluid restriction is
inappropriate because hypovolemia reduces cerebral perfusion.
Question 3 of 50
A 45-year-old client with multiple sclerosis is admitted with an exacerbation
characterized by leg weakness, urinary urgency, and double vision. The provider orders
methylprednisolone 500 mg IV daily for 3 days. The client asks why the room must be
kept cool.
A. Cool temperatures prevent the IV medication from degrading
B. Heat exposure worsens nerve conduction in demyelinated axons ✓ CORRECT
C. The air conditioning reduces humidity to prevent urinary tract infections
,D. A cool room promotes better sleep and healing
Correct Answer: B
Rationale: The Uhthoff phenomenon causes temporary worsening of MS symptoms
when body temperature rises because heat slows conduction in demyelinated nerves.
Maintaining a cool environment prevents this pseudo-exacerbation during acute
treatment. While sleep is important, the specific rationale for cooling relates directly to
MS pathophysiology rather than general comfort.
Question 4 of 50
A 68-year-old client with Parkinson's disease reports increasing tremor and difficulty
initiating movement in the morning before taking medications. The client takes
carbidopa-levodopa four times daily and eats a high-protein breakfast.
A. Take the medication with breakfast so protein aids absorption
B. Take the medication 30 minutes before or 1 hour after meals ✓ CORRECT
C. Switch to a protein shake because liquids absorb faster
D. Increase the morning dose on days when tremor is worse
Correct Answer: B
Rationale: Dietary protein competes with levodopa for absorption across the blood-brain
barrier, so taking medication away from high-protein meals maximizes therapeutic
effectiveness. Protein shakes contain amino acids that cause the same competition,
and clients should never self-adjust dopaminergic medications because sudden
changes can cause dyskinesias or neuroleptic malignant syndrome.
Question 5 of 50
A 34-year-old client had a witnessed generalized tonic-clonic seizure lasting 4 minutes.
The seizure has stopped, and the client is drowsy with slow, irregular respirations.
Which nursing action is the priority?
, A. Insert an oropharyngeal airway to maintain the airway
B. Turn the client onto the side and suction the mouth as needed ✓ CORRECT
C. Restrain the client's arms to prevent injury during the post-ictal phase
D. Start oxygen at 4 L/min via nasal cannula and obtain a chest x-ray
Correct Answer: B
Rationale: Turning the client onto the side uses gravity to drain oral secretions and
prevents aspiration during the post-ictal phase when airway reflexes are depressed.
Oropharyngeal airways should not be forced into the mouth of a semiconscious client
because they can trigger vomiting or laryngospasm. Restraints cause injury and are
never used during seizures.
Question 6 of 50
A 22-year-old client sustained a T4 spinal cord injury in a diving accident. The client is
hypotensive at 82/48 mmHg, bradycardic at 46 bpm, and has warm, dry skin. Which
intervention should the nurse prepare?
A. Atropine 0.5 mg IV push for symptomatic bradycardia ✓ CORRECT
B. Epinephrine 1 mg IV push every 3 to 5 minutes
C. Trendelenburg position and high-flow oxygen
D. Norepinephrine infusion to maintain systolic pressure above 100 mmHg
Correct Answer: A
Rationale: Neurogenic shock from high thoracic cord injury causes unopposed vagal
tone and bradycardia, which often responds to atropine to increase heart rate and
improve cardiac output. Epinephrine is for cardiac arrest, Trendelenburg increases
venous pooling in paralyzed lower extremities, and norepinephrine may be used for
persistent hypotension but does not address the primary bradycardia.
Question 7 of 50
