Nclex Review Neurologic PDF

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Neurological NCLEX questions with answers...

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NCLEX Review – Neurologic

1. The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. Which is the best response by the nurse? A. “It is an infectious disease of the central nervous system.” B. “It is an inflammation of the brain resulting from a viral illness.” C. “It is a congenital condition that results in moderate to severe retardation.” D. “It is a chronic disability characterized by impaired muscle movement and posture.”

2. The nurse notes documentation that a child with meningitis is exhibiting a positive Kernig’s sign. Which observation is characteristic of this sign? A. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip. B. The child complains of muscle and joint pain. C. Petechial and purpuric rashes are noted on the child’s trunk. D. Neck flexion causes adduction and flexion movements of the lower extremities.

3. A mother arrives at an emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected, and the nurse checks the child’s airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP? A. B. C. D.

Nausea Irritability Bradycardia Headache

4. A child is diagnosed with Reye’s Syndrome. The nurse develops a nursing care plan for the child and should include which priority intervention in the plan? A. B. C. D.

Assessing hearing loss Providing a quiet atmosphere with dimmed lighting Changing body position every 6 hours Obtain daily weight

5. The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should take priority?

A. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics. B. Maintain enteric precautions. C. No precautions are needed as long as antibiotics have been started. D. Maintain neutropenic precautions.

6. The nurse is aware that cloudy cerebral spinal fluid (CSF) most likely indicates. A. B. C. D.

viral meningitis. bacterial meningitis. no infection since CSF is usually cloudy. sepsis.

7. Which activity should an adolescent just diagnosed with epilepsy avoid?

A. B. C. D.

Swimming, even with a friend. Participating in any strenuous activities. Driving a car at night. Returning to school right away.

8. A child with a ventriculoperitoneal (VP) shunt complains of headache and blurry vision and is now experiencing irritability and sleeping more than usual. The parents ask the nurse what they should do. Select the nurse’s best response. A. “Give her some acetaminophen and see if her symptoms improve. If they do not improve, bring her to the pediatrician’s office.” B. “You should immediately take her to the emergency room as these may be symptoms of a shunt malfunction.” C. “It is common for girls to have these symptoms, especially prior to beginning their menstrual period. Give her a few days and see if she improves.” D. “You are likely worried that she is having problems with her shunt. This is very unlikely as it has been working well for 9 years.”

9. A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. One oral anticonvulsant medication to observe for effectiveness and minimize side effects. B. Two or three oral anticonvulsant medications so dosing can be low and side effects minimized. C. One rectal anticonvulsant medication to be administered in the event of a seizure. D. A combination of oral and intravenous anticonvulsant medications to ensure compliance.

10. Which medication should the nurse anticipate administering first to a child is status epilepticus?

A. B. C. D.

Establish an intravenous line and administer IV lorazepam. Administer an oral glucose gel to the side of the child’s mouth. Administer oral diazepam. Administer rectal diazepam.

11. A child in PICU with a head injury is comatose and unresponsive. The parent asks if the child needs pain medication. Which is the best response by the nurse? A. “Pain medication is not necessary as he is unresponsive and cannot feel pain.” B. “Pain medication may interfere with his ability to respond and may mask any signs of improvement.” C. “Pain medication is necessary to make him comfortable.” D. “Pain medication is necessary for comfort, but we use it cautiously as it increases the demand for oxygen.”

12. The nurse knows that young infants are at risk for injury from shaken baby syndrome because: A. the anterior fontanel is open. B. they have insufficient musculoskeletal support and a disproportionate head-to-body ratio. C. they have an immature vascular system with veins and arteries that are more superficial. D. there is immature myelination of the nervous system in a young infant.

13. A 6-month-old infant was just diagnosed with craniosynostosis. The infant’s father asks the nurse for more information about reconstructive surgery. Which is the best response by the nurse? A. “”The surgery is done for cosmetic reasons and is without many complications.” B. “The surgery is mainly done for cosmetic reasons, and most surgeon wait until the child is 3 years old as the head has finished growing at that time.” C. “The surgery is important to allow the brain to grow properly. Although most children do well, serious complications can occur, so your child will be closely monitored in an intensive care unit.” D. “The surgery is important to allow the brain to grow properly. Most surgeons wait until the child is 3 years old to minimize potential complications.”

14. The nurse is caring for an infant with myelomeningocele. The parents ask the nurse why she measures the infant’s head every day. Which is the best response by the nurse? A. “Babies’ heads are measured to ensure growth is on track.” B. “Many infants with myelomeningocele have microcephaly, which can show up as a decrease in head size.” C. “Because your baby has an opening on the spinal cord, your infant is at risk for meningitis, which can show up as an increase in size.” D. “Babies with myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size.”

15. A child with cerebral palsy (CP) has been fitted for braces and is beginning physical therapy to assist with ambulation. The parents ask why he needs the braces when he was crawling without any assistive devices. Which is the best response by the nurse? A. “As your child grows, different muscle groups may need more assistance.” B. “The CP has progressed and he now needs more assistance to ambulate.” C. “Most children with CP need braces to help with ambulation.” D. “We have found that when children with CP use braces, they are less likely to fall.”

16. The parents of a child with CP are learning how to feed their child to avoid aspiration. The nurse should question which of the following when reviewing the teaching plan?

A. B. C. D.

“We will keep our child in an upright position while feeding.” “We will feed our child slowly.” “We will place the food on the tip of his tongue.” “We will feed our child soft and blended foods.”

17. Which should be included in the plan of care for a child who has a neuroblastoma with metastasis to the bone marrow and pancytopenia? A. B. C. D.

Administer red blood cells. Limit school attendance to less than 4 hours daily. Administer Coumadin. Encourage a diet high in fresh fruits and vegetables.

18. A child has been diagnosed with a midline brain tumor. In addition to showing signs of increased intracranial pressure (ICP), she has been voiding large amounts of very dilute urine. Which medication should the nurse anticipate administering? A. B. C. D.

Mannitol Vasopressin Lasix Dopamine

19. Which has the potential to alter a child’s level of consciousness? Select all that apply. A. B. C. D. E.

Metabolic disorders Trauma Hypoxic episode Dehydration Endocrine disorders

20. Which child is at increased risk for CP? A. Infant born at 34 weeks with an Apgar score of 6 at 5 minutes B. 17-day-old infant with group B streptococcus meningitis. C. 24-month-old child who has experienced a febrile seizure. D. 5-year-old with a closed head injury after falling off a bike....