A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?

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NCLEX Questions on Neurological System Questions

Question 1 of 5

A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?

Correct Answer: B

Rationale: Bell's palsy is a condition characterized by sudden, unilateral facial paralysis due to inflammation or compression of the facial nerve (CN VII). It often follows a viral infection and presents with drooping of the face, inability to close the eye, and flattening of the nasolabial fold. A cortical stroke typically spares the forehead, and Horner's syndrome involves ptosis and miosis.

Question 2 of 5

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons?

Correct Answer: C

Rationale: Mannitol is an osmotic diuretic that draws fluid from the brain tissue into the vascular system, reducing intracranial pressure (ICP). This is critical in cases of subdural hematoma, where increased ICP can lead to brain herniation and further neurological damage. The drug works by creating an osmotic gradient, pulling water from the extracellular space of the brain into the bloodstream, which is then excreted by the kidneys. This mechanism helps alleviate symptoms like restlessness, confusion, and pupil dilation caused by increased ICP.

Question 3 of 5

The nurse is caring for a client with ICP. Why will the nurse position the client in bed with HOB elevated to 30 degrees?

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

The nurse notes that a patient is not able to voluntarily move the right arm. Which part of the brain should the nurse suspect is affected in this patient?

Correct Answer: B

Rationale: The frontal lobes contain the motor areas that generate the impulses that bring about voluntary movement. Each motor area controls movement on the opposite side of the body. The cerebellum is responsible for coordination and balance, while the parietal lobe processes sensory information. The hypothalamus regulates autonomic functions and is not directly involved in voluntary movement.

Question 5 of 5

The nurse is caring for a patient diagnosed with a cerebral tumor. For which function should the nurse expect to assess an abnormality?

Correct Answer: B

Rationale: A cerebral tumor in the frontal lobe may affect movement and speech, as this area contains the motor cortex and Broca's area. Reflex movements are controlled by the spinal cord, coordination by the cerebellum, and heart rate by the medulla. Assessing movement and speech is critical for localizing the tumor's effects.

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