ATI LPN
Neurological Assessment NCLEX Questions Questions
Question 1 of 5
A patient with a left-brain stroke suddenly bursts into tears when family members visit. The nurse should
Correct Answer: D
Rationale: Patients who have left-sided brain stroke are prone to emotional outbursts that are not necessarily related to the emotional state of the patient. Depression after a stroke is common, but the suddenness of the patient's outburst suggests that depression is not the major cause of the behavior. The family should stay with the patient. The crying is not within the patient's control, and asking the patient to stop will lead to embarrassment.
Question 2 of 5
A 68-year-old male is brought to the emergency department by his wife. She reports that her husband has been unable to speak or move the right side of his body. She states that his symptoms occurred suddenly, while they were discussing vacation plans. He suddenly fell to the right, was unable to speak or follow commands, or move his right arm or leg. Past medical history is significant for hypertension and atrial fibrillation. He has smoked 1 pack of cigarettes daily for the past 40 years. His temperature is 100.4 deg F (38 deg C), blood pressure 186/108 mmHg, pulse is 109/min and irregularly irregular, and respirations are 17/min. On exam, he has a left-gaze preference, with marked weakness and sensory loss of the right side. EKG reveals atrial fibrillation. D-dimer level is 320 ng/mL (normal ≤ 250 ng/mL). Head imaging shows an occlusion of the proximal left middle cerebral artery. Which of the following is most likely the cause of this patient's clinical presentation?
Correct Answer: A
Rationale: Sudden aphasia and right-sided weakness with atrial fibrillation and MCA occlusion suggest cardioembolic stroke from an atrial thrombus. Thrombosis is gradual, aneurysm rupture causes hemorrhage, and hypoperfusion lacks focal deficits.
Question 3 of 5
A 27-year-old woman is brought to the emergency department by her co-workers after falling to the ground, followed by full-body shaking and jerking lasting less than 30 seconds. The event occurred after she received the news of the death of her grandmother. Just before falling, she felt lightheaded and nauseous. Her co-workers state she fell suddenly, her eyes rolled back, she had some groaning, and it looked like she had a 'grand mal seizure' for 10-15 seconds. Shortly after the jerking stopped, she regained consciousness and got up from the ground within a minute or so. She was fully awake afterward. She had some mild urinary incontinence. On physical examination, the patient appears anxious. Heart auscultation reveals normal S1 and S2 without murmurs, rubs, or gallops. there is no evidence of a tongue bite. Which of the following is the best next step in management?
Correct Answer: A
Rationale: Brief shaking after emotional stress with prodrome (lightheadedness, nausea) and rapid recovery suggests syncope, possibly vasovagal or cardiac. A 12-lead ECG is critical to rule out arrhythmia (e.g., long QT). Seizures typically last longer and have postictal confusion.
Question 4 of 5
A 34-year-old woman is brought to the emergency department by her husband due to worsening lower extremity weakness. Her symptoms began approximately one week prior to presentation, when she experienced mild weakness of the left leg, causing her to limp. The lower extremity weakness progressed to the point of not being able to get out of bed. The patient also reports a period of left arm weakness and numbness eight months ago that spontaneously resolved over the course of a few days. Approximately two weeks ago, she experienced an upper respiratory infection that has resolved. Her temperature is 98.6°F (37°C), pulse is 74/min, respiratory rate 18/min, blood pressure 129/75 mm Hg. Neurological exam is significant for 1/5 strength in both lower extremities and 3+ patellar tendon reflexes. A magnetic resonance imaging (MRI) of the brain and spine is performed. Which of the following is the best initial treatment?
Correct Answer: D
Rationale: Progressive weakness with prior resolved episode and hyperreflexia suggest an MS relapse. IV methylprednisolone is the initial treatment for acute exacerbations to reduce inflammation.
Question 5 of 5
The tiny space between neurons or a neuron and its target muscle is the:
Correct Answer: D
Rationale: The synapse is the small gap between neurons or between a neuron and a target cell (e.g., muscle), where signal transmission occurs.