ATI LPN
Medical Surgical Neurology Questions
Question 1 of 5
The nurse is caring for a patient who has been experiencing stroke symptoms for 60 minutes. Which action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
Correct Answer: C
Rationale: Administration of subcutaneous medications is included in LPN/LVN education and scope of practice. The other actions require more education and scope of practice and should be done by the registered nurse (RN).
Question 2 of 5
A 65-year-old female is brought to the emergency department by her husband due to abnormal speech. She does not appear to be aware of her deficit. She was last normal 2 hours ago. Past medical history is significant for hypertension, coronary artery disease, and hypercholesterolemia. On exam, her blood pressure is 181/94, her speech is fluent, but empty, with paraphasic errors. Comprehension and repetition is impaired. There appears to be a visual deficit in the right upper quadrant. Non-contrast head CT is shown. Which of the following is the best next step in management?
Correct Answer: C
Rationale: Wernicke’s aphasia and right visual field deficit within 2 hours suggest ischemic stroke. If CT (assumed negative for bleed) confirms no hemorrhage, tPA is the best step within the 4.5-hour window to restore perfusion. Thrombectomy is for large vessel occlusion, labetalol manages BP post-tPA.
Question 3 of 5
A 42-year-old man presents with generalized tonic-clonic convulsions on day 2 of his hospitalization for the management of acute pancreatitis. Prior to the convulsive event, the patient felt anxious, tremulous, and agitated. Medical history is significant for alcohol-use disorder, with multiple hospitalizations for alcohol intoxication and acute pancreatitis. On physical examination, the patient is diaphoretic and convulsing. There is no evidence of stigmata of liver disease. The patient does not appear malnourished. Appropriate laboratory tests are obtained. Which of the following is the best initial treatment?
Correct Answer: D
Rationale: Seizures on day 2 of hospitalization in an alcohol-use disorder patient suggest alcohol withdrawal. Chlordiazepoxide (a benzodiazepine) is the initial treatment to manage withdrawal and prevent further seizures.
Question 4 of 5
An 8-year-old boy presents to the Emergency Department with altered mental status and weakness. The mother reports that her son had a fever and complained of a headache two days prior to presentation, along with upper extremity weakness. Earlier in the day, his headache worsened, he had vomiting, and appeared confused. The mother states that approximately one week ago, he had a viral illness but appeared to have fully recovered. Beyond this, he is neurologically normal at baseline. While performing the physical exam, he has a generalized tonic-clonic seizure, requiring benzodiazepine administration. Vital signs show that he is afebrile with a normal blood pressure. On physical exam, the patient has mild nuchal rigidity, a right relative afferent pupillary defect, right and left-sided weakness, and a bilateral Babinski reflex. Magnetic resonance imaging (MRI) showed diffuse white matter lesions. Which of the following is most likely the diagnosis?
Correct Answer: B
Rationale: Post-viral illness with acute encephalopathy, weakness, seizure, and diffuse white matter lesions in a child suggest ADEM, an immune-mediated demyelinating disorder.
Question 5 of 5
The Central Nervous System is made up of the:
Correct Answer: A
Rationale: The central nervous system (CNS) consists solely of the brain and spinal cord, which process and coordinate information.