ATI LPN
Neurological Assessment NCLEX Questions Questions
Question 1 of 5
When a person turns the head to the left about the axis of the neck, the motion begins when the chin is directly over the right shoulder and ends with the chin directly over the left shoulder. Which option best describes the eye movements associated with this type of head rotation in a normal person?
Correct Answer: A
Rationale: Eyes move right to fixate during left head turn, with leftward saccades to refixate. TMP13 pp. 667-668
Question 2 of 5
During the change of shift report, a nurse is told that a patient has an occluded left posterior cerebral artery. The nurse will anticipate that the patient may have
Correct Answer: C
Rationale: Visual disturbances are expected with posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and changes in judgment are more typical of anterior cerebral artery occlusion.
Question 3 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 4 of 5
What is the correct term for the loss of a visual field?
Correct Answer: D
Rationale: Hemianopsia is the loss of half the visual field, often due to stroke affecting the optic tract or cortex. Hemiplegia is paralysis, hemiparesis is weakness, and homonymous describes identical field loss in both eyes but isn’t the full term.
Question 5 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.