NCLEX-PN
Neurological Disorders NCLEX Questions Questions
Extract:
Question 1 of 5
The client has had recurrent episodes of low back pain. Which statement indicates that the client has incorporated positive lifestyle changes to decrease the incidence of future back problems?
Correct Answer: A
Rationale: Stooping and avoiding bending and twisting motions when lifting objects lessen the likelihood of injury. The client should wear supportive shoes. The client should include regular daily exercise as a program (not excessive walking over 2 days on the weekend). Clients should avoid prolonged sitting or standing.
Question 2 of 5
Which problem is the highest priority for the client diagnosed with West Nile virus?
Correct Answer: A
Rationale: Fever (alteration in body temperature,
A) is a primary symptom of West Nile virus, requiring priority management to prevent complications. Perfusion (
B), fluid excess (
C), and skin integrity (
D) are less immediate.
Question 3 of 5
When the nursing team plans the care of a client with Guillain-Barré syndrome, which assessment finding most accurately determines whether the client is developing ineffective breathing?
Correct Answer: D
Rationale: A pulse oximetry reading of 82% indicates significant hypoxemia, suggesting ineffective breathing, which is a critical concern in Guillain-Barré syndrome due to potential respiratory muscle weakness.
Question 4 of 5
The nurse is caring for a client diagnosed with an epidural hematoma. Which nursing interventions should the nurse implement? Select all that apply.
Correct Answer: B,C
Rationale: Stool softeners (
B) prevent straining, which could increase ICP. Maintaining pulse oximetry >93% (
C) ensures adequate oxygenation. High HOB elevation (
A) may reduce cerebral perfusion, deep suction (
D) risks increasing ICP, and sedatives (E) may mask neurological changes.
Question 5 of 5
The nurse is caring for the client with a leaking cerebral aneurysm. What is the earliest sign that would indicate to the nurse that increased ICP may be developing?
Correct Answer: D
Rationale: Pupillary changes may occur with ICP as it progresses, but they are not an early sign of developing ICP. A drop in BP is not directly associated with neurological deterioration. A BP with a wide pulse pressure is a late sign of increased ICP. Diminished sensation may occur with increased ICP, but it is not the earliest sign. A change in the level of consciousness is the first sign of neurological deterioration and is often associated with the development of increased ICP.