NCLEX-PN
NCLEX Neurological Disorders Questions
Extract:
Question 1 of 5
The client is admitted to the medical floor with a diagnosis of closed head injury. Which nursing intervention has priority?
Correct Answer: D
Rationale: Airway maintenance (
D) is the highest priority in any critically ill patient, including those with head injuries, to ensure oxygenation. Neurological assessment (
A), vital signs (
B), and IV access (
C) follow after securing the airway.
Question 2 of 5
Which intervention is most appropriate for a client diagnosed with Bell's palsy?
Correct Answer: B
Rationale: Drinking from a straw helps clients with Bell's palsy manage liquids, compensating for facial muscle weakness.
Question 3 of 5
The home health nurse evaluates the foot care of the dark-skinned African client who has peripheral neuropathy. Which client actions in providing foot care are appropriate? Select all that apply.
Correct Answer: A,B,D
Rationale: Using a mirror allows for visual inspection of the bottom of the feet and between the toes for areas of skin breakdown. Keeping the skin adequately lubricated with lotion prevents drying and cracking. Lotion should not be applied between the toes because it increases moisture and the risk for infection. Clients should avoid going barefoot because this increases the risk for foot injury. Wearing appropriate clothing protects the skin from injury because sensation is diminished with peripheral neuropathy.
Toenails should be trimmed straight across to avoid damaging the tissue, which is slow to heal in the presence of peripheral neuropathy. In a dark-skinned client, areas of inflammation may appear purplish-blue or violet rather than appearing reddened (erythematous).
Question 4 of 5
Which clinical manifestation is the educator most likely to include as the initial sign of Parkinson's disease?
Correct Answer: B
Rationale: Muscle tremors, particularly resting tremors, are often the initial sign of Parkinson's disease.
Question 5 of 5
The male client is admitted to the emergency department following a motorcycle accident. The client was not wearing a helmet and struck his head on the pavement. The nurse identifies the concept as impaired intracranial regulation. Which interventions should the emergency department nurse implement in the first five (5) minutes? Select all that apply.
Correct Answer: A,D,E
Rationale: Stabilizing the cervical spine (
A) prevents spinal injury, Glasgow Coma Scale (
D) assesses neurological status, and IV access (E) prepares for interventions. Organ procurement (
B) is premature, high HOB (
C) risks perfusion, and checking for blood acceptance (F) is secondary.