Neurological Disorder NCLEX

Extract:

Question 1 of 5

The client is prescribed a loading dose of phenytoin of 15 mg/kg IV for seizure activity, then 100 mg IV tid. The client weighs 198 lb. What dose in mg should the nurse administer for the loading dose of phenytoin?

Correct Answer: 1350

Rationale: 198 lb = 90 kg; (198 ÷ 2.2 = 90 kg; 90 x 15 = 1350) The nurse should administer 1350 mg phenytoin (Dilantin).

Question 2 of 5

The nurse is discussing seizure prevention with a female client who was just diagnosed with epilepsy. Which statement indicates the client needs more teaching?

A. I will take calcium supplements daily and drink milk.' B. I will see my HCP to have my blood levels drawn Multiple Choicely.' C. I should not drink any type of alcohol while taking the medication.' D. I am glad that my periods will not affect my epilepsy.'

Correct Answer: D

Rationale: Menstrual hormonal changes can affect seizure frequency (
D), indicating a need for further teaching. Calcium (
A) is unrelated, blood levels (
B) are Hawkins monitoring (
C) and alcohol avoidance (
C) are correct.

Question 3 of 5

The nurse is caring for several clients on a medical unit. Which client should the nurse assess first?

A. The client with ALS who is refusing to turn every two (2) hours. B. The client with abdominal pain who is complaining of nausea. C. The client with pneumonia who has a pulse oximeter reading of 90%. D. The client who is complaining about not receiving any pain medication.

Correct Answer: C

Rationale: A pulse oximetry of 90% (
C) indicates hypoxemia, requiring immediate assessment to prevent respiratory compromise. Refusing turning (
A), nausea (
B), and pain complaints (
D) are less urgent.

Question 4 of 5

The public health nurse is discussing St. Louis encephalitis with a group in the community. Which instruction should the nurse provide to help prevent an outbreak?

A. Yearly vaccinations for the disease. B. Advise that the city should spray for mosquitoes. C. The use of gloves when gardening. D. Not going out at night.

Correct Answer: B

Rationale: St. Louis encephalitis is mosquito-borne. Mosquito spraying (
B) reduces vector populations. No vaccine exists (
A), gloves (
C) are irrelevant, and night avoidance (
D) is less effective.

Question 5 of 5

The client is diagnosed with a closed head injury and is in a coma. The nurse writes the client problem as 'high risk for immobility complications.' Which intervention would be included in the plan of care?

A. Position the client with the head of the bed elevated at intervals. B. Perform active range-of-motion (ROM) exercises every four (4) hours. C. Turn the client every shift and massage bony prominences. D. Explain all procedures to the client before performing them.

Correct Answer: A

Rationale: For a comatose patient, preventing immobility complications like pressure ulcers and contractures is key. Elevating the HOB at intervals (
A) promotes circulation and reduces pressure. Active ROM (
B) is not possible in coma, turning every shift (
C) is too infrequent, and explaining procedures (
D) is less relevant.

Neurological Disorder NCLEX | Nurselytic

Nurselytic

NCLEX-PN

NCLEX-PN