NCLEX-PN
Neurological Disorder NCLEX Questions
Extract:
Question 1 of 4
The client, who had a stroke, follows the nurse’s instructions without problems, but an attempt to verbally respond to the nurse’s question was garbled. The nurse should identify that the client has which type of aphasia?
Correct Answer: C
Rationale: With receptive aphasia (Wernicke’s aphasia or fluent aphasia) the client would hear the voice but would be unable to comprehend the meaning of the message. Global aphasia is a combination of receptive and expressive aphasia. The client would have difficulty speaking and understanding words and would not be able to read or write. The nurse should identify that the client has expressive aphasia (Broca’s aphasia or non-fluent aphasia). The client is able to comprehend and responds appropriately. The client may attempt to speak but has difficulty communicating with the correct words. With anomic aphasia, the client would have word-finding difficulties; this client does not verbalize.
Question 2 of 4
The client, diagnosed with an ischemic stroke, is being evaluated for thrombolytic therapy. Which assessment finding should prompt the nurse to withhold thrombolytic therapy?
Correct Answer: B
Rationale: A negative CT scan is a criterion for administering the thrombolytic therapy. Contraindications to thrombolytic therapy for the client with an ischemic stroke include a serious head injury within the previous 3 months. This would put the client at risk of developing serious bleeding problems, specifically cerebral hemorrhage. History of type 1 DM is not a contraindication for thrombolytic therapy. The onset of neurological deficits within 3 hours is a criterion for administering thrombolytic therapy.
Question 3 of 4
The client has right homonymous hemianopia following an ischemic stroke. The nurse asks the NA to help the client with meals knowing that this problem may result in which client response?
Correct Answer: B
Rationale: Tendency to fall to the contralateral side would be a concern if the client were weak or paralyzed. Homonymous hemianopia (hemianopsia) is a visual field abnormality that results in blindness in half of the visual field in the same side of both eyes. It results from damage to the optic tract or occipital lobe. Using the silverware inappropriately is a concern if the client has agnosia. Choking when swallowing any liquids is a concern if the client has dysphagia.
Question 4 of 4
The client, undergoing testing for a possible brain tumor, asks the nurse about treatment options. The nurse’s response should be based on knowing that treatment of a brain tumor depends on which factors? Select all that apply.
Correct Answer: A,B,C,D
Rationale: Surgery, radiation therapy, and/or chemotherapy may be used to treat a slowly or rapidly growing tumor. Surgery, radiation therapy, and/or chemotherapy may be used to treat a benign or malignant tumor. Surgery, radiation therapy, and/or chemotherapy may be used to treat tumors of different cell types. The tumor’s location in the brain may affect whether surgery is an option or whether the surgical approach with radiation therapy and/or chemotherapy is used to treat the tumor. Comorbid conditions, not age, may be determining factors in treatment options. The type of insurance is irrelevant to treatment unless treatment is experimental.
Question 5 of 4
The client with muscle weakness asks the nurse during the initial assessment if the symptoms suggest 'Lou Gehrig’s' disease. Which is the nurse’s most appropriate response?
Correct Answer: B
Rationale: There is no information that the client is working too much. Telling the client to avoid thinking the worst belittles the client’s concern. This is the most appropriate response because it focuses on the client’s concern, encourages verbalization, and solicits more information. ALS (Lou Gehrig’s disease) is a degenerative disease that affects the motor system and does not have a dementia component; thus, a question about memory is inappropriate. This response does not take the client seriously and does not address the client’s concern.