Neurological Disorder NCLEX

Extract:

Question 1 of 5

The client with a C6 SCI is admitted to the emergency department complaining of a severe pounding headache and has a BP of 180/110. Which intervention should the emergency department nurse implement?

Correct Answer: C

Rationale: Severe headache and hypertension in C6 SCI suggest autonomic dysreflexia, often triggered by bladder distention (
C). Assessing and relieving the trigger is the priority. Flat positioning (
A) may worsen symptoms, dimming lights (
B) is not effective, and narcotics (
D) do not address the cause.

Question 2 of 5

The client is scheduled for an electroencephalogram (EEG) to help diagnose a seizure disorder. Which preprocedure teaching should the nurse implement?

A. Tell the client to take any routine antiseizure medication prior to the EEG. B. Tell the client not to eat anything for eight (8) hours prior to the procedure. C. Instruct the client to stay awake for 24 hours prior to the EEG. D. Explain to the client that there will be some discomfort during the procedure.

Correct Answer: A

Rationale: Taking routine antiseizure medications (
A) ensures therapeutic levels during the EEG, avoiding seizures that could skew results. Fasting (
B) is unnecessary, sleep deprivation (
C) may be used in specific cases but not routinely, and EEGs are painless (
D).

Question 3 of 5

The client with a C6 SCI is admitted to the emergency department complaining of a severe pounding headache and has a BP of 180/110. Which intervention should the emergency department nurse implement?

A. Keep the client flat in bed. B. Dim the lights in the room. C. Assess for bladder distention. D. Administer a narcotic analgesic.

Correct Answer: C

Rationale: Severe headache and hypertension in C6 SCI suggest autonomic dysreflexia, often triggered by bladder distention (
C). Assessing and relieving the trigger is the priority. Flat positioning (
A) may worsen symptoms, dimming lights (
B) is not effective, and narcotics (
D) do not address the cause.

Question 4 of 5

The client diagnosed with delirium tremens when trying to quit drinking cold turkey is admitted to the medical unit. Which medications would the nurse anticipate administering?

A. Thiamine (vitamin B6) and librium, a benzodiazepine. B. Dilantin, an anticonvulsant, and Feosol, an iron preparation. C. Methadone, a synthetic narcotic, and Depakote, a mood stabilizer. D. Mannitol, an osmotic diuretic, and Ritalin, a stimulant.

Correct Answer: A

Rationale: Delirium tremens requires thiamine (vitamin B1, not B6) to prevent Wernicke’s encephalopathy and benzodiazepines like Librium (
A) to manage withdrawal symptoms. Other options are unrelated to delirium tremens management.

Question 5 of 5

The 28-year-old client is on the rehabilitation unit post spinal cord injury at level T10. Which collaborative team members should participate with the nurse at the case conference? Select all that apply.

A. Occupational Therapist (OT). B. Physical therapist (PT). C. Registered dietitian (RD). D. Rehabilitation physician. E. Social Worker (SW). F. Patient care tech (PCT).

Correct Answer: A,B,D,E

Rationale: OT (
A) and PT (
B) address functional and mobility needs, the physician (
D) oversees medical care, and the social worker (E) coordinates resources. Dietitian (
C) and PCT (F) are less critical for case conferences.

Neurological Disorder NCLEX | Nurselytic

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NCLEX-PN

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