NCLEX Neurological Disorders

Extract:

Question 1 of 5

The client with PD has a new surgically implanted DBS. After the stimulator is operational, which criterion should the nurse use to evaluate that the DBS is effective?

Correct Answer: B

Rationale: Cogwheel rigidity, a symptom of PD, is interrupted muscular movement and is not treated with the DBS. DBS is a treatment used for intractable tremors associated with PD. The electrical current interferes with the brain cells initiating the tremors. Severe facial pain is associated with trigeminal neuralgia, not PD rau. The DBS will not affect facial expression. Auras are unusual sensations experienced before a seizure occurs and are not associated with PD.

Question 2 of 5

Which response by the nurse would be best to prevent distress when the client repeatedly asks, 'Where is my mother?'

A. Explain to the client, 'Your mother died several years ago.' B. Tell the client, 'Your mother will visit later.' C. State, 'You miss your mother. What was she like?' D. Ask the client, 'When did you last see your mother?'

Correct Answer: C

Rationale: Redirecting the conversation to memories of the mother validates the client's feelings without causing distress from confronting reality.

Question 3 of 5

The client has undergone a craniotomy for a brain tumor. Which data indicate a complication of this surgery?

A. The client complains of a headache at '3' to '4' on a 1-to-10 scale. B. The client has an intake of 1,000 mL and an output of 3,500 mL. C. The client complains of a raspy, sore throat. D. The client experiences dizziness when trying to get up too quickly.

Correct Answer: B

Rationale: Significant output (3,500 mL) compared to intake (1,000 mL,
B) suggests diabetes insipidus, a complication of craniotomy due to pituitary dysfunction. Mild headache (
A), sore throat (
C), and orthostatic dizziness (
D) are less concerning.

Question 4 of 5

Which nursing actions are essential when finding a client experiencing a tonic-clonic seizure? Select all that apply.

A. Calling out the client's name B. Padding the client's body during the seizure activity C. Placing an emesis basin close to the client's mouth D. Rolling the client's body to the side E. Removing environmental hazards to protect the client F. Calling the respiratory therapy department

Correct Answer: D,E

Rationale: Rolling the client to the side prevents aspiration, and removing environmental hazards minimizes injury risk during a tonic-clonic seizure.

Question 5 of 5

Spinal precautions are ordered for the client who sustained a neck injury during an MVA. The client has yet to be cleared that there is no cervical fracture. Which action is the nurse’s priority when receiving the client in the ED?

A. Assessing the client using the Glasgow Coma Scale (GCS) B. Assessing the level of sensation in the client’s extremities C. Checking that the cervical collar was correctly placed by EMS D. Applying antiembolism hose to the client’s lower extremities

Correct Answer: C

Rationale: The nurse should determine the neurological status using the GCS, but this is not the priority. The nurse should assess sensation status at intervals to determine neurological injury progression, but this is not the priority. Maintaining the correct placement of the cervical collar will keep the client’s head and neck in a neutral position and prevent further injury if a spinal fracture or SCI is present. Because ensuring that the cervical collar is correctly placed will prevent further injury, it is priority. Applying antiembolism hose is an intervention to prevent thromboembolic complications, but this is not the priority.

NCLEX Neurological Disorders | Nurselytic

Nurselytic

NCLEX-PN

NCLEX-PN