NCLEX Neurological Disorders

Extract:

Question 1 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 2 of 5

The nurse is preparing the male client for an electroencephalogram (EEG). Which intervention should the nurse implement?

A. Explain that this procedure is not painful. B. Premedicate the client with a benzodiazepine drug. C. Instruct the client to shave all facial hair. D. Tell the client it will cause him to see 'floaters.'

Correct Answer: A

Rationale: Explaining that the EEG is painless (
A) reduces anxiety. Benzodiazepines (
B) are not routine, shaving (
C) is unnecessary, and floaters (
D) are not associated.

Question 3 of 5

Which intervention is most appropriate for a client diagnosed with Bell's palsy?

A. Reduce the amount of light in the room. B. Advise the client to drink liquids from a straw. C. Inspect the buccal pouch for food after eating. D. Instruct the client on how to walk with a cane.

Correct Answer: B

Rationale: Drinking from a straw helps clients with Bell's palsy manage liquids, compensating for facial muscle weakness.

Question 4 of 5

When planning care for a client with a stroke, which goal is most appropriate for addressing dysphagia?

A. The client will swallow soft foods without choking. B. The client will eat three full meals daily. C. The client will gain 2 pounds in one week. D. The client will verbalize hunger before meals.

Correct Answer: A

Rationale: Swallowing soft foods without choking is a realistic and safe goal for managing dysphagia in stroke clients.

Question 5 of 5

The nurse is admitting the client for rule-out encephalitis. Which interventions should the nurse assess to support the diagnosis of encephalitis? Select all that apply.

A. Determine if the client has recently received any immunizations. B. Ask the client if he or she has had a cold in the last week. C. Check to see if the client has active herpes simplex 1. D. Find out if the client has traveled to the Great Lakes region. E. Assess for exposure to soil with fungal spores.

Correct Answer: C

Rationale: Encephalitis is often viral, with herpes simplex virus (HSV-1,
C) a common cause, supporting the diagnosis. Recent immunizations (
A), colds (
B), travel (
D), and fungal exposure (E) are less directly linked to encephalitis.

NCLEX Neurological Disorders | Nurselytic

Nurselytic

NCLEX-PN

NCLEX-PN