NCLEX-PN
NCLEX Neurological Disorders Questions
Extract:
Question 1 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.
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.
Question 2 of 5
Which intervention should the nurse implement when caring for the client diagnosed with encephalitis? Select all that apply.
Correct Answer: A,D,E
Rationale: Turning every 2 hours (
A) prevents pressure ulcers, assessing DVT (
D) addresses immobility risks, and monitoring elimination (E) ensures bowel/bladder function. Increased fluids (
B) depend on status, and supine positioning (
C) may increase ICP.
Question 3 of 5
The nurse is developing a plan of care for a client diagnosed with West Nile virus. Which intervention should the nurse include in this plan?
Correct Answer: A
Rationale: Severe West Nile virus can cause neurological and respiratory complications, so monitoring respirations (
A) is critical. Rash (
B) is self-limiting, hypothermia (
C) is not typical, and lymph glands (
D) are not a primary concern.
Question 4 of 5
The male client is admitted to the emergency department following a motorcycle accident. The client was not wearing a helmet and struck his head on the pavement. The nurse identifies the concept as impaired intracranial regulation. Which interventions should the emergency department nurse implement in the first five (5) minutes? Select all that apply.
Correct Answer: A,D,E
Rationale: Stabilizing the cervical spine (
A) prevents spinal injury, Glasgow Coma Scale (
D) assesses neurological status, and IV access (E) prepares for interventions. Organ procurement (
B) is premature, high HOB (
C) risks perfusion, and checking for blood acceptance (F) is secondary.
Question 5 of 5
The concept of intracranial regulation is identified for a client diagnosed with a brain tumor. Which intervention should the nurse include in the client’s plan of care?
Correct Answer: D
Rationale: Brain tumors increase seizure risk, so seizure precautions (
D) are essential. Bedrest (
A) is unnecessary unless indicated, IV rate (
B) depends on status, and diet (
C) is not specific to intracranial regulation.