NCLEX Neurological Questions (1-5)
Welcome to NCLEX Neurological Questions. Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
1. The nurse is caring for a client with a herniated lumbar intervertebral disk. The nurse plans to place the client in which position to minimize the pain?
a) flat with the knees raised
b) high fowler’s position with the foot of the bed flat
c) semi-fowler’s position with the foot of the bed flat
d) semi-fowler’s position with the knees slightly raised
2. A client with myasthenia gravis is experiencing prolonged periods of weakness, and the physician orders an edrophonium (Tensilon) test. A test dose is administered and the client becomes weaker. The nurse interprets this test result as:
c) myasthenic crisis
d) cholinergic crisis
3. A nursing instructor has taught a student about the protective structures of the brain and asks the student to identify the membranes that surround the brain and spinal cord. The student responds correctly by stating that these are the:
b) basal ganglia
c) gray matter areas
d) corticospinal tract
4. A client with trigeminal neuralgia (tic doulureux) asks the nurse for a snack and something to drink. Which of the following selections should the nurse provide for the client?
a) hot cocoa with honey and toast
b) vanilla wafers and lukewarm milk
c) hot herbal tea with graham crackers
d) iced coffee and peanut butter and crackers
5. A nurse is assessing a client with a brainstem injury. In addition to performing the Glascow Coma Scale, the nurse plans to:
a) perform arterial blood gases
b) assist with a lumbar puncture
c) perform a pulmonary wedge pressure
d) check cranial nerve functioning and respiratory rate and rhythm
NCLEX Neurological Questions
Answers and Rationale
- Clients with low back pain are often more comfortable in the semi-Fowler’s position with the knees raised sufficiently to flex the knees (William’s position). This relaxes the muscles of the lower back and relieves pressure on the spinal nerve root. Keeping the foot of the bed flat will enhance extension of the spine. Keeping the bed flat with the knees raised would excessively stretch the lower back and put the client at risk for thrombophlebitis.
- A Tensilon test may be performed to determine whether increasing weakness in a previously diagnosed myasthenic client is a result of cholinergic crisis (overmedication with anticholinesterase drugs) or myasthenic crisis (undermedication with cholinesterase inhibitors). Worsening of the symptoms after the test dose of medication is administered indicates a cholinergic crisis.
- The meninges, three membranes that surround the brain and spinal cord, are predominantly for protection. Each layer (pia mater, arachnoid, and dura mater) is a separate membrane. The basal ganglia consist of subcortical gray matter buried deep in the cerebral hemispheres. The basal ganglia, along with the corticospinal tract, is important in controlling complex motor activity.
- Because mild tactile stimulation of the face of clients with trigeminal neuralgia can trigger pain, the client needs to eat or drink lukewarm, nutritious foods that are soft and easy to chew. Extremes of temperature will cause trigeminal pain.
- Assessment should be specific to the area of the brain involved. Assessing the respiratory status and cranial nerve function is a critical component of the assessment process in a client with a brainstem injury. Options A, B, and C are not necessary, based on the data in the question.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions: