NCLEX Neurological Questions (6-10)
Welcome to NCLEX Neurological Questions. Enjoy answering and I hope that Nurse Certifications can somehow help you in your future examination.
6. An adult client has undergone a lumbar puncture to obtain cerebrospinal fluid (CSF) for analysis. The nurse assesses for which of the following values that should be negative if the CSF is normal?
c) red blood cells
d) white blood cells
7. A nurse caring for a client with a neurological disorder is planning care to maintain nutritional status. The nurse is concerned about the client’s swallowing ability. Which of the following food items would the nurse plan to avoid in this client’s diet?
c) scrambled eggs
d) mashed potatoes
8. A nurse is caring for a client following a supratentorial craniotomy. The nurse places a sign above the client’s bed stating that the client should be maintained in which of the following positions?
d) dorsal recumbent
9. A nurse is performing a physical assessment on a client and is testing the client’s reflexes. What action would the nurse take to assess the pharyngeal reflex?
a) ask the client to swallow
b) pull down on the lower eyelid
c) shine a light toward the bridge of the nose
d) stimulate the back of the throat with a tongue depressor
10. The nurse performs a neurovascular assessment on a client with a newly applied cast. Close observation and further evaluation would be required if the nurse notes which of the following?
a) palpable pulses distal to the cast
b) capillary refill less than 6 seconds
c) blanching of the nail bed when it is depressed
d) sensation when the area distal to the cast is pinched
NCLEX Neurological Questions
Answers and Rationale
- The adult with normal CSF has no red blood cells in the CSF. The client may have small levels of white blood cells (0 to 8 cells/mm3). Protein (15 to 45 mg/dL) and glucose (45 to 74 mg/dL) are normally present in CSF.
- In general, flavorful, warm, or well-chilled foods with texture stimulate the swallowing reflex. Soft and semisoft foods, such as custards or puddings, egg dishes, and potatoes, are usually effective. Raw vegetables, chunky vegetables, such as diced beets, and stringy vegetables, such as spinach, corn, and peas, are foods commonly excluded from the diet of a client with a poor swallowing reflex.
- Following supratentorial surgery (surgery above the brain’s tentorium), the client’s head is usually elevated 30 degrees to promote venous outflow through the jugular veins and modulate intracranial pressure (ICP). Options A, B and D are incorrect positions following this surgery because they are likely to increase ICP.
- The pharyngeal (gag) reflex is tested by touching the back of the throat with an object, such as a tongue depressor. A positive response to this reflex is considered normal. The corneal light reflex is tested by shining a penlight toward the bridge of the nose at a distance of 12 to 15 inches (light reflection should be symmetrical in both corneas). Asking the client to swallow assesses the swallowing reflex. To assess the palpebral conjunctiva, the nurse would pull down and evert the lower eyelid.
- To assess for adequate circulation, the nail bed of each finger or toe is depressed until it blanches, and then the pressure is released. Optimally, the color will change from white to pink rapidly (less than 3 seconds). If this does not occur, the toes or fingers will require close observation and further evaluation. Palpable pulses and sensations distal to the cast are expected. However, if pulses could not be palpated or if the client complained of numbness or tingling, the physician should be notified.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
or you can go back and start from the beginning: