PRACTICE TEST QUESTIONS (NEUROLOGIC DISORDER)

Instructions: Read and understand the questions. Choose the best answer
and provide your rationale for each answer.
1. A 68-year-old male patient who had a left-sided stroke is admitted
to the hospital. The patient has right-sided weakness and is unable
to perform activities of daily living without assistance. The nurse is
providing oral hygiene to the patient and is preparing to use a
padded tongue blade to open the patient’s mouth. Which nursing
measure is inappropriate when providing oral hygiene to a patient
who had a stroke?
A. Placing the client on the back with a small pillow under the head.
B. Keeping portable suctioning equipment at the bedside.
C. Opening the client’s mouth with a padded tongue blade.
D. Cleaning the client’s mouth and teeth with a toothbrush.
A helpless client should be positioned on the side, not on the back. This
lateral position helps secretions escape from the throat and mouth,
minimizing the risk of aspiration. It may be necessary to suction, so
having suction equipment at the bedside is necessary. Padded tongue
blades are safe to use. A toothbrush is appropriate to use.
2. A 64-year-old client with a history of hypertension is admitted to
the emergency department with sudden onset right-sided weakness,
facial droop, and difficulty speaking. Which nursing intervention is
the highest priority in the initial management of this client?
A. Prepare to administer recombinant tissue plasminogen activator (rt-
PA).
B. Discuss the precipitating factors that caused the symptoms.
C. Schedule for A STAT computer tomography (CT) scan of the head.
D. Notify the speech pathologist for an emergency consultation.
3. A client arrives in the emergency department with an ischemic
stroke and receives tissue plasminogen activator (t-PA)
administration. Which is the priority nursing assessment?
A. Time of onset of current stroke
B. Complete physical and history
C. Current medications
D. Upcoming surgical procedures
The time of onset of a stroke to t-PA administration is critical.
Administration within 3 hours has better outcomes. A complete history is
not possible in emergency care. Upcoming surgical procedures will need
to be delay if t-PA is administered. Current medications are relevant, but
onset of current stroke takes priority.
4. The nurse is assigned to care for a 60 YEAR-OLD female client with
complete right-sided hemiparesis. The nurse plans care knowing
that this condition:
A. The client has complete bilateral paralysis of the arms and legs.
B. The client has weakness on the right side of the body. including the
face and tongue.
C. The client has lost the ability to move the right arm but can walk
independently.
D. The client has lost the ability to move the right arm but can walk
independently.
Hemiparesis is a weakness of one side of the body that may occur after a
stroke. It involves weakness of the face and tongue, arm, and leg on one
side.
5. The client with a brain attack (stroke) has residual dysphagia. When
a diet order is initiated. the nurse avoids doing which of the
following?
A. Giving the client thin liquids
B. Thickening liquids to the consistency of oatmeal
C. Placing food on the unaffected side of the mouth
D. Allowing plenty of time for chewing and swallowing
Before the client with dysphagia is started on a diet, the gag and swallow
reflexes must have returned. The client is assisted with meals as needed
and is given ample time to chew and swallow. Food is placed on the
unaffected side of the mouth. Liquids are thickened to avoid aspiration.
6. The nurse is assessing the adaptation of the female client to
changes in functional status after a brain attack (stroke). The nurse
assesses that the client is adapting 50-year old most successfully if
the client:
A. Gets angry with family if they interrupt a task
B. Experiences bouts of depression and irritability
C. Has difficulty with using modified feeding utensils
D. Consistently uses adaptive equipment in dressing self
Clients are evaluated as coping successfully with lifestyle changes after a
brain attack (stroke) if they make appropriate lifestyle alterations, use
the assistance of others, and have appropriate social interactions.
Options A, B, and C are not adaptive behaviors.
7. Which nursing diagnosis takes the highest priority for a client with
Parkinson’s crisis?
A. An imbalanced nutrition: Less than body requirements
B. Impaired urinary elimination
C. Ineffective airway clearance
D. Risk for injury
 In parkinsonian crisis, dopamine-related symptoms are severely
exacerbated, virtually immobilizing the client. A client confined to bed
during such a crisis is at risk for aspiration and pneumonia. Also,
excessive drooling increases the risk of airway obstruction. Because of
these concerns, the nursing diagnosis of an ineffective airway clearance
takes the highest priority. Although imbalanced nutrition: less than body
requirements, impaired urinary elimination, and risk for injury are also
appropriate nursing diagnoses, they are not immediately life-threatening.
8. Nurse Oliver is monitoring a client for adverse reactions to
dantrolene (Dantrium). Which adverse reaction is most common?
A. Slurred speech
B. Excessive tearing
C. Urine retention
D. Muscle weakness
The most common adverse reaction to dantrolene is muscle weakness.
The
drug also may depress liver function or cause idiosyncratic hepatitis.
Muscle weakness is rarely severe enough to cause slurring of speech,
drooling, and enuresis. Although excessive tearing and urine retention
are
adverse reactions associated with dantrolene use, they aren’t as common
as muscle weakness
9. To encourage adequate nutritional intake for a female client with
Alzheimer’s disease, the nurse should:
A. help the client fill out his menu.
B. fill out the menu for the client
C. give the client privacy during meals.
D. stay with the client and encourage him to eat
Staying with the client and encouraging him to feed himself will ensure
adequate food intake. A client with Alzheimer’s disease can forget how to
eat. Allowing privacy during meals, filling out the menu, or helping the
client to complete the menu doesn’t ensure adequate nutritional intake.
10. A 75-year-old woman appears in the emergency room with a
wrist fracture sustained during a minor fall. Which of the following
conditions is most likely related to the patient’s condition?
A. Osteoporosis
B. Carpal tunnel syndrome
C. Fibromyalgia
D. Rheumatoid arthritis
A wrist fracture can narrow the carpal tunnel and irritate the nerve,
as can the swelling and inflammation caused by rheumatoid arthritis.