NCLEX style practice neurological disorder quiz for RNSG-1413

A patient with a history of hypertension and atrial fibrillation asks the nurse which lifestyle changes could reduce the risk of stroke. The nurse correctly identifies the most effective modifiable interventions as:

• Reducing sodium intake, stopping smoking, and increasing physical activity
• Taking calcium supplements daily and doing crossword puzzles
• Increasing fluid intake only
• Avoiding all social alcohol consumption

Answer explanation

Lifestyle modifications like controlling blood pressure, quitting smoking, and exercising reduce stroke risk.

Which patient scenario indicates a priority need for immediate stroke assessment?

• A 65-year-old reporting intermittent headaches over several weeks
• A 72-year-old with sudden slurred speech, right arm weakness, and facial droop
• A 60-year-old with mild forgetfulness over six months
• A 50-year-old complaining of occasional dizziness

Answer explanation

Sudden onset of neurological deficits is an emergency and requires immediate stroke evaluation.

A patient presents with left-sided neglect after a right-hemisphere stroke. The nurse anticipates which behavior?

• The patient consistently eats all food on the left side of the plate
• The patient ignores stimuli on the left side and may only attend to the right side
• The patient is overly cautious and slow to move
• The patient has trouble understanding speech

Answer explanation

Left-sided neglect occurs after right-hemisphere stroke; patients fail to attend to left-sided stimuli.

A nurse is assessing a patient for aphasia after a left-hemisphere stroke. Which finding indicates expressive aphasia?

• The patient cannot understand spoken language but speaks fluently
• The patient speaks in short, fragmented sentences but understands language
• The patient demonstrates left-sided weakness
• The patient is unable to recognize familiar faces

Answer explanation

Expressive (Broca’s) aphasia: difficulty producing language, comprehension mostly intact.

Which nursing intervention is most important for a patient with impaired swallowing (dysphagia) after a stroke?

• Encourage rapid drinking of fluids
• Place the patient in a semi-recumbent position and give small bites
• Provide large meals quickly
• Allow patient to feed themselves independently without monitoring

Answer explanation

Dysphagia precautions include upright positioning and small, manageable bites to prevent aspiration.

A patient with dementia becomes agitated when asked to perform ADLs. The best nursing strategy is to:

• Force the patient to complete tasks
• Offer step-by-step guidance and maintain a calm environment
• Leave the patient to perform tasks independently
• Ignore the agitation

Answer explanation

Stepwise guidance and calm interaction reduce stress and agitation in dementia patients.

The caregiver of a patient with Alzheimer’s Disease asks how to reduce sundowning behaviors. The nurse recommends:

• Increasing evening activity and caffeine intake
• Maintaining a consistent daily schedule and limiting late-day stimulation
• Turning on bright lights all night
• Administering a PRN antipsychotic every evening

Answer explanation

Consistent routines and limiting evening stimulation reduce sundowning; excessive lighting or medications are secondary measures.

A patient with vascular dementia has sudden cognitive changes and worsening neurological deficits. The nurse recognizes this as:

• Progressive Alzheimer’s Disease
• Acute-onset vascular events contributing to cognitive decline
• Normal aging
• A reversible delirium

Answer explanation

Vascular dementia progresses in a stepwise manner; sudden changes indicate new vascular events.

The nurse is educating a family about Alzheimer’s Disease progression. Which statement accurately reflects the stages?

• Mild: total dependence; Moderate: mild memory loss; Severe: sundowning
• Mild: memory lapses; Moderate: assistance with ADLs; Severe: total dependence
• Mild: total dependence; Moderate: total dependence; Severe: memory lapses
• Mild: confusion only; Moderate: agitation only; Severe: depression only

Answer explanation

Moderate AD requires assistance with ADLs; severe AD leads to total dependence; mild stage shows memory lapses.

Which clinical feature differentiates delirium from dementia?

• Delirium has acute onset and fluctuating course; dementia is chronic and progressive
• Delirium involves gradual memory loss; dementia has sudden onset
• Delirium only affects older adults; dementia affects all ages
• Delirium does not affect attention; dementia always affects attention

Answer explanation

Delirium is acute and often reversible; dementia is chronic and progressive.