WorksheetsNCLEX - NERVOUS SYSTEM Day1
Total questions: 25
Worksheet time: 25mins
Name
Class
Date
1.
The nurse is talking with a client who is receiving phenytoin. Which of the following statements by the client would require immediate follow-up?
a)
I have begun to feel unsteady while walking.
b)
I wake up frequently during the night to urinate.
c)
There is a metallic taste in my mouth when I eat.
d)
There is mild swelling and tenderness in my gums.
e)
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2.
The nurse in the emergency department is caring for assigned clients. Which of the following clients should the nurse assess first?
a)
1-year-old client with a ventriculoperitoneal shunt who is lethargic and has bradycardia
b)
3-year-old client with a history of meningocele who has unilateral ear pain and urinary incontinence
c)
6-year-old client with muscular dystrophy who has flu-like symptoms and a temperature of 100.4 F (38 C)
d)
8-year-old client with a history of cerebral palsy who has a foot injury and spastic clonus
e)
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3.
The nurse in the same-day surgery unit admits a client who will receive general anesthesia. The client has never had surgery before. Which question is most critical for the nurse to ask the client during the preoperative assessment and health history?
a)
Has any family member ever had a bad reaction to general anesthesia?
b)
Have you ever experienced low back pain?
c)
Have you ever had an anaphylactic reaction to a bee sting?
d)
Have you ever received opioid pain medications?
e)
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4.
The clinic nurse performs assessments on four infants. The nurse should alert the health care provider to see which client first?
a)
3-month-old whose posterior occiput appears flattened
b)
4-month-old who has sclera visible above the iris (sunset eyes)
c)
6-month-old who has vomited twice and has had 8 wet diapers in the last 24 hours
d)
9-month-old whose toes fan out and big toe dorsiflexes when plantar surface is stroked
e)
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5.
The health care provider prescribes a multivitamin regimen that includes thiamine for a client with a history of chronic alcohol abuse. The nurse is aware that thiamine is given to this client population for which purpose?
a)
To lower the blood alcohol level
b)
To prevent gross tremors
c)
To prevent Wernicke encephalopathy
d)
To treat seizures related to acute alcohol withdrawal
e)
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6.
A nurse is preparing for a medical relief trip to West Africa and is concerned about a disruption in circadian rhythm from traveling across several time zones. Which supplement might help synchronize the body to environmental time?
a)
Evening primrose
b)
Ginseng
c)
Melatonin
d)
St. John wort
e)
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7.
The nurse is assessing the cranial nerves and begins testing the facial nerve (cranial nerve VII). Which direction should the nurse give the client to test this cranial nerve?
a)
Close your eyes and identify this smell.
b)
Follow my finger with your eyes without moving your head.
c)
Look straight ahead and let me know when you can see my finger.
d)
Raise your eyebrows, smile, and frown.
e)
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8.
The nurse has been made aware of laboratory test results for assigned clients. Which of the following test results would require immediate follow-up?
a)
phenytoin level of 8 mcg/mL for a client who is receiving enteral feedings
b)
digoxin level of 1.3 ng/ml for a client who has a heart rate of 62/min
c)
lithium level of 0.8 mEq/L for a client who is reporting a decreased appetite
d)
international normalized ratio (INR) of 3 for a client who has a prosthetic aortic valve
e)
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9.
The nurse is preparing to administer sumatriptan to a client with a migraine headache. Which of the following findings would require follow-up prior to administering the medication?
a)
BMI of 34 kg/m2 recorded during today's examination
b)
past medical history of uncontrolled hypertension
c)
takes alprazolam as prescribed for anxiety
d)
BUN of 12 mg/dL
e)
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10.
The nurse is caring for a client who is experiencing hypotension and respiratory depression after receiving IV midazolam. Which of the following medications should the nurse anticipate administering to the client?
a)
benztropine
b)
acetylcysteine
c)
flumazenil
d)
phentolamine
e)
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11.
The nurse is caring for a client who sustained a traumatic brain injury after falling off a bicycle. The client was alert and oriented 15 minutes ago but is now lethargic. It would be a priority for the nurse to
a)
apply padding to the side rails of the client's bed
b)
request a prescription for IV dexamethasone
c)
check the client's capillary blood glucose level
d)
elevate the head of the client's bed to 30 degrees
e)
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12.
The nurse receives the assigned clients for today on a neurology unit. The nurse should check on which client first?
a)
Client with history of head injury whose Glasgow Coma Scale changes from 13 to 14
b)
Client with history of myasthenia gravis who had ptosis in the evening
c)
Client with history of T2 spinal injury who has diaphoresis, pulse 54/min, and hypertension
d)
Client with history of transverse myelitis with 2+ bilateral lower extremity muscle strength
e)
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13.
The home health nurse prepares to give benztropine to a 70-year-old client with Parkinson disease. Which client statement is most concerning and would warrant health care provider notification?
a)
I am going for repeat testing to confirm glaucoma.
b)
I am not able to exercise as much as I used to.
c)
I started taking esomeprazole for heartburn.
d)
My bowel movements are not regular.
e)
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14.
The nurse is teaching the parent of an 18-month-old client who experienced a febrile seizure about home management of fevers. Which of the following information should the nurse include?
a)
Give your baby frequent cold sponge baths.
b)
Wrap your baby snuggly in a blanket to prevent chills.
c)
Place ice bags under your baby's arms and around your baby's neck.
d)
Administer acetaminophen to your baby to reduce fever and promote comfort.
e)
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15.
The nurse is talking to a client with a newly diagnosed seizure disorder who has a prescription for levetiracetam. Which of the following statements by the client would require follow-up?
a)
I can begin driving my car again after I have been taking this medication for 2 weeks.
b)
I need to contact my health care provider if I develop a rash while taking this medication.
c)
I should report any new or increased anxiety I experience while taking this medication.
d)
I understand that drowsiness is an adverse effect of this medication that may improve over time.
e)
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16.
The nurse and unlicensed assistive personnel (UAP) are caring for a client who is at increased risk for falls. The nurse should intervene if the UAP is observed
a)
Check on the client every hour
b)
Raise all 4 side rails of the client's bed
c)
Put nonslip socks on the client's feet
d)
Place a fall risk identification bracelet on the client's wrist
e)
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17.
A client is seen in the clinic for the third time for a nonhealing, infected diabetic foot ulcer. The client is able to verbalize the correct procedure for wound care but reports not adhering to the ordered routine at home. What intervention does the nurse prioritize to promote proper self care?
a)
Assess the client's feelings about placement at a skilled nursing facility for care
b)
Educate the client on the risks of tissue death if not properly cared for at home
c)
Explore the client's abilities and motivation to perform care at home
d)
Provide the client with the supplies needed to change dressings as recommended
e)
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18.
A new nurse attends a risk management class on the indications and legal implications of using chemical restraints to maintain client safety. Which prescription should the nurse question before administering?
a)
Haloperidol for a client with a fall history who keeps getting out of bed without assistance
b)
Lorazepam for a client who is in alcohol withdrawal and is extremely agitated
c)
Olanzapine for a client with schizophrenia who is exhibiting violent behavior
d)
Propofol for a client who is intubated and receiving mechanical ventilation
e)
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19.
A nurse is evaluating an acutely ill client with suspected meningitis. The nurse should take what action first?
a)
Check for Kernig's and Brudzinski's signs
b)
Establish IV access
c)
Place the client on droplet precautions
d)
Prepare the client for lumbar puncture
e)
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20.
The nurse in the emergency department is caring for a client who sustained blunt force head trauma and is experiencing blurry vision. The nurse should suspect the client has sustained injury to the
a)
temporal lobe
b)
occipital lobe
c)
parietal lobe
d)
frontal lobe
e)
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21.
A client diagnosed with trigeminal neuralgia is given a prescription of carbamazepine by the health care provider. Which intervention does the nurse add to this client's care plan?
a)
Encourage client to drink cold beverages
b)
Encourage client to eat a high-fiber diet
c)
Encourage client to perform facial massage
d)
Encourage client to report any fever or sore throat
e)
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22.
The office nurse, while reviewing a client's health information, notices that the client has recently started taking St. John's wort for symptoms of depression. What additional information is most important for the nurse to obtain?
a)
Ask if the client is currently taking any prescription antidepressant medications
b)
Ask if the client has been diagnosed with depression by a mental health care provider
c)
Ask if the client takes a multivitamin with iron
d)
Ask if the client uses tanning beds
e)
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23.
The nurse is talking with a client with a brain tumor who has a new prescription for levetiracetam. Which of the following statements would be appropriate for the nurse to make?
a)
The medication will prevent blood clots in your legs.
b)
The medication will decrease the size of your tumor.
c)
The medication helps prevent seizures from occurring.
d)
The medication helps decrease swelling around your tumor.
e)
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24.
The nurse taught the caregiver of a child with a ventriculoperitoneal (VP) shunt about when to contact the health care provider (HCP). The caregiver shows understanding of the instructions by contacting the HCP about which symptom?
a)
A temperature of 99 F (37 C) that occurs during the evening
b)
The child cannot recall items eaten for lunch the previous day
c)
The child vomits after awakening from a nap and 1 hour later
d)
The VP shunt is palpated along the posterior-lateral portion of the skull
e)
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25.
A client is receiving scheduled doses of carbidopa-levodopa. The nurse evaluates the medication as having the intended effect if which finding is noted?
a)
Improvement in short-term memory
b)
Improvement in spontaneous activity
c)
Reduction in number of visual hallucinations
d)
Reduction of dizziness with standing
e)
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