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WorksheetsNCLEX style practice neurological disorder quiz for RNSG-1413
Total questions: 58
Worksheet time: 29mins
Name
Class
Date
1.
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:
a)
Reducing sodium intake, stopping smoking, and increasing physical activity
b)
Taking calcium supplements daily and doing crossword puzzles
c)
Increasing fluid intake only
d)
Avoiding all social alcohol consumption
2.
Which patient scenario indicates a priority need for immediate stroke assessment?
a)
A 65-year-old reporting intermittent headaches over several weeks
b)
A 72-year-old with sudden slurred speech, right arm weakness, and facial droop
c)
A 60-year-old with mild forgetfulness over six months
d)
A 50-year-old complaining of occasional dizziness
3.
A patient presents with left-sided neglect after a right-hemisphere stroke. The nurse anticipates which behavior?
a)
The patient consistently eats all food on the left side of the plate
b)
The patient ignores stimuli on the left side and may only attend to the right side
c)
The patient is overly cautious and slow to move
d)
The patient has trouble understanding speech
4.
A nurse is assessing a patient for aphasia after a left-hemisphere stroke. Which finding indicates expressive aphasia?
a)
The patient cannot understand spoken language but speaks fluently
b)
The patient speaks in short, fragmented sentences but understands language
c)
The patient demonstrates left-sided weakness
d)
The patient is unable to recognize familiar faces
5.
Which nursing intervention is most important for a patient with impaired swallowing (dysphagia) after a stroke?
a)
Encourage rapid drinking of fluids
b)
Place the patient in a semi-recumbent position and give small bites
c)
Provide large meals quickly
d)
Allow patient to feed themselves independently without monitoring
6.
A patient with dementia becomes agitated when asked to perform ADLs. The best nursing strategy is to:
a)
Force the patient to complete tasks
b)
Offer step-by-step guidance and maintain a calm environment
c)
Leave the patient to perform tasks independently
d)
Ignore the agitation
7.
The caregiver of a patient with Alzheimer’s Disease asks how to reduce sundowning behaviors. The nurse recommends:
a)
Increasing evening activity and caffeine intake
b)
Maintaining a consistent daily schedule and limiting late-day stimulation
c)
Turning on bright lights all night
d)
Administering a PRN antipsychotic every evening
8.
A patient with vascular dementia has sudden cognitive changes and worsening neurological deficits. The nurse recognizes this as:
a)
Progressive Alzheimer’s Disease
b)
Acute-onset vascular events contributing to cognitive decline
c)
Normal aging
d)
A reversible delirium
9.
The nurse is educating a family about Alzheimer’s Disease progression. Which statement accurately reflects the stages?
a)
Mild: total dependence; Moderate: mild memory loss; Severe: sundowning
b)
Mild: memory lapses; Moderate: assistance with ADLs; Severe: total dependence
c)
Mild: total dependence; Moderate: total dependence; Severe: memory lapses
d)
Mild: confusion only; Moderate: agitation only; Severe: depression only
10.
Which clinical feature differentiates delirium from dementia?
a)
Delirium has acute onset and fluctuating course; dementia is chronic and progressive
b)
Delirium involves gradual memory loss; dementia has sudden onset
c)
Delirium only affects older adults; dementia affects all ages
d)
Delirium does not affect attention; dementia always affects attention
11.
A patient with AD is prescribed cholinesterase inhibitors. The nurse explains that this medication:
a)
Reverses disease progression
b)
Improves cognitive function temporarily
c)
Treats agitation and aggression
d)
Cures the disease completely
12.
A patient with moderate AD is being discharged home. The nurse advises the family to:
a)
Keep the patient unsupervised for independence
b)
Remove hazards, label cabinets, and provide supervision for ADLs
c)
Increase caffeine intake to stimulate alertness
d)
Restrict all physical activity
13.
Which action is most important when assessing stroke risk in a community health setting?
a)
Focus solely on age and gender
b)
Evaluate modifiable risk factors like hypertension, smoking, cholesterol
c)
Only ask about family history
d)
Conduct a full neurological exam
14.
The nurse notes a patient has slurred speech, right arm weakness, and facial droop that started 1 hour ago. What is the first action?
a)
Obtain a detailed dietary history
b)
Call for a STAT CT scan and notify the stroke team
c)
Schedule a routine follow-up
d)
Administer a sedative to reduce anxiety
15.
A patient with a left-hemisphere stroke demonstrates cautious behavior, depression, and slow movement. Which nursing interventions support safety?
a)
Use frequent reminders, close supervision, and simple instructions
b)
Encourage independent exploration without guidance
c)
Administer sedatives routinely
d)
Allow the patient to move freely in an unsupervised environment
16.
The nurse is teaching a caregiver how to reduce stroke risk for their family member with hypertension. Which recommendation is most evidence-based?
a)
Control blood pressure, maintain healthy diet, exercise, stop smoking
b)
Avoid all social activities
c)
Take only herbal supplements
d)
Limit water intake
17.
A patient exhibits sudden-onset confusion, disorientation, and agitation after surgery. Which assessment is most critical?
a)
Evaluate for delirium and underlying causes such as infection or metabolic imbalance
b)
Attribute symptoms to normal postoperative fatigue
c)
Wait 24 hours before intervention
d)
Assess for mild memory loss only
18.
A patient with right-hemisphere stroke ignores food on the left side of the plate. The nurse should:
a)
Move food to the left side
b)
Reposition food to the right side and cue the patient
c)
Force the patient to eat from the left
d)
Avoid assisting with meals
19.
Which nursing intervention is appropriate for a patient with moderate dementia to promote nutrition?
a)
Serve finger foods, allow adequate time, provide cues
b)
Rush meals to finish quickly
c)
Force patient to eat everything
d)
Offer only liquid meals
20.
A patient is at risk for aspiration post-stroke. The nurse should:
a)
Encourage lying flat when eating
b)
Keep the head elevated and provide small bites, thickened liquids if needed
c)
Give large amounts of thin liquids
d)
Avoid monitoring during meals
21.
Which behavior indicates effective communication with a patient with expressive aphasia?
a)
Asking yes/no questions and providing visual cues
b)
Speaking rapidly and using complex sentences
c)
Avoiding all communication
d)
Expecting patient to write full sentences
22.
The nurse is educating a family about signs of TIA. Which symptom is most indicative?
a)
Gradual memory loss over months
b)
Sudden unilateral weakness or numbness that resolves within 24 hours
c)
Chronic headaches
d)
Persistent dizziness for weeks
23.
A patient with AD shows increased agitation at night. Which environmental intervention is most appropriate?
a)
Maintain a quiet, dimly lit environment and minimize disruptions
b)
Keep lights bright and loud music playing
c)
Restrict fluid intake
d)
Increase evening activity
24.
A patient is prescribed memantine for moderate AD. The family asks about expected effects. The nurse explains:
a)
It will restore lost memory completely
b)
It slows cognitive decline and may improve function
c)
It will prevent all future cognitive deficits
d)
It will treat depression
25.
A patient with delirium is restless, trying to get out of bed. The nurse first:
a)
Applies restraints immediately
b)
Assesses for underlying cause and ensures safety
c)
Administers sedatives without evaluation
d)
Leaves the patient alone
26.
Which statement reflects the primary distinction between dementia and normal age-related memory changes?
a)
Dementia leads to functional impairment and interferes with daily life; normal aging does not
b)
Dementia affects only older adults; normal aging affects all ages
c)
Dementia is reversible; normal aging is not
d)
Dementia is always sudden; normal aging is gradual
27.
A patient with mild AD becomes lost in familiar surroundings. The nurse should:
a)
Reassure the patient, provide orientation cues, and ensure safe environment
b)
Leave the patient to navigate independently
c)
Administer sedatives immediately
d)
Ignore the confusion
28.
The nurse observes a patient with left-sided hemiparesis neglecting the left side. The patient is asked to dress. How should the nurse assist?
a)
Place clothing on the affected side first and provide cues
b)
Allow patient to dress independently without guidance
c)
Dress the patient fully without attempting engagement
d)
Ignore left-sided neglect
29.
Which intervention is critical for stroke prevention in a patient with atrial fibrillation?
a)
Encourage frequent naps
b)
Prescribe anticoagulation therapy
c)
Recommend high-protein diet
d)
Focus solely on exercise
30.
A patient with delirium is observed to be disoriented and hallucinating. The nurse’s priority action is:
a)
Provide reality orientation, assess underlying causes, ensure safety
b)
Administer antipsychotic immediately without assessment
c)
Ignore the hallucinations
d)
Wait until the patient becomes calmer
31.
Which action is most effective for improving nutrition in a patient with moderate Alzheimer’s Disease?
a)
Serve small, frequent meals with supervision
b)
Provide a single large meal daily
c)
Restrict fluids to avoid incontinence
d)
Leave patient to feed self without monitoring
32.
A patient with right-hemisphere stroke exhibits impulsivity. Nursing strategies include:
a)
Close supervision, clear instructions, safety measures
b)
Encourage risk-taking
c)
Ignore impulsive behaviors
d)
Administer sedatives routinely
33.
The nurse is evaluating a patient with a suspected TIA. Which finding is most important for urgent intervention?
a)
Short-lived numbness in one arm
b)
Gradual onset of mild headaches
c)
Sudden right-sided weakness and slurred speech
d)
Chronic fatigue
34.
A patient with dementia is experiencing agitation during bathing. Which intervention is best?
a)
Use a calm, slow approach, offering choices and reassurance
b)
Force the patient to complete bath quickly
c)
Ignore agitation
d)
Administer sedatives immediately
35.
A patient recovering from a stroke is observed exhibiting quick, impulsive behavior and impaired judgment, leading to increased safety risks. The nurse recognizes that these manifestations are typically characteristic of a stroke affecting which brain area?
a)
Left hemisphere, resulting in difficulty processing sequences
b)
Right hemisphere, resulting in a safety risk due to impulsivity
c)
Cerebellum, resulting in immediate loss of coordination and balance
d)
Brainstem, resulting in severe motor and communication deficits
36.
A 60-year-old patient reports experiencing numbness in the right arm and transient vision loss in the left eye, which resolved completely within 15 minutes. The patient is demanding discharge. The nurse insists on further diagnostic evaluation because this episode is a:
a)
Benign event likely caused by temporary muscle tension, resolving spontaneously
b)
Completed lacunar stroke, which is usually asymptomatic and requires only prophylactic monitoring
c)
Transient Ischemic Attack (TIA), which is a warning sign of progressive cerebrovascular disease and indicates a high risk of future major stroke
d)
Subarachnoid hemorrhage that clotted off naturally, necessitating immediate surgical intervention
37.
A patient is being evaluated in the ED for an ischemic stroke that began 2 hours ago. The nurse notes the STAT head CT without contrast is complete. The CT scan is essential at this time primarily to:
a)
Detect small infarctions in the brainstem, which are often missed by MRI
b)
Visualize the location of the occlusive clot to prepare for thrombectomy
c)
Rule out a hemorrhagic stroke, determining patient eligibility for immediate thrombolytic administration (tPA)
d)
Assess the extent of cerebral atrophy characteristic of chronic hypertension
38.
A patient with a known history of severe, uncontrolled hypertension (HTN) and diabetes mellitus (DM) is admitted with slurred speech and right-sided facial weakness that gradually worsened over 12 hours. The nurse suspects which stroke classification?
a)
Embolic stroke, due to the sudden and severe presentation
b)
Thrombotic stroke, due to the gradual onset and common association with HTN and DM
c)
Subarachnoid hemorrhage, due to the slow onset of symptoms
d)
Vascular dementia, due to the fluctuating nature of the symptoms
39.
The nurse is caring for a patient who suffered a stroke resulting in severe receptive aphasia (Wernicke's area involvement). Which communication strategy is most appropriate for the nurse to implement?
a)
Encouraging the patient to speak in full, complex sentences to rebuild language structure
b)
Providing short, simple commands and supplementing verbal cues with gestures and nonverbal communication
c)
Asking complex questions to stimulate cognitive function
d)
Speaking in a loud voice to ensure the patient hears the directions clearly
40.
A patient with a left-hemisphere stroke has severe right-sided hemiplegia and expressive aphasia. When preparing the patient's meal tray, the nurse should place the tray and call light on the patient's left side. This action is intended primarily to:
a)
Compensate for homonymous hemianopsia (visual field cut) and neglect
b)
Reduce the patient's impulsivity and impaired judgment
c)
Encourage the patient to scan the environment toward the field of vision loss
d)
Support the patient's ability to safely reach and feed themselves using the unaffected side
41.
The incidence of ischemic stroke in patients with TIAs and other vascular risk factors is reduced with the long-term use of antiplatelet medications. Which medication is commonly used for this preventative purpose?
a)
Warfarin (Coumadin), an anticoagulant
b)
Nimodipine, a calcium channel blocker
c)
Daily low-dose aspirin, an antiplatelet agent
d)
Haloperidol (Haldol), an antipsychotic drug
42.
A patient is admitted following a thrombotic stroke. The nurse collaborates with the interdisciplinary team to prevent complications. Which nursing intervention is directed at preventing one of the most serious complications following a stroke?
a)
Administering stool softeners daily
b)
Repositioning the patient every two hours
c)
Assessing the patient's gag reflex before administering any oral medications or food
d)
Providing a communication board for the patient with expressive aphasia
43.
A patient is exhibiting right-sided weakness, difficulty producing words (expressive aphasia), and is overly cautious and anxious about movement. The nurse determines that the patient’s affected hemisphere is the:
a)
Right hemisphere, which controls logic and sequencing
b)
Left hemisphere, which controls speech and language in most people
c)
Cerebellum, controlling balance and coordination
d)
Posterior cerebral artery territory, controlling vision
44.
A 75-year-old patient admitted with dehydration and a urinary tract infection (UTI) develops acute confusion, is calling out to unfamiliar people, and attempts to pull out his IV lines. The nurse correctly identifies these findings as primarily characteristic of:
a)
Alzheimer’s disease, requiring chronic memory medication
b)
Dementia, characterized by an insidious onset
c)
Delirium, characterized by reduced awareness and sudden onset
d)
Normal age-related changes in cognition
45.
When caring for an agitated patient diagnosed with delirium, the nurse knows that applying wrist restraints or administering a benzodiazepine (e.g., lorazepam) should be avoided unless absolutely necessary because these actions can:
a)
Delay the definitive diagnosis of the underlying cause
b)
Increase the patient's confusion, agitation, and risk of injury
c)
Only treat the symptom, rather than the underlying cause
d)
Inhibit the use of appropriate cognitive assessment tools like the MMSE
46.
Which combination of clinical findings best differentiates delirium from Alzheimer’s disease (AD)?
a)
Delirium involves a gradual decline and is chronic; AD involves a sudden change
b)
Delirium is short-term and often reversible; AD is long-term and irreversible
c)
Delirium causes short-term memory loss only; AD causes long-term memory loss only
d)
Delirium rarely involves behavioral problems; AD frequently involves agitation
47.
A patient in the ICU who has been stable for two days develops restlessness, disorganized thinking, and difficulty focusing attention. Based on the DELIRIUM mnemonic, which underlying cause should the nurse investigate first?
a)
Previous history of stroke (Intracranial problems)
b)
Unfamiliar, noisy hospital environment (Unfamiliar environment/ICU)
c)
Chronic neurodegenerative changes (Dementia)
d)
Untreated pain or infection (Pain/Infection)
48.
A patient with severe, hyperactive delirium is uncontrollably agitated and posing an immediate risk of self-injury. Which medication is appropriate for the nurse to administer to manage acute agitation?
a)
Donepezil (Aricept)
b)
Memantine (Namenda)
c)
Risperidone (Risperdal)
d)
Fluoxetine (Prozac)
49.
The nurse is assessing a patient with newly diagnosed cognitive impairment. The key criterion that defines dementia, distinguishing it from normal age-related forgetfulness, is that the cognitive decline:
a)
Is caused primarily by overproduction of β-amyloid protein
b)
Requires hospitalization and intensive treatment
c)
Significantly interferes with the patient's ability to function and perform daily activities
d)
Is diagnosed definitively using the Mini-Mental State Examination (MMSE) score
50.
A patient with AD is in the moderate stage. The nurse should anticipate that this patient will require regular assistance primarily with which activity?
a)
Finding the right word or name (Mild stage)
b)
Total dependence for feeding and bathing (Severe stage)
c)
Dressing, selecting clothes, and wandering (Moderate stage)
d)
Orientation to their place of residence (Normal function)
51.
A patient with Alzheimer’s Disease is prescribed donepezil (Aricept). The nurse instructs the family that the goal of this medication is to:
a)
Cure the disease by dissolving amyloid plaques
b)
Reduce severe agitation and hallucinations
c)
Slow the progression of cognitive decline and improve memory
d)
Stabilize mood and treat concurrent depression
52.
A patient with AD experiences increasing confusion and agitation ("sundowning") every evening. What is the most effective nursing intervention to manage this behavior?
a)
Confront the patient firmly about the confused reality to bring them back to the present
b)
Administer a PRN antipsychotic medication at the onset of sundowning symptoms
c)
Maintain a consistent daily routine and use distraction techniques instead of confrontation
d)
Keep the television and overhead lights on to increase sensory stimulation during the evening
53.
The daughter of a patient with advanced AD reports feeling overwhelmed, unable to concentrate, and having trouble sleeping, stating, "I just can't make decisions anymore." The nurse determines that these manifestations are most indicative of which nursing diagnosis?
a)
Impaired memory
b)
Risk for injury
c)
Caregiver role strain
d)
Disturbed thought processes
54.
A patient with AD is prescribed memantine (Namenda). The nurse understands that this drug is classified as an NMDA receptor antagonist and works to:
a)
Reduce the patient's sleep disturbances and insomnia
b)
Regulate glutamate activity, thereby decreasing memory decline and improving cognition
c)
Prevent further vascular damage from hypertension
d)
Treat concurrent symptoms of depression
55.
Which nursing action is included in the plan of care to ensure the safety and cognitive support of a patient with moderate Alzheimer's disease? (Select all that apply)
a)
Encourage the patient to wear a MedicAlert bracelet or ID device
b)
Use short, simple instructions and maintain a consistent daily schedule
c)
Promptly correct all mistakes the patient makes to reinforce reality
d)
Discuss Advanced Directives and Durable Power of Attorney for healthcare
e)
Remove throw rugs and install locks on outside doors
56.
The nurse is teaching a community group about stroke prevention. Which cluster of factors represents the highest priority for the nurse to emphasize regarding modifiable risk reduction for stroke?
a)
Age, race, and family history
b)
Hypertension, smoking, high cholesterol, and heart disease (like atrial fibrillation)
c)
Gender, previous stroke, and TIA
d)
High dietary fat intake and sedentary lifestyle only
57.
Which action represents an objective assessment finding used by the nurse to evaluate a patient's current neurological status?
a)
The patient reports a subjective feeling of dizziness and lightheadedness
b)
The nurse observes the patient's body posture, hygiene, and facial expression
c)
The patient's family reports a history of sudden symptom onset
d)
The patient reports feelings of depression and apathy
58.
A patient is newly diagnosed with dementia, and the family asks how the medical team confirms the diagnosis. The nurse explains that Alzheimer’s Disease (the most common form of dementia) is usually confirmed when:
a)
Neuroimaging (CT/MRI) detects severe brain atrophy
b)
The patient’s score on the Mini-Mental State Examination (MMSE) falls below 15
c)
The patient exhibits characteristic sundowning behavior
d)
All other possible reversible causes of cognitive impairment (e.g., thyroid disorders, vitamin deficiencies) have been systematically eliminated
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