12/30/23, 1:10 AM NLE NEURO 2 ONLINE PRETEST

NLE NEURO 2 ONLINE PRETEST

DECEMBER 30, 2023

* Indicates required question

1. Email *

2. Name: *

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3. 1. Daniel contracted traumatic brain injury after attending the year-end party of * 2 points

their company. Nurse Bona assesses his neurological function. The following
signs are noted. Headache, projectile vomiting, abnormal pupillary responses
and neurologic deficits are present. Abnormal gait, balance and general
motors are related to the damage of:

Mark only one oval.

A. B

C D

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4. 2. Andrea, a 78-year-old client is admitted to the Emergency Department (ED) * 2 points

via emergency medical service (EMS). She is unconscious and the ER nurse
is checking her GCS. Which of the following tests the Verbal Response?

Mark only one oval.

A. Ask the client to stick out the tongue to the midline

B. Do the trapezius squeeze

C. Enter the client's room

D. Apply pressure to the nail bed or do sternal rub

E. Ask the client's name

5. 3. *When assessing patient with Cushing's triad which of the following would * 2 points

be most important to assess? Select all that apply:

Check all that apply.

A. The presence of early symptoms as Intentional tremors, nystagmus and slow

speech
B. Widening pulse pressure
C. ↓BP, ↑HR, ↑RR
D. Irregular breathing
E. Slowing of the heart rate

6. 4. *A client is admitted with a head injury to monitor medulla oblongata * 2 points

function. The nurse should monitor what parameters?

Mark only one oval.

A GCS

B. Gastric pH

C Heart rate and papillary responses

D Respiratory rate and blood pressure

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7. 5. *A client is seen in the emergency one day after falling in his bathroom at * 2 points

home. The client reports having “a few drinks” prior to the fall. Which finding
requires the nurse's immediate attention?

Mark only one oval.

A. piloerection

B. (-) Brudzinski

C. BS 35/minute

D. Presence of Mastoid ecchymosis

8. 6. A nurse detects fluid leaking from the nose and ears of a client admitted for * 2 points

head trauma. Which is the appropriate nursing action?

Mark only one oval.

A Pack the nose and ears with sterile gauze

B Raise the head of the bed so the client is sitting upright

C Position an ice pack on the back of the neck

D Place loose sterile gauze dressings below the nostril and ear, notify the MD and
document

9. 7. A client with a closed head injury is confused, drowsy and has unequal * 2 points

pupils. Which of the following nursing diagnosis is most important at this time?

Mark only one oval.

A Altered level of cognitive function

B High risk for injury

C Ineffective tissue perfusion

D Sensory perceptual alteration

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10. 8. The client has increased intracranial pressure with cerebral edema, and * 2 points

mannitol is administered. Which assessment should the nurse make to

evaluate if a complication from the mannitol is occurring?

Mark only one oval.

A. Auscultate breath sounds to assess for crackles

B. Monitor for >50 mL/hr urine output

C. Monitor Glasglow Coma Scale increasing from 8/15 to 9/15.

D. Press over the tibia to assess for pitting edema.

11. 9. Which of the following reduces cerebral edema by constricting cerebral * 2 points

veins?

Mark only one oval.

A Dexamethasone (Decadron)

B Mechanical hyperventilation

C Mannitol (Osmitrol)

D Ventriculostomy

12. 10. Which of the following are the positive outcomes of MANNITOL in a client * 2 points

with closed head injury and glaucoma? Select all that apply:

Check all that apply.

A Desired diuresis with decrease edema

B Decrease ICP and IOP
C Improvement in LOC
D Increase crystallization of the IV
E Occurrence of dizziness and blurred vision

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13. 11. The nurse is caring for a confused client who sustained a head injury * 2 points

resulting in a subdural hematoma. The client’s blood pressure is 100/60

mmHg and he is unresponsive. Select the most effective position for the
client as the nurse transports him to the operating room.

Mark only one oval.

A Semi-Fowler’s

B Trendelenburg

C High-Fowlers

D Supine

14. 12. The client has a new order for an oral form of dexamethasone. What * 2 points

should the nurse understand about this medication?

Mark only one oval.

A The client should start on the highest dose possible for the shortest length of
time

B The client should avoid being near people who are sick or have infections

C It should be given on an empty stomach

D If ordered once a day, it should be given at bedtime

15. 13. The nurse is caring for a patient with increased intracranial pressure * 2 points

(IICP). The nurse realizes that some nursing actions are contraindicated with
IICP. Which nursing action should be avoided?

Mark only one oval.

A. Reposition the patient every two hours.

B. Position the patient with the head elevated 30 degrees.

C. Suction the airway every two hours per standing orders.

D. Provide continuous oxygen as ordered.

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16. 14. A nurse is evaluating the status of a client who had a craniotomy 3 days * 2 points

ago. The nurse would suspect that the client is developing meningitis as a
complication of surgery if the client exhibits:

Mark only one oval.

A A GCS of 15

B A negative Kernig’s sign

C Absence of nuchal rigidity

D Neck and hip flexion

17. 15. A client has a fever of 103ºF, nuchal rigidity, tachycardia and flushed skin. * 2 points

Based on these findings, the most important nursing diagnosis is

Mark only one oval.

A Acute Pain

B Hyperthermia

C Anxiety

D Altered Thought Process

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18. 16. The nurse is caring for a client who is to have a lumbar puncture (L-P). * 2 points

How should the client be positioned during the procedure?

Mark only one oval.

A B

C D

19. 17. A client is admitted with a C4 complete transection. In the immediate * 2 points

post injury period, the nurse plan for

Mark only one oval.

A Bladder and bowel training

B Possible ventilatory support

C Complications of autonomic Dysreflexia

D Teach to do self catheterization

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20. 18. A patient with head and spinal injury is admitted in the emergency room. * 2 points

He is alert but anxious. His heart rate and BP are falling and manifest flaccid
paralysis. These findings suggest

Mark only one oval.

1 cardiogenic shock

2 anaphylactic shock

3 neurogenic shock

4 septic shock

21. 19. An 18-year-old, is involved in a climbing accident. He fell from a ledge * 2 points

and a spinal cord injury is suspected. A nurse is in the area and is the first
one to find him. He is lying on his back and says he cannot move his legs. An
appropriate action on the part of the nurse would be to:

Mark only one oval.

A turn him on his side

B keep him still, call for help

C have him bend his knees to relieve the pain

D carry to the road and summon help

22. 20. A patient with a spinal cord injury (SCI) is admitted to the unit and placed * 2 points

in traction. Which of the following actions is the nurse not responsible for
when caring for this patient?

Mark only one oval.

A. assessing the patient's skin integrity

B. applying the traction upon admission

C. administering pain medication

D. providing passive range of motion

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23. 21. Following a decompression laminectomy, the nurse should monitor the * 2 points

client’s vital signs and:

Mark only one oval.

A Log-roll the client to the prone position (cannot log roll alone)

B Check circulation and sensation to the client’s feet

C Encourage the client to maintain a moderate fluid intake

D Observe pupillary reflex in the neuro checks

24. 22. A client with a cervical spine injury was placed in Halo traction yesterday. * 2 points

When the client complains of discomfort around the pins, what action should
the nurse take?

Mark only one oval.

A Carefully loosen the pins and notify the physician immediately

B Cleanse the skin around the pin sites and dry the area thoroughly.

C Give the ordered analgesic and reassure the client that the pain is temporary.

D Loosen the pins immediately and maintain the head in neutral position.

25. 23. A nurse is caring for a client who has suffered a spinal cord injury. The * 2 points

nurse further assesses the client for other signs of autonomic dysreflexia if the
client experiences:

Mark only one oval.

A Severe, pounding headache

B Pallor of the face and neck

C Sudden tachycardia

D Severe and sudden hypotension

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26. 24. Spinal cord injury may cause a patient to experience seizure. Which of * 2 points

the following is common in children?

Mark only one oval.

A Tonic clonic

B Status epilepticus

C Myoclonic

D Petit mal

27. 25. A client with C6 spinal cord injury 2 months ago now complains of * 2 points

pounding headache. The pulse is 64 and the blood pressure is 220/110

mmHg. Which of the actions should the nurse take first?

Mark only one oval.

A. Give the analgesic as ordered.

B. Check for fecal impaction

C. Elevate the client’s head and lower the legs.

D. Notify the physician.

28. 26. When comparing a cerebrovascular accident (CVA) to a transient * 2 points

ischemic attack (TIA), the nurse understands that TIA is

Mark only one oval.

A Permanent with long-term focal deficits

B Intermittent with spontaneous resolution of the neurologic deficits

C Intermittent with permanent motor and sensory deficits.

D Permanent with no long-term neurologic deficits

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29. 27. A patient with carotid atherosclerosis asks the nurse to describe a * 2 points

carotid endarterectomy. Which response by the nurse is accurate?

Mark only one oval.

A "The obstructing plaque is surgically removed from an artery in the neck."

B "The diseased portion of the artery in the brain is replaced with a synthetic
graft."

C "A wire is threaded through an artery in the leg to the clots in the carotid artery
and the clots are removed."

D "A catheter with a deflated balloon is positioned at the narrow area, and the
balloon is inflated to flatten the plaque."

30. 28. The client develops hepatic toxicity to Dilantin (phenytoin sodium). Which * 2 points

of the following herbal alternative is used?

Mark only one oval.

A Kava Kava

B St. John’s Wort

C Dong quai

D Milk thistle

E Niyog-niyogan

31. 29. During the change of shift report a nurse is told that a patient has an * 2 points

occluded left posterior cerebral artery. The nurse will anticipate that the
patient may have

Mark only one oval.

A poor speech

B poor intellect

C visual deficits.

D poor judgment.

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32. 30. To prepare a female client for an MRI, the nurse explains that the client * 2 points

will:

Mark only one oval.

A Be asked to lie still during the entire procedure and will hear a humming sound

B Have an injection of a radiopaque contrast medium into her vein

C Have many small electrodes placed on her scalp

D Need to stay in bed with the head of the bed elevated for 6-8 hours after the
procedure

33. 31. A nurse is assessing a client who has returned from a cerebral * 2 points

arteriogram. The left carotid was the site punctured. Which of the following
indicates complications?

Mark only one oval.

A Difficulty of swallowing

B Puncture site is dry and red

C BP 120/82, HR 86, RR 22

D No swelling or hematoma at the Site

34. 32. The nurse is teaching a client with transient ischemic attacks about * 2 points

aspirin therapy. Which statement by the client indicates understanding of the

reason for his aspirin therapy?

Mark only one oval.

A “I must take the aspirin regularly to prevent the headache that many people
have with this disorder.”

B “If I take aspirin, I am less likely to develop bleedings in my brain.”

C “The aspirin will help to prevent me from having stroke

D “Taking aspirin regularly will reduce my chances of having a heart attack.”

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35. 33. The nurse is caring for a patient who has just returned after having left * 2 points

carotid artery angioplasty and stenting. Which assessment information is of

most concern to the nurse?

Mark only one oval.

A The pulse rate is 102 beats/min.

B The patient has difficulty speaking and uneven face

C The blood pressure is 144/86 mm Hg.

D There are fine crackles at the lung bases

36. 34. Which stroke risk factor for a 48-year-old male patient in the clinic is * 2 points

most important for the nurse to address?

Mark only one oval.

A The patient is 25 pounds above the ideal weight.

B The patient drinks a glass of red wine with dinner daily

C The patient's usual blood pressure (BP) is 170/94 mm Hg.

D The patient works at a desk and relaxes by watching television.

37. 35. Six in ten adults in the US have a chronic disease and four in ten adults. * 2 points

The BEST definition of a chronic disease is:

Mark only one oval.

a. Problems that are experienced by individuals in their life time that may cause
financial hardship

b. A condition that requires ongoing medical care, limits one can do, which is
likely to last three months or more

c. Problems in body functions and structure which is a lifetime debilitation.

d. A multidimensional phenomenon resulting from the interaction between

people and their environment

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38. 36. Demography is concerned with the study of population. Which of the * 2 points

following are included in a demographic profile?

Mark only one oval.

a. Change in population, distribution and health status.

b. Size, distribution, composition and change in population

c. Size, composition health status, and environment

d. Size, distribution, and composition

39. 37. The Nurse emphasizes the responsibility of the nurse to increase the * 2 points

knowledge of the community regarding the important of physical activity. The

minimum amount of daily physical activity required for health benefits is:

Mark only one oval.

a. 60 minutes of intensive activity, once a week

b. 15 minutes, to be achieved every morning or afternoon, twice a week

c. At least 30 minutes, cumulative, of moderate intensity on most days of the

week

d. 300 minutes of aerobic activities sporadically during the week

40. 38. Some common examples of screening tests are the following, EXCEPT * 2 points

Mark only one oval.

a. Urinalysis for male and female clients

b. Cholesterol levels in heart disease screening

c. PSA levels for prostate CA in men

d. Pap smears for cervical cancer screening in women

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41. 39. *As the nurse prepares for the home health care visits, which of the * 2 points

following patients should be seen FIRST? A client with

Mark only one oval.

a. A stroke with nasogastric tube (NGT)

b. A thoracostomy six months ago

c. Parkinson’s disease with imbalance gait

d. A client with Atrial Fibrillation

42. 40. A client refuses to take his daily medication for hypertension. Which of * 2 points

the following actions should the nurse take at this time?

Mark only one oval.

a. Explore the reason for the client refusal to take the medication

b. Administer the medication by injection

c. Obtain help from relatives in administering the medication

d. Tell your client that he will suffer from stroke

43. 41. *Your younger brother contacted head injury. Which of the following * 2 points

medication might be prescribed?

Mark only one oval.

A. Adenosine

B. Decadron

C. Aspirin

D. Tandura

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44. 42. Which of the following drugs is contraindicated In open head injury? * 2 points

Mark only one oval.

A. Mannitol

B. Anticonvulsant

C. Decadron

D. Dabigatran

45. 43. The foundation of medication administered administration is the * 2 points

application of the “Right of Medication Administration.” Which of the following

is NOT included in these rights?

Mark only one oval.

a. Right drug

b. Right route

c. Right dosage

d. Right patient

e. Right ID bracelet

46. 44. After a patient experienced a brief episode of tinnitus, diplopia, and * 2 points

dysarthria with no residual effects, the nurse anticipates teaching the patient
about

Mark only one oval.

a. cerebral aneurysm clipping.

b. heparin intravenous infusion.

c. oral low-dose aspirin therapy.

d. tissue plasminogen activator (tPA)

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47. 45. A client is taking prescribed Aspirin, 325 mg daily for her transient * 2 points

ischemic attacks. Nurse QL explains that aspirin was prescribed to

Mark only one oval.

A. Prevent headaches

B. Boost coagulation

C. Decrease platelet aggregation

D. Prevent cerebral anoxia

48. 46. When teaching about clopidogrel (Plavix), the nurse will tell the patient * 2 points

with cerebral atherosclerosis

Mark only one oval.

A to monitor and record the blood pressure daily.

B that Plavix will dissolve clots in the cerebral arteries.

C that Plavix will reduce cerebral artery plaque formation

D to call the health care provider if stools are bloody or tarry

49. 47. A 56-year-old patient arrives in the emergency department with * 2 points

hemiparesis and dysarthria that started 2 hours previously, and health

records show a history of several transient ischemic attacks (TIAs). The nurse
anticipates preparing the patient for

Mark only one oval.

a. surgical endarterectomy.

b. transluminal angioplasty or PCI

c. intravenous heparin administration.

d. tissue plasminogen activator (tPA) infusion

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50. 48. Which of the following will not require sterile technique approach? * 2 points

Mark only one oval.

a. Carotid endarterectomy

b. Scalp biopsy

c. Lumbar puncture

d. Blood pressure taking

51. 49. Which one is NOT a risk factor in CVA or stroke? * 2 points

Mark only one oval.

A. Diabetes Mellitus

B. Embolic stroke

C. Smoking

D. Stress

52. 50. A 70-year-old female patient with left-sided hemiparesis arrives by * 2 points

ambulance to the emergency department. Which action should the nurse take
first?

Mark only one oval.

A Monitor the blood pressure.

B Send the patient for a computed tomography

C Check the airway patency, respiratory rate and effort

D Assess the Glasgow Coma Scale score

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