NCLEX : Neural and Psychological Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #1094 : Nclex

You are the nurse in a psychiatrist's office taking care of a patient who presents with three years of pulling at her hair in a compulsive manner. The patient states that she has a strong urge to pull her hair out, especially in times of stress, and that removing hairs helps to relieve tension. She is bald on two-thirds of her scalp, and feels very distressed and socially impaired. Which of the following best describes this patient's illness?

Possible Answers:

Social phobia

Trichotillomania

Agoraphobia

Arachnophobia 

Walking-corpse syndrome

Correct answer:

Trichotillomania

Explanation:

The correct answer is "trichotillomania." This is the correct answer, as this term describes the obsessive-compulsive condition in which patients have an uncontrollable urge to remove their hair, which causes baldness, and social/emotional distress and impairment. Patients typically pull hair from the scalp, eyebrows, lashes, and extremities. Treatment includes a variable combination of psychotherapy and/or medications.

On the other hand, the other choices are incorrect. Walking-corpse syndrome is a psychiatric condition in which a patient thinks that they are dead, while in reality, they are indeed alive. Arachnophobia is a fear of spiders. Agoraphobia is a fear of being in public places. Last, social phobia is a fear of social situations.

Example Question #31 : Identifying Neural Conditions

A patient with a past medical history of hypertension comes into the emergency room reporting the sudden onset of the "worst headache of their life". They feel nauseous with blurry vision and generally appear unwell. What is the most likely diagnosis based on this history?

Possible Answers:

Subarachnoid hemorrhage

Herpes simplex virus

Subdural hemoatoma

Epidural hematoma

Correct answer:

Subarachnoid hemorrhage

Explanation:

The "worst headache of my life" or "thunderclap headache" is characteristic of subarachnoid hemorrhage. This is bleeding in the brain and must be treated urgently. It is usually caused by the rupture of a berry aneurysm within the blood supply to the brain. Hypertension is a major risk factor.

Example Question #291 : Conditions And Treatments

A 50-year-old female client recently diagnosed with multiple sclerosis, presents to the clinic after having a history of several neurological symptoms and is asking the nurse about her condition. The nurse is glad to teach the client about multiple sclerosis.

Which of the following statements about multiple sclerosis is correct?

Possible Answers:

Multiple sclerosis is a genetically transmitted disease which affects the basal ganglia and the extra pyramidal system with a deficiency of acetylcholine. The effects are seen in both physical and cognitive dysfunction.  

Multiple sclerosis is a disease where excess release of dopamine and increase serotonin levels of the brain lead to neurological dysfunction.

Multiple sclerosis is a autoimmune disease of the neuromuscular junction characterized by variable weakness of different muscle groups. 

Multiple sclerosis is a progressive and chronic degenerative disorder. The condition leads to demyelination of the nerve fibers of the central nervous system, causing various neurological defects. 

Multiple sclerosis is a disease of the dopamine producing neurons of the substancia nigra of the midbrain, causing overall weakness. 

Correct answer:

Multiple sclerosis is a progressive and chronic degenerative disorder. The condition leads to demyelination of the nerve fibers of the central nervous system, causing various neurological defects. 

Explanation:

Multiple sclerosis is an autoimmune process with no exact known cause. The myelin sheath is attacked and plaque formation occurs in various regions of the CNS. Without myelin, nerve conduction slows down and may eventually be completely blocked leading to widespread loss of function. 

Loss of the dopamine-producing neurons describes Parkinson's disease. Excess dopamine describes dementia. Deficiency of acetylcholine describes Huntington's disease, and the autoimmune disease of the neuromuscular junction is known as Myasthenia Gravis.

Example Question #291 : Conditions And Treatments

Bell's palsy is due to dysfunction of which of the following cranial nerves?

Possible Answers:

Cranial nerve IV

Cranial nerve III

Cranial nerve VII

Cranial nerve VIII

Correct answer:

Cranial nerve VII

Explanation:

Bell's palsy is due to dysfunction of cranial nerve VII, the facial nerve. The facial nerve provides motor control to the musculature of the face and sensory innervation of taste, facial sensation, and parasympathetic innervation of the submandibular and sublingual glands. 

  

Example Question #292 : Conditions And Treatments

Which of the following classes of medication is not used for treatment of migraine headaches?

Possible Answers:

Triptans

All of these may be used to treat migraines

Beta blockers

Antidepressants

Correct answer:

All of these may be used to treat migraines

Explanation:

Migraine headaches are commonly treated at first by over the counter (OTC) medications such as NSAIDS and acetaminophen. Other treatment options include triptans, antidepressants such as amitriptyline, and anti-hypertensives (beta blockers and calcium channel blockers).

Example Question #1 : Causes And Treatments Of Neural Conditions

Which of the following herbs has been shown to be effective in prevention of migraine symptoms?

Possible Answers:

Uncaria tomentosa (cat's claw)

Hypericum perforatum (St John's wort)

Petasites hybridus (butterbur)

Agrimonia eupatoria (agrimony)

Correct answer:

Petasites hybridus (butterbur)

Explanation:

Petasites hybridus (butterbur) is a flowering plant of the family asteraceae. It has been shown in studies to reduce the frequency of migraine headaches by as much as 68%. None of the other herbs listed have any significant medicinal benefit in migraine headaches. 

Example Question #2 : Causes And Treatments Of Neural Conditions

Which of the following interventions has been shown to be effective in reducing the severity of pain in cluster headaches?

Possible Answers:

Heel-drop maneuver

100% oxygen at minimum 12 liters per minute

Hot and cold alternating applications

Carotid sinus massage

Correct answer:

100% oxygen at minimum 12 liters per minute

Explanation:

One non-pharmaceutical intervention that has shown to provide relief for a significant number of individuals with cluster headaches is 100% oxygen, delivered via mask at a minimum of 12 liters per minute. Relief can be felt in as little as 15 minutes. None of the other interventions mentioned would be likely to improve symptoms of a cluster headache.

Example Question #1 : Causes And Treatments Of Neural Conditions

Bell's palsy is associated with infection by which of the following pathogens?

Possible Answers:

All of these are correct

Epstein Barr virus

Herpes zoster

Herpes simplex 1

Correct answer:

All of these are correct

Explanation:

While Bell's palsy is most frequently associated with prior infection with herpes simplex 1, is may also be associated with cytomegalovirus, Epstein Barr virus, and herpes zoster.

Example Question #3 : Causes And Treatments Of Neural Conditions

What is the prognosis with Bell's palsy?

Possible Answers:

Nerve resection is required to prevent corneal abrasions

Antiviral treatment is required to prevent permanent paralysis

Corticosteroid treatment is required to prevent permanent loss of taste

Self-resolving in 1-6 months

Correct answer:

Self-resolving in 1-6 months

Explanation:

In the vast majority of cases Bell's palsy resolves within 1-6 months without medical intervention. Moistening of the affected eye (rather than nerve resection) is required during this period to prevent corneal damage. There is very little risk of permanent paralysis or loss of taste. 

Example Question #4 : Causes And Treatments Of Neural Conditions

All of the following are common etiologies of seizure disorders except __________.

Possible Answers:

marijuana use

infection

genetic predisposition

brain tumor

Correct answer:

marijuana use

Explanation:

The most common causes of seizures include brain injury or tumor, genetic predisposition, medications, and infections such as meningitis. While marijuana may be a trigger for sensitive individuals with seizure disorders, it has not been known to cause seizures in a non-epileptic individual and has shown to reduce seizure incidence in some individuals with this condition when used in a medical setting. 

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