NCLEX : NCLEX

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #2 : Symptoms And Tests For Neural Conditions

Swaying or inability to maintain balance while standing with the eyes closed is considered a positive finding in what test?

Possible Answers:

Test for ataxia

Romberg's test

Rapidly alternating movement test

Gait test

Correct answer:

Romberg's test

Explanation:

Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further. 

Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.

Example Question #3 : Symptoms And Tests For Neural Conditions

A 46-year-old patient presents with dysdiadochokinesis (an inability to perform rapidly alternating movements). What condition is the most common cause of dysdiadochokinesis in adults?

Possible Answers:

Multiple sclerosis

Parkinson's disease

Cerebellar lesion

Lesion in the pons

Correct answer:

Multiple sclerosis

Explanation:

In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.

Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.

Example Question #1113 : Nclex

A 26-year-old woman presents to urgent care after a bike accident in which she got "a bad bump on the head." She was not wearing a helmet. She must now be assessed for increased intracranial pressure. All of the following are signs of increased intracranial pressure except __________.

Possible Answers:

effort-related or positional headache 

one or both pupils are dilated and unresponsive to light

migraine aura that persists after headache has resolved

altered consciousness

Correct answer:

migraine aura that persists after headache has resolved

Explanation:

Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.

Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation. 

Example Question #4 : Symptoms And Tests For Neural Conditions

Which of the following terms denotes neurological impairment of the ability to speak or understand language?

Possible Answers:

Apraxia

Ataxia

Aphasia

Dysmetria

Correct answer:

Aphasia

Explanation:

Aphasia is the term for neurological impairment of a person's ability to speak or understand language. 

The other terms listed all denote various deficiencies:

  • Ataxia is a loss or lack of coordinated motor function. 
  • Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
  • Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object

Example Question #4 : Symptoms And Tests For Neural Conditions

The nurse cares for a patient who is prescribed phenytoin for seizures. Which of the following serum drug levels would most concern the nurse?

Possible Answers:

Correct answer:

Explanation:

The therapeutic serum phenytoin level is between .

 would be below the therapeutic level and may be due to non-compliance by the client or increased metabolism of the drug. The other options are within the listed therapeutic range.

Example Question #311 : Conditions And Treatments

Which of the following is a term for an abnormal surge or excess of electrical activity in the brain?

Possible Answers:

Twitch

Spasm

Seizure

Dyskinesia

Correct answer:

Seizure

Explanation:

A seizure is defined as an abnormal surge or excess of electrical activity in the brain. This can result in partial or total loss of consciousness, and may cause muscular spasms, twitches, or other types of dyskinesia (disorders of movement). Spasms, twitches, and dyskinesias are not always caused by seizure disorders, however - they may be caused by a wide range of neuromuscular dysfunctions. 

Example Question #312 : Conditions And Treatments

Schizophrenic individuals frequently have abnormally high levels of what signaling molecule?

Possible Answers:

Dopamine

Norepinephrine

Serotonin

Acetylcholine

Correct answer:

Dopamine

Explanation:

While many people with schizophrenia do seem to have dysfunctions in multiple signaling molecules, excess levels of dopamine have been clearly associated with this disorder. 

Example Question #53 : Neural And Psychological Conditions

Hank is a schizophrenic 46 year old male. He experiences a persistent belief that a particular television commercial actor is addressing him directly, and that the commercial was created specifically to communicate with him. What type of delusion is Hank experiencing?

Possible Answers:

Cotard delusion

Delusion of control

Delusion of reference

Erotomania

Correct answer:

Delusion of reference

Explanation:

The belief that general or innocuous events exist specifically for or relate specifically to an individual is called a delusion of reference. Examples include belief that a billboard or television commercial is attempting to communicate directly to an individual, the ascribing of significance to random coincidences, or the observation of coded signals or signs in the general environment.

Example Question #311 : Conditions And Treatments

Charlotte is a 19 year old female with new onset of paranoia and auditory hallucinations. She has a positive family history for schizophrenia. Recently she admitted to her nurse that she can “hear” what other people are thinking. As she describes it, this does not come in the form of sound, but is communicated directly to her brain. Charlotte is likely experiencing which of the following?

Possible Answers:

Thought broadcasting

Auditory hallucination

Telepathy

Delusions of persecution

Correct answer:

Thought broadcasting

Explanation:

The belief that other people can hear one's thoughts is described by the term thought broadcasting. This is a common symptom in schizophrenia. It is differentiated from telepathy in that thought broadcasting, there is a delusion that thoughts can be heard by anyone, while telepathy is generally non-verbal communication between specific individuals, and may be receptive as well as projective. Auditory hallucinations are false perceptions of sounds (or internal thought perceived at emanating from another source), while delusions of persecution can take many forms but generally include a degree of paranoia or feeling of being targeted for harm or attack.

Example Question #11 : Symptoms And Tests For Neural Conditions

The term "positive symptoms" in schizophrenia refers to which of the following?

Possible Answers:

Repetitive physical movements or gestures

The loss of a specific sense, such as loss of sense of smell (anosmia) 

Any symptom that increases confidence or leads to grandiosity

Any cognitive excess or distortions, such as delusions or hallucinations

Correct answer:

Any cognitive excess or distortions, such as delusions or hallucinations

Explanation:

Positive symptoms in schizophrenia are any symptoms of cognitive excess or disordered thinking. These include delusions, such as delusions of grandeur or persecution, hallucinations, and disorganized speech or behavior. 

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