All NCLEX-RN Resources
Example Questions
Example Question #1105 : Nclex
All of the following medications are considered first-line treatments of absence seizures except __________.
Ethosuximide
Valproic acid
Lamotrigine
Carbamazepine
Carbamazepine
The most commonly prescribed medication for absence seizures is Ethosuximide. Lamotrigine and valproic acid may also be used if seizures are unable to be controlled with ethosuximide. Carbamazepine, a common medication prescribed for simple and complex partial seizures, is specifically contraindicated in absence seizures.
Example Question #1106 : Nclex
A patient is hospitalized for alcohol withdrawal and is started on medication to prevent complications from withdrawal. Which type of medication is used to attenuate the possibility of seizures during this hospitalization?
Anti-epileptic drug (AED)
Typical antipsychotic
Benzodiazepines
Selective serotonin re-uptake inhibitor (SSRI)
Atypical antipsychotic
Benzodiazepines
Benzodiazepines are the mainstay of treatment for alcohol withdrawal. Anti-epileptic drug (AEDs) are not to be used during alcohol withdrawal, and are reserved for patients who have a true seizure disorder. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA) protocol is used as symptom based therapy with benzodiazepines to prevent seizures and other complications from withdrawal.
Example Question #41 : Neural And Psychological Conditions
Which of the following is the first-line treatment for cauda equina syndrome?
Physiotherapy
Muscle relaxants
Surgical decompression
Chiropractic manipulation
Surgical decompression
Cauda equina syndrome is a serious condition in which the cauda equina is disturbed within the spinal cord, generally due to impingement, trauma, local lesion, or compression. The first-line treatment is surgical decompression. Neither physiotherapy nor muscle relaxants would address the cause of this condition, and chiropractic manipulation may actually exacerbate the symptoms.
Example Question #1 : Symptoms And Tests For Neural Conditions
A client admitted to the neuro intensive care unit is having his level of responsiveness assessed by the nurse on duty. Her findings include eyes opening to verbal command, is disoriented but can converse, and obeys commands.
What is this client's Glasgow Coma Scale score?
The score of this client includes: eye open response is a , best verbal response is and best motor response is .
Example Question #2 : Symptoms And Tests For Neural Conditions
An unconscious patient exhibits stiffly extended arms that are also adducted with the wrists hyperpronated. The nurse recognizes this presentation to be __________.
vestibulospinal reflex
Babinski reflex
crossed extensor reflex
decerebrate positioning
decorticate positioning
decerebrate positioning
Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.
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?
Test for ataxia
Romberg's test
Rapidly alternating movement test
Gait test
Romberg's test
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?
Multiple sclerosis
Parkinson's disease
Cerebellar lesion
Lesion in the pons
Multiple sclerosis
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 __________.
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
migraine aura that persists after headache has resolved
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?
Apraxia
Ataxia
Aphasia
Dysmetria
Aphasia
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?
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.