NCLEX Neurological Disorders Exam Practice Questions and Answers

Sample Questions and Answers

• A patient with multiple sclerosis (MS) is most likely to exhibit which of the following symptoms?

• A. Bradykinesia
• B. Muscle spasticity
• C. Hyperreflexia
• D. Resting tremor

Answer: B. Muscle spasticity

• Which neurotransmitter is primarily deficient in Parkinson’s disease?

• A. Acetylcholine
• B. Dopamine
• C. Serotonin
• D. Norepinephrine

Answer: B. Dopamine

• The initial sign of increased intracranial pressure (ICP) is often:

• A. Bradycardia
• B. Hypertension
• C. Altered level of consciousness
• D. Pupillary dilation

Answer: C. Altered level of consciousness

• Which of the following is a common early symptom of amyotrophic lateral sclerosis (ALS)?

• A. Visual disturbances
• B. Muscle weakness
• C. Cognitive decline
• D. Sensory loss

Answer: B. Muscle weakness

• In Guillain-Barré syndrome, the primary pathological process involves:

• A. Demyelination of peripheral nerves
• B. Degeneration of motor neurons
• C. Plaque formation in the CNS
• D. Neurofibrillary tangles

Answer: A. Demyelination of peripheral nerves

• Which medication is commonly prescribed to manage spasticity in multiple sclerosis patients?

• A. Levodopa
• B. Baclofen
• C. Donepezil
• D. Phenytoin

Answer: B. Baclofen

• A positive Brudzinski’s sign is indicative of:

• A. Meningeal irritation
• B. Cerebellar dysfunction
• C. Vestibular disorder
• D. Spinal cord injury

Answer: A. Meningeal irritation

• The primary goal in the acute management of a patient with a stroke is to:

• A. Reduce intracranial pressure
• B. Maintain airway patency
• C. Prevent aspiration
• D. Restore cerebral blood flow

Answer: D. Restore cerebral blood flow

• Which of the following is a characteristic feature of myasthenia gravis?

• A. Progressive muscle weakness with activity
• B. Involuntary muscle contractions
• C. Loss of muscle coordination
• D. Sensory deficits

Answer: A. Progressive muscle weakness with activity

• The most common type of stroke is:

• A. Ischemic
• B. Hemorrhagic
• C. Transient ischemic attack
• D. Subarachnoid hemorrhage

Answer: A. Ischemic

• Which cranial nerve is assessed by evaluating the gag reflex?

• A. Glossopharyngeal (IX)
• B. Vagus (X)
• C. Hypoglossal (XII)
• D. Trigeminal (V)

Answer: A. Glossopharyngeal (IX)

• A patient presents with a sudden, severe headache described as “the worst headache of my life.” This is most indicative of:

• A. Migraine
• B. Tension headache
• C. Subarachnoid hemorrhage
• D. Cluster headache

Answer: C. Subarachnoid hemorrhage

• Which of the following is a modifiable risk factor for stroke?

• A. Age
• B. Family history
• C. Hypertension
• D. Gender

Answer: C. Hypertension

• The Glasgow Coma Scale assesses which of the following functions?

• A. Motor response, verbal response, and eye opening
• B. Pupillary response, motor strength, and reflexes
• C. Sensory perception, coordination, and balance
• D. Memory, orientation, and judgment

Answer: A. Motor response, verbal response, and eye opening

• Which of the following is a common side effect of phenytoin (Dilantin) therapy?

• A. Weight gain
• B. Gingival hyperplasia
• C. Insomnia
• D. Hypotension

Answer: B. Gingival hyperplasia

• A patient with a spinal cord injury at the level of T1-T4 is at risk for which complication?

• A. Autonomic dysreflexia
• B. Respiratory failure
• C. Quadriplegia
• D. Loss of bowel and bladder function

Answer: A. Autonomic dysreflexia

• Which diagnostic test is most definitive for diagnosing multiple sclerosis?

• A. MRI of the brain and spinal cord
• B. CT scan of the head
• C. Electroencephalogram (EEG)
• D. Lumbar puncture

Answer: A. MRI of the brain and spinal cord

 

• Which sign is most characteristic of increased intracranial pressure in a pediatric patient?

• A. Bulging fontanel
• B. Nuchal rigidity
• C. High-pitched cry
• D. Seizures

Answer: A. Bulging fontanel

• A nurse is caring for a patient with a basilar skull fracture. Which finding is most concerning?

• A. Clear fluid draining from the nose
• B. Bruising around the eyes (raccoon eyes)
• C. Bruising behind the ears (Battle’s sign)
• D. Nausea and vomiting

Answer: A. Clear fluid draining from the nose

• The main goal of administering tissue plasminogen activator (tPA) to a stroke patient is to:

• A. Dissolve the clot blocking blood flow to the brain
• B. Decrease blood pressure
• C. Prevent seizures
• D. Reduce intracranial pressure

Answer: A. Dissolve the clot blocking blood flow to the brain

• Which cranial nerve is tested when asking the patient to shrug their shoulders against resistance?

• A. Cranial nerve IX (Glossopharyngeal)
• B. Cranial nerve X (Vagus)
• C. Cranial nerve XI (Accessory)
• D. Cranial nerve XII (Hypoglossal)

Answer: C. Cranial nerve XI (Accessory)

• In patients with myasthenia gravis, the Tensilon test is used to:

• A. Confirm the diagnosis of myasthenia gravis
• B. Identify the location of the tumor
• C. Assess respiratory function
• D. Monitor the progression of the disease

Answer: A. Confirm the diagnosis of myasthenia gravis

• Which condition is characterized by sudden, severe, unilateral facial weakness?

• A. Trigeminal neuralgia
• B. Bell’s palsy
• C. Stroke
• D. Multiple sclerosis

Answer: B. Bell’s palsy

• Which clinical manifestation is an early sign of Guillain-Barré syndrome?

• A. Sudden loss of consciousness
• B. Progressive ascending paralysis
• C. Loss of deep tendon reflexes
• D. Difficulty breathing

Answer: B. Progressive ascending paralysis

• A nurse is providing care to a patient with a seizure disorder. Which action is a priority during a seizure?

• A. Insert a bite block into the patient’s mouth
• B. Protect the patient’s head from injury
• C. Restrain the patient’s movements
• D. Administer anticonvulsants immediately

Answer: B. Protect the patient’s head from injury

• What is the primary intervention for a patient diagnosed with bacterial meningitis?

• A. Administer intravenous antibiotics immediately
• B. Monitor for signs of hemorrhage
• C. Perform a lumbar puncture
• D. Isolate the patient to prevent the spread

Answer: A. Administer intravenous antibiotics immediately

• Which finding is most consistent with Cushing’s triad in a patient with increased intracranial pressure?

• A. Tachycardia, hypotension, and irregular respirations
• B. Hypertension, bradycardia, and irregular respirations
• C. Hypotension, tachycardia, and Kussmaul breathing
• D. Bradycardia, hypertension, and Cheyne-Stokes respirations

Answer: B. Hypertension, bradycardia, and irregular respirations

• Which of the following is the most reliable indicator of a patient’s neurologic status?

• A. Pupil size and reactivity
• B. Glasgow Coma Scale score
• C. Motor strength and coordination
• D. Reflex responses

Answer: B. Glasgow Coma Scale score

• Which is a priority nursing diagnosis for a patient with advanced Alzheimer’s disease?

• A. Risk for infection
• B. Impaired verbal communication
• C. Risk for injury
• D. Impaired social interaction

Answer: C. Risk for injury

• A patient with a history of epilepsy is prescribed phenytoin (Dilantin). Which statement by the patient indicates a need for further teaching?

• A. “I will take my medication at the same time every day.”
• B. “I can stop taking the medication once my seizures stop.”
• C. “I should have regular dental check-ups.”
• D. “I will avoid drinking alcohol while on this medication.”

Answer: B. “I can stop taking the medication once my seizures stop.”