NCLEX Neurological Practice Questions

15 free NCLEX-RN neurological questions with answers and rationales — perfect for neuro nclex questions practice. Want them as an interactive timed quiz?

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1. A 68-year-old male patient is admitted to the emergency department with symptoms of aphasia and right-sided weakness. What is the priority nursing action?
- A. Assess the patient's airway and breathing. ✓
- B. Perform a full neurological assessment.
- C. Administer prescribed antihypertensive medication.
- D. Prepare the patient for a CT scan.
Answer: A. Assess the patient's airway and breathing. — Airway and breathing are the top priorities in the initial management of a suspected stroke, as adequate oxygenation is critical.
2. A patient with a history of epilepsy is observed having a tonic-clonic seizure. What is the BEST initial nursing action?
- A. Insert an oral airway to maintain patency.
- B. Restrain the patient to prevent injury.
- C. Turn the patient onto their side. ✓
- D. Administer IV lorazepam immediately.
Answer: C. Turn the patient onto their side. — Turning the patient onto their side helps maintain an open airway and prevents aspiration, which is a priority during a seizure.
3. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 6. What does this score indicate?
- A. Mild brain injury.
- B. Moderate brain injury.
- C. Severe brain injury. ✓
- D. Normal brain function.
Answer: C. Severe brain injury. — A GCS score of 6 indicates severe brain injury, as scores of 8 or less are categorized as severe.
4. Which clinical manifestation would the nurse expect in a patient with Parkinson's disease?
- A. Flaccid paralysis.
- B. Resting tremor. ✓
- C. Severe headache.
- D. Bradycardia.
Answer: B. Resting tremor. — Resting tremor is a classic symptom of Parkinson's disease, often described as 'pill-rolling' tremor.
5. A patient with multiple sclerosis is experiencing diplopia. Which nursing intervention is appropriate?
- A. Encourage the patient to wear an eye patch over one eye. ✓
- B. Teach the patient to perform eye exercises.
- C. Instruct the patient to avoid bright lights.
- D. Administer prescribed corticosteroids.
Answer: A. Encourage the patient to wear an eye patch over one eye. — Wearing an eye patch over one eye can help alleviate diplopia by blocking visual input from one eye.
6. What is the most appropriate nursing action for a patient with increased intracranial pressure (ICP)?
- A. Encourage coughing and deep breathing exercises.
- B. Position the patient in Trendelenburg position.
- C. Elevate the head of the bed to 30 degrees. ✓
- D. Administer hypotonic IV fluids.
Answer: C. Elevate the head of the bed to 30 degrees. — Elevating the head of the bed to 30 degrees helps reduce ICP by promoting venous drainage.
7. In a patient with myasthenia gravis, which symptom would indicate a potentially life-threatening complication?
- A. Ptosis.
- B. Dysphagia. ✓
- C. Muscle weakness.
- D. Diplopia.
Answer: B. Dysphagia. — Dysphagia can lead to aspiration and is a sign of myasthenic crisis, which requires immediate attention.
8. A patient with a complete spinal cord injury at T6 is at risk for autonomic dysreflexia. Which symptom should prompt the nurse to take immediate action?
- A. Headache. ✓
- B. Bradycardia.
- C. Nasal congestion.
- D. Sweating above the level of injury.
Answer: A. Headache. — A severe headache is often the first symptom of autonomic dysreflexia, a medical emergency requiring prompt intervention.
9. Which of the following assessments is MOST indicative of a basilar skull fracture?
- A. Raccoon eyes.
- B. Hemotympanum.
- C. Battle's sign. ✓
- D. Nausea and vomiting.
Answer: C. Battle's sign. — Battle's sign, bruising behind the ear, is a classic sign of a basilar skull fracture.
10. A patient with a recent stroke presents with expressive aphasia. What is the best nursing intervention to facilitate communication?
- A. Use a picture board. ✓
- B. Speak in a louder voice.
- C. Provide written instructions.
- D. Encourage verbalization of thoughts.
Answer: A. Use a picture board. — A picture board can help a patient with expressive aphasia communicate more effectively by providing visual options.
11. An 80-year-old female patient with a history of hypertension is suspected of having a transient ischemic attack (TIA). Which statement by the patient suggests this condition?
- A. I had a severe headache that lasted all day yesterday.
- B. I suddenly couldn't move my right arm for a few minutes. ✓
- C. I've been feeling dizzy for the past week.
- D. I've had a constant tingling sensation in my legs.
Answer: B. I suddenly couldn't move my right arm for a few minutes. — TIAs are characterized by sudden, temporary neurological deficits such as weakness or numbness lasting minutes to hours.
12. A nurse is assessing a patient with a possible brain tumor. Which symptom is considered a red flag for increased intracranial pressure?
- A. Persistent vomiting. ✓
- B. Muscle twitching.
- C. Fatigue.
- D. Intermittent fever.
Answer: A. Persistent vomiting. — Persistent vomiting can be a sign of increased intracranial pressure, often associated with brain tumors.
13. Which medication is most likely to be prescribed for a patient with myasthenia gravis to improve muscle strength?
- A. Prednisone.
- B. Pyridostigmine. ✓
- C. Diazepam.
- D. Gabapentin.
Answer: B. Pyridostigmine. — Pyridostigmine is an acetylcholinesterase inhibitor commonly used to improve muscle strength in myasthenia gravis.
14. A patient with multiple sclerosis is experiencing urinary retention. What nursing intervention should be implemented?
- A. Restrict fluid intake to prevent overflow.
- B. Insert a Foley catheter for continuous drainage.
- C. Encourage the Valsalva maneuver during voiding.
- D. Schedule regular toileting every 2 hours. ✓
Answer: D. Schedule regular toileting every 2 hours. — Regular toileting can help manage urinary retention by establishing a consistent voiding pattern.
15. Which of the following is a classic symptom of a hemorrhagic stroke?
- A. Sudden severe headache. ✓
- B. Gradual speech difficulty.
- C. Mild muscle weakness.
- D. Progressive memory loss.
Answer: A. Sudden severe headache. — A sudden severe headache is often described as a 'thunderclap' headache, common in hemorrhagic strokes.

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NCLEX Neurological Practice Questions

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