NCLEX 24 practice questions: Neuro - ICP, LOC, meningitis
While cooking, your client couldn’t feel the temperature of a hot oven. Which lobe could be dysfunctional?
1. Parietal - Given
2. Occipital
3. Temporal
4. Frontal
Problems with memory and learning would relate to which of the following lobes?
1. Frontal - Given
2. Occipital
3. Parietal
4. Temporal
Which of the following pathologic processes is often associated with aseptic meningitis?
1. Ischemic infarction of cerebral tissue
2. Childhood diseases of viral causation such as mumps
3. Brain abscesses caused by a variety of pyogenic organisms
4. Cerebral ventricular irritation from a traumatic brain injury - Given
Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular
coagulation?
1. Edema
2. Hemorrhagic skin rash - Given
3. Dyspnea on exertion
4. Cyanosis
The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing
meningitis as a complication of surgery if the client exhibits:
1. A positive Brudzinski’s sign - Given
2. Absence of nuchal rigidity
3. A Glascow Coma Scale score of 15
4. A negative Kernig’s sign
A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the
results of the CSF analysis and determines that which of the following results would verify the diagnosis?
1. Cloudy CSF, decreased protein, and decreased glucose
2. Clear CSF, elevated protein, and decreased glucose
3. Clear CSF, decreased pressure, and elevated protein
4. Cloudy CSF, elevated protein, and decreased glucose - Given
When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect
pneumococcal meningitis?
1. Bladder infection
2. Septic arthritis
3. Middle ear infection - Given
4. Fractured clavicle
Which of the following values is considered normal for ICP?
1. 0 to 15 mm Hg - Given
2. 120/80 mm Hg
3. 25 mm Hg
4. 35 to 45 mm Hg
A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders
mannitol for which of the following reasons?
1. To prevent acute tubular necrosis
2. To reduce intraocular pressure
3. To draw water into the vascular system to increase blood pressure
4. To promote osmotic diuresis to decrease ICP - Given
A client admitted to the hospital with a subarachnoid hemorrhage has complaints of severe headache, nuchal rigidity, and projectile
vomiting. The nurse knows lumbar puncture (LP) would be contraindicated in this client in which of the following
circumstances?
1. The client needs mechanical ventilation
2. Blood is anticipated in the cerebralspinal fluid (CSF) - Given
3. Intracranial pressure (ICP) is increased
4. Vomiting continues
The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the
procedure?
1. Prone, in a slight Trendelenburg’s position
2. Prone, with a pillow under the abdomen.
3. Side-lying, with legs pulled up and head bent down onto the chest - Given
4. Side-lying, with a pillow under the hip
Which of the following signs and symptoms of increased ICP after head trauma would appear first?
1. Bradycardia
2. Widened pulse pressure
3. Large amounts of very dilute urine
4. Restlessness and confusion - Given
A nurse is assisting with caloric testing of the oculovestibular reflex of an unconscious client. Cold water is injected into the left
auditory canal. The client exhibits eye conjugate movements toward the left followed by a rapid nystagmus toward the right. The
nurse understands that this indicates the client has:
1. A cerebral lesion
2. A temporal lesion
3. An intact brainstem - Given
4. Brain death
A client is arousing from a coma and keeps saying, “Just stop the pain.” The nurse responds based on the knowledge that the
human body typically and automatically responds to pain first with attempts to:
1. Divert attention from the source of pain.
2. Tolerate the pain
3. Escape the source of pain - Given
4. Decrease the perception of pain
A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would
best show the mannitol was effective?
1. Pupils are 8 mm and nonreactive
2. BUN and creatinine levels return to normal
3. Urine output increases - Given
4. Systolic blood pressure remains at 150 mm Hg
Which of the following symptoms may occur with a phenytoin level of 32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion - Given
3. Urinary incontinence
4. Tonic-clonic seizure
Which of the following assessment data indicated nuchal rigidity?
1. Negative Brudzinski’s sign
2. Positive Kernig’s sign - Given
3. Positive homan’s sign
4. Negative Kernig’s sign
The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms would the nurse expect the
child to demonstrate? Select all that apply.
1. Vomiting - Given
2. Polydipsia - Given
3. Lethargy - Given
4. Increased appetite - Given
5. Head tilt
6. Increased pulse
Meningitis occurs as an extension of a variety of bacterial infections due to which of the following conditions?
1. Natural affinity of the CNS to certain pathogens - Given
2. Congenital anatomic abnormality of the meninges
3. Occlusion or narrowing of the CSF pathway
4. Lack of acquired resistance to the various etiologic organisms
The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the
client’s peripheral response to pain?
1. Pressure on the orbital rim
2. Nail bed pressure - Given
3. Sternal rub
4. Squeezing the sternocleidomastoid muscle
The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital
signs if the ICP is rising?
1. Decreasing temperature, decreasing pulse, increasing respirations, decreasing blood pressure.
2. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure. - Given
3. Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure.
4. Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure.
A nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing.
On assessment of the child, the nurse would expect to note which of the following if this type of posturing was present?
1. Rigid extension and pronation of the arms and legs - Given
2. Flaccid paralysis of all extremities
3. Abnormal flexion of the upper extremities and extension of the lower extremities
4. Rigid pronation of all extremities
A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the
following would be included in the plan of care?
1. Maintain neutropenic precautions
2. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics - Given
3. Maintain enteric precautions
4. No precautions are required as long as antibiotics have been started
During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to
institute?
1. Allowing the child to play in the bathtub
2. Performing treatments quickly
3. Limiting conversation with the child
4. Keeping extraneous noise to a minimum - Given
