NCLEX Questions on Neurological System

NCLEX Questions on Neurological System Related

Review NCLEX Questions on Neurological System related questions and content

An elderly patient presents with a right-sided headache and acute loss of vision on the same side. Tenderness is noted to the right temporal region as well as to the scalp. To obtain a definitive diagnosis, the nurse practitioner will order:

  • A. Erythrocyte sedimentation rate (ESR)
  • B. C-reactive protein (CRP)
  • C. Temporal artery biopsy
  • D. CT scan of the head
Correct Answer: C

Rationale: The correct answer is C: Temporal artery biopsy. This is the gold standard for diagnosing giant cell arteritis, which presents with symptoms such as headache, vision loss, and tenderness to the temporal region and scalp. The biopsy will show characteristic inflammatory changes in the artery wall.

A: ESR and B: CRP are nonspecific markers of inflammation and can be elevated in various conditions, including giant cell arteritis, but they do not provide a definitive diagnosis.

D: CT scan of the head may show signs of inflammation in the temporal artery, but it is less sensitive than a biopsy for diagnosing giant cell arteritis.

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All of the following are branches of the ophthalmic division of the trigeminal nerve EXCEPT:

  • A. Lacrimal nerve
  • B. Infraorbital nerve
  • C. Supraorbital nerve
  • D. Infratrochlear nerve
Correct Answer: B

Rationale: The infraorbital nerve is a branch of the maxillary division (V2) of the trigeminal nerve, not the ophthalmic division (V1). It supplies sensation to the lower eyelid, cheek, and upper lip.

What do we call the layer of fatty tissue surrounding the axon of some neurons?

  • A. cutaneous coating
  • B. myelin sheath
  • C. dendritic barrier
  • D. synaptic sleeve
Correct Answer: B

Rationale: The myelin sheath is a layer of fatty tissue that surrounds the axons of some neurons, providing insulation and increasing the speed of electrical signal transmission. Myelin is produced by glial cells, such as oligodendrocytes in the central nervous system and Schwann cells in the peripheral nervous system. Damage to the myelin sheath, as seen in conditions like multiple sclerosis, can impair neural communication and lead to neurological symptoms.

In obtaining the history for the patient with carpal tunnel syndrome, you would expect to note a history of

  • A. Pain and numbness or tingling sensation in the hand (over the palmar surface of the thumb, index finger, middle finger, and lateral aspect of the ring finger) that is worse at night.
  • B. Crepitus (grating feeling on palpation over joint during range of motion) due to loss of articular cartilage and bony overgrowth in joint.
  • C. Excessive forward curvature of the thoracic spine (kyphosis) owing to pathologic vertebral fractures, and collapsing of the anterior portion of the vertebral bodies in the thoracic area.
  • D. Acute onset of excruciating pain in joint because of accumulation of uric acid within the joint.
Correct Answer: A

Rationale: Carpal tunnel syndrome symptoms include nocturnal pain and paresthesia in the median nerve distribution.

The nurse is caring for a patient diagnosed with a cerebral tumor. For which function should the nurse expect to assess an abnormality?

  • A. Reflex movement
  • B. Movement and speech
  • C. Coordination and posture
  • D. Heart rate and respiratory rate
Correct Answer: B

Rationale: A cerebral tumor in the frontal lobe may affect movement and speech, as this area contains the motor cortex and Broca's area. Reflex movements are controlled by the spinal cord, coordination by the cerebellum, and heart rate by the medulla. Assessing movement and speech is critical for localizing the tumor's effects.

A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?

  • A. Cortical stroke
  • B. Bell's palsy
  • C. Horner's syndrome
  • D. Stress reaction
Correct Answer: B

Rationale: Bell's palsy is a condition characterized by sudden, unilateral facial paralysis due to inflammation or compression of the facial nerve (CN VII). It often follows a viral infection and presents with drooping of the face, inability to close the eye, and flattening of the nasolabial fold. A cortical stroke typically spares the forehead, and Horner's syndrome involves ptosis and miosis.

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