NCLEX Neuro Practice Questions 1-6

This 6-item NCLEX Neuro Practice Questions covering topics about Reye's Syndrome, Bacterial Meningitis and Hydrocephalus. It will help you understand more about the disorders involving the neurological system and appropriate nursing management. Try answering the questions.

 1. A child is diagnosed with Reye’s syndrome. The nurse develops a nursing care plan for the child and should include which intervention in the plan?

a) Assessing hearing loss
b) Monitoring urine output
c) Changing body position every 2 hours
d) Providing a quiet atmosphere with dimmed lighting

2. NCLEX Neuro Practice Questions about the nurse who develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item( s) need to be placed at the child’s bedside?

a) Emergency cart
b) Tracheotomy set
c) Padded tongue blade
d) Suctioning equipment and oxygen

3. A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis?

a) Clear CSF, decreased pressure, and elevated protein level
b) Clear CSF, elevated protein, and decreased glucose levels
c) Cloudy CSF, elevated protein, and decreased glucose levels
d) Cloudy CSF, decreased protein, and decreased glucose levels

4. NCLEX Neuro Practice Questions about the nurse who is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care?

a) Maintain enteric precautions.
b) Maintain neutropenic precautions.
c) No precautions are required as long as antibiotics have been started.
d) Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

5. An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period?

a) Test the urine for protein.
b) Reposition the infant frequently.
c) Provide a stimulating environment.
d) Assess blood pressure every 15 minutes.

6. NCLEX Neuro Practice Questions about the nurse who is developing a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

a) Time the seizure.
b) Restrain the child.
c) Stay with the child.
d) Place the child in a prone position.
e) Move furniture away from the child.
f) Insert a padded tongue blade in the child’s mouth.





NCLEX Neuro Practice Questions
Answers and Rationale

1) D
- Rationale: Reye’s syndrome is an acute encephalopathy that follows a viral illness and is characterized pathologically by cerebral edema and fatty changes in the liver. A definitive diagnosis is made by liver biopsy. In Reye’s syndrome, supportive care is directed toward monitoring and managing cerebral edema. Decreasing stimuli in the environment by providing a quiet environment with dimmed lighting would decrease the stress on the cerebral tissue and neuron responses. Hearing loss and urine output are not affected. Changing the body position every 2 hours would not affect the cerebral edema directly. The child should be positioned with the head elevated to decrease the progression of the cerebral edema and promote drainage of cerebrospinal fluid.

- Test-Taking Strategy: Focus on the subject, nursing care for the child with Reye’s syndrome. Think about the pathophysiology associated with Reye’s syndrome. Recalling that cerebral edema is a concern for a child with Reye’s syndrome will direct you to the correct option.

2) D
- NCLEX Neuro Practice Questions Rationale: A seizure results from the excessive and unorganized neuronal discharges in the brain that activate associated motor and sensory organs. A type of generalized seizure is a tonic-clonic seizure. This type of seizure causes rigidity of all body muscles, followed by intense jerking movements. Because increased oral secretions and apnea can occur during and after the seizure, oxygen and suctioning equipment are placed at the bedside. A tracheotomy is not performed during a seizure. No object, including a padded tongue blade, is placed into the child’s mouth during a seizure. An emergency cart would not be left at the bedside, but would be available in the treatment room or nearby on the nursing unit.

- Test-Taking Strategy: Focus on the subject, seizure precautions. Note the words need to be placed at the child’s bedside. Eliminate option B, knowing that a tracheotomy is not performed. Next, recalling that no object is placed into the mouth of a child experiencing a seizure assists in eliminating option C. From the remaining options, focus on the primary concern during seizure activity. This will direct you to the correct option.

3) C
- Rationale: Meningitis is an infectious process of the central nervous system caused by bacteria and viruses; it may be acquired as a primary disease or as a result of complications of neurosurgery, trauma, infection of the sinus or ears, or systemic infections. Meningitis is diagnosed by testing cerebrospinal fluid obtained by lumbar puncture. In the case of bacterial meningitis, findings usually include an elevated pressure; turbid or cloudy cerebrospinal fluid; and elevated leukocyte, elevated protein, and decreased glucose levels.

- NCLEX Neuro Practice Questions Test-Taking Strategy: Use knowledge regarding the diagnostic findings in meningitis. Eliminate options A and B first because they are comparable or alike; recall that clear cerebrospinal fluid is not likely to be found in an infectious process such as meningitis. From this point, recall that an elevated protein level indicates a possible diagnosis of meningitis to direct you to the correct option.

4) D
- Rationale: Meningitis is an infectious process of the central nervous system caused by bacteria and viruses; it may be acquired as a primary disease or as a result of complications of neurosurgery, trauma, infection of the sinus or ears, or systemic infections. A major priority of nursing care for a child suspected to have meningitis is to administer the antibiotic as soon as it is prescribed. The child also is placed on respiratory isolation precautions for at least 24 hours while culture results are obtained and the antibiotic is having an effect. Enteric precautions and neutropenic precautions are not associated with the mode of transmission of meningitis. Enteric precautions are instituted when the mode of transmission is through the gastrointestinal tract. Neutropenic precautions are instituted when a child has a low neutrophil count.

- NCLEX Neuro Practice Questions Test-Taking Strategy: Focus on the subject, the mode of transmission of meningitis. Eliminate options A and B first because they are comparable or alike, and are unrelated to the mode of transmission. Recalling that it takes about 24 hours for antibiotics to reach a therapeutic blood level will assist in directing you to the correct option.

5) B
- Rationale: Hydrocephalus occurs as a result of an imbalance of cerebrospinal fluid absorption or production that is caused by malformations, tumors, hemorrhage, infections, or trauma. It results in head enlargement and increased intracranial pressure. In infants with hydrocephalus, the head grows at an abnormal rate, and if the infant is not repositioned frequently, pressure ulcers can occur on the back and side of the head. An egg crate mattress under the head is also a nursing intervention that can help prevent skin breakdown. Proteinuria is not specific to hydrocephalus. Stimulus should be kept at a minimum because of the increase in intracranial pressure. It is not necessary to check the blood pressure every 15 minutes.

- Test-Taking Strategy: Note the strategic word priority. Focus on the child’s diagnosis. Eliminate option D because of the words 15 minutes. From the remaining options, recall that because of the severe head enlargement, the nursing intervention that has priority is to reposition the infant frequently to prevent the development of pressure areas.

6) A, C, E
- NCLEX Neuro Practice Questions Rationale: A seizure is a disorder that occurs as a result of excessive and unorganized neuronal discharges in the brain that activate associated motor and sensory organs. During a seizure, the child is placed on his or her side in a lateral position. Positioning on the side prevents aspiration because saliva drains out the corner of the child’s mouth. The child is not restrained because this could cause injury to the child. The nurse would loosen clothing around the child’s neck and ensure a patent airway. Nothing is placed into the child’s mouth during a seizure because this action may cause injury to the child’s mouth, gums, or teeth. The nurse would stay with the child to reduce the risk of injury and allow for observation and timing of the seizure.

- Test-Taking Strategy: Focus on the subject and visualize this clinical situation. Recalling that airway patency and safety is the priority will assist in determining the appropriate interventions.


After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

NCLEX Neuro Practice Questions 7-10

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