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I have processed the content from pages 7 to 25 of "Theory Final Term Exam Compilation (2).pdf" and generated NCLEX-style questions with rationales.

Here is your questionnaire:

Question 1

A nurse is caring for a patient experiencing a stroke. Which of the following is the most common cause of stroke?

A. Cerebral aneurysm rupture

B. Thrombosis

C. Embolism

D. Hemorrhage

B. Thrombosis

Rationale: Thrombosis is the most common cause of stroke, accounting for about half of all cases. It occurs when a blood clot forms in an artery supplying blood to the brain, blocking blood flow. Cerebral aneurysm rupture and hemorrhage are causes of hemorrhagic stroke, which is less common than ischemic stroke. Embolism is another cause of ischemic stroke, but thrombosis is more frequent.

Question 2

A patient presents with symptoms of a subarachnoid hemorrhage. Which of the following is the hallmark symptom of a subarachnoid hemorrhage?

A. Gradual onset of headache

B. "Worst headache of my life"

C. Mild, throbbing headache

D. Headache relieved by rest

B. "Worst headache of my life"

Rationale: The classic symptom of a subarachnoid hemorrhage (SAH) is a sudden, severe headache often described as the "worst headache of my life." This is due to the sudden increase in intracranial pressure from the bleeding. Other symptoms like gradual onset or mild headaches are not characteristic of SAH.

Question 3

Which cranial nerve is primarily responsible for transmitting impulses for smell?

A. Olfactory (CN I)

B. Optic (CN II)

C. Oculomotor (CN III)

D. Trochlear (CN IV)

A. Olfactory (CN I)

Rationale: The Olfactory nerve (Cranial Nerve I) is the sensory nerve responsible for the sense of smell. The Optic nerve (CN II) is for vision, Oculomotor (CN III) is for eye movement and pupil constriction, and Trochlear (CN IV) is for downward and inward eye movement.

Question 4

A nurse is assessing a patient's cranial nerves. Which cranial nerve is responsible for the movement of the tongue?

A. Facial (CN VII)

B. Glossopharyngeal (CN IX)

C. Vagus (CN X)

D. Hypoglossal (CN XII)

D. Hypoglossal (CN XII)

Rationale: The Hypoglossal nerve (Cranial Nerve XII) is primarily responsible for the motor control of the tongue, enabling speech and swallowing. The Facial nerve (CN VII) controls facial expressions and taste, the Glossopharyngeal nerve (CN IX) is involved in taste and swallowing, and the Vagus nerve (CN X) has widespread functions including heart rate, digestion, and voice.

Question 5

A nurse is preparing to assess a patient's Gag Reflex. Which cranial nerves are involved in the Gag Reflex?

A. Trigeminal (CN V) and Facial (CN VII)

B. Glossopharyngeal (CN IX) and Vagus (CN X)

C. Abducens (CN VI) and Accessory (CN XI)

D. Oculomotor (CN III) and Trochlear (CN IV)

B. Glossopharyngeal (CN IX) and Vagus (CN X)

Rationale: The Gag Reflex involves the afferent (sensory) limb carried by the Glossopharyngeal nerve (CN IX) and the efferent (motor) limb carried by the Vagus nerve (CN X), which innervates the pharyngeal muscles.

Question 6

A nurse is caring for a patient with increased intracranial pressure (ICP). Which of the following is an early sign of increased ICP?

A. Projectile vomiting

B. Bradycardia

C. Headache

D. Papilledema

C. Headache

Rationale: Headache, often described as throbbing or severe, is an early and common symptom of increased ICP due to stretching of pain-sensitive intracranial structures. Projectile vomiting, bradycardia (part of Cushing's triad), and papilledema (swelling of the optic disc) are typically later signs of significantly increased ICP.

Question 7

Which of the following Glasgow Coma Scale (GCS) scores indicates a severe head injury?

A. 13-15

B. 9-12

C. 3-8

D. 1-2

C. 3-8

Rationale: On the Glasgow Coma Scale, a score of 3-8 indicates a severe head injury. A score of 9-12 indicates a moderate head injury, and 13-15 indicates a minor head injury. A score of 1-2 is not possible on the GCS, as the minimum score is 3.

Question 8

A nurse is assessing a patient for a suspected stroke. Which assessment tool is commonly used for a rapid neurological assessment in the pre-hospital setting?

A. National Institutes of Health Stroke Scale (NIHSS)

B. Glasgow Coma Scale (GCS)

C. Cincinnati Prehospital Stroke Scale (CPSS)

D. Mini-Mental State Examination (MMSE)

C. Cincinnati Prehospital Stroke Scale (CPSS)

Rationale: The Cincinnati Prehospital Stroke Scale (CPSS) is a quick and easy assessment tool used by emergency medical services (EMS) to identify potential stroke patients in the pre-hospital setting. It assesses three key findings: facial droop, arm drift, and abnormal speech. The NIHSS is a more comprehensive scale used in hospitals, the GCS assesses level of consciousness, and the MMSE assesses cognitive function.

Question 9

A patient is diagnosed with expressive aphasia. Which area of the brain is typically affected in expressive aphasia?

A. Wernicke's area

B. Broca's area

C. Temporal lobe

D. Parietal lobe

B. Broca's area

Rationale: Expressive aphasia, also known as Broca's aphasia, is characterized by difficulty producing language, while comprehension is relatively intact. This is due to damage to Broca's area, located in the frontal lobe of the dominant hemisphere. Wernicke's area is associated with receptive aphasia (difficulty understanding language), and the temporal and parietal lobes have various other functions.

Question 10

A nurse is caring for a patient post-craniotomy. Which of the following is a priority nursing intervention to prevent complications?

A. Encouraging vigorous coughing and deep breathing

B. Positioning the patient flat on their back

C. Monitoring for signs of increased intracranial pressure

D. Administering prophylactic antibiotics for several weeks

C. Monitoring for signs of increased intracranial pressure

Rationale: Post-craniotomy, close monitoring for signs of increased intracranial pressure (ICP) is a priority to prevent complications such as herniation. Vigorous coughing can increase ICP and should be avoided. Positioning depends on the location of the surgery and surgeon's orders, but a flat position may not always be appropriate. Prophylactic antibiotics are typically given for a shorter duration, not several weeks.

Question 11

Which type of seizure is characterized by a brief loss of consciousness, staring into space, and no post-ictal confusion?

A. Tonic-clonic seizure

B. Absence seizure

C. Myoclonic seizure

D. Atonic seizure

B. Absence seizure

Rationale: Absence seizures (formerly petit mal seizures) are characterized by brief periods of impaired consciousness, often manifesting as staring or a blank expression, and the person usually returns to normal activity immediately without post-ictal confusion. Tonic-clonic seizures involve loss of consciousness, muscle rigidity, and rhythmic jerking, followed by a post-ictal state. Myoclonic seizures involve sudden, brief jerks of a muscle or muscle group. Atonic seizures involve a sudden loss of muscle tone, leading to a "drop attack."

Question 12

A patient with a history of seizures is experiencing status epilepticus. What is the priority nursing intervention for a patient in status epilepticus?

A. Administering oral anti-epileptic medications

B. Establishing a patent airway and administering oxygen

C. Documenting the duration and characteristics of the seizure

D. Providing a quiet and dark environment

B. Establishing a patent airway and administering oxygen

Rationale: Status epilepticus is a medical emergency requiring immediate intervention. The priority is to establish a patent airway, provide oxygen, and protect the patient from injury. Oral medications are not appropriate during a seizure; intravenous medications are needed. While documenting is important, airway management and safety take precedence. A quiet environment is helpful after the seizure is controlled.

Question 13

Which of the following is a common early manifestation of Parkinson's Disease?

A. Severe muscle spasticity

B. Resting tremor

C. Ataxia

D. Complete paralysis

B. Resting tremor

Rationale: A resting tremor, often described as "pill-rolling," is one of the cardinal and earliest symptoms of Parkinson's Disease. Muscle spasticity is more characteristic of conditions like multiple sclerosis. Ataxia (lack of coordination) can occur in Parkinson's but is not typically an early, prominent symptom. Complete paralysis is not a feature of Parkinson's Disease.

Question 14

A nurse is educating a patient with Parkinson's Disease about medication management. Which neurotransmitter deficiency is primarily targeted by medications for Parkinson's Disease?

A. Acetylcholine

B. Serotonin

C. Dopamine

D. Norepinephrine

C. Dopamine

Rationale: Parkinson's Disease is primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra. Medications for Parkinson's aim to increase dopamine levels or mimic its effects in the brain to alleviate symptoms.

Question 15

A patient with Multiple Sclerosis (MS) reports worsening fatigue and vision problems during periods of stress. This describes which characteristic of MS?

A. Progressive course

B. Relapsing-remitting course

C. Primary progressive course

D. Secondary progressive course

B. Relapsing-remitting course

Rationale: The relapsing-remitting course is the most common form of MS, characterized by clearly defined attacks (relapses) with partial or complete recovery (remission) between attacks. Symptoms may worsen during periods of stress. Progressive courses involve a steady worsening of neurological function from the onset.

Question 16

Which diagnostic test is considered the gold standard for diagnosing Multiple Sclerosis?

A. Electromyography (EMG)

B. Lumbar puncture (LP)

C. Magnetic Resonance Imaging (MRI) of the brain and spinal cord

D. Evoked potentials

C. Magnetic Resonance Imaging (MRI) of the brain and spinal cord

Rationale: MRI of the brain and spinal cord is the gold standard for diagnosing MS as it can visualize the characteristic demyelinating lesions (plaques) in the central nervous system. While other tests like LP (looking for oligoclonal bands) and evoked potentials (measuring nerve conduction) can support the diagnosis, MRI is crucial for definitive diagnosis and monitoring disease progression. EMG is used to assess muscle and nerve function in peripheral neuropathies.

Question 17

A nurse is preparing a patient for a lumbar puncture (LP). What is the most important post-procedure instruction for the patient?

A. Ambulate frequently to prevent complications

B. Remain supine for several hours

C. Consume a low-sodium diet

D. Avoid pain medication

B. Remain supine for several hours

Rationale: After a lumbar puncture, the patient should remain supine (flat on their back) for several hours (typically 4-8 hours) to minimize the risk of post-lumbar puncture headache, which is caused by leakage of cerebrospinal fluid. Frequent ambulation is not recommended immediately after the procedure. Diet and pain medication are not the most important post-procedure instructions related to preventing complications.

Question 18

A patient with Myasthenia Gravis is experiencing a Myasthenic Crisis. Which of the following is the priority nursing intervention?

A. Administering a sedating medication

B. Assessing respiratory effort and airway patency

C. Encouraging ambulation

D. Providing a high-calorie diet

B. Assessing respiratory effort and airway patency

Rationale: Myasthenic crisis is a life-threatening exacerbation of Myasthenia Gravis characterized by severe muscle weakness, particularly affecting the respiratory muscles. The priority nursing intervention is to assess and maintain respiratory effort and airway patency to prevent respiratory failure. Sedating medications can further depress respiration. Ambulation and diet are not priorities in a crisis situation.

Question 19

A nurse is preparing to administer pyridostigmine (Mestinon) to a patient with Myasthenia Gravis. What is the most important consideration for administering this medication?

A. Administer on an empty stomach

B. Administer at regular intervals to maintain muscle strength

C. Administer only when the patient reports severe weakness

D. Administer with dairy products

B. Administer at regular intervals to maintain muscle strength

Rationale: Pyridostigmine (Mestinon) is an anticholinesterase medication used to improve muscle strength in patients with Myasthenia Gravis. It is crucial to administer this medication at regular, scheduled intervals to maintain consistent therapeutic levels and optimize muscle strength throughout the day. Administering only when severe weakness occurs is not effective for consistent management. Food and dairy interactions are not the primary concern.

Question 20

A nurse is assessing a patient with Guillain-Barré Syndrome (GBS). Which of the following is a classic manifestation of GBS?

A. Ascending paralysis

B. Sudden onset of cognitive deficits

C. Unilateral muscle weakness

D. Spasticity and hyperreflexia

A. Ascending paralysis

Rationale: Guillain-Barré Syndrome (GBS) is characterized by a rapid, progressive, ascending symmetric paralysis, usually starting in the lower extremities and progressing upwards. Cognitive deficits are not typically a primary manifestation. Unilateral weakness would suggest a different neurological issue (e.g., stroke), and GBS causes flaccid paralysis with absent or diminished reflexes, not spasticity or hyperreflexia.

Question 21

A patient with Guillain-Barré Syndrome (GBS) is at risk for respiratory failure. What is the priority nursing intervention?

A. Providing frequent range-of-motion exercises

B. Monitoring vital capacity and respiratory effort

C. Administering high-dose corticosteroids

D. Encouraging oral fluid intake

B. Monitoring vital capacity and respiratory effort

Rationale: Respiratory muscle weakness is a significant concern in GBS, potentially leading to respiratory failure. Therefore, closely monitoring vital capacity and respiratory effort is a priority to detect impending respiratory compromise and intervene promptly (e.g., intubation and mechanical ventilation). While other interventions are important for GBS, respiratory monitoring is paramount for patient safety. Corticosteroids are generally not effective in GBS.

Question 22

A patient is diagnosed with Trigeminal Neuralgia. Which of the following is a common trigger for the severe facial pain associated with this condition?

A. Lying down

B. Chewing

C. Listening to music

D. Sleeping

B. Chewing

Rationale: Trigeminal Neuralgia is characterized by sudden, severe, unilateral facial pain, often triggered by light touch, chewing, talking, or even a cool breeze. Lying down, listening to music, or sleeping are generally not triggers for the pain.

Question 23

A nurse is providing education to a patient with Bell's Palsy. Which cranial nerve is affected in Bell's Palsy?

A. Trigeminal (CN V)

B. Abducens (CN VI)

C. Facial (CN VII)

D. Vestibulocochlear (CN VIII)

C. Facial (CN VII)

Rationale: Bell's Palsy is an acute, unilateral facial paralysis caused by inflammation or damage to the Facial nerve (Cranial Nerve VII). This affects the muscles of facial expression on one side of the face.

Question 24

A patient with a recent head injury is exhibiting signs of increased ICP. Which of the following is part of Cushing's Triad, indicating severe increased ICP?

A. Hypotension, tachycardia, hypothermia

B. Hypertension, bradycardia, irregular respirations

C. Hyperthermia, tachypnea, hypotension

D. Normotension, normal heart rate, regular respirations

B. Hypertension, bradycardia, irregular respirations

Rationale: Cushing's Triad is a classic but late sign of severely increased ICP, indicating brainstem compression. It consists of:

Hypertension (widening pulse pressure - increasing systolic pressure with a stable or decreasing diastolic pressure)

Bradycardia (decreased heart rate)

Irregular respirations (e.g., Cheyne-Stokes breathing)

Question 25

A nurse is teaching a patient about seizure precautions. Which action is appropriate to implement during a generalized tonic-clonic seizure?

A. Restrain the patient's limbs

B. Insert a tongue blade into the patient's mouth

C. Turn the patient to their side

D. Leave the patient unattended to call for help

C. Turn the patient to their side

Rationale: During a generalized tonic-clonic seizure, the priority is to protect the patient from injury. Turning the patient to their side helps maintain a patent airway and prevents aspiration of secretions. Restraining limbs can cause injury. Inserting a tongue blade or anything into the mouth can cause oral injury and block the airway. Leaving the patient unattended is unsafe.

Question 26

A nurse is assessing a patient for Meningitis. Which of the following signs would indicate irritation of the meninges?

A. Romberg's sign

B. Brudzinski's sign

C. Trousseau's sign

D. Chvostek's sign

B. Brudzinski's sign

Rationale: Brudzinski's sign and Kernig's sign are classic signs of meningeal irritation seen in meningitis. Brudzinski's sign is positive when passive flexion of the neck causes involuntary flexion of the hip and knee. Romberg's sign assesses proprioception and balance, Trousseau's and Chvostek's signs are associated with hypocalcemia.

Question 27

Which of the following is a key characteristic of the cerebrospinal fluid (CSF) in bacterial meningitis?

A. Clear, colorless, with normal protein and glucose

B. Cloudy, high protein, low glucose, high WBC count (neutrophils)

C. Clear, high protein, normal glucose, high WBC count (lymphocytes)

D. Bloody, high protein, normal glucose

B. Cloudy, high protein, low glucose, high WBC count (neutrophils)

Rationale: In bacterial meningitis, the CSF typically appears cloudy or turbid, has elevated protein levels, decreased glucose levels (bacteria consume glucose), and a high white blood cell count with a predominance of neutrophils. Viral meningitis usually presents with clear CSF, normal glucose, and a predominance of lymphocytes.

Question 28

A nurse is caring for a patient with encephalitis. Which of the following is a common cause of encephalitis?

A. Bacterial infection

B. Viral infection

C. Fungal infection

D. Parasitic infection

B. Viral infection

Rationale: Encephalitis, which is inflammation of the brain parenchyma, is most commonly caused by viral infections (e.g., Herpes Simplex Virus, West Nile Virus, measles, mumps). While other pathogens can cause encephalitis, viruses are the predominant cause.

Question 29

A nurse is preparing a patient for electroencephalography (EEG). Which instruction should the nurse give to the patient prior to the procedure?

A. Consume a large meal before the test

B. Avoid caffeine for 8-12 hours before the test

C. Wash hair immediately before the test with conditioner

D. Discontinue all medications for 24 hours

B. Avoid caffeine for 8-12 hours before the test

Rationale: Patients undergoing an EEG should avoid caffeine and other stimulants for 8-12 hours prior to the test, as these can alter brain wave activity and interfere with the results. Hair should be clean and free of products (like conditioner) that could interfere with electrode placement. Medication adjustments are typically determined by the physician, and not all medications are discontinued. A large meal is not necessary and might make the patient uncomfortable during the procedure.

Question 30

A nurse is providing education on stroke prevention. Which of the following is a modifiable risk factor for stroke?

A. Age

B. Family history of stroke

C. Hypertension

D. Race

C. Hypertension

Rationale: Hypertension (high blood pressure) is a major modifiable risk factor for stroke, meaning it can be controlled or changed through lifestyle modifications and medication. Age, family history, and race are non-modifiable risk factors.

Question 31

Which lobe of the brain is primarily responsible for visual processing?

A. Frontal lobe

B. Parietal lobe

C. Temporal lobe

D. Occipital lobe

D. Occipital lobe

Rationale: The Occipital lobe is located at the back of the brain and is primarily responsible for processing visual information. The frontal lobe is involved in executive functions, the parietal lobe processes sensory information, and the temporal lobe is involved in auditory processing and memory.

Question 32

A nurse is assessing a patient with a suspected injury to the cerebellum. Which of the following symptoms would the nurse expect to find?

A. Aphasia

B. Ataxia

C. Hemiparesis

D. Sensory loss

B. Ataxia

Rationale: The cerebellum is crucial for coordination, balance, and fine motor control. Damage to the cerebellum often results in ataxia (lack of voluntary coordination of muscle movements), intention tremor, and dysmetria. Aphasia is associated with cerebral cortex damage, hemiparesis (weakness on one side) is often seen with motor cortex lesions, and sensory loss with parietal lobe or spinal cord lesions.

Question 33

A nurse is caring for a patient experiencing receptive aphasia. Which area of the brain is likely affected?

A. Broca's area

B. Wernicke's area

C. Prefrontal cortex

D. Motor cortex

B. Wernicke's area

Rationale: Receptive aphasia, also known as Wernicke's aphasia, is characterized by difficulty understanding spoken and written language. This is due to damage to Wernicke's area, typically located in the temporal lobe of the dominant hemisphere. Broca's area is associated with expressive aphasia.

Question 34

Which component of the brainstem is responsible for regulating vital functions such as breathing, heart rate, and blood pressure?

A. Midbrain

B. Pons

C. Medulla Oblongata

D. Thalamus

C. Medulla Oblongata

Rationale: The Medulla Oblongata, the lowest part of the brainstem, contains vital centers that regulate essential autonomic functions, including respiration, heart rate, and blood pressure. The midbrain is involved in visual and auditory reflexes, and the pons helps regulate breathing and sleep. The thalamus is part of the diencephalon, not the brainstem, and acts as a relay station for sensory information.

Question 35

A patient undergoes a carotid endarterectomy. What is the primary purpose of this procedure?

A. To repair a cerebral aneurysm

B. To remove plaque from the carotid artery

C. To reduce intracranial pressure

D. To shunt cerebrospinal fluid

B. To remove plaque from the carotid artery

Rationale: Carotid endarterectomy is a surgical procedure performed to remove atherosclerotic plaque buildup from the carotid artery, which is a major artery supplying blood to the brain. This procedure aims to prevent stroke by improving blood flow and reducing the risk of embolism from the plaque. Repairing an aneurysm, reducing ICP, or shunting CSF are different procedures for different neurological conditions.

Question 36

Which of the following is a common complication of a subarachnoid hemorrhage (SAH)?

A. Myasthenic crisis

B. Vasospasm

C. Status epilepticus

D. Bell's Palsy

B. Vasospasm

Rationale: Vasospasm is a common and serious complication following a subarachnoid hemorrhage (SAH). It involves the narrowing of cerebral blood vessels, which can lead to delayed cerebral ischemia and neurological deficits. Myasthenic crisis, status epilepticus, and Bell's Palsy are not direct complications of SAH.

Question 37

A nurse is preparing to assess a patient's pupillary response. Which cranial nerves are involved in the pupillary light reflex?

A. Optic (CN II) and Oculomotor (CN III)

B. Trochlear (CN IV) and Abducens (CN VI)

C. Trigeminal (CN V) and Facial (CN VII)

D. Vestibulocochlear (CN VIII) and Glossopharyngeal (CN IX)

A. Optic (CN II) and Oculomotor (CN III)

Rationale: The pupillary light reflex involves the Optic nerve (CN II) as the afferent (sensory) pathway, detecting the light stimulus, and the Oculomotor nerve (CN III) as the efferent (motor) pathway, causing pupillary constriction.

Question 38

A nurse is educating a patient about ways to reduce the risk of stroke. Which of the following is a key lifestyle modification to prevent stroke?

A. Consuming a high-sodium diet

B. Avoiding regular exercise

C. Maintaining a healthy weight

D. Smoking cessation is not necessary if blood pressure is controlled

C. Maintaining a healthy weight