Question 1

Which type of glial cell is responsible for producing the myelin sheath in the central nervous system?

Accepted Answer

Answer reason: These cells form myelin in the central nervous system by extending processes that wrap around multiple axons, enabling faster saltatory conduction. In contrast, Schwann cells produce myelin in the peripheral nervous system, not the CNS. Microglia are primarily immune/phagocytic cells, and astrocytes provide metabolic and structural support and help maintain the blood–brain barrier rather than forming myelin.
Category reason: This tests foundational knowledge of nervous system cell types and their functions (CNS myelination), which is a core Neurology topic rather than a nursing care decision-making scenario.

Question 2

Which of the following is a late sign of increased intracranial pressure?

Accepted Answer

Answer reason: This reflects brainstem compression and dysfunction, which occurs as intracranial pressure rises to a severe, late stage. Progressive intracranial hypertension can lead to abnormal respiratory patterns and eventual hypoventilation as herniation risk increases. Earlier findings are typically subtle neurologic changes (e.g., restlessness) and symptoms like vomiting, while late deterioration includes respiratory compromise.
Category reason: This question tests recognition of neurologic pathophysiology and clinical signs of increased intracranial pressure, which is core Neurology foundational knowledge rather than a nursing intervention or prioritization task.

Question 3

Paralysis occurring on 1 side of the body opposite to side of brain lesion

Accepted Answer

Answer reason: d) contralateral hemiplegia Motor pathways (corticospinal tracts) decussate in the medulla, so a lesion in one cerebral hemisphere typically produces weakness or paralysis on the opposite side of the body. This pattern is described as hemiplegia affecting the side contralateral to the brain lesion. Orthopnea is a breathing symptom, tetraplegia involves all four limbs, and “congenital disorder” is nonspecific and not a localization term.
Category reason: This tests neuroanatomy/localization of motor deficits based on corticospinal tract crossing, which is foundational Neurology rather than a nursing intervention or prioritization task.

Question 4

Cannot read or write, speak or understand

Accepted Answer

Answer reason: a) global aphasia This presentation describes near-complete loss of language function, affecting both expressive and receptive abilities, and commonly also includes impaired reading and writing. Global aphasia typically results from a large dominant-hemisphere lesion involving both Broca and Wernicke language networks (often a major MCA stroke). Dysphagia is a swallowing disorder, not a language disorder, and anomic aphasia primarily causes word-finding difficulty with relatively preserved comprehension and fluency. The generic term “aphasia” is nonspecific compared with the severe, pan-language deficits described here.
Category reason: This question tests recognition of a neurologic language syndrome (types of aphasia), which is foundational neuroscience knowledge rather than a nursing intervention or prioritization scenario.

Question 5

Trouble using correct words for objects/ places

Accepted Answer

Answer reason: This describes difficulty with word-finding and naming, especially for objects and places, while comprehension and fluency can otherwise be relatively preserved. Receptive (Wernicke) aphasia primarily impairs understanding of spoken/written language rather than isolated naming. Global aphasia involves severe impairment of both expression and comprehension and would present far more broadly. The generic term “aphasia” is nonspecific compared with the characteristic naming deficit described.
Category reason: This item tests recognition of a specific language disorder type (word-finding/naming deficit), which is a neuroanatomy/neurology concept rather than a nursing intervention or prioritization decision.

Question 6

A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. For the last 2 months, his family describes him as being "on the go", sleeping 3-4 hours nightly, spending lots of money, and losing approximately 10 lb. During the initial interview assessment with the client, the nurse would expect him to exhibit which of the following?

Accepted Answer

Answer reason: The described symptoms (decreased need for sleep, increased goal-directed activity/"on the go," excessive spending, weight loss) are classic for a manic episode. Mania commonly features grandiosity, inflated self-esteem, and pressured, expansive behavior that can appear as exaggerated self-importance. The other options align more with depression (helplessness/hopelessness), insight/introspection (often reduced during mania), or constricted affect/withdrawal.
Category reason: This item tests recognition of manic vs depressive symptom patterns in bipolar disorder, which is a neuropsychiatric/mental health knowledge question rather than a nursing intervention or safety-prioritization decision.

Question 7

A 57yr old man with left sided facial weakness for 2 days. He can't close his left eye and can't raise his left eye brow. Pulse is 68 and regular, B.p is 168/88. What is the most therapeutic treatment?

Accepted Answer

Answer reason: Inability to raise the eyebrow along with ipsilateral facial weakness indicates a peripheral facial nerve palsy (Bell palsy), rather than a central stroke pattern that typically spares the forehead. Early corticosteroids reduce facial nerve inflammation and edema, improving the likelihood of complete recovery, especially when started within 72 hours of symptom onset. Antiplatelet therapy is not indicated for isolated lower motor neuron facial palsy, and antivirals are generally reserved for severe palsy or suspected herpetic involvement (e.g., vesicular rash or Ramsay Hunt features).
Category reason: This question tests recognition and treatment of a neurologic condition (peripheral facial nerve palsy) and the evidence-based first-line therapy, which fits foundational clinical knowledge in Neurology rather than nursing-care prioritization.

Question 8

Nerve tissue is composed of neurons and connective tissue cells that are referred to as which of the following?

Accepted Answer

Answer reason: These are the supportive cells of nervous tissue, providing structural support, metabolic assistance, myelination (in certain types), and immune defense within the CNS/PNS. Neurons are the excitable cells responsible for signal transmission, while these supporting cells maintain the environment needed for neuronal function. The other options are unrelated cell types: arterioles are small blood vessels, and osteocytes/osteoblasts are bone cells.
Category reason: This is a foundational question about the cellular composition of nervous tissue, which is primarily studied under Neurology in nursing science.

Question 9

Which assessment finding suggests a herniated intervertebral disk?

Accepted Answer

Answer reason: A. Pain that radiates down the posterior thigh. Radicular pain radiating down the posterior thigh is classic for sciatic nerve root irritation from lumbar disk herniation (e.g., L5/S1). Nerve root compression produces shooting, dermatomal pain that may extend below the knee and can be provoked by increased intraspinal pressure or straight-leg raise. Muscle atrophy can occur later but is not as typical an initial indicator as radicular pain. A positive Homans’ sign relates to suspected deep vein thrombosis, not spinal disk pathology.
Category reason: This question tests recognition of a neurologic sign (radicular/sciatic pain pattern) associated with lumbar disk herniation, which is foundational neuroanatomy/pathophysiology rather than a nursing intervention decision.

Question 10

The nurse observes a client who is admitted to the mental health unit and identifies that the client is talking continuously, using words that rhyme but that have no context or relationship with one topic to the next in the conversation. This client's behavior and thought processes are consistent with which syndrome?

Accepted Answer

Answer reason: The described speech pattern is consistent with disorganized thinking, including loose associations and clang associations (rhyming words without meaningful connection). These are classic positive symptoms seen in psychotic disorders, especially schizophrenia. Depression and dementia can impair cognition and communication but do not typically produce this characteristic form of disorganized, rhyming speech. “Chronic brain syndrome” is an older, nonspecific term and does not best match the psychotic thought-process disturbance described.
Category reason: This question tests recognition of a characteristic thought-process abnormality (disorganized speech) and its association with a neuropsychiatric disorder, which aligns best with Neurology as foundational disease/syndrome knowledge rather than a nursing intervention decision.

Question 11

Delayed milestones and persistent head lag in infancy indicate:

Accepted Answer

Answer reason: Persistent head lag beyond the expected age suggests abnormal tone and impaired motor control, which are classic early signs of an upper motor neuron disorder affecting posture and gross motor development. Cerebral palsy commonly presents in infancy with delayed motor milestones, poor head control, and abnormal muscle tone (often spasticity), reflecting nonprogressive injury to the developing brain. Down syndrome can have hypotonia and delayed milestones, but persistent head lag as a key indicator more strongly points to a central motor disorder. Myelomeningocele/neural tube defects typically produce level-dependent lower extremity weakness and bladder/bowel dysfunction rather than a primary global head control problem.
Category reason: This question tests recognition of an early neurologic clinical sign (persistent head lag) and its association with a neurologic disorder, which is foundational disease recognition rather than a nursing intervention scenario, so it fits Neurology under NursingScience.

Question 12

A baby with lumbosacral myelomeningocele is most likely to have which neurological problem?

Accepted Answer

Answer reason: Lumbosacral myelomeningocele (a form of spina bifida) is strongly associated with Chiari II malformation, which can obstruct cerebrospinal fluid flow. This obstruction leads to ventricular enlargement and increased intracranial pressure, producing hydrocephalus. The other options are not the classic or most common neurologic complication linked to myelomeningocele.
Category reason: This item tests a common neurologic association/complication of a congenital neural tube defect (myelomeningocele) rather than a nursing intervention or prioritization decision, so it best fits Neurology within NursingScience.

Question 13

In Arnold-Chiari II malformation, which brain structure is herniated?

Accepted Answer

Answer reason: Arnold-Chiari II is a congenital hindbrain malformation characterized by downward displacement of posterior fossa structures through the foramen magnum. This includes herniation of the cerebellar tonsils (often with vermis/brainstem involvement) and is classically associated with myelomeningocele and hydrocephalus. The other listed structures are supratentorial and are not the typical components that herniate in Chiari malformations.
Category reason: This is a foundational neuroanatomy/pathophysiology recognition question about which CNS structure herniates in a specific congenital malformation, not a nursing intervention or prioritization scenario, so it fits Neurology under NursingScience.

Question 14

The most common site of meningomyelocele is?

Accepted Answer

Answer reason: Meningomyelocele (myelomeningocele), an open neural tube defect, most frequently occurs in the lumbosacral region, with the lumbar area being a common site. This reflects the higher vulnerability of caudal neural tube closure during early embryologic development. Lesions at this level are also commonly associated with lower-extremity motor/sensory deficits and neurogenic bladder/bowel dysfunction.
Category reason: This question tests foundational knowledge about the typical anatomic distribution of a congenital neural tube defect, which is primarily a neuroanatomy/neurodevelopment fact rather than a nursing intervention decision.

Question 15

A child with macrocephaly, sun-setting eyes, and bulging fontanelle likely has:

Accepted Answer

Answer reason: These findings indicate increased intracranial pressure in an infant, where open sutures allow head enlargement (macrocephaly) and the anterior fontanelle becomes tense/bulging. “Sun-setting” eyes (downward gaze) is a classic sign from pressure affecting the periaqueductal region and impaired upward gaze. The other options do not match this triad: anencephaly causes absence of major brain structures, cerebral palsy is a chronic motor disorder, and craniosynostosis typically restricts skull expansion rather than causing macrocephaly with a bulging fontanelle.
Category reason: This is primarily recognition of a neurologic condition based on hallmark signs of increased intracranial pressure in infants, which falls under Neurology as foundational disease identification rather than nursing intervention/priority setting.

Question 16

Best time to perform surgical repair of meningomyelocele is?

Accepted Answer

Answer reason: Early closure of a myelomeningocele is recommended to reduce the risk of ascending infection (especially meningitis) and to protect exposed neural tissue from further mechanical and chemical injury. Delaying repair increases complications such as cerebrospinal fluid leakage, wound contamination, and deterioration of neurologic function. Standard practice is surgical closure within the first 24–48 hours if the infant is stable and there is no overriding contraindication.
Category reason: This item tests foundational timing of neurosurgical management for a congenital neural tube defect rather than nursing prioritization or bedside interventions, fitting Neurology under NursingScience.

Question 17

Surgical correction of hydrocephalus involves placement of:

Accepted Answer

Answer reason: C. Ventriculoperitoneal shunt This is the standard definitive surgical treatment for chronic hydrocephalus, diverting excess cerebrospinal fluid from the cerebral ventricles into the peritoneal cavity for absorption. An external ventricular drain is typically a temporary measure for acute intracranial pressure control and CSF diversion/monitoring in critical care settings. An Ommaya reservoir is mainly used for intrathecal medication delivery or intermittent CSF sampling rather than long-term diversion, and a lumbar drain is also generally temporary and used in specific situations (e.g., CSF leak management or short-term diversion).
Category reason: The question tests a foundational medical fact about the definitive surgical management of hydrocephalus, which is primarily a neurologic/neurosurgical concept rather than a nursing judgment or care-prioritization scenario.

Question 18

In Arnold-Chiari II malformation, which condition is commonly associated?

Accepted Answer

Answer reason: Arnold-Chiari II is classically linked to open neural tube defects, especially spina bifida with myelomeningocele. The hindbrain herniation is thought to relate to altered CSF dynamics and posterior fossa development in the setting of an open spinal defect. This association is far stronger and more characteristic than with anencephaly, encephalocele, or an arachnoid cyst.
Category reason: This question tests a characteristic association of a congenital hindbrain malformation, which is foundational neuroanatomy/neurodevelopment knowledge rather than a nursing intervention or safety decision.

Question 19

Congenital hydrocephalus in males is commonly caused by?

Accepted Answer

Answer reason: A. Aqueductal stenosis X-linked (often L1CAM-associated) aqueductal stenosis is a classic cause of congenital hydrocephalus with a male predominance. Obstruction at the cerebral aqueduct prevents normal CSF flow from the third to the fourth ventricle, producing noncommunicating hydrocephalus. Myelomeningocele is also associated with hydrocephalus (via Chiari II), but it is not specifically more common in males. TORCH infections and subdural hematoma can cause hydrocephalus or increased head size, but are less typical as the common male-linked congenital cause.
Category reason: This question tests the etiologic/neurologic pathophysiology of congenital hydrocephalus and its sex-linked association, which is foundational biomedical knowledge in Neurology rather than nursing interventions.

Question 20

A child with difficulty walking, weak lower limbs, and bladder incontinence likely has:

Accepted Answer

Answer reason: This presentation suggests a neural tube defect with spinal cord/meningeal involvement causing lower motor weakness and neurogenic bladder due to sacral nerve disruption. Spina bifida occulta is typically mild and often asymptomatic, and usually does not cause significant paralysis or incontinence. Muscular dystrophy causes progressive weakness without early bladder dysfunction. Cerebral palsy is an upper motor neuron disorder with spasticity and does not classically present with neurogenic bladder from spinal cord involvement.
Category reason: The question tests recognition of a specific congenital neurologic disorder based on characteristic signs (lower-limb weakness and bladder dysfunction), which is foundational disease-identification knowledge in Neurology rather than a nursing intervention/prioritization scenario.

Question 21

Arnold-Chiari II malformation is commonly associated with?

Accepted Answer

Answer reason: Chiari II malformation classically involves downward displacement of the cerebellar vermis and brainstem through the foramen magnum due to a small posterior fossa. It is strongly associated with open neural tube defects, particularly myelomeningocele, and frequently coexists with hydrocephalus. The other options are not the typical paired congenital association for Chiari II in standard neuroembryology and pediatric neurology.
Category reason: This is a foundational biomedical question testing a characteristic congenital neurologic association rather than nursing interventions or prioritization, fitting Neurology within NursingScience.

Question 22

What is the basic functional unit of the nervous system?

Accepted Answer

Answer reason: Neurons are the primary excitable cells responsible for receiving, processing, and transmitting electrical and chemical signals throughout the nervous system. They integrate inputs via dendrites and cell bodies and communicate outputs through action potentials and synapses. A nephron is the kidney’s functional unit, and an alveolus is the lung’s gas-exchange unit. An axon is only one part of a neuron, not the entire functional unit.
Category reason: This question tests foundational knowledge of the nervous system’s cellular organization and function, which falls under Neurology.

Question 23

Which part of the brain controls balance and coordination?

Accepted Answer

Answer reason: It integrates vestibular, proprioceptive, and visual input to fine-tune motor activity, producing smooth, coordinated voluntary movement. Cerebellar function is essential for maintaining posture, gait stability, and balance, and lesions classically cause ataxia, dysmetria, and intention tremor. In contrast, the cerebrum primarily handles higher cognition and voluntary motor planning, the medulla regulates vital autonomic functions, and the hypothalamus controls homeostasis and endocrine-autonomic regulation.
Category reason: This question tests knowledge of brain region functions (balance and coordination), which is a foundational topic in neurology rather than a nursing intervention or care-prioritization scenario.

Question 24

Chiari II malformation typically includes herniation of:

Accepted Answer

Answer reason: This malformation involves a small posterior fossa with downward displacement through the foramen magnum, producing hindbrain herniation. It is classically associated with myelomeningocele and can obstruct CSF flow, leading to hydrocephalus and brainstem dysfunction (e.g., apnea, swallowing difficulties). The other listed brain regions are not the characteristic structures herniated in Chiari II.
Category reason: This question tests recognition of the characteristic anatomic/neurologic abnormality in a congenital brain malformation, which is foundational neurology knowledge rather than a nursing care decision.

Question 25

Most common cause of congenital hydrocephalus is?

Accepted Answer

Answer reason: This is the most common congenital cause of obstructive (non-communicating) hydrocephalus, due to blockage at the cerebral aqueduct (of Sylvius) preventing CSF flow from the third to the fourth ventricle. The obstruction causes upstream ventricular dilation and increased intracranial pressure. Post-meningitis is a common acquired cause (often communicating hydrocephalus), and germinal matrix hemorrhage is typically a preterm intraventricular hemorrhage-related cause rather than congenital. Arnold-Chiari malformation can cause hydrocephalus but is less common than aqueductal stenosis as a primary congenital etiology.
Category reason: This question tests a foundational neurologic etiology of hydrocephalus (disease mechanism and common cause), which is biomedical knowledge rather than nursing intervention/priority-setting, so it fits Neurology under NursingScience.

Question 26

A neonate presents with weak cry, poor sucking, and hypotonia. Likely diagnosis?

Accepted Answer

Answer reason: The combination of hypotonia (“floppy” infant), weak cry, and poor suck strongly suggests a lower motor neuron disorder affecting anterior horn cells, which is classic for infantile-onset SMA. Sepsis can cause poor feeding and lethargy but is usually accompanied by systemic signs (temperature instability, respiratory distress, poor perfusion) rather than isolated profound hypotonia. Hypoxic-ischemic encephalopathy more typically presents with altered consciousness, seizures, and abnormal reflexes in the context of perinatal asphyxia. Anencephaly is a major neural tube defect that would be evident at birth and is not consistent with a subtle neuromuscular feeding/cry weakness presentation.
Category reason: This item tests recognition of a neurologic disease pattern (infantile motor neuron disorder) based on symptoms rather than a nursing intervention or prioritization decision, so it fits NursingScience under Neurology.

Question 27

The cranial nerve disorder responsible for causing Bell’s Palsy is?

Accepted Answer

Answer reason: Bell’s palsy results from acute dysfunction of cranial nerve VII, which innervates the muscles of facial expression. Inflammation and edema of this nerve (often idiopathic, sometimes viral-associated) lead to unilateral lower motor neuron facial weakness. Other listed cranial nerves primarily mediate different functions (e.g., hearing/balance for VIII, mastication/sensation for V), so they do not best explain the classic presentation.
Category reason: This question tests identification of the cranial nerve involved in a neurologic disorder, which is foundational neuroanatomy/neurology knowledge rather than a nursing care decision.

Question 28

Dilated Pupil Could Result From ?

Accepted Answer

Answer reason: Fixed, bilaterally dilated pupils can occur with loss of brainstem reflexes due to severe intracranial catastrophe and are a classic sign in the clinical determination of brain death. Morphine (opioid) toxicity typically causes miosis rather than mydriasis. Pilocarpine is a muscarinic agonist that constricts the pupil (miosis). Pontine lesions classically produce pinpoint pupils due to sympathetic pathway disruption with preserved parasympathetic tone, not dilation.
Category reason: This question tests recognition of pupil size changes and their neurologic causes (brainstem reflexes and pharmacologic effects), which is foundational neurophysiology/clinical neurology knowledge rather than a nursing intervention decision.

Question 29

Which of the following is the common causes of congenital hydrocephalus?

Accepted Answer

Answer reason: It is the most common obstructive cause of congenital hydrocephalus, producing blockage of CSF flow between the third and fourth ventricles via the cerebral aqueduct. The resulting ventricular dilation typically presents in infancy with increasing head circumference and signs of raised intracranial pressure. Other listed conditions can be associated with hydrocephalus but are less common as primary congenital causes compared with aqueductal obstruction.
Category reason: This is a foundational question about the etiologies of congenital hydrocephalus, focusing on nervous system pathophysiology rather than nursing interventions, so it fits Neurology under NursingScience.

Question 30

Which form of cerebral palsy is associated with prematurity?

Accepted Answer

Answer reason: Prematurity is strongly associated with periventricular leukomalacia and intraventricular hemorrhage affecting periventricular white matter near the corticospinal tracts to the legs, producing predominant lower-extremity spasticity. This classic pattern is spastic diplegia, often seen in preterm infants with low birth weight. Hemiplegic patterns are more linked to focal perinatal stroke, and dyskinetic (athetoid) forms are more linked to kernicterus or basal ganglia injury.
Category reason: This is testing an association between a neurologic condition subtype and an etiologic risk factor (prematurity), which is foundational neurodevelopmental knowledge rather than a nursing intervention or prioritization task.

Question 31

Most common clinical sign in infants with hydrocephalus.

Accepted Answer

Answer reason: In infants, increased intracranial pressure from excess cerebrospinal fluid commonly manifests as a tense, bulging anterior fontanelle because the cranial sutures have not yet fused. This physical finding is a classic, frequent early sign along with increasing head circumference and widened sutures. Seizures and nystagmus can occur but are less common presenting signs, and irritability is nonspecific and not as characteristic as the fontanelle change.
Category reason: This question tests recognition of a classic clinical manifestation of a neurologic condition (hydrocephalus), which is foundational disease-sign knowledge rather than a nursing intervention or prioritization scenario.

Question 32

Dandy-Walker malformation is characterized by?

Accepted Answer

Answer reason: Dandy-Walker malformation classically involves developmental abnormality of the posterior fossa with partial or complete absence (agenesis) of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa. This disrupted CSF pathway commonly leads to hydrocephalus, but hydrocephalus is a consequence rather than the defining anatomic lesion. The other options describe unrelated findings that are not characteristic of this condition.
Category reason: This question tests recognition of a congenital CNS malformation’s defining neuroanatomical feature, which is foundational biomedical knowledge in Neurology rather than a nursing management decision.

Question 33

Which cranial nerve is responsible for hearing?

Accepted Answer

Answer reason: Hearing is mediated by the vestibulocochlear nerve, which carries auditory sensory information from the cochlea to the brainstem and auditory pathways. This nerve is purely sensory for hearing (cochlear division) and balance (vestibular division). By contrast, CN V is primarily facial sensation and mastication, CN VI controls lateral rectus eye movement, and CN VII controls facial expression and taste to the anterior two-thirds of the tongue.
Category reason: This tests foundational identification of cranial nerve functions (hearing), which is core neuroanatomy/neuroscience knowledge rather than a nursing care decision.

Question 34

The most common symptom of increased intracranial pressure is?

Accepted Answer

Answer reason: Raised intracranial pressure most commonly presents with headache due to stretching/irritation of pain-sensitive intracranial structures and meninges. It is often worse in the morning or with coughing/straining because these transiently increase intracranial pressure. Nausea and vomiting can occur (sometimes projectile), but they are less consistently present than headache. Seizures may occur in some intracranial pathologies, but they are not the most common symptom of increased intracranial pressure overall.
Category reason: This item tests recognition of a classic clinical manifestation of increased intracranial pressure, which is a neurological pathophysiology concept rather than a nursing intervention or prioritization task.

Question 35

The most common type of seizure in childhood is?

Accepted Answer

Answer reason: D. Partial seizures Focal (partial) seizures are the most common seizure type in childhood overall. Generalized tonic-clonic seizures are common and dramatic but are not the most frequent category across pediatric ages. Many pediatric epilepsies begin with focal onset that may remain focal or secondarily generalize. Recognizing focal onset is important for etiology evaluation and antiseizure medication selection.
Category reason: This asks for the most common seizure type in children, which is foundational knowledge about seizure classification and epidemiology within the nervous system, fitting Neurology rather than nursing intervention decision-making.

Question 36

A distinguishing EEG pattern in absence seizures is?

Accepted Answer

Answer reason: B. 3 Hz spike and wave Absence seizures classically show generalized, symmetric 3-Hz spike-and-wave discharges on EEG, often provoked by hyperventilation. Polyspike-and-wave patterns are more typical of myoclonic epilepsies rather than classic absence. Burst suppression is associated with deep anesthesia, severe encephalopathy, or post-anoxic injury. Slow background activity suggests diffuse cerebral dysfunction rather than a specific absence-seizure signature.
Category reason: This question tests recognition of a characteristic EEG finding for a seizure type, which is foundational neurodiagnostic knowledge rather than a nursing intervention or prioritization task.

Question 37

The most common presentation of neonatal seizures is?

Accepted Answer

Answer reason: B. Subtle seizures Neonates most often exhibit seizure activity as subtle, poorly organized behaviors rather than the dramatic tonic-clonic patterns seen in older children. Common subtle manifestations include eye deviation, lip smacking, chewing, bicycling or pedaling movements, apnea, and autonomic changes, which can be easily missed. This predominance is related to the immature neonatal brain and incomplete myelination, producing less synchronized cortical discharge. Recognizing subtle events is critical because untreated seizures may signal serious underlying pathology such as hypoxic-ischemic injury or metabolic disturbances.
Category reason: This question tests recognition of the typical clinical phenotype of seizures in newborns, a neurodevelopmental clinical science concept best categorized under Neurology rather than nursing interventions or prioritization.

Question 38

A client changes topics quickly while relating past psychiatric history. This client's pattern of thinking is called?

Accepted Answer

Answer reason: Rapid shifting from one topic to another with accelerated thought processes is characteristic of this pattern, commonly seen in mania or hypomania. The ideas are connected by understandable associations, but the pace makes the conversation difficult to follow. This differs from tangentiality (never returning to the point), circumstantiality (overinclusive detail but eventually gets to the point), and loosening of associations (illogical or incoherent connections).
Category reason: This item tests recognition of a specific thought-process abnormality (a neuropsychiatric/mental status examination concept), which is foundational biomedical/behavioral science knowledge rather than a nursing intervention or prioritization decision.

Question 39

What is the primary neurotransmitter imbalance involved in Delirium Tremens?

Accepted Answer

Answer reason: Delirium tremens occurs after abrupt cessation of chronic alcohol use, which removes alcohol’s CNS depressant effects. Chronic alcohol exposure enhances inhibitory tone and suppresses excitatory tone; the brain compensates by downregulating GABAergic activity and upregulating glutamatergic (NMDA) activity. When alcohol is withdrawn, the unopposed increased excitatory drive and reduced inhibition produces autonomic hyperactivity, agitation, tremor, and seizures. This is why benzodiazepines (GABA-A agonists) are first-line to restore inhibitory signaling.
Category reason: This question tests the neurochemical pathophysiology of alcohol withdrawal/delirium tremens (inhibitory vs excitatory neurotransmission), which is foundational neuroscience rather than a nursing intervention or prioritization task.

Question 40

The most common complication following surgical repair of myelomeningocele is?

Accepted Answer

Answer reason: Myelomeningocele is strongly associated with Arnold–Chiari II malformation, which disrupts CSF flow and leads to ventriculomegaly. After closure, changes in CSF dynamics can unmask or worsen this obstruction, so many infants require CSF diversion (e.g., VP shunt). While wound infection, orthopedic deformities, and neurogenic bladder are common issues in this condition overall, the most frequent complication specifically recognized after repair is development or progression of hydrocephalus.
Category reason: This question tests knowledge of a common neurologic complication and its pathophysiologic association with myelomeningocele rather than a nursing intervention or prioritization decision, so it best fits Neurology within NursingScience.

Question 41

Which of the following is the definitive treatment for hydrocephalus?

Accepted Answer

Answer reason: D. VP shunt surgery Hydrocephalus is characterized by pathologic accumulation of cerebrospinal fluid leading to ventricular dilation and increased intracranial pressure, and definitive management typically requires permanent CSF diversion. A ventriculoperitoneal shunt provides continuous drainage from the ventricles to the peritoneal cavity, addressing the underlying problem long term. Acetazolamide and lumbar puncture may be temporizing or condition-specific measures, and external ventricular drainage is generally a temporary emergency/bridge therapy rather than definitive treatment.
Category reason: This question tests foundational knowledge of the standard definitive medical/surgical management of a neurologic condition (hydrocephalus), which fits Neurology rather than nursing judgment or care prioritization.

Question 42

Which of the following signs and symptoms would you most likely find when assessing an infant with Arnold-Chiari malformation?

Accepted Answer

Answer reason: Arnold–Chiari (Chiari II) malformation involves herniation of hindbrain structures with brainstem involvement, which can impair cranial nerves IX and X and medullary respiratory centers. This commonly presents in infants with feeding/swallowing difficulty and weak/absent gag due to bulbar dysfunction. Brainstem compression can also cause stridor/apnea and other signs of respiratory compromise. The other options are less specific or suggest different conditions (e.g., spinal cord-level deficits or gastrointestinal illness).
Category reason: This question tests recognition of clinical manifestations of a congenital hindbrain/brainstem disorder, which is primarily a neurologic science concept rather than a nursing intervention/prioritization scenario.

Question 43

A person seeing a design in the floor thought it was a fossil. It is an example of?

Accepted Answer

Answer reason: An illusion is a misinterpretation of a real external sensory stimulus. Here, there is an actual visual stimulus (a floor design), but it is incorrectly perceived as a fossil. A hallucination would involve perceiving something without any external stimulus present, which is not described. A delusion is a fixed false belief not based on sensory misperception, and an idea of reference is misattributing neutral events as personally significant, neither of which fits this scenario.

Question 44

The nurse is completing a health history for the client with narcolepsy. Which finding should the nurse anticipate when completing the assessment?

Accepted Answer

Answer reason: Narcolepsy is characterized by excessive daytime sleepiness with recurrent, irresistible sleep attacks that occur at inappropriate times. This directly matches the expectation that the client may suddenly fall asleep during normal activities (e.g., talking, eating, working). Sudden loss of muscle tone can occur in narcolepsy as cataplexy, but it is not required for diagnosis and is not as universally anticipated as daytime sleep attacks. The option linking loss of muscle tone to narcotic analgesics reflects medication effect (sedation/respiratory depression), not a defining narcolepsy history feature.

Question 45

CSF is secreted by?

Accepted Answer

Answer reason: Cerebrospinal fluid is produced primarily by specialized ependymal cells within the choroid plexus located in the brain’s ventricles. This structure filters plasma and actively secretes ions and water to form CSF, maintaining CNS buoyancy and chemical stability. The meninges are protective membranes and do not perform CSF secretion, though they help contain CSF within the subarachnoid space. The pituitary and pineal glands are endocrine organs that secrete hormones rather than CSF.

Question 46

Which of the following values is considered normal for ICP?

Accepted Answer

Answer reason: Normal intracranial pressure in adults is typically in the range of about 5–15 mm Hg when measured in a stable, supine patient. Values around 20–25 mm Hg and above suggest intracranial hypertension and increase the risk of decreased cerebral perfusion and herniation. The 35–45 mm Hg range is a normal arterial carbon dioxide tension (PaCO2), not an ICP value. 120/80 mm Hg refers to systemic arterial blood pressure, not intracranial pressure.

Question 47

Which nerve controls hearing?

Accepted Answer

Answer reason: Hearing is mediated by cranial nerve VIII, which carries auditory sensory input from the cochlea to the brainstem auditory pathways. This nerve also carries vestibular information for balance, making it the primary sensory nerve of the inner ear. The facial nerve (VII) is mainly motor to facial expression and taste to the anterior tongue, not auditory perception. Glossopharyngeal (IX) relates to swallowing and taste posterior tongue, and trigeminal (V) is facial sensation and mastication.

Question 48

This reflex, present at birth is elicited by stroking the sole of the infants foot resulting in the fanning of the toes?

Accepted Answer

Answer reason: The principle is recognition of primitive neonatal reflexes and how they are elicited. Stroking the lateral sole of an infant’s foot normally produces dorsiflexion of the great toe with fanning of the other toes, which defines the Babinski reflex in newborns due to immature corticospinal tract myelination. Moro is triggered by sudden head extension or loud noise and causes symmetric abduction/extension of the arms, not toe fanning. Rooting and sucking are oral reflexes related to feeding behaviors rather than plantar stimulation.

Question 49

Reflex hallucination occur in :

Accepted Answer

Answer reason: This aligns with synesthesia, which involves blending of senses (e.g., a sound eliciting a visual experience). Kinesthesia refers to perception of movement/position, paresthesia to abnormal tingling sensations, and hyperesthesia to increased sensitivity, none of which describe cross-sensory evoked perceptions. Therefore the concept tested best matches synesthesia rather than purely somatic sensory disturbances.

Question 50

Coining of new words is..........?

Accepted Answer

Answer reason: This phenomenon is termed neologism and reflects disorganized or idiosyncratic language production not shared by the listener. Aphasia refers to impaired language function from brain injury and does not specifically mean making new words. Word salad describes incoherent, jumbled speech, whereas circumstantiality is overinclusive but ultimately goal-directed speech.

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