1. Which of the following best describes the function of the Diancephalon?
a. Provides information necessary for balance and posture.
b. Serves as sites for decussation of tracts.
c. Conducts sensory and motor impulses.
d. Process intellect, emotions and contains skill memory.
2. Which of the following are true regarding the spinal nerves?
a. Thoracic Nerves 1-8
b. Sacral Nerves 1-5
c. Lumbar Nerves 1-6
d. Cervical Nerves 1-6
3. You were assessing a patient after a Motovehicular Accident. The patient opens eyes
after initiation of pain, withdraws arms after nail-bed pressure, and talks with
incomprehensible words. Which of the following is the patient’s GCS?
a. 6 b. 7 c. 8 d. 9
4. The patient was seen with lesions at the upper and lower motor neurons, the cerebellum,
and the extrapyramidal tract. Which of the following speech problem can be seen from
the patient?
a. Apathy b. Aphasia c. Dysphonia d. Dysarthria
5. Myasthenia Gravis is diagnosed to a 45 female patient. The doctor also wrote in the
patient’s chart Horner Syndrome. Which of the following best describes Horner
Syndrome?
a. Sudden respiratory arrest. c. Drooping of the eyelids.
b. Changes in the tone of voice. d. Associated with myasthenic crisis
6. A patient was rushed in the Emergency Room due to CVA. According to the MD, the
stroke was caused by a clot from atrial fibrillation. Which of the following type of stroke
does the patient has?
a. a. Transient Ischemic Attack. c. Cardiogenic Embolic Stroke
b. Large Vessel Stroke d. Small Vessel Stroke
7. Which of the following is true regarding the location of an Intracerebral Hematoma?
a. Located in the space between the skull and the dura mater.
b. Located in the space below the dural surface.
c. Located directly on the brain tissue.
d. None of the above.
8. Which of the following is defined as the inability to carry out some motor patterns?
a. Agnosia b. Aphasia. c. Apraxia d. Ataxia
9. A patient was diagnosed with Herniated Intervertebral Disk at L5. The patient has
developed a syndrome in which the patient experiences bowel and bladder incontinence,
and paralysis of lower extremities. Which of the following syndrome is this?
a. Zollinger-Ellison Syndrome
b. Wernicke-Korsakoff Syndrome
c. Cauda Equina Syndrome
d. Prader-Willi Syndrome
10.Which of the following is a type of Antiepileptic Drugs?
a. Lamictal. b. Nexium. c. Riopan d. Mylanta
11.A nurse notes that a client’s brain MRI shows a mass crossing the corpus callosum.
Which malignancy is most consistent with this finding?
a. Meningioma
b. Medulloblastoma
c. Glioblastoma multiforme
d. Oligodendroglioma
12.A client with a spinal cord injury at T5 reports a severe, throbbing headache and nasal
congestion. The nurse notes flushed skin above the lesion and cool, pale legs. The foley
tubing is kinked. Which of the following should the nurse prioritize?
a. Elevate the head of the bed and immediately relieve the bladder distention
b. Administer the prescribed PRN antihypertensive medication
c. Call the physician and prepare for vasodilator therapy
d. Apply high-flow oxygen via non-rebreather mask
13.A patient with a left middle cerebral artery stroke demonstrates right-sided neglect and
confusion. The family asks why the patient cannot recognize her own arm. What is the
most accurate explanation?
a. “This is a common response to left-brain strokes and will likely improve.”
b. “She has anosognosia, where the brain fails to recognize the affected body part
as one’s own.”
c. “She has apraxia, a condition that affects motor planning.”
d. “It’s expressive aphasia, which makes her unable to identify her body parts
correctly.”
14.Which of the following findings in a patient with IICP should alert the nurse that the client
is approaching brainstem herniation?
a. Disorientation to time and place with photophobia
b. Nuchal rigidity and positive Kernig’s sign
c. Fixed, dilated pupils with extensor posturing
d. Papilledema with a decrease in visual acuity
15.A patient recovering from a spinal cord injury is demonstrating signs of spinal shock
resolution. Which of the following would the nurse expect to observe?
a. Hypotension and flaccid paralysis below the level of injury
b. Tachycardia with muscle atrophy below the lesion
c. Absence of deep tendon reflexes and priapism
d. Return of reflexes with spasticity and hyperreflexia
16.A client with a CVA is receiving warfarin and reports new-onset headache and visual
disturbances. What should the nurse do first?
a. Hold the next dose and notify the physician of possible hemorrhagic conversion
b. Administer PRN acetaminophen and assess response
c. Teach the client to report worsening symptoms
d. Request an ophthalmology referral for further evaluation
17.In Alzheimer’s disease, which behavior best distinguishes moderate-stage from
late-stage progression?
a. Inability to perform activities of daily living without total assistance
b. Repeating the same question every few minutes
c. Forgetting the names of close family members
d. Wandering and getting lost in familiar settings
18.A nurse is evaluating a client’s response to mannitol therapy for IICP. Which of the
following indicates therapeutic effectiveness?
a. Output of 120 mL/hr with blood pressure of 150/90 mmHg
b. Decreased heart rate and narrowing pulse pressure
c. Increased alertness and improved pupil reactivity
d. Sudden decrease in ICP from 20 mmHg to 5 mmHg in 10 minutes
19.A patient with C3 spinal cord injury is receiving mechanical ventilation. Which finding
requires immediate intervention?
a. A. ABG: pH 7.38, PaO2 85, PaCO2 42
b. Use of accessory muscles and shallow RR
c. Client is alert but unable to move limbs
d. Absence of gag reflex during suctioning
20.A nurse is caring for a patient with Alzheimer’s who insists her long-deceased husband
is alive. What is the most therapeutic response?
a. “Let’s not talk about that right now.”
b. “Remember, your husband passed away years ago, tell me more.”
c. “Tell me more about your husband. What was he like?”
d. “You must be confused; no one else remembers seeing him, tell me more.”
21.A patient with a recent stroke refuses to eat and says the food “tastes like metal.” What
is the most likely cause of this symptom?
a. Dysgeusia related to cranial nerve damage
b. Residual motor deficits affecting chewing ability
c. Side effect of increased ICP causing nausea
d. Onset of post-stroke depression with appetite changes
22.During the acute phase of a CVA, a patient is hypertensive with a BP of 190/105 mmHg.
Which nursing judgment is most accurate?
a. Permissive hypertension may be allowed to maintain cerebral perfusion
b. This level of hypertension must be corrected immediately to reduce ICP
c. Hypertension after a stroke always requires urgent intervention
d. Blood pressure should be titrated aggressively to normotensive levels
23.A client with primary open-angle glaucoma (POAG) asks why peripheral vision is
gradually lost. The nurse best explains that this is due to:
a. Progressive opacification of the crystalline lens
b. Posterior displacement of the retina due to subretinal hemorrhage
c. Chronic elevation of intraocular pressure causing optic nerve cupping
d. Lens dislocation impinging upon the retinal periphery
24.A nurse observes a grey, curtain-like shadow descending in a client’s visual field. This
most likely signifies:
a. Rapid accumulation of aqueous humor in the posterior chamber
b. Rhegmatogenous retinal detachment due to vitreoretinal traction
c. Hyperplastic degeneration of the macula lutea
d. Cortical lens fiber sclerotic change leading to visual haze
25.In evaluating tonometric readings, which of the following pressures necessitates
immediate ophthalmologic referral?
a. 14 mmHg
b. 28 mmHg
c. 18 mmHg
d. 10 mmHg
26.A postoperative patient recovering from extracapsular cataract extraction with intraocular
lens implantation suddenly complains of severe eye pain and nausea. The nurse
suspects:
a. Posterior capsule opacification
b. Acute angle-closure glaucoma secondary to pupillary block
c. Iritis resulting from surgical trauma
d. Cystoid macular edema from vitreous traction
27.Which of the following accurately describes the pathophysiology of a nuclear sclerotic
cataract?
a. Degeneration of Müller cells within the macula
b. Detachment of the sensory retina from the retinal pigment epithelium
c. Progressive compaction and yellowing of the central lens nucleus
d. Trabecular meshwork fibrosis obstructing aqueous outflow
28.A nurse assessing a client with angle-closure glaucoma would expect which pupillary
finding?
a. Pinpoint and non-reactive
b. Mid-dilated, sluggish to light, and fixed
c. Rapidly reactive to near accommodation
d. Irregularly shaped with afferent pupillary defect
29.Which anatomical structure is chiefly responsible for maintaining intraocular pressure via
aqueous humor drainage?
a. Ciliary processes
b. Trabecular meshwork within the iridocorneal angle
c. Central retinal artery
d. Choroidal vasculature
30.The client with a long-standing cataract reports progressive loss of vision. The nurse
knows this is due to:
a. Detachment of the retina from the choroid
b. Light scattering and refractive error caused by lens protein denaturation
c. Increased vitreous pressure leading to corneal flattening
d. Atrophy of the optic disc due to ischemia
31.A pharmacologic agent contraindicated in a patient with narrow-angle glaucoma is which
of the following?
a. Brimonidine
b. Dorzolamide
c. Atropine sulfate
d. Latanoprost
32.Which of the following findings is most characteristic of optic nerve head cupping in
chronic glaucoma?
a. Cherry red spot in the fovea centralis
b. Increased cup-to-disc ratio exceeding 0.6
c. Flame-shaped hemorrhages in the macula
d. Bull’s eye maculopathy
33.The nurse educates a client with aphakia that this condition refers to:
a. Partial detachment of the macula from the choroid
b. Inflammation of the ciliary body and iris
c. Absence of the crystalline lens
d. Optic disc pallor due to retinal ischemia
34.Which clinical manifestation best suggests posterior vitreous detachment leading to
retinal tear?
a. Gradual dimming of central vision
b. Sudden onset of photopsia and floaters
c. Progressive narrowing of the peripheral visual field
d. Loss of color discrimination
35.An emergency complication following laser iridotomy in angle-closure glaucoma
includes:
a. Posterior synechiae formation
b. Malignant glaucoma with aqueous misdirection
c. Progressive cortical lens opacification
d. Exudative retinal detachment
36.Which pharmacologic mechanism reduces intraocular pressure most directly by
enhancing uveoscleral outflow?
a. Beta-adrenergic blockade reducing aqueous humor production
b. Prostaglandin analogues facilitating unconventional aqueous outflow
c. Alpha-agonist-induced vasoconstriction of ciliary processes
d. Carbonic anhydrase inhibition within the non-pigmented ciliary epithelium
37.A nurse performing an eye assessment notes a “shadow reflex” obscuring the red reflex
in the affected eye. This is most indicative of which of the following?
a. Posterior vitreous hemorrhage
b. Mature senile cataract with nuclear opacity
c. Iris bombe from posterior synechiae
d. Optic nerve edema with papilledema
