Final Review Practice Exam .pdf

Based on the content of the uploaded file, here is an NCLEX-style multiple-choice quiz focusing on nursing critical thinking questions. The quiz consists of 50 questions, each with four answer choices. An answer key is provided at the end. ### Nursing Critical Thinking Quiz 1. A patient with multi...

Based on the content of the uploaded file, here is an NCLEX-style multiple-choice quiz focusing on nursing critical thinking questions. The quiz consists of 50 questions, each with four answer choices. An answer key is provided at the end. ### Nursing Critical Thinking Quiz 1. A patient with multiple sclerosis (MS) is experiencing a relapse. Which of the following medications would be most appropriate to help suppress the immune system? A. Phenytoin B. Methotrexate C. Carbamazepine D. Baclofen 2. A nurse is caring for a patient with autonomic dysreflexia. What is the priority action? A. Administer antihypertensive medication B. Place the patient in a supine position C. Identify and remove the triggering stimulus D. Initiate seizure precautions 3. After a lumbar puncture, the nurse should place the patient in which position to prevent a headache? A. Supine B. Semi-Fowler’s C. High-Fowler’s D. Prone 4. During a tonic-clonic seizure, which of the following interventions is the priority? A. Administering antiepileptic medication B. Restraining the patient C. Maintaining a patent airway D. Documenting the seizure activity 5. A patient with a right-sided stroke may exhibit which of the following symptoms? A. Aphasia B. Right-sided neglect C. Impulsive behavior D. Depression 6. Which sign is indicative of meningitis when a patient’s hip is flexed to 90 degrees and there is resistance to straightening the leg? A. Brudzinski's sign B. Kernig's sign C. Babinski's sign D. Hoffman’s sign 7. A positive Babinski reflex in an adult patient indicates: A. Normal neurological function B. Upper motor neuron lesion C. Lower motor neuron lesion D. Peripheral neuropathy 8. Which of the following is a priority assessment for a patient with Guillain-Barré syndrome? A. Monitoring blood pressure B. Assessing respiratory function C. Checking deep tendon reflexes D. Evaluating muscle strength 9. The nurse knows that myasthenia gravis symptoms typically improve with: A. Exercise B. Rest C. Warm temperatures D. High-calorie meals 10. For a patient experiencing a seizure, what is the first action the nurse should take? A. Insert an oral airway B. Place the patient in a side-lying position C. Administer lorazepam D. Apply restraints 11. What is the most appropriate position for a patient post-lumbar puncture? A. High Fowler’s position B. Supine for 6-8 hours C. Prone with head turned to the side D. Semi-Fowler’s position with head elevated 12. A patient is scheduled for a lumbar puncture. Which pre-procedure action is essential? A. Administering a sedative B. Obtaining an informed consent C. Administering antibiotics prophylactically D. Placing the patient in a prone position 13. A patient with Parkinson's disease is at risk for aspiration due to: A. Bradykinesia B. Muscle rigidity C. Pill-rolling tremor D. Dysphagia 14. The nurse is assessing a patient with increased intracranial pressure (ICP). Which finding requires immediate intervention? A. Decreased heart rate B. Increased respiratory rate C. Elevated blood pressure D. Narrowing pulse pressure 15. A patient with myasthenia gravis is taking anticholinesterase medications. What is the purpose of these medications? A. To decrease muscle spasms  B. To improve muscle strength C. To reduce inflammation D. To increase dopamine levels 16. A nurse is caring for a patient post-cholecystectomy with a T-tube in place. What color should the drainage be? A. Clear B. Greenish C. Yellowish-brown D. Red 17. A patient is experiencing symptoms of autonomic dysreflexia. Which of the following is a potential cause? A. Full bladder B. Low blood pressure C. Hyperglycemia D. Hypothermia 18. What is the most appropriate intervention for a patient with increased intracranial pressure (ICP)? A. Administering a hypertonic solution B. Elevating the head of the bed to 90 degrees C. Providing a quiet environment D. Encouraging coughing exercises 19. A patient presents with a stroke affecting Broca's area. Which symptom is most likely? A. Difficulty understanding speech B. Difficulty expressing thoughts C. Vision loss D. Hemiplegia 20. Which nursing diagnosis is a priority for a patient with Guillain-Barré syndrome? A. Risk for infection B. Impaired physical mobility C. Ineffective breathing pattern D. Acute pain 21. A patient is being treated for multiple sclerosis with immunosuppressants. What is the most important nursing consideration? A. Monitoring for signs of infection B. Checking blood glucose levels C. Assessing for muscle spasms D. Evaluating for visual disturbances 22. Which of the following is a common side effect of phenytoin (Dilantin)? A. Hypertension B. Gingival hyperplasia C. Weight gain D. Urinary retention 23. A patient with multiple sclerosis is being treated with plasmapheresis. What is the purpose of this treatment? A. To remove antibodies B. To increase red blood cells C. To replace electrolytes D. To provide hydration 24. In managing a patient with a seizure disorder, the nurse should: A. Restrain the patient during the seizure B. Insert a tongue blade into the patient’s mouth C. Maintain an open airway D. Apply a cold compress to the patient’s forehead 25. A patient with a suspected stroke arrives at the emergency department. What is the nurse’s priority action? A. Administering aspirin B. Starting an IV line C. Conducting a neurological assessment D. Preparing the patient for a CT scan 26. A patient with myasthenia gravis is at risk for myasthenic crisis. What is a primary cause of this condition? A. Overmedication with anticholinesterase drugs B. Emotional stress C. Decreased physical activity D. High-protein diet 27. Which intervention is appropriate for a patient post-lumbar puncture to prevent a headache? A. Administering analgesics B. Encouraging fluid intake C. Elevating the head of the bed D. Applying a cold compress 28. A patient with Parkinson's disease is prescribed levodopa. What should the nurse monitor for? A. Muscle spasms B. Nausea and vomiting C. Dry mouth D. Increased salivation 29. For a patient with increased ICP, which positioning is recommended? A. Supine with head elevated 15 degrees B. Lying flat C. Semi-Fowler’s position D. High Fowler’s position 30. A patient with a seizure disorder is prescribed phenytoin (Dilantin). Which statement indicates the patient understands the medication regimen? A. “I will take the medication with my meals.” B. “I should avoid drinking alcohol.” C. “I can stop taking the medication once my seizures are controlled.” D. “I should take the medication only when I feel a seizure coming on.” 31. A nurse is caring for a patient with multiple sclerosis who is experiencing fatigue. What is the best nursing intervention? A. Encourage the patient to take short naps throughout the day B. Advise the patient to avoid all physical activity C. Recommend a high-protein diet D. Instruct the patient to increase fluid intake 32. Which of the following is a clinical manifestation of a left-sided stroke? A. Left-sided neglect B. Impulsive behavior C. Right-sided hemiplegia D. Spatial-perceptual deficits 33. A patient with multiple sclerosis is prescribed baclofen. What is the primary purpose of this medication? A. To reduce muscle spasticity B. To improve cognitive function C. To enhance immune response D. To decrease fatigue 34. What is the most appropriate nursing intervention for a patient experiencing autonomic dysreflexia? A. Administering IV fluids B. Placing the patient in a supine position C. Identifying and eliminating the triggering stimulus D. Applying warm compresses to the affected area 35. A patient with Parkinson’s disease is at risk for which of the following complications? A. Seizures B. Dysphagia C. Hyperglycemia D. Hypertension 36. Which of the following is an early sign of increased intracranial pressure (ICP)? A. Bradycardia B. Hypertension C. Altered level of consciousness D. Fixed, dilated pupils 37. The nurse is educating a patient with myasthenia gravis about cholinesterase inhibitors. Which statement by the patient indicates a need for further teaching? A. “I should take my medication at the same time every day.” B. “I can skip a dose if I am feeling well.” C. “I need to report any muscle weakness to my doctor.” D. “I should avoid activities that require muscle strength after taking my medication.” 38. What is the primary goal in the management of Guillain-Barré syndrome?  A. Pain management B. Enhancing mobility C. Respiratory support D. Nutritional support 39. A patient with multiple sclerosis is experiencing diplopia. What is the best nursing intervention? A. Covering both eyes with a patch B. Covering the affected eye with a patch C. Encouraging the patient to close their eyes periodically D. Teaching the patient to focus on a single point 40. The nurse is assessing a patient with meningitis. Which of the following findings is most concerning? A. Fever B. Nuchal rigidity C. Photophobia D. Altered mental status 41. A patient with myasthenia gravis is prescribed pyridostigmine. What is the mechanism of action of this drug? A. It blocks acetylcholine receptors B. It increases acetylcholine availability at the neuromuscular junction C. It decreases acetylcholine production D. It enhances dopamine levels 42. Which nursing diagnosis is a priority for a patient with Parkinson’s disease? A. Risk for infection B. Risk for injury C. Chronic pain D. Impaired social interaction 43. What is a common side effect of baclofen? A. Hyperactivity B. Drowsiness C. Diarrhea D. Insomnia 44. A patient with multiple sclerosis is experiencing an exacerbation. Which of the following medications is commonly prescribed? A. Prednisone B. Atorvastatin C. Lisinopril D. Metformin 45. A nurse is preparing to administer phenytoin (Dilantin) to a patient. What is an important consideration? A. It should be taken with food B. It can be given IM C. It should not be given with antacids D. It can cause hyperkalemia 46. A patient with a spinal cord injury at T6 is at risk for autonomic dysreflexia. Which symptom should the nurse monitor for? A. Hypotension B. Tachycardia C. Severe headache D. Hyperglycemia 47. For a patient with multiple sclerosis, which of the following symptoms is expected? A. Hyperreflexia B. Muscle flaccidity C. Hypotonia D. Spasticity 48. Which intervention is appropriate for a patient with increased intracranial pressure (ICP)? A. Administering IV fluids rapidly B. Performing frequent suctioning C. Keeping the head of the bed elevated D. Encouraging the patient to cough and deep breathe 49. A patient with Parkinson’s disease is prescribed a dopamine agonist. What is the expected effect of this medication? A. Decrease muscle rigidity B. Increase acetylcholine levels C. Decrease tremors D. Increase dopamine availability 50. A nurse is teaching a patient with multiple sclerosis about energy conservation. Which statement indicates understanding? A. “I should take a hot shower every morning.” B. “I should plan my activities in the morning when I have more energy.” C. “I should avoid taking rest breaks during activities.” D. “I should engage in strenuous exercise daily.” Answer Key 1. B 26. B 2. C 27. B 3. A 28. B 4. C 29. C 5. C 30. B 6. B 31. A 7. B 32. C 8. B 33. A 9. B 34. C 10. B 35. B 11. B 36. C 12. B 37. B 13. D 38. C 14. A 39. B 15. B 40. D 16. C 41. B 17. A 42. B 18. C 43. B 19. B 44. A 20. C 45. C 21. A 46. C 22. B 47. D 23. A 48. C 24. C 49. A 25. D 50. B