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Neurological System

1. Mr. Gervais, a 72-year-old man with hypertension and atrial fibrillation, arrives at the clinic after experiencing sudden difficulty speaking and right-arm weakness that lasted about 12 minutes before resolving on its own. He reports feeling normal again, but his wife is frightened because this is the first time he has experienced such symptoms. His blood pressure is 162/94 mmHg, and he admits to inconsistently taking his anticoagulant medication. The physician suspects a transient ischemic attack. Which clinical manifestation best supports the suspected condition? *
2. Ms. Delacroix, a 25-year-old college student, presents with intense headache, fever, and nausea. She reports feeling extremely sensitive to light and notes increasing neck stiffness. She took acetaminophen at home with no relief. On assessment, she keeps her eyes closed and curls toward her chest due to discomfort. Her temperature is 39.2°C. The physician suspects bacterial meningitis. Which manifestation most strongly correlates with meningitis? *
3. Ms. Roy, a 39-year-old woman with relapsing-remitting multiple sclerosis, reports new symptoms of blurred vision and difficulty maintaining balance for the last two days. She also describes numbness in her left leg and fatigue that worsens throughout the day. She denies fever. The LPN notes an unsteady gait during ambulation. Which clinical manifestation reflects an MS exacerbation? *
4. Mr. Houle, a 66-year-old man diagnosed with Parkinson’s disease 4 years ago, arrives for follow-up. His wife reports that he has become slower in daily tasks and often freezes mid-step. Upon entering the room, the LPN observes a shuffling gait and decreased facial expression. Mr. Houle states his hands tremble more when resting. Which manifestation is characteristic of Parkinson’s? *
5. Mr. Desbiens, 48, recently recovered from a gastrointestinal infection. Over the last 24 hours, he has experienced progressive weakness beginning in his feet and now reaching his thighs. He states he “can't lift his legs like yesterday.” His reflexes are diminished, and he has difficulty climbing onto the stretcher. The physician suspects Guillain-Barré syndrome. Which finding supports the suspected diagnosis? *
6. Ms. Leduc, 63, with uncontrolled hypertension, suddenly collapses at home. She is brought to the ED conscious but extremely confused. She complains of “the worst headache of my life,” and her blood pressure is 210/115 mmHg. The LPN notes unequal pupils and vomiting. The physician suspects a hemorrhagic stroke. Which clinical sign is strongly associated with hemorrhagic stroke? *
7. Mr. Ibrahim, 52, diagnosed with MG, reports difficulty chewing and swallowing by late afternoon. He says his eyes feel “droopy,” especially after working all day. During assessment, his eyelids sag, and his voice fades as he speaks. Symptoms improve slightly after resting. Which finding is typical of myasthenia gravis? *
8. Ms. Arsenault, 29, with a known seizure disorder, arrives after an episode witnessed by her partner. He reports she suddenly stiffened, fell, and began rhythmic jerking for about 90 seconds. She was confused afterward and extremely tired. The LPN places her on side-lying position for safety. What post-seizure finding best confirms a generalized tonic-clonic seizure? *
9. A 19-year-old student, Samuel, suffered a head injury during a hockey game. Over the next two hours, he becomes increasingly drowsy and complains of worsening headache and nausea. The LPN observes a drop in his level of consciousness and notes widening pulse pressure. Which sign indicates increased ICP? *
10. Ms. Tremblay, 41, arrives with sudden facial drooping on one side. She has difficulty closing her right eye and notes excessive tearing. Her speech is slightly slurred, but she denies limb weakness or confusion. Symptoms began upon waking. Her vital signs are normal. Which manifestation is characteristic of Bell’s palsy? *
11. amantha Leclair, 29, is admitted with rapidly ascending muscle weakness following a viral illness. Within 24 hours, weakness spreads to her arms, and she struggles to swallow. RR increases to 28/min, with shallow breaths and weak cough effort. ABG shows rising CO₂. What complication is most likely developing? *
12. Marc-André Poirier, 40, has poorly controlled epilepsy. He experiences a tonic-clonic seizure lasting 2 minutes, followed immediately by another without regaining consciousness. The pattern continues for 10 minutes. What is the nurse most concerned about? *
13. Raymond Hébert, 79, with Parkinson disease, presents with worsening rigidity, masked facial expression, drooling, and difficulty swallowing. He coughs during meals, and today he has a fever of 38.2°C, productive cough, and crackles in the right lower lobe. The new respiratory symptoms suggest what complication? *
14. Amira Ouedraogo, 19, arrives with fever, photophobia, neck stiffness, and purpuric rash. VS: BP 102/60, HR 120, temp 39.4°C. After antibiotic initiation, she becomes irritable, then confused, with projectile vomiting and worsening headache. These findings most likely indicate: *
15. Patrice Gagnon, 28, hits his head during a bicycle crash. Initially unconscious, he wakes up alert and oriented. One hour later, he rapidly deteriorates, developing a dilated pupil on the injured side and severe headache. This progression is characteristic of: *
16. Laura Savoie, 62, with ALS, shows progressive limb weakness. Over weeks, she develops dyspnea on minimal exertion, weak cough, and difficulty clearing secretions. Today her RR is 34/min, with shallow breaths and oxygen saturation dropping. What complication is most likely developing? *
17. An LPN working in the long-term care unit must apply a dressing to an 80-year-old beneficiary’s bottom wound. The nursing care and treatment plan indicates that it’s necessary to alternate lateral positioning q2h. The beneficiary has a buccal temperature of 38.5 and says that he sweats a lot. He also feels pain in the area of his dressing. While replacing the dressing, the LPN notes the increasing presence of sero-sanguinous exudate and foul smelling odors emanating from the dressing. Which of the following clinical manifestations relates to local infection? *
18. A patient is admitted to the medical unit for lesions filled with serous filled on her upper body. While reading the patient’s file, the LPN notices that the patient is taking anti-ulcer for stomach problems and that she is undergoing oral chemotherapy treatment, which weakens her. Three years ago, she was treated for breast cancer and became immuno-deficient. While filling out the questionnaire, she indicates that she has intense pain at 9/10 on her left torso as well as a rash on her nerve path. She complains of a burning sensation on the skin, as well as stinging an electric tingling. The physician diagnoses shingles. Which of the following clinical manifestations relate to the patient’s condition? *
19. A 65-year-old beneficiary has been living in a CHSLD for two years because of Parkinson’s disease. She wears hearing aids, and needs to be spoken to loudly so that she can hear. She has head and extremity tremors, that increase during periods of stress. She uses a walker to move around and takes small steps. Its takes a long time for her to carry her activities, and her movements are increasingly difficult and slow. Embarrassed by her condition, she expresses herself with difficulty and eats less and less. The LPN notes that the risk of falling has increased for this patient, due to a flu-like state that weakens her. This will be recorded in the TNP by the RN in charge. Which of the clinical manifestations relates to the beneficiary’s condition? *
20. A 77-year-old man who has worked with the public all his life will soon celebrate 60 years living with his spouse. For some time, his children have noticed major changes in their father. He has difficulty sleeping despite he medication he takes at bedtime. He is inclined to forget certain facts, such as appointments and the names of experiences perceptual problems and when he describes what he sees and is then corrected by those around him, he gets angry and becomes anxious. The patient is assessed at the geriatric unit. The geriatrician announces to the family that it will be impossible for their father to return home because he is suffering from a dementia with Lewy bodies. Whenever the patient meets the LPN, he acts familiar with her because he believes she’s his daughter. Which of the following clinical manifestations relate to the patient’s condition? *