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Neurological System

1. A beneficiary suffering from Alzheimer’s disease for the past five years is admitted to a CHSLD. Following a discussion with the beneficiary’s family, the nurse decides to place her in a room with a half-door to keep her from wandering off. During her afternoon visit, the LPN sees the beneficiary standing on her chair trying to climb over the door. While bringing her back to bed, the LPN gives the beneficiary back the glasses she found in her blankets and notices a sign of urinary incontinence. Which of the following fall prevention measures is not appropriate in this situation? *
2. An 82-year old woman has been hospitalized in the department of medicine for decreased general condition (DGC). Ever since her husband died six months ago, she no longer leaves her home and spends most of her time lying down. Muscle weakness and atrophy caused by lack of exercise has impaired her mobility. Moreover, the patient’s vision is diminished by the presence of cataracts. To help her move without falling, the LPN shows the patient how to use a walker. Which of the following fall prevention measures is not appropriate in this situation? *
3. An LPN visits the home of a 38-year-old woman to check her ADL (activities of daily living) and DA (domestic activities) needs. She observes that the interior of the client’s home is very cluttered. For the past few months, the client has had severe labyrinthitis, and her physician suspects Meniere’s disease. The client experiences dizziness and light-headedness whenever she makes twisting motions. She walks very slowly and becomes discouraged when she has to move too far because her symptoms come on very quickly, causing her to stop her activities without being able to finish them. Which of the following fall prevention methods is appropriate in this situation? *
4. Mr. Benoît Charest, 72, is brought to the emergency room after suddenly developing right-sided weakness and slurred speech while eating breakfast. On arrival, he is alert but confused about the date. His BP is 186/98 mm Hg, HR 92, RR 20, SpO₂ 96%. He has a right facial droop and difficulty raising his right arm. The physician orders CT scan, NPO status, and frequent neuro checks. Which intervention is most appropriate while awaiting CT results? *
5. Ms. Chloé Durocher, 33, with known epilepsy, experiences a tonic-clonic seizure lasting 90 seconds while in her hospital bed. After the seizure stops, she is drowsy and confused but breathing normally. The physician orders vital signs, postictal monitoring, and documentation of duration. What should the LPN do immediately after the seizure? *
6. Mr. Daniel Pigeon, 41, suffered a fall from a ladder. He is awake but complains of a “crushing headache” and nausea. His pupils are equal and reactive. Vital signs: BP 150/90, HR 58, RR 18. The physician orders head elevation, neuro checks, and avoiding stimuli that increase ICP. Which intervention helps reduce intracranial pressure? *
7. Ms. Laurence Côté, 29, recently diagnosed with MS, reports worsening fatigue and numbness in her legs by mid-day. Her gait is unsteady. The physician orders energy-conservation teaching and fall prevention. Which instruction is priority? *
8. Mr. Émile Bourassa, 68, has Parkinson’s disease and reports increased rigidity and difficulty initiating steps. He walks with a shuffling gait. The physician orders physiotherapy, fall precautions, and mobility support. What technique helps initiate movement? *
9. Mr. Frédéric Deslauriers, 54, hospitalized for progressive ascending weakness, now reports difficulty coughing. His voice sounds weak. The physician orders vital signs, SpO₂ monitoring, and to report changes in breathing. Which finding is most concerning? *
10. Ms. Jade Fontaine, 26, presents with severe throbbing headaches accompanied by nausea and light sensitivity. She notes they often occur after skipping meals. The physician orders pain management and lifestyle teaching. What teaching is appropriate? *
11. Mr. Louis Marchand, 35, with a T4 spinal cord injury, suddenly develops pounding headache and sweating above the level of injury. His BP is 190/100. Orders: check bladder, remove triggers, notify RN. What should the LPN do first? *
12. Mrs. Stéphanie Côté, 38, living with relapsing–remitting multiple sclerosis, was admitted after a flare-up marked by new leg weakness and overwhelming fatigue. She tells the LPN that even walking to the washroom “feels like running a marathon.” This morning, she attempted to get up on her own but had to sit back down due to sudden exhaustion. She expresses frustration about losing independence. Orders include: fall prevention, energy conservation teaching, and assistance with ADLs as needed. Which intervention best supports her functional capacity? *
13. Mr. Pascal Dumas, 41, arrives to the unit clutching the right side of his face, eyes tearing from pain. He has a history of cluster headaches that occur at night. Today, he reports the pain as “sharp and drilling,” radiating behind his right eye. His nostril on that side appears congested. Orders include high-flow oxygen, dark room, and pain assessment every 15 minutes. Which immediate intervention should the LPN anticipate? *
14. Mrs. Renée Martel, 57, is hospitalized for intensified trigeminal neuralgia. She describes the facial pain as “electric shocks” triggered by brushing her teeth or feeling the cold breeze from the window. Today, she avoided breakfast because chewing caused a stabbing sensation. Orders include pain management, soft-food diet, and education on avoiding triggers. Which teaching is most appropriate? *
15. Mr. Olivier Thériault, 62, diagnosed with a frontal lobe tumor, has been increasingly confused over the past 24 hours. The LPN notes he becomes irritable, has difficulty concentrating, and occasionally asks the same question repeatedly. His wife reports that he vomited suddenly without nausea. Orders include neuro checks every 2 hours, fall precautions, and HOB elevation. Which finding suggests increased intracranial pressure? *
16. Mr. Samuel Fontaine, 70, has chronic peripheral neuropathy secondary to long-standing diabetes. He reports burning sensations in both feet and difficulty feeling small objects on the floor. Today he stumbled after stepping on a pen he hadn’t noticed. Orders include foot inspection teaching, safe footwear, and pain management. What intervention should the LPN prioritize? *
17. Mrs. Mathilde Bérubé, 74, recovering from a right-sided ischemic stroke, has left-side weakness and expresses frustration about depending on others to eat. During breakfast, the LPN observes coughing and watery eyes when she attempts to swallow thin liquids. Her speech is slightly slurred. Orders include swallow precautions, thickened fluids, and positioning upright during meals. Which intervention is safest during feeding? *
18. Ms. Léonie Ratelle, 33, presents with sudden facial drooping on the right side, inability to fully close her eye, and drooling when she drinks. She is anxious that she may be having a stroke, but imaging confirms Bell’s palsy. She states her eye feels dry and irritated. Orders include artificial tears, eye patch, and facial exercises. Which intervention should the LPN implement first? *
19. Mr. Denis Gagné, 54, diagnosed with Guillain-Barré syndrome, reports worsening tingling in his legs that has progressed to his thighs. The LPN notices reduced strength when he attempts to lift his legs. He appears anxious, asking if the paralysis will reach his lungs. Orders include respiratory monitoring, neuro checks, and support with mobility. Which assessment is most critical? *
20. Ms. Camille Lajoie, 25, with known epilepsy, is admitted for medication adjustment after two recent tonic-clonic seizures. She expresses embarrassment and fear of having another seizure in front of others. Orders include side-rail padding, seizure precautions, and vital signs after seizure events. What is the MOST appropriate action during a seizure? *
21. Mr. Émile Parent, 69, diagnosed with Parkinson’s disease, takes levodopa–carbidopa. This morning he reports increased tremors and difficulty initiating movement because he “forgot a dose yesterday.” His gait appears shuffling and rigid. Orders: administer medication on schedule, fall precautions, and mobility assistance. Which LPN action is most important? *
22. Ms. Karine Houle, 22, arrives with fever, severe headache, stiff neck, and photophobia. She curls up in bed, shielding her eyes from the light. Her temperature is 39.4°C, and she reports nausea. Orders include droplet precautions, neuro checks, hydration, and comfort measures. What is the FIRST action for the LPN? *
23. Mr. Jacob Tremblay, 18, was admitted after a fall during hockey practice. He briefly lost consciousness and now complains of a headache, mild nausea, and sensitivity to light. He keeps asking what happened even though the LPN already explained it twice. Orders include neuro checks every hour, minimal stimulation, and monitoring for worsening symptoms. Which instruction best supports recovery? *