NCLEX : Causes and Treatments of Neural Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : Causes And Treatments Of Neural Conditions

A 50-year-old female client recently diagnosed with multiple sclerosis, presents to the clinic after having a history of several neurological symptoms and is asking the nurse about her condition. The nurse is glad to teach the client about multiple sclerosis.

Which of the following statements about multiple sclerosis is correct?

Possible Answers:

Multiple sclerosis is a genetically transmitted disease which affects the basal ganglia and the extra pyramidal system with a deficiency of acetylcholine. The effects are seen in both physical and cognitive dysfunction.  

Multiple sclerosis is a disease of the dopamine producing neurons of the substancia nigra of the midbrain, causing overall weakness. 

Multiple sclerosis is a disease where excess release of dopamine and increase serotonin levels of the brain lead to neurological dysfunction.

Multiple sclerosis is a autoimmune disease of the neuromuscular junction characterized by variable weakness of different muscle groups. 

Multiple sclerosis is a progressive and chronic degenerative disorder. The condition leads to demyelination of the nerve fibers of the central nervous system, causing various neurological defects. 

Correct answer:

Multiple sclerosis is a progressive and chronic degenerative disorder. The condition leads to demyelination of the nerve fibers of the central nervous system, causing various neurological defects. 

Explanation:

Multiple sclerosis is an autoimmune process with no exact known cause. The myelin sheath is attacked and plaque formation occurs in various regions of the CNS. Without myelin, nerve conduction slows down and may eventually be completely blocked leading to widespread loss of function. 

Loss of the dopamine-producing neurons describes Parkinson's disease. Excess dopamine describes dementia. Deficiency of acetylcholine describes Huntington's disease, and the autoimmune disease of the neuromuscular junction is known as Myasthenia Gravis.

Example Question #2 : Causes And Treatments Of Neural Conditions

Bell's palsy is due to dysfunction of which of the following cranial nerves?

Possible Answers:

Cranial nerve VIII

Cranial nerve VII

Cranial nerve IV

Cranial nerve III

Correct answer:

Cranial nerve VII

Explanation:

Bell's palsy is due to dysfunction of cranial nerve VII, the facial nerve. The facial nerve provides motor control to the musculature of the face and sensory innervation of taste, facial sensation, and parasympathetic innervation of the submandibular and sublingual glands. 

  

Example Question #3 : Causes And Treatments Of Neural Conditions

Which of the following classes of medication is not used for treatment of migraine headaches?

Possible Answers:

Triptans

Antidepressants

Beta blockers

All of these may be used to treat migraines

Correct answer:

All of these may be used to treat migraines

Explanation:

Migraine headaches are commonly treated at first by over the counter (OTC) medications such as NSAIDS and acetaminophen. Other treatment options include triptans, antidepressants such as amitriptyline, and anti-hypertensives (beta blockers and calcium channel blockers).

Example Question #4 : Causes And Treatments Of Neural Conditions

Which of the following herbs has been shown to be effective in prevention of migraine symptoms?

Possible Answers:

Agrimonia eupatoria (agrimony)

Petasites hybridus (butterbur)

Hypericum perforatum (St John's wort)

Uncaria tomentosa (cat's claw)

Correct answer:

Petasites hybridus (butterbur)

Explanation:

Petasites hybridus (butterbur) is a flowering plant of the family asteraceae. It has been shown in studies to reduce the frequency of migraine headaches by as much as 68%. None of the other herbs listed have any significant medicinal benefit in migraine headaches. 

Example Question #5 : Causes And Treatments Of Neural Conditions

Which of the following interventions has been shown to be effective in reducing the severity of pain in cluster headaches?

Possible Answers:

Carotid sinus massage

Hot and cold alternating applications

Heel-drop maneuver

100% oxygen at minimum 12 liters per minute

Correct answer:

100% oxygen at minimum 12 liters per minute

Explanation:

One non-pharmaceutical intervention that has shown to provide relief for a significant number of individuals with cluster headaches is 100% oxygen, delivered via mask at a minimum of 12 liters per minute. Relief can be felt in as little as 15 minutes. None of the other interventions mentioned would be likely to improve symptoms of a cluster headache.

Example Question #6 : Causes And Treatments Of Neural Conditions

Bell's palsy is associated with infection by which of the following pathogens?

Possible Answers:

Herpes zoster

Epstein Barr virus

All of these are correct

Herpes simplex 1

Correct answer:

All of these are correct

Explanation:

While Bell's palsy is most frequently associated with prior infection with herpes simplex 1, is may also be associated with cytomegalovirus, Epstein Barr virus, and herpes zoster.

Example Question #7 : Causes And Treatments Of Neural Conditions

What is the prognosis with Bell's palsy?

Possible Answers:

Self-resolving in 1-6 months

Corticosteroid treatment is required to prevent permanent loss of taste

Antiviral treatment is required to prevent permanent paralysis

Nerve resection is required to prevent corneal abrasions

Correct answer:

Self-resolving in 1-6 months

Explanation:

In the vast majority of cases Bell's palsy resolves within 1-6 months without medical intervention. Moistening of the affected eye (rather than nerve resection) is required during this period to prevent corneal damage. There is very little risk of permanent paralysis or loss of taste. 

Example Question #8 : Causes And Treatments Of Neural Conditions

All of the following are common etiologies of seizure disorders except __________.

Possible Answers:

genetic predisposition

infection

brain tumor

marijuana use

Correct answer:

marijuana use

Explanation:

The most common causes of seizures include brain injury or tumor, genetic predisposition, medications, and infections such as meningitis. While marijuana may be a trigger for sensitive individuals with seizure disorders, it has not been known to cause seizures in a non-epileptic individual and has shown to reduce seizure incidence in some individuals with this condition when used in a medical setting. 

Example Question #9 : Causes And Treatments Of Neural Conditions

All of the following medications are considered first-line treatments of absence seizures except __________.

Possible Answers:

Carbamazepine

Valproic acid

Ethosuximide

Lamotrigine

Correct answer:

Carbamazepine

Explanation:

The most commonly prescribed medication for absence seizures is Ethosuximide. Lamotrigine and valproic acid may also be used if seizures are unable to be controlled with ethosuximide. Carbamazepine, a common medication prescribed for simple and complex partial seizures, is specifically contraindicated in absence seizures. 

Example Question #10 : Causes And Treatments Of Neural Conditions

A patient is hospitalized for alcohol withdrawal and is started on medication to prevent complications from withdrawal. Which type of medication is used to attenuate the possibility of seizures during this hospitalization?

Possible Answers:

Typical antipsychotic

Benzodiazepines

Anti-epileptic drug (AED)

Atypical antipsychotic

Selective serotonin re-uptake inhibitor (SSRI)

Correct answer:

Benzodiazepines

Explanation:

Benzodiazepines are the mainstay of treatment for alcohol withdrawal. Anti-epileptic drug (AEDs) are not to be used during alcohol withdrawal, and are reserved for patients who have a true seizure disorder. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA) protocol is used as symptom based therapy with benzodiazepines to prevent seizures and other complications from withdrawal.

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