NCLEX Deck

Neurology

NCLEX Clinical Study Booklet · 12 cards

Contents

Ischemic Stroke.

Cerebrovascular
What is Ischemic Stroke?
  • Blood flow to part of the brain is blocked by a clot.
  • Brain cells die within minutes without oxygen.
What are the Causes / Risk Factors?
  • Atherosclerosis / thrombus
  • Atrial fibrillation (embolus)
  • Hypertension
  • Diabetes
  • Smoking, high cholesterol
What are the Symptoms? (Think FAST)
  • F Face drooping
  • A Arm weakness
  • S Speech difficulty
  • T Time — call 911
  • Unilateral weakness/numbness
  • Aphasia, slurred speech
  • Facial droop
  • Vision changes
  • Sudden confusion, ataxia
How is it Diagnosed?
  • CT FIRST (rule out bleed)
  • MRI
  • Carotid Doppler, ECG/echo
  • Blood glucose (rule out mimics)
What is the Treatment?
  • tPA within 3–4.5 hrs (ischemic, no bleed)
  • Antiplatelets/anticoagulation after
  • Neuro checks; swallow eval (aspiration)
  • Rehab: PT/OT/speech
NCLEX TipGet a CT FIRST to rule out hemorrhage before tPA. tPA is only for ischemic stroke within the time window.
© NCLEX Deck1 / 12

Hemorrhagic Stroke.

Cerebrovascular
What is Hemorrhagic Stroke?
  • Rupture of a cerebral vessel → bleeding into the brain.
  • Rising ICP and tissue damage.
What are the Causes / Risk Factors?
  • Uncontrolled hypertension
  • Aneurysm rupture
  • AV malformation
  • Anticoagulant use
  • Trauma
What are the Symptoms?
  • Sudden severe 'worst headache of my life'
  • ↓LOC, vomiting
  • Nuchal rigidity
  • Seizures
  • Focal deficits
How is it Diagnosed?
  • CT (shows blood)
  • Cerebral angiography
  • Avoid LP if ↑ICP
What is the Treatment?
  • NO tPA or anticoagulants
  • Control BP; lower ICP
  • Surgery (clipping/coiling/evacuation)
  • HOB 30°, neuro monitoring
NCLEX TipHemorrhagic stroke = NO thrombolytics or anticoagulants. Control BP and ICP.
© NCLEX Deck2 / 12

Transient Ischemic Attack.

Cerebrovascular
What is Transient Ischemic Attack?
  • Temporary neuro deficit from brief ischemia — resolves within 24h (usually minutes).
  • A warning sign of impending stroke.
What are the Causes / Risk Factors?
  • Carotid atherosclerosis
  • A-fib emboli
  • Hypertension
  • Hypercoagulable states
What are the Symptoms?
  • Transient unilateral weakness/numbness
  • Brief speech difficulty
  • Temporary vision loss (amaurosis fugax)
  • Dizziness
  • Resolves completely
How is it Diagnosed?
  • CT/MRI (rule out stroke)
  • Carotid Doppler
  • ECG (a-fib)
  • Lipids, glucose
What is the Treatment?
  • Antiplatelets (aspirin, clopidogrel)
  • Manage risk factors (BP, lipids, DM)
  • Carotid endarterectomy if stenosis
  • Anticoagulate if a-fib
NCLEX TipA TIA is a warning sign — treat aggressively to prevent a full stroke.
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Seizures / Epilepsy.

Seizure
What is Seizures / Epilepsy?
  • Abnormal, excessive electrical activity in the brain.
  • Generalized (whole brain) or focal (one area).
What are the Causes / Risk Factors?
  • Epilepsy (idiopathic)
  • Fever (children), head injury
  • Infection, tumor, stroke
  • Electrolyte imbalance, hypoglycemia
  • Alcohol/drug withdrawal
What are the Symptoms?
  • Tonic-clonic movements
  • Loss of consciousness
  • Aura (some)
  • Postictal confusion/fatigue
  • Incontinence, tongue biting
How is it Diagnosed?
  • EEG
  • MRI/CT
  • Labs (glucose, electrolytes, tox screen)
What is the Treatment?
  • SAFETY: protect head, turn side-lying, do NOT restrain or put anything in mouth
  • Antiepileptics (phenytoin, levetiracetam, valproate)
  • Time the seizure
  • Status epilepticus >5 min = emergency (IV benzodiazepines)
NCLEX TipDuring a seizure: protect from injury, turn to the side, never restrain or place objects in the mouth.
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Increased ICP.

Emergency
What is Increased ICP?
  • Rising pressure inside the skull from swelling, bleeding, or a mass.
  • Compromises cerebral perfusion — emergency.
What are the Causes / Risk Factors?
  • Head injury / hemorrhage
  • Tumor
  • Hydrocephalus
  • Stroke, cerebral edema
  • Meningitis
What are the Symptoms?
  • EARLY: ↓LOC, restlessness, headache
  • LATE — Cushing's triad: ↑BP (widening pulse pressure), bradycardia, irregular respirations
  • Vomiting, pupil changes
  • Papilledema, posturing
How is it Diagnosed?
  • CT/MRI
  • ICP monitoring
  • Neuro assessment (GCS)
What is the Treatment?
  • HOB 30°, head midline/neutral
  • Mannitol (osmotic diuretic), hypertonic saline
  • Avoid coughing/straining (raises ICP)
  • Maintain airway/oxygenation; monitor GCS
NCLEX TipCushing's triad (↑BP with widening pulse pressure, bradycardia, irregular breathing) is a LATE sign of ↑ICP.
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Parkinson's Disease.

Degenerative
What is Parkinson's Disease?
  • Progressive loss of dopamine-producing neurons.
  • Impaired control of movement.
What are the Causes / Risk Factors?
  • Idiopathic (dopamine deficiency)
  • Advancing age
  • Genetic/environmental factors
What are the Symptoms? (Think TRAP)
  • T Tremor (resting, pill-rolling)
  • R Rigidity (cogwheel)
  • A Akinesia / bradykinesia
  • P Postural instability
  • Masklike face
  • Shuffling gait
  • Stooped posture
  • Soft monotone speech
  • Drooling
How is it Diagnosed?
  • Clinical diagnosis
  • Rule out other causes
  • Response to levodopa
What is the Treatment?
  • Levodopa-carbidopa (mainstay)
  • Dopamine agonists, MAO-B inhibitors
  • Fall prevention
  • PT; small frequent meals (dysphagia)
NCLEX TipParkinson's = TRAP: Tremor, Rigidity, Akinesia, Postural instability. Levodopa-carbidopa is first-line.
© NCLEX Deck6 / 12

Multiple Sclerosis.

Neuromuscular
What is Multiple Sclerosis?
  • Autoimmune demyelination of CNS neurons.
  • Relapsing-remitting or progressive.
What are the Causes / Risk Factors?
  • Autoimmune (myelin destruction)
  • Genetic + environmental
  • More common in women, cooler climates
What are the Symptoms?
  • Fatigue
  • Visual disturbances (diplopia, optic neuritis)
  • Muscle weakness, spasticity
  • Paresthesias
  • Ataxia, bladder dysfunction
  • Symptoms worsen with heat
How is it Diagnosed?
  • MRI (plaques/lesions)
  • Lumbar puncture (oligoclonal bands)
  • Evoked potentials
What is the Treatment?
  • Corticosteroids (acute exacerbations)
  • Immunomodulators (interferon)
  • Avoid heat & overexertion
  • PT, energy conservation, bladder training
NCLEX TipMS symptoms worsen with heat — teach patients to avoid hot baths and overheating.
© NCLEX Deck7 / 12

Myasthenia Gravis.

Neuromuscular
What is Myasthenia Gravis?
  • Autoimmune attack on acetylcholine receptors at the neuromuscular junction.
  • Fluctuating weakness that worsens with use.
What are the Causes / Risk Factors?
  • Autoimmune (anti-ACh receptor antibodies)
  • Thymus abnormalities
What are the Symptoms?
  • Ptosis, diplopia
  • Difficulty chewing/swallowing/speaking
  • Weakness worse with activity, better with rest
  • Respiratory muscle weakness (crisis)
How is it Diagnosed?
  • Tensilon (edrophonium) test
  • Anti-ACh receptor antibodies
  • EMG
  • CT of thymus
What is the Treatment?
  • Anticholinesterases (pyridostigmine)
  • Immunosuppressants, plasmapheresis, IVIG
  • Thymectomy
  • Monitor respiratory status (myasthenic crisis)
NCLEX TipMG = weakness that WORSENS with activity. Watch for respiratory failure (myasthenic crisis); airway is the priority.
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Guillain-Barré Syndrome.

Neuromuscular
What is Guillain-Barré Syndrome?
  • Autoimmune demyelination of peripheral nerves.
  • ASCENDING paralysis, usually reversible.
What are the Causes / Risk Factors?
  • Often follows a viral/bacterial infection (e.g., Campylobacter)
  • Recent vaccination (rare)
  • Autoimmune
What are the Symptoms?
  • Ascending symmetric weakness (feet → up)
  • Paresthesias
  • Diminished reflexes
  • Respiratory muscle involvement (danger)
  • Autonomic instability
How is it Diagnosed?
  • Lumbar puncture (↑protein, normal WBC)
  • EMG / nerve conduction
  • Clinical history
What is the Treatment?
  • Plasmapheresis or IVIG
  • MONITOR RESPIRATORY status (priority — may need ventilation)
  • Supportive care, DVT prevention
  • Rehab as it resolves
NCLEX TipGuillain-Barré is ASCENDING paralysis — the priority is monitoring respiratory function for failure.
© NCLEX Deck9 / 12

Meningitis.

Infection
What is Meningitis?
  • Inflammation of the meninges, usually infectious.
  • Bacterial meningitis is a medical emergency.
What are the Causes / Risk Factors?
  • Bacterial (N. meningitidis, S. pneumoniae)
  • Viral
  • Close-contact settings (dorms)
What are the Symptoms?
  • Severe headache
  • Nuchal rigidity (stiff neck)
  • Fever, photophobia
  • +Kernig's & +Brudzinski's signs
  • Altered LOC, seizures
  • Petechial rash (meningococcal)
How is it Diagnosed?
  • Lumbar puncture (↓glucose, ↑protein, ↑WBC in bacterial)
  • Blood cultures
  • CT before LP if ↑ICP
What is the Treatment?
  • DROPLET precautions (bacterial)
  • IV antibiotics ASAP (bacterial)
  • Quiet, dark room; lower ICP
  • Antipyretics; seizure precautions
NCLEX TipSuspected bacterial meningitis → droplet precautions + antibiotics immediately after cultures/LP.
© NCLEX Deck10 / 12

Spinal Cord Injury.

Trauma
What is Spinal Cord Injury?
  • Damage to the spinal cord → loss of function below the level of injury.
  • Higher (cervical) injuries are more severe.
What are the Causes / Risk Factors?
  • Trauma (MVA, falls, diving, violence)
  • C3–C5 involvement threatens the diaphragm (breathing)
What are the Symptoms?
  • Paralysis/paresthesia below the injury
  • Loss of bowel/bladder control
  • Spinal shock (flaccid, areflexic early)
  • Cervical: respiratory compromise
  • Autonomic dysreflexia (T6 and above)
How is it Diagnosed?
  • CT/MRI
  • Neuro exam (level of injury)
  • Immobilize the C-spine
What is the Treatment?
  • Immobilize; maintain airway (especially cervical)
  • Prevent secondary injury
  • Autonomic dysreflexia: SIT UP, find & remove the trigger (usually full bladder), lower BP
  • Rehab; skin & bladder care
NCLEX TipAutonomic dysreflexia (severe HTN + pounding headache in a T6+ injury) → sit the patient UP and remove the trigger (usually a full bladder).
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Alzheimer's / Dementia.

Degenerative
What is Alzheimer's / Dementia?
  • Progressive, irreversible decline in memory and cognition.
  • Most common cause of dementia.
What are the Causes / Risk Factors?
  • Advancing age
  • Genetics (family history)
  • Amyloid plaques & neurofibrillary tangles
What are the Symptoms?
  • Progressive memory loss
  • Confusion, disorientation
  • Impaired judgment
  • Wandering, sundowning
  • Personality changes
  • Later: ADL dependence
How is it Diagnosed?
  • Clinical + cognitive testing (MMSE)
  • Rule out reversible causes
  • MRI (atrophy)
What is the Treatment?
  • Cholinesterase inhibitors (donepezil), memantine
  • Safe environment, routine, reorientation
  • Simple, clear communication
  • Caregiver support
NCLEX TipProvide a safe, consistent environment with simple routines. Manage wandering and sundowning with structure.
© NCLEX Deck12 / 12
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