Lauren was assigned a patient with primary diagnosis of CVA.  Her patient was ordered on neuro checks every two hours.  At 9:00 am, I went in with Lauren to observe her perform a head-to-toe assessment.  She asked her patient where she was and the patient said \"the hospital.\"  Lauren asked her which hospital and the patient replied, \"You\'re cute.\"  Lauren did not repeat the question, nor did she assess the patient\'s orientation to time.  Lauren also did not have a pen light with her to assess pupils.  Her pre-plan sheet did not address a neuro assessment except that she stated she would use the glascow coma scale.  When I questioned Lauren about the glascow coma scale, she could not verbalize to me what it was, nor could she verbalize the components of a neuro assessment.  I asked Lauren if she new how to do a neuro assessment and she stated \"I\'ve done them before, but not on confused patients.\"  I explained to Lauren that the components of a neuro assessment are the same whether or not the patient is confused.  I counseled Lauren regarding these issues and she became tearful, stating that she gets nervous, especially with me in the room.  I expressed concern to Lauren that her pre-plan sheet was lacking and that she still could not verbalize to me a neuro assessment outside of the patient\'s room and regardless she did not have a pen light.