Question 1

A score of 6 on the Glasgow Coma Scale (GCS)indicates

Accepted Answer

A)  a vegetative state. 
B)  paraplegia. 
C)  coma. 
D)  obtundation. 
A)  a vegetative state. 
B)  paraplegia. 
C)  coma. 
D)  obtundation.

Question 2

With an intact oculocephalic reflex, the

Accepted Answer

A)  patient's eyes move in the same direction the head is turned. 
B)  patient's eyes move in the opposite direction to the movement of the patient's head. 
C)  patient's eyes remain midline. 
D)  doll's eye reflex is absent. 
A)  patient's eyes move in the same direction the head is turned. 
B)  patient's eyes move in the opposite direction to the movement of the patient's head. 
C)  patient's eyes remain midline. 
D)  doll's eye reflex is absent.

Question 3

Indications for the use of EEG include

Accepted Answer

A)  cerebral infarct. 
B)  metabolic encephalopathy. 
C)  confirmation of brain death. 
D)  altered consciousness. 
E)  all head injuries. 
A)  cerebral infarct. 
B)  metabolic encephalopathy. 
C)  confirmation of brain death. 
D)  altered consciousness. 
E)  all head injuries.

Question 4

Decerebrate posturing (abnormal extension)indicates dysfunction in which area of the central nervous system?

Accepted Answer

A)  Cerebral cortex 
B)  Thalamus 
C)  Cerebellum 
D)  Brainstem 
A)  Cerebral cortex 
B)  Thalamus 
C)  Cerebellum 
D)  Brainstem

Question 5

When assessing motor function, which of the following are correct?

Accepted Answer

A)  The presence of a Babinski reflex is an abnormal finding in an adult. 
B)  Lower extremity muscle tone is assessed by asking the patient to push or pull his or her foot against resistance. 
C)  When using noxious stimuli to elicit a motor response, each limb is tested separately. 
D)  Abnormal extension, or decerebrate posturing, indicates a less positive outcome than abnormal flexion. 
E)  Evaluation of deep tendon reflexes is an essential part of the nursing assessment. 
A)  The presence of a Babinski reflex is an abnormal finding in an adult. 
B)  Lower extremity muscle tone is assessed by asking the patient to push or pull his or her foot against resistance. 
C)  When using noxious stimuli to elicit a motor response, each limb is tested separately. 
D)  Abnormal extension, or decerebrate posturing, indicates a less positive outcome than abnormal flexion. 
E)  Evaluation of deep tendon reflexes is an essential part of the nursing assessment.

Question 6

Identify the sites for monitoring ICP.

Accepted Answer

A)  Intraventricular space 
B)  Epidural space 
C)  Jugular veins 
D)  Subdural space 
E)  Parenchyma 
A)  Intraventricular space 
B)  Epidural space 
C)  Jugular veins 
D)  Subdural space 
E)  Parenchyma

Question 7

Which of the following patients may need sedation before having an MRI scan?

Accepted Answer

A)  Claustrophobic patient 
B)  Comatose patient 
C)  Elderly patient 
D)  Patient with a spinal cord injury 
A)  Claustrophobic patient 
B)  Comatose patient 
C)  Elderly patient 
D)  Patient with a spinal cord injury

Question 8

A critical care patient is diagnosed with massive head trauma.The patient is receiving brain tissue oxygen pressure (PbtO2)monitoring.The nurse recognized that the goal of this treatment is to maintain PbtO2

Accepted Answer

A)  greater than 20 mm Hg. 
B)  less than 15 mm Hg. 
C)  between 15 and 20 mm Hg. 
D)  between 10 and 20 mm Hg. 
A)  greater than 20 mm Hg. 
B)  less than 15 mm Hg. 
C)  between 15 and 20 mm Hg. 
D)  between 10 and 20 mm Hg.

Question 9

The clinical manifestations of the Cushing reflex are

Accepted Answer

A)  bradycardia, systolic hypertension, and widening pulse pressure. 
B)  tachycardia, systolic hypotension, and tachypnea. 
C)  headache, nuchal rigidity, and hyperthermia. 
D)  bradycardia, aphasia, and visual field disturbances. 
A)  bradycardia, systolic hypertension, and widening pulse pressure. 
B)  tachycardia, systolic hypotension, and tachypnea. 
C)  headache, nuchal rigidity, and hyperthermia. 
D)  bradycardia, aphasia, and visual field disturbances.

Question 10

Studies have shown that the intraparenchymal catheter has a better result than the intraventricular catheter.Identify the answer that supports this statement.

Accepted Answer

A)  The intraparenchymal catheter allows for CSF drainage. 
B)  The intraparenchymal catheter has increased monitoring time. 
C)  The intraparenchymal catheter has a longer insertion time for monitoring ICP. 
D)  The intraparenchymal catheter has decreased device-related complications. 
A)  The intraparenchymal catheter allows for CSF drainage. 
B)  The intraparenchymal catheter has increased monitoring time. 
C)  The intraparenchymal catheter has a longer insertion time for monitoring ICP. 
D)  The intraparenchymal catheter has decreased device-related complications.

Question 11

Considering anatomic location, which cranial nerve will be affected first by downward pressure onto the infratentorial structures?

Accepted Answer

A)  III 
B)  VI 
C)  IX 
D)  X 
A)  III 
B)  VI 
C)  IX 
D)  X

Question 12

While starting an intravenous line on the right hand of an unconscious patient, the patient reaches over with his left hand and tries to remove the noxious stimuli.This response is called

Accepted Answer

A)  decorticate posturing. 
B)  decerebrate posturing. 
C)  withdrawal. 
D)  localization. 
A)  decorticate posturing. 
B)  decerebrate posturing. 
C)  withdrawal. 
D)  localization.

Question 13

Testing of extraocular eye movements assesses

Accepted Answer

A)  pupillary response to light. 
B)  function of the three cranial nerves of the eye. 
C)  the ability of the eyes to accommodate to a closer moving object. 
D)  the oculocephalic reflex. 
A)  pupillary response to light. 
B)  function of the three cranial nerves of the eye. 
C)  the ability of the eyes to accommodate to a closer moving object. 
D)  the oculocephalic reflex.

Question 14

The oculovestibular reflex, or cold caloric test,

Accepted Answer

A)  should not be performed on an unconscious patient because of the risk of aspiration. 
B)  has an abnormal response of rapid nystagmus-like deviation to the side of the body that is tested. 
C)  is a routine test of the nursing neurologic examination. 
D)  is one of the final clinical assessments of brainstem function. 
A)  should not be performed on an unconscious patient because of the risk of aspiration. 
B)  has an abnormal response of rapid nystagmus-like deviation to the side of the body that is tested. 
C)  is a routine test of the nursing neurologic examination. 
D)  is one of the final clinical assessments of brainstem function.

Question 15

The respiratory pattern with rhythmic increase and decrease of rate and depth of respiration, then brief periods of apnea, is known as

Accepted Answer

A)  central neurogenic hyperventilation. 
B)  apneustic breathing. 
C)  ataxic respirations. 
D)  Cheyne-Stokes respirations. 
A)  central neurogenic hyperventilation. 
B)  apneustic breathing. 
C)  ataxic respirations. 
D)  Cheyne-Stokes respirations.

Question 16

A patient is admitted to the critical care unit with a subdural hematoma.The GCS is used to assess his level of consciousness.In assessing the patient's best motor response, the movement that receives the lowest score is

Accepted Answer

A)  decerebrate posturing. 
B)  localizing pain. 
C)  withdrawing from pain. 
D)  decorticate posturing. 
A)  decerebrate posturing. 
B)  localizing pain. 
C)  withdrawing from pain. 
D)  decorticate posturing.

Question 17

The most serious complication of lumbar puncture in a critically ill patient is

Accepted Answer

A)  bacterial meningitis. 
B)  dural tear. 
C)  brainstem herniation. 
D)  spinal cord trauma. 
A)  bacterial meningitis. 
B)  dural tear. 
C)  brainstem herniation. 
D)  spinal cord trauma.

Question 18

Which of the following is an abnormal finding in the analysis of the cerebrospinal fluid?

Accepted Answer

A)  Clear and colorless 
B)  Glucose of 60 mg/dL 
C)  Protein of 20 mg/dL 
D)  30 red blood cells 
A)  Clear and colorless 
B)  Glucose of 60 mg/dL 
C)  Protein of 20 mg/dL 
D)  30 red blood cells

Question 19

The initial history for the neurologically impaired patient needs to be

Accepted Answer

A)  limited to the chief complaint. 
B)  comprehensive, including events preceding hospitalization. 
C)  directed to level of consciousness and pupillary reaction. 
D)  information that only the patient can provide. 
A)  limited to the chief complaint. 
B)  comprehensive, including events preceding hospitalization. 
C)  directed to level of consciousness and pupillary reaction. 
D)  information that only the patient can provide.

Question 20

Successful completion of digital subtraction angiography requires what participation on the part of the patient?

Accepted Answer

A)  Responding appropriately to various commands 
B)  Repositioning at appropriate intervals 
C)  Remaining motionless 
D)  Holding inspiration during imaging 
A)  Responding appropriately to various commands 
B)  Repositioning at appropriate intervals 
C)  Remaining motionless 
D)  Holding inspiration during imaging

Exam 17: Neurologic Clinical Assessment and Diagnostic Procedures

A score of 6 on the Glasgow Coma Scale (GCS)indicates

With an intact oculocephalic reflex, the

Indications for the use of EEG include

Decerebrate posturing (abnormal extension)indicates dysfunction in which area of the central nervous system?

When assessing motor function, which of the following are correct?

Identify the sites for monitoring ICP.

Which of the following patients may need sedation before having an MRI scan?

A critical care patient is diagnosed with massive head trauma.The patient is receiving brain tissue oxygen pressure (PbtO2)monitoring.The nurse recognized that the goal of this treatment is to maintain PbtO2

The clinical manifestations of the Cushing reflex are

Studies have shown that the intraparenchymal catheter has a better result than the intraventricular catheter.Identify the answer that supports this statement.

Considering anatomic location, which cranial nerve will be affected first by downward pressure onto the infratentorial structures?

While starting an intravenous line on the right hand of an unconscious patient, the patient reaches over with his left hand and tries to remove the noxious stimuli.This response is called

Testing of extraocular eye movements assesses

The oculovestibular reflex, or cold caloric test,

The respiratory pattern with rhythmic increase and decrease of rate and depth of respiration, then brief periods of apnea, is known as

A patient is admitted to the critical care unit with a subdural hematoma.The GCS is used to assess his level of consciousness.In assessing the patient's best motor response, the movement that receives the lowest score is

The most serious complication of lumbar puncture in a critically ill patient is

Which of the following is an abnormal finding in the analysis of the cerebrospinal fluid?

The initial history for the neurologically impaired patient needs to be

Successful completion of digital subtraction angiography requires what participation on the part of the patient?

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

Filters

A critical care patient is diagnosed with massive head trauma.The patient is receiving brain tissue oxygen pressure (PbtO₂)monitoring.The nurse recognized that the goal of this treatment is to maintain PbtO₂