Question 1

According to the 2007 Brain Trauma Foundation guidelines,the recommended CPP range is

Accepted Answer

A)  10 to 30 mm Hg. 
B)  30 to 50 mm Hg. 
C)  50 to 70 mm Hg. 
D)  70 to 85 mm Hg. 
A)  10 to 30 mm Hg. 
B)  30 to 50 mm Hg. 
C)  50 to 70 mm Hg. 
D)  70 to 85 mm Hg.

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

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 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

Postprocedural care of a patient undergoing a water-based contrast myelogram should include which of the following interventions?

Accepted Answer

A)  Maintain the patient flat in bed for 4 to 6 hours. 
B)  Observe the puncture sight every 15 minutes for 2 hours for signs of bleeding. 
C)  Keep the patient's head elevated 30 to 45 degrees for 8 hours. 
D)  Administer a sedative to keep the patient from moving around. 
A)  Maintain the patient flat in bed for 4 to 6 hours. 
B)  Observe the puncture sight every 15 minutes for 2 hours for signs of bleeding. 
C)  Keep the patient's head elevated 30 to 45 degrees for 8 hours. 
D)  Administer a sedative to keep the patient from moving around.

Question 6

Before performing the doll's eye or oculocephalic reflex,the nurse must verify

Accepted Answer

A)  the absence of cervical injury. 
B)  the depth and rate of respiration. 
C)  a physician's order to perform the maneuver. 
D)  the patient's ability to follow a verbal command. 
A)  the absence of cervical injury. 
B)  the depth and rate of respiration. 
C)  a physician's order to perform the maneuver. 
D)  the patient's ability to follow a verbal command.

Question 7

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 8

The patient's ICP reading has gradually climbed from 15 to 23 mm Hg.The nurse's primary action is to:

Accepted Answer

A)  drain off 7 mm of CSF from the catheter. 
B)  notify the physician. 
C)  place the patient in a high Fowler position to decrease the pressure. 
D)  check level of consciousness. 
A)  drain off 7 mm of CSF from the catheter. 
B)  notify the physician. 
C)  place the patient in a high Fowler position to decrease the pressure. 
D)  check level of consciousness.

Question 9

Carotid Doppler studies are used to monitor

Accepted Answer

A)  blood flow in the anterior, middle, or posterior cerebral arteries. 
B)  blood flow in the common and internal carotid arteries. 
C)  arteriovenous circulation in the intracranial space. 
D)  global cerebral blood flow. 
A)  blood flow in the anterior, middle, or posterior cerebral arteries. 
B)  blood flow in the common and internal carotid arteries. 
C)  arteriovenous circulation in the intracranial space. 
D)  global cerebral blood flow.

Question 10

The most clinically significant ICP waveform is

Accepted Answer

A)  A waves. 
B)  B waves. 
C)  C waves. 
D)  D waves. 
A)  A waves. 
B)  B waves. 
C)  C waves. 
D)  D waves.

Question 11

Which nuclear medicine studies are used to detect cerebrovascular disease,seizures,and tumors?

Accepted Answer

A)  PET 
B)  MRI 
C)  MRA 
D)  SPECT 
A)  PET 
B)  MRI 
C)  MRA 
D)  SPECT

Question 12

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 13

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 14

A critically injured patient can be aroused only by vigorous and continuous external stimuli.The patient's level of consciousness is considered

Accepted Answer

A)  lethargic. 
B)  obtunded. 
C)  stuporous. 
D)  comatose. 
A)  lethargic. 
B)  obtunded. 
C)  stuporous. 
D)  comatose.

Question 15

The patient is ordered a CT scan with contrast.Which question should the nurse ask the conscious patient before the procedure?

Accepted Answer

A)  Are you allergic to penicillin? 
B)  Are you allergic to iodine-based dye? 
C)  Are you allergic to latex? 
D)  Are you allergic to eggs? 
A)  Are you allergic to penicillin? 
B)  Are you allergic to iodine-based dye? 
C)  Are you allergic to latex? 
D)  Are you allergic to eggs?

Question 16

Identify the drawbacks to using continuous electroencephalography (cEEG)in a critical care unit.

Accepted Answer

A)  Size of machine 
B)  Expensive 
C)  Labor-intensive program 
D)  Requires expertise for interpretation 
E)  Artifacts from ICU environment 
A)  Size of machine 
B)  Expensive 
C)  Labor-intensive program 
D)  Requires expertise for interpretation 
E)  Artifacts from ICU environment

Question 17

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 18

How much of a size difference between the two pupils is still considered normal?

Accepted Answer

A)  1 mm 
B)  1.5 mm 
C)  2 mm 
D)  2.5 mm 
A)  1 mm 
B)  1.5 mm 
C)  2 mm 
D)  2.5 mm

Question 19

Which of the following procedures is the diagnostic study of choice for acute head injury?

Accepted Answer

A)  Magnetic resonance imaging 
B)  Computed tomography 
C)  Transcranial Doppler 
D)  Electroencephalography 
A)  Magnetic resonance imaging 
B)  Computed tomography 
C)  Transcranial Doppler 
D)  Electroencephalography

Question 20

Which of the following statements best describes assessment of arousal?

Accepted Answer

A)  It measures content of consciousness and is a higher level function. 
B)  It is an evaluation of the reticular activating system and its connection with the thalamus and the cerebral cortex. 
C)  It becomes a valid parameter when the patient is able to respond to verbal stimuli, such as squeezing the hands on command. 
D)  Noxious stimuli are not to be used as an assessment parameter. 
A)  It measures content of consciousness and is a higher level function. 
B)  It is an evaluation of the reticular activating system and its connection with the thalamus and the cerebral cortex. 
C)  It becomes a valid parameter when the patient is able to respond to verbal stimuli, such as squeezing the hands on command. 
D)  Noxious stimuli are not to be used as an assessment parameter.

Exam 23: Neurologic Clinical Assessment and Diagnostic Procedures

According to the 2007 Brain Trauma Foundation guidelines,the recommended CPP range is

With an intact oculocephalic reflex,the

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

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

Postprocedural care of a patient undergoing a water-based contrast myelogram should include which of the following interventions?

Before performing the doll's eye or oculocephalic reflex,the nurse must verify

The initial history for the neurologically impaired patient needs to be

The patient's ICP reading has gradually climbed from 15 to 23 mm Hg.The nurse's primary action is to:

Carotid Doppler studies are used to monitor

The most clinically significant ICP waveform is

Which nuclear medicine studies are used to detect cerebrovascular disease,seizures,and tumors?

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

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

A critically injured patient can be aroused only by vigorous and continuous external stimuli.The patient's level of consciousness is considered

The patient is ordered a CT scan with contrast.Which question should the nurse ask the conscious patient before the procedure?

Identify the drawbacks to using continuous electroencephalography (cEEG)in a critical care unit.

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

How much of a size difference between the two pupils is still considered normal?

Which of the following procedures is the diagnostic study of choice for acute head injury?

Which of the following statements best describes assessment of arousal?

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