,NSG 4100 Final Exam | Questions & Verified
Answers | 2026 Edition | Galen College
1. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) score of 12 (Eye
opening to pain, Incomprehensible sounds, Abnormal flexion). How should the nurse interpret
this score?
A) Mild head injury
B) Moderate head injury
C) Severe head injury
D) The patient is alert and oriented
Correct Answer: Moderate head injury
Rationale: A GCS score of 9-12 indicates a moderate head injury. Scores of 13-15 indicate mild
injury, and scores of 8 or less indicate severe injury (coma). This patient requires close
monitoring for potential deterioration.
2. Which finding should the nurse recognize as the earliest sign of neurologic deterioration in a
patient with a traumatic brain injury?
A) Change in level of consciousness
B) Pupillary changes
C) Vital sign changes
D) Motor weakness
Correct Answer: Change in level of consciousness
Rationale: Change in level of consciousness (LOC) is the earliest and most sensitive indicator of
neurologic deterioration. Pupillary changes and vital sign changes are later signs of increased
ICP.
,3. What is the normal range for intracranial pressure (ICP)?
A) 0-5 mmHg
B) 5-15 mmHg
C) 15-25 mmHg
D) 25-35 mmHg
Correct Answer: 5-15 mmHg
Rationale: Normal intracranial pressure ranges from 5 to 15 mmHg. Sustained ICP above 20
mmHg requires immediate intervention to prevent brain herniation.
4. A patient has a GCS score of 6. How should the nurse interpret this finding?
A) The patient is alert and oriented
B) The patient has a mild head injury
C) The patient is in a comatose state
D) The patient has a moderate head injury
Correct Answer: The patient is in a comatose state
Rationale: A GCS score of 8 or less indicates a severe head injury and coma. A score of 6
indicates severe impairment and requires immediate intervention.
5. Which of the following is a late sign of increased intracranial pressure (ICP)?
A) Headache
B) Restlessness
C) Decerebrate posturing
D) Vomiting
, Correct Answer: Decerebrate posturing
Rationale: Decerebrate posturing, characterized by the extension of the arms and legs, is a late
and ominous sign of increased ICP, indicating severe brainstem compression.
6. A patient with a brain tumor is prescribed dexamethasone. The nurse understands that this
medication is used to:
A) Reduce cerebral edema
B) Treat seizures
C) Control nausea and vomiting
D) Prevent infection
Correct Answer: Reduce cerebral edema
Rationale: Dexamethasone is a corticosteroid used to reduce cerebral edema and inflammation
in patients with brain tumors. It can also be used to manage increased ICP.
7. A patient is diagnosed with herpes simplex encephalitis. The nurse anticipates that the
patient will be treated with which medication?
A) Acyclovir
B) Amphotericin B
C) Fluconazole
D) Ceftriaxone
Correct Answer: Acyclovir
Rationale: Herpes simplex encephalitis is treated with IV acyclovir for 3 weeks. The medication
should be given over 1 hour to prevent crystallization in the urine.
Answers | 2026 Edition | Galen College
1. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) score of 12 (Eye
opening to pain, Incomprehensible sounds, Abnormal flexion). How should the nurse interpret
this score?
A) Mild head injury
B) Moderate head injury
C) Severe head injury
D) The patient is alert and oriented
Correct Answer: Moderate head injury
Rationale: A GCS score of 9-12 indicates a moderate head injury. Scores of 13-15 indicate mild
injury, and scores of 8 or less indicate severe injury (coma). This patient requires close
monitoring for potential deterioration.
2. Which finding should the nurse recognize as the earliest sign of neurologic deterioration in a
patient with a traumatic brain injury?
A) Change in level of consciousness
B) Pupillary changes
C) Vital sign changes
D) Motor weakness
Correct Answer: Change in level of consciousness
Rationale: Change in level of consciousness (LOC) is the earliest and most sensitive indicator of
neurologic deterioration. Pupillary changes and vital sign changes are later signs of increased
ICP.
,3. What is the normal range for intracranial pressure (ICP)?
A) 0-5 mmHg
B) 5-15 mmHg
C) 15-25 mmHg
D) 25-35 mmHg
Correct Answer: 5-15 mmHg
Rationale: Normal intracranial pressure ranges from 5 to 15 mmHg. Sustained ICP above 20
mmHg requires immediate intervention to prevent brain herniation.
4. A patient has a GCS score of 6. How should the nurse interpret this finding?
A) The patient is alert and oriented
B) The patient has a mild head injury
C) The patient is in a comatose state
D) The patient has a moderate head injury
Correct Answer: The patient is in a comatose state
Rationale: A GCS score of 8 or less indicates a severe head injury and coma. A score of 6
indicates severe impairment and requires immediate intervention.
5. Which of the following is a late sign of increased intracranial pressure (ICP)?
A) Headache
B) Restlessness
C) Decerebrate posturing
D) Vomiting
, Correct Answer: Decerebrate posturing
Rationale: Decerebrate posturing, characterized by the extension of the arms and legs, is a late
and ominous sign of increased ICP, indicating severe brainstem compression.
6. A patient with a brain tumor is prescribed dexamethasone. The nurse understands that this
medication is used to:
A) Reduce cerebral edema
B) Treat seizures
C) Control nausea and vomiting
D) Prevent infection
Correct Answer: Reduce cerebral edema
Rationale: Dexamethasone is a corticosteroid used to reduce cerebral edema and inflammation
in patients with brain tumors. It can also be used to manage increased ICP.
7. A patient is diagnosed with herpes simplex encephalitis. The nurse anticipates that the
patient will be treated with which medication?
A) Acyclovir
B) Amphotericin B
C) Fluconazole
D) Ceftriaxone
Correct Answer: Acyclovir
Rationale: Herpes simplex encephalitis is treated with IV acyclovir for 3 weeks. The medication
should be given over 1 hour to prevent crystallization in the urine.
