, NUR 2755 Multidimensional Care IV MDC 4 Exam 3
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Section 1: Neurological Disorders & Stroke
This is a heavily tested area covering stroke types, increased intracranial pressure
(ICP), seizures, and neurodegenerative diseases .
Q1. Subarachnoid Hemorrhage Presentation
A patient presents with a severe headache described as "the worst headache of
my life." This is a classic sign of:
• A) Tension headache
• B) Migraine with aura
• C) Subarachnoid hemorrhage ( Correct)
• D) Cluster headache
Rationale: A sudden, severe "thunderclap" headache is the hallmark
symptom of a subarachnoid hemorrhage (SAH), often indicating a ruptured
cerebral aneurysm .
Q2. Right-Hemisphere Stroke Manifestations
A patient with a right-hemisphere stroke would most likely exhibit:
• A) Aphasia and right-sided weakness
• B) Left-sided neglect, impulsivity, and left-sided weakness ( Correct)
• C) Bilateral lower extremity paralysis
• D) Ataxia and dysmetria
Rationale: Right-hemisphere strokes affect the left side of the body and
commonly cause left-sided neglect, impulsivity, and left-sided weakness .
Q3. Left-Hemisphere Stroke Manifestations
A patient with a left-hemisphere stroke is likely to present with:
, • A) Aphasia and right-sided weakness ( Correct)
• B) Left-sided neglect and impulsivity
• C) Ataxia and nystagmus
• D) Bilateral lower extremity weakness
Rationale: The left hemisphere controls language in most people and
motor function for the right side. Thus, left-hemisphere stroke typically
causes aphasia and right-sided weakness .
Q4. Earliest Sign of Increased Intracranial Pressure (ICP)
The earliest sign of increased intracranial pressure is:
• A) Cushing's triad
• B) Pupillary changes
• C) Decreased level of consciousness (LOC) ( Correct)
• D) Projectile vomiting
Rationale: A change in LOC, such as restlessness or confusion, is the most
sensitive and earliest indicator of increasing ICP. Cushing's triad and
pupillary changes are late signs .
Q5. Cushing's Triad Findings
Which assessment finding constitutes Cushing's triad?
• A) Hypotension, tachycardia, and tachypnea
• B) Bradycardia, hypertension with widening pulse pressure, and irregular
respirations ( Correct)
• C) Fever, neck stiffness, and photophobia
• D) Unilateral weakness, facial droop, and aphasia
Rationale: Cushing's triad reflects the brain's response to severe
intracranial hypertension: rising systolic BP, widening pulse pressure,
bradycardia, and irregular respirations. This is a late, life-threatening sign .
Q6. ICP Management: Head of Bed Position
For a patient with increased ICP, the head of bed should be positioned at:
Actual 2026/2027 – 100% Verified | Detailed Rationales
– Pass Guaranteed – A+ Graded
Section 1: Neurological Disorders & Stroke
This is a heavily tested area covering stroke types, increased intracranial pressure
(ICP), seizures, and neurodegenerative diseases .
Q1. Subarachnoid Hemorrhage Presentation
A patient presents with a severe headache described as "the worst headache of
my life." This is a classic sign of:
• A) Tension headache
• B) Migraine with aura
• C) Subarachnoid hemorrhage ( Correct)
• D) Cluster headache
Rationale: A sudden, severe "thunderclap" headache is the hallmark
symptom of a subarachnoid hemorrhage (SAH), often indicating a ruptured
cerebral aneurysm .
Q2. Right-Hemisphere Stroke Manifestations
A patient with a right-hemisphere stroke would most likely exhibit:
• A) Aphasia and right-sided weakness
• B) Left-sided neglect, impulsivity, and left-sided weakness ( Correct)
• C) Bilateral lower extremity paralysis
• D) Ataxia and dysmetria
Rationale: Right-hemisphere strokes affect the left side of the body and
commonly cause left-sided neglect, impulsivity, and left-sided weakness .
Q3. Left-Hemisphere Stroke Manifestations
A patient with a left-hemisphere stroke is likely to present with:
, • A) Aphasia and right-sided weakness ( Correct)
• B) Left-sided neglect and impulsivity
• C) Ataxia and nystagmus
• D) Bilateral lower extremity weakness
Rationale: The left hemisphere controls language in most people and
motor function for the right side. Thus, left-hemisphere stroke typically
causes aphasia and right-sided weakness .
Q4. Earliest Sign of Increased Intracranial Pressure (ICP)
The earliest sign of increased intracranial pressure is:
• A) Cushing's triad
• B) Pupillary changes
• C) Decreased level of consciousness (LOC) ( Correct)
• D) Projectile vomiting
Rationale: A change in LOC, such as restlessness or confusion, is the most
sensitive and earliest indicator of increasing ICP. Cushing's triad and
pupillary changes are late signs .
Q5. Cushing's Triad Findings
Which assessment finding constitutes Cushing's triad?
• A) Hypotension, tachycardia, and tachypnea
• B) Bradycardia, hypertension with widening pulse pressure, and irregular
respirations ( Correct)
• C) Fever, neck stiffness, and photophobia
• D) Unilateral weakness, facial droop, and aphasia
Rationale: Cushing's triad reflects the brain's response to severe
intracranial hypertension: rising systolic BP, widening pulse pressure,
bradycardia, and irregular respirations. This is a late, life-threatening sign .
Q6. ICP Management: Head of Bed Position
For a patient with increased ICP, the head of bed should be positioned at:
