,NUR 3280 Exam 3 – Nursing Practice I – Q&A
(2026) | William Paterson
1. Which physiologic change is most likely to increase intracranial pressure?
A) Cerebral vasoconstriction
B) Hyperventilation
C) Cerebral vasodilation
D) Decreased cerebral blood volume
Correct Answer: C) Cerebral vasodilation
Rationale: Cerebral vasodilation increases cerebral blood volume, which raises
intracranial pressure because the cranial vault is a closed space.
Hyperventilation causes vasoconstriction and lowers ICP. Decreased cerebral
blood volume would reduce pressure. This principle is central to managing
elevated ICP.
2. Which manifestation reflects the Cushing reflex in acute brain ischemia?
A) Sympathetic nervous system activation producing hypertension and
bradycardia
B) Parasympathetic activation causing hypotension
C) Loss of pupillary response
D) Decreased respiratory rate with hypercapnia
Correct Answer: A) Sympathetic nervous system activation producing
hypertension and bradycardia
,Rationale: The Cushing reflex is a late response to brain ischemia and increased
ICP. It is driven by sympathetic activation, causing hypertension with a widening
pulse pressure and bradycardia. Parasympathetic activation would cause
hypotension, and pupillary or respiratory changes are not the defining features.
3. Which set of clinical findings indicates the poorest neurologic functioning?
A) Spontaneous eye opening, follows commands, oriented to self
B) Eyes open to light touch, pupils reactive, verbalizes pain
C) Withdraws to painful stimulus, confused speech
D) Assumes decorticate posture with light touch, no verbal response
Correct Answer: D) Assumes decorticate posture with light touch, no verbal
response
Rationale: Decorticate posturing indicates severe brain injury, and the absence
of verbal response further reflects poor neurologic function. Spontaneous eye
opening and following commands indicate better function. This finding requires
immediate neurologic evaluation and intervention.
4. Which neurotransmitter is responsible for most brain function and causes an
influx of calcium during ischemia?
A) Dopamine
B) Glutamate
C) Serotonin
D) GABA
, Correct Answer: B) Glutamate
Rationale: Glutamate is the primary excitatory neurotransmitter in the brain.
During ischemia, excessive glutamate release overstimulates receptors and
causes calcium influx, leading to cell death. Dopamine, serotonin, and GABA do
not play this primary excitotoxic role in cerebral ischemia.
5. A client with a headache, nausea, vomiting, blurred vision, and altered level
of consciousness is most likely experiencing which condition?
A) Increased intracranial pressure
B) Parkinson disease
C) Peripheral neuropathy
D) Migraine without neurologic findings
Correct Answer: A) Increased intracranial pressure
Rationale: Headache, nausea, vomiting, blurred vision, and altered level of
consciousness are classic signs of increased intracranial pressure. Parkinson
disease causes motor symptoms, peripheral neuropathy affects sensation, and
migraine without neurologic findings would not typically cause altered
consciousness.
6. What is the final stage of increased intracranial pressure?
A) Cushing reflex
B) Midline shift
C) Brain compression and herniation
D) Reperfusion injury
(2026) | William Paterson
1. Which physiologic change is most likely to increase intracranial pressure?
A) Cerebral vasoconstriction
B) Hyperventilation
C) Cerebral vasodilation
D) Decreased cerebral blood volume
Correct Answer: C) Cerebral vasodilation
Rationale: Cerebral vasodilation increases cerebral blood volume, which raises
intracranial pressure because the cranial vault is a closed space.
Hyperventilation causes vasoconstriction and lowers ICP. Decreased cerebral
blood volume would reduce pressure. This principle is central to managing
elevated ICP.
2. Which manifestation reflects the Cushing reflex in acute brain ischemia?
A) Sympathetic nervous system activation producing hypertension and
bradycardia
B) Parasympathetic activation causing hypotension
C) Loss of pupillary response
D) Decreased respiratory rate with hypercapnia
Correct Answer: A) Sympathetic nervous system activation producing
hypertension and bradycardia
,Rationale: The Cushing reflex is a late response to brain ischemia and increased
ICP. It is driven by sympathetic activation, causing hypertension with a widening
pulse pressure and bradycardia. Parasympathetic activation would cause
hypotension, and pupillary or respiratory changes are not the defining features.
3. Which set of clinical findings indicates the poorest neurologic functioning?
A) Spontaneous eye opening, follows commands, oriented to self
B) Eyes open to light touch, pupils reactive, verbalizes pain
C) Withdraws to painful stimulus, confused speech
D) Assumes decorticate posture with light touch, no verbal response
Correct Answer: D) Assumes decorticate posture with light touch, no verbal
response
Rationale: Decorticate posturing indicates severe brain injury, and the absence
of verbal response further reflects poor neurologic function. Spontaneous eye
opening and following commands indicate better function. This finding requires
immediate neurologic evaluation and intervention.
4. Which neurotransmitter is responsible for most brain function and causes an
influx of calcium during ischemia?
A) Dopamine
B) Glutamate
C) Serotonin
D) GABA
, Correct Answer: B) Glutamate
Rationale: Glutamate is the primary excitatory neurotransmitter in the brain.
During ischemia, excessive glutamate release overstimulates receptors and
causes calcium influx, leading to cell death. Dopamine, serotonin, and GABA do
not play this primary excitotoxic role in cerebral ischemia.
5. A client with a headache, nausea, vomiting, blurred vision, and altered level
of consciousness is most likely experiencing which condition?
A) Increased intracranial pressure
B) Parkinson disease
C) Peripheral neuropathy
D) Migraine without neurologic findings
Correct Answer: A) Increased intracranial pressure
Rationale: Headache, nausea, vomiting, blurred vision, and altered level of
consciousness are classic signs of increased intracranial pressure. Parkinson
disease causes motor symptoms, peripheral neuropathy affects sensation, and
migraine without neurologic findings would not typically cause altered
consciousness.
6. What is the final stage of increased intracranial pressure?
A) Cushing reflex
B) Midline shift
C) Brain compression and herniation
D) Reperfusion injury
