,NSG 3280 Exam 4 Galen Pathophysiology
Actual Questions, Verified Answers with
Rationales | Guarantee Pass
1. A patient presents with right-sided weakness, facial droop, and slurred speech
that began 60 minutes ago. What is the priority action?
• A) Obtain a head CT scan
• B) Administer aspirin 324 mg
• C) Prepare for IV tPA administration
• D) Start oxygen at 2 L/min
Answer: C
Rationale: tPA is most effective within 3 hours (ideal 4.5 hours) of ischemic stroke onset.
This patient is within the window.
2. A patient with a left-sided cerebrovascular accident (CVA) presents with right-
sided weakness. This indicates involvement of which area?
• A) Left cerebral hemisphere, motor cortex
• B) Right cerebral hemisphere, motor cortex
• C) Brainstem, corticospinal tract
• D) Cerebellum, purkinje fibers
Answer: A
Rationale: Motor cortex in each hemisphere controls contralateral movement. Left brain
injury = right-sided weakness.
3. Which finding in a patient with a new stroke is most concerning for increased
intracranial pressure (ICP)?
, • A) Blood pressure 140/90 mmHg
• B) Pupil asymmetry (anisocoria)
• C) Heart rate 88 bpm
• D) Respiratory rate 18/min
Answer: B
Rationale: Pupil asymmetry or sluggish reaction is a late sign of herniation and CN III
compression from increased ICP—medical emergency.
4. A patient with increased ICP exhibits hypertension, bradycardia, and irregular
respirations. This triad is known as:
• A) Kernig's sign
• B) Brudzinski's sign
• C) Cushing's triad
• D) Decerebrate posturing
Answer: C
Rationale: Cushing's triad (HTN + bradycardia + irregular breathing) is a late, life-
threatening sign of brainstem compression.
5. Which type of cerebral edema results from disruption of the blood-brain
barrier?
• A) Cytotoxic
• B) Vasogenic
• C) Interstitial
• D) Ischemic
Answer: B
Rationale: Vasogenic edema occurs when BBB breaks down, allowing fluid to leak into
extracellular space—seen in tumors, abscesses, trauma.
, 6. In an ischemic stroke, the ischemic penumbra is:
• A) Necrotic core
• B) Reversibly injured tissue surrounding the core
• C) Area of hemorrhagic transformation
• D) Zone of vasospasm
Answer: B
Rationale: Penumbra is hypoperfused but salvageable tissue—target for reperfusion
therapy.
7. Which of the following is a modifiable risk factor for ischemic stroke?
• A) Age
• B) Gender
• C) Hypertension
• D) Family history
Answer: C
Rationale: Hypertension is the single most important modifiable risk factor.
8. A patient with Alzheimer's disease has memory loss, aphasia, and apraxia. The
underlying pathophysiology involves:
• A) Dopamine depletion in the substantia nigra
• B) Beta-amyloid plaques and neurofibrillary tangles
• C) Demyelination of the CNS
• D) Lewy body accumulation in the brainstem
Actual Questions, Verified Answers with
Rationales | Guarantee Pass
1. A patient presents with right-sided weakness, facial droop, and slurred speech
that began 60 minutes ago. What is the priority action?
• A) Obtain a head CT scan
• B) Administer aspirin 324 mg
• C) Prepare for IV tPA administration
• D) Start oxygen at 2 L/min
Answer: C
Rationale: tPA is most effective within 3 hours (ideal 4.5 hours) of ischemic stroke onset.
This patient is within the window.
2. A patient with a left-sided cerebrovascular accident (CVA) presents with right-
sided weakness. This indicates involvement of which area?
• A) Left cerebral hemisphere, motor cortex
• B) Right cerebral hemisphere, motor cortex
• C) Brainstem, corticospinal tract
• D) Cerebellum, purkinje fibers
Answer: A
Rationale: Motor cortex in each hemisphere controls contralateral movement. Left brain
injury = right-sided weakness.
3. Which finding in a patient with a new stroke is most concerning for increased
intracranial pressure (ICP)?
, • A) Blood pressure 140/90 mmHg
• B) Pupil asymmetry (anisocoria)
• C) Heart rate 88 bpm
• D) Respiratory rate 18/min
Answer: B
Rationale: Pupil asymmetry or sluggish reaction is a late sign of herniation and CN III
compression from increased ICP—medical emergency.
4. A patient with increased ICP exhibits hypertension, bradycardia, and irregular
respirations. This triad is known as:
• A) Kernig's sign
• B) Brudzinski's sign
• C) Cushing's triad
• D) Decerebrate posturing
Answer: C
Rationale: Cushing's triad (HTN + bradycardia + irregular breathing) is a late, life-
threatening sign of brainstem compression.
5. Which type of cerebral edema results from disruption of the blood-brain
barrier?
• A) Cytotoxic
• B) Vasogenic
• C) Interstitial
• D) Ischemic
Answer: B
Rationale: Vasogenic edema occurs when BBB breaks down, allowing fluid to leak into
extracellular space—seen in tumors, abscesses, trauma.
, 6. In an ischemic stroke, the ischemic penumbra is:
• A) Necrotic core
• B) Reversibly injured tissue surrounding the core
• C) Area of hemorrhagic transformation
• D) Zone of vasospasm
Answer: B
Rationale: Penumbra is hypoperfused but salvageable tissue—target for reperfusion
therapy.
7. Which of the following is a modifiable risk factor for ischemic stroke?
• A) Age
• B) Gender
• C) Hypertension
• D) Family history
Answer: C
Rationale: Hypertension is the single most important modifiable risk factor.
8. A patient with Alzheimer's disease has memory loss, aphasia, and apraxia. The
underlying pathophysiology involves:
• A) Dopamine depletion in the substantia nigra
• B) Beta-amyloid plaques and neurofibrillary tangles
• C) Demyelination of the CNS
• D) Lewy body accumulation in the brainstem
