FINAL EXAM: NR 574 / NR574 (LATEST
UPDATE) ACUTE CARE
PRACTICUM I – CHAMBERLAIN
UNIVERSITY TEST BANK | 450
QUESTIONS WITH VERIFIED ANSWERS |
100% CORRECT | GRADE A+
SECTION 1: NEUROLOGIC EMERGENCIES & INTRACRANIAL
PRESSURE (Questions 1-100)
1. The Glasgow Coma Scale (GCS) score ranges from which minimum to maximum?
A) 0 to 10
B) 3 to 15
C) 1 to 12
D) 5 to 20
Answer: B
Rationale: The GCS is a standardized tool used to assess a patient's level of
consciousness. Scores range from 3 (indicating deep coma or unresponsiveness) to 15
(indicating full alertness). It evaluates three components: eye-opening (1-4), verbal
response (1-5), and motor response (1-6).
2. A GCS score of 3 indicates which condition?
A) Normal neurologic status
B) Moderate head injury
,C) Deep coma or unresponsiveness
D) Mild confusion
Answer: C
Rationale: A GCS score of 3 is the lowest possible score and indicates deep coma or
unresponsiveness. It may suggest severe brain injury or brain death and requires
immediate evaluation and intervention.
3. A patient with a head injury briefly loses consciousness, wakes up, and then
rapidly deteriorates. This pattern is most consistent with which condition?
A) Subdural hematoma
B) Concussion
C) Subarachnoid hemorrhage
D) Epidural hematoma
Answer: D
Rationale: An epidural hematoma classically presents with a brief loss of consciousness,
followed by a "lucid interval" where the patient appears awake and alert. This is then
followed by rapid neurologic deterioration as arterial bleeding (often from the middle
meningeal artery) expands the hematoma and increases ICP. This is a surgical
emergency.
4. Which type of traumatic intracranial hematoma is most common?
A) Subdural hematoma
B) Epidural hematoma
C) Intraventricular hemorrhage
D) Subarachnoid hemorrhage
Answer: A
,Rationale: Subdural hematoma is the most common traumatic intracranial hematoma.
It results from tearing of bridging veins between the dura and brain. It may be acute,
subacute, or chronic depending on the time course of symptom development.
5. Cushing's triad in increased intracranial pressure includes which set of findings?
A) Hypotension, tachycardia, and tachypnea
B) Hypertension, tachycardia, and bradypnea
C) Hypotension, bradycardia, and apnea
D) Hypertension, bradycardia, and irregular respirations
Answer: D
Rationale: Cushing's triad is a late, ominous sign of increased ICP and impending
brainstem herniation. It is characterized by hypertension with a widened pulse pressure,
bradycardia, and irregular respirations. This finding signals a critical need for immediate
intervention to reduce ICP.
6. What is the recommended head-of-bed position for a patient with increased
intracranial pressure?
A) Flat (0 degrees)
B) 30 degrees
C) 45 degrees
D) 90 degrees
Answer: B
Rationale: Elevating the head of the bed to 30 degrees is an effective, immediate
intervention to reduce ICP. This position promotes venous drainage from the brain and
helps maintain cerebral perfusion. The head should also be kept in a midline position to
avoid jugular vein compression, which can impede venous drainage.
7. Mannitol administration requires monitoring of which parameter?
, A) Central venous pressure
B) Temperature
C) Urine color
D) Bowel sounds
Answer: A
Rationale: Mannitol is an osmotic diuretic that can cause hypovolemia and electrolyte
shifts. Central venous pressure monitoring is required to assess volume status and
prevent dehydration. This monitoring helps guide safe therapy and prevents
complications such as hypovolemia that could reduce cerebral perfusion.
8. Which adverse effect is associated with mannitol therapy?
A) Hypovolemia
B) Hyperkalemia
C) Hypertension
D) Weight gain
Answer: A
Rationale: Mannitol is an osmotic diuretic that increases urine output and can cause
hypovolemia. Careful monitoring of fluid status and central venous pressure is
necessary. Hypovolemia may reduce cerebral perfusion and worsen neurologic
outcomes.
9. A patient with a basilar skull fracture has clear drainage from the left naris.
What is the best nursing action?
A) Pack the nares with gauze
B) Place a nasal drip pad under the nose
C) Suction the nares
D) Obtain a culture of the drainage
UPDATE) ACUTE CARE
PRACTICUM I – CHAMBERLAIN
UNIVERSITY TEST BANK | 450
QUESTIONS WITH VERIFIED ANSWERS |
100% CORRECT | GRADE A+
SECTION 1: NEUROLOGIC EMERGENCIES & INTRACRANIAL
PRESSURE (Questions 1-100)
1. The Glasgow Coma Scale (GCS) score ranges from which minimum to maximum?
A) 0 to 10
B) 3 to 15
C) 1 to 12
D) 5 to 20
Answer: B
Rationale: The GCS is a standardized tool used to assess a patient's level of
consciousness. Scores range from 3 (indicating deep coma or unresponsiveness) to 15
(indicating full alertness). It evaluates three components: eye-opening (1-4), verbal
response (1-5), and motor response (1-6).
2. A GCS score of 3 indicates which condition?
A) Normal neurologic status
B) Moderate head injury
,C) Deep coma or unresponsiveness
D) Mild confusion
Answer: C
Rationale: A GCS score of 3 is the lowest possible score and indicates deep coma or
unresponsiveness. It may suggest severe brain injury or brain death and requires
immediate evaluation and intervention.
3. A patient with a head injury briefly loses consciousness, wakes up, and then
rapidly deteriorates. This pattern is most consistent with which condition?
A) Subdural hematoma
B) Concussion
C) Subarachnoid hemorrhage
D) Epidural hematoma
Answer: D
Rationale: An epidural hematoma classically presents with a brief loss of consciousness,
followed by a "lucid interval" where the patient appears awake and alert. This is then
followed by rapid neurologic deterioration as arterial bleeding (often from the middle
meningeal artery) expands the hematoma and increases ICP. This is a surgical
emergency.
4. Which type of traumatic intracranial hematoma is most common?
A) Subdural hematoma
B) Epidural hematoma
C) Intraventricular hemorrhage
D) Subarachnoid hemorrhage
Answer: A
,Rationale: Subdural hematoma is the most common traumatic intracranial hematoma.
It results from tearing of bridging veins between the dura and brain. It may be acute,
subacute, or chronic depending on the time course of symptom development.
5. Cushing's triad in increased intracranial pressure includes which set of findings?
A) Hypotension, tachycardia, and tachypnea
B) Hypertension, tachycardia, and bradypnea
C) Hypotension, bradycardia, and apnea
D) Hypertension, bradycardia, and irregular respirations
Answer: D
Rationale: Cushing's triad is a late, ominous sign of increased ICP and impending
brainstem herniation. It is characterized by hypertension with a widened pulse pressure,
bradycardia, and irregular respirations. This finding signals a critical need for immediate
intervention to reduce ICP.
6. What is the recommended head-of-bed position for a patient with increased
intracranial pressure?
A) Flat (0 degrees)
B) 30 degrees
C) 45 degrees
D) 90 degrees
Answer: B
Rationale: Elevating the head of the bed to 30 degrees is an effective, immediate
intervention to reduce ICP. This position promotes venous drainage from the brain and
helps maintain cerebral perfusion. The head should also be kept in a midline position to
avoid jugular vein compression, which can impede venous drainage.
7. Mannitol administration requires monitoring of which parameter?
, A) Central venous pressure
B) Temperature
C) Urine color
D) Bowel sounds
Answer: A
Rationale: Mannitol is an osmotic diuretic that can cause hypovolemia and electrolyte
shifts. Central venous pressure monitoring is required to assess volume status and
prevent dehydration. This monitoring helps guide safe therapy and prevents
complications such as hypovolemia that could reduce cerebral perfusion.
8. Which adverse effect is associated with mannitol therapy?
A) Hypovolemia
B) Hyperkalemia
C) Hypertension
D) Weight gain
Answer: A
Rationale: Mannitol is an osmotic diuretic that increases urine output and can cause
hypovolemia. Careful monitoring of fluid status and central venous pressure is
necessary. Hypovolemia may reduce cerebral perfusion and worsen neurologic
outcomes.
9. A patient with a basilar skull fracture has clear drainage from the left naris.
What is the best nursing action?
A) Pack the nares with gauze
B) Place a nasal drip pad under the nose
C) Suction the nares
D) Obtain a culture of the drainage
