NRMS 5190 Advanced Pathophysiology Exam 3
Comprehensive Review | Questions and
Answers with Rationales | 2026/27 Update |
100% Correct -SUNY Downstate Medical
Center
NRMS 5190 Advanced Pathophysiology Exam 3 Comprehensive Review |
Questions and Answers with Rationales | 2026/27 Update | 100% Correct -
SUNY Downstate Medical Center
SECTION 1: Neurological Pathophysiology
1. A student is studying the rotation of the cerebrospinal fluid (CSF) in a client
with hydrocephalus. Which of the following is the primary pathophysiologic
mechanism of non-communicating hydrocephalus?
A) Obstruction of CSF flow within the ventricular system
B) Impaired CSF absorption by the arachnoid villi
C) Increased CSF production by the choroid plexus
D) Decreased CSF production by the choroid plexus
Correct Answer: A
Rationale: The rotation of the cerebrospinal fluid (CSF) in hydrocephalus: non-
,communicating (obstructive) hydrocephalus is caused by obstruction of CSF flow
within the ventricular system (e.g., aqueductal stenosis, tumor). Communicating
hydrocephalus is caused by impaired CSF absorption by the arachnoid villi.
2. A nurse is assessing a client with increased intracranial pressure (ICP). Which
of the following findings is an early sign?
A) Decreased level of consciousness
B) Fixed and dilated pupils
C) Cushing's triad
D) Decerebrate posturing
Correct Answer: A
Rationale: Decreased level of consciousness is an early sign of increased ICP. Fixed
and dilated pupils, Cushing's triad (hypertension, bradycardia, irregular
respirations), and decerebrate posturing are late signs indicating brainstem
herniation.
3. A student is studying the rotation of the brain in a client with traumatic brain
injury (TBI). Which type of hematoma involves bleeding between the dura mater
and the skull?
A) Epidural hematoma
B) Subdural hematoma
C) Subarachnoid hemorrhage
D) Intracerebral hemorrhage
Correct Answer: A
Rationale: The rotation of the brain in TBI: an epidural hematoma involves
bleeding between the dura mater and the skull, often due to a middle meningeal
artery tear. Subdural hematoma is between the dura and arachnoid. Subarachnoid
hemorrhage is in the subarachnoid space. Intracerebral hemorrhage is within
brain tissue.
,4. A nurse is assessing a client with a stroke. Which of the following findings is
most indicative of a left hemisphere stroke?
A) Left-sided hemiparesis
B) Aphasia
C) Neglect of the left side
D) Impulsivity
Correct Answer: B
Rationale: The left hemisphere is typically responsible for language. A left
hemisphere stroke often results in aphasia (expressive, receptive, or global). Right-
sided hemiparesis is also common. Neglect and impulsivity are more characteristic
of a right hemisphere stroke.
5. A student is studying the rotation of the cerebral blood vessels in a client with
a hemorrhagic stroke. Which of the following is the most common cause?
A) Hypertension
B) Hypotension
C) Atrial fibrillation
D) Carotid stenosis
Correct Answer: A
Rationale: The rotation of the cerebral blood vessels in hemorrhagic stroke:
hypertension is the most common cause of intracerebral hemorrhage. Other
causes include cerebral amyloid angiopathy, anticoagulation, and vascular
malformations.
6. A nurse is assessing a client with meningitis. Which of the following findings is
most indicative?
, A) Positive Kernig's sign
B) Positive Babinski sign
C) Positive Romberg sign
D) Positive Tinel sign
Correct Answer: A
Rationale: Kernig's sign is a positive sign of meningitis. It is assessed by flexing the
client's hip and knee, then attempting to extend the knee. Pain and resistance
indicate a positive sign. Brudzinski's sign is another positive sign.
7. A student is studying the rotation of the neurons in a client with multiple
sclerosis (MS). Which of the following is the primary pathophysiologic
mechanism?
A) Demyelination of the central nervous system
B) Demyelination of the peripheral nervous system
C) Degeneration of dopamine-producing neurons
D) Degeneration of motor neurons
Correct Answer: A
Rationale: The rotation of the neurons in MS: the primary pathophysiologic
mechanism is demyelination of the central nervous system (brain and spinal cord),
leading to impaired nerve conduction and neurological symptoms.
8. A nurse is assessing a client with Parkinson's disease. Which of the following
findings is most common?
A) Resting tremor
B) Intention tremor
C) Spastic paralysis
D) Flaccid paralysis
Correct Answer: A
Rationale: Parkinson's disease is characterized by resting tremor, rigidity,
Comprehensive Review | Questions and
Answers with Rationales | 2026/27 Update |
100% Correct -SUNY Downstate Medical
Center
NRMS 5190 Advanced Pathophysiology Exam 3 Comprehensive Review |
Questions and Answers with Rationales | 2026/27 Update | 100% Correct -
SUNY Downstate Medical Center
SECTION 1: Neurological Pathophysiology
1. A student is studying the rotation of the cerebrospinal fluid (CSF) in a client
with hydrocephalus. Which of the following is the primary pathophysiologic
mechanism of non-communicating hydrocephalus?
A) Obstruction of CSF flow within the ventricular system
B) Impaired CSF absorption by the arachnoid villi
C) Increased CSF production by the choroid plexus
D) Decreased CSF production by the choroid plexus
Correct Answer: A
Rationale: The rotation of the cerebrospinal fluid (CSF) in hydrocephalus: non-
,communicating (obstructive) hydrocephalus is caused by obstruction of CSF flow
within the ventricular system (e.g., aqueductal stenosis, tumor). Communicating
hydrocephalus is caused by impaired CSF absorption by the arachnoid villi.
2. A nurse is assessing a client with increased intracranial pressure (ICP). Which
of the following findings is an early sign?
A) Decreased level of consciousness
B) Fixed and dilated pupils
C) Cushing's triad
D) Decerebrate posturing
Correct Answer: A
Rationale: Decreased level of consciousness is an early sign of increased ICP. Fixed
and dilated pupils, Cushing's triad (hypertension, bradycardia, irregular
respirations), and decerebrate posturing are late signs indicating brainstem
herniation.
3. A student is studying the rotation of the brain in a client with traumatic brain
injury (TBI). Which type of hematoma involves bleeding between the dura mater
and the skull?
A) Epidural hematoma
B) Subdural hematoma
C) Subarachnoid hemorrhage
D) Intracerebral hemorrhage
Correct Answer: A
Rationale: The rotation of the brain in TBI: an epidural hematoma involves
bleeding between the dura mater and the skull, often due to a middle meningeal
artery tear. Subdural hematoma is between the dura and arachnoid. Subarachnoid
hemorrhage is in the subarachnoid space. Intracerebral hemorrhage is within
brain tissue.
,4. A nurse is assessing a client with a stroke. Which of the following findings is
most indicative of a left hemisphere stroke?
A) Left-sided hemiparesis
B) Aphasia
C) Neglect of the left side
D) Impulsivity
Correct Answer: B
Rationale: The left hemisphere is typically responsible for language. A left
hemisphere stroke often results in aphasia (expressive, receptive, or global). Right-
sided hemiparesis is also common. Neglect and impulsivity are more characteristic
of a right hemisphere stroke.
5. A student is studying the rotation of the cerebral blood vessels in a client with
a hemorrhagic stroke. Which of the following is the most common cause?
A) Hypertension
B) Hypotension
C) Atrial fibrillation
D) Carotid stenosis
Correct Answer: A
Rationale: The rotation of the cerebral blood vessels in hemorrhagic stroke:
hypertension is the most common cause of intracerebral hemorrhage. Other
causes include cerebral amyloid angiopathy, anticoagulation, and vascular
malformations.
6. A nurse is assessing a client with meningitis. Which of the following findings is
most indicative?
, A) Positive Kernig's sign
B) Positive Babinski sign
C) Positive Romberg sign
D) Positive Tinel sign
Correct Answer: A
Rationale: Kernig's sign is a positive sign of meningitis. It is assessed by flexing the
client's hip and knee, then attempting to extend the knee. Pain and resistance
indicate a positive sign. Brudzinski's sign is another positive sign.
7. A student is studying the rotation of the neurons in a client with multiple
sclerosis (MS). Which of the following is the primary pathophysiologic
mechanism?
A) Demyelination of the central nervous system
B) Demyelination of the peripheral nervous system
C) Degeneration of dopamine-producing neurons
D) Degeneration of motor neurons
Correct Answer: A
Rationale: The rotation of the neurons in MS: the primary pathophysiologic
mechanism is demyelination of the central nervous system (brain and spinal cord),
leading to impaired nerve conduction and neurological symptoms.
8. A nurse is assessing a client with Parkinson's disease. Which of the following
findings is most common?
A) Resting tremor
B) Intention tremor
C) Spastic paralysis
D) Flaccid paralysis
Correct Answer: A
Rationale: Parkinson's disease is characterized by resting tremor, rigidity,
