NUR 210 (MED/SURG - Test 3) Study Notes Questions with Correct
Answers (Grade A+)
Question 1: Increased Intracranial Pressure (ICP)
Answer: Sustained elevated pressure in the cranial cavity (greater than or equal to 15 mmHg in adults)
Question 2: T/F: Intracranial pressure (ICP) increases/decreases throughout the day depending on the
individual's activities
Answer: TRUE
Question 3: What are 4 activities that can cause a brief and non harmful increase in intracranial
pressure in a patient?
Answer: 1. Coughing 2. Bending 3. Sneezing 4. Straining
Question 4: What is the MOST frequent cause of sustained increases in intracranial pressure in
patients?
Answer: Cerebral edema
Question 5: If intracranial pressure increases in a patient, what happens to the volume of cerebrospinal
fluid (CSF) and blood?
Answer: Decreases **Opposites of one another
Question 6: The brain requires a constant supply of oxygen and glucose. If the blood flow is
interrupted, what could occur?
Answer: Ischemia and disruption of cerebral metabolism
Question 7: Increased intracranial pressure may result from:
Answer: 1. Head injury 2. Hydrocephalus 3. Cerebral edema 4. Excess cerebrospinal fluid (CSF) 5. Brain
tumor or abscess 6. Intracranial hemorrhage
Question 8: The nurse know they can teach a patient about what ways to prevent trauma that can lead
to intracranial pressure (ICP)?
Answer: 1. Use personal protective equipment 2. Seat belts 3. Avoid phone use while driving or in motion
4. Avoid recreational drugs/alcohol 5. Fall precautions
Page 1
,Question 9: What clinical manifestations can be seen in a patient with increased intracranial pressure
(ICP)?
Answer: 1. Decreased loss of consciousness 2. Pupillary dysfunction (sluggish response to light that
progresses to fixed pupils) 3. Oculomotor dysfunction (Inability to move eyes upward, ptosis (drooping) of
eyelid 4. Blurred vision/Diplopia (double vision) 5. Vomiting (projectile without nausea) 6. Headache 7.
Seizures 8. Cushing triad/response 9. Motor impairment (decorticate/decerebrate positioning, flaccidity) 10.
Elevated temperature
Question 10: A patient with increased intracranial pressure who has Cushings Triad would have what
type of vitals present?
Answer: 1. Increased blood pressure (Widening pulse pressure) 2. Decreased pulse (Bradycardia) 3.
Decreased respirations (Bradypnea) **Can be seen after patient is given epinephrine
Question 11: Intracranial pressure that is greater than 40 mmHg is considered what?
Answer: Life-threatening medical emergency
Question 12: What is the first visible symptom that a patient is experiencing increased intracranial
pressure?
Answer: Loss of consciousness **Ex: Confusion, Restlessness/Lethargy, Disoriented
Question 13: What diagnostic test is usually used to find the possible causes of increased intracranial
pressure and also to evaluate therapeutic options?
Answer: CT or MRI
Question 14: Why would a lumbar puncture not be performed when increased intracranial pressure is
suspected in a patient?
Answer: The sudden release of the pressure in the skull may cause cerebral herniation
Question 15: Why would a patient with increased intracranial pressure undergo surgery to resect
infarcted or necrotic tissue?
Answer: Reduce brain mass
Question 16: Why would a patient with increased intracranial pressure undergo surgery to insert a
drainage catheter or shunt?
Answer: Drain excess cerebrospinal fluid (CSF) and reduce hydrocephalus
Page 2
, Question 17: A patient with chronic increased intracranial pressure may undergo surgery for insertion
of what?
Answer: Permanent shunt
Question 18: What types of medications may be used for treatment of increased intracranial pressure?
Answer: 1. Diuretics (draw water out the brain tissue) 2. Antipyretics (decrease temperature) 3. Antiseizure
drugs (manage seizure activity) 4. Antihypertensives (when BP is high) 5. Vasopressors (when BP is low) 6.
Gastrointestinal (GI) prophylaxis (prevent ulcers) 7. IV fluids (manage fluid/electrolyte balance)
Question 19: Why are osmotic diuretics such as mannitol used in the treatment of increased
intracranial pressure?
Answer: They increase the osmolarity of the blood of the blood, which draws water out of the edematous
brain tissue and into the vascular system for elimination by the kidneys
Question 20: What is the MOST reliable and accurate way to measure intracranial pressure?
Answer: Intraventricular intracranial pressure catheter
Question 21: Why do most patients with increased intracranial pressure often require intubation and
being placed on mechanical ventilation?
Answer: Airway protection and respiratory management **maintains partial pressure of O2 and CO2 to
prevent hypoxemia and hypercapnia
Question 22: What are some nonpharmacological therapies that may be used during the care of a
patient with increased intracranial pressure?
Answer: 1. Limit environmental stimulation 2. Raise head of bed to 30 degrees 3. Physical therapy 4.
Occupational therapy 5. Speech therapy 6. Spiritual/Psychological counseling
Question 23: Older adults are often prone to what, that can result in increased intracranial pressure?
Answer: Falls
Question 24: Observation of the patient with increased intracranial pressure begins by noting the
patient's LOC using what?
Answer: Glasgow Coma Scale (GCS)
Question 25: T/F: An elevated temperature with increased oxygen consumption further increases
intracranial pressure leading the patient to possibly need hypothermic therapy
Answer: TRUE
Page 3
Answers (Grade A+)
Question 1: Increased Intracranial Pressure (ICP)
Answer: Sustained elevated pressure in the cranial cavity (greater than or equal to 15 mmHg in adults)
Question 2: T/F: Intracranial pressure (ICP) increases/decreases throughout the day depending on the
individual's activities
Answer: TRUE
Question 3: What are 4 activities that can cause a brief and non harmful increase in intracranial
pressure in a patient?
Answer: 1. Coughing 2. Bending 3. Sneezing 4. Straining
Question 4: What is the MOST frequent cause of sustained increases in intracranial pressure in
patients?
Answer: Cerebral edema
Question 5: If intracranial pressure increases in a patient, what happens to the volume of cerebrospinal
fluid (CSF) and blood?
Answer: Decreases **Opposites of one another
Question 6: The brain requires a constant supply of oxygen and glucose. If the blood flow is
interrupted, what could occur?
Answer: Ischemia and disruption of cerebral metabolism
Question 7: Increased intracranial pressure may result from:
Answer: 1. Head injury 2. Hydrocephalus 3. Cerebral edema 4. Excess cerebrospinal fluid (CSF) 5. Brain
tumor or abscess 6. Intracranial hemorrhage
Question 8: The nurse know they can teach a patient about what ways to prevent trauma that can lead
to intracranial pressure (ICP)?
Answer: 1. Use personal protective equipment 2. Seat belts 3. Avoid phone use while driving or in motion
4. Avoid recreational drugs/alcohol 5. Fall precautions
Page 1
,Question 9: What clinical manifestations can be seen in a patient with increased intracranial pressure
(ICP)?
Answer: 1. Decreased loss of consciousness 2. Pupillary dysfunction (sluggish response to light that
progresses to fixed pupils) 3. Oculomotor dysfunction (Inability to move eyes upward, ptosis (drooping) of
eyelid 4. Blurred vision/Diplopia (double vision) 5. Vomiting (projectile without nausea) 6. Headache 7.
Seizures 8. Cushing triad/response 9. Motor impairment (decorticate/decerebrate positioning, flaccidity) 10.
Elevated temperature
Question 10: A patient with increased intracranial pressure who has Cushings Triad would have what
type of vitals present?
Answer: 1. Increased blood pressure (Widening pulse pressure) 2. Decreased pulse (Bradycardia) 3.
Decreased respirations (Bradypnea) **Can be seen after patient is given epinephrine
Question 11: Intracranial pressure that is greater than 40 mmHg is considered what?
Answer: Life-threatening medical emergency
Question 12: What is the first visible symptom that a patient is experiencing increased intracranial
pressure?
Answer: Loss of consciousness **Ex: Confusion, Restlessness/Lethargy, Disoriented
Question 13: What diagnostic test is usually used to find the possible causes of increased intracranial
pressure and also to evaluate therapeutic options?
Answer: CT or MRI
Question 14: Why would a lumbar puncture not be performed when increased intracranial pressure is
suspected in a patient?
Answer: The sudden release of the pressure in the skull may cause cerebral herniation
Question 15: Why would a patient with increased intracranial pressure undergo surgery to resect
infarcted or necrotic tissue?
Answer: Reduce brain mass
Question 16: Why would a patient with increased intracranial pressure undergo surgery to insert a
drainage catheter or shunt?
Answer: Drain excess cerebrospinal fluid (CSF) and reduce hydrocephalus
Page 2
, Question 17: A patient with chronic increased intracranial pressure may undergo surgery for insertion
of what?
Answer: Permanent shunt
Question 18: What types of medications may be used for treatment of increased intracranial pressure?
Answer: 1. Diuretics (draw water out the brain tissue) 2. Antipyretics (decrease temperature) 3. Antiseizure
drugs (manage seizure activity) 4. Antihypertensives (when BP is high) 5. Vasopressors (when BP is low) 6.
Gastrointestinal (GI) prophylaxis (prevent ulcers) 7. IV fluids (manage fluid/electrolyte balance)
Question 19: Why are osmotic diuretics such as mannitol used in the treatment of increased
intracranial pressure?
Answer: They increase the osmolarity of the blood of the blood, which draws water out of the edematous
brain tissue and into the vascular system for elimination by the kidneys
Question 20: What is the MOST reliable and accurate way to measure intracranial pressure?
Answer: Intraventricular intracranial pressure catheter
Question 21: Why do most patients with increased intracranial pressure often require intubation and
being placed on mechanical ventilation?
Answer: Airway protection and respiratory management **maintains partial pressure of O2 and CO2 to
prevent hypoxemia and hypercapnia
Question 22: What are some nonpharmacological therapies that may be used during the care of a
patient with increased intracranial pressure?
Answer: 1. Limit environmental stimulation 2. Raise head of bed to 30 degrees 3. Physical therapy 4.
Occupational therapy 5. Speech therapy 6. Spiritual/Psychological counseling
Question 23: Older adults are often prone to what, that can result in increased intracranial pressure?
Answer: Falls
Question 24: Observation of the patient with increased intracranial pressure begins by noting the
patient's LOC using what?
Answer: Glasgow Coma Scale (GCS)
Question 25: T/F: An elevated temperature with increased oxygen consumption further increases
intracranial pressure leading the patient to possibly need hypothermic therapy
Answer: TRUE
Page 3
