Critical Care Neuro- practice questions and answers 2022
3. A nurse is caring for a patient with autonomic dysreflexia. What clinical manifestations
would the nurse expect in this patient?
A) Tachycardia and hypotension
B) Bradycardia and hypertension
C) Tachycardia and hypertension
D) Bradycardia and hypotension - answer===Ans: B
Feedback: Autonomic dysreflexia is characterized by a pounding headache, profuse sweating,
nasal congestion, piloerection ("goose bumps"), bradycardia, and hypertension. It occurs in
cord lesions above T6 after spinal shock has resolved. This makes options A, C, and D
incorrect.
4. The nurse is caring for a patient with increased intracranial pressure (IICP) caused by a
traumatic brain injury. Which of the following clinical manifestations would indicate that the
patient is experiencing increased brain compression causing brainstem damage?
A) Hyperthermia
B) Tachycardia
C) Hypertension
D) Bradypnea - answer===Ans: A
Feedback: Signs of increasing ICP include slowing of the heart rate (bradycardia), increasing
systolic blood pressure, and widening pulse pressure. As brain compression increases,
respirations become rapid, blood pressure may decrease, and the pulse slows further. A rapid
rise in body temperature is regarded as unfavorable. Hyperthermia increases the metabolic
demands of the brain and may indicate brainstem damage.
6. The staff educator is precepting a nurse new to the unit when a patient with a T2 spinal
cord injury is admitted. The patient is soon exhibiting manifestations of neurogenic shock.
What would the staff educator and the new nurse monitor this patient for?
A) Increased cardiac markers
B) Hypotension
C) Tachycardia
D) Excessive sweating - answer===Ans: B
Feedback: Manifestations of neurogenic shock include decreased blood pressure and heart
rate. Cardiac markers would be expected to rise in cardiogenic shock. Patients do not perspire
on the paralyzed portions of their body due to blockage of sympathetic activity.
7. An emergency department nurse has just received a call from EMS that they are
transporting a 17-year-old male who has just sustained a spinal cord injury. The nurse
recognizes that the most common cause of this type of injury is what?
A) Sports-related injuries
B) Acts of violence
C) Injuries due to a fall
D) Motor vehicle accidents - answer===Ans: D
Feedback: Motor vehicle crashes account for 48% of reported cases of SCI, with falls (23%),
violence primarily from gunshot wounds (14%), recreational sporting activities (9%), and
other events accounting for the remaining injuries. Therefore options A, B, and C are
incorrect.
, 8. A patient with spinal cord injury has a nursing diagnosis of altered mobility. This increases
the risk of deep vein thrombosis (DVT) in this patient. Which of the following would be
included as an appropriate nursing intervention to prevent a DVT from occurring?
A) Placing the patient on a fluid restriction
B) Applying thigh-high elastic stockings
C) Administering an antifibrinolyic agent
D) Assisting the patient with PROM exercises - answer===Ans: B
Feedback: It is important to promote venous return to the heart and prevent venous stasis in a
patient with altered mobility. Applying elastic stockings will aid in the prevention of a DVT.
The patient should not be placed on fluid restriction because a dehydrated state will increase
the risk of clotting throughout the body. Antifibrinolytic agents cause the blood to clot, which
is absolutely contraindicated in this situation.
10. A patient who has sustained a basal skull fracture is admitted to your unit. You know that
the patient should be observed for what?
A) An area of bruising over the mastoid bone
B) Bleeding from the ears
C) An increase in pulse
D) Difficulty sleeping - answer===Ans: B
Feedback: Fractures of the base of the skull tend to traverse the paranasal sinus of the frontal
bone; thus, they frequently produce hemorrhage from the nose, pharynx, or ears. Bruising
over the mastoid bone and difficulty sleeping may occur in this patient, but are not areas to be
observed for. An increase in pulse would be noted when vital signs are assessed.
11. A patient has suffered a spinal cord injury. These patients are prone to having an
exaggerated autonomic response triggered by what stimuli?
A) Listening to quiet music
B) Placing the patient in semi-Fowler's position
C) Voiding
D) Constipation - answer===Ans: D
Feedback: A number of stimuli may trigger this reflex: distended bladder (most common
cause), distention or contraction of the visceral organs (especially the bowel—constipation,
impaction), or stimulation of the skin (tactile, pain, thermal stimuli, pressure ulcer).
12. A patient is admitted to the Neuro ICU with a spinal cord injury. In writing the care plan
the nurse plans that contractures can be prevented by what?
A) Repositioning the patient every 2 hours
B) Initiating range-of-motion exercises 1 week following the injury
C) Initiating range-of-motion exercises 48 hours after the injury
D) Performing range-of-motion exercises once a day - answer===Ans: C
Feedback: Contractures develop rapidly with immobility and muscle paralysis. The exercises
can be implemented within 48 to 72 hours after the injury. The exercises should ideally be
preformed five times a day. Repositioning alone will not prevent contractures.
13. Many head-injured patients are restless and thrash around in bed. What is the nurse's best
intervention for preventing injury?
A) Restrain the patient.
B) Administer a narcotic analgesic.
C) Arrange for friends and family members to sit with the patient.
D) Pad the side rails. - answer===Ans: D
3. A nurse is caring for a patient with autonomic dysreflexia. What clinical manifestations
would the nurse expect in this patient?
A) Tachycardia and hypotension
B) Bradycardia and hypertension
C) Tachycardia and hypertension
D) Bradycardia and hypotension - answer===Ans: B
Feedback: Autonomic dysreflexia is characterized by a pounding headache, profuse sweating,
nasal congestion, piloerection ("goose bumps"), bradycardia, and hypertension. It occurs in
cord lesions above T6 after spinal shock has resolved. This makes options A, C, and D
incorrect.
4. The nurse is caring for a patient with increased intracranial pressure (IICP) caused by a
traumatic brain injury. Which of the following clinical manifestations would indicate that the
patient is experiencing increased brain compression causing brainstem damage?
A) Hyperthermia
B) Tachycardia
C) Hypertension
D) Bradypnea - answer===Ans: A
Feedback: Signs of increasing ICP include slowing of the heart rate (bradycardia), increasing
systolic blood pressure, and widening pulse pressure. As brain compression increases,
respirations become rapid, blood pressure may decrease, and the pulse slows further. A rapid
rise in body temperature is regarded as unfavorable. Hyperthermia increases the metabolic
demands of the brain and may indicate brainstem damage.
6. The staff educator is precepting a nurse new to the unit when a patient with a T2 spinal
cord injury is admitted. The patient is soon exhibiting manifestations of neurogenic shock.
What would the staff educator and the new nurse monitor this patient for?
A) Increased cardiac markers
B) Hypotension
C) Tachycardia
D) Excessive sweating - answer===Ans: B
Feedback: Manifestations of neurogenic shock include decreased blood pressure and heart
rate. Cardiac markers would be expected to rise in cardiogenic shock. Patients do not perspire
on the paralyzed portions of their body due to blockage of sympathetic activity.
7. An emergency department nurse has just received a call from EMS that they are
transporting a 17-year-old male who has just sustained a spinal cord injury. The nurse
recognizes that the most common cause of this type of injury is what?
A) Sports-related injuries
B) Acts of violence
C) Injuries due to a fall
D) Motor vehicle accidents - answer===Ans: D
Feedback: Motor vehicle crashes account for 48% of reported cases of SCI, with falls (23%),
violence primarily from gunshot wounds (14%), recreational sporting activities (9%), and
other events accounting for the remaining injuries. Therefore options A, B, and C are
incorrect.
, 8. A patient with spinal cord injury has a nursing diagnosis of altered mobility. This increases
the risk of deep vein thrombosis (DVT) in this patient. Which of the following would be
included as an appropriate nursing intervention to prevent a DVT from occurring?
A) Placing the patient on a fluid restriction
B) Applying thigh-high elastic stockings
C) Administering an antifibrinolyic agent
D) Assisting the patient with PROM exercises - answer===Ans: B
Feedback: It is important to promote venous return to the heart and prevent venous stasis in a
patient with altered mobility. Applying elastic stockings will aid in the prevention of a DVT.
The patient should not be placed on fluid restriction because a dehydrated state will increase
the risk of clotting throughout the body. Antifibrinolytic agents cause the blood to clot, which
is absolutely contraindicated in this situation.
10. A patient who has sustained a basal skull fracture is admitted to your unit. You know that
the patient should be observed for what?
A) An area of bruising over the mastoid bone
B) Bleeding from the ears
C) An increase in pulse
D) Difficulty sleeping - answer===Ans: B
Feedback: Fractures of the base of the skull tend to traverse the paranasal sinus of the frontal
bone; thus, they frequently produce hemorrhage from the nose, pharynx, or ears. Bruising
over the mastoid bone and difficulty sleeping may occur in this patient, but are not areas to be
observed for. An increase in pulse would be noted when vital signs are assessed.
11. A patient has suffered a spinal cord injury. These patients are prone to having an
exaggerated autonomic response triggered by what stimuli?
A) Listening to quiet music
B) Placing the patient in semi-Fowler's position
C) Voiding
D) Constipation - answer===Ans: D
Feedback: A number of stimuli may trigger this reflex: distended bladder (most common
cause), distention or contraction of the visceral organs (especially the bowel—constipation,
impaction), or stimulation of the skin (tactile, pain, thermal stimuli, pressure ulcer).
12. A patient is admitted to the Neuro ICU with a spinal cord injury. In writing the care plan
the nurse plans that contractures can be prevented by what?
A) Repositioning the patient every 2 hours
B) Initiating range-of-motion exercises 1 week following the injury
C) Initiating range-of-motion exercises 48 hours after the injury
D) Performing range-of-motion exercises once a day - answer===Ans: C
Feedback: Contractures develop rapidly with immobility and muscle paralysis. The exercises
can be implemented within 48 to 72 hours after the injury. The exercises should ideally be
preformed five times a day. Repositioning alone will not prevent contractures.
13. Many head-injured patients are restless and thrash around in bed. What is the nurse's best
intervention for preventing injury?
A) Restrain the patient.
B) Administer a narcotic analgesic.
C) Arrange for friends and family members to sit with the patient.
D) Pad the side rails. - answer===Ans: D
