Neurology CCRN Questions with Correct Answers

Neurology CCRN Questions with Correct Answers Which of the following is a false statement? a. head injuries in infants are associated with increased mortality secondary to open fontanels. b. if an infant is not restrained and is propelled during a MVA, the head usually leads. Resulting in critical injury c. The infant has less myelinated nerves that are easily injured. d. the cranial bones are thin and offer inadequate protection - ANSWER-A, open fontanels allow for a certain decree of expansion reducing the mortality associated with head injuries. When an infant is propelled, the head usually leads. The infant has thin cranial bones and less myelinated nerves. The nurse is caring for Jacob, an infant with a closed head injury. His vital signs at 0200 are as follows. BP 90/60 HR 130 RR 22, At 0230 the nruse notes that Jacob is not responding to stimuli and his vital signs are as follows: BP 110/42 HR 54 RR . In addition to attending to his airway which of the following should the nurse anticipate as a top priority. a. administer a 10ml/kg bolus of an isotonic solution b. administer PRN morphine c. administer mannitol Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 2/21 c. administer glucose - ANSWER-c. the scenario describes a child with Cushing's reflex. an emergency where increased ICP may lead to herniation. In Cushing's reflex, the systolic BP increases greater than the diastolic pressure, creating a widened pulse pressure. Bradycardia and apnea accompany the widened pulse pressure. Increased ICP is usually managed with an osmotic diuretic such as Mannitol. The nurse is caring for Samantha, a 5 year old with a closed head injury. When the nurse stimulated Samantha, the child flexed her arms, clenches her fists and extends her legs. Which of the following is accurate? a. Samantha is demonstrating decorticate posturing which indicates cerebral damage b. Samantha is demonstrating decorticate posturing which indicates damage to the midbrain. c. Samantha is demonstrating decerebrate posturing which indicates cerebral damage b. Samantha is demonstrating decerebrate posturing which indicates damage to the midbrain. - ANSWER-A. Decorticate posturing which indicates cerebral damage occurs when the response to stimuli includes, clenched fists, flexed arms and extended legs. Tyrone is in the PICU after haing a brain tumor resected. His ICP is 15 and his MAP is 80. What is his CPP? a. 95mmHG b. 45mmHg c. 65mmHg d.33mmHg - ANSWER-C. CPP is calculated by subtracting the ICP from the MAP. Which of the following is an acceptable CPP for an adolescent? a. 35mmHg Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 3/21 b. 45mmHg c. 55mmHg d. 65mmHg - ANSWER-D. An adolescent should have a CPP of 65mmHg or greater Which of the following is true regarding diagnosing brain death? a. the body temperature must be greater than 33 degrees centrigrade. b. a diagnosis of brain death can still be made if the child is receiving CNS depressants and paralytic agents c. spinal reflexes may still be present d. no solid criteria exist for diagnosis brain death in children. - ANSWER-c. Spinal reflexes may still be present despite brain death. Criteria does exist for the diagnosis of brain death in children. The body temperature must be greater than 32C. A diagnosis of braing death cannot be made if the child has received any CNS depressants. The neurologist is assessing Josie for brain death. When Josie's head is turned from side to side the nurse notes that she has a dolls eyes response. What response should be noted in the neurologically intact child when the head is rapidly turned from side to side. a. the eyes should deviate to the opposite side that the head is turned to b. the eyes should deviate to the same side that the head is turned to c. the eyes should open and close in rapid succession d. the eyes should close tightly. - ANSWER-A. in a neurologically intact child, when the head is turned rapidly from side to side, the eyes should deviate to the opposite side that the head is turned to. Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 4/21 An apnea test is considered positive is which of the following are present? a. respiratory effort is made when the pco2 is >60mmGh b. respiratory effort is made when the PCO2 is <60mmHg c. No respiratory effort is made when the pco2 is >60mmGh d. No respiratory effort is made when the PCO2 is <60mmHg - ANSWER-C. An apnea test is considered positive when no respiratory effort is made and the PCO2 is >60mmHgl. It is also considered positive if there is no respiratory effort despite a rise in PCO@ of 22mmHg above baseline as that is considered a sufficient rise to stimulate the respiratory centers Adam is a 6 year old who is returning to the PICU after having a shunt revision for hydrocephalus. Which of the following is the lowest acceptable systolic blood pressure for adam? - ANSWER-D. a quick way to estimate the lowest acceptable systolic blood pressure is to add 70 to 2x the child's age In addition to altering fluid and electrolyte balance, SIADH is a concern in neurosurgical patient because it can lead to a. cerebral edema b. massive intravascular volume depletion c. cerebral hypernatremia d. altered LOC - ANSWER-A. SIADH needs to be managed as it causes hyponatremia which can lead to cerebral edema Which of the following is a false statement? a. meningitis can lead to noncommunicating hydrocephalus. Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024 Copyright ©Stuvia International BV Page 5/21 b. Arnold chiari is an example of communicating hydrocephalus c. communicating hydrocephalus is due to impaired absorption of CSF d. non obstructive hydrocephalus is also known as communicating hydrocephalus. - ANSWER-B Arnold chiari is an example of non communicating or obstructive hydrocephalus. the nurse is caring for Becca, a 12 year old with hydrocephalus who is being evaluated for a possible shunt malfunction. Which of the following is considered to be an early sign of increased ICP? a. alteration in LOC b. changes in the reactivity of the pupils c. changes in respiratory rate d. changes in heart rate - ANSWER-a. an alteration in LOC is considered to be the earliest indication of increased ICP. Changes in vital signs and reactivity of the pupils can occur as well, but are generally later signs. which of the following is a true statement concerning TBIs? a. concussions always involve a loss of consciousness b. diffuse cerebral swelling is due to decreased blood volume c. cerebral lacerations are often accodiated with skull fractures d. skull fractures are examples of secondary injury. - ANSWER-C. cerebral lacerations are often associated with skull fractures. Concussions do not always involve loss of consciousness. Diffuse cerebral swelling id due to increased blood volume. Skull fractures are examples of pri