NSG 4100
NSG-4100 Final Review Questions with Correct
Detailed Answers Updated 2025
what are some causes for head injuries? -Correct Answer ✔Sports
MVCs
Men are more at risk
What is the best action for obtaining an informed consent for an emergency craniotomy
for a pt brought by EMS? -Correct Answer ✔transport the victim to the operating room
for surgery
What is a clinical manifestation of a brain herniation/ increased ICP? -Correct Answer
✔abnormal pupil response - dilate or nonreactive; normal pupil size is 2-4mm
Pt has a brain injury and possible hemorrhage, what needs to be notified to PCP? -
Correct Answer ✔-new onset restlessness is a priority
-pt is at home, spouse notices pupil response, slurred speech - take them to
hospital
what is a nursing intervention for a patient with a closed head injury to decrease ICP? -
Correct Answer ✔- they will have an increased ICP so you want to elevate the HOB in a
neutral
position to 30 degrees to reduce the pressure.
- do constant neuro checks
- no flexion of neck or hips (it increases abdominal pressure = increased bp =
increased ICP)
- no Valsalva maneuvers (stool softeners, high fiber)
when moving in bed, exhale (opens your glottis to prevent Valsalva maneuver)
-Normal ICP: 5-15mmHg
-control fever
- use dobutamine (Dobutrex)
- norepinephrine (Levophed)
- drain the CSF
- restrict fluids
- reduce cellular metabolic demands
- give humidified oxygen
- monitor ABG
- suction only when needed
-space nursing care = ICP should not go above 25 and should return to baseline
within 5 minutes
- reduce stimulation: turn off the lights, tell pt it can't be too loud, seizure
precautions
An unconscious patient comes into the ER with bruising behind the ears, over mastoid
NSG 4100
, NSG 4100
bone, what do you suspect they had? -Correct Answer ✔a. patient is suspected to have
a head trauma because of the battle signs from
CSF leaking
b. cm: halo, clear pink-tinged coming from ears, nose, salty taste in back of
their mouth
c. if you have increased drainage, there is a leak somewhere which needs to be
reported; test for glucose
if a patient has increased urine output after a head injury, what can you suspect they
have
and what should you do? -Correct Answer ✔a. monitor for diabetes insipidus (DI)
normal is 30ml/hr
b. notify the doctor
c. insert a foley, monitor I/Os
what is normal to see when doing a head-to-toe assessment on a patient with a TBI? -
Correct Answer ✔- bruising and swelling
If a patient with a head injury is now having doll eyes, what should the nurse do? -
Correct Answer ✔call the doctor because their neurologic status is getting worse
Glasco Coma Scale (GCS) question -Correct Answer ✔a. Use for monitoring changes
during the acute phase the first few days after
head injury. It does not take place of an in-depth neurologic assessment.
b. Eye (4): spontaneous (4), sound (3), pressure (2), none (1)
c. Response (5): oriented (5), confused (4), inappropriate words (3),
incomprehensible sounds (2), no response (1)
d. Motor (6): obeys (6), moves to localized pain (5), flexion withdrawal from pain
(4), decorticate (3), decerebrate (2), none (1)
e. 15 max, 8 or less = coma, 3 = unresponsive; 5 = brain death
what are AVM/aneurysms caused by, cm, and treatment for them? -Correct Answer ✔a.
cause: cocaine use
b. cm: severe generalized headache
c. tx: reverse anticoagulant is necessary= heparin (protamine sulfate)
Warfarin (vitamin k) antihypertensives
what is a common cause for brain abscesses? -Correct Answer ✔frequent ear or sinus
infections
CSF leak increases to 50-100, should this be reported? -Correct Answer ✔a. if patient
reports postnasal drainage or salty taste = call PCP
b. any changes of above 20mmHg in BP is significant = call PCP
c. post craniotomy 3 days, periorbital edema is expected; PaO2 of 72 is
expected
NSG 4100
NSG-4100 Final Review Questions with Correct
Detailed Answers Updated 2025
what are some causes for head injuries? -Correct Answer ✔Sports
MVCs
Men are more at risk
What is the best action for obtaining an informed consent for an emergency craniotomy
for a pt brought by EMS? -Correct Answer ✔transport the victim to the operating room
for surgery
What is a clinical manifestation of a brain herniation/ increased ICP? -Correct Answer
✔abnormal pupil response - dilate or nonreactive; normal pupil size is 2-4mm
Pt has a brain injury and possible hemorrhage, what needs to be notified to PCP? -
Correct Answer ✔-new onset restlessness is a priority
-pt is at home, spouse notices pupil response, slurred speech - take them to
hospital
what is a nursing intervention for a patient with a closed head injury to decrease ICP? -
Correct Answer ✔- they will have an increased ICP so you want to elevate the HOB in a
neutral
position to 30 degrees to reduce the pressure.
- do constant neuro checks
- no flexion of neck or hips (it increases abdominal pressure = increased bp =
increased ICP)
- no Valsalva maneuvers (stool softeners, high fiber)
when moving in bed, exhale (opens your glottis to prevent Valsalva maneuver)
-Normal ICP: 5-15mmHg
-control fever
- use dobutamine (Dobutrex)
- norepinephrine (Levophed)
- drain the CSF
- restrict fluids
- reduce cellular metabolic demands
- give humidified oxygen
- monitor ABG
- suction only when needed
-space nursing care = ICP should not go above 25 and should return to baseline
within 5 minutes
- reduce stimulation: turn off the lights, tell pt it can't be too loud, seizure
precautions
An unconscious patient comes into the ER with bruising behind the ears, over mastoid
NSG 4100
, NSG 4100
bone, what do you suspect they had? -Correct Answer ✔a. patient is suspected to have
a head trauma because of the battle signs from
CSF leaking
b. cm: halo, clear pink-tinged coming from ears, nose, salty taste in back of
their mouth
c. if you have increased drainage, there is a leak somewhere which needs to be
reported; test for glucose
if a patient has increased urine output after a head injury, what can you suspect they
have
and what should you do? -Correct Answer ✔a. monitor for diabetes insipidus (DI)
normal is 30ml/hr
b. notify the doctor
c. insert a foley, monitor I/Os
what is normal to see when doing a head-to-toe assessment on a patient with a TBI? -
Correct Answer ✔- bruising and swelling
If a patient with a head injury is now having doll eyes, what should the nurse do? -
Correct Answer ✔call the doctor because their neurologic status is getting worse
Glasco Coma Scale (GCS) question -Correct Answer ✔a. Use for monitoring changes
during the acute phase the first few days after
head injury. It does not take place of an in-depth neurologic assessment.
b. Eye (4): spontaneous (4), sound (3), pressure (2), none (1)
c. Response (5): oriented (5), confused (4), inappropriate words (3),
incomprehensible sounds (2), no response (1)
d. Motor (6): obeys (6), moves to localized pain (5), flexion withdrawal from pain
(4), decorticate (3), decerebrate (2), none (1)
e. 15 max, 8 or less = coma, 3 = unresponsive; 5 = brain death
what are AVM/aneurysms caused by, cm, and treatment for them? -Correct Answer ✔a.
cause: cocaine use
b. cm: severe generalized headache
c. tx: reverse anticoagulant is necessary= heparin (protamine sulfate)
Warfarin (vitamin k) antihypertensives
what is a common cause for brain abscesses? -Correct Answer ✔frequent ear or sinus
infections
CSF leak increases to 50-100, should this be reported? -Correct Answer ✔a. if patient
reports postnasal drainage or salty taste = call PCP
b. any changes of above 20mmHg in BP is significant = call PCP
c. post craniotomy 3 days, periorbital edema is expected; PaO2 of 72 is
expected
NSG 4100
