NURS 350 EXAM 3 UPDATED ACTUAL
Exam Questions and CORRECT Answers
what are the high risk groups for head injury and the most common cause of head injury? -
CORRECT ANSWER - -males have highest incidence in every age group
-most common causes are falls for children/elderly followed by unintentional blunt trauma and
motor vehicle accidents
distinguish between coup and contrecoup - CORRECT ANSWER - Coup: injury at site of
impact
Contrecoup: injury from brain rebounding and hitting opposite side of skull
-both are blunt focal primary brain injuries
what is a primary head injury? - CORRECT ANSWER - -direct impact/injury
-can be focal or diffuse
-examples: scalp laceration, skull fracture, hemorrhage (subdural hematoma), concussion
what is a secondary head injury? - CORRECT ANSWER - -indirect consequence of
primary injury (including trauma and stroke symptoms)
-includes cascade of cellular and molecular brain events as well as systemic responses
-brain damage develops hours to days later
-brain hypoperfusion, ischemia
-treatment: removal of hematoma and management of symptoms
-examples: hypoxia, hypotension, cerebral edema, increased ICP
what is a tertiary head injury? - CORRECT ANSWER - injuries that arise as a result of the
care or interventions provided to the TBI pt. interventions that worsen the outcome.
what is the difference between focal and diffuse axonal injury in TBI? - CORRECT
ANSWER - focal: affects 1 area of the brain. specific with grossly observable brain
,lesions. force of impact typically produces contusions (blood leaks from injured vessel and
causes bruising on brain), smaller area of impact = greater severity of injury
diffuse: affects 2+ areas of the brain. rotational and twisting damage. acceleration-deceleration
forces. shearing/stretching of nerve fibers. severity corresponds to amount of shearing force
applied to brain.
what is the difference between blunt and open injuries? - CORRECT ANSWER - closed
(blunt): head strikes hard surface or rapidly moving object strikes head, dura remains intact and
brain tissues are not exposed to the environment, causes focal or diffuse brain injuries, more
common than open trauma injuries
Open (penetrating trauma): injury breaks dura and exposes cranial contents to the environment,
causes primarily focal injuries
what is a CVA and what are the 3 main types? - CORRECT ANSWER - -sudden, non-
convulsive focal neurological deficit
-effects can range from minimal to death
3 types: ischemic (thrombotic, embolic), hemorrhagic, cryptogenic
What is a TIA (transient ischemic attack)? - CORRECT ANSWER - CVA where
neurologic deficits are not permanent
what is a stroke-in-evolution? - CORRECT ANSWER - deterioration of neurological
deficits that occur hours-days after initial presentation
what is a completed stroke? - CORRECT ANSWER - a stroke where the neurological
symptoms have stabilized and remain for more than 24 hours
what is a cerebral infarction? - CORRECT ANSWER - -ischemic stroke
-thrombotic: arterial occlusions caused by thrombi formed in arteries that supply brain or in
intracranial vessels
-embolic: fragments break from a thrombus (clot) that is formed outside of the brain
-treatment: thrombolysis, antiplatelet, anticoagulants, aspirin
, what is a cerebral hemorrhage? - CORRECT ANSWER - -spontaneous bleeding into the
brain
-hypertension is major risk factor
-clinical manifestations: focal neurological deficits, altered consciousness, headache
-treatment must be initiated within 3-4 hours of symptom onset
what is an intracranial aneurysm? - CORRECT ANSWER - -weak bulging area of arterial
vessel wall
-most located at bifurcations in or near circle of willis
-clinical manifestations: frequently asymptomatic, cranial nerves 3, 4, 5, 6 affected
-treatment: control hypertension, surgery may be needed
what are the different classifications of intracranial aneurysms? - CORRECT ANSWER -
saccular (berry): congenital abnormality and degenerative changes
fusiform (giant): diffuse arteriosclerotic changes
mycotic: arteritis caused by bacterial emboli
traumatic (dissecting)
what is an AV malformation? - CORRECT ANSWER - -arteriovenous malformation (rare
congenital vascular lesions)
-arteries feed directly into veins through vascular tangle of malformed vessels
-chronic nondescript headache is characteristic of malformation
-seizures possible
-may suffer intracerebral, subarachnoid, or subdural hemorrhage
-treatment includes direct surgical excision, endovascular embolization, or radiotherapy
what is a subarachnoid hemorrhage? - CORRECT ANSWER - -blood escapes from
defective/injured vasculature into subarachnoid space
Exam Questions and CORRECT Answers
what are the high risk groups for head injury and the most common cause of head injury? -
CORRECT ANSWER - -males have highest incidence in every age group
-most common causes are falls for children/elderly followed by unintentional blunt trauma and
motor vehicle accidents
distinguish between coup and contrecoup - CORRECT ANSWER - Coup: injury at site of
impact
Contrecoup: injury from brain rebounding and hitting opposite side of skull
-both are blunt focal primary brain injuries
what is a primary head injury? - CORRECT ANSWER - -direct impact/injury
-can be focal or diffuse
-examples: scalp laceration, skull fracture, hemorrhage (subdural hematoma), concussion
what is a secondary head injury? - CORRECT ANSWER - -indirect consequence of
primary injury (including trauma and stroke symptoms)
-includes cascade of cellular and molecular brain events as well as systemic responses
-brain damage develops hours to days later
-brain hypoperfusion, ischemia
-treatment: removal of hematoma and management of symptoms
-examples: hypoxia, hypotension, cerebral edema, increased ICP
what is a tertiary head injury? - CORRECT ANSWER - injuries that arise as a result of the
care or interventions provided to the TBI pt. interventions that worsen the outcome.
what is the difference between focal and diffuse axonal injury in TBI? - CORRECT
ANSWER - focal: affects 1 area of the brain. specific with grossly observable brain
,lesions. force of impact typically produces contusions (blood leaks from injured vessel and
causes bruising on brain), smaller area of impact = greater severity of injury
diffuse: affects 2+ areas of the brain. rotational and twisting damage. acceleration-deceleration
forces. shearing/stretching of nerve fibers. severity corresponds to amount of shearing force
applied to brain.
what is the difference between blunt and open injuries? - CORRECT ANSWER - closed
(blunt): head strikes hard surface or rapidly moving object strikes head, dura remains intact and
brain tissues are not exposed to the environment, causes focal or diffuse brain injuries, more
common than open trauma injuries
Open (penetrating trauma): injury breaks dura and exposes cranial contents to the environment,
causes primarily focal injuries
what is a CVA and what are the 3 main types? - CORRECT ANSWER - -sudden, non-
convulsive focal neurological deficit
-effects can range from minimal to death
3 types: ischemic (thrombotic, embolic), hemorrhagic, cryptogenic
What is a TIA (transient ischemic attack)? - CORRECT ANSWER - CVA where
neurologic deficits are not permanent
what is a stroke-in-evolution? - CORRECT ANSWER - deterioration of neurological
deficits that occur hours-days after initial presentation
what is a completed stroke? - CORRECT ANSWER - a stroke where the neurological
symptoms have stabilized and remain for more than 24 hours
what is a cerebral infarction? - CORRECT ANSWER - -ischemic stroke
-thrombotic: arterial occlusions caused by thrombi formed in arteries that supply brain or in
intracranial vessels
-embolic: fragments break from a thrombus (clot) that is formed outside of the brain
-treatment: thrombolysis, antiplatelet, anticoagulants, aspirin
, what is a cerebral hemorrhage? - CORRECT ANSWER - -spontaneous bleeding into the
brain
-hypertension is major risk factor
-clinical manifestations: focal neurological deficits, altered consciousness, headache
-treatment must be initiated within 3-4 hours of symptom onset
what is an intracranial aneurysm? - CORRECT ANSWER - -weak bulging area of arterial
vessel wall
-most located at bifurcations in or near circle of willis
-clinical manifestations: frequently asymptomatic, cranial nerves 3, 4, 5, 6 affected
-treatment: control hypertension, surgery may be needed
what are the different classifications of intracranial aneurysms? - CORRECT ANSWER -
saccular (berry): congenital abnormality and degenerative changes
fusiform (giant): diffuse arteriosclerotic changes
mycotic: arteritis caused by bacterial emboli
traumatic (dissecting)
what is an AV malformation? - CORRECT ANSWER - -arteriovenous malformation (rare
congenital vascular lesions)
-arteries feed directly into veins through vascular tangle of malformed vessels
-chronic nondescript headache is characteristic of malformation
-seizures possible
-may suffer intracerebral, subarachnoid, or subdural hemorrhage
-treatment includes direct surgical excision, endovascular embolization, or radiotherapy
what is a subarachnoid hemorrhage? - CORRECT ANSWER - -blood escapes from
defective/injured vasculature into subarachnoid space
