NR 325 Exam 2 – Questions With Appropriate
Solutions
Normal intracranial pressurev (ICP) Correct Answer - 5-15
mm Hg, if it's greater than 20 it's elevated.
Normal Cerebral Perfusion pressure (CPP) Correct Answer -
60-100 mm Hg
Decerebrate Correct Answer - "e"; arms and legs held straight
out, toes pointed downward, head and neck being arched backward,
muscles tightened and held rigidly.
Decorticate Correct Answer - "c"; stiff with bent arms,
clenched fists, legs held out straight, arms bent in toward the body,
wrists and fingers are bent and held on the chest.
CM of increased intracranial pressure Correct Answer -
Change in LOC, lethargy, headache, aphasia, seizures, Cushing's
triage, ocular signs, unilateral pupil dilation, projectile vomiting
without nausea, decerebrate posturing.
Cushing's triage Correct Answer - Increased BP, Decreased HR,
Decreased respirations
Encephalitis Correct Answer - Acute inflammation of the brain
and spinal coed; caused by a virus and can be FATAL
CM: fever, headache, seizures, rigidity, altered LOC, agitation,
lethargy, photosensitivity, N/V
Brain abscess Correct Answer - Pus in the brain tissue
, CM: headache, lethargy, drowsiness, confusion, depressed, infection
ALS (Lou Gehrig's Disease) Correct Answer - Progressive
degenerative neurological disease with muscle weakness and there
is no cure.
Respiratory insufficiency (airway is a priority), safety, diversional
activities, death from pneumonia, suction at bedside, upright to eat
and 30 min. after, semisolid foods or NG tube feedings.
Bell's palsy Correct Answer - Acute peripheral facial paralysis
central or peripheral in origin; inflammation of the CN VII on one
side of the face in absence of another disease; accompanied by
herpes vesicles in/around the ears.
CM: drooping of the mouth, inability to close eye, loss of extensive
tearing due to lacrimal muscle weakness.
Surgery may be needed
Meningitis Correct Answer - Inflammation of the brain
covering.
Check the CSF, positive Kernig's and Brudzinski signs, put patient in
a dark room, get a family member to stay at the bedside since the
patient is confused, bedrest.
Hepatitis A Correct Answer - Vaccine, will resolve itself,
incidence decreased with vaccine, fecal oral route through
contaminated food or drinking water.
Hepatitis B Correct Answer - Vaccine, transmitted through
mucosal exposure to infectious blood, blood products, body fluids.
Solutions
Normal intracranial pressurev (ICP) Correct Answer - 5-15
mm Hg, if it's greater than 20 it's elevated.
Normal Cerebral Perfusion pressure (CPP) Correct Answer -
60-100 mm Hg
Decerebrate Correct Answer - "e"; arms and legs held straight
out, toes pointed downward, head and neck being arched backward,
muscles tightened and held rigidly.
Decorticate Correct Answer - "c"; stiff with bent arms,
clenched fists, legs held out straight, arms bent in toward the body,
wrists and fingers are bent and held on the chest.
CM of increased intracranial pressure Correct Answer -
Change in LOC, lethargy, headache, aphasia, seizures, Cushing's
triage, ocular signs, unilateral pupil dilation, projectile vomiting
without nausea, decerebrate posturing.
Cushing's triage Correct Answer - Increased BP, Decreased HR,
Decreased respirations
Encephalitis Correct Answer - Acute inflammation of the brain
and spinal coed; caused by a virus and can be FATAL
CM: fever, headache, seizures, rigidity, altered LOC, agitation,
lethargy, photosensitivity, N/V
Brain abscess Correct Answer - Pus in the brain tissue
, CM: headache, lethargy, drowsiness, confusion, depressed, infection
ALS (Lou Gehrig's Disease) Correct Answer - Progressive
degenerative neurological disease with muscle weakness and there
is no cure.
Respiratory insufficiency (airway is a priority), safety, diversional
activities, death from pneumonia, suction at bedside, upright to eat
and 30 min. after, semisolid foods or NG tube feedings.
Bell's palsy Correct Answer - Acute peripheral facial paralysis
central or peripheral in origin; inflammation of the CN VII on one
side of the face in absence of another disease; accompanied by
herpes vesicles in/around the ears.
CM: drooping of the mouth, inability to close eye, loss of extensive
tearing due to lacrimal muscle weakness.
Surgery may be needed
Meningitis Correct Answer - Inflammation of the brain
covering.
Check the CSF, positive Kernig's and Brudzinski signs, put patient in
a dark room, get a family member to stay at the bedside since the
patient is confused, bedrest.
Hepatitis A Correct Answer - Vaccine, will resolve itself,
incidence decreased with vaccine, fecal oral route through
contaminated food or drinking water.
Hepatitis B Correct Answer - Vaccine, transmitted through
mucosal exposure to infectious blood, blood products, body fluids.
