NURS 400 Exam 3 Questions with Complete Solutions
What is hydrocephalus? Correct Answer-Hydrocephalus is the excessive
accumulation of CSF that increases intracranial pressure.
-Blockage in flow of CSF through ventricles of brain or when cannot be
absorbed by arachnoid villi.
What types of substances are able to directly cross the blood-brain
barrier? Correct Answer-Lipophilic substances are able to cross the
blood-brain barrier directly and enter the brain.
*Water crosses membrane by simple diffusion. Most nutrients cross
blood brain barrier by facilitated diffusion.
Cerebral Autoregulation Correct Answer-Autoregulatory mechanisms
fail: Loss of match between oxygen supply and demand of tissues.
Intracranial pressure: Pressure exerted by brain tissue, blood, and
cerebrospinal fluid (the contents of the cranium).
Monro-Kellie hypothesis Correct Answer-If the volume of one
component of intracranial pressure increases slightly, it is offset by
reduction in volume of the other two.
What are the risk factors for TIA/ stroke? Correct Answer-
Nonmodifiable risk factors:
-Age, family history, prior TIA/stroke, race, sex, sickle cell disease.
Modifiable risk factors:
,-CV disease, diabetes, excess weight, hypertension, hyperlipidemia,
smoking, heavy drinking, physical inactivity, poor nutrition, birth
control.
What are the manifestations of a TIA? Correct Answer-Clinical
manifestations: Facial drooping, arm or leg weakness on one side of
body, speech difficulty, sudden trouble seeing in one or both eyes,
difficult walking with dizziness, lack of balance or coordination, severe
headache.
Treatment of TIA Correct Answer-Diagnosis and treatment- Seek
Urgent Medical Attention
- Exclusion of conditions that mimic TIA
- Blood glucose and other blood tests
- Electrocardiography
- Noncontrast CT
- MRI with diffusion-weighted imaging
- CT angiography or magnetic resonance angiography
- Carotid Doppler
What are causes of Ischemic Stroke? Correct Answer--Partial or
complete occlusion of cerebral blood flow due to thrombus or embolus.
Most embolisms are of cardiac origin: Atherosclerosis, A-fib, Breakage
of atherosclerotic plaque form carotid artery.
,What is the most common location for a ischemic stroke? Correct
Answer-Middle cerebral artery
Interventions for Embolic stroke and Determining Timing and
Appropriateness if use. Correct Answer-Treatment of ischemic stroke.
Restoration of blood flow and reducing area of infarction.
Penumbra: tissue surrounding infarction
Know when the symptoms started
-Supplemental oxygen
-Glycemic control
Fibrinolytic control
-Antihypertensive therapy
-Aspirin 325 mg
-Hypothermia
What are cause of hemorrhagic stroke? Correct Answer--
Thrombocytosis
- Sickle cell disease
- Hypercoagulable states- Medication
What are the treatment/ Interventions for hemorrhagic stroke? Correct
Answer-- Priority of care depends on adequate ventilation and
management of blood pressure.
Reverse Medications
- Osmotic diuretics decrease intracranial pressure
, - Glucose is monitored and normoglycemia maintained.
- Surgical treatment.
Cerebral Edema: Correct Answer-Delayed cerebral ischemia (DCI):
Clinical syndrome of focal neurological deficits, cognitive deficits, or
both:
-Most important cause of morbidity and mortality in survivors
aneurysmal subarachnoid hemorrhage.
-Occurs in about 30% of patients in the first two weeks following
hemorrhage.
-Brain injury in first 72 hours leads to spontaneous waves of cerebral
tissue depolarization and profound hypoperfusion of the cortex.
-Coagulation cascade activation impairs fibrinolytic cascade and causes
microthrombosis
A subdural hematoma of blood between which two membranes? Correct
Answer-A subdural hematoma is an accumulation of blood between the
dura matter and arachnoid membrane.
Manifestations of spinal cord hemorrhages? Correct Answer-Patient's
typically present with sudden, severe, localized back pain.
Intramedullary, epidural, and subdural symptoms.
-hemiparesis, paraparesis, quadriparesis, sensory loss below lesion, loss
of sphincter control.
-Subarachnoid symptoms: Headache, neck stiffness, and
photosensitivity.
What is hydrocephalus? Correct Answer-Hydrocephalus is the excessive
accumulation of CSF that increases intracranial pressure.
-Blockage in flow of CSF through ventricles of brain or when cannot be
absorbed by arachnoid villi.
What types of substances are able to directly cross the blood-brain
barrier? Correct Answer-Lipophilic substances are able to cross the
blood-brain barrier directly and enter the brain.
*Water crosses membrane by simple diffusion. Most nutrients cross
blood brain barrier by facilitated diffusion.
Cerebral Autoregulation Correct Answer-Autoregulatory mechanisms
fail: Loss of match between oxygen supply and demand of tissues.
Intracranial pressure: Pressure exerted by brain tissue, blood, and
cerebrospinal fluid (the contents of the cranium).
Monro-Kellie hypothesis Correct Answer-If the volume of one
component of intracranial pressure increases slightly, it is offset by
reduction in volume of the other two.
What are the risk factors for TIA/ stroke? Correct Answer-
Nonmodifiable risk factors:
-Age, family history, prior TIA/stroke, race, sex, sickle cell disease.
Modifiable risk factors:
,-CV disease, diabetes, excess weight, hypertension, hyperlipidemia,
smoking, heavy drinking, physical inactivity, poor nutrition, birth
control.
What are the manifestations of a TIA? Correct Answer-Clinical
manifestations: Facial drooping, arm or leg weakness on one side of
body, speech difficulty, sudden trouble seeing in one or both eyes,
difficult walking with dizziness, lack of balance or coordination, severe
headache.
Treatment of TIA Correct Answer-Diagnosis and treatment- Seek
Urgent Medical Attention
- Exclusion of conditions that mimic TIA
- Blood glucose and other blood tests
- Electrocardiography
- Noncontrast CT
- MRI with diffusion-weighted imaging
- CT angiography or magnetic resonance angiography
- Carotid Doppler
What are causes of Ischemic Stroke? Correct Answer--Partial or
complete occlusion of cerebral blood flow due to thrombus or embolus.
Most embolisms are of cardiac origin: Atherosclerosis, A-fib, Breakage
of atherosclerotic plaque form carotid artery.
,What is the most common location for a ischemic stroke? Correct
Answer-Middle cerebral artery
Interventions for Embolic stroke and Determining Timing and
Appropriateness if use. Correct Answer-Treatment of ischemic stroke.
Restoration of blood flow and reducing area of infarction.
Penumbra: tissue surrounding infarction
Know when the symptoms started
-Supplemental oxygen
-Glycemic control
Fibrinolytic control
-Antihypertensive therapy
-Aspirin 325 mg
-Hypothermia
What are cause of hemorrhagic stroke? Correct Answer--
Thrombocytosis
- Sickle cell disease
- Hypercoagulable states- Medication
What are the treatment/ Interventions for hemorrhagic stroke? Correct
Answer-- Priority of care depends on adequate ventilation and
management of blood pressure.
Reverse Medications
- Osmotic diuretics decrease intracranial pressure
, - Glucose is monitored and normoglycemia maintained.
- Surgical treatment.
Cerebral Edema: Correct Answer-Delayed cerebral ischemia (DCI):
Clinical syndrome of focal neurological deficits, cognitive deficits, or
both:
-Most important cause of morbidity and mortality in survivors
aneurysmal subarachnoid hemorrhage.
-Occurs in about 30% of patients in the first two weeks following
hemorrhage.
-Brain injury in first 72 hours leads to spontaneous waves of cerebral
tissue depolarization and profound hypoperfusion of the cortex.
-Coagulation cascade activation impairs fibrinolytic cascade and causes
microthrombosis
A subdural hematoma of blood between which two membranes? Correct
Answer-A subdural hematoma is an accumulation of blood between the
dura matter and arachnoid membrane.
Manifestations of spinal cord hemorrhages? Correct Answer-Patient's
typically present with sudden, severe, localized back pain.
Intramedullary, epidural, and subdural symptoms.
-hemiparesis, paraparesis, quadriparesis, sensory loss below lesion, loss
of sphincter control.
-Subarachnoid symptoms: Headache, neck stiffness, and
photosensitivity.
