NURS 418 - INCREASED INTRACRANIAL PRESSURE UPDATED EXAM
WITH MOST TESTED QUESTIONS AND ANSWERS | GRADED A+ |
ASSURED SUCCESS WITH DETAILED RATIONALES
1) The skull is an enclosed space with what three essential volume components?
A. Brain tissue, arterial blood, lymph
B. Brain tissue, blood, cerebrospinal fluid (CSF)
C. CSF, lymph, brainstem
D. Blood, skull bone, meninges
Rationale: ICP is determined by the volumes of brain tissue, blood, and CSF within a fixed
cranial vault.
2) The primary injury phase of brain injury occurs:
A. Days after injury due to edema
B. Hours after injury due to infection
C. Immediately at the time of injury (impact/trauma)
D. Only after hypotension develops
Rationale: Primary injury is the initial mechanical damage occurring at the moment of insult.
3) Primary brain injury results in which direct effect?
A. SIADH and diabetes insipidus
B. Hypoxia from airway compromise
C. Displacement, bruising, or structural brain damage
D. Increased cytokine release days later
Rationale: Primary injury reflects direct tissue disruption (fibers, nerves, vessels) from trauma.
4) The secondary injury phase of brain injury is best described as:
A. Only the bleeding that occurs during impact
B. Hypoxia, ischemia, hypotension, edema, or increased ICP that follows primary injury
C. A protective compensatory mechanism
D. Limited to skull fractures
,ESTUDYR
Rationale: Secondary injury is the physiologic cascade after the initial insult, worsening
outcomes.
5) Secondary injury is primarily related to:
A. Bone remodeling
B. Metabolic and physiologic processes initiated by ischemia
C. Long-term rehabilitation response
D. Hypercalcemia from immobility
Rationale: Secondary injury involves cellular metabolic failure, inflammation, and ischemic
processes.
6) Intracranial pressure (ICP) is:
A. The pressure inside cerebral arteries only
B. The pressure inside the dura mater only
C. The hydrostatic force measured in the brain CSF compartment
D. The same as mean arterial pressure (MAP)
Rationale: ICP is typically referenced to the CSF space and reflects pressure within the cranial
vault.
7) Which factor influences ICP under normal conditions?
A. Serum potassium
B. Hemoglobin A1c
C. Blood gases, especially CO₂
D. Skin temperature only
Rationale: CO₂ strongly affects cerebral vessel diameter, changing cerebral blood volume and
ICP.
8) Blood gases influence ICP most significantly through changes in:
A. O₂ saturation
B. Hematocrit
C. Nitrogen levels
, ESTUDYR
D. CO₂
Rationale: CO₂ is a potent vasodilator; increased CO₂ increases cerebral blood flow → increases
ICP.
9) Why can increased temperature (fever) increase ICP?
A. Fever causes cerebral vasoconstriction
B. Fever decreases cerebral blood flow
C. Fever causes vasodilation, increasing cerebral blood flow and ICP
D. Fever eliminates autoregulation
Rationale: Fever increases metabolic demand and often promotes vasodilation, increasing
cerebral blood volume.
10) Why can increased CO₂ increase ICP?
A. CO₂ causes vasoconstriction, decreasing venous return
B. CO₂ decreases cerebral blood flow
C. CO₂ is a powerful vasodilator, increasing cerebral blood flow and ICP
D. CO₂ decreases CSF production
Rationale: Hypercapnia → vasodilation → increased intracranial blood volume → increased
ICP.
11) Normal ICP is:
A. 0–5 mmHg
B. 5–15 mmHg
C. 15–25 mmHg
D. 25–40 mmHg
Rationale: Normal ICP is typically 5–15 mmHg in adults.
12) An ICP sustained above what value diminishes CPP?
A. 10 mmHg
B. 15 mmHg
C. 20 mmHg