EXAMINATION TEST 2026 COMPLETE
QUESTIONS WITH SOLUTIONS GRADED A+
⩥ What does Cushing's triad indicate? Answer: Increased ICP; includes
elevated BP, bradycardia, irregular respirations.
⩥ What does a clear fluid after head trauma suggest? Answer: CSF; test,
then notify provider.
⩥ What is the recommended position to optimize venous drainage and
decrease ICP? Answer: HOB 30-45° and neck straight.
⩥ What is the effect of straining or coughing on ICP? Answer: It
increases ICP and should be avoided.
⩥ What is the risk of stopping anticonvulsants abruptly? Answer: It can
lead to seizures.
⩥ What is the importance of logging headaches and triggers? Answer: It
supports evaluation and treatment planning.
,⩥ What is a common symptom of autonomic neuropathy? Answer:
Constipation, BP changes, sweating, GI issues.
⩥ What should be done to prevent aspiration in clients with dysphagia?
Answer: Chin-tuck, upright position, small bites, no straws.
⩥ What is the role of PT/OT after TBI? Answer: Help regain strength
and ADL independence.
⩥ What does new unequal pupils after TBI indicate? Answer: Possible
herniation; highest priority.
⩥ What should be monitored closely when using hypertonic saline?
Answer: Fluid and sodium levels.
⩥ What is the effect of elevated BP and bradycardia? Answer: It
indicates Cushing's triad.
⩥ What is the significance of daily foot inspection in clients with
decreased sensation? Answer: It reduces ulcer risk.
⩥ What is the recommended action for clients needing help with ADLs?
Answer: Provide assistance to address self-care deficit.
, ⩥ What is the best practice for clients with Parkinson disease regarding
routine care? Answer: Stable clients may be assigned to LPN; unstable
clients stay with RN.
⩥ Which assessment finding is most concerning for deterioration in a
client with a suspected traumatic brain injury? Answer: Increasing
drowsiness and one pupil larger than the other
⩥ What is the nurse's priority action when a client with a TBI has a
Glasgow Coma Scale score that decreased from 12 to 9? Answer: Notify
the provider immediately
⩥ Which change requires immediate intervention in a client with
cerebral edema after a head injury? Answer: New onset vomiting and
worsening headache
⩥ Which positioning is most appropriate for a client with increased
intracranial pressure? Answer: HOB 30° with head midline
⩥ What is an early sign of increased intracranial pressure? Answer:
Confusion and restlessness
⩥ What does the sudden development of systolic hypertension,
bradycardia, and irregular respirations indicate in a client with suspected
increased ICP? Answer: Cushing's triad