NUR 376 Week 3 Module 3A Study Guide
| Applied Pathophysiology
1. Intracranial pressure (ICP) is defined as the balance between the pressure of:
A. Brain tissue and blood only
B. Blood pressure and CSF
C. Brain tissue, blood, and cerebrospinal fluid (CSF)
D. Neurons and glial cells
Rationale: ICP reflects the pressure exerted by all three intracranial components. A change in
one affects the others.
2. Normal ICP in adults is:
A. 0–5 mm Hg
B. 5–15 mm Hg
C. 15–25 mm Hg
D. 25–35 mm Hg
Rationale: Sustained ICP above 20 mm Hg is pathologic.
3. The Monroe–Kellie hypothesis states that:
A. Blood pressure controls ICP
B. CSF is the main determinant of ICP
C. An increase in one intracranial component is compensated by a decrease in another
D. Brain tissue volume is fixed
Rationale: Compensation initially prevents ICP rise but eventually fails.
4. Early pathophysiologic effect of increased ICP is:
A. Brainstem herniation
B. Compression of cerebral blood vessels causing hypoxia
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C. Irreversible neuronal death
D. Seizure activity
Rationale: Reduced cerebral perfusion is the earliest consequence.
5. The earliest clinical sign of increased ICP is:
A. Vomiting without nausea
B. Headache
C. Change in level of consciousness (LOC)
D. Dilated pupils
Rationale: LOC changes occur before motor or pupillary changes.
6. Sudden projectile vomiting without nausea occurs due to pressure on the:
A. Hypothalamus
B. Cerebellum
C. Medulla oblongata
D. Temporal lobe
Rationale: The vomiting center is located in the medulla.
7. Cushing’s triad includes:
A. Hypotension, tachycardia, tachypnea
B. Hypertension (wide pulse pressure), bradycardia, bradypnea
C. Fever, headache, vomiting
D. Seizures, coma, hypoxia
Rationale: Indicates late, life-threatening ICP with brainstem compression.
8. Fixed and dilated pupils in increased ICP indicate compression of which nerve?
A. CN II (optic)
B. CN IV (trochlear)
C. CN III (oculomotor)
D. CN VI (abducens)