NUR 240 exam 1 review UPDATED ACTUAL Questions and
CORRECT Answers
brain death:
brain death- *Absent cerebral and brainstem function associated with a unsurvivable head
injury or metabolic injury
*Brain death is determined based on neurological criteria, not when the heart
stops beating (circulatory death)
determining brain death- *Exam completed by neurologist or neurosurgeon
1. Establish irreversible coma and cause of coma
2. Achieve normal core temp
3. Achieve normal systolic blood pressure
4. Perform neurologic examination
diagnostic tests for brain death- *EEG
*Cerebral angiogram or radionuclide cerebral perfusion scan
radionuclide cerebral perfusion scanning- scan that shows what's perfusing to the brain
cerebral angiogram- x-ray of blood vessels in the brain after intracarotid injection of contrast medium
electroenchephalography (EEG)- recording of the electrical activity of the brain
,brain death diagnosis- Made in the ABSENCE of...
*Hypothermia (temperature < 32.2 C or 89.6 F)
-Have to have a normal core temp
*CNS depressants
-Can't have in their system
*Hypotension
-Have to free of hypotension; needs to be normal
*Metabolic disturbances
clinical evaluation for brain death- *Patient lacks all evidence of responsiveness
*Noxious stimuli should not produce a motor response other than spinally
mediated reflexes
-They don't come from the brainstem; occur after declared brain dead
-Kinda like a muscle spasm
*Absence of corneal reflexes
*Absence of pharyngeal or gag reflexes
*Absence of breathing drive
*Positive for flat EEG (if performed)
*Positive for absence of cerebral blood flow
potential cofounding factors affecting brain death *High cervical spinal cord injury
testing- *Complex spinal reflex movements
*Muscle fasciculations
-Muscle spasms after brain death
*Ventilator auto-triggering
*Targeted temperature management
organ donation:
standard criteria donor- *under 50 years old
*declared dead from traumatic injuries or stroke
organs donated- liver, kidneys, pancreas, intestine, heart, lungs, tissue
deceased after circulatory death- *donation after withdrawal of life-sustaining therapy
*patient must become asystolic within a prescribed period following withdrawal
of controlled ventilation and vasoactive meds
organs donated- kidney, liver, lung
deceased, heart beating donors- *declared brain dead because of nonsurviveble head injuries or neurological
events such as prolonged cardiopulmonary arrest, severe stroke, or intracranial
hemorrhage
organs donated- kidney, pancreas, liver, intestine, heart, lung, abdominal wall,
face, penis, uterus, upper limb
living donor- *organ or part of an organ if offered by a healthy individual to a patient with end-
organ disease
*may be related or not
organs donated- kidney, one or two lobes of the liver, a lung or part of a lung,
part of pancreas, part of intestine
, non directed/altruistic living donor- *an individual who donates an organ or part of an organ to a stranger
organs donated- kidney (most common), liver lobe (rare)
increased risk donor- *Decision to transplant an increased-risk donor organ is based on the critical state
of the recipient in whom the risk of not transplanting an organ is greater than the
risk of disease transmission from a donor.
*Patient and family must consent to accept an increased-risk donor
organs donated- heart, lung, kidney, pancreas, liver, islet cells, small bowel,
stomach, uterus, face, appendages, skin
CDC defines increased risk donors as- • People who have had sex with a person known to have HIV, HBV, or HCV in the
preceding 12 months
• Men who have had sex with men in the preceding 12 months
• Women who have had sex with a man who had sex with men in the
preceding 12 months
• People who have had sex in exchange for money in the preceding 12 months
• People who have had sex with a person who has injected drugs by IV,
intramuscular, or subcutaneous route for nonmedical reasons in the preceding 12
months
• A child who is ≤18 months of age, born to a mother known to be infected with or
at increased risk for HIV. HBV, or HCV
• A child who has been breastfed within the preceding 12 months whose mother is
known to be infected with or at increased risk for HIV
• People who have injected drugs by IV, intramuscular, or subcutaneous
route for nonmedical reasons in the preceding 12 months
• People who have been in lockup, jail, prison, or a juvenile correctional
facility for more than 72 hours in the preceding 12 months
• People who have been newly diagnosed with or have been treated for
syphilis, gonorrhea, Chlamydia, or genital ulcers in the preceding 12 months
• People who test positive for Epstein-Barr virus (EBV), cytomegalovirus (CMV), or
toxoplasmosis
• People who have been on hemodialysis in the preceding 12 months
• Donor at increased risk for HIV., HBV, or HCV infection when medical and
behavioral history cannot be obtained or risk factors cannot be determined
CORRECT Answers
brain death:
brain death- *Absent cerebral and brainstem function associated with a unsurvivable head
injury or metabolic injury
*Brain death is determined based on neurological criteria, not when the heart
stops beating (circulatory death)
determining brain death- *Exam completed by neurologist or neurosurgeon
1. Establish irreversible coma and cause of coma
2. Achieve normal core temp
3. Achieve normal systolic blood pressure
4. Perform neurologic examination
diagnostic tests for brain death- *EEG
*Cerebral angiogram or radionuclide cerebral perfusion scan
radionuclide cerebral perfusion scanning- scan that shows what's perfusing to the brain
cerebral angiogram- x-ray of blood vessels in the brain after intracarotid injection of contrast medium
electroenchephalography (EEG)- recording of the electrical activity of the brain
,brain death diagnosis- Made in the ABSENCE of...
*Hypothermia (temperature < 32.2 C or 89.6 F)
-Have to have a normal core temp
*CNS depressants
-Can't have in their system
*Hypotension
-Have to free of hypotension; needs to be normal
*Metabolic disturbances
clinical evaluation for brain death- *Patient lacks all evidence of responsiveness
*Noxious stimuli should not produce a motor response other than spinally
mediated reflexes
-They don't come from the brainstem; occur after declared brain dead
-Kinda like a muscle spasm
*Absence of corneal reflexes
*Absence of pharyngeal or gag reflexes
*Absence of breathing drive
*Positive for flat EEG (if performed)
*Positive for absence of cerebral blood flow
potential cofounding factors affecting brain death *High cervical spinal cord injury
testing- *Complex spinal reflex movements
*Muscle fasciculations
-Muscle spasms after brain death
*Ventilator auto-triggering
*Targeted temperature management
organ donation:
standard criteria donor- *under 50 years old
*declared dead from traumatic injuries or stroke
organs donated- liver, kidneys, pancreas, intestine, heart, lungs, tissue
deceased after circulatory death- *donation after withdrawal of life-sustaining therapy
*patient must become asystolic within a prescribed period following withdrawal
of controlled ventilation and vasoactive meds
organs donated- kidney, liver, lung
deceased, heart beating donors- *declared brain dead because of nonsurviveble head injuries or neurological
events such as prolonged cardiopulmonary arrest, severe stroke, or intracranial
hemorrhage
organs donated- kidney, pancreas, liver, intestine, heart, lung, abdominal wall,
face, penis, uterus, upper limb
living donor- *organ or part of an organ if offered by a healthy individual to a patient with end-
organ disease
*may be related or not
organs donated- kidney, one or two lobes of the liver, a lung or part of a lung,
part of pancreas, part of intestine
, non directed/altruistic living donor- *an individual who donates an organ or part of an organ to a stranger
organs donated- kidney (most common), liver lobe (rare)
increased risk donor- *Decision to transplant an increased-risk donor organ is based on the critical state
of the recipient in whom the risk of not transplanting an organ is greater than the
risk of disease transmission from a donor.
*Patient and family must consent to accept an increased-risk donor
organs donated- heart, lung, kidney, pancreas, liver, islet cells, small bowel,
stomach, uterus, face, appendages, skin
CDC defines increased risk donors as- • People who have had sex with a person known to have HIV, HBV, or HCV in the
preceding 12 months
• Men who have had sex with men in the preceding 12 months
• Women who have had sex with a man who had sex with men in the
preceding 12 months
• People who have had sex in exchange for money in the preceding 12 months
• People who have had sex with a person who has injected drugs by IV,
intramuscular, or subcutaneous route for nonmedical reasons in the preceding 12
months
• A child who is ≤18 months of age, born to a mother known to be infected with or
at increased risk for HIV. HBV, or HCV
• A child who has been breastfed within the preceding 12 months whose mother is
known to be infected with or at increased risk for HIV
• People who have injected drugs by IV, intramuscular, or subcutaneous
route for nonmedical reasons in the preceding 12 months
• People who have been in lockup, jail, prison, or a juvenile correctional
facility for more than 72 hours in the preceding 12 months
• People who have been newly diagnosed with or have been treated for
syphilis, gonorrhea, Chlamydia, or genital ulcers in the preceding 12 months
• People who test positive for Epstein-Barr virus (EBV), cytomegalovirus (CMV), or
toxoplasmosis
• People who have been on hemodialysis in the preceding 12 months
• Donor at increased risk for HIV., HBV, or HCV infection when medical and
behavioral history cannot be obtained or risk factors cannot be determined
