NSG 233 Exam 2 Review: (Latest 2026/2027 Update) Neurological & Cardiac
Emergencies | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NSG 233 – Emergency Nursing / Medical-Surgical Nursing
Source: NSG 233 Exam 2 Review Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the Glasgow Coma Scale (GCS)?
Correct Answer: A scale used to assess level of consciousness in clients with traumatic brain injury
(eye, verbal, and motor responses).
1. Score range 3 (deep coma) to 15 (fully awake).
2. GCS ≤8 indicates severe TBI (intubation recommended).
3. Serial GCS monitoring tracks neurologic deterioration.
2. What is diplopia and what does it indicate?
Correct Answer: Double vision, indicating a risk for damage to the optic tract (cranial nerve II or
brainstem).
1. Diplopia can result from increased ICP, brainstem lesions, or cranial nerve palsy.
2. Assess for binocular vs monocular diplopia.
3. Neurologic emergency if sudden onset with other focal deficits.
3. What heart rate finding indicates increasing intracranial pressure (ICP)?
Correct Answer: Tachycardia? (Correction: Cushing's triad includes bradycardia – but tachycardia can
be early sign; some sources cite bradycardia as late sign). Clarification: Early ICP may cause
tachycardia; late ICP causes bradycardia.
1. Cushing's triad: hypertension, bradycardia, irregular respirations (late sign).
2. Early signs: restlessness, irritability, tachycardia.
3. Monitor trends, not single vital sign.
4. What is ataxia and what does it indicate?
Correct Answer: Loss of coordination, indicating a risk for brainstem or cerebellar injury.
1. Ataxia affects gait, speech, fine motor control.
2. Cerebellar injury results in ipsilateral incoordination.
3. Assess finger-to-nose, heel-to-shin, Romberg sign.
, 5. Is tachycardia a sign of increased ICP?
Correct Answer: Yes (early sign). Late sign is bradycardia (Cushing's triad).
1. Early increased ICP causes sympathetic activation → tachycardia.
2. As ICP worsens, parasympathetic response → bradycardia.
3. Bradycardia with hypertension indicates imminent herniation.
6. Is amnesia an indicator of increased ICP?
Correct Answer: No – loss of memory does NOT indicate increased ICP (more associated with
concussion or temporal lobe injury).
1. Amnesia from head trauma (post-traumatic amnesia) does not reflect ICP.
2. Increased ICP signs: decreased LOC, headache, vomiting, papilledema.
3. Pupil changes and motor posturing are late findings.
7. Is hypotension a sign of increased ICP?
Correct Answer: Hypotension is NOT a sign of increased ICP (Cushing's triad causes hypertension).
Hypotension in head injury suggests other injury (hemorrhage).
1. Cushing reflex: hypertension with bradycardia.
2. Hypotension in TBI patient indicates hypovolemic shock (concomitant injuries).
3. Maintain CPP = MAP – ICP (aim >60 mmHg).
8. What are signs of increasing ICP including restlessness?
Correct Answer: Restlessness, irritability, and confusion are early signs of increasing ICP (precede
changes in LOC).
1. EARLY: change in LOC (restlessness, confusion, lethargy).
2. MID: Cushing's triad, pupil changes.
3. LATE: decorticate/decerebrate posturing, coma, death.
9. What are manifestations of increased ICP?
Correct Answer: Decreased level of consciousness, severe headache, unreactive pupils (late sign).
1. Headache worse in morning (supine increases ICP).
2. Projectile vomiting without nausea.
3. Papilledema on fundoscopic exam.
10. Is tachypnea a sign of increasing ICP?
Correct Answer: Tachypnea can be early sign; late sign is irregular respirations (Cheyne-Stokes,
central neurogenic hyperventilation, apneustic).
1. Respiratory pattern changes with brainstem compression.
2. Cheyne-Stokes respirations: cyclic crescendo-decrescendo with apnea.
3. Central neurogenic hyperventilation: sustained deep, rapid breaths.
Emergencies | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NSG 233 – Emergency Nursing / Medical-Surgical Nursing
Source: NSG 233 Exam 2 Review Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the Glasgow Coma Scale (GCS)?
Correct Answer: A scale used to assess level of consciousness in clients with traumatic brain injury
(eye, verbal, and motor responses).
1. Score range 3 (deep coma) to 15 (fully awake).
2. GCS ≤8 indicates severe TBI (intubation recommended).
3. Serial GCS monitoring tracks neurologic deterioration.
2. What is diplopia and what does it indicate?
Correct Answer: Double vision, indicating a risk for damage to the optic tract (cranial nerve II or
brainstem).
1. Diplopia can result from increased ICP, brainstem lesions, or cranial nerve palsy.
2. Assess for binocular vs monocular diplopia.
3. Neurologic emergency if sudden onset with other focal deficits.
3. What heart rate finding indicates increasing intracranial pressure (ICP)?
Correct Answer: Tachycardia? (Correction: Cushing's triad includes bradycardia – but tachycardia can
be early sign; some sources cite bradycardia as late sign). Clarification: Early ICP may cause
tachycardia; late ICP causes bradycardia.
1. Cushing's triad: hypertension, bradycardia, irregular respirations (late sign).
2. Early signs: restlessness, irritability, tachycardia.
3. Monitor trends, not single vital sign.
4. What is ataxia and what does it indicate?
Correct Answer: Loss of coordination, indicating a risk for brainstem or cerebellar injury.
1. Ataxia affects gait, speech, fine motor control.
2. Cerebellar injury results in ipsilateral incoordination.
3. Assess finger-to-nose, heel-to-shin, Romberg sign.
, 5. Is tachycardia a sign of increased ICP?
Correct Answer: Yes (early sign). Late sign is bradycardia (Cushing's triad).
1. Early increased ICP causes sympathetic activation → tachycardia.
2. As ICP worsens, parasympathetic response → bradycardia.
3. Bradycardia with hypertension indicates imminent herniation.
6. Is amnesia an indicator of increased ICP?
Correct Answer: No – loss of memory does NOT indicate increased ICP (more associated with
concussion or temporal lobe injury).
1. Amnesia from head trauma (post-traumatic amnesia) does not reflect ICP.
2. Increased ICP signs: decreased LOC, headache, vomiting, papilledema.
3. Pupil changes and motor posturing are late findings.
7. Is hypotension a sign of increased ICP?
Correct Answer: Hypotension is NOT a sign of increased ICP (Cushing's triad causes hypertension).
Hypotension in head injury suggests other injury (hemorrhage).
1. Cushing reflex: hypertension with bradycardia.
2. Hypotension in TBI patient indicates hypovolemic shock (concomitant injuries).
3. Maintain CPP = MAP – ICP (aim >60 mmHg).
8. What are signs of increasing ICP including restlessness?
Correct Answer: Restlessness, irritability, and confusion are early signs of increasing ICP (precede
changes in LOC).
1. EARLY: change in LOC (restlessness, confusion, lethargy).
2. MID: Cushing's triad, pupil changes.
3. LATE: decorticate/decerebrate posturing, coma, death.
9. What are manifestations of increased ICP?
Correct Answer: Decreased level of consciousness, severe headache, unreactive pupils (late sign).
1. Headache worse in morning (supine increases ICP).
2. Projectile vomiting without nausea.
3. Papilledema on fundoscopic exam.
10. Is tachypnea a sign of increasing ICP?
Correct Answer: Tachypnea can be early sign; late sign is irregular respirations (Cheyne-Stokes,
central neurogenic hyperventilation, apneustic).
1. Respiratory pattern changes with brainstem compression.
2. Cheyne-Stokes respirations: cyclic crescendo-decrescendo with apnea.
3. Central neurogenic hyperventilation: sustained deep, rapid breaths.
