AO Pathophysiology NURS 3366 Q &
A Exam #4 Complete Solution Latest
Neurological System (Questions 1-20)
Q1: What is Cerebral Perfusion Pressure (CPP), and what happens if it is too
high or too low? Commented [jw1]:
Answer: CPP is the pressure required to get oxygenated blood into the brain to
perfuse the cells. If CPP is too high or too low, it can lead to cerebral edema and an
increase in intracranial pressure (ICP) .
Rationale: The pathophysiology of too low CPP involves ineffective perfusion
leading to ischemia, cellular hypoxia, cell injury/death, loss of cell membrane
integrity, and release of water and other cells. This results in cerebral edema and
increased ICP, further decreasing effective perfusion .
Q2: A patient is exhibiting signs of increased intracranial pressure (IICP). The
primary culprit causing IICP and the resulting imbalance between ICP and CPP
is:
A. Hypernatremia causing dehydration of brain cells
B. Cerebral edema secondary to ischemia
C. Excess cerebrospinal fluid production
D. Systemic hypertension leading to increased cardiac output
Answer: B. Cerebral edema secondary to ischemia
Rationale: Cerebral edema from trauma, stroke, or infection disrupts the balance
between ICP and CPP. The increased ICP compresses cerebral arteries, reducing
oxygenated blood flow and leading to neurological dysfunction .
Q3: The nurse is caring for a patient with a traumatic brain injury. The nurse
understands that increased ICP can lead to decreased CPP. What is the best
explanation for this phenomenon?
, A. Increased ICP reduces cerebrospinal fluid production, limiting oxygen delivery
B. Elevated ICP compresses brain arteries, limiting oxygenated blood flow
C. Decreased ICP causes vasoconstriction in the cerebral vessels
D. High CPP causes blood to leak into brain tissue, increasing ICP
Answer: B. Elevated ICP compresses brain arteries, limiting oxygenated blood flow
Rationale: Increased ICP causes compression of cerebral arteries, which reduces the
flow of oxygenated blood into the brain, leading to decreased CPP. This decrease in
perfusion pressure can cause malfunction of brain tissue .
Q4: A stroke patient is unaware that anything is wrong, denies their condition,
and has some facial drooping. Which of the following is most likely?
A. Left hemispheric stroke with right facial droop and aphasia
B. Brain stem stroke with bilateral flaccidity and dilated pupils
C. Right hemispheric stroke with left facial droop and spatial neglect
D. Cerebellar stroke with nystagmus and vertigo
Answer: C. Right hemispheric stroke with left facial droop and spatial neglect
Rationale: Denial of illness and lack of insight (anosognosia) are classic signs of a
right hemisphere stroke. These patients often show left-sided facial droop, left-sided
hemiparesis, and neglect of the left environment .
Q5: A patient presents with sudden onset of vertigo, nausea, unsteady gait, and
rapid, jerking eye movements (nystagmus). Which of the following best
describes the location of the stroke?
A. Left cerebral hemisphere
B. Right cerebral hemisphere
A Exam #4 Complete Solution Latest
Neurological System (Questions 1-20)
Q1: What is Cerebral Perfusion Pressure (CPP), and what happens if it is too
high or too low? Commented [jw1]:
Answer: CPP is the pressure required to get oxygenated blood into the brain to
perfuse the cells. If CPP is too high or too low, it can lead to cerebral edema and an
increase in intracranial pressure (ICP) .
Rationale: The pathophysiology of too low CPP involves ineffective perfusion
leading to ischemia, cellular hypoxia, cell injury/death, loss of cell membrane
integrity, and release of water and other cells. This results in cerebral edema and
increased ICP, further decreasing effective perfusion .
Q2: A patient is exhibiting signs of increased intracranial pressure (IICP). The
primary culprit causing IICP and the resulting imbalance between ICP and CPP
is:
A. Hypernatremia causing dehydration of brain cells
B. Cerebral edema secondary to ischemia
C. Excess cerebrospinal fluid production
D. Systemic hypertension leading to increased cardiac output
Answer: B. Cerebral edema secondary to ischemia
Rationale: Cerebral edema from trauma, stroke, or infection disrupts the balance
between ICP and CPP. The increased ICP compresses cerebral arteries, reducing
oxygenated blood flow and leading to neurological dysfunction .
Q3: The nurse is caring for a patient with a traumatic brain injury. The nurse
understands that increased ICP can lead to decreased CPP. What is the best
explanation for this phenomenon?
, A. Increased ICP reduces cerebrospinal fluid production, limiting oxygen delivery
B. Elevated ICP compresses brain arteries, limiting oxygenated blood flow
C. Decreased ICP causes vasoconstriction in the cerebral vessels
D. High CPP causes blood to leak into brain tissue, increasing ICP
Answer: B. Elevated ICP compresses brain arteries, limiting oxygenated blood flow
Rationale: Increased ICP causes compression of cerebral arteries, which reduces the
flow of oxygenated blood into the brain, leading to decreased CPP. This decrease in
perfusion pressure can cause malfunction of brain tissue .
Q4: A stroke patient is unaware that anything is wrong, denies their condition,
and has some facial drooping. Which of the following is most likely?
A. Left hemispheric stroke with right facial droop and aphasia
B. Brain stem stroke with bilateral flaccidity and dilated pupils
C. Right hemispheric stroke with left facial droop and spatial neglect
D. Cerebellar stroke with nystagmus and vertigo
Answer: C. Right hemispheric stroke with left facial droop and spatial neglect
Rationale: Denial of illness and lack of insight (anosognosia) are classic signs of a
right hemisphere stroke. These patients often show left-sided facial droop, left-sided
hemiparesis, and neglect of the left environment .
Q5: A patient presents with sudden onset of vertigo, nausea, unsteady gait, and
rapid, jerking eye movements (nystagmus). Which of the following best
describes the location of the stroke?
A. Left cerebral hemisphere
B. Right cerebral hemisphere
