Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the
Neuromuscular Junction
Rogers: McCance & Huether’s Pathophysiology, 9th Edition
MULTIPLE CHOICE
1. What do diffuse axonal injuries (DAIs) of the brain often result in?
a. Reduced levels of consciousness
b. Mild but permanent dysfunction
c. Fine motor tremors
d. Visual disturbances
ANS: A
Diffuse axonal injuries occur from mechanical forces of acceleration, deceleration, and
rotation that cause stretching and shearing of axons. The injury can be mild, moderate, or
severe. Persons with head injury can experience headaches, nausea and vomiting, confusion,
disorientation, attention-deficit, dizziness, and impaired ability to concentrate for days after
the injury, contributed to DAI among other processes. DAI can cause permanent or temporary
dysfunction. DAI do not cause fine motor tremors or visual disturbances.
DIF: Cognitive Level: Remembering
2. What event is most likely to occur when a person experiences a closed head injury?
a. Brief period of vital sign instability
b. Cerebral edema throughout the cerebral cortex
c. Cerebral edema throughout the diencephalon
d. Disruption of axons extending from the diencephalon and brainstem
ANS: A
Transient cessation of respiration can occur with brief periods of bradycardia, and a decrease
in blood pressure occurs, lasting 30 sec or less. Vital signs stabilize within a few seconds to
within normal limits. Edema does not occur immediately. Disruption of axons in the
diencephalon and brainstem may or may not occur.
DIF: Cognitive Level: Remembering
3. A healthcare professional wants to volunteer for a community education project to help
prevent spinal cord injury. What activity would the professional most likely volunteer for?
a. Teaching school aged children bicycle safety
b. Teaching stretching to high school athletes
c. Teaching adults good body mechanics for lifting
d. Teaching older adults how to prevent trip-and-fall events
ANS: D
Because of preexisting degenerative vertebral disorders, older adults are particularly at risk for
minor trauma, resulting in serious spinal cord injury, especially from falls. Although any of
the events listed could help prevent spinal cord injury, the activity targeting older adults
would have the biggest impact because the risk to the other groups is less than that of the
older adult.
Download the Complete Test Bank here: https://linktr.ee/nclexrn
, DIF: Cognitive Level: Applying
4. A patient has a spinal cord injury at C4. What should the healthcare professional assess as the
priority in this patient?
a. Blood pressure
b. Respirations
c. Pulse
d. Temperature
ANS: B
In the cervical region, the swelling that accompanies an injury to C3 to C5 can be
life-threatening because of the possibility of resulting impairment of the diaphragm function
(phrenic nerves exit C3 to C5). All vital signs are important, but because of this possibility the
priority is to monitor signs of respiratory impairment.
DIF: Cognitive Level: Applying
5. What indicates that spinal shock is terminating?
a. Voluntary movement below the level of injury
b. Reflex emptying of the bladder
c. Paresthesia below the level of injury
d. Decreased deep tendon reflexes and flaccid paralysis
ANS: B
Indications that spinal shock is terminating include the reappearance of reflex activity,
hyperreflexia, spasticity, and reflex emptying of the bladder. Termination of spinal shock is
not evidenced by voluntary movement, paresthesia, decreased deep tendon reflexes, or
paralysis.
DIF: Cognitive Level: Remembering
6. A healthcare professional is caring for a patient who has a spinal cord injury at T5. The
patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the
spinal cord lesion. How does the professional chart this event?
a. Craniosacral dysreflexia
b. Parasympathetic dysreflexia
c. Autonomic hyperreflexia
d. Retrograde hyperreflexia
ANS: C
Individuals most likely to be affected have lesions at the T6 level or above. Paroxysmal
hypertension (up to 300 mmHg systolic), a pounding headache, blurred vision, sweating
above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection
caused by pilomotor spasm, and bradycardia (30 to 40 beats/min) characterize autonomic
hyperreflexia. This does not describe craniosacral dysreflexia, parasympathetic dysreflexia, or
retrograde hyperreflexia.
DIF: Cognitive Level: Remembering
7. Why does a person who has a spinal cord injury experience faulty control of sweating?
a. The hypothalamus is unable to regulate body heat as a result of damage to the
Download the Complete Test Bank here: https://linktr.ee/nclexrn
Neuromuscular Junction
Rogers: McCance & Huether’s Pathophysiology, 9th Edition
MULTIPLE CHOICE
1. What do diffuse axonal injuries (DAIs) of the brain often result in?
a. Reduced levels of consciousness
b. Mild but permanent dysfunction
c. Fine motor tremors
d. Visual disturbances
ANS: A
Diffuse axonal injuries occur from mechanical forces of acceleration, deceleration, and
rotation that cause stretching and shearing of axons. The injury can be mild, moderate, or
severe. Persons with head injury can experience headaches, nausea and vomiting, confusion,
disorientation, attention-deficit, dizziness, and impaired ability to concentrate for days after
the injury, contributed to DAI among other processes. DAI can cause permanent or temporary
dysfunction. DAI do not cause fine motor tremors or visual disturbances.
DIF: Cognitive Level: Remembering
2. What event is most likely to occur when a person experiences a closed head injury?
a. Brief period of vital sign instability
b. Cerebral edema throughout the cerebral cortex
c. Cerebral edema throughout the diencephalon
d. Disruption of axons extending from the diencephalon and brainstem
ANS: A
Transient cessation of respiration can occur with brief periods of bradycardia, and a decrease
in blood pressure occurs, lasting 30 sec or less. Vital signs stabilize within a few seconds to
within normal limits. Edema does not occur immediately. Disruption of axons in the
diencephalon and brainstem may or may not occur.
DIF: Cognitive Level: Remembering
3. A healthcare professional wants to volunteer for a community education project to help
prevent spinal cord injury. What activity would the professional most likely volunteer for?
a. Teaching school aged children bicycle safety
b. Teaching stretching to high school athletes
c. Teaching adults good body mechanics for lifting
d. Teaching older adults how to prevent trip-and-fall events
ANS: D
Because of preexisting degenerative vertebral disorders, older adults are particularly at risk for
minor trauma, resulting in serious spinal cord injury, especially from falls. Although any of
the events listed could help prevent spinal cord injury, the activity targeting older adults
would have the biggest impact because the risk to the other groups is less than that of the
older adult.
Download the Complete Test Bank here: https://linktr.ee/nclexrn
, DIF: Cognitive Level: Applying
4. A patient has a spinal cord injury at C4. What should the healthcare professional assess as the
priority in this patient?
a. Blood pressure
b. Respirations
c. Pulse
d. Temperature
ANS: B
In the cervical region, the swelling that accompanies an injury to C3 to C5 can be
life-threatening because of the possibility of resulting impairment of the diaphragm function
(phrenic nerves exit C3 to C5). All vital signs are important, but because of this possibility the
priority is to monitor signs of respiratory impairment.
DIF: Cognitive Level: Applying
5. What indicates that spinal shock is terminating?
a. Voluntary movement below the level of injury
b. Reflex emptying of the bladder
c. Paresthesia below the level of injury
d. Decreased deep tendon reflexes and flaccid paralysis
ANS: B
Indications that spinal shock is terminating include the reappearance of reflex activity,
hyperreflexia, spasticity, and reflex emptying of the bladder. Termination of spinal shock is
not evidenced by voluntary movement, paresthesia, decreased deep tendon reflexes, or
paralysis.
DIF: Cognitive Level: Remembering
6. A healthcare professional is caring for a patient who has a spinal cord injury at T5. The
patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the
spinal cord lesion. How does the professional chart this event?
a. Craniosacral dysreflexia
b. Parasympathetic dysreflexia
c. Autonomic hyperreflexia
d. Retrograde hyperreflexia
ANS: C
Individuals most likely to be affected have lesions at the T6 level or above. Paroxysmal
hypertension (up to 300 mmHg systolic), a pounding headache, blurred vision, sweating
above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection
caused by pilomotor spasm, and bradycardia (30 to 40 beats/min) characterize autonomic
hyperreflexia. This does not describe craniosacral dysreflexia, parasympathetic dysreflexia, or
retrograde hyperreflexia.
DIF: Cognitive Level: Remembering
7. Why does a person who has a spinal cord injury experience faulty control of sweating?
a. The hypothalamus is unable to regulate body heat as a result of damage to the
Download the Complete Test Bank here: https://linktr.ee/nclexrn
