NSG 3280 PATHOPHYSIOLOGY EXAM 3 MASTERY: COMPLETE NCLEX-STYLE QUESTION BANK COVERING NEUROLOGICAL DISORDERS, STROKE MANAGEMENT, SEIZURE DISORDERS, NEURODEGENERATIVE DISEASES, AND INCREASED INTRACRANIAL PRESSURE FOR NURSING STUDENTS

NSG 3280 PATHOPHYSIOLOGY EXAM 3 MASTERY: COMPLETE NCLEX-STYLE QUESTION BANK COVERING NEUROLOGICAL DISORDERS, STROKE MANAGEMENT, SEIZURE DISORDERS, NEURODEGENERATIVE DISEASES, AND INCREASED INTRACRANIAL PRESSURE FOR NURSING STUDENTS 1. A patient with increased intracranial pressure exhibits decorticate posturing. This indicates damage to which area of the brain? A. Brainstem B. Cerebral cortex C. Cerebellum D. Spinal cord Correct Answer: B. Cerebral cortex Rationale: Decorticate posturing (flexion of arms, extension of legs) indicates damage to the cerebral cortex or corticospinal tracts above the brainstem. Decerebrate posturing is more severe and indicates brainstem damage. ________________________________________ 2. Which finding is the earliest sign of increased intracranial pressure? A. Papilledema B. Altered level of consciousness C. Cushing's triad D. Pupillary dilation Correct Answer: B. Altered level of consciousness Rationale: Altered level of consciousness is the earliest and most sensitive indicator of increasing ICP. Papilledema, Cushing's triad, and pupillary changes occur later as ICP significantly rises. ________________________________________ 3. A patient with suspected meningitis undergoes a lumbar puncture. Which cerebrospinal fluid finding is most consistent with bacterial meningitis? A. Clear fluid with normal glucose B. Cloudy fluid with decreased glucose and increased protein C. Clear fluid with increased lymphocytes D. Bloody fluid with normal glucose Correct Answer: B. Cloudy fluid with decreased glucose and increased protein Rationale: Bacterial meningitis typically presents with cloudy CSF, decreased glucose, elevated protein, and polymorphonuclear leukocytosis. Viral meningitis shows clear fluid with lymphocytic predominance. ________________________________________ 4. The nurse understands that cerebral autoregulation fails when mean arterial pressure falls below which value? A. 50 mmHg B. 60 mmHg C. 70 mmHg D. 80 mmHg Correct Answer: A. 50 mmHg Rationale: Cerebral autoregulation maintains cerebral blood flow when MAP is between 50-150 mmHg. Below 50 mmHg, blood flow decreases proportionally with pressure, leading to cerebral ischemia. ________________________________________ 5. A patient with Parkinson's disease experiences "on-off" phenomenon. This is most related to: A. Disease progression B. Fluctuating levodopa levels C. Dietary protein intake D. Stress and anxiety Correct Answer: B. Fluctuating levodopa levels Rationale: The "on-off" phenomenon is characterized by unpredictable fluctuations in motor response related to varying levodopa levels. Patients alternate between good mobility ("on") and poor mobility ("off") periods. ________________________________________ 6. Which type of stroke is most commonly associated with atrial fibrillation? A. Thrombotic stroke B. Embolic stroke C. Hemorrhagic stroke D. Lacunar stroke Correct Answer: B. Embolic stroke Rationale: Atrial fibrillation predisposes to thrombus formation in the left atrium, which can embolize to cerebral vessels. Embolic strokes typically have sudden onset and are often caused by cardiac sources. ________________________________________ 7. The triad of bradypnea, hypertension, and bradycardia is known as: A. Decerebrate posturing B. Cushing's triad C. Cheyne-Stokes respiration D. Autonomic dysreflexia Correct Answer: B. Cushing's triad Rationale: Cushing's triad (hypertension, bradycardia, irregular respirations) is a late sign of increased ICP indicating brainstem compression and impending herniation. ________________________________________ 8. A patient with Guillain-Barré syndrome is at greatest risk for: A. Seizures B. Respiratory failure C. Cardiac arrhythmias D. Deep vein thrombosis Correct Answer: B. Respiratory failure Rationale: Guillain-Barré syndrome causes ascending paralysis that can affect respiratory muscles. Respiratory failure is the most serious complication and requires close monitoring of vital capacity. ________________________________________