NSG 3280
EXAM 3
Tested Questions with Rationales
Pathophysiology
Galen College of Nursing
This Document Description:
This document contains a collection of tested
and verified questions with accurate answers
from EXAM 3 of NSG 3280 at the Galen College of
Nursing. It covers core topics assessed in the
course and reflects the actual exam format and
question style. Ideal for exam preparation and concept
reinforcement.
,Table of Contents
NSG 3280 Exam 3. ............................................................ 2
NSG 3280 Exam 3 Review. ........................................... 35
NSG 3280 Exam 3.
1.1 What assessment finding is the earliest indicator of increasing
intracranial pressure (ICP) in a client with acute brain injury?
A. Fixed dilated pupils
B. Change in level of consciousness
C. Cushing triad
D. Decerebrate posturing
Answer: B. Change in level of consciousness
Expert Rationale: A change in LOC is typically the first sign of rising ICP
because cerebral perfusion and reticular activating system function are
affected early. Late findings such as fixed pupils and posturing suggest
worsening brain compression.
1.2 A client with suspected increased ICP develops headache,
vomiting, and blurred vision. How should the nurse interpret these
findings?
A. They are late signs of brain herniation
B. They are initial manifestations of increased ICP
C. They indicate spinal cord injury
D. They suggest seizure activity only
Answer: B. They are initial manifestations of increased ICP
Expert Rationale: The study guide identifies headache, vomiting, and
blurred vision as early manifestations of increased ICP. Recognizing these
,early signs supports rapid intervention before late neurologic deterioration
occurs.
1.3 Which cranial nerves are primarily responsible for the pupillary
light reflex?
A. CN I and CN II
B. CN II and CN III
C. CN III and CN IV
D. CN V and CN VII
Answer: B. CN II and CN III
Expert Rationale: CN II detects light, and CN III mediates pupillary
constriction. Changes in pupillary size, shape, or reactivity can indicate
worsening ICP or possible brain herniation.
1.4 A comatose client has a negative oculocephalic (“doll’s eyes”)
reflex. What does this finding suggest?
A. Intact brainstem function
B. Cerebellar irritation only
C. Brainstem dysfunction
D. Normal response in coma
Answer: C. Brainstem dysfunction
Expert Rationale: A positive doll’s eyes reflex indicates intact brainstem
pathways. A negative response suggests a defect in brainstem function,
which is a serious neurologic finding in the comatose patient.
1.5 Which Glasgow Coma Scale (GCS) score indicates severe
traumatic brain injury (TBI)?
A. 14
B. 12
C. 10
D. 8
Answer: D. 8
Expert Rationale: The study guide classifies TBI severity as mild (13–15),
moderate (9–12), and severe (8 or less). A score of 8 reflects significant
neurologic impairment and often correlates with coma.
, 1.6 A client is in a motor vehicle crash and sustains injury at the site
of impact and the opposite side of the brain. Which primary injury
pattern is most likely?
A. Diffuse axonal injury
B. Coup-contrecoup injury
C. Ischemic stroke
D. Secondary edema
Answer: B. Coup-contrecoup injury
Expert Rationale: Coup-contrecoup injury occurs when acceleration-
deceleration causes damage at two opposite poles of the brain. This is
common in MVAs and may produce bruising, bleeding, and edema.
1.7 Which statement best distinguishes diffuse brain injury from focal
injury?
A. Diffuse injury is always less severe
B. Diffuse injury causes widespread neuronal damage from brain
movement
C. Focal injury only affects the cerebellum
D. Focal injury is always associated with hemorrhage
Answer: B. Diffuse injury causes widespread neuronal damage from
brain movement
Expert Rationale: Diffuse injury results from shifting and rotational forces
that damage nerve fibers across the cerebral cortex. It is often associated
with immediate coma and broader neurologic dysfunction than focal injury.
1.8 A client has a subdural hematoma after a fall. Which
pathophysiologic change is expected?
A. Arterial bleeding between skull and dura
B. Bleeding between pia and arachnoid
C. Venous bleeding below the dura from bridging veins
D. Bleeding limited to the ventricles
Answer: C. Venous bleeding below the dura from bridging veins
Expert Rationale: Subdural hematomas involve bridging veins and blood
EXAM 3
Tested Questions with Rationales
Pathophysiology
Galen College of Nursing
This Document Description:
This document contains a collection of tested
and verified questions with accurate answers
from EXAM 3 of NSG 3280 at the Galen College of
Nursing. It covers core topics assessed in the
course and reflects the actual exam format and
question style. Ideal for exam preparation and concept
reinforcement.
,Table of Contents
NSG 3280 Exam 3. ............................................................ 2
NSG 3280 Exam 3 Review. ........................................... 35
NSG 3280 Exam 3.
1.1 What assessment finding is the earliest indicator of increasing
intracranial pressure (ICP) in a client with acute brain injury?
A. Fixed dilated pupils
B. Change in level of consciousness
C. Cushing triad
D. Decerebrate posturing
Answer: B. Change in level of consciousness
Expert Rationale: A change in LOC is typically the first sign of rising ICP
because cerebral perfusion and reticular activating system function are
affected early. Late findings such as fixed pupils and posturing suggest
worsening brain compression.
1.2 A client with suspected increased ICP develops headache,
vomiting, and blurred vision. How should the nurse interpret these
findings?
A. They are late signs of brain herniation
B. They are initial manifestations of increased ICP
C. They indicate spinal cord injury
D. They suggest seizure activity only
Answer: B. They are initial manifestations of increased ICP
Expert Rationale: The study guide identifies headache, vomiting, and
blurred vision as early manifestations of increased ICP. Recognizing these
,early signs supports rapid intervention before late neurologic deterioration
occurs.
1.3 Which cranial nerves are primarily responsible for the pupillary
light reflex?
A. CN I and CN II
B. CN II and CN III
C. CN III and CN IV
D. CN V and CN VII
Answer: B. CN II and CN III
Expert Rationale: CN II detects light, and CN III mediates pupillary
constriction. Changes in pupillary size, shape, or reactivity can indicate
worsening ICP or possible brain herniation.
1.4 A comatose client has a negative oculocephalic (“doll’s eyes”)
reflex. What does this finding suggest?
A. Intact brainstem function
B. Cerebellar irritation only
C. Brainstem dysfunction
D. Normal response in coma
Answer: C. Brainstem dysfunction
Expert Rationale: A positive doll’s eyes reflex indicates intact brainstem
pathways. A negative response suggests a defect in brainstem function,
which is a serious neurologic finding in the comatose patient.
1.5 Which Glasgow Coma Scale (GCS) score indicates severe
traumatic brain injury (TBI)?
A. 14
B. 12
C. 10
D. 8
Answer: D. 8
Expert Rationale: The study guide classifies TBI severity as mild (13–15),
moderate (9–12), and severe (8 or less). A score of 8 reflects significant
neurologic impairment and often correlates with coma.
, 1.6 A client is in a motor vehicle crash and sustains injury at the site
of impact and the opposite side of the brain. Which primary injury
pattern is most likely?
A. Diffuse axonal injury
B. Coup-contrecoup injury
C. Ischemic stroke
D. Secondary edema
Answer: B. Coup-contrecoup injury
Expert Rationale: Coup-contrecoup injury occurs when acceleration-
deceleration causes damage at two opposite poles of the brain. This is
common in MVAs and may produce bruising, bleeding, and edema.
1.7 Which statement best distinguishes diffuse brain injury from focal
injury?
A. Diffuse injury is always less severe
B. Diffuse injury causes widespread neuronal damage from brain
movement
C. Focal injury only affects the cerebellum
D. Focal injury is always associated with hemorrhage
Answer: B. Diffuse injury causes widespread neuronal damage from
brain movement
Expert Rationale: Diffuse injury results from shifting and rotational forces
that damage nerve fibers across the cerebral cortex. It is often associated
with immediate coma and broader neurologic dysfunction than focal injury.
1.8 A client has a subdural hematoma after a fall. Which
pathophysiologic change is expected?
A. Arterial bleeding between skull and dura
B. Bleeding between pia and arachnoid
C. Venous bleeding below the dura from bridging veins
D. Bleeding limited to the ventricles
Answer: C. Venous bleeding below the dura from bridging veins
Expert Rationale: Subdural hematomas involve bridging veins and blood
