NSG 3280 EXAM 3 2026-2027
PATHOPHYSIOLOGY FOR NURSES I
EXAM PREP | VERIFIED Q&A | GALEN
COLLEGE OF NURSING
A patient with severe cerebral ischemia experiences
mitochondrial failure leading to calcium overload. Which
mechanism directly contributes to cytotoxic edema and cell
death in this pathway?
A. Decreased glutamate release into the extracellular space
B. Increased production of nitric oxide and free radical
formation
C. Activation of the Na+/K+ pump causing cellular shrinkage
D. Inhibition of calcium entry into the mitochondria
Correct Answer: B
Rationale: Excess glutamate leads to calcium overload and
cytotoxic edema, which stimulates neuron production of nitric
oxide, leading to free radical formation and eventual cell death.
A patient admitted with a traumatic brain injury has an
intracranial pressure (ICP) of 24 mmHg sustained for 8 minutes.
What is the primary concern for this patient?
,A. Normal physiological compliance response
B. Transient increase secondary to a cough or sneeze
C. Sustained brain impairment due to cerebral tissue
compression
D. Compensatory increase in cerebrospinal fluid production
Correct Answer: C
Rationale: Normal ICP is 0–15 mmHg. An ICP exceeding 22
mmHg for longer than 5 minutes causes severe compression of
brain tissue, leading to sustained brain impairment.
According to the Monro-Kellie doctrine, which initial
compensatory mechanism occurs when an intracranial mass
expands?
A. Increased production of cerebrospinal fluid (CSF)
B. Venous blood displacement and CSF shunting into the spinal
cord
C. Arterial vasodilation to increase cerebral blood flow
D. Dilation of the cranial vault to accommodate volume
Correct Answer: B
Rationale: The Monro-Kellie doctrine states that the cranial
vault is a fixed volume containing brain tissue, blood, and CSF;
an increase in one component requires a decrease in others,
typically accomplished by displacing CSF and venous blood.
,A patient involved in a high-speed motor vehicle accident
suffers severe diffuse axonal injury (DAI). Which pathological
process best characterizes this type of traumatic brain injury?
A. Direct focal damage limited strictly to the point of impact
B. Rotational and shearing forces stretching white matter axons
across the brain
C. Rapid arterial bleeding into the epidural space forming a
hematoma
D. Localized necrosis isolated to the site opposite the impact
point
Correct Answer: B
Rationale: Diffuse TBI involves widespread damage caused by
shifting and rotational forces that stretch and shear white
matter fibers, often leaving the patient comatose.
A patient presents with a history of head trauma 3 hours ago.
They experienced a brief loss of consciousness, woke up feeling
fine (lucid interval), but are now rapidly deteriorating. What
condition is suspected?
A. Subdural hematoma
B. Subarachnoid hemorrhage
C. Epidural hematoma
, D. Lacunar infarct
Correct Answer: C
Rationale: Epidural hematomas occur between the skull and
dura mater, are typically arterial, and classically present with a
lucid interval followed by rapid neurological decline.
An elderly patient with cerebral atrophy presents 48 hours
after a fall with progressive headache and confusion. Brain
imaging reveals a venous bleed between the dura and outer
arachnoid membrane. What is the diagnosis?
A. Epidural hematoma
B. Subdural hematoma
C. Subarachnoid hemorrhage
D. Arteriovenous malformation
Correct Answer: B
Rationale: Subdural hematomas occur between the dura and
arachnoid membrane due to shearing of bridging veins. Elderly
patients with cerebral atrophy are at higher risk due to
increased brain mobility within the skull.
A patient presents with a sudden, excruciating "thunderclap"
headache, nuchal rigidity, and photophobia. Lumbar puncture
demonstrates blood in the CSF. What is the primary etiology?
PATHOPHYSIOLOGY FOR NURSES I
EXAM PREP | VERIFIED Q&A | GALEN
COLLEGE OF NURSING
A patient with severe cerebral ischemia experiences
mitochondrial failure leading to calcium overload. Which
mechanism directly contributes to cytotoxic edema and cell
death in this pathway?
A. Decreased glutamate release into the extracellular space
B. Increased production of nitric oxide and free radical
formation
C. Activation of the Na+/K+ pump causing cellular shrinkage
D. Inhibition of calcium entry into the mitochondria
Correct Answer: B
Rationale: Excess glutamate leads to calcium overload and
cytotoxic edema, which stimulates neuron production of nitric
oxide, leading to free radical formation and eventual cell death.
A patient admitted with a traumatic brain injury has an
intracranial pressure (ICP) of 24 mmHg sustained for 8 minutes.
What is the primary concern for this patient?
,A. Normal physiological compliance response
B. Transient increase secondary to a cough or sneeze
C. Sustained brain impairment due to cerebral tissue
compression
D. Compensatory increase in cerebrospinal fluid production
Correct Answer: C
Rationale: Normal ICP is 0–15 mmHg. An ICP exceeding 22
mmHg for longer than 5 minutes causes severe compression of
brain tissue, leading to sustained brain impairment.
According to the Monro-Kellie doctrine, which initial
compensatory mechanism occurs when an intracranial mass
expands?
A. Increased production of cerebrospinal fluid (CSF)
B. Venous blood displacement and CSF shunting into the spinal
cord
C. Arterial vasodilation to increase cerebral blood flow
D. Dilation of the cranial vault to accommodate volume
Correct Answer: B
Rationale: The Monro-Kellie doctrine states that the cranial
vault is a fixed volume containing brain tissue, blood, and CSF;
an increase in one component requires a decrease in others,
typically accomplished by displacing CSF and venous blood.
,A patient involved in a high-speed motor vehicle accident
suffers severe diffuse axonal injury (DAI). Which pathological
process best characterizes this type of traumatic brain injury?
A. Direct focal damage limited strictly to the point of impact
B. Rotational and shearing forces stretching white matter axons
across the brain
C. Rapid arterial bleeding into the epidural space forming a
hematoma
D. Localized necrosis isolated to the site opposite the impact
point
Correct Answer: B
Rationale: Diffuse TBI involves widespread damage caused by
shifting and rotational forces that stretch and shear white
matter fibers, often leaving the patient comatose.
A patient presents with a history of head trauma 3 hours ago.
They experienced a brief loss of consciousness, woke up feeling
fine (lucid interval), but are now rapidly deteriorating. What
condition is suspected?
A. Subdural hematoma
B. Subarachnoid hemorrhage
C. Epidural hematoma
, D. Lacunar infarct
Correct Answer: C
Rationale: Epidural hematomas occur between the skull and
dura mater, are typically arterial, and classically present with a
lucid interval followed by rapid neurological decline.
An elderly patient with cerebral atrophy presents 48 hours
after a fall with progressive headache and confusion. Brain
imaging reveals a venous bleed between the dura and outer
arachnoid membrane. What is the diagnosis?
A. Epidural hematoma
B. Subdural hematoma
C. Subarachnoid hemorrhage
D. Arteriovenous malformation
Correct Answer: B
Rationale: Subdural hematomas occur between the dura and
arachnoid membrane due to shearing of bridging veins. Elderly
patients with cerebral atrophy are at higher risk due to
increased brain mobility within the skull.
A patient presents with a sudden, excruciating "thunderclap"
headache, nuchal rigidity, and photophobia. Lumbar puncture
demonstrates blood in the CSF. What is the primary etiology?
