,NUR 224 Exam 1 Advanced Concepts of Medical-Surgical Nursing
Questions And Answers 2026/2027 Jersey College
Q1. Which three responses are evaluated when determining a
Glasgow Coma Scale score?
A) Pupillary response, reflexes, and speech
B) Orientation, memory, and gait
C) Eye opening, verbal response, and motor response
D) Cranial nerve function, sensation, and coordination
Correct Answer: C) Eye opening, verbal response, and motor response
Rationale: The Glasgow Coma Scale evaluates eye opening, verbal
response, and motor response to provide a standardized measure of level of
consciousness.
Q2. Which cranial nerve should be assessed when evaluating visual
acuity?
A) Cranial nerve I
B) Cranial nerve II
C) Cranial nerve III
D) Cranial nerve VIII
Correct Answer: B) Cranial nerve II
Rationale: The optic nerve, cranial nerve II, transmits visual information
from the retina to the brain.
Q3. A patient suddenly develops a dilated pupil that reacts poorly to
light along with declining consciousness. Which interpretation is
most concerning?
A) Normal adaptation to a dark environment
B) Possible compression of cranial nerve III from increasing intracranial
pressure
C) Expected effect of fatigue
D) Isolated hearing dysfunction
Correct Answer: B) Possible compression of cranial nerve III from increasing
intracranial pressure
Rationale: Oculomotor nerve compression can impair pupillary constriction
and may occur with dangerous intracranial pressure or brain herniation.
,Q4. During neurologic assessment, one arm slowly pronates and
drifts downward when both arms are extended. What does this
finding suggest?
A) Normal cerebellar function
B) Peripheral vascular disease
C) Intact corticospinal function
D) Subtle upper motor neuron weakness
Correct Answer: D) Subtle upper motor neuron weakness
Rationale: Pronator drift can reveal mild corticospinal weakness that may
not be obvious during routine strength testing.
Q5. Which bedside test primarily evaluates cerebellar coordination
of the upper extremities?
A) Finger-to-nose testing
B) Snellen testing
C) Pupillary light response
D) Babinski testing
Correct Answer: A) Finger-to-nose testing
Rationale: Finger-to-nose testing evaluates coordination and accuracy of
voluntary movement and can reveal cerebellar dysfunction.
Q6. A patient responds to painful stimulation by flexing the arms
toward the chest with the wrists and fingers flexed. How should this
response be described?
A) Flaccidity
B) Normal withdrawal
C) Decerebrate posturing
D) Decorticate posturing
Correct Answer: D) Decorticate posturing
Rationale: Decorticate posturing consists of abnormal flexion of the upper
extremities and suggests significant injury involving pathways above the
brainstem.
Q7. Extension of the great toe with fanning of the remaining toes
after plantar stimulation in an adult suggests dysfunction of which
system?
, A) Vestibular system
B) Peripheral autonomic system
C) Corticospinal tract
D) Auditory pathway
Correct Answer: C) Corticospinal tract
Rationale: A positive Babinski response in an adult can indicate upper
motor neuron or corticospinal tract dysfunction.
Q8. Which relationship correctly describes cerebral perfusion
pressure?
A) Cerebral perfusion pressure is influenced by mean arterial pressure minus
intracranial pressure
B) Cerebral perfusion pressure equals intracranial pressure plus heart rate
C) Cerebral perfusion pressure is determined only by oxygen saturation
D) Cerebral perfusion pressure is unrelated to systemic blood pressure
Correct Answer: A) Cerebral perfusion pressure is influenced by mean arterial
pressure minus intracranial pressure
Rationale: Cerebral perfusion depends on the pressure gradient between
systemic arterial pressure and intracranial pressure. Rising intracranial
pressure can therefore reduce brain perfusion.
CHAPTER 2 — ALTERED NEUROLOGIC FUNCTION, INTRACRANIAL
PRESSURE, AND SEIZURES
Q9. Which finding is often one of the earliest indicators of
increasing intracranial pressure?
A) Fixed bilateral pupils
B) Cushing triad
C) Subtle change in level of consciousness
D) Complete respiratory arrest
Correct Answer: C) Subtle change in level of consciousness
Rationale: Changes in alertness, behavior, or responsiveness commonly
appear before late brainstem manifestations of severe intracranial
hypertension.
Q10. Which group of findings constitutes Cushing triad?
Questions And Answers 2026/2027 Jersey College
Q1. Which three responses are evaluated when determining a
Glasgow Coma Scale score?
A) Pupillary response, reflexes, and speech
B) Orientation, memory, and gait
C) Eye opening, verbal response, and motor response
D) Cranial nerve function, sensation, and coordination
Correct Answer: C) Eye opening, verbal response, and motor response
Rationale: The Glasgow Coma Scale evaluates eye opening, verbal
response, and motor response to provide a standardized measure of level of
consciousness.
Q2. Which cranial nerve should be assessed when evaluating visual
acuity?
A) Cranial nerve I
B) Cranial nerve II
C) Cranial nerve III
D) Cranial nerve VIII
Correct Answer: B) Cranial nerve II
Rationale: The optic nerve, cranial nerve II, transmits visual information
from the retina to the brain.
Q3. A patient suddenly develops a dilated pupil that reacts poorly to
light along with declining consciousness. Which interpretation is
most concerning?
A) Normal adaptation to a dark environment
B) Possible compression of cranial nerve III from increasing intracranial
pressure
C) Expected effect of fatigue
D) Isolated hearing dysfunction
Correct Answer: B) Possible compression of cranial nerve III from increasing
intracranial pressure
Rationale: Oculomotor nerve compression can impair pupillary constriction
and may occur with dangerous intracranial pressure or brain herniation.
,Q4. During neurologic assessment, one arm slowly pronates and
drifts downward when both arms are extended. What does this
finding suggest?
A) Normal cerebellar function
B) Peripheral vascular disease
C) Intact corticospinal function
D) Subtle upper motor neuron weakness
Correct Answer: D) Subtle upper motor neuron weakness
Rationale: Pronator drift can reveal mild corticospinal weakness that may
not be obvious during routine strength testing.
Q5. Which bedside test primarily evaluates cerebellar coordination
of the upper extremities?
A) Finger-to-nose testing
B) Snellen testing
C) Pupillary light response
D) Babinski testing
Correct Answer: A) Finger-to-nose testing
Rationale: Finger-to-nose testing evaluates coordination and accuracy of
voluntary movement and can reveal cerebellar dysfunction.
Q6. A patient responds to painful stimulation by flexing the arms
toward the chest with the wrists and fingers flexed. How should this
response be described?
A) Flaccidity
B) Normal withdrawal
C) Decerebrate posturing
D) Decorticate posturing
Correct Answer: D) Decorticate posturing
Rationale: Decorticate posturing consists of abnormal flexion of the upper
extremities and suggests significant injury involving pathways above the
brainstem.
Q7. Extension of the great toe with fanning of the remaining toes
after plantar stimulation in an adult suggests dysfunction of which
system?
, A) Vestibular system
B) Peripheral autonomic system
C) Corticospinal tract
D) Auditory pathway
Correct Answer: C) Corticospinal tract
Rationale: A positive Babinski response in an adult can indicate upper
motor neuron or corticospinal tract dysfunction.
Q8. Which relationship correctly describes cerebral perfusion
pressure?
A) Cerebral perfusion pressure is influenced by mean arterial pressure minus
intracranial pressure
B) Cerebral perfusion pressure equals intracranial pressure plus heart rate
C) Cerebral perfusion pressure is determined only by oxygen saturation
D) Cerebral perfusion pressure is unrelated to systemic blood pressure
Correct Answer: A) Cerebral perfusion pressure is influenced by mean arterial
pressure minus intracranial pressure
Rationale: Cerebral perfusion depends on the pressure gradient between
systemic arterial pressure and intracranial pressure. Rising intracranial
pressure can therefore reduce brain perfusion.
CHAPTER 2 — ALTERED NEUROLOGIC FUNCTION, INTRACRANIAL
PRESSURE, AND SEIZURES
Q9. Which finding is often one of the earliest indicators of
increasing intracranial pressure?
A) Fixed bilateral pupils
B) Cushing triad
C) Subtle change in level of consciousness
D) Complete respiratory arrest
Correct Answer: C) Subtle change in level of consciousness
Rationale: Changes in alertness, behavior, or responsiveness commonly
appear before late brainstem manifestations of severe intracranial
hypertension.
Q10. Which group of findings constitutes Cushing triad?
