NUR 272 Exam 3 NCLEX Style Review Questions and
Correct Answers plus Rationale | New 2026-2027 Update
1. The nurse is caring for a patient admitted for evaluation and surgical removal
of a brain tumor. The nurse will plan interventions for this patient based on
knowledge that brain tumors can lead to which complications (select all that
apply)?
A. Vision loss
B. Cerebral edema
C. Pituitary dysfunction
D. Parathyroid dysfunction
E. Focal neurologic deficits
Correct Answer: A, B, C, E
Rationale: Brain tumors can compress visual pathways, cause cerebral edema,
impair pituitary function, and produce focal deficits. Parathyroid dysfunction is not
a direct complication of brain tumors.
2. A patient with a suspected traumatic brain injury has bloody nasal drainage.
What observation should cause the nurse to suspect that this patient has a
cerebrospinal fluid (CSF) leak?
A. A halo sign on the nasal drip pad
B. Decreased blood pressure and urinary output
C. A positive reading for glucose on a Test-tape strip
D. Clear nasal drainage along with the bloody discharge
Correct Answer: A
Rationale: The halo sign (blood coalesces in center, yellowish CSF ring surrounds)
is classic for CSF leak. Glucose testing is unreliable because blood also contains
glucose.
3. The nurse assesses a patient for signs of meningeal irritation and observes for
nuchal rigidity. What indicates the presence of this sign of meningeal irritation?
,A. Tonic spasms of the legs
B. Curling in a fetal position
C. Arching of the neck and back
D. Resistance to flexion of the neck
Correct Answer: D
Rationale: Nuchal rigidity is resistance to neck flexion, a sign of meningeal
irritation.
4. The nurse is caring for a patient admitted with a subdural hematoma
following a motor vehicle accident. Which change in vital signs would the nurse
interpret as a manifestation of increased intracranial pressure (ICP)?
A. Tachypnea
B. Bradycardia
C. Hypotension
D. Narrowing pulse pressure
Correct Answer: B
Rationale: Increased ICP causes Cushing's triad: bradycardia, hypertension, and
irregular respirations. Bradycardia is a key sign.
5. The nurse is providing care for a patient who has been admitted to the
hospital with a head injury and who requires regular neurologic and vital sign
assessment. Which assessments will be components of the patient's score on
the Glasgow Coma Scale (GCS) (select all that apply)?
A. Judgment
B. Eye opening
C. Abstract reasoning
D. Verbal response
E. Motor response
F. Cranial nerve function
Correct Answer: B, D, E
Rationale: GCS measures eye opening, verbal response, and motor response.
Judgment, abstract reasoning, and cranial nerve function are not part of GCS.
,6. What nursing intervention should be implemented in the care of a patient
who is experiencing increased ICP?
A. Monitor fluid and electrolyte status carefully.
B. Position the patient in a high Fowler's position.
C. Administer vasoconstrictors to maintain cerebral perfusion.
D. Maintain physical restraints to prevent episodes of agitation.
Correct Answer: A
Rationale: Fluid/electrolyte disturbances worsen ICP. HOB should be 30 degrees,
not high Fowler's. Vasoconstrictors and restraints are not routine.
7. Magnetic resonance imaging (MRI) has revealed the presence of a brain
tumor in a patient. The nurse should recognize that the patient will most likely
need which treatment modality?
A. Surgery
B. Chemotherapy
C. Radiation therapy
D. Biologic drug therapy
Correct Answer: A
Rationale: Surgical removal is the preferred treatment for brain tumors. Other
modalities may be adjuncts.
8. A patient has a systemic blood pressure of 120/60 and an ICP of 24 mm Hg.
After calculating the patient's cerebral perfusion pressure (CPP), how does the
nurse interpret the results?
A. High blood flow to the brain
B. Normal intracranial pressure
C. Impaired blood flow to the brain
D. Adequate autoregulation of blood flow
, Correct Answer: C
Rationale: MAP = 120 + 2(60)/3 = 80. CPP = MAP – ICP = 80 – 24 = 56 mm Hg.
Normal CPP is 60–100; 56 indicates impaired perfusion.
9. The patient with increased ICP from a brain tumor is being monitored with a
ventriculostomy. What nursing intervention is the priority in caring for this
patient?
A. Administer IV mannitol (Osmitrol).
B. Ventilator use to hyperoxygenate the patient
C. Use strict aseptic technique with dressing changes.
D. Be aware of changes in ICP related to leaking CSF.
Correct Answer: C
Rationale: Preventing infection at the ventriculostomy site is the priority. Aseptic
technique is essential.
10. A male patient suffered a diffuse axonal injury from a traumatic brain injury
(TBI). He has been maintained on IV fluids for 2 days. The nurse seeks enteral
feeding for this patient based on what rationale?
A. Free water should be avoided.
B. Sodium restrictions can be managed.
C. Dehydration can be better avoided with feedings.
D. Malnutrition promotes continued cerebral edema.
Correct Answer: D
Rationale: TBI causes hypermetabolic state; malnutrition worsens cerebral
edema. Early enteral feeding improves outcomes.
11. In planning long-term care for a patient after a craniotomy, what must the
nurse include when teaching the patient, family, and caregiver?
A. Seizure disorders may occur in weeks or months.
B. The family will be unable to cope with role reversals.
Correct Answers plus Rationale | New 2026-2027 Update
1. The nurse is caring for a patient admitted for evaluation and surgical removal
of a brain tumor. The nurse will plan interventions for this patient based on
knowledge that brain tumors can lead to which complications (select all that
apply)?
A. Vision loss
B. Cerebral edema
C. Pituitary dysfunction
D. Parathyroid dysfunction
E. Focal neurologic deficits
Correct Answer: A, B, C, E
Rationale: Brain tumors can compress visual pathways, cause cerebral edema,
impair pituitary function, and produce focal deficits. Parathyroid dysfunction is not
a direct complication of brain tumors.
2. A patient with a suspected traumatic brain injury has bloody nasal drainage.
What observation should cause the nurse to suspect that this patient has a
cerebrospinal fluid (CSF) leak?
A. A halo sign on the nasal drip pad
B. Decreased blood pressure and urinary output
C. A positive reading for glucose on a Test-tape strip
D. Clear nasal drainage along with the bloody discharge
Correct Answer: A
Rationale: The halo sign (blood coalesces in center, yellowish CSF ring surrounds)
is classic for CSF leak. Glucose testing is unreliable because blood also contains
glucose.
3. The nurse assesses a patient for signs of meningeal irritation and observes for
nuchal rigidity. What indicates the presence of this sign of meningeal irritation?
,A. Tonic spasms of the legs
B. Curling in a fetal position
C. Arching of the neck and back
D. Resistance to flexion of the neck
Correct Answer: D
Rationale: Nuchal rigidity is resistance to neck flexion, a sign of meningeal
irritation.
4. The nurse is caring for a patient admitted with a subdural hematoma
following a motor vehicle accident. Which change in vital signs would the nurse
interpret as a manifestation of increased intracranial pressure (ICP)?
A. Tachypnea
B. Bradycardia
C. Hypotension
D. Narrowing pulse pressure
Correct Answer: B
Rationale: Increased ICP causes Cushing's triad: bradycardia, hypertension, and
irregular respirations. Bradycardia is a key sign.
5. The nurse is providing care for a patient who has been admitted to the
hospital with a head injury and who requires regular neurologic and vital sign
assessment. Which assessments will be components of the patient's score on
the Glasgow Coma Scale (GCS) (select all that apply)?
A. Judgment
B. Eye opening
C. Abstract reasoning
D. Verbal response
E. Motor response
F. Cranial nerve function
Correct Answer: B, D, E
Rationale: GCS measures eye opening, verbal response, and motor response.
Judgment, abstract reasoning, and cranial nerve function are not part of GCS.
,6. What nursing intervention should be implemented in the care of a patient
who is experiencing increased ICP?
A. Monitor fluid and electrolyte status carefully.
B. Position the patient in a high Fowler's position.
C. Administer vasoconstrictors to maintain cerebral perfusion.
D. Maintain physical restraints to prevent episodes of agitation.
Correct Answer: A
Rationale: Fluid/electrolyte disturbances worsen ICP. HOB should be 30 degrees,
not high Fowler's. Vasoconstrictors and restraints are not routine.
7. Magnetic resonance imaging (MRI) has revealed the presence of a brain
tumor in a patient. The nurse should recognize that the patient will most likely
need which treatment modality?
A. Surgery
B. Chemotherapy
C. Radiation therapy
D. Biologic drug therapy
Correct Answer: A
Rationale: Surgical removal is the preferred treatment for brain tumors. Other
modalities may be adjuncts.
8. A patient has a systemic blood pressure of 120/60 and an ICP of 24 mm Hg.
After calculating the patient's cerebral perfusion pressure (CPP), how does the
nurse interpret the results?
A. High blood flow to the brain
B. Normal intracranial pressure
C. Impaired blood flow to the brain
D. Adequate autoregulation of blood flow
, Correct Answer: C
Rationale: MAP = 120 + 2(60)/3 = 80. CPP = MAP – ICP = 80 – 24 = 56 mm Hg.
Normal CPP is 60–100; 56 indicates impaired perfusion.
9. The patient with increased ICP from a brain tumor is being monitored with a
ventriculostomy. What nursing intervention is the priority in caring for this
patient?
A. Administer IV mannitol (Osmitrol).
B. Ventilator use to hyperoxygenate the patient
C. Use strict aseptic technique with dressing changes.
D. Be aware of changes in ICP related to leaking CSF.
Correct Answer: C
Rationale: Preventing infection at the ventriculostomy site is the priority. Aseptic
technique is essential.
10. A male patient suffered a diffuse axonal injury from a traumatic brain injury
(TBI). He has been maintained on IV fluids for 2 days. The nurse seeks enteral
feeding for this patient based on what rationale?
A. Free water should be avoided.
B. Sodium restrictions can be managed.
C. Dehydration can be better avoided with feedings.
D. Malnutrition promotes continued cerebral edema.
Correct Answer: D
Rationale: TBI causes hypermetabolic state; malnutrition worsens cerebral
edema. Early enteral feeding improves outcomes.
11. In planning long-term care for a patient after a craniotomy, what must the
nurse include when teaching the patient, family, and caregiver?
A. Seizure disorders may occur in weeks or months.
B. The family will be unable to cope with role reversals.
