NSG 3280 UNIT 5 Acute Disorders of
Brain Function | 2026 Update with
complete solutions.
Question 1
A patient experiences severe cerebral ischemia. Which cellular change occurs first as oxygen
delivery becomes inadequate?
A. Increased ATP production
B. Cellular energy failure
C. Increased protein synthesis
D. Increased cerebral perfusion
Correct Answer: B. Cellular energy failure
Rationale: Ischemia decreases oxygen and nutrient delivery to brain tissue. Because neurons
depend heavily on aerobic metabolism, ATP production falls, leading to failure of cellular pumps
and progressive neuronal injury.
Question 2
Which statement best describes cerebral hypoxia?
A. Complete absence of cerebral blood flow
B. Insufficient oxygen available to brain tissue
C. Increased cerebrospinal fluid production
D. Excessive glucose delivery to neurons
Correct Answer: B. Insufficient oxygen available to brain tissue
Rationale: Hypoxia refers specifically to inadequate oxygen availability to tissue. Ischemia
involves inadequate blood flow and therefore commonly produces hypoxia.
Question 3
Why are neurons particularly vulnerable to ischemia?
A. They have very low metabolic requirements
B. They store large amounts of oxygen
,C. They have high metabolic demands and limited energy reserves
D. They can easily regenerate after injury
Correct Answer: C. They have high metabolic demands and limited energy reserves
Rationale: Neurons require continuous oxygen and glucose to maintain normal function.
Prolonged interruption of blood flow rapidly causes cellular dysfunction and irreversible injury.
Question 4
Which process occurs when cerebral ischemia persists?
A. Infarction
B. Hyperperfusion
C. Increased neuronal regeneration
D. Increased oxygen delivery
Correct Answer: A. Infarction
Rationale: Prolonged ischemia and hypoxia can cause irreversible cellular death and tissue
infarction.
Question 5
Which mechanism is characteristic of cytotoxic cerebral edema?
A. Breakdown of the blood-brain barrier only
B. Intracellular fluid accumulation caused by cellular energy failure
C. Increased CSF absorption
D. Decreased intracellular sodium
Correct Answer: B. Intracellular fluid accumulation caused by cellular energy failure
Rationale: ATP depletion impairs membrane ion pumps, particularly the sodium-potassium
pump. Sodium accumulates intracellularly, drawing water into cells and producing cytotoxic
edema.
Question 6
Which mechanism is most closely associated with vasogenic cerebral edema?
,A. Blood-brain barrier disruption
B. Increased intracellular potassium only
C. Complete neuronal regeneration
D. Reduced vascular permeability
Correct Answer: A. Blood-brain barrier disruption
Rationale: Vasogenic edema occurs when the blood-brain barrier becomes more permeable,
allowing fluid and proteins to move into extracellular brain tissue.
Question 7
Which three components are contained within the cranial vault according to the Monroe-Kellie
doctrine?
A. Brain tissue, CSF, and blood
B. Brain tissue, lymph, and muscle
C. CSF, bone marrow, and blood
D. Blood, lymph, and cartilage
Correct Answer: A. Brain tissue, CSF, and blood
Rationale: The Monroe-Kellie doctrine states that the intracranial vault contains brain tissue,
cerebrospinal fluid, and blood. Because the skull is rigid, an increase in one component must
initially be compensated for by a reduction in another.
Question 8
What is the normal approximate intracranial pressure in an adult?
A. 0–5 mmHg
B. 0–15 mmHg
C. 20–30 mmHg
D. 35–50 mmHg
Correct Answer: B. 0–15 mmHg
Rationale: Normal adult ICP is generally approximately 0–15 mmHg. Sustained elevations can
compromise cerebral perfusion and cause neurological injury.
, Question 9
A patient develops a brain tumor that increases intracranial volume. According to the Monroe-
Kellie doctrine, what initially occurs?
A. The skull expands
B. Compensatory displacement or reduction of another intracranial component
C. Cerebral perfusion always increases
D. Neurons immediately regenerate
Correct Answer: B. Compensatory displacement or reduction of another intracranial
component
Rationale: Because the adult skull is rigid, the intracranial contents must compensate when one
component increases. Compensation may initially involve displacement of CSF or venous blood.
Question 10
When compensatory mechanisms become exhausted, what is most likely to occur?
A. ICP rises rapidly
B. Cerebral oxygen demand disappears
C. Brain tissue regenerates
D. Blood pressure always decreases
Correct Answer: A. ICP rises rapidly
Rationale: Once intracranial compliance is exhausted, even a small additional increase in
volume can cause a significant increase in ICP.
Question 11
Which condition can cause increased intracranial pressure?
A. Cerebral hemorrhage
B. Mild dehydration only
C. Normal sleep
D. Stable blood glucose
Correct Answer: A. Cerebral hemorrhage
Brain Function | 2026 Update with
complete solutions.
Question 1
A patient experiences severe cerebral ischemia. Which cellular change occurs first as oxygen
delivery becomes inadequate?
A. Increased ATP production
B. Cellular energy failure
C. Increased protein synthesis
D. Increased cerebral perfusion
Correct Answer: B. Cellular energy failure
Rationale: Ischemia decreases oxygen and nutrient delivery to brain tissue. Because neurons
depend heavily on aerobic metabolism, ATP production falls, leading to failure of cellular pumps
and progressive neuronal injury.
Question 2
Which statement best describes cerebral hypoxia?
A. Complete absence of cerebral blood flow
B. Insufficient oxygen available to brain tissue
C. Increased cerebrospinal fluid production
D. Excessive glucose delivery to neurons
Correct Answer: B. Insufficient oxygen available to brain tissue
Rationale: Hypoxia refers specifically to inadequate oxygen availability to tissue. Ischemia
involves inadequate blood flow and therefore commonly produces hypoxia.
Question 3
Why are neurons particularly vulnerable to ischemia?
A. They have very low metabolic requirements
B. They store large amounts of oxygen
,C. They have high metabolic demands and limited energy reserves
D. They can easily regenerate after injury
Correct Answer: C. They have high metabolic demands and limited energy reserves
Rationale: Neurons require continuous oxygen and glucose to maintain normal function.
Prolonged interruption of blood flow rapidly causes cellular dysfunction and irreversible injury.
Question 4
Which process occurs when cerebral ischemia persists?
A. Infarction
B. Hyperperfusion
C. Increased neuronal regeneration
D. Increased oxygen delivery
Correct Answer: A. Infarction
Rationale: Prolonged ischemia and hypoxia can cause irreversible cellular death and tissue
infarction.
Question 5
Which mechanism is characteristic of cytotoxic cerebral edema?
A. Breakdown of the blood-brain barrier only
B. Intracellular fluid accumulation caused by cellular energy failure
C. Increased CSF absorption
D. Decreased intracellular sodium
Correct Answer: B. Intracellular fluid accumulation caused by cellular energy failure
Rationale: ATP depletion impairs membrane ion pumps, particularly the sodium-potassium
pump. Sodium accumulates intracellularly, drawing water into cells and producing cytotoxic
edema.
Question 6
Which mechanism is most closely associated with vasogenic cerebral edema?
,A. Blood-brain barrier disruption
B. Increased intracellular potassium only
C. Complete neuronal regeneration
D. Reduced vascular permeability
Correct Answer: A. Blood-brain barrier disruption
Rationale: Vasogenic edema occurs when the blood-brain barrier becomes more permeable,
allowing fluid and proteins to move into extracellular brain tissue.
Question 7
Which three components are contained within the cranial vault according to the Monroe-Kellie
doctrine?
A. Brain tissue, CSF, and blood
B. Brain tissue, lymph, and muscle
C. CSF, bone marrow, and blood
D. Blood, lymph, and cartilage
Correct Answer: A. Brain tissue, CSF, and blood
Rationale: The Monroe-Kellie doctrine states that the intracranial vault contains brain tissue,
cerebrospinal fluid, and blood. Because the skull is rigid, an increase in one component must
initially be compensated for by a reduction in another.
Question 8
What is the normal approximate intracranial pressure in an adult?
A. 0–5 mmHg
B. 0–15 mmHg
C. 20–30 mmHg
D. 35–50 mmHg
Correct Answer: B. 0–15 mmHg
Rationale: Normal adult ICP is generally approximately 0–15 mmHg. Sustained elevations can
compromise cerebral perfusion and cause neurological injury.
, Question 9
A patient develops a brain tumor that increases intracranial volume. According to the Monroe-
Kellie doctrine, what initially occurs?
A. The skull expands
B. Compensatory displacement or reduction of another intracranial component
C. Cerebral perfusion always increases
D. Neurons immediately regenerate
Correct Answer: B. Compensatory displacement or reduction of another intracranial
component
Rationale: Because the adult skull is rigid, the intracranial contents must compensate when one
component increases. Compensation may initially involve displacement of CSF or venous blood.
Question 10
When compensatory mechanisms become exhausted, what is most likely to occur?
A. ICP rises rapidly
B. Cerebral oxygen demand disappears
C. Brain tissue regenerates
D. Blood pressure always decreases
Correct Answer: A. ICP rises rapidly
Rationale: Once intracranial compliance is exhausted, even a small additional increase in
volume can cause a significant increase in ICP.
Question 11
Which condition can cause increased intracranial pressure?
A. Cerebral hemorrhage
B. Mild dehydration only
C. Normal sleep
D. Stable blood glucose
Correct Answer: A. Cerebral hemorrhage
