,NU 545 Unit 7 Exam | Physio-Path Basis of Adv Nursing
(2026) Q&A | University of South Alabama
1. Which of the following best describes the primary mechanism of vasogenic
cerebral edema?
A) Cellular swelling from impaired Na+/K+ ATPase activity
B) Increased permeability of the blood-brain barrier with protein-rich fluid
leakage
C) Cerebrospinal fluid accumulation in the ventricles
D) Osmotic shift of water into brain cells from hyponatremia
Correct Answer: Increased permeability of the blood-brain barrier with
protein-rich fluid leakage
Rationale: Vasogenic edema results from breakdown of the blood-brain barrier,
allowing protein-rich fluid to enter the extracellular space, commonly seen with
tumors, abscesses, and inflammation. Cytotoxic edema involves cellular swelling
from ATPase failure, interstitial edema occurs with hydrocephalus, and osmotic
edema results from hyponatremia.
2. What is the primary pathophysiologic mechanism of neurogenic shock following
a spinal cord injury above T6?
A) Loss of intravascular volume from hemorrhage
B) Pump failure due to myocardial contusion
C) Loss of sympathetic vascular tone leading to vasodilation and bradycardia
D) Physical obstruction of blood flow by a thrombus
,Correct Answer: Loss of sympathetic vascular tone leading to vasodilation and
bradycardia
Rationale: Neurogenic shock results from disruption of sympathetic outflow,
causing widespread vasodilation, decreased systemic vascular resistance, and
unopposed vagal tone with bradycardia. Hemorrhagic shock involves volume loss,
cardiogenic shock involves pump failure, and obstructive shock involves physical
obstruction.
3. Which herniation syndrome is characterized by ipsilateral pupillary dilation and
contralateral hemiparesis?
A) Central herniation
B) Subfalcine herniation
C) Tonsillar herniation
D) Uncal herniation
Correct Answer: Uncal herniation
Rationale: Uncal herniation compresses the oculomotor nerve, causing
ipsilateral pupillary dilation, and compresses the cerebral peduncle, causing
contralateral hemiparesis. Central herniation causes bilateral small pupils,
subfalcine herniation causes contralateral leg weakness, and tonsillar herniation
causes respiratory arrest.
4. The nurse is reviewing the mechanism of seizure generation in epilepsy. Which
imbalance is primarily responsible?
A) Excessive GABA activity and decreased glutamate activity
B) Imbalance between excitatory and inhibitory neurotransmission
, C) Increased serotonin activity
D) Decreased dopamine activity
Correct Answer: Imbalance between excitatory and inhibitory
neurotransmission
Rationale: Seizures result from an imbalance between excitatory glutamate and
inhibitory GABA neurotransmission, leading to abnormal, excessive, synchronous
neuronal firing. Excessive GABA would inhibit seizures, and serotonin and
dopamine are not the primary neurotransmitters involved in seizure generation.
5. What is the primary pathophysiologic mechanism of a concussion?
A) Intracerebral hemorrhage
B) Epidural hematoma formation
C) Diffuse axonal injury and metabolic dysfunction without structural damage
D) Skull fracture with bone fragment displacement
Correct Answer: Diffuse axonal injury and metabolic dysfunction without
structural damage
Rationale: Concussion is a mild traumatic brain injury characterized by diffuse
axonal injury, ionic shifts, and metabolic dysfunction without gross structural
damage on standard imaging. Intracerebral hemorrhage, epidural hematoma, and
skull fracture are distinct structural injuries.
6. Which vessel is most commonly injured in an epidural hematoma?
A) Bridging veins
B) Middle meningeal artery
(2026) Q&A | University of South Alabama
1. Which of the following best describes the primary mechanism of vasogenic
cerebral edema?
A) Cellular swelling from impaired Na+/K+ ATPase activity
B) Increased permeability of the blood-brain barrier with protein-rich fluid
leakage
C) Cerebrospinal fluid accumulation in the ventricles
D) Osmotic shift of water into brain cells from hyponatremia
Correct Answer: Increased permeability of the blood-brain barrier with
protein-rich fluid leakage
Rationale: Vasogenic edema results from breakdown of the blood-brain barrier,
allowing protein-rich fluid to enter the extracellular space, commonly seen with
tumors, abscesses, and inflammation. Cytotoxic edema involves cellular swelling
from ATPase failure, interstitial edema occurs with hydrocephalus, and osmotic
edema results from hyponatremia.
2. What is the primary pathophysiologic mechanism of neurogenic shock following
a spinal cord injury above T6?
A) Loss of intravascular volume from hemorrhage
B) Pump failure due to myocardial contusion
C) Loss of sympathetic vascular tone leading to vasodilation and bradycardia
D) Physical obstruction of blood flow by a thrombus
,Correct Answer: Loss of sympathetic vascular tone leading to vasodilation and
bradycardia
Rationale: Neurogenic shock results from disruption of sympathetic outflow,
causing widespread vasodilation, decreased systemic vascular resistance, and
unopposed vagal tone with bradycardia. Hemorrhagic shock involves volume loss,
cardiogenic shock involves pump failure, and obstructive shock involves physical
obstruction.
3. Which herniation syndrome is characterized by ipsilateral pupillary dilation and
contralateral hemiparesis?
A) Central herniation
B) Subfalcine herniation
C) Tonsillar herniation
D) Uncal herniation
Correct Answer: Uncal herniation
Rationale: Uncal herniation compresses the oculomotor nerve, causing
ipsilateral pupillary dilation, and compresses the cerebral peduncle, causing
contralateral hemiparesis. Central herniation causes bilateral small pupils,
subfalcine herniation causes contralateral leg weakness, and tonsillar herniation
causes respiratory arrest.
4. The nurse is reviewing the mechanism of seizure generation in epilepsy. Which
imbalance is primarily responsible?
A) Excessive GABA activity and decreased glutamate activity
B) Imbalance between excitatory and inhibitory neurotransmission
, C) Increased serotonin activity
D) Decreased dopamine activity
Correct Answer: Imbalance between excitatory and inhibitory
neurotransmission
Rationale: Seizures result from an imbalance between excitatory glutamate and
inhibitory GABA neurotransmission, leading to abnormal, excessive, synchronous
neuronal firing. Excessive GABA would inhibit seizures, and serotonin and
dopamine are not the primary neurotransmitters involved in seizure generation.
5. What is the primary pathophysiologic mechanism of a concussion?
A) Intracerebral hemorrhage
B) Epidural hematoma formation
C) Diffuse axonal injury and metabolic dysfunction without structural damage
D) Skull fracture with bone fragment displacement
Correct Answer: Diffuse axonal injury and metabolic dysfunction without
structural damage
Rationale: Concussion is a mild traumatic brain injury characterized by diffuse
axonal injury, ionic shifts, and metabolic dysfunction without gross structural
damage on standard imaging. Intracerebral hemorrhage, epidural hematoma, and
skull fracture are distinct structural injuries.
6. Which vessel is most commonly injured in an epidural hematoma?
A) Bridging veins
B) Middle meningeal artery
