AACN NEURO-encephalopathy BLUEPRINT
ACNPC-AG Exam Reviewed Questions and
Answers Latest 2025/2026 GRADED A
Approach to diagnosis for altered mental status: - CORRECT ANSWER-[1.] Identify the
problem (history, exam);
[ 2.] Are there focal neuro findings? (If so--needs CT scan; If no--
need MRI);
[3.] If not do toxic-metabolic workup
EEG can be useful for testing encephalopathy because - CORRECT ANSWER-[1] can
help to differentiate neuro vs. psych;
[2]. Rule out subclinical seizures or "non-convulsive status epilepticus"
(encephalopathy mimic)
Encephalopathy - CORRECT ANSWER-Definition: Inability to carry out a coherent plan
of thought or
Action.
What mental status exam tests would you do in an
encephalopathic patient? level of alertness, orientation, and attention
What test for encephalopathy? Vital signs and labs; Brain imaging can be normal but
EEG shows encephalopathy, EEG can be useful for testing encephalopathy because [1]
can help to differentiate neuro vs. psych; [2]. Rule out subclinical seizures or "non-
convulsive status epilepticus" (encephalopathy mimic)
, Mimics of Encephalopathy include: Dementia with Lewy Bodies; REM sleep behavior
disorder (act out dreams) and parasomnias (sleepwalking); Wernicke's aphasia;
Psychosis, mania, depression; Nonconvulsive status epilepticus (last two: differentiate
with EEG)
The hallmark of encephalopathy is: Impaired ATTENTION (early finding in delirium, late
finding in dementia)
Symptoms of encephalopathy include: Hallucinations, delusions, agitation or lethargy;
Irritation to light touch; Withdraw limbs unequally; Asterixis, myoclonus, tremor,
sometimes hyperreflexia (acute liver malfunction)/hyporeflexia (thyroid derangement)
T/F: Encephalopathy is often multifactorial: TRUE
Why does encephalopathy occur? Metabolic homeostasis imbalance
What can global disruption of metabolic homeostasis result in:
Behavior change, poor coordination, ataxia, confusion, seizures, stupor and coma; May
be a lag in recovery of CNS symptoms after the metabolic problem is corrected
Encephalopathy causes include:
VIITTAMIN: Vascular, Inflammatory, Infectious, Traumatic, Toxins, Autoimmune,
Metabolic, Idopathic/Genetic; Neoplastic
Vascular- Hypertensive encephalopathy
Inflammatory- Urinary tract infection in elderly; Infection of the
CNS (encephalitis)
ACNPC-AG Exam Reviewed Questions and
Answers Latest 2025/2026 GRADED A
Approach to diagnosis for altered mental status: - CORRECT ANSWER-[1.] Identify the
problem (history, exam);
[ 2.] Are there focal neuro findings? (If so--needs CT scan; If no--
need MRI);
[3.] If not do toxic-metabolic workup
EEG can be useful for testing encephalopathy because - CORRECT ANSWER-[1] can
help to differentiate neuro vs. psych;
[2]. Rule out subclinical seizures or "non-convulsive status epilepticus"
(encephalopathy mimic)
Encephalopathy - CORRECT ANSWER-Definition: Inability to carry out a coherent plan
of thought or
Action.
What mental status exam tests would you do in an
encephalopathic patient? level of alertness, orientation, and attention
What test for encephalopathy? Vital signs and labs; Brain imaging can be normal but
EEG shows encephalopathy, EEG can be useful for testing encephalopathy because [1]
can help to differentiate neuro vs. psych; [2]. Rule out subclinical seizures or "non-
convulsive status epilepticus" (encephalopathy mimic)
, Mimics of Encephalopathy include: Dementia with Lewy Bodies; REM sleep behavior
disorder (act out dreams) and parasomnias (sleepwalking); Wernicke's aphasia;
Psychosis, mania, depression; Nonconvulsive status epilepticus (last two: differentiate
with EEG)
The hallmark of encephalopathy is: Impaired ATTENTION (early finding in delirium, late
finding in dementia)
Symptoms of encephalopathy include: Hallucinations, delusions, agitation or lethargy;
Irritation to light touch; Withdraw limbs unequally; Asterixis, myoclonus, tremor,
sometimes hyperreflexia (acute liver malfunction)/hyporeflexia (thyroid derangement)
T/F: Encephalopathy is often multifactorial: TRUE
Why does encephalopathy occur? Metabolic homeostasis imbalance
What can global disruption of metabolic homeostasis result in:
Behavior change, poor coordination, ataxia, confusion, seizures, stupor and coma; May
be a lag in recovery of CNS symptoms after the metabolic problem is corrected
Encephalopathy causes include:
VIITTAMIN: Vascular, Inflammatory, Infectious, Traumatic, Toxins, Autoimmune,
Metabolic, Idopathic/Genetic; Neoplastic
Vascular- Hypertensive encephalopathy
Inflammatory- Urinary tract infection in elderly; Infection of the
CNS (encephalitis)
