CCN Final Exam Questions & Answers
1. Most sensitive indicator to anoxia or increase in ICP is - ANSWERSchange in LOC
2. Headache N&V, Cushing reflex: irregular respiratory patterns, wide pulse pressure,
bradycardia, increased systolic are signs of - ANSWERSelevation of ICP
Body has 2 ways to control ICP= - ANSWERScompliance (vols) and compensation (absorption &
production)
Cerebral perfusion pressure (CPP) = MAP-ICP = - ANSWERS=(60-90) maintained >70 decrease
mortality
When auto regulation fall CPP is dependent of - ANSWERSMAP alone
The highest CPP found in constriction is - ANSWERS150
The lowest CPP found in dilation - ANSWERS60
Medical Management of ICP (0-15) - ANSWERSHyperventilation on first 24-48 h, Osmotic
diuresis, Elevate HOB 30 degrees, prevent neck flexion, avoid hip flexion, group nursing
interventions, prevent straining, gagging or combative behavior, suction only when needed,
control stimulation and visitors.
ICP drain care - ANSWERSStrict aseptic technique, dressing should be occlusive, clean and dry,
and only cover drain site and immediate tubing, never secure tubing to bed.
,drill kit, PPE, Transducer set with sterile saline (no pressure bag, no heparin, no flushing, zero to
Foramen of Monroe [tragus of ear]) Document qh. - ANSWERSEquipement needed for insertion:
Green is to grass as Medulla is to - ANSWERSVasovagal
Epidural space - ANSWERSpotential
Arachnoid mater - ANSWERS(fragile membrane)
Subarachnoid space - ANSWERSbetween Arachnoid and Pia)-flow of CSF in this space
Circle of Willis - ANSWERSlarger arteries, site of many aneurysms
brocca area/Motor strip anterior to fissure of Rolando/personality, emotions, judgment, eye
motion, speech (majority in left (dominant) hemisphere) - ANSWERSFrontal lobe Speech
Spatial and pain awareness, touch and sensory input. Sensory strip posterior to fissure of
Rolando - ANSWERSParietal lobe
Hearing (Wernike's area), speech (understanding), behavior, emotion memory, intellect. -
ANSWERSTemporal lobe
Occipital lobe - ANSWERSvision
Diencephalon - ANSWERSThalamus and Hypothalamus
Hallmark sign of encephalitis - ANSWERSolfactory and taste hallucination
,Part of RAS, communicates pain, sleep and wake cycles - ANSWERSThalamus
Hypothalamus - ANSWERSusing endocrine system regulates homeostasis, respiration,
temperature water balance, heart rate, CO
Cerebellum - ANSWERSmuscle mov. and balance
Brainstem - ANSWERS(Midbrain, Pons, Medulla) origin of all nerves but I and II
Midbrain - ANSWERS(III and IV) visual and auditory reflexes
Pons - ANSWERS(V, VI, VII, VIII) portion of respiratory function
Medulla (IX, X, XI, XII) - ANSWERSregulates respiration and blood pressure (vasomotor function)
Nerve III (oculomotor) - ANSWERSconstrict pupils
Any suspicion about nerve X (pharynx & larynx) - ANSWERSdo neurocheck before feeding pt
Internal carotid artery - ANSWERSfeeds anterior brain
Posterior vertebral artery - ANSWERSfeeds posterior brain
thrombus - ANSWERSCircle of Willis most common place for aneurism and bifurcation of carotid
artery most common place for
, Central artery lesion (cortex) - ANSWERScontra lateral weakness, eyes deviates toward affected
hemisphere.
Basal vertebral artery affects - ANSWERSOccipital (vision
Brainstem damage - ANSWERS(pinpoint pupils, apneustic breathing)
36. NIH stroke exam (Neurological Deficit exam) - ANSWERSMental status: can follow
commands? Alert, Orient, Can you see?/Cranial Nerves: Smile, show me your teeth, facial drop?
Repeat this phrase.../Limbs: pronator drift?, sensation on limbs.
Stroke can be mimicked by - ANSWERShypoxia, hypoglycemia, seizures, brain tumor
Sub Arachnoid hemorrhage SAH - ANSWERS(meningues become irritated by circulating blood in
CSF s/s severe headache, N&V, decreased LOC
Secondary brain injuries: - ANSWERSresult by sequelae occurs mins to days after original insult
and are provoques by imbalance between O2 supply and demand or presence of waste
products.
Sub acute subdural hematoma - ANSWERS(symptoms develop in 2-4 days) changes in LOC,
headache, slow thinking, muscles weakness
Chronic subdural hematoma - ANSWERS(symptoms develop in 2 weeks-2 months) changes in
LOC, headache, slow thinking, muscles weakness, incontinence, steady decline, good prognosis.
Clinical signs of Seizure can be - ANSWERSmotor or sensory
Status epilepticus - ANSWERSMost common cause is suboptimal levels of anti-seizure meds
1. Most sensitive indicator to anoxia or increase in ICP is - ANSWERSchange in LOC
2. Headache N&V, Cushing reflex: irregular respiratory patterns, wide pulse pressure,
bradycardia, increased systolic are signs of - ANSWERSelevation of ICP
Body has 2 ways to control ICP= - ANSWERScompliance (vols) and compensation (absorption &
production)
Cerebral perfusion pressure (CPP) = MAP-ICP = - ANSWERS=(60-90) maintained >70 decrease
mortality
When auto regulation fall CPP is dependent of - ANSWERSMAP alone
The highest CPP found in constriction is - ANSWERS150
The lowest CPP found in dilation - ANSWERS60
Medical Management of ICP (0-15) - ANSWERSHyperventilation on first 24-48 h, Osmotic
diuresis, Elevate HOB 30 degrees, prevent neck flexion, avoid hip flexion, group nursing
interventions, prevent straining, gagging or combative behavior, suction only when needed,
control stimulation and visitors.
ICP drain care - ANSWERSStrict aseptic technique, dressing should be occlusive, clean and dry,
and only cover drain site and immediate tubing, never secure tubing to bed.
,drill kit, PPE, Transducer set with sterile saline (no pressure bag, no heparin, no flushing, zero to
Foramen of Monroe [tragus of ear]) Document qh. - ANSWERSEquipement needed for insertion:
Green is to grass as Medulla is to - ANSWERSVasovagal
Epidural space - ANSWERSpotential
Arachnoid mater - ANSWERS(fragile membrane)
Subarachnoid space - ANSWERSbetween Arachnoid and Pia)-flow of CSF in this space
Circle of Willis - ANSWERSlarger arteries, site of many aneurysms
brocca area/Motor strip anterior to fissure of Rolando/personality, emotions, judgment, eye
motion, speech (majority in left (dominant) hemisphere) - ANSWERSFrontal lobe Speech
Spatial and pain awareness, touch and sensory input. Sensory strip posterior to fissure of
Rolando - ANSWERSParietal lobe
Hearing (Wernike's area), speech (understanding), behavior, emotion memory, intellect. -
ANSWERSTemporal lobe
Occipital lobe - ANSWERSvision
Diencephalon - ANSWERSThalamus and Hypothalamus
Hallmark sign of encephalitis - ANSWERSolfactory and taste hallucination
,Part of RAS, communicates pain, sleep and wake cycles - ANSWERSThalamus
Hypothalamus - ANSWERSusing endocrine system regulates homeostasis, respiration,
temperature water balance, heart rate, CO
Cerebellum - ANSWERSmuscle mov. and balance
Brainstem - ANSWERS(Midbrain, Pons, Medulla) origin of all nerves but I and II
Midbrain - ANSWERS(III and IV) visual and auditory reflexes
Pons - ANSWERS(V, VI, VII, VIII) portion of respiratory function
Medulla (IX, X, XI, XII) - ANSWERSregulates respiration and blood pressure (vasomotor function)
Nerve III (oculomotor) - ANSWERSconstrict pupils
Any suspicion about nerve X (pharynx & larynx) - ANSWERSdo neurocheck before feeding pt
Internal carotid artery - ANSWERSfeeds anterior brain
Posterior vertebral artery - ANSWERSfeeds posterior brain
thrombus - ANSWERSCircle of Willis most common place for aneurism and bifurcation of carotid
artery most common place for
, Central artery lesion (cortex) - ANSWERScontra lateral weakness, eyes deviates toward affected
hemisphere.
Basal vertebral artery affects - ANSWERSOccipital (vision
Brainstem damage - ANSWERS(pinpoint pupils, apneustic breathing)
36. NIH stroke exam (Neurological Deficit exam) - ANSWERSMental status: can follow
commands? Alert, Orient, Can you see?/Cranial Nerves: Smile, show me your teeth, facial drop?
Repeat this phrase.../Limbs: pronator drift?, sensation on limbs.
Stroke can be mimicked by - ANSWERShypoxia, hypoglycemia, seizures, brain tumor
Sub Arachnoid hemorrhage SAH - ANSWERS(meningues become irritated by circulating blood in
CSF s/s severe headache, N&V, decreased LOC
Secondary brain injuries: - ANSWERSresult by sequelae occurs mins to days after original insult
and are provoques by imbalance between O2 supply and demand or presence of waste
products.
Sub acute subdural hematoma - ANSWERS(symptoms develop in 2-4 days) changes in LOC,
headache, slow thinking, muscles weakness
Chronic subdural hematoma - ANSWERS(symptoms develop in 2 weeks-2 months) changes in
LOC, headache, slow thinking, muscles weakness, incontinence, steady decline, good prognosis.
Clinical signs of Seizure can be - ANSWERSmotor or sensory
Status epilepticus - ANSWERSMost common cause is suboptimal levels of anti-seizure meds
