NURS 332 FINAL EXAM – 2025 COMPREHENSIVE
NEUROLOGY STUDY GUIDE WITH DETAILED EXAM
CONCEPTS AND DEFINITIONS
What does the blood-brain barrier do? - CORRECT ANSWER-Keeps some substances in the
bloodstream out of the cerbrospinal circulation and out of the brain tissue, substances that can pass
barrier: O2, glucose, CO2, alchohol, anestics and H2O
What are the 2 main components of the CNS - CORRECT ANSWER-1)Brain (controls all bodily
functions- interprets all stimuli) 2)Spinal cord (primary pathways for nerve impulses travelling
between peripheral areas of the body and brain)
What is a diffuse injury concussion? Name some signs and symptoms. - CORRECT ANSWER-
Physiologic disruption in brain function caused by a sudden traumatic impact that may or may not
involve loss of consciousness
-• Amnesia• Headache• Dizziness• Vertigo• Nausea/vomiting• Slurred speech• Confusion• *Post-
concussion syndrome
What is diffuse axonal injury? Clinical manifestations - CORRECT ANSWER-Widespread axonal
damage that occurs as a result of damage to the axons or disruption of axonal transmission of the
neural impulses- stretching/ tearing of the axons (swelling of neuronal axons)
-Clinical manifestations; immediate loss of consciousness → persistent coma increased ICP
decerebration or decortication global cerebral edema
What is the difference between decorticate and decerebrate? - CORRECT ANSWER--
Decorticate; posturing, with the arms flexed over the chest
-Decerebrate; posturing, with the arms extended at the sides
What can potentially occur in a secondary brain injury? - CORRECT ANSWER--Hypoxia, ischemia,
hypotension, hemorrhage, edema, or increased ICP- can occur hours- days after primary injury
(priority concern)
What type of injury is the leading cause of death for patients with head traumas? - CORRECT
ANSWER-Increased Intracranial pressure; brain is non-compliant and unable to compensate for
increased volume
,How can intracranial pressure develop? - CORRECT ANSWER--increase in brain tissue volume
(cerebral edema, hematoma), increase in cerebral blood volume (hypoxia or hypercapnia) and
increase in cerebrospinal fluid (hydrocephalus)
What is the mechanism of action for increased ICP - CORRECT ANSWER--Mechanism that
increases the volume in either; the circulation, brain tissue or the cerebrospinal fluid
-Increased volume- decreases the cerebral perfusion pressure- causing brain ischemia and infarction-
dire outcome (death)
Define Vasogenic cerebral edema and Hemorrhage - CORRECT ANSWER--Vasogenic cerebral
edema; most common → d/t a blood-brain barrier defect that allows proteins & fluids to leak from
blood into tissues & ↑ extracellular fluid volume
-Hemorrhage; d/t ruptured cerebral vessel that creates a space-occupying lesion (blood) within the
closed cranium
Explain each different hematoma; Epidural hematoma, subdural hematoma and intracerebral
hematoma - CORRECT ANSWER-Epidural hematoma; collection of blood b/w the dura & the
inner surface of the skull *classic presentation is a brief loss of consciousness followed by an episode
of being alert & oriented, & followed by a loss of consciousness
-Subdural hematoma; the most common type of traumatic intracranial hematoma accumulation of
blood below the dura & above the subarachnoid layer covering the brain bleeding from subdural
veins slow & neurologic deficits not apparent until substantial bleeding
-Intracerebral hematoma; accumulation of blood in the parenchyma of brain tissue rather than b/w
meninges *most often caused by a hypertensive rupture of a cerebral vessel
What is the best way to diagnose cranio cerebral trauma? - CORRECT ANSWER-CT scan-
perform neuro assessment and any changes in LOC
What is a subarachnoid hemorrhage? - CORRECT ANSWER--accumulation of blood/hematoma
between the meningeal arachnoid layer and the pia mater surrounding the brain most commonly
results from a ruptured cerebral aneurysm*
Name some signs and symptoms of a sub arachnoid hemorrhage? - CORRECT ANSWER-*Severe
headache* Intracranial hypotension Nuchal rigidity Intermittent nausea Stiff back & legs
, What type of assessments would you do for a patient with a suspected hemorrhage? - CORRECT
ANSWER-Assess for signs of increased ICP, hypotension, hypoxemia, hypercarbia and hypocarbia
-Priority is ABC's- notice changes in breathing patterns (Cheynne stokes)
-spine precations and vital sign assessments
-Neurological assessments; any changes
What is Cushing's triad? - CORRECT ANSWER-hypertension
bradycardia
irregular respirations
-Indicative of ICP
Acute nursing interventions for resp. function, fluid and electrolyte balance and monitoring
intracranial pressure - CORRECT ANSWER--Resp. function; prevent hypoxia and hypercapnia
and pain management
-Fluid and electrolyte balance; serum glucose, sodium, potassium, & osmolality
-Monitoring intracranial pressure; body position protection from injury psychological considerations
What are some acute nursing interventions for increased ICP? - CORRECT ANSWER-Keep neck
in neutral alignment and hip flexion less than 90 degrees ↑ HOB 30 degrees Suction < 10 seconds at
a time Space nursing activities Monitor environmental stimuli Monitor for therapeutic &
nontherapeutic effects of drugs
What is the difference between traumatic and non-traumatic spinal cord injuries? - CORRECT
ANSWER--Traumatic; Results of external impact and most often preventable- majority are cervical
injuries cause devestating neurological impairment (Trauma is the leading cause of spinal cord
injuries)
-Non- traumatic; Result of disease, infection or tumors (aging population)
complete spinal cord injury. What are the 2 types? - CORRECT ANSWER-injury in which there is
complete loss of sensation and muscle control below the level of the injury
(Tetraplegia and paraplegia)
NEUROLOGY STUDY GUIDE WITH DETAILED EXAM
CONCEPTS AND DEFINITIONS
What does the blood-brain barrier do? - CORRECT ANSWER-Keeps some substances in the
bloodstream out of the cerbrospinal circulation and out of the brain tissue, substances that can pass
barrier: O2, glucose, CO2, alchohol, anestics and H2O
What are the 2 main components of the CNS - CORRECT ANSWER-1)Brain (controls all bodily
functions- interprets all stimuli) 2)Spinal cord (primary pathways for nerve impulses travelling
between peripheral areas of the body and brain)
What is a diffuse injury concussion? Name some signs and symptoms. - CORRECT ANSWER-
Physiologic disruption in brain function caused by a sudden traumatic impact that may or may not
involve loss of consciousness
-• Amnesia• Headache• Dizziness• Vertigo• Nausea/vomiting• Slurred speech• Confusion• *Post-
concussion syndrome
What is diffuse axonal injury? Clinical manifestations - CORRECT ANSWER-Widespread axonal
damage that occurs as a result of damage to the axons or disruption of axonal transmission of the
neural impulses- stretching/ tearing of the axons (swelling of neuronal axons)
-Clinical manifestations; immediate loss of consciousness → persistent coma increased ICP
decerebration or decortication global cerebral edema
What is the difference between decorticate and decerebrate? - CORRECT ANSWER--
Decorticate; posturing, with the arms flexed over the chest
-Decerebrate; posturing, with the arms extended at the sides
What can potentially occur in a secondary brain injury? - CORRECT ANSWER--Hypoxia, ischemia,
hypotension, hemorrhage, edema, or increased ICP- can occur hours- days after primary injury
(priority concern)
What type of injury is the leading cause of death for patients with head traumas? - CORRECT
ANSWER-Increased Intracranial pressure; brain is non-compliant and unable to compensate for
increased volume
,How can intracranial pressure develop? - CORRECT ANSWER--increase in brain tissue volume
(cerebral edema, hematoma), increase in cerebral blood volume (hypoxia or hypercapnia) and
increase in cerebrospinal fluid (hydrocephalus)
What is the mechanism of action for increased ICP - CORRECT ANSWER--Mechanism that
increases the volume in either; the circulation, brain tissue or the cerebrospinal fluid
-Increased volume- decreases the cerebral perfusion pressure- causing brain ischemia and infarction-
dire outcome (death)
Define Vasogenic cerebral edema and Hemorrhage - CORRECT ANSWER--Vasogenic cerebral
edema; most common → d/t a blood-brain barrier defect that allows proteins & fluids to leak from
blood into tissues & ↑ extracellular fluid volume
-Hemorrhage; d/t ruptured cerebral vessel that creates a space-occupying lesion (blood) within the
closed cranium
Explain each different hematoma; Epidural hematoma, subdural hematoma and intracerebral
hematoma - CORRECT ANSWER-Epidural hematoma; collection of blood b/w the dura & the
inner surface of the skull *classic presentation is a brief loss of consciousness followed by an episode
of being alert & oriented, & followed by a loss of consciousness
-Subdural hematoma; the most common type of traumatic intracranial hematoma accumulation of
blood below the dura & above the subarachnoid layer covering the brain bleeding from subdural
veins slow & neurologic deficits not apparent until substantial bleeding
-Intracerebral hematoma; accumulation of blood in the parenchyma of brain tissue rather than b/w
meninges *most often caused by a hypertensive rupture of a cerebral vessel
What is the best way to diagnose cranio cerebral trauma? - CORRECT ANSWER-CT scan-
perform neuro assessment and any changes in LOC
What is a subarachnoid hemorrhage? - CORRECT ANSWER--accumulation of blood/hematoma
between the meningeal arachnoid layer and the pia mater surrounding the brain most commonly
results from a ruptured cerebral aneurysm*
Name some signs and symptoms of a sub arachnoid hemorrhage? - CORRECT ANSWER-*Severe
headache* Intracranial hypotension Nuchal rigidity Intermittent nausea Stiff back & legs
, What type of assessments would you do for a patient with a suspected hemorrhage? - CORRECT
ANSWER-Assess for signs of increased ICP, hypotension, hypoxemia, hypercarbia and hypocarbia
-Priority is ABC's- notice changes in breathing patterns (Cheynne stokes)
-spine precations and vital sign assessments
-Neurological assessments; any changes
What is Cushing's triad? - CORRECT ANSWER-hypertension
bradycardia
irregular respirations
-Indicative of ICP
Acute nursing interventions for resp. function, fluid and electrolyte balance and monitoring
intracranial pressure - CORRECT ANSWER--Resp. function; prevent hypoxia and hypercapnia
and pain management
-Fluid and electrolyte balance; serum glucose, sodium, potassium, & osmolality
-Monitoring intracranial pressure; body position protection from injury psychological considerations
What are some acute nursing interventions for increased ICP? - CORRECT ANSWER-Keep neck
in neutral alignment and hip flexion less than 90 degrees ↑ HOB 30 degrees Suction < 10 seconds at
a time Space nursing activities Monitor environmental stimuli Monitor for therapeutic &
nontherapeutic effects of drugs
What is the difference between traumatic and non-traumatic spinal cord injuries? - CORRECT
ANSWER--Traumatic; Results of external impact and most often preventable- majority are cervical
injuries cause devestating neurological impairment (Trauma is the leading cause of spinal cord
injuries)
-Non- traumatic; Result of disease, infection or tumors (aging population)
complete spinal cord injury. What are the 2 types? - CORRECT ANSWER-injury in which there is
complete loss of sensation and muscle control below the level of the injury
(Tetraplegia and paraplegia)
