Exam 3: TBI (NCLEX) Graded A 2025

1. Patient with head injury. Which of the following are manifestations of Increased ICP? SELECT ALL THAT APPLY A.Headache. B.Tachycardia C.Hypotension D.Pupillary changes. E.Abnormal posturing. - ADE 2. Abnormal extension (Decerebrate) posturing is characterized by which of the following? A. Extension of extremities and pronation of the arms B. Flexion of extremities and pronation of arms C. Upper extremity flexion with lower extremity extension D. Upper extremity extension with lower extremity flexion. - D 3. A client with increased ICP is prescribed the following tests. The nurse would clarify which test with the physician? A. MRI B. LP C. CT Scan. D. Cerebral angiography - B 4. Client sustained closed head injury. Nurse assesses for which early sign of impending neurological deterioration? A. Loss of corneal reflex B.Increased visual acuity C.Bilateral pupil equality and reactivity D.Ipsilateral pupil dilation. - D 5. Client with diagnosis of SIADH. The nurse would expect to see what laboratory finding? A. Serum sodium 125. B. Serum potassium 2.7 C. Serum glucose 250 D. Serum chloride 110 - A