9/21/25, 11:56 AM
NURS 4100 (AHIII) Test Bank Exam 4 Complete 80
Questions and Accurate Detailed Answers \Actual
Exam NSG 4100 Latest Update 2025-2026
The nurse is caring for a pt w D
increased
ICP. The pt has a nursing dx
of ineffective cerebral tissue
perfusion. What would be
an expected outcome that
the nurse would document
for this diagnosis?
a. copes w sensory deprivation
b. registers nml body
temperature
c. pays attention to grooming
d. obeys commands w
appropriate motor
responses
A pt exhibiting an altered LOC B
due to
blunt-force trauma to the
head is admitted to the ED.
The physician determines the
pt's injury is causing
increased ICP. The nurse
should gauge the pt's LOC
on the results of what
diagnostic tool?
a. Monro-Kellie hypothesis
b. Glasgow Coma Scale
c. Cranial nerve function
d. mental status examination
/ 1/107
,9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
A pt w increased ICP has a C
ventriculostomy for
monitoring ICP. The nurses
most recent assessment
reveals that the pt is now
exhibiting nuchal rigidity
and photophobia. The
nurse would be correct in
suspecting the presence
of what complication?
a. encephalitis
b. CSF leak
c. meningitis
d. catheter occlusion
The nurse is participating in B
the care of a pt w increased
ICP. What diagnostic test
is
contraindicated in this pt's
treatment?
a. computed tomography (CT)
scan
b. lumbar puncture
c. magnetic resonance imaging
(MRI)
d. venous doppler studies
The nurse has created a A
plan of care for a pt who is
at risk for increased ICP.
The pt's care plan should
specify monitoring for
what early sign of
increased ICP?
a. disorientation and
restlessness
b. decreased pulse and
respirations
c. projectile vomiting
d. loss of corneal reflex
/ 2/107
,9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
The neurologic ICU nurse is B
admitting a pt following a
craniotomy using the
supratentorial approach.
How should the nurse best
position the pt?
a. position the pt supine
b. maintain HOB elevated at
30-45 degrees
c. position pt in prone position
d. maintain bed in
Trendelenberg position
A pt has developed A
diabetes insipidness after
having increased ICP
following head trauma. What
nursing assessment best
addresses this complication?
a. vigilant monitoring of fluid
balance
b. continuous BP monitoring
c. serial arterial blood gases
(ABGs)
d. monitoring of the pt's airway
for patency
What would the nurse D
suspect when hourly
assessment of UO on a pt
postcrainiotomy exhibits a
urine output from a
catheter of 1,500mL for 2
consecutive hours?
a. ruching syndrom
b. syndrome of
inappropriate antidiuretic
hormone (SIADH)
c. adrenal crisis
d. diabetes insipidus
/ 3/107
, 9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
During the exam of an D
unconscious pt, the nurse
observes that the pt's pupils
are fixed and dilated. What
is the most plausible
clinical significant of the
nurses finding?
a. it suggests onset of
metabolic problems
b. it indicates paralysis on
the right side of the body
c. it indicates paralysis of
cranial nerve X
d. it indicates an injury at the
midbrain level
Following a traumatic brain C
injury, a pt has been in a
coma for several days.
Which of the following
statements is true of this
pt's current LOC?
a. the pt
occasionally
makes
incomprehensibl
e sounds
b. the pt's current LOC will
likely become a permanent
state
c. the pt may
occasionally make non
purposeful
movements
d. the pt is incapable of
spontaneous
respirations
/ 4/107
NURS 4100 (AHIII) Test Bank Exam 4 Complete 80
Questions and Accurate Detailed Answers \Actual
Exam NSG 4100 Latest Update 2025-2026
The nurse is caring for a pt w D
increased
ICP. The pt has a nursing dx
of ineffective cerebral tissue
perfusion. What would be
an expected outcome that
the nurse would document
for this diagnosis?
a. copes w sensory deprivation
b. registers nml body
temperature
c. pays attention to grooming
d. obeys commands w
appropriate motor
responses
A pt exhibiting an altered LOC B
due to
blunt-force trauma to the
head is admitted to the ED.
The physician determines the
pt's injury is causing
increased ICP. The nurse
should gauge the pt's LOC
on the results of what
diagnostic tool?
a. Monro-Kellie hypothesis
b. Glasgow Coma Scale
c. Cranial nerve function
d. mental status examination
/ 1/107
,9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
A pt w increased ICP has a C
ventriculostomy for
monitoring ICP. The nurses
most recent assessment
reveals that the pt is now
exhibiting nuchal rigidity
and photophobia. The
nurse would be correct in
suspecting the presence
of what complication?
a. encephalitis
b. CSF leak
c. meningitis
d. catheter occlusion
The nurse is participating in B
the care of a pt w increased
ICP. What diagnostic test
is
contraindicated in this pt's
treatment?
a. computed tomography (CT)
scan
b. lumbar puncture
c. magnetic resonance imaging
(MRI)
d. venous doppler studies
The nurse has created a A
plan of care for a pt who is
at risk for increased ICP.
The pt's care plan should
specify monitoring for
what early sign of
increased ICP?
a. disorientation and
restlessness
b. decreased pulse and
respirations
c. projectile vomiting
d. loss of corneal reflex
/ 2/107
,9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
The neurologic ICU nurse is B
admitting a pt following a
craniotomy using the
supratentorial approach.
How should the nurse best
position the pt?
a. position the pt supine
b. maintain HOB elevated at
30-45 degrees
c. position pt in prone position
d. maintain bed in
Trendelenberg position
A pt has developed A
diabetes insipidness after
having increased ICP
following head trauma. What
nursing assessment best
addresses this complication?
a. vigilant monitoring of fluid
balance
b. continuous BP monitoring
c. serial arterial blood gases
(ABGs)
d. monitoring of the pt's airway
for patency
What would the nurse D
suspect when hourly
assessment of UO on a pt
postcrainiotomy exhibits a
urine output from a
catheter of 1,500mL for 2
consecutive hours?
a. ruching syndrom
b. syndrome of
inappropriate antidiuretic
hormone (SIADH)
c. adrenal crisis
d. diabetes insipidus
/ 3/107
, 9/21/25, 12:56 PM NSG 4100 (AHIII) Exam 4 Testbank
During the exam of an D
unconscious pt, the nurse
observes that the pt's pupils
are fixed and dilated. What
is the most plausible
clinical significant of the
nurses finding?
a. it suggests onset of
metabolic problems
b. it indicates paralysis on
the right side of the body
c. it indicates paralysis of
cranial nerve X
d. it indicates an injury at the
midbrain level
Following a traumatic brain C
injury, a pt has been in a
coma for several days.
Which of the following
statements is true of this
pt's current LOC?
a. the pt
occasionally
makes
incomprehensibl
e sounds
b. the pt's current LOC will
likely become a permanent
state
c. the pt may
occasionally make non
purposeful
movements
d. the pt is incapable of
spontaneous
respirations
/ 4/107
