NR572 Final Exam Questions AND Correct Answers
24hr restraint/seclusion review - ✔✔A physician or LIP must
evaluate and document the continued need for restraints or
seclusion every 24 hours.
72 hour psychiatric hold - ✔✔Allowed if patient shows or
expresses homicidal or suicidal behavior. Evaluation and risk
assessment required. Voluntary patients may be discharged
earlier if improved.
ACA - ✔✔Anterior cerebral artery
Acute meningitis treatment: antibiotics - ✔✔Start antibiotics
within 60 mins; dexamethasone + 3rd/4th gen cephalosporin
+ vanco + acyclovir
Acyclovir - ✔✔Used for HSV, EBV, VZV encephalitis (10 mg/kg
q8h x 21 days)
Additional brain abscess management - ✔✔Anticonvulsants x3
months; EEG to guide discontinuation; Dexamethasone for
ICP/mass effect; Serial CT/MRI monthly.
Additional CSF findings in bacterial meningitis - ✔✔PMN
leukocytosis (>100); low glucose; CSF/serum glucose <0.4;
protein >0.45 g/L; Gram+/Culture+/PCR+
,After giving IV alteplase, what should be done 24 hours prior
to initiating anticoagulants or antiplatelet agents? - ✔✔A
follow-up CT scan of the head
Agnosia - ✔✔Inability to recognize familiar objects
Antibiotic treatment for patients >55 or with
immunosuppression - ✔✔Add ampicillin
Antibiotics for brain abscess (immunocompetent) - ✔✔3rd/4th
gen cephalosporin (cefepime/cefotaxime/ceftriaxone) +
metronidazole; Add vancomycin if neurosurgery/trauma.
Assessing substance-abuse and depression -
✔✔Antidepressants can be dangerous with alcohol; assess for
sedative abuse; use labs and collateral
Basal ganglia/thalamus involvement suggests - ✔✔Arboviruses,
TB, Creutzfeldt-Jacob disease, respiratory viral infections
Baseline labs for encephalitis - ✔✔Electrolytes, serum
glucose, CBC w/ diff, ESR/CRP, liver panel, coags, HIV testing
BE FAST - ✔✔Balance, Eyes, Face, Arms, Speech, Time
,Before diagnosing a hospitalized patient with delirium, what
should be done first? - ✔✔Begin with ruling out potential
underlying causes
Benzodiazepine precautions - ✔✔Avoid with CNS depressants;
caution in liver disease, elderly, mentally ill, respiratory
disease
Benzodiazepine side effects - ✔✔Sedation; paradoxical
agitation; dependence; withdrawal
Blood culture significance in brain abscess - ✔✔Positive blood
cultures occur in ~10%; Listeria: 85% show positive cultures.
Brain abscess - ✔✔Intracranial abscess above/below dura;
potentially life-threatening
Brief psychotic disorder - ✔✔Acute psychosis, stress-related;
lasts < 1 month; full remission with return to function
Brudzinski's sign - ✔✔Positive when passive neck flexion
causes spontaneous hip/knee flexion
, CAM-ICU (Confusion Assessment Method for ICU) - ✔✔Tool to
assess delirium: acute onset mental status change,
inattention, disorganized thinking, altered level of
consciousness; assess every shift
CAM-ICU scale - ✔✔See scale
Can restraint orders be PRN? - ✔✔No
Caregiver burden - ✔✔Stress during prolonged home care,
often seen in chronic illness like dementia; leads to physical
and psychiatric illness in caregivers
Causes of hemorrhagic stroke - ✔✔HTN, aneurysm, ischemic
stroke conversion, coagulopathy, trauma, AVM, drugs,
tumors, angiopathy
Central Sleep Apnea (CSA) - ✔✔Brain fails to signal respiratory
muscles; causes repeated breathing pauses.
Central vs Obstructive Sleep Apnea - ✔✔Central = no effort to
breathe, no snoring; brain doesn't send signal
Chemical restraints - ✔✔Any substance used to control
behaviors in a patient.
24hr restraint/seclusion review - ✔✔A physician or LIP must
evaluate and document the continued need for restraints or
seclusion every 24 hours.
72 hour psychiatric hold - ✔✔Allowed if patient shows or
expresses homicidal or suicidal behavior. Evaluation and risk
assessment required. Voluntary patients may be discharged
earlier if improved.
ACA - ✔✔Anterior cerebral artery
Acute meningitis treatment: antibiotics - ✔✔Start antibiotics
within 60 mins; dexamethasone + 3rd/4th gen cephalosporin
+ vanco + acyclovir
Acyclovir - ✔✔Used for HSV, EBV, VZV encephalitis (10 mg/kg
q8h x 21 days)
Additional brain abscess management - ✔✔Anticonvulsants x3
months; EEG to guide discontinuation; Dexamethasone for
ICP/mass effect; Serial CT/MRI monthly.
Additional CSF findings in bacterial meningitis - ✔✔PMN
leukocytosis (>100); low glucose; CSF/serum glucose <0.4;
protein >0.45 g/L; Gram+/Culture+/PCR+
,After giving IV alteplase, what should be done 24 hours prior
to initiating anticoagulants or antiplatelet agents? - ✔✔A
follow-up CT scan of the head
Agnosia - ✔✔Inability to recognize familiar objects
Antibiotic treatment for patients >55 or with
immunosuppression - ✔✔Add ampicillin
Antibiotics for brain abscess (immunocompetent) - ✔✔3rd/4th
gen cephalosporin (cefepime/cefotaxime/ceftriaxone) +
metronidazole; Add vancomycin if neurosurgery/trauma.
Assessing substance-abuse and depression -
✔✔Antidepressants can be dangerous with alcohol; assess for
sedative abuse; use labs and collateral
Basal ganglia/thalamus involvement suggests - ✔✔Arboviruses,
TB, Creutzfeldt-Jacob disease, respiratory viral infections
Baseline labs for encephalitis - ✔✔Electrolytes, serum
glucose, CBC w/ diff, ESR/CRP, liver panel, coags, HIV testing
BE FAST - ✔✔Balance, Eyes, Face, Arms, Speech, Time
,Before diagnosing a hospitalized patient with delirium, what
should be done first? - ✔✔Begin with ruling out potential
underlying causes
Benzodiazepine precautions - ✔✔Avoid with CNS depressants;
caution in liver disease, elderly, mentally ill, respiratory
disease
Benzodiazepine side effects - ✔✔Sedation; paradoxical
agitation; dependence; withdrawal
Blood culture significance in brain abscess - ✔✔Positive blood
cultures occur in ~10%; Listeria: 85% show positive cultures.
Brain abscess - ✔✔Intracranial abscess above/below dura;
potentially life-threatening
Brief psychotic disorder - ✔✔Acute psychosis, stress-related;
lasts < 1 month; full remission with return to function
Brudzinski's sign - ✔✔Positive when passive neck flexion
causes spontaneous hip/knee flexion
, CAM-ICU (Confusion Assessment Method for ICU) - ✔✔Tool to
assess delirium: acute onset mental status change,
inattention, disorganized thinking, altered level of
consciousness; assess every shift
CAM-ICU scale - ✔✔See scale
Can restraint orders be PRN? - ✔✔No
Caregiver burden - ✔✔Stress during prolonged home care,
often seen in chronic illness like dementia; leads to physical
and psychiatric illness in caregivers
Causes of hemorrhagic stroke - ✔✔HTN, aneurysm, ischemic
stroke conversion, coagulopathy, trauma, AVM, drugs,
tumors, angiopathy
Central Sleep Apnea (CSA) - ✔✔Brain fails to signal respiratory
muscles; causes repeated breathing pauses.
Central vs Obstructive Sleep Apnea - ✔✔Central = no effort to
breathe, no snoring; brain doesn't send signal
Chemical restraints - ✔✔Any substance used to control
behaviors in a patient.
