NURS 370 FINAL EXAM QUESTIONS
AND ANSWERS 100% PASS.
What is a subdural hemorrhage? - ANS A type of focal head injury between the dura &
arachnoid layers. Sheering of veins so occurs much slower
What is a epidural hemorrhage? - ANS A type of focal head injury between the skull & dura
layer. Sheering of arteries so occurs rapidly, compresses brain quickly, and rapid surgical
intervention is needed to prevent herniation
What's cushing's triad? - ANS A set of 3 manifestations that indicate impending
herniation/coning:
1. Bradycardia
2. Bradypnea/irregular respirations
3. Widening pulse pressure (sBP increases. dBP decreases)
What is normal ICP in an adult lying flat? - ANS 5-15 mmHg
What are temporal brain contusions? - ANS A type of focal head injury that bruises brain
tissue. Only treatment is treating elevated ICP
What is a subarachnoid hemorrhage? - ANS A diffuse head injury that occurs between the
arachnoid & pia layer. Pia layer so thin that bleeding spreads quite quickly through brain &
2026 STUDY MATERIAL @COPYRIGHT RESERVED 1
,causes damage fast. Manifestations similar to meningitis (sore/stiff neck, photophobia, severe
headache)
Manifestations of a subarachnoid hemorrhage are similar to meningitis. Why? - ANS The
meninges sit just below the pia layer
How do you measure mean arterial pressure (MAP)? - ANS MAP = (2xdBP + 1xsBP) / 3
What is cerebral perfusion pressure? - ANS The pressure needed to adequately perfuse brain
tissue
When do we start to worry about CPP (cerebral perfusion pressure)? Why? - ANS If CPP
drops below 60 we worry. Not enough perfusion to the brain
If CPP drops below 60 we aren't getting enough O2 to the brain. How can we improve brain
perfusion? - ANS Either increase mean arterial pressure or decrease intracranial pressure
(fine line between increasing MAP to increase CPP, but not so high that it increases ICP)
CPP = MAP - ICP
What is the formula for CPP? - ANS CPP = MAP - ICP
What is battle's sign? - ANS Bruising behind the ear. It indicates a skull fracture in the middle
cranial fossa
What is rhinorrhea? Otorrhea? - ANS Rhinorrhea - CSF leakage from nose
Otorrhea - CSF leakage from ear
How do you know if leakage is CSF or not? - ANS CSF will be clear and will form Halo Sign (the
interior part of the stain will look bloody)
2026 STUDY MATERIAL @COPYRIGHT RESERVED 2
, What do you do if your pt is leaking CSF? - ANS Apply a 3 sided dressing/loose 2x2. Lets fluid
out but prevents bacteria from entering
What is bilateral periorbital ecchymosis and what must you keep into consideration if someone
has this? - ANS Bilateral periorbital ecchymosis: bruising around eyes - indicates basil skull
fracture
If someone has this DO NOT insert NG/anything up nose (why? may go into brain)
What drug do you give to pts to decrease cerebral volume and lower ICP? - ANS Manitol
(osmotic diuretic) - most effective diuretic for pts with head injuries (draws out fluid from brain
tissue - fluid goes into vascular space and gets voided out)
What do you do if a pt with a brain injury starts hypoventilating? Why? - ANS Manually bag
them - then transfer pt to ICU & put on ventilator
Why? CO2 rises in hypoventilation - causes blood vessels to dilate - increased blood volume in
brain - increases ICP
When does peak swelling take place? - ANS 48-72 hr window
What is preload? What could increase/decrease preload? - ANS Preload: stretch in ventricles
at end diastole
Increases in: HF, hypervolemia
Decreases in: Blood loss/hemorrhage, vomit
What is after load? What could increase/decrease after load? - ANS After load: resistance left
ventricle must overcome to circulate blood
Increases in: hypertension, vasoconstriction
Decreases in: vasodilator administration
What is the formula to determine cardiac output? - ANS CO = HR x SV
2026 STUDY MATERIAL @COPYRIGHT RESERVED 3
AND ANSWERS 100% PASS.
What is a subdural hemorrhage? - ANS A type of focal head injury between the dura &
arachnoid layers. Sheering of veins so occurs much slower
What is a epidural hemorrhage? - ANS A type of focal head injury between the skull & dura
layer. Sheering of arteries so occurs rapidly, compresses brain quickly, and rapid surgical
intervention is needed to prevent herniation
What's cushing's triad? - ANS A set of 3 manifestations that indicate impending
herniation/coning:
1. Bradycardia
2. Bradypnea/irregular respirations
3. Widening pulse pressure (sBP increases. dBP decreases)
What is normal ICP in an adult lying flat? - ANS 5-15 mmHg
What are temporal brain contusions? - ANS A type of focal head injury that bruises brain
tissue. Only treatment is treating elevated ICP
What is a subarachnoid hemorrhage? - ANS A diffuse head injury that occurs between the
arachnoid & pia layer. Pia layer so thin that bleeding spreads quite quickly through brain &
2026 STUDY MATERIAL @COPYRIGHT RESERVED 1
,causes damage fast. Manifestations similar to meningitis (sore/stiff neck, photophobia, severe
headache)
Manifestations of a subarachnoid hemorrhage are similar to meningitis. Why? - ANS The
meninges sit just below the pia layer
How do you measure mean arterial pressure (MAP)? - ANS MAP = (2xdBP + 1xsBP) / 3
What is cerebral perfusion pressure? - ANS The pressure needed to adequately perfuse brain
tissue
When do we start to worry about CPP (cerebral perfusion pressure)? Why? - ANS If CPP
drops below 60 we worry. Not enough perfusion to the brain
If CPP drops below 60 we aren't getting enough O2 to the brain. How can we improve brain
perfusion? - ANS Either increase mean arterial pressure or decrease intracranial pressure
(fine line between increasing MAP to increase CPP, but not so high that it increases ICP)
CPP = MAP - ICP
What is the formula for CPP? - ANS CPP = MAP - ICP
What is battle's sign? - ANS Bruising behind the ear. It indicates a skull fracture in the middle
cranial fossa
What is rhinorrhea? Otorrhea? - ANS Rhinorrhea - CSF leakage from nose
Otorrhea - CSF leakage from ear
How do you know if leakage is CSF or not? - ANS CSF will be clear and will form Halo Sign (the
interior part of the stain will look bloody)
2026 STUDY MATERIAL @COPYRIGHT RESERVED 2
, What do you do if your pt is leaking CSF? - ANS Apply a 3 sided dressing/loose 2x2. Lets fluid
out but prevents bacteria from entering
What is bilateral periorbital ecchymosis and what must you keep into consideration if someone
has this? - ANS Bilateral periorbital ecchymosis: bruising around eyes - indicates basil skull
fracture
If someone has this DO NOT insert NG/anything up nose (why? may go into brain)
What drug do you give to pts to decrease cerebral volume and lower ICP? - ANS Manitol
(osmotic diuretic) - most effective diuretic for pts with head injuries (draws out fluid from brain
tissue - fluid goes into vascular space and gets voided out)
What do you do if a pt with a brain injury starts hypoventilating? Why? - ANS Manually bag
them - then transfer pt to ICU & put on ventilator
Why? CO2 rises in hypoventilation - causes blood vessels to dilate - increased blood volume in
brain - increases ICP
When does peak swelling take place? - ANS 48-72 hr window
What is preload? What could increase/decrease preload? - ANS Preload: stretch in ventricles
at end diastole
Increases in: HF, hypervolemia
Decreases in: Blood loss/hemorrhage, vomit
What is after load? What could increase/decrease after load? - ANS After load: resistance left
ventricle must overcome to circulate blood
Increases in: hypertension, vasoconstriction
Decreases in: vasodilator administration
What is the formula to determine cardiac output? - ANS CO = HR x SV
2026 STUDY MATERIAL @COPYRIGHT RESERVED 3
