ECCO HEMODYNAMIC MONITORING
CRITICALLY ILL PATIENTS PART 2 ACTUAL
EXAM 2026 QUESTIONS WITH COMPLETE
SOLUTIONS GRADED A+
⩥ A patient is admitted after sustaining traumatic brain injury in a
motorcycle crash. The patent's GCS score on admission is E 2, M 3, V
1T = 6T. Which of the following should the nurse perform to prepare the
patient for ICP monitoring? Answer: Prior to placement of an ICP
monitoring catheter, a neurologic assessment is performed in order to
have a baseline assessment to compare to the postinsertion assessment.
⩥ A patient is admitted following a drug overdose. The patient does not
open eyes upon verbal request but localizes to a trapezius muscle
squeeze without opening eyes. The nurse should document the patient's
mental status as: Answer: Responsive to painful stimuli
⩥ You are caring for an unconscious patient with traumatic brain injury
from a motor vehicle crash. His alcohol and toxicology screen are
negative, he has no facial fractures, and he's not receiving pain or
sedation medication. Vital signs: BP 100/70 (80), HR 86 sinus rhythm,
SpO2 95% with endotracheal tube secured. Upon application of painful
stimuli with supraorbital notch pressure, the patient clenches fists, holds
legs straight out, and bends arms inward toward the body. Fingers are
bent and held on the chest. The nurse should document this response as:
Answer: Abnormal flexor posturing
,⩥ In a patient with a subarachnoid hemorrhage, what is the purpose of a
transcranial Doppler (TCD) test? Answer: Measure blood flow velocity
to assess for vasospasm.
Transcranial Doppler (TCD) uses ultrasound technology to evaluate
cerebral blood flow and arterial narrowing in the major cerebral vessels.
If arterial passages have narrowed, as in vasospasm, blood flow velocity
is increased.
⩥ Which of the following patients should the nurse anticipate as most
likely to develop hyponatremia and hypo-osmolality? A patient: Answer:
Two days post severe traumatic brain injury
⩥ A nurse finds that a patient does not move spontaneously or follow
commands. To assess the patient's motor function, the nurse applies a
central pain stimulus, without response. What is the nurse's next step?
Answer: Apply peripheral pain stimulus
⩥ In determining LOC, a nurse finds that a patient post multisystem
trauma does not respond to loud questions, statements, or a light
shoulder touch. What should be the nurse's next step? Answer: Assess a
central pain stimulus response
,⩥ Which of the following may result in a decreased supply of oxygen to
the brain? Answer: Hypotension and hypoxia are the primary systemic
causes of decreased oxygen supply.
⩥ In assessing an unconscious patient who is noted to have new-onset
sluggish pupillary light reflex, deficits in what other cranial nerve
reflexes can indicate brainstem compression? Answer: Deficits in pupil
reactivity to light and the basic protective reflexes (e.g., gag, cough,
corneal) in an unconscious patient can indicate brainstem compression.
Report new-onset or previously unknown deficits immediately to the
provider.
⩥ Which of the following should the nurse perform immediately after
insertion of the ICP monitoring device is completed? Answer: Assess
neurologic status and compare to assessment before insertion.
⩥ Which of the following central pain stimuli should the nurse use to
assess motor function in a patient who is unconscious and who has facial
fractures? Answer: Use the trapezius squeeze as a central pain stimulus
in patients who have facial injuries.
⩥ A patient is admitted after an unwitnessed cardiac arrest at home.
Review the EMR. What criterion is anticipated as part of the decision-
making process to support declaration of death by neurologic criteria?
Answer: The PaCO2 increases to 68 when off ventilator for 8 minutes.
, During an apnea test, patients without brainstem function will remain
apneic even when the PaCO2 reaches very high levels.
⩥ A patient with an EVD in place suddenly develops disorientation to
place, and ICP suddenly increases from 15 to 22 mm Hg. EVD drainage
system troubleshooting indicates no visible blockages and no CSF fluid
fluctuation, and the EVD is no longer draining. Which of the following
interventions is the highest priority? Answer: Inform the provider of the
assessment and EVD status
⩥ Your patient blinks and can move eyes up and down. Respirations are
irregular with periods of apnea; gag reflex and motor movement of
extremities are absent. What is your highest priority intervention?
Answer: Secure the airway
⩥ A patient is admitted with a subarachnoid hemorrhage. She is restless
and agitated, and complaining of an ongoing headache 10/10. Which of
the following changes in signs and symptoms requires an immediate call
to the provider? Answer: Unresponsiveness to physical stimuli and
sluggish pupillary response
⩥ When a nurse asks a patient's name, The patient replies with the name
of the town where the hospital is located. When asked what day it is, he
replies "house." Shown a hairbrush and asked to name it, he replies
"dog." What other step(s) should the nurse take to evaluate the patient's
language functioning? Answer: Ask the patient to raise one arm slowly.
CRITICALLY ILL PATIENTS PART 2 ACTUAL
EXAM 2026 QUESTIONS WITH COMPLETE
SOLUTIONS GRADED A+
⩥ A patient is admitted after sustaining traumatic brain injury in a
motorcycle crash. The patent's GCS score on admission is E 2, M 3, V
1T = 6T. Which of the following should the nurse perform to prepare the
patient for ICP monitoring? Answer: Prior to placement of an ICP
monitoring catheter, a neurologic assessment is performed in order to
have a baseline assessment to compare to the postinsertion assessment.
⩥ A patient is admitted following a drug overdose. The patient does not
open eyes upon verbal request but localizes to a trapezius muscle
squeeze without opening eyes. The nurse should document the patient's
mental status as: Answer: Responsive to painful stimuli
⩥ You are caring for an unconscious patient with traumatic brain injury
from a motor vehicle crash. His alcohol and toxicology screen are
negative, he has no facial fractures, and he's not receiving pain or
sedation medication. Vital signs: BP 100/70 (80), HR 86 sinus rhythm,
SpO2 95% with endotracheal tube secured. Upon application of painful
stimuli with supraorbital notch pressure, the patient clenches fists, holds
legs straight out, and bends arms inward toward the body. Fingers are
bent and held on the chest. The nurse should document this response as:
Answer: Abnormal flexor posturing
,⩥ In a patient with a subarachnoid hemorrhage, what is the purpose of a
transcranial Doppler (TCD) test? Answer: Measure blood flow velocity
to assess for vasospasm.
Transcranial Doppler (TCD) uses ultrasound technology to evaluate
cerebral blood flow and arterial narrowing in the major cerebral vessels.
If arterial passages have narrowed, as in vasospasm, blood flow velocity
is increased.
⩥ Which of the following patients should the nurse anticipate as most
likely to develop hyponatremia and hypo-osmolality? A patient: Answer:
Two days post severe traumatic brain injury
⩥ A nurse finds that a patient does not move spontaneously or follow
commands. To assess the patient's motor function, the nurse applies a
central pain stimulus, without response. What is the nurse's next step?
Answer: Apply peripheral pain stimulus
⩥ In determining LOC, a nurse finds that a patient post multisystem
trauma does not respond to loud questions, statements, or a light
shoulder touch. What should be the nurse's next step? Answer: Assess a
central pain stimulus response
,⩥ Which of the following may result in a decreased supply of oxygen to
the brain? Answer: Hypotension and hypoxia are the primary systemic
causes of decreased oxygen supply.
⩥ In assessing an unconscious patient who is noted to have new-onset
sluggish pupillary light reflex, deficits in what other cranial nerve
reflexes can indicate brainstem compression? Answer: Deficits in pupil
reactivity to light and the basic protective reflexes (e.g., gag, cough,
corneal) in an unconscious patient can indicate brainstem compression.
Report new-onset or previously unknown deficits immediately to the
provider.
⩥ Which of the following should the nurse perform immediately after
insertion of the ICP monitoring device is completed? Answer: Assess
neurologic status and compare to assessment before insertion.
⩥ Which of the following central pain stimuli should the nurse use to
assess motor function in a patient who is unconscious and who has facial
fractures? Answer: Use the trapezius squeeze as a central pain stimulus
in patients who have facial injuries.
⩥ A patient is admitted after an unwitnessed cardiac arrest at home.
Review the EMR. What criterion is anticipated as part of the decision-
making process to support declaration of death by neurologic criteria?
Answer: The PaCO2 increases to 68 when off ventilator for 8 minutes.
, During an apnea test, patients without brainstem function will remain
apneic even when the PaCO2 reaches very high levels.
⩥ A patient with an EVD in place suddenly develops disorientation to
place, and ICP suddenly increases from 15 to 22 mm Hg. EVD drainage
system troubleshooting indicates no visible blockages and no CSF fluid
fluctuation, and the EVD is no longer draining. Which of the following
interventions is the highest priority? Answer: Inform the provider of the
assessment and EVD status
⩥ Your patient blinks and can move eyes up and down. Respirations are
irregular with periods of apnea; gag reflex and motor movement of
extremities are absent. What is your highest priority intervention?
Answer: Secure the airway
⩥ A patient is admitted with a subarachnoid hemorrhage. She is restless
and agitated, and complaining of an ongoing headache 10/10. Which of
the following changes in signs and symptoms requires an immediate call
to the provider? Answer: Unresponsiveness to physical stimuli and
sluggish pupillary response
⩥ When a nurse asks a patient's name, The patient replies with the name
of the town where the hospital is located. When asked what day it is, he
replies "house." Shown a hairbrush and asked to name it, he replies
"dog." What other step(s) should the nurse take to evaluate the patient's
language functioning? Answer: Ask the patient to raise one arm slowly.
