10/15/24, 10:15 TB Chapter 16- Disorders of Brain
AM Function
1. A nurse on a neurology unit is assessing a female brain-injured client. The client is
unresponsive to speech, and her pupils are dilated and do not react to light. She is
breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a
noxious stimulus, her arms and legs extend rigidly. What is her level of
impairment?
A) Delirium
B) Coma
C) Brain death
D) Vegetative
state Ans: B
Feedback:
The continuum of loss of consciousness is marked by the degree of client's
responsiveness to stimuli, in addition to the preservation of brain stem reflexes. Since
this client still exhibits a pain response (the extended arms and legs indicate
decerebrate posturing), even though her pupils are not responsive to light, she has
sustained sufficient brain function that she fails to qualify as being brain dead or in a
vegetative state.
2. Following a motor vehicle accident 3 months prior, a 20-year-old female who has
been in a coma since her accident has now had her condition declared a persistent
vegetative state. How can her care providers most accurately explain an aspect of her
situation to her parents?
A) “Your daughter has lost all her cognitive functions as well as all her basic
reflexes.”
B) “Though she still goes through a cycle of sleeping and waking, her condition
is unlikely to change.”
C) “If you or the care team notices any spontaneous eye opening, then we
will change our treatment plan.”
D) “Your daughter's condition is an unfortunate combination with total loss
of consciousness but continuation of all other normal brain functions.”
Ans: B
Feedback:
A continuation of the sleep–wake cycle can exist in a persistent vegetative state.
Reflexes often remain, as does spontaneous eye opening. Aspects of brain function
beyond those governing consciousness are affected.
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, 10/15/24, 10:15 TB Chapter 16- Disorders of Brain
AM Function
3. Which of the following individuals would most likely experience global ischemia to
his or her brain?
A) A male client who has just had an ischemic stroke confirmed by CT of his head
B) A woman who has been admitted to the emergency department with a
suspected intracranial bleed
C) A man who has entered cardiogenic shock following a severe
myocardial infarction
D) A woman who is being brought to hospital by ambulance following suspected
carbon monoxide poisoning related to a faulty portable heater
Ans: C
Feedback:
Global ischemia is associated with a cessation of blood flow to the entire brain, as
often occurs during cardiac arrest or myocardial infarction. Ischemic stroke and
intracranial bleeding are likely to cause focal ischemia; carbon monoxide toxicity is
associated with hypoxia.
4. Which of the following diagnostic findings is likely to result in the most serious
brain insult?
A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
B) Moderate decrease in brain tissue volume secondary to a brain tumor removal
C) Increased ICP accompanied by hyperventilation
D) High intracellular concentration of
glutamate Ans: A
Feedback:
When the pressure in the cranial cavity approaches or exceeds the MAP, tissue
perfusion becomes inadequate; cellular hypoxia results; and neuronal death may occur.
Displacement of CSF and blood can partially compensate for decreased brain tissue
volume. Hyperventilation partially mitigates, rather than exacerbates, increase in ICP.
Glutamate is normally in far higher concentrations intracellularly than extracellularly.
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AM Function
1. A nurse on a neurology unit is assessing a female brain-injured client. The client is
unresponsive to speech, and her pupils are dilated and do not react to light. She is
breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a
noxious stimulus, her arms and legs extend rigidly. What is her level of
impairment?
A) Delirium
B) Coma
C) Brain death
D) Vegetative
state Ans: B
Feedback:
The continuum of loss of consciousness is marked by the degree of client's
responsiveness to stimuli, in addition to the preservation of brain stem reflexes. Since
this client still exhibits a pain response (the extended arms and legs indicate
decerebrate posturing), even though her pupils are not responsive to light, she has
sustained sufficient brain function that she fails to qualify as being brain dead or in a
vegetative state.
2. Following a motor vehicle accident 3 months prior, a 20-year-old female who has
been in a coma since her accident has now had her condition declared a persistent
vegetative state. How can her care providers most accurately explain an aspect of her
situation to her parents?
A) “Your daughter has lost all her cognitive functions as well as all her basic
reflexes.”
B) “Though she still goes through a cycle of sleeping and waking, her condition
is unlikely to change.”
C) “If you or the care team notices any spontaneous eye opening, then we
will change our treatment plan.”
D) “Your daughter's condition is an unfortunate combination with total loss
of consciousness but continuation of all other normal brain functions.”
Ans: B
Feedback:
A continuation of the sleep–wake cycle can exist in a persistent vegetative state.
Reflexes often remain, as does spontaneous eye opening. Aspects of brain function
beyond those governing consciousness are affected.
Page 1
about:blan 1/
k 10
, 10/15/24, 10:15 TB Chapter 16- Disorders of Brain
AM Function
3. Which of the following individuals would most likely experience global ischemia to
his or her brain?
A) A male client who has just had an ischemic stroke confirmed by CT of his head
B) A woman who has been admitted to the emergency department with a
suspected intracranial bleed
C) A man who has entered cardiogenic shock following a severe
myocardial infarction
D) A woman who is being brought to hospital by ambulance following suspected
carbon monoxide poisoning related to a faulty portable heater
Ans: C
Feedback:
Global ischemia is associated with a cessation of blood flow to the entire brain, as
often occurs during cardiac arrest or myocardial infarction. Ischemic stroke and
intracranial bleeding are likely to cause focal ischemia; carbon monoxide toxicity is
associated with hypoxia.
4. Which of the following diagnostic findings is likely to result in the most serious
brain insult?
A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
B) Moderate decrease in brain tissue volume secondary to a brain tumor removal
C) Increased ICP accompanied by hyperventilation
D) High intracellular concentration of
glutamate Ans: A
Feedback:
When the pressure in the cranial cavity approaches or exceeds the MAP, tissue
perfusion becomes inadequate; cellular hypoxia results; and neuronal death may occur.
Displacement of CSF and blood can partially compensate for decreased brain tissue
volume. Hyperventilation partially mitigates, rather than exacerbates, increase in ICP.
Glutamate is normally in far higher concentrations intracellularly than extracellularly.
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