CEN Neurological Emergencies Questions with
Complete Solutions
You are caring for a 30-year-old patient who has been diagnosed with Guillain-Barre syndrome.
Which of the following is NOT an appropriate intervention?
a. Prepare for emergency intubation.
b. Prepare to administer succinylcholine.
c. Prepare for possible plasmapheresis.
d. Prepare to administer immunoglobulin. B. Administration of succinylcholine is
absolutely contraindicated in a patient with Guillain-Barre syndrome. This drug can cause lethal
hyperkalemia in these patients.
A 25-year-old female is brought to the emergency department with complaint of sudden onset
right sided headache described as throbbing. Before the pain began, she complained of seeing
flashing lights. She is now vomiting when she moves her head. It is likely that this patient is
experiencing:
a. Vascular migraine headache
b. Temporal arteritis
c. Tension headache
,d. Traumatic headache A. A vascular migraine headache typically progresses through
specific stages. In the prodromal phase, the patient may experience an aura. This aura may be
visual disturbances including flashing lights or other disturbances. During the second phase,
vasodilation causes the typical throbbing headache that usually begins on one side of the head.
After the headache subsides, the patient may have a very tender head.
A young woman presents to the emergency department with a headache described as "the
worst I've ever had". On arrival, she was alert and oriented with pupils equal and reactive. As
she waits for a CT scan, she becomes confused. She continues to obey commands and continues
to be awake and alert. Using the Glasgow Coma Scale, her GCS score is:
a. 3
b. 10
c. 14
d. 15 C. The GCS ranges from 3 to 15. Since the patient has become confused, you can
only award 4 points for Orientation; her other scores will continue to be normal. The GCS for
this patient is 14. The ED physician must be made aware of this change and aggressive
treatment must be started.
A 26-year-old woman presents with eye complaints including ptosis, diplopia and difficulty in
keeping one eye closed. Pupils are equal and reactive to light and accommodation. She notes
, that she has had some difficulty swallowing recently, but denies any episodes of choking. What
does this patient likely have?
a. Increased ICP
b. Muscular dystrophy
c. Myasthenia gravis
d. Multiple sclerosis C. Myasthenia gravis occurs most frequently in women between the
ages of 20 and 30. Ocular symptoms are the most common initial complaint and typically
include ptosis, diplopia when looking in one direction for a sustained period of time, and
difficulty closing one eye. Pupils are usually normal.
Methods to reduce increased intracranial pressure include all of the following EXCEPT:
a. Administration of diuretics
b. Administration of sedatives
c. Keeping the head of the bed elevated
d. Routine suctioning to maintain a patent airway. D. Stimulation should be avoided in
the patient with increased intracranial pressure. This will include minimizing suctioning except
as absolutely necessary.
Which of the following would NOT be a treatment for meningitis?
Complete Solutions
You are caring for a 30-year-old patient who has been diagnosed with Guillain-Barre syndrome.
Which of the following is NOT an appropriate intervention?
a. Prepare for emergency intubation.
b. Prepare to administer succinylcholine.
c. Prepare for possible plasmapheresis.
d. Prepare to administer immunoglobulin. B. Administration of succinylcholine is
absolutely contraindicated in a patient with Guillain-Barre syndrome. This drug can cause lethal
hyperkalemia in these patients.
A 25-year-old female is brought to the emergency department with complaint of sudden onset
right sided headache described as throbbing. Before the pain began, she complained of seeing
flashing lights. She is now vomiting when she moves her head. It is likely that this patient is
experiencing:
a. Vascular migraine headache
b. Temporal arteritis
c. Tension headache
,d. Traumatic headache A. A vascular migraine headache typically progresses through
specific stages. In the prodromal phase, the patient may experience an aura. This aura may be
visual disturbances including flashing lights or other disturbances. During the second phase,
vasodilation causes the typical throbbing headache that usually begins on one side of the head.
After the headache subsides, the patient may have a very tender head.
A young woman presents to the emergency department with a headache described as "the
worst I've ever had". On arrival, she was alert and oriented with pupils equal and reactive. As
she waits for a CT scan, she becomes confused. She continues to obey commands and continues
to be awake and alert. Using the Glasgow Coma Scale, her GCS score is:
a. 3
b. 10
c. 14
d. 15 C. The GCS ranges from 3 to 15. Since the patient has become confused, you can
only award 4 points for Orientation; her other scores will continue to be normal. The GCS for
this patient is 14. The ED physician must be made aware of this change and aggressive
treatment must be started.
A 26-year-old woman presents with eye complaints including ptosis, diplopia and difficulty in
keeping one eye closed. Pupils are equal and reactive to light and accommodation. She notes
, that she has had some difficulty swallowing recently, but denies any episodes of choking. What
does this patient likely have?
a. Increased ICP
b. Muscular dystrophy
c. Myasthenia gravis
d. Multiple sclerosis C. Myasthenia gravis occurs most frequently in women between the
ages of 20 and 30. Ocular symptoms are the most common initial complaint and typically
include ptosis, diplopia when looking in one direction for a sustained period of time, and
difficulty closing one eye. Pupils are usually normal.
Methods to reduce increased intracranial pressure include all of the following EXCEPT:
a. Administration of diuretics
b. Administration of sedatives
c. Keeping the head of the bed elevated
d. Routine suctioning to maintain a patent airway. D. Stimulation should be avoided in
the patient with increased intracranial pressure. This will include minimizing suctioning except
as absolutely necessary.
Which of the following would NOT be a treatment for meningitis?
