NUR 334 FINAL UPDATED ACTUAL
Exam Questions and CORRECT Answers
Kernig's Sign - CORRECT ANSWER - Lying supine with hip flexed at 90 degree angle,
shows resistance to passive extension of the knee
-Sign of Meningitis
Meningitis manifestations - CORRECT ANSWER - Nuchal rigidity
Positive Kernig's sign
Positive Brudzinski's sign
Photophobia
Rash indicative of N. meningitidis
Myasthenia Gravis - CORRECT ANSWER - Autoimmune disorder characterized by
weakness and rapid fatigue of any of the muscles under voluntary control. Caused by breakdown
in the normal communication between nerves and muscles
Myasthenia Gravis Pathophysiology - CORRECT ANSWER - Reduction in the number of
acetylcholine receptor sites (continuous binding of the ACTH is required for muscle contraction)
Myasthenia Gravis Manifestations - CORRECT ANSWER - Initial manifestation involves
ocular muscles: diplopia (double vision) and ptosis
Blood tests reveal ACTH receptor antibodies in the blood
Postictal State Characteristics - CORRECT ANSWER - Confusion, nausea, hypertension,
headache or migraine, and amnesia
Parkinson's complications - CORRECT ANSWER - Thinking difficulties, depression,
emotional changes, swallowing problems, sleep disorders, bladder problems, constipation, blood
,pressure changes (orthostatic hypertension), smell dysfunction, fatigue, pain in specific areas of
the body, sexual dysfunction
Parkinson's Nursing Management - CORRECT ANSWER - Controlling symptoms and
maintaining functional independence
Antiparkinsonian medications and deep brain stimulation
Enhancing mobility
Enhancing self-care
Improving nutrition
Maintaining bowel function
Enhancing swallowing
Improving communication
Supporting coping ability
Encephalitis - CORRECT ANSWER - Inflammation of the brain tissue (cerebral cortex)
Often due to infection
Secondary to vituses (HIV, HSV,) bacteria, fungi, or parasites
Multiple Sclerosis - CORRECT ANSWER - An immune-mediated progressive demyelinating
disease of the CNS
Immune system eats away at protective covering of nerves
Relapse remitting (RR) course is most common
MS nursing management - CORRECT ANSWER - Promoting and preserving mobility,
minimizing spasticity and contractures, preventing injury, promoting bowel and bladder control
Skull fracture nursing management - CORRECT ANSWER - Look for CSF leakage from
nose, ears, bruising around the eyes, battles sign
NOTHING should be allowed in patient's nose or ears to prevent meningitis
,Clinical manifestations from increased brain compression - CORRECT ANSWER - Acute:
changes in LOC, pupillary changes, hemiparesis (onesided weakness), coma, BP changes,
decreased HR/RR
Chronic: Neurologic deficits followed by headache
Epidural Hematoma - CORRECT ANSWER - Collection of blood in the epidural space
between the skull and the dura
Can result from a skull fracture that causes a rupture or laceration of the middle meningeal
artery, which causes a rapid increase in pressure of the brain
Medical emergency
Respiratory arrest can occur within minutes
Subdural Hematoma - CORRECT ANSWER - Collection of blood between the dura and the
brain
Most common cause is trauma, but it can also occur as a result of coagulopathies (bleeding
disorders) or rupture of an aneurysm
elderly are at increased risk
Could be acute or chronic
Neurogenic shock signs and symptoms - CORRECT ANSWER - Increased heart rate and
blood pressure
Decreasing cardiac output causes venous pooling which results in hypotension and bradycardia
and warm skin
Pt doesn't perspire on paralyzed areas because of the blocking of the sympathetic nervous
system- abrupt onset of fever
SCI Nursing Management - CORRECT ANSWER - Assessing altered breathing, changes in
motor or sensory function, spinal shock, urinary retention, overdistension of the bladder, and
paralytic ileus (paralysis of intestinal muscles
Nursing interventions for Increased Intracranial pressure - CORRECT ANSWER - Treating
cerebral edema (with mannitol), controlling fever, maintaining BP and oxygenation, reducing
, metabolic demand, preventing seizures, preserving the integrity of the skin and corneas,
promoting nutrition, and preserving bladder and bowel function
Sit the patient up
Cushing's Response - CORRECT ANSWER - Occurs when cerebral blood flow decreases
significantly
Compensatory measure that attempts to restore blood flow by increasing arterial pressure to
overcome the increased intracranial pressure; includes rising systolic pressure, widening pulse
pressure, bradycardia
Cushing's Syndrome - CORRECT ANSWER - Disorder characterized by high levels of serum
cortisol
Symptoms resulting from excess free circulating cortisol from the adrenal cortex
Cushing's Syndrome Causes - CORRECT ANSWER - Pituitary tumor that overproduces
ACTH, termed Cushing's disease
An adrenal tumor that overproduces ACTH, termed Cushing's syndrome
Long-term glucocorticoid pharmacological therapy, termed iantrogenic
Overuse of corticosteroid
Cushing's Triad - CORRECT ANSWER - Three classic signs of Cushing's disease
-bradycardia
-hypertension
-bradypnea
Represents a loss of compensatory mechanism, a presentation of brainstem dysfunction
Herniation and brainstem occlusion of the cerebral blood flow occur if therapeutic intervention is
not initiated immediately
Exam Questions and CORRECT Answers
Kernig's Sign - CORRECT ANSWER - Lying supine with hip flexed at 90 degree angle,
shows resistance to passive extension of the knee
-Sign of Meningitis
Meningitis manifestations - CORRECT ANSWER - Nuchal rigidity
Positive Kernig's sign
Positive Brudzinski's sign
Photophobia
Rash indicative of N. meningitidis
Myasthenia Gravis - CORRECT ANSWER - Autoimmune disorder characterized by
weakness and rapid fatigue of any of the muscles under voluntary control. Caused by breakdown
in the normal communication between nerves and muscles
Myasthenia Gravis Pathophysiology - CORRECT ANSWER - Reduction in the number of
acetylcholine receptor sites (continuous binding of the ACTH is required for muscle contraction)
Myasthenia Gravis Manifestations - CORRECT ANSWER - Initial manifestation involves
ocular muscles: diplopia (double vision) and ptosis
Blood tests reveal ACTH receptor antibodies in the blood
Postictal State Characteristics - CORRECT ANSWER - Confusion, nausea, hypertension,
headache or migraine, and amnesia
Parkinson's complications - CORRECT ANSWER - Thinking difficulties, depression,
emotional changes, swallowing problems, sleep disorders, bladder problems, constipation, blood
,pressure changes (orthostatic hypertension), smell dysfunction, fatigue, pain in specific areas of
the body, sexual dysfunction
Parkinson's Nursing Management - CORRECT ANSWER - Controlling symptoms and
maintaining functional independence
Antiparkinsonian medications and deep brain stimulation
Enhancing mobility
Enhancing self-care
Improving nutrition
Maintaining bowel function
Enhancing swallowing
Improving communication
Supporting coping ability
Encephalitis - CORRECT ANSWER - Inflammation of the brain tissue (cerebral cortex)
Often due to infection
Secondary to vituses (HIV, HSV,) bacteria, fungi, or parasites
Multiple Sclerosis - CORRECT ANSWER - An immune-mediated progressive demyelinating
disease of the CNS
Immune system eats away at protective covering of nerves
Relapse remitting (RR) course is most common
MS nursing management - CORRECT ANSWER - Promoting and preserving mobility,
minimizing spasticity and contractures, preventing injury, promoting bowel and bladder control
Skull fracture nursing management - CORRECT ANSWER - Look for CSF leakage from
nose, ears, bruising around the eyes, battles sign
NOTHING should be allowed in patient's nose or ears to prevent meningitis
,Clinical manifestations from increased brain compression - CORRECT ANSWER - Acute:
changes in LOC, pupillary changes, hemiparesis (onesided weakness), coma, BP changes,
decreased HR/RR
Chronic: Neurologic deficits followed by headache
Epidural Hematoma - CORRECT ANSWER - Collection of blood in the epidural space
between the skull and the dura
Can result from a skull fracture that causes a rupture or laceration of the middle meningeal
artery, which causes a rapid increase in pressure of the brain
Medical emergency
Respiratory arrest can occur within minutes
Subdural Hematoma - CORRECT ANSWER - Collection of blood between the dura and the
brain
Most common cause is trauma, but it can also occur as a result of coagulopathies (bleeding
disorders) or rupture of an aneurysm
elderly are at increased risk
Could be acute or chronic
Neurogenic shock signs and symptoms - CORRECT ANSWER - Increased heart rate and
blood pressure
Decreasing cardiac output causes venous pooling which results in hypotension and bradycardia
and warm skin
Pt doesn't perspire on paralyzed areas because of the blocking of the sympathetic nervous
system- abrupt onset of fever
SCI Nursing Management - CORRECT ANSWER - Assessing altered breathing, changes in
motor or sensory function, spinal shock, urinary retention, overdistension of the bladder, and
paralytic ileus (paralysis of intestinal muscles
Nursing interventions for Increased Intracranial pressure - CORRECT ANSWER - Treating
cerebral edema (with mannitol), controlling fever, maintaining BP and oxygenation, reducing
, metabolic demand, preventing seizures, preserving the integrity of the skin and corneas,
promoting nutrition, and preserving bladder and bowel function
Sit the patient up
Cushing's Response - CORRECT ANSWER - Occurs when cerebral blood flow decreases
significantly
Compensatory measure that attempts to restore blood flow by increasing arterial pressure to
overcome the increased intracranial pressure; includes rising systolic pressure, widening pulse
pressure, bradycardia
Cushing's Syndrome - CORRECT ANSWER - Disorder characterized by high levels of serum
cortisol
Symptoms resulting from excess free circulating cortisol from the adrenal cortex
Cushing's Syndrome Causes - CORRECT ANSWER - Pituitary tumor that overproduces
ACTH, termed Cushing's disease
An adrenal tumor that overproduces ACTH, termed Cushing's syndrome
Long-term glucocorticoid pharmacological therapy, termed iantrogenic
Overuse of corticosteroid
Cushing's Triad - CORRECT ANSWER - Three classic signs of Cushing's disease
-bradycardia
-hypertension
-bradypnea
Represents a loss of compensatory mechanism, a presentation of brainstem dysfunction
Herniation and brainstem occlusion of the cerebral blood flow occur if therapeutic intervention is
not initiated immediately
