NR340 Week 3 Evolve Practice
Questions & Complete Study
Guide
(Complete solutions and resources for the course exam)
Questions
1. 1.ID: 43154241
Whatis thetherapeuticeffectofhead-of-the-bedelevationandneutralhead andneck alignment on
j j
increased intracranial pressure (ICP)?
o Lowering ICPbyallowing forelevationsinCO2 todilatecerebralarteries
j
o LoweringICPbyfacilitatingvenousdrainageanddecreasing venous
j
obstruction Correct
o LoweringICPbymaintaining an openairway
j
o LoweringICPbyreducing theriskofsnoring
j
Head-of-the-bed elevation and a neutral head position that avoids hyperextension or
hyperflexion facilitate jugular venous drainage, helping to minimize increases in ICP.
j
Elevated CO2 contributes to cerebral vessel vasodilation, which can increase cerebral blood
volume and further elevate ICP. Maintaining an open airwayalone does not minimize
increasesinICP.Reducingtheriskofsnoringbymaintaininganopenairway alone does not
minimize increases in ICP.
Awarded0.0pointsoutof1.0possiblepoints.
2. 2.ID:43154255
Undernormalcircumstancesthecerebralvasculatureexhibitspressureandchemical j
,autoregulation. What happens when autoregulation is lost?
, o Centralvenousengorgementoccurs.
o Cerebralbloodflowisnotaffected.
o Hypertensionincreasescerebralblood flow.Correct
j j
o Shunting ofcerebrospinal fluid(CSF) isblocked.
j
Autoregulation is theabilityof the cerebral vessels to adjust their diameter in responseto
arterial pressure changes within the brain. If mean arterial blood pressure rises, cerebral
vessels will constrict to prevent excessive distention of the cerebral arteries. When
autoregulation is lost, cerebral vessels are no longer able to regulate diameter and as a result
hypertension increases cerebral perfusion pressure. Cerebral vessels maybecome engorged
asaresultofthe lossofautoregulation. Cerebralbloodflowisaffected with the loss of
j
autoregulation. Loss of autoregulation does not block CSF flow.
Awarded0.0pointsoutof1.0possiblepoints.
3. 3.ID:43154263
The nurseis monitoring a patient’s intracranial pressure (ICP). While the nurse is providing
hygienemeasures,she observesthat theICPreadingissustained at 18mmHg. What is the
j j j
prioritynursingaction?
o Ceasestimulatingthepatient. Correct
o Continuewithhygienemeasures.
o Lowerthe head ofthe bed to 10 degrees.
o OpentheICPmonitortocontinuousdrainage.
Sustainedincreasesin ICPshouldbeavoided. Nursingcareactivitiesshouldbespacedto
prevent an increase in ICP.Actions that cause a sustained elevation in ICPshould be avoided
until ICPreturns to baseline restingvalues. Elevating the head of the bed to 30 degrees or
j
more can help reduce ICP. Continuous drainage of CSF fluid will result in herniation.
j
Awarded0.0pointsoutof1.0possiblepoints.
4. 4.ID:43154273
, Herniation syndromes can be life-threatening situations. Which syndrome causes the
supratentorialcontents toshiftdownward and compressvitalcentersofthebrainstem?
j j j
o CentralherniationCorrect
o Cingulateherniation
j
o Tonsillarherniation
o Uncalherniation
Adownward shift of the cerebral hemispheres, basal ganglia, and diencephalon through the
tentorial notch causes central herniation, which compresses the vital centers of the brainstem.
This results in a shift of one cerebral hemisphere under the falx cerebri to the othercerebral
hemisphere.Cerebellartonsils aredisplacedthroughtheforamenmagnum, causingfatal
j
damage to the respiratory and cardiac centers. Uncal herniation compresses the midbrain,
causing dysfunction of the ipsilateral third nerve, resulting in unilateral pupil dilation.
Awarded0.0pointsoutof1.0possiblepoints.
5. 5.ID:43154282
In a patient with increased intracranial pressure (ICP), which of the followingcranial nerves
wouldbeassessedforconsensuallightresponse,elevationoftheeyelids, andeye movement?
o I, IX, X
o II,V,VII
j
o II,VI, X
o III,IV,VICorrect
j
Cranialnerve IIIisresponsiblefortheconsensuallightresponse,elevationofthe eyelids, and
eye movements. In addition, cranial nerves III, IV, and VIaffect extraocular eye movements.
Awarded0.0pointsoutof1.0possiblepoints.
Questions & Complete Study
Guide
(Complete solutions and resources for the course exam)
Questions
1. 1.ID: 43154241
Whatis thetherapeuticeffectofhead-of-the-bedelevationandneutralhead andneck alignment on
j j
increased intracranial pressure (ICP)?
o Lowering ICPbyallowing forelevationsinCO2 todilatecerebralarteries
j
o LoweringICPbyfacilitatingvenousdrainageanddecreasing venous
j
obstruction Correct
o LoweringICPbymaintaining an openairway
j
o LoweringICPbyreducing theriskofsnoring
j
Head-of-the-bed elevation and a neutral head position that avoids hyperextension or
hyperflexion facilitate jugular venous drainage, helping to minimize increases in ICP.
j
Elevated CO2 contributes to cerebral vessel vasodilation, which can increase cerebral blood
volume and further elevate ICP. Maintaining an open airwayalone does not minimize
increasesinICP.Reducingtheriskofsnoringbymaintaininganopenairway alone does not
minimize increases in ICP.
Awarded0.0pointsoutof1.0possiblepoints.
2. 2.ID:43154255
Undernormalcircumstancesthecerebralvasculatureexhibitspressureandchemical j
,autoregulation. What happens when autoregulation is lost?
, o Centralvenousengorgementoccurs.
o Cerebralbloodflowisnotaffected.
o Hypertensionincreasescerebralblood flow.Correct
j j
o Shunting ofcerebrospinal fluid(CSF) isblocked.
j
Autoregulation is theabilityof the cerebral vessels to adjust their diameter in responseto
arterial pressure changes within the brain. If mean arterial blood pressure rises, cerebral
vessels will constrict to prevent excessive distention of the cerebral arteries. When
autoregulation is lost, cerebral vessels are no longer able to regulate diameter and as a result
hypertension increases cerebral perfusion pressure. Cerebral vessels maybecome engorged
asaresultofthe lossofautoregulation. Cerebralbloodflowisaffected with the loss of
j
autoregulation. Loss of autoregulation does not block CSF flow.
Awarded0.0pointsoutof1.0possiblepoints.
3. 3.ID:43154263
The nurseis monitoring a patient’s intracranial pressure (ICP). While the nurse is providing
hygienemeasures,she observesthat theICPreadingissustained at 18mmHg. What is the
j j j
prioritynursingaction?
o Ceasestimulatingthepatient. Correct
o Continuewithhygienemeasures.
o Lowerthe head ofthe bed to 10 degrees.
o OpentheICPmonitortocontinuousdrainage.
Sustainedincreasesin ICPshouldbeavoided. Nursingcareactivitiesshouldbespacedto
prevent an increase in ICP.Actions that cause a sustained elevation in ICPshould be avoided
until ICPreturns to baseline restingvalues. Elevating the head of the bed to 30 degrees or
j
more can help reduce ICP. Continuous drainage of CSF fluid will result in herniation.
j
Awarded0.0pointsoutof1.0possiblepoints.
4. 4.ID:43154273
, Herniation syndromes can be life-threatening situations. Which syndrome causes the
supratentorialcontents toshiftdownward and compressvitalcentersofthebrainstem?
j j j
o CentralherniationCorrect
o Cingulateherniation
j
o Tonsillarherniation
o Uncalherniation
Adownward shift of the cerebral hemispheres, basal ganglia, and diencephalon through the
tentorial notch causes central herniation, which compresses the vital centers of the brainstem.
This results in a shift of one cerebral hemisphere under the falx cerebri to the othercerebral
hemisphere.Cerebellartonsils aredisplacedthroughtheforamenmagnum, causingfatal
j
damage to the respiratory and cardiac centers. Uncal herniation compresses the midbrain,
causing dysfunction of the ipsilateral third nerve, resulting in unilateral pupil dilation.
Awarded0.0pointsoutof1.0possiblepoints.
5. 5.ID:43154282
In a patient with increased intracranial pressure (ICP), which of the followingcranial nerves
wouldbeassessedforconsensuallightresponse,elevationoftheeyelids, andeye movement?
o I, IX, X
o II,V,VII
j
o II,VI, X
o III,IV,VICorrect
j
Cranialnerve IIIisresponsiblefortheconsensuallightresponse,elevationofthe eyelids, and
eye movements. In addition, cranial nerves III, IV, and VIaffect extraocular eye movements.
Awarded0.0pointsoutof1.0possiblepoints.
