NSG 3280 Unit 5 Neurological Practice Questions
(SCROLL DOWN FOR ANSWERS)
Question 1 A patient suffered severe global ischemia following a myocardial infarction (MI). The
nurse understands that the resulting generalized brain edema is primarily due to which cellular
mechanism?
A. Increased vessel pressure causing a midline shift (vasogenic edema)
B. Cellular energy failure leading to decreased ATP and subsequent Na+ accumulation inside the
cell
C. Excessive influx of water and Ca+ into the cells due to increased glutamate
D. Compression of the cerebral vessels causing secondary interstitial edema
Question 2 A patient's Intracranial Pressure (ICP) monitor reading has been consistently above
22 mmHg for the past 10 minutes. The nurse recognizes that this finding indicates:
A. The patient is compensating via the Monroe-Kellie doctrine, as this slight increase is
manageable.
B. Brain impairment is occurring due to sustained compression.
C. The patient is experiencing a temporary, slight increase in ICP typical of a sneeze or laugh.
D. The CSF component is decreasing to offset the increased pressure.
Question 3 A nurse is preparing a presentation on the Monroe-Kellie doctrine. The nurse should
include that the three main cranial components whose volume must remain relatively constant
are:
A. Brain, Neurons, and Arterial Blood
B. Brain tissue, Venous Sinuses, and CSF
C. Brain, Cerebral Spinal Fluid (CSF), and Blood
D. Dura Mater, Pia Mater, and Arachnoid Membrane
Question 4 A patient presents to the Emergency Department following a fall. Which finding
would the nurse recognize as the MOST sensitive indicator of increasing intracranial pressure
(ICP)?
A. Worsening headache
B. Increased drowsiness
,C. Onset of Cushing’s Triad
D. Hypotension
Question 5 (SATA) The nurse assesses a patient and identifies Cushing's Triad. The nurse
understands this is a sympathetic nervous system reaction to increased ICP in an attempt to
maintain cerebral perfusion. Which findings are components of Cushing’s Triad?
A. Decreased blood pressure (BP)
B. Increased respiratory rate
C. Increased systolic blood pressure (BP)
D. Decreased heart rate (HR)
E. Respiratory changes
Question 6 The nurse is performing a neurological assessment on an unresponsive patient.
Upon checking the cranial nerve reflexes, the patient exhibits fixed and dilated pupils. The
nurse should immediately conclude that this sign indicates:
A. Early pressure on Cranial Nerve (CN) III due to midbrain displacement.
B. An issue localized to the Pons.
C. The presence of significant opioid drug effects.
D. Poor brain perfusion.
Question 7 When testing the Oculovestibular Reflex using the Doll’s Eyes Test, the nurse turns
the patient's head to the right. A normal response is documented if the patient's eyes:
A. Deviate toward the side of the head movement (right).
B. Stay midline, appearing "painted on".
C. Move opposite the direction of head movement (left).
D. Blinked
Question 8 A nurse is caring for a patient admitted with a Traumatic Brain Injury (TBI). The
patient's injury is described as "Coup-countercoup." The nurse understands that this injury
classification is:
A. Diffuse, involving widespread damage from shearing forces.
B. Focal, localized strictly to the site of impact.
C. Polar, involving damage at the site of impact and the opposite side of the brain.
,D. Secondary, resulting from vessel spasm or edema.
Question 9 A patient presents to the ED after falling off a ladder. Initially, the patient appeared
stable and lucid, but they rapidly deteriorated 30 minutes later. The CT scan reveals a bleed
located between the inner skull and the dura mater, originating from an artery. The nurse
recognizes this presentation as consistent with which type of hematoma?
A. Subdural Hematoma
B. Subarachnoid Hemorrhage
C. Epidural Hematoma
D. Lacunar Infarct
Question 10 An older adult patient with cerebral atrophy is at particularly high risk for which
type of intracranial bleed following a fall?
A. Epidural Hematoma
B. Subarachnoid Hemorrhage (caused by aneurysm)
C. Subdural Hematoma
D. Pontine bleed (small pupils)
Question 11 (SATA) A patient is diagnosed with a Subarachnoid Hemorrhage (SAH). The nurse
plans for potential complications that can arise, which include:
A. Vasospasm
B. Hydrocephalus
C. Ischemia
D. Blood in the cerebrospinal fluid
E. Rapid deterioration followed by lucidity
Question 12 A patient arrives at the hospital exhibiting sudden left-sided hemiparesis. The
nurse understands that this physical manifestation suggests that the ischemic injury likely
occurred in which hemisphere of the brain?
A. Left hemisphere
B. Right hemisphere
C. Cerebellum
D. Pons
, Question 13 (SATA) A nurse is educating a community group about primary prevention of
ischemic stroke. Which risk factors should the nurse address in the education plan?
A. Diabetes
B. Family history of Polycystic Kidney Disease (PKD)
C. Atrial fibrillation
D. Hyperlipidemia
E. Advanced age
Question 14 In the pathology of an ischemic stroke, the area of brain tissue surrounding the
central necrosis that is still viable due to collateral circulation is known as the:
A. Lacunar infarct
B. Penumbra
C. Circle of Willis
D. Bridging vein area
Question 15 A nurse is reviewing the causes of Hemorrhagic Stroke. The nurse understands
that the most common cause is:
A. Chronic alcoholism
B. Longstanding hypertension (HTN)
C. Saccular (berry) aneurysms
D. Atherosclerosis causing thrombus formation
Question 16 A patient is admitted 5 days after suffering a cerebral aneurysm rupture. The nurse
knows that a major complication risk at this point is vasospasm, which leads to secondary
ischemia. This occurs because:
A. The patient is undergoing anticoagulant therapy.
B. The highest risk for rebleeding is now present.
C. Blood has entered the Cerebral Spinal Fluid (CSF).
D. The aneurysm was located on the Circle of Willis.
Question 17 A nurse is assessing a patient who reports a sudden, excruciating "thunderclap"
headache, stiff neck, photophobia, and nausea. These symptoms are characteristic of:
A. A migraine preceded by an aura
(SCROLL DOWN FOR ANSWERS)
Question 1 A patient suffered severe global ischemia following a myocardial infarction (MI). The
nurse understands that the resulting generalized brain edema is primarily due to which cellular
mechanism?
A. Increased vessel pressure causing a midline shift (vasogenic edema)
B. Cellular energy failure leading to decreased ATP and subsequent Na+ accumulation inside the
cell
C. Excessive influx of water and Ca+ into the cells due to increased glutamate
D. Compression of the cerebral vessels causing secondary interstitial edema
Question 2 A patient's Intracranial Pressure (ICP) monitor reading has been consistently above
22 mmHg for the past 10 minutes. The nurse recognizes that this finding indicates:
A. The patient is compensating via the Monroe-Kellie doctrine, as this slight increase is
manageable.
B. Brain impairment is occurring due to sustained compression.
C. The patient is experiencing a temporary, slight increase in ICP typical of a sneeze or laugh.
D. The CSF component is decreasing to offset the increased pressure.
Question 3 A nurse is preparing a presentation on the Monroe-Kellie doctrine. The nurse should
include that the three main cranial components whose volume must remain relatively constant
are:
A. Brain, Neurons, and Arterial Blood
B. Brain tissue, Venous Sinuses, and CSF
C. Brain, Cerebral Spinal Fluid (CSF), and Blood
D. Dura Mater, Pia Mater, and Arachnoid Membrane
Question 4 A patient presents to the Emergency Department following a fall. Which finding
would the nurse recognize as the MOST sensitive indicator of increasing intracranial pressure
(ICP)?
A. Worsening headache
B. Increased drowsiness
,C. Onset of Cushing’s Triad
D. Hypotension
Question 5 (SATA) The nurse assesses a patient and identifies Cushing's Triad. The nurse
understands this is a sympathetic nervous system reaction to increased ICP in an attempt to
maintain cerebral perfusion. Which findings are components of Cushing’s Triad?
A. Decreased blood pressure (BP)
B. Increased respiratory rate
C. Increased systolic blood pressure (BP)
D. Decreased heart rate (HR)
E. Respiratory changes
Question 6 The nurse is performing a neurological assessment on an unresponsive patient.
Upon checking the cranial nerve reflexes, the patient exhibits fixed and dilated pupils. The
nurse should immediately conclude that this sign indicates:
A. Early pressure on Cranial Nerve (CN) III due to midbrain displacement.
B. An issue localized to the Pons.
C. The presence of significant opioid drug effects.
D. Poor brain perfusion.
Question 7 When testing the Oculovestibular Reflex using the Doll’s Eyes Test, the nurse turns
the patient's head to the right. A normal response is documented if the patient's eyes:
A. Deviate toward the side of the head movement (right).
B. Stay midline, appearing "painted on".
C. Move opposite the direction of head movement (left).
D. Blinked
Question 8 A nurse is caring for a patient admitted with a Traumatic Brain Injury (TBI). The
patient's injury is described as "Coup-countercoup." The nurse understands that this injury
classification is:
A. Diffuse, involving widespread damage from shearing forces.
B. Focal, localized strictly to the site of impact.
C. Polar, involving damage at the site of impact and the opposite side of the brain.
,D. Secondary, resulting from vessel spasm or edema.
Question 9 A patient presents to the ED after falling off a ladder. Initially, the patient appeared
stable and lucid, but they rapidly deteriorated 30 minutes later. The CT scan reveals a bleed
located between the inner skull and the dura mater, originating from an artery. The nurse
recognizes this presentation as consistent with which type of hematoma?
A. Subdural Hematoma
B. Subarachnoid Hemorrhage
C. Epidural Hematoma
D. Lacunar Infarct
Question 10 An older adult patient with cerebral atrophy is at particularly high risk for which
type of intracranial bleed following a fall?
A. Epidural Hematoma
B. Subarachnoid Hemorrhage (caused by aneurysm)
C. Subdural Hematoma
D. Pontine bleed (small pupils)
Question 11 (SATA) A patient is diagnosed with a Subarachnoid Hemorrhage (SAH). The nurse
plans for potential complications that can arise, which include:
A. Vasospasm
B. Hydrocephalus
C. Ischemia
D. Blood in the cerebrospinal fluid
E. Rapid deterioration followed by lucidity
Question 12 A patient arrives at the hospital exhibiting sudden left-sided hemiparesis. The
nurse understands that this physical manifestation suggests that the ischemic injury likely
occurred in which hemisphere of the brain?
A. Left hemisphere
B. Right hemisphere
C. Cerebellum
D. Pons
, Question 13 (SATA) A nurse is educating a community group about primary prevention of
ischemic stroke. Which risk factors should the nurse address in the education plan?
A. Diabetes
B. Family history of Polycystic Kidney Disease (PKD)
C. Atrial fibrillation
D. Hyperlipidemia
E. Advanced age
Question 14 In the pathology of an ischemic stroke, the area of brain tissue surrounding the
central necrosis that is still viable due to collateral circulation is known as the:
A. Lacunar infarct
B. Penumbra
C. Circle of Willis
D. Bridging vein area
Question 15 A nurse is reviewing the causes of Hemorrhagic Stroke. The nurse understands
that the most common cause is:
A. Chronic alcoholism
B. Longstanding hypertension (HTN)
C. Saccular (berry) aneurysms
D. Atherosclerosis causing thrombus formation
Question 16 A patient is admitted 5 days after suffering a cerebral aneurysm rupture. The nurse
knows that a major complication risk at this point is vasospasm, which leads to secondary
ischemia. This occurs because:
A. The patient is undergoing anticoagulant therapy.
B. The highest risk for rebleeding is now present.
C. Blood has entered the Cerebral Spinal Fluid (CSF).
D. The aneurysm was located on the Circle of Willis.
Question 17 A nurse is assessing a patient who reports a sudden, excruciating "thunderclap"
headache, stiff neck, photophobia, and nausea. These symptoms are characteristic of:
A. A migraine preceded by an aura
