NSG 4100 (AH111) FINAL EXAM 2026 UPDATE
COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS
(complete solutions) ASSURED SUCCESS/GRADED A+!!!
What emergency procedure would be preformed for a patient with a epidural
hematoma? - CORRECT ANSWER-Burr holes - release blood accumulated in the
between the skull and dura bc it can cause neurological deficits and respiratory
arrest
Early s/s of increased ICP - CORRECT ANSWER-- change in LOC - earliest
- disorientation, restlessness, increased respiratory effort (Kussmals), purposeless
movements, mental confusion,
- pupillary changes and impaired extraocular movements
-
late s/s of increased ICP (vital sign changes) - CORRECT ANSWER-- Cushing's
Triad
- bradycardia, bradypnea, widen pulse pressure (increased systolic, decreased
diastolic_
- increased BP and temp
,Late signs of increased ICP - CORRECT ANSWER-- patient becomes erratic
- GCS score <8
- LOC continues to deteriorate
- Chain-stokes (rhythmic waxing and waning of ate and depth with brief episodes
of apnea
- Ataxic breathing - irregular breathing with random deep and shallow breath
- projectile vomiting
- hemiplegia
- decorticate
- decerebrate
- flaccidity before death
- loss of brain stem reflexes: pupillary, corneal, gag, and swallowing reflexes are
not present
(signs of approaching death)
what would require immediate intervention for a patient with head trauma? -
CORRECT ANSWER-- CSF drainage: meningitis infection can occur
- A depressed fracture - require surgery within 24 hrs
- A battle sign (bruising over the mastoid bone)
- Pts who pees ALOT - indicate dilute urine --> DI
- GCS - score <8
- Decorticate and Decerebrate posturing
- Changes in pupils
,What would require immediate intervention for a patient with TBIs? - CORRECT
ANSWER-- Dolls eyes (dilation of eyes), fixation of pupils, paralysis of extremity --
-> indicate herniation
- When Turing pt head to one side, and if eyes turn into the same direction = bad
response
- opposite direction = normal response
Clinical manifestations that require immediate intervention for acute SDH? -
CORRECT ANSWER-- Coma, increase BP, decreased HR, slow RR
Normal ICP pressure - CORRECT ANSWER-5-15 mmHg
Normal CPP - CORRECT ANSWER-70-100 mmHg
an ICP >25 indicates? - CORRECT ANSWER-worsening if pressure does not
return within 5 minutes
a CPP <50mmHg indicates - CORRECT ANSWER-No blood glow and irreversible
damage
What is the goal for a Craniotomy post op? - CORRECT ANSWER-- aimed at
detecting and reducing cerebral edema, relieve ing pain, preventing seizures,
monitoring ICP, and neurological status
, Plan of care post op for a craniotomy? - CORRECT ANSWER-- reduce cerebral
edema by giving: mannitol, IV dexamethasone, and taper off when discontinuing
- relieve pain and decrease temp with:
- acetaminophen (mild)
- codeine and morphine - for intense pain
- prophylactic anticonvulsants: phenytoin and levetiracetam
- remove the ICP monitor as soon as ICP is regulated and is stable
Post-op assessments for craniotomy? - CORRECT ANSWER-- Respiratory
function ( s/s of hypoxia, RR, pattern and ABGs)
- Temp (hyperthermia indicates infection; hypothermia during procedure)
- tx periorbital edema with cold compresses, this can last for 1-2 days
- neurological: Q15-60min, avoid head rotation, HOB 30 degrees, resposition Q2H,
promote deep breathing and IS use
- Assess foley - output >200ml indicate DI
What are complication of craniotomy? - CORRECT ANSWER-- increased ICP
- bleeding from site
- CSF leakage - emergency
- infections - assess with REEDA
- DI
- SIADH
- seizures
COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS
(complete solutions) ASSURED SUCCESS/GRADED A+!!!
What emergency procedure would be preformed for a patient with a epidural
hematoma? - CORRECT ANSWER-Burr holes - release blood accumulated in the
between the skull and dura bc it can cause neurological deficits and respiratory
arrest
Early s/s of increased ICP - CORRECT ANSWER-- change in LOC - earliest
- disorientation, restlessness, increased respiratory effort (Kussmals), purposeless
movements, mental confusion,
- pupillary changes and impaired extraocular movements
-
late s/s of increased ICP (vital sign changes) - CORRECT ANSWER-- Cushing's
Triad
- bradycardia, bradypnea, widen pulse pressure (increased systolic, decreased
diastolic_
- increased BP and temp
,Late signs of increased ICP - CORRECT ANSWER-- patient becomes erratic
- GCS score <8
- LOC continues to deteriorate
- Chain-stokes (rhythmic waxing and waning of ate and depth with brief episodes
of apnea
- Ataxic breathing - irregular breathing with random deep and shallow breath
- projectile vomiting
- hemiplegia
- decorticate
- decerebrate
- flaccidity before death
- loss of brain stem reflexes: pupillary, corneal, gag, and swallowing reflexes are
not present
(signs of approaching death)
what would require immediate intervention for a patient with head trauma? -
CORRECT ANSWER-- CSF drainage: meningitis infection can occur
- A depressed fracture - require surgery within 24 hrs
- A battle sign (bruising over the mastoid bone)
- Pts who pees ALOT - indicate dilute urine --> DI
- GCS - score <8
- Decorticate and Decerebrate posturing
- Changes in pupils
,What would require immediate intervention for a patient with TBIs? - CORRECT
ANSWER-- Dolls eyes (dilation of eyes), fixation of pupils, paralysis of extremity --
-> indicate herniation
- When Turing pt head to one side, and if eyes turn into the same direction = bad
response
- opposite direction = normal response
Clinical manifestations that require immediate intervention for acute SDH? -
CORRECT ANSWER-- Coma, increase BP, decreased HR, slow RR
Normal ICP pressure - CORRECT ANSWER-5-15 mmHg
Normal CPP - CORRECT ANSWER-70-100 mmHg
an ICP >25 indicates? - CORRECT ANSWER-worsening if pressure does not
return within 5 minutes
a CPP <50mmHg indicates - CORRECT ANSWER-No blood glow and irreversible
damage
What is the goal for a Craniotomy post op? - CORRECT ANSWER-- aimed at
detecting and reducing cerebral edema, relieve ing pain, preventing seizures,
monitoring ICP, and neurological status
, Plan of care post op for a craniotomy? - CORRECT ANSWER-- reduce cerebral
edema by giving: mannitol, IV dexamethasone, and taper off when discontinuing
- relieve pain and decrease temp with:
- acetaminophen (mild)
- codeine and morphine - for intense pain
- prophylactic anticonvulsants: phenytoin and levetiracetam
- remove the ICP monitor as soon as ICP is regulated and is stable
Post-op assessments for craniotomy? - CORRECT ANSWER-- Respiratory
function ( s/s of hypoxia, RR, pattern and ABGs)
- Temp (hyperthermia indicates infection; hypothermia during procedure)
- tx periorbital edema with cold compresses, this can last for 1-2 days
- neurological: Q15-60min, avoid head rotation, HOB 30 degrees, resposition Q2H,
promote deep breathing and IS use
- Assess foley - output >200ml indicate DI
What are complication of craniotomy? - CORRECT ANSWER-- increased ICP
- bleeding from site
- CSF leakage - emergency
- infections - assess with REEDA
- DI
- SIADH
- seizures
