HEMISPHERE 3.0 LEVEL 6 EXAM (Latest
Update ) Questions & Answers
{Grade A} 100% Correct
When is reversal of anticoagulants required - correct answer ICH stroke patients with
INR >1.4
When to consider activated charcoal for anticoagulant reversal - correct answer if
most recent oral anticoagulant dose was < 2 hrs
Warfarin Reversal - correct answer 4 factor prothrombin complex concentrate (PCC)
and IV vit K
Fresh frozen plasma if 4 factor PCC unavailable
ICP monitor inserted in ventricles warranted if - correct answer GCS score <8
Evidence of herniation
Intraventricular hemorrhage
Acute hydrocephalus
, CPP - correct answer Cerebral perfusion pressure
Pressure goals - correct answer ICP <20
CPP <50-70
Prevention of ICP - correct answer Elevate HOB to 30 degrees
Support midline head position
Control ventilation to maintain adequate oxygenation and normal paco2
Maintain normal body temp and BG
Avoid constricting cervical veins as with endotracheal tube ties
Provide analgesia or mild sedation for patient comfort
Osmotic therapy - correct answer Hypertonic saline and mannitol - draws water from
brain tissue to decrease brain volume and lower ICP
Hypertonic saline - hypertonic saline nacl 3% infusion to 23.4% bolus administered via
Central venous catheter - should not cause volume depletion and hypernatremia
Update ) Questions & Answers
{Grade A} 100% Correct
When is reversal of anticoagulants required - correct answer ICH stroke patients with
INR >1.4
When to consider activated charcoal for anticoagulant reversal - correct answer if
most recent oral anticoagulant dose was < 2 hrs
Warfarin Reversal - correct answer 4 factor prothrombin complex concentrate (PCC)
and IV vit K
Fresh frozen plasma if 4 factor PCC unavailable
ICP monitor inserted in ventricles warranted if - correct answer GCS score <8
Evidence of herniation
Intraventricular hemorrhage
Acute hydrocephalus
, CPP - correct answer Cerebral perfusion pressure
Pressure goals - correct answer ICP <20
CPP <50-70
Prevention of ICP - correct answer Elevate HOB to 30 degrees
Support midline head position
Control ventilation to maintain adequate oxygenation and normal paco2
Maintain normal body temp and BG
Avoid constricting cervical veins as with endotracheal tube ties
Provide analgesia or mild sedation for patient comfort
Osmotic therapy - correct answer Hypertonic saline and mannitol - draws water from
brain tissue to decrease brain volume and lower ICP
Hypertonic saline - hypertonic saline nacl 3% infusion to 23.4% bolus administered via
Central venous catheter - should not cause volume depletion and hypernatremia
