HEMISPHERE 3.0 LEVEL 6 EXAM
QUESTIONS WITH CORRECT
ANSWERS|| LATEST UPDATE 2026||
GRADED A
1. Which clinical syndrome after cerebral hemorrhage may be managed with induced
hypertension?
A. Cerebral edema
B. Delayed cerebral ischemia
C. Meningitis
D. Seizure
Answer: B
Rationale: Induced hypertension improves perfusion during delayed cerebral ischemia
following hemorrhagic events.
2. What condition may cause rapid-onset dyspnea after acute neurological injury?
A. Pulmonary embolism
B. Neurogenic pulmonary edema
C. Pneumonia
D. Bronchospasm
Answer: B
Rationale: Neurological insult can lead to neurogenic pulmonary edema, causing sudden
respiratory distress.
3. An indication for external ventricular drain (EVD) insertion is:
A. Acute asymptomatic hydrocephalus
B. Acute symptomatic hydrocephalus
C. Migraine headaches
D. Low ICP
Answer: B
Rationale: EVD is indicated to manage symptomatic hydrocephalus and elevated
intracranial pressure.
4. A main benefit of endovascular coiling over clipping is that it is:
A. More invasive
B. Less invasive, with lower immediate surgical risk
C. Better for all aneurysm types
D. More expensive with worse outcomes
Answer: B
Rationale: Endovascular coiling is minimally invasive with reduced surgical morbidity.
5. A key consideration in EVD care bundles includes:
A. Administering antibiotics before insertion
B. Withholding all medications
, C. Immediately removing drain after stabilization
D. Avoiding any neurologic checks
Answer: A
Rationale: Prophylactic antibiotics help reduce infection risk with EVD placement.
6. Target intracranial pressure (ICP) in hemorrhagic stroke management is typically:
A. Less than 10 mm Hg
B. Less than 20 mm Hg
C. Less than 30 mm Hg
D. No target is defined
Answer: B
Rationale: ICP < 20 mm Hg is often targeted to minimize secondary injury.
7. Which hemorrhagic stroke procedure permits intracranial pressure monitoring?
A. Laminectomy
B. Ventricular drain insertion
C. Cranioplasty only
D. Lumbar puncture
Answer: B
Rationale: EVD allows both cerebrospinal fluid drainage and ICP monitoring.
8. In patients without mechanical heart valves after hemorrhagic stroke,
anticoagulants should be avoided for at least:
A. 1 week
B. 2 weeks
C. 4 weeks
D. 6 months
Answer: C
Rationale: Avoiding anticoagulation for at least four weeks reduces rebleeding risk.
9. Nimodipine is given to aneurysmal subarachnoid hemorrhage patients to:
A. Improve perfusion
B. Reduce rebleeding
C. Improve outcomes by reducing vasospasm
D. Lower blood pressure only
Answer: C
Rationale: Nimodipine reduces cerebral vasospasm and improves neurologic outcomes.
10. A benefit of surgical clipping of aneurysms is:
A. Lower infection risk only
B. No need for monitoring afterward
C. Decreased risk of rebleeding
D. Always faster recovery than coiling
Answer: C
Rationale: Surgical clipping directly secures the aneurysm to reduce rebleeding.
11–20: Complications & Assessment
, 11. A common tool to detect cerebral vasospasm after hemorrhage is:
A. Transcranial Doppler ultrasound
B. CT angiography only
C. MRI for muscle
D. Chest X-ray
Answer: A
Rationale: Transcranial Doppler helps assess vasospasm severity.
12. Continuous ICP monitoring is critical to mitigate:
A. Stroke volume
B. Brain herniation
C. Peripheral numbness
D. Fever
Answer: B
Rationale: Elevated ICP monitoring allows early detection of herniation risks.
13. A reasonable systolic blood pressure target for subarachnoid hemorrhage patients
is:
A. < 120 mm Hg
B. < 140 mm Hg
C. < 160 mm Hg
D. < 180 mm Hg
Answer: C
Rationale: Maintaining SBP < 160 mm Hg helps reduce stress on bleeding risk without
compromising perfusion.
14. Hyponatremia in hemorrhagic stroke can lead to:
A. Cerebral vasospasm
B. Stroke recovery acceleration
C. Hypokalemia only
D. No neurological effect
Answer: A
Rationale: Sodium imbalances can worsen cerebral vasospasm and secondary injury.
15. Aneurysmal clipping requires:
A. Endoscopy
B. Craniotomy
C. Angioplasty only
D. No surgery
Answer: B
Rationale: Clipping involves open craniotomy to access and secure the aneurysm.
16. Chronic non-obstructive hydrocephalus may be treated with:
A. Anticonvulsants
B. VP shunt
C. Physical therapy only
D. BP meds
Answer: B
Rationale: A ventriculoperitoneal shunt diverts CSF to reduce hydrocephalus.
17. Neurogenic pulmonary edema typically develops:
A. Immediately
QUESTIONS WITH CORRECT
ANSWERS|| LATEST UPDATE 2026||
GRADED A
1. Which clinical syndrome after cerebral hemorrhage may be managed with induced
hypertension?
A. Cerebral edema
B. Delayed cerebral ischemia
C. Meningitis
D. Seizure
Answer: B
Rationale: Induced hypertension improves perfusion during delayed cerebral ischemia
following hemorrhagic events.
2. What condition may cause rapid-onset dyspnea after acute neurological injury?
A. Pulmonary embolism
B. Neurogenic pulmonary edema
C. Pneumonia
D. Bronchospasm
Answer: B
Rationale: Neurological insult can lead to neurogenic pulmonary edema, causing sudden
respiratory distress.
3. An indication for external ventricular drain (EVD) insertion is:
A. Acute asymptomatic hydrocephalus
B. Acute symptomatic hydrocephalus
C. Migraine headaches
D. Low ICP
Answer: B
Rationale: EVD is indicated to manage symptomatic hydrocephalus and elevated
intracranial pressure.
4. A main benefit of endovascular coiling over clipping is that it is:
A. More invasive
B. Less invasive, with lower immediate surgical risk
C. Better for all aneurysm types
D. More expensive with worse outcomes
Answer: B
Rationale: Endovascular coiling is minimally invasive with reduced surgical morbidity.
5. A key consideration in EVD care bundles includes:
A. Administering antibiotics before insertion
B. Withholding all medications
, C. Immediately removing drain after stabilization
D. Avoiding any neurologic checks
Answer: A
Rationale: Prophylactic antibiotics help reduce infection risk with EVD placement.
6. Target intracranial pressure (ICP) in hemorrhagic stroke management is typically:
A. Less than 10 mm Hg
B. Less than 20 mm Hg
C. Less than 30 mm Hg
D. No target is defined
Answer: B
Rationale: ICP < 20 mm Hg is often targeted to minimize secondary injury.
7. Which hemorrhagic stroke procedure permits intracranial pressure monitoring?
A. Laminectomy
B. Ventricular drain insertion
C. Cranioplasty only
D. Lumbar puncture
Answer: B
Rationale: EVD allows both cerebrospinal fluid drainage and ICP monitoring.
8. In patients without mechanical heart valves after hemorrhagic stroke,
anticoagulants should be avoided for at least:
A. 1 week
B. 2 weeks
C. 4 weeks
D. 6 months
Answer: C
Rationale: Avoiding anticoagulation for at least four weeks reduces rebleeding risk.
9. Nimodipine is given to aneurysmal subarachnoid hemorrhage patients to:
A. Improve perfusion
B. Reduce rebleeding
C. Improve outcomes by reducing vasospasm
D. Lower blood pressure only
Answer: C
Rationale: Nimodipine reduces cerebral vasospasm and improves neurologic outcomes.
10. A benefit of surgical clipping of aneurysms is:
A. Lower infection risk only
B. No need for monitoring afterward
C. Decreased risk of rebleeding
D. Always faster recovery than coiling
Answer: C
Rationale: Surgical clipping directly secures the aneurysm to reduce rebleeding.
11–20: Complications & Assessment
, 11. A common tool to detect cerebral vasospasm after hemorrhage is:
A. Transcranial Doppler ultrasound
B. CT angiography only
C. MRI for muscle
D. Chest X-ray
Answer: A
Rationale: Transcranial Doppler helps assess vasospasm severity.
12. Continuous ICP monitoring is critical to mitigate:
A. Stroke volume
B. Brain herniation
C. Peripheral numbness
D. Fever
Answer: B
Rationale: Elevated ICP monitoring allows early detection of herniation risks.
13. A reasonable systolic blood pressure target for subarachnoid hemorrhage patients
is:
A. < 120 mm Hg
B. < 140 mm Hg
C. < 160 mm Hg
D. < 180 mm Hg
Answer: C
Rationale: Maintaining SBP < 160 mm Hg helps reduce stress on bleeding risk without
compromising perfusion.
14. Hyponatremia in hemorrhagic stroke can lead to:
A. Cerebral vasospasm
B. Stroke recovery acceleration
C. Hypokalemia only
D. No neurological effect
Answer: A
Rationale: Sodium imbalances can worsen cerebral vasospasm and secondary injury.
15. Aneurysmal clipping requires:
A. Endoscopy
B. Craniotomy
C. Angioplasty only
D. No surgery
Answer: B
Rationale: Clipping involves open craniotomy to access and secure the aneurysm.
16. Chronic non-obstructive hydrocephalus may be treated with:
A. Anticonvulsants
B. VP shunt
C. Physical therapy only
D. BP meds
Answer: B
Rationale: A ventriculoperitoneal shunt diverts CSF to reduce hydrocephalus.
17. Neurogenic pulmonary edema typically develops:
A. Immediately
