NURS 370 Final Exam Questions With
Correct Answers
What |is |a |subdural |hemorrhage? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |between
|the |dura |& |arachnoid |layers. |Sheering |of |veins |so |occurs |much |slower
What |is |a |epidural |hemorrhage? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |between |
the |skull |& |dura |layer. |Sheering |of |arteries |so |occurs |rapidly, |compresses |brain |quickly, |and |
rapid |surgical |intervention |is |needed |to |prevent |herniation
What's |cushing's |triad? |- |CORRECT |ANSWER✔✔-A |set |of |3 |manifestations |that |indicate |
impending |herniation/coning:
1. |Bradycardia
2. |Bradypnea/irregular |respirations
3. |Widening |pulse |pressure |(sBP |increases. |dBP |decreases)
What |is |normal |ICP |in |an |adult |lying |flat? |- |CORRECT |ANSWER✔✔-5-15 |mmHg
What |are |temporal |brain |contusions? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |that
|bruises |brain |tissue. |Only |treatment |is |treating |elevated |ICP
What |is |a |subarachnoid |hemorrhage? |- |CORRECT |ANSWER✔✔-A |diffuse |head |injury |that |
occurs |between |the |arachnoid |& |pia |layer. |Pia |layer |so |thin |that |bleeding |spreads |quite |quickly
|through |brain |& |causes |damage |fast. |Manifestations |similar |to |meningitis |(sore/stiff |neck, |
photophobia, |severe |headache)
,Manifestations |of |a |subarachnoid |hemorrhage |are |similar |to |meningitis. |Why? |- |CORRECT |
ANSWER✔✔-The |meninges |sit |just |below |the |pia |layer
How |do |you |measure |mean |arterial |pressure |(MAP)? |- |CORRECT |ANSWER✔✔-MAP |= |(2xdBP |+
|1xsBP) |/ |3
What |is |cerebral |perfusion |pressure? |- |CORRECT |ANSWER✔✔-The |pressure |needed |to |
adequately |perfuse |brain |tissue
When |do |we |start |to |worry |about |CPP |(cerebral |perfusion |pressure)? |Why? |- |CORRECT |
ANSWER✔✔-If |CPP |drops |below |60 |we |worry. |Not |enough |perfusion |to |the |brain
If |CPP |drops |below |60 |we |aren't |getting |enough |O2 |to |the |brain. |How |can |we |improve |brain |
perfusion? |- |CORRECT |ANSWER✔✔-Either |increase |mean |arterial |pressure |or |decrease |
intracranial |pressure |(fine |line |between |increasing |MAP |to |increase |CPP, |but |not |so |high |that |it
|increases |ICP)
CPP |= |MAP |- |ICP
What |is |the |formula |for |CPP? |- |CORRECT |ANSWER✔✔-CPP |= |MAP |- |ICP
What |is |battle's |sign? |- |CORRECT |ANSWER✔✔-Bruising |behind |the |ear. |It |indicates |a |skull |
fracture |in |the |middle |cranial |fossa
What |is |rhinorrhea? |Otorrhea? |- |CORRECT |ANSWER✔✔-Rhinorrhea |- |CSF |leakage |from |nose
Otorrhea |- |CSF |leakage |from |ear
How |do |you |know |if |leakage |is |CSF |or |not? |- |CORRECT |ANSWER✔✔-CSF |will |be |clear |and |will |
form |Halo |Sign |(the |interior |part |of |the |stain |will |look |bloody)
, What |do |you |do |if |your |pt |is |leaking |CSF? |- |CORRECT |ANSWER✔✔-Apply |a |3 |sided
|dressing/loose |2x2. |Lets |fluid |out |but |prevents |bacteria |from |entering
What |is |bilateral |periorbital |ecchymosis |and |what |must |you |keep |into |consideration |if |
someone |has |this? |- |CORRECT |ANSWER✔✔-Bilateral |periorbital |ecchymosis: |bruising |around |
eyes |- |indicates |basil |skull |fracture
If |someone |has |this |DO |NOT |insert |NG/anything |up |nose |(why? |may |go |into |brain)
What |drug |do |you |give |to |pts |to |decrease |cerebral |volume |and |lower |ICP? |- |CORRECT |
ANSWER✔✔-Manitol |(osmotic |diuretic) |- |most |effective |diuretic |for |pts |with |head |injuries |
(draws |out |fluid |from |brain |tissue |- |fluid |goes |into |vascular |space |and |gets |voided |out)
What |do |you |do |if |a |pt |with |a |brain |injury |starts |hypoventilating? |Why? |- |CORRECT |
ANSWER✔✔-Manually |bag |them |- |then |transfer |pt |to |ICU |& |put |on |ventilator
Why? |CO2 |rises |in |hypoventilation |- |causes |blood |vessels |to |dilate |- |increased |blood |volume |in
|brain |- |increases |ICP
When |does |peak |swelling |take |place? |- |CORRECT |ANSWER✔✔-48-72 |hr |window
What |is |preload? |What |could |increase/decrease |preload? |- |CORRECT |ANSWER✔✔-Preload: |
stretch |in |ventricles |at |end |diastole
Increases |in: |HF, |hypervolemia
Decreases |in: |Blood |loss/hemorrhage, |vomit
What |is |after |load? |What |could |increase/decrease |after |load? |- |CORRECT |ANSWER✔✔-After |
load: |resistance |left |ventricle |must |overcome |to |circulate |blood
Increases |in: |hypertension, |vasoconstriction
Decreases |in: |vasodilator |administration
Correct Answers
What |is |a |subdural |hemorrhage? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |between
|the |dura |& |arachnoid |layers. |Sheering |of |veins |so |occurs |much |slower
What |is |a |epidural |hemorrhage? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |between |
the |skull |& |dura |layer. |Sheering |of |arteries |so |occurs |rapidly, |compresses |brain |quickly, |and |
rapid |surgical |intervention |is |needed |to |prevent |herniation
What's |cushing's |triad? |- |CORRECT |ANSWER✔✔-A |set |of |3 |manifestations |that |indicate |
impending |herniation/coning:
1. |Bradycardia
2. |Bradypnea/irregular |respirations
3. |Widening |pulse |pressure |(sBP |increases. |dBP |decreases)
What |is |normal |ICP |in |an |adult |lying |flat? |- |CORRECT |ANSWER✔✔-5-15 |mmHg
What |are |temporal |brain |contusions? |- |CORRECT |ANSWER✔✔-A |type |of |focal |head |injury |that
|bruises |brain |tissue. |Only |treatment |is |treating |elevated |ICP
What |is |a |subarachnoid |hemorrhage? |- |CORRECT |ANSWER✔✔-A |diffuse |head |injury |that |
occurs |between |the |arachnoid |& |pia |layer. |Pia |layer |so |thin |that |bleeding |spreads |quite |quickly
|through |brain |& |causes |damage |fast. |Manifestations |similar |to |meningitis |(sore/stiff |neck, |
photophobia, |severe |headache)
,Manifestations |of |a |subarachnoid |hemorrhage |are |similar |to |meningitis. |Why? |- |CORRECT |
ANSWER✔✔-The |meninges |sit |just |below |the |pia |layer
How |do |you |measure |mean |arterial |pressure |(MAP)? |- |CORRECT |ANSWER✔✔-MAP |= |(2xdBP |+
|1xsBP) |/ |3
What |is |cerebral |perfusion |pressure? |- |CORRECT |ANSWER✔✔-The |pressure |needed |to |
adequately |perfuse |brain |tissue
When |do |we |start |to |worry |about |CPP |(cerebral |perfusion |pressure)? |Why? |- |CORRECT |
ANSWER✔✔-If |CPP |drops |below |60 |we |worry. |Not |enough |perfusion |to |the |brain
If |CPP |drops |below |60 |we |aren't |getting |enough |O2 |to |the |brain. |How |can |we |improve |brain |
perfusion? |- |CORRECT |ANSWER✔✔-Either |increase |mean |arterial |pressure |or |decrease |
intracranial |pressure |(fine |line |between |increasing |MAP |to |increase |CPP, |but |not |so |high |that |it
|increases |ICP)
CPP |= |MAP |- |ICP
What |is |the |formula |for |CPP? |- |CORRECT |ANSWER✔✔-CPP |= |MAP |- |ICP
What |is |battle's |sign? |- |CORRECT |ANSWER✔✔-Bruising |behind |the |ear. |It |indicates |a |skull |
fracture |in |the |middle |cranial |fossa
What |is |rhinorrhea? |Otorrhea? |- |CORRECT |ANSWER✔✔-Rhinorrhea |- |CSF |leakage |from |nose
Otorrhea |- |CSF |leakage |from |ear
How |do |you |know |if |leakage |is |CSF |or |not? |- |CORRECT |ANSWER✔✔-CSF |will |be |clear |and |will |
form |Halo |Sign |(the |interior |part |of |the |stain |will |look |bloody)
, What |do |you |do |if |your |pt |is |leaking |CSF? |- |CORRECT |ANSWER✔✔-Apply |a |3 |sided
|dressing/loose |2x2. |Lets |fluid |out |but |prevents |bacteria |from |entering
What |is |bilateral |periorbital |ecchymosis |and |what |must |you |keep |into |consideration |if |
someone |has |this? |- |CORRECT |ANSWER✔✔-Bilateral |periorbital |ecchymosis: |bruising |around |
eyes |- |indicates |basil |skull |fracture
If |someone |has |this |DO |NOT |insert |NG/anything |up |nose |(why? |may |go |into |brain)
What |drug |do |you |give |to |pts |to |decrease |cerebral |volume |and |lower |ICP? |- |CORRECT |
ANSWER✔✔-Manitol |(osmotic |diuretic) |- |most |effective |diuretic |for |pts |with |head |injuries |
(draws |out |fluid |from |brain |tissue |- |fluid |goes |into |vascular |space |and |gets |voided |out)
What |do |you |do |if |a |pt |with |a |brain |injury |starts |hypoventilating? |Why? |- |CORRECT |
ANSWER✔✔-Manually |bag |them |- |then |transfer |pt |to |ICU |& |put |on |ventilator
Why? |CO2 |rises |in |hypoventilation |- |causes |blood |vessels |to |dilate |- |increased |blood |volume |in
|brain |- |increases |ICP
When |does |peak |swelling |take |place? |- |CORRECT |ANSWER✔✔-48-72 |hr |window
What |is |preload? |What |could |increase/decrease |preload? |- |CORRECT |ANSWER✔✔-Preload: |
stretch |in |ventricles |at |end |diastole
Increases |in: |HF, |hypervolemia
Decreases |in: |Blood |loss/hemorrhage, |vomit
What |is |after |load? |What |could |increase/decrease |after |load? |- |CORRECT |ANSWER✔✔-After |
load: |resistance |left |ventricle |must |overcome |to |circulate |blood
Increases |in: |hypertension, |vasoconstriction
Decreases |in: |vasodilator |administration
