NSG 3280 - EXAM 3 (NEURO) QUESTIONS AND ANSWERS PRACTICE QUESTIONS WITH
SOLUTIONS NEWEST | ALREADY GRADED A+/NEWEST UPDATE
Question 1
Which statement best describes the response of nerve tissue to ischemia?
A) Nerve tissue is highly resistant to decreased oxygen.
B) Nerve tissue thrives during anaerobic metabolism.
C) Nerve tissue struggles with anaerobic metabolism and is very sensitive to oxygen loss.
D) Nerve tissue maintains its function for hours without perfusion.
E) Nerve tissue produces oxygen internally during periods of low flow.
Correct Answer: C) Nerve tissue struggles with anaerobic metabolism and is very sensitive
to oxygen loss.
Rationale: Nerve tissue has a very high metabolic rate and lacks the ability to store
significant amounts of oxygen or glucose. It is highly dependent on aerobic metabolism;
when ischemia occurs, anaerobic metabolism is insufficient to meet energy demands,
leading to rapid cell dysfunction.
Question 2
What is the primary cellular consequence of hypoxia in the brain?
A) Increased ATP production
B) Mitochondrial failure and cell damage
C) Decreased glutamate release
D) Cellular alkalosis
E) Stabilization of the sodium-potassium pump
Correct Answer: B) Mitochondrial failure and cell damage.
Rationale: Hypoxia refers to decreased oxygen delivery. Oxygen is necessary for the
mitochondria to produce ATP. Without it, the mitochondria fail, leading to an energy crisis
that damages the cell and triggers various injury cascades.
Question 3
Which of the following is the main excitatory neurotransmitter in the Central Nervous System
(CNS)?
A) GABA
B) Acetylcholine
C) Dopamine
D) Glutamate
E) Serotonin
Correct Answer: D) Glutamate.
Rationale: Glutamate is the primary excitatory neurotransmitter in the CNS. While
essential for normal function, excessive amounts—as seen in brain injury—lead to
excitotoxicity and cell death.
Question 4
What effect does ischemia have on the release of glutamate in the brain?
, 2
A) Ischemia causes an immediate halt in glutamate release.
B) Ischemia increases glutamate release.
C) Ischemia converts glutamate into GABA.
D) Ischemia prevents glutamate from binding to receptors.
E) Ischemia only affects inhibitory neurotransmitters.
Correct Answer: B) Ischemia increases glutamate release.
Rationale: When brain cells are ischemic, they lose the ability to regulate neurotransmitters.
This leads to a massive, uncontrolled release of glutamate into the extracellular space.
Question 5
Excessive glutamate release during brain ischemia leads to "calcium overload." What is the
direct result of this influx?
A) Cell dehydration
B) Cytotoxic edema and cell death
C) Increased mitochondrial efficiency
D) Decreased production of free radicals
E) Hyperpolarization of the neuron
Correct Answer: B) Cytotoxic edema and cell death.
Rationale: Excess glutamate opens channels that allow massive amounts of calcium and
water to enter the cell. This causes the cell to swell (cytotoxic edema) and activates enzymes
that lead to cell death.
Question 6
Excessive glutamate production in the brain is associated with the increased production of which
harmful substance?
A) Glucose
B) Nitrous oxide and free radicals
C) Adenosine
D) Myelin
E) Endorphins
Correct Answer: B) Nitrous oxide and free radicals.
Rationale: Calcium overload triggered by glutamate activates pathways that produce nitric
oxide and free radicals. These substances are highly reactive and cause oxidative stress,
further damaging cell membranes and DNA.
Question 7
What is the normal physiological range for intracranial pressure (ICP)?
A) 0-15 mmHg
B) 20-30 mmHg
C) 40-60 mmHg
D) 70-100 mmHg
, 3
E) 120/80 mmHg
Correct Answer: A) 0-15 mmHg.
Rationale: The pressure within the rigid skull is normally low, ranging from 0 to 15 mmHg.
Maintaining this pressure is vital for adequate cerebral perfusion.
Question 8
Brain impairment is likely to occur when the ICP exceeds what threshold for more than 5
minutes?
A) 5 mmHg
B) 10 mmHg
C) 15 mmHg
D) 22 mmHg
E) 50 mmHg
Correct Answer: D) 22 mmHg.
Rationale: While minor fluctuations occur, a sustained ICP greater than 22 mmHg is
considered a medical emergency as it compromises cerebral blood flow and leads to brain
herniation and death.
Question 9
According to the Monroe-Kellie doctrine, which three components must maintain a balance to
keep ICP normal?
A) Brain tissue, Cerebrospinal Fluid (CSF), and Blood
B) Bone, Skin, and Hair
C) Glucose, Oxygen, and Carbon Dioxide
D) Neurons, Glia, and Myelin
E) Arteries, Veins, and Capillaries
Correct Answer: A) Brain tissue, Cerebrospinal Fluid (CSF), and Blood.
Rationale: The Monroe-Kellie doctrine states that the skull is a rigid container with a fixed
volume. If the volume of one component (brain, CSF, or blood) increases, the others must
decrease to maintain a stable ICP.
Question 10
The ability of the cranial components to adjust to changes in volume to minimize the impact on
ICP is known as:
A) Cerebral Perfusion Pressure
B) Intracranial compliance
C) Autoregulation
D) Excitotoxicity
E) The Blood-Brain Barrier
Correct Answer: B) Intracranial compliance.
Rationale: Compliance is the "buffer" capacity of the brain. For example, if a small tumor
, 4
grows, the brain may compensate by shunting CSF into the spinal cord to keep the pressure
from rising immediately.
Question 11
Which of the following everyday activities can cause a slight, temporary increase in ICP?
A) Sleeping
B) Sneezing or coughing
C) Reading a book
D) Watching television
E) Drinking water
Correct Answer: B) Sneezing or coughing.
Rationale: Activities that increase intrathoracic or intra-abdominal pressure, such as
sneezing, coughing, laughing, or bending over, momentarily increase ICP by hindering
venous return from the brain.
Question 12
Swelling caused by fluid, electrolytes, and proteins being forced into the intercellular space due
to vessel damage is called:
A) Intracellular edema
B) Cytotoxic edema
C) Interstitial edema
D) Hydrocephalus
E) Ischemic necrosis
Correct Answer: C) Interstitial edema.
Rationale: Interstitial (or vasogenic) edema occurs when the blood-brain barrier is
disrupted, allowing fluid and proteins to leak out of the vessels and into the spaces between
the brain cells.
Question 13
Which condition causes intracellular edema in the brain?
A) A small scalp laceration
B) Global ischemia leading to energy failure and Na+ accumulation
C) High protein intake
D) Excessive sneezing
E) Normal aging
Correct Answer: B) Global ischemia leading to energy failure and Na+ accumulation.
Rationale: In intracellular (cytotoxic) edema, the failure of the ATP-dependent Na+/K+
pump causes sodium to accumulate inside the cell. This pulls water into the cell via osmosis,
causing the individual cells to swell.
SOLUTIONS NEWEST | ALREADY GRADED A+/NEWEST UPDATE
Question 1
Which statement best describes the response of nerve tissue to ischemia?
A) Nerve tissue is highly resistant to decreased oxygen.
B) Nerve tissue thrives during anaerobic metabolism.
C) Nerve tissue struggles with anaerobic metabolism and is very sensitive to oxygen loss.
D) Nerve tissue maintains its function for hours without perfusion.
E) Nerve tissue produces oxygen internally during periods of low flow.
Correct Answer: C) Nerve tissue struggles with anaerobic metabolism and is very sensitive
to oxygen loss.
Rationale: Nerve tissue has a very high metabolic rate and lacks the ability to store
significant amounts of oxygen or glucose. It is highly dependent on aerobic metabolism;
when ischemia occurs, anaerobic metabolism is insufficient to meet energy demands,
leading to rapid cell dysfunction.
Question 2
What is the primary cellular consequence of hypoxia in the brain?
A) Increased ATP production
B) Mitochondrial failure and cell damage
C) Decreased glutamate release
D) Cellular alkalosis
E) Stabilization of the sodium-potassium pump
Correct Answer: B) Mitochondrial failure and cell damage.
Rationale: Hypoxia refers to decreased oxygen delivery. Oxygen is necessary for the
mitochondria to produce ATP. Without it, the mitochondria fail, leading to an energy crisis
that damages the cell and triggers various injury cascades.
Question 3
Which of the following is the main excitatory neurotransmitter in the Central Nervous System
(CNS)?
A) GABA
B) Acetylcholine
C) Dopamine
D) Glutamate
E) Serotonin
Correct Answer: D) Glutamate.
Rationale: Glutamate is the primary excitatory neurotransmitter in the CNS. While
essential for normal function, excessive amounts—as seen in brain injury—lead to
excitotoxicity and cell death.
Question 4
What effect does ischemia have on the release of glutamate in the brain?
, 2
A) Ischemia causes an immediate halt in glutamate release.
B) Ischemia increases glutamate release.
C) Ischemia converts glutamate into GABA.
D) Ischemia prevents glutamate from binding to receptors.
E) Ischemia only affects inhibitory neurotransmitters.
Correct Answer: B) Ischemia increases glutamate release.
Rationale: When brain cells are ischemic, they lose the ability to regulate neurotransmitters.
This leads to a massive, uncontrolled release of glutamate into the extracellular space.
Question 5
Excessive glutamate release during brain ischemia leads to "calcium overload." What is the
direct result of this influx?
A) Cell dehydration
B) Cytotoxic edema and cell death
C) Increased mitochondrial efficiency
D) Decreased production of free radicals
E) Hyperpolarization of the neuron
Correct Answer: B) Cytotoxic edema and cell death.
Rationale: Excess glutamate opens channels that allow massive amounts of calcium and
water to enter the cell. This causes the cell to swell (cytotoxic edema) and activates enzymes
that lead to cell death.
Question 6
Excessive glutamate production in the brain is associated with the increased production of which
harmful substance?
A) Glucose
B) Nitrous oxide and free radicals
C) Adenosine
D) Myelin
E) Endorphins
Correct Answer: B) Nitrous oxide and free radicals.
Rationale: Calcium overload triggered by glutamate activates pathways that produce nitric
oxide and free radicals. These substances are highly reactive and cause oxidative stress,
further damaging cell membranes and DNA.
Question 7
What is the normal physiological range for intracranial pressure (ICP)?
A) 0-15 mmHg
B) 20-30 mmHg
C) 40-60 mmHg
D) 70-100 mmHg
, 3
E) 120/80 mmHg
Correct Answer: A) 0-15 mmHg.
Rationale: The pressure within the rigid skull is normally low, ranging from 0 to 15 mmHg.
Maintaining this pressure is vital for adequate cerebral perfusion.
Question 8
Brain impairment is likely to occur when the ICP exceeds what threshold for more than 5
minutes?
A) 5 mmHg
B) 10 mmHg
C) 15 mmHg
D) 22 mmHg
E) 50 mmHg
Correct Answer: D) 22 mmHg.
Rationale: While minor fluctuations occur, a sustained ICP greater than 22 mmHg is
considered a medical emergency as it compromises cerebral blood flow and leads to brain
herniation and death.
Question 9
According to the Monroe-Kellie doctrine, which three components must maintain a balance to
keep ICP normal?
A) Brain tissue, Cerebrospinal Fluid (CSF), and Blood
B) Bone, Skin, and Hair
C) Glucose, Oxygen, and Carbon Dioxide
D) Neurons, Glia, and Myelin
E) Arteries, Veins, and Capillaries
Correct Answer: A) Brain tissue, Cerebrospinal Fluid (CSF), and Blood.
Rationale: The Monroe-Kellie doctrine states that the skull is a rigid container with a fixed
volume. If the volume of one component (brain, CSF, or blood) increases, the others must
decrease to maintain a stable ICP.
Question 10
The ability of the cranial components to adjust to changes in volume to minimize the impact on
ICP is known as:
A) Cerebral Perfusion Pressure
B) Intracranial compliance
C) Autoregulation
D) Excitotoxicity
E) The Blood-Brain Barrier
Correct Answer: B) Intracranial compliance.
Rationale: Compliance is the "buffer" capacity of the brain. For example, if a small tumor
, 4
grows, the brain may compensate by shunting CSF into the spinal cord to keep the pressure
from rising immediately.
Question 11
Which of the following everyday activities can cause a slight, temporary increase in ICP?
A) Sleeping
B) Sneezing or coughing
C) Reading a book
D) Watching television
E) Drinking water
Correct Answer: B) Sneezing or coughing.
Rationale: Activities that increase intrathoracic or intra-abdominal pressure, such as
sneezing, coughing, laughing, or bending over, momentarily increase ICP by hindering
venous return from the brain.
Question 12
Swelling caused by fluid, electrolytes, and proteins being forced into the intercellular space due
to vessel damage is called:
A) Intracellular edema
B) Cytotoxic edema
C) Interstitial edema
D) Hydrocephalus
E) Ischemic necrosis
Correct Answer: C) Interstitial edema.
Rationale: Interstitial (or vasogenic) edema occurs when the blood-brain barrier is
disrupted, allowing fluid and proteins to leak out of the vessels and into the spaces between
the brain cells.
Question 13
Which condition causes intracellular edema in the brain?
A) A small scalp laceration
B) Global ischemia leading to energy failure and Na+ accumulation
C) High protein intake
D) Excessive sneezing
E) Normal aging
Correct Answer: B) Global ischemia leading to energy failure and Na+ accumulation.
Rationale: In intracellular (cytotoxic) edema, the failure of the ATP-dependent Na+/K+
pump causes sodium to accumulate inside the cell. This pulls water into the cell via osmosis,
causing the individual cells to swell.
