NUR 176 EXAM 2: (Latest 2026/2027) Neurologic Disorders – ICP,
Stroke, MS, Seizures, Dementia, Meningitis, Encephalitis,
Incontinence | Q&A Grade A
Complete Review: Increased ICP, Ischemic/Hemorrhagic Stroke, Multiple Sclerosis, Seizure Types & Management,
Alzheimer's, Delirium vs Dementia, Meningitis/Encephalitis, Bladder Dysfunction & Medications
SUBJECT SOURCE FORMAT
Geriatrics / NUR 176 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What are the causes of increased intracranial pressure (ICP)?
CORRECT ANSWER
Trauma, tumor, stroke, infection
RATIONALE
• Increased ICP occurs when any of the three intracranial components (brain tissue, blood, CSF) increases in volume.
• Early signs: headache, vomiting (projectile), LOC changes.
• Late signs: Cushing's triad (HTN, bradycardia, irregular respirations), dilated pupils, decerebrate/decorticate posturing.
Q2
What are nursing interventions for a patient with increased ICP?
CORRECT ANSWER
Elevate HOB (30‑45°), avoid hip flexion (maintain midline neck position), monitor ICP, administer
mannitol (osmotic diuretic).
RATIONALE
• Elevating HOB promotes venous drainage; hip flexion increases intra‑abdominal pressure → increased ICP.
• Avoid suctioning, coughing, straining, Valsalva maneuver.
• Dexamethasone reduces inflammation; mannitol reduces cerebral edema.
, Q3
What is the most common type of stroke and its cause?
CORRECT ANSWER
Ischemic stroke (~87%). Cause: blockage in a blood vessel due to blood clot or plaque buildup.
RATIONALE
• Thrombotic stroke: clot forms in a cerebral artery (often at atherosclerosis site).
• Embolic stroke: clot travels from elsewhere (heart → brain).
• Hemorrhagic stroke: rupture of blood vessel (intracerebral or subarachnoid).
Q4
What is the treatment for ischemic stroke within the window period?
CORRECT ANSWER
tPA (alteplase) within 3‑4.5 hours of symptom onset; thrombectomy (mechanical clot removal) up to 24
hours.
RATIONALE
• tPA is contraindicated in hemorrhagic stroke, recent surgery, active bleeding, uncontrolled hypertension.
• Time is brain; BEFAST: Balance, Eyes, Face drooping, Arm weakness, Speech difficulty, Time to call 911.
• TIA is a warning sign; high risk of full stroke within 48 hours.
Q5
What are the symptoms of hemorrhagic stroke?
CORRECT ANSWER
Sudden severe headache ("worst headache of life"), nausea, vomiting, loss of consciousness, seizures.
RATIONALE
• Intracerebral hemorrhage: bleeding into brain tissue (often from hypertension).
• Subarachnoid hemorrhage: bleeding into space around brain (often from ruptured aneurysm).
• Treatment: control bleeding/ICP, surgery (clip aneurysm, evacuate hematoma), BP management.
Stroke, MS, Seizures, Dementia, Meningitis, Encephalitis,
Incontinence | Q&A Grade A
Complete Review: Increased ICP, Ischemic/Hemorrhagic Stroke, Multiple Sclerosis, Seizure Types & Management,
Alzheimer's, Delirium vs Dementia, Meningitis/Encephalitis, Bladder Dysfunction & Medications
SUBJECT SOURCE FORMAT
Geriatrics / NUR 176 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What are the causes of increased intracranial pressure (ICP)?
CORRECT ANSWER
Trauma, tumor, stroke, infection
RATIONALE
• Increased ICP occurs when any of the three intracranial components (brain tissue, blood, CSF) increases in volume.
• Early signs: headache, vomiting (projectile), LOC changes.
• Late signs: Cushing's triad (HTN, bradycardia, irregular respirations), dilated pupils, decerebrate/decorticate posturing.
Q2
What are nursing interventions for a patient with increased ICP?
CORRECT ANSWER
Elevate HOB (30‑45°), avoid hip flexion (maintain midline neck position), monitor ICP, administer
mannitol (osmotic diuretic).
RATIONALE
• Elevating HOB promotes venous drainage; hip flexion increases intra‑abdominal pressure → increased ICP.
• Avoid suctioning, coughing, straining, Valsalva maneuver.
• Dexamethasone reduces inflammation; mannitol reduces cerebral edema.
, Q3
What is the most common type of stroke and its cause?
CORRECT ANSWER
Ischemic stroke (~87%). Cause: blockage in a blood vessel due to blood clot or plaque buildup.
RATIONALE
• Thrombotic stroke: clot forms in a cerebral artery (often at atherosclerosis site).
• Embolic stroke: clot travels from elsewhere (heart → brain).
• Hemorrhagic stroke: rupture of blood vessel (intracerebral or subarachnoid).
Q4
What is the treatment for ischemic stroke within the window period?
CORRECT ANSWER
tPA (alteplase) within 3‑4.5 hours of symptom onset; thrombectomy (mechanical clot removal) up to 24
hours.
RATIONALE
• tPA is contraindicated in hemorrhagic stroke, recent surgery, active bleeding, uncontrolled hypertension.
• Time is brain; BEFAST: Balance, Eyes, Face drooping, Arm weakness, Speech difficulty, Time to call 911.
• TIA is a warning sign; high risk of full stroke within 48 hours.
Q5
What are the symptoms of hemorrhagic stroke?
CORRECT ANSWER
Sudden severe headache ("worst headache of life"), nausea, vomiting, loss of consciousness, seizures.
RATIONALE
• Intracerebral hemorrhage: bleeding into brain tissue (often from hypertension).
• Subarachnoid hemorrhage: bleeding into space around brain (often from ruptured aneurysm).
• Treatment: control bleeding/ICP, surgery (clip aneurysm, evacuate hematoma), BP management.
