NUR 2755 MULTIDIMENSIONAL CARE IV (MDC 4) FINAL EXAM PRACTICE
QUESTIONS AND ANSWERS – CRITICAL CARE, NEUROLOGICAL EMERGENCIES,
ARDS, MECHANICAL VENTILATION, SHOCK, AND SEPSIS REVIEW
Neurological Emergencies (Questions 1–20)
1. A client with increased intracranial pressure (ICP) develops bradycardia, widened pulse pressure, and
irregular respirations. The nurse recognizes these findings as:
A. Neurogenic shock
B. Cushing's triad
C. Brain stem reflexes
D. Meningeal irritation
2. Which intervention has the highest priority for a client with increased ICP?
A. Frequent suctioning
B. Maintaining neck in neutral alignment
C. Trendelenburg position
D. Restricting oxygen therapy
3. A client arrives with sudden right-sided weakness and aphasia. Which action is the priority?
A. Obtain blood cultures
B. Perform swallow screening
C. Determine time symptoms began
D. Administer aspirin
4. Which finding is most consistent with a left hemispheric stroke?
A. Impulsive behavior
B. Left-sided neglect
C. Expressive aphasia
D. Poor judgment
5. A client is receiving alteplase (tPA). Which assessment finding requires immediate intervention?
A. Mild headache
B. BP 142/84 mmHg
C. Hematuria
D. HR 88 bpm
6. Status epilepticus is defined as:
A. More than one seizure in a lifetime
B. A seizure lasting >5 minutes or recurrent seizures without recovery
C. Any tonic-clonic seizure
D. Seizures occurring during sleep
7. During an active seizure, the nurse should:
A. Restrain the client
B. Insert an oral airway
,C. Protect the client from injury
D. Place the client supine
8. Which medication is commonly administered first-line for status epilepticus?
A. Furosemide
B. Lorazepam
C. Digoxin
D. Mannitol
9. An early sign of increasing ICP is:
A. Fixed dilated pupils
B. Decreased level of consciousness
C. Decerebrate posturing
D. Cushing's triad
10. Which GCS score indicates severe neurological impairment?
A. 15
B. 13
C. 10
D. 7
11. Which assessment finding suggests brain herniation?
A. Stable pupils
B. Bilateral equal strength
C. Unilateral fixed dilated pupil
D. Normal LOC
12. A nurse caring for a client with ICP should avoid:
A. Elevating HOB 30 degrees
B. Clustered nursing activities
C. Maintaining oxygenation
D. Monitoring neurological status
13. Which finding suggests aspiration after a stroke?
A. Dysarthria
B. Facial droop
C. Coughing during meals
D. Aphasia
14. A priority intervention after ischemic stroke is:
A. Lowering BP aggressively
B. Preventing aspiration
C. Restricting fluids
D. Bedrest for 72 hours
15. Which assessment finding indicates improvement after stroke treatment?
A. Increasing confusion
B. Improved speech clarity
, C. Worsening headache
D. Decreased LOC
16. Which electrolyte imbalance increases seizure risk?
A. Hypernatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperphosphatemia
17. A patient with ICP should be positioned:
A. Flat
B. Trendelenburg
C. HOB 30 degrees
D. Prone
18. Which pupil change is most concerning?
A. Equal and reactive
B. Sluggish bilaterally
C. Fixed and dilated unilateral pupil
D. 3 mm bilaterally
19. The most important assessment for a patient after seizure activity is:
A. Skin turgor
B. Airway and oxygenation
C. Pain level
D. Appetite
20. Which finding requires immediate notification of the provider?
A. Mild headache
B. GCS decrease from 14 to 11
C. BP 130/80 mmHg
D. HR 78 bpm
Respiratory Failure, ARDS & Mechanical Ventilation (Questions 21–45)
21. The hallmark of ARDS is:
A. Cardiogenic pulmonary edema
B. Refractory hypoxemia
C. Bradycardia
D. Hyperglycemia
22. Which intervention improves oxygenation in severe ARDS?
A. Supine positioning
B. Prone positioning
C. Trendelenburg
D. Fluid restriction only
QUESTIONS AND ANSWERS – CRITICAL CARE, NEUROLOGICAL EMERGENCIES,
ARDS, MECHANICAL VENTILATION, SHOCK, AND SEPSIS REVIEW
Neurological Emergencies (Questions 1–20)
1. A client with increased intracranial pressure (ICP) develops bradycardia, widened pulse pressure, and
irregular respirations. The nurse recognizes these findings as:
A. Neurogenic shock
B. Cushing's triad
C. Brain stem reflexes
D. Meningeal irritation
2. Which intervention has the highest priority for a client with increased ICP?
A. Frequent suctioning
B. Maintaining neck in neutral alignment
C. Trendelenburg position
D. Restricting oxygen therapy
3. A client arrives with sudden right-sided weakness and aphasia. Which action is the priority?
A. Obtain blood cultures
B. Perform swallow screening
C. Determine time symptoms began
D. Administer aspirin
4. Which finding is most consistent with a left hemispheric stroke?
A. Impulsive behavior
B. Left-sided neglect
C. Expressive aphasia
D. Poor judgment
5. A client is receiving alteplase (tPA). Which assessment finding requires immediate intervention?
A. Mild headache
B. BP 142/84 mmHg
C. Hematuria
D. HR 88 bpm
6. Status epilepticus is defined as:
A. More than one seizure in a lifetime
B. A seizure lasting >5 minutes or recurrent seizures without recovery
C. Any tonic-clonic seizure
D. Seizures occurring during sleep
7. During an active seizure, the nurse should:
A. Restrain the client
B. Insert an oral airway
,C. Protect the client from injury
D. Place the client supine
8. Which medication is commonly administered first-line for status epilepticus?
A. Furosemide
B. Lorazepam
C. Digoxin
D. Mannitol
9. An early sign of increasing ICP is:
A. Fixed dilated pupils
B. Decreased level of consciousness
C. Decerebrate posturing
D. Cushing's triad
10. Which GCS score indicates severe neurological impairment?
A. 15
B. 13
C. 10
D. 7
11. Which assessment finding suggests brain herniation?
A. Stable pupils
B. Bilateral equal strength
C. Unilateral fixed dilated pupil
D. Normal LOC
12. A nurse caring for a client with ICP should avoid:
A. Elevating HOB 30 degrees
B. Clustered nursing activities
C. Maintaining oxygenation
D. Monitoring neurological status
13. Which finding suggests aspiration after a stroke?
A. Dysarthria
B. Facial droop
C. Coughing during meals
D. Aphasia
14. A priority intervention after ischemic stroke is:
A. Lowering BP aggressively
B. Preventing aspiration
C. Restricting fluids
D. Bedrest for 72 hours
15. Which assessment finding indicates improvement after stroke treatment?
A. Increasing confusion
B. Improved speech clarity
, C. Worsening headache
D. Decreased LOC
16. Which electrolyte imbalance increases seizure risk?
A. Hypernatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperphosphatemia
17. A patient with ICP should be positioned:
A. Flat
B. Trendelenburg
C. HOB 30 degrees
D. Prone
18. Which pupil change is most concerning?
A. Equal and reactive
B. Sluggish bilaterally
C. Fixed and dilated unilateral pupil
D. 3 mm bilaterally
19. The most important assessment for a patient after seizure activity is:
A. Skin turgor
B. Airway and oxygenation
C. Pain level
D. Appetite
20. Which finding requires immediate notification of the provider?
A. Mild headache
B. GCS decrease from 14 to 11
C. BP 130/80 mmHg
D. HR 78 bpm
Respiratory Failure, ARDS & Mechanical Ventilation (Questions 21–45)
21. The hallmark of ARDS is:
A. Cardiogenic pulmonary edema
B. Refractory hypoxemia
C. Bradycardia
D. Hyperglycemia
22. Which intervention improves oxygenation in severe ARDS?
A. Supine positioning
B. Prone positioning
C. Trendelenburg
D. Fluid restriction only
