A+, QUESTIONS AND ANSWERS BREAKDOWN
Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the
emergency department with a traumatic brain injury. He has severe cerebral edema following
emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in
his assessment. Which of the following assessments correspond to a supratentorial herniation that
has progressed to include midbrain involvement? Select all that apply.
A) Clouding of consciousness
B) Decorticate posturing with painful stimulation
C) Pupils fixed at approximately 5 mm in diameter
D) Respiration rate of 40 breaths/minute
E) Decerebrate posturing following painful stimulation of the sternum
C) Pupils fixed at approximately 5 mm in diameter
D) Respiration rate of 40 breaths/minute
E) Decerebrate posturing following painful stimulation of the sternum
1. A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care
team suspects that water and protein have crossed the blood brain barrier and been transferred from
the vascular space into the client's interstitial space. Which of the following diagnoses best captures
this pathophysiology?
Focal hypoxia
Cytotoxic edema
Hydrocephalus
Vasogenic edema
Vasogenic edema
1. A clinician is conducting an assessment of a male client suspected of having a disorder of motor
function. Which of the following assessment findings would suggest a possible upper motor neuron
(UMN) lesion?
A) The client has decreased deep tendon reflexes.
B) The client displays increased muscle tone.
C) The client's muscles appear atrophied.
D) The client displays weakness in the distal portions of his limbs.
The client displays increased muscle tone.
1. Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma
since her accident has now had her condition declared a persistent vegetative state. How can her care
providers most accurately explain an aspect of her situation to her parents?
A) Your daughter has lost all her cognitive functions as well as all her basic reflexes.
B) Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.
C) If you or the care team notices any spontaneous eye opening, then we will change our treatment
plan.
, D) Your daughter's condition is an unfortunate combination with total loss of consciousness but
continuation of all other normal brain functions.
Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.
1. Which of the following diagnostic findings is likely to result in the most serious brain insult?
A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
B) Moderate decrease in brain tissue volume secondary to a brain tumor removal
C) Increased ICP accompanied by hyperventilation
D) High intracellular concentration of glutamate
Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
1. The unique clinical presentation of a 3-month-old infant in the emergency department leads the
care team to suspect botulism. Which of the following assessment questions posed to the parents is
likely to be most useful in the differential diagnosis?
A) Have you ever given your child any honey or honey-containing products?
B) Is there any family history of neuromuscular diseases?
C) Has your baby ever been directly exposed to any chemical cleaning products?
D) Is there any mold in your home that you know of?
Have you ever given your child any honey or honey-containing products?
When reviewing the purpose/action of neurotransmitters as they interact with different receptors,
the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the
sinoatrial node in the right atrium of the heart, it is
A) positively charged.
B) inhibitory.
C) overstimulated.
D) dormant.
inhibitory
A toddler is displaying signs and symptoms of weakness and muscle atrophy. The pediatric neurologist
suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The patient's
family asks how he got this. The nurse will respond
A) This could result from playing in soil and then ingesting bacteria that are now attacking his motor
neurons.
B) No one really knows how this disease is formed. We just know that in time, he may grow out of it.
C) This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
D) This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle
groups as well.
This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the
following cells may be innervating specialized gut-related receptors that provide taste and smell?
A) Special somatic afferent fibers
B) General somatic afferents