NS EXAM QUESTIONS WITH SOLUTIONS 2025 GRADED A+
✔✔Your patient suddenly has a BP of 180/65, HR of 45 and irregular respiration
pattern. What sign is he showing? - ✔✔Cushing's Triad--> Late sign of increased ICP
✔✔What are ICP and CPP goals when managing increased intracranial pressure?
delete - ✔✔
✔✔what is a ventriculostomy? - ✔✔Drain place into ventricles in brain to drain off
excess CSF. High infection risk.
✔✔What is the zero reference with a fluid-filled ICP monitor system? - ✔✔Foramen of
Munro(earlobe)
✔✔Describe the ICP waveform. - ✔✔p1: Cardiac cycle/systole(percussion wave)
p2: Intracranial bulk (tidal wave)
p3: aortic valve closure/diastole (Dicrotic wave)
✔✔On an ICP monitor, you notice that the P2 wave is larger than the P1 wave. What
does this mean? - ✔✔there is an significant increase in ICP
✔✔Your patient with SjO2 monitoring shows 45% SjO2. What does this mean? -
✔✔This means there is cerebral ischemia (under 50%= cerebral ischemia)
✔✔What is the PbtO2? - ✔✔partial pressure of O2 in brain tissue
✔✔How do you use hyperventilation medical management for an individual with
increase ICP? - ✔✔THis decrease the CO2 within the blood(therefore less vasodilation)
- SHORT TERM
✔✔What is the difference btw mannitol and furosemide regarding diuretics that are used
with increased ICP? - ✔✔Mannitol: Increase the osmotic pressure--> pulls in water into
the vascular(more risk for neuro changes with this)
Furosemide: draws Na and water out of the brain tissue(more fluid overload risk)
✔✔How does hypertonic saline able to decrease Intracranial pressure? -
✔✔Mobilization of water into the vascular--> decrease cerebral water content
✔✔what line do you adm hypertonic saline??? - ✔✔central line
, ✔✔what should you maintain the osmolarity at when you caring for a patient with
increased ICP - ✔✔310-320
✔✔what is the BP management for an individual with increased ICP? - ✔✔Maintain
MAP at 70-90 and CPP at least 70 mmHg
✔✔What position should an individual be when s/he has increase ICP? - ✔✔HOB 30
degrees
neutral head position
careful side-to-side rotation
✔✔The nurse admits a patient who hit his head on the concrete following a fall from a
ladder. The nurse assesses bruising behind the left ear, bilateral periorbital bruising,
and clear nasal drainage. What do these findings indicate?
A.Subdural hematoma
B.Basilar skull fracture
C.Linear skull fracture
D.Depressed skull fracture - ✔✔B.Basilar skull fracture
✔✔What is the difference between primary and secondary injury of the traumatic brain
injury? - ✔✔Primary: from direct impact
Secondary: Consequences of initial trauma(inflammation and vasogenic edema)
✔✔Paramedics arrive on the scene of a high school baseball game. The pitcher, after
being struck in the left temple with a line drive, was knocked unconscious. Now the
paramedics note the player to be sitting up on the mound and talking. What is the best
interpretation of these assessment findings?
A.Subdural hematoma
B.Epidural hematoma
C.Concussion
D.Coup/Contrecoup injury - ✔✔ANS: B. Epidural hematoma
✔✔what are the 3 main causes of a hemorrhagic stroke? - ✔✔Uncontrolled HTN
Ruptured cerebral aneurysm (SAH)
Arteriovenous malformation (AVM)
✔✔what happens when an aneurysm ruptures? - ✔✔rupture of aneurysm --> SAH-->
increase ICP, impaired cerebroregulation, decrease CBF --> irritatione of the meninges
✔✔Your patient suddenly has a BP of 180/65, HR of 45 and irregular respiration
pattern. What sign is he showing? - ✔✔Cushing's Triad--> Late sign of increased ICP
✔✔What are ICP and CPP goals when managing increased intracranial pressure?
delete - ✔✔
✔✔what is a ventriculostomy? - ✔✔Drain place into ventricles in brain to drain off
excess CSF. High infection risk.
✔✔What is the zero reference with a fluid-filled ICP monitor system? - ✔✔Foramen of
Munro(earlobe)
✔✔Describe the ICP waveform. - ✔✔p1: Cardiac cycle/systole(percussion wave)
p2: Intracranial bulk (tidal wave)
p3: aortic valve closure/diastole (Dicrotic wave)
✔✔On an ICP monitor, you notice that the P2 wave is larger than the P1 wave. What
does this mean? - ✔✔there is an significant increase in ICP
✔✔Your patient with SjO2 monitoring shows 45% SjO2. What does this mean? -
✔✔This means there is cerebral ischemia (under 50%= cerebral ischemia)
✔✔What is the PbtO2? - ✔✔partial pressure of O2 in brain tissue
✔✔How do you use hyperventilation medical management for an individual with
increase ICP? - ✔✔THis decrease the CO2 within the blood(therefore less vasodilation)
- SHORT TERM
✔✔What is the difference btw mannitol and furosemide regarding diuretics that are used
with increased ICP? - ✔✔Mannitol: Increase the osmotic pressure--> pulls in water into
the vascular(more risk for neuro changes with this)
Furosemide: draws Na and water out of the brain tissue(more fluid overload risk)
✔✔How does hypertonic saline able to decrease Intracranial pressure? -
✔✔Mobilization of water into the vascular--> decrease cerebral water content
✔✔what line do you adm hypertonic saline??? - ✔✔central line
, ✔✔what should you maintain the osmolarity at when you caring for a patient with
increased ICP - ✔✔310-320
✔✔what is the BP management for an individual with increased ICP? - ✔✔Maintain
MAP at 70-90 and CPP at least 70 mmHg
✔✔What position should an individual be when s/he has increase ICP? - ✔✔HOB 30
degrees
neutral head position
careful side-to-side rotation
✔✔The nurse admits a patient who hit his head on the concrete following a fall from a
ladder. The nurse assesses bruising behind the left ear, bilateral periorbital bruising,
and clear nasal drainage. What do these findings indicate?
A.Subdural hematoma
B.Basilar skull fracture
C.Linear skull fracture
D.Depressed skull fracture - ✔✔B.Basilar skull fracture
✔✔What is the difference between primary and secondary injury of the traumatic brain
injury? - ✔✔Primary: from direct impact
Secondary: Consequences of initial trauma(inflammation and vasogenic edema)
✔✔Paramedics arrive on the scene of a high school baseball game. The pitcher, after
being struck in the left temple with a line drive, was knocked unconscious. Now the
paramedics note the player to be sitting up on the mound and talking. What is the best
interpretation of these assessment findings?
A.Subdural hematoma
B.Epidural hematoma
C.Concussion
D.Coup/Contrecoup injury - ✔✔ANS: B. Epidural hematoma
✔✔what are the 3 main causes of a hemorrhagic stroke? - ✔✔Uncontrolled HTN
Ruptured cerebral aneurysm (SAH)
Arteriovenous malformation (AVM)
✔✔what happens when an aneurysm ruptures? - ✔✔rupture of aneurysm --> SAH-->
increase ICP, impaired cerebroregulation, decrease CBF --> irritatione of the meninges
