NSG 233 MED SURG 3 EXAM 3
COMPREHENSIVE EXAM 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◉ Define Autonomic Dysreflexia (AD)? Answer: Severe headache
with hypertension, nausea, nasal congestion, and bradycardia.
Autonomic dysreflexia (AD) is a potentially life-threatening medical
condition that can occur in people with spinal cord injuries in the
upper back. It occurs when the nervous system overreacts to
something below the site of the injury, leading to uncontrolled
hypertension, cardiac arrhythmia, and other symptoms.
◉ What are the three most common causes of AD? Answer: 1.
distended bladder (MOST COMMON).
2. distention/contraction of the visceral organs.
3. stimulation of the skin (tactile, pain, thermal, stimuli, pressure
injury).
◉ What are some nursing management considerations or
interventions for patients with spinal cord injuries? Answer: - avoid
external pressure on lower extremities.
- do NOT raise knee gatch when patient is laying down.
,- closely monitor vital signs (specifically BP) before and during
position changes.
- contractures and other complications may be prevented by range
of motion exercises.
- careful inspection of the skin is made each time the patient is
turned. Pressure sensitive areas should be kept well lubricated and
soft with oil or emollient lotion.
◉ What are two pharmacologic interventions to dehydrate the brain
tissue and reduce cerebral edema? Answer: 1. Mannitol osmotic
diuretic).
2. Hypertonic saline (3%).
◉ Why is Mannitol given? Answer: To control cerebral edema and
swelling.
◉ What is Baclofen? What is it used for? Answer: An anti-spasmodic
(muscle relaxant).
Agonist specific inhibitor to GABAB receptors in the spinal cord. It's
mechanism of action is to restrict the influx of calcium to decrease
neurotransmitter release in the spine. This is how it alleviates s/s of
spasticity.
,◉ What are some adverse reactions of this Baclofen? What are three
major teaching points? Answer: Adverse reactions
- drowsiness.
- dizziness.
- weakness.
- fatigue.
- confusion.
- headache.
- insomnia.
- urinary frequency.
- HYPOTENSION.
- CNS DEPRESSION.
Teaching points
- DO NOT abruptly stop taking this medication.
- avoid alcohol.
- Stand slowly, this medication may cause orthostatic HoTN.
◉ What Dantrolene? How does it work (MOA)? Answer: A direct-
acting skeletal muscle relaxant.
, The mechanism of action for this medication is to interfere with the
release of calcium from skeletal muscle.
◉ What is conditions is Dantrolene used for? Answer: Controls
spasticity for patients with...
- Multiple Sclerosis.
- Cerebral Palsy.
- Spinal Cord Injury.
- Stroke.
◉ What are the adverse reactions of Dantrolene? What are some
important patient teaching points? Answer: Adverse reactions
- drowsiness.
- dizziness.
- diarrhea.
- fatigue.
- hepatitis.
Patient Teaching
- BLACK BOX: liver function tests needed regularly.
- contraindicated in patients with liver failure or issues.
COMPREHENSIVE EXAM 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◉ Define Autonomic Dysreflexia (AD)? Answer: Severe headache
with hypertension, nausea, nasal congestion, and bradycardia.
Autonomic dysreflexia (AD) is a potentially life-threatening medical
condition that can occur in people with spinal cord injuries in the
upper back. It occurs when the nervous system overreacts to
something below the site of the injury, leading to uncontrolled
hypertension, cardiac arrhythmia, and other symptoms.
◉ What are the three most common causes of AD? Answer: 1.
distended bladder (MOST COMMON).
2. distention/contraction of the visceral organs.
3. stimulation of the skin (tactile, pain, thermal, stimuli, pressure
injury).
◉ What are some nursing management considerations or
interventions for patients with spinal cord injuries? Answer: - avoid
external pressure on lower extremities.
- do NOT raise knee gatch when patient is laying down.
,- closely monitor vital signs (specifically BP) before and during
position changes.
- contractures and other complications may be prevented by range
of motion exercises.
- careful inspection of the skin is made each time the patient is
turned. Pressure sensitive areas should be kept well lubricated and
soft with oil or emollient lotion.
◉ What are two pharmacologic interventions to dehydrate the brain
tissue and reduce cerebral edema? Answer: 1. Mannitol osmotic
diuretic).
2. Hypertonic saline (3%).
◉ Why is Mannitol given? Answer: To control cerebral edema and
swelling.
◉ What is Baclofen? What is it used for? Answer: An anti-spasmodic
(muscle relaxant).
Agonist specific inhibitor to GABAB receptors in the spinal cord. It's
mechanism of action is to restrict the influx of calcium to decrease
neurotransmitter release in the spine. This is how it alleviates s/s of
spasticity.
,◉ What are some adverse reactions of this Baclofen? What are three
major teaching points? Answer: Adverse reactions
- drowsiness.
- dizziness.
- weakness.
- fatigue.
- confusion.
- headache.
- insomnia.
- urinary frequency.
- HYPOTENSION.
- CNS DEPRESSION.
Teaching points
- DO NOT abruptly stop taking this medication.
- avoid alcohol.
- Stand slowly, this medication may cause orthostatic HoTN.
◉ What Dantrolene? How does it work (MOA)? Answer: A direct-
acting skeletal muscle relaxant.
, The mechanism of action for this medication is to interfere with the
release of calcium from skeletal muscle.
◉ What is conditions is Dantrolene used for? Answer: Controls
spasticity for patients with...
- Multiple Sclerosis.
- Cerebral Palsy.
- Spinal Cord Injury.
- Stroke.
◉ What are the adverse reactions of Dantrolene? What are some
important patient teaching points? Answer: Adverse reactions
- drowsiness.
- dizziness.
- diarrhea.
- fatigue.
- hepatitis.
Patient Teaching
- BLACK BOX: liver function tests needed regularly.
- contraindicated in patients with liver failure or issues.
