Quiz 11: Intracranial Regulation

Concepts For Nursing Practice

Nursing
7
Questions
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True/False
7
Choices
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Essay
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Questions

Q1
Free

The nurse is caring for a patient with increased intracranial pressure. Which action is considered unsafe?

Multiple Choice
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A) Aligning the neck with the body
B) Clustering many nursing activities
C) Elevating the head of the bed 30 degrees
D) Providing stool softeners or laxatives as ordered
Answer:
B) Clustering many nursing activities

Explanation:
It is important to minimize stress and activities that could increase intracranial pressure. Combining many nursing activities could increase oxygen demand and intracranial pressure. This would not be safe. Interventions which can promote venous outflow can help decrease intracranial pressure. The stress of constipation or bowel movements can increase intracranial pressure; stool softeners or laxatives can minimize this.
Q2
Free

The earliest and most sensitive assessment finding that would indicate an alteration in intracranial regulation would be

Multiple Choice
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A) change in level of consciousness.
B) inability to focus visually.
C) loss of primitive reflexes.
D) unequal pupil size.
Answer:
A) change in level of consciousness.

Explanation:
A change in level of consciousness is the earliest and most sensitive indication of a change in intracranial processing. This is assessed with the Glasgow Coma Scale (GCS), which assesses eye opening and verbal and motor response. The inability to focus may indicate a change, but it is not one of the earliest indicators or a component of the GCS. Primitive reflexes refers to those reflexes found in a normal infant that disappear with maturation. These reflexes may reappear with frontal lobe dysfunction and may be tested for with a suspected brain injury, so it would be the reappearance of primitive reflexes. A change in pupil size or unequal pupils may indicate a change, but they are not one of the earliest indicators or a component of the GCS.
Q3
Free

When caring for the patient after a head injury, the nurse would be most concerned with assessment findings which included respiratory changes,

Multiple Choice
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A) hypertension, and bradycardia.
B) hypertension, and tachycardia.
C) hypotension, and bradycardia.
D) hypotension, and tachycardia.
Answer:
A) hypertension, and bradycardia.

Explanation:
Hypertension with widening pulse pressure, bradycardia, and respiratory changes are the ominous late signs of increased intracranial pressure and indications of impending herniation (Cushings triad). It is bradycardia, not tachycardia, which is the component of this ominous triad. It is hypertension, not hypotension, which is the component of this ominous triad.
Q4

Components of the GCS the nurse would use to assess a patient after a head injury include

Multiple Choice
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A) blood pressure.
B) cranial nerve function.
C) head circumference.
D) verbal responsiveness.
Answer:

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Q5

Primary prevention strategies to reduce the occurrence of head injuries would include

Multiple Choice
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A) blood pressure control.
B) smoking cessation.
C) maintaining a healthy weight.
D) violence prevention.
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Q6

The nurse preparing to care for a patient after a suspected stroke would question an order for a(n)

Multiple Choice
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A) antihypertensive.
B) antipyretic.
C) osmotic diuretic.
D) sedative.
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Q7

After shunt procedure, the nurse would monitor the patients neurologic status by using the

Multiple Choice
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A) electroencephalogram.
B) GCS.
C) National Institutes of Health Stroke Scale.
D) Monro-Kellie doctrine.
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