Deck 44: Acute Disorders of Brain Function

Question 1

Secondary injury after head trauma refers to

A) brain injury due to the initial trauma.
B) focal areas of bleeding.
C) brain injury due to the body's response to tissue damage.
D) injury as a result of medical therapy.

Answer 1

brain injury due to the body's response to tissue damage.

Question 2

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion.This is necessary because subarachnoid hemorrhage predisposes to

A) cerebral vasospasm.
B) hypotension.
C) excessive volume loss.
D) increased intracranial pressure.

Answer 2

cerebral vasospasm.

Question 3

Risk factors for hemorrhagic stroke include

A) atherosclerosis.
B) dysrhythmias.
C) acute hypertension.
D) sedentary lifestyle.

Answer 3

acute hypertension.

Question 4

The most important determinant for prescribing therapy for acute stroke is

A) location of ischemia.
B) thrombotic versus embolic cause.
C) ischemic versus hemorrhagic cause.
D) age of the patient.

Question 5

Manifestations of acute brain ischemia (Cushing reflex)are due primarily to

A) parasympathetic nervous system activation.
B) sympathetic nervous system activation.
C) autoregulation of body systems.
D) loss of brainstem reflexes.

Question 6

Which group of clinical findings indicates the poorest neurologic functioning?

A) Spontaneous eye opening, movement to command, oriented to self only
B) Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally
C) Assumes decorticate posture with light touch, no verbal response
D) No eye opening, responds to painful stimulus by withdrawing

Question 7

In the acute phase of stroke, treatment is focused on

A) stabilization of respiratory and cardiovascular function.
B) risk factor modification.
C) prevention of bedsores and contractures.
D) neurologic rehabilitation.

Question 8

Cerebral aneurysm is most frequently the result of

A) embolic stroke.
B) subarachnoid hemorrhage.
C) subdural hemorrhage.
D) meningitis.

Question 9

Acceleration-deceleration movements of the head often result in polar injuries in which

A) injury is localized to the site of initial impact.
B) widespread neuronal damage is incurred.
C) bleeding from venules fills the subdural space.
D) focal injuries occur in two places at opposite poles.

Question 10

It is true that encephalitis is usually

A) due to a bacterial infection in the CNS.
B) fatal.
C) due to a viral infection in brain cells.
D) asymptomatic.

Question 11

The most important preventative measure for hemorrhagic stroke is

A) anticoagulation.
B) blood pressure control.
C) thrombolytics.
D) management of dysrhythmias.

Question 12

It is true that epidural bleeding is

A) associated with widespread vascular disruption.
B) located between the arachnoid and the dura mater.
C) usually due to venous leakage.
D) characterized by a lucid interval immediately after injury.

Question 13

A college student living in a dormitory, reports a stiff neck and headache and is found to have a fever of 102° F.This information is most consistent with

A) encephalitis.
B) meningitis.
C) skull fracture.
D) cerebral ischemia.

Question 14

Clinical manifestations of a stroke within the right cerebral hemisphere include

A) cortical blindness.
B) right visual field blindness.
C) expressive and receptive aphasia.
D) left-sided muscle weakness and neglect.

Question 15

The stroke etiology with the highest morbidity and mortality is

A) intracranial hemorrhage.
B) intracranial thrombosis.
C) intracranial embolization.
D) cardiac arrest.

Question 16

The physiologic change most likely to lead to an increase in intracranial pressure is

A) cerebral vasodilation.
B) hypernatremia.
C) respiratory hyperventilation.
D) REM sleep.

Question 17

Leakage of CSF from the nose or ears is commonly associated with

A) epidural hematoma.
B) temporal skull fracture.
C) basilar skull fracture.
D) cerebral aneurysm.

Question 18

Intracranial pressure normally ranges from ______ mm Hg.

A) 0 to 15
B) 10 to 20
C) 15 to 25
D) 20 to 30

Question 19

An example of inappropriate treatment for head trauma would be

A) head elevation.
B) free water restriction.
C) hypoventilation.
D) bed rest.

Question 20

Rupture of a cerebral aneurysm should be suspected if the patient reports

A) ringing in the ears.
B) transient episodes of numbness.
C) transient episodes of vertigo.
D) sudden, severe headache.

Question 21

________ edema occurs when ischemic tissue swells because of cellular energy failure.

A) Interstitial
B) Osmotic
C) Vasogenic
D) Cytotoxic

Question 22

Which brain disorders are a cause of acute brain injury?

A) Seizure disorders
B) Brain trauma
C) Dementias
D) Brain hemorrhage
E) Central nervous system infections.

Question 23

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage.

A) 3
B) 8
C) 12
D) 15

Question 24

The first indication of brain compression from increasing intracranial pressure (ICP)may be

A) decorticate posturing.
B) absence of verbalization.
C) sluggish pupil response to light.
D) Glasgow Coma Scale score of 13.

Question 25

________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.

A) Nystagmus
B) Dysconjugate movement
C) Ocular palsy
D) Doll's eye

Question 26

Stroke is the leading cause of disability in the United States.Among the long-term survivors, the most common disability is

A) inability to perform ADLs.
B) aphasia.
C) clinical depression.
D) hemiparesis.

Question 27

A tool used to assess levels of consciousness is

A) magnetic resonance imaging (MRI).
B) intracranial pressure (ICP) monitoring.
C) Glasgow Coma Scale (GCS).
D) central perfusion pressure (CPP).

Question 28

A severe complication of elevated intracranial pressure is

A) Cushing reflex.
B) brain herniation.
C) burr hole.
D) hydrocephalus.