Clinical PDF

1. What are the three components that make up the intracranial vault according to the Monro-Kellie rule? a) Skin, Skull, Brain b) Brain, Blood, and Bone c) Brain, Blood, and CSF d) Arteries, Veins, and Nerves 2. What is the normal range for intracranial pressure (ICP) in adults? a) 2-8 mmHg b) 10-20...

1. What are the three components that make up the intracranial vault according to the Monro-Kellie rule? a) Skin, Skull, Brain b) Brain, Blood, and Bone c) Brain, Blood, and CSF d) Arteries, Veins, and Nerves 2. What is the normal range for intracranial pressure (ICP) in adults? a) 2-8 mmHg b) 10-20 cm H2O c) 15-22 cm H2O d) 70-100 mmHg 3. In the context of intracranial pressure, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 4. What is the late sign of increased ICP involving pupil response? a) Constricted and reactive b) Dilated and fixed c) Constricted and fixed d) Unequal pupil size 5. Which breathing pattern is associated with midbrain involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 6. What is Kernohan’s sign? a) A sign of increased ICP in infants b) A sign of central herniation c) Affecting the opposite cerebral peduncle d) Bilateral damage to the medulla oblongata 7. Which type of brain edema follows the white matter distribution? a) Vasogenic b) Cytotoxic c) Interstitial d) None of the above 8. What is the primary treatment for increased ICP in cases such as tumors and hematomas? a) Hyperventilation b) Removal of causative lesion c) IV mannitol d) Steroids 9. What is the recommended nursing management for a patient with increased ICP? a) Keep the head of the bed flat b) Frequent suctioning c) Encourage coughing d) Elevate head of bed about 30 degrees 10. Which medication can be used to increase mean arterial pressure (MAP) without increasing ICP? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation Answers: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. c) Brain, Blood, and CSF c) 15-22 cm H2O b) Cerebral Perfusion Pressure b) Dilated and fixed b) Central Neurogenic Hyperventilation c) Affecting the opposite cerebral peduncle a) Vasogenic b) Removal of causative lesion d) Elevate head of bed about 30 degrees b) Hypertonic Saline 11. What is the primary danger of increased ICP that can disturb brain function? a) Increased cerebral blood flow b) Increased oxygen delivery c) Decreased cerebral perfusion pressure d) Decreased heart rate 12. What is the term for the condition where the medial temporal lobe is squeezed by a unilateral mass under the tent? a) Subfalcine herniation b) Central herniation c) Tonsillar herniation d) Transtentorial herniation 13. What is the recommended treatment for increased ICP due to a causative lesion such as a tumor? a) Fluid restriction b) Hyperventilation c) Steroids d) Surgical removal of the lesion 14. Which breathing pattern is associated with pons involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 15. What is the term for the upward movement of the cerebellum that compresses the brainstem? a) Central herniation b) Subfalcine herniation c) Tonsillar herniation d) Upward transtentorial herniation 16. Which medication can result in improved cerebral perfusion pressure (CPP) by increasing mean arterial pressure (MAP) without significantly increasing ICP? a) Hyperventilation b) IV mannitol c) Steroids d) Hypertonic Saline Answers: 11. 12. 13. 14. 15. 16. c) Decreased cerebral perfusion pressure d) Transtentorial herniation d) Surgical removal of the lesion c) Apneustic Breathing d) Upward transtentorial herniation d) Hypertonic Saline 17. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 18. What is the term for the condition where an infratentorial mass compresses the brainstem, causing patchy ischemia? a) Central herniation b) Subfalcine herniation c) Tonsillar herniation d) Upward transtentorial herniation 19. What type of brain edema is primarily associated with obstruction of CSF flow? a) Vasogenic b) Cytotoxic c) Interstitial d) None of the above 20. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above Answers: 17. 18. 19. 20. c) IV mannitol c) Tonsillar herniation c) Interstitial a) Brain 21. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery 22. What type of breathing pattern is associated with medulla involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 23. Which part of the brain is pushed under the falx cerebri by an expanding mass high in a cerebral hemisphere, causing infarction of paramedian cortex? a) Cingulate gyrus b) Medial temporal lobe c) Occipital lobe d) Parietal lobe 24. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 25. Which medication is primarily used for patients with a brain tumor or abscess but is ineffective for patients with head trauma, cerebral hemorrhage, ischemic stroke, or hypoxic brain damage after cardiac arrest? a) Fluid restriction b) IV mannitol c) Steroids d) Hypertonic Saline Answers: 21. 22. 23. 24. 25. b) Transtentorial herniation d) Rapid and shallow respiration a) Cingulate gyrus b) Cerebral Perfusion Pressure c) Steroids 26. What is the earliest and most reliable indicator of increased ICP? a) Abnormal posturing b) Papilledema c) Decreased level of consciousness d) Cushing’s Triad 27. In infants, what is a potential sign of increased ICP? a) Bulging fontanelle b) Papilledema c) Hemiplegia d) Decorticate posturing 28. Which part of the brain is squeezed by a unilateral mass under the tent in cases of transtentorial herniation? a) Temporal lobe b) Parietal lobe c) Occipital lobe d) Frontal lobe 29. What is the primary treatment for increased ICP when it is due to a causative lesion like a tumor? a) Hyperventilation b) IV mannitol c) Steroids d) Fluid restriction 30. What is the recommended nursing management for a patient with increased ICP? a) Frequent suctioning b) Minimal suctioning c) Encourage vomiting d) Elevate head of bed about 60 degrees 31. Which part of the brain is responsible for the control of temperature? a) Hippocampus b) Hypothalamus c) Cerebellum d) Thalamus 32. Which part of the brain is pushed under the falx cerebri by an expanding mass high in a cerebral hemisphere? a) Medial temporal lobe b) Frontal lobe c) Occipital lobe d) Parietal lobe 33. What breathing pattern is associated with diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 34. What is the term for the condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 35. What is the term for a sustained regular, rapid, and deep breathing pattern associated with midbrain involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration Answers: 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. c) Decreased level of consciousness a) Bulging fontanelle a) Temporal lobe c) Steroids b) Minimal suctioning b) Hypothalamus a) Medial temporal lobe a) Cheyne-Stokes respiration a) Kernohan’s sign b) Central Neurogenic Hyperventilation 36. What is the term for a prolonged pause at the end of inspiration in the context of increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Ataxic breathing 37. What is the term for a breathing pattern with apnea alternating with hyperventilation in cases of diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 38. What is the term for a condition where one or both anterior cerebral arteries become trapped, causing infarction of paramedian cortex? a) Cingulate gyrus b) Cerebral peduncle c) Hypoxia d) Brain death 39. Which type of brain edema is primarily associated with failure of normal homeostatic mechanisms that maintain cell size? a) Vasogenic b) Cytotoxic c) Interstitial d) Hypertonic 40. What is the term for the condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 41. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 42. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above 43. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 44. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery 45. What is the term for the condition where the medial temporal lobe is squeezed by a unilateral mass under the tent? a) Subfalcine herniation b) Central herniation c) Tonsillar herniation d) Transtentorial herniation 46. What is the primary treatment for increased ICP when it is due to a causative lesion like a tumor? a) Hyperventilation b) IV mannitol c) Steroids d) Fluid restriction 47. What is the recommended nursing management for a patient with increased ICP? a) Frequent suctioning b) Minimal suctioning c) Encourage vomiting d) Elevate head of bed about 60 degrees 48. Which part of the brain is responsible for the control of temperature? a) Hippocampus b) Hypothalamus c) Cerebellum d) Thalamus 49. Which part of the brain is pushed under the falx cerebri by an expanding mass high in a cerebral hemisphere? a) Medial temporal lobe b) Frontal lobe c) Occipital lobe d) Parietal lobe 50. What breathing pattern is associated with diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration Answers: 36. 37. c) Apneustic breathing a) Cheyne-Stokes respiration 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. a) Cingulate gyrus b) Cytotoxic a) Kernohan’s sign b) Cerebral Perfusion Pressure a) Brain c) IV mannitol b) Transtentorial herniation d) Transtentorial herniation c) Steroids b) Minimal suctioning b) Hypothalamus a) Medial temporal lobe a) Cheyne-Stokes respiration 51. What is the term for a prolonged pause at the end of inspiration in the context of increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Ataxic breathing 52. What is the term for a breathing pattern with apnea alternating with hyperventilation in cases of diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 53. What is the term for a condition where one or both anterior cerebral arteries become trapped, causing infarction of paramedian cortex? a) Cingulate gyrus b) Cerebral peduncle c) Hypoxia d) Brain death 54. Which type of brain edema is primarily associated with failure of normal homeostatic mechanisms that maintain cell size? a) Vasogenic b) Cytotoxic c) Interstitial d) Hypertonic 55. What is the term for the condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 56. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 57. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above 58. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 59. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery 60. What is the term for the condition where the medial temporal lobe is squeezed by a unilateral mass under the tent? a) Subfalcine herniation b) Central herniation c) Tonsillar herniation d) Transtentorial herniation 61. What is the primary treatment for increased ICP when it is due to a causative lesion like a tumor? a) Hyperventilation b) IV mannitol c) Steroids d) Fluid restriction 62. What is the recommended nursing management for a patient with increased ICP? a) Frequent suctioning b) Minimal suctioning c) Encourage vomiting d) Elevate head of bed about 60 degrees 63. Which part of the brain is responsible for the control of temperature? a) Hippocampus b) Hypothalamus c) Cerebellum d) Thalamus 64. Which part of the brain is pushed under the falx cerebri by an expanding mass high in a cerebral hemisphere? a) Medial temporal lobe b) Frontal lobe c) Occipital lobe d) Parietal lobe 65. What breathing pattern is associated with diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 66. What is the term for a condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 67. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 68. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above 69. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 70. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery Answers: 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. c) Apneustic breathing a) Cheyne-Stokes respiration a) Cingulate gyrus b) Cytotoxic a) Kernohan’s sign b) Cerebral Perfusion Pressure a) Brain c) IV mannitol b) Transtentorial herniation d) Transtentorial herniation c) Steroids b) Minimal suctioning b) Hypothalamus a) Medial temporal lobe a) Cheyne-Stokes respiration a) Kernohan’s sign b) Cerebral Perfusion Pressure a) Brain c) IV mannitol b) Transtentorial herniation 71. What is the term for a prolonged pause at the end of inspiration in the context of increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Ataxic breathing 72. What is the term for a breathing pattern with apnea alternating with hyperventilation in cases of diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 73. What is the term for a condition where one or both anterior cerebral arteries become trapped, causing infarction of paramedian cortex? a) Cingulate gyrus b) Cerebral peduncle c) Hypoxia d) Brain death 74. Which type of brain edema is primarily associated with failure of normal homeostatic mechanisms that maintain cell size? a) Vasogenic b) Cytotoxic c) Interstitial d) Hypertonic 75. What is the term for the condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 76. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 77. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above 78. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 79. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery 80. What is the term for the condition where the medial temporal lobe is squeezed by a unilateral mass under the tent? a) Subfalcine herniation b) Central herniation c) Tonsillar herniation d) Transtentorial herniation 81. What is the primary treatment for increased ICP when it is due to a causative lesion like a tumor? a) Hyperventilation b) IV mannitol c) Steroids d) Fluid restriction 82. What is the recommended nursing management for a patient with increased ICP? a) Frequent suctioning b) Minimal suctioning c) Encourage vomiting d) Elevate head of bed about 60 degrees 83. Which part of the brain is responsible for the control of temperature? a) Hippocampus b) Hypothalamus c) Cerebellum d) Thalamus 84. Which part of the brain is pushed under the falx cerebri by an expanding mass high in a cerebral hemisphere? a) Medial temporal lobe b) Frontal lobe c) Occipital lobe d) Parietal lobe 85. What breathing pattern is associated with diffuse cortical involvement in increased ICP? a) Cheyne-Stokes respiration b) Central Neurogenic Hyperventilation c) Apneustic Breathing d) Rapid and shallow respiration 86. What is the term for a condition where the contralateral 3rd cranial nerve and cerebral peduncle can be affected in transtentorial herniation? a) Kernohan’s sign b) Cushing’s sign c) Decerebrate posturing d) Papilledema 87. In the context of increased ICP, what does CPP stand for? a) Central Processing Power b) Cerebral Perfusion Pressure c) Cranial Pressure Point d) Central Perfusion Pressure 88. Which component of the Monro-Kellie rule describes the brain itself? a) Brain b) Blood c) CSF d) None of the above 89. Which medication is known to have a delayed osmotic effect and is used for the management of increased ICP, with an onset in 15-30 minutes and duration from 1 to 6 hours? a) Steroids b) Hypertonic Saline c) IV mannitol d) Hyperventilation 90. What is the primary danger of increased ICP that can disturb brain function by leading to a loss of all brainstem reflexes, cessation of respiration, and brain death? a) Decreased cerebral blood flow b) Transtentorial herniation c) Papilledema d) Increased oxygen delivery Answers: 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. c) Apneustic breathing a) Cheyne-Stokes respiration a) Cingulate gyrus b) Cytotoxic a) Kernohan’s sign b) Cerebral Perfusion Pressure a) Brain c) IV mannitol b) Transtentorial herniation d) Transtentorial herniation c) Steroids b) Minimal suctioning b) Hypothalamus a) Medial temporal lobe a) Cheyne-Stokes respiration a) Kernohan’s sign b) Cerebral Perfusion Pressure a) Brain . c) IV mannitol b) Transtentorial herniation