PCCN Neurological System

Question 1

A patient presents with slurred speech, facial droop, and right-sided weakness. Which diagnostic test should be prioritized first?

Accepted Answer

Computed Tomography (CT) scan of the head

Answer

A patient presenting with acute neurological deficits like slurred speech, facial droop, and weakness suggests a possible stroke. A CT scan of the head is prioritized to rapidly differentiate between ischemic and hemorrhagic stroke, as this distinction dictates immediate treatment. This quick assessment is critical for timely intervention, such as administering thrombolytics for ischemic stroke, and improving patient outcomes.

Question 2

Which of the following Glasgow Coma Scale (GCS) scores indicates moderate brain injury?

Accepted Answer

9–12

Answer

The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool used to measure a person's level of consciousness. A GCS score of 9–12 indicates a moderate brain injury, reflecting a significant but not severe impairment. Scores of 13–15 are considered mild, while 3–8 signify a severe brain injury, requiring close monitoring and intervention.

Question 3

A patient with a spinal cord injury at the level of T4 is at risk for which potentially life-threatening complication?

Accepted Answer

Autonomic dysreflexia

Answer

Autonomic dysreflexia is a potentially life-threatening condition that can occur in patients with spinal cord injuries at or above T6. It is characterized by an exaggerated sympathetic response to noxious stimuli below the level of injury, leading to severe hypertension, bradycardia, and headache. A T4 injury places the patient at high risk for this emergency, requiring immediate recognition and management.

Question 4

Which medication is most appropriate for treating increased intracranial pressure (ICP)?

Accepted Answer

Mannitol

Answer

Mannitol is an osmotic diuretic commonly used to treat increased intracranial pressure (ICP). It works by drawing fluid from the brain tissue into the vascular space, thereby reducing cerebral edema and ICP. This medication is crucial in neurocritical care to prevent secondary brain injury by maintaining adequate cerebral perfusion pressure. Other options like morphine or lorazepam are not primary treatments for ICP.

Question 5

A patient with a known seizure disorder experiences a tonic-clonic seizure lasting 8 minutes. What is the priority nursing action?

Accepted Answer

Administer IV lorazepam

Answer

A tonic-clonic seizure lasting 8 minutes is considered status epilepticus, a medical emergency requiring immediate intervention to prevent brain damage. IV lorazepam is a benzodiazepine that is the first-line treatment to abort prolonged seizures by enhancing GABAergic inhibition in the brain. Administering it promptly is the priority to stop the seizure activity.

PCCN Exam Practice Test

PCCN Exam Practice Test

PCCN Neurological System