Acute Care Nurse Practitioner Neurological Assessment and Management in the ICU

Question 1

A patient's Glasgow Coma Scale is assessed as E2V3M4. What is the total GCS score?

Accepted Answer

9

Answer

7

Answer

11

Answer

13

Question 2

Which finding on CT scan of the head indicates a subdural hematoma rather than an epidural hematoma?

Accepted Answer

Crescent-shaped hyperdense collection crossing suture lines

Answer

Biconvex (lens-shaped) hyperdense collection

Answer

Hypodense midline shift

Answer

Bilateral symmetric hyperdensities

Question 3

The ACNP is managing a patient with elevated ICP. What is the target range for cerebral perfusion pressure (CPP)?

Accepted Answer

60–70 mmHg

Answer

40–50 mmHg

Answer

50–60 mmHg

Answer

80–90 mmHg

Question 4

Which intervention is MOST appropriate for acutely managing elevated ICP (>22 mmHg) in a TBI patient?

Accepted Answer

Elevate head of bed to 30° and administer hypertonic saline or mannitol

Answer

Administer hypotonic saline

Answer

Hyperventilate to PaCO₂ of 25 mmHg

Answer

Administer furosemide IV

Question 5

Cushing's triad, indicating impending cerebral herniation, consists of which three findings?

Accepted Answer

Hypertension, bradycardia, irregular respirations

Answer

Hypotension, tachycardia, bradypnea

Answer

Hypertension, tachycardia, hyperpnea

Answer

Hypotension, bradycardia, apnea

Question 6

A patient with a subarachnoid hemorrhage (SAH) develops worsening neurological deficits on day 5. Which complication should the ACNP suspect?

Accepted Answer

Cerebral vasospasm

Answer

Re-bleeding

Answer

Hydrocephalus

Answer

Meningitis