Neurological Assessment & Monitoring Flashcards
7 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neurological Assessment & Monitoring flashcards as text
A patient with a right MCA stroke presents with left-sided neglect. Which assessment tool best quantifies this deficit?
Answer: Catherine Bergego Scale
The Catherine Bergego Scale (CBS) is specifically validated to assess unilateral neglect in functional activities after stroke.
When performing serial NIH Stroke Scale assessments, a 4-point worsening is considered clinically significant because it indicates:
Answer: Early neurological deterioration requiring intervention
A ≥4-point increase in NIHSS score defines early neurological deterioration (END), which triggers urgent reassessment and intervention.
A patient's pupils are 3mm bilaterally and reactive. Six hours later they are 6mm and sluggish on the left. This change most likely indicates:
Answer: Uncal herniation compressing CN III
Unilateral pupil dilation with sluggish reactivity is a classic sign of uncal herniation compressing the ipsilateral oculomotor nerve (CN III).
Which finding on continuous EEG monitoring in a post-stroke patient indicates subclinical seizure activity requiring treatment?
Answer: Periodic lateralized epileptiform discharges (PLEDs) evolving into rhythmic ictal pattern
PLEDs that evolve into a rhythmic ictal pattern on cEEG represent non-convulsive seizures requiring antiepileptic intervention.
The 'locked-in syndrome' following basilar artery occlusion is best distinguished from coma by the presence of:
Answer: Preserved vertical eye movements and blinking
Locked-in syndrome spares the dorsal midbrain, preserving vertical gaze and volitional blinking as the only motor output.
A patient 24 hours post-thrombolysis develops sudden headache and NIHSS worsens by 6 points. The priority neurological assessment is:
Answer: Immediate non-contrast CT head to rule out hemorrhagic transformation
Symptomatic hemorrhagic transformation post-tPA requires immediate non-contrast CT as the fastest way to detect intracranial blood.
When assessing swallowing safety in an acute stroke patient, which bedside screening finding is the strongest predictor of aspiration pneumonia risk?
Answer: Silent aspiration identified on water swallow test
Silent aspiration — aspiration without cough — detected on bedside swallow screening carries the highest risk for subsequent aspiration pneumonia.