CEN Neurological Emergencies 3

Question 1

Cushing's triad, indicating severely elevated ICP, consists of which three findings?

Accepted Answer

Bradycardia, hypertension, irregular respirations

Answer

Cushing's triad is bradycardia, hypertension (widened pulse pressure), and irregular respirations, representing a brainstem response to severely elevated ICP.

Question 2

A patient taking phenytoin presents with a seizure. Phenytoin level is therapeutic. Which electrolyte abnormality is the most common correctable cause of breakthrough seizures?

Accepted Answer

Hyponatremia

Answer

Hyponatremia is the most common electrolyte disturbance causing or exacerbating seizures, and must be corrected carefully to avoid osmotic demyelination.

Question 3

A patient presents with altered mental status, fever, autonomic instability, and clonus after starting a new SSRI. What condition should be suspected?

Accepted Answer

Serotonin syndrome

Answer

Serotonin syndrome is caused by excess serotonergic activity and presents with the triad of altered mental status, autonomic instability, and neuromuscular abnormalities including clonus.

Question 4

Which imaging finding on non-contrast CT is most consistent with a hypertensive intracerebral hemorrhage?

Accepted Answer

Hyperdense lesion in the basal ganglia

Answer

Hypertensive intracerebral hemorrhage most commonly occurs in the basal ganglia (putamen) and appears as a hyperdense (bright white) lesion on non-contrast CT.

Question 5

A patient presents with ascending muscle weakness that began in the lower extremities one week after a GI illness. Deep tendon reflexes are absent. What is the most likely diagnosis?

Accepted Answer

Guillain-Barré syndrome

Answer

Guillain-Barré syndrome is an acute demyelinating polyneuropathy that presents with ascending weakness and areflexia, often triggered by a preceding infection.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Neurological Emergencies 3