CNRN Neurological Assessment and Monitoring 1 — Questions and Answers
Question 1: Which component of the Glasgow Coma Scale (GCS) assesses the patient's ability to follow commands?
- Verbal response
- Eye opening
- Motor response (Correct answer)
- Pupillary reaction
Correct answer: Motor response
The motor response component of the GCS evaluates the patient's best motor function, including the ability to follow commands.
Question 2: A CNRN nurse notes that a patient's pupils are 6 mm and non-reactive bilaterally. This finding is MOST consistent with:
- Midbrain herniation (Correct answer)
- Pontine lesion
- Metabolic encephalopathy
- Cerebral contusion
Correct answer: Midbrain herniation
Bilateral fixed and dilated pupils indicate midbrain herniation due to compression of the oculomotor (CN III) nerves.
Question 3: When performing a neurological assessment, the nurse tests the patient's ability to identify objects by touch alone. This evaluates which sensory function?
- Proprioception
- Stereognosis (Correct answer)
- Two-point discrimination
- Graphesthesia
Correct answer: Stereognosis
Stereognosis is the ability to identify objects by touch without visual input, testing parietal lobe sensory integration.
Question 4: Which cranial nerve is tested when the nurse asks the patient to shrug their shoulders against resistance?
- CN IX
- CN X
- CN XI (Correct answer)
- CN XII
Correct answer: CN XI
Cranial nerve XI (spinal accessory nerve) innervates the sternocleidomastoid and trapezius muscles, tested by shoulder shrug resistance.
Question 5: A patient exhibits decerebrate posturing. The nurse understands this involves:
- Flexion of arms and extension of legs
- Extension and internal rotation of all extremities (Correct answer)
- Flaccidity of all extremities
- Flexion of all extremities
Correct answer: Extension and internal rotation of all extremities
Decerebrate posturing involves rigid extension, adduction, and internal rotation of all extremities, indicating severe brainstem injury.
Question 6: Which intracranial pressure (ICP) waveform component reflects ventricular compliance and is normally the smallest peak?
- P1 (percussion wave)
- P2 (tidal wave)
- P3 (dicrotic wave) (Correct answer)
- P4 (notch wave)
Correct answer: P3 (dicrotic wave)
P3 (dicrotic wave) reflects closure of the aortic valve and is normally the smallest of the three ICP waveform peaks.
CNRN Neurological Assessment and Monitoring 1
Which component of the Glasgow Coma Scale (GCS) assesses the patient's ability to follow commands?