Neuroscience Registered Nurse Certification Flashcards

A patient with normal pressure hydrocephalus (NPH) classically presents with which triad?

Answer: Gait disturbance, urinary incontinence, and cognitive decline

NPH is characterized by the Hakim triad: gait disturbance (magnetic gait), urinary incontinence, and dementia, occurring in the absence of elevated CSF opening pressure.

Which of the following best describes the primary mechanism of secondary brain injury following TBI?

Answer: Ischemia from disrupted autoregulation, excitotoxicity, and inflammatory cascade

Secondary brain injury occurs hours to days after TBI through ischemia, glutamate excitotoxicity, calcium influx, mitochondrial dysfunction, and neuroinflammation — all potentially modifiable targets.

A patient with multiple sclerosis reports worsening of symptoms each time she showers. This phenomenon is known as:

Answer: Uhthoff's phenomenon

Uhthoff's phenomenon is a temporary worsening of MS symptoms with increased body temperature (heat, fever, exercise), caused by heat-induced conduction failure in demyelinated axons.

The nurse is caring for a patient after a ventriculostomy (EVD) placement. Which action correctly manages the drainage system?

Answer: Level the air-fluid interface of the drip chamber to the specified reference point (usually tragus of the ear) before opening the drain

The EVD reference point (typically the foramen of Monro, approximated by the tragus) must be leveled before opening drainage to ensure accurate pressure measurement and appropriate drainage rate.

A patient is admitted with suspected ischemic stroke. CT head is negative. The next most appropriate diagnostic study to detect early infarction is:

Answer: MRI brain with DWI sequence

DWI-MRI detects acute ischemic changes within minutes of onset with far greater sensitivity than CT, making it the gold standard for early stroke diagnosis.

Which Glasgow Coma Scale (GCS) component score indicates the greatest severity of neurological impairment?

Answer: E1V1M1 (GCS 3)

A GCS of 3 (E1V1M1) is the lowest possible score, indicating no eye opening, no verbal response, and no motor response — consistent with deep coma or brain death.

A nurse caring for a patient with a spinal cord injury at T6 notes the patient has not had a bowel movement in 4 days. The most appropriate intervention is:

Answer: Initiate a scheduled bowel program with digital stimulation and rectal suppository

Neurogenic bowel in SCI requires a structured bowel program using reflex bowel techniques (digital stimulation, suppositories) timed to exploit the gastrocolic reflex for effective evacuation.