CNS Patient Safety Protocols 4

Question 1

Which finding in a patient with Guillain-Barré syndrome most strongly suggests the need for intubation?

Accepted Answer

Vital capacity under 20 mL/kg

Answer

The 20/30/40 rule (VC <20 mL/kg, NIF weaker than -30, PEF <40) signals impending respiratory failure in GBS.

Question 2

Which statement about the Universal Protocol before a neurosurgical procedure is correct?

Accepted Answer

A time-out happens right before the incision with the whole team

Answer

Joint Commission's Universal Protocol requires pre-procedure verification, site marking, and a team time-out right before the procedure starts.

Question 3

A patient on phenytoin shows nystagmus, ataxia, and slurred speech. What is the priority?

Accepted Answer

Hold the dose, check a serum level, and use fall precautions

Answer

Nystagmus and ataxia are classic signs of phenytoin toxicity, which raises fall risk and requires holding the drug and checking levels.

Question 4

What is the main safety risk when giving IV phenytoin too fast?

Accepted Answer

Hypotension and cardiac arrhythmias

Answer

IV phenytoin should not exceed 50 mg/min in adults because faster rates can cause hypotension and arrhythmias.

Question 5

A patient with a spinal cord injury at T4 suddenly develops a pounding headache, BP 210/110, and flushing above the injury. What is the first action?

Accepted Answer

Sit the patient upright and look for the trigger, such as a full bladder

Answer

Autonomic dysreflexia is managed by sitting the patient up to lower BP and quickly removing the noxious stimulus, most often bladder distension.

CNS - Certified Neuro Specialist Practice Test