MSNCB Neurological Nursing 2 — Questions and Answers
Question 1: A patient with a subarachnoid hemorrhage suddenly develops worsening headache, photophobia, and neck stiffness. Which complication is most likely occurring?
- Rebleeding (Correct answer)
- Cerebral vasospasm
- Hydrocephalus
- Hyponatremia
Correct answer: Rebleeding
Sudden worsening of headache after subarachnoid hemorrhage is the classic sign of rebleeding, the most dangerous early complication.
Question 2: Which Glasgow Coma Scale score indicates severe traumatic brain injury?
- 13-15
- 9-12
- 8 or below (Correct answer)
- 6 or below
Correct answer: 8 or below
A GCS score of 8 or below classifies a traumatic brain injury as severe and typically requires intubation to protect the airway.
Question 3: A nurse is caring for a patient post-craniotomy. Which finding requires IMMEDIATE intervention?
- Serosanguineous drainage on the dressing
- Blood pressure 148/88 mmHg
- Pupils unequal and non-reactive (Correct answer)
- Temperature 37.8°C (100°F)
Correct answer: Pupils unequal and non-reactive
Unequal, non-reactive pupils post-craniotomy indicate uncal herniation and brainstem compression, requiring immediate intervention.
Question 4: What is the priority nursing intervention for a patient experiencing status epilepticus?
- Administer oral diazepam
- Protect the airway and administer IV benzodiazepine (Correct answer)
- Place a tongue blade between the teeth
- Restrain the patient to prevent injury
Correct answer: Protect the airway and administer IV benzodiazepine
Airway protection and rapid administration of IV benzodiazepines (such as lorazepam) are the immediate priorities in status epilepticus.
Question 5: A patient with Guillain-Barré syndrome is admitted. Which assessment finding is most critical to monitor?
- Deep tendon reflexes
- Respiratory rate and tidal volume (Correct answer)
- Muscle pain level
- Blood pressure variability
Correct answer: Respiratory rate and tidal volume
Ascending paralysis in Guillain-Barré syndrome can involve respiratory muscles, making respiratory function the most critical assessment.
Question 6: Which position is most appropriate for a patient with increased intracranial pressure (ICP)?
- Trendelenburg position
- Head of bed elevated 30 degrees, neck midline (Correct answer)
- Prone position
- Lateral decubitus with knees flexed
Correct answer: Head of bed elevated 30 degrees, neck midline
Elevating the HOB to 30 degrees with the neck in midline promotes venous drainage from the brain, helping to reduce ICP.
Question 7: A patient with a C5 spinal cord injury is at greatest risk for which complication during the acute phase?
- Urinary tract infection
- Respiratory failure (Correct answer)
- Pressure ulcer formation
- Deep vein thrombosis
Correct answer: Respiratory failure
A C5 injury affects the phrenic nerve (C3-C5), significantly impairing diaphragm function and placing the patient at high risk for respiratory failure.
MSNCB Neurological Nursing 2
A patient with a subarachnoid hemorrhage suddenly develops worsening headache, photophobia, and neck stiffness.
Which complication is most likely occurring?