MSNCB Neurological Nursing 4

Question 1

Which finding on CT scan would CONTRAINDICATE administration of tPA for acute stroke?

Accepted Answer

Large hyperdense area indicating intracranial hemorrhage

Answer

Intracranial hemorrhage on CT is an absolute contraindication to tPA because the thrombolytic would worsen the bleeding.

Question 2

A nurse is caring for a patient with bacterial meningitis. Which precaution is required until 24 hours after antibiotics are initiated?

Accepted Answer

Droplet precautions

Answer

Droplet precautions are required for bacterial meningitis (especially Neisseria meningitidis) until 24 hours of effective antibiotic therapy have been completed.

Question 3

Which ICP waveform component, when elevated above the other components, indicates decreased intracranial compliance?

Accepted Answer

P2 (tidal wave)

Answer

When P2 exceeds P1, it indicates decreased intracranial compliance, meaning the brain has less ability to accommodate changes in volume.

Question 4

A patient receiving phenytoin (Dilantin) for seizure control should be monitored for which serious adverse effect?

Accepted Answer

Cardiac dysrhythmias during rapid IV infusion

Answer

Rapid IV infusion of phenytoin can cause severe hypotension and cardiac dysrhythmias; it must be administered no faster than 50 mg/min.

Question 5

A patient with Alzheimer's disease becomes agitated and tries to climb out of bed at night. The BEST nursing intervention is to:

Accepted Answer

Reorient the patient, reduce environmental stimuli, and ensure safety

Answer

Non-pharmacological interventions including reorientation, calm reassurance, and a safe low-stimulation environment are the first-line approach for sundowning.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Neurological Nursing 4