CMSRN Neurological and Musculoskeletal Care

Question 1

A patient admitted with a suspected stroke has a blood pressure of 185/105 mmHg. Before tPA administration, what is the BP threshold that must be achieved?

Accepted Answer

Less than 185/110 mmHg

Answer

Blood pressure must be below 185/110 mmHg before administering tPA for ischemic stroke to reduce the risk of hemorrhagic transformation.

Question 2

When assessing level of consciousness using the Glasgow Coma Scale (GCS), which three components are evaluated?

Accepted Answer

Eye opening, verbal response, motor response

Answer

The GCS assesses eye opening (1–4), verbal response (1–5), and motor response (1–6), with a maximum score of 15 indicating full consciousness.

Question 3

A patient with a traumatic brain injury (TBI) has a GCS of 7 and widening pulse pressure, bradycardia, and irregular respirations. What does this triad indicate?

Accepted Answer

Cushing's triad — sign of increased intracranial pressure

Answer

Cushing's triad (hypertension with widened pulse pressure, bradycardia, and irregular respirations) is a late sign of dangerously elevated intracranial pressure.

Question 4

The nurse is caring for a patient with a C5 spinal cord injury. Which complication should be the priority concern?

Accepted Answer

Respiratory compromise due to loss of diaphragmatic function

Answer

Injuries at or above C4 affect the phrenic nerve and diaphragm; C5 injuries may partially spare diaphragm function but respiratory compromise remains the top priority.

Question 5

A post-operative patient reports numbness and tingling in the fingers and toes, and has a positive Chvostek's sign. What electrolyte imbalance does the nurse suspect?

Accepted Answer

Hypocalcemia

Answer

Hypocalcemia causes neuromuscular excitability, peripheral paresthesias, and positive Chvostek's sign (facial muscle twitching with cheek tap).

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Neurological and Musculoskeletal Care