NSG 222 Prerequisite pretest Exam training
Questions with Rated A + Marking Scheme
Latest 2024/2025
Meningeal signs - correct answer Nuchal rigidity- neck stiffness W/Meningitis
photophobia, inflammation of meninges- blood or infection
Brudzinski's sign - correct answer resistance, pain with neck flexion, flexion of ct's
hops & knees
Kernig's sign - correct answer Flex ct's legs at hips and knee, with straightening- note
resistance or pain
Decorticate Post- up- brainstem
Decerebrate post- down- brainstem
Flaccid- poor prognosis
Bladder funct.
Changes in VS - correct answer Occurs with increasing pressure on pons, medulla,
hypothalamus, thalamus. Occurs late, on verge of herniation. (brain death)
Cushings triad- changes in VS
Presence of HA- brain tumor possible- prominent in the morning while laying down.
When pt is upright, the swelling decreases and the HA gets better.
cerebral edema
Glasgow Coma Scale - correct answer Ability to respond.
,Verbal response.
Motor response.
1-15- higher the better
Cerebral angiography - correct answer Cerebral circ. Corated access site.
Series of x-rays after injections of contrast medium- detects aneurysms, A-V
malformations, thrombosis, tumors, hydrocephalus
Preop for Cer. Ang - correct answer NPO x8 hrs.
Pre-op meds, check allergies, consent, immobilized throughout exam
Post op Cer Ang - correct answer Bedrest 4-6 Hrs.
VS.
Nero checks.
Maintain pressure dressing, ice area.
Check for dysphasia, resp distress, keep leg or arm straight x12hr.
Check distal circ.
Keep ccess sites extended- arms, legs
CAT scan - correct answer Cross sectional images of layers of the head.
Detects hemorrhage, tumors, cysts, edema, areas of infarction.
Pre-op- NPO x4 and check allergies with contrast, consent
Check Creatinine studies
EEG - correct answer Records elect. activity of brain, painless, not dangerous.
Dx brain death, epilepsy, tumors, abscess
, Pre-op- hold stimulants/other meds ******, drugs as ordered, wash hair pre and post
test. Ct may be asked to perform activities ie hyperventilate, flashing lights.
Lumbar puncture - correct answer Dx CNS function, intracranial bleed or lesions
Pre-op- ct. on left side in fetal position (separates vert. so surgeon can get between 3rd
and 4th disks, local anesthetic, consent. No twitching or movements, RN helps hold pt
steady.
Post-test- Ct lie in flat x4-6 hrs, encourage fluids to replace CSF taken out. Check site
for infection, check s/s of meningitis
MRI - correct answer Pre-op- No metal in or on body
Increased Intracranial Pressure - correct answer Nondistendable intracranial cavity
filled with blood, brain tissue, and CSF.
Monroe-Kellie hypothesis- if increase in one constituent, a reciprocal decrease of vol. of
others is necessary to prevent increased ICP
Causes of Increased Intracran. Pressure - correct answer Increased brain vol.-
subdural, epidural.
Cerebral edema- hypoxia, injury, CVA
Increased CSF vol.- obstruction, infection (rare)
Clinical manifest - correct answer Decreased 1. LOC *****, HA, 3. Decreased motor
ability****, Vomitting, VS changes, 2. Pupil changes****, papil edema- long standing
hypoxia, increased ICP
Cushing triad - correct answer Increased cerebral edema, increased with hypoxia,
increased ICP.
