Elsevier Adaptive Quizzing Quiz performance Intracranial Problems Practice Quiz.pdf

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 1/30 Exit Performance Intracranial Problems Practice Quiz Due Mar 10, 2024 by 11:59 pm Final Score 80% 24 out of 30 questions answered correctly Completed on Mar 20, 2024 6:15 pm Incorrect (6) Report content error Which priority outcome would the nurse expect after administration of IV mannitol prescribed for a patient experiencing an increased intracranial pressure (ICP)? Increased urine output

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 2/30 Rationale Mannitol is an osmotic diuretic that increases osmotic pressure in the renal tubules to increase the uptake of water and diuresis by the kidneys, which specifically helps to relieve cerebral edema, thereby decreasing ICP, which is the priority outcome. Increased urine output, decreased BP, and increased intracranial perfusion are secondary outcomes of administration of mannitol. Of these, increased intracranial perfusion is most desirable because it reduces ICP. The nurse monitors BP closely because an extreme decrease in BP may occur, resulting in decreased intracranial perfusion. p. 1491 Report content error For the patient who sustained a head injury in a motor vehicle crash, which initial intervention would the nurse include in the patient’s plan of care? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Decreased blood pressure (BP) Reduced ICP Increased intracranial perfusion Control external bleeding. Administer oxygen. Assume neck injury. Maintain normothermia.

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 3/30 Rationale Controlling external bleeding with sterile pressure dressings, administering oxygen, assuming a neck injury with the head injury, and establishing IV access are priority interventions to ensure the health and safety of the patient. Maintaining normothermia and administering ﬂuids cautiously are part of ongoing monitoring to help prevent secondary injury; these interventions can take place after the priority interventions have been administered. p. 1500 Report content error Which clinical manifestation is characteristic of Cushing triad? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Administer ﬂuids cautiously. Establish/maintain IV access. Tachycardia Bradycardia Systolic hypotension Systolic hypertension Widening pulse pressure Narrowing pulse pressure

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 4/30 Rationale Cushing triad is a neurologic emergency characterized by bradycardia, systolic hypertension, and a widening pulse pressure. The heart rate slows, so Cushing triad does not include tachycardia. Systolic BP increases, so hypotension is not present. Pulse pressure widens, not narrows, with Cushing triad. p. 1487 Report content error When the nurse is preparing to administer a hypertonic saline infusion to a patient with an increased intracranial pressure (ICP), which parameter would the nurse monitor frequently? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Rationale Hypertonic saline solutions can be used to treat increased ICP. Hypertonic saline infusions increase the intravascular ﬂuid volume, which may alter Blood glucose Serum sodium BP Level of sedation Gastrointestinal disturbances

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 5/30 the serum sodium levels and BP in the body. Monitoring blood glucose levels would be necessary if administering corticosteroids to a patient. Monitoring sedation levels would be required if administering barbiturates to the patient. Monitoring gastrointestinal disturbances would be necessary if administering corticosteroids to the patient. Test-Taking Tip: Be alert for details about what you are asked. In this question type, you need to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 1491 Report content error Which factor would the nurse consider prior to repositioning a patient with an increased intracranial pressure (ICP)? Select all that apply. One, some, or all responses may be correct. Rationale Maintain the patient's hips in ﬂexed position while lying on the side. Take care to prevent extreme neck ﬂexion of patient. Adjust body position to decrease ICP. Rotate the patient to a side-lying position to prevent skin breakdown. Follow protocol standards to maintain a head-up position for the patient.

3/20/24, 7:21 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/54956077 6/30 The nurse should take care to prevent extreme neck ﬂexion of the patient because it can cause venous obstruction and contribute to elevated ICP. The nurse would position the patient's body to decrease ICP and improve the cerebral perfusion pressure (CPP). Maintaining a head-up position for the patient is important because elevation of the head of the bed promotes drainage and decreases the vascular congestion that can produce cerebral edema. The patient avoids extreme hip ﬂexion to decrease the risk for raising the intraabdominal pressure, which increases ICP. Rotating the patient to a side-lying position may further increase the ICP. Special air beds can alternate skin pressures to prevent tissue damage. pp. 1494-1495 Report content error Which factor would the nurse associate with inﬂuencing a patient’s intracranial pressure (ICP)? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Rationale Posture Swallowing Drowsiness Suctioning Hypoxemia Intraabdominal pressure

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