Understanding Pathophysiology – ANZ Adaptation 2nd Ed By Craft – Test Bank

Understanding Pathophysiology – ANZ Adaptation 2nd Ed By Craft – Test Bank

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

Chapter 08: Concepts of neurological dysfunction

Test Bank

MULTIPLE CHOICE

1. A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:

a. herniation.
b. vasodilation.
c. autoregulation.
d. amyotrophy.

ANS: C REF: p 156

2. A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure is recorded at 24 mmHg. This reading is:

a. higher than normal.
b. lower than normal.
c. normal.
d. borderline.

ANS: A REF: p 157

3. A 70-year-old female is being closely monitored in the neurological critical care unit for a severe closed head injury. After 48 hours her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension (raised intracranial pressure)?

a. early compensated
b. late compensated
c. early decompensated
d. fully decompensated

ANS: C REF: p 159

4. A decrease in cerebral perfusion pressure is related to which of the following changes?

a. increase in arterial blood pressure
b. increase in cerebral blood flow
c. increase in intracranial pressure
d. cerebral artery vasodilation

ANS: C REF: p 158

5. A direct consequence of increased intracranial pressure is:

a. brain tissue hypoxia.
b. intracranial hypotension.
c. ventricular swelling.
d. expansion of the cranial vault.

ANS: A REF: p 159

6. A 15-year-old female is admitted to the intensive care unit with a severe closed head injury. This diagnosis puts her at risk for:

a. cerebral oedema.
b. metabolic coma.
c. dysphagia.
d. echolalia.

ANS: A REF: p 158

7. Cerebral oedema is an accumulation of fluid in the:

a. brain ventricles.
b. brain tissue.
c. subarachnoid space.
d. neuroglia.

ANS: B REF: p 161

8. Vasogenic oedema is clinically important because (ICP = intracranial pressure):

a. it usually has an infectious cause.
b. the blood-brain barrier is disrupted.
c. ICP is higher than in other forms of cerebral oedema.
d. it always causes herniation.

ANS: B REF: p 161

9. An infant is diagnosed with non-communicating hydrocephalus. An immediate concern for this patient is:

a. metabolic oedema.
b. interstitial oedema.
c. vasogenic oedema.
d. ischemic oedema.

ANS: B REF: p 163

10. Hydrocephalus in adults is most often caused by (CSF = cerebral spinal fluid):

a. overproduction of CSF.
b. intercellular oedema.
c. elevated arterial blood pressure.
d. defective CSF reabsorption.

ANS: D REF: p 163

11. An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would you expect to see?

a. enlarged ventricles
b. decreased cerebrospinal fluid production
c. increased resorption of cerebrospinal fluid
d. smaller than average head circumference

ANS: A REF: p 163

12. Arousal is mediated by the:

a. cerebral cortex.
b. medulla oblongata.
c. reticular activating system.
d. cingulate gyrus.

ANS: C REF: p 164

13. A 16-year-old male took a recreational drug that decreased his level of arousal. Physical exam revealed a localised response to pain, equal and reactive pupils, and roving eye movements. Which of the following is the most likely diagnosis?

a. psychogenic arousal alteration
b. metabolically induced coma
c. structurally induced coma
d. structural arousal alteration

ANS: B REF: p 165

14. A teenage boy sustains a severe closed head injury following an automobile accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. Which of the following describes his condition?

a. confusion
b. coma
c. obtundation
d. stupor

ANS: D REF: p 167

15. The breathing pattern that reflects respirations based primarily on CO2 levels in the blood is:

a. Cheyne-Stokes.
b. ataxic.
c. central neurogenic.
d. normal.

ANS: A REF: p 168

16. A 50-year-old male suffers a severe head injury when his motorcycle hits a tree. His breathing becomes deep and rapid but with normal pattern. This condition is called:

a. gasping.
b. ataxic breathing.
c. apneusis.
d. central neurogenic hyperventilation.

ANS: D REF: p 168

17. Dilated fixed pupils can be caused by:

a. brain stem hypoxia.
b. cerebral contusions.
c. compression of the optic nerve.
d. spinal shock.

ANS: A REF: p 169

18. A 51-year-old male is admitted to the neurological critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. This condition is known as:

a. decorticate posturing.
b. decerebrate posturing.
c. caloric posturing.
d. excitation posturing.

ANS: B REF: p 170

19. A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. In ED he is comatose with flexion of his forearms, wrists and fingers, adduction of his upper extremities and internal rotation and plantar flexion in his lower limbs. His abnormal posturing is:

a. decorticate rigidity.
b. decerebrate rigidity.
c. pontine level dysfunction.
d. spinal cord dysfunction.

ANS: A REF: p 170

20. Pupillary reflexes to light are controlled by cranial nerves:

a. I and II.
b. II and III.
c. III and IV.
d. IV and V.

ANS: B REF: p 165

21. A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a post-coma unresponsive state one month after the accident. He does not require assistance to breathe. Which of the following structures is most likely damaged?

a. cerebral cortex
b. brain stem
c. spinal cord
d. cerebellum

ANS: A REF: p 170

22. When thought content and arousal level are intact but a patient cannot communicate, the patient has:

a. cerebral death.
b. locked-in syndrome.
c. dysphagia.
d. cerebellar motor syndrome.

ANS: B REF: p 171

23. A 10-year-old female was brought to the ED following a sudden onset of convulsions. The doctors think she experienced an explosive, disorderly discharge of cerebral neurons referred to as:

a. reflex.
b. seizure.
c. inattentiveness.
d. brain death.

ANS: B REF: p 171

24. A peculiar sensation that immediately precedes a seizure is called a(n):

a. prodroma.
b. agnosia.
c. spasm.
d. aura.

ANS: D REF: p 174

25. A 30-year-old female had a seizure that causes her to experience numbness and tingling extending from her left forearm to her left fingertips without loss of consciousness. This condition is known as:

a. myoclonic seizure.
b. Toni-clonic seizure.
c. simple partial seizure.
d. atonic seizure.

ANS: C REF: p 174

26. A 20-year-old male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed several times. He most likely was experiencing a(n):

a. partial seizure.
b. absence seizure.
c. myoclonic seizure.
d. tonic-clonic seizure.

ANS: D REF: pp 174-175

27. Febrile seizures in children are thought to arise as a result of:

a. the rate at which the core temperature increases.
b. a combination of genetic and environmental factors.
c. a hypersensitivity reaction to analgesic medication.
d. congenital abnormalities in the central nervous system.

ANS: B REF: p 176

28. An alcoholic checked into a rehabilitation centre. He experiences delirium, inability to concentrate, and is easily distracted. Which of the following is he most likely to be affected by?

a. acute confusional state
b. echolalia
c. dementia
d. dysphagia

ANS: A REF: p 175

29. Dementia is manifested by:

a. violent behaviour.
b. hyperactivity.
c. depressive personality.
d. loss of recent and remote memory.

ANS: D REF: p 178

30. A 65-year-old male recently suffered a stroke. He is now unable to recognise and identify objects by sight even though his vision is intact. This condition is a form of:

a. hypomimesis.
b. agnosia.
c. dysphasia.
d. agraphia.

ANS: B REF: p 178

31. A 75-year-old female with a history of dementia develops impaired comprehension of language, but she is able to speak. This clinical manifestation is called:

a. motor aphasia.
b. Broca’s aphasia.
c. expressive dysphasia.
d. receptive dysphasia.

ANS: D REF: p 178