NEURO - TEST BANKS - BRUNNER

NEURO - TEST BANKS - BRUNNER &

SUDDARTH'S TEXTBOOK OF MEDICAL -

SURGICAL NURSING 14E (ACTUAL 2025/2026)

QUESTIONS AND VERIFIED ANSWERS

• A patient is brought to the ER following a motor vehicle accident

in which he sustained head trauma. Preliminary assessment reveals a vision deficit in the patients left eye. The nurse should associate this abnormal finding with trauma to which of the following cerebral lobes?

• Temporal
• Occipital
• Parietal
• Frontal - <<>>B

Feedback:

The posterior lobe of the cerebral hemisphere is responsible for visual interpretation. The temporal lobe contains the auditory receptive areas. The parietal lobe contains the primary sensory cortex, and is essential to an individuals awareness of the body in space, as well as orientation in space and spatial relations. The frontal lobe functions in concentration, abstract thought, information storage or memory, and motor function.

• The neurologic ICU nurse is admitting a patient following a

craniotomy using the supratentorial approach. How should the nurse best position the patient?

• Position the patient supine. 1 / 4

• Maintain head of bed (HOB) elevated at 30 to 45 degrees.
• Position patient in prone position.
• Maintain bed in Trendelenberg position. - <<>>B

Feedback:

The patient undergoing a craniotomy with a supratentorial (above the tentorium) approach should be placed with the HOB elevated 30 to 45 degrees, with the neck in neutral alignment. Each of the other listed positions would cause a dangerous elevation in ICP.

• A clinic nurse is caring for a patient diagnosed with migraine

headaches. During the patient teaching session, the patient questions the nurse regarding alcohol consumption. What would the nurse be correct in telling the patient about the effects of alcohol?

• Alcohol causes hormone fluctuations.
• Alcohol causes vasodilation of the blood vessels.
• Alcohol has an excitatory effect on the CNS.
• Alcohol diminishes endorphins in the brain. - <<>>B

Feedback:

Alcohol causes vasodilation of the blood vessels and may exacerbate migraine headaches. Alcohol has a depressant effect on the CNS. Alcohol does not cause hormone fluctuations, nor does it decrease endorphins (morphine-like substances produced by the body) in the brain.

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• A patient has developed diabetes insipidus after having increased

ICP following head trauma. What nursing assessment best addresses this complication?

• Vigilant monitoring of fluid balance
• Continuous BP monitoring
• Serial arterial blood gases (ABGs)
• Monitoring of the patients airway for patency - <<>>A

Feedback:

Diabetes insipidus requires fluid and electrolyte replacement, along with the administration of vasopressin, to replace and slow the urine output. Because of these alterations in fluid balance, careful monitoring is necessary. None of the other listed assessments directly addresses the major manifestations of diabetes insipidus.

• What should the nurse suspect when hourly assessment of urine

output on a patient postcraniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours?

• Cushing syndrome
• Syndrome of inappropriate antidiuretic hormone (SIADH)
• Adrenal crisis
• Diabetes insipidus - <<>>D

Feedback:

Diabetes insipidus is an abrupt onset of extreme polyuria that commonly occurs in patients after brain 3 / 4

surgery. Cushing syndrome is excessive glucocorticoid secretion resulting in sodium and water retention. SIADH is the result of increased secretion of ADH; the patient becomes volume-overloaded, urine output diminishes, and serum sodium concentration becomes dilute. Adrenal crisis is undersecretion of glucocorticoids resulting in profound hypoglycemia, hypovolemia, and hypotension.

• During the examination of an unconscious patient, the nurse

observes that the patients pupils are fixed and dilated. What is the most plausible clinical significance of the nurses finding?

• It suggests onset of metabolic problems.
• It indicates paralysis on the right side of the body.
• It indicates paralysis of cranial nerve X.
• It indicates an injury at the midbrain level. - <<>>D

Feedback:

Pupils that are fixed and dilated indicate injury at the midbrain level.This finding is not suggestive of unilateral paralysis, metabolic deficits, or damage to CN X.

• Following a traumatic brain injury, a patient has been in a coma

for several days. Which of the following statements is true of this patients current LOC?

• The patient occasionally makes incomprehensible sounds.
• The patients current LOC will likely become a permanent state.
• The patient may occasionally make nonpurposeful movements.
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