Assessment Task 1 - Case Study
Question 1 (1 point)
Which pressure will be increased if there is a haemorrhage inside the skull?
a) Cerebrospinal fluid pressure
b) Intracranial Pressure
c) Cerebral Perfusion Pressure
d) Mean Arterial Pressure (Systemic)
Question 2 (1 point)
The Monroe Kellie doctrine describes
a) pressure volume relationship within the intracranial cavity
b) classification of traumatic brain injury
c) physiological electrical function of the brain cells
d) cerebral volume and pressure relationship
Question 3 (1 point)
Which Pressure, if it drops, can lead to brain ischaemia?
a) Mean Arterial Pressure (Systemic)
b) Intracranial Pressure
c) Cerebrospinal fluid pressure
d) Cerebral Perfusion Pressure
Question 4 (1 point)
Which pressure, if raised, can lead to compression of the vessels inside the skull?
a) Cerebrospinal fluid pressure
b) Cerebral Perfusion Pressure
c) Intracranial Pressure
d) Mean Arterial Pressure (Systemic)
Question 5 (1 point)
Which of the answers below would correctly complete the following statement?
The cerebro ischaemic response (Cushing's reflex) states that upon raised intracranial pressure, the increases to overcome the and ensure that the is above 60mmHg.
a) MABP; CPP; ICP
b)ICP, CPP; MABP
c) mABP, ICP; CPP
d) CPP; MABP; 1CP
Question 6 (1 point)
As Zac deteriorates, an accumulation of CO2 in the brain results in an increase in intracranial pressure due to which of the following?
a) Vascular compression
b) Venous haemorrhage
c) Vasodilation
d) Arterial haemorrhage
Question 7 (1 point)
After head injury, ICP will increase quickly due to which of the following?
a) Vascular compression
b) Arterial haemorrhage
c) Venous haemorrhage
d) Vasodilation
Question 8 (1 point)
If Zac deteriorates, the may require a pain stimulus as part of his GCS assessment. In response to a pain stimulus, Zac may exhibit if he has lost all brain function, excepting function of the brainstem.
a) withdrawn from pain
b) decorticate flexion
c) decerebrate extension
d) localised to pain
Question 9 (1 point)
Zac hit his head, possibly experiencing a traumatic brain injury. Which of the following is a primary injury?
a) Neurogenic shock
b) Neural ischaemia
c)Subdural haematoma
d) Diffuse axonal injury
Question 10 (1 point)
The most likely physical mechanism of Zac's traumatic brain injury was
a) static loading
b) contact loading
c) impact loading
d) impulsive loading
Question 11 (1 point)
Zac's cues prior to 0700 indicate
a) mild neurotrauma
b) severe neurotrauma
c) minimal neurotrauma
d) moderate neurotrauma
Question 12 ( 1 point)
Zac hit his head, experiencing a traumatic brain injury (TBI). Which of the following is considered a tertiary presentation subsequent to a TBI?
a) subdural haematoma
b) hypoxaemia
c) neural ischaemia
d) contrecoup contusion
Question 13 (1 point)
Which of the following is a direct result of the baroreceptor reflex towards end-stage elevation in ICP?
a) Widening pulse pressure
b) High blood pressure
c) Bradycardia
d) Reactive pupils
Question 14 (1 point)
Zac hit his head, experiencing a traumatic brain injury (TB I). Which of the following is a consequence of secondary injury subsequent to TBI?
a) Concussion
b) Brain Herniation
c) Neurogenic Shock
d) Diffuse axonal Injury
Question 15 (1 point)
Of Zac's 0700 cues, which of the following is a response to reduced cerebral perfusion pressure?
a) Bradycardia
b) Widening pulse pressure
c) Normally reactive pupils
d) High blood pressure
Question 16 (1 point)
Cues for brain function deterioration due to rising ICP include all of the following except:
a) Widening pulse pressure
b) High blood pressure
c) Bradycardia
d) Reactive pupils
Question 17 (1 point)
Which of the following cues from Zac's data is indicative of raised ICP?
a) elevated systolic blood pressure, widening pulse pressure, tachycardia
b) sluggish pupillary reflex
c) elevated systolic, lowered diastolic blood pressure, tachycardia
d) nausea and vomiting
Question 18 (1 point)
Haemorrhage into brain tissue is known as
a) intraventricular haemorrhage
b) intracerebral haemorrhage
c) intralobe haemorrhage
d) intercerebral haemorrhage
Question 19 (1 point)
A subdural haematoma occurs when the
a) cortical bridging veins are ruptured
b) subependymal veins are damaged
c) superficial arterial and venous vessels are ruptured
d) intracerebral vessels are torn
Question 20 (2 points)
Identify the injury types in which the primary injury involves/affects the entire brain. Select only TWO (2) options
a) haematoma
b) concussion
c) diffuse axonal injury
d) open skull fracture
e) contusion
f) intracerebral haemorrhage
Question 21 (4 points)
If Zac were to remain untreated, which of the following would be evidence of life-threatening deterioration due to raised intra-cranial pressure? Select only FOUR (4) options
a) widening pulse pressure
b) decreased blood pressure
c) decorticate posturing
d) fixed pupils
e) tachycardia
f) rhinitis
g) exopthalmus
h) hyporeflexia
i) neurogenic shock
j) bradycardia
k) altered respiratory pattern
l) GCS 12
Question 22
A very important intervention for any deteriorating patient is to increase in the frequency of observations undertaken. If Zac were to significantly deteriorate, what trend in his blood pressure might be observed? Explain the pathophysiological mechanisms which would cause these changes.
Word limit: 200 words excluding in-text references. Use the School of Nursing guidelines for UTas Harvard referencing. These can be found in the "Assessment help and resources" section on MyLO.
Question 23 (0.0001 points)
If Zac deteriorates further, mannitol may be administered. Explain the rationale if this therapy were to be used in Zac's care, and the changes in parameters (or lack thereof) that would be evidence that the intervention is having the desired effect. You should also explain why administration to Zac should proceed with caution.
Word limit: 200 words excluding in-text references. Use the School of Nursing guidelines for UTas Harvard referencing. These can be found in the "Assessment help and resources" section on MyLO.
CXA243 Pathophysiology for Health Care 2
Multiple Choice Questions