NCLEX-RN® Question of the Day: Increased intracranial pressure

In This Article

Today’s NCLEX-RN® question of the day focuses on a patient with increased intracranial pressure (ICP). Do you know how to describe their condition? Let’s find out!

The nurse is caring for a patient diagnosed with increased intracranial pressure (ICP) secondary to vasogenic edema. Which statement best describes the pathophysiology of this condition?

A. “Excess cerebrospinal fluid (CSF) flows from the brain ventricles into the interstitium.”

B. “A diffuse injury occurs to the brain cells.”

C. “Water from the blood is pulled into brain cells.”

D. “The blood-brain barrier is disrupted.”

Scroll down for the correct answer!

The correct answer to today’s NCLEX® Question is…

D. “The blood-brain barrier is disrupted.”

Rationale: Vasogenic edema, the most common type of cerebral edema, occurs when the blood-brain barrier is disrupted, allowing proteins and other molecules to leak from the blood vessels into the brain interstitium. The resulting increase in interstitial osmotic pressure draws fluid into the tissue, increasing ICP.

Main Takeaway

There are four major causes of increased intracranial pressure (ICP).

Vasogenic edema, the most common type, occurs when the blood-brain barrier is disrupted, allowing proteins and fluid to leak into the brain interstitium. Cytotoxic (cellular) edema occurs when injury to brain cells causes intracellular sodium and water accumulation. Interstitial cerebral edema occurs when cerebrospinal fluid (CSF) moves from the ventricles into the surrounding brain tissue. Osmotic edema occurs when decreased plasma osmolality, such as with hyponatremia, causes water to move from the blood into brain cells.

Incorrect Answer Explanations

A. “Excess cerebrospinal fluid (CSF) flows from the brain ventricles into the interstitium.”

Rationale: A cause of increased ICP is interstitial cerebral edema, which occurs when CSF flows from the brain ventricles into the interstitium.

B. “A diffuse injury occurs to the brain cells.”

Rationale: A cause of increased ICP is cellular edema, also known as cytotoxic edema. In this case, injury to brain cells causes increased intracellular sodium, which draws water into the cells, causing increased ICP.

C. “Water from the blood is pulled into brain cells.”

Rationale: In patients with osmotic edema, disturbances in the osmotic pressure can occur due to conditions such as hyponatremia, causing water to move from the blood into brain cells, increasing the ICP.

References

Barnett, N. (n.d.). Cerebral correlates of hyponatremia. Neurocritical care. Retrieved January 21, 2022, from https://pubmed.ncbi.nlm.nih.gov/17356196/