Discuss AACN CCRN-Adult Exam Topic 2 Question 14

In a patient with hypertensive crisis, neurologic changes are caused by

Aexcessive secretion of catecholamines.

Bvasospasm of the cerebral arterioles.

Chypoxemia as a result of pulmonary interstitial edema.

Dincreased ICP as a result of loss of cerebral autoregulation.

Suggested Answer: D

In hypertensive crisis, neurologic changes are often caused by increased intracranial pressure (ICP) as a result of loss of cerebral autoregulation. Autoregulation normally maintains consistent cerebral blood flow despite changes in systemic blood pressure. In hypertensive crisis, the extremely high blood pressure overwhelms these mechanisms, leading to increased cerebral blood flow, disruption of the blood-brain barrier, and cerebral edema, which subsequently increases ICP and causes neurologic changes. Reference: = CCRN Exam Handbook, page 48

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17 comments · newest first

Maybelle 10 months ago

C seems unlikely, hypoxemia isn't the main player in hypertensive crises.

Azzie 10 months ago

Wait, are we sure it's not A? Catecholamines can mess things up too.

Janine 10 months ago

D sounds a bit off, increased ICP isn't always the cause, right?

Vilma 10 months ago

I agree, B makes the most sense here!

Erick 11 months ago

Definitely B, vasospasm is a big issue in these cases.

Elouise 11 months ago

I practiced a question similar to this, and I think vasospasm was the answer, but I’m torn between that and increased ICP.

Elouise 11 months ago

Increased ICP sounds familiar, but I can't recall if it's specifically linked to loss of autoregulation in this context.

Tamesha 11 months ago

I think excessive catecholamines might play a role, but I feel like the cerebral arterioles are more directly affected by the high blood pressure.

Cory 12 months ago

I remember studying that vasospasm can lead to ischemia, but I'm not completely sure if that's the main cause in a hypertensive crisis.

Dorethea 12 months ago

I think the key here is understanding the pathophysiology of hypertensive crisis. Based on that, I'd say the answer is most likely B - vasospasm of the cerebral arterioles. But I'll review my notes to confirm.

Beckie 12 months ago

Okay, let's see. I remember learning that hypertensive crisis can cause increased intracranial pressure, so I'm leaning towards D as the answer. But I'll double-check the other options just to be sure.

France 1 year ago

Hmm, I'm a bit unsure about this one. I know hypertensive crisis can affect the brain, but I'm not sure if it's specifically through vasospasm or another mechanism. I'll have to think this through carefully.

Clarinda 1 year ago

I'm pretty confident that the answer is B. Hypertensive crisis can cause vasospasm of the cerebral arterioles, leading to the neurologic changes.

Golda 1 year ago

But wouldn't hypoxemia from pulmonary interstitial edema also play a role?

Shawnda 1 year ago

I think it's option B. Vasospasm of the cerebral arterioles is the key cause of the neurologic changes in hypertensive crisis.

Emiko 1 year ago

I disagree, I believe it's vasospasm of the cerebral arterioles.

Golda 1 year ago

I think the neurologic changes are caused by excessive secretion of catecholamines.

AACN CCRN-Adult Exam - Topic 2 Question 14 Discussion