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AACN CCRN-Adult Exam - Topic 2 Question 14 Discussion

Actual exam question for AACN's CCRN-Adult exam
Question #: 14
Topic #: 2
[All CCRN-Adult Questions]

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

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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


by Annice at Aug 17, 2025, 06:15 AM

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Maybelle
5 months ago
C seems unlikely, hypoxemia isn't the main player in hypertensive crises.
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Azzie
5 months ago
Wait, are we sure it's not A? Catecholamines can mess things up too.
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Janine
6 months ago
D sounds a bit off, increased ICP isn't always the cause, right?
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Vilma
6 months ago
I agree, B makes the most sense here!
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Erick
6 months ago
Definitely B, vasospasm is a big issue in these cases.
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Elouise
6 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.
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Elouise
7 months ago
Increased ICP sounds familiar, but I can't recall if it's specifically linked to loss of autoregulation in this context.
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Tamesha
7 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.
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Cory
7 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.
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Dorethea
7 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.
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Beckie
7 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.
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France
8 months 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.
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Clarinda
8 months ago
I'm pretty confident that the answer is B. Hypertensive crisis can cause vasospasm of the cerebral arterioles, leading to the neurologic changes.
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Golda
8 months ago
But wouldn't hypoxemia from pulmonary interstitial edema also play a role?
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Shawnda
9 months ago
I think it's option B. Vasospasm of the cerebral arterioles is the key cause of the neurologic changes in hypertensive crisis.
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Emiko
9 months ago
I disagree, I believe it's vasospasm of the cerebral arterioles.
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Golda
9 months ago
I think the neurologic changes are caused by excessive secretion of catecholamines.
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