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AACN CCRN-Adult Exam - Topic 2 Question 23 Discussion

A caloric irrigation test of the oculovestibular reflex is performed on a patient who is comatose following a hypoxic brain injury. When cold water is introduced into the left ear, nystagmus occurs with slow deviation of the eyes toward the left, followed by faster eye deviation to the right. This pattern is indicative of a
C) normal response.
A) persistent vegetative state.
B) brain-stem infarction.
D) third cranial nerve palsy.

AACN CCRN-Adult Exam - Topic 2 Question 23 Discussion

Actual exam question for AACN's CCRN-Adult exam
Question #: 23
Topic #: 2
[All CCRN-Adult Questions]

A caloric irrigation test of the oculovestibular reflex is performed on a patient who is comatose following a hypoxic brain injury. When cold water is introduced into the left ear, nystagmus occurs with slow deviation of the eyes toward the left, followed by faster eye deviation to the right. This pattern is indicative of a

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Suggested Answer: C

The caloric irrigation test, also known as the oculovestibular reflex test, is used to assess brainstem function in patients, especially those who are comatose. In this test, cold water is introduced into the ear canal, which should induce a predictable response if the brainstem is intact. The normal response to cold water irrigation is nystagmus with slow deviation of the eyes toward the side of the cold water (in this case, the left) and a fast phase of eye movement (nystagmus) away from the side of the cold water (to the right). This indicates that the brainstem pathways are functioning properly. Reference: =

American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook

Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN


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Anjelica
5 hours ago
This is a normal response to caloric testing.
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Lauryn
5 days ago
I’m a bit confused about the options. I thought a response like this could indicate a third cranial nerve issue, but I’m not confident.
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Martina
11 days ago
I practiced a similar question where nystagmus was involved, and I believe it pointed to brain-stem function. Maybe B is the right answer?
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Mendy
16 days ago
I'm not entirely sure, but I remember something about cold water irrigation and how it can help differentiate between brain states. Could it be A?
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Wilburn
2 months ago
I think the nystagmus response indicates a normal functioning vestibular system, so it might be C.
upvoted 0 times
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