Certified Emergency Nurse (CEN) Practice Test

Hypertensive encephalopathy is a severe and acute condition that occurs due to significant elevation in blood pressure, typically above 180/120 mmHg, leading to disruption in cerebral autoregulation. This disruption can cause cerebral edema and an increase in intracranial pressure, resulting in neurological symptoms.

An altered level of consciousness is a key characteristic symptom. As blood pressure rises, it can result in impaired perfusion to the brain or direct damage to cerebral vessels, affecting various brain areas responsible for consciousness and cognitive functioning. Patients may present with confusion, drowsiness, or agitation, progressing to more severe levels of altered consciousness such as stupor or coma if not promptly treated.

In contrast, other symptoms like syncope, excessive thirst, and fever are not typically direct manifestations of hypertensive encephalopathy. While syncope can be seen in various conditions, it does not specifically indicate hypertensive encephalopathy. Excessive thirst may arise from various causes, including dehydration or diabetes, and is not specific to high blood pressure emergencies. Fever may indicate an infectious process or other systemic conditions, but it is not a hallmark of hypertensive encephalopathy.