CCRN Neurological Critical Care 2

Question 1

A patient with a severe traumatic brain injury has an ICP of 25 mmHg and a MAP of 80 mmHg. What is the cerebral perfusion pressure (CPP)?

Accepted Answer

55 mmHg

Answer

65 mmHg

Answer

105 mmHg

Answer

45 mmHg

Question 2

Which finding is the earliest and most sensitive indicator of increasing intracranial pressure?

Accepted Answer

Change in level of consciousness

Answer

Fixed dilated pupils

Answer

Cushing's triad

Answer

Decerebrate posturing

Question 3

Cushing's triad, a late sign of increased ICP, consists of which combination?

Accepted Answer

Hypertension with widening pulse pressure, bradycardia, and irregular respirations

Answer

Hypotension, tachycardia, and tachypnea

Answer

Fever, tachycardia, and hypertension

Answer

Hypotension, bradycardia, and apnea

Question 4

A patient receiving mannitol for elevated ICP should be monitored most closely for which complication?

Accepted Answer

Serum hyperosmolality and dehydration

Answer

Hyperkalemia

Answer

Fluid overload and hyponatremia

Answer

Metabolic acidosis

Question 5

Which position is most appropriate to optimize cerebral venous drainage in a patient with increased ICP?

Accepted Answer

Head of bed at 30 degrees with the head midline

Answer

Trendelenburg position

Answer

Flat with the head turned to the side

Answer

Prone with head elevated

Question 6

A patient with a TBI suddenly develops polyuria with dilute urine, hypernatremia, and rising serum osmolality. Which condition is most likely?

Accepted Answer

Diabetes insipidus

Answer

SIADH

Answer

Cerebral salt wasting

Answer

Acute tubular necrosis

Question 7

What is the primary goal of maintaining normocapnia (PaCO2 35-45 mmHg) in a patient with elevated ICP?

Accepted Answer

To avoid cerebral vasoconstriction or vasodilation that worsens perfusion or pressure

Answer

To increase cerebral oxygen consumption

Answer

To promote metabolic alkalosis

Answer

To stimulate the respiratory drive