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

CPP equals MAP minus ICP, so 80 minus 25 equals 55 mmHg.

Question 2

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

Accepted Answer

Change in level of consciousness

Answer

A declining level of consciousness is the earliest and most sensitive sign of rising ICP.

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

Cushing's triad is widening pulse pressure (rising systolic), bradycardia, and irregular respirations.

Question 4

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

Accepted Answer

Serum hyperosmolality and dehydration

Answer

Mannitol's osmotic diuresis can cause dehydration and dangerously high serum osmolality.

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

Elevating the head 30 degrees and keeping it midline promotes venous outflow and lowers ICP.

CCRN Review Practice Test