CNRN Traumatic Brain Injury and Spinal Cord Injury 3

Question 1

Which herniation syndrome occurs when the cerebellar tonsils herniate through the foramen magnum, compressing the medulla?

Accepted Answer

Tonsillar herniation

Answer

Uncal herniation

Answer

Central herniation

Answer

Subfalcine herniation

Question 2

A patient with TBI is receiving mannitol for ICP reduction. The nurse monitors serum osmolality, knowing the maximum safe osmolality is:

Accepted Answer

320 mOsm/kg

Answer

295–300 mOsm/kg

Answer

310–320 mOsm/kg

Answer

Greater than 340 mOsm/kg

Question 3

Which type of TBI is characterized by diffuse white matter damage from rotational acceleration-deceleration forces, often with prolonged unconsciousness despite minimal CT findings?

Accepted Answer

Diffuse axonal injury (DAI)

Answer

Contusion

Answer

Epidural hematoma

Answer

Subdural hematoma

Question 4

The nurse is preparing a patient for lumbar puncture to assess for meningitis after TBI. Before performing the LP, the priority is to:

Accepted Answer

Administer empiric antibiotics and obtain CT head to rule out elevated ICP

Answer

Perform the LP immediately to avoid treatment delay

Answer

Obtain informed consent only

Answer

Place the patient in prone position

Question 5

Which pharmacological agent is recommended to reduce spasticity in patients with chronic spinal cord injury, delivered intrathecally for severe cases?

Accepted Answer

Baclofen

Answer

Diazepam

Answer

Dantrolene sodium

Answer

Tizanidine

Question 6

A patient with acute SCI is at high risk for deep vein thrombosis. Pharmacological prophylaxis should be initiated:

Accepted Answer

After 24 hours if no active bleeding

Answer

Immediately upon diagnosis

Answer

Only after surgical stabilization

Answer

Not until the patient is ambulating