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

Tonsillar herniation (downward herniation) occurs when cerebellar tonsils are pushed through the foramen magnum, causing rapid medullary compression and cardiorespiratory arrest.

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

Serum osmolality should not exceed 320 mOsm/kg during mannitol therapy to avoid renal toxicity and rebound cerebral edema.

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

Diffuse axonal injury (DAI) results from shear-strain forces disrupting axons throughout the white matter; CT may appear near-normal despite severe neurological dysfunction.

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

CT head must be obtained first to rule out elevated ICP before LP; antibiotics should be started empirically without delaying treatment pending imaging.

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

Intrathecal baclofen (ITB) therapy via an implanted pump is used for severe spasticity in SCI when oral medications are insufficient.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Traumatic Brain Injury and Spinal Cord Injury 3