TCRN Neurological Trauma 3

Question 1

A patient with a TBI is ordered 3% hypertonic saline. What is the primary goal of this therapy?

Accepted Answer

Reduce cerebral edema and lower intracranial pressure by creating an osmotic gradient

Answer

Hypertonic saline draws free water out of brain tissue via osmosis, reducing cerebral edema and lowering ICP.

Question 2

Which position is recommended for patients with TBI to minimize ICP elevation?

Accepted Answer

Head of bed elevated 30 degrees with head midline

Answer

HOB 30° with neutral head alignment promotes cerebral venous drainage without compromising cerebral perfusion pressure.

Question 3

When assessing pupils in a TBI patient, which finding indicates the most critical concern?

Accepted Answer

One fixed, dilated pupil on the side of a known hematoma

Answer

Ipsilateral fixed, dilated pupil indicates uncal herniation with CN III compression, a neurosurgical emergency.

Question 4

A trauma patient is noted to have cerebrospinal fluid (CSF) draining from the ear. The nurse should:

Accepted Answer

Place a loose sterile dressing to collect fluid and notify the provider; do not pack the ear

Answer

CSF otorrhea must not be obstructed; the ear should be loosely covered and the provider notified to prevent meningitis risk.

Question 5

Which statement about pediatric head trauma and TBI is correct?

Accepted Answer

Children have a larger head-to-body ratio than adults, making them more susceptible to acceleration-deceleration injuries

Answer

Children's disproportionately large heads make them more vulnerable to rotational and acceleration-deceleration forces.

TCRN Exam Practice Test