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

Increase systemic blood pressure through volume expansion

Answer

Correct hyponatremia caused by excessive diuresis

Answer

Prevent cerebral vasospasm

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

Prone position

Answer

Trendelenburg position

Answer

Supine flat with bilateral cervical rolls

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

Both pupils 3 mm and reactive

Answer

Bilateral 4 mm pupils that react sluggishly

Answer

Anisocoria of 0.5 mm present since childhood

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

Pack the ear canal tightly with sterile gauze to stop the leak

Answer

Irrigate the ear canal with sterile saline

Answer

Reposition the patient so the affected ear is dependent

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 tolerate increased ICP better than adults due to open fontanelles until age 18

Answer

Pediatric skulls are thicker and less compliant, providing greater protection

Answer

GCS cannot be used in pediatric patients under 5 years old

Question 6

Post-traumatic seizures in TBI patients are classified as immediate (within 24 hours), early (1–7 days), or late (>7 days). Which type is associated with the highest risk of developing epilepsy?

Accepted Answer

Late seizures

Answer

Immediate seizures

Answer

Early seizures

Answer

All types carry equal risk

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

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