TCRN TCRN Head and Neck Trauma 3

Question 1

Which of the following is a Class I indication for ICP monitoring according to Brain Trauma Foundation guidelines?

Accepted Answer

Severe TBI (GCS 3–8) with abnormal CT scan

Answer

ICP monitoring is indicated in patients with severe TBI (GCS 3–8) and an abnormal CT scan showing hematoma, contusion, or compressed cisterns.

Question 2

A patient develops Cushing's triad after TBI. Which set of vital signs best represents this response?

Accepted Answer

Hypertension, bradycardia, irregular respirations

Answer

Cushing's triad is hypertension, bradycardia, and irregular respirations, representing a late sign of severely elevated ICP and impending herniation.

Question 3

A patient with facial trauma and suspected Le Fort III fracture is at greatest risk for which airway complication?

Accepted Answer

Complete craniofacial separation with airway loss

Answer

Le Fort III fractures involve craniofacial disjunction, placing the patient at risk for total airway obstruction due to posterior displacement of the midfacial skeleton.

Question 4

Which medication is considered first-line for reducing cerebral edema and ICP in patients with TBI when osmotic therapy is indicated?

Accepted Answer

Mannitol 0.25–1 g/kg IV

Answer

Mannitol is the first-line osmotic agent for ICP reduction, drawing fluid from brain parenchyma into the vascular space.

Question 5

A patient post-TBI develops sudden agitation, diaphoresis, hyperthermia, tachycardia, and hypertension three days after injury. What syndrome is most likely?

Accepted Answer

Sympathetic storming (paroxysmal sympathetic hyperactivity)

Answer

Paroxysmal sympathetic hyperactivity (sympathetic storming) occurs after severe TBI due to loss of inhibitory control, causing episodic autonomic surges.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Head and Neck Trauma 3