TNCC Head and Neck Trauma 2

Question 1

A patient with a traumatic brain injury presents with a GCS of 6, unequal pupils (left fixed and dilated), and decorticate posturing. These findings suggest:

Accepted Answer

Left-sided uncal herniation compressing cranial nerve III

Answer

Diffuse axonal injury without mass effect

Answer

Bilateral brainstem infarction

Answer

Spinal cord injury at C3-C5

Question 2

The Monroe-Kellie doctrine states that the total volume of the intracranial compartment is fixed. The three components are:

Accepted Answer

Brain tissue, cerebrospinal fluid, and blood

Answer

Blood, bone, and cerebrospinal fluid

Answer

Gray matter, white matter, and ventricles

Answer

Cerebrum, cerebellum, and brainstem

Question 3

Which type of intracranial hemorrhage is MOST commonly associated with a lucid interval followed by rapid deterioration?

Accepted Answer

Epidural hematoma

Answer

Subdural hematoma

Answer

Subarachnoid hemorrhage

Answer

Intraparenchymal hemorrhage

Question 4

When managing elevated intracranial pressure, the nurse should position the trauma patient with the head of bed elevated to what degree?

Accepted Answer

15-30 degrees

Answer

Flat (0 degrees)

Answer

45-60 degrees

Answer

90 degrees (sitting upright)

Question 5

A patient with penetrating neck trauma in Zone II (angle of mandible to cricoid cartilage) has an expanding hematoma with stridor. The priority is:

Accepted Answer

Emergent surgical exploration

Answer

CT angiography of the neck

Answer

Observation with serial examinations

Answer

Apply direct pressure and await specialist consultation

Question 6

Cerebral perfusion pressure (CPP) is calculated by which formula?

Accepted Answer

CPP = MAP - ICP

Answer

CPP = ICP + MAP

Answer

CPP = Systolic BP - ICP

Answer

CPP = ICP - CVP