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

A fixed, dilated pupil on one side with contralateral motor findings and declining GCS indicates uncal herniation, where the medial temporal lobe herniates through the tentorial notch and compresses the ipsilateral CN III.

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

The Monroe-Kellie doctrine states that the rigid skull contains brain tissue (80%), cerebrospinal fluid (10%), and blood (10%), and an increase in one must be compensated by a decrease in another.

Question 3

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

Accepted Answer

Epidural hematoma

Answer

Epidural hematoma, typically from middle meningeal artery rupture, classically presents with a brief loss of consciousness, a lucid interval, followed by rapid neurological deterioration.

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

Head of bed elevation to 30 degrees promotes venous drainage from the brain via gravity, helping to reduce intracranial pressure while maintaining adequate cerebral perfusion.

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

An expanding hematoma with stridor in Zone II indicates vascular injury with impending airway compromise, requiring emergent surgical exploration.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Head and Neck Trauma 2