TNCC Head and Neck Trauma 3

Question 1

A patient presents after an assault with Battle's sign and hemotympanum. These findings are most consistent with:

Accepted Answer

Basilar skull fracture of the posterior fossa

Answer

Battle's sign (mastoid ecchymosis) and hemotympanum (blood behind the tympanic membrane) are classic indicators of a basilar skull fracture involving the temporal bone/posterior fossa.

Question 2

A TBI patient's ICP monitor shows sustained readings of 25 mmHg. The first-line medical intervention is:

Accepted Answer

Osmotic therapy with mannitol or hypertonic saline

Answer

Osmotic therapy (mannitol 20% or hypertonic saline 3-23.4%) is the first-line medical treatment for sustained intracranial hypertension (ICP >20-22 mmHg).

Question 3

Le Fort II fractures are characterized by which pattern?

Accepted Answer

Pyramidal fracture involving the maxilla, nasal bones, and orbital floor

Answer

Le Fort II is a pyramidal fracture that extends from the nasal bridge through the medial orbital walls, across the orbital floor, and through the pterygoid plates, separating a pyramid-shaped segment of the midface.

Question 4

Which medication is recommended for seizure prophylaxis in the first 7 days following severe traumatic brain injury?

Accepted Answer

Levetiracetam or phenytoin

Answer

Levetiracetam (Keppra) or phenytoin (Dilantin) is recommended for early seizure prophylaxis (first 7 days) after severe TBI to prevent early post-traumatic seizures.

Question 5

A patient with a cervical spine injury at C4 presents with hypotension and bradycardia but warm, dry skin. This presentation is consistent with:

Accepted Answer

Neurogenic shock

Answer

Neurogenic shock from high cervical spinal cord injury presents with hypotension, bradycardia, and warm/dry skin due to loss of sympathetic tone below the injury level.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Head and Neck Trauma 3