TNCC Neurological Assessment 3

Question 1

Which neurological finding in a trauma patient warrants immediate neurosurgical consultation for possible epidural hematoma?

Accepted Answer

Brief loss of consciousness followed by a lucid interval then rapid deterioration

Answer

The classic lucid interval followed by rapid neurological deterioration is the hallmark presentation of an epidural hematoma from middle meningeal artery rupture.

Question 2

When performing the AVPU scale, a patient who opens eyes and groans when you call their name is classified as:

Accepted Answer

V - Responds to Voice

Answer

The AVPU scale classifies V as any response—eye opening, vocalization, or movement—elicited by verbal stimulation.

Question 3

A spinal cord injury patient has diaphragmatic breathing but absent intercostal muscle function. The injury level is most likely:

Accepted Answer

C4

Answer

The phrenic nerve (C3-C5) controls the diaphragm, so C4 injury preserves diaphragmatic breathing while T1 intercostal innervation is lost.

Question 4

Which assessment finding best differentiates neurogenic shock from hypovolemic shock in a spinal cord injury patient?

Accepted Answer

Bradycardia with warm, dry skin in neurogenic shock

Answer

Neurogenic shock causes paradoxical bradycardia with vasodilation (warm, dry skin) due to loss of sympathetic tone, unlike the tachycardia and vasoconstriction of hypovolemic shock.

Question 5

The recommended MAP target for maintaining spinal cord perfusion in an acute spinal cord injury during the first 7 days is:

Accepted Answer

85-90 mmHg

Answer

Current guidelines recommend maintaining MAP at 85-90 mmHg for the first 7 days after acute SCI to optimize spinal cord perfusion pressure.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Neurological Assessment 3