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Worksheets520101 Traumatic Brain Injury
Total questions: 20
Worksheet time: 10mins
What is the best definition of traumatic brain injury?
A. A degenerative condition of the brain
B. A congenital brain abnormality
C. A non‑congenital insult to the brain from an external mechanical force
D. A psychological trauma
Which of the following is a common symptom after mild TBI?
A. Spinal cord paralysis
B. Complete loss of vision
C. Headache, nausea, dizziness
D. Permanent unconsciousness
In managing elevated intracranial pressure (ICP), which approach is MOST important for improving neurologic outcome?
A. First-line hemicraniectomy
B. Hypertonic saline always superior to mannitol
C. Prolonged hyperventilation is benign
D. Maintaining cerebral perfusion pressure (CPP), even if ICP remains elevated
Which option best captures the primary definition of cerebral protection?
A. Administering sedatives to all patients after brain injury
B. Preventing coronary artery disease
C. Interventions aimed at preventing or minimizing neuronal damage during hypoxia or ischemia
D. Stimulating neuronal regrowth after chronic neurodegeneration
What is the most critical step in prehospital management of suspected severe TBI?
A. Immediate CT scan
B. Securing the airway and maintaining oxygenation
C. Administering mannitol
D. Measuring intracranial pressure
Which agent and dose is appropriate to lower increased ICP in TBI?
A. 250 mL D₅W
B. Oral hypertonic saline
C. Intravenous mannitol 0.25–1 g/kg over 15 min
D. IV furosemide 20 mg
Which head-of-bed position is optimal for reducing intracranial pressure (ICP) in TBI patients?
A. Supine
B. Elevated 30° with neutral neck alignment
C. Elevated 30° with neck turned
D. Trendelenburg position
Effective temperature control in TBI nursing care aims to:
A. Maintain core temperature at 38 °C to keep patient warm
B. Lower temperature to 35 °C consistently to avoid getting fever
C. Keep temperature below 37 °C to avoid metabolic increases and ICP spikes
D. Avoid antipyretics
Which fluid strategy supports cerebral perfusion while minimizing cerebral edema?
A. Use isotonic crystalloids; avoid hypotonic fluids like D₅W
B. Aggressive hypotonic IV fluids
C. Use 5% dextrose as maintenance fluid
D. Restrict all fluids
When administering mannitol to reduce ICP, the nurse should routinely monitor:
A. Serum potassium
B. Liver enzymes
C. Serum osmolality and volume status
D. Platelet count
At what anatomical landmark should the EVD transducer be leveled for accurate intracranial pressure (ICP) readings when the patient is supine?
A. 4th midline Intercostal
B. Xiphoid process
C. External auditory meatus
D. Umbilicus
Before repositioning a patient with an open EVD, the nurse should:
A. Clamp the EVD and re-level after position change
B. Leave EVD open and reposition directly
C. Increase drainage height without clamping
D. Remove drainage chamber
You are monitoring an EVD-connected patient’s intracranial pressure waveform. Normally, the waveform shows three peaks—P1 (percussion), P2 (tidal), and P3 (dicrotic)—with P1 > P2 > P3. If you observe that P2 now exceeds P1 in height, what does this most likely indicate?
A. Normal intracranial compliance
B. Transducer occlusion or muffled signal
C. Decreased brain compliance and rising intracranial pressure
D. Presence of small Lundberg B waves
You are reviewing the continuous ICP waveform of a patient and the waveform displays three distinct peaks:
P1: The tallest peak
P2: The second tallest peak
P3: The smallest peak
Which of the following statements accurately describes this waveform?
A) The waveform is normal, with P1 > P2 > P3, indicating good intracranial compliance.
B) The waveform is abnormal, with P2 > P1, suggesting elevated ICP and poor compliance
C) The waveform is normal, but P3 > P1, which is a common variant.
D) Waveform is abnormal, with P1 < P2 < P3, indicating impending herniation
Which of the following mechanisms is NOT typically associated with secondary brain injury following traumatic brain injury (TBI)?
A) Excitotoxicity due to excessive release of glutamate.
B) Oxidative stress leading to neuronal injury.
C) Increased blood-brain barrier permeability.
D) Immediate mechanical disruption of neuronal structures.
Which of the following hyperosmolar agents is commonly used to reduce intracranial pressure (ICP) in patients with severe TBI?
A) Mannitol
B) Hypertonic saline
C) Both A and B
D) Steroids
A nurse is assessing a patient with a traumatic brain injury for signs of increased intracranial pressure (ICP). Which of the following findings would suggest a late sign of increased ICP?
A) Nausea
B) Headache
C) Decreased level of consciousness (LOC)
D) Cushing’s triad (bradycardia, hypertension, irregular respirations)
Which of the following nursing interventions is most appropriate to minimize elevation of ICP during patient care?
A) Cluster nursing activities to reduce the number of interruptions
B) Administer sedatives and analgesics as prescribed to prevent agitation
C) Encourage the patient to cough and deep breathe to clear secretion
D) Perform endotracheal suctioning every 2 hours
Which statement best defines cerebral protection in a clinical context?
A. Enhancing neuronal regrowth after chronic neurodegeneration
B. Reducing intracranial pressure through surgical decompression
C. Interventions aimed at preventing or minimizing neuronal damage during acute metabolic stress such as ischemia, hypoxia, trauma, or inflammation
D. Sedating patients to eliminate EEG activity indefinitely
Which type of TBI is characterized by widespread axonal damage from acceleration-deceleration forces, often seen in high-speed motor vehicle accidents?
A. Epidural hematoma
B. Coup-contrecoup contusion
C. Diffuse axonal injury (DAI
D. Intracerebral hemorrhage
