NSG 3280 – EXAM 3 Study Guide
Galen College
2026
,1. Primary brain injury is best defined as which of the following?
A. Progressive cerebral edema that occurs hours after trauma
B. Delayed neuronal death caused by hypoxia
C. Initial damage to brain tissue that occurs at the time of injury
D. Increased intracranial pressure resulting from cerebral swelling
Answer: C
Rationale:
Primary brain injury occurs at the moment of trauma and includes contusions, lacerations, and
diffuse axonal injury. This damage is immediate and irreversible, unlike secondary injury,
which develops over time.
2. Secondary brain injury refers to which process?
A. Injury that occurs at the time of the traumatic event
B. Damage caused by progressive cellular and metabolic changes after injury
C. Structural damage to the skull and meninges
D. Injury limited to cerebral contusions
Answer: B
Rationale:
Secondary brain injury occurs after the initial insult and includes hypoxia, ischemia, cerebral
edema, and increased ICP. These injuries are potentially preventable with prompt nursing and
medical intervention.
3. The statement “time is tissue” emphasizes which concept related to
brain injury?
A. Neurons regenerate slowly over time
B. Prolonged injury leads to greater loss of brain tissue
C. Swelling resolves quickly if treated
D. Brain tissue is resistant to hypoxia
Answer: B
,Rationale:
Brain tissue is extremely sensitive to oxygen deprivation. The longer ischemia or hypoxia
persists, the greater the irreversible neuronal death, hence “time is tissue.”
4. Which mechanisms most commonly contribute to secondary brain
injury?
A. Ischemia, hypoxia, increased intracranial pressure
B. Infection, hemorrhage, fever
C. Hypotension, anemia, dehydration
D. Trauma, concussion, skull fracture
Answer: A
Rationale:
Secondary brain injury is primarily driven by decreased oxygen delivery and perfusion, often
caused by ischemia, hypoxia, and elevated ICP.
5. Which three components make up the contents of the cranial vault?
A. Skull, dura mater, brain tissue
B. Blood, oxygen, cerebrospinal fluid
C. Brain tissue, cerebrospinal fluid, blood
D. Neurons, glial cells, ventricles
Answer: C
Rationale:
According to the Monroe-Kellie doctrine, the skull contains brain tissue, blood, and CSF. An
increase in one must be offset by a decrease in another to maintain normal ICP.
6. What is the normal adult intracranial pressure (ICP) range?
A. 5–20 mm Hg
B. 0–15 mm Hg
C. 10–25 mm Hg
D. 15–30 mm Hg
Answer: B
, Rationale:
Normal ICP in adults is 0–15 mm Hg. Sustained pressures above this range indicate increased
ICP and require intervention.
7. Which ICP value requires immediate intervention?
A. 15 mm Hg
B. 18 mm Hg
C. 20 mm Hg
D. 25 mm Hg
Answer: D
Rationale:
An ICP of 25 mm Hg is critically elevated and places the client at high risk for brain herniation
and decreased cerebral perfusion.
8. Cerebral perfusion pressure (CPP) is calculated using which formula?
A. MAP + ICP
B. ICP − MAP
C. MAP − ICP
D. MAP ÷ ICP
Answer: C
Rationale:
CPP = Mean Arterial Pressure (MAP) − Intracranial Pressure (ICP). This value reflects the
pressure needed to perfuse the brain.
9. What is the minimum CPP needed to maintain adequate cerebral
perfusion?
A. 40 mm Hg
B. 50 mm Hg
C. 60 mm Hg
D. 70 mm Hg
Answer: C
Galen College
2026
,1. Primary brain injury is best defined as which of the following?
A. Progressive cerebral edema that occurs hours after trauma
B. Delayed neuronal death caused by hypoxia
C. Initial damage to brain tissue that occurs at the time of injury
D. Increased intracranial pressure resulting from cerebral swelling
Answer: C
Rationale:
Primary brain injury occurs at the moment of trauma and includes contusions, lacerations, and
diffuse axonal injury. This damage is immediate and irreversible, unlike secondary injury,
which develops over time.
2. Secondary brain injury refers to which process?
A. Injury that occurs at the time of the traumatic event
B. Damage caused by progressive cellular and metabolic changes after injury
C. Structural damage to the skull and meninges
D. Injury limited to cerebral contusions
Answer: B
Rationale:
Secondary brain injury occurs after the initial insult and includes hypoxia, ischemia, cerebral
edema, and increased ICP. These injuries are potentially preventable with prompt nursing and
medical intervention.
3. The statement “time is tissue” emphasizes which concept related to
brain injury?
A. Neurons regenerate slowly over time
B. Prolonged injury leads to greater loss of brain tissue
C. Swelling resolves quickly if treated
D. Brain tissue is resistant to hypoxia
Answer: B
,Rationale:
Brain tissue is extremely sensitive to oxygen deprivation. The longer ischemia or hypoxia
persists, the greater the irreversible neuronal death, hence “time is tissue.”
4. Which mechanisms most commonly contribute to secondary brain
injury?
A. Ischemia, hypoxia, increased intracranial pressure
B. Infection, hemorrhage, fever
C. Hypotension, anemia, dehydration
D. Trauma, concussion, skull fracture
Answer: A
Rationale:
Secondary brain injury is primarily driven by decreased oxygen delivery and perfusion, often
caused by ischemia, hypoxia, and elevated ICP.
5. Which three components make up the contents of the cranial vault?
A. Skull, dura mater, brain tissue
B. Blood, oxygen, cerebrospinal fluid
C. Brain tissue, cerebrospinal fluid, blood
D. Neurons, glial cells, ventricles
Answer: C
Rationale:
According to the Monroe-Kellie doctrine, the skull contains brain tissue, blood, and CSF. An
increase in one must be offset by a decrease in another to maintain normal ICP.
6. What is the normal adult intracranial pressure (ICP) range?
A. 5–20 mm Hg
B. 0–15 mm Hg
C. 10–25 mm Hg
D. 15–30 mm Hg
Answer: B
, Rationale:
Normal ICP in adults is 0–15 mm Hg. Sustained pressures above this range indicate increased
ICP and require intervention.
7. Which ICP value requires immediate intervention?
A. 15 mm Hg
B. 18 mm Hg
C. 20 mm Hg
D. 25 mm Hg
Answer: D
Rationale:
An ICP of 25 mm Hg is critically elevated and places the client at high risk for brain herniation
and decreased cerebral perfusion.
8. Cerebral perfusion pressure (CPP) is calculated using which formula?
A. MAP + ICP
B. ICP − MAP
C. MAP − ICP
D. MAP ÷ ICP
Answer: C
Rationale:
CPP = Mean Arterial Pressure (MAP) − Intracranial Pressure (ICP). This value reflects the
pressure needed to perfuse the brain.
9. What is the minimum CPP needed to maintain adequate cerebral
perfusion?
A. 40 mm Hg
B. 50 mm Hg
C. 60 mm Hg
D. 70 mm Hg
Answer: C
