NUR 265 Exam 3 Medical Surgical Nursing Galen college Actual Exam Newest With Complete
Questions And Correct Detailed Answers| Brand New Version!
Question 1`
Which of the following best defines a Traumatic Brain Injury (TBI)?
A) Brain damage caused by an internal stroke
B) Damage to the brain caused by an external force
C) Inflammation of the brain due to a viral infection
D) Degeneration of neurons due to aging
E) Congenital malformation of the skull
Correct Answer: B) Damage to the brain caused by an external force
Rationale: By definition, a TBI occurs when an external physical force hits the head or
causes rapid acceleration/deceleration of the brain within the skull, leading to functional
impairment or structural damage.
Question 2
A patient presents to the Emergency Department after a fall. They have a Glasgow Coma Scale
(GCS) score of 14 and experienced a loss of consciousness for 10 minutes. How is this TBI
classified?
A) Minimal TBI
B) Mild TBI
C) Moderate TBI
D) Severe TBI
E) Critical TBI
Correct Answer: B) Mild TBI
Rationale: A mild TBI is classified by a GCS score of 13-15 and a loss of consciousness
(LOC) of up to 30 minutes. These are often referred to as concussions.
Question 3
Which GCS range and loss of consciousness (LOC) duration are associated with a "Moderate
TBI"?
A) GCS 13-15; LOC < 30 minutes
B) GCS 3-8; LOC > 6 hours
C) GCS 9-12; LOC 30 minutes to 6 hours
D) GCS 7-10; LOC 1 to 2 hours
E) GCS 10-14; LOC > 24 hours
Correct Answer: C) GCS 9-12; LOC 30 minutes to 6 hours
Rationale: Moderate TBI is characterized by a GCS of 9-12 and a loss of consciousness
lasting between 30 minutes and 6 hours. This reflects a more significant injury than a
concussion but less severe than a coma-state injury.
Question 4
A patient has been unconscious for 8 hours following a motor vehicle accident and has a GCS of
, 2
6. This injury is classified as:
A) Mild TBI
B) Moderate TBI
C) Severe TBI
D) Non-accidental TBI
E) Secondary TBI
Correct Answer: C) Severe TBI
Rationale: Severe TBI is defined by a GCS score of 3-8 and a loss of consciousness lasting
longer than 6 hours. These patients usually require intensive care and mechanical
ventilation.
Question 5
In comparing "open" and "closed" TBIs, which statement is most accurate regarding a closed
TBI?
A) The integrity of the skull is compromised.
B) It is generally less dangerous than an open TBI.
C) It is caused by blunt force trauma where the skull remains intact.
D) It only occurs in the frontal lobe.
E) It involves a visible fracture of the skull.
Correct Answer: C) It is caused by blunt force trauma where the skull remains intact.
Rationale: A closed TBI occurs when the skull is not fractured or penetrated, but the brain
is damaged by blunt force or shaking. Closed TBIs are often "worse" because the pressure
from swelling has no way to escape the intact skull.
Question 6
A nurse observes a patient with IICP exhibiting Cheyne-Stokes breathing, hemodynamic
instability, and fixed, non-reactive pupils. Which complication does this suggest?
A) Myasthenic crisis
B) Autonomic dysreflexia
C) Brain herniation
D) Spinal shock
E) Bell's Palsy
Correct Answer: C) Brain herniation
Rationale: Brain herniation is a fatal complication of IICP where brain tissue is shifted into
other compartments. Symptoms include abnormal breathing patterns (Cheyne-Stokes),
unstable vitals, and fixed, dilated pupils.
Question 7
Which medication is administered via an IV filter to treat cerebral edema in a TBI patient, and
what is the limit for serum osmolarity?
A) Furosemide; limit 280 mOsm
, 3
B) Mannitol; limit 310-320 mOsm
C) Propofol; limit 350 mOsm
D) Midazolam; limit 300 mOsm
E) Lidocaine; limit 400 mOsm
Correct Answer: B) Mannitol; limit 310-320 mOsm
Rationale: Mannitol is an osmotic diuretic that pulls fluid out of the brain cells into the
bloodstream. It must be filtered due to crystallization risks and is stopped if serum
osmolarity exceeds 310-320 to prevent kidney failure.
Question 8
Why is Lidocaine sometimes used in the management of a TBI patient who is being suctioned?
A) To increase the heart rate
B) To induce deep sedation
C) To suppress the cough reflex and prevent spikes in ICP
D) To treat a petechial rash
E) To prevent gastric stress ulcers
Correct Answer: C) To suppress the cough reflex and prevent spikes in ICP
Rationale: Coughing and gagging during suctioning significantly increase intracranial
pressure. Lidocaine can be used to blunt this reflex to protect the brain from pressure
spikes.
Question 9
What is the purpose of "therapeutic hypothermia" in the treatment of a primary brain injury?
A) To increase the metabolic rate of brain cells
B) To prevent the patient from shivering
C) To decrease cellular demands and reduce secondary brain injury
D) To cure bacterial meningitis
E) To increase cerebral blood flow
Correct Answer: C) To decrease cellular demands and reduce secondary brain injury
Rationale: Reducing the core body temperature to 89.6-93.2°F for 24-48 hours slows down
brain metabolism, reducing the oxygen and glucose required by damaged cells and helping
to control IICP.
Question 10
During the assessment of a TBI patient, which finding requires the nurse to notify the healthcare
provider immediately?
A) A GCS point change of 1
B) The patient is sleepy but arousable
C) A GCS point change of 2 or more
D) A temperature of 99.0°F
E) The patient asks for water
Questions And Correct Detailed Answers| Brand New Version!
Question 1`
Which of the following best defines a Traumatic Brain Injury (TBI)?
A) Brain damage caused by an internal stroke
B) Damage to the brain caused by an external force
C) Inflammation of the brain due to a viral infection
D) Degeneration of neurons due to aging
E) Congenital malformation of the skull
Correct Answer: B) Damage to the brain caused by an external force
Rationale: By definition, a TBI occurs when an external physical force hits the head or
causes rapid acceleration/deceleration of the brain within the skull, leading to functional
impairment or structural damage.
Question 2
A patient presents to the Emergency Department after a fall. They have a Glasgow Coma Scale
(GCS) score of 14 and experienced a loss of consciousness for 10 minutes. How is this TBI
classified?
A) Minimal TBI
B) Mild TBI
C) Moderate TBI
D) Severe TBI
E) Critical TBI
Correct Answer: B) Mild TBI
Rationale: A mild TBI is classified by a GCS score of 13-15 and a loss of consciousness
(LOC) of up to 30 minutes. These are often referred to as concussions.
Question 3
Which GCS range and loss of consciousness (LOC) duration are associated with a "Moderate
TBI"?
A) GCS 13-15; LOC < 30 minutes
B) GCS 3-8; LOC > 6 hours
C) GCS 9-12; LOC 30 minutes to 6 hours
D) GCS 7-10; LOC 1 to 2 hours
E) GCS 10-14; LOC > 24 hours
Correct Answer: C) GCS 9-12; LOC 30 minutes to 6 hours
Rationale: Moderate TBI is characterized by a GCS of 9-12 and a loss of consciousness
lasting between 30 minutes and 6 hours. This reflects a more significant injury than a
concussion but less severe than a coma-state injury.
Question 4
A patient has been unconscious for 8 hours following a motor vehicle accident and has a GCS of
, 2
6. This injury is classified as:
A) Mild TBI
B) Moderate TBI
C) Severe TBI
D) Non-accidental TBI
E) Secondary TBI
Correct Answer: C) Severe TBI
Rationale: Severe TBI is defined by a GCS score of 3-8 and a loss of consciousness lasting
longer than 6 hours. These patients usually require intensive care and mechanical
ventilation.
Question 5
In comparing "open" and "closed" TBIs, which statement is most accurate regarding a closed
TBI?
A) The integrity of the skull is compromised.
B) It is generally less dangerous than an open TBI.
C) It is caused by blunt force trauma where the skull remains intact.
D) It only occurs in the frontal lobe.
E) It involves a visible fracture of the skull.
Correct Answer: C) It is caused by blunt force trauma where the skull remains intact.
Rationale: A closed TBI occurs when the skull is not fractured or penetrated, but the brain
is damaged by blunt force or shaking. Closed TBIs are often "worse" because the pressure
from swelling has no way to escape the intact skull.
Question 6
A nurse observes a patient with IICP exhibiting Cheyne-Stokes breathing, hemodynamic
instability, and fixed, non-reactive pupils. Which complication does this suggest?
A) Myasthenic crisis
B) Autonomic dysreflexia
C) Brain herniation
D) Spinal shock
E) Bell's Palsy
Correct Answer: C) Brain herniation
Rationale: Brain herniation is a fatal complication of IICP where brain tissue is shifted into
other compartments. Symptoms include abnormal breathing patterns (Cheyne-Stokes),
unstable vitals, and fixed, dilated pupils.
Question 7
Which medication is administered via an IV filter to treat cerebral edema in a TBI patient, and
what is the limit for serum osmolarity?
A) Furosemide; limit 280 mOsm
, 3
B) Mannitol; limit 310-320 mOsm
C) Propofol; limit 350 mOsm
D) Midazolam; limit 300 mOsm
E) Lidocaine; limit 400 mOsm
Correct Answer: B) Mannitol; limit 310-320 mOsm
Rationale: Mannitol is an osmotic diuretic that pulls fluid out of the brain cells into the
bloodstream. It must be filtered due to crystallization risks and is stopped if serum
osmolarity exceeds 310-320 to prevent kidney failure.
Question 8
Why is Lidocaine sometimes used in the management of a TBI patient who is being suctioned?
A) To increase the heart rate
B) To induce deep sedation
C) To suppress the cough reflex and prevent spikes in ICP
D) To treat a petechial rash
E) To prevent gastric stress ulcers
Correct Answer: C) To suppress the cough reflex and prevent spikes in ICP
Rationale: Coughing and gagging during suctioning significantly increase intracranial
pressure. Lidocaine can be used to blunt this reflex to protect the brain from pressure
spikes.
Question 9
What is the purpose of "therapeutic hypothermia" in the treatment of a primary brain injury?
A) To increase the metabolic rate of brain cells
B) To prevent the patient from shivering
C) To decrease cellular demands and reduce secondary brain injury
D) To cure bacterial meningitis
E) To increase cerebral blood flow
Correct Answer: C) To decrease cellular demands and reduce secondary brain injury
Rationale: Reducing the core body temperature to 89.6-93.2°F for 24-48 hours slows down
brain metabolism, reducing the oxygen and glucose required by damaged cells and helping
to control IICP.
Question 10
During the assessment of a TBI patient, which finding requires the nurse to notify the healthcare
provider immediately?
A) A GCS point change of 1
B) The patient is sleepy but arousable
C) A GCS point change of 2 or more
D) A temperature of 99.0°F
E) The patient asks for water
