NUR 265 EXAM 3 REVIEW 2026 – QUESTIONS AND
ANSWERS | LATEST UPDATE
Complications of TBI include? Secondary injury, hypotension decreased cerebral percussion.
NSG for tbi? Maintain O2, monitor for S/S of ICP, Check drainage for glucose/halo sign,
hyperventilate pt to blow off CO2. Midline positioning, stay on backboard & do
not remove C-collar. ABC's!!! No hip flexing, log roll, elevate HOB.
S/S of increased ICP Early: Change in LOC, agitation, headache, and vomiting.
Late: Pupillary dilation, compression and loss of reflexes.
Medication that can lower ICP? Mannitol
High spinal chord injuries have a huge risk of causing? Respiratory compromise
What is Cushing's triad? Widened Pulse pressure
bradycardia
irregular respirations
What is decorticate posturing? Extremities are pointing towards the "core" meaning severe brain damage
What is decerebrate posturing? Extremities are pointing away from the core.
ICP NSG? Avoid coughing, straining, gagging.
Neuro & VS checks Q1-2H
Monitor for fever & give cooling blanket to treat
HOB lower than 25
Neck midline, no hip flexion
ANSWERS | LATEST UPDATE
Complications of TBI include? Secondary injury, hypotension decreased cerebral percussion.
NSG for tbi? Maintain O2, monitor for S/S of ICP, Check drainage for glucose/halo sign,
hyperventilate pt to blow off CO2. Midline positioning, stay on backboard & do
not remove C-collar. ABC's!!! No hip flexing, log roll, elevate HOB.
S/S of increased ICP Early: Change in LOC, agitation, headache, and vomiting.
Late: Pupillary dilation, compression and loss of reflexes.
Medication that can lower ICP? Mannitol
High spinal chord injuries have a huge risk of causing? Respiratory compromise
What is Cushing's triad? Widened Pulse pressure
bradycardia
irregular respirations
What is decorticate posturing? Extremities are pointing towards the "core" meaning severe brain damage
What is decerebrate posturing? Extremities are pointing away from the core.
ICP NSG? Avoid coughing, straining, gagging.
Neuro & VS checks Q1-2H
Monitor for fever & give cooling blanket to treat
HOB lower than 25
Neck midline, no hip flexion
