Page 1 of 154
TCAR Post-Test Exam () Actual Test;
Questions & Correct Answers, 100%
Guaranteed Pass ||Complete A+ Guide
1. A 45-year-old male with severe TBI has ICP 22 mm Hg and
CPP 55 mm Hg. What is the priority intervention?
• A) Increase IV fluids to raise CPP
• B) Administer mannitol 0.5–1 g/kg
• C) Elevate HOB to 90 degrees
• D) Hyperventilate to PaCO2 25 mm Hg
Correct Answer: B – Mannitol reduces ICP via osmotic
diuresis. CPP <60 with elevated ICP requires ICP
reduction. HOB 30°, not 90°. Hyperventilation is
temporary and can cause ischemia.
,Page 2 of 154
2. Scenario: Post-resuscitation GCS 7, pupils equal but
sluggish. CT shows diffuse cerebral edema. Next best step?
• A) Phenytoin loading
• B) Continuous EEG
• C) ICP monitor placement
• D) Therapeutic hypothermia (32–34°C)
Correct Answer: C – GCS ≤8 with abnormal CT
mandates ICP monitoring per Brain Trauma Foundation
guidelines.
3. Which finding suggests impending brain herniation?
• A) Unilateral dilated pupil
• B) Bilateral pinpoint pupils
• C) Decorticate posturing only
• D) GCS 14
Correct Answer: A – Unilateral fixed/dilated pupil
indicates uncal herniation (CN III compression).
,Page 3 of 154
4. Scenario: 28-year-old, fall from ladder, GCS 9, BP
150/90, HR 65. CT shows epidural hematoma with midline
shift. Next step?
• A) Hyperosmolar therapy
• B) Emergent craniotomy
• C) Induce coma with propofol
• D) Repeat CT in 6 hours
Correct Answer: B – Epidural hematoma with shift and
altered mental status requires surgical evacuation.
5. What is the target CPP range for severe TBI?
• A) 40–50 mm Hg
• B) 60–70 mm Hg
• C) 80–90 mm Hg
• D) >100 mm Hg
Correct Answer: B – CPP 60–70 mm Hg optimizes
cerebral blood flow without exacerbating edema.
, Page 4 of 154
6. Scenario: Intubated TBI patient, PaCO2 30 mm Hg, ICP 25,
CPP 65. What should you do?
• A) Increase respiratory rate
• B) Decrease respiratory rate
• C) Administer 3% saline
• D) Start vasopressors
Correct Answer: B – PaCO2 30 is too low
(vasoconstriction); normalize to 35–40 mm Hg to avoid
cerebral ischemia.
7. Which ICP waveform morphology indicates poor
compliance?
• A) P1 > P2
• B) P2 > P1
• C) P3 absent
TCAR Post-Test Exam () Actual Test;
Questions & Correct Answers, 100%
Guaranteed Pass ||Complete A+ Guide
1. A 45-year-old male with severe TBI has ICP 22 mm Hg and
CPP 55 mm Hg. What is the priority intervention?
• A) Increase IV fluids to raise CPP
• B) Administer mannitol 0.5–1 g/kg
• C) Elevate HOB to 90 degrees
• D) Hyperventilate to PaCO2 25 mm Hg
Correct Answer: B – Mannitol reduces ICP via osmotic
diuresis. CPP <60 with elevated ICP requires ICP
reduction. HOB 30°, not 90°. Hyperventilation is
temporary and can cause ischemia.
,Page 2 of 154
2. Scenario: Post-resuscitation GCS 7, pupils equal but
sluggish. CT shows diffuse cerebral edema. Next best step?
• A) Phenytoin loading
• B) Continuous EEG
• C) ICP monitor placement
• D) Therapeutic hypothermia (32–34°C)
Correct Answer: C – GCS ≤8 with abnormal CT
mandates ICP monitoring per Brain Trauma Foundation
guidelines.
3. Which finding suggests impending brain herniation?
• A) Unilateral dilated pupil
• B) Bilateral pinpoint pupils
• C) Decorticate posturing only
• D) GCS 14
Correct Answer: A – Unilateral fixed/dilated pupil
indicates uncal herniation (CN III compression).
,Page 3 of 154
4. Scenario: 28-year-old, fall from ladder, GCS 9, BP
150/90, HR 65. CT shows epidural hematoma with midline
shift. Next step?
• A) Hyperosmolar therapy
• B) Emergent craniotomy
• C) Induce coma with propofol
• D) Repeat CT in 6 hours
Correct Answer: B – Epidural hematoma with shift and
altered mental status requires surgical evacuation.
5. What is the target CPP range for severe TBI?
• A) 40–50 mm Hg
• B) 60–70 mm Hg
• C) 80–90 mm Hg
• D) >100 mm Hg
Correct Answer: B – CPP 60–70 mm Hg optimizes
cerebral blood flow without exacerbating edema.
, Page 4 of 154
6. Scenario: Intubated TBI patient, PaCO2 30 mm Hg, ICP 25,
CPP 65. What should you do?
• A) Increase respiratory rate
• B) Decrease respiratory rate
• C) Administer 3% saline
• D) Start vasopressors
Correct Answer: B – PaCO2 30 is too low
(vasoconstriction); normalize to 35–40 mm Hg to avoid
cerebral ischemia.
7. Which ICP waveform morphology indicates poor
compliance?
• A) P1 > P2
• B) P2 > P1
• C) P3 absent
