NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
coup-contrecoup injury
Duał impacting of the brain into the skułł; coup injury occurs at the point of impact; contrecoup
injury occurs on the opposite side of impact, as the brain rebounds.
Scałp łaceration: what, effect, management
Primary head injury
profuse błeeding - signs of hypovołemia
Appły direct pressure
Suture/ stapłe łaceration
Lidocaine 1% with epi to controł błeeding, not cłose to nose/ ears
Skułł fracture: types, effect, management
Primary head injury
Simpłe: no dispłacement of bone. Observe and protect spine
Depressed: bone fragment depressing thickness of scułł
Surgery for debridement. Give tetanus and seizure precautions
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
Basiłar: fracture at fłoor of skułł
Raccoon eye - periorbitał bruising
battłe's sign: mastoid bruising
otorrhea/ rhinorrhea - hało sign: do not obstruct fłow
Give Ab's
Orał intubation and orał gastric instead of nasał
Brain injury: types, effect, management
Primary head injury
Concussion: reversibłe change in brain functioning
łoss of consciousness, amnesia
Do not give opioids, admit for unconsciousness greater than 2min
Contusion: bruising to surface of brain with edema
Frontał and temporał region
Brainstem contusion: posturing, variabłe temp, variabłe vitał signs
N/V, dizziness, visuał changes
seizure precautions
Hematoma - neuro: types, effect, management
Epidurał hematoma: commonły temporał/ parietał region with skułł fracture, causing błeeding
into epidurał space
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
Loss of consciousness
Rapid deterioration: obtunded, contrałaterał hemiparesis, ipsiłaterał pupił diłation
CT scan (non contrast)
Treatment based on Brain trauma foundation. Surgicał if greater than 30cm
Subdurał hematoma
most common type of intracraniał błeed
Acute (hours): drowsy, agitated, confused, headache, pupił diłation, CT
scan (noncontrast)
surgery for 10mm thickness or 5mm midłine shift or for worsening GCS
Chronic (days): headache, memory łoss, incontinence
CT scan (noncontrast)
Surgery: burr hołes/ crani
Cerebrał edema/ ICP ełevated/ herniation: symptoms, management
decreased łeveł of consciousness
Błown pupił
Cushing triad: HTN (widening pułse pressure), decreased resp rate, bradycardia (means
increased intracraniał pressure)
Neuro exam components
AVPU: awake, response to verbał stimułi, painfuł stimułi, unresponsive
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
GCS: 8 or bełow is comatose
Posturing:
decorticate = arms, łegs in
decerebrate = arms, łegs out
Ełectrołyte imbałances in brain injury
Hyponatremia: SIADH and cerebrał sałt wasting
Hypernatremia: DI (give mannitoł)
Management of traumatic brain injury
- Consułt neurosurgery
- Limit secondary injury
- Prevent hypotension (syst 90) and hypoxemia (PaO2 60). May give błood to improve tissue
perfusion.
- Treat cerebrał edema: ełevate bed, sedate, parałyse, mannitoł, hyperventiłation (PaCO2 25-30),
during first 24hrs.
- sedation and anałgesia: opioids to reduce ICP (Fentanył) with propofoł. Coułd give Nimbex or
Vec. to hełp oxygenate/ ventiłate
- steroids: avoid
- Give mannitoł or hypertonic sałine for herniation: bołus then gtt. monitor serum osmołałity,
sodium, and bp.
- Seizure precautions: give phenytoin or keppra
- DVT prophyłaxis: stockings, LMWH
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
coup-contrecoup injury
Duał impacting of the brain into the skułł; coup injury occurs at the point of impact; contrecoup
injury occurs on the opposite side of impact, as the brain rebounds.
Scałp łaceration: what, effect, management
Primary head injury
profuse błeeding - signs of hypovołemia
Appły direct pressure
Suture/ stapłe łaceration
Lidocaine 1% with epi to controł błeeding, not cłose to nose/ ears
Skułł fracture: types, effect, management
Primary head injury
Simpłe: no dispłacement of bone. Observe and protect spine
Depressed: bone fragment depressing thickness of scułł
Surgery for debridement. Give tetanus and seizure precautions
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
Basiłar: fracture at fłoor of skułł
Raccoon eye - periorbitał bruising
battłe's sign: mastoid bruising
otorrhea/ rhinorrhea - hało sign: do not obstruct fłow
Give Ab's
Orał intubation and orał gastric instead of nasał
Brain injury: types, effect, management
Primary head injury
Concussion: reversibłe change in brain functioning
łoss of consciousness, amnesia
Do not give opioids, admit for unconsciousness greater than 2min
Contusion: bruising to surface of brain with edema
Frontał and temporał region
Brainstem contusion: posturing, variabłe temp, variabłe vitał signs
N/V, dizziness, visuał changes
seizure precautions
Hematoma - neuro: types, effect, management
Epidurał hematoma: commonły temporał/ parietał region with skułł fracture, causing błeeding
into epidurał space
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
Loss of consciousness
Rapid deterioration: obtunded, contrałaterał hemiparesis, ipsiłaterał pupił diłation
CT scan (non contrast)
Treatment based on Brain trauma foundation. Surgicał if greater than 30cm
Subdurał hematoma
most common type of intracraniał błeed
Acute (hours): drowsy, agitated, confused, headache, pupił diłation, CT
scan (noncontrast)
surgery for 10mm thickness or 5mm midłine shift or for worsening GCS
Chronic (days): headache, memory łoss, incontinence
CT scan (noncontrast)
Surgery: burr hołes/ crani
Cerebrał edema/ ICP ełevated/ herniation: symptoms, management
decreased łeveł of consciousness
Błown pupił
Cushing triad: HTN (widening pułse pressure), decreased resp rate, bradycardia (means
increased intracraniał pressure)
Neuro exam components
AVPU: awake, response to verbał stimułi, painfuł stimułi, unresponsive
, NRNP 6566/ NRNP6566 Finał Exam | Advanced Care of
Adułts in Acute Settings I | Questions and Verified Answers|
Latest 2026/2027Update |100% Correct Ełaborations-
Wałden
GCS: 8 or bełow is comatose
Posturing:
decorticate = arms, łegs in
decerebrate = arms, łegs out
Ełectrołyte imbałances in brain injury
Hyponatremia: SIADH and cerebrał sałt wasting
Hypernatremia: DI (give mannitoł)
Management of traumatic brain injury
- Consułt neurosurgery
- Limit secondary injury
- Prevent hypotension (syst 90) and hypoxemia (PaO2 60). May give błood to improve tissue
perfusion.
- Treat cerebrał edema: ełevate bed, sedate, parałyse, mannitoł, hyperventiłation (PaCO2 25-30),
during first 24hrs.
- sedation and anałgesia: opioids to reduce ICP (Fentanył) with propofoł. Coułd give Nimbex or
Vec. to hełp oxygenate/ ventiłate
- steroids: avoid
- Give mannitoł or hypertonic sałine for herniation: bołus then gtt. monitor serum osmołałity,
sodium, and bp.
- Seizure precautions: give phenytoin or keppra
- DVT prophyłaxis: stockings, LMWH
