Chapter 16: Disorders of the Central and Peripheral Nervous
Systems and the Neuromuscular Junction
MULTIPLE CHOICE
1. A nurse is preparing to teach staff about the most common type of traumatic brain injury.
Which type of traumatic brain injury should the nurse discuss?
a. Penetrating trauma
b. Diffuse axonal injury
c. Focal brain injury
d. Concussion
ANS: D
A concussion is the most common type of traumatic brain injury. A concussion is a much
more common brain injury than penetrating trauma, diffuse axonal injury, or focal injury.
REF: p. 394
2. A coup injury resulting from a blow to the frontal portion of the skull would occur in
which region of the brain?
a. Frontal
b. Temporal
c. Parietal
d. Occipital
ANS:
A
When there is force applied to the skull, an injury may occur to the corresponding location on
the brain. The injury may be coup (injury at site of impact) or contrecoup (injury from brain
rebounding and hitting opposite side of skull).
REF: pp. 390-391
3. What is the main source of bleeding in extradural (epidural) hematomas?
a. Arterial
b. Venous
c. Capillary
d. Sinus
ANS: A
An artery is the source of bleeding in 85% of extradural hematomas. The bleeding
associated with an extradural hematoma is not a result of damage to a vein, a capillary, or a
sinus.
REF: p. 391
4. A 69-year-old patient with a history of alcohol abuse presents to the emergency room
(ER) after a month-long episode of headaches and confusion. The patient’s history and
symptomology support which medical diagnosis?
a. Concussion
b. Chronic subdural hematoma
, c. Epidural hematoma
d. Subacute subdural hematoma
ANS: B
Chronic subdural hematomas are commonly found in persons who abuse alcohol and develop
over weeks to months. A concussion is more acute in nature. Epidural hematomas are not
associated with the patient’s history or symptoms. Subacute subdural hematomas present
with confusion but are more acute in nature.
REF: p. 393
5. Immediately after being struck by a motor vehicle, a patient is unconscious, but the patient
regains consciousness before arriving at the hospital and appears alert and oriented. The next
morning the patient is confused and demonstrates impaired responsiveness. The patient’s
history and symptoms support which medical diagnosis?
a. Mild concussion
b. Subdural hematoma
c. Extradural (epidural) hematoma
d. Mild diffuse axonal injury
ANS: C
Individuals with extradural hematomas lose consciousness at injury; one third then become
lucid for a few minutes to a few days. Mild concussion is characterized by immediate but
transitory confusion that lasts for one to several minutes, possibly with amnesia for events
preceding the trauma. Subdural hematomas begin with headache, drowsiness, restlessness or
agitation, slowed cognition, and confusion. These symptoms worsen over time and progress to
loss of consciousness, respiratory pattern changes, and pupillary dilation. Individuals with
mild diffuse axonal injury disNpUlaRy SdeIceNrGebTraBte.oCr OdeMcorticate posturing
and may experience
prolonged periods of stupor or restlessness.
REF: p. 392
6. Which assessment finding by the nurse characterizes a mild concussion?
a. A brief loss of consciousness
b. Significant behavioral changes
c. Retrograde amnesia
d. Permanent confusion
ANS: C
Mild concussion is characterized by immediate but transitory confusion that lasts for one
to several minutes, possibly with amnesia for events preceding the trauma. Individuals
with extradural hematomas lose consciousness at injury; one third then become lucid for a
few minutes to a few days. Persons with diffuse brain injury demonstrate behavioral
changes. Individuals with a mild concussion experience transient, not permanent,
confusion.
REF: p. 394
7. A CT scan reveals that a patient has an open basilar skull fracture. Which major complication
should the nurse observe for in this patient?
a. Hematoma formation
b. Meningeal infection
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