TBI NCLEX PRACTICE QUESTIONS 2023 QUESTIONS AND ANSWERS ALREADY PASSED A+

A client presents with a head injury after being in a motor vehicle accident and is diagnosed with a brain contusion with a coup-contrecoup injury. The client is stabilized and sent home, but the healthcare provider instructs the client to return in 3 days for a repeat MRI. Which explains the rationale for a repeat MRI? The MRI will be repeated to determine the cause of the client's injuries. It can take hours to days for contusions to form from a coup-contrecoup injury. It is protocol for all MRIs to be repeated in traumatic brain injuries (TBIs). The MRI can determine the grade of concussion that the client sustained. - CORRECT ANSWER It can take hours to days for contusions to form from a coup-contrecoup injury. Brain contusions are classified as coup or contrecoup. Individuals can also have a coup-contrecoup injury. It can take a few hours to a few days to determine the full extent of the injury from these contusions. Therefore, the MRI would be repeated in a few days to determine the full extent of the injury. The healthcare provider knows the cause of the injuries. It may be protocol, but that does not explain the reason MRIs are repeated. Concussions are no longer graded by the American Association of Neurology. The nurse is caring for an adolescent who presents with headache, memory loss, and blurred vision after sustaining an injury playing football. The healthcare provider diagnoses the client with a concussion and instructs the client to refrain from sports for a minimum of 4 weeks to prevent second impact syndrome (SIS). Which client statement indicates an understanding of the instructions provided? "I should stay away from any type of sports activity for a month." "I should avoid playing all sports until the headaches dissipate." "I should be out on the field with my teammates but not participate." "I should refrain from going to school until my symptoms go away." - CORRECT ANSWER "I should stay away from any type of sports activity for a month." When the adolescent states that they should stay away from any type of sports activity for a month, this indicates an understanding of instructions provided. The client should not rely on headaches alone to go away before resuming sports, because this does not indicate that full healing has occurred. A concussion would not keep the client from attending school. Being out on the field, even without participation, should be avoided, because the client could still be injured. Which information regarding postconcussion syndrome and signs to report should the nurse provide to the client who sustained a concussion? (Select all that apply.) Rash or hives Personality changes Sensitivity to light and noise Insomnia Nausea - CORRECT ANSWER Personality changes Sensitivity to light and noise Insomnia Nausea Signs of postconcussion syndrome include nausea, insomnia, headaches, personality changes, light and noise sensitivity, memory problems, dizziness, and fatigue. Although the client may want to report a rash or hives, this finding would not be related to postconcussion syndrome. A client is seen in the urgent care center with signs of a mild traumatic brain injury (TBI). Which clinical manifestation would indicate a need to see a neurologist? Unequal pupils Raccoon eyes Irritability Tinnitus - CORRECT ANSWER Unequal pupils Unequal pupils indicate that the traumatic brain injury (TBI) was more severe than was actually diagnosed. This neurologic deficit would require further follow-up from a neurologist to determine possible cranial nerve damage or damage to the ocular portion of the brain. Tinnitus, irritability, and raccoon eyes are all manifestations of a mild traumatic brain injury and should resolve with rest. The nurse is caring for a client who reports being hit over the head by their significant other. Which assessment finding should lead the nurse to suspect that the client has a skull fracture? (Select all that apply.) Loss of consciousness