NR 574 Final Exam: (Latest 2026/2027 Update) Traumatic Head Injuries - Skull
Fractures, TBI, ICP, GCS | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Advanced Acute Care – Traumatic Head Injuries, Skull Fractures (Linear, Basilar, Depressed,
Penetrating), Glasgow Coma Scale, Intracranial Pressure, Cerebral Perfusion Pressure, Brain Death
Source: NR 574 Final Exam Content Week 5 / Chamberlain University / Clinical Practice Guidelines
(2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What are the four types of skull fractures?
Correct Answer: Linear, basilar, depressed, and penetrating.
1. Linear: single fracture traversing the skull.
2. Basilar: involves at least one bone of the skull base.
3. Depressed: comminuted fracture with bones displaced inward (blunt force trauma).
4. Penetrating: "open" fracture with breach of dura; foreign bodies may extend into brain.
2. What are subjective findings of a skull fracture?
Correct Answer: Pain and/or bleeding/hematoma at injury site, drowsiness, blurred vision, diplopia,
dizziness, nausea, vomiting, headache.
1. Symptoms depend on fracture type and severity.
2. Basilar fractures may present with CSF leak symptoms.
3. What are physical exam findings of a skull fracture?
Correct Answer: Altered LOC, large scalp laceration, penetrating object projecting from skull,
neurologic deficits (aphasia, motor weakness, paralysis), palpable skull bone step-off.
1. Scalp wounds should NEVER be probed due to risk of penetrating the brain.
2. Always include GCS score in assessment.
4. What are specific clinical findings of a basilar skull fracture?
Correct Answer: Hemotympanum (blood behind tympanic membrane), Battle's sign (mastoid
ecchymosis), Raccoon eyes (periorbital ecchymosis), Otorrhea or rhinorrhea (CSF leak from nose or
ear).
1. Battle's sign indicates posterior fossa fracture.
2. Raccoon eyes indicates anterior fossa fracture.
3. CSF leak increases risk of meningitis.
, 5. What are the Glasgow Coma Scale (GCS) components and scoring?
Correct Answer: Eye Opening (1-4), Verbal Response (1-5), Motor Response (1-6). Total score 3-15.
1. Eye: 4 spontaneous, 3 to voice, 2 to pain, 1 none.
2. Verbal: 5 oriented, 4 confused, 3 inappropriate, 2 incomprehensible, 1 none.
3. Motor: 6 obeys, 5 localizes, 4 withdraws, 3 flexion, 2 extension, 1 none.
6. Aasan opens eyes to voice, has incomprehensible speech, and localizes to pain. Calculate his GCS.
Correct Answer: GCS 10 (Eye: 3 to voice, Verbal: 2 incomprehensible, Motor: 5 localizes to pain).
1. Eye opening to verbal command = 3.
2. Incomprehensible sounds = 2.
3. Localizes to painful stimuli = 5.
4. Total = 3+2+5 = 10.
7. Which finding increases suspicion for a basilar skull fracture?
a. Periorbital ecchymosis
b. Large, gaping forehead laceration
c. Palpable bony step-off on top of skull
d. Motor and sensory loss distal to shoulders
Correct Answer: a. Periorbital ecchymosis (raccoon eyes)
1. Raccoon eyes, Battle's sign, hemotympanum, and rhinorrhea/otorrhea are signs of basilar skull
fracture.
2. Motor/sensory loss suggests cervical spine injury.
3. Step-off at top of head is not basilar.
8. What is normal intracranial pressure (ICP)?
Correct Answer: Less than or equal to 15 mmHg.
1. Pressures >15 mmHg indicate intracranial hypertension.
2. Persistent elevation can lead to cerebral herniation.
9. What is cerebral perfusion pressure (CPP) and how is it calculated?
Correct Answer: Pressure needed to ensure blood flow to the brain. Normal CPP is 60-100 mm Hg.
CPP = MAP - ICP.
1. CPP <50 is associated with ischemia and neuronal death.
2. Maintaining CPP is critical to prevent secondary brain injury.
Fractures, TBI, ICP, GCS | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Advanced Acute Care – Traumatic Head Injuries, Skull Fractures (Linear, Basilar, Depressed,
Penetrating), Glasgow Coma Scale, Intracranial Pressure, Cerebral Perfusion Pressure, Brain Death
Source: NR 574 Final Exam Content Week 5 / Chamberlain University / Clinical Practice Guidelines
(2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What are the four types of skull fractures?
Correct Answer: Linear, basilar, depressed, and penetrating.
1. Linear: single fracture traversing the skull.
2. Basilar: involves at least one bone of the skull base.
3. Depressed: comminuted fracture with bones displaced inward (blunt force trauma).
4. Penetrating: "open" fracture with breach of dura; foreign bodies may extend into brain.
2. What are subjective findings of a skull fracture?
Correct Answer: Pain and/or bleeding/hematoma at injury site, drowsiness, blurred vision, diplopia,
dizziness, nausea, vomiting, headache.
1. Symptoms depend on fracture type and severity.
2. Basilar fractures may present with CSF leak symptoms.
3. What are physical exam findings of a skull fracture?
Correct Answer: Altered LOC, large scalp laceration, penetrating object projecting from skull,
neurologic deficits (aphasia, motor weakness, paralysis), palpable skull bone step-off.
1. Scalp wounds should NEVER be probed due to risk of penetrating the brain.
2. Always include GCS score in assessment.
4. What are specific clinical findings of a basilar skull fracture?
Correct Answer: Hemotympanum (blood behind tympanic membrane), Battle's sign (mastoid
ecchymosis), Raccoon eyes (periorbital ecchymosis), Otorrhea or rhinorrhea (CSF leak from nose or
ear).
1. Battle's sign indicates posterior fossa fracture.
2. Raccoon eyes indicates anterior fossa fracture.
3. CSF leak increases risk of meningitis.
, 5. What are the Glasgow Coma Scale (GCS) components and scoring?
Correct Answer: Eye Opening (1-4), Verbal Response (1-5), Motor Response (1-6). Total score 3-15.
1. Eye: 4 spontaneous, 3 to voice, 2 to pain, 1 none.
2. Verbal: 5 oriented, 4 confused, 3 inappropriate, 2 incomprehensible, 1 none.
3. Motor: 6 obeys, 5 localizes, 4 withdraws, 3 flexion, 2 extension, 1 none.
6. Aasan opens eyes to voice, has incomprehensible speech, and localizes to pain. Calculate his GCS.
Correct Answer: GCS 10 (Eye: 3 to voice, Verbal: 2 incomprehensible, Motor: 5 localizes to pain).
1. Eye opening to verbal command = 3.
2. Incomprehensible sounds = 2.
3. Localizes to painful stimuli = 5.
4. Total = 3+2+5 = 10.
7. Which finding increases suspicion for a basilar skull fracture?
a. Periorbital ecchymosis
b. Large, gaping forehead laceration
c. Palpable bony step-off on top of skull
d. Motor and sensory loss distal to shoulders
Correct Answer: a. Periorbital ecchymosis (raccoon eyes)
1. Raccoon eyes, Battle's sign, hemotympanum, and rhinorrhea/otorrhea are signs of basilar skull
fracture.
2. Motor/sensory loss suggests cervical spine injury.
3. Step-off at top of head is not basilar.
8. What is normal intracranial pressure (ICP)?
Correct Answer: Less than or equal to 15 mmHg.
1. Pressures >15 mmHg indicate intracranial hypertension.
2. Persistent elevation can lead to cerebral herniation.
9. What is cerebral perfusion pressure (CPP) and how is it calculated?
Correct Answer: Pressure needed to ensure blood flow to the brain. Normal CPP is 60-100 mm Hg.
CPP = MAP - ICP.
1. CPP <50 is associated with ischemia and neuronal death.
2. Maintaining CPP is critical to prevent secondary brain injury.
