TNCC 9TH EDITION COMPREHENSIVE TEST
PAPER 2026 QUESTIONS WITH ANSWERS
GRADED A+
⩥ What is a cerebral contusion and its S/S? Answer: A common focal
brain injury in which brain tissue is bruised and damaged in a local area.
Mainly located in frontal and temporal lobes. May cause hemorrhage,
infarction, necrosis and edema. Max effects of bleeding & edema peak
18-36 post injury.
S/S:
- Alteration in LOC
- Behavior, motor or speech deficits
- Abnormal motor posturing
- Signs of increased ICP
⩥ What is an epidural hematoma and its S/S?. Answer: Results when a
collection of blood forms between the skull and the dura mater. Bleeding
is arterial=blood accumulates rapidly:
- Compression of underlying brain
- rapid increase in ICP
- Decreased CBF
- Secondary brain injury
* Usually requires surgical intervention
,S/S:
- Transient LOC
- Lucid period lasting a few minutes to several hours
- Rapid deterioration in neurologic status
- Severe H/A
- Sleepiness
- Dizziness
- N/V
- Hemiparesis or hemiplegia on opposite side of hematoma
- Unilateral fixed and dilated pupil on same side of hematoma
⩥ What is a subdural hematoma and its S/S?. Answer: A focal brain
injury beneath the dura mater that results from acceleration/deceleration.
Usually venous, and not necessarily from a fx. Formation may be acute
or chronic.
Acute pt's hematoma manifest 48 hrs post injury
S/S:
- Altered LOC or steady decline in LOC
- S/S of increased ICP
- Hemiparesis or hemiplegia on opposite side of hematoma
- Unilateral fixed and dilated pupil on same side of hematoma
,Chronic pt's " " up to 2 wks post injury
- H/A
- Progressive decrease in LOC
- Ataxia
- Incontinence
- Sz's
⩥ What are intracerebral hematoma's and its S/S?. Answer: Occur deep
within brain tissue, may be single or multiple and commonly associated
with contusions (frontal & temporal lobes). They result in significant
mass effect, leading to increased ICP and neurologic deterioration.
S/S:
- Progressive and often rapid decline in LOC
- H/A
- Signs of increasing ICP
- Pupil abnormalities
- Contralateral hemiplegia
⩥ What are the S/S of a linear skull fx?. Answer: - H/A
- Possible decreased LOC
⩥ What are the S/S of a depressed skull fx?. Answer: - H/A
- Possible decreased LOC
, - Possible open fx
- Palpable depression of skull over the fx site
⩥ What are the S/S of a basilar skull fx?. Answer: - H/A
- Altered LOC
- Periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle's
sign), or blood behind tympanic membrane (hemotympanum)
- Facial nerve (VII) palsy
- CSF rhinorrhea or otorrhea
⩥ How would you assess a pt with a cranial injury?. Answer: (Initial
assessment)
INSPECTION:
- Assess airway
- RR, pattern and effort
- Assess pupil size and response to light
- Unilateral fixed and dilated pupil = oculomotor nerve compression
from increased ICP + herniation syndrome
- Bilateral fixed and pinpoint pupils indicate a pontine lesion or effects
of opiates
- Mildly dilated pupil w/sluggish response may be early sign of
herniation syndrome
- Widely dilated pupil occasionally occurs w/direct trauma to globe of
eye
PAPER 2026 QUESTIONS WITH ANSWERS
GRADED A+
⩥ What is a cerebral contusion and its S/S? Answer: A common focal
brain injury in which brain tissue is bruised and damaged in a local area.
Mainly located in frontal and temporal lobes. May cause hemorrhage,
infarction, necrosis and edema. Max effects of bleeding & edema peak
18-36 post injury.
S/S:
- Alteration in LOC
- Behavior, motor or speech deficits
- Abnormal motor posturing
- Signs of increased ICP
⩥ What is an epidural hematoma and its S/S?. Answer: Results when a
collection of blood forms between the skull and the dura mater. Bleeding
is arterial=blood accumulates rapidly:
- Compression of underlying brain
- rapid increase in ICP
- Decreased CBF
- Secondary brain injury
* Usually requires surgical intervention
,S/S:
- Transient LOC
- Lucid period lasting a few minutes to several hours
- Rapid deterioration in neurologic status
- Severe H/A
- Sleepiness
- Dizziness
- N/V
- Hemiparesis or hemiplegia on opposite side of hematoma
- Unilateral fixed and dilated pupil on same side of hematoma
⩥ What is a subdural hematoma and its S/S?. Answer: A focal brain
injury beneath the dura mater that results from acceleration/deceleration.
Usually venous, and not necessarily from a fx. Formation may be acute
or chronic.
Acute pt's hematoma manifest 48 hrs post injury
S/S:
- Altered LOC or steady decline in LOC
- S/S of increased ICP
- Hemiparesis or hemiplegia on opposite side of hematoma
- Unilateral fixed and dilated pupil on same side of hematoma
,Chronic pt's " " up to 2 wks post injury
- H/A
- Progressive decrease in LOC
- Ataxia
- Incontinence
- Sz's
⩥ What are intracerebral hematoma's and its S/S?. Answer: Occur deep
within brain tissue, may be single or multiple and commonly associated
with contusions (frontal & temporal lobes). They result in significant
mass effect, leading to increased ICP and neurologic deterioration.
S/S:
- Progressive and often rapid decline in LOC
- H/A
- Signs of increasing ICP
- Pupil abnormalities
- Contralateral hemiplegia
⩥ What are the S/S of a linear skull fx?. Answer: - H/A
- Possible decreased LOC
⩥ What are the S/S of a depressed skull fx?. Answer: - H/A
- Possible decreased LOC
, - Possible open fx
- Palpable depression of skull over the fx site
⩥ What are the S/S of a basilar skull fx?. Answer: - H/A
- Altered LOC
- Periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle's
sign), or blood behind tympanic membrane (hemotympanum)
- Facial nerve (VII) palsy
- CSF rhinorrhea or otorrhea
⩥ How would you assess a pt with a cranial injury?. Answer: (Initial
assessment)
INSPECTION:
- Assess airway
- RR, pattern and effort
- Assess pupil size and response to light
- Unilateral fixed and dilated pupil = oculomotor nerve compression
from increased ICP + herniation syndrome
- Bilateral fixed and pinpoint pupils indicate a pontine lesion or effects
of opiates
- Mildly dilated pupil w/sluggish response may be early sign of
herniation syndrome
- Widely dilated pupil occasionally occurs w/direct trauma to globe of
eye
