NSG 233 MED SURG 2 EXAM 4 PRACTICE TEST
2026 QUESTIONS WITH CORRECT
SOLUTIONS GRADED A+
◉ HEAD INJURY (TBI)
nutrition for head injury that's leaking CSF. Answer: -going to give
TPN
-NO NG bc you don't want it to go somewhere it's not supposed to
◉ HEAD INJURY (TBI)
includes (4). Answer: -scalp laceration
-skull fractures
-head trauma
-coup-countercoup injury
◉ HEAD INJURY (TBI)
scalp lacerations (3). Answer: linear vs decompressed
-linear: looks like a crack
-decompressed: skull punched into brain
simple vs comminuted vs compound
,-compound: more of a severe decompressed fracture with part of
bone in brain and several linear fractures
closed vs open
-closed: not better than open, bc still have swelling
-open: depends how open it is; if we have most of skull being
pressed into brain we're unlikely to recover
◉ HEAD INJURY (TBI)
head trauma (2). Answer: diffuse injury (concussion or diffuse
axonal injury)
-concussion: hit that's mild or moderate; neurons get stunned; s/sx
go away generally over time
-diffuse axonal injury: moderate to severe; axons are damage and
often don't regenerate
focal injury (lacerations, contusions, hematomas, CN injuries)
-specific areas of the brain
-internal hematoma/internal bleed is also focal
◉ HEAD INJURY (TBI)
coup-countercoup. Answer: -most common type of injury in MVA
,-brain goes forward and hits front of skull, then sudden stop and
brain goes back and hits back of skull
-damage on both sides of the brain
-swelling is intense
◉ HEAD INJURY (TBI)
complications (3). Answer: -epidural hematoma
-subdural hematoma
-intracerebral hematoma
◉ HEAD INJURY (TBI) - complications
epidural hematoma (6). Answer: -medical emergency
-happens on top of duramater
-happens quickly
-bleeding happens on top of dura and pushes on brain itself
-usually more arterial = high mortality
-tx: drill a hole to relieve pressure or cranial window to give brain
more room
◉ HEAD INJURY (TBI) - complications
subdural hematoma (5). Answer: -right under dura
-tends to be venous, so doesn't bleed as fast
, -depends on the luck of where it happens
-can heal in a couple days to weeks later
-may or may not get cranial procedure, depending on how big the
hematoma is and how much damage is being done
◉ HEAD INJURY (TBI) - complications
intracerebral hematoma. Answer: - doesn't usually occur right after
a trauma, usually occurs further down the line
-bc so far into brain tissue, there's not a lot to do besides decrease
ICP
-neurology of their brain isn't going to be salvagable once they get to
the hospital
◉ HEAD INJURY (TBI)
manifestations (. Answer: very dependent on where the damage is
-rhinorrhea/otorrhea
-"battle sign": bruising behind ear
-periorbital bruising: "raccoon eyes"
-hearing/vision changes
-decreased LOC
-seizures: extremely common post head injury
-GSC <12: tells us that some brain trauma has occurred; <5 - have to
intubate
2026 QUESTIONS WITH CORRECT
SOLUTIONS GRADED A+
◉ HEAD INJURY (TBI)
nutrition for head injury that's leaking CSF. Answer: -going to give
TPN
-NO NG bc you don't want it to go somewhere it's not supposed to
◉ HEAD INJURY (TBI)
includes (4). Answer: -scalp laceration
-skull fractures
-head trauma
-coup-countercoup injury
◉ HEAD INJURY (TBI)
scalp lacerations (3). Answer: linear vs decompressed
-linear: looks like a crack
-decompressed: skull punched into brain
simple vs comminuted vs compound
,-compound: more of a severe decompressed fracture with part of
bone in brain and several linear fractures
closed vs open
-closed: not better than open, bc still have swelling
-open: depends how open it is; if we have most of skull being
pressed into brain we're unlikely to recover
◉ HEAD INJURY (TBI)
head trauma (2). Answer: diffuse injury (concussion or diffuse
axonal injury)
-concussion: hit that's mild or moderate; neurons get stunned; s/sx
go away generally over time
-diffuse axonal injury: moderate to severe; axons are damage and
often don't regenerate
focal injury (lacerations, contusions, hematomas, CN injuries)
-specific areas of the brain
-internal hematoma/internal bleed is also focal
◉ HEAD INJURY (TBI)
coup-countercoup. Answer: -most common type of injury in MVA
,-brain goes forward and hits front of skull, then sudden stop and
brain goes back and hits back of skull
-damage on both sides of the brain
-swelling is intense
◉ HEAD INJURY (TBI)
complications (3). Answer: -epidural hematoma
-subdural hematoma
-intracerebral hematoma
◉ HEAD INJURY (TBI) - complications
epidural hematoma (6). Answer: -medical emergency
-happens on top of duramater
-happens quickly
-bleeding happens on top of dura and pushes on brain itself
-usually more arterial = high mortality
-tx: drill a hole to relieve pressure or cranial window to give brain
more room
◉ HEAD INJURY (TBI) - complications
subdural hematoma (5). Answer: -right under dura
-tends to be venous, so doesn't bleed as fast
, -depends on the luck of where it happens
-can heal in a couple days to weeks later
-may or may not get cranial procedure, depending on how big the
hematoma is and how much damage is being done
◉ HEAD INJURY (TBI) - complications
intracerebral hematoma. Answer: - doesn't usually occur right after
a trauma, usually occurs further down the line
-bc so far into brain tissue, there's not a lot to do besides decrease
ICP
-neurology of their brain isn't going to be salvagable once they get to
the hospital
◉ HEAD INJURY (TBI)
manifestations (. Answer: very dependent on where the damage is
-rhinorrhea/otorrhea
-"battle sign": bruising behind ear
-periorbital bruising: "raccoon eyes"
-hearing/vision changes
-decreased LOC
-seizures: extremely common post head injury
-GSC <12: tells us that some brain trauma has occurred; <5 - have to
intubate
