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Neurological Assessment Flashcards

7 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurological Assessment flashcards as text

  1. Which neurological finding in a trauma patient warrants immediate neurosurgical consultation for possible epidural hematoma?

    Answer: Brief loss of consciousness followed by a lucid interval then rapid deterioration

    The classic lucid interval followed by rapid neurological deterioration is the hallmark presentation of an epidural hematoma from middle meningeal artery rupture.

  2. When performing the AVPU scale, a patient who opens eyes and groans when you call their name is classified as:

    Answer: V - Responds to Voice

    The AVPU scale classifies V as any response—eye opening, vocalization, or movement—elicited by verbal stimulation.

  3. A spinal cord injury patient has diaphragmatic breathing but absent intercostal muscle function. The injury level is most likely:

    Answer: C4

    The phrenic nerve (C3-C5) controls the diaphragm, so C4 injury preserves diaphragmatic breathing while T1 intercostal innervation is lost.

  4. Which assessment finding best differentiates neurogenic shock from hypovolemic shock in a spinal cord injury patient?

    Answer: Bradycardia with warm, dry skin in neurogenic shock

    Neurogenic shock causes paradoxical bradycardia with vasodilation (warm, dry skin) due to loss of sympathetic tone, unlike the tachycardia and vasoconstriction of hypovolemic shock.

  5. The recommended MAP target for maintaining spinal cord perfusion in an acute spinal cord injury during the first 7 days is:

    Answer: 85-90 mmHg

    Current guidelines recommend maintaining MAP at 85-90 mmHg for the first 7 days after acute SCI to optimize spinal cord perfusion pressure.

  6. A patient with a head injury has a PaCO2 of 55 mmHg. What is the most likely effect on cerebral blood flow?

    Answer: Increased CBF due to vasodilation

    Hypercapnia (elevated PaCO2) causes cerebral vasodilation, increasing cerebral blood flow and potentially worsening intracranial hypertension.

  7. Which intervention is the first priority when a trauma patient shows signs of transtentorial herniation?

    Answer: Ensure airway, optimize oxygenation, and elevate HOB 30°

    Airway management with oxygenation and head-of-bed elevation are the immediate priorities to reduce ICP before pharmacologic or surgical interventions.