Review Traumatic Brain Injury: Concussions,

Pathophysiology of the Nervous System > Pathophysiology

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Traumatic Brain Injury: Concussions,

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Total Questions : 8

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Question 1:

A nurse is assessing a client who has a history of multiple concussions. Which of the following findings should alert the nurse to the possibility of chronic traumatic encephalopathy (CTE)?

A. Frequent headaches B. Memory loss C. Personality changes D. All of the above

Answer and Explanation

Choice A:

This is a correct answer. Frequent headaches are a common symptom of CTE, which is a progressive degenerative brain disease caused by repeated head trauma. Headaches may be triggered by physical or mental exertion, stress, or noise.

Choice B:

This is a correct answer. Memory loss is another common symptom of CTE, which affects the areas of the brain responsible for learning and recall. Memory loss may manifest as difficulty remembering names, dates, events, or conversations.

Choice C:

This is a correct answer. Personality changes are also a common symptom of CTE, which affects the areas of the brain responsible for mood and behavior. Personality changes may include irritability, aggression, depression, anxiety, impulsivity, or apathy.

Choice D:

This is a correct answer. All of the above are possible symptoms of CTE, which can vary in severity and onset depending on the individual and the extent of brain damage. Other possible symptoms include confusion, cognitive impairment, speech problems, vision problems, balance problems, motor problems, or suicidal thoughts.

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Question 2:

A nurse is caring for a client who sustained a concussion after falling from a ladder. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A. Monitor the client's Glasgow Coma Scale (GCS) score B. Administer acetaminophen for pain relief C. Encourage the client to rest in a dark and quiet room D. Provide stimulating activities such as puzzles and games E. Educate the client about the signs of post-concussion syndrome

Answer and Explanation

Choice A:

This is a correct answer. Monitoring the client's GCS score helps to assess the level of consciousness and neurological function after a concussion. The GCS score ranges from 3 to 15, with lower scores indicating more severe brain injury.

Choice B:

This is a correct answer. Administering acetaminophen for pain relief helps to reduce headache and discomfort after a concussion. Acetaminophen is preferred over nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, which can increase the risk of bleeding.

Choice C:

This is a correct answer. Encouraging the client to rest in a dark and quiet room helps to promote healing and recovery after a concussion. Rest includes physical and mental rest, which means avoiding strenuous activities, sports, driving, work, school, or screen time until symptoms resolve.

Choice D:

This is an incorrect answer. Providing stimulating activities such as puzzles and games can worsen symptoms and delay recovery after a concussion. The client should avoid cognitive tasks that require concentration, attention, or memory until cleared by a health care provider.

Choice E:

This is a correct answer. Educating the client about the signs of post-concussion syndrome helps to prepare them for possible complications and when to seek medical attention. Post-concussion syndrome is a condition in which symptoms persist for weeks or months after a concussion. Symptoms may include headache, dizziness, fatigue, insomnia, anxiety, depression, or cognitive impairment.

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Question 3:

A nurse is reviewing discharge instructions with a client who had a concussion two days ago. The client says to the nurse, "I feel fine now. Can I go back to playing soccer tomorrow?" How should the nurse respond?

A. "Yes, you can resume your normal activities as long as you wear a helmet." B. "No, you should avoid any physical activity until your symptoms are completely gone." C. "Maybe, you should consult your doctor first and follow their recommendations." D. "I don't know, you should ask your coach or trainer what they think."

Answer and Explanation

Choice A:

This is an incorrect answer. The nurse should not advise the client to resume their normal activities as long as they wear a helmet. A helmet does not prevent concussions from occurring and may give a false sense of security. The client should not return to sports or other physical activities until they are asymptomatic and cleared by their doctor.

Choice B:

This is an incorrect answer. The nurse should not advise the client to avoid any physical activity until their symptoms are completely gone. While the client should avoid strenuous or risky activities that could cause another concussion, they may be able to engage in some light or moderate activities that do not worsen their symptoms or increase their heart rate. The client should follow a gradual return-to-play protocol under the guidance of their doctor.

Choice C:

This is a correct answer. The nurse should advise the client to consult their doctor first and follow their recommendations. The doctor will evaluate the client's recovery and determine when it is safe for them to return to sports or other physical activities. The doctor will also provide a gradual return-to-play protocol that involves increasing the intensity and duration of activity over several days or weeks.

Choice D:

This is an incorrect answer. The nurse should not advise the client to ask their coach or trainer what they think. The coach or trainer may not be qualified or knowledgeable enough to assess the client's condition and readiness to return to sports or other physical activities. The client should rely on their doctor's advice and not on their coach's or trainer's opinion.

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Question 4:

A nurse is evaluating the effectiveness of the education provided to a client who had a concussion. Which of the following statements by the client indicates a need for further teaching?

A. "I will take acetaminophen if I have a headache." B. "I will avoid drinking alcohol or taking sleeping pills." C. "I will check my pupils every hour for any changes." D. "I will have someone stay with me for the next 24 hours."

Answer and Explanation

Choice A:

This is an incorrect answer. The client does not need further teaching if they say they will take acetaminophen if they have a headache. Acetaminophen is a safe and effective medication for pain relief after a concussion. It does not increase the risk of bleeding or interfere with brain function.

Choice B:

This is an incorrect answer. The client does not need further teaching if they say they will avoid drinking alcohol or taking sleeping pills. Alcohol and sleeping pills can worsen the symptoms and recovery of a concussion. They can also mask the signs of worsening brain injury or increase the risk of falls or accidents.

Choice C:

This is a correct answer. The client needs further teaching if they say they will check their pupils every hour for any changes. Checking the pupils is not a reliable or accurate way to monitor the condition of a concussion. Pupil changes may not occur until late stages of brain injury or may be caused by other factors such as light exposure or medication use.

Choice D:

This is an incorrect answer. The client does not need further teaching if they say they will have someone stay with them for the next 24 hours. Having someone stay with them is a recommended precaution after a concussion. The person can observe the client for any signs of worsening brain injury such as confusion, vomiting, seizures, or loss of consciousness and call for help if needed.

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Question 5:

A nurse is preparing to discharge a client who had a concussion from the emergency department. Which of the following instructions should the nurse include in the discharge teaching?

A. Return to work or school as soon as possible B. Avoid driving or operating machinery until cleared by the provider C. Resume sports or physical activities within a week D. Take ibuprofen or aspirin for pain relief

Answer and Explanation

Choice A:

This is an incorrect answer. The nurse should not instruct the client to return to work or school as soon as possible after a concussion. The client should rest and avoid cognitive tasks that require concentration, attention, or memory until their symptoms resolve and they are cleared by their provider.

Choice B:

This is a correct answer. The nurse should instruct the client to avoid driving or operating machinery until cleared by the provider after a concussion. Driving or operating machinery can be dangerous and impairing for the client who may have symptoms such as headache, dizziness, fatigue, blurred vision, or slowed reaction time.

Choice C:

This is an incorrect answer. The nurse should not instruct the client to resume sports or physical activities within a week after a concussion. The client should avoid strenuous or risky activities that could cause another concussion or worsen their symptoms until they are asymptomatic and cleared by their provider.

Choice D:

This is an incorrect answer. The nurse should not instruct the client to take ibuprofen or aspirin for pain relief after a concussion. Ibuprofen and aspirin are nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bleeding in the brain or interfere with blood clotting.

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Question 6:

A nurse is caring for a client who has a concussion and reports nausea and vomiting. Which of the following actions should the nurse take first?

A. Administer antiemetic medication as prescribed B. Assess the client's level of consciousness and orientation C. Provide oral fluids and crackers to the client D. Notify the provider of the client's condition

Answer and Explanation

Choice A:

This is an incorrect answer. Administering antiemetic medication as prescribed is an appropriate action for the nurse to take, but not the first one. The nurse should first assess the client's neurological status, as nausea and vomiting can be signs of increased intracranial pressure (ICP) or worsening brain injury.

Choice B:

This is a correct answer. Assessing the client's level of consciousness and orientation is the first action that the nurse should take when caring for a client who has a concussion and reports nausea and vomiting. The nurse should use tools such as the Glasgow Coma Scale (GCS) or the Alert, Verbal, Painful, Unresponsive (AVPU) scale to evaluate the client's neurological function and identify any changes or deterioration.

Choice C:

This is an incorrect answer. Providing oral fluids and crackers to the client is not an appropriate action for the nurse to take, especially not the first one. The nurse should avoid giving anything by mouth to the client who has nausea and vomiting, as this can increase the risk of aspiration or dehydration.

Choice D:

This is an incorrect answer. Notifying the provider of the client's condition is an important action for the nurse to take, but not the first one. The nurse should first assess the client's neurological status and gather relevant data before reporting to the provider.

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Question 7:

A nurse is performing a neurological assessment on a client who has a concussion. Which of the following findings should the nurse report to the provider immediately?

A. The client has a Glasgow Coma Scale (GCS) score of 15 B. The client has unequal pupils with a difference of 2 mm C. The client has a positive Babinski reflex on both feet D. The client has difficulty performing finger-to-nose test

Answer and Explanation

Choice A:

This is an incorrect answer. The client does not need immediate reporting if they have a GCS score of 15. This is the highest possible score on the GCS, which indicates that the client is fully alert and oriented.

Choice B:

This is a correct answer. The client needs immediate reporting if they have unequal pupils with a difference of 2 mm. This is an abnormal finding that indicates increased intracranial pressure (ICP) or cranial nerve damage, which can be life-threatening.

Choice C:

This is an incorrect answer. The client does not need immediate reporting if they have a positive Babinski reflex on both feet. This is a normal finding in infants and young children, but an abnormal finding in adults. However, it does not indicate an acute or urgent condition, but rather a chronic or long-term damage to the corticospinal tract.

Choice D:

This is an incorrect answer. The client does not need immediate reporting if they have difficulty performing finger-to-nose test. This is an abnormal finding that indicates cerebellar dysfunction, which affects coordination and balance. However, it does not indicate an acute or urgent condition, but rather a mild or moderate impairment.

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Question 8:

A nurse is providing education to a group of high school athletes about concussion prevention and management. Which of the following information should the nurse include in the teaching? (Select all that apply.)

A. Wear appropriate protective equipment such as helmets and mouth guards B. Report any symptoms of concussion to the coach or trainer immediately C. Seek medical attention if symptoms persist for more than 24 hours D. Take a baseline cognitive test before the season starts E. Drink plenty of fluids and eat a balanced diet after a concussion

Answer and Explanation

Choice A:

This is a correct answer. Wearing appropriate protective equipment such as helmets and mouth guards helps to reduce the risk and severity of concussion by absorbing some of the impact force and protecting the head and teeth from injury.

Choice B:

This is a correct answer. Reporting any symptoms of concussion to the coach or trainer immediately helps to ensure proper diagnosis and treatment of concussion by a health care provider. Symptoms may include headache, dizziness, nausea, vomiting, confusion, memory loss, blurred vision, or sensitivity to light or noise.

Choice C:

This is an incorrect answer. Seeking medical attention if symptoms persist for more than 24 hours is not enough for concussion management. The nurse should advise the athletes to seek medical attention as soon as possible after a suspected concussion, regardless of how long the symptoms last or how severe they are.

Choice D:

This is a correct answer. Taking a baseline cognitive test before the season starts helps to establish a reference point for comparison after a concussion. A cognitive test measures mental functions such as memory, attention, reaction time, and problem-solving.

Choice E:

This is a correct answer. Drinking plenty of fluids and eating a balanced diet after a concussion helps to promote healing and recovery by providing hydration and nutrition to the brain and body.

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Traumatic Brain Injury: Concussions,

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