Which of the following statements regarding the pathophysiology, clinical presentation, and management of concussions are correct? Select all that apply.
Symptoms: Headache, drowsiness, confusion, visual disturbances.
Diagnosis based CT of the head only
Blunt acceleration-deceleration force
Classified as mild or classic
Concussion must always be considered severe
Seek help for worsening symptoms
Correct Answer : A,C,D,F
Rationale:
A. Concussion presents with a range of neurologic symptoms including headache, dizziness, confusion, drowsiness, nausea, vomiting, and visual disturbances. These are key indicators for clinical assessment.
B. Concussions are typically diagnosed clinically through history and neurologic examination. CT scans are often normal and are used primarily to rule out more serious brain injuries, such as intracranial hemorrhage or skull fractures, rather than to confirm a concussion.
C. Concussions usually result from a blunt impact or rapid acceleration-deceleration of the head, causing transient brain dysfunction. Common mechanisms include falls, sports injuries, motor vehicle collisions, and assaults.
D. Concussions are generally classified based on severity: mild (brief confusion, no loss of consciousness) or classic (loss of consciousness lasting less than 6 hours and post-traumatic amnesia less than 24 hours).
E. Most concussions are mild to moderate and resolve with rest and monitoring. Severe traumatic brain injury is a distinct condition involving structural brain damage, prolonged loss of consciousness, or significant neurologic deficits.
F. Patients with concussion should be monitored for any worsening symptoms, such as repeated vomiting, severe headache, increasing confusion, slurred speech, or neurologic deficits, which may indicate a more serious injury requiring immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Triage in a mass casualty incident is a dynamic and continuous process. A patient’s status may change from the time of the scene assessment to arrival at the hospital. This eight-year-old boy was initially tagged green, indicating minor injuries or stable condition. However, upon reassessment, he is now unresponsive, which is a critical change that signifies a potentially life-threatening deterioration. According to triage protocols such as START (Simple Triage and Rapid Treatment) or pediatric modifications like JumpSTART, an unresponsive child requires immediate medical attention. The triage color should be upgraded to red (for immediate intervention if there are life-threatening injuries with a chance of survival) or yellow (for urgent care if life-threatening injuries are present but not immediately critical), ensuring he receives prompt treatment. Re-triaging prevents delays in interventions that could be lifesaving.
B. Triage decisions are based on the patient’s current clinical condition, not the initial assessment. Sticking with the green tag despite the patient now being unresponsive would delay critical interventions, potentially worsening outcomes and increasing mortality risk.
C. Green tags are reserved for patients with minor injuries who can safely wait for treatment. An unresponsive child is not minor, and assigning green in this situation would be unsafe and inappropriate.
D. Black is used for deceased patients or those with injuries so severe that survival is unlikely even with immediate treatment. Since the patient is unresponsive but still has a chance of survival with rapid intervention, black is not appropriate.
Correct Answer is A
Explanation
Rationale:
A. Diffuse axonal injury (DAI) is primarily caused by rotational or acceleration-deceleration forces, which produce shearing stress on axons. This mechanism disrupts axonal integrity, leading to widespread neuronal injury and is a hallmark feature of DAI.
B. DAI often involves microscopic or small hemorrhagic lesions in areas such as the corpus callosum, brainstem, and gray-white matter junction. The statement that there are no hemorrhagic lesions is false.
C. While this statement is true about the pathophysiology of DAI, the question asks which statement is true among false statements. This option is misleading without the context of mechanism. The primary defining feature is the shearing from rotational forces.
D. DAI is more common than 20%, accounting for a significant proportion of severe traumatic brain injuries, particularly those resulting from high-speed motor vehicle accidents. The exact prevalence varies by study but is generally higher than 20% in severe TBI populations.
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