Practice Question
A nurse assesses an alert adolescent who sustained a recent sports related head injury. The client reports feeling nauseated with head pain 8/10. Which additional finding(s) require Immediate intervention?
Answer Choices:
Correct Answer:
The client experiences confusion and slurred speech.
Rationale:
✅Confusion and slurred speech after a head injury are red-flag neurologic findings that can indicate intracranial hemorrhage, rising intracranial pressure (ICP), or brain herniation risk.
✅These signs reflect altered level of consciousness and focal neurologic deficit, which take priority over less severe post-concussive symptoms.
✅Immediate intervention is required: activate rapid evaluation, maintain airway and cervical spine precautions, and prepare for urgent neuroimaging.
✅Timely treatment can prevent secondary brain injury, which strongly influences outcomes.
✅Delays in care when these deficits are present are associated with higher morbidity and mortality.
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This question is from W6 NR302 Exam 2 which contains 55 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 4