Trauma Certified Registered Nurse (TCRN) Practice Exam

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In which situation is an urgent brain CT scan not indicated?

Acute closed head injury with right homonymous hemianopsia

Acute closed head injury

Acute closed head injury with nausea, vomiting, and lethargy

A supraorbital, throbbing headache of acute onset, which is exacerbated by light and attempts at visual accommodation

An urgent brain CT scan is not indicated in the scenario involving a supraorbital, throbbing headache of acute onset, which is exacerbated by light and visual accommodation because this clinical presentation suggests a primary headache disorder, such as migraine or cluster headache, rather than acute intracranial pathology, such as a hemorrhage or traumatic injury.

In this context, other acute closed head injury scenarios (including symptoms like homonymous hemianopsia or associated symptoms of nausea, vomiting, and lethargy) typically indicate potential complications such as intracranial bleeding or brain injury that require immediate imaging for diagnosis and management. The absence of trauma history and the nature of the headache points more toward a neurological condition less likely to necessitate urgent imaging. While it is still important to evaluate headaches carefully, the immediate urgency of a brain CT scan is less critical in this instance. Thus, the correct scenario is where an urgent scan is not required due to the nature of symptoms presenting a lower risk of acute intracranial pathology.

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