Critical Care Registered Nurse (CCRN) Practice Exam

What may increase without showing signs in elderly patients after a head injury?

1. Intracranial pressure

2. Heart rate

3. Blood pressure

4. Respiratory rate

The correct answer is: Intracranial pressure

In elderly patients who experience a head injury, intracranial pressure may increase without exhibiting overt clinical signs. This phenomenon is largely attributable to age-related changes in the brain and the body's compensatory mechanisms. In older adults, the brain's ability to adapt to increased pressure can be diminished, often resulting in silent increases in intracranial pressure that do not manifest as typical symptoms such as headache, altered consciousness, or vomiting. Moreover, the subtle nature of these changes can make it challenging to identify deteriorations in condition promptly. For instance, elderly patients may not show common signs of elevated intracranial pressure due to the aging process altering their perception and reporting of symptoms. This can lead to delays in diagnosis and management, which is critical in minimizing potential complications from the head injury. In contrast, while heart rate, blood pressure, and respiratory rate may change in response to stress or injury, these changes are typically more evident and distinctive in terms of symptoms or observable signs. This makes the increase in intracranial pressure particularly insidious in elderly patients, underscoring the importance of careful monitoring and assessment following head trauma in this population.