Traumatic Brain and Spinal Cord Injury · NCLEX Exam

What does a unilateral dilated non-reactive pupil most strongly suggest when monitoring a patient with severe TBI?

  1. It is a benign anatomical variation of no concern
  2. Impending uncal herniation with cranial nerve III compression
  3. An acute migraine headache without structural cause
  4. A mild concussion with intact brainstem function
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Correct answer: Impending uncal herniation with cranial nerve III compression

A dilated non-reactive pupil in TBI indicates impending uncal herniation and the need for urgent neurosurgical intervention.

Difficulty: Hard Question 6 of 20

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