Certified Medical-Surgical Registered Nurse Practice Exam

Which intervention is effective in preventing increases in intracranial pressure (ICP) for a comatose patient?

1. Elevate the head of the bed 30-45 degrees

2. Suctioning the airway regularly

3. Maintaining a well-lit room

4. Frequent patient positioning changes

The correct answer is: Elevate the head of the bed 30-45 degrees

Elevating the head of the bed 30-45 degrees is an effective intervention in preventing increases in intracranial pressure (ICP) for a comatose patient. This position helps facilitate venous drainage from the brain, thereby reducing ICP. When the head is elevated, gravity assists in the return of cerebral venous blood to the heart, which decreases the volume of blood within the cranial cavity. This is a critical intervention in managing patients with head injuries or other conditions that may lead to increased ICP. While other options may have their own benefits in a general nursing context, they do not specifically address the primary goal of reducing ICP effectively. Regular suctioning of the airway, for instance, is more related to maintaining airway patency and removing secretions rather than directly influencing ICP. A well-lit room can create a stressful environment for a comatose patient, which may not be conducive to optimal care. Frequent positioning changes, although they may help in preventing complications like pressure ulcers, might not specifically target ICP reduction as would the elevation of the head of the bed.