The nurse anticipates that which initial diagnostic test will be performed to identify the scope and extent of damage in a patient after a traumatic brain injury?

• A. X-ray
• B. Ultrasound
• C. MRI
• D. CT

Answer: (D)

In the acute setting after a traumatic brain injury, the priority is to quickly detect life-threatening intracranial changes. A non-contrast CT scan of the head is the test of choice because it can be done rapidly, is widely available, and is highly sensitive for acute hemorrhage, skull fractures, and mass effect. This information immediately guides urgent decisions about surgical intervention or intensive monitoring. MRI, while more sensitive for certain injuries, takes longer to perform and is less practical for unstable patients or in the emergency phase. X-ray doesn’t adequately visualize brain tissue, and ultrasound is not used for routine brain imaging in adults. Therefore, the initial diagnostic test is a non-contrast CT scan of the head.