BCEN Trauma and Injury Management 2

Question 1

A patient arrives after a high-speed MVC with hypotension, distended neck veins, and muffled heart sounds. Which condition does this triad indicate?

Accepted Answer

Cardiac tamponade

Answer

Beck's triad (hypotension, distended neck veins, muffled heart sounds) is classic for cardiac tamponade requiring emergent pericardiocentesis.

Question 2

A trauma patient has a GCS of 8. After intubation, the nurse should set initial ventilator settings to target a PaCO2 of:

Accepted Answer

35-45 mmHg

Answer

Normal PaCO2 (35-45 mmHg) is targeted unless signs of herniation require brief hyperventilation; routine hyperventilation is no longer recommended in TBI.

Question 3

Which assessment finding is most consistent with a splenic injury in a blunt abdominal trauma patient?

Accepted Answer

Left upper quadrant tenderness with Kehr's sign

Answer

Left upper quadrant tenderness with Kehr's sign (referred left shoulder pain from diaphragmatic irritation by blood) suggests splenic injury.

Question 4

A construction worker falls 20 feet and presents with midline thoracic back pain and inability to move his legs. Spinal precautions are in place. Which intervention has the highest priority?

Accepted Answer

Ensure airway patency and adequate ventilation

Answer

Airway and breathing always take priority in trauma management; thoracic cord injury can impair respiratory muscles.

Question 5

When using the FAST exam (Focused Assessment with Sonography in Trauma), which finding indicates a positive result requiring immediate intervention?

Accepted Answer

Free fluid in the hepatorenal space (Morrison's pouch)

Answer

Free fluid in Morrison's pouch on FAST indicates intraperitoneal hemorrhage and warrants urgent surgical evaluation.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Trauma and Injury Management 2