BCEN Trauma and Injury Management 3

Question 1

A patient with a stab wound to zone II of the neck is hemodynamically stable. The appropriate initial management is:

Accepted Answer

Computed tomography angiography (CTA) of the neck

Answer

Hemodynamically stable patients with zone II neck injuries undergo CTA to evaluate vascular and aerodigestive structures before surgical decisions.

Question 2

Which intervention is CONTRAINDICATED in a patient with a suspected basilar skull fracture?

Accepted Answer

Nasogastric tube insertion

Answer

Nasogastric tube insertion is contraindicated in basilar skull fracture due to risk of intracranial placement through the cribriform plate.

Question 3

A burn patient has circumferential full-thickness burns to both lower extremities with absent distal pulses. The priority intervention is:

Accepted Answer

Perform escharotomy

Answer

Circumferential full-thickness burns cause compartment syndrome requiring escharotomy to restore distal perfusion.

Question 4

According to the Parkland formula, how much fluid should be given in the first 8 hours for a 70 kg patient with 40% TBSA burns?

Accepted Answer

5,600 mL

Answer

Parkland formula: 4 mL × kg × %TBSA = 4 × 70 × 40 = 11,200 mL total; half (5,600 mL) given in first 8 hours.

Question 5

A pedestrian struck by a vehicle presents with ecchymosis in a 'tire track' pattern across the abdomen and pelvis. The nurse anticipates injury to which organ most commonly?

Accepted Answer

Small bowel and mesentery

Answer

Crush injury from tire tracks most commonly injures the small bowel and mesentery due to compression against the spine.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Trauma and Injury Management 3