BCEN Trauma Care 3

Question 1

A patient with a pelvic fracture is hemodynamically unstable despite resuscitation. What is the most effective immediate intervention to reduce pelvic hemorrhage?

Accepted Answer

Application of a pelvic binder or sheet

Answer

A pelvic binder reduces pelvic volume and tamponades venous hemorrhage, making it the fastest first-line intervention for unstable pelvic fractures.

Question 2

During a secondary trauma survey, you note a patient has a scrotal hematoma and blood at the urethral meatus after a straddle injury. What should you avoid?

Accepted Answer

Inserting a urinary catheter before urologic consultation

Answer

Blood at the urethral meatus is a sign of urethral injury; a Foley catheter must not be inserted until urethral integrity is confirmed, typically via urethrogram.

Question 3

A pediatric trauma patient weighs 20 kg. Using the Broselow tape, what is the correct estimated weight-based fluid bolus for hemorrhagic shock?

Accepted Answer

400 mL

Answer

Pediatric initial fluid resuscitation for hemorrhagic shock is 20 mL/kg, so for a 20 kg child the bolus is 400 mL.

Question 4

Which mechanism is most likely to cause an aortic disruption (traumatic aortic injury)?

Accepted Answer

High-speed deceleration or horizontal impact MVC

Answer

Sudden deceleration creates shear forces at the aortic isthmus (ligamentum arteriosum), making high-speed MVCs the most common cause of traumatic aortic injury.

Question 5

A patient has a gunshot wound to the right upper quadrant. CT scan shows a Grade III liver laceration. The patient is hemodynamically stable. What management is preferred?

Accepted Answer

Nonoperative management with serial abdominal exams and repeat imaging

Answer

Hemodynamically stable patients with Grade III liver lacerations are candidates for nonoperative management with close monitoring.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Trauma Care 3