CCRN Multisystem Trauma and Shock 2

Question 1

A trauma patient presents with hypotension, jugular venous distention, and muffled heart sounds. Which condition is most likely?

Accepted Answer

Cardiac tamponade

Answer

Beck's triad (hypotension, JVD, muffled heart sounds) is the classic presentation of cardiac tamponade.

Question 2

What is the earliest reliable sign of compensated shock in a young trauma patient?

Accepted Answer

Tachycardia

Answer

Tachycardia is an early compensatory response, while hypotension is a late and ominous sign.

Question 3

Which class of hemorrhagic shock corresponds to a 30-40% blood volume loss?

Accepted Answer

Class III

Answer

Class III hemorrhage involves 30-40% blood loss with marked tachycardia, hypotension, and altered mental status.

Question 4

A patient with a femur fracture develops sudden dyspnea, petechiae, and confusion 24-48 hours after injury. What is the likely cause?

Accepted Answer

Fat embolism syndrome

Answer

Fat embolism syndrome classically presents with the triad of respiratory distress, neurologic changes, and petechial rash after long bone fracture.

Question 5

What is the recommended target for permissive hypotension in an actively bleeding trauma patient without head injury?

Accepted Answer

SBP 80-90 mmHg

Answer

Permissive hypotension targets an SBP of approximately 80-90 mmHg to limit clot disruption until surgical control is achieved.

CCRN Review Practice Test