CCRN Multisystem Trauma and Shock 3

Question 1

What is the recommended ratio of packed red blood cells, plasma, and platelets in a massive transfusion protocol?

Accepted Answer

1:1:1

Answer

A balanced 1:1:1 ratio of PRBCs, FFP, and platelets best mimics whole blood and reduces coagulopathy.

Question 2

Which component of the 'lethal triad' of trauma worsens as a result of large-volume crystalloid resuscitation?

Accepted Answer

Hypothermia and coagulopathy

Answer

The lethal triad is hypothermia, acidosis, and coagulopathy, all aggravated by excessive crystalloid.

Question 3

A trauma patient receiving massive transfusion develops perioral tingling and a prolonged QT interval. What electrolyte abnormality is most likely?

Accepted Answer

Hypocalcemia

Answer

Citrate in stored blood binds calcium, causing hypocalcemia with QT prolongation and perioral tingling.

Question 4

Which assessment finding most strongly suggests an obstructive cause of shock rather than hypovolemia?

Accepted Answer

Distended neck veins

Answer

Distended neck veins suggest obstructive shock (tamponade or tension pneumothorax), whereas hypovolemia produces flat neck veins.

Question 5

What is the primary goal of damage control surgery in the unstable polytrauma patient?

Accepted Answer

Control hemorrhage and contamination

Answer

Damage control surgery prioritizes rapid hemorrhage and contamination control over definitive repair to avoid the lethal triad.

CCRN Review Practice Test