CEN Trauma Emergencies 3

Question 1

A patient presents with a traumatic amputation of the right hand. What is the proper preservation method for the amputated part before replantation?

Accepted Answer

Wrap in dry sterile gauze, place in a sealed bag, then place the bag on ice

Answer

The amputated part should be wrapped in moist sterile gauze, placed in a sealed bag, and then placed over ice to prevent direct freezing and tissue maceration.

Question 2

A burn patient has burns covering the entire anterior trunk, both arms completely, and the head. Using the Rule of Nines, what is the TBSA burned?

Accepted Answer

45%

Answer

Anterior trunk = 18%, both arms = 18% total (9% each), head = 9% = total 45% TBSA using the Rule of Nines.

Question 3

For fluid resuscitation of a burn patient, the Parkland formula calculates volume based on which variables?

Accepted Answer

TBSA burned (%) and weight (kg): 4 mL × kg × %TBSA of LR in 24 hours

Answer

The Parkland formula is 4 mL × weight (kg) × %TBSA burned of lactated Ringer's, with half given in the first 8 hours and the second half over the next 16 hours.

Question 4

A patient with a stab wound to the right chest has decreased breath sounds on the right, hypotension, and tracheal deviation to the left. What is the immediate priority?

Accepted Answer

Needle decompression at 2nd ICS right MCL

Answer

This presentation is classic for right-sided tension pneumothorax; immediate needle decompression is required before imaging to prevent cardiovascular collapse.

Question 5

Damage control surgery (DCS) in trauma is characterized by which primary principle?

Accepted Answer

Controlling hemorrhage and contamination quickly, then closing and resuscitating before definitive repair

Answer

DCS involves a rapid initial surgery to control bleeding and contamination, temporary abdominal closure, ICU resuscitation to correct the lethal triad, and then planned reoperation for definitive repair.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Trauma Emergencies 3