CEN Trauma Nursing 2

Question 1

Which assessment finding indicates a class III hemorrhagic shock (estimated blood loss 1500–2000 mL)?

Accepted Answer

Heart rate 120–140, decreased BP, confused, decreased urine output

Answer

Class III shock presents with HR 120–140, decreased BP, confusion, and urine output <5–15 mL/hr from significant volume loss.

Question 2

A patient with a traumatic amputation of the right forearm has uncontrolled arterial bleeding. A tourniquet is applied. Which documentation is mandatory?

Accepted Answer

Time of tourniquet application

Answer

The time of tourniquet application must be documented because prolonged application beyond 2 hours increases the risk of limb loss.

Question 3

A patient with multiple rib fractures (ribs 4–8) on the right side splints their breathing and has SpO2 of 91%. What is the most effective initial pain management strategy to restore ventilation?

Accepted Answer

Thoracic epidural or regional nerve block

Answer

Thoracic epidural or intercostal nerve blocks provide superior pain control for rib fractures, allowing deep breathing and preventing atelectasis.

Question 4

A patient sustains an impalement injury to the right chest with the object still in place. What is the correct field management of the impaled object?

Accepted Answer

Stabilize the object in place and do not remove it

Answer

Impaled objects should never be removed in the field as they may be tamponading hemorrhage; stabilize and transport for OR removal.

Question 5

Which trauma patient is most likely to benefit from permissive hypotension strategy (target MAP 50 mmHg) during resuscitation?

Accepted Answer

25-year-old with penetrating abdominal trauma, no TBI

Answer

Permissive hypotension is used in penetrating trauma without TBI to prevent coagulopathy worsening while limiting crystalloid dilution.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Trauma Nursing 2