CEN Trauma Nursing 3

Question 1

A patient with a blunt abdominal trauma has a positive FAST exam showing free fluid in Morrison's pouch. The patient is hemodynamically unstable. What is the priority intervention?

Accepted Answer

Emergent surgical exploration (trauma laparotomy)

Answer

A positive FAST with hemodynamic instability indicates significant intraperitoneal hemorrhage requiring emergent operative intervention.

Question 2

Which spinal injury pattern is most commonly associated with a diving accident causing cervical spine injury?

Accepted Answer

Compression (burst) fracture with spinal cord injury

Answer

Axial loading from diving into shallow water typically causes burst fractures of the cervical spine with risk of spinal cord injury.

Question 3

A pregnant trauma patient at 28 weeks gestation is in hemorrhagic shock. Which positioning modification is essential during resuscitation?

Accepted Answer

Left lateral uterine displacement to relieve aortocaval compression

Answer

Left lateral uterine displacement relieves aortocaval compression by the gravid uterus, improving venous return and cardiac output.

Question 4

A patient with a closed head injury and GCS of 14 presents to the ED. CT scan shows no intracranial hemorrhage. Which observation criteria allows discharge?

Accepted Answer

The patient has no history of anticoagulant use, has a reliable adult companion, and clear discharge instructions

Answer

Mild TBI discharge requires no anticoagulant use, a reliable companion for home observation, and written instructions for return precautions.

Question 5

A trauma patient develops a massive hemothorax. Initial management includes placement of a large-bore (36–40 Fr) chest tube. If initial drainage exceeds what volume, is operative intervention indicated?

Accepted Answer

1000–1500 mL

Answer

Initial drainage >1000–1500 mL from a hemothorax or ongoing drainage >200 mL/hr is the threshold for operative intervention.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Trauma Nursing 3