TCRN Thoracic and Cardiovascular Trauma 2

Question 1

Which chest injury is characterized by multiple rib fractures in two or more places creating a free-floating segment?

Accepted Answer

Flail chest

Answer

Flail chest occurs when multiple contiguous ribs fracture in two or more places, creating a segment that moves independently.

Question 2

An intubated trauma patient's ventilator shows rising peak airway pressures with sudden hemodynamic deterioration. What should the nurse suspect?

Accepted Answer

Tension pneumothorax

Answer

Rising peak pressures combined with hemodynamic collapse in a ventilated patient strongly suggests tension pneumothorax.

Question 3

What is the most immediate intervention for an open (sucking) chest wound?

Accepted Answer

Apply a three-sided occlusive dressing and prepare for chest tube

Answer

A three-sided occlusive dressing allows air to escape on expiration while preventing air from entering on inspiration.

Question 4

Which finding would most suggest cardiac tamponade in a trauma patient?

Accepted Answer

Beck's triad: hypotension, muffled heart sounds, and distended neck veins

Answer

Beck's triad—hypotension, muffled heart sounds, and JVD—classically indicates pericardial tamponade.

Question 5

A penetrating chest wound at the fifth intercostal space, left midclavicular line is most likely to injure which structure?

Accepted Answer

Heart

Answer

The heart occupies the mediastinum between approximately the second and sixth intercostal spaces; a wound at the fifth left ICL puts the left ventricle at high risk.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Thoracic and Cardiovascular Trauma 2