TCRN Thoracic and Cardiovascular Trauma 3

Question 1

Pulmonary contusion is best described as which of the following?

Accepted Answer

Bruising of lung tissue causing alveolar hemorrhage and edema without laceration

Answer

Pulmonary contusion is direct injury to lung parenchyma causing alveolar hemorrhage and edema, worsening over 24–48 hours.

Question 2

A trauma patient develops worsening hypoxia 24 hours after admission despite supplemental oxygen. Chest X-ray shows bilateral opacities. Which condition is most likely?

Accepted Answer

Acute respiratory distress syndrome (ARDS)

Answer

ARDS following trauma presents with bilateral infiltrates and refractory hypoxia, typically peaking 24–72 hours after injury.

Question 3

Which intervention is contraindicated in a patient with suspected esophageal perforation from trauma?

Accepted Answer

Nasogastric tube insertion by the nurse without further assessment

Answer

Blind nasogastric tube placement can worsen esophageal perforation; surgical consultation should guide any tube placement.

Question 4

A trauma patient has breath sounds on the right but gastric sounds audible over the left chest. Which injury does this suggest?

Accepted Answer

Left diaphragmatic rupture with herniation of abdominal contents

Answer

Bowel sounds auscultated in the chest cavity indicate diaphragmatic rupture with herniation of abdominal organs into the thorax.

Question 5

Which mechanism of injury most commonly causes traumatic diaphragmatic rupture?

Accepted Answer

High-energy blunt abdominal trauma causing a sudden increase in intra-abdominal pressure

Answer

Sudden compression of the abdomen raises intra-abdominal pressure beyond the diaphragm's tensile limit, causing it to rupture.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Thoracic and Cardiovascular Trauma 3