TCRN Thoracic and Cardiovascular Trauma

Question 1

A trauma patient presents with absent breath sounds on the left, tracheal deviation to the right, and hypotension. Which condition should the nurse suspect first?

Accepted Answer

Tension pneumothorax

Answer

Tension pneumothorax causes tracheal deviation away from the affected side along with hemodynamic compromise.

Question 2

Which finding is most consistent with a massive hemothorax on initial assessment?

Accepted Answer

Dullness to percussion with decreased breath sounds

Answer

Massive hemothorax produces dullness to percussion due to blood accumulation and absent breath sounds from lung compression.

Question 3

A patient with blunt chest trauma has paradoxical chest wall movement. Which intervention takes priority?

Accepted Answer

Administer high-flow oxygen and prepare for intubation

Answer

Flail chest with paradoxical movement causes respiratory failure, so oxygen delivery and airway management take top priority.

Question 4

Which ECG finding is most associated with myocardial contusion following blunt chest trauma?

Accepted Answer

New right bundle branch block or ST-segment changes

Answer

Myocardial contusion most commonly manifests as new bundle branch block or ST changes on ECG, indicating direct cardiac injury.

Question 5

During chest tube insertion for hemothorax, the nurse notes 1,500 mL of blood drains immediately. What is the priority action?

Accepted Answer

Notify the surgeon immediately for possible operative intervention

Answer

Immediate drainage of ≥1,000–1,500 mL indicates massive hemothorax requiring surgical evaluation for operative control.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Thoracic and Cardiovascular Trauma