TCRN Abdominal and Pelvic Trauma Questions and Answers

Question 1

A patient brought to the trauma center after a high-speed motor vehicle collision is hemodynamically unstable with a suspected unstable pelvic fracture.
After initiating massive transfusion protocol, what is the most appropriate next step for hemorrhage control?

Accepted Answer

Application of a pelvic binder or sheet.

Answer

Immediate transfer to the operating room for exploratory laparotomy.

Answer

Urgent transfer to interventional radiology for angioembolization.

Answer

Obtaining a CT scan of the abdomen and pelvis with contrast.

Question 2

A trauma nurse is assessing a restrained driver from a frontal impact collision and notes a linear ecchymosis across the lower abdomen. This finding, known as the 'seatbelt sign,' should raise the highest suspicion for which type of injury?

Accepted Answer

Hollow viscus injury

Answer

Splenic laceration

Answer

Lumbar spine fracture

Answer

Diaphragmatic rupture

Question 3

A patient with blunt abdominal trauma is complaining of acute, sharp pain in the left shoulder. This finding, known as Kehr's sign, is most indicative of an injury to which organ?

Accepted Answer

Spleen

Answer

Liver

Answer

Stomach

Answer

Left Kidney

Question 4

A trauma patient is undergoing a Focused Assessment with Sonography for Trauma (FAST) exam. The primary purpose of this examination in the initial assessment of a trauma patient is to detect:

Accepted Answer

The presence of free fluid in the peritoneum or pericardium.

Answer

Specific solid organ injury grades.

Answer

Retroperitoneal hemorrhage.

Answer

Bowel wall thickening or perforation.

Question 5

A patient with a pelvic fracture has gross hematuria. A CT cystogram reveals extravasation of contrast into the peritoneal cavity. Which of the following is the most definitive management for this type of injury?

Accepted Answer

Surgical exploration and repair.

Answer

Placement of a suprapubic catheter.

Answer

Prolonged Foley catheter drainage for 10-14 days.

Answer

Serial abdominal examinations and bed rest.

Question 6

Which of the following interventions is the priority for a hemodynamically unstable patient with a severe pelvic fracture and a positive FAST exam?

Accepted Answer

Application of a pelvic binder and transfer to the operating room.

Answer

CT scan to delineate the pelvic fracture pattern.

Answer

Insertion of a suprapubic catheter for bladder decompression.

Answer

Immediate transfer for angiographic embolization.