TCRN Head and Neck Trauma Questions and Answers

Question 1

A trauma patient presents with periorbital ecchymosis (raccoon eyes), postauricular ecchymosis (Battle's sign), and clear fluid draining from the nares.
Which type of head injury are these findings most indicative of?

Accepted Answer

Basilar skull fracture

Answer

Epidural hematoma

Answer

Le Fort III fracture

Answer

Diffuse axonal injury

Question 2

A patient involved in a high-speed motor vehicle collision has significant mid-face trauma, including mobility of the entire maxilla and zygomatic bones, resulting in craniofacial disjunction. Which Le Fort fracture classification does this presentation represent?

Accepted Answer

Le Fort III

Answer

Le Fort I

Answer

Le Fort II

Answer

Le Fort IV

Question 3

A trauma nurse is assessing a patient with a penetrating neck injury located in Zone II. Which of the following is considered a 'hard sign' of significant vascular or airway injury, mandating immediate surgical exploration?

Accepted Answer

Pulsatile external bleeding

Answer

Dysphonia

Answer

Non-expanding hematoma

Answer

Subcutaneous emphysema

Question 4

A patient arrives after being struck in the anterior neck with a baseball bat. They are hoarse, have subcutaneous emphysema, and are in moderate respiratory distress. What is the most appropriate initial airway management strategy for this patient?

Accepted Answer

Awake surgical cricothyroidotomy or tracheostomy

Answer

Rapid sequence intubation (RSI)

Answer

Nasotracheal intubation

Answer

Placement of a supraglottic airway device

Question 5

According to the NEXUS (National Emergency X-Radiography Utilization Study) low-risk criteria, which of the following findings would require cervical spine imaging in a trauma patient?

Accepted Answer

A distracting painful injury, such as a femur fracture

Answer

Absence of posterior midline cervical spine tenderness

Answer

Normal level of alertness

Answer

No evidence of intoxication

Question 6

A patient is diagnosed with a Le Fort I fracture following an assault. The primary goal in the surgical management of this specific fracture is to restore:

Accepted Answer

Functional dental occlusion

Answer

Craniofacial height

Answer

Naso-orbital-ethmoid complex

Answer

Zygomatic projection