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

Fractured rib penetrating the lung parenchyma

Answer

Air leak into the pleural space from the lung surface

Answer

Collapse of an entire lung lobe

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

Spontaneous pneumothorax

Answer

Pulmonary embolism

Answer

Diaphragmatic hernia

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

Early surgical consultation

Answer

NPO status and IV antibiotics

Answer

CT scan of the chest

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

Left hemothorax

Answer

Left pneumothorax

Answer

Tracheal tear

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

Penetrating injury to the shoulder

Answer

Fall onto an outstretched hand

Answer

Rib fractures from a direct blow

Question 6

When monitoring a patient after pericardiocentesis for traumatic tamponade, which improvement indicates successful decompression?

Accepted Answer

Increasing blood pressure, decreasing JVD, and improving heart sounds

Answer

Decreasing blood pressure and widening pulse pressure

Answer

Onset of pulsus paradoxus

Answer

Rising central venous pressure