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

Hemothorax

Answer

Pulmonary contusion

Answer

Flail chest

Question 2

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

Accepted Answer

Dullness to percussion with decreased breath sounds

Answer

Tracheal deviation toward the affected side

Answer

Hyperresonance on percussion

Answer

Distended neck veins

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

Apply a bulky dressing over the flail segment

Answer

Place the patient in Trendelenburg position

Answer

Obtain a stat chest X-ray before any intervention

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

Peaked T waves in V1-V2

Answer

Prolonged PR interval only

Answer

Left axis deviation

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

Clamp the chest tube to slow blood loss

Answer

Document findings and reassess in 30 minutes

Answer

Increase IV fluid rate to compensate for blood loss

Question 6

A patient with suspected aortic disruption is most likely to have which mechanism of injury?

Accepted Answer

High-speed deceleration injury such as a motor vehicle crash or fall from height

Answer

Low-speed rear-end collision

Answer

Penetrating stab wound to the abdomen

Answer

Direct blow to the sternum during CPR