TCR-Nurse Flashcards

Which of the following is a PRIMARY survey finding that requires IMMEDIATE intervention?

Answer: Open pneumothorax (sucking chest wound)

An open pneumothorax allows air to enter the pleural space with each breath, rapidly causing respiratory failure and must be immediately sealed with an occlusive dressing.

In the primary survey, the 'E' in ABCDE stands for Exposure. What is the KEY nursing consideration during this step?

Answer: Fully undressing the patient while preventing hypothermia

Full exposure allows identification of all injuries, but active warming measures must immediately prevent hypothermia, which worsens coagulopathy.

A patient with a traumatic amputation of the right hand is brought to the ED. How should the amputated part be transported?

Answer: Wrapped in moist sterile gauze, placed in a sealed bag on ice

The amputated part should be wrapped in moist sterile gauze, sealed in a plastic bag, then placed on ice — direct contact with ice causes tissue damage.

Which sign is MOST suggestive of a basilar skull fracture?

Answer: Battle's sign (ecchymosis over mastoid) and raccoon eyes

Battle's sign (retroauricular ecchymosis) and periorbital ecchymosis (raccoon eyes) are classic late signs of basilar skull fracture.

A trauma patient develops neurogenic shock after a cervical spinal cord injury. What hemodynamic pattern differentiates neurogenic shock from hemorrhagic shock?

Answer: Hypotension with bradycardia and warm skin

Neurogenic shock presents with hypotension, bradycardia, and warm/flushed skin due to loss of sympathetic tone — unlike hemorrhagic shock which causes tachycardia and vasoconstriction.

Which intervention is CONTRAINDICATED in a patient with a suspected anterior cranial fossa fracture who needs airway suctioning?

Answer: Nasopharyngeal suctioning

Nasopharyngeal suctioning (and nasogastric tube insertion) is contraindicated with anterior cranial fossa fracture due to risk of intracranial placement through the cribriform plate.

A trauma nurse is caring for a pregnant patient at 28 weeks gestation with blunt abdominal trauma. Which position BEST improves maternal hemodynamics?

Answer: Left lateral tilt of 15–30 degrees

Left lateral tilt displaces the uterus off the inferior vena cava, preventing aortocaval compression and improving venous return and cardiac output.