TNCC Geriatric Trauma

Question 1

Why is an older adult's heart rate an unreliable indicator of hypovolemic shock?

Accepted Answer

Beta-blocker therapy and reduced cardiac responsiveness can blunt tachycardia

Answer

Age-related changes and medications such as beta-blockers can prevent a tachycardic response, so shock can go unrecognized. Use other indicators, including mental status, lactate, and skin perfusion.

Question 2

A 78-year-old on a home medication list has a blood pressure of 100/60 mm Hg after a fall. Their usual blood pressure is 160/90. How should you interpret this?

Accepted Answer

Possible hypoperfusion, because a relative hypotension may indicate shock

Answer

Older adults with chronic hypertension may be in shock at pressures that look normal in younger patients. Many trauma guidelines treat a systolic pressure below 110 mm Hg in older adults as concerning. Compare readings with the patient's baseline.

Question 3

Which mechanism is the most common cause of injury in older adults?

Accepted Answer

Falls

Answer

Falls, often from standing height, are the leading cause of injury and injury death in older adults. Low-energy falls can still produce serious injuries, such as intracranial hemorrhage and hip fractures.

Question 4

An older adult on warfarin hits their head in a fall and is alert with a normal initial neurologic exam. What is the best action?

Accepted Answer

Obtain a head CT and monitor closely, since delayed intracranial bleeding is possible

Answer

Anticoagulants raise the risk of intracranial hemorrhage, which can appear late or after a minor mechanism. These patients need prompt head CT and serial neurologic checks even with a normal initial exam.

Question 5

Which nursing consideration matters most when giving IV fluids to an older trauma patient?

Accepted Answer

Give fluids cautiously and reassess often, because reduced cardiac reserve raises the risk of overload

Answer

Older adults tolerate hypovolemia poorly but also tolerate fluid overload poorly because of reduced cardiac reserve. Give boluses in measured amounts, reassess lung sounds and perfusion, and consider early blood products when needed.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Geriatric Trauma