TNCC Maxillofacial, Ocular, and Neck Trauma

Question 1

A trauma patient has a mobile midface, and the entire facial skeleton moves separately from the cranium. Which injury does this describe?

Accepted Answer

Le Fort III fracture

Answer

A Le Fort III fracture is craniofacial dissociation: the facial bones separate from the skull base. Le Fort I is a horizontal maxillary fracture, and Le Fort II is pyramidal. A Le Fort III carries a high risk of airway compromise and CSF leak.

Question 2

A patient with facial trauma has bilateral periorbital ecchymosis and clear fluid draining from the nose. Which action is most appropriate?

Accepted Answer

Place an orogastric tube and avoid nasal instrumentation

Answer

Raccoon eyes with clear nasal drainage (CSF rhinorrhea) suggest a basilar skull fracture. Nasal tubes could enter the cranial vault, so gastric decompression should go through the mouth.

Question 3

A patient has a suspected open globe injury after blunt trauma to the eye. Which intervention is appropriate?

Accepted Answer

Apply a rigid eye shield without pressure on the globe

Answer

With a suspected ruptured globe, protect the eye with a rigid shield that rests on the bony orbit. Avoid pressure, irrigation, or palpation, which could extrude intraocular contents.

Question 4

A worker comes in after an alkaline cleaning solution splashed into the eyes. What is the priority intervention?

Accepted Answer

Immediate continuous irrigation with copious isotonic fluid

Answer

Chemical eye burns are time-critical, so irrigation starts immediately and continues until the pH is neutral. Alkali burns are especially damaging. Acuity testing should not delay irrigation, and neutralizing agents are not used.

Question 5

A patient has a stab wound to the neck. Which finding is a hard sign of vascular injury that calls for immediate surgical evaluation?

Accepted Answer

An expanding hematoma

Answer

An expanding or pulsatile hematoma, active bleeding, a bruit or thrill, or a neurologic deficit are hard signs of vascular injury. Penetrating neck wounds that violate the platysma need surgical evaluation, and an expanding hematoma can also compress the airway.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Maxillofacial, Ocular, and Neck Trauma