TNCC - Trauma Nurse Core Curriculum Shock and Fluid Resuscitation Questions and Answers

Question 1

A 34-year-old male arrives after a motorcycle crash with a deformed left femur, a heart rate of 130 beats/min, blood pressure of 88/52 mmHg, and cool, clammy skin.
After initiating two large-bore IVs, which fluid is most appropriate for initial resuscitation of this patient in suspected hemorrhagic shock?

Accepted Answer

Lactated Ringer's solution

Answer

0.9% Sodium Chloride

Answer

5% Dextrose in water (D5W)

Answer

Hetastarch (6% Hydroxyethyl Starch)

Question 2

A trauma patient with a penetrating chest wound is receiving a massive transfusion. The nurse should be most concerned about the 'lethal triad' of trauma, which consists of which of the following combinations?

Accepted Answer

Hypothermia, Acidosis, and Coagulopathy

Answer

Hypothermia, Hyperkalemia, and Acidosis

Answer

Acidosis, Coagulopathy, and Hypocalcemia

Answer

Coagulopathy, Alkalosis, and Hyperthermia

Question 3

A 28-year-old female involved in a high-speed motor vehicle collision has a blood pressure of 85/60 mmHg despite receiving 1 liter of Lactated Ringer's. She has no signs of external bleeding and a negative FAST exam. Her heart rate is 125, respiratory rate is 28, and neck veins are distended. What type of shock is most likely?

Accepted Answer

Obstructive

Answer

Hypovolemic

Answer

Cardiogenic

Answer

Distributive

Question 4

The concept of 'permissive hypotension' is a strategy used in the initial management of certain trauma patients. In which of the following patient populations is this approach generally contraindicated?

Accepted Answer

Patients with a severe traumatic brain injury (TBI)

Answer

Patients with penetrating torso trauma

Answer

Patients with suspected uncontrolled internal hemorrhage

Answer

Patients with extremity fractures and a palpable radial pulse

Question 5

During the resuscitation of a patient with hemorrhagic shock, a balanced approach using a 1:1:1 ratio of blood products is often initiated. This ratio refers to the administration of:

Accepted Answer

1 unit of packed red blood cells, 1 unit of fresh frozen plasma, and 1 unit of platelets.

Answer

1 unit of packed red blood cells, 1 unit of albumin, and 1 unit of platelets.

Answer

1 unit of packed red blood cells, 1 unit of fresh frozen plasma, and 1 unit of cryoprecipitate.

Answer

1 unit of whole blood, 1 liter of crystalloid, and 1 unit of platelets.

Question 6

A trauma nurse is assessing the effectiveness of fluid resuscitation for a patient in hypovolemic shock. Which of the following is the most reliable indicator of improved tissue perfusion?

Accepted Answer

A decrease in the serum lactate level

Answer

Normalization of blood pressure to 120/80 mmHg

Answer

A heart rate less than 100 beats/min

Answer

A urine output of exactly 30 mL/hr