TNCC - Trauma Nurse Core Curriculum Special Populations in Trauma Questions and Answers

Question 1

A 25-year-old male is brought in by police after being found wandering in the street, smelling strongly of alcohol.
He has a GCS of 13 (E4, V4, M5) and a laceration on his forehead.
He is uncooperative with the cervical collar.
What is the most appropriate approach to assessing this patient's altered mental status?

Accepted Answer

Rule out a traumatic brain injury before attributing altered mental status to intoxication.

Answer

Defer the neurological exam until the patient is clinically sober.

Answer

Assume the altered mental status is solely due to alcohol intoxication.

Answer

Administer a reversal agent for alcohol to facilitate the exam.

Question 2

An 82-year-old male on a beta-blocker for hypertension fell down a flight of stairs. His initial blood pressure is 110/70 mmHg, and his heart rate is 78 bpm. He has a fractured femur. Which of the following is the most accurate interpretation of this patient's vital signs?

Accepted Answer

The patient is likely in compensated shock, and the beta-blocker is masking tachycardia.

Answer

The patient's blood pressure indicates he is hemodynamically stable.

Answer

The vital signs are within normal limits and not concerning.

Answer

The heart rate is low due to a potential cervical spine injury.

Question 3

When calculating the initial fluid bolus for a 4-year-old child weighing 18 kg who is showing signs of hypovolemic shock, which of the following is the most appropriate dose and fluid type?

Accepted Answer

360 mL of Lactated Ringer's.

Answer

500 mL of 0.9% Normal Saline.

Answer

180 mL of D5W.

Answer

100 mL of 5% Albumin.

Question 4

A 32-week pregnant patient arrives after a motor vehicle collision. Her blood pressure is 90/60 mmHg and her heart rate is 115 bpm. She is secured to a backboard. In addition to standard resuscitation measures, which intervention is a priority for this patient to improve maternal hemodynamics?

Accepted Answer

Place a wedge under the right hip to achieve left uterine displacement.

Answer

Administer a tocolytic agent to prevent preterm labor.

Answer

Prepare for an immediate emergency Cesarean section.

Answer

Place the patient in a reverse Trendelenburg position.

Question 5

Which of the following represents a primary challenge when performing the initial airway assessment and management on a bariatric trauma patient?

Accepted Answer

Difficulty achieving optimal positioning and a higher risk of rapid desaturation.

Answer

Reduced pharyngeal soft tissue and a smaller tongue.

Answer

Decreased likelihood of underlying obstructive sleep apnea.

Answer

Lower risk of rapid oxygen desaturation during apnea.

Question 6

A 78-year-old female presents after a fall, complaining of right-sided chest pain. An x-ray reveals fractures of the 7th and 8th ribs. Her oxygen saturation is 95% on room air, and her respiratory rate is 22 breaths/min with shallow breaths. What is the primary focus of management for this geriatric patient?

Accepted Answer

Adequate pain management to promote effective ventilation.

Answer

Immediate surgical fixation of the rib fractures.

Answer

Application of a chest binder to splint the fractures.

Answer

Aggressive intravenous fluid resuscitation.