TNCC Abdominal Trauma 2

Question 1

A patient with blunt abdominal trauma has a positive FAST exam showing free fluid in the hepatorenal space. Which structure is most commonly injured with right upper quadrant fluid on FAST?

Accepted Answer

Liver

Answer

The hepatorenal space (Morrison's pouch) collects fluid from liver injuries, making the liver the most commonly injured organ when fluid is seen in that location.

Question 2

Which mechanism of injury is most associated with hollow viscus (bowel) perforation in blunt abdominal trauma?

Accepted Answer

Lap belt restraint without shoulder harness

Answer

Lap belt–only restraint causes a classic pattern of bowel perforation and lumbar spine fracture (Chance fracture) because the bowel is compressed against the spine.

Question 3

A trauma patient develops sudden hypotension 2 hours after a seat belt injury. Initial FAST was negative. What should be the priority diagnostic consideration?

Accepted Answer

Delayed hollow viscus injury with peritonitis

Answer

A negative initial FAST does not exclude bowel injury; delayed hollow viscus perforation can present with peritonitis and hemodynamic deterioration hours after injury.

Question 4

Which physical finding is most specific for diaphragmatic rupture in a patient with left-sided blunt thoracoabdominal trauma?

Accepted Answer

Bowel sounds auscultated in the left chest

Answer

Bowel sounds in the chest are pathognomonic for diaphragmatic rupture with herniation of abdominal contents into the thoracic cavity.

Question 5

During the secondary survey of a stab wound patient, you note evisceration of small bowel through the abdominal wound. What is the correct initial management?

Accepted Answer

Cover with a sterile, moist dressing and do not attempt to reinsert the bowel

Answer

Eviscerated bowel should be covered with a sterile, moist (saline-soaked) dressing to prevent desiccation without attempting to reduce the bowel.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Abdominal Trauma 2