TNCC Abdominal Trauma 3

Question 1

A patient with splenic laceration is being managed non-operatively. Which vital sign trend is the most critical indicator requiring reassessment for operative intervention?

Accepted Answer

Persistent tachycardia above 100 bpm despite 2L crystalloid

Answer

SpO2 dropping from 99% to 97%

Answer

Temperature of 37.8°C

Answer

Respiratory rate of 20 breaths per minute

Question 2

In the TNCC framework, which finding on abdominal inspection is considered a high-priority finding suggesting serious intra-abdominal injury?

Accepted Answer

Mild periumbilical ecchymosis appearing 6 hours post-injury

Answer

Cullen's sign present on initial assessment

Answer

Visible peristalsis through thin abdominal wall

Answer

Symmetric abdominal contour

Question 3

When performing the abdominal assessment in the TNCC primary survey, auscultation is performed before palpation because:

Accepted Answer

Palpation may stimulate bowel sounds and falsely alter auscultation findings

Answer

Palpation can cause a vasovagal response altering heart rate auscultation

Answer

Auscultation is less painful for the patient if done first

Answer

TNCC protocol requires percussion before palpation

Question 4

A patient with abdominal trauma has Grey Turner's sign. This finding is associated with:

Accepted Answer

Retroperitoneal hemorrhage tracking to the flank

Answer

Intraperitoneal hemorrhage from splenic injury

Answer

Mesenteric vessel injury causing bowel ischemia

Answer

Pelvic fracture with pelvic hematoma

Question 5

Which of the following is the most appropriate fluid resuscitation strategy for a hemodynamically unstable patient with suspected massive intra-abdominal hemorrhage?

Accepted Answer

Permissive hypotension with damage control resuscitation using blood products

Answer

3L of normal saline boluses to restore normal blood pressure

Answer

High-dose vasopressors to maintain MAP above 90 mmHg

Answer

Colloid infusion (albumin) as first-line resuscitation fluid

Question 6

A patient with a grade III liver laceration is being monitored in the ICU. Which complication, specific to liver injury, must the trauma nurse monitor for in the first 72 hours?

Accepted Answer

Delayed bile leak or biloma formation

Answer

Hepatic artery aneurysm formation

Answer

Spontaneous bacterial peritonitis

Answer

Hepatic vein thrombosis

Question 7

In a child with blunt abdominal trauma, which organ is most commonly injured, and why is it at greater risk compared to adults?

Accepted Answer

Spleen, because the pediatric spleen is proportionally larger and the rib cage is more pliable

Answer

Liver, because children have a proportionally smaller thoracic cage offering less protection

Answer

Kidney, because pediatric kidneys are not yet encased in perirenal fat

Answer

Pancreas, because children have a thinner abdominal wall