TNCC Abdominal Trauma 4

Question 1

A patient with a gunshot wound entering the left upper quadrant has a BP of 70/40 despite 2L of crystalloid. What is the most appropriate next intervention?

Accepted Answer

Immediate operative intervention (exploratory laparotomy)

Answer

A hemodynamically unstable patient with penetrating abdominal trauma requires immediate operative intervention; diagnostic imaging delays definitive hemorrhage control.

Question 2

Which laboratory result best guides the decision to transfuse fresh frozen plasma (FFP) in a massively bleeding abdominal trauma patient?

Accepted Answer

INR greater than 1.5 or PT ratio elevated

Answer

FFP replaces all clotting factors and is indicated when the INR is elevated (>1.5), reflecting coagulopathy from hemorrhage or dilution.

Question 3

A patient with abdominal trauma develops acute abdominal compartment syndrome (ACS). Which finding is the hallmark diagnostic criterion?

Accepted Answer

Intra-abdominal pressure (IAP) greater than 20 mmHg with new organ dysfunction

Answer

ACS is defined as sustained IAP >20 mmHg associated with new organ dysfunction; bladder pressure measurement is the standard surrogate for IAP.

Question 4

Which vessel injury should be suspected when a patient with penetrating midline abdominal trauma develops profound shock with minimal external hemorrhage?

Accepted Answer

Abdominal aorta

Answer

The abdominal aorta runs midline and its injury causes rapid exsanguination; penetrating midline trauma with profound shock should raise immediate concern for aortic injury.

Question 5

A patient with blunt abdominal trauma complains of left shoulder pain despite no shoulder injury. This is most likely due to:

Accepted Answer

Diaphragmatic irritation from splenic hemorrhage (Kehr's sign)

Answer

Kehr's sign is left shoulder pain caused by diaphragmatic irritation from blood or fluid beneath the left hemidiaphragm, commonly from splenic injury.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Abdominal Trauma 4