TNCC Musculoskeletal Trauma 2

Question 1

A patient with a femur fracture develops sudden onset chest pain, hypoxia, and petechiae on the chest and axillae 48 hours post-injury. Which complication is most likely?

Accepted Answer

Fat embolism syndrome

Answer

Fat embolism syndrome classically presents 24–72 hours after long bone fractures with the triad of hypoxemia, neurologic changes, and petechial rash on the upper body.

Question 2

When assessing a patient with a suspected pelvic fracture, which clinical sign indicates significant retroperitoneal hemorrhage?

Accepted Answer

Grey Turner's sign

Answer

Grey Turner's sign (flank ecchymosis) indicates retroperitoneal hemorrhage, which is a serious complication of pelvic fractures due to disruption of pelvic vasculature.

Question 3

A patient arrives after a crush injury to the lower extremity. Which serum lab value is the BEST early indicator of rhabdomyolysis?

Accepted Answer

Creatine kinase (CK)

Answer

CK is the most sensitive and specific marker for skeletal muscle damage, rising within 2–12 hours of injury and peaking at 24–72 hours.

Question 4

Which type of pelvic fracture is associated with the highest risk of life-threatening hemorrhage?

Accepted Answer

Anterior-posterior compression fracture

Answer

Anterior-posterior compression (open-book) fractures disrupt the pelvic ring and tear the posterior venous plexus and iliac vessels, causing massive hemorrhage.

Question 5

During reassessment, a patient with a tibial fracture reports worsening pain that is unresponsive to opioid analgesia and pain with passive stretch of the toes. What is the priority intervention?

Accepted Answer

Notify the physician immediately for compartment pressure measurement

Answer

Pain unrelieved by opioids and pain with passive stretch are hallmark signs of acute compartment syndrome requiring urgent pressure measurement and possible fasciotomy.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Musculoskeletal Trauma 2