TNCC Special Populations in Trauma 2

Question 1

A 70-year-old trauma patient on warfarin presents with a GCS of 13 after a fall. The nurse should anticipate which urgent intervention?

Accepted Answer

Immediate CT head and warfarin reversal given high risk of intracranial hemorrhage

Answer

Observe for 6 hours before ordering a CT scan

Answer

Discharge with head injury instructions since GCS is near-normal

Answer

Administer additional warfarin to prevent DVT from immobility

Question 2

Which physiological change in pregnancy makes assessment of hemorrhagic shock more challenging?

Accepted Answer

Physiological hypervolemia of pregnancy masking significant blood loss

Answer

Decreased blood volume making hemorrhage more obvious

Answer

Increased blood viscosity slowing hemorrhage

Answer

Decreased cardiac output reducing the significance of blood loss

Question 3

In pediatric trauma, the most common cause of death is:

Accepted Answer

Traumatic brain injury

Answer

Abdominal solid organ injury

Answer

Thoracic aortic disruption

Answer

Extremity hemorrhage

Question 4

An obese patient (BMI 45) involved in an MVC requires intubation. Which airway challenge should the nurse anticipate?

Accepted Answer

Rapid oxygen desaturation during apnea, difficult bag-mask ventilation, and challenging laryngoscopy

Answer

Easier intubation due to larger oral opening

Answer

No significant difference from normal-weight patients

Answer

Longer safe apnea time due to greater oxygen reserves

Question 5

When assessing a geriatric trauma patient, which physiological change most increases vulnerability to thoracic injuries?

Accepted Answer

Chest wall stiffening from calcified costal cartilage and osteoporotic ribs

Answer

Increased lung compliance and elastic recoil

Answer

Increased respiratory muscle strength

Answer

Enhanced cough reflex and airway protection

Question 6

A trauma patient with a known history of adrenal insufficiency on chronic corticosteroids presents in shock disproportionate to the apparent injury severity. The nurse should consider:

Accepted Answer

Adrenal crisis requiring stress-dose steroids

Answer

The patient is exaggerating symptoms

Answer

The patient's medications are causing the hypotension

Answer

No special consideration — treat shock per standard protocol