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

Elderly patients on anticoagulants have significantly increased risk of intracranial hemorrhage even with minor head trauma. Immediate CT and anticoagulant reversal are priorities.

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

Pregnancy increases blood volume by 40-50% (1,500-2,000 mL), allowing the pregnant patient to lose significant blood before showing traditional signs of shock.

Question 3

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

Accepted Answer

Traumatic brain injury

Answer

Traumatic brain injury is the leading cause of death in pediatric trauma patients, owing to the proportionally larger and heavier head and thinner cranial bones in children.

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

Obese patients have reduced functional residual capacity, increased oxygen consumption, redundant upper airway tissue, and challenging body habitus, leading to rapid desaturation and difficult airway management.

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

Age-related changes including calcified costal cartilage, osteoporotic ribs, and decreased chest wall compliance increase the risk of rib fractures and associated pulmonary injuries from relatively minor mechanisms.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Special Populations in Trauma 2