TNCC Thoracic and Abdominal Trauma 2

Question 1

A patient with a stab wound to the left chest at the 5th intercostal space, anterior axillary line presents with hypotension and muffled heart sounds. The most likely diagnosis is:

Accepted Answer

Cardiac tamponade

Answer

A penetrating wound in the cardiac box with hypotension and muffled heart sounds strongly suggests cardiac tamponade from pericardial blood accumulation.

Question 2

Which organ is most commonly injured in blunt abdominal trauma?

Accepted Answer

Spleen

Answer

The spleen is the most commonly injured abdominal organ in blunt trauma due to its relatively fixed position, vascular nature, and location beneath the left lower ribs.

Question 3

A patient with blunt chest trauma develops progressive respiratory distress over 24-48 hours with bilateral diffuse infiltrates on chest X-ray. This presentation is most consistent with:

Accepted Answer

Pulmonary contusion progressing to ARDS

Answer

Pulmonary contusion is a common blunt thoracic injury that typically worsens over 24-48 hours and can progress to acute respiratory distress syndrome (ARDS) with bilateral infiltrates.

Question 4

An open pneumothorax (sucking chest wound) should be immediately treated by:

Accepted Answer

Applying a three-sided occlusive dressing taped on three sides

Answer

A three-sided occlusive dressing creates a flutter-valve effect: it seals the wound during inspiration (preventing air entry) and allows air to escape during expiration (preventing tension pneumothorax development).

Question 5

A patient with blunt abdominal trauma has a positive FAST exam but is hemodynamically stable with a blood pressure of 128/78. The appropriate next step is:

Accepted Answer

CT scan of the abdomen and pelvis with IV contrast for injury grading

Answer

A hemodynamically stable patient with a positive FAST exam should undergo CT scanning to grade the injury and guide management, as many solid organ injuries can be managed non-operatively.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Thoracic and Abdominal Trauma 2