TNCC Trauma Care 2

Question 1

In the management of hemorrhagic shock, which class of hemorrhage is characterized by blood loss of 750-1,500 mL with tachycardia but normal blood pressure?

Accepted Answer

Class II

Answer

Class II hemorrhage involves 750-1,500 mL (15-30%) blood loss, presenting with tachycardia, tachypnea, and narrowed pulse pressure, but systolic blood pressure typically remains normal.

Question 2

A patient involved in a high-speed MVC presents with a seatbelt sign across the abdomen. The nurse should have a high index of suspicion for:

Accepted Answer

Lumbar spine fracture and hollow viscus injury

Answer

The seatbelt sign across the abdomen is strongly associated with lumbar spine (Chance) fractures and hollow viscus injuries such as small bowel perforation.

Question 3

Which finding on a secondary survey is most indicative of a ruptured diaphragm?

Accepted Answer

Bowel sounds heard in the chest on auscultation

Answer

Bowel sounds auscultated in the chest cavity indicate herniation of abdominal contents through a diaphragmatic rupture.

Question 4

During damage control resuscitation, the 'lethal triad' that must be aggressively corrected includes:

Accepted Answer

Hypothermia, acidosis, coagulopathy

Answer

The lethal triad of trauma — hypothermia, acidosis, and coagulopathy — creates a self-perpetuating cycle that increases mortality if not interrupted.

Question 5

A patient with blunt abdominal trauma has a positive FAST exam. Blood pressure is 82/60 mmHg and heart rate is 130 bpm despite 2 liters of crystalloid. The appropriate next step is:

Accepted Answer

Prepare for emergent exploratory laparotomy

Answer

A hemodynamically unstable trauma patient with a positive FAST exam who is not responding to initial resuscitation requires emergent surgical exploration.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Trauma Care 2