TCRN Thoracic and Cardiovascular Trauma 2

Question 1

Which chest injury is characterized by multiple rib fractures in two or more places creating a free-floating segment?

Accepted Answer

Flail chest

Answer

Open pneumothorax

Answer

Pulmonary contusion

Answer

Diaphragmatic rupture

Question 2

An intubated trauma patient's ventilator shows rising peak airway pressures with sudden hemodynamic deterioration. What should the nurse suspect?

Accepted Answer

Tension pneumothorax

Answer

Endotracheal tube displacement into the esophagus

Answer

Ventilator malfunction

Answer

Pulmonary embolism

Question 3

What is the most immediate intervention for an open (sucking) chest wound?

Accepted Answer

Apply a three-sided occlusive dressing and prepare for chest tube

Answer

Needle decompression at the second intercostal space

Answer

Pack the wound with sterile gauze

Answer

Initiate positive pressure ventilation before any dressing

Question 4

Which finding would most suggest cardiac tamponade in a trauma patient?

Accepted Answer

Beck's triad: hypotension, muffled heart sounds, and distended neck veins

Answer

Tracheal deviation, flat neck veins, hypotension

Answer

Hyperresonance to percussion and absent breath sounds

Answer

Widened pulse pressure and bounding pulses

Question 5

A penetrating chest wound at the fifth intercostal space, left midclavicular line is most likely to injure which structure?

Accepted Answer

Heart

Answer

Thoracic aorta

Answer

Trachea

Answer

Left kidney

Question 6

Which radiographic sign on chest X-ray suggests traumatic aortic injury?

Accepted Answer

Widened mediastinum (>8 cm) with obliteration of the aortic knob

Answer

Pneumomediastinum with subcutaneous emphysema only

Answer

Unilateral pleural effusion without rib fractures

Answer

Elevated left hemidiaphragm