TCRN Practice Questions Trunk Part 1 (Thoracic & Abdominal Trauma., Exams of Nursing

Download TCRN Practice Questions Trunk Part 1 (Thoracic & Abdominal Trauma. and more Exams Nursing in PDF only on Docsity! TCRN Practice Questions: Trunk Part 1 (Thoracic & Abdominal Trauma) When should impaled objects be removed? - ✔✔Preferably in the OR, under controlled circumstances. True or false: Bullet wounds follow a predictable pattern of injury? - ✔✔False: A bullet wound is an example of a "blast" wound which has an unpredictable trajectory and must consider path of tissue injury related to shock/stress waves. Name six life-threatning chest injuries: - ✔✔1. Laryngeotracheal Injury/Airway Obstruction 2. Tension Pneumothorax 3. Open Pneumothorax 4.Flail chest and pulmonary contusion 5. Massive hemothorax 6. Cardiac tamponade What are the four pathophysiological consequenses of life-threatning chest injuries? - ✔✔1. Hypoxia 2. Hypoventilation 3. Respiratory/metabolic acidosis 4. Inadequate tissue perfusion What alternative should you consider with an abusive and/or belligerant patient? - ✔✔Hypoxia (beyond intoxication of alcohol and drugs) Is cyanosis an early or late finding of hypoxemia? - ✔✔Late During a tension pneumothorax the mediastinal structures shift where? - ✔✔Opposite the affected side A needle thoracentesis is performed where anatomically? - ✔✔2nd-3rd intercostal space, mid-clavicular line A tube thoracostomy (chest tube insertion) is performed where anatomically? - ✔✔4th-5th intercostal space, mid-axillary line How should an open pneumothorax initally be managed? What should you be cautious of? - ✔✔Application of a sterile 3-sided dressing. Caution exercised to avoid creating an occlusive dressing which can lead to a tension pneumothorax. True or false: blood from a massive hemothorax can be transfused? - ✔✔True, autotranfusion can be done if a facility uses autotransfusion equipment. How can the discomfort of flail chest be managed during pulmonary toileting? Does flail chest always require surgical repair? - ✔✔Splinting the chest with a supportive device (ex. pillow, folded and taped towel). No, flail chest is usually managed non-operatively. How much fluid does it take to distend the pericardial sac and lead to cardiac tamponade? - ✔✔75-100 ml. Patient's report a "feeling of impending doom" A widened mediastinum on xray is concerning for? - ✔✔Traumatic aortic disruption What drug drip would you anticipate to be running a patient with an aortic injury awaiting operative management? - ✔✔Esmolol (short-acting beta blocker): decreases vessel wall tension and keeps patient's blood pressure lower until patient stabilized for operative procedure. What is the most common symptom of a tracheobronchial injury? - ✔✔Subcutaneous emphysema True or false: An esophageal perforation is a surgical emergency? - ✔✔True What is the most common mechanism of abdominal trauma? - ✔✔Blunt trauma via Motor vehicle crashes (75%) A positive seatbelt sign across the lower abdomen should raise suspicion for? - ✔✔Small bowel injury *Seatbelt should be low and close-fitting to hips Blunt duodenal injuries are the result of? - ✔✔Compression injuries *Commonly seen with Chance fracture, transverse process fractures, etc. Trauma to the stomach is most common in what group? - ✔✔Rare, more common in children What is the most common cause of trauma to the large intestine? - ✔✔Penetrating trauma Trauma to the liver places the patient at greatest risk for? - ✔✔Severe hemorrhage True or false: Treatment of spleen injury requires splenectomy? - ✔✔False, splenectomy is avoided if at all possible related to resulting immunocompetence.