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 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. You are discharging a patient who had a splenectomy during this hospitalization. What must be done prior to discharge? Administration of vaccinations: Pneumococcal, H. influenza, and meningococcal What percentage of the pancreas can be removed without concern for resulting diabetes? 90% Retroperitoneal injuries are commonly seen with what other injury? Pelvic fractures True or false: Abdominal vascular injury can lead to abdominal compartment syndrome? True, the retroperitoneal space can hold up to 4L of blood