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Nursing 354 Trauma Nursing Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
Question 1
A trauma patient arrives after a motor vehicle collision with severe respiratory
distress, absent breath sounds on the right, hypotension, and distended neck
veins. Which condition should the nurse suspect?
A. Hemothorax
B. Pulmonary contusion
C. Tension pneumothorax
D. Cardiac tamponade
Answer: Tension pneumothorax
Rationale: Tension pneumothorax causes pressure within the pleural space,
compressing the lung and impairing venous return. Classic findings include
severe respiratory distress, unilateral absent breath sounds, hypotension, and
jugular venous distention.
Question 2
Which assessment should receive the highest priority when a patient with major
trauma arrives in the emergency department?
,A. Pain intensity
B. Abdominal tenderness
C. Airway patency
D. History of allergies
Answer: Airway patency
Rationale: Airway assessment is the first priority in trauma care because airway
obstruction can rapidly cause hypoxia, brain injury, and death.
Question 3
A trauma patient has a Glasgow Coma Scale score of 7. Which intervention should
the nurse anticipate?
A. Oral fluids
B. Ambulation
C. Airway protection with endotracheal intubation
D. Discharge after observation
Answer: Airway protection with endotracheal intubation
Rationale: A Glasgow Coma Scale score of 8 or less generally indicates inability
to reliably protect the airway and should prompt consideration of definitive
airway management.
Question 4
Which finding is most concerning for internal hemorrhage following blunt
abdominal trauma?
A. Mild nausea
B. Warm skin
C. Hypotension with increasing abdominal distention
D. Increased appetite
Answer: Hypotension with increasing abdominal distention
,Rationale: Hypotension and abdominal distention after trauma can indicate
significant intra-abdominal bleeding and require immediate evaluation and
intervention.
Question 5
Which assessment finding is characteristic of hypovolemic shock after trauma?
A. Bradycardia and warm skin
B. Tachycardia and cool, clammy skin
C. Hypertension and bounding pulses
D. Slow respiratory rate and flushed skin
Answer: Tachycardia and cool, clammy skin
Rationale: Blood loss activates the sympathetic nervous system, producing
tachycardia, peripheral vasoconstriction, cool clammy skin, and eventually
hypotension.
Question 6
A patient with a pelvic fracture is hypotensive. What is the nurse's priority
concern?
A. Infection
B. Pain-related hypertension
C. Massive internal hemorrhage
D. Urinary tract infection
Answer: Massive internal hemorrhage
Rationale: Pelvic fractures can cause life-threatening hemorrhage into the
retroperitoneal and pelvic spaces. Early hemorrhage control and resuscitation
are priorities.
Question 7
Which intervention is appropriate for a patient with suspected cervical spine
injury?
, A. Flex the patient's neck
B. Encourage neck rotation
C. Maintain cervical spinal alignment
D. Place a pillow under the head
Answer: Maintain cervical spinal alignment
Rationale: Maintaining neutral spinal alignment reduces the risk of secondary
spinal cord injury until cervical spine injury has been evaluated and cleared.
Question 8
A trauma patient has paradoxical chest movement after blunt chest trauma.
Which injury should the nurse suspect?
A. Simple pneumothorax
B. Cardiac tamponade
C. Flail chest
D. Pulmonary embolism
Answer: Flail chest
Rationale: Flail chest occurs when multiple adjacent ribs are fractured in
multiple locations, creating a free chest-wall segment that moves paradoxically
during respiration.
Question 9
Which finding is most consistent with cardiac tamponade after penetrating chest
trauma?
A. Hypertension and bradycardia
B. Hypotension, muffled heart sounds, and jugular venous distention
C. Unilateral absent breath sounds
D. Increased bowel sounds
Answer: Hypotension, muffled heart sounds, and jugular venous distention
Rationale: Beck's triad—hypotension, muffled heart sounds, and jugular venous
distention—is classically associated with cardiac tamponade.
Nursing 354 Trauma Nursing Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
Question 1
A trauma patient arrives after a motor vehicle collision with severe respiratory
distress, absent breath sounds on the right, hypotension, and distended neck
veins. Which condition should the nurse suspect?
A. Hemothorax
B. Pulmonary contusion
C. Tension pneumothorax
D. Cardiac tamponade
Answer: Tension pneumothorax
Rationale: Tension pneumothorax causes pressure within the pleural space,
compressing the lung and impairing venous return. Classic findings include
severe respiratory distress, unilateral absent breath sounds, hypotension, and
jugular venous distention.
Question 2
Which assessment should receive the highest priority when a patient with major
trauma arrives in the emergency department?
,A. Pain intensity
B. Abdominal tenderness
C. Airway patency
D. History of allergies
Answer: Airway patency
Rationale: Airway assessment is the first priority in trauma care because airway
obstruction can rapidly cause hypoxia, brain injury, and death.
Question 3
A trauma patient has a Glasgow Coma Scale score of 7. Which intervention should
the nurse anticipate?
A. Oral fluids
B. Ambulation
C. Airway protection with endotracheal intubation
D. Discharge after observation
Answer: Airway protection with endotracheal intubation
Rationale: A Glasgow Coma Scale score of 8 or less generally indicates inability
to reliably protect the airway and should prompt consideration of definitive
airway management.
Question 4
Which finding is most concerning for internal hemorrhage following blunt
abdominal trauma?
A. Mild nausea
B. Warm skin
C. Hypotension with increasing abdominal distention
D. Increased appetite
Answer: Hypotension with increasing abdominal distention
,Rationale: Hypotension and abdominal distention after trauma can indicate
significant intra-abdominal bleeding and require immediate evaluation and
intervention.
Question 5
Which assessment finding is characteristic of hypovolemic shock after trauma?
A. Bradycardia and warm skin
B. Tachycardia and cool, clammy skin
C. Hypertension and bounding pulses
D. Slow respiratory rate and flushed skin
Answer: Tachycardia and cool, clammy skin
Rationale: Blood loss activates the sympathetic nervous system, producing
tachycardia, peripheral vasoconstriction, cool clammy skin, and eventually
hypotension.
Question 6
A patient with a pelvic fracture is hypotensive. What is the nurse's priority
concern?
A. Infection
B. Pain-related hypertension
C. Massive internal hemorrhage
D. Urinary tract infection
Answer: Massive internal hemorrhage
Rationale: Pelvic fractures can cause life-threatening hemorrhage into the
retroperitoneal and pelvic spaces. Early hemorrhage control and resuscitation
are priorities.
Question 7
Which intervention is appropriate for a patient with suspected cervical spine
injury?
, A. Flex the patient's neck
B. Encourage neck rotation
C. Maintain cervical spinal alignment
D. Place a pillow under the head
Answer: Maintain cervical spinal alignment
Rationale: Maintaining neutral spinal alignment reduces the risk of secondary
spinal cord injury until cervical spine injury has been evaluated and cleared.
Question 8
A trauma patient has paradoxical chest movement after blunt chest trauma.
Which injury should the nurse suspect?
A. Simple pneumothorax
B. Cardiac tamponade
C. Flail chest
D. Pulmonary embolism
Answer: Flail chest
Rationale: Flail chest occurs when multiple adjacent ribs are fractured in
multiple locations, creating a free chest-wall segment that moves paradoxically
during respiration.
Question 9
Which finding is most consistent with cardiac tamponade after penetrating chest
trauma?
A. Hypertension and bradycardia
B. Hypotension, muffled heart sounds, and jugular venous distention
C. Unilateral absent breath sounds
D. Increased bowel sounds
Answer: Hypotension, muffled heart sounds, and jugular venous distention
Rationale: Beck's triad—hypotension, muffled heart sounds, and jugular venous
distention—is classically associated with cardiac tamponade.
