BSN 445 Week 15 Sherpath 2026/2027 – 55+ Questions & Answers | Trauma, TBI, Spinal Cord Injury, Hemorrhagic Shock & Emergency Care

This BSN 445 Week 15 Sherpath 2026/2027 exam preparation resource contains 55+ questions with correct answers across 25 pages, providing an intensive review of emergency trauma nursing, triage, primary and secondary surveys, hemorrhagic shock, massive transfusion, traumatic brain injury (TBI), spinal cord injury (SCI), maxillofacial and thoracic trauma, abdominal and genitourinary injuries, pelvic and orthopedic trauma, and post-traumatic complications. The opening questions establish emergency priorities by emphasizing multisystem injuries and uncontrolled arterial bleeding, followed by airway management in severe maxillofacial trauma, vascular access during peripheral vasoconstriction, active internal rewarming, the AMPLE secondary-survey history, and trauma laboratory evaluation including CBC, electrolytes, coagulation studies, and serum lactate. A major section focuses on hemorrhagic shock and initial trauma resuscitation. Students review massive transfusion protocols, definitive surgical control of hemorrhage, and hemodynamic goals in selected penetrating-trauma scenarios. The resource also identifies acute respiratory distress syndrome (ARDS) as a potential complication following massive transfusion. Together, these questions reinforce rapid recognition of life-threatening blood loss, prioritization of circulation after airway and breathing stabilization, appropriate blood-product replacement, and ongoing surveillance for complications of major trauma resuscitation. The traumatic brain injury section covers mild through severe TBI, Glasgow Coma Scale interpretation, loss of consciousness, respiratory compromise, skull fractures, Battle sign, raccoon eyes, head CT, epidural hematoma, intracranial pressure monitoring, cerebral perfusion, mechanical ventilation, serial imaging, and osmotic therapy. A fixed and dilated pupil following unilateral head trauma is connected with an intracranial emergency, while a GCS of 5 is associated with critical-care admission, ventilatory support and consideration of ICP monitoring. Students also interpret abnormal ICP, MAP and cerebral perfusion pressure values and review mannitol for severe intracranial hypertension. Another substantial section concentrates on spinal cord trauma and neurologic emergencies. Students differentiate central cord syndrome and Brown-Séquard syndrome and review the characteristic ipsilateral motor/touch deficits and contralateral pain/temperature loss associated with hemisection of the spinal cord. Immediate priorities include maintaining the airway while protecting the cervical spine and ensuring ventilatory equipment is available for high cervical injuries. The resource additionally covers spinal and neurogenic shock, spinal-cord perfusion, tetraplegia, and autonomic dysreflexia. Severe hypertension, bradycardia, pounding headache and facial flushing are presented as warning findings requiring rapid positioning and assessment for triggers such as bladder distention. The maxillofacial and thoracic trauma section reviews airway obstruction, nausea and aspiration concerns, contraindications to nasotracheal intubation in selected facial injuries, Le Fort III fractures, postoperative monitoring and bedside availability of wire cutters when appropriate. Thoracic-trauma questions address fractured ribs, deep breathing and coughing, pain management, early ambulation, blunt traumatic aortic injury, oliguria after endovascular repair and paradoxical chest-wall movement associated with flail chest. These scenarios reinforce the close relationship between trauma, ventilation, oxygenation, cardiovascular stability and rapid recognition of postoperative deterioration. Abdominal and genitourinary trauma receive similarly detailed treatment. Students review intra-abdominal hypertension through bladder-pressure measurement, Kehr sign as referred left-shoulder pain, FAST examination considerations, pelvic fractures as a risk factor for genitourinary injury, flank ecchymosis, renal diagnostic procedures, hematuria and critically reduced urine output. The material encourages students to integrate mechanism of injury with physical findings, hemodynamic changes, urinary assessment and imaging when identifying occult abdominal or urinary-system trauma. The resource also examines pelvic and orthopedic trauma. High-energy motor vehicle crashes are linked with pelvic fractures, while clinical findings include leg shortening, crepitus, scrotal swelling and vaginal bleeding. Students review serious complications following open unstable pelvic fractures, including sepsis, wound infection, venous thromboembolism and ARDS. Orthopedic trauma questions additionally address fat embolism syndrome and VTE prevention through low-molecular-weight heparin, sequential compression devices and early mobilization. The closing section integrates post-traumatic complications, missed injuries and special considerations in older adults. Students examine risk factors for post-traumatic acute kidney injury, including hypovolemic shock and rhabdomyolysis, and recognize a falling hematocrit after fluid administration as a possible indicator of occult injury. Analgesia, intoxication and sedation are identified as factors that can interfere with recognition of missed injuries. The material also incorporates the Institute for Healthcare Improvement's age-friendly “What Matters” principle, emphasizing alignment of care with an older patient's individual health goals and preferences, and includes AUDIT screening for alcohol-related risk. For evidence-based reinforcement, the trauma content corresponds closely with principles found in the American College of Surgeons’ Advanced Trauma Life Support (ATLS) framework and the Emergency Nurses Association’s Trauma Nursing Core Course (TNCC). TBI assessment and intracranial-pressure concepts should be compared with current Brain Trauma Foundation recommendations, while acute spinal cord injury management can be reinforced through contemporary spinal-trauma guidelines. Current authoritative guidance should take precedence where it differs from question-bank answers, particularly regarding permissive hypotension, massive transfusion, ICP/CPP targets, MAP management after SCI, airway techniques, fluid resuscitation and trauma imaging. Relevant Students: This document is particularly relevant for BSN 445 students, Sherpath nursing students, BSN and RN students, emergency nursing students, trauma nursing students, ICU and critical-care nursing students, and adult medical-surgical nursing students. It can also support ATI Adult Medical-Surgical, HESI, NCLEX-RN and trauma-exam preparation involving emergency triage, hemorrhagic shock, massive transfusion, TBI, GCS, ICP, spinal cord injury, autonomic dysreflexia, maxillofacial trauma, thoracic trauma, abdominal injuries, pelvic fractures and post-traumatic complications. 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