Advanced Trauma Care for Nurses (ATCN) Skills
Evaluation – Practice Exam: Detailed Verified
Questions and Answers, Comprehensive
Multiple-Choice Practice Test & Instant PDF
Study Guide
1. A patient arrives after a high-speed motor vehicle collision.
He is restless, pale, tachycardic, and hypotensive. What should
the trauma nurse prioritize during the initial assessment?
A. Obtain a complete medical history
B. Assess for distal neurological function
C. Establish and maintain adequate airway and oxygenation
D. Obtain a detailed medication history
Answer: C. Establish and maintain adequate airway and
oxygenation
Rationale: Trauma assessment follows a systematic primary
survey. Airway management with cervical-spine protection is
addressed first because airway compromise can rapidly cause
hypoxia, cardiac arrest, and death. A detailed history and
secondary assessment occur after immediately life-threatening
problems have been identified and treated.
,2. A trauma patient has a Glasgow Coma Scale (GCS) score of
E2 V2 M4. What is the patient's total GCS score?
A. 6
B. 8
C. 10
D. 12
Answer: B. 8
Rationale: The GCS is calculated by adding eye opening, verbal
response, and motor response. E2 + V2 + M4 = 8. A GCS of 8 or
less generally indicates severe neurological impairment and
should prompt consideration of definitive airway protection
when clinically appropriate.
3. Which finding most strongly indicates impending airway
compromise in a trauma patient?
A. Mild tachycardia
B. Hoarse voice and stridor
C. Blood pressure of 140/90 mmHg
D. Mild abdominal tenderness
Answer: B. Hoarse voice and stridor
Rationale: Hoarseness, stridor, abnormal phonation, facial or
neck trauma, and increasing work of breathing can indicate
significant upper-airway injury or obstruction. Stridor is
,particularly concerning because it indicates turbulent airflow
through a narrowed upper airway and may precede complete
obstruction.
4. A patient with suspected cervical-spine injury requires
airway management. Which approach is most appropriate?
A. Hyperextend the neck to open the airway
B. Perform a head-tilt/chin-lift without regard to the spine
C. Maintain cervical-spine protection while establishing the
airway
D. Delay airway management until cervical imaging is
completed
Answer: C. Maintain cervical-spine protection while
establishing the airway
Rationale: Airway management takes priority, but suspected
cervical-spine injury requires simultaneous spinal protection.
Excessive neck movement should be avoided. The airway must
never be left unsecured simply because cervical-spine injury is
suspected.
5. A trauma patient has severe respiratory distress,
hypotension, distended neck veins, and absent breath sounds
on the right. What condition should the nurse suspect?
, A. Pulmonary contusion
B. Tension pneumothorax
C. Cardiac tamponade
D. Massive hemothorax
Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax results from accumulating
pleural air under pressure, causing lung collapse and impaired
venous return. Hypotension, respiratory distress, unilateral
absent breath sounds, and distended neck veins are classic
findings. This is an immediately life-threatening condition
requiring rapid decompression rather than waiting for definitive
imaging.
6. Which assessment finding is most consistent with massive
hemothorax?
A. Hyperresonance and absent breath sounds
B. Hypotension with dullness to percussion and decreased
breath sounds
C. Bilateral wheezing
D. Tracheal deviation without blood loss
Answer: B. Hypotension with dullness to percussion and
decreased breath sounds
Evaluation – Practice Exam: Detailed Verified
Questions and Answers, Comprehensive
Multiple-Choice Practice Test & Instant PDF
Study Guide
1. A patient arrives after a high-speed motor vehicle collision.
He is restless, pale, tachycardic, and hypotensive. What should
the trauma nurse prioritize during the initial assessment?
A. Obtain a complete medical history
B. Assess for distal neurological function
C. Establish and maintain adequate airway and oxygenation
D. Obtain a detailed medication history
Answer: C. Establish and maintain adequate airway and
oxygenation
Rationale: Trauma assessment follows a systematic primary
survey. Airway management with cervical-spine protection is
addressed first because airway compromise can rapidly cause
hypoxia, cardiac arrest, and death. A detailed history and
secondary assessment occur after immediately life-threatening
problems have been identified and treated.
,2. A trauma patient has a Glasgow Coma Scale (GCS) score of
E2 V2 M4. What is the patient's total GCS score?
A. 6
B. 8
C. 10
D. 12
Answer: B. 8
Rationale: The GCS is calculated by adding eye opening, verbal
response, and motor response. E2 + V2 + M4 = 8. A GCS of 8 or
less generally indicates severe neurological impairment and
should prompt consideration of definitive airway protection
when clinically appropriate.
3. Which finding most strongly indicates impending airway
compromise in a trauma patient?
A. Mild tachycardia
B. Hoarse voice and stridor
C. Blood pressure of 140/90 mmHg
D. Mild abdominal tenderness
Answer: B. Hoarse voice and stridor
Rationale: Hoarseness, stridor, abnormal phonation, facial or
neck trauma, and increasing work of breathing can indicate
significant upper-airway injury or obstruction. Stridor is
,particularly concerning because it indicates turbulent airflow
through a narrowed upper airway and may precede complete
obstruction.
4. A patient with suspected cervical-spine injury requires
airway management. Which approach is most appropriate?
A. Hyperextend the neck to open the airway
B. Perform a head-tilt/chin-lift without regard to the spine
C. Maintain cervical-spine protection while establishing the
airway
D. Delay airway management until cervical imaging is
completed
Answer: C. Maintain cervical-spine protection while
establishing the airway
Rationale: Airway management takes priority, but suspected
cervical-spine injury requires simultaneous spinal protection.
Excessive neck movement should be avoided. The airway must
never be left unsecured simply because cervical-spine injury is
suspected.
5. A trauma patient has severe respiratory distress,
hypotension, distended neck veins, and absent breath sounds
on the right. What condition should the nurse suspect?
, A. Pulmonary contusion
B. Tension pneumothorax
C. Cardiac tamponade
D. Massive hemothorax
Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax results from accumulating
pleural air under pressure, causing lung collapse and impaired
venous return. Hypotension, respiratory distress, unilateral
absent breath sounds, and distended neck veins are classic
findings. This is an immediately life-threatening condition
requiring rapid decompression rather than waiting for definitive
imaging.
6. Which assessment finding is most consistent with massive
hemothorax?
A. Hyperresonance and absent breath sounds
B. Hypotension with dullness to percussion and decreased
breath sounds
C. Bilateral wheezing
D. Tracheal deviation without blood loss
Answer: B. Hypotension with dullness to percussion and
decreased breath sounds
