Advanced Trauma Care for Nurses (ATCN):
Verified Questions and Answers | Instant PDF
Study Guide
1. A trauma patient arrives with severe respiratory distress,
hypotension, distended neck veins, and absent breath sounds
on the right. What is the nurse's priority intervention?
A. Obtain a portable chest radiograph
B. Establish two large-bore IVs
C. Prepare for immediate needle/finger thoracostomy
D. Administer a rapid crystalloid bolus
Rationale: The combination of respiratory distress, hypotension,
unilateral absent breath sounds, and jugular venous distention
strongly suggests tension pneumothorax. Tension
pneumothorax is an immediately life-threatening condition
caused by progressive intrathoracic pressure that impairs
venous return and cardiac output. Treatment should not be
delayed for a chest radiograph in a hemodynamically unstable
patient. Immediate decompression followed by definitive chest
drainage is required.
,2. During the primary survey, which finding requires the most
immediate intervention?
A. Open femur fracture with controlled bleeding
B. Abdominal tenderness without hypotension
C. Airway obstruction with inability to speak
D. Closed tibial fracture with deformity
Rationale: Trauma assessment follows the priority of identifying
immediately life-threatening problems. An obstructed airway
can rapidly cause hypoxia, cardiac arrest, and death. A patient
who cannot speak because of airway obstruction requires
immediate airway intervention. Other injuries remain important
but should not take precedence over an immediately threatened
airway.
3. A trauma patient has facial fractures, blood in the mouth,
and gurgling respirations. What is the initial nursing action?
A. Insert an oral airway
B. Give high-flow oxygen by nonrebreather mask
C. Suction the airway while preparing for definitive airway
management
D. Place the patient in a supine position without intervention
,Rationale: Gurgling respirations in a trauma patient commonly
indicate blood, secretions, or other material obstructing the
airway. Immediate suctioning is necessary to clear the airway.
Because facial trauma may make conventional airway
management difficult, the team should simultaneously prepare
for definitive airway control. An oral airway may be
inappropriate in an awake patient and does not address the
underlying obstruction.
4. Which assessment finding is most concerning for impending
airway compromise after a neck injury?
A. Mild neck tenderness
B. Small superficial abrasion
C. Progressively increasing hoarseness and stridor
D. Stable respiratory rate of 18/min
Rationale: Hoarseness and stridor can indicate edema or
structural injury involving the upper airway. Progressive airway
edema may make later intubation extremely difficult or
impossible. Early recognition is therefore critical, and the
trauma team should prepare for definitive airway management
before complete obstruction develops.
, 5. A patient with suspected cervical spine injury requires
airway management. Which technique is preferred for
opening the airway?
A. Head-tilt/chin-lift
B. Hyperextension of the neck
C. Jaw-thrust maneuver with cervical spine protection
D. Rotation of the head to the side
Rationale: In patients with possible cervical spine injury,
excessive neck movement should be avoided. The jaw-thrust
maneuver can help open the airway while minimizing cervical
spine movement. Manual stabilization and appropriate spinal
precautions should be maintained until cervical spine injury has
been adequately evaluated.
6. Which finding most strongly suggests inadequate tissue
perfusion in a trauma patient?
A. Warm skin and normal mentation
B. Blood pressure of 130/80 mmHg
C. Altered mental status with cool, clammy skin
D. Respiratory rate of 16/min
Rationale: Altered mental status and cool, clammy skin are
important indicators of inadequate systemic perfusion. Early
shock may occur before profound hypotension develops,
Verified Questions and Answers | Instant PDF
Study Guide
1. A trauma patient arrives with severe respiratory distress,
hypotension, distended neck veins, and absent breath sounds
on the right. What is the nurse's priority intervention?
A. Obtain a portable chest radiograph
B. Establish two large-bore IVs
C. Prepare for immediate needle/finger thoracostomy
D. Administer a rapid crystalloid bolus
Rationale: The combination of respiratory distress, hypotension,
unilateral absent breath sounds, and jugular venous distention
strongly suggests tension pneumothorax. Tension
pneumothorax is an immediately life-threatening condition
caused by progressive intrathoracic pressure that impairs
venous return and cardiac output. Treatment should not be
delayed for a chest radiograph in a hemodynamically unstable
patient. Immediate decompression followed by definitive chest
drainage is required.
,2. During the primary survey, which finding requires the most
immediate intervention?
A. Open femur fracture with controlled bleeding
B. Abdominal tenderness without hypotension
C. Airway obstruction with inability to speak
D. Closed tibial fracture with deformity
Rationale: Trauma assessment follows the priority of identifying
immediately life-threatening problems. An obstructed airway
can rapidly cause hypoxia, cardiac arrest, and death. A patient
who cannot speak because of airway obstruction requires
immediate airway intervention. Other injuries remain important
but should not take precedence over an immediately threatened
airway.
3. A trauma patient has facial fractures, blood in the mouth,
and gurgling respirations. What is the initial nursing action?
A. Insert an oral airway
B. Give high-flow oxygen by nonrebreather mask
C. Suction the airway while preparing for definitive airway
management
D. Place the patient in a supine position without intervention
,Rationale: Gurgling respirations in a trauma patient commonly
indicate blood, secretions, or other material obstructing the
airway. Immediate suctioning is necessary to clear the airway.
Because facial trauma may make conventional airway
management difficult, the team should simultaneously prepare
for definitive airway control. An oral airway may be
inappropriate in an awake patient and does not address the
underlying obstruction.
4. Which assessment finding is most concerning for impending
airway compromise after a neck injury?
A. Mild neck tenderness
B. Small superficial abrasion
C. Progressively increasing hoarseness and stridor
D. Stable respiratory rate of 18/min
Rationale: Hoarseness and stridor can indicate edema or
structural injury involving the upper airway. Progressive airway
edema may make later intubation extremely difficult or
impossible. Early recognition is therefore critical, and the
trauma team should prepare for definitive airway management
before complete obstruction develops.
, 5. A patient with suspected cervical spine injury requires
airway management. Which technique is preferred for
opening the airway?
A. Head-tilt/chin-lift
B. Hyperextension of the neck
C. Jaw-thrust maneuver with cervical spine protection
D. Rotation of the head to the side
Rationale: In patients with possible cervical spine injury,
excessive neck movement should be avoided. The jaw-thrust
maneuver can help open the airway while minimizing cervical
spine movement. Manual stabilization and appropriate spinal
precautions should be maintained until cervical spine injury has
been adequately evaluated.
6. Which finding most strongly suggests inadequate tissue
perfusion in a trauma patient?
A. Warm skin and normal mentation
B. Blood pressure of 130/80 mmHg
C. Altered mental status with cool, clammy skin
D. Respiratory rate of 16/min
Rationale: Altered mental status and cool, clammy skin are
important indicators of inadequate systemic perfusion. Early
shock may occur before profound hypotension develops,
