Advanced Trauma Life Support (ATLS/ITLS) Review for Nurses

Trauma Life Support Test for Nurses (Short Questions)

Question 1: What is the initial priority for an unconscious trauma patient with a snoring airway?
A) Insert an oropharyngeal airway.
B) Perform a jaw-thrust maneuver.
C) Administer supplemental oxygen.
D) Prepare for intubation.

Question 2: A tension pneumothorax is characterized by hypotension, tracheal deviation, and what breath sound finding on the affected side?
A) Wheezing
B) Rales
C) Diminished or absent
D) Rhonchi

Question 3: For a bleeding scalp laceration, what is the most appropriate initial intervention after ensuring patient safety?
A) Apply a tourniquet.
B) Pack with sterile gauze and apply direct pressure.
C) Elevate the head of the bed.
D) Prepare for immediate suturing.

Question 4: In an adult trauma patient in hemorrhagic shock, what is the preferred initial crystalloid for fluid resuscitation?
A) Dextrose 5% in water.
B) 0.45% Normal Saline.
C) Lactated Ringer’s solution.
D) 7.5% Hypertonic Saline.

Question 5: A GCS score of 8 or less typically indicates what level of head injury and often necessitates what intervention?
A) Mild; observation.
B) Moderate; frequent neurological checks.
C) Severe; definitive airway management.
D) Minimal; discharge home.

Question 6: What physical finding is characteristic of a flail chest?
A) Subcutaneous emphysema.
B) Paradoxical chest wall movement.
C) Muffled heart sounds.
D) Unilateral absence of breath sounds.

Question 7: What is the primary concern when managing an impaled object in a trauma patient?
A) Immediate removal.
B) Cutting it short for transport.
C) Stabilizing the object in place.
D) Applying a heating pad.

Question 8: What is a critical sign of spinal cord injury in a male patient, especially with neurogenic shock?
A) Tachycardia.
B) Hypertension.
C) Priapism.
D) Warm, flushed skin.

Question 9: For a patient with a suspected pelvic fracture, what finding mandates avoiding a urethral Foley catheter insertion?
A) Hematuria.
B) Absent bowel sounds.
C) Blood at the urethral meatus.
D) Lower extremity weakness.

Question 10: What is the target minimum urine output per hour for an adult trauma patient indicating adequate fluid resuscitation?
A) 10 mL/hr
B) 20 mL/hr
C) 30 mL/hr
D) 60 mL/hr

Trauma Life Support Test for Nurses – Set 2 (Short Questions)

Question 11: What is the most common cause of airway obstruction in an unconscious trauma patient?
A) Vomit.
B) Blood.
C) The tongue.
D) Foreign body.

Question 12: In a patient with a suspected cervical spine injury, which maneuver is used to open the airway?
A) Head-tilt, chin-lift.
B) Jaw-thrust maneuver.
C) Nasal trumpet insertion.
D) Oropharyngeal airway insertion.

Question 13: What is the most rapid way to assess for intra-abdominal bleeding in an unstable trauma patient?
A) Abdominal X-ray.
B) CT scan.
C) FAST exam.
D) MRI.

Question 14: What is the critical complication to prevent in a fully exposed trauma patient during assessment?
A) Hyperglycemia.
B) Hypothermia.
C) Hypertension.
D) Hypercalcemia.

Question 15: What is the most immediate life-threatening complication of massive blood transfusion?
A) Hypernatremia.
B) Hypocalcemia and hypothermia.
C) Hyperkalemia.
D) Respiratory acidosis.

Question 16: A patient with electrical burns is at highest risk for what immediate life-threatening complication?
A) Renal failure.
B) Cardiac arrhythmias.
C) Deep vein thrombosis.
D) Wound infection.

Question 17: What GCS score indicates a patient is likely to require definitive airway management (intubation)?
A) 15.
B) 10.
C) 8 or less.
D) 13.

Question 18: What type of dressing is used for an eviscerated bowel?
A) Dry sterile dressing.
B) Petroleum gauze.
C) Moist sterile dressing.
D) Non-adherent dressing.

Question 19: What condition is indicated by muffled heart sounds, JVD, and hypotension (Beck’s Triad)?
A) Tension pneumothorax.
B) Hemothorax.
C) Cardiac tamponade.
D) Myocardial contusion.

Question 20: What is the earliest indicator of shock in a pediatric patient?
A) Hypotension.
B) Tachycardia.
C) Bradycardia.
D) Bradypnea.

Trauma Life Support Test for Nurses – Set 3 (Short Questions)

Question 21: What is the primary method for controlling external hemorrhage in the field?
A) Tourniquet application.
B) Elevation.
C) Pressure points.
D) Direct pressure.

Question 22: What is the most common cause of preventable death after trauma?
A) Head injury.
B) Spinal cord injury.
C) Uncontrolled hemorrhage.
D) Sepsis.

Question 23: What is the purpose of the “E” in the primary survey (ABCDE)?
A) External bleeding control.
B) Evaluating for fractures.
C) Exposure/Environment.
D) Emotional support.

Question 24: A patient with a severe crush injury to the lower extremity is at high risk for what systemic complication?
A) Fat embolism.
B) Rhabdomyolysis and acute kidney injury.
C) Deep vein thrombosis.
D) Compartment syndrome.

Question 25: In pregnant trauma patients, what position is crucial to avoid vena cava compression?
A) Supine with legs elevated.
B) Trendelenburg.
C) Left lateral decubitus or wedge under right hip.
D) Semi-Fowler’s.

Question 26: What is the immediate treatment for a tension pneumothorax after diagnosis?
A) Chest tube insertion.
B) Needle decompression.
C) Occlusive dressing.
D) Bronchodilators.

Question 27: What common neurological assessment tool is used rapidly in the D (Disability) part of the primary survey?
A) GCS.
B) NIHSS.
C) AVPU.
D) Cranial nerve assessment.

Question 28: What type of IV catheter is preferred for rapid fluid resuscitation in an adult trauma patient?
A) 22-gauge.
B) 20-gauge.
C) 18-gauge.
D) 14 or 16-gauge.

Question 29: What percentage of total body surface area (TBSA) does an adult’s entire arm account for in burn assessment?
A) 4.5%.
B) 9%.
C) 18%.
D) 1%.

Question 30: What is a key consideration for elderly trauma patients, even with minor injuries?
A) Increased pain tolerance.
B) Diminished physiological reserves.
C) Faster healing times.
D) Lower risk of complications.

Trauma Life Support Test for Nurses – Set 4 (Short Questions)

Question 31: What is the first line of defense against hypothermia in a trauma patient after exposure?
A) Warm IV fluids.
B) Overhead warmer.
C) Warm blankets.
D) Room temperature adjustment.

Question 32: What is the immediate intervention for a large, actively bleeding laceration unresponsive to direct pressure?
A) Tourniquet application.
B) Pressure dressing and elevation.
C) Hemostatic agent.
D) Wound closure.

Question 33: What complication is indicated by pain out of proportion to injury, especially on passive stretch, and a tense compartment?
A) DVT.
B) Cellulitis.
C) Compartment syndrome.
D) Sprain.

Question 34: What fluid is generally contraindicated for initial resuscitation in severe trauma due to fluid shifts?
A) 0.9% Normal Saline.
B) Lactated Ringer’s.
C) Dextrose-containing solutions.
D) Packed Red Blood Cells.

Question 35: What is the definitive treatment for a massive hemothorax?
A) Needle decompression.
B) Occlusive dressing.
C) Large-bore chest tube insertion.
D) Thoracentesis.

Question 36: What finding is highly suggestive of intra-abdominal injury and peritonitis during abdominal assessment?
A) Absent bowel sounds.
B) Abdominal distension.
C) Rebound tenderness.
D) Ecchymosis.

Question 37: What is the primary purpose of spinal immobilization in trauma?
A) Pain relief.
B) Facilitate transport.
C) Prevent further spinal cord injury.
D) Improve breathing.

Question 38: What vital sign change is often the first to appear in a patient developing shock?
A) Hypotension.
B) Bradypnea.
C) Tachycardia.
D) Hypothermia.

Question 39: When is it appropriate to remove an impaled object in the prehospital or initial ED setting?
A) Never.
B) If it obstructs the airway or prevents CPR.
C) Only if small.
D) After X-ray confirmation.

Question 40: What is the primary concern for a trauma patient on anticoagulants who sustains a head injury?
A) Delayed pain.
B) Risk of seizures.
C) High risk of intracranial hemorrhage.
D) Superficial bruising.

Trauma Life Support Test for Nurses – Set 5 (Short Questions)

Question 41: What is the purpose of secondary survey in trauma?
A) Identify immediate life threats.
B) Head-to-toe assessment for all injuries.
C) Establish definitive airway.
D) Initiate massive transfusion.

Question 42: What is the most critical immediate intervention for an expanding neck hematoma causing respiratory distress?
A) Direct pressure.
B) Rapid sequence intubation.
C) Emergency surgical airway (cricothyrotomy).
D) Administer oxygen.

Question 43: What is a common complication of blunt trauma to the chest, leading to impaired gas exchange?
A) Pleural effusion.
B) Pulmonary contusion.
C) Pneumonia.
D) Bronchitis.

Question 44: What is the appropriate initial management for an open fracture after addressing life threats?
A) Immediate wound irrigation.
B) Surgical reduction.
C) Sterile dressing and splinting.
D) Direct compression.

Question 45: What is the initial response when a patient develops symptoms of a transfusion reaction during blood administration?
A) Slow the infusion.
B) Stop the infusion.
C) Administer antihistamines.
D) Administer fluids.

Question 46: What is the primary reason for inserting a Foley catheter in a severely burned patient?
A) Prevent UTI.
B) Monitor fluid resuscitation adequacy.
C) Decompress bladder.
D) Obtain urine for drug screen.

Question 47: What is the “golden hour” in trauma care?
A) Time for diagnosis.
B) Time for surgery.
C) Critical time for rapid assessment, resuscitation, and definitive care.
D) Time for patient transfer.

Question 48: What is the primary concern for a patient with a circumferential burn to an extremity?
A) Infection.
B) Pain.
C) Compromised circulation/compartment syndrome.
D) Fluid loss.

Question 49: In pediatric trauma, what should a nurse always consider in cases where injury mechanism seems inconsistent?
A) Normal play injuries.
B) Non-accidental trauma/child abuse.
C) Underlying medical condition.
D) Parental exaggeration.

Question 50: What is the immediate post-needle decompression definitive treatment for a tension pneumothorax?
A) Observation.
B) Repeat needle decompression.
C) Chest tube insertion.
D) Surgical repair.

Scenario-Based Trauma Life Support (TLS) Sample Test

Question 1: A 45-year-old male presents to the ED after a high-speed motor vehicle collision. He is unresponsive, and his airway appears obstructed by his tongue. What is the immediate priority for the nursing staff?
A) Administer high-flow oxygen via a non-rebreather mask.
B) Insert an oropharyngeal airway (OPA).
C) Perform a jaw-thrust maneuver.
D) Prepare for immediate intubation.

Question 2: A 28-year-old female is brought in with a stab wound to the left chest. She is tachypneic (respiratory rate 30 bpm), tachycardic (heart rate 120 bpm), hypotensive (BP 88/50 mmHg), and has diminished breath sounds on the left side with tracheal deviation to the right. What is the most likely diagnosis and immediate intervention?
A) Hemothorax; prepare for chest tube insertion.
B) Tension pneumothorax; perform needle decompression.
C) Flail chest; provide positive pressure ventilation.
D) Cardiac tamponade; prepare for pericardiocentesis.

Question 3: You are assessing a 60-year-old male who fell from a ladder. He is conscious but disoriented. His Glasgow Coma Scale (GCS) score is E3 V4 M5. What does this GCS score indicate, and what is your primary concern?
A) Mild head injury; monitor for signs of increased intracranial pressure.
B) Moderate head injury; perform a neurological assessment every 15 minutes.
C) Severe head injury; prepare for immediate surgical intervention.
D) Normal neurological status; focus on other injuries.

Question 4: A 35-year-old pedestrian is struck by a car. Upon arrival, he is pale, clammy, and has a rapid, thready radial pulse. His blood pressure is 70/40 mmHg. You suspect hemorrhagic shock. What is the most appropriate initial fluid resuscitation for this patient?
A) Dextrose 5% in water (D5W) at a keep-vein-open rate.
B) 0.9% Normal Saline (NS) 2 liters rapidly.
C) Colloids (e.g., albumin) to expand intravascular volume.
D) Lactated Ringer’s (LR) 1-2 liters rapidly, with consideration for blood products if no response.

Question 5: A patient presents with a large, actively bleeding laceration on the forearm. After applying direct pressure, the bleeding continues. What is your next immediate intervention?
A) Apply a tourniquet proximal to the wound.
B) Apply a pressure dressing and elevate the limb.
C) Apply a hemostatic dressing.
D) Prepare for surgical wound exploration.

Question 6: During the secondary survey of a trauma patient, you notice a paradoxical movement of the chest wall on one side. This finding is indicative of what injury?
A) Simple pneumothorax
B) Rib fracture
C) Flail chest
D) Hemothorax

Question 7: A 70-year-old patient involved in a low-speed fender-bender complains of neck pain. On assessment, you note tenderness over the cervical spine. What is the most crucial initial nursing intervention related to this finding?
A) Administer pain medication.
B) Apply a cervical collar and maintain spinal immobilization.
C) Encourage gentle range of motion exercises.
D) Obtain immediate X-rays of the cervical spine.

Question 9: You are triaging patients after a mass casualty incident. A patient with a sucking chest wound is breathing shallowly and is hypotensive. According to standard trauma triage principles, what category would this patient most likely fall under?
A) Green (Minor)
B) Yellow (Delayed)
C) Red (Immediate)
D) Black (Deceased/Expectant)

Question 10: A patient arrives in the ED with full-thickness burns covering their entire left arm and the anterior trunk. What is the estimated total body surface area (TBSA) burned using the Rule of Nines?
A) 9%
B) 18%
C) 27%
D) 36%

Okay, I understand! You’d like me to provide 10 scenario-based Trauma Life Support (TLS) questions for nurses at a time, following the specified format, with the correct answer immediately after the options. I will ensure the questions are aligned with general trauma care principles and include a mix of topics.
Question 11: A 50-year-old male motorcyclist is brought in after a collision. He is conscious but complaining of severe abdominal pain. His abdomen is distended and rigid, and he has a faint bruise over the umbilical area. His vital signs are HR 110 bpm, BP 92/58 mmHg, RR 22 bpm. What is the most immediate concern?
A) Mesenteric ischemia
B) Bowel perforation with peritonitis
C) Solid organ injury with internal hemorrhage
D) Pelvic fracture

Question 12: A 30-year-old pregnant woman (28 weeks gestation) is involved in a motor vehicle accident. She is stable, but complains of uterine contractions and some vaginal spotting. What is the most critical nursing action regarding her position in the ED?
A) Place her supine with legs elevated.
B) Place her in the Trendelenburg position.
C) Place her on her left side or with a wedge under her right hip.
D) Place her in a semi-Fowler’s position.

Question 13: A trauma patient has sustained a significant open fracture of the tibia and fibula with gross contamination. After ensuring airway, breathing, and circulation, what is the priority nursing intervention for this specific injury?
A) Immediate wound irrigation with saline.
B) Application of a splint and sterile dressing.
C) Administration of broad-spectrum antibiotics.
D) Reduction of the fracture.

Question 14: During the primary survey, you note that a 40-year-old trauma patient is responsive to pain but not verbalizing words, and his pupils are unequal and sluggishly reactive. Which component of the GCS is most clearly indicated by this assessment finding, and what should be your immediate next action?
A) Verbal response; prepare for intubation.
B) Eye opening; elevate the head of the bed.
C) Motor response; check for posturing.
D) Pupil assessment; notify the physician immediately regarding neurological deterioration.

Question 15: A patient presents with a deep penetrating injury to the right upper quadrant of the abdomen. The nurse anticipates the need for imaging to assess for organ damage. Which diagnostic study is typically the most rapid and effective for detecting free fluid (indicating hemorrhage) in the abdomen in a hemodynamically unstable trauma patient?
A) Abdominal X-ray
B) Computed Tomography (CT) scan of the abdomen
C) Focused Assessment with Sonography for Trauma (FAST) exam
D) Magnetic Resonance Imaging (MRI) of the abdomen

Question 16: You are preparing a patient for transport to a higher-level trauma center. The patient has a stable impaled object in the chest. What is the most appropriate action for this object during transport?
A) Remove the object to prevent further damage.
B) Secure the object in place and stabilize it.
C) Cut the object short to facilitate transport.
D) Apply direct pressure over the object’s entry site.

Question 17: A 25-year-old male has suffered an electrical burn. He is conscious but appears confused. His skin at the entry and exit points shows charred appearance. What is the most critical immediate concern for this patient, even if external burn size seems small?
A) Risk of infection at the burn sites.
B) Potential for significant internal tissue damage, especially cardiac arrhythmias.
C) Severe pain management.
D) Fluid resuscitation based on external burn size.

Question 18: During the “E” (Exposure/Environment) phase of the primary survey, after fully exposing the patient, what is a crucial nursing action to prevent complications?
A) Apply warm blankets and initiate fluid warmers.
B) Document all visible injuries.
C) Obtain a complete set of vital signs.
D) Perform a rapid head-to-toe assessment.

Question 19: A patient is brought in after being extricated from a collapsed building. He has crush injuries to both lower extremities. What is a significant potential complication the nurse should anticipate and monitor for closely upon reperfusion?
A) Deep vein thrombosis (DVT)
B) Fat embolism syndrome
C) Rhabdomyolysis and acute kidney injury
D) Compartment syndrome

Question 20: You are administering blood products to a severely bleeding trauma patient. After initiating the transfusion, the patient develops sudden shortness of breath, hives, and a drop in blood pressure. What is your immediate priority nursing action?
A) Administer a rapid fluid bolus.
B) Slow down the transfusion rate.
C) Stop the transfusion immediately.
D) Administer epinephrine.

Question 21: A 4-year-old child presents after a fall from a second-story window. The child is crying inconsolably and has a noticeable deformity of the right femur. Beyond standard trauma assessment, what specific consideration is paramount in pediatric trauma care related to potential abuse?
A) Rapid administration of pain medication to calm the child.
B) Avoiding questioning the child directly about the incident.
C) A high index of suspicion for non-accidental trauma, especially with mechanism inconsistencies.
D) Prioritizing parental comfort and reassurance.

Question 22: A patient is brought in with a severe facial injury, including significant bleeding and fractured nasal bones. Despite attempts at airway repositioning, the airway remains partially obstructed by blood and debris. What is the most appropriate immediate airway management strategy?
A) Nasopharyngeal airway insertion.
B) Oropharyngeal airway insertion.
C) Suctioning the airway and preparing for definitive airway management (e.g., intubation/cricothyrotomy).
D) Administering a nebulized bronchodilator.

Question 24: A 68-year-old patient on anticoagulants fell and hit their head. They are now presenting with a decreased level of consciousness. The CT scan is pending. What is the most significant concern for this patient given their medication and injury?
A) Delayed onset of symptoms.
B) High risk of intracranial hemorrhage.
C) Increased risk of long bone fractures.
D) Difficulty in assessing pain.

Question 25: You are participating in a trauma resuscitation. The patient is receiving massive transfusion protocol. What specific complication related to rapid and large-volume blood product administration should the nurse be vigilant for?
A) Hyperglycemia
B) Hypernatremia
C) Hypocalcemia and hypothermia
D) Respiratory alkalosis

Question 26: A patient with a severe crush injury to the chest is experiencing significant pain. What is the most appropriate pain management strategy in the acute phase of trauma care, considering potential respiratory compromise?
A) Oral opioid analgesics.
B) Intravenous NSAIDs.
C) Small, titrated doses of intravenous opioids.
D) Application of a heat pack to the chest.

Question 27: During the “D” (Disability) component of the primary survey, what is the most rapid and widely used assessment tool for determining a patient’s level of consciousness in the trauma setting?
A) Mini-Mental State Examination (MMSE).
B) Glasgow Coma Scale (GCS).
C) National Institutes of Health Stroke Scale (NIHSS).
D) Arousal, Voice, Pain, Unresponsive (AVPU) scale.

Question 28: A patient involved in a motor vehicle collision has significant external bleeding from a scalp laceration. You have applied direct pressure. What is a key consideration when assessing and managing scalp lacerations in trauma?
A) They are usually minor and do not cause significant blood loss.
B) They can lead to rapid and substantial blood loss, especially in children and the elderly.
C) They always indicate underlying skull fracture.
D) They primarily pose a risk for infection rather than hemorrhage.

Question 29: You are inserting a peripheral intravenous catheter for fluid resuscitation in a trauma patient. Which gauge catheter is most appropriate for rapid fluid delivery in an adult trauma patient in shock?
A) 22-gauge
B) 20-gauge
C) 18-gauge
D) 14- or 16-gauge

Question 30: A patient has just arrived from a motor vehicle collision and is found to have absent radial pulses bilaterally. What is the immediate and most critical implication of this finding during the primary survey?
A) Peripheral arterial disease.
B) Hypovolemic shock.
C) Spinal cord injury with neurogenic shock.
D) Localized injury to the upper extremities.

Question 31: A 40-year-old male presents to the ED after a fall from a height. He complains of severe lower back pain and weakness in both legs. During your assessment, you note a palpable step-off deformity in his lumbar spine. What is your immediate priority for this patient?
A) Assist him to a comfortable position.
B) Perform a detailed neurological assessment of the lower extremities.
C) Maintain strict spinal immobilization.
D) Administer strong pain medication intravenously.

Question 32: You are assessing a patient with a large, actively bleeding scalp laceration. You’ve applied direct pressure, but the bleeding is still significant. What is the most appropriate next step to control this hemorrhage?
A) Apply a tourniquet to the neck.
B) Pack the wound with gauze and apply a pressure dressing.
C) Elevate the patient’s head to reduce blood flow.
D) Prepare for immediate surgical ligation of scalp vessels.

Question 33: A patient is brought in with severe blunt chest trauma. During the primary survey, you observe paradoxical chest wall movement and cyanosis. What is the most likely diagnosis, and what intervention is crucial to improve oxygenation?
A) Simple pneumothorax; apply an occlusive dressing.
B) Flail chest; positive pressure ventilation (e.g., intubation and mechanical ventilation).
C) Hemothorax; large-bore chest tube insertion.
D) Pulmonary contusion; aggressive diuretic therapy.

Question 34: An elderly patient with multiple comorbidities is involved in a low-impact fall and sustains a hip fracture. What specific physiological difference in elderly trauma patients puts them at higher risk for poor outcomes, even from seemingly minor injuries?
A) Decreased pain perception.
B) Exaggerated physiological response to injury.
C) Diminished physiological reserves and blunted compensatory mechanisms.
D) Increased bone density.

Question 35: A patient is receiving fluid resuscitation for hypovolemic shock. You are monitoring urine output via a Foley catheter. What is the minimum acceptable urine output for an adult trauma patient to indicate adequate renal perfusion?
A) 10 mL/hour
B) 20 mL/hour
C) 30 mL/hour (or 0.5 mL/kg/hour)
D) 50 mL/hour

Question 36: In the context of a trauma patient requiring multiple interventions, what is the primary purpose of the “golden hour” concept?
A) To ensure all diagnostic tests are completed within 60 minutes.
B) To complete the entire secondary survey within the first hour.
C) To highlight the critical importance of rapid assessment, resuscitation, and definitive care.
D) To limit the total resuscitation time to 60 minutes.

Question 37: A trauma patient presents with muffled heart sounds, jugular venous distension (JVD), and hypotension despite adequate fluid resuscitation. This triad of symptoms (Beck’s Triad) is indicative of what life-threatening condition?
A) Tension pneumothorax
B) Massive hemothorax
C) Cardiac tamponade
D) Myocardial contusion

Question 38: You are preparing a trauma room for an incoming patient with suspected multi-system trauma. What is a key piece of equipment that should be readily available and functioning for airway management?
A) Defibrillator pads
B) Intraosseous (IO) drill and needles
C) Suction apparatus with rigid (Yankauer) and flexible catheters
D) External pacing capabilities

Question 39: A patient is complaining of severe pain in their lower leg following a crush injury. On assessment, you note the leg is tense, shiny, and pain is out of proportion to the injury described, especially on passive stretch of the muscles. Pulses are still present. What serious complication should you suspect?
A) Deep vein thrombosis
B) Cellulitis
C) Compartment syndrome
D) Superficial thrombophlebitis

Question 40: When performing the “E” (Exposure/Environment) step of the primary survey, after fully exposing the patient, what essential action should immediately follow to prevent a common and dangerous complication in trauma patients?
A) Initiate wound care for all open injuries.
B) Cover the patient with warm blankets or a warming device.
C) Begin a head-to-toe assessment.
D) Obtain a complete set of baseline vital signs.

Question 41: A patient arrives in the ED after being hit by a car while cycling. He is confused and has obvious external signs of head trauma. During your primary survey, you are unable to obtain a blood pressure reading using a cuff. What is your immediate nursing intervention?
A) Obtain a manual blood pressure reading using palpation.
B) Insert two large-bore IVs immediately.
C) Obtain a stat CT scan of the head.
D) Perform a rapid neurological assessment.

Question 42: A patient has sustained a penetrating injury to the abdomen. On assessment, you note active bleeding from the wound and evisceration of bowel. After covering the patient, what is the most appropriate initial nursing management for the eviscerated bowel?
A) Gently attempt to push the bowel back into the abdominal cavity.
B) Cover the bowel with a dry, sterile dressing.
C) Cover the bowel with a moist, sterile dressing.
D) Apply direct pressure to the eviscerated bowel.

Question 43: You are assisting with the resuscitation of a patient in traumatic cardiac arrest. Despite aggressive fluid resuscitation and addressing reversible causes, the patient remains in asystole. What is the nurse’s role in supporting the family during this critical time?
A) Ask the family to leave the room immediately.
B) Provide a quiet space for them away from the patient, with periodic updates.
C) Allow family presence during resuscitation, if feasible and desired, with a designated support person.
D) Focus solely on patient care and defer family interaction until after resuscitation efforts cease.

Question 44: A patient presents with a large, actively expanding hematoma on the neck after blunt trauma. The patient’s voice is becoming hoarse, and they are experiencing increasing respiratory distress. What is the immediate priority?
A) Administer IV fluids.
B) Prepare for an emergency surgical airway (cricothyrotomy).
C) Apply direct pressure to the hematoma.
D) Monitor vital signs closely.

Question 45: When assessing a patient with suspected abdominal trauma during the secondary survey, what physical examination finding is highly suggestive of intra-abdominal injury, even if initial vital signs are stable?
A) Absent bowel sounds.
B) Rebound tenderness.
C) Abdominal distension.
D) Cullen’s sign (periumbilical ecchymosis).

Question 46: A patient with a severe head injury is hyperventilating spontaneously (respiratory rate 35 bpm, deep). What effect does this hyperventilation have on intracranial pressure (ICP), and what is the nursing implication?
A) It increases ICP; the nurse should encourage slower breathing.
B) It decreases ICP; the nurse should maintain this breathing pattern.
C) It has no effect on ICP; the nurse should monitor for other signs of deterioration.
D) It increases ICP; the nurse should administer a sedative to reduce the respiratory rate.

Question 47: You are receiving a trauma patient in the ED. The pre-hospital report indicates a positive FAST exam. What does a positive FAST exam primarily indicate, and what is the typical next step for a hemodynamically unstable patient with this finding?
A) Solid organ contusion; observation.
B) Free fluid (likely blood) in the abdomen/pericardium; likely emergent laparotomy/thoracotomy.
C) Bowel injury; immediate endoscopy.
D) Kidney damage; prepare for dialysis.

Question 48: A patient has sustained a significant burn injury to the lower extremities. What is the primary reason for inserting a Foley catheter early in the management of a severely burned patient?
A) To prevent urinary tract infections.
B) To monitor fluid resuscitation adequacy.
C) To decompress the bladder.
D) To obtain urine for toxicology screening.

Question 49: A male trauma patient presents with a suspected pelvic fracture. During your initial assessment, you observe blood at the urethral meatus. What is the critical nursing consideration before inserting a Foley catheter?
A) Insert a smaller gauge Foley catheter.
B) Administer a local anesthetic.
C) Anticipate the need for a suprapubic catheter and avoid urethral catheterization.
D) Force the Foley catheter if there is resistance.

Question 50: During the management of a trauma patient, the nurse identifies a tension pneumothorax. After needle decompression is performed by the physician, what is the anticipated definitive treatment that the nurse should prepare for?
A) Immediate surgical repair of the lung.
B) Insertion of a chest tube.
C) Application of an occlusive dressing.
D) Administration of diuretics.

Okay, I will now provide 10 short, single-line trauma life support questions for nurses, following the format you’ve requested.
Question 51: What is the initial priority for an unconscious trauma patient with a snoring airway?
A) Insert an oropharyngeal airway.
B) Perform a jaw-thrust maneuver.
C) Administer supplemental oxygen.
D) Prepare for intubation.

Question 52: A tension pneumothorax is characterized by hypotension, tracheal deviation, and what breath sound finding on the affected side?
A) Wheezing
B) Rales
C) Diminished or absent
D) Rhonchi

Question 53: For a bleeding scalp laceration, what is the most appropriate initial intervention after ensuring patient safety?
A) Apply a tourniquet.
B) Pack with sterile gauze and apply direct pressure.
C) Elevate the head of the bed.
D) Prepare for immediate suturing.

Question 54: In an adult trauma patient in hemorrhagic shock, what is the preferred initial crystalloid for fluid resuscitation?
A) Dextrose 5% in water.
B) 0.45% Normal Saline.
C) Lactated Ringer’s solution.
D) 7.5% Hypertonic Saline.

Question 55: A GCS score of 8 or less typically indicates what level of head injury and often necessitates what intervention?
A) Mild; observation.
B) Moderate; frequent neurological checks.
C) Severe; definitive airway management.
D) Minimal; discharge home.

Question 56: What physical finding is characteristic of a flail chest?
A) Subcutaneous emphysema.
B) Paradoxical chest wall movement.
C) Muffled heart sounds.
D) Unilateral absence of breath sounds.

Question 57: What is the primary concern when managing an impaled object in a trauma patient?
A) Immediate removal.
B) Cutting it short for transport.
C) Stabilizing the object in place.
D) Applying a heating pad.

Question 58: What is a critical sign of spinal cord injury in a male patient, especially with neurogenic shock?
A) Tachycardia.
B) Hypertension.
C) Priapism.
D) Warm, flushed skin.

Question 59: For a patient with a suspected pelvic fracture, what finding mandates avoiding a urethral Foley catheter insertion?
A) Hematuria.
B) Absent bowel sounds.
C) Blood at the urethral meatus.
D) Lower extremity weakness.

Question 60: What is the target minimum urine output per hour for an adult trauma patient indicating adequate fluid resuscitation?
A) 10 mL/hr
B) 20 mL/hr
C) 30 mL/hr
D) 60 mL/hr

Disclaimer: Please remember that this is a sample, and for actual exam preparation, nurses should refer to the official course materials and guidelines from recognized trauma organizations (e.g., ATLS, ITLS, TNCC).