NCLEX Review Questions

TRAUMA
1. All of the following injuries are considered penetrating

except:
a. An Impaled object to the L lower quadrant of the

abdomen
b. A gunshot wound to the R upper abdominal quadrant
c. A 5 cm abdominal laceration secondary to trip and fall
d. A stab wound to the lower abdomen
2. A patient arrives in the Emergency Department with a

knife protruding from his abdomen. An appropriate nursing
action would be to
a. Remove the knife and apply firm pressure to the wound

b. Place two large bore IV lines, then remove the object
c. Obtain an abdominal CT , then remove the object
d. Leave the knife in place until the patient is taken to the
OR
3. The nurse is expected to perform which of the following

preoperative procedures for a patient with a stab wound to
the abdomen
a. Insertion of two large-bore IV lines
b. Insertion of French 16 indwelling catheter
c. A only
d. A and B
4. How will you document in your assessment findings the

type of penetrating injury for a patient with a gunshot
wound at the sixth intercostal space
a.Chest
b.Abdomen
c.Thoracoabdominal
d.Pelvic
5. The patient with a stab wound on the LUQ of the

abdomen develops dyspnea. The nurse would suspect
that this symptom may result from
a.Pain and Anxiety

b.Peritoneal irritation
c.Gastric Rupture
d.Associated chest injury
Scenario: A 26 year old male was brought to the
Emergency Department (ED) after a head-on collision
vehicular accident. EMT reports airbag deployment,
shattered windshield and steering wheel. On arrival,
patient is AO x 3, skin is cool and dry.
Viital signs are BP 110/70, HR 102, RR 22. (Questions
6-7)
6. After assessment of the patient's Airway, Breathing, and

Circulation, the next priority intervention for the nurse is
to;
a. Assist the physician for insertion of NG tube

b. Ask the patient when was the last time he ate
c. Establish two large bore intravenous lines
d. Check the patient's rectal temperature
7. Based on the patient’s presentation upon arrival, what is

the earliest indication of impending shock?
a. Tachycardia
b. Hypotension
c. Narrowing pulse pressure
D.Cool and clammy skin
Scenario: A 42 year old male with no past medical history
was involved in a motorcycle accident. He presents to the
Emergency Department with chief complaints of chestpain
and shortness of breath. The nurse performed an ECG
which shows sinus tachycardia with frequent PVC’s. (refer
for questions 8-10)
8. Based on the complaints and the ECG result, the nurse

suspects that the patient has
a. Myocardial Infarction
b. Fractured rib
c. Cardiac contusion
d. Pericarditis
9. Based on the anatomical structure of the heart, blunt

trauma to the chest commonly results in damage to the
a.Left ventricle
b.Right ventricle
c.Left Atrium
d.Right Atrium
10. Based on the above scenario, what medication or

treatment is contraindicated?
a.Nitroglycerine
b.Lidocaine
c.Morphine sulfate
d.Oxygen `
11. A 30 year old construction worker fell off a 10 ft

scaffolding and landed on his R side. He is complaining of
shortness of breath and significant chestpain. All of the
following nursing interventions would help the patient
except;
a.Encourage slow, deep breathing

b.Splinting the affected side with a pillow
c.Positioning the patient on the affected side
d.Positioning the patient on the unaffected side
12. Patient fell forward from 10 ft. ladder, the nurse

suspects blunt injury to the chest. Which injury constitutes
a flail chest?
a. Single fractures of the 4th, 5th,6th, and 7th left lateral

ribs
b. SIngle fracture of the 7th and 8th left and right anterior
rib
c. Fractured xiphoid process
d.Fractured sternum
13. What signs and symptoms will help the nurse suspect
flail chest in a patient with blunt trauma to the chest
a.Parodoxical movement of chestwall

b.Patient’s reluctance to take a deep breath
c.Pain on movement and respiration
d.All of the above
14. All of the following factors are indicated to provide

ventilatory support for the patient with flail chest except
a.Advanced age and obese patient

b.Imminent surgery
c.Hypercapnia
d.Hypoxia
15. What nursing intervention would be appropriate for

patient with multple rib fractures in its early stage to
ensure optimal ventilation
a. Binding the chestwall
b.Round the clock low dose narcotics as ordered
c.Performing postural drainage and incentive spirometry
d.Encouraging forceful coughing after chest percussion
16. Immediate needle decompression is indicated for a

trauma patient who has
a.Hemothorax
b.Tension pneumothorax
c.Ascites
d.Flail chest
17. A needle decompression is indicated for the patient

with blunt chest trauma. The nurse is aware that the
correct site for needle insertion is
a.Under the 4th rib at the anterior axillary line

b.Over the 3rd rib at the midclavicular line
c.On the right side to avoid puncturing the heart
d.On the side toward which the trachea deviates
18. A patient with tension pneumothorax exhibits the

followiing classic signs and symptoms
a.Paradoxical chest movement but no jugular venous
distention
b.Muffled heart sounds, jugular venous distention,
hypotension
c.Decreased breath sounds, Jugular venous distention
and tracheal deviation
d.Fever, cough, and chestpain
19. A patient with a stab wound to the R anterior axillary

line, 6th intercostal space suddenly becomes pale and
restless, vital signs show BP 90/60, HR 118, RR 26. What
procedure is immediately necessary for the nurse to
prepare for
a.Needle decompression
b.Endotracheal intubation
c.Chest tube insertion
d.Blood transfusion
20. A patient was brought to the trauma slot after he was

found on the street with multiple injuries. Patient
suddenly becomes restless and cyanotic, the nurse should
:
a.Prepare for rapid sequence endotracheal intubation
b.Evaluate and open the patient’s airway
c.Insert two large-bore I.V. lines
d.Prepare for chest tube insertion
21. The patient presents with hypotension, jugular venous

distention, and muffled heart sounds, these findings are
indicative of what condition?
a,Tension Pneumothorax
b.Cardiac Tamponade
c.Acute heart failure
d.Myocardial infarction
22. Hypotension associated with tension pneumothorax is

most likely caused by
a.Increased volume losses

b.Osmotic intravascular changes
c.Loss of systemic vascular resistance
d.Decreased venous return to the heart
23. A pedestrian was struck by a bicyclist speeding at
approximately 30 mph, he presents to the emergency
department with severe abdominal pain. Pt is restless and
anxious with BP 90/52, HR 100, RR 22. What procedures
would be indicated initially?
a.Focused assessment sonography for trauma (FAST)

b.Computed tomography (CT) of the abdomen
c.Diagnostic peritoneal lavage (DPL)
d.Ultrasound of abdomen
24. A patient was brought in a long-board and c-collar,

upon completing the primary and secondary assessment
for trauma, it is determined that the patient has an isolated
lower extremity closed fracture. Which intervention should
the nurse be prepared to perform FIRST?
a.Obtain a complete set of vital signs

b.Obtain xray of the injured extremity
c.Obtain additional history
d.Remove the patient from the long-board
25. A patient has clear fluid draining from his left nostril
after he was assaulted with a bat. The nurse is aware that
the presence of this drainage may indicate
a.Sinus infection
b.Concussion
c.Basilar skull fracture
d..Orbital blow out fracture
26.A sudden onset tearing medisternal chestpain and a

widened mediastinum indicates which of the following
a.Thoracic aortic aneurysm

b.Pulmonary aneurysm
c.Pleurisy
d.Pneumonia
TRIAGE
27.The hospital is receiving 30 patients following a

massive active shooter incident. The nurse should triage a
patient with agonal respirations and no pulse to which
area?
a.Hospital morgue
b.Emergency department critical care area
c.Emergency department urgent care area
d.Ambulatory care clinic area
28. In a mass casualty event, a patient who is screaming

and pacing has a hematoma to the forehead and 2 cm
laceration on his R eyebrow will be triaged and tagged as
a.Red
b.Yellow
c.Green
d.Black
29. Based on the START method, how will you tagged a

42 year patient patient who has altered mental status,
hypotensive, and in respiratory distress
a.Red
b.Yellow
c.Green
d. Black
30. In a mass casualty event, a patient with obvious

deformity of the R wrist, multiple superficial lacerations to
bilateral lower extremities can be tagged as
a.Red
b.Yellow
c.Green
d.Black

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What are some important considerations when treating a patient with a penetrating trauma?

What are some important considerations when treating a patient with a penetrating trauma?

What signs and symptoms indicate tension pneumothorax?

What signs and symptoms indicate tension pneumothorax?

TRAUMA

1. All of the following injuries are considered penetrating

a. An Impaled object to the L lower quadrant of the

2. A patient arrives in the Emergency Department with a

a. Remove the knife and apply firm pressure to the wound

3. The nurse is expected to perform which of the following

4. How will you document in your assessment findings the

5. The patient with a stab wound on the LUQ of the

a.Pain and Anxiety

6. After assessment of the patient's Airway, Breathing, and

a. Assist the physician for insertion of NG tube

7. Based on the patient’s presentation upon arrival, what is

8. Based on the complaints and the ECG result, the nurse

9. Based on the anatomical structure of the heart, blunt

10. Based on the above scenario, what medication or

11. A 30 year old construction worker fell off a 10 ft

a.Encourage slow, deep breathing

12. Patient fell forward from 10 ft. ladder, the nurse

a. Single fractures of the 4th, 5th,6th, and 7th left lateral

a.Parodoxical movement of chestwall

14. All of the following factors are indicated to provide

a.Advanced age and obese patient

15. What nursing intervention would be appropriate for

16. Immediate needle decompression is indicated for a

17. A needle decompression is indicated for the patient

a.Under the 4th rib at the anterior axillary line

18. A patient with tension pneumothorax exhibits the

19. A patient with a stab wound to the R anterior axillary

20. A patient was brought to the trauma slot after he was

21. The patient presents with hypotension, jugular venous

22. Hypotension associated with tension pneumothorax is

a.Increased volume losses

a.Focused assessment sonography for trauma (FAST)

24. A patient was brought in a long-board and c-collar,

a.Obtain a complete set of vital signs

26.A sudden onset tearing medisternal chestpain and a

a.Thoracic aortic aneurysm

27.The hospital is receiving 30 patients following a

28. In a mass casualty event, a patient who is screaming

29. Based on the START method, how will you tagged a

30. In a mass casualty event, a patient with obvious

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