Trauma Nurse Core Course (TNCC) Practice Exam

After a car accident, what negative FAST exam result can a nurse anticipate in a patient with multiple trauma?

1. Diagnostic peritoneal lavage

2. Serial FAST exams

3. Abdominal and pelvic CT scans

4. Serial abdominal assessments

The correct answer is: Diagnostic peritoneal lavage

In a patient with multiple trauma following a car accident, a negative FAST (Focused Assessment with Sonography for Trauma) exam result indicates that there are no immediate signs of significant intra-abdominal bleeding detected via ultrasound. However, the choice regarding diagnostic peritoneal lavage is pertinent because, despite a negative FAST, the patient's clinical status may warrant further exploration, especially if they exhibit ongoing signs of shock or deteriorating vital signs. Diagnostic peritoneal lavage can be indicated in this scenario as it is a more invasive procedure used to determine if there is intra-abdominal injury that may not have been captured by the FAST exam. This technique involves introducing fluid into the abdominal cavity and analyzing it for blood, which can confirm or rule out significant intraperitoneal hemorrhage. This option aligns with the complex nature of trauma assessment, as reliance solely on a negative FAST may overlook significant injuries. The context of multiple trauma suggests a high risk for internal injuries that may not be evident without further diagnostic measures. Therefore, a nurse needs to be aware that additional methods like peritoneal lavage might be necessary even if the initial FAST suggests no immediate concerns.