Trauma Nurse Core Course (TNCC) Practice Exam

Which injury is least likely to be identified promptly in a trauma assessment?

1. Spleen

2. Lung

3. Bowel

4. Brain

The correct answer is: Bowel

The bowel injury is often the least likely to be identified promptly in a trauma assessment due to several factors. First, bowel injuries may not produce immediate, overt symptoms, especially if the injury is subtle or if there isn’t significant blood loss. In many cases, the clinical presentation can evolve over time, with delayed symptoms such as abdominal distention, fever, or signs of peritonitis appearing hours or even days after the initial trauma. Moreover, the bowel can be located deep within the abdominal cavity, making it more difficult to assess without specific imaging studies like a CT scan. In contrast, injuries to the spleen, lung, or brain often present with more noticeable signs and symptoms immediately following trauma. For instance, splenic injuries tend to manifest with clear abdominal pain and potential signs of internal bleeding, while lung injuries can lead to respiratory distress, and brain injuries often present with altered levels of consciousness or neurological deficits. As a result of these factors, bowel injuries often remain undetected during initial assessments, leading to potentially significant morbidity if not identified and managed appropriately.