Trauma Nurse Core Course (TNCC) Practice Exam

In cases of a large open chest wound accompanied by anxiety and severe respiratory distress, the priority is to manage the immediate life-threatening situation, which involves ensuring adequate ventilation and oxygenation. Immediate interventions should be considered based on the characteristics of the wound and the patient's clinical presentation.

Needle decompression is typically indicated in cases of tension pneumothorax, where air accumulates in the pleural space and compromises respiratory function. However, the presence of a large open chest wound may already compromise pleural pressure, potentially negating the need for this procedure at this time.

Similarly, a tube thoracostomy is performed to allow for drainage of air or fluid collection in the pleural cavity, which would be necessary in cases of pneumothorax or hemothorax. However, if the chest wound is open and the patient's symptoms are directly related to the wound, immediate management of the superficial aspect of the injury may take precedence.

Surgical repair is usually reserved for cases where internal structures are damaged, and it typically cannot be performed immediately in an emergency setting outside of the definitive surgical environment.

Removing the dressing may seem appropriate in certain cases, but in a patient presenting with severe respiratory distress and anxiety, simply removing a dressing without providing necessary