Trauma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma

Sample item

After blunt chest trauma, a man is hypotensive and tachycardic with distended neck veins, absent breath sounds on the right and tracheal deviation to the left. What is the immediate step?

AEndotracheal intubation and ventilation firstBChest radiograph before any interventionCImmediate needle decompression of the right chestDPericardiocentesis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Immediate needle decompression of the right chest

This is tension pneumothorax, a clinical diagnosis. Trapped air compresses the mediastinum and impairs venous return, so decompression must not wait for imaging. A chest drain follows decompression.

Option by option

A. Endotracheal intubation and ventilation first
Positive pressure ventilation without decompression would worsen the tension.
B. Chest radiograph before any intervention
Waiting for imaging delays treatment of a rapidly fatal condition.
C. Immediate needle decompression of the right chest (correct)
Correct. Rapid decompression relieves the life-threatening obstruction of venous return.
D. Pericardiocentesis
Pericardiocentesis treats tamponade, but absent breath sounds and tracheal deviation point to the pleural space.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Immediate needle decompression of the right chest. This is tension pneumothorax, a clinical diagnosis.

Why is "Endotracheal intubation and ventilation first" not the answer?

Positive pressure ventilation without decompression would worsen the tension.

Why is "Chest radiograph before any intervention" not the answer?

Waiting for imaging delays treatment of a rapidly fatal condition.

Why is "Pericardiocentesis" not the answer?

Pericardiocentesis treats tamponade, but absent breath sounds and tracheal deviation point to the pleural space.

What concept does this question test?

It tests Trauma in General Surgery. Trapped air compresses the mediastinum and impairs venous return, so decompression must not wait for imaging. A chest drain follows decompression.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.