# Out of his mouth goes a sharp sword

The sword blade was sticking out of his mouth. The sword itself was not in motion. 

# strikes down the nations

"destroys the nations" or "brings the nations under his control"

# rule them with an iron rod

John speaks of the rider's power as if he were ruling with an iron rod. 

# He tramples in the winepress of the fury of the wrath of God Almighty

"He crushes his enemies according to the judgment of God Almighty, just as a person crushes grapes in a winepress"