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Out of his mouth goes a sharp sword
The sword blade was sticking out of his mouth. The sword itself was not in motion. See how you translated a similar phrase in Revelation 1:16.
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. See how you translated this in Revelation 12:5. (See: rc://en/ta/man/translate/figs-metaphor)
He tramples in the winepress of the fury of the wrath of God Almighty
John speaks of the rider's destroying his enemies as if they were grapes that a person tramples in a winepress. Here "wrath" refers to God's punishment of evil persons. Alternate translation: "He crushes his enemies according to the judgment of God Almighty, just as a person crushes grapes in a winepress" (See: rc://en/ta/man/translate/figs-metaphor and rc://en/ta/man/translate/figs-explicit)