Question 1

A nurse in a level III trauma center is preparing her patient for transport to a level I trauma center. How should the nurse describe a level I trauma center to the patient and family?

Accepted Answer

A level I trauma center provides comprehensive trauma care, including trauma and specialty surgical services, and is involved in community education and injury prevention programs.

Question 2

Which principle should guide the trauma nurse's plan of care for a pregnant woman?

Accepted Answer

Pregnant women have a 45% increase in plasma volume, which means they can lose up to 50% of blood volume before showing signs of hypovolemia.

Question 3

Which concept should the nurse consider when planning care for an older adult trauma patient?

Accepted Answer

Older adults are often on anticoagulants for conditions like atrial fibrillation or stroke, which can complicate trauma care due to increased bleeding risk.

Question 4

When assessing a trauma patient using the ABCDE approach, what does the nurse understand the "E" to represent?

Accepted Answer

"E" in the ABCDE approach stands for "Exposure and Environment," which involves exposing the patient to assess for any hidden injuries while taking measures to prevent hypothermia.

Question 5

The nurse, assessing a patient who was in a motor vehicle accident, notes a large purple discoloration of the thigh. The nurse explains to the patient that he has:

Accepted Answer

A contusion is a bruise, which is characterized by a purple discoloration of the skin due to bleeding underneath, typically caused by trauma such as a motor vehicle accident.

Question 6

The nurse is assessing a dog bite on a child's forearm and notes that the epidermis, dermis, and subcutaneous tissues have been damaged and the wound is bleeding profusely. The nurse classifies the severity of the bite as:

Accepted Answer

The wound involves damage to the epidermis, dermis, and subcutaneous tissues with profuse bleeding, indicating a severe injury.

Question 7

The initial plan of care for a patient with a contaminated dog bite wound, with an animal that is available for testing, should include:

Accepted Answer

Irrigating and debriding the wound is essential to reduce the risk of infection and remove any foreign material. Suturing is typically avoided initially in contaminated wounds to prevent trapping bacteria inside. Rabies vaccination is considered based on the animal's testing results, and antivenom is not applicable for dog bites.

Question 8

The nurse should expect to assess which finding in a patient with a mild reaction to a snake bite of the index finger?

Accepted Answer

In a mild reaction to a snake bite, localized symptoms such as scratches or small lacerations and localized edema of the finger are expected. More severe systemic symptoms like those described in options C and D are not typical of a mild reaction.

Question 9

The nurse is assessing a patient who was burned lighting a charcoal grill and is in severe pain. The nurse notes blistering red, moist skin. How should the nurse classify this burn?

Accepted Answer

The description of blistering, red, moist skin is characteristic of a superficial partial thickness burn, which affects the epidermis and part of the dermis.

Question 10

A patient in the emergency department has sustained burns to the back of the torso and the back of one leg. The nurse calculates that this patient has burns covering what percentage of total body surface area using the Rule of Nines formula?

Accepted Answer

The Rule of Nines estimates the total body surface area affected by burns. The back of the torso accounts for 18% (9% for the upper back and 9% for the lower back), and the back of one leg accounts for 9%. Therefore, the total is 27%.

Question 11

The nurse is caring for a pediatric patient who has sustained burns to the back of the torso and the back of one leg. The nurse calculates that this child has burns covering what percentage of total body surface area using the Rule of Nines formula?

Accepted Answer

The Rule of Nines is a method used to estimate the total body surface area affected by burns. In children, the back of the torso is approximately 18% and the back of one leg is approximately 7% (half of 14% for a full leg), totaling 25%.

Question 12

A patient is brought to the emergency department with chemical burns on his skin. The nurse obtains the materials safety data sheet (MDS) on the chemical substance. Which information is not included on the MDS?

Accepted Answer

The MDS typically includes information on first aid measures, effects on the body, and precautions for handling the chemical, but it does not usually include information on the uses of the chemical.

Question 13

A patient performing home renovations is brought to the emergency department with electrical burns. When assessing the patient, the nurse should recall that:

Accepted Answer

Electricity tends to travel along the path of least resistance, which often means it will bounce off bone and travel through softer tissues, causing more damage to these areas.

Question 14

A patient is being assessed in the emergency department following a skiing accident in which the patient was found unconscious at the foot of a tree with his left leg at an obtuse angle. Which concept of hypothermia should guide the nurse's assessment and plan of care?

Accepted Answer

Hypothermia reduces perfusion to the tissues, which is a critical consideration in managing a patient with potential injuries and hypothermia following an accident.

Question 15

The nurse is caring for a patient with major blood loss following a motor vehicle accident. Which ratio does the nurse anticipate for replacement of red blood cells, platelets, and fresh frozen plasma?

Accepted Answer

The 1:1:1 ratio is commonly used in massive transfusion protocols to replace red blood cells, platelets, and fresh frozen plasma to mimic whole blood and improve outcomes in patients with significant blood loss.

Question 16

The trauma committee at a level II trauma center is discussing ways to reduce death during the second peak of the trimodal distribution for trauma deaths. The trauma nurse on the committee suggests which intervention to reduce deaths during this time frame?

Accepted Answer

Transporting victims to a trauma center with qualified staff is crucial for reducing deaths during the second peak of the trimodal distribution, which occurs minutes to hours after injury and requires rapid and effective medical intervention.

Question 17

Which of the following should the nurse consider when assessing a pregnant trauma victim?

Accepted Answer

Pregnant women often have mild tachycardia due to increased blood volume and cardiac output during pregnancy.

Question 18

The nurse is caring for a trauma patient in the emergency department who is 26-weeks pregnant. Which maternal test does the nurse anticipate will be performed to determine if there is fetal blood in the maternal circulation?

Accepted Answer

The Kleihauer-Betke test is used to detect fetal blood cells in the maternal circulation, which is important in trauma cases to assess for fetal-maternal hemorrhage.

Question 19

A 77-kilogram patient with burns to the front of the torso, both arms, and face is being treated in the emergency department. Using the Parkland formula, how much lactated Ringer's solution does the nurse anticipate infusing of the first 8 hours?

Accepted Answer

The Parkland formula is 4 mL x body weight (kg) x % total body surface area (TBSA) burned. The front torso (18%), both arms (9% each), and face (4.5%) total 40.5% TBSA. Thus, 4 mL x 77 kg x 40.5 = 12,474 mL for 24 hours. Half of this, 6,237 mL, is given in the first 8 hours.

Question 20

A patient has burns that are pale and leathery and reports little pain from the burn site. How should the nurse classify this burn?

Accepted Answer

Full thickness burns are characterized by a pale, leathery appearance and a lack of pain due to nerve damage.

Quiz 50: Mechanisms of Traumatic Injury