Deck 35: Multiple Trauma

Question 1

While conducting the secondary survey of a patient admitted with multiple traumas,the nurse assesses paralysis of the patient's left lower leg.Which nursing intervention is indicated?

A)Move the patient to a semi-sitting position.
B)Support limb by placing it on pillows.
C)Turn the patient to assess the back.
D)Immediately immobilize the patient.

Answer 1

Immediately immobilize the patient.

Question 2

A patient with a gunshot wound to the knee is complaining of groin and hip pain.The nurse realizes that this patient's pain might be because of which effect?

A)Cavitation
B)Tumble
C)Yaw
D)Blast effect

Answer 2

Blast effect

Question 3

Which consideration will the nurse apply to the assessment of a patient who sustained penetrating trauma?

A)The extent of injury is related to the amount of energy transferred to the body tissues.
B)The amount of trauma sustained is related to the patient's nutritional status before the injury.
C)If the patient was well hydrated at the time of injury,the extent will be diminished.
D)The primary determinant of injury is the arc traveled by the penetrating object.

Answer 3

The extent of injury is related to the amount of energy transferred to the body tissues.

Question 4

The nurse is providing discharge care for a patient who required splenectomy following a motorcycle accident.Which intervention is most important prior to this patient's discharge?

A)Administer required vaccinations.
B)Discuss the risk of sepsis with the patient.
C)Teach leg exercises to prevent deep vein thrombosis.
D)Discuss risk and prevention of acute respiratory distress syndrome (ARDS).

Question 5

A patient who sustained a chest injury has developed tracheal deviation to the left side.The emergency department nurse would provide which equipment for immediate treatment of this complication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)A venous cut down tray
B)A chest tube
C)Intubation equipment
D)18-gauge needle

Question 6

A 24-year-old woman was critically injured when hit by a car while she was walking to work.Emergency department staff has been working for one hour to stabilize her.Which parameters would the nurse evaluate as indicating the patient is adequately fluid resuscitated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Her core temperature is 98.2°F.
B)Her mean arterial pressure (MAP)has been in the 70s for the last 30 minutes.
C)She is no longer tachycardic.
D)Her last lactate level was 2 mMol/L.
E)Her last sublingual capnography reading was 74.

Question 7

A patient who sustained multiple trauma now requires dialysis.Which information should the nurse provide about the need for this treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"Temporary dialysis is commonly required when patients have had multiple trauma."
B)"The kidneys are somewhat fragile and can be stunned by trauma."
C)"Some of the life-saving drugs we use can be hard on the kidneys."
D)"Most patients with severe abdominal trauma have coexisting kidney damage."
E)"Crushing injuries to muscles can release substances that are harmful to the kidneys."

Question 8

The nurse is preparing to assess a motor vehicle accident victim who was lap and shoulder harness restrained.Due to the mechanism of injury the nurse will look for which most common injuries? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Lumbar spine fractures
B)Fractured patella
C)Pulmonary contusion
D)Flexion fracture of the cervical spine
E)Contusion of the small bowel

Question 9

It is suspected that a patient who sustained multiple traumas is developing cardiac tamponade.Which nursing assessment finding would help to support this tentative diagnosis?

A)Flat neck veins despite fluid resuscitation
B)Persistent hypotension
C)Atrial fibrillation per cardiac monitor
D)Bilateral basilar crackles

Question 10

The nurse is providing care to a farmworker who was pinned against a steel gate by a horse.Deformation of the patient's pelvis and femurs is obvious,but little blood is present on the patient's clothing.Initial blood pressure is 110/68 mm Hg.What nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Initiate intravenous access with a 16-gauge catheter.
B)Start fluid resuscitation with normal saline.
C)Prepare to administer vasopressor medication.
D)Turn the patient to assess for injuries to the back.
E)Prepare to insert a chest tube.

Question 11

A patient is in the intensive care unit with a pulmonary contusion sustained from a motor vehicle accident.Which posttraumatic complication should the nurse focus on when providing care to this patient?

A)Abdominal compartment syndrome
B)Sepsis
C)Acute respiratory distress syndrome (ARDS)
D)Acute renal failure

Question 12

The nurse is assessing a patient injured in a fall from a tree.During the assessment the patient suddenly loses consciousness.Which interventions should the nurse use to protect this patient's airway? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Hyperextend the neck.
B)Suction the patient.
C)Stabilize the neck.
D)Remove the tape the paramedics used to tape the patient's head to the backboard.
E)Pull up on the patient's lower jaw.

Question 13

The nurse has adequately managed a patient's airway,breathing,and circulation.What is the next nursing action?

A)Assess level of consciousness.
B)Administer prophylactic tetanus toxoid as prescribed.
C)Auscultate heart sounds.
D)Assess the chest for paradoxical movements.

Question 14

A patient is brought into the emergency department after a car accident.Injuries include fractured left femur,tibia,and fibula with a mild contralateral head injury.The nurse would identify this injury pattern as consistent with which situation?

A)Unrestrained front seat passenger of a motor vehicle
B)Adult pedestrian hit by an automobile
C)Unrestrained driver of a motor vehicle
D)Child pedestrian hit by an automobile

Question 15

A 78-year-old woman slipped and fell on an ice-covered sidewalk.The nurse would be most concerned that the patient has an unstable pelvic fracture if which assessment finding is present?

A)The patient fell directly on her coccyx.
B)The patient was incontinent of urine at the time of the fall.
C)The patient has bruising across her labia.
D)The patient complains of sharp pain just above her waist on the right side.

Question 16

A 14-year-old white male is brought into the emergency room of an urban hospital with a penetrating wound caused by the accidental discharge of a gun.Which risk factor for this injury pattern would the nurse rank as the most influential?

A)Living in an urban area
B)Being white
C)Age
D)Gender

Question 17

A patient brought into the emergency department with injuries sustained from a motor vehicle accident (MVA)is complaining of abdominal pain and begins to vomit.The nurse suspects injury from which most likely source?

A)Shearing
B)Deceleration
C)Compression
D)Acceleration

Question 18

A patient was injured when the car he was driving hit a telephone pole.The patient is 6 feet tall and weighs 200 pounds.The car was traveling at approximately 25 miles per hour when it hit the 36-inch diameter wooden pole.The nurse would calculate which pounds per square inch of impact for this patient?

A)833.3
B)30,000
C)5
D)12,245

Question 19

A teenage patient comes into the emergency department with an arrow lodged in his right lower thoracic region.Which nursing intervention is indicated?

A)Have the patient assume a left side lying position and pull on the arrow to remove it.
B)Slowly move the arrow to the left and right to attempt to dislodge it.
C)Stabilize the arrow by padding around the wound with gauze rolls.
D)Slowly rotate the arrow to attempt to dislodge it.

Question 20

A pregnant patient in her third trimester has been involved in a motor vehicle accident.Which intervention should the nurse implement to treat the patient's symptoms of hypotension?

A)Turn the patient to the right lateral position.
B)Turn the patient to the left lateral position.
C)Place the patient in Trendelenburg's position.
D)Place the patient in the supine position.