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?

Accepted Answer

Paralysis of a limb is a potential sign of spinal cord injury, so the nurse should immediately immobilize the patient to prevent further injury. The other interventions may be appropriate for other aspects of the assessment, but immobilization is the priority in this situation.

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?

Accepted Answer

Blast effect causes damage to organs and tissues that are not directly in the path of the projectile. The blast wave can cause damage to the groin and hip area, which is why the patient is complaining of pain in these areas.

Question 3

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

Accepted Answer

The extent of injury in penetrating trauma is related to the amount of energy transferred to the body tissues. The more energy transferred, the greater the extent of injury. Factors such as the size and velocity of the object, as well as the depth of penetration, will affect the amount of energy transferred. Therefore, the nurse will need to assess the extent of injury and determine the appropriate interventions based on the amount of energy transferred.

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?

Accepted Answer

The most important intervention prior to discharge for a patient who required splenectomy following a motorcycle accident is to administer required vaccinations. Patients who have undergone splenectomy are at increased risk for bacterial infections, particularly those caused by encapsulated organisms such as Streptococcus pneumoniae. As such, it is recommended that patients receive vaccinations against S. pneumoniae, meningococcus, and Haemophilus influenzae type b prior to discharge. While the other interventions may also be important aspects of the patient's care, administering vaccinations is the most critical intervention to prevent serious complications.

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.

Accepted Answer

The answer of A patient who sustained a chest injury...

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.

Accepted Answer

Mean arterial pressure in the 70s indicates adequate perfusion. Absence of tachycardia suggests improved hemodynamic status. A lactate level of 2 mMol/L indicates improved tissue perfusion and oxygenation.

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.

Accepted Answer

The answer of A patient who sustained multiple trauma now...

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.

Accepted Answer

Pulmonary contusions and contusions of the small bowel are common injuries in motor vehicle accidents where the victim was restrained by a lap and shoulder harness. The harness can cause compression injuries to the chest and abdomen, leading to these specific types of contusions.

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?

Accepted Answer

Persistent hypotension is a common and critical manifestation of cardiac tamponade, as the accumulation of blood in the pericardial sac restricts cardiac filling and therefore impairs cardiac output. Flat neck veins would suggest dehydration rather than cardiac tamponade, atrial fibrillation may be present but is not a specific finding for cardiac tamponade, and bilateral basilar crackles may indicate pulmonary edema but are not specific to cardiac tamponade.

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.

Accepted Answer

The patient's low blood pressure and potential for internal bleeding indicate the need for intravenous access with a large-bore catheter and fluid resuscitation with normal saline. Administration of a vasopressor medication is not indicated at this time, and there is no indication for a chest tube. The priority is to address the patient's potential hypovolemia from internal bleeding. Turning the patient is also not indicated until spinal injuries have been ruled out.

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?

Accepted Answer

A pulmonary contusion can lead to the development of acute respiratory distress syndrome (ARDS), which is characterized by severe respiratory failure and can result in the need for mechanical ventilation. The other complications (abdominal compartment syndrome, sepsis, acute renal failure) may also occur in trauma patients but are less directly related to a pulmonary contusion.

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.

Accepted Answer

Hyperextending the neck or removing tape used for stabilization could exacerbate potential spinal injuries. Suctioning the patient can help clear the airway of any obstructions. Stabilizing the neck is crucial to prevent further injury, especially after a fall which could involve spinal damage. Pulling up on the patient's lower jaw (jaw thrust maneuver) can help open the airway without moving the neck.

Question 13

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

Accepted Answer

After managing the patient's airway, breathing, and circulation, the nurse should assess the patient's level of consciousness to determine if the patient is appropriately responsive and alert. This will help in determining the further plan of care for the patient.

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?

Accepted Answer

This pattern of injuries, particularly the fractures in the lower extremities, is consistent with an adult pedestrian being struck by a vehicle, as the impact often occurs at the level of the legs.

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?

Accepted Answer

Bruising across the labia can indicate an unstable pelvic fracture due to the potential for significant internal injury and bleeding, which is a concern in pelvic fractures.

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?

Accepted Answer

The answer of A 14-year-old white male is brought into...

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?

Accepted Answer

Compression injuries from an MVA can cause damage to abdominal organs, leading to abdominal pain and vomiting. Shearing injuries involve the tearing of tissues and usually occur when there is a difference in movement between different parts of the body during the MVA. Deceleration injuries occur when a body is suddenly stopped, causing internal damage. Acceleration injuries occur when a body is suddenly accelerated, causing internal damage. While these types of injuries can also cause abdominal pain and vomiting, compression injuries are most likely in this scenario.

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?

Accepted Answer

The answer of A patient was injured when the car...

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?

Accepted Answer

The nurse should stabilize the arrow by padding around the wound with gauze rolls. Attempting to remove or dislodge the arrow could cause further injury and should only be done by medical professionals.

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?

Accepted Answer

Turning the patient to the left lateral position can improve blood flow and prevent hypotension in pregnant patients. The left lateral position helps to displace the uterus and alleviate pressure on the inferior vena cava, which can become compressed in the supine position. The other options may exacerbate the patient's hypotension or cause further harm.

Quiz 35: Multiple Trauma