Question 1

The correct sequence of primary survey in trauma patient is:

Accepted Answer

The correct sequence for the primary survey in trauma patients, according to Advanced Trauma Life Support (ATLS) guidelines, is Airway with cervical spine stabilization, Breathing and ventilation, Circulation, and then assessment of Neurological status. This ensures life-threatening issues are addressed in a systematic manner.

Question 2

Tension pneumothorax is a life-threatening injury. Which clinical findings are specific to this condition?

Accepted Answer

Tension pneumothorax is characterized by severe respiratory distress, tracheal deviation away from the affected side, hypotension due to decreased venous return, and tachycardia as a compensatory mechanism.

Question 3

Cardiogenic shock in trauma patient may be caused by cardiac tamponade. Which among the following make up the defining symptoms for tamponade?

Accepted Answer

Cardiac tamponade is characterized by the classic triad of distended neck veins, hypotension, and muffled heart sounds, known as Beck's triad. These symptoms occur due to the accumulation of fluid in the pericardial space, which restricts the heart's ability to fill and pump efficiently.

Question 4

A 40-year-old male patient presents to the ED after a motor vehicle collision (MVC) yelling in pain. He is noted to have severe dyspnoea, decreased left-sided chest movement and tracheal deviation to the right side. You are the emergency nurse caring for this patient. What will you do first?

Accepted Answer

EThe patient's symptoms suggest a tension pneumothorax, which is a life-threatening condition requiring immediate intervention. The first step is to ensure the airway is patent (E) to maintain airway patency and support breathing. Following this, initiating high-flow oxygen via a non-rebreather mask (C) is crucial to address the severe dyspnea and improve oxygenation. These interventions are critical initial steps before proceeding with more invasive procedures like needle thoracentesis or chest tube insertion to relieve the pressure in the chest.

Question 5

A 19-year-old woman walks into the ED post MVC with complaints of neck pain and a tingling sensation on both arms and legs. You are the triage nurse assessing the patient. What is your first intervention?

Accepted Answer

Given the patient's complaints of neck pain and tingling in the extremities following a motor vehicle collision, the priority is to prevent further spinal injury by immobilizing and stabilizing the cervical spine. This action helps prevent any potential exacerbation of a spinal injury that could lead to more severe neurological deficits.

Question 6

Paediatric patients in shock are given fluid resuscitation. The initial fluid bolus is:

Accepted Answer

The initial fluid bolus for pediatric patients in shock is 20 mL/kg of isotonic crystalloid solutions such as NaCl (normal saline) or Hartmann's solution (also known as Ringer's lactate). This approach is recommended to restore intravascular volume and improve perfusion. Packed RBCs are typically not used for initial fluid resuscitation unless there is specific concern for significant blood loss or hemoglobinopathies.

Question 7

Which among the following are included in the secondary survey assessing trauma patients?

Accepted Answer

The secondary survey in trauma assessment includes a full set of vital signs, comfort measures, taking a detailed history, head-to-toe assessment, and inspection of posterior surfaces. This phase focuses on a thorough evaluation after life-threatening injuries have been addressed in the primary survey.

Question 8

An emergency nurse is about to insert an indwelling catheter (IDC). Which of the following is the major contraindication in inserting an IDC?

Accepted Answer

Blood at the urethral meatus is a major contraindication for inserting an indwelling catheter because it suggests urethral or bladder trauma, which could be exacerbated by catheter insertion.

Question 9

Which of the following is contraindicated in patients with maxillary/facial injuries and basilar skull fracture?

Accepted Answer

Insertion of a nasogastric tube is contraindicated in patients with basilar skull fractures due to the risk of the tube being inadvertently placed into the cranial cavity through the fracture site.

Question 10

To prevent secondary brain injury, what is the ideal blood pressure for patients who have uncontrolled haemorrhage with suspected traumatic brain injuries?

Accepted Answer

The answer of To prevent secondary brain injury, what is...

Quiz 42: Major Trauma Initial Assessment and Management