Question 1

During assessment of a patient who is new to the critical care unit,the nurse observes perianal ecchymosis.The nurse suspects the patient has a

Accepted Answer

A)  pelvic fracture. 
B)  bladder trauma. 
C)  rectal laceration. 
D)  spleen laceration. 
A)  pelvic fracture. 
B)  bladder trauma. 
C)  rectal laceration. 
D)  spleen laceration.

Question 2

A patient is admitted to the ICU with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.Which of the following statements is true about his spinal cord injury?

Accepted Answer

A)  He is likely to be in supraventricular tachycardia. 
B)  Hyperthermia is common in patients with spinal cord injury. 
C)  These patients do not usually require mechanical ventilation. 
D)  The patient has a central cord syndrome. 
A)  He is likely to be in supraventricular tachycardia. 
B)  Hyperthermia is common in patients with spinal cord injury. 
C)  These patients do not usually require mechanical ventilation. 
D)  The patient has a central cord syndrome.

Question 3

When preparing a patient for a diagnostic peritoneal lavage (DPL),the nurse should

Accepted Answer

A)  insert a nasogastric tube and urinary catheter before the procedure. 
B)  make sure that a computed tomography scan is performed first to rule out abdominal adhesions. 
C)  know that the test will tell which specific organ has been injured. 
D)  know that the return of clear fluid from the abdominal cavity means that the patient does not have an injury. 
A)  insert a nasogastric tube and urinary catheter before the procedure. 
B)  make sure that a computed tomography scan is performed first to rule out abdominal adhesions. 
C)  know that the test will tell which specific organ has been injured. 
D)  know that the return of clear fluid from the abdominal cavity means that the patient does not have an injury.

Question 4

Fat embolism syndrome can occur as a complication of

Accepted Answer

A)  liver trauma. 
B)  burns. 
C)  orthopedic trauma. 
D)  spleen trauma. 
A)  liver trauma. 
B)  burns. 
C)  orthopedic trauma. 
D)  spleen trauma.

Question 5

Signs and symptoms of compartment syndrome in the lower extremities include

Accepted Answer

A)  paresis. 
B)  increased pain. 
C)  pain in the affected extremity. 
D)  swelling in the affected extremity. 
E)  decrease pulses and capillary refill.
F) increase urinary output. 
A)  paresis. 
B)  increased pain. 
C)  pain in the affected extremity. 
D)  swelling in the affected extremity. 
E)  decrease pulses and capillary refill.
F) increase urinary output.

Question 6

A strategy to minimize secondary brain injury in head-injured patients is

Accepted Answer

A)  hyperventilation to keep PCO2 less than 30. 
B)  fluid restriction to keep central venous pressure less than 6 cm H2O. 
C)  maintaining body temperature more than 37.5° C. 
D)  fluid resuscitation as needed to keep the systolic blood pressure greater than 90 mm Hg. 
A)  hyperventilation to keep PCO2 less than 30. 
B)  fluid restriction to keep central venous pressure less than 6 cm H2O. 
C)  maintaining body temperature more than 37.5° C. 
D)  fluid resuscitation as needed to keep the systolic blood pressure greater than 90 mm Hg.

Question 7

The most important aspect of a secondary survey is to

Accepted Answer

A)  check circulatory status. 
B)  check electrolyte profile. 
C)  insert a urinary catheter. 
D)  obtain patient history. 
A)  check circulatory status. 
B)  check electrolyte profile. 
C)  insert a urinary catheter. 
D)  obtain patient history.

Question 8

Major trauma patients are at a high risk of developing deep venous thrombosis and pulmonary embolism because of

Accepted Answer

A)  blood stasis. 
B)  hypernatremia. 
C)  injury to the intimal surface of the vessel. 
D)  hyperosmolarity. 
E)  hypercoagulopathy.
F) immobility. 
A)  blood stasis. 
B)  hypernatremia. 
C)  injury to the intimal surface of the vessel. 
D)  hyperosmolarity. 
E)  hypercoagulopathy.
F) immobility.

Question 9

A patient is admitted to the ICU for observation of his grade II splenic laceration.Which of the following signs and symptoms would suggest that he has had a delayed rupture of his splenic capsule and is now in hemorrhagic shock?

Accepted Answer

A)  BP, 110/70 mm Hg; HR, 120 beats/min; Hct, 42 mg/dL; UO, 40 mL/hr; skin that is pink, warm, and dry with capillary refill of 3 seconds 
B)  BP, 90/70 mm Hg; HR, 140 beats/min; Hct, 21 mg/dL; UO, 10 mL/hr; pale, cool, clammy skin; confused 
C)  BP, 100/60 mm Hg; HR, 100 beats/min; Hct, 35 mg/dL; UO, 30 mL/hr; pale, cool, dry skin; alert and oriented 
D)  BP, 110/60 mm Hg; HR, 118 beats/min; Hct, 38 mg/dL; UO, 60 mL/hr; flushed, warm, diaphoretic skin; agitated and confused 
A)  BP, 110/70 mm Hg; HR, 120 beats/min; Hct, 42 mg/dL; UO, 40 mL/hr; skin that is pink, warm, and dry with capillary refill of 3 seconds 
B)  BP, 90/70 mm Hg; HR, 140 beats/min; Hct, 21 mg/dL; UO, 10 mL/hr; pale, cool, clammy skin; confused 
C)  BP, 100/60 mm Hg; HR, 100 beats/min; Hct, 35 mg/dL; UO, 30 mL/hr; pale, cool, dry skin; alert and oriented 
D)  BP, 110/60 mm Hg; HR, 118 beats/min; Hct, 38 mg/dL; UO, 60 mL/hr; flushed, warm, diaphoretic skin; agitated and confused

Question 10

Which of the following statements is true about a patient with a blunt cardiac injury/cardiac contusion?

Accepted Answer

A)  It will probably be diagnosed by pericardiocentesis. 
B)  Hemodynamic parameters will most likely show a low cardiac output and low systemic vascular resistance. 
C)  Treatment can require insertion of a temporary pacemaker for conduction control. 
D)  The only accurate way to evaluate cardiac contusion is to check the creatine phosphokinase fraction. 
A)  It will probably be diagnosed by pericardiocentesis. 
B)  Hemodynamic parameters will most likely show a low cardiac output and low systemic vascular resistance. 
C)  Treatment can require insertion of a temporary pacemaker for conduction control. 
D)  The only accurate way to evaluate cardiac contusion is to check the creatine phosphokinase fraction.

Exam 34: Trauma

During assessment of a patient who is new to the critical care unit,the nurse observes perianal ecchymosis.The nurse suspects the patient has a

A patient is admitted to the ICU with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.Which of the following statements is true about his spinal cord injury?

When preparing a patient for a diagnostic peritoneal lavage (DPL),the nurse should

Fat embolism syndrome can occur as a complication of

Signs and symptoms of compartment syndrome in the lower extremities include

A strategy to minimize secondary brain injury in head-injured patients is

The most important aspect of a secondary survey is to

Major trauma patients are at a high risk of developing deep venous thrombosis and pulmonary embolism because of

A patient is admitted to the ICU for observation of his grade II splenic laceration.Which of the following signs and symptoms would suggest that he has had a delayed rupture of his splenic capsule and is now in hemorrhagic shock?

Which of the following statements is true about a patient with a blunt cardiac injury/cardiac contusion?

Critical Care Nursing Practice

Ethical Issues

Legal Issues

Genetics and Genomics in Critical Care

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations and Management

Nutrition Alterations and Management

Pain and Pain Management

Sedation,Agitation,Delirium: Assessment and Management

End-Of-Life Issues

Cardiovascular Anatomy and Physiology

Cardiovascular Clinical Assessment

Cardiovascular Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Anatomy and Physiology

Pulmonary Clinical Assessment

Pulmonary Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Anatomy and Physiology

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Anatomy and Physiology

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Burns

Organ Donation and Transplantation

Hematologic Disorders and Oncologic Emergencies

The Obstetric Patient

The Pediatric Patient

The Older Adult Patient

The Perianesthesia Patient

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