Question 1

Major trauma patients are at high risk of developing deep venous thrombosis and pulmonary embolism.The nurse understands that trauma patients are at risk due to which factors?

Accepted Answer

A)   Blood stasis
B)   Hypernatremia
C)   Injury to the intimal surface of the vessel
D)   Hyperosmolarity
E)   HypercoagulopathyF)  Immobility A,C,E,F

Question 2

A patient is admitted with a C5-C6 subluxation fracture.He is able to move his legs better than he can move his arms.Nursing care for the patient includes which intervention?

Accepted Answer

A)   Keep the room cool, dark, and quiet.
B)   Maintain mean arterial pressure (MAP)  at 85 to 95 mm Hg.
C)   Elevate the head of the bed 45 degrees.
D)   Resuscitate low blood pressure by only using intravenous fluid. B

Question 3

A patient has been admitted with a flail chest and pulmonary contusion.Which finding will cause a nurse to suspect that the patient's condition is deteriorating?

Accepted Answer

A)   Increased bruising on the chest wall
B)   Increased need for pain medication
C)   The development of respiratory alkalosis
D)   Increased work of breathing D

Question 4

A patient with a Le Fort III facial fracture has been admitted to the critical care unit.Which statements is true regarding this type of facial fracture?

Accepted Answer

A)   It is frequently associated with cerebrospinal fluid leaks.
B)   It is not as severe as Le Forte I and II injuries.
C)   The patient's airway is not usually compromised.
D)   It is associated with a low risk for hemorrhagic shock.

Question 5

The nurse is caring for a patient with blunt abdominal trauma.The nurse understands that patient is at risk for abdominal compartment syndrome.Which findings would the nurse expect to note as evidence of this complication?

Accepted Answer

A)   Decreased cardiac output
B)   Increased peak pulmonary pressures
C)   Decreased urine output
D)   Hypoxemia
E)   Bradycardia

Question 6

Older trauma patients have a higher mortality than younger trauma patients.The nurse understands that this fact is probably related to what physiologic change?

Accepted Answer

A)   Deterioration of cerebral and motor skills
B)   Poor vision and hearing
C)   Diminished pain perception
D)   Limited physiologic reserve

Question 7

A patient developed a hemothorax after a blunt chest trauma.The practitioner inserted a chest tube on the left side,and 1800 mL of blood was evacuated from the chest.The nurse expects that the patient will be taken to surgery for what procedure?

Accepted Answer

A)   Thoracotomy
B)   Pericardiocentesis
C)   Splenectomy
D)   Pneumonectomy

Question 8

The nurse is working on an organization-wide falls prevention project.The nurse understands that the majority of falls accounting for traumatic injury occur in what population?

Accepted Answer

A)   Construction workers
B)   Adolescents
C)   Older adults
D)   Young adults

Question 9

A patient who was an unrestrained driver in a high-speed,head-on motor vehicle collision presents with dyspnea,tachycardia,hypotension,jugular venous distention,tracheal deviation to the left,and decreased breath sounds on the right side.The nurse suspects these findings are indicative of which disorder?

Accepted Answer

A)   Tension pneumothorax
B)   Cardiac tamponade
C)   Simple pneumothorax
D)   Ruptured diaphragm

Question 10

A patient is admitted with a blunt cardiac injury (BCI)with no evidence of rupture.The nursing management plan should include which intervention?

Accepted Answer

A)   Administer nitroglycerine for chest pain as needed.
B)   Monitor the patient for new onset dysrhythmias.
C)   Monitor serial biomarkers for evidence of further damage.
D)   Do not administer antidysrhythmic medications, as they are ineffective.

Question 11

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

Accepted Answer

A)   Blood pressure (BP) , 110/70 mm Hg; HR, 120 beats/min; Hct, 42 mg/dL; UO, 40 mL/h; 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/h; pale, cool, clammy skin; confused
C)   BP, 100/60 mm Hg; HR, 100 beats/min; Hct, 35 mg/dL; UO, 30 mL/h; pale, cool, dry skin; alert and oriented
D)   BP, 110/60 mm Hg; HR, 118 beats/min; Hct, 38 mg/dL; UO, 60 mL/h; flushed, warm, diaphoretic skin; agitated and confused

Question 12

A patient with severe traumatic brain injury has been admitted to the critical care unit.What is one intervention to minimize secondary brain injury?

Accepted Answer

A)   Hyperventilate the patient to keep PCO₂ less than 30.
B)   Restrict fluids to keep central venous pressure less than 6 cm H2O.
C)   Maintain the patient's body temperature more than 37.5° C.
D)   Administer fluids to keep the systolic blood pressure greater than 90 mm Hg.

Question 13

A patient with multisystem trauma has been in the critical care unit for 2 days.The patient is still intubated and mechanically ventilated and has a chest tube,urinary drainage catheter,nasogastric tube,and two abdominal drains.The nurse understands that immobility places the patient at risk for developing which complication?

Accepted Answer

A)   Pneumonia
B)   Infection
C)   Venous thromboembolism
D)   Fat embolism syndrome

Question 14

A patient was admitted after a motor vehicle crash (MVC).The nurse knows that this type of injury is the greatest cause of what type of trauma?

Accepted Answer

A)   Spinal shock
B)   Blunt thoracic trauma
C)   Maxillofacial injuries
D)   Penetrating thoracic injuries

Question 15

During assessment of a new trauma patient,the nurse observes perianal ecchymosis.The nurse suspects the patient has what problem?

Accepted Answer

A)   Pelvic fracture
B)   Bladder trauma
C)   Rectal laceration
D)   Spleen laceration

Question 16

A patient has sustained an epidural hematoma after a 10-foot fall from a roof.The nurse understands that an epidural hematoma is a condition that has which characteristic?

Accepted Answer

A)   Usually arterial in nature
B)   Worse mortality rate than subdural hematomas
C)   Associated with a permanent loss of consciousness
D)   Signs and symptoms include bilateral pupil dilation

Question 17

An unresponsive trauma patient has been admitted to the emergency department.Which statement regarding opening the airway is accurate?

Accepted Answer

A)   Airway assessment must incorporate cervical spine immobilization.
B)   Hyperextension of the neck is the only acceptable technique.
C)   Flexion of the neck protects the patient from further injury.
D)   Airway patency takes priority over cervical spine immobilization.

Question 18

A nurse and a nursing student are discussing management of the trauma patient.The nurse asks the student what the AVPU method is used for during the primary survey.Which response would indicate the new graduate nurse understood the information?

Accepted Answer

A)   Used to assess respiratory status
B)   Used to assess circulatory status
C)   Used to assess pain status
D)   Used to assess level of consciousness

Question 19

Patients immobilized because of spinal trauma are at a high risk for contractures.The nursing management plan for these patients should include which preventive measures?

Accepted Answer

A)   Consultation by physical therapist (PT)  and occupational therapist (OT)  early in the treatment of the patient.
B)   Turning and repositioning the patient every 2 hours as ordered by the physician.
C)   Range of motion exercises 1 month after the spine has been stabilized.
D)   Removal of splints every 4 hours and at bedtime.
E)   Hand splints for patients with paraplegia.F)  Hand and foot splints for patients with quadriplegia.

Question 20

A patient with multisystem trauma has been in the intensive care unit (ICU)for 6 days.The patient is still intubated and mechanically ventilated and has a chest tube,urinary drainage catheter,nasogastric tube,and two abdominal drains.The patient's vital signs include blood pressure (BP),92/66 mm Hg; heart rate (HR),118 beats/min; temperature (T),38.7° C; and central venous pressure (CVP),5 mm Hg.What is the most likely cause of this hemodynamic picture?

Accepted Answer

A)   Septic shock
B)   Hemorrhagic shock
C)   Cardiogenic shock
D)   Neurogenic shock

Exam 33: Trauma