TCAR POST TEST EXAM QUESTIONS WITH 100% CORRECTLY SOLVED ANSWERS, Exams of Nursing

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TCAR POST TEST EXAM QUESTIONS

WITH 100% CORRECTLY SOLVED

ANSWERS , FULLY SOLVED AND

UPDATED

A+ GRADED

1. Helmets and automobiles work because A) They prevent blows to the head B) Reduce acceleration injuries C) Increase deceleration speed D) Add deceleration distance -- ANSWER ✔✔ Reduce acceleration injuries
2. Which of the following statements best describes knife wounds? Their velocity is , the temporary cavity , and damage. A) low; depends on the size of the knife; is usually extensive B) low; is insignificant; is limited to structures directly in object's path C) high; will be small; affects structures at some distance from the wound tract D) high; may be massive; results in widespread tissue destruction -- ANSWER ✔✔ low; is insignificant; is limited to structures directly in object's path
3. Injury to which body structure is commonly a DELAYED finding in the blast trauma patient? A) Heart Bladder B) Bowel C) Spleen -- ANSWER ✔✔ Bowel

4. Shock occurs when? A) the sodium-potassium pump fails. B) ATP levels are less than lactic acid levels. C) cellular oxygen demand is greater than supply. D) aerobic metabolism exceeds anaerobic metabolism. -- ANSWER ✔✔ cellular oxygen demand is greater than supply.
5. ________shock is the most common type of shock immediately after traumatic injury. A) Distributive B) Septic C) Cardiogenic D) Hypovolemic -- ANSWER ✔✔ Hypovolemic
6. Which findings suggest a trauma patient is experiencing cardiogenic shock? A) Bradycardia, cyanosis, and elevated mean arterial pressure B) High shock index, mottling, and hypotension C) Tachycardia, flushing, and widened pulse pressure D) Pallor, course breath sounds, and hypertension -- ANSWER ✔✔ High shock index, mottling, and hypotension
7. A multisystem trauma patient has become progressively tachycardic and hypotensive one week after hospital admission. Pulse pressure is wide. The most likely explanation for this finding is: A) dehydration. B) fat embolism syndrome. C) surgical site bleeding. D) sepsis. -- ANSWER ✔✔ sepsis.
8. Normalizing a trauma patient's body temperature helps control bleeding because: A) hypothermia produces shivering and makes platelets hyperactive.

B) causes platelet dysfunction and clotting system failure. C) stimulates the clotting cascade and reduces blood pressure. D) increases tissue oxygen consumption and cold diuresis. -- ANSWER ✔✔ causes platelet dysfunction and clotting system failure.

9. What are the 3 components of the "trauma triad of death"? A) Coagulopathy, hypothermia, and acidosis B) Hypothermia, alkalosis, and coagulopathy C) Alkalosis, hyperthermia, and tissue injury D) Tissue injury, hyperthermia, and acidosis -- ANSWER ✔✔ Coagulopathy, hypothermia, and acidosis
10. Compensatory responses to hypovolemic shock include A) vasoconstriction, tachycardia, and oliguria. B) immune system activation, water retention, and bradycardia. C) tachycardia, diuresis, and hypoglycemia. D) fluid shifts, histamine release, and increased urine output. -- ANSWER ✔✔ vasoconstriction, tachycardia, and oliguria.
11. What four factors determine a patient's cardiac output? A) Pulse pressure, afterload, shock index, and blood pressure B) Heart rate, preload, contractility, and afterload C) Preload, mean pressure, heart rate, and central venous pressure D) Contractility, systolic pressure, shock index, and pulse pressure -- ANSWER ✔✔ Heart rate, preload, contractility, and afterload
12. Trauma resuscitation is considered complete when hemorrhage is controlled, the patient has normal vital signs, and body temperature has been stabilized. hemoglobin level is greater than 8 g/dL.

aerobic metabolism is reestablished. the Glasgow Coma Scale score exceeds 13. -- ANSWER ✔✔ aerobic metabolism is reestablished.

13. A patient with posterior rib fractures is at the highest risk for concomitant fractures of the sternum. A) T-spine. B) clavicles. C) ribs 1 and 2. -- ANSWER ✔✔ T-spine.
14. A motocross racer hit a ditch at high speed. The rider's chest was thrown against the handlebars. Which assessment finding indicates the patient has a flail chest? A) Paradoxical movement of the right chest wall B) A bubbling wound located on the upper thorax C) Subcutaneous emphysema and pain on palpation D) Chest dissymmetry with unilateral hyper expansion -- ANSWER ✔✔ Paradoxical movement of the right chest wall
15. Pulmonary contusions cause a problem at what point on the tissue oxygenation cascade? A) Hemoglobin availability B) Cardiac output C) Diffusion D) Ventilation -- ANSWER ✔✔ Ventilation
16. What is the usual intervention for a patient with subcutaneous emphysema? A) Chest tube insertion B) Emergent surgical repair C) Needle decompression D) Observation and reassessment -- ANSWER ✔✔ Observation and reassessment
17. 15 hours after a motor vehicle collision, an unrestrained driver is experiencing frequent, irregular heartbeats. The most likely cause of this finding is injury to the:

A) Left atrium. B) Left ventricle. C) Right atrium. D) Right ventricle. -- ANSWER ✔✔ right atrium.

18. In the patient with chest trauma, which of these findings is the earliest indicator of cardiac tamponade? A) Elevated heart rate B) Systolic hypotension C) Jugular vein distention D) Unilateral breath sounds -- ANSWER ✔✔ Elevated heart rate
19. In a patient with blunt chest trauma, what simple assessment can be used to screen for thoracic aortic injury? A) Side-to-side pulse oximeter saturation comparisons B) Bilateral upper extremity BP measurements C) Pulsus paradoxus calculation D) BP cuff inflation to elicit carpal spasm -- ANSWER ✔✔ Bilateral upper extremity BP measurements
20. A hemorrhaging patient is receiving 1:1:1 transfusion. This man will also need cryoprecipitate to boost his_______ level. A) tranexamic acid B) fibrinogen C) platelet factor VIII -- ANSWER ✔✔ fibrinogen
21. When a patient is receiving multiple blood transfusions, a priority nursing intervention is to prevent A) hemoconcentration. B) alkalosis. C) hypercalcemia. D) hypothermia. -- ANSWER ✔✔ hypothermia.
22. Following emergent transfusion, which electrolyte disturbances can be anticipated in the patient who received 12 units of blood products? A) Hyponatremia and hyperkalemia

B) Hypernatremia and hypomagnesemia C) Hypochloremia and hypercalcemia D) Hyperkalemia and hypocalcemia -- ANSWER ✔✔ Hyperkalemia and hypocalcemia

23. A trauma patient underwent damage control surgery for major abdominal hemorrhage. Post- operatively, her hand spasms when the blood pressure cuff inflates. Which of the following blood tests is indicated? A) TEG or ROTEM B) Lipase level C) ALT or AST level D) Ionized calcium -- ANSWER ✔✔ Ionized calcium
24. In the trauma patient with a blood pressure of 110/ mm Hg, mean arterial pressure is approximately A) 83 mm Hg B) 90 mm Hg C) 76 mm Hg D) 40 mm Hg -- ANSWER ✔✔ 83 mm Hg
25. A trauma patient has a heart rate of 92/min; systolic blood pressure is 115 mm Hg. This patient's shock index is A) 0. B) 1. C) 2. D) 0.8 -- ANSWER ✔✔ 0.
26. A young adult who fell from a third-floor balcony has a blood pressure of 110/70 mm Hg and a heart rate of 108/min. Pulse pressure is A) 55 mm Hg

B) 70 mm Hg C) 40 mm Hg D) 35 mm Hg -- ANSWER ✔✔ 40 mm Hg

27. A jockey was thrown from a running horse and hit the rail. On hospital Day 3, right flank bruising is present. This finding suggests the patient has a A) subcapsular splenic hematoma. B) renal laceration. C) aortic rupture. D) pancreatic contusion. -- ANSWER ✔✔ renal laceration.
28. An amateur boxer sustained a powerful punch to the upper abdomen. 36 hours after the event, which of the following findings suggests pancreatic injury? A) Bowel sounds in the chest B) Serum lipase elevation C) Left shoulder pain D) Blood in the urine -- ANSWER ✔✔ Serum lipase elevation
29. The goals of damage control surgery in the trauma patient include each of the following EXCEPT A) restoration of normal physiology. B) repair of all traumatic injuries. C) early blood product transfusion. D) active hemorrhage control. -- ANSWER ✔✔ repair of all traumatic injuries.
30. A hemodynamically stable patient was transfused 500 mL of red blood cells. Approximately how much of that volume will remain in the vascular space 60 minutes later? A) 250 mL B) 83 mL C) 333 mL D) 500 mL -- ANSWER ✔✔ 500 mL

31. Common causes of non-hemorrhagic fluid loss in the trauma patient during the post-resuscitation phase of care include A) mechanical ventilation and isotonic tube feedings. B) hypometabolism and interstitial fluid shifts. C) diarrhea and hypertonic enteral formulas. D) pressure dressings and renal contusions. -- ANSWER ✔✔ hypometabolism and interstitial fluid shifts.
32. The primary goal of early, small-volume enteral feeding is to support the intestinal mucosa and reduce A) bacterial and toxin translocation. B) post-traumatic muscle wasting. C) the hyperglycemic stress response. D) protein-calorie malnutrition. -- ANSWER ✔✔ bacterial and toxin translocation.
33. Clinical findings that suggest sepsis development in the trauma patient include: A) bradycardia, hypertension, and an elevated shock index. B) tachycardia, a narrowed pulse pressure, and a low shock index. C) bradycardia, hypotension, and a high mean pressure. D) tachycardia, a widened pulse pressure, and tachypnea. -- ANSWER ✔✔ tachycardia, a widened pulse pressure, and tachypnea.
34. On hospital Day 5, a polytrauma patient has the following vital signs: BP 97/50; HR 133/min; RR 22/min. Urine output is 12 mL/hr. Skin is cool and mottled. The pulse oximeter is not sensing dependably. These findings suggest A) an anaphylactic reaction. B) hemorrhagic hypovolemia. C) early sepsis. D) neurogenic shock. -- ANSWER ✔✔ early sepsis.

35. A patient has a positive "seat belt sign" across the epigastrium. This patient is at greatest risk for trauma to the; A) colon, kidneys, and stomach. B) duodenum, mesentery, and pancreas. C) T-spine, urethra, and gallbladder. D) spleen, pelvis, and bladder. -- ANSWER ✔✔ duodenum, mesentery, and pancreas.
36. A construction worker crushed by a falling beam has compartment syndrome of the left thigh. This patient will be closely monitored for signs of rhabdomyolysis, including; A) dark-colored urine and dropping urine output. B) dilute urine and an elevated creatine kinase level. C) increasing urine output and myoglobinemia. D) diminished urine output and hypokalemia. -- ANSWER ✔✔ dark-colored urine and dropping urine output.
37. Care of the trauma patient with prerenal failure chiefly involves A) initiating hemodialysis. B) limiting fluid intake. C) refilling the vascular space. D) administering diuretics. -- ANSWER ✔✔ refilling the vascular space.
38. A previously healthy young adult is recovering from a motorcycle crash that resulted in complex orthopedic injuries. Which of the following dietary discharge instructions is appropriate for this patient? A) Reduce total carbohydrates and eliminate lactose- containing products. B) Restrict fats, increase calcium intake, and avoid foods with high-protein content. C) Take an iron supplement and limit both leafy green vegetables and salty foods. D) Eat a standard diet but increase total calories, protein, and calcium-rich foods. -- ANSWER ✔✔ Eat a standard diet but increase total calories, protein, and calcium-rich foods.

39. In the patient with an open fracture, IV antibiotics significantly decrease the risk of osteomyelitis if administered within of hospital arrival. A) hour B) 4 hours C) 6 hours D) 8 hours -- ANSWER ✔✔ 1 hour
40. An 82-year-old man was admitted to the hospital after he fell down two steps. The patient is alert and oriented but has several bruises and abrasions. Which vital sign findings would be most concerning? A) Heart rate 97/min; blood pressure 134/78 mm Hg B) Heart rate 65/min; blood pressure 108/90 mm Hg C) Heart rate 94/min; blood pressure 101/82 mm Hg D) Heart rate 118/min; blood pressure 163/82 mm Hg -- ANSWER ✔✔ Heart rate 118/min; blood pressure 163/82 mm Hg
41. Two days after an episode of intimate partner violence, a patient complains of headache and nausea. She has poor recall of the events leading up to the injury. However, her brain computed tomography scan is normal. These findings suggest which type of brain trauma? A) Subdural hematoma B) Concussion C) Diffuse axonal injury D) Traumatic stroke -- ANSWER ✔✔ Concussion
42. In the first week after injury, interventions for the patient with a diffuse axonal injury primarily focus on ; A) preventing post-traumatic hydrocephalus. B) initiating cognitive rehabilitation. C) restoring axonal connections. D) limiting secondary brain damage. -- ANSWER ✔✔ limiting secondary brain damage.

43. A patient sustained a cribriform plate fracture. Which of the following is an expected assessment finding? Cerebral spinal fluid rhinorrhea. flow obstruction. Otorrhea accumulation. -- ANSWER ✔✔ rhinorrhea.
44. What is the priority intervention for the patient with a large expanding subdural hematoma? A) Emergent surgery for clot evacuation B) Craniectomy to increase intracranial pressure C) Ventriculostomy drainage to remove CSF D) Hospital admission for hourly neuro checks -- ANSWER ✔✔ Emergent surgery for clot evacuation
45. Which triad of symptoms are LATE signs of deterioration in a traumatic A) Agitation, bradycardia, and narrowing pulse pressure B) Tachycardia, dropping mean pressure, and headache C) Disorientation, nausea/vomiting, and posturing D) Bradycardia, irregular respirations, and hypertension -- ANSWER ✔✔ Bradycardia, irregular respirations, and hypertension
46. Which findings suggest impending herniation in a patient with a right temporal epidural hematoma? A) Left pupillary dilation, right-sided weakness B) Right pupillary dilation, right sided weakness C) Right pupillary dilation, left-sided weakness D) Left pupillary dilation, left-sided weakness -- ANSWER ✔✔ Right pupillary dilation, left-sided weakness

47. A patient with a spinal cord injury has no motor function below the T4 level but retains his sense of vibration. Which incomplete cord syndrome does this man have? A) Central cord syndrome B) Posterior cord syndrome C) Anterior cord syndrome D) Brown-Séquard syndrome -- ANSWER ✔✔ Anterior cord syndrome
48. A patient who sustained a complete C7 spinal cord injury nine days ago is being transferred from bed to a reclining wheelchair. This maneuver is likely to cause A) respiratory arrest. B) autonomic dysreflexia. C) postural hypotension. D) neurogenic bladder. -- ANSWER ✔✔ autonomic dysreflexia.
49. A patient who was ejected from a moving vehicle has a complete spinal cord injury at the T1 level. Bedside care providers can anticipate this patient will have issues maintaining a A) stable acid-base balance. B) urine output. C) body temperature. D) intracranial pressure. -- ANSWER ✔✔ urine output.