TCAR-POST TEST REAL EXAM QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+, Exams of Nursing

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TCAR-POST TEST REAL EXAM QUESTIONS AND CORRECT ANSWERS

ALREADY GRADED A+

1. Helmets and automobile airbags work because they prevent blows to the head. reduce acceleration injuries. increase deceleration speed. 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 _____. low; depends on the size of the knife; is usually extensive low; is insignificant; is limited to structures directly in object's path high; will be small; affects structures at some distance from the wound tract 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? Heart Bladder Bowel Spleen - answer-Bowel
4. Shock occurs when the sodium-potassium pump fails. ATP levels are less than lactic acid levels. cellular oxygen demand is greater than supply. 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.

Distributive Septic Cardiogenic Hypovolemic - answer-Hypovolemic

7. Which findings suggest a trauma patient is experiencing cardiogenic shock? Bradycardia, cyanosis, and elevated mean arterial pressure High shock index, mottling, and hypotension Tachycardia, flushing, and widened pulse pressure Pallor, course breath sounds, and hypertension - answer-High shock index, mottling, and hypotension
8. 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 dehydration. fat embolism syndrome. surgical site bleeding. sepsis. - answer-sepsis.
9. Normalizing a trauma patient's body temperature helps control bleeding because hypothermia produces shivering and makes platelets hyperactive. causes platelet dysfunction and clotting system failure. stimulates the clotting cascade and reduces blood pressure. increases tissue oxygen consumption and cold diuresis. - answer-causes platelet dysfunction and clotting system failure.
10. What are the 3 components of the "trauma triad of death"? Coagulopathy, hypothermia, and acidosis Hypothermia, alkalosis, and coagulopathy Alkalosis, hyperthermia, and tissue injury Tissue injury, hyperthermia, and acidosis - answer-Coagulopathy, hypothermia, and acidosis
11. Compensatory responses to hypovolemic shock include

Subcutaneous emphysema and pain on palpation Chest dissymmetry with unilateral hyperexpansion - answer-Paradoxical movement of the right chest wall

16. Pulmonary contusions cause a problem at what point on the tissue oxygenation cascade? Hemoglobin availability Cardiac output Diffusion Ventilation - answer-Ventilation
17. What is the usual intervention for a patient with subcutaneous emphysema? Chest tube insertion Emergent surgical repair Needle decompression Observation and reassessment - answer-Observation and reassessment
18. 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 left atrium. left ventricle. right atrium. right ventricle. - answer-right atrium.
19. In the patient with chest trauma, which of these findings is the earliest indicator of cardiac tamponade? Elevated heart rate Systolic hypotension Jugular vein distention Unilateral breath sounds - answer-Elevated heart rate

20. In a patient with blunt chest trauma, what simple assessment can be used to screen for thoracic aortic injury? Side-to-side pulse oximeter saturation comparisons Bilateral upper extremity BP measurements Pulsus paradoxus calculation BP cuff inflation to elicit carpal spasm - answer-Bilateral upper extremity BP measurements
21. A hemorrhaging patient is receiving 1:1:1 transfusion. This man will also need cryoprecipitate to boost his ________ level. tranexamic acid fibrinogen platelet factor VIII - answer-fibrinogen
22. When a patient is receiving multiple blood transfusions, a priority nursing intervention is to prevent hemoconcentration. alkalosis. hypercalcemia. hypothermia. - answer-hypothermia.
23. Following emergent transfusion, which electrolyte disturbances can be anticipated in the patient who received 12 units of blood products? Hyponatremia and hyperkalemia Hypernatremia and hypomagnesemia Hypochloremia and hypercalcemia Hyperkalemia and hypocalcemia - answer-Hyperkalemia and hypocalcemia

40 mm Hg 35 mm Hg - answer-40 mm Hg

28. 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 subcapsular splenic hematoma. renal laceration. aortic rupture. pancreatic contusion. - answer-renal laceration.
29. An amateur boxer sustained a powerful punch to the upper abdomen. 36 hours after the event, which of the following findings suggests pancreatic injury? Bowel sounds in the chest Serum lipase elevation Left shoulder pain Blood in the urine - answer-Serum lipase elevation
30. The goals of damage control surgery in the trauma patient include each of the following EXCEPT restoration of normal physiology. repair of all traumatic injuries. early blood product transfusion. active hemorrhage control. - answer-repair of all traumatic injuries.
31. 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? 250 mL

83 mL 333 mL 500 mL - answer-500 mL

32. Common causes of non-hemorrhagic fluid loss in the trauma patient during the post-resuscitation phase of care include mechanical ventilation and isotonic tube feedings. hypometabolism and interstitial fluid shifts. diarrhea and hypertonic enteral formulas. pressure dressings and renal contusions. - answer-hypometabolism and interstitial fluid shifts.
33. The primary goal of early, small-volume enteral feeding is to support the intestinal mucosa and reduce bacterial and toxin translocation. post-traumatic muscle wasting. the hyperglycemic stress response. protein-calorie malnutrition. - answer-bacterial and toxin translocation.
34. Clinical findings that suggest sepsis development in the trauma patient include bradycardia, hypertension, and an elevated shock index. tachycardia, a narrowed pulse pressure, and a low shock index. bradycardia, hypotension, and a high mean pressure. tachycardia, a widened pulse pressure, and tachypnea. - answer-tachycardia, a widened pulse pressure, and tachypnea.
35. 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

39. 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? Reduce total carbohydrates and eliminate lactose-containing products. Restrict fats, increase calcium intake, and avoid foods with high-protein content. Take an iron supplement and limit both leafy green vegetables and salty foods. 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.
40. In the patient with an open fracture, IV antibiotics significantly decrease the risk of osteomyelitis if administered within ____ of hospital arrival. 1 hour 4 hours 6 hours 8 hours - answer-1 hour
41. 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? Heart rate 97/min; blood pressure 134/78 mm Hg Heart rate 65/min; blood pressure 108/90 mm Hg Heart rate 94/min; blood pressure 101/82 mm Hg Heart rate 118/min; blood pressure 163/82 mm Hg - answer-Heart rate 118/min; blood pressure 163/82 mm Hg
42. 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? Subdural hematoma

Concussion Diffuse axonal injury Traumatic stroke - answer-Concussion

43. In the first week after injury, interventions for the patient with a diffuse axonal injury primarily focus on preventing post-traumatic hydrocephalus. initiating cognitive rehabilitation. restoring axonal connections. limiting secondary brain damage. - answer-limiting secondary brain damage.
44. 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.
45. What is the priority intervention for the patient with a large expanding subdural hematoma? Emergent surgery for clot evacuation Craniectomy to increase intracranial pressure Ventriculostomy drainage to remove CSF Hospital admission for hourly neuro checks - answer-Emergent surgery for clot evacuation
46. Which triad of symptoms are LATE signs of deterioration in a traumatic

50. 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 stable acid-base balance. urine output. body temperature. intracranial pressure. - answer-urine output.