TNCC Final Exam 2: Trauma Nursing Core Curriculum Questions and Answers, Exams of Nursing

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CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED 500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation? a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the following patients warrants referral to a burn center? a pertinent medical hx is crucial - ansWhich of the following considerations is the most important when caring for a geriatric trauma pt? acidosis - ansWhich of the following is a component of the trauma triad of death? advanced age - ansWhich of the following is most likely to contribute to inadequate oxygenation and ventilation? after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar? apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? bardycardia and absent motor function below the level of injury - ansA pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? bowel - ansWhich of the following injuries is LEAST likely to be promptly identified? calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock? Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of the following types of spinal cord injury? defusings - ansAll of these are considered a critical communication point in trauma care EXCEPT which of the following?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED dressing removal - ansA patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED chest wound and taped it on three sides. he is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention? dysrhythmias - ansPatients with a crush injury should be monitored for which of the following conditions? elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain medications. Which of the following is the priority nursing intervention? endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device? Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the following conditions? flucuation in the water seal chamber - ansWhich of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system? globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of hypothermia on the oxyhemoglobin dissociation curve? identifying individuals who made mistakes during the traumatic event - ansWhich of the following is NOT considered a benefit of debriefings? increased work of breathing? - answhich of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic injuries

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED are noted in the primary survey, which of the following is the priority interventions?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing interventions should be preformed next? it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true about the log-roll? MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future disaster

. Which phase of the disaster life cycle does this describe? Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine clearance? narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock? nausea and vomiting - ansWhich of the following is a late sign of increased intracranial pressure? padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority? pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is which of the following? pericardiocentesis - ansWhich of the following is NOT considered goal- directed therapy for cardiogenic shock? placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent with which of the following? pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing compartment syndrome. What is the most reliable indication of compartment syndrome in a patient who is unconscious?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of ventilation? Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority survey. Which of the following is the priority nursing intervention? serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN question? subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? subdural hematoma - ansTearing of the bridging veins is most frequently associated with which brain injury? the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following occurs during the third impact of a motor vehicle crash? to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate obtained in the initial assessment of a trauma patient? velocity - ansWhat factor contributes most to the kinetic energy of a body in motion? ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt? worsening pneumothorax - ansWhich of the following is possible

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED complication of positive-pressure ventilation? 500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the following patients warrants referral to a burn center? a pertinent medical hx is crucial - ansWhich of the following considerations is the most important when caring for a geriatric trauma pt? acidosis - ansWhich of the following is a component of the trauma triad of death? advanced age - ansWhich of the following is most likely to contribute to inadequate oxygenation and ventilation? after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar? apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? bardycardia and absent motor function below the level of injury - ansA pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? bowel - ansWhich of the following injuries is LEAST likely to be promptly identified? calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock? Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of the following types of spinal cord injury? defusings - ansAll of these are considered a critical communication point in trauma care EXCEPT which of the following? dressing removal - ansA patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. he is now

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED dysrhythmias - ansPatients with a crush injury should be monitored for which of the following conditions? elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain medications. Which of the following is the priority nursing intervention? endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device? Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the following conditions? flucuation in the water seal chamber - ansWhich of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system? globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of hypothermia on the oxyhemoglobin dissociation curve? identifying individuals who made mistakes during the traumatic event - ansWhich of the following is NOT considered a benefit of debriefings? increased work of breathing? - answhich of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey, which of the following is the priority interventions?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing interventions should be preformed next? it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true about the log-roll? MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future disaster

. Which phase of the disaster life cycle does this describe? Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine clearance? narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock? nausea and vomiting - ansWhich of the following is a late sign of increased intracranial pressure? padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority? pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is which of the following? pericardiocentesis - ansWhich of the following is NOT considered goal- directed therapy for cardiogenic shock? placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent with which of the following? pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing compartment syndrome. What is the most reliable indication of compartment syndrome in a patient who is unconscious?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of ventilation? Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority survey. Which of the following is the priority nursing intervention? serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN question? subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? subdural hematoma - ansTearing of the bridging veins is most frequently associated with which brain injury? the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following occurs during the third impact of a motor vehicle crash? to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate obtained in the initial assessment of a trauma patient? velocity - ansWhat factor contributes most to the kinetic energy of a body in motion? ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt? worsening pneumothorax - ansWhich of the following is possible

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED complication of positive-pressure ventilation? 500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the following patients warrants referral to a burn center? a pertinent medical hx is crucial - ansWhich of the following considerations is the most important when caring for a geriatric trauma pt? acidosis - ansWhich of the following is a component of the trauma triad of death? advanced age - ansWhich of the following is most likely to contribute to inadequate oxygenation and ventilation? after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar? apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? bardycardia and absent motor function below the level of injury - ansA pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? bowel - ansWhich of the following injuries is LEAST likely to be promptly identified? calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock? Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of the following types of spinal cord injury? defusings - ansAll of these are considered a critical communication point in trauma care EXCEPT which of the following? dressing removal - ansA patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. he is now

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED dysrhythmias - ansPatients with a crush injury should be monitored for which of the following conditions? elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain medications. Which of the following is the priority nursing intervention? endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device? Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the following conditions? flucuation in the water seal chamber - ansWhich of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system? globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of hypothermia on the oxyhemoglobin dissociation curve? identifying individuals who made mistakes during the traumatic event - ansWhich of the following is NOT considered a benefit of debriefings? increased work of breathing? - answhich of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey, which of the following is the priority interventions?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing interventions should be preformed next? it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true about the log-roll? MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future disaster

. Which phase of the disaster life cycle does this describe? Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine clearance? narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock? nausea and vomiting - ansWhich of the following is a late sign of increased intracranial pressure? padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority? pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is which of the following? pericardiocentesis - ansWhich of the following is NOT considered goal- directed therapy for cardiogenic shock? placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent with which of the following? pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing compartment syndrome. What is the most reliable indication of compartment syndrome in a patient who is unconscious?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of ventilation? Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority survey. Which of the following is the priority nursing intervention? serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN question? subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? subdural hematoma - ansTearing of the bridging veins is most frequently associated with which brain injury? the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following occurs during the third impact of a motor vehicle crash? to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate obtained in the initial assessment of a trauma patient? velocity - ansWhat factor contributes most to the kinetic energy of a body in motion? ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt? worsening pneumothorax - ansWhich of the following is possible

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED complication of positive-pressure ventilation? 500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ansWhich of the following patients warrants referral to a burn center? a pertinent medical hx is crucial - ansWhich of the following considerations is the most important when caring for a geriatric trauma pt? acidosis - ansWhich of the following is a component of the trauma triad of death? advanced age - ansWhich of the following is most likely to contribute to inadequate oxygenation and ventilation? after a physical examination if the pt has no radiologic abnormalities on CT - ansEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar? apply splint and elevate above the level of the heart - ansa 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? bardycardia and absent motor function below the level of injury - ansA pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? bowel - ansWhich of the following injuries is LEAST likely to be promptly identified? calcium - ansif a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? compensated - ansA trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock? Complete - ansEMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of the following types of spinal cord injury? defusings - ansAll of these are considered a critical communication point in trauma care EXCEPT which of the following? dressing removal - ansA patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. he is now

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED dysrhythmias - ansPatients with a crush injury should be monitored for which of the following conditions? elevating the extremity to the level of the heart - ansA pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain medications. Which of the following is the priority nursing intervention? endotracheal tube - ansThe trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device? Expedite transfer to the closest trauma center - ansA 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? fat embolism - ansa pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the following conditions? flucuation in the water seal chamber - ansWhich of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system? globe rupture - ansA 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? hemoglobin does not readily release O2 for use by the tissues - ansWhat is the effect of hypothermia on the oxyhemoglobin dissociation curve? identifying individuals who made mistakes during the traumatic event - ansWhich of the following is NOT considered a benefit of debriefings? increased work of breathing? - answhich of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? Initiate transfer to a trauma center - ansA pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey, which of the following is the priority interventions?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED insert an oropharyngeal airway if there is no gag reflex - ansDuring the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing interventions should be preformed next? it can worsen cord damage from an unstable spinal injury - ansWhich of the following is true about the log-roll? MARCH - ansWhich of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Mitigation - ansFollowing a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future disaster

. Which phase of the disaster life cycle does this describe? Multiple requests for water - ansEMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine clearance? narrowed - ansWhich of the following pulse pressures indicate early hypovolemic shock? nausea and vomiting - ansWhich of the following is a late sign of increased intracranial pressure? padding the upper back while stabilizing the cervical spine - ansCaregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority? pelvic stability - ansthe most reassuring finding for a male pt with hip pain after a fall is which of the following? pericardiocentesis - ansWhich of the following is NOT considered goal- directed therapy for cardiogenic shock? placental abruption - ansYou are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent with which of the following? pressure - ansAn intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing compartment syndrome. What is the most reliable indication of compartment syndrome in a patient who is unconscious?

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED pulse oximetry and capnography - ansWhat bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of ventilation? Report your suspicion of maltreatment in accordance with local regulations - ansa 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority survey. Which of the following is the priority nursing intervention? serial FAST exams - ansa 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? straight cath for urine sample - ansA 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN question? subdural hematoma - ansAn elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? subdural hematoma - ansTearing of the bridging veins is most frequently associated with which brain injury? the aorta is torn at its attachment with the ligamentum arteriosum - answhich of the following occurs during the third impact of a motor vehicle crash? to guage end-organ perfusion and tissue hypoxia - ansWhy is a measure of serum lactate obtained in the initial assessment of a trauma patient? velocity - ansWhat factor contributes most to the kinetic energy of a body in motion? ventilate with a bag mask device - ansAn unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? within 24 hrs of trauma - ansWhen is the tertiary survey completed fora trauma pt? worsening pneumothorax - ansWhich of the following is possible

CORRECT ANSWER VERIFIED ANSWERS|ALREADY GRADED A+ VERIFIED complication of positive-pressure ventilation? 500 mL/hr - ansYou are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation?