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Trauma and Surgical Management (CC)

Terms in this set (31)

Which of the following best defines the term traumatic injury?
a. All trauma patients can be successfully rehabilitated.
b. Traumatic injuries cause more deaths than heart disease and cancer.
c. Alcohol consumption, drug abuse, or other substance abuse contribute to traumatic events.
d. Trauma mainly affects the older adult population.
c. Alcohol consumption, drug abuse, or other substance abuse contribute to traumatic events.
When providing information on trauma prevention, it is important to realize that individuals age 35 to 54 years are most likely to experience which type of trauma incident?
a. High-speed motor vehicle crashes
b. Poisonings from prescription or illegal drugs
c. Violent or domestic traumatic altercations
d. Work-related falls
b. Poisonings from prescription or illegal drugs
An 18-year-old unrestrained passenger who sustained multiple traumatic injuries from a motor vehicle crash has a blood pressure of 80/60 mm Hg at the scene. This patient should be treated at which level trauma center?
a. Level I
b. Level II
c. Level III
d. Level IV
a. Level I
Which of the following injuries would result in a greater likelihood of internal organ damage and risk for infection?
a. A fall from a 6-foot ladder onto the grass
b. A shotgun wound to the abdomen
c. A knife wound to the right chest
d. A motor vehicle crash in which the driver hits the steering wheel
b. A shotgun wound to the abdomen
A 24-year-old unrestrained driver who sustained multiple traumatic injuries from a motor vehicle crash has a blood pressure of 80/60 mm Hg at the scene. The primary survey of this patient upon arrival to the ED:
a. includes a cervical spine x-ray study to determine the presence of a fracture.
b. involves turning the patient from side to side to get a look at his back.
c. is done quickly in the first few minutes to get a baseline assessment and establish priorities.
d. is a methodical head-to-toe assessment identifying injuries and treatment priorities.
c. is done quickly in the first few minutes to get a baseline assessment and establish priorities.
The nurse has admitted a patient to the ED following a fall from a first-floor hotel balcony. The patient is 22 years old and smells of alcohol. The patient begins to vomit in the ED. Which of the following interventions is most appropriate?
a. Insert an oral airway to prevent aspiration and to protect the airway.
b. Offer the patient an emesis basin so that you can measure the amount of emesis.
c. Prepare to suction the oropharynx while maintaining cervical spine immobilization.
d. Send a specimen of the emesis to the laboratory for analysis of blood alcohol content.
c. Prepare to suction the oropharynx while maintaining cervical spine immobilization.
Which of the following interventions would not be appropriate for a patient who is admitted with a suspected basilar skull fracture?
a. Insertion of a nasogastric tube
b. Insertion of an indwelling urinary catheter
c. Endotracheal intubation
d. Placement of an oral airway
a. Insertion of a nasogastric tube
The nurse is having difficulty inserting a large caliber intravenous catheter to facilitate fluid resuscitation to a hypotensive trauma patient. The nurse recommends which of the following emergency procedures to facilitate rapid fluid administration?
a. Placement of an intraosseous catheter
b. Placement of a central line placement
c. Insertion of a femoral catheter by a trauma surgeon
d. Rapid transfer to the operating room
a. Placement of an intraosseous catheter
In the trauma patient, symptoms of decreased cardiac output are most commonly caused by:
a. cardiac contusion.
b. cardiogenic shock.
c. hypovolemia.
d. pericardial tamponade.
c. hypovolemia.
A community-based external disaster is initiated after a tornado moved through the city. A nurse from the medical records review department arrives at the emergency department asking how she can assist. The best response by a nurse working for the trauma center would be to:
a. assign the nurse administrative duties, such as obtaining patient demographic information.
b. assign the nurse to a triage room with another nurse from the emergency department.
c. thank the nurse but inform her to return to her department as her skill set is not a good match for patients' needs.
d. have the nurse assist with transport of patients to procedural areas.
a. assign the nurse administrative duties, such as obtaining patient demographic information.
A near-infrared spectroscopy (NIRS) probe is placed in a trauma patient during the resuscitation phase to:
a. assess severity of metabolic acidosis.
b. determine intraperitoneal bleeding.
c. determine tissue oxygenation.
d. prevent complications of over-resuscitation.
c. determine tissue oxygenation.
The need for fluid resuscitation can be assessed best in the trauma patient by monitoring and trending which of the following tests?
a. Arterial oxygen saturation
b. Hourly urine output
c. Mean arterial pressure
d. Serum lactate levels
d. Serum lactate levels
The nurse is caring for a patient who sustained rib fractures after hitting the steering wheel of his car. The patient is spontaneously breathing and receiving oxygen via a face mask; the oxygen saturation is 95%. During the nurse's assessment, the oxygen saturation drops to 80%. The patient's blood pressure has dropped from 128/76 mm Hg to 84/60 mm Hg. The nurse assesses that breath sounds are absent throughout the left lung fields. The nurse notifies the physician and anticipates:
a. administration of lactated Ringer's solution (1 L) wide open.
b. chest x-ray study to determine the etiology of the symptoms.
c. endotracheal intubation and mechanical ventilation.
d. needle thoracostomy and chest tube insertion.
d. needle thoracostomy and chest tube insertion.
Which of the following patients have the greatest risk of developing acute respiratory distress syndrome (ARDS) after traumatic injury?
a. A patient who has a closed head injury with a decreased level of consciousness
b. A patient who has a fractured femur and is currently in traction
c. A patient who has received large volumes of fluid and/or blood replacement
d. A patient who has underlying chronic obstructive pulmonary disease
c. A patient who has received large volumes of fluid and/or blood replacement
Patients with musculoskeletal injury are at increased risk for compartment syndrome. What is an initial symptom of a suspected compartment syndrome?
a. Absence of pulse in affected extremity
b. Pallor in the affected area
c. Paresthesia in the affected area
d. Severe, throbbing pain in the affected area
d. Severe, throbbing pain in the affected area
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