A adult patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. They complain of difficulty swallowing and speaking. In the
primary survey, further assessment is indicated next for which of the following
conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ansa. Damage to the cervical spine
A patient arrives at the emergency department by private vehicle after sustaining an
injury to the right lower extremity while using a saw. There is a large gaping wound to
the right thigh area with significant bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure
A patient fell two weeks ago, striking their head. Today, the patient presented with a
persistent headache and nausea and was diagnosed with a small subdural hematoma.
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports the patient has been anxious, restless, shaky, and vomited twice during
the night. The patient states they couldn't sleep because a young child kept coming into
the room. What is the most likely cause for these signs and symptoms?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus - ansb. alcohol withdrawal
A patient involved in a MVC has sustained a fracture to the second rib of the anterior left
chest. Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - ansb. Brachial plexus injury
A patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management for this patient?
a. maintain adequate respiratory status.
b. administer balanced resuscitation fluid
c. perform serial assessments of neurologic function
d. maintain core temperature - ansa. maintain adequate respiratory status
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
called in sick for a couple of days and is now back working on the team. Which of the
following behaviors would indicate this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
d. They are thinking about transferring out of the emergency department. - ansa. They
are talking about taking the emergency nursing certification examination.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
d. quaternary - ansb. secondary
In a patient with severe traumatic brain injury, hypocapnia causes which condition?
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction
The general impression step in the initial assessment provides the opportunity to do
which of the following?
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.
The nurse is obtaining a history for a patient who presents following sexual assault. This
history is completed using which of the following techniques?
a. Bring the family in to the interview room.
b. Use direct quotes to record information.
c. Obtain information specific only to the assault.
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record
information.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of
94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124
beats/minute. The emergency nurse interprets the patient's hemodynamic findings as
an indication of which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c. administer tissue plasminogen activator
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator
Understanding the kinematic concepts associated with the mechanism of injury and
energy transfer can initially assist the trauma care provider in which of the following?
a. Anticipating the types of injuries that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries
that may be present
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests, downward and laterally.
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply gentle
pressure over the iliac crests, downward and medially.
What is the best measure of the adequacy of cellular perfusion and can help to predict
the outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hematocrit level
c. Base deficit
d. Oxygen saturation - ansc. Base deficit
What is the best position for maintaining an open airway in the obese patient?
a. Prone
b. Supine
c. Reverse Trendelenburg
d. Right lateral recumbent - ansc. Reverse Trendelenburg
What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
a. Airway compromise
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled external hemorrhage - ansd. Uncontrolled external hemorrhage
Which of the following accurately describes ventilation principles associated with use of
a bag-mask device for an adult?
a. Compress the bag-mask device at a rate of one breath every 6 seconds.
b. Delivers 100% oxygen.
c. Squeeze the bag-mask device completely for each breath.
d. Maintain the oxygen saturation levels between 92% and 94%. - ansa. Compress the
bag-mask device at a rate of one breath every 6 seconds.
Which of the following is considered a cornerstone of a high-performance trauma team?
a. Individual goals
b. Use of TeamSTEPPS
c. Identification of a single decision maker
d. Effective communication - ansd. Effective communication
While performing an assessment on a 13-month-old involved in a motor vehicle
collision, the nurse identifies which of the following findings from the patient as a sign of
possible altered mental status?
a. Sunken fontanel
b. Crying, but consolable
c. Spontaneous movement of arms and legs
d. Cooperation with the assessment - ansd. Cooperation with the assessment
A (AVPU) - ansAlert. Will be able to maintain airway once clear.
A (Primary Survey) - ansAirway and alertness with simultaneous cervical spinal
stabilization.
Airway Assessment - ansInspect: tongue obstruction, loose/missing teeth, foreign
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
Airway Interventions: - ansSuction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
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