A 5-year-old child presents to the emergency department with bruises to the upper arms
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 nursing intervention?
A.Report your suspicion of maltreatment in accordance with local regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communicati - ansA.Report your suspicion of maltreatment in
accordance with local regulations
A 35-year-old male 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?
A driver involved in a high-speed motor vehicle collision arrives in the emergency
department. The vehicle's air-bag failed to deploy. The patient is drowsy but arousable
and complaining of chest pain with ecchymosis noted to the chest. The patient is
tachycardic and hypotensive with no evidence of uncontrolled bleeding. Cardiac monitor
shows premature ventricular contractions. Which of the following is the most appropriate
intervention for this patient?
A.Rapid fluid boluses
B.Tranexamic acid - ansC.Inotropic support
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients
during a staffing crisis. The nurse expresses anger stating that the patients did not
receive quality care and begins exhibiting aggression toward colleagues. This is most
consistent with which condition?
A patient arrives following prolonged exposure of their left hand to the cold. The patient
is awake and alert and complains of a tingling sensation to the fingers. Assessment
reveals swelling and bright red skin to the left hand and a 1-inch round clear blister to
the dorsum of that hand. Which of the following nursing interventions is most
appropriate for this patient?
A.Massage the injured areas to promote circulation
B.Drain and debride the blister on the hand
C.Immerse in water between 37.5 - ansD.Gently rewarm over 15 to 30 minutes
A patient arrives with a large metal rod embedded in their left thigh and no active
bleeding. Which intervention is most appropriate for this patient?
A.Remove the rod immediately to facilitate cleansing.
B.Apply a tourniquet to the leg above the metal rod.
C.Hold antibiotics until after the rod is removed.
D.Prepare the patient for surgery to remove the rod. - ansD.Prepare the patient for
surgery to remove the rod.
A 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. The patient 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?
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding
would indicate sacral sparing?
A.Involuntary flexion of the great toe
B.Priapism
C.Voluntary anal sphincter tone
D.Numbness to the perianal area - ansVoluntary anal sphincter tone
A patient has been in the emergency department for several hours waiting to be
admitted. They sustained multiple rib fractures and a femur fracture after a fall. The
patient has been awake, alert, and complaining of leg pain. Their spouse reported that
the patient suddenly became anxious and confused. Upon reassessment, the patient is
restless, with respiratory distress and petechiae to his neck. The patient is exhibiting
signs and symptoms most commonly associated with which of the following co - ansfat
embolism
A patient has uncontrolled bleeding from a wound to his right upper extremity. What is
the priority intervention?
A.Initiate two intravenous access sites
B.Place the patient on supplemental oxygen
C.Apply direct pressure to the wound
D.Use a tourniquet to control the bleeding - ansC.Apply direct pressure to the wound
A patient involved in a high-speed rollover is complaining of increased difficulty
breathing. There is a small penetrating wound to the sixth intercostal space in the left
lateral chest. Which finding is most consistent with an injury to the diaphragm?
A.Severe left-sided abdominal pain
B.Bowel sounds heard in the left lower chest
C.Pain radiating to the left shoulder.
D.Decreased breath sounds on the left side - ansBowel sounds heard in the left lower
chest
A patient is brought to the emergency department following a snowmobile crash with
prolonged exposure time prior to transport. The patient is confused. Vital signs are BP
96/54 mm Hg, HR 114 beats/minute, RR 24 breaths/minute, T 34.6oC (94.2oF) and an
SpO2 of 90% on oxygen at 15L per non-rebreather mask. Other findings include
ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based on these findings, what
is the most appropriate intervention?
A.Initiate warming measures
B.Titrate oxygen to - ansA.Initiate warming measures
A patient is brought to the emergency department with chest pain and shortness of
breath following a high-speed motor vehicle collision in which they were the
unrestrained driver. There is crepitus to the left chest with clear and equal breath
sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular
contractions. These findings are most consistent with which type of shock?
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which
finding is consistent with spinal shock?
A.Bradycardia
B.Loss of reflexes
C.Widened pulse pressure
D.Warm skin - ansB.Loss of reflexes
A patient is thrown against a car during a tornado and presents with obvious bilateral
femur fractures. The patient is pale, alert, disoriented, and has delayed capillary refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principles?
A.Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
B.Administer intravenous medications for pain.
C.Place the patient in an observation area for care within the n - ansInitiate two large-
caliber intravenous lines for isotonic crystalloid administration.
A patient who sustained severe injuries was brought to the emergency department
following a high-speed motor vehicle collision. Interventions for hypovolemic shock have
been initiated. What component of the trauma triad of death is most likely to have begun
at the time of injury?
A patient who weighs 120 kg is brought to the emergency department after sustaining
partial thickness burns to both upper extremities and chest with a total body surface
area burned of 27%. How much intravenous fluid should be administered in the first 8
hours?
A.1620 mL
B.2160 mL
C.3240 mL
D.6480 mL - ansC.3240 mL
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