1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve -
correct answer Hemoglobin does not readily release oxygen for use by the tissues
A shift to the left occurs in an environment of low metabolic demand
(hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash.
EMS reports significant damage to the driver's side of the car. The patient is
asking to have the cervical collar removed. When it is appropriate to remove the
cervical collar? - correct answer After a physical examination if the patient has no
radiologic abnormalities on CT A CT is recommended for spinal clearance in an
impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to
the entire surface of both upper extremities and superficial burns to the anterior
chest. Using the modified Lund and Browder chart to calculate the total body
surface area burned, how much IV fluid would be administered in the first 8
hours? - correct answer 2280 mL Both upper arms = 8%, both lower arms = 6%,
and both hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to
2280 mL. Superficial burns are not included in the TBSA calculation for fluid
resuscitation.
Which of the following is an expected finding in a patient with a tube
thoracostomy connected to a chest drainage system - correct answer Fluctuation
in the water seal chamber Fluctuation in the water seal chamber indicates the
tube is placed correctly in the pleural space.
.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? - correct answer Globe rupture A teardrop-shaped pupil suggests a
globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - correct answer Bradycardia and
absent motor function below the level of injury Patients with a complete spinal
cord injury will have absent motor function below the level of the lesion. They
become hypotensive and bradycardic due to loss of autonomic nervous system
function.
Which of the following patients warrants referral to a burn center? - correct
answer A 52-year-old diabetic male with a partial-thickness burn to the left lower
leg This patient has a 7% TBSA burn with a preexisting medical history that could
complicate management, prolong recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32
weeks pregnant. Findings of your secondary survey include abdominal pain on
palpation, fundal height at the costal margin, and some dark bloody show.
Varying accelerations and decelerations are noted on cardiotocography. These
findings are most consistent with which of the following? - correct answer
Placental abruption The findings of abdominal pain, elevated fundal height, dark
bloody show, and fetal distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal
pain after landing hard on the bicycle cross bars while performing an aerial BMX
maneuver. Secondary assessment reveals lower abdominal tenderness and
scrotal ecchymosis. Which of the following orders would the nurse question? -
correct answer Straight catheter for urine sample Insertion of a urinary catheter is
contraindicated if urethral transection is suspected. Signs and symptoms of
urethral injury include blood at the meatus, perineal ecchymosis, scrotal
ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? -
correct answer The aorta is torn at its attachment with the ligamentum
arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT
which of the following? - correct answer Defusings A defusing is part of critical
incident stress management but is not considered a critical communication point
in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma
patient with massive uncontrolled hemorrhage? - correct answer MARCH The
MARCH mnemonic stands for massive hemorrhage, airway, respiration,
circulation, and head injury/hypothermia. The MARCH mnemonic recognizes
uncontrolled hemorrhage as the major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a
house fire. Calculating total body surface area (TBSA) burned is deferred due to
the need for emergent intubation. At what rate should you begin fluid
resuscitation? - correct answer 500 mL/hour Prior to calculating TBSA, this is the
recommended starting point for fluid resuscitation for patients 14 years of age
and older
A 49-year-old restrained driver involved in a motor vehicle collision presents to
the trauma center complaining of abdominal, pelvic, and bilateral lower extremity
pain. Vital signs are stable. The nurse can anticipate all of these after a negative
FAST exam EXCEPT which of the following? - correct answer Diagnostic peritoneal
lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable
patients or if FAST and CT are not available.
An 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? - correct answer Subdural hematoma Subdural hematomas are
characterized by nausea, vomiting, headache, changes in level of consciousness,
ipsilateral dilated, nonreactive pupil, and unilateral weakness or hemiparesis.
These typically occur after a fall or assault.
Tearing of the bridging veins is most frequently associated with which brain
injury? - correct answer Subdural hematoma Subdural hematomas are usually
caused by tearing of the bridging veins and associated with direct injury to the
underlying brain tissue.
.During the primary survey of an unconscious patient with multi-system trauma,
the nurse notes snoring respirations. What priority nursing intervention should be
performed next? - correct answer Insert an oropharyngeal airway if there is no
gag reflex Snoring respirations may indicate airway obstruction from the tongue.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller gradebooster. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
