1. Anadult patient who sustained asevereheadtraumahasbeenintubatedandisbeing
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient
hasreceiveoneintravenousfluidbolus500mLofwarmedisotoniccrystalloidsolution. The
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg.
What is the most important intervention to manage the cerebral blood flow?
A. Decreasetherateofmanual ventilation.***
B. Initiateanotherfluidbolus.
C. Recheckendotrachealtubeplacement.
D. Increasetheamountofoxygendelivered.
2. Apatientwithcompletespinalcordinjurywhoisinneurogenicshockwilldemonstrate
hypotension and which other clinical signs?
A. Bradycardiaandipsilateralasenseofmotor function.
B. Tachycardiaandrespiratorydepression.
C. Tachycardiaandpiokilothermia.
D. Bradycardiaandabsentmotorfunctionbelowthelevelofinjury.***
3. Youarecaringforapatientwhowasshotmultipletimesinthechestandabdomen.The patient is
unresponsive with snoring, shallow respirations. Assessment reveals absent radial
pulses, weak and rapid carotid pulse, and cool, diaphoretic skin. Which management
strategy should the nurse anticipate?
A. Autotransfusion
B. Massivetransfusion
C. Controlledfluidboluses***
D. Inotropicmedications
4. Threeadultspresentatdifferenttimesduringaone-hourwithahighfever,fatigue,and
headache. All three patients have a rash which started on their mouth, face, and arms
with progression to the chest and abdomen. They all visited the same grocery store
within the last week. What is the most appropriate intervention from triage for these
patients?
A. Movethemtoadecontaminationarea
B. Maskthepatientsandsendthemtothewaiting room
C. Immediatelyinitiateisolationprecautions***
D. Sendthemtothewaitingroomwithoutamask
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A. Interdisciplinarycollaboration***
B. Provideon-the-jobtraining
C. Workindividually
D. Minimalfeedbacktodecreaseconfusion
6. An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their
body 2 hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400
mL/hr.Theurineoutputoverthelasthourwas15mL.Whatinterventionshouldthenurse
anticipate?
A. Addbloodproductstothe resuscitation
B. Increaseisotoniccrystalloidinfusionrate***
C. Administeranintravenousdiuretic
D. Switchtoahypertonicsalinesolution
7. Anadultpedestrianwasstruckontherightsidebyasportutilityvehicletraveling40 mph.
The patient is awake and alert and the right leg is shortened. Following initial
resuscitation with fluids, the patient remains hypotensive. What would the priority
intervention be?
A. Sendbloodfortypeand crossmatch
B. Applyapelvic binder***
C. Preparethepatientfor surgery
D. Insertaurinary catheter
8. Youarespeakingwiththefamilyofacriticallyinjuredpatient.Thespouseiscrying loudly
and the daughter is angry and yelling at staff. Which of the following nursing
interventions is most appropriate?
A. Havethefamilyescortedoutofthe department
B. Askifthefamilywouldlikespiritualsupport***
C. Allowonlythespousetoseethepatient
D. Donotincludethefamilyindecision-makingatthistime
9. Aseverelyinjuredpatienthasbeenintubatedandisbeingmechanicallyventilated.The patient
has received a balanced resuscitation including multiple blood products. Under which
circumstance will it be harder for hemoglobin to release oxygen to the tissues?
A. DecreasedpH
B. Elevatedcarbondioxidelevel
C. Decreasedbodytemperature***
D. Increasedmetabolicdemand
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