1. Your patient was a passenger in a motor vehicle crash
yesterday and suffered an open fracture of the femur. His
condition was stable until an hour ago, when he began to complain
of shortness of breath. His heart rate is 104 beats/min, respiratory
rate is 30 breaths/min, BP is 90/60 mm Hg, and temperature is
now 38.4°
C. You suspect that he:
A. has a fat embolism.
B. has developed metabolic acidosis.
C. is developing systemic inflammatory response syndrome
(SIRS).
D. is experiencing early multiple organ dysfunction syndrome
(MODS).
ANS: A
Rationale: These are classic signs and symptoms of a fat embolism.
The history of a long-bone fracture adds to the evidence of a fat
embolism. The patient may develop metabolic acidosis associated
with poor oxygenation from the fat emboli. SIRS possibly
,progressing to MODS would also be a consequence of the fat
emboli
2. Poor patient outcomes after a traumatic injury are associated
with:
A. chest tube placement for treatment of a hemothorax.
B. immediate decompression of a tension pneumothorax.
C. massive transfusions of blood products.
D. intraosseous cannulation for intravenous fluid administration.
Ans:C
Rationale: Current evidence suggests that patients receiving
massive blood transfusions have poorer outcomes. Although a
chest tube may be necessary in the treatment of trauma patients,
it is not associated with poor patient outcomes. Immediate
decompression of a tension pneumothorax is also not associated
with poor patient outcomes. Intraosseous cannulation for
intravenous fluid administration has not been shown to have
adverse patient outcomes.
3. Which condition is a common cause of death after chest
trauma?
A. Cardiac tamponade
,B. Flail chest
C. Hemothorax
D. Pulmonary contusion ANS: D
Rationale: Pulmonary contusion as a result of blunt chest trauma
increases the risk for development of pneumonia, acute lung
injury, and/or ARDS. Cardiac tamponade is life threatening if
untreated, but it is not a common complication after blunt chest
trauma.Flail chest and hemothorax may result with blunt chest
trauma, but they are notcommon causes of death.
4. A trauma patient with a fractured forearm complains of
extreme, throbbing pain at the fracture site and paresthesia in the
fingers. Upon further assessment, you note that the forearm is
extremely edematous and you are now having difficulty palpating
a radial pulse. You notify the physician immediately because you
suspect:
A. compartment syndrome.
B. fat emboli.
C. hypothermia.
D. rhabdomyolysis.
Ans: A
Rationale: These signs and symptoms are characteristic of late
signs of compartment
, syndrome. Fat emboli are associated with long-bone fractures and
typically manifest pulmonary symptoms. These signs and
symptoms are characteristic of compartment syndrome, not
hypothermia. Rhabdomyolysis is associated with a crush injury and
compartment syndrome. A clinical sign that may be noted by the
nurse is dark tea- colored urine.
5. The trauma patient presenting with left lower rib fractures
develops left upper quadrant tenderness, hypotension, and
referred pain to the left shoulder. You suspect:
A. bowel obstruction.
B. cardiac tamponade.
C. pulmonary contusion.
D. splenic injury.
Ans: D
Rationale: Splenic injury occurs most often as a result of blunt
trauma to the abdomen.However, penetrating trauma to the left
upper quadrant of the abdomen or fracture of the anterior left
lower ribs also contributes to splenic injuries. The patient may
present with left upper quadrant tenderness, peritoneal irritation,
and/or referred pain to the left shoulder (Kehr’s sign). Hypotension
or signs of hypovolemic shock may also be noted. The patient’s
injury and associated signs and symptoms suggest an injury to the
spleen rather than cardiac, bowel, or pulmonary injury.
6. Spinal cord injury causes a loss of sympathetic output,
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 dennohz2000. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
