1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ANS 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 oxy...
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ANS
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? - ANS 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? - ANS 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 - ANS 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? - ANS 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? - ANS 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? - ANS 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? -
ANS 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? - ANS 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? - ANS 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? - ANS 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? - ANS 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? - ANS 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? - ANS 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
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