Deck 45: Care of Patients With Trauma or Shock

Question 1

The nurse recognizes indications of respiratory distress,which include: (Select all that apply.)

A)gasping.
B)wheezing.
C)stridor.
D)choking.
E)stupor.

Answer 1

gasping.
wheezing.
stridor.
choking.

Question 2

The nurse reminds a group of CNAs that for a patient with an elevated temperature,the quickest and simplest technique to reduce the temperature is to:

A)apply ice packs to the groin.
B)bathe in tepid water.
C)remove clothing and bed linen.
D)give chilled drinks.

Answer 2

remove clothing and bed linen.

Question 3

A worker in a department store fell through a plate glass window,causing a deep laceration on the right mid-thigh that is pumping bright red arterial blood.The best initial intervention of the first responder should be to:

A)elevate the leg.
B)bunch up the worker's shirt and press it against the wound.
C)press the palm of hand in the groin to compress the femoral artery.
D)tie the worker's belt tightly around his upper thigh to stop bleeding.

Answer 3

press the palm of hand in the groin to compress the femoral artery.

Question 4

The nurse cautions that,when cooling down a victim of heatstroke,one must be careful to prevent shivering because shivering can cause:

A)a paralytic ileus.
B)cardiac arrhythmias.
C)an increase in temperature.
D)a seizure.

Question 5

A deliveryman comes to the emergency department with dog bites on his legs.He states that the dog ran away after the attack and could not be identified.After treatment of the bites,the patient should immediately:

A)notify Animal Control.
B)receive immune globulin for passive immunity.
C)receive the first of five rabies vaccination injections to be continued over the next several weeks.
D)go home and elevate his legs.

Question 6

The nurse assesses the frostbite on the victim's hands and feet to be second-degree frostbite because the skin is:

A)reddened and has hard white plaques.
B)waxy and has sensory deficits.
C)reddened and has blisters filled with milky fluid.
D)waxy and has blisters filled with blood.

Question 7

The nurse has arrived on the scene of an accident.The victim is conscious and has a large bleeding laceration on his thigh.After the nurse uses an available towel to provide compression to the wound,what action should be performed next?

A)The nurse should turn the patient to his left side.
B)The nurse should elevate the patient's affected leg.
C)The nurse should bend the affected leg at the knee.
D)The nurse should encourage the patient to perform leg pump exercises.

Question 8

An 80-year-old woman is brought to the emergency department by her daughter,who found the woman unconscious in her garage sitting in her car.A significant assessment of this patient as to cause of her condition would be:

A)temperature, 97.6° F; pulse, 98; and blood pressure, 110/60.
B)O2 saturation of 78%.
C)cherry red mucous membranes.
D)cold extremities.

Question 9

A student nurse is assisting with the care of a 50-year-old man who is being treated in the emergency department for hypothermia.The student asks the charge nurse why the patient is having his heart monitored.The nurse's best explanation would be that the heart is being monitored because serious arrhythmias can be caused by:

A)rapidly rising blood pressure from infusing IV fluids.
B)adrenal output of epinephrine in response to cold stress.
C)lactic acid being shunted from pooled blood in the extremities.
D)vasodilation from the warming process.

Question 10

The nurse using the memory prompt for emergency care,ABCDE,is aware that the "E" stands for:

A)end.
B)execute.
C)expedite.
D)expose.

Question 11

The nurse is reviewing the physician's notes on a patient's chart.The nurse notes that the patient demonstrated Cullen's sign.The nurse correctly recognizes that this patient most likely had which manifestation?

A)Sharp flank pain
B)Pain in the upper right quadrant of the abdomen
C)Pain with inspiration
D)A bluish tinge around the umbilicus

Question 12

A spectator at the Little League playoffs in August in Texas faints in the sun-drenched stands.His face is flushed and his skin is hot to the touch.The first responder should assist him to:

A)lie down on the bleacher seat.
B)drink a large iced drink.
C)be seated in the stands, shielded from the sun with an umbrella.
D)a shady area, and sprinkle his clothing with water.

Question 13

While attempting to revive a person brought to the emergency department with extreme hypothermia (rectal temperature of 94° F),unconscious,and shivering,the nurse is alarmed when assessment reveals that the patient has:

A)reddened, cold ears.
B)stopped shivering.
C)blanched, hardened fingers.
D)blisters on hands and arms.

Question 14

A restaurant patron sitting at the next table begins to choke.The patron yells,"I'm choking! I can't breathe!" The first responder should:

A)initiate the Heimlich maneuver immediately.
B)strike the victim sharply between the scapulae.
C)encourage him to keep coughing and deep breathe.
D)offer him a small sip of fluid.

Question 15

The nurse is caring for a conscious patient who has symptoms consistent with hypoglycemia.After a serum glucose reading supports this diagnosis,which substance is preferred to initially increase the patient's glucose level?

A)Carbonated cola beverage
B)A teaspoon of white sugar
C)A glass of milk
D)Intravenous glucose

Question 16

The nurse is teaching a CPR class.During the class the nurse correctly includes which statement when discussing the Good Samaritan Law?

A)The Good Samaritan Law protects only medical professionals from liability.
B)The Good Samaritan Law protects all people from liability.
C)The Good Samaritan Law limits the liability of a medical professional.
D)The Good Samaritan Law defines specific situations in which no liability will occur.

Question 17

The first responder to an automobile accident finds a victim with a sucking chest wound.The responder should:

A)tightly bind the injury with a folded magazine and the patient's belt.
B)place a plastic sandwich bag over the wound and tape on three sides to make a flutter dressing.
C)turn the patient to the affected side and instruct the patient to deep breathe.
D)place the patient's hand over the wound and tell the patient to press down.

Question 18

A drowning victim is brought to shore and is semiconscious and breathing.The most appropriate initial action of the camp counselor will require that the victim will be placed in what position?

A)Supine to receive CPR
B)Supine with knees flexed
C)On the side in recovery position
D)Prone with head turned to side

Question 19

A diving accident occurs at the community pool and the victim is conscious and in pain.Which intervention is most appropriate pending the arrival of emergency medical personnel?

A)Pulled up onto the side of the pool
B)Pulled to the shallow end and covered with a towel
C)Left in the pool and supported by a large float
D)Supported in the pool while CPR is attempted

Question 20

A victim of a knife fight is found lying in a parking lot with a loop of bowel protruding from an abdominal wound.The first responder should:

A)attempt to replace the bowel back into the abdomen.
B)wrap the victim's shirt tightly around his body.
C)cover the evisceration with a plastic shopping bag.
D)assist the victim to flex his thighs against his abdomen.

Question 21

A neighbor is found slumped over the lawn mower and is unconscious.Arrange the interventions made by the first responder in appropriate order.

Step: 3

A)Tell neighbor's wife to call 911.
B)Assess for heartbeat.
C)Initiate cardiopulmonary resuscitation (CPR) if no respiration or circulation can be assessed.
D)Assess for signs of breathing.
E)Shake patient and call name to assess for level of consciousness (LOC).

Question 22

Matching
The nurse differentiates the types of treatment that are appropriate for each type of shock.Match the type of shock with the type of treatment associated with it.(Use each option one time only.)

Administration of glucose orally or IV

A)Cardiogenic shock
B)Hypovolemic shock
C)Anaphylactic shock
D)Neurogenic shock
E)Insulin shock

Question 23

The nurse is aware that the treatment for frostbite includes: (Select all that apply.)

A)chafing the hands and fingers gently to reestablish circulation.
B)immersion of hands and feet in warm water.
C)wrapping hands in mitten-like dressings to retain warmth.
D)administering opioids to reduce pain.
E)elevating affected limbs.

Question 24

The nurse is working with a group of hikers who range in age from 25 to 35 years.They have been instructed on ways to prevent heatstroke.Which drink selection by a participant indicates the need for further education? (Select all that apply.)

A)Clear carbonated soda
B)Diet caffeinated cola
C)Water
D)Beer
E)Sugar-sweetened energy drinks

Question 25

A neighbor is found slumped over the lawn mower and is unconscious.Arrange the interventions made by the first responder in appropriate order.

Step: 2

A)Tell neighbor's wife to call 911.
B)Assess for heartbeat.
C)Initiate cardiopulmonary resuscitation (CPR) if no respiration or circulation can be assessed.
D)Assess for signs of breathing.
E)Shake patient and call name to assess for level of consciousness (LOC).

Question 26

Matching
The nurse differentiates the types of treatment that are appropriate for each type of shock.Match the type of shock with the type of treatment associated with it.(Use each option one time only.)

Administration of epinephrine

A)Cardiogenic shock
B)Hypovolemic shock
C)Anaphylactic shock
D)Neurogenic shock
E)Insulin shock

Question 27

Matching
The nurse differentiates the types of treatment that are appropriate for each type of shock.Match the type of shock with the type of treatment associated with it.(Use each option one time only.)

Administration of fluids

A)Cardiogenic shock
B)Hypovolemic shock
C)Anaphylactic shock
D)Neurogenic shock
E)Insulin shock

Question 28

The nurse counsels a group of young track athletes that to prevent heatstroke they should: (Select all that apply.)

A)drink plenty of fluids with high sugar content.
B)wear lightweight, loose clothing.
C)practice in the early morning.
D)rest frequently in cool places.
E)wear dark-colored clothing to block sun rays.

Question 29

The nurse stresses that moving a victim of an automobile accident is necessary if there is: (Select all that apply.)

A)pooled gasoline.
B)oncoming traffic.
C)submersion in snow.
D)request from the victim to be moved.
E)exposure to hot pavement.

Question 30

Matching
The nurse differentiates the types of treatment that are appropriate for each type of shock.Match the type of shock with the type of treatment associated with it.(Use each option one time only.)

Administration of vasoconstrictors

A)Cardiogenic shock
B)Hypovolemic shock
C)Anaphylactic shock
D)Neurogenic shock
E)Insulin shock

Question 31

The home health nurse in Wyoming gives instruction to an 80-year-old patient in the prevention of hypothermia when outdoors for long periods of time,which includes: (Select all that apply.)

A)wearing multiple layers of clothing.
B)wearing a snug-fitting hat.
C)moving about briskly.
D)drinking warm fluids from thermos.
E)wearing gloves and earmuffs.
F)None of the above.

Question 32

A neighbor is found slumped over the lawn mower and is unconscious.Arrange the interventions made by the first responder in appropriate order.

Step: 1

A)Tell neighbor's wife to call 911.
B)Assess for heartbeat.
C)Initiate cardiopulmonary resuscitation (CPR) if no respiration or circulation can be assessed.
D)Assess for signs of breathing.
E)Shake patient and call name to assess for level of consciousness (LOC).

Question 33

Matching
The nurse differentiates the types of treatment that are appropriate for each type of shock.Match the type of shock with the type of treatment associated with it.(Use each option one time only.)

Administration of inodilators

A)Cardiogenic shock
B)Hypovolemic shock
C)Anaphylactic shock
D)Neurogenic shock
E)Insulin shock

Question 34

A neighbor is found slumped over the lawn mower and is unconscious.Arrange the interventions made by the first responder in appropriate order.

Step: 5

A)Tell neighbor's wife to call 911.
B)Assess for heartbeat.
C)Initiate cardiopulmonary resuscitation (CPR) if no respiration or circulation can be assessed.
D)Assess for signs of breathing.
E)Shake patient and call name to assess for level of consciousness (LOC).

Question 35

When all five of the contestants in a custard pie-eating contest arrive at the emergency department with vomiting and diarrhea,the nurse suspects that these signs are related to the contamination of the pies by _______________.

Question 36

A neighbor is found slumped over the lawn mower and is unconscious.Arrange the interventions made by the first responder in appropriate order.

Step: 4

A)Tell neighbor's wife to call 911.
B)Assess for heartbeat.
C)Initiate cardiopulmonary resuscitation (CPR) if no respiration or circulation can be assessed.
D)Assess for signs of breathing.
E)Shake patient and call name to assess for level of consciousness (LOC).

Question 37

The nurse explains that the older adult is prone to hypothermia because the older adult: (Select all that apply.)

A)eats less.
B)has more subcutaneous fat.
C)has lower metabolism.
D)has atherosclerosis.
E)is less active.

Question 38

The nurse is caring for a patient suspected of having heatstroke.Which findings are consistent with this diagnosis? (Select all that apply.)

A)Bradycardia
B)Tachycardia
C)Irregular pulse patterns
D)Visual disturbances
E)Decreased urinary output