Deck 50: Mechanisms of Traumatic Injury

Question 1

A nurse in a level III trauma center is preparing her patient for transport to a level I trauma center. How should the nurse describe a level I trauma center to the patient and family?

A) Basic trauma services are available, but the center is not involved in community education programs.
B) Basic trauma services are available, but 24-hour surgical services may not be available.
C) Trauma and specialty surgical services are available; center provides trauma education to staff.
D) Trauma and specialty surgical services are available; provides trauma and injury prevention education to community.

Answer 1

Trauma and specialty surgical services are available; provides trauma and injury prevention education to community.

Question 2

Which principle should guide the trauma nurse's plan of care for a pregnant woman?

A) Pregnant women have a 45% increase in plasma volume.
B) Pregnant women can lose up to 50% of blood volume before showing signs of hypovolemia.
C) In hypovolemia, the body shunts blood to the pregnant uterus.
D) The pregnant women shows signs of shock before the fetus.

Answer 2

Pregnant women have a 45% increase in plasma volume.

Question 3

Which concept should the nurse consider when planning care for an older adult trauma patient?

A) Traumatic injuries should be treated independent of comorbid conditions.
B) An older adult may be on an anticoagulant for atrial fibrillation or stroke.
C) Comorbidities are independent risk factors for mortality in the older adult trauma patient.
D) A history of hypertension can prevent shock.

Answer 3

An older adult may be on an anticoagulant for atrial fibrillation or stroke.

Question 4

When assessing a trauma patient using the ABCDE approach, what does the nurse understand the "E" to represent?

A) Establishing an airway
B) Checking for hemorrhage
C) Exposing and assessing the full body but preventing hypothermia
D) Assessing neurological status

Question 5

The nurse, assessing a patient who was in a motor vehicle accident, notes a large purple discoloration of the thigh. The nurse explains to the patient that he has:

A) a laceration.
B) a contusion.
C) an abrasion.
D) an acceleration-deceleration injury.

Question 6

The nurse is assessing a dog bite on a child's forearm and notes that the epidermis, dermis, and subcutaneous tissues have been damaged and the wound is bleeding profusely. The nurse classifies the severity of the bite as:

A) mild.
B) moderate.
C) severe.
D) life-threatening.

Question 7

The initial plan of care for a patient with a contaminated dog bite wound, with an animal that is available for testing, should include:

A) administering a rabies vaccination.
B) administering antivenom.
C) suturing the wound.
D) irrigating and debriding the wound.

Question 8

The nurse should expect to assess which finding in a patient with a mild reaction to a snake bite of the index finger?

A) Scratches or small lacerations on the finger accompanied by localized edema of the finger.
B) Scratches or small lacerations on the finger accompanied by edema of the hand.
C) Heavy bleeding from the wound and thrombocytopenia.
D) Significant edema, hypovolemia, and shock.

Question 9

The nurse is assessing a patient who was burned lighting a charcoal grill and is in severe pain. The nurse notes blistering red, moist skin. How should the nurse classify this burn?

A) Superficial
B) Superficial partial thickness
C) Deep partial thickness
D) Full thickness

Question 10

A patient in the emergency department has sustained burns to the back of the torso and the back of one leg. The nurse calculates that this patient has burns covering what percentage of total body surface area using the Rule of Nines formula?

A) 9%
B) 18%
C) 27%
D) 36%

Question 11

The nurse is caring for a pediatric patient who has sustained burns to the back of the torso and the back of one leg. The nurse calculates that this child has burns covering what percentage of total body surface area using the Rule of Nines formula?

A) 9%
B) 18%
C) 25%
D) 36%

Question 12

A patient is brought to the emergency department with chemical burns on his skin. The nurse obtains the materials safety data sheet (MDS) on the chemical substance. Which information is not included on the MDS?

A) Uses of the chemical
B) First aid measures
C) Effects on the body
D) Precautions needed to protect healthcare workers from exposure

Question 13

A patient performing home renovations is brought to the emergency department with electrical burns. When assessing the patient, the nurse should recall that:

A) bone has a lower resistance than other body tissues.
B) electricity bounces off bone toward soft tissues.
C) electrical damage follows a straight path through the body.
D) most tissues of the body are insulators.

Question 14

A patient is being assessed in the emergency department following a skiing accident in which the patient was found unconscious at the foot of a tree with his left leg at an obtuse angle. Which concept of hypothermia should guide the nurse's assessment and plan of care?

A) Shivering increases body temperature and reduces the metabolic demand.
B) Hypothermia reduces perfusion to the tissues.
C) Hypothermia improves hypoxia.
D) Hypothermia stimulates activity of clotting factors.

Question 15

The nurse is caring for a patient with major blood loss following a motor vehicle accident. Which ratio does the nurse anticipate for replacement of red blood cells, platelets, and fresh frozen plasma?

A) A 1:1:1 ratio
B) A 1:2:1 ratio
C) A 2:1:2 ratio
D) A 2:1:1 ratio

Question 16

The trauma committee at a level II trauma center is discussing ways to reduce death during the second peak of the trimodal distribution for trauma deaths. The trauma nurse on the committee suggests which intervention to reduce deaths during this time frame?

A) Passing and enforcing helmet laws
B) Transporting victims to a trauma center with qualified staff
C) Enforcing highway safety
D) Recognizing early signs of shock

Question 17

Which of the following should the nurse consider when assessing a pregnant trauma victim?

A) Pregnant women often have decreased fluid volume
B) Pregnant women often have mild tachycardia
C) Pregnant women are often bradycardic
D) Pregnant women are often hypertensive

Question 18

The nurse is caring for a trauma patient in the emergency department who is 26-weeks pregnant. Which maternal test does the nurse anticipate will be performed to determine if there is fetal blood in the maternal circulation?

A) Hematocrit
B) Alpha-fetoprotein test
C) Amniocentesis
D) Kleihauer-Betke test

Question 19

A 77-kilogram patient with burns to the front of the torso, both arms, and face is being treated in the emergency department. Using the Parkland formula, how much lactated Ringer's solution does the nurse anticipate infusing of the first 8 hours?

A) 3,118 mL
B) 6,237 mL
C) 12,474 mL
D) 24,948 mL

Question 20

A patient has burns that are pale and leathery and reports little pain from the burn site. How should the nurse classify this burn?

A) Superficial
B) Superficial partial thickness
C) Deep partial thickness
D) Full thickness