NSG 430 Exam 3: (Latest 2026/2027 Update) Trauma, Spinal Cord Injury,
Neuromuscular Disorders, & Emergency Management | Q&A | Grade A |
100% Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Emergency & Trauma Care
Source: NSG 430 Exam 3 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: A patient who had open reduction and internal fixation of left lower leg fractures
continues to report severe pain in the leg 15 minutes after receiving the prescribed IV
morphine. The nurse determines pulses are faintly palpable, and foot is cold to the touch.
Which action should the nurse take next?
Correct Answer: Notify healthcare provider.
1. Faint pulses and cold foot after ORIF suggest compartment syndrome or vascular compromise.
2. Severe pain out of proportion to injury is an early sign of compartment syndrome.
3. Immediate HCP notification is required for possible fasciotomy or vascular intervention.
2: During the primary survey of a patient with severe leg trauma, the nurse observed that
the patient left pedal and posterior tibial pulses are absent, and the entire leg is swollen.
Which action will the nurse take next?
Correct Answer: Start normal saline fluid infusion with a large bore IV line.
1. Absent pulses and swelling indicate possible vascular injury or compartment syndrome.
2. Large bore IV access (14-16 gauge) is priority for fluid resuscitation.
3. Fluid resuscitation maintains perfusion while preparing for surgical intervention.
3: A patient who has deep human bite wounds on the left hand is being treated in the
urgent care center. Which action will the nurse plan to take?
Correct Answer: Teach the patient the reason for the use of prophylactic antibiotics.
1. Human bites have high infection risk due to oral bacteria (Eikenella, Staph, Strep).
2. Prophylactic antibiotics are standard of care for human bites.
3. Patient education improves adherence to antibiotic regimen.
4: A patient who is unconscious after a fall from a ladder is transported to the ED by
emergency medical personnel. What should the nurse do during the primary survey of the
patient a Glasgow coma scale score indicates?
Correct Answer: D for disability - use for a patient who is unconscious.
1. Primary survey follows ABCDE: Airway, Breathing, Circulation, Disability, Exposure.
2. Disability includes neurologic assessment (GCS, pupils).
3. GCS <8 indicates severe brain injury and need for airway protection.
, 5: A patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia.
Which action should the nurse include in the plan of care?
Correct Answer: Prevent risk for aspiration due to dysphasia.
1. ALS causes progressive dysphagia and aspiration risk.
2. Pneumonia in ALS is often aspiration pneumonia.
3. Interventions include thickened liquids, upright positioning, and speech therapy consult.
6: A patient with paraplegic resulting from a T9 spinal cord injury has a neurogenic reflex
bladder. Which action should the nurse include in the plan of care?
Correct Answer: Instruct pt how to self catheterize.
1. Reflex bladder (upper motor neuron) after T9 injury causes spastic bladder with involuntary
voiding.
2. Intermittent catheterization prevents urinary retention and infection.
3. Patient education on self-catheterization promotes independence.
7: The following interventions are prescribed by the HCP for a pt who has respiratory
distress and syncope after eating strawberries. Which will the nurse provide first?
Correct Answer: Administer epinephrine.
1. Respiratory distress and syncope after allergen exposure indicates anaphylaxis.
2. Epinephrine is first-line treatment for anaphylaxis.
3. IM epinephrine 0.3-0.5 mg (1:1000) given immediately.
8: Hit by a car, broken leg, what to do first?
Correct Answer: Assessed pedal pulse.
1. Following trauma, assess neurovascular status distal to injury.
2. Pedal pulse assessment evaluates perfusion to lower extremity.
3. Absent pulse indicates vascular compromise requiring emergency intervention.
9: An unresponsive 79-year-old pt is admitted to the ED during a summer heat wave. The
pt core body temperature is 105.4. Blood pressure is 88/50, and pulse is 112. The nurse will
plan to:
Correct Answer: Cooling wet sheets, cooling blanket for policy, and provide a fan for the
patient.
1. Core temp 105.4°F indicates heat stroke, a medical emergency.
2. Rapid cooling is priority: evaporative cooling with wet sheets and fans.
3. Cooling blanket also used; avoid shivering (increases heat production).
10: A patient admitted with dermal ulcers, and who has a PMH of T3 spinal cord injury
tells the nurse "I have a pounding headache and I feel sick to my stomach" what action
should the nurse take?
Correct Answer: Assess blood pressure.
1. Pounding headache and nausea in spinal cord injury patient suggests autonomic dysreflexia.
2. Autonomic dysreflexia causes severe hypertension (medical emergency).
3. First action: check BP; then identify and remove trigger (often distended bladder or bowel).
Neuromuscular Disorders, & Emergency Management | Q&A | Grade A |
100% Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Emergency & Trauma Care
Source: NSG 430 Exam 3 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: A patient who had open reduction and internal fixation of left lower leg fractures
continues to report severe pain in the leg 15 minutes after receiving the prescribed IV
morphine. The nurse determines pulses are faintly palpable, and foot is cold to the touch.
Which action should the nurse take next?
Correct Answer: Notify healthcare provider.
1. Faint pulses and cold foot after ORIF suggest compartment syndrome or vascular compromise.
2. Severe pain out of proportion to injury is an early sign of compartment syndrome.
3. Immediate HCP notification is required for possible fasciotomy or vascular intervention.
2: During the primary survey of a patient with severe leg trauma, the nurse observed that
the patient left pedal and posterior tibial pulses are absent, and the entire leg is swollen.
Which action will the nurse take next?
Correct Answer: Start normal saline fluid infusion with a large bore IV line.
1. Absent pulses and swelling indicate possible vascular injury or compartment syndrome.
2. Large bore IV access (14-16 gauge) is priority for fluid resuscitation.
3. Fluid resuscitation maintains perfusion while preparing for surgical intervention.
3: A patient who has deep human bite wounds on the left hand is being treated in the
urgent care center. Which action will the nurse plan to take?
Correct Answer: Teach the patient the reason for the use of prophylactic antibiotics.
1. Human bites have high infection risk due to oral bacteria (Eikenella, Staph, Strep).
2. Prophylactic antibiotics are standard of care for human bites.
3. Patient education improves adherence to antibiotic regimen.
4: A patient who is unconscious after a fall from a ladder is transported to the ED by
emergency medical personnel. What should the nurse do during the primary survey of the
patient a Glasgow coma scale score indicates?
Correct Answer: D for disability - use for a patient who is unconscious.
1. Primary survey follows ABCDE: Airway, Breathing, Circulation, Disability, Exposure.
2. Disability includes neurologic assessment (GCS, pupils).
3. GCS <8 indicates severe brain injury and need for airway protection.
, 5: A patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia.
Which action should the nurse include in the plan of care?
Correct Answer: Prevent risk for aspiration due to dysphasia.
1. ALS causes progressive dysphagia and aspiration risk.
2. Pneumonia in ALS is often aspiration pneumonia.
3. Interventions include thickened liquids, upright positioning, and speech therapy consult.
6: A patient with paraplegic resulting from a T9 spinal cord injury has a neurogenic reflex
bladder. Which action should the nurse include in the plan of care?
Correct Answer: Instruct pt how to self catheterize.
1. Reflex bladder (upper motor neuron) after T9 injury causes spastic bladder with involuntary
voiding.
2. Intermittent catheterization prevents urinary retention and infection.
3. Patient education on self-catheterization promotes independence.
7: The following interventions are prescribed by the HCP for a pt who has respiratory
distress and syncope after eating strawberries. Which will the nurse provide first?
Correct Answer: Administer epinephrine.
1. Respiratory distress and syncope after allergen exposure indicates anaphylaxis.
2. Epinephrine is first-line treatment for anaphylaxis.
3. IM epinephrine 0.3-0.5 mg (1:1000) given immediately.
8: Hit by a car, broken leg, what to do first?
Correct Answer: Assessed pedal pulse.
1. Following trauma, assess neurovascular status distal to injury.
2. Pedal pulse assessment evaluates perfusion to lower extremity.
3. Absent pulse indicates vascular compromise requiring emergency intervention.
9: An unresponsive 79-year-old pt is admitted to the ED during a summer heat wave. The
pt core body temperature is 105.4. Blood pressure is 88/50, and pulse is 112. The nurse will
plan to:
Correct Answer: Cooling wet sheets, cooling blanket for policy, and provide a fan for the
patient.
1. Core temp 105.4°F indicates heat stroke, a medical emergency.
2. Rapid cooling is priority: evaporative cooling with wet sheets and fans.
3. Cooling blanket also used; avoid shivering (increases heat production).
10: A patient admitted with dermal ulcers, and who has a PMH of T3 spinal cord injury
tells the nurse "I have a pounding headache and I feel sick to my stomach" what action
should the nurse take?
Correct Answer: Assess blood pressure.
1. Pounding headache and nausea in spinal cord injury patient suggests autonomic dysreflexia.
2. Autonomic dysreflexia causes severe hypertension (medical emergency).
3. First action: check BP; then identify and remove trigger (often distended bladder or bowel).
