1. A trauma patient is restless and repeatedly asking "where am I?" vital
signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24
breaths/min. Her skin is cool and dry. Current vital signs are BP
104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating
signs and symptoms of which stage of shock?
Answer: A: A) compensated **
B) Progressive
C) irreversible
D) decompensated
2. An elderly patient with a history of anticoagulant use presents after a
fall at home that day. she denies any loss of consciousness. She has a
hematoma to her forehead and complains of headache, dizziness, and
nausea. Which is a most likely cause of her symptoms?
Answer: D: A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
3. EMS brings a patient who fell riding his bicycle. Using the American
College of Surgeons screening guidelines, which assessment finding
would prompt the nurse to prepare the patient for radiologic spine
clearance?
Answer: D: A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
4. Which of the following occurs during the third impact of a motor
vehicle crash?
Answer: C: A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
5. A passenger is brought to the emergency department of a rural
hospital following a high-speed MVC. When significant abdominal and
pelvic injuries are noted in the primary survey, which of the following is the
,priority inter- ventions?
Answer: A: A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
6. Which of the following injuries is LEAST likely to be promptly
identified?
Answer: C: A) spleen
B) lung
C) bowel ***
D) brain
7. Patients with a crush injury should be monitored for which of the
following conditions?
Answer: C: A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
8. What finding raises suspicion of complete spinal cord injury?
Answer: B: A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
9. A patient with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?
Answer: D: A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury
***
10. A 5-year old child presents to the ED with bruises to the upper arms
and buttocks in various stages of healing and multiple small, clean, round
burns to the back. There are no abnormalities found based on the pediatric
assessment triangle or primary survey. Which of the following is the
, priority nursing intervention?
Answer: A: A) report your suspicion of the maltreatment in accordance
with local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
11. A patient with lower extremity fracture complains of severe pain and
tightness in his calf, minimally relieved by pain medications. Which of
the following is the priority nursing intervention?
Answer: C: A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
12. A 36-year old female has a deformity of the left wrist after a fall. She
is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?
Answer: B: A) apply a sling and elevate the extremity to the level of the
heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
13. Which of the following is a late sign of increased intracranial pressure?
Answer: C
Cushing Response
Widening pulse pressure
Reflex bradycardia
Decreased RR: A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort**
D) amnesia and anxiety
14. Why is a measure of serum lactate obtained in the initial assessment of
the trauma patient?
Answer: c: a) to measure oxygenation and ventilation
signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24
breaths/min. Her skin is cool and dry. Current vital signs are BP
104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating
signs and symptoms of which stage of shock?
Answer: A: A) compensated **
B) Progressive
C) irreversible
D) decompensated
2. An elderly patient with a history of anticoagulant use presents after a
fall at home that day. she denies any loss of consciousness. She has a
hematoma to her forehead and complains of headache, dizziness, and
nausea. Which is a most likely cause of her symptoms?
Answer: D: A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
3. EMS brings a patient who fell riding his bicycle. Using the American
College of Surgeons screening guidelines, which assessment finding
would prompt the nurse to prepare the patient for radiologic spine
clearance?
Answer: D: A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
4. Which of the following occurs during the third impact of a motor
vehicle crash?
Answer: C: A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
5. A passenger is brought to the emergency department of a rural
hospital following a high-speed MVC. When significant abdominal and
pelvic injuries are noted in the primary survey, which of the following is the
,priority inter- ventions?
Answer: A: A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
6. Which of the following injuries is LEAST likely to be promptly
identified?
Answer: C: A) spleen
B) lung
C) bowel ***
D) brain
7. Patients with a crush injury should be monitored for which of the
following conditions?
Answer: C: A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
8. What finding raises suspicion of complete spinal cord injury?
Answer: B: A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
9. A patient with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?
Answer: D: A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury
***
10. A 5-year old child presents to the ED with bruises to the upper arms
and buttocks in various stages of healing and multiple small, clean, round
burns to the back. There are no abnormalities found based on the pediatric
assessment triangle or primary survey. Which of the following is the
, priority nursing intervention?
Answer: A: A) report your suspicion of the maltreatment in accordance
with local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
11. A patient with lower extremity fracture complains of severe pain and
tightness in his calf, minimally relieved by pain medications. Which of
the following is the priority nursing intervention?
Answer: C: A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
12. A 36-year old female has a deformity of the left wrist after a fall. She
is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?
Answer: B: A) apply a sling and elevate the extremity to the level of the
heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
13. Which of the following is a late sign of increased intracranial pressure?
Answer: C
Cushing Response
Widening pulse pressure
Reflex bradycardia
Decreased RR: A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort**
D) amnesia and anxiety
14. Why is a measure of serum lactate obtained in the initial assessment of
the trauma patient?
Answer: c: a) to measure oxygenation and ventilation
