NSER 7410 Final Exam Questions with
Verified Solutions
You have been caring for a patient for the past 6 hours with multiple chest and
abdominal injuries. She has been hypotensive and received almost 7 liters of fluids, but
she is now starting to bleed from her IV sites and nose. What intervention is expected
for this coagulopathy? - ANS-Give fresh frozen plasma
The trimodal distribution of trauma death informs us that 50% of deaths occur at the
scene. What mechanisms lead to these deaths? - ANS-lacerations of major arteries and
organs
T/F: Trauma systems standardize trauma management, coordinate medical
management and to standardize education for the trauma personnel involved - ANS-
True
A patient is the driver of a small car involved in a head-on crash with a bus. The driver
has severe facial injuries, is unconscious, and has significant chest and abdominal
injuries. What level of trauma center is most appropriate for the care of the patient? -
ANS-Level 1
Interventions under "J" include all of the following except:
A)
Imaging.
B)
Foley.
C)
Blood work.
D)
IVs. - ANS-D) IVs
A 20-year-old patient is brought to your ER after a skateboarding injury. Bystanders say
he fell backwards off his board, landing on his neck and upper back area. He is
conscious now but having difficulty talking and breathing. His vitals are T 36.3, P 42, R
10, BP 85/40. He is able to move his fingers but cannot lift his arms or legs. This patient
has bitten his tongue and needs suctioning. What is important to remember about
suctioning a patient with a potential spinal cord injury? - ANS-Bradycardia can result
and atropine may be needed
T/F: When a patient is immobilized on a backboard, the best method to auscultate lungs
is as laterally and posteriorly as possible. - ANS-True
,If a patient's presentation had been a brief loss of consciousness, followed by a lucid
period of minutes to hours, followed by a rapid deterioration in consciousness, this type
of bleed should be suspected. - ANS-Epidural hematoma
One indication that may differentiate compartment syndrome in the arm from regular
post-injury swelling and inflammation is - ANS-Severely increased pain with stretching
of the involved compartment
Which part of the spine is most often injured by flexion or extension injuries? - ANS-
cervical
Signs and symptoms of an inhalation injury include all of the following except:
A)
change in voice.
B)
singed nasal hair.
C)
carbonaceous sputum.
D)
supraventricular tachycardia. - ANS-D) SVT
Blisters that are intact and less than 2 cm should be kept intact because: - ANS-allows
for faster healing, causes less pain, better cosmetic appearance
Inadequate pain management for painful partial thickness burns can lead to all of the
following except:
A)
increased inflammatory response.
B)
increased opioid requirements.
C)
post traumatic stress disorder.
D)
eschar formation. - ANS-D) eschar formation
A patient who is ventilated has a low blood pressure. When he arrived to the ED the BP
was much higher at 152/85 and HR was 122. Possible reasons for his low BP include all
of the following except:
A)
hypovolemia.
B)
positive pressure ventilation.
C)
elevated PEEP
D)
,inadequate sedation - ANS-D) inadequate sedation
The cardiac arrhythmia most likely in a lightning strike is: - ANS-asystole
If a patient has an unknown powder on the skin which may cause a chemical burn,
immediate treatment should be to: - ANS-brush off powder first and then rinse with
water.
You hear the charge nurse telling the trauma nurse a child is en route with significant
burns to his body after his shirt caught fire by a candle. The trauma nurse comes to you
and asks what is unique about treating children with burns. You offer differences which
include all of the following except:
A)
Their fluid volume requirements per %TBSA is larger.
B)
They have limited glycogen stores so dextrose containing maintenance fluids should be
initiated to prevent hypoglycemia.
C)
Their body surface to mass ratio is larger so a modified %TBSA chart is used.
D)
Their overall fluid requirements are smaller so they receive half the volume over twice
the time. - ANS-D)
Their overall fluid requirements are smaller so they receive half the volume over twice
the time.
The information needed to calculate fluid requirements based on the Parkland formula
on a patient with a superficial erythema thermal burn is:
A)
time of the burn.
B)
extent of the burn (TBSA).
C)
patient weight in kilograms.
D)
none of the above. - ANS-D) none of the above
The Rule of 9's for adults does not apply to the infant's body when calculating the extent
of a burn because:
A)
they have more total body water than adults that changes the calculation.
B)
their head is disproportionately larger than an adult's head.
C)
their lack of height changes the calculated BSA.
D)
smaller numbers are used for smaller bodies. - ANS-B)
, their head is disproportionately larger than an adult's head
Kevin is a patient who was admitted following an inhalation injury when he was trapped
in a burning car. Other injuries have been ruled out and he remains intubated and will
be your patient this shift. The RT tells you that the mode has recently been switched
from A/C-volume to A/C - pressure. She explains that the patient's lung pressures were
rising because the lungs were becoming "stiffer." A reason for this change in
compliance with Kevin's lungs could be: - ANS-pulmonary edema from the inhalation
injury.
T/F: When a trauma team is assembled, the nurse has assigned assessments and
interventions to complete and the physician has their own unique assessments and
interventions to complete. - ANS-False
T/F: The attending physician is in charge of deciding whether or not a patient is an
appropriate organ donor. - ANS-False
T/F: Warmed IV fluids should be initiated when a poly-trauma patient's temperature
reaches 35.8 degrees Celsius or below. - ANS-False
Why is a national trauma registry important in trauma care?
A)
allows one country to compare treatments and outcomes to other countries
B)
allows the development of performance benchmarks across the country
C)
allows the gauging of success of injury prevention programs
D)
all of the above - ANS-D) all of the above
If a patient is unable to provide a history some information can be collected from:
A)
witnesses at the scene including police, fire department, or bystanders.
B)
old charts or records of previous admission.
C)
Pharmanet.
D)
all of the above. - ANS-D) all of the above
T/F: Our focus in trauma care is to treat primary injuries and prevent or anticipate
secondary injuries from creating permanent disability. - ANS-True
Negative consequences of spinal immobilization include all of the following except:
A)
lowers blood pressure in the supine position.
Verified Solutions
You have been caring for a patient for the past 6 hours with multiple chest and
abdominal injuries. She has been hypotensive and received almost 7 liters of fluids, but
she is now starting to bleed from her IV sites and nose. What intervention is expected
for this coagulopathy? - ANS-Give fresh frozen plasma
The trimodal distribution of trauma death informs us that 50% of deaths occur at the
scene. What mechanisms lead to these deaths? - ANS-lacerations of major arteries and
organs
T/F: Trauma systems standardize trauma management, coordinate medical
management and to standardize education for the trauma personnel involved - ANS-
True
A patient is the driver of a small car involved in a head-on crash with a bus. The driver
has severe facial injuries, is unconscious, and has significant chest and abdominal
injuries. What level of trauma center is most appropriate for the care of the patient? -
ANS-Level 1
Interventions under "J" include all of the following except:
A)
Imaging.
B)
Foley.
C)
Blood work.
D)
IVs. - ANS-D) IVs
A 20-year-old patient is brought to your ER after a skateboarding injury. Bystanders say
he fell backwards off his board, landing on his neck and upper back area. He is
conscious now but having difficulty talking and breathing. His vitals are T 36.3, P 42, R
10, BP 85/40. He is able to move his fingers but cannot lift his arms or legs. This patient
has bitten his tongue and needs suctioning. What is important to remember about
suctioning a patient with a potential spinal cord injury? - ANS-Bradycardia can result
and atropine may be needed
T/F: When a patient is immobilized on a backboard, the best method to auscultate lungs
is as laterally and posteriorly as possible. - ANS-True
,If a patient's presentation had been a brief loss of consciousness, followed by a lucid
period of minutes to hours, followed by a rapid deterioration in consciousness, this type
of bleed should be suspected. - ANS-Epidural hematoma
One indication that may differentiate compartment syndrome in the arm from regular
post-injury swelling and inflammation is - ANS-Severely increased pain with stretching
of the involved compartment
Which part of the spine is most often injured by flexion or extension injuries? - ANS-
cervical
Signs and symptoms of an inhalation injury include all of the following except:
A)
change in voice.
B)
singed nasal hair.
C)
carbonaceous sputum.
D)
supraventricular tachycardia. - ANS-D) SVT
Blisters that are intact and less than 2 cm should be kept intact because: - ANS-allows
for faster healing, causes less pain, better cosmetic appearance
Inadequate pain management for painful partial thickness burns can lead to all of the
following except:
A)
increased inflammatory response.
B)
increased opioid requirements.
C)
post traumatic stress disorder.
D)
eschar formation. - ANS-D) eschar formation
A patient who is ventilated has a low blood pressure. When he arrived to the ED the BP
was much higher at 152/85 and HR was 122. Possible reasons for his low BP include all
of the following except:
A)
hypovolemia.
B)
positive pressure ventilation.
C)
elevated PEEP
D)
,inadequate sedation - ANS-D) inadequate sedation
The cardiac arrhythmia most likely in a lightning strike is: - ANS-asystole
If a patient has an unknown powder on the skin which may cause a chemical burn,
immediate treatment should be to: - ANS-brush off powder first and then rinse with
water.
You hear the charge nurse telling the trauma nurse a child is en route with significant
burns to his body after his shirt caught fire by a candle. The trauma nurse comes to you
and asks what is unique about treating children with burns. You offer differences which
include all of the following except:
A)
Their fluid volume requirements per %TBSA is larger.
B)
They have limited glycogen stores so dextrose containing maintenance fluids should be
initiated to prevent hypoglycemia.
C)
Their body surface to mass ratio is larger so a modified %TBSA chart is used.
D)
Their overall fluid requirements are smaller so they receive half the volume over twice
the time. - ANS-D)
Their overall fluid requirements are smaller so they receive half the volume over twice
the time.
The information needed to calculate fluid requirements based on the Parkland formula
on a patient with a superficial erythema thermal burn is:
A)
time of the burn.
B)
extent of the burn (TBSA).
C)
patient weight in kilograms.
D)
none of the above. - ANS-D) none of the above
The Rule of 9's for adults does not apply to the infant's body when calculating the extent
of a burn because:
A)
they have more total body water than adults that changes the calculation.
B)
their head is disproportionately larger than an adult's head.
C)
their lack of height changes the calculated BSA.
D)
smaller numbers are used for smaller bodies. - ANS-B)
, their head is disproportionately larger than an adult's head
Kevin is a patient who was admitted following an inhalation injury when he was trapped
in a burning car. Other injuries have been ruled out and he remains intubated and will
be your patient this shift. The RT tells you that the mode has recently been switched
from A/C-volume to A/C - pressure. She explains that the patient's lung pressures were
rising because the lungs were becoming "stiffer." A reason for this change in
compliance with Kevin's lungs could be: - ANS-pulmonary edema from the inhalation
injury.
T/F: When a trauma team is assembled, the nurse has assigned assessments and
interventions to complete and the physician has their own unique assessments and
interventions to complete. - ANS-False
T/F: The attending physician is in charge of deciding whether or not a patient is an
appropriate organ donor. - ANS-False
T/F: Warmed IV fluids should be initiated when a poly-trauma patient's temperature
reaches 35.8 degrees Celsius or below. - ANS-False
Why is a national trauma registry important in trauma care?
A)
allows one country to compare treatments and outcomes to other countries
B)
allows the development of performance benchmarks across the country
C)
allows the gauging of success of injury prevention programs
D)
all of the above - ANS-D) all of the above
If a patient is unable to provide a history some information can be collected from:
A)
witnesses at the scene including police, fire department, or bystanders.
B)
old charts or records of previous admission.
C)
Pharmanet.
D)
all of the above. - ANS-D) all of the above
T/F: Our focus in trauma care is to treat primary injuries and prevent or anticipate
secondary injuries from creating permanent disability. - ANS-True
Negative consequences of spinal immobilization include all of the following except:
A)
lowers blood pressure in the supine position.
