Module 2 practice questions

Which blood products may be administered intravenously under pressure? A. Packed cells and fresh frozen plasma B. Packed cells and platelets C. Platelets and cryoprecipitate D. Fresh frozen plasma and platelets

A

Which client would be triaged first based on condition? A. Severe respiratory distress B. Chest pain resulting from trauma C. Hip fracture in older client D. Cystitis

A Client A with severe respiratory distress is triaged under emergency severity index 1 and should be seen immediately because of their condition is more severe. Client B with chest pain is ESI-2 and should be seen within 1 hour. Client C is less severe and is ESI-3. Client D is a ESI-4

Which findings with the nurse expect when assessing a client diagnosed with hypovolemic shock? A. Oliguria B. Crackles C. Dyspnea D. Bounding pulse

A Urine output decreases to less than 20 to 30 ML's per hour because of decreased renal perfusion secondary to decreasing circulating blood volume. Crackles are associated with pulmonary edema caused by cardiogenic shock, not hypovolemic shock. This dyspnea be associated with hypervolemia, not hypovolemia, and also with pulmonary edema and respiratory disorders. Bounding pulse will occur with hypervolemia

Bright red blood at urethral meatus confirmed by a retrograde urethrogram (RUG) may be indicative of which injury? A. Kidney laceration B. Transected urethra C. Pelvic fracture D. Ruptured bladder

B

Kehr sign is indicative of which of the following? A. Ruptured spleen B. Retropertioneal bleeding C. Cracked kidney D. Liver laceration

A

The nurse observes perianal ecchymosis. The nurse suspects the patient has a A. pelvic fracture B. bladder trauma C. rectal laceration D. spleen laceration

A

An MVC patient is ejected and has an open pelvic fracture. The admitting nurse in the ICU knows that A. aggressive fluid and blood replacement is probably be needed. B. patient will probably be able to walk when hemodynamically stable. C. patient will probably not need surgery to stabilize the fracture. D. there is little likelihood of damage to the GI or GU tracts.

A

Which injury is considered penetrating trauma? A. Gunshot wound B. Hit in the head by baseball C. Concussion from a sports collision D. Neck injury from a motor vehicle crash

A. Penetrating trauma, which includes gunshot wounds, stabs, and impalement, are injuries that puncture the body and result in damage to internal structures. Blunt injury occurs because of the forces sustained during a rapid change in velocity, such as deceleration. Blunt trauma is seen most often with blunt-force injuries, such as being hit in the head with an object like a baseball, but also in motor vehicle injuries, falls, and contact sports. This would also include experiencing a concussion from a sports collision or having a neck injury that resulted from an automobile accident.

Patient admitted for grade II splenic lac. What S/S suggest a delayed rupture of the splenic capsule? A. BP 110/70; HR 120; Hct 42; UOP 40 mL/hr; skin pink, W/D; cap refill 3 sec. B. BP 90/70; HR 140; Hct 21; UOP 10 mL/hr; pale, cool, clammy; confused C. BP 100/60; HR 100; Hct 35; UOP 30 mL/hr; pale, cool, dry; A&O D. BP 110/60, HR 118, Hct 38, UOP 60mL/hr, flushed, agitated, confused

B

Tranexamic Acid (TXA) was which mechanism of action? A. Causes cells to clump together to increase bleeding B. Decreases clot breakdown to decrease bleeding C. Increases clotting to increase bleeding D. Causes cell lysis to decrease bleeding

B

Which is the most appropriate treatment for a grader IV liver injury? A. Serial H/H and close monitoring B. Surgical repair C. Application of a warming blanket D. IV fluids alone

B

Which vaccines are required to prevent overwhelming post-splenectomy sepsis? A. Diphtheria, tetanus, and pertussis B. Haemophilius influenze e, polyvalent pnuemococcal, and meningococcal C. Measles, mumps, and rubella D. Hepatitis A, B, and C

B

Your patient has signs of bruising across his abdomen after a motor vehicle crash. Which of the following assessments should be immediately reported to the physician? A. A decrease in Hb from 1.2 to 10.9 g per dl B. Bloody urine output C. Hyper active bowel sounds D. Complaint of generalized pain in the abdomen

B Bloody urine output mayindicate a ruptured bladder. Hemoglobin changes are minimal, bowel sounds are still active and within normal, pain would be expected in this condition

The healthcare team is caring for clients in an emergency department. How soon would the clients triaged as an emergency severity index-3(ESI-3) be seen by the provider according to the five-level triage system? A. immediately B. Within 1 hour C. Could be delayed D. Within 10 mins

B The clients triaged as an ESI-3 should be seen by the provider within an hour. The clients with life-threatening problems are triaged as ESI-1, and they should be provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be delayed for some time because the condition of the clients in this level is stable. Clients with major injuries are triaged as an ESI-2 and require treatment within 10 mins

A client was admitted to the hospital with blunt trauma to the abdomen. The client was treated for a lacerated liver and abdominal hemorrhage. During the recovery period, the nurse would monitor the client for which indications of peritonitis? SATA A. Jaundice B. Boardlike abdomen C. Abdominal tenderness D. Decreased bowel sounds E. Rapid decrease in coagulation ability

BCD A boardlike abdomen is associated with the inflammatory process in the peritoneum. Abdominal tenderness is caused by the local inflammatory process and resulting bowel distention and irritation of the peritoneum. A decrease or absence of bowel sounds occurs in response to bowel distention caused by gas and shifting of fluid into the bowel. Jaundice is not a sign of peritonitis; it is caused by a disturbance in bilirubin metabolism. A rapid decrease in coagulation ability is associated with acute liver failure, not peritonitis

Which is the most common assessment finding associated with genitourinary injury? A. Perineal ecchymosis B. Decreased urine output C. Hematuria D. Flank Pain

C

Which assessment finding in a patient with genitourinary trauma requires immediate nursing intervention? A. Bloody urine B. Lower abdominal bruising C. Urinary output 0.5mL/kg/h D. Report of pain at a level 5/10

C Urinary output for patients with genitourinary trauma should be at least 0.5mL/kg/h. The nurse will need to immediately intervene when output is lower by contacting the HCP after ensuring that all tubes are patent. Bloody urine, lower abdominal bruising, and a pain level of 5/10 are all expected findings that do not require immediate nursing intervention.

Bladder injuries are most often caused by which of the following? A. Urinary tract infection B. Blunt trauma C. Penetrating trauma D. Pelvic fracture

D

Which is a part of the trauma triad of death? A. Clotting B. Alkalosis C. Hyperthermia D. Acidosis

D

Which sustained pressure is indicative of abdominal compartment syndrome? A. 8 mmHg B. 12 mmHg C. 18mmHg D. 25 mmHg

D

Which injury is considered blunt trauma? A. Gunshot wound B. Stab caused by knife C. Impalement on a pitchfork D. Neck injury from automobile crash

D Blunt trauma is seen most often with motor vehicle crashes, falls, contact sports, or blunt-force injuries (e.g trauma caused by a baseball bat). Blunt injury occurs because of the forces sustained during a rapid change in velocity (deceleration). Penetrating trauma, which includes gunshot wounds, stabs, and impalement, are injuries that puncture the body and result in damage to internal structures.

Applying the emergency severity index (ESI) criteria, which client condition is considered least severe? A. Cardiac arrest B. Abdominal pain C. Multiple trauma D. Closed extremity trauma

D Care for a client with closed extremity trauma could be delayed because it is considered less severe compared with other client conditions and triaged in emergency severity index (ESI-4). This client is given least priority. The client with cardiac arrest is triaged under ESI-1 and should be immediately because the condition is more severe. The client with abdominal pain is triaged under ESI-3 and should be seen within one hour. The client with multiple trauma should be seen within 1 hour and is triaged under ESI-2

When reviewing the medical record of a patient who underwent surgical decompression, which finding does the nurse anticipate when noting that the patient has an 'open abdomen'? A. Ruptured spleen B. An unexpected protrusion of organs outside the abdominal wall C. Opening for colostomy or urostomy D. Skin and abdominal fascia exposed after surgery

D Surgical decompression of the abdomen may be required for abdominal pressures greater than 20 to 25 mm Hg accompanied by a taut, tense abdomen and signs of organ dysfunction such as deteriorating heart, lung, and kidney status. After surgical decompression is completed and the pressure is relieved, the patient may return to the critical care unit with an 'open abdomen.' For example, the abdomen may be temporarily closed with a sterile perforated plastic sheet, clips, vacuum-assisted device, or other option, and the skin and abdominal fascia are left open. The wound is closed permanently in the days or weeks following the surgery or, depending on its size, may be allowed to heal by secondary intention and eventual skin grafting. The term 'open abdomen' does not apply to a ruptured spleen. Evisceration is a protrusion of the organs outside the abdominal wall. A stoma is an opening for a colostomy or urostomy.

Name the 3 components of the trauma triad of death

Hypothermia, coagulopathy, acidosis

A clients SpO2- 75%, bleeding from multiple gunshot wounds, is what ESI level?

Level 1

A client requiring a CT scan, lab studies, IV fluids, and a consult from surgery is what ESI level?

Level 3

A client comes in with a fever and a sore throat, what ESI level?

Level 4

Splenectomy clients are at risk for and require what?

OPSS and trivalent vaccines

What blood products cannot be given under pressure

Platelets and cryoprecipitate

Labs, IV/IM nebulized medications, and specialty consultation are all?

Resources

If blood is at the urethral meatus how is this diagnosed?

Retrograde urethrogram RUG

A client that has run out of blood pressure medication is what ESI level?

level 5