TNS quizes/pretests

which of the following best represents the law requiring that a person seeking medical care be provided a medical screening by a qualified medical professional?

a. HIPPA

b. COBRA/EMTALA

c. START

d. Illinois EMS act and trauma system code 515.210

b. COBRA/EMTALA

which of the following is the most accurate statement regarding the transfer of a trauma patient from a non-trauma hospital to a trauma center?

a. the transferring hospital should have all radiographic workups completed on the patient before transfer

b. the receiving trauma center must have an accepting physician

c. the receiving trauma center is responsible for determining the type and level of transportation

d. the receiving trauma center is responsible for complications of the patient during the transfer

b. the receiving trauma center must have an accepting physician

A trauma patient with a face mask for supplemental oxygen is brought into the ER with a GCS of 6. The pt continues to deteriorate and goes into respiratory arrest. The physician is unable to obtain an airway and the patient expires. How would this death be classified?

a. nonpreventable death

b. potentially preventable death

c. preventable death

d. adverse event

c. preventable death

A patient in the ER following a MVC is refusing care and wants to leave the hospital without care. What does EMTALA require the hospital to document?

a. medicare is revoked because patient left without treatment

b. the physician discussed the risks of leaving and the benefits of the treatment

c. family notified to give patient a ride home

d. security notified to hold patient until medical imaging is completed to clear C-Spine

b. the physician discussed the risks of leaving and the benefits of the treatment

which of the following would not be indicated before transfer from the initial hospital to a trauma center?

a. chest tube placed for pneumothorax

b. IV fluid resuscitation

c. intubation to secure airway

d. full set of radiographs

d. full set of radiographs

if a spontaneously ventilating patient has no detectable breath sounds over one side following chest trauma, what should the TNS suspect?

a. consolidation of lung tissue due to aspiration

b. bronchodilation and air trapping from hx of COPD

c. air or blood in the pleural cavity

d. fluid in alveoli and terminal bronchioles

c. air or blood in the pleural cavity

Bob was injured in a collision with another person while playing football. He is drooling, lethargic, and noted to have stridor. His face appears elongated. Which of the following is the priority for this patient with obvious facial trauma?

a. obtain a CT scan for suspected brain injury

b. obtain an airway

c. assess for a CSF leak

d. assess pupil size and reaction to light (PERLA)

b. obtain an airway

A 16 year old girl was struck in the mouth with a softball. The patient is experiencing epistaxis, facial swelling and missing teeth. How would the nurse assess the patient for a possible LeFort I type fracture?

a. rock the maxilla back and forth and watch for movement of the midface

b. face separation from the cranium is noted on the rocking the maxilla

c. rock the maxilla to assess whether the maxilla is independent from the remainder of the face

d. place 2 fingers on the lower jaw and assess whether it moves freely.

c. rock the maxilla to assess whether the maxilla is independent from the remainder of the face

A patient with a pulmonary contusion after MVC is intubated on a ventilator with PEEP. What is the patient at risk of developing?

a. airway obstruction

b. pneumothorax

c. fever

d. atelectasis

b. pneumothorax

which airway access method is indicated for an adult who presents with massive facial trauma with no detectable oral openings with extremely labored ventilations with loud gurgling noises?

a. repositioning the mandible and oropharyngeal airway

b. in-line orotracheal intubation

c. nasotracheal intubation

d. cricothryotomy

d. cricothryotomy

which facial fracture is most likely to have an associated CSF leak?

a. blow out fracture

b. LeFort III fracture

c. maxillary ridge fracture

d. zygoma fracture

b. LeFort III fracture

which emergent resuscitative intervention is indicated first for a patient with thoracic trauma that presents with severe ventilator distress, absent breath sounds and hyperresonance to percussion on the one side, distended neck veins and hypotension?

a. pericardiocentesis

b. ABGs and portable chest x-ray

c. chest tube insertion

d. needle pleural decompression

d. needle pleural decompression

The ED has received multiple trauma patients and the one TNS on duty cannot care for all of them at the same time. Based on the Illinois Trauma Center regulations, who can be assigned to care for the next category 2 trauma activation patient who just arrived to the ED?

a. a certified emergency nurse

b. a nurse with 4 documented hours of trauma training

c. a nurse with telemetry experience

d. a nurse with ICU experience

b. a nurse with 4 documented hours of trauma training

what do the Illinois Trauma center rules recommend for minimum staffing of a trauma center without a backup plan?

a. two TNS trained nurses per shift

b. one TNS trained nurse and one ECRN trained nurse

c. one TNS trained nurse per shift

d. two TNCC trained nurses per shift

a. two TNS trained nurses per shift

what is afterload?

a. ed diastolic filling pressure

b. changes in the force of myocardial contraction

c. the amount of blood ejected with on contraction

d. resistance or impedance to ventricular ejection

d. resistance or impedance to ventricular ejection

which of these is likely to result in an increased tidal volume?

a. pneumothorax

b. narcotic overdose

c. profound intoxication

d. assisted ventilations

d. assisted ventilations

which of these is a component of the primary survey?

a. a full set of vitals

b. assess for immediate life threats

c. obtain a chief complaint and patient history

d. rapidly palpate head, chest, abdomen, and limbs

b. assess for immediate life threats

which of these is the best method of providing and maintaining an airway in a restless, agitated, intoxicated head trauma patient with a GCS of 9 who cannot protect their own airway?

a. blind nasotracheal intubation

b. oral airway with assisted ventilations using ambu bag

c. rapid sequence intubation

d. laryngeal mask airway (LMA)

c. rapid sequence intubation

which of these would indicate complete upper airway obstruction?

a. stridor

b. silence

c. wheezes

d. coughing

b. silence

what is considered Beck's triad associated with cardiac tamponade?

a. distant heart sounds, fractured ribs, crepitus

b. jugular vein distension, hypotension, and muffled heart tones

c. pulsus alternans, bradycardia, wheezes

d. increased WOB, tachycardia, diffused crackles

b. jugular vein distension, hypotension, and muffled heart tones

a driver of a motor vehicle involved in a front end collision suddenly develops short runs of V tach. what would be the most likely cause of this arrhythmia?

a. pericardial tamponade

b. cardiomyopathy

c. pulmonary contusion

d. cardiac contusion

d. cardiac contusion

a patient in the ER presents with a penetrating trauma of the left chest. the patient continues to be unresponsive to fluids and is hemodynamically unstable. the TNS should suspect which injury?

a. pericardial tamponade

b. ruptured aorta

c. intracardiac thrombus

d. pulmonary contusion

a. pericardial tamponade

the family of a trauma patient is requesting transfer to another facility. the patient is unstable. which of the following statements is NOT true regarding the transfer request?

a. risk and benefits of transfer must be clearly documented using the certificate of transfer

b. responsibility for arranging transfer falls on the receiving institution

c. the receiving hospital must be notified before initiation of the transfer

d. the transferring facility must provide proper level of trained personnel to accompany the patient

b. responsibility for arranging transfer falls on the receiving institution

there are many complications for cardiac contusions. which of the following is NOT considered one of them?

a. cardiogenic shock

b. congestive heart failure

c. hypovolemic shock

d. thrombus formation

c. hypovolemic shock

if the pulse ox reading is 90%, what is the pO2 likely to be?

a. 50

b. 60

c. 75

d. 90

b. 60

what might a burn with well-demarcated lines and no splash pattern on a child indicate?

a. a more serious chemical burn from an acid

b. changes from an electrical burn

c. child abuse

d. a contaminated wound

c. child abuse

in the rule of nines for an adult patient, the patient's palm represents how much of the patient's body surface area?

a. 1%

b. 2%

c. 3%

d. 4%

a. 1%

a child's head counts as how much body surface area when doing the rule of nine's to determine extent of burns?

a. 5%

b. 9%

c. 12%

d. 18%

d. 18%

a child is admitted to the trauma hospital with burns to his lower extremities. the trauma nurse should do which of the following?

a. start running LR wide open

b. cooling the burned areas with ice water

c. use the Parkland formula based on partial or full thickness burns only

d. children have limited glycogen storage, so use D5W instead of normal saline IV

c. use the Parkland formula based on partial or full thickness burns only

which finding on assessment of an extremity at risk for compartment syndrome would indicate irreversible tissue injury?

a. pain score of 10

b. paralysis or weakness of involved extremity

c. loss of pulse

d. paresthesia

c. loss of pulse

a patient has suffered an abdominal GSW. the TNS has secured the airway and started 2 large bore IVs. the abdomen is open and there is eviscerated abdominal contents protruding. How should the nurse address the abdominal wound?

a. attempt to place abdominal contents back into the abdominal cavity and use a T-POD to hold direct pressure

b. irrigate the wound site with NS and leave open to air

c. cover the intestines with vaseline gauze

d. cover with moist sterile dressing, no pressure applied

d. cover with moist sterile dressing, no pressure applied

The FAST bedside exam can be used to examine patients with all of the following except:

a. brain injury

b. free fluid in pelvis

c. pericardial tamponade

d. intraperitoneal hemorrhage

a. brain injury

The physician tells your trauma patient that he has a minor pancreatic injury from his bicycle accident today. After the physician leaves the room, the patient asks you, "what happens now?" your best response is:

a. we have to prepare you to go to emergency surgery now to remove your pancreas

b. the trauma surgeon might need to put a temporary drain into your back to remove pancreatic fluid for the next week until your pancreas heals

c. we have to make sure your are up to date on your vaccines

d. you will be started on insulin shots for the rest of your life since your pancreas is not functioning

b. the trauma surgeon might need to put in a temporary drain into your back to remove pancreatic fluid for the next week until your pancreas heals.

what is the most common injured structure within the renal system?

a. penis

b. kidney

c. bladder

d. urethra

b. kidney

in the primary survey, AVPU is perfomred to determine if a trauma patient can:

a. protect his airway

b. sustain perfusion status

c. provide a medical history

d. maintain c-spine alignment

a. protect his airway

which circumstance may lead to an unreliable reading on the pulse ox?

a. hyperthermia

b. carboxyhemoglobin

c. hypertension

d. pneumothroax

b. carboxyhemoglobin

a patient arrives in the ED after being pinned against a brick wall. The priority assessment on this patient with crush injuries includes:

a. hypokalemia and sepsis evaluation

b. myoglobinemia and renal failure prevention with aggressive fluid resuscitation

c. hypernatremia and fluid retension

d. compartment syndrome with fasciotomy

b. myoglobinemia and renal failure prevention with aggressive fluid resuscitation

a patient involved in an MVC develops bilateral pupil non-reactive dilation, loss of reflexes, change in LOC and abnormal posturing. what does the nurse suspect is the cause?

a. chronic subdural hematoma

b. herniation syndrome

c. diffuse axonal injury

d. cerebral contusion

b. herniation syndrome

a patient has multiple rib fx and compains of pain with each breath. Ventilations are shallow at 12 bpm. which ABG results are likely in this patient?

a. pH 7.26 pCO2 55 HCO3 26

b. pH 7.48 pCO2 25 HCO3 24

c. pH 7.17 pCO2 32 HCO3 18

d. pH 7.50 pCO2 45 HCO3 32

a. pH 7.26 pCO2 55 HCO3 26

which is a complication of a ruptured bladder?

a. peritonitis

b. impotence

c. venous thrombosis

d. urethral stricture

a. peritonitis

what intervention is indicated first for a massive hemothorax due to blunt chest trauma?

a. exploratory thoracotomy

b. needle pleural decompression

c. chest tube insertion with autotransfusion

d. consecuative fluid challenges to maintain SBP of 110 or higher

c. chest tube insertion with autotransfusion

a category I trauma patient has arrived at the trauma center. according to the Illinois trauma center regulations, which is required documentation on the trauma nursing flow sheet?

a. the time the patient arrived at the trauma center

b. the time the patient was removed from the backboard

c. the time the chest x-ray was performed

d. the time the CT results were given to the physician

a. the time the patient arrived at the trauma center

what is the primary neurotransmitter of the sympathetic nervous system?

a. norepinephrine

b. acetylcholine

c. cholinesterase

d. vasopressin

a. norepinepherine

which mechanism of cellular transport moves molecules passively from an area of higher concentration to an area of lower concentration along their concentration gradient?

a. osmosis

b. diffusion

c. active transport

d. facilitated diffusion

d. diffusion

which occurs following release of aldosterone from the adrenal cortex?

a. vasodilation lowers the blood pressure

b. liver retains hydrogen and potassium

c. kidneys reabsorb sodium and water

d. kidneys excrete excess water

c. kidneys reabsorb sodium and water

which of these is associated with hyponatremia?

a. respiratory depression

b. carpal pedal spasms

c. histamine release

d. seizures

d. seizure

which two cranial nerves provide a gag reflex?

a. trigeminal V and facial VII

b. trochlear IV and abducens VI

c. glossopharyngeal IX and vagus X

d. accessory XI and hypoglossal XII

c. glossopharyngeal IX and vagus X

what should a TNS expect when the parasympathetic system is stimulated?

a. pupil dialtion

b. bronchial constriction

c. slowing of the digestive tract

d. acceleration of the HR

b. bronchial constriction

what is the dome shaped muscle that separates the thorax from the abdominal cavity?

a. pectoral

b. scalene

c. diaphragm

d. external intercostal

c. diaphragm

when does expiration become an active process?

a. during sleep

b. during exercise

c. when sedated

d. when intoxicated

b. during exercise

which condition results in a left shift of the oxyhemoglobin curve limiting O2 diffusion to the tissues?

a. acidosis

b. hypercapnia

c. hyperthermia

d. carbon monoxide poisoning

d. carbon monoxide poisoning

which sign indicates the possibility of a difficult intubation?

a. mallampati I visualization of the uvula

b. mouth can open three finger breadths wide

c. short neck with limited mandibular mobility

d. thyromental distance is 4 finger breadths

c. short neck with limited mandibular mobility

an unconscious adult presents with massive tissue trauma to the mouth and chin. Orotracheal intubation attempts have been unsuccessful and the patient cannot be ventilated with a BVM. which of these is indicated?

a. emergency tracheostomy

b. cricothyrotomy

c. transilluminated intubation

d. rapid sequence intubation

b. cricothyrotomy

if auscultation reveals sounds over the stomach and no breath sounds after placing an ET tube, what action is indicated?

a. hyperventilate the patient and prepare for a surgical cricothyrotomy

b. withdraw the tube slightly and re-check breath and gastric sounds

c. insert a needle into the 4th or 5th ICS, midaxillary line

d. remove the tube, ventilate with 15 L O2 and reinsert the tube

d. remove the tube, ventilate with 15 L O2 and reinsert the tube

which of these will cause respiratory alkalosis?

a. hyperventilation due to anxiety or pain

b. cellular hypoxia due to sustained hypoperfusion

c. over-ingestion of H2 blockers or Milk of Magnesia

d. slow or shallow ventilation that result in hypercarbia

a. hyperventilation due to anxiety or pain

what GSC eye opening rating should be given to a patient that does not respond when spoken to, but opens both eyes when one earlobe is pinched firmly for 5 seconds?

a. spontaneous

b. to voice

c. to pain

d. none

c. to pain

what can increase the risk of a poor outcome of an adult patient with traumatic cerebral hemorrhage when noted in a SAMPLE history?

a. recent use of plavix

b. migraine headaches

c. febrile seizures as an infant

d. prescription for tylenol #3 for chronic pain

a. recent use of plavix

what injuries are the most commonly missed during the primary and secondary surveys?

a. vascular

b. thoracic

c. spinal cord

d. musculoskeletal

d. musculoskeletal

which change/condition increases the risk of traumatic brain injury in an older adult?

a. increased cerebral perfusion pressure resulting in cerebral edema

b. brain atrophy that allows more movement within the cranium

c. cerebral edema secondary to polypharmacy and alcoholism

d. increased risk of skull fractures and penetrating injury

b. brain atrophy that allows more movement within the cranium

which is the most common cause of sepsis in the older adult trauma patient?

a. open orthopedic fxs

b. UTIs

c. chest tube insertion site

d. central line placement

b. UTIs

during which phase of shock does initial release of catecholamines and shunting of blood flow to the vital organs occur?

a. phase I (compensated-reversible)

b. phase II (uncompensated-progressive)

c. phase III (irreversible/refractory)

d. phase IV (neural compensation)

a. phase I (compensated-reversible)

a patient arrives with a GSW to the abdomen. HR 130, SBP 90, skin is cool and pale. Abdomen is rigid, FAST exam is positive. what class of shock is this patient exhibiting?

a. Class IV

b. class III

c. class II

d. class I

b. class III

after receiving 15 units of packed RBCs, the patient later goes into metabolic alkalosis. what is the best explanation for this?

a. banked blood is acidic and is not the cause of the alkalosis

b. citrate in stored blood is broken down into bicarbonate

c. potassium in stored blood is transported out of the RBC.

d. banked blood is alkalotic with an initial pH of 7.35

b. citrate in stored blood is broken down into bicarbonate

what is the goal of IV fluid administration in the hypovolemic shock patient?

a. to replace volume to prevent capillary sludging

b. to replace volume to liberate sugar from the liver

c. to replace volume to support cardiovascular function

d. to replace volume to decrease osmotic pressure

c. to replace volume to support cardiovascular function

which is viewed as the single best indicator of the presence and severity of shock?

a. urine osmolarity

b. blood pressure

c. base deficit

d. arterial pH

c. base deficit

an adult patient returns to the ED following multiple orthopedic injuries. the patient is extremely anxious, agitated, and complains of dyspnea with pCO2 of 35 mmHg. what should a TNS do?

a. notify the physician and anticipate a spiral chest CT

b. have the patient breathe into a paper bag to re breathe her CO2.

c. treat the patient for respiratory acidosis related to anxiety

d. administer a sedative or anti-anxiety agent as ordered

a. notify the physician and anticipate a spiral chest CT

which factor contributes to the development of SIRS/MODS?

a. prolonged acidosis

b. autotransfusion of 1 L of blood

c. short-term specific antibiotic regimens

d. initiating nutrition within 3 days of severe injury

a. prolonged acidosis

what is a complication of a massive blood transfusion?

a. hyperthermia

b. hypercalcemia

c. elevated platelets

d. metabolic alkalosis

d. metabolic alkalosis

which is the most common site of deceleration injury to the chest?

a. aorta

b. ribs

c. lungs

d. sternum

a. aorta

what clinical presentations indicate medial brain shifting with compression of the midbrain and CN III (oculomotor)?

a. bilaterally dilated pupils, headache, and vertigo

b. contralateral pupil dilatation and projectile vomiting

c. ipsilateral pupil dilatation and contralateral hemiparesis

d. bilaterally pinpoint pupils, non-reactive pupils, and abnormal ventilatory patterns

c. ipsilateral pupil dilatation and contralateral hemiparesis

how should a TNS assess extraocular movements (EOMs)?

a. have the patient tightly close both eyelids and then blink rapidly

b. have the patient follow your finger with their eyes in all fields of gaze

c. rapidly turn the patient's head to one side and observe the direction of eye movements

d. instill iced saline into one ear at a time and observe eye movements for nystagmus

b. have the patient follow your finger with their eyes in all fields of gaze

which of these best describes an intracerebral hemorrhage?

a. arterial bleeding that peels the dura away from the inner table of the skull

b. blood accumulation in the potential space between the dura arachnoid layer

c. tear in cortical blood vessels resulting in hemorrhage into the brain parenchyma

d. bruising or bleeding into the corical tissue without puncutre of the pial covering

c. tear in cortical blood vessels resulting in hemorrhage into the brain parenchyma

an adult presents after a minor car crash. the neuro exam is normal but the patient is amnestic for the event. what should a TNS suspect?

a. moderate diffuse axonal injury

b. suarachnoid hemorrhage

c. brain stem contusion

d. cerebral concussion

d. cerebral concussion

which is an indicator for an open depressed frontal skull fx?

a. pre-op administration of IV antibiotics

b. serial EEGs to detect early deficits in cerebral blood flow

c. packing the wound prior to surgery to tamponade bleeding

d. hyperventilation with 100% oxygen to reduce cerebral edema

a. pre-op administration of IV antibiotics

which of these has been proven to dramatically worsen the outcome in patients with traumatic brain injruy?

a. ventilatory rate of 12 bpm

b. cerebral perfusion pressure of 70

c. permissive hypercapnia

d. hypotension

d. hypotension

an adult presents with a GCS of 6 following blunt head injury. VS: BP 240/118, HR 46, RR 12 and irregular. the patient is positioned supine with head elevated on 2 pillows. the airway is patent and O2 is being administered at 6 L/NC. An IV was started with D5W infusing at 300 mL/hr. Dextrose 50% was given because of the altered mental status and procardia 5 mg SL was given to rapidly reduce the BP. VS and LOC were assessed and recorded every 5 mins ursing the GCS. which complied with the brain trauma foundation guidelines?

a. positioning

b. airway and ventilatory support

c. continued monitoring and documentation

d. fluid resuscitation and pharmagologic management

c. continued monitoring and documentation

which change does the TNS recognize as a sign of deterioration and need to alert the physician for a patient with multiple cerebral contusions and SAH?

a. GCS is fluctuating between 8 and 9

b. patient has persistent weakness in all 4 extremities

c. pupils have become dilated after atropine administration

d. flexor posturing has now become extensor posturing

d. flexor posturing has now become extensor posturing

what should a TNS suspect if a patient complains of a painless visual deficit and seeing black dots or "flaoters" in one eye?

a. retrobulbar hemorrhage

b. retinal detatchment

c. globe luxation

d. iridodialysis

b. retinal detachment

which LeFort fx produces injury in the transverse alveolar plate?

a. I

b. II

c. III

d. IV

a. I

where does decussation (crossing) of the corticospinal (motor) and some sensory tracts occur?

a. spinal cord

b. midbrain

c. medulla

d. pons

c. medulla

what definitive care should a TNS anticipate for a Blow out fracture with displacement greater than 3 cm?

a. administration of topical and IV antibiotics followed by irrigation and metal shield

b. patching of the affected eye for 3 weeks followed by a globe prosthesis

c. open reduction and internal fixation of the orbit floor

d. internal immobilization and reduction using globe stints

c. open reduction and internal fixation of the orbit floor

a victim of a rear impact MVC cannot identify the position of their arms and legs and cannot perceive vibration and deep pressure. What should the TNS suspect?

a. central cord syndrome

b. anterior cord syndrome

c. posterior cord syndrome

d. brown sequard syndrome

c. posterior cord syndrome

how can a nurse assess for sacral sparing without a rectal exam?

a. have the patient dorsiflex both feet

b. assess Babinski reflexes for a downgoing great toe.

c. pinch the back of the patient's upper thigh and assessing sensory integrity

d. check two point discrimination of the anterior thigh

c. pinch the back of the patient's upper thigh and assessing sensory integrity

which is a finding associated with a complete spinal cord injury at the cervical level within the first hour after the injury?

a. priapism

b. tachycardia

c. sacral sparing

d. hypertension

a. priapism

a 20 year old patient who sustained a GSW to the neck cannot take a deep breath, and is lethargic with VS: BP 80/50, HR 74, RR8. Extremities are warm and dry to touch. What should the TNS suspect?

a. septic shock

b. neurogenic shock

c. hypovolemic shock

d. cardiogenic shock

b. neurogenic shock

a post-acute T1 paraplegic patient is now presenting with a severe headache, BP 200/100, HR 60, diaphoresis of the face and neck but with pale nailbeds and cool extremities. What should the TNS suspect?

a. horner's syndrome

b. neurogenic shock

c. autonomic dysreflexia

d. anaphylactic shock

c. autonomic dysreflexia

what injury should be suspected if a patient with trauma to the left lateral chest wall develops referred pain to the left shoulder?

a. splenic rupture

b. liver laceration

c. intestinal rupture

d. renal contusion

a. splenic rupture

An adult patient presents with severe abdominal pain after an MVC. the abdomen is rigid with diminished bowel sounds. What should a TNS suspect?

a. liver contusion

b. omental herniation

c. peritoneal irritation

d. compression of the portal vein

c. peritoneal irritation

An adult with blunt abdominal trauma and head injury is not stable enough to go to CT. what can be used to immediately assess for intra-abdominal bleeding?

a. rectosigmoidoscopy

b. flat plate of the abdomen

c. esophagogastric duodenoscopy

d. focused abdominal sonography

d. focused abdominal sonography

which is a complication of a ruptured bladder?

a. peritonitis

b. impotence

c. venous thrombosis

d. urethral stricture

a. peritonitis

which is an appropriate intervention for rupture of the corpus cavernosum?

a. splinting the affected area and ice applications

b. elevation of the testicles with athletic supporter

c. hematoma evacuation with injury repair

d. skin grafts with primary wound closure

c. hematoma evacuation with injury repair

A conscious and alert pediatric patient presents to triage with a forearm deformity after a fall. He is crying and points to the face with tears on the pain scale. What should the TNS do first?

a. Splint the extremity, apply a cold pack, and elevate the arm

b. Provide an oral NSAID and apply a TENS unit to the arm

c. Have the child blow bubbles as a distraction technique

d. Obtain an order for morphine sulfate 6 mg IV push

a. Splint the extremity, apply a cold pack and elevate the arm

Why is the patient with crush injury at risk for ventricular fibrillation?

a. Loss of potassium causing hypokalemia

b. Reduced renal function resulting in hypercalcemia

c. Acidotic state secondary to lactic acid accumulation

d. Excess sodium in the plasma cause cardiac irritability

c. Acidotic state secondary to lactic acid accumulation

What intervention is indicated first for a massive hemothorax due to blunt chest trauma?

a. Exploratory thoracotomy

b. Needle pleural decompression

c. Chest tube insertion with autotransfusion

d. Consecutive fluid challenges to maintain SBP at 110 or higher

c. Chest tube insertion with autotransfusion

Which can lead to the development of an empyema?

a. Infected pleural infusion

b. Tension pneumothorax

c. Thoracotomy

d. Atelectasis

a. Infected pleural infusion

Which of these is an indication for urgent thoracotomy?

a. Respiratory arrest

b. Tension pneumothorax

c. Greater than 500 mL initial chest tube output

d. Greater than 250 mL/hr chest tube output for 3 consecutive hours

d. Greater than 250 mL/hr chest tube output for 3 consecutive hours

An adult weighing 70 kg received deep partial thickness burns totaling 50% BSA. Using the parkland formula, how much IV fluid is needed during the first 8 hours?

a. 2L

b. 4.5L

c. 7L

d. 14L

c. 7L

Which of the following medications should be appropriately dosed based on ideal body weight of the bariatric trauma patient?

a. Propofol

b. Etomidate

c. Succinylcholine

d. Midazolam

a. Propofol