A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After initial
... [Show More] fluid resuscitation his blood pressure increases to
122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per
minute. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a
small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is:
ANS: re-examine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In
the emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in
both heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The
suspected diagnosis is most likely to be confirmed by: ANS: complete spine x-ray series
What is true regarding the initial resuscitation of a trauma patient? ANS: Evidence of improved
perfusion after fluid resuscitation could include improvement in Glasgow Coma Scale score on
reevaluation
In managing a patient with a severe traumatic brain injury, the most important initial step is to: ANS:
secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. What
applies to this patient? ANS: An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by: ANS: increasing the volume of blood loss to produce maternal
hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: ANS: urinary output of 0.5
mL/kg/hr
The diagnosis of shock must include: ANS: evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell
through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of: ANS: direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent:
ANS: cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has
surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic
injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is: ANS: perform an exploratory laparotomy... [Show Less]