What is the key to a high performing trauma team?
effective communication
rationale: skilled communication, cooperation, and coordination are the
... [Show More] cornerstones of high-performance teams and high-quality trauma care
When obtaining a history for an injured patient, understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the trauma provider in:
evaluating and anticipating the types of injuries that may be present
rationale: mechanism of injury and energy transfer can assist the provider in evaluating and anticipating damage
the major preventable cause of death in the trauma patient is:
uncontrolled hemorrhage
rationale: uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment to identify uncontrolled hemorrhage is key to the initial assessment process
the across-the-room observation step in the initial assessment provides the opportunity to
reprioritize circulation before airway or breathing
rationale: the across-the-room observation is done at the beginning of the primary survey to rapidly assess the need to reprioritize circulation before airway or breathing. This is done if uncontrolled external hemorrhage is identified.
Which of the following accurately describes ventilation prinicples associated with a bag-mask device?
ventilate at a rate of 10-12 breaths/minute
rationale: if ventilation is ineffective, assist ventilation at 10-12 breaths/minute or one every 5-6 seconds
Which of the following is the best measure of the adequacy of cellular perfusion and helps to predict the outcome of resuscitation?
base deficit
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and when used in conjunction with serum lactate helps predict the success of resuciation
What is the safe pharmacological alternative to opioids for rib fracture pain management in the anticoagulated patient?
intercostal nerve blocks
rationale: continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and effective pain management for the anticoagulated patient.
In a patient with severe traumatic brain injury, hypocapnia causes:
cerebral vasoconstriction
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the cerebra; vasculature
A patient with a knife injury to the neck has an intact airway and is hemodynamically stable. He complains of difficulty swallowing and speaking. Further assessment is indicated next for which of the following?
damage to spinal cord
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or vascular neck structures. With an intact airway and hemodynamic stability, the other common concurrent injury is to the spinal cord
What is the appropriate technique for palpating the pelvis for stability?
apply gentle pressure over the iliac downward and medially
rationale: to assess for pelvic instability, gentle pressure is applied over the iliac crests downward and medially
a patient with a spinal cord injury at C5 is being cared for in the emergency department while awaiting transport to a trauma center. which of the following represents the highest priority for ongoing assessment and management?
maintain adequate respiratory status
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function, resulting in a paralyzed diaphragm and inability to breathe
Based on proper bleeding control techniques, what is the first step to stop the bleeding of a penetrating injury to the lower extremity?
initiate direct pressure
rationale: the first step in controlling any bleeding is direct pressure. if that is not adequate, the application of a tourniquet may be needed
treatment for frostbite includes:
administer tissue plasminogen activator
rationale: with frostbite, thrombus formation is a risk. tissue plasminogen or nonsteroidal anti-inflammatory medication can be administered. The tissue plasminogen activator has been effective in maintaining perfusion and decreasing the need for amputation when administered within 24 hours of rewarming
A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following?
normal vital signs in pregnancy
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in peripheral resistance. Normal fetal rate is between 120 and 160 bpm
While performing an assessment on a 13-month old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a potential sign of mental status change?
cooperation with the assessment
rationale: an alert older infant or toddler will recognize his or her caregiver, be cautious of strangers, and may not respond to commands, which is a normal response
What is the best position for maintaining an open airway in the bariatric patient?
reverse trendelenburg
rationale: the reverse trendelenburg position will benefit both airway maintenance and work of breathing in the bariatric patient.
The nurse is obtaining for a patient who presents following sexual assault. The history is completed using which of the following techniques?
use direct quotes to record information
rationale: history includes a detailed description of the incident that is objective, using direct quotes
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in sick for a couple of days and is now back working on the team. Which of the following behaviors would indicate this nurse is coping well?
she is talking about taking the emergency nursing certification examination
rationale: this is an indication she is taking positive steps to advance her own practice, a sign of resilience
Following a bomb explosion, fragmentation injuries from the bomb or objects in the enviroment are examples of which phase of injury?
secondary
rationale: the secondary phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries [Show Less]