answers
A patient arrives at the emergency department by private
vehicle after sustaining an injury to the right lower extremity
while using a saw. There is a large gaping wound to the right
thigh area with significant bleeding. What is the priority
intervention?
A. Elevate the extremity to the level of the heart
B. Initiate direct pressure
C. Apply a tourniquet
D. Cover the open wound with sterile saline dressings -
CORRECT ANSWER-B. Initiate direct pressure
Rationale: The first step inn controlling any bleeding is
application of direct pressure.
A patient fell two weeks ago, striking their head. Today, the
patient presented with a persistent headache and nausea and
was diagnosed with a small subdural hematoma. The patient
has been in the ED for 24 hours awaiting an inpatient bed. The
night shift nurse reports the patient has been anxious, restless,
shaky, and vomited twice during the night. The patient states
they couldn't sleep because a young child kept coming into the
room. What is the most likely cause for these signs and
symptoms?
A. Increased intracranial pressure
B. Alcohol withdrawal
C. Rhabdomyolysis
D. Pulmonary embolus - CORRECT ANSWER-B. Alcohol
withdrawal
, Rationale: Alcohol withdrawal is a common delayed condition
because symptoms are difficult to identify early. Signs include
autonomic hyperactivity, hand tremors, nausea or vomiting,
psychomotor agitation, anxiety, insomnia, transient
hallucinations, or seizures.
A patient involved in a MVC has sustained a fracture to the
second rib of the anterior left chest. Which concurrent injury is
most commonly associated with this fracture?
A. Blunt cardiac injury
B. Brachial plexus injury
C. Pneumothorax
D. Hemothorax - CORRECT ANSWER-B. Brachial plexus
injury
Rationale: First and second rib fractures are most commonly
associated with great vessel, head and spinal cord, and
brachial plexus injuries.
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 for this patient?
A. Maintain adequate respiratory status
B. Administer balanced resuscitation fluid
C. Perform serial assessments of neurologic function
D. Maintain core temperature - CORRECT ANSWER-A.
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. Maintenance of respiratory function is
the highest priority.