ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT
DETAILED ANSWERS
Traumatology
Chamberlain College of Nursing
52 pag.
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A 22-year-
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old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. Hi
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s blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution his blo
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od pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute an
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d his respiratory rate is 28 breaths per minute. His breath sounds are decreased in the l
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eft hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is
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performed for decreased left breath sounds with the return of a small amount of blood
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nand no air leak. After chest tube insertion, the most appropriate next step is:
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a) reexamine the chest. n n
b) perform an aortogram. n n
c) obtain a CT scan of the chest.
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d) obtain arterial blood gas analyses - ANSWER: a) reexamine the chest
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Which one of the following physical findings suggests a cause of hypotension other t
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han spinal cord injury?
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a) priapism.
b) bradycardia.
c) diaphragmatic breathing. n
d) presence of deep tendon reflexes. - n n n n n
ANSWER: d) presence of deep tendon reflexes.
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A construction worker falls two stories from a building and sustains bilateral calcan
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eal fractures. In the emergency department, he is alert, vital signs are normal, and he
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is complaining of severe pain in both heels and his lower back. Lower extremity puls
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es are strong and there is no other deformity. The suspected diagnosis is most likely t
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o be confirmed by:
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a) compartment pressures n
b) retrograde urethrogram n
c) Doppler-ultrasound studies n
d) complete spine x-ray series - ANSWER: d) complete spine x-ray series
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In managing the head-injured patient, the most important initial step is to:
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a) obtain c-spine film.
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b) secure the airway.
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c) support the circulation. n n
d) control scalp hemorrhage. - ANSWER: b) secure the airway.
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A previously healthy, 70-kg (154-
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pound) man suffers an estimated acute blood loss of 2 liters. Which one of the followi
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ng statements applies to this patient?
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a) His pulse pressure will be widened.
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b) His urinary output will be at the lower limits of normal.
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c) He will have tachycardia, but no change in his systolic blood pressure.
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d) His systolic blood pressure will be decreased with a narrowed pulse pres
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sure. - n
nANSWER: d) His systolic blood pressure will be decreased with a narrowed p
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ulse pressure. n
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The physiologic hypervolemia of pregnancy has clinical significance in the management
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of the severely injured, gravid woman by:
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a) reducing the need for blood transfusion.
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b) increasing the risk of pulmonary edema. n n n n n
c) increasing the volume of blood loss to produce maternal hypotension.
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d) complicating the mangement of closed head injury. - n n n n n n n
ANSWER: c) increasing the volume of blood loss to produce maternal hyp
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otension.
The best assessment of fluid resuscitation of the burn patient is:
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a) adequate urinary output. n n
b) reversal of systemic acidosis.
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c) normalization of the heart rate. n n n n
d) a normal central venous pressure. - ANSWER: a) adequate urinary output.
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The diagnosis of shock must include:
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a) increased vascular resistance. n n
b) evidence of inadequate organ perfusion.
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c) acidosis.
d) hypoxemia. - ANSWER: b) evidence of inadequate organ perfusion.
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A 7-year-
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old boy is brought to the emergency department by his parents several minutes after
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he fell through a window. He is bleeding profusely from a 6-
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cm wound of his medial right thigh. Immediate management of the wound should co
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nsist of: n
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