Poor patient outcomes after a traumatic injury are associated with
A) chest tube placement for treatment of a hemothorax.
B) immediate decompression of a tension pneumothorax.
C) massive transfusions of blood products.
D) intraosseous cannulation for intravenous fluid administration.
Give this one a try later!
C - Current evidence suggests that patients receiving massive blood
transfusions have poorer outcomes. Although a chest tube may be
necessary in the treatment of trauma patients, it is not associated with poor
patient outcomes. Immediate decompression of a tension pneumothorax is
also not associated with poor patient outcomes. Intraosseous cannulation
for intravenous fluid administration has not been shown to have adverse
patient outcomes.
,The nurse is preparing a patient for withdrawal from the ventilator. Which action by
the nurse shows competence in managing dyspnea during terminal weaning?
A) Administration of opioids
B) Administration of bronchodilators
C) Administration of neuromuscular blockade
D) Administration of inhaled steroids
Give this one a try later!
A - Opioids are a class of pharmacological agents that are beneficial in
managing dyspnea during the final stages of life.
To maintain the patient's airway, which interventions are appropriate to implement
with a trauma patient who sustained a spinal cord injury? (Select all that apply.)
A) Maintain complete spinal immobilization.
B) Avoid hyperextension of the neck.
C) Insert an oral airway if patient is alert.
D) Observe respiratory pattern.
E) Observe depth of ventilation.
F) Elevate the head of bed 30 degrees.
Give this one a try later!
, A, B, D, E - Maintaining a patent airway is an essential intervention in the
care of the trauma patient. When the patient has a spinal cord injury,
additional precautions are needed, including the following: (1) avoid
hyperextension or rotation of the neck; (2) maintain spinal immobilization;
(3) observe ventilatory effort, rate, depth, and effectiveness of breathing;
(4) monitor motor and sensory function; and (5) anticipate the need for
intubation and mechanical ventilation. Oral airways should not be inserted
in an awake patient, as it will cause an airway obstruction. The patient's
head of bed should remain flat, and spinal precautions should be taken.
The nurse is orienting a new RN in the care of a patient with respiratory distress due to
emphysema. The patient is being treated with O2 via a Venturi mask with 35% oxygen.
Which statement by the new RN indicates that teaching has been effective, when the
nurse questions the new RN about the use of the Venturi mask?
A) "Her respiratory center requires low O2 concentration to stimulate breathing."
B) "Her alveoli cannot absorb higher levels of O2 because of the emphysema."
C) "A nasal cannula will dry the mucous membranes and cause an increased risk of
infection."
D) "Her alveoli have been damaged and may rupture with higher doses of O2."
Give this one a try later!
A - In patients with COPD, the respiratory drive is stimulated by hypoxemia,
not increased levels of carbon dioxide. Administration of oxygen in high
levels will impair the respiratory drive.
The trauma patient presenting with left lower rib fractures develops left upper
quadrant tenderness, hypotension, and referred pain to the left shoulder. You suspect
A) bowel obstruction.
B) cardiac tamponade.
, C) pulmonary contusion.
D) splenic injury.
Give this one a try later!
D - Splenic injury occurs most often as a result of blunt trauma to the
abdomen. However, penetrating trauma to the left upper quadrant of the
abdomen or fracture of the anterior left lower ribs also contributes to
splenic injuries. The patient may present with left upper quadrant
tenderness, peritoneal irritation, and/or referred pain to the left shoulder
(Kehr's sign). Hypotension or signs of hypovolemic shock may also be
noted. The patient's injury and associated signs and symptoms suggest an
injury to the spleen rather than cardiac, bowel, or pulmonary injury.
The nurse is on a committee related to family visitation in the critical care unit and
discusses evidence to help in the planning. Which statement reflects evidence?
A) Visitation shapes the critical care experience for the family but not the nurse.
B) Allowing children to visit is stressful for the patient and the child.
C) Restricted visitation prevents family exhaustion.
D) Family presence during procedures promotes adaptation.
Give this one a try later!
D - Family presence during procedures has been shown to promote
adaptation and reduce fear and anxiety. Allowing children to visit should be
determined on an individual basis. Research has not shown child visitation
to be associated with negative effects. Restricted visitation will not prevent
family exhaustion and adds to stress. Visitation shapes the critical care
experience for both the family and the nurse.
The nurse is assessing a patient for suspected alcohol withdrawal and identifies which
signs and symptoms as suspicious? (Select all that apply.)
A) chest tube placement for treatment of a hemothorax.
B) immediate decompression of a tension pneumothorax.
C) massive transfusions of blood products.
D) intraosseous cannulation for intravenous fluid administration.
Give this one a try later!
C - Current evidence suggests that patients receiving massive blood
transfusions have poorer outcomes. Although a chest tube may be
necessary in the treatment of trauma patients, it is not associated with poor
patient outcomes. Immediate decompression of a tension pneumothorax is
also not associated with poor patient outcomes. Intraosseous cannulation
for intravenous fluid administration has not been shown to have adverse
patient outcomes.
,The nurse is preparing a patient for withdrawal from the ventilator. Which action by
the nurse shows competence in managing dyspnea during terminal weaning?
A) Administration of opioids
B) Administration of bronchodilators
C) Administration of neuromuscular blockade
D) Administration of inhaled steroids
Give this one a try later!
A - Opioids are a class of pharmacological agents that are beneficial in
managing dyspnea during the final stages of life.
To maintain the patient's airway, which interventions are appropriate to implement
with a trauma patient who sustained a spinal cord injury? (Select all that apply.)
A) Maintain complete spinal immobilization.
B) Avoid hyperextension of the neck.
C) Insert an oral airway if patient is alert.
D) Observe respiratory pattern.
E) Observe depth of ventilation.
F) Elevate the head of bed 30 degrees.
Give this one a try later!
, A, B, D, E - Maintaining a patent airway is an essential intervention in the
care of the trauma patient. When the patient has a spinal cord injury,
additional precautions are needed, including the following: (1) avoid
hyperextension or rotation of the neck; (2) maintain spinal immobilization;
(3) observe ventilatory effort, rate, depth, and effectiveness of breathing;
(4) monitor motor and sensory function; and (5) anticipate the need for
intubation and mechanical ventilation. Oral airways should not be inserted
in an awake patient, as it will cause an airway obstruction. The patient's
head of bed should remain flat, and spinal precautions should be taken.
The nurse is orienting a new RN in the care of a patient with respiratory distress due to
emphysema. The patient is being treated with O2 via a Venturi mask with 35% oxygen.
Which statement by the new RN indicates that teaching has been effective, when the
nurse questions the new RN about the use of the Venturi mask?
A) "Her respiratory center requires low O2 concentration to stimulate breathing."
B) "Her alveoli cannot absorb higher levels of O2 because of the emphysema."
C) "A nasal cannula will dry the mucous membranes and cause an increased risk of
infection."
D) "Her alveoli have been damaged and may rupture with higher doses of O2."
Give this one a try later!
A - In patients with COPD, the respiratory drive is stimulated by hypoxemia,
not increased levels of carbon dioxide. Administration of oxygen in high
levels will impair the respiratory drive.
The trauma patient presenting with left lower rib fractures develops left upper
quadrant tenderness, hypotension, and referred pain to the left shoulder. You suspect
A) bowel obstruction.
B) cardiac tamponade.
, C) pulmonary contusion.
D) splenic injury.
Give this one a try later!
D - Splenic injury occurs most often as a result of blunt trauma to the
abdomen. However, penetrating trauma to the left upper quadrant of the
abdomen or fracture of the anterior left lower ribs also contributes to
splenic injuries. The patient may present with left upper quadrant
tenderness, peritoneal irritation, and/or referred pain to the left shoulder
(Kehr's sign). Hypotension or signs of hypovolemic shock may also be
noted. The patient's injury and associated signs and symptoms suggest an
injury to the spleen rather than cardiac, bowel, or pulmonary injury.
The nurse is on a committee related to family visitation in the critical care unit and
discusses evidence to help in the planning. Which statement reflects evidence?
A) Visitation shapes the critical care experience for the family but not the nurse.
B) Allowing children to visit is stressful for the patient and the child.
C) Restricted visitation prevents family exhaustion.
D) Family presence during procedures promotes adaptation.
Give this one a try later!
D - Family presence during procedures has been shown to promote
adaptation and reduce fear and anxiety. Allowing children to visit should be
determined on an individual basis. Research has not shown child visitation
to be associated with negative effects. Restricted visitation will not prevent
family exhaustion and adds to stress. Visitation shapes the critical care
experience for both the family and the nurse.
The nurse is assessing a patient for suspected alcohol withdrawal and identifies which
signs and symptoms as suspicious? (Select all that apply.)
