1) A 68-year-old male is admitted after

1) A 68-year-old male is admitted after a car accident with multiple contusions to his left chest, arms and legs. After several hours the client becomes very anxious, short of breath and has noticeable jugular vein distention. His heart sounds are muffled, his blood pressure is 62/38. Muffled heart sounds result from which of the following (trauma). A. Pneumothorax B. Increased fluid or bleeding in the pericardial sac producing distant heart sounds C. Decreased pericardial fluid producing friction against the pericardial sac D. Blood in the pleural space causing echoing distant heart sounds 2) Put the following emergency room orders in priority (Trauma) 1. Apply normal saline dressing to eviscerated intestines ______ 2. Obtain a beside bladder scan ___ 3. Vasopressin drip to maintain BP>100 SYSTOLIC ____ 4. Place an occlusive dressing on a open sucking chest wound taping it down three sides. ____ 3) Which of the following assessments findings would indicate to the nurse that a trauma patient is developing a complication (trauma) A. Temperature 97.8 degree Fahrenheit B. Urine output 3ml per hour C. Respiratory rate 18 and regular D. Heart rate 94 beats per min and regular 4) The order reads: “Give 1000 mls D5W in 2 hours.” The nurse noticed on the chart that at 0900 hours, the IV was first hung and regulated to flow at 125/gtt/min; at 0930 hours, the nurse noted that there was 450 mls LEFT in the bag. The administration tubing delivers 15 gtt/ml. how fast should the flow rate be to finish the delivering the required amount? A. 50 gtt/min B. 65 gtt/min C. 70 gtt/min D. 75 gtt/min 5) A patient admitted with injuries sustained from sky diving accident. While completing the primary survey, the nurse suspects the patient has an injury to the liver because of which finding (Select all that apply)? A. Hemodynamically unstable B. Prolonged coagulation results C. Positive Kehr’s sign D. Upper left quadrant abdominal pain E. MD orders platelets and fresh frozen plasma 6) The nurse has been asked to assess the memory of a 54 year old client. A. Ask the client to recall events from childhood B. Ask the client to recall events that have occurred over the past few days. C. Ask the client to recall events that have occurred over the past few weeks D. Ask the client to recall the name of high school attended 7) Your patient is wheeled into the emergency room for having severe motor vehicle accident with significant facial trauma. He has a cervical collar in place and is lying in a supine position. He was talking to you about the accident when he suddenly develops respiratory distress. Which of the following is a priority nursing intervention A. Turn his head sideways and encourage him to take deep breaths B. Intubate and place the patient on a ventilator C. Clearing the airway of debris D. Place a tongue blade in mouth to prevent aspiration of tongue 8) A patient arrives with multiple injuries from a collapsed building. The nurse would perform the following primary survey in what order (1,2,3,4,5). A. Do a quick neurological exam of the LOC and motor function ______ B. completely undress the patient to visualize eternal causes of injury ______ C. Evaluate circulation and determine if there is any acute blood loss. _______ D. immobilize the cervical spine if not done at the site and ensure there is a patent airway _____ E. assess to see if the patient is breathing effectively and if he needs assistance _______ 9) A patient is admitted with abdominal injuries sustained from a motor vehicle accident. The nurse realizes that damage to which of the vital organs will impact the patients coagulation ability (trauma) A. Liver B. Spleen C. Stomach D. Duodenum

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