Chapter 25: Trauma

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient is hypovolemic, has decreased breath sounds, and shows dullness to percussion on the injured side. The nurse prepares to treat which of the following?

a.	Pneumothorax
b.	Hemothorax
c.	Atelectasis
d.	Pulmonary effusion

 

ANS:   B

Blunt or penetrating thoracic trauma can cause bleeding into the pleural space, resulting in hemothorax. Breath sounds may be diminished or absent over the affected lung. In hemothorax, the neck veins are collapsed and the trachea is at midline. Massive hemothorax can be diagnosed on the basis of clinical manifestations of hypotension associated with the absence of breath sounds and/or dullness to percussion on one side of the chest.

 

DIF:    Cognitive Level: Analysis      REF:    529

OBJ:    Nursing Process: Evaluation   TOP:    Trauma

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. In trauma patients with multiple fractures, deadly pulmonary complications can arise from:

a.	air embolism.
b.	thrombosis.
c.	fat embolism.
d.	atelectasis.

 

ANS:   C

Fat embolism syndrome is thought to develop when fat droplets leak from fractured bone and embolize to the lungs. The droplets are broken down into free fatty acids that are toxic to the pulmonary microvascular membranes. Pulmonary fat embolization alters pulmonary hemodynamics and pulmonary vascular permeability.

 

DIF:    Cognitive Level: Comprehension       REF:    536

OBJ:    Nursing Process: Analysis      TOP:    Trauma
MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. Trauma patients who lost consciousness for up to 6 hours are at high risk for cerebral edema, and who have a Glasgow Coma Scale (GCS) score of 9 to 12 are categorized as having which level of traumatic brain injury?

a.	Mild
b.	Moderate
c.	Severe

 

ANS:   B

Moderate traumatic brain injury is defined as a GCS score of 9 to 12, with loss of consciousness for up to 6 hours.

 

DIF:    Cognitive Level: Comprehension       REF:    517

OBJ:    Nursing Process: Analysis      TOP:    Trauma

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Trauma patients who lose consciousness for up to 15 minutes and have a GCS score of 13 to 15 are classified as having which level of traumatic brain injury?

a.	Mild
b.	Moderate
c.	Severe

 

ANS:   A

Mild traumatic brain injury is defined as a GCS score of 13 to 15, with loss of consciousness for up to 15 minutes.

 

DIF:    Cognitive Level: Comprehension       REF:    517

OBJ:    Nursing Process: Analysis      TOP:    Trauma

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. Trauma patients who show a deterioration of neurological status within 48 hours of injury, require mechanical ventilation, and have a GCS score of less than 8 are categorized as having which level of traumatic brain injury?

a.	Mild
b.	Moderate
c.	Severe

 

ANS:   C

Severe traumatic brain injury is defined as a GCS score of 8 or less after resuscitation or deterioration to that level within 48 hours of hospital admission.

 

DIF:    Cognitive Level: Comprehension       REF:    517

OBJ:    Nursing Process: Analysis      TOP:    Trauma

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation