1. A patient, who was on a snowboarding trip, is admitted to the ER with his friend's ski
pole protruding from the side of his abdomen. What is the mechanism of injury with this
patient?
A) Penetrating
B) Blunt
C) Crushing
D) Acceleration
2. A patient is admitted to the emergency department after he was hit by a car. The car was
going about 30 mph and was braking at the time of impact. The patient was struck just
above the right knee, fell forward over the hood of the car, striking his anterior chest,
and then slipped off the hood of the car and hit the pavement head first. Based on the
mechanism of injury and transfer of force, what injuries does the nurse most expect?
Select all that apply.
A) Fracture of the left femur and damage to the left knee
B) Fractures of the thoracic and lumbar spine
C) Fractured ribs and cardiac and lung contusion
D) Bilateral radial and humerus fractures
E) Closed head injury and cervical spine fracture
F) Bilateral clavicle and scapular fractures
3. A patient has received a gunshot wound. To help predict the amount of damage, what
information does the nurse collect?
A) Location of the shooting
B) Information about the shooter
C) Type of weapon and caliber of bullet
D) Whether the injury involved a felony
4. A patient was in a serious motor vehicle crash. At the scene, what is the highest priority
of care?
A) Extrication from the vehicle
B) Cervical spine protection
C) Establishing two large-bore intravenous lines
D) Collecting information about the crash
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5. On initial admission of a trauma victim to the emergency department, the nurse
completes a primary survey. The patient is awake and tachypneic, is using accessory
muscles of respiration, has unequal chest expansion, and is very anxious. There are
absent breath sounds on the right and cyanosis on 100% oxygen, and the trachea is
deviated to the left. What action takes the highest priority during the primary survey?
A) Jaw thrust maneuver
B) Suctioning the oral pharynx
C) Chest tube insertion
D) Assisting ventilation with bag-mask device
6. A patient has been transferred to the ED posttrauma. The patient's airway has been
established. What is the next priority in assessing this patient?
A) Assess for hypovolemia.
B) Assess for hyperthermia.
C) Assess for mechanism of action.
D) Assess the patient from head-to-toe.
7. A patient has been admitted to the emergency department after being in a severe motor
vehicle crash. The patient was a passenger and had a lap and seat belt in place. The
patient is lethargic and moaning. Initial exposure and head-to-toe examination reveals
scattered minor abrasions and contusions and bruising over the upper abdomen. The
patient moans more when the abdomen is palpated, and the abdomen is rigid. Heart rate
is 110, capillary refill is greater than 4 seconds, and blood pressure is 140/88 mm Hg.
What is the nursing priority of care?
A) Administer intravenous opioid for pain.
B) Increase the rate of intravenous crystalloid.
C) Obtain CT of the abdomen.
D) Prepare for immediate endotracheal intubation.
8. The critical care nurse who is floating to the ER is getting a patient arriving via EMS
status postchest and neck trauma. Upon assessment, the nurse notes the patient has
hemoptysis, hoarseness, stridor, and cyanosis. Which trauma is suspected?
A) Tracheobronchial trauma
B) Boney thoracic trauma
C) Plural space trauma
D) Cardiac contusion
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9. As part of a major trauma, a patient has suffered a flail chest injury. What hallmark sign
of flail chest does the nurse expect to find?
A) Flail segment elevation during inhalation
B) Evidence of rib fractures on chest radiograph
C) Flail segment depression during inhalation
D) Hypoxemia evident on arterial blood gases
10. A patient is admitted to the CCU after experiencing blunt trauma to the chest. Among
other injuries, the patient has a flail chest on the left and several extremity fractures.
About 12 hours after admission, the patient is tachypneic and complaining of shortness
of breath. Breath sounds are present bilaterally with scattered fine crackles. Chest
radiograph shows an ill-defined, patchy, ground-glass area of density on the left. If the
patient has a pulmonary contusion, what is the nursing priority?
A) Monitor pulse oximetry and arterial blood gases closely.
B) Place an oral endotracheal tube immediately.
C) Increase the amounts of intravenous crystalloid administration.
D) Obtain sputum culture and sensitivity and Gram stain.
11. A patient is postabdominal trauma. The nurse notes the patient has respiratory distress,
dyspnea, and palpation of abdominal contents when inserting a chest tube. The nurse
suspects a diaphragm rupture. This is confirmed when the nurse auscultates which of the
following?
A) Bowel sounds in the thorax
B) S3 at the apex
C) Rhonchi bilaterally
D) Bowel sounds in the left upper quadrant
12. A patient has suffered severe blunt trauma to the abdomen with bruising, diffuse pain,
guarding, and rigidity evident. Damage to which structure is most likely?
A) Stomach
B) Bladder
C) Large intestine
D) Liver
13. As part of a multiple trauma injury, the patient has suffered a closed fracture of the
radius. What nursing assessment finding indicates a significant complication warranting
immediate treatment?
A) Swelling and pain over the fracture
B) Loss of pulses distal to the fracture
C) Ecchymosis over the fracture
D) Deformity of forearm
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14. A patient has experienced multiple fractures, including pelvic and long bone fractures.
After 72 hours, the patient complains of tachypnea and dyspnea and is found to have
cyanosis, tachycardia, confusion, and fever. Laboratory analysis reveals a normal
complete blood count except for thrombocytopenia and progressive respiratory
insufficiency. What is the nursing care priority?
A) Administer oxygen and monitor pulse oximetry.
B) Initiate low-molecular-weight heparin therapy.
C) Obtain cultures of all body substances.
D) Initiate fall and seizure precautions.
15. During a motor vehicle accident, a patient sustained blunt trauma to the head and face,
resulting in hairline skull fracture and a LeFort III maxillofacial fracture. The patient
also has bruising across the chest and upper abdomen and multiple small superficial
bleeding abrasions and lacerations. On admission to the emergency department, what is
the nursing care priority?
A) Apply direct pressure to bleeding areas.
B) Assess neurologic status.
C) Perform endotracheal intubation.
D) Administer tetanus booster immunization.
16. A 50-year-old male presents to the trauma unit post-MVC with multiple maxillofacial
injuries. He was intubated in the field. In relation to this injury, the nurse continually
assesses which of the following?
A) Neurological status
B) Distal pulses
C) Bowel sounds
D) Urine output
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Answer Key
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
A
A, C, E
C
B
C
A
B
A
C
A
A
D
B
A
C
A
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