TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST

BANK | INCLUDES 3 TESTED VERSIONS OF THE EXAM

WITH 50 MULTIPLE CHOICE QUESTIONS AND
ANSWERS EACH | EXPERT VERIFIED DETAILED
ANSWERS | GUARANTEED PASS | ALREADY GRADED
A

TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK

QUESTIONS AND ANSWERS EXPERT VERIFIED DETAILED
ANSWERS| ALREADY GRADED A

A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest.
Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax
b. Brachial plexus injury
A patient arrives at the emergency department by private vehicle after sustaining an injury to the
right lower extremity while using a saw. There is a large gaping wound to the right thigh area
with significant bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings
b. Initiate direct pressure
What is the best position for maintaining an open airway in the obese patient?
a. Prone
b. Supine
c. Reverse Trendelenburg
d. Right lateral recumbent
c. Reverse Trendelenburg
Understanding the kinematic concepts associated with the mechanism of injury and energy
transfer can initially assist the trauma care provider in which of the following?
a. Anticipating the types of injuries that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure
a. Anticipating the types of injuries that may be present
What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
a. Airway compromise
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled external hemorrhage
d. Uncontrolled external hemorrhage
A adult patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. They complain of difficulty swallowing and speaking. In the primary survey, further
assessment is indicated next for which of the following conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland
a. Damage to the cervical spine
What is the best measure of the adequacy of cellular perfusion and can help to predict the
outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hematocrit level
c. Base deficit
d. Oxygen saturation
c. Base deficit
Which of the following is considered a cornerstone of a high-performance trauma team?
a. Individual goals
b. Use of TeamSTEPPS
c. Identification of a single decision maker
d. Effective communication
d. Effective communication
The nurse is obtaining a history for a patient who presents following sexual assault. This history
is completed using which of the following techniques?
a. Bring the family in to the interview room.
b. Use direct quotes to record information.
c. Obtain information specific only to the assault.
d. Provide food and drink to help create rapport.
b. Use direct quotes to record information.
In a patient with severe traumatic brain injury, hypocapnia causes which condition?
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction
d. Cerebral vasoconstriction
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests, downward and laterally.
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Apply firm pressure over the iliac crests, downward and medially.
b. Apply gentle pressure over the iliac crests, downward and medially.
A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent
headache and nausea and was diagnosed with a small subdural hematoma. The patient has been
in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has
been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn't
sleep because a young child kept coming into the room. What is the most likely cause for these
signs and symptoms?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus
b. alcohol withdrawal
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c. administer tissue plasminogen activator
d. leave all of the blisters intact
c. administer tissue plasminogen activator
A patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. Which of the following represents the highest priority for
ongoing assessment and management for this patient?
a. maintain adequate respiratory status.
b. administer balanced resuscitation fluid
c. perform serial assessments of neurologic function
d. maintain core temperature
a. maintain adequate respiratory status
Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment
are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
d. quaternary
b. secondary
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick
for a couple of days and is now back working on the team. Which of the following behaviors
would indicate this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
d. They are thinking about transferring out of the emergency department.
a. They are talking about taking the emergency nursing certification examination.
Which of the following accurately describes ventilation principles associated with use of a bag-
mask device for an adult?
a. Compress the bag-mask device at a rate of one breath every 6 seconds.
b. Delivers 100% oxygen.
c. Squeeze the bag-mask device completely for each breath.
d. Maintain the oxygen saturation levels between 92% and 94%.
a. Compress the bag-mask device at a rate of one breath every 6 seconds.
The general impression step in the initial assessment provides the opportunity to do which of the
following?
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team
c. Reprioritize circulation before airway or breathing.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm
Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency
nurse interprets the patient's hemodynamic findings as an indication of which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome
b. Normal vital signs in pregnancy
While performing an assessment on a 13-month-old involved in a motor vehicle collision, the
nurse identifies which of the following findings from the patient as a sign of possible altered
mental status?
a. Sunken fontanel
b. Crying, but consolable
c. Spontaneous movement of arms and legs
d. Cooperation with the assessment
d. Cooperation with the assessment
An adult pt who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. the PaCO2 is
30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most
important intervention to manage the cerebral blood flow?
Decrease the rate of manual ventilation
An older adult presents to the emergency department with complaints of dizziness, headache,
and nausea. The pt was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The pt is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
post-concussive syndrome
A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally
relieved by pain medication. Which of the following is the priority nursing intervention?
Elevating the leg to the LEVEL of the heart
(compression/crush- level of the heart)
(regular fracture- above the heart)
A pt involved in a high-speed rollover is complaining of increased difficulty breathing. There is a
small penetrating wound to the 6th intercostal space in the left lateral chest. Which finding is
most consistent with an injury to the diaphragm?
Bowel sounds heard in the lower left chest
A pt has been in the emergency department for several hours waiting to be admitted. They
sustained multiple rib fractures and a femur fracture after a fall. The pt has been awake, alert, and
complaining of leg pain. Their spouse reported that the pt suddenly became anxious and
confused. Upon reassessment, the pt is restless, with respiratory distress and petechiae to his
neck. The pt is exhibiting signs and symptoms most commonly associated with which of the
following conditions?
Fat embolism
3 adult pts present at different times during a 1-hour period with a high fever, fatigue, and
headache. All 3 pts have a rash which started on their mouth, face, and arms with progression to
the chest and abdomen. They all visited the same grocery store within the last week. What is the
most appropriate intervention from triage for these pts?
Immediately initiate contact precautions
A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam.
Witai type of injury is suspecied?
Globe rupture
A trauma patient who is 30 - weeks pregnant arrives at the emergency department following a
motor vehicle collision Which normal physiologic change should be considered when assessing
ventilatory status ?
Increased oxygen consumption
A patient who sustained severe injuries was brought to the emergency department following a
high - speed motor vehicle collision . Interventions for hypovolemic shock have been initiated .
What component of the trauma triad of death is most likely to have begun at the time of injury ?
Coagulopathy
An adult patient involved in a motor vehicle collision is brought to the emergency department of
a rural critical access facility . They complain of neck pain , shortness of breath , and diffuse
abdominal pain . The Glasgow Coma Score is 15. Vital signs are : BP 98/71 mm Hg , HR 125
beats / minute , RR 26 breaths / minute , and SpO2 94 % on high - flow oxygen via non -
rebreather mask . Which of the following is the priority intervention for this patient ?
Expedite transfer to the closest trauma center
A patient who weighs 120 kg is brought to the emergency department after sustaining partial
thickness burns to both upper extremities and chest with a total body surface area burned of 27 %
. How much intravenous fluid should be administered in the first 8 hours ?
3240 mL
A trauma patient is being held in the emergency department because there are no available
inpatient beds . The patient sustained a femur fracture and required multiple blood products . The
patient now has blood oozing from abrasions , IV sites , the nose , and gums . What condition is
most consistent with these findings ?
Disseminated intravascular coagulopathy
A patient is brought to the emergency department following a snowmobile crash with prolonged
exposure time prior to transport . The patient is confused . Vital signs are BP 96/54 mm Hg , HR
114 beats / minute , RR 24 breaths / minute , T 34.60C ( 94.20F ) and an SpO2 of 90 % on
oxygen at 15L per non - rebreather mask . Other findings include ETCO2 24 , scrum lactate of 6
mmol / L , and a pH of 6.8 . Based on these findings what is the most appropriate intervention
Initiate warming measures
Which of the following is a late sign of increased intracranial pressure ?
Decreased respiratory effort
Based on fall mechanism , which patient warrants prehospital transfer to a trauma center ?
A 2 - year - old lands on grass from a second - story balcony nurse is caring for an unrestrained
The trauma nurse is caring for an unrestrained driver who struck their head on the windshield
following a high - speed MVC . The patient has been diagnosed with an anterior spinal cord
injury at the level of C6 . Which assessment finding would be most concerning ?
Increasing work of breathing
While caring for a child who has been injured , what nursing intervention consistent with a
family center approach
Allowing family to participate in the care of the patient
A patient is brought to the emergency department with chest pain and shortness of breath
following a high - speed motor vehicle collision in which they were the unrestrained driver There
is crepitus to the left chest with clear and equal breath sounds . The vital signs are BP 80/40
mmHg HR 140 beats / minute , and RR 40 breaths / minute . Cardiac monitor shows sinus
tachycardia with premature ventricular contractions . These findings are most consistent with
which type of shock
Cardiogenic
Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision .
Assessment reveals tenderness in the upper right quadiani , crepitus in the lower right ribs , and
cechymosis around the umbilicus The nurse is concerned about injury to which organ
Liver
A 5 - year - old child presents to the emergency department with bruises to the upper arms and
buttocks in various stages of healing and multiple small clean , round burns to the back . There
are no abnormalities found based on the pediatric assessment triangle or primary survey . Which
of the following is the priority nursing intervention ?
Report your suspicion of maltreatment in accordance with local regulations
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding.
Which intervention is most appropriate for this patent?
Prepare the patient for surgery to remove the rod.
When should the definitive calculation for intravenous fluid resuscitation rate be performed for a
patient with burns ?
During the secondary survey
Which of the following is true about use of the focused assessment sonography for trauma exam
for a patient with abdominal trauma ?
It can be used in hypotensive patients too unstable for computed tomography scan
What is the priority intervention for a child who has been diagnosed th an atlanto - occipital
dislocation following a high - speed motor vehicle collision ?
Maintaining spinal motion restriction
What position optimizes ventilation in the obese patient with a lumbar Fracture
Reverse Trendelenburg
During the primary survey of an unconscious patient with multi system trauma , the nurse notes
snoring respirations Which priority nursing tervention should be performed next ?
Insert an oropharyngeal airway if there is no gag reflex
The patient was the unrestrained driver involved in a moderate speed motor vehicle collision .
Assessment reveals tenderness in the upper right quadrani , crepitus in the lower rigini rius , and
cechymosis around the umbilicus . The nurse is concerned about injury to which organ ?
Liver
A patient arrives following prolonged exposure of their left hand to the cold The patient is awake
and alert and complains of a tingling sensation to the fingers . Assessment reveals swelling and
bright red skin to the left hand and a 1 - inch round clear blister to the dorsum of that hand .
Which of the following nursing interventions is most appropriate for this patient ?
Gently rewarm over 15 to 30 minutes
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during a
staffing crisis . The nurse expresses anger stating that the patients did not receive quality care
and begins exhibiting aggression toward colleagues . This is most consistent with which
condition ?
Moral injury
What is the rationale for obtaining a serum lactate level during the initial assessment of a trauma
patient ?
Gauges end organ perfusion and tissue hypoxia
What is the most important consideration during the initial assessment when caring for an older
adult who has sustained serious injuries ?
Medical history including current medications
Following a gun shot wound , pre - hospital providers report diminished breath sounds bilaterally
. Upon emergency department arrival , the patient is unresponsive with shallow respirations and
an 02 sai of 90 % . What is the priority intervention for this patient ?
Assist ventilation with a bag - mask device
A patient is diagnosed with a T12 spinal cord injury following a 20 - foot fall . Which finding is
consistent with spinal shock ?
Loss of reflexes
A patient with a traumatic brain injury has a mean arterial pressure ( MAP ) of 65 mm Hg ( 8.66
kPa ) and an intracranial pressure ( ICP ) of 22 mun Hg ( 2.93 kPa ) . Which finding is most
likely an indication of the body's response to these findings ?
Widening pulse pressure
An unconscious patient arrives following a motor vehicle collision . The patient is on a
backboard with a cervical collar in place and one intravenous line running . Respirations are
shallow and there is active brisk bleeding from a large leg wound . What is the priority
intervention for this patient ?
Control the bleeding
An obese trauma patient requires intubation . Assuming there are no contraindications , which
position will provide the best visualization for insertion of the endotracheal tube ?
Ramped
Your patient is a pedestrian struck by a car and thrown 35 feet . They were unconscious at the
scene but became responsive with initial and subsequeni Glasgow Coma Scale ( GCS ) scores of
13 ( E - 3 , V - 4 , M - 6 ) . The patient has bilateral subdural hematomas and is awaiting transfer
to the ICU . Your next assessment reveals a GCS of 9 ( E - 2 , V - 2 , M - 5 What is the priority
nursing intervention ?
Notify the provider of the change
A severely injured patient has been intubated and is being mechanically ventilated . The patient
has received a balanced resuscitation including multiple blood producis . Under which
circumstance will it be harder for the hemoglobin to release oxygen to the tissues ?
Decreased body temperature
A patient is thrown against a car during a tornado and presents with obvious bilateral femur
fractures . The patient is paie , aleri , disoriented , and has delayed capillary refill . Which of the
following interventions would be most appropriate for this patient based on the disaster triage
principles ?
Initiate two large caliber intravenous lines for isotonic crystalloid administration .
A patient arrives with a large open chest wound after being assaulted with a machete .
Prehospital providers placed nonporous dressing over the chest wound and taped it on three sides
. The patient is now showing signs of anxiety , restlessness , severe respiratory distress , cyanosis
, and decreasing blood pressure . Which of the following is the MOST appropriate immediate
intervention ?
Dressing removal
A driver involved in a high - speed motor vehicle collision arrives in the emergency department .
The vehicle's air - bag failed to deploy . The patient is drowsy bui arousable and complaining of
chest pain wit ecchymosis noted to the chest . The patient is tachycardic and hypotensive with no
evidence of uncontrolled bleeding . Cardiac monitor shows premature ventricular contractions
Which of the following is the most appropriate intervention for this patient?
Inotropic support
Which of the following situations could cause functional grief ?
Amputation of a limb
Using the American College of Surgeons screening guidelines what assessment finding would
prompt the nurse to prepare a patient for cervical spine imaging ?
Alert with no neurologic deficits
An adult was thrown against a concrete wall during a factory explosion and sustained a femur
fracture , liver laceration , and a small subdural hematoma These injuries most likely occurred
during what level of blast trauma ?
Tertiary
An adult patient was brought to the emergency department following a motorcycle crash . On
arrival , the patient is only responsive to pain , has bleeding from the nose , and multiple
abrasions and contusions to the face . What is the priority intervention ?
Use a law thrust to open the air way and look for signs of obstruction
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph .
The patient is awake and alert and the right leg is shortened . Following initial resuscitation with
fluids , the patient remains hypotensive . What would be the priority intervention ?
Apply a pelvic binder
A patient has a closed fracture to the left lower leg. Which symptoms are consistent with
compartment syndrome
Pain, diminished pedal pulse, pressure
Which of the following characteristics is found in high performing teams
Interdisciplinary collaboration
An unresponsive patient has an oropharyngeal airway in place, shallow and labored respirations,
and dusky skin. Medication for drug-assisted intubation have been administered but intubation
was unsuccessful. What is the most appropriate next step?
Ventilate with a bag-mask device
An adult arrives at the emergency department with superficial burns to the extremities following
a house fire. The patient is reporting a headache with nausea and is drowsy and confused. What
is most likely cause of these symptoms?
CO2 poisoning
An adult patient was a restrained passenger involved in a high-speed motor vehicle collision. The
patient complained of generalized abdominal and left leg pain. A FAST exam was negative for
fluid in the abdominal cavity. While awaiting inpatient bed placement, the patient develops
increased abdominal pain w/rebound tenderness, fever and elevated WBC. These findings are
most consistent w/ an injury to which organ?
Small bowel
A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the
priority intervention?
Apple direct pressure to the wound
A 36 year old patient has a deformity of left wrist after a fall. The patient is reluctant to move
their hand due to pain. Which of the following is the most appropriate intervention?
Apply a splint and elevate the extremity above the level of the heart
A trauma patient is being resuscitated in the emergency department when the radiology staff
notifies the charge nurse that the CT scanner will be out of service for several hours. The team
gathers to plan accordingly. Which of the following terms best describes this trauma teams
communication?
Huddle
A seriously injured patient is noted to have a weak, thready pulse and cool, clammy skin. There
is instability of the pelvis on palpating and blood at the urinary meatus. A pelvic binder is
appropriately applied and balanced fluid resuscitation is being managed by the team. What
would be the most appropriate next intervention for this patient?
Insertion of a suprapubic catheter
A teenaged patient presents to the ED w/ left arm pain after a ground level fall. The patient
identifies as transgender and shares they are homeless. The ED staff are concerned the patient is
experiencing human trafficking. What is the most consistent w/ human trafficking
Those experiencing human trafficking rarely self disclose
An older patient w/a history of anticoagulant use presents after a fall at home the previous day.
They deny loss of consciousness. The patient has a hematoma to their forehead and complains of
headache, dizziness, left arm weakness, and nausea. What is the most likely cause of these
symptoms?
Subdural hematoma
Which of the following is an expected finding when assessing a patient with a tube thoracostomy
connected to a chest drainage system
Fluctuation in the water seal chamber
What two noninvasive interventions are used to assess for the adequacy of oxygenation and
effectiveness of ventilation
Pulse oxide try and capnography
A trauma patient involved in a fall from 25 ft has a TBI, three anterior rib fractures on the right
side, a small pneumothorax on the right, and grade III liver injury. The patient was intubated and
placed on a ventilator w/ PEEP. Chest tube was deferred at this time. Upon reassessment, which
finding is most concerning
Severely diminished breath sounds on the right
Which blood pressure finding is associated with early or compensated hypovolemic shock?
Rising diastolic
What assessment finding is consistent w/impending herniation syndrome?
Unilaterally fixed and dilated pupil
Which commonly prescribed medication may worsen a complication that is associated with
massive transfusion
Diltiazem
Patient w/ a crush injury should be monitored for which of the following conditions
Dysthymias
An intubated trauma patient has just been transported back from CT scan. Upon arrival to their
room in the emergency department, resistance is noted with bag-mask ventilations and
auscultation reveals unequal breath sounds. What is the most appropriate initial intervention for
this patient?
Reposition the endotracheal tube
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would
indicate sacral sparing
Voluntary anal sphincter tone
You are caring for a patient who was shot multiple times in the chest and abdomen. The patient
is unresponsive w/snoring, shallow respirations. Assessment reveals absent radial pulses, weak
and carotid pulse, and cool, diaphoretic skin. Which management strategy should the nurse
anticipate?
Massive transfusion
While caring for a trauma patient in the ED, what finding raises suspicion of a complete spinal
cord injury?
Urinary incontinence
You are caring for a patient who was involved in a MTV crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain w/rigidity on palpation, fundal height
at the costal margin, and bloody vaginal discharge. Varying acceleration and decelerations are
noted on cardiotocography. These findings are most consistent w/ which of the following?
Placental abruption
A patient present after a 25 ft fall, w/ paradoxical chest wall movement to the right lower chest
and complaints of shortness of breath. What is the priority intervention?
Airway and ventilation support
What intravascular solution is most commonly used for patients who have sustained burns?
LR
An adult patient is being treated in the ED after falling 30 ft and landing on their head. The
patient has been intubated and initial stabilization efforts are ongoing. The vital sign are BP
70/40, HR 44, and respirations are being assisted at 16. The patient skin is warm, dry, and
normal color. These findings are most consistent w/ what type of shock?
Neurogenic
Which of the following is true regarding cavitation
Energy causes the tissues to accelerate and displace outward
Which of the following is true about the log roll maneuver
It should be avoided with a suspected spine injury prior to imaging
Version 2
1. An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm
Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
A. Decrease the rate of manual ventilation
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered.
A. Decrease the rate of manual ventilation
2. Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as amputation of a limb,
paralysis, or loss of sight.
B. Amputation of a limb
3. What is the most important consideration during the initial assessment when caring for an
older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the
following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
5. When should the definitive calculation for intravenous fluid resuscitation rate be performed
for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage of total body
surface area which requires a good skin assessment and is calculated after clothing is removed.
B. After removal of clothing
6. In a motor vehicle collision, which injury pathway is most likely to increase the patient's
morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
B. Ejection
7. A patient with a lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medications. Which of the following is the priority nursing
intervention?
A. Elevating the leg above the level of the heart
B. Repositioning the leg and applying ice
C. Elevating the leg to the level of the heart
D. Preparing the patient for ultrasound of the leg
Rationale: Musculoskeletal and Wounds\Musculoskeletal
This patient is exhibiting signs of possible compartment syndrome which is a dangerous
complication of fractured extremities. The pain is often out of proportion to the injury and might
not respond to pain medications. Elevate the limb to the level of the heart to decrease dependent
edema but not above the heart, which can cause increased venous congestion and pressure within
the compartment.
C. Elevating the leg to the level of the heart
8. A teenaged patient presents to the emergency department with left arm pain after a ground
level fall. The patient identifies as transgender and shares they are homeless. The ED staff are
concerned the patient is experiencing human trafficking. What is most consistent with human
trafficking?
A. The individual appears well nourished.
B. Those who are being trafficked rarely seek medical care.
C. It is infrequently associated with substance abuse.
D. Those experiencing human trafficking rarely self-disclose.
D. Those experiencing human trafficking rarely self-disclose.
9. An intubated trauma patient has just been transported back from CT scan. Upon arrival to their
room in the emergency department, resistance is noted with bag-mask ventilations and
auscultation reveals unequal breath sounds. What is the most appropriate initial intervention for
this patient?
A. Place the patient back on the ventilator.
B. Extubated the patient.
C. Reposition the endotracheal tube.
D. Suction the endotracheal tube.
C. Reposition the endotracheal tube.
10. Which of the following assessment findings differentiates a tension pneumothorax from a
simple pneumothorax?
A. Increased work of breathing
B. Unilaterally diminished breath sounds
C. Tachycardia
D. Hypotension
D. Hypotension
11. A patient is brought to the emergency department of a rural hospital following a high-speed
motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary
survey, what is the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter
A. Initiate transfer to a trauma center
12. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the
priority intervention?
A. Initiate two intravenous access sites
B. Place the patient on supplemental oxygen
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding
C. Apply direct pressure to the wound
13. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib
fractures on the right side, a small pneumothorax on the right, and a Grade III liver injury. The
patient was intubated and placed on a ventilator with PEEP. Chest tube was deferred at this time.
Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest
A. Severely diminished breath sounds on the right
14. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg
(8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most
likely an indication of the body's response to these findings?
A. Increased respiratory effort
B. Widening pulse pressure
C. Reflex tachycardia
D. Reflex hypotension
Rationale: Head and Torso Trauma\Head Trauma
This patient has a CPP (MAP − ICP) of less than 60 mm Hg (8 kPa) which is associated with
poor outcomes. When the CPP falls below normal levels, the central nervous system initiates the
Cushing response in an attempt to increase mean arterial pressure and improve CPP. Cushing
response assessment findings include widening pulse pressure, reflex bradycardia, and irregular,
decreased respiratory effort.
Widening pulse pressure
15. An older adult presents to the emergency department with complaints of dizziness, headache,
and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss
of consciousness and a hematoma is noted to the forehead. The patient is currently on
anticoagulant therapy. What is most likely the cause of their symptoms?
A. Intracerebral hemorrhage
B. Epidural hematoma
C. Diffuse axonal injury
D. Post-concussive syndrome
Rationale: Special Populations\Older Adult
Post-concussive syndrome can occur days to weeks after injury or trauma. The other three
conditions present as a more rapid decline, especially in patients who are on anticoagulants.
Post-concussive syndrome
16. 1. An older adult presents to the emergency department with complaints of dizziness,
headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There
was no loss of consciousness and a hematoma is noted to the forehead. The patient is currently
on anticoagulant therapy. What is most likely the cause of their symptoms?
A. Intracerebral hemorrhage
B. Epidural hematoma
C. Diffuse axonal injury
D. Post-concussive syndrome
Rationale: Special Populations\Older Adult
Post-concussive syndrome can occur days to weeks after injury or trauma. The other three
conditions present as a more rapid decline, especially in patients who are on anticoagulants.
D. Post-concussive syndrome
A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right lower
chest and complaints of shortness of breath. What is the priority intervention?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support
D. Airway and ventilation support
18. A trauma patient is being held in the emergency department because there are no available
inpatient beds. The patient sustained a femur fracture and required multiple blood products. The
patient now has blood oozing from abrasions, IV sites, the nose, and gums. What condition is
most consistent with these findings?
A. Rhabdomyolysis
B. Fat embolism
C. Disseminated intravascular coagulopathy
D. Multiple organ dysfunctions syndrome
C. Disseminated intravascular coagulopathy
1. Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision.
Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and
ecchymosis around the umbilicus. The nurse is concerned about injury to which organ?
A. Transverse colon
B. Pancreas
C. Liver
D. Spleen
Rationale: Head and Torso Trauma\Abdominal and Pelvic Trauma
Liver injuries are associated with right, lower rib fractures. They also can present with
tenderness, guarding, or rigidity in the right upper quadrant, along with ecchymosis of the right
upper quadrant or around the umbilicus, known as Cullen's sign.
C. Liver
20. 1. A 35-year-old male presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
A. Oculomotor nerve palsy
B. Globe rupture
C. Retrobulbar hematoma
D. Retinal detachment
Rationale: Head and Torso Trauma\Head Trauma
The globe of the eye consists of multiple layers. The sclera is the white outer layer, while the
cornea covers the iris and pupil. When a full thickness injury occurs to the cornea, sclera, or
both, the globe will rupture, causing the shape of the pupil to become irregular or teardrop-
shaped.
B. Globe rupture
21. An adult arrives at the emergency department with superficial burns to the extremities
following a house fire. The patient is reporting a headache with nausea and is drowsy and
confused. What is the most likely cause of these symptoms?
A. Capillary leak syndrome
B. Rhabdomyolysis
C. Carbon monoxide poisoning
D. Hypothermia
C. Carbon monoxide poisoning
22. An adult patient is being treated in the emergency department after falling 30 feet and
landing on their head. The patient has been intubated and initial stabilization efforts are ongoing.
The vital signs are BP 70/40 mm Hg, HR 44 beats/minute, and respirations are being assisted at
16 breath/minute. The patient's skin is warm, dry, and of a normal color. These findings are most
consistent with what type of shock?
A. Spinal
B. Hypovolemic
C. Obstructive
D. Neurogenic
D. Neurogenic
23. A patient with a chest tube is being transported to the intensive care unit and fluctuation is
noted in the water seal chamber during inspiration and expiration. What is the best action for the
nurse to take?
A. Clamp the chest tube
B. Return to the emergency department
C. Assist ventilations with bag-mask device
D. Continue to the intensive care unit
D. Continue to the intensive care unit
24. 1. Which one of the following characteristics is found in high performing teams?
A. Interdisciplinary collaboration
B. Provide on-the-job training
C. Work individually
D. Minimal feedback to decrease confusion
A. Interdisciplinary collaboration
25. 1. A severely injured patient has been intubated and is being mechanically ventilated. The
patient has received a balanced resuscitation including multiple blood products. Under which
circumstance will it be harder for the hemoglobin to release oxygen to the tissues?
A. Decreased pH
B. Elevated carbon dioxide level
C. Decreased body temperature
D. Increased metabolic demand
Rationale: Primary Assessment\Airway and Ventilation
If the blood is not sufficiently warmed when transfused, it can produce hypothermia. In the
oxyhemoglobin dissociation curve, a shift to the left increases the affinity of hemoglobin for
oxygen making it harder to release for use by the tissues. Factors that can cause this shift include
an elevated pH, decreased carbon dioxide, decreased temperature, and low metabolic demand.
C. Decreased body temperature
Version 3
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?

Answer: c
a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) to gauge end-organ perfusion and tissue hypoxia *
d) to determine the underlying cause of shock

A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP
100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital
signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and
symptoms of which stage of shock?

Answer: A
A) compensated **
B) Progressive
C) irreversible
D) decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home that day. she
denies any loss of consciousness. She has a hematoma to her forehead and complains of
headache, dizziness, and nausea. Which is a most likely cause of her symptoms?

Answer: D
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons
screening guidelines, which assessment finding would prompt the nurse to prepare the patient for
radiologic spine clearance?

Answer: D
A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?

Answer: C
A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following a high-speed
MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of
the following is the priority interventions?

Answer: A
A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
Which of the following injuries is LEAST likely to be promptly identified?

Answer: C
A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?

Answer: C
A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?

Answer: B
A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs?

Answer: D
A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various
stages of healing and multiple small, clean, round burns to the back. There are no abnormalities
found based on the pediatric assessment triangle or primary survey. Which of the following is the
priority nursing intervention?

Answer: A
A) report your suspicion of the maltreatment in accordance with local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
A patient with lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medications. Which of the following is the priority nursing
intervention?

Answer: C
A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her
hand due to pain. Which of the following is the most appropriate intervention?

Answer: B
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
Which of the following is a late sign of increased intracranial pressure?

Answer: C

Cushing Response
Widening pulse pressure
Reflex bradycardia
Decreased RR
A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort**
D) amnesia and anxiety
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?

Answer: B
A) ABC
B) MARCH***
C) AVPU
D) VIPP
A patient is thrown against a car during a tornado and presents with obvious bilateral femoral
fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the
following interventions would be most appropriate for this patient based on the disaster triage
principle?

Answer: A
A) initiate two large caliber intravenous lines for Ringers lactate solution administration ***
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin.
A patient arrives with a large open chest wound after being assault ed with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it on 3 sides.
He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis, and
decreasing blood pressure. Which of the following is the MOST appropriate interventions?

Answer: C
A) needle decompression
B) tube thoracostomy
C) dressing removal **
D) surgical repair
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values
is expected with a musculoskeletal complication associated with this presentation?

Answer: A
A) elevated creatine kinase ***
B) decreased potassium level
C) decreased WBC
D) elevated GFR
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility.
He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask

which of the following is the priority intervention for this patient?

Answer: C
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center ***
D) notify the patients family
Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake
and crying with increased work of breathing and pale skin. which of the following interventions
has the highest priority?

Answer: A
A) padding the upper back while stabilizing the cervical spine ***
B) applying a tight-fitting NRB mask with an attached resevior
C) establishing intravenous access and administering a 20mL/kg bolus
D) preparing for drug assisted intubation
Which of the following is a component of the trauma triad of death?

Answer: A

hypothermia, metabolic acidosis, coagulopathy

A) Acidosis **
B) hyperthermia
C) hemorrhage
D) sepsis
A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a
tear-drop shaped left pupil is noted on exam. What type of injury is suspected?

Answer: B
A) oculomotor nerve palsy
B) globe rupture ***
C) uncal herniation
D) retinal detachment
Which of the following is true about the log roll maneuver?

Answer: C
A) it causes less spinal motion than the lift and slide manuever
B) it is recommended for patients with unstable pelvic fractures
C) it can worsen cord damage from an unstable spinal injury ***
D) it does not increases the risk of life threatening hemorrhage from unstable injuries
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant
damage to the drivers side of the car. The patient is asking to have the cervical color removed.
when is it appropriate to remove the cervical collar?

Answer: A
A) after a physical examination if the patient has no radiologic abnormalities on a computed
tomography scan ***
B) after physician evaluation if the patient has not neurologic abnormalities on exam
C) after palpation of the spine if the patient has no point tenderness the the vertebral column
D) after physical examination if the patient has not neck pain with movement
Tearing of the bridging veins is most frequently associated with which brain injury?

Answer: B
A) epidural hematoma
B) subdural hematoma ***
C) diffuse axonal injury
D) intracerebral hematoma
If a patient has received multiple transfusions of banked blood preserved with citrate, which
electrolyte is most likely to drop and require supplementation?

Answer: D
A) potassium
B) magnesium
C) sodium
D) calcium ***
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT
scanner will be out of service for several of hours. The team gathers to plan accordingly. Which
of the following terms best describes this trauma teams communication?

Answer: D
A) Brief
B) loop
C) debrief
D) huddle ***
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the
patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper
extremities and superficial burns to the anterior chest. Using the modified Lund and Browder
chart to calculate the total BSA burned, how much IV fluids would be administered in the first 8
hours?

(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.

120 kg x (2 mL) x (19% TBSA) = 4560 mL

4560 / 2 (half of fluids given in first 8 hours) = 2280 mL

Answer: A
A) 2280 mL ***
B) 3840 mL
C) 4560 mL
D) 7680 mL
Which of the following assessment findings differentiates a tension PTX from a simple PTX?

answer: D

Assessment findings associated with tension pneumothorax include anxiety, severe restlessness,
severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to
compression of the heart and great vessels is consistent with obstructive shock. Hypotension
worsens with inspiration due to increased intrathoracic pressure. Late signs include distended
neck veins, tracheal deviation, and cyanosis.
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration ***
Which of the following considerations is most important when caring for a geriatric trauma
patient?

Answer: B
A) head to to exam
B) medical history **
C) incontinence
D) falls
An intubated trauma patient is being transferred to a tertiary care center. After moving the patient
to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is
the priority interventions?

Answer: D
A) call for a portable CXR stat
B) chest to make sure the ventilator is plugged in
C) suction the ET tube
D) confirm ET tube placement
What factor contributes most the kinetic energy of a body in motion?

answer: C
A) acceleration
B) mass
C) velocity ***
D) inertia
During the primary survey of an unconscious patient with multi-system trauma, the nurse notes
snoring respirations. Which priority nursing interventions should be performed next?

Answer: D
A) open the airway with the head-tilt/chin lift maneuver
B) auscultate bilateral breath sounds to assess ventilatory status
C) assist respirations using a BVM
D) insert an oropharyngeal airway if there is no gag reflex ***
Following a review of recent drills and a real disaster event, a hospital has identified deficiencies
and is taking steps to minimize the impact of future disaster. Which phase of the disaster life
cycle does this describe?

Answer: A
A) mitigation ***
B) preparedness
C) response
D) recovery
Which pulse pressure description is an indication of early hypovolemic shock?

Answer: B
A) widened
B) narrowed ***
C) bounding
D) weak

The most reassuring finding for a male patient with hop pain after a fall is which of the
following?

Answer: D
A) a normal prostate exam
B) absence of abdominal distension
C) a normal fast exam
D) pelvic stability ***
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic,
and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative
fast exam except which of the following?

Answer: A

The FAST exam is done at the bedside to identify pathological fluid in the abdominal and pelvic
cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be
repeated if clinical changes or hemodynamic changes occur. A negative FAST study does not
rule out injury and may warrant a follow-up computed tomography scan. Serial FAST exams can
identify increasing abdominal fluid collections from hemorrhage. Diagnostic peritoneal
lavage/diagnostic peritoneal aspiration is performed by the surgical team to rapidly identify the
presence of hemorrhage in patients who are hemodynamically unstable after trauma.
A) diagnostic peritoneal lavage ***
B) serial fast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments
Which of the following is an expected finding in a patient with a thoracostomy connected to a
chest drainage system?

Answer: D
A) output of 200 mL/hr
B) tubing clamp closed for transport
C) dependent loops in the tubing to promote drainage
D) fluctuations in the water serial chamber ***
Which of the following patients warrants referral to a burn center?

Answer: C
A) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
C) a 52-year old diabetic male with partial thickness burn to the left lower leg ***
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax.
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib
fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife
reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless,
with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms
commonly associated with which of the following conditions?

Answer: B
A) acute lung injury
B) fat embolism ***
C) PTX
D) pulmonary contusion
Which is the effect of hypothermia on the oxyhemoglobin dissociation curve?

Answer: A
A) Hemoglobin does not readily release oxygen for use by the tissues ***
B) The amount of oxygen available to the tissues increases
C) Tissue oxygenation (PaO2) increases
D) Hemoglobin molecule saturation (SaO2) decreases
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the
bicycle cross bars which performing an aerial BMX maneuver. Secondary assessment reveals
lower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurse
questions?

Answer: C
A) Fast exam
B) CT scan
C) straight cath for urine sample ***
D) ice and elevation of the scrotum
You are treating a 27-year old male in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should
you begin fluid resuscitation?

Answer: B
A) 1000 mL/hr
B) 500 mL/hr ***
C) 250 mL/hr
D) 125 mL/hr
Which of the following is possible complication of positive-pressure ventilation?

Answer: A
A) worsening pneumothorax
B) worsening flail chest
C) reabsorption of pleural air
D) negative intrapleural pressure
Which of the following is NOT considered goal-directed therapy of cardiogenic shock?

Answer: C
A) controlled fluid boluses
B) antidysrhythmic administration
C) pericardiocentesis ***
D) cardiac cath
What bedside monitoring parameters are used to assess for adequacy of oxygenation and
effectiveness of ventilation?

Answer: A
A) pulse oximetry and capnogaphy **
B) respiratory rate and capnography
C) pulse oximetry and respiratory rate
D) capnography and capnometry
Which if the following values indicates the need for alcohol withdrawal interventions?

Answer: A
A) CIWA-Ar of 36 ***
B) GCS 13
C) ETCo2 of 48 mm Hg
D) heart rate of 45 beats/min
An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored
respiratory, and dusky skin. the trauma team has administered medications for drug assisted
intubation and attempted intubation but was unsuccessful. What is the most appropriate
immediate next step?

Answer: A
A) Ventilate with a BVM ***
B) Prepare for cricothyroidotomy
C) administer reversal medications
D) contact anesthesia for assistance
The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better
visualization during the insertion of which device?

Answer: C
A) Intraosseous line
B) orogastric tube
C) ET tube ***
D) urinary catheter

You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of
your secondary survey include abd pain on palpation, fundal high at the costal margin, and some
dark bloody show. Varying, accelerations and decelerations are noted on the cardiotocography.
These findings are most consistent with which of the following?

Answer: A
A) placental abruption ***
B) preterm labor
C) uterine rupture
D) fetal demise