A patient is admitted to the ED after being involved in a motor vehicle crash. The patient has multiple injuries. After establishing an airway and adequate ventilation, the ED team should prioritize what aspect of care?

Control the patient's hemorrhage.

Assess for cognitive effects of the injury.

Splint the patient's fractures.

Assess the patient's neurologic status.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Control the patient’s hemorrhage is correct because, after ensuring airway and ventilation, circulation is the next priority in trauma care. Uncontrolled bleeding can quickly lead to hypovolemic shock and death, making hemorrhage control life-saving and time-sensitive.

B. Assessing for cognitive effects of the injury is incorrect at this stage because neurologic assessment is important but comes after airway, breathing, and circulation are stabilized. Cognitive assessment alone does not prevent immediate death from hemorrhage.

C. Splinting the patient’s fractures is incorrect because although immobilization prevents further injury and pain, it is secondary to controlling life-threatening bleeding.

D. Assessing the patient’s neurologic status is incorrect because, while the neurologic assessment is part of the secondary survey, life-threatening conditions such as uncontrolled hemorrhage take priority in the initial management of trauma.

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Correct Answer is C

Explanation

Rationale:
A. Controlled bleeding of facial and head lacerations is incorrect because while facial lacerations require care, the bleeding is controlled and there is no airway compromise, making it a lower priority than life-threatening injuries.

B. Open femur fracture with controlled bleeding is incorrect because even though femur fractures can lead to significant blood loss, the bleeding is controlled, and the patient is hemodynamically stable, so airway or circulation threats take priority.

C. Tension pneumothorax is correct because it is a life-threatening emergency. Signs include respiratory distress, hypotension, absent breath sounds on the affected side, and distended neck veins. Immediate intervention with needle decompression followed by chest tube placement is required to prevent cardiac arrest and death.

D. Pneumothorax is incorrect because a simple pneumothorax may be serious but is usually less immediately life-threatening than a tension pneumothorax. It can often be monitored and treated after emergent life-threatening conditions are addressed.

A. Hypovolemia B. Difficulty breathing C. Cardiovascular overload D. Pulmonary edema E. Hypoglycemia

Correct Answer is ["B","C","D"]

Explanation

Rationale:
A. Hypovolemia is incorrect in this context because the patient is receiving fluid replacement. While hypovolemia is the initial problem in many types of shock, the question focuses on complications of fluid therapy, not the underlying shock itself.

B. Difficulty breathing is correct because rapid or excessive fluid administration can lead to fluid overload, which increases pulmonary vascular pressure and can cause dyspnea.

C. Cardiovascular overload is correct because excessive fluid replacement can result in volume overload, leading to hypertension, tachycardia, jugular venous distention, and strain on the heart, particularly in patients with preexisting cardiac conditions.

D. Pulmonary edema is correct because fluid replacement complications can cause fluid accumulation in the alveoli, leading to impaired gas exchange, crackles on auscultation, hypoxia, and respiratory distress.

E. Hypoglycemia is incorrect because fluid replacement with crystalloids does not directly cause hypoglycemia. Hypoglycemia may occur in critically ill patients for other reasons, such as sepsis or insulin therapy, but it is not a typical complication of fluid resuscitation.

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A patient is admitted to the ED after being involved in a motor vehicle crash. The patient has multiple injuries. After establishing an airway and adequate ventilation, the ED team should prioritize what aspect of care?

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Naxlex Comprehensive Predictor Exams

Four victims of an automobile crash are brought by ambulance to the emergency department. The triage nurse determines that the victim who has the highest priority for treatment is the one with

Correct Answer is C

Explanation

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Correct Answer is ["B","C","D"]

Explanation

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