A patient presents to the Level I trauma center after being involved in a 70-car pile-up on Interstate 35. He has multiple injuries and was crushed between several cars. This is a life-threatening injury, and he has severe muscle trauma. What is your suspicion regarding the possible complications this patient might be experiencing? (Select all that apply)
Hydration to prevent kidney injury from myoglobin
Rhabdomyolysis
Electrolyte monitoring, especially for potassium, to manage the risk of hyperkalemia
Acute kidney injury (AKI)
Monitoring kidney function, including creatinine, BUN, and urine output
Correct Answer : B,C,D,E
Choice A reason: Hydration is a treatment, not a complication. Rhabdomyolysis, hyperkalemia, and AKI are complications of crush injuries, with kidney function monitoring essential. This describes an intervention, not a complication, so it’s incorrect.
Choice B reason: Rhabdomyolysis is likely from severe muscle trauma in a crush injury, releasing myoglobin and electrolytes, risking kidney damage. This matches the patient’s injury, making it a correct complication.
Choice C reason: Electrolyte monitoring, especially potassium, is critical due to hyperkalemia risk from muscle breakdown. This can cause arrhythmias, making it a correct selection for complications.
Choice D reason: Acute kidney injury (AKI) is common in rhabdomyolysis, as myoglobin damages kidneys. Given the crush injury, AKI is likely, making this a correct complication.
Choice E reason: Monitoring kidney function (creatinine, BUN, urine output) detects AKI from rhabdomyolysis. This ensures timely intervention, making it a correct choice for complications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Active lifestyle and community engagement are protective, not risk factors, for hip fractures. Small frame and age-related bone loss increase fracture risk, so this misidentifies beneficial factors as risks and is incorrect.
Choice B reason: Active lifestyle and social engagement may reduce risk, but the question asks for risk factors. Small frame and age-related bone loss are primary risks for Ms. Major’s fracture, so this is incorrect.
Choice C reason: Healthy diet and social support are protective, not risk factors. Ms. Major’s small frame and age (60) increase bone density loss, elevating fracture risk, so this is incorrect.
Choice D reason: Small frame and age-related bone density loss (at 60) increase Ms. Major’s hip fracture risk, as lower bone mass and aging weaken bones. These are key risk factors, making this correct.
Correct Answer is C
Explanation
Choice A reason: Wheezing is associated with lung conditions or left heart failure, not right-sided heart failure. Peripheral edema results from venous congestion in right heart failure, so this is incorrect.
Choice B reason: Vasospasms are linked to vascular conditions, not right-sided heart failure. Peripheral edema is a hallmark due to fluid backup, so this is incorrect for the manifestation.
Choice C reason: Peripheral edema, swelling in legs or ankles, is a primary manifestation of right-sided heart failure, caused by venous congestion from impaired right heart pumping. This is the correct choice.
Choice D reason: Tingling in extremities is neurological or vascular, not typical of right-sided heart failure. Peripheral edema is more characteristic, so this is incorrect for the manifestation.
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