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

Answer and Explanation

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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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Nasal mucosa is a portal of entry for cold viruses, not the primary source of spread. Sneezing propels virus-laden droplets, infecting others, making it the greatest spread mechanism, so this is incorrect for the source.

Choice B reason: Conjunctival surfaces can be an entry point but are not the main source of spread. Sneezing disperses viruses widely through respiratory droplets, driving transmission, so this is incorrect for the greatest source.

Choice C reason: Sneezing is the greatest source of cold virus spread, as it releases aerosolized droplets containing viruses, infecting others via inhalation or surface contact. This is the primary transmission mode, making it the correct choice.

Choice D reason: Fingers spread viruses via fomites, but sneezing generates more widespread droplet transmission. Hand contact is secondary to respiratory spread, so this is incorrect for the greatest source of cold virus spread.

A. Nerve damage from the prosthetic B. Heart attack referred pain C. Muscle strain in the remaining part of the arm D. Phantom limb pain

Correct Answer is D

Explanation

Choice A reason: Nerve damage from the prosthetic may cause local discomfort, but pain in the entire absent arm suggests phantom limb pain. This is less likely than neural misfiring, so it’s incorrect.

Choice B reason: Heart attack referred pain typically affects the left arm but is unlikely in a prosthetic limb. Phantom limb pain explains pain in the absent arm, so this is incorrect.

Choice C reason: Muscle strain affects existing muscles, not a prosthetic arm. Phantom limb pain, from neural signals in the brain, explains pain in the missing limb, so this is incorrect.

Choice D reason: Phantom limb pain occurs when the brain perceives pain in an amputated limb, common in prosthetic users. This matches Mr. Jones’s pain in his prosthetic arm, making it correct.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Mr. Jones presents to the clinic with extreme pain in his left arm. During your assessment, you notice that he has a prosthetic left arm (from the shoulder down). What explanation can you provide for Mr. Jones reporting extreme pain in his left arm?

Correct Answer is D

Explanation

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