During a robbery, a 54-year-old local Starbucks owner was hit on the head with a wooden bat and he lost consciousness.
Anterior fossa fracture
Basilar skull fracture
Cranial nerve entrapment
Epidural hematoma
The Correct Answer is B
Rationale:
A. While fractures of the anterior cranial fossa can cause frontal bone or orbital injuries, they do not typically produce clear fluid (CSF) drainage from the ear. CSF rhinorrhea is more characteristic of anterior fossa involvement, but otorrhea (ear drainage of clear fluid) points to a different site.
B. Basilar skull fractures involve the base of the skull and can result in CSF leakage from the ear (otorrhea) or nose (rhinorrhea), bruising behind the ears (Battle sign), and periorbital ecchymosis (raccoon eyes). The patient’s clear fluid from the right ear, multiple contusions on the head, and altered orientation are consistent with a basilar skull fracture, likely involving the temporal bone. This type of fracture can occur from blunt trauma to the head, such as being struck with a wooden bat.
C. While basilar fractures can injure cranial nerves, cranial nerve entrapment alone would not explain CSF drainage from the ear, contusions, and altered orientation. Cranial nerve deficits are usually specific neurologic deficits (e.g., facial droop, eye movement issues).
D. Epidural hematomas often present with a lucid interval, followed by rapid deterioration, and are typically associated with arterial bleeding, not CSF leakage. While this patient could develop an epidural hematoma, the hallmark sign of clear fluid from the ear specifically points to a basilar skull fracture, not an epidural hematoma.Top of FormBottom of Form
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. While these injuries are serious, they are not immediately life-threatening. The patient can generally wait for treatment without immediate risk of death, so they would likely be triaged yellow (delayed).
B. A closed clavicle fracture with mild neurologic symptoms is significant but not immediately life-threatening, so the patient would also be triaged yellow or green depending on mobility and stability.
C. A forehead contusion and epistaxis are usually minor injuries unless accompanied by altered consciousness or other complications. These patients are generally triaged green (minor).
D. Rib fractures combined with respiratory compromise such as shortness of breath indicate a potential life-threatening injury, such as flail chest or pulmonary contusion. These patients require immediate intervention to stabilize airway and breathing, making a red tag (immediate priority) appropriate.
Correct Answer is C
Explanation
Rationale:
A. This definition applies to Level IV or Level V Trauma Centers, which are typically smaller facilities focused on initial assessment, resuscitation, stabilization, and preparing patients for transfer to higher-level centers. While these centers play a critical role in early trauma management, they lack the full surgical and specialty services available at Level II centers.
B. Although some community hospitals may serve as lower-level trauma centers, Level II Trauma Centers are larger facilities equipped with specialized personnel and resources. They are capable of providing comprehensive care for seriously injured patients and do not rely primarily on transfer to higher-level centers for most trauma cases.
C. Level II Trauma Centers provide a broad range of services, including immediate resuscitation, emergency surgery, intensive care, orthopedic and neurosurgical interventions, and rehabilitation services. They are staffed with 24-hour availability of surgical specialists, critical care teams, and trauma-trained personnel. While they may not have the same research, education, or state-of-the-art technology emphasis as Level I centers, Level II centers are capable of delivering definitive trauma care for the majority of cases without requiring transfer.
D. This describes a Level I Trauma Center, which serves as a regional referral hub, supports trauma research, education, and prevention programs, and has the highest level of resources and specialist availability. Level II centers provide high-level clinical care but are not required to fulfill the academic, research, and regional leadership roles of Level I centers.
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