You are triaging clients arriving at the hospital after a mass casualty. Which clients are correctly classified? (Select one, some or all that apply)

A 60-year-old male with an open fracture with distal pulses: yellow tag

A 33-year-old male unconscious with bilateral leg amputations: yellow tag

A 35-year-old female with severe chest pain red tag

An 8-year-old male with shortness of breath and chest bruises: green tag

A 55-year-old female with a scalp laceration: black tag

A 42-year-old male with full thickness body burns: green tag

Answer and Explanation

Correct Answer : A,C

Rationale:
A. A yellow (delayed) tag is appropriate because, although the injury is serious, the presence of distal pulses indicates adequate perfusion and no immediate life-threatening compromise. Treatment can be delayed without immediate risk to life.

B. This client is critically injured with a high risk of hemorrhagic shock and airway compromise. He requires immediate intervention and should be tagged red (immediate), not yellow.

C. Severe chest pain may indicate a life-threatening condition such as myocardial infarction or internal thoracic injury. Red tags are assigned to clients who require immediate care to survive.

D. Respiratory distress and chest trauma suggest potential life-threatening injury (e.g., pulmonary contusion). This client should be classified as red (immediate), not green (minor).

E. A scalp laceration, while it may bleed significantly, is generally not life-threatening if controlled. This client would more appropriately receive a green (minor) or possibly yellow tag, not black (expectant/deceased).

F. Full-thickness burns are severe, potentially life-threatening injuries that require urgent or emergent care depending on extent. This client would not be classified as green (minor) and would more likely be red or possibly black if injuries are unsurvivable.

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Correct Answer is ["A","B","D","E"]

Explanation

Rationale:
A. Spinal shock refers to a temporary loss of all neurologic activity (motor, sensory, and reflexes) below the level of spinal cord injury. Reflex activity is initially absent and gradually returns over hours to weeks, with the return of reflexes often signaling the end of spinal shock.

B. Neurogenic shock is a distributive type of shock caused by disruption of sympathetic pathways after a spinal cord injury, leading to unopposed parasympathetic activity and loss of autonomic control below the lesion.

C. Several of the statements (A, B, D, E) accurately describe spinal or neurogenic shock.

D. Spinal shock typically begins immediately or within minutes after acute spinal cord injury and may last days to weeks depending on severity.

E. Loss of sympathetic tone in neurogenic shock leads to vasodilation (causing hypotension), unopposed vagal tone (causing bradycardia), and impaired thermoregulation (leading to hypothermia). These features differentiate neurogenic shock from other forms of shock such as hypovolemic shock.

A. Associated with rotational deceleration forces with shearing B. No hemorrhagic lesions of the corpus callosum C. Axons undergo changes with eventual neuronal death D. Accounts for up to 20% of primary brain injuries

Correct Answer is A

Explanation

Rationale:

A. Diffuse axonal injury (DAI) is primarily caused by rotational or acceleration-deceleration forces, which produce shearing stress on axons. This mechanism disrupts axonal integrity, leading to widespread neuronal injury and is a hallmark feature of DAI.

B. DAI often involves microscopic or small hemorrhagic lesions in areas such as the corpus callosum, brainstem, and gray-white matter junction. The statement that there are no hemorrhagic lesions is false.

C. While this statement is true about the pathophysiology of DAI, the question asks which statement is true among false statements. This option is misleading without the context of mechanism. The primary defining feature is the shearing from rotational forces.

D. DAI is more common than 20%, accounting for a significant proportion of severe traumatic brain injuries, particularly those resulting from high-speed motor vehicle accidents. The exact prevalence varies by study but is generally higher than 20% in severe TBI populations.

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You are triaging clients arriving at the hospital after a mass casualty. Which clients are correctly classified? (Select one, some or all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Indicate the correct descriptions of spinal shock and neurogenic shock. (Select all that apply, one, some or all.)

Correct Answer is ["A","B","D","E"]

Explanation

All of the following are false of diffuse axonal injury except

Correct Answer is A

Explanation

A patient presents to the emergency department after an assault with a bat to his chest. Pulmonary contusion can lead to death due to which of the following mechanisms?

Emergency medical services (EMS) brings a large number of clients to the emergency department following a mass casualty incident. The nurse identifies the clients with which injuries with yellow tags? (Select one, some or all that apply)

What are the 5 guiding principles of Trauma-Informed Care? (Select all that apply)

Primary Survey in trauma includes all of the following except.

A 19-year-old male sustained a single gunshot wound (GSW) to the right neck. He was awake at the scene but unable to move his arms or legs. He was brought by EMS to the hospital. Exhibits Which of the following most accurately describes the patient's pulse of 52 and BP of 90/50?

A trauma client with multiple open wounds is brought to the emergency department in cardiac arrest. Which action should the nurse take prior to providing advanced cardiac life support?