CCRN - Review Multisystem Trauma and Shock Questions and Answers

Question 1

A 34-year-old male is admitted to the ICU after a high-speed motor vehicle collision.
The patient is intubated, has bilateral chest tubes, and an external fixator on a fractured pelvis.
Initial labs show a pH of 7.18, a temperature of 35.1°C (95.2°F), and an INR of 2.1.
The nurse recognizes these findings as components of which critical condition in trauma?

Accepted Answer

The Trauma Triad of Death

Answer

Disseminated Intravascular Coagulation (DIC)

Answer

Systemic Inflammatory Response Syndrome (SIRS)

Answer

Multiple Organ Dysfunction Syndrome (MODS)

Question 2

A patient arrives in the ICU after a severe crush injury to both lower extremities. The urine is dark reddish-brown, and the serum Creatine Kinase (CK) level is 65,000 U/L. Which of the following interventions is the highest priority to prevent a common, life-threatening complication of this condition?

Accepted Answer

Initiating aggressive intravenous fluid resuscitation

Answer

Administering sodium polystyrene sulfonate

Answer

Preparing the patient for emergent fasciotomy

Answer

Applying a warming blanket to correct hypothermia

Question 3

A 25-year-old patient with a C4 spinal cord injury is hypotensive with a blood pressure of 82/46 mmHg and a heart rate of 50 bpm. The skin is warm and dry. Which type of shock is most consistent with this clinical presentation?

Accepted Answer

Neurogenic Shock

Answer

Cardiogenic Shock

Answer

Hypovolemic Shock

Answer

Anaphylactic Shock

Question 4

A patient with blunt abdominal trauma has received 12 units of packed red blood cells, 8 units of fresh frozen plasma, and 2 units of platelets. The nurse notes the development of a prolonged QT interval on the cardiac monitor and new-onset muscle tremors. Which electrolyte imbalance should the nurse suspect?

Accepted Answer

Hypocalcemia

Answer

Hyperkalemia

Answer

Hypermagnesemia

Answer

Hyponatremia

Question 5

A critical care nurse is caring for a patient who underwent an emergency laparotomy for a ruptured spleen. Over the past two hours, the nurse notes the patient's abdomen is becoming increasingly tense and distended, peak airway pressures are rising, and urine output has dropped to less than 10 mL/hr despite adequate MAP. These findings are most indicative of what complication?

Accepted Answer

Abdominal Compartment Syndrome

Answer

Septic shock

Answer

Hemorrhagic shock

Answer

Acute mesenteric ischemia

Question 6

A patient is admitted to the ICU with multiple stab wounds to the chest. The patient is hypotensive (BP 80/55 mmHg), tachycardic (HR 130 bpm), has muffled heart sounds, and pronounced jugular venous distention (JVD). A bedside ultrasound reveals fluid in the pericardial sac. Which type of shock is this patient experiencing?

Accepted Answer

Obstructive Shock

Answer

Distributive Shock

Answer

Hypovolemic Shock

Answer

Cardiogenic Shock