CCRN Multisystem Trauma and Shock 4

Question 1

A patient with crush injury to both legs is at highest risk for which life-threatening complication during reperfusion?

Accepted Answer

Hyperkalemia

Answer

Reperfusion of crushed muscle releases potassium, causing dangerous hyperkalemia and arrhythmias.

Question 2

Which finding in a patient with suspected abdominal compartment syndrome is most diagnostic?

Accepted Answer

Bladder pressure greater than 20 mmHg with organ dysfunction

Answer

Sustained intra-abdominal (bladder) pressure above 20 mmHg with new organ dysfunction confirms abdominal compartment syndrome.

Question 3

A trauma patient develops dark, tea-colored urine after a crush injury. Which complication should be suspected?

Accepted Answer

Rhabdomyolysis

Answer

Myoglobinuria from rhabdomyolysis produces tea-colored urine and can cause acute kidney injury.

Question 4

Which type of shock is characterized by a low systemic vascular resistance and a high cardiac output in its early phase?

Accepted Answer

Septic (distributive) shock

Answer

Early septic shock produces vasodilation with low SVR and a compensatory high cardiac output ('warm shock').

Question 5

What is the most appropriate initial fluid for resuscitation of acute hemorrhagic shock when blood products are not yet available?

Accepted Answer

Balanced crystalloid such as lactated Ringer's

Answer

Balanced isotonic crystalloids like lactated Ringer's are the initial fluid of choice while awaiting blood products.

CCRN Review Practice Test