Surgery Questions

A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale score is __, and the MOST appropriate treatment for him involves:A. 6, intubation hyperventilation at a rate of 20 breaths/min, two large-bore IV lines running wide open, keeping him warm, and maintaining his oxygen saturation at greater than 90%B. 7, intubation, ventilations performed at a rate of 12 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90mmHG, and maintaining his oxygen saturation at greater than 90%C. 9, high-flow oxygen via nonrebreathing mask, IV fluids as needed to maintain a systolic blood pressure of at least 100mmHg, monitoring his oxygen saturation, and administering 1.5 mg/kg of lidocaine to decrease intracranial pressureD. 8, ventilation assistance with a bag-mask device, a 2 L bolus of normal saline or lactated ringer solution, elevating his head 12inches, and hyperventilating him if his heart rate falls below 60 beats/min

Which of the following signs of a basilar skull fracture would MOST likely be observed in the prehospital setting?A. Battle's signB. Ecchymosis around the eyesC. Bruising over the mastoid processD. Cerebrospinal fluid drainage from the ear

Which of the following statements regarding the brainstem is correct?A. The brainstem is responsible for muscle coordinationB. All but 4 of the 12 cranial nerves exit the brainstemC. The brainstem provides protection to the cerebellumD. The brainstem connects the spinal cord to the brain

Positive babinski reflex is observed when the:A. Patient's reflexes are hyperactive in response to an external stimulusB. Patient responds to pain by flexing the arms and extending the legsC. Toes move upward in response to stimulation of the sole of the footD. Toes curve or move downward when the sole of the foot is touched

When assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's:A. Blood pressureB. Response to verbal stimuliC. Initial Glasgow Coma Scale scoreD. Level of consciousness

A subdural hematoma is classified as acute if clinical signs and symptoms develop:A. Within 24 hrs following the injuryB. Within 48 hrs following the injuryC. Within 36 hrs following the injuryD. Immediately following the injury

Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT:A. An underlying skull fractureB. A fluctuating level of consciousnessC. Unilateral hemiparesis or slurred speechD. Rapidly increasing intracranial pressure

Chronic subdural hematomas are MOST commonly seen in patients who:A. Are prone to hypoglycemiaB. Have alcoholismC. Have high cholesterolD. Are less than 2 years of age

Bleeding from a scalp laceration with an underlying skull deformity:A. Should be controlled with firm direct pressureB. Commonly causes severe shock in adultsC. Is limited due to the scalp's minimal vasculatureD. May contribute to hypovolemia in adults

A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include:A. Manually stabilizing his head and opening his airway with the jaw-thrust maneuverB. Rolling the patient onto his side as a unit and suctioning his mouth for 15sC. Applying a cervical collar and assisting his ventilations with a bag valve mask deviceD. Performing a tongue-jaw lift and looking in his mouth for any obvious obstructions

A diffuse axonal injury:A. Is a specific, grossly observable brain injury that can easily be diagnosed with a computer tomography scan of the headB. Involves stretching, shearing, or tearing of the extension neuron that conducts electrical impulses away from the cell bodyC. Results in severe stretching or tearing of the portion of the nerve cell that receives sensory messages from the rest of the bodyD. Is generally associated with better neurologic outcomes than a cerebral concussion because permanent brain damage does not occur

The innermost meningeal layer that rests directly on the brain and spinal cord is the:A. ArachnoidB. CortexC. Pia materD. Dura mater

Hyperventilation of the brain-injured patient:A. Has clearly demonstrated decreased mortality and morbidity in patients with a sever head injuryB. Is only appropriate if the patient is unresponsive and has bilaterally dilated and sluggishly reactive pupilsC. Shunts oxygen away from the brain and may result in decreased cerebral perfusion pressureD.

Which of the following statements regarding a cerebral concussion is correct?A. Concussions are usually not associated with structural brain injuryB. Prolonged loss of consciousness is common with a cerebral concussionC. A concussion results in permanent dysfunction of the cerebral cortexD. A cerebral concussion is a moderate focal brain injury

Early signs and symptoms of increased intracranial pressure include:A. Arm flexion and leg extensionB. Widening of the pulse pressureC. Headache and vomitingD. Hypertension and bradycardia

Deceberate posturing is characterized by:A. Inward flexion of the wrists and flexed kneesB. Extension of the arms and extension of the legsC. Flexion of the arms and extension of the legsD. Pulling in of the arms toward the core of the body

the nurse identifies a decrease in urine output in the postop pt and considers which of the following as a potential cause?

The nurse monitors the patient for which of the following major postop complication after an abd hysterectomy?

the nurse monitors the pts response to pain medications, especially opioid med such as morphine, for adverse effects. which of the following would reverse the effects of morphine?

the nurse is aware that signs and symptoms indicating a postop hemorrhage include which of the following?