A 23-Year-Old Man Was Extricated from His Vehicle Following a Motor

question 447

Multiple Choice

A 23-year-old man was extricated from his vehicle following a motor vehicle collision in which he was the unrestrained driver.  The patient was found unresponsive at the scene and intubated by paramedics.  He received 2.5 L of normal saline over 20 minutes en route to the emergency department.  His medical history is not known.  At the emergency department, blood pressure is 70/30 mm Hg and pulse is 120/min.  The patient responds to strong vocal and tactile stimuli by opening his eyes.  Pupils are equal and reactive to light.  There are multiple bruises over the anterior chest and upper abdomen.  Neck veins are flat, trachea is midline, and extremities are cold.  The abdomen is mildly distended.  Cardiac monitoring shows sinus tachycardia.  Which of the following is most likely to be seen in this patient?

• A)Diastolic collapse with elevated right ventricular pressure
• B)Dilated left ventricle with apical hypokinesis
• C)Inferior vena cava engorgement
• D)Right ventricular dilation and hypokinesis
• E)Small left ventricular cavity volume with ejection fraction of 75%

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Definitions:

Medical Diagnosis

The process of determining which disease or condition explains a person's symptoms and signs.

Boundary Violation

An infringement or breach of a set limit, often referring to inappropriate behaviors in professional or personal settings.

Staff Nurse

A registered nurse responsible for providing patient care within a healthcare setting.

Client

In healthcare, this refers to a person who is under the care or treatment of a professional or an institution.