A patient was an unrestrained driver in a frontal-impact motor vehicle collision. The nurse would expect which finding?
1. Unstable pelvic structure, causing severe pain on palpation
2. Neck muscle spasms caused by hyperextension of the neck
3. Paradoxical movement of the chest caused by multiple rib fractures
4. Unequal pulses in the lower extremities due to possible femur fracture
3
Rationale 1: Pelvic fractures are usually a result of frontal-impact collision when a seatbelt is worn.
Rationale 2: Hyperextension of the neck usually occurs in rear-end-impact collisions.
Rationale 3: If the driver has no seatbelt or the airbag does not deploy, the body might travel down and under the steering wheel or over the steering wheel, incurring injury at the body's point of impact. Thus, rib fractures are common and can result in flailed chest injuries.
Rationale 4: Femur fracture is possible but is not as likely as another injury.
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