In the event that an unrestrained passenger was injured in a frontal-impact collision, the nurse should assess for:
1. Paradoxical movement of the chest caused by multiple rib fractures.
2. Unstable pelvic structure causing severe pain on palpation.
3. Unequal pulses in the lower extremities due to possible femur fracture.
4. Neck muscle spasms caused by hyperextension of the neck.
Paradoxical movement of the chest caused by multiple rib fractures.
Rationale: If the passenger 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. Pelvic fractures are usually a result of frontal-impact collision when a seatbelt is being worn. Femur fractures may occur when motorcycles are involved in a collision. Hyperextension of the neck usually occurs in rear-end-impact collisions.
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