Chapter 28 EMT

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: a. a rapid deterioration of neurologic signs. b. a progressively lowering blood pressure. c. an acute increase in the patient's pulse rate. d. acute unilateral paralysis following the injury.

a. a rapid deterioration of neurologic signs.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: a. a rapid, thready pulse. b. widening pulse pressure. c. CSF leakage from the ears. d. decerebrate posturing.

a. a rapid, thready pulse.

A tight-fitting motorcycle helmet should be left in place unless: a. it interferes with your assessment of the airway. b. the patient must be placed onto a long backboard. c. the patient complains of severe neck or back pain. d. the helmet is equipped with a full face shield or visor.

a. it interferes with your assessment of the airway.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: a. pupillary constriction. b. increase in heart rate. c. shunting of blood to vital organs. d. dilation of the bronchiole smooth muscle.

a. pupillary constriction.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: a. slow. b. weak. c. rapid. d. irregular.

a. slow.

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? a. 2 b. 3 c. 4 d. 5

b. 3

Which of the following breathing patterns is MOST indicative of increased intracranial pressure? a. Increased rate with a normal inspiratory time and a prolonged expiratory time b. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea c. Increased rate and depth with the distinct odor of acetone on the patient's breath d. Slow, shallow, occasional gasps that progress to prolonged periods of apnea

b. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of: a. distraction. b. axial loading. c. hyperextension. d. hyperflexion.

b. axial loading.

The central nervous system (CNS) is composed of the: a. cerebellum and brain. b. brain and spinal cord. c. cerebrum and meninges. d. meninges and spinal cord.

b. brain and spinal cord.

The five sections of the spinal column, in descending order, are the: a. thoracic, cervical, lumbar, coccygeal, and sacral. b. cervical, thoracic, lumbar, sacral, and coccygeal. c. coccygeal, sacral, lumbar, thoracic, and cervical. d. cervical, coccygeal, thoracic, sacral, and lumbar.

b. cervical, thoracic, lumbar, sacral, and coccygeal.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: a. assist his ventilations with a BVM. b. suction his oropharynx for up to 15 seconds. c. immobilize his spine and transport immediately. d. pack his nostrils to stop the drainage of blood.

b. suction his oropharynx for up to 15 seconds.

The ideal procedure for moving an injured patient from the ground to a backboard is: a. the clothes drag. b. the four-person log roll. c. the use of a scoop stretcher. d. the direct patient carry.

b. the four-person log roll.

Which of the following statements regarding secondary brain injury is correct? a. It results from direct brain trauma following an impact to the head. b. Because cerebral edema develops quickly, it is considered to be a primary brain injury. c. Hypoxia and hypotension are the two most common causes of secondary brain injury. d. Signs are often present immediately after an impact to the head.

c. Hypoxia and hypotension are the two most common causes of secondary brain injury.

What part of the nervous system controls the body's voluntary activities? a. Central b. Sensory c. Somatic d. Autonomic

c. Somatic

Hyperextension injuries of the spine are MOST commonly the result of: a. falls. b. diving. c. hangings. d. compression.

c. hangings.

In contrast to a cerebral concussion, a cerebral contusion: a. does not cause pressure within the skull. b. results from a laceration to the brain tissue. c. involves physical injury to the brain tissue. d. usually does not cause a loss of consciousness.

c. involves physical injury to the brain tissue.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: a. the patient adamantly denies neck pain. b. lateral immobilization has been applied. c. it causes a problem managing the airway. d. sensory and motor functions remain intact.

c. it causes a problem managing the airway.

The Glasgow Coma Scale (GCS) is used to assess: a. mental status, eye opening, and respiratory rate. b. sensory response, pupil reaction, and heart rate. c. verbal response, eye opening, and mental status. d. eye opening, verbal response, and motor response.

d. eye opening, verbal response, and motor response.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: a. fractures to the internal structures of the ear following direct trauma. b. a linear skull fracture and a significant increase in intracranial pressure. c. significant pressure and bleeding in between the skull and dura mater. d. rupture of the tympanic membrane following diffuse impact to the head.

d. rupture of the tympanic membrane following diffuse impact to the head.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: a. an appropriately sized cervical collar has been applied. b. the patient has been secured to the ambulance stretcher. c. the head has been stabilized with lateral immobilization. d. the patient has been completely secured to the backboard.

d. the patient has been completely secured to the backboard.