Chapter 28 Head And Spine Injuries

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

Chapter 28, page 1000, Patient Assessment The correct answer is: a rapid deterioration of neurologic signs.

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: Select one: A. suction his oropharynx for up to 15 seconds. B. immobilize his spine and transport immediately. C. assist his ventilations with a BVM. D. pack his nostrils to stop the drainage of blood.

Chapter 28, page 1001, Emergency Medical Care of Head Injuries The correct answer is: suction his oropharynx for up to 15 seconds.

The ideal procedure for moving an injured patient from the ground to a backboard is: Select one: A. the direct patient carry. B. the four-person log roll. C. the clothes drag. D. the use of a scoop stretcher.

Chapter 28, page 1007, Preparation for Transport The correct answer is: the four-person log roll.

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

Chapter 28, page 1017, Emergency Medical Care of Spinal Injuries The correct answer is: the patient has been completely secured to the backboard.

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

Chapter 28, page 1018, Helmet Removal The correct answer is: it interferes with your assessment of the airway.

The central nervous system (CNS) is composed of the: Select one: A. brain and spinal cord. B. meninges and spinal cord. C. cerebellum and brain. D. cerebrum and meninges.

Chapter 28, page 981, Anatomy and Physiology The correct answer is: brain and spinal cord.

What part of the nervous system controls the body's voluntary activities? Select one: A. Sensory B. Somatic C. Autonomic D. Central

Chapter 28, page 984, Anatomy and Physiology The correct answer is: Somatic

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: Select one: A. dilation of the bronchiole smooth muscle. B. pupillary constriction. C. shunting of blood to vital organs. D. increase in heart rate.

Chapter 28, page 984, Anatomy and Physiology The correct answer is: pupillary constriction.

The five sections of the spinal column, in descending order, are the: Select one: A. cervical, thoracic, lumbar, sacral, and coccygeal. B. thoracic, cervical, lumbar, coccygeal, and sacral. C. cervical, coccygeal, thoracic, sacral, and lumbar. D. coccygeal, sacral, lumbar, thoracic, and cervical.

Chapter 28, page 985, Anatomy and Physiology The correct answer is: cervical, thoracic, lumbar, sacral, and coccygeal.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: Select one: A. a rapid, thready pulse. B. widening pulse pressure. C. CSF leakage from the ears. D. decerebrate posturing.

Chapter 28, page 986, Head Injuries The correct answer is: a rapid, thready pulse.

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

Chapter 28, page 987, Head Injuries The correct answer is: rupture of the tympanic membrane following diffuse impact to the head.

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

Chapter 28, page 988, Head Injuries The correct answer is: Hypoxia and hypotension are the two most common causes of secondary brain injury.

Which of the following breathing patterns is MOST indicative of increased intracranial pressure? Select one: A. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea B. Increased rate with a normal inspiratory time and a prolonged expiratory time 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

Chapter 28, page 989, Head Injuries The correct answer is: Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Hyperextension injuries of the spine are MOST commonly the result of: Select one: A. compression. B. diving. C. falls. D. hangings.

Chapter 28, page 991, Spine Injuries The correct answer is: hangings.

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: Select one: A. hyperflexion. B. axial loading. C. distraction. D. hyperextension.

Chapter 28, page 992, Patient Assessment The correct answer is: axial loading.

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

Chapter 28, page 994, Patient Assessment The correct answer is: it causes a problem managing the airway.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: Select one: A. irregular. B. weak. C. rapid. D. slow.

Chapter 28, page 995, Patient Assessment The correct answer is: slow.

The Glasgow Coma Scale (GCS) is used to assess: Select one: A. sensory response, pupil reaction, and heart rate. B. eye opening, verbal response, and motor response. C. mental status, eye opening, and respiratory rate. D. verbal response, eye opening, and mental status.

Chapter 28, page 997, Patient Assessment The correct answer is: eye opening, verbal response, and motor response.

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? Select one: A. 5 B. 2 C. 4 D. 3

Chapter 28, page 998, Patient Assessment The correct answer is: 3

In contrast to a cerebral concussion, a cerebral contusion: Select one: A. does not cause pressure within the skull. B. usually does not cause a loss of consciousness. C. involves physical injury to the brain tissue. D. results from a laceration to the brain tissue.

Chapter 28, pages 990-991, Head Injuries The correct answer is: involves physical injury to the brain tissue.