Chapter 30 questions

A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his: A. liver B. kidney C. bladder D. spleen

B

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: A. covering him with a warm blanket. B. giving him small sips of plain water. C. promptly transporting to the hospital. D. administering supplemental oxygen.

B

According to the US Department of Justice's National Crime Victimization Survey, there are ______________ victims (age 12 years or older) of rape and sexual assault each year. A. 478,722 B. 293,066 C. 512,466 D. 325,415

B

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should: A. open the patient's airway. B. apply direct pressure to the wound. C. apply oxygen via nonrebreathing mask. D. ventilate the patient with a BVM.

B

Most of the ________ system lies behind the digestive tract. A. reproductive B. urinary C. endocrine D. peripheral nervous

B

What is the purpose of wrapping a sexual assault victim in a burn sheet? A. to protect the patient's privacy B. to preserve potential evidence C. to maintain body temperatures as a result of shock D. to keep the patient calm (swaddling)

B

When a patient either consciously or unintentionally stiffens the muscles of the surface of the abdomen in response to abdominal pain, it's called: A. rebound pain B. guarding C. stiffening D. rigidity

B

Where is abdominal injury most likely to occur in young children? A. fractured ribs B. liver C. gallbladder D. appendix

B

Which of the following is NOT something you should do when treating injuries involving external male genitalia? A. Make the patient as comfortable as possible B. If possible, remove impaled instruments or foreign bodies from the urethra C. Apply direct pressure with dry, sterile gauze dressings D. If possible, take avulsed parts to the hospital in a labeled bag

B

Which of the following statements regarding trauma during pregnancy is correct? A. Uterine trauma in the pregnant patient rarely leads to severe bleeding. B. Uterine trauma is likely to cause shock in the pregnant patient. C. Uterine blood supply is greatly reduced during pregnancy. D. The uterus serves as a reservoir for blood supply during pregnancy.

B

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: A. perform a head-to-toe assessment while she is in the car. B. lift the air bag and look for deformity to the steering wheel. C. carefully assess her upper chest for seatbelt-related injuries. D. extricate her immediately and transport to a trauma center.

B

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if: A. the patient is conscious. B. law enforcement is at the scene. C. there are other patients involved. D. the severity of the injury is known.

B

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: A. transport only if signs of shock begin to develop. B. carefully probe the wound to determine its depth. C. assume that the arrow injured an internal organ. D. clean the wound and apply a dry, sterile dressing.

C

A common finding during assessment of patients with an injured liver is: A. the patient will want to remain upright B. referred pain to the left shoulder C. referred pain to the right shoulder D. bruises in the flank

C

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for: A. external genitalia injury. B. a lacerated liver or spleen. C. blunt injury to the kidney. D. a ruptured urinary bladder.

C

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should: A. cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage. B. gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing. C. cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket. D. make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.

C

Abdominal rigidity and periumbilical bruising are signs of _______. A. infection B. umbilical trauma C. internal bleeding D. intestinal blockage

C

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: A. air bag deployment. B. failure to wear seatbelts. C. a poorly placed lap belt. D. rapid vehicle deceleration.

C

The temporary wound channel caused by high-velocity weapons is called _______. A. ballistics B. projectile C. cavitation D. wound cycling

C

What is a very common early sign of a significant abdominal injury? A. Changes in mental status B. Decreased blood pressure C. Tachycardia D. Shock

C

When treating a patient whose foreskin has gotten caught in more than a few teeth of a zipper, you should: A. ice the area B. All of these answers are correct C. cut the zipper out of the pants D. apply sterile saline solution

C

Which of the following is an indication of a spleen injury? A. referred right shoulder pain B. hematuria C. referred left shoulder pain D. radiating pain from left upper quadrant down through the flank

C

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? A. Pancreas B. Fallopian tubes C. Urinary bladder D. Liver or spleen

C

Which of the following statements regarding rebound tenderness is correct? A. It should be assessed for by vigorously palpating the abdomen. B. Rebound tenderness is a specific sign found with a spleen injury. C. It is often discovered when the patient is jarred or moved suddenly. D. The absence of rebound tenderness rules out intra-abdominal injury.

C

Which of the following symptoms is NOT one of the first signs of peritonitis? A. Severe abdominal pain B. Muscle spasm C. Diarrhea D. Tenderness

C

Which organs are at risk of injury from falls, particularly in geriatric patients? A. Stomach, pancreas, and small intestine B. Spleen, adrenal gland, and kidney C. Aorta, spleen, and liver D. Inferior vena cava, urinary bladder, and pancreas

C

You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will they MOST likely prefer to assume? A. On his right side B. Sitting up C. Legs drawn up D. Legs outstretched

C

You should have an index of suspicion that a patient with pain referred to the right shoulder has an injury to which organ? A. Kidney B. Intestine C. Liver D. Bladder

C

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him? A. What does your blood pressure normally run? B. Do you take any over-the-counter medications? C. Has blood soaked through your undergarments? D. Have you experienced recent abdominal trauma?

D

Damage to solid organs typically leads to _______. A. sepsis B. fever C. hypertension D. hemorrhage

D

During the second assessment in a patient with spinal injury, what can you do to help alleviate tension in the abdominal wall? A. Administer fluids B. Provide an analgesic C. Place a towel under his or her lower back D. Place blankets and pillows under his or her knees

D

During the secondary assessment of a patient with a genitourinary injury, if there is significant trauma, what should you do FIRST? A. Palpate for tenderness B. Obtain the patient's vital signs C. Inspect the region for deformities D. Look for DCAP-BTLS

D

Following a motorcycle accident in which a patient collided with a tree and sustained multiple injuries, you notice the presence of blood at the urethral opening. What does this suggest? A. Massive kidney injury B. A ruptured gallbladder C. A fractured spleen D. A ruptured bladder

D

How should you place a woman who is in her third trimester of pregnancy on a backboard? A. Supine B. On her right side C. Sitting up D. On her left side

D

If the patient who was raped or assaulted will tolerate being wrapped in a sterile burn sheet, what might the investigators find left behind from the alleged offender? A. Fiber B. Fluid C. Hair D. All of these answers are correct

D

In the second and third trimesters of pregnancy, the incidence of injury to the _______________ is increased by displacement of the uterus. A. endometrium B. urethra C. ovaries D. urinary bladder

D

In which position should a patient who has sustained a blunt abdominal injury be placed on the backboard? A. Semi-Fowler's B. Lateral C. Prone D. Supine

D

Management of evisceration injuries includes _______. A. keeping the injury cool and dry B. applying firm, direct pressure C. closing the injury with duct tape D. keeping the injury moist and warm

D

The uterus, ovaries, and fallopian tubes are: A. found in the retroperitoneal space B. part of the external genitalia C. prone to injury, because they lie close to the surface D. rarely damaged

D

What is the major cause of death following injury to a hollow organ in the abdomen? A. evisceration B. rigidity C. Internal hemorrhage D. sepsis

D

When documenting a call involving a female patient who was sexually assaulted, the EMT should: A. theorize as to why the sexual assault occurred. B. include the results of his or her internal vaginal exam. C. include a description of the suspected perpetrator. D. avoid speculation and document only factual data.

D

When treating a trauma patient with an abdominal injury, what should you do if you suspect shock? A. Evaluate the patient's temperature B. Evaluate the patient's pulse C. Evaluate the patient's skin color D. All of these answers are correct

D

Which of the following signs would indicate that an injury to the kidney has occurred? A. hemoptysis B. hematoma C. hematemesis D. hematuria

D

Which two bodily functions are controlled by the genitourinary system? A. Regulation of metabolism and circulation of blood throughout the body B. Protection against disease and infection and the break down of food C. Control of voluntary and involuntary actions; involved in the production of blood cells and storage of calcium D. Reproduction and waste discharge

D

A patient who has sustained a blunt abdominal injury should be log rolled to a supine position onto a backboard. True False

True

A very common early sign of a significant abdominal injury is tachycardia. True False

True

Free air in the peritoneal cavity is abnormal and indicates that a hollow organ or loop of bowel has perforated. True False

True

You should allow patients with peritonitis to lie still with their legs drawn up. True False

True

A sign of kidney damage following blunt trauma is: A. hematuria. B. hemoptysis. C. hematemesis. D. hematochezia.

A

Abdominal distention or swelling can sometimes be the result of _______________ from the bowel or infection. A. air B. pus C. water D. blood

A

All of the following are common associated complaints with genitourinary injuries EXCEPT: A. abdominal tenderness B. nausea C. blood in the urine D. absence of the need to void

A

Bruising over the right upper quadrant could indicate injury to which of the following? A. Liver B. Kidney C. Colon D. Appendix

A

Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include: A. applying an occlusive dressing, secured by trauma dressings B. applying the PASG to stop the associated bleeding C. placing dry towels over the open wound D. cleaning the exposed bowel with sterile saline

A

The term hematuria is defined as: A. blood in the urine B. urinary bladder rupture C. blood in the stool D. vomiting in the blood

A

What is another name for the distal end of the descending colon? A. Appendix B. Transverse colon C. Duodenum D. Spleen

A

What is the most common mechanism of injury in geriatric patients? A. Falls B. Motor vehicle accidents C. Assaults D. Suicide

A

Which of the following are considered solid organs? A. pancreas and spleen B. kidneys and bladder C. liver and intestines D. spleen and stomach

A

Which of the following organs is a solid organ? A. Kidney B. Ureter C. Urethra D. Urinary bladder

A

Which of the following organs would be the MOST likely to bleed profusely if severely injured? A. Liver B. Gallbladder C. Stomach D. Kidney

A

Which of the following parts of the female genitalia is NOT contained within the pelvis? A. Vulva B. Ovaries C. Fallopian tubes D. Cervix

A

Which of the following statements is true? A. The higher the velocity of a projectile, the larger the cavity it produces. B. Low-velocity injuries produce extensive temporary wound channels. C. The velocity of an object is not a critical determination in your assessment. D. There are four levels of velocity.

A

You are assessing a patient who reports pain that is tearing and describes it as going from the abdomen posteriorly. What should you suspect? A. dissecting abdominal aneurysm B. kidney damage C. ruptured appendix D. gallbladder inflammation

A

You are called to respond to a rape at a local mall parking lot. Which of the following would NOT be proper treatment in dealing with this situation? A. Place the evidence in a plastic bag B. Make sure the EMT is the same gender as the patient C. Wrap the patient in a sterile burn sheet to preserve any evidence D. Document history, assessment, and treatment in great detail, only using objective information

A

what percentage of all trauma patients have some form of genitourinary injury? A. 10% B. 5% C. 25% D. 15%

A

Which of the following is true about injuries to the kidneys? A. A penetrating wound that reaches the kidneys almost always involves other organs. B. A sign of kidney damage is hematuria. C. An indication of kidney injury is bruising to the left upper quadrant. D. Injuries are unusual because the kidneys are well protected.

A and B