Chapter 35

A patient suffering blunt trauma to the abdomen has a lacerated liver. Which of the following represents the most immediate threat to life? A) Pain B) Hemorrhage C) Peritonitis D) Infection

B) Hemorrhage

A middle-aged male has sustained blunt force trauma to the abdomen resulting in an isolated tear and perforation of the large intestine. When following up on the patient, which of the following should the EMT not suppose, given the organ that was injured? A) The patient has profound hypoxia. B) The patient rapidly decompensated into shock. C) The patient developed an infection. D) The patient suffered from severe internal bleeding.

C) The patient developed an infection.

If a patient has severe retroperitoneal bleeding from an organ located within this cavity, she has most likely injured her: A) Liver B) Stomach C) Large intestine D) Kidney

D) Kidney

The EMT has fundamental understanding of abdominal trauma when he states: A) "Blunt trauma tends to be more lethal than penetrating trauma because of the large number of organs affected." B) "Injury to the hollow organs tends to be worse than the solid organs because of the increased potential for blood loss." C) "Injury to the solid organs like the bladder tend to be more lethal than injury to of hollow organs." D) "Evisceation injuries can be recognized by dark-colored bruising over the top of the injury site."

A) "Blunt trauma tends to be more lethal than penetrating trauma because of the large number of organs affected."

You have arrived on the scene for a patient assaulted with a baseball bat. As you approach, which one of the following positions would seemingly indicate that he has suffered an injury to the abdomen? A) On his side with knees drawn to the chest B) Prone with hands on the back C) Supine with legs extended and toes pointed D) Standing with restless movement and pacing

A) On his side with knees drawn to the chest

Which one of the following injuries is most likely to cause peritonitis? A) Stab wound to the small intestine B) Blunt trauma to the spleen C) Bullet injury to the liver D) Contusion to the pancreas

A) Stab wound to the small intestine

The EMT recognizes that the division between the thoracic and abdominal cavities lies approximately: A) at the fifth intercostal space. B) at the level of the umbilicus. C) above the twelfth thoracic vertebra. D) below the twelfth rib.

A) at the fifth intercostal space.

You are assessing a young male patient who was assaulted with a baseball bat and struck once on the left upper quadrant of the abdomen. You would recognize that this patient has Kehr's sign when he makes which statement? A) "It really hurts for me to breathe." B) "My left shoulder is killing me!" C) "I am having a hard time breathing!" D) "My belly hurts really bad."

B) "My left shoulder is killing me!"

A confused unrestrained male struck the steering wheel with his abdomen. Currently, he is complaining of generalized abdominal pain and rates it a 6/10. Assessment indicates red marks across his lower abdomen caused by the steering wheel. His pulse is 140, respirations 18, blood pressure 108/88, and SpO2 at 94%. He looks pale with moist skin. Which of the following is most appropriate when providing oxygen to this patient? A) 8 liters per minute through a simple face mask B) 15 liters per minute through nonrebreather C) 2 liters per minute through a nasal cannula D) Oxygen can be withheld due to the SpO2 reading.

B) 15 liters per minute through nonrebreather

While cleaning a window, the glass broke and a sharp piece sliced the groin of a 43-year-old man. Assessment shows him to have a large laceration to his left scrotum, with a testicle exposed and protruding through the sac. Blood is pouring from the laceration and the patient rates the pain as an 8/10. Which of the following should be done first? A) Call for advanced life support assistance. B) Apply direct pressure to the injury. C) Cover the exposed testicle with moist dressing. D) Provide oxygen at 15 liters per minute.

B) Apply direct pressure to the injury.

On scene, you encounter a restless patient who has been stabbed in the right upper quadrant of the abdomen and now complains of abdominal pain and a dry mouth. Assessment reveals no immediate life threats to the airway or breathing. The radial pulse is rapid and weak, and the skin cool and diaphoretic. Vital signs are pulse, 124 beats/min; respirations, 20 breaths/min; blood pressure, 122/88 mmHg; and SpO2, 90% on room air. The injury is isolated, with no involvement of the head, neck, or back. In managing the scene and the patient, which observation would cause you to immediately intervene? A) An EMR placing the patient in a lateral recumbent position with the knees flexed B) Family giving the patient water to drink since he is thirsty C) An EMR placing his gloved hand over the injury to control the bleeding D) Application of supplemental oxygen

B) Family giving the patient water to drink since he is thirsty

A 45-year-old female was at a family reunion and fell off a trampoline. She hit a picnic table with the left side of her lower rib cage and is now very anxious and confused. Her airway is open and her breathing adequate. Her radial pulse is rapid and weak and her skin is cool and diaphoretic. Vital signs are: pulse 132, respirations 20, blood pressure 102/78 mmHg, and SpO2 97%. She has ecchymosis to the left lower rib area as well as tenderness and instability. She also has a superficial abrasion to her forehead. Given these findings, you would suspect and treat her for what condition? A) Spinal shock B) Hypovolemic shock C) Hypoxia D) Closed head injury

B) Hypovolemic shock

A patient has been stabbed in the right upper quadrant of the abdomen. Which organ or structure should the EMT be concerned with being injured? A) Spleen B) Liver C) Pancreas D) Small intestine

B) Liver

A patient has been shot in the abdomen. Assessment reveals that the bullet entered the body in the right upper quadrant and exited the lower right back. Given this finding, the EMT should assume which of the following organs may have been injured? A) Liver, gallbladder, right kidney, small intestine B) Liver, gallbladder, right kidney, small intestine, pancreas C) Liver, gallbladder, right kidney D) Liver, gallbladder

B) Liver, gallbladder, right kidney, small intestine, pancreas

The EMT has fundamental understanding of abdominal trauma when he states: A) "Evisceration injuries can be recognized by dark-colored bruising over the top of the injury site." B) "Injuries to hollow organs tend to be worse than injuries to solid organs because of the increased potential for blood loss." C) "Blunt trauma is especially lethal because of the large number of organs that can be affected." D) "Injuries to solid organs like the bladder tend to be more lethal than injuries to hollow organs."

C) "Blunt trauma is especially lethal because of the large number of organs that can be affected."

At the scene of a motor vehicle accident, a car has extensive front-end damage and a deformed steering wheel. The restrained driver, who was self-extricated, is in the care of EMRs, who have applied a cervical collar and continue to maintain spine motion restriction precautions. The patient's airway is patent and respirations adequate. His radial pulse is rapid and weak, and his skin is cool and diaphoretic. The EMRs report the following vital signs: pulse, 136 beats/min; respirations, 20 breaths/min; blood pressure, 100/68 mmHg; and SpO2, 95% with supplemental O2 being administered. The right forearm is deformed, and the head, chest, and upper back are uninjured according to your assessment. Your next action would be to: A) Repeat the vital signs B) Change the nonrebreather mask to a nasal cannula C) Check the abdomen for injury D) Start positive pressure ventilation

C) Check the abdomen for injury

A patient has suffered an abdominal evisceration. There is no evidence of spinal injury. How should you place the patient on the stretcher? A) Prone, to maintain pressure on the abdomen B) Lateral recumbent with legs extended C) Supine, with knees flexed to his chest D) Semi-Fowler's, to promote adequate breathing

C) Supine, with knees flexed to his chest

Which organ, if seriously injured, would cause the most rapid death? A) Stomach B) Large intestine C) Vena cava D) Spleen

C) Vena cava

You have been called for a male patient who has been shot. Assessment reveals an entrance wound to the left upper quadrant of the abdomen. An exit wound to the left upper back is also located. Which of the following should you do immediately? A) Cover the abdominal wound with saline-soaked gauze. B) Place a cervical collar on the patient. C) Auscultate the patient's breath sounds. D) Cover the exit wound with a gloved hand.

Cover the exit wound with a gloved hand.

You have been called for a 42-year-old male complaining of back pain. On scene, the man tells you that he was lying on the floor when his 5-year-old son unexpectedly jumped feet first onto his back. He gives a medical history of high blood pressure and asthma, for which he takes medications. As you assess the patient, which one of the following signs or symptoms provides the greatest indication that the patient has sustained an abdominal injury? A) Mild nausea B) Shortness of breath C) Bruise to his back D) Blood in his urine

D) Blood in his urine

A patient has referred pain to her left shoulder. Which of the following should the EMT suspect? A) Damage to the gallbladder B) Rupture of the small intestine C) Trauma to the right kidney D) Hemorrhage from the spleen

D) Hemorrhage from the spleen

While returning from a call, you are flagged down by a frantic family member of a 12-year-old male patient who reports him as being shot in the abdomen and inside the house in which she is standing. She states that the shooter is another family member who has since left the scene. What is your best course of action? A) Cautiously enter the house and be ready to vacate if any hazards are found. B) Go to the porch and have the patient brought to you. C) Carefully look for scene hazards and enter once you feel safe. D) Move the ambulance and wait for law enforcement to arrive.

D) Move the ambulance and wait for law enforcement to arrive.

You have been called for a deeply disturbed psychiatric patient who has cut off the tip of his penis with a steak knife. Assessment reveals the 31-year-old male to be crying, with blood noted to his hands and pants. The primary assessment reveals no life threats and Emergency Medical Responders are applying oxygen to the patient. At this time, your priority is to: A) place the amputated penis in sterile water. B) determine why the patient cut himself. C) prevent the patient from urinating. D) control the bleeding.

D) control the bleeding.

A patient with severe retroperitoneal bleeding from an organ located within this cavity, has most likely injured her: A) large intestine. B) stomach. C) liver. D) kidney.

D) kidney.

EMT care for an open chest wound and an abdominal evisceration are similar in that: A) air must be periodically released from both wounds. B) moist dressings are placed over both wounds. C) both wounds can cause the trapping of air in the body. D) occlusive dressings are placed over both wounds.

D) occlusive dressings are placed over both wounds.