EMT Chapter 30

Which of the following is true regarding injury to the kidneys? Select one: A. Injury to the kidneys usually indicates injury to other organs. B. Only minimal force is needed to damage the kidneys. C. The kidneys are not well protected. D. Kidney injuries are rarely caused by blunt trauma.

A. Injury to the kidneys usually indicates injury to other organs.

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked? Select one: A. Shoulder fracture B. Pelvic fracture C. Lumbar spine fracture D. Femur fracture

A. Shoulder fracture

The mesentery is: Select one: A. a membranous fold that attaches the intestines to the walls of the body. B. a complex network of blood vessels that supply blood to the liver. C. the point of attachment between the small and large intestines. D. a layer of thick skeletal muscles that protects the abdominal organs.

A. a membranous fold that attaches the intestines to the walls of the body.

Abdominal pain, vomiting, and fever are most likely due to _______. Select one: A. infection B. hemorrhage C. evisceration D. hypovolemia

A. infection

The largest organ in the abdomen is the: A. liver B. spleen C. pancreas D. kidneys

A. liver

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: A. liver. B. spleen. C. kidney. D. stomach.

A. liver.

When worn properly, a seatbelt should lie: Select one: A. above the anterior posterior iliac spines of the pelvis and below the hip joints. B. below the anterior superior iliac spines of the pelvis and against the hip joints. C. across the abdominal wall at the level of the diaphragm and below the hip joints. D. across the abdominal wall at the level of the umbilicus and against the hip joints.

B. below the anterior superior iliac spines of the pelvis and against the hip joints.

Peritonitis usually occurs when: Select one: A. bacteria or viruses invade the walls of the gastrointestinal tract. B. hollow abdominal organs are damaged and spill their contents into the peritoneal cavity. C. solid abdominal organs bleed secondary to penetrating trauma. D. the vessels that supply the abdominal organs become inflamed.

B. hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.

Because the depth of an open abdominal wound is often difficult to determine: Select one: A. the abdomen must be vigorously palpated. B. prompt transport to the hospital is essential. C. vital signs should be monitored frequently. D. the EMT must perform a thorough exam.

B. prompt transport to the hospital is essential.

Early bruising following abdominal trauma often manifests as: Select one: A. dark-purple marks. B. red areas of skin. C. localized pain. D. gross distention.

B. red areas of skin.

You should suspect a kidney injury anytime the patient presents with _______. Select one: A. abdominal distention B. dyspnea C. a hematoma in the flank region D. nausea

C. a hematoma in the flank region

When treating a patient with an evisceration, you should: A. attempt to replace the abdominal contents B. cover the protruding organs with a dry, sterile dressing C. cover the protruding contents with moist, sterile gauze compresses

C. cover the protruding contents with moist, sterile gauze compresses

The presence of tachycardia following a significant abdominal injury: A. indicates a state of decompensated shock B. should be assumed to be a sign of shock C. is most commonly caused by severe pain D. is always accompanied by hypo tension

C. is most commonly caused by severe pain

When a hollow organ is punctured during a penetrating injury to the abdomen: Select one: A. the abdomen will become instantly distended. B. it commonly protrudes through the injury site. C. peritonitis may not develop for several hours. D. it will bleed profusely and rapidly cause shock.

C. peritonitis may not develop for several hours.

All of the following are hollow abdominal organs, EXCEPT the: Select one: A. ureters. B. stomach. C. spleen. D. bladder.

C. spleen.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes: Select one: A. requesting a paramedic to administer pain medication. B. covering the avulsion with moist, sterile dressings. C. administering 100% oxygen via a nonrebreathing mask. D. applying direct pressure with a dry, sterile dressing.

D. applying direct pressure with a dry, sterile dressing.

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: Select one: A. stomach. B. aorta. C. spleen. D. diaphragm.

D. diaphragm.

Accumulation of blood in the abdominal cavity will MOST likely cause: Select one: A. referred pain. B. nausea or vomiting. C. diffuse bruising. D. distention.

D. distention.

Contraction or tensing of the abdominal muscles in an effort to ease pain is called: Select one: A. referring. B. flexing. C. withdrawing. D. guarding.

D. guarding.

Which of the following organs would MOST likely bleed profusely when injured? Select one: A. Bladder B. Liver C. Stomach D. Intestine

B. Liver

Your presence is requested by law enforcement to assess a 33 year old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: A. arrange for a rape crisis center representative to speak with the patient. B. control any external bleeding, administer oxygen, and transport at once. C. visualize the vaginal area and pack the vagina with sterile dressings D. allow her to change her clothes and take a shower before you transport

B. control any external bleeding, administer oxygen, and transport at once.

When should you visually inspect the external genitalia on your patient? Select one: A. Only when ordered by medical direction B. Anytime the patient agrees to treatment and transport C. Always during the secondary assessment D. Only when there is a complaint of severe pain or other injury

D. Only when there is a complaint of severe pain or other injury

Which of the following statements regarding abdominal evisceration's is correct? A. Adherent material is preferred when covering an evisceration. B. The organs should be replaced carefully to avoid heat loss. C. Most evisceration's occur to the left upper quadrant D. The protruding organs should be kept warm and moist.

D. The protruding organs should be kept warm and moist.

Suspect kidney damage if the patient has a history or physical evidence of all of the following EXCEPT: A. an abrasion, laceration, or contusion in the flank B. a penetrating wound in the lower rib cage or the upper abdomen C. fractures on either side of the lower rib cage D. a hematoma in the umbilical region

D. a hematoma in the umbilical region

Injuries to the external male genitalia _______. Select one: A. usually result in permanent damage B. are often life-threatening C. frequently lead to hypovolemic shock D. are rarely life-threatening

D. are rarely life-threatening

Your documentation on a sexual assault victim should _______. Select one: A. include your opinion of the nature of the incident B. describe the status of the suspect(s) C. be subjective and summarize the crime D. be objective and factual

D. be objective and factual

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: Select one: A. begin documenting the call on the patient care form. B. perform a comprehensive secondary assessment. C. forgo the hospital radio report because of his condition. D. closely monitor him and reassess him frequently.

D. closely monitor him and reassess him frequently.

When a patient stiffens the muscles of the abdomen, it is known as _______. Select one: A. crepitus. B. distention. C. instability. D. guarding.

D. guarding.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: Select one: A. a ruptured spleen. B. rupture of a hollow organ. C. a severe liver laceration. D. intra-abdominal bleeding.

D. intra-abdominal bleeding.

In pediatric patients, the liver and spleen are _______. Select one: A. more protected by the thorax compared to adults B. smaller in proportion to the abdomen C. less likely to bleed when injured D. larger in proportion to the abdomen

D. larger in proportion to the abdomen

Placing a pregnant patient in a supine position during the third trimester of pregnancy: Select one: A. results in spontaneous urinary incontinence if the bladder is full. B. is recommended if the patient has severe abdominal discomfort. C. often causes hypotension secondary to cardiac compression. D. may decrease the amount of blood that returns to the heart.

D. may decrease the amount of blood that returns to the heart.