EMT Chapter 31 - Abdominal & Genitourinary

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

C

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

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

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 heart rate is elevated. 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

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

A

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

A

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

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

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

A

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

When caring for a female with trauma to the external genitalia, the EMT should: A. use local pressure to control bleeding. B. carefully pack the vagina to reduce bleeding. C. remove any impaled objects from the vagina. D. cover any open wounds with moist, sterile dressings.

A

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

While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find: A. a deformed steering wheel. B. that the airbags deployed. C. a crushed instrument panel. D. damage to the lower dashboard.

A

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, 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

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

Compression injury is most likely due to which of the following?Select one: A. Stabbing B. Improperly placed lab belt C. Hollow-organ rupture D. Ejection of unrestrained driver

B

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

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

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

B

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

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

B

Which of the following statements regarding abdominal trauma is MOST correct? A. Most of the vital abdominal organs lie within the retroperitoneal space. B. The absence of abdominal pain does not rule out intra-abdominal bleeding. C. The liver is well-protected and is rarely injured during a traumatic event. D. Hollow abdominal organs are vascular and bleed profusely when injured.

B

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should: A. perform a rapid trauma assessment while she is in the car. B. lift the airbag 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 by her boyfriend. While en route to the scene, you should ask the dispatcher if: A. the patient is conscious or not. B. law enforcement is at the scene. C. there are other patients involved. D. the severity of the injury is known.

B

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

B

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

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. spleen. C. kidney. D. bladder.

C

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

Airbags, in conjunction with properly worn seatbelts, are of MOST benefit when a person is involved in a: A. rollover crash. B. lateral collision. C. head-on crash. D. rear-end collision.

C

All of the following are signs of a significant abdominal injury, EXCEPT: A. tachycardia. B. hypotension. C. localized pain. D. diffuse bruising.

C

Even when seatbelts are worn properly and the airbags deploy, injury may occur to the: A. chest. B. extremities. C. iliac crests. D. lower ribcage.

C

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

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

C

Which of the following statements regarding intra-abdominal bleeding is FALSE? A. Intra-abdominal bleeding often causes abdominal distention. B. Intra-abdominal bleeding is common following blunt force trauma. C. The absence of pain and tenderness rules out intra-abdominal bleeding. D. Bruising may not occur immediately following blunt abdominal trauma.

C

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 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

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

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

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

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

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

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

It can be difficult to assess the severity of injuries to the genitourinary system following sexual assault because: A. the police must collect evidence before you begin care. B. the patient typically minimizes the pain or discomfort. C. patients generally prefer to remain in a prone position. D. patients may be hesitant to allow you to examine them.

D

The mesentery is/are: A. the point of attachment between the small and large intestines. B. layers of thick skeletal muscles that protect the abdominal organs. C. a complex network of blood vessels that supply blood to the liver. D. membranous folds that attach the intestines to the walls of the body.

D

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

D

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

D

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

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

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:Select one: A. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. B. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. C. perform a comprehensive secondary assessment to determine why his clinical status has changed. D. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.

D

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

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

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

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. placing dry towels over the open wound. B. cleaning the exposed bowel with sterile saline. C. applying the PASG to stop the associated bleeding. D. applying an occlusive dressing, secured by trauma dressings.

D

Peritonitis would MOST likely result following injury to the: A. liver. B. spleen. C. kidney. D. stomach.

D

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

D

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

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 30-year-old male has a large laceration to his right lower abdominal quadrant with a loop of bowel protruding through the wound. When treating this patient, the EMT-B should recall that the: A. protruding bowel should be kept warm and moist. B. open abdomen rapidly draws heat into the wound. C. wound should be covered with a dry, sterile dressing. D. bowel should be replaced in order to avoid infection.

A

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 BP is 98/58 mm Hg, pulse is 130 beats/min, and respirations are 24 breaths/min. You should: A. visualize the vaginal area and pack the vagina with sterile dressings. B. allow her to change her clothes and take a shower before you transport. C. arrange for a rape crisis center representative to speak with the patient. D. control any external bleeding, administer oxygen, and transport at once.

D