EMTB CH 28 HW and Quiz Questions

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) Has blood soaked through your undergarments? b) What does your blood pressure normally run? c) Have you experienced recent abdominal trauma? d) Do you take any over-the-counter medications?

Have you experienced recent abdominal trauma?

Contraction or tensing of the abdominal muscles in an effort to ease pain is called: a) guarding. b) referring. c) flexing. d) withdrawing.

guarding.

Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a: a) rear-end collision. b) head-on crash. c) rollover crash. d) lateral collision.

head-on crash.

Early bruising following abdominal trauma often manifests as: a) red areas of skin. b) gross distention. c) dark purple marks. d) localized pain.

red areas of skin.

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the: a) Kehr sign. b) Brudzinski sign. c) Cullen sign. d) Grey Turner sign.

Kehr sign.

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the: a) Kehr sign. b) Cullen sign. c) Brudzinski sign. d) Grey Turner sign.

Kehr sign.

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

The absence of abdominal pain does not rule out intra-abdominal bleeding.

Which of the following statements regarding abdominal eviscerations is correct? a) Adherent material is preferred when covering an evisceration. b) The protruding organs should be kept warm and moist. c) The organs should be replaced carefully to avoid heat loss. d) Most eviscerations occur to the left upper quadrant.

The protruding organs should be kept warm and moist.

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: a) covering the avulsion with moist, sterile dressings. b) administering 100% oxygen via a nonrebreathing mask. c) applying direct pressure with a dry, sterile dressing. d) requesting a paramedic to administer pain medication.

applying direct pressure with a dry, sterile dressing.

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) assume that the arrow injured an internal organ. b) clean the wound and apply a dry, sterile dressing. c) carefully probe the wound to determine its depth. d) transport only if signs of shock begin to develop.

assume that the arrow injured an internal organ.

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

avoid speculation and document only factual data.

When worn properly, a seatbelt should lie: a) below the anterior superior iliac spines of the pelvis and against the hip joints. b) across the abdominal wall at the level of the umbilicus and against the hip joints. c) across the abdominal wall at the level of the diaphragm and below the hip joints. d) above the anterior posterior iliac spines of the pelvis and below the hip joints.

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

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) blunt injury to the kidney. b) a ruptured urinary bladder. c) a lacerated liver or spleen. d) external genitalia injury.

blunt injury to the kidney.

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: a) forgo the hospital radio report because of his condition. b) closely monitor him and reassess him frequently. c) perform a comprehensive secondary assessment. d begin documenting the call on the patient care form.

closely monitor him and reassess him frequently.

Accumulation of blood in the abdominal cavity will MOST likely cause: a) nausea or vomiting. b) diffuse bruising. c) distention. d) referred pain.

distention.

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.

giving him small sips of plain water.

A sign of kidney damage following blunt trauma is: a) hemoptysis. b) hematemesis. c) hematochezia. d) hematuria.

hematuria.

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

hollow abdominal organs are damaged and spill their contents.

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: a) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device. b) suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. c) reassess his vital signs and then notify the receiving hospital of the change in his clinical status. d) perform a comprehensive secondary assessment to determine why his clinical status has changed.

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: a) a ruptured spleen. b) rupture of a hollow organ. c) a severe liver laceration. d) intra-abdominal bleeding.

intra-abdominal bleeding.

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) there are other patients involved. b) the patient is conscious. c) the severity of the injury is known. d) law enforcement is at the scene.

law enforcement is at the scene.

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) lift the air bag and look for deformity to the steering wheel. b) extricate her immediately and transport to a trauma center. c) carefully assess her upper chest for seatbelt-related injuries. d) perform a head-to-toe assessment while she is in the car.

lift the air bag and look for deformity to the steering wheel.

Which of the following organs would MOST likely bleed profusely when injured? a) bladder b) intestine c) liver d) stomach

liver

All of the following are hollow abdominal organs, EXCEPT for the: a) liver. b) ureters. c) stomach. d) bladder.

liver.

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: a) kidney. b) spleen. c) liver. d) stomach.

liver.

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

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

When a hollow organ is punctured during a penetrating injury to the abdomen: a) peritonitis may not develop for several hours. b) it will bleed profusely and rapidly cause shock. c) the abdomen will become instantly distended. d) it commonly protrudes through the injury site.

peritonitis may not develop for several hours.

Because the depth of an open abdominal wound is often difficult to determine: a) vital signs should be monitored frequently. b) the abdomen must be vigorously palpated. c) the EMT must perform a thorough exam. d) prompt transport to the hospital is essential.

prompt transport to the hospital is essential.

The presence of tachycardia following a significant abdominal injury: a) is always accompanied by hypotension. b) should be assumed to be a sign of shock. c) indicates a state of decompensated shock. d) is most commonly caused by severe pain.

should be assumed to be a sign of shock.

A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: a) place him supine but allow him to keep his knees bent. b) transport him in the position in which you found him. c) apply full spinal motion restriction precautions. d) keep him on his side but gently straighten his legs.

transport him in the position in which you found him.

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? a) pancreas b) liver or spleen c) fallopian tubes d) urinary bladder

urinary bladder