Paramedic Chapter 33 - Face and Neck Trauma - Multiple Choice

A 16-year-old male was struck in the face by a baseball bat during practice. He presents supine on the ground and is unresponsive with blood and broken teeth in the airway. What is your next step? A. Measure and apply a cervical collar. B. Roll the patient onto his side and suction. C. Administer high-flow oxygen using a nonrebreather mask. D. Ventilate the patient with a bag-mask device and high-flow oxygen.

B. Roll the patient onto his side and suction.

What is the correct treatment for profuse bleeding of facial injuries? A. Apply direct pressure. B. Apply occlusive dressings. C. Apply cold packs. D. Suction the airway.

A. Apply direct pressure.

You are providing care to a 17-year-old male patient who sustained facial injuries as a result of a motor vehicle collision. The patient suffered a horizontal fracture separating the hard palate and inferior maxilla, separating them from the skull. Based on this information, the patient has sustained a: A. Le Fort I fracture. B. Le Fort II fracture. C. Le Fort III fracture. D. Le Fort IV fracture.

A. Le Fort I fracture.

A young patient was assaulted. You note ecchymosis, orbital swelling, and malocclusion. As you continue your inspection, you sense movement in the palate. Which of the following should you suspect? A. Le Fort fracture B. Skull fracture C. Temporomandibular joint dislocation D. Zygomatic fracture

A. Le Fort fracture

What is anisocoria? A. Naturally occurring uneven pupil size B. Bleeding into the anterior chamber of the eye due to blunt trauma C. A fracture of the orbit or the bones that support the floor of the orbit D. A condition where the eyeball retracts posteriorly into the space created when the orbital cavity is enlarged

A. Naturally occurring uneven pupil size

Which of the following anatomical structures are found in zone I of the neck? Select all that apply. A. Subclavian veins B. Pharynx C. Salivary glands D. Aortic arch

A. Subclavian veins D. Aortic arch

If a knife is impaled in the neck: A. a cricothyrotomy may be required to establish a patent airway. B. it should be removed in case the airway becomes compromised. C. you should stabilize the object in place, regardless of its location. D. it should be shortened to facilitate proper airway management.

A. a cricothyrotomy may be required to establish a patent airway.

The third cranial nerve controls: A. motion of the eyeballs and eyelids. B. sense of vision. C. smile and the ability to chew. D. gag reflex and the ability to swallow.

A. motion of the eyeballs and eyelids.

You are providing care for a 38-year-old female patient who has sustained facial injuries as a result of motor vehicle collision. There is a laceration that extends from the right side of her mouth to her right cheek with significant bleeding. The patient is awake but unable to speak because of the blood. The patient has also sustained two fractured teeth. Based on this information, your most appropriate course of action should be to: A. provide airway management as required, take spinal precautions, and rapid transport. B. replace the broken teeth and have the patient bite down to secure them in place, take spinal precautions, and rapid transport. C. replace the broken teeth and have the patient bite down to secure them in place, and transport the patient promptly in a semi-sitting position with her head tilted forward. D. provide airway management as required, and rapid transport.

A. provide airway management as required, take spinal precautions, and rapid transport.

With respect to injuries to the anterior portion of the neck, the highest mortality rates are associated with injuries to the area between: A. the cricoid cartilage and the clavicles and sternum. B. the angle of the mandible and the cricoid cartilage. C. the area above the angle of the mandible. D. the area from the cricoid cartilage to above the angle of the mandible.

A. the cricoid cartilage and the clavicles and sternum.

What is subcutaneous emphysema? A. The presence of air in the veins, leading to cardiac arrest B. A crackling sensation felt on palpation caused by the presence of air in the soft tissue C. The presence of blood in subarachnoid space D. The high-pitched, wheezing sound indicative of disrupted airflow

B. A crackling sensation felt on palpation caused by the presence of air in the soft tissue

What is the MOST significant complication associated with facial injuries? A. Spinal injury B. Airway compromise C. Altered mental status D. Shock

B. Airway compromise

You are assessing a patient and note bright red blood in the anterior chamber of the eye. How should you transport this patient? A. Inferior to the injury B. On a backboard with the head elevated 40° C. Supine D. In the prone position

B. On a backboard with the head elevated 40°

Hyphema is defined as: A. severe ecchymosis to the orbital region. B. blood in the anterior chamber of the eye. C. marked swelling of the globe of the eye. D. double vision following blunt eye trauma.

B. blood in the anterior chamber of the eye.

Loss of function of the lower arms and hands following trauma to the anterior neck is indicative of damage to the: A. carotid artery. B. brachial plexus. C. vagus nerves. D. parathyroid glands.

B. brachial plexus.

You are providing care for an 8-year-old male patient who has a piece of plastic toy lodged in his left ear. There is some bleeding and the area appears inflamed. Based on this information, your most appropriate course of action should be to: A. gently manipulate the back of the ear to expose the object and allow for its removal. B. cover the ear loosely with a clean dressing. C. utilize tweezers to remove the object. D. place a soft sterile pad behind the ear and bandage both ears.

B. cover the ear loosely with a clean dressing.

You are providing care for an 18-year-old male patient involved in a motor vehicle collision. The patient has sustained soft-tissue trauma to his face but he is able to talk. In order to gain a better understanding of how the patient was injured all of the following questions are appropriate except: A. was the patient wearing a seatbelt? B. how fast was the car travelling? C. where was the patient travelling to? D. did the airbags deploy?

B. how fast was the car travelling?

When caring for a patient with a seemingly isolated ear injury, you should: A. carefully assess the external ear canal and inner ear for blood or CSF. B. perform a careful assessment to detect or rule out more serious injuries. C. recall that the pinna of the ear is highly vascular and bleeds profusely. D. consider direct transport of the patient to an audiologist for evaluation.

B. perform a careful assessment to detect or rule out more serious injuries.

What is the primary treatment for a patient with a chemical burn to the eye? A. Covering both eyes with bulky dressings B. Covering both eyes with gauze pads soaked in distilled water C. Irrigation with sterile saline solution D. Administering 0.5% tetracaine hydrochloride drops

C. Irrigation with sterile saline solution

For a patient with a penetrating injury to the neck, which type of dressing should you apply? A. Bulky dressing, lightly bandaged in place B. Bulky dressing, tightly bandaged in place C. Occlusive dressing, sealed on three sides D. Moist dressing with direct pressure and roller gauze wrapped loosely around the neck

C. Occlusive dressing, sealed on three sides

You are assessing a patient who has suffered several facial lacerations during an automobile accident. As you examine her eyes with your penlight, you observe a circular shadow over the patient's left iris. What does this indicate? A. She has an orbital blowout. B. She has a corneal abrasion. C. The patient is wearing hard contact lenses. D. There is glass impaled in the lens.

C. The patient is wearing hard contact lenses.

When caring for a patient with fractured or avulsed teeth following an assault, you should: A. handle any avulsed teeth by the root only, not the crown. B. flush the patient's mouth with sterile water for 20 minutes. C. assess the knuckles of the person who assaulted the patient. D. remove any partially avulsed teeth and immerse them in water.

C. assess the knuckles of the person who assaulted the patient.

A patient with a dysconjugate gaze following an ocular injury: A. most likely has a concomitant basilar skull fracture. B. should have ice applied to the eyes to prevent blindness. C. has discoordination between the movements of both eyes. D. should be treated by irrigating both eyes for 20 minutes.

C. has discoordination between the movements of both eyes.

You are providing care for a 46-year-old female patient who sustained blunt trauma to her face during an industrial accident. On closer inspection of the right eye, you can see an accumulation of blood in the anterior chamber of the eye. Based on this information, the patient has most likely sustained a(n): A. conjunctivitis. B. laceration to the globe. C. hyphema. D. retinal detachment.

C. hyphema.

The middle ear consists of the: A. cochlea and semicircular canals. B. organ of Corti and the external auditory canal. C. inner portion of the tympanic membrane and the ossicles. D. pinna and the exterior portion of the tympanic membrane.

C. inner portion of the tympanic membrane and the ossicles.

If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be MOST suspicious for a(n): A. Le Fort II fracture. B. nasal bone fracture. C. orbital skull fracture. D. basilar skull fracture.

C. orbital skull fracture.

If a patient had a foreign body impaled in the globe of the eye, which type of dressing would be applied? A. Bulky dressing, lightly bandaged in place for both eyes B. Bulky dressing, tightly bandaged in place for the affected eye C. Moist, sterile dressing and protective cup for the affected eye D. Moist, sterile dressing; protective cup for the affected eye; and bandage for the unaffected eye

D. Moist, sterile dressing; protective cup for the affected eye; and bandage for the unaffected eye

All of the following statements are true of cervical strains except: A. the most common form of cervical strain is whiplash. B. thought to be the result of an injury to the facet joint. C. you should maintain a high index of suspicion for cervical spine involvement. D. involves stretching or tearing of ligaments.

D. involves stretching or tearing of ligaments.

Bradycardia that occurs shortly after you have dressed and bandaged an open neck wound is MOST likely the result of: A. decreased vagal tone secondary to direct injury to the vagus nerve. B. decreased venous return from the brain and an increase in intracranial pressure. C. an acute pulmonary embolism due to the entrainment of air into one of the jugular veins. D. parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.

D. parasympathetic nervous system stimulation due to excessive pressure on the carotid artery.