Trauma Test 1 (Ch.29-32)

Which of the following locations would provide the BEST protection from a lightning strike?

A car with the windows rolled up

Which of the following general statements regarding trauma is correct?

Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma.

Which of the following burn injuries would MOST likely require transport to a burn specialty center?

Burns that involve the hands, feet, or genitalia

Which of the following is the LEAST common cause of death from fires?

Integument burns

Which of the following organs is LEAST susceptible to pressure changes caused by an explosion?

Liver.

Which of the following is NOT a benefit of a properly worn seat belt?

Minimal risk of whiplash injuries after a rear-end collision

Which of the following statements regarding carbon monoxide (CO) poisoning is correct?

Never rule out CO poisoning because of the absence of cherry red skin.

Which of the following chemicals causes a painless burn and can result in significant damage before it is identified?

Phenol

Which of the following statements regarding primary blast injuries is correct?

Primary blast injuries are the most easily overlooked.

Which of the following mechanisms of injury poses the LEAST threat for significant injury?

Rear-end collision with restrained driver

Which of the following characteristics of an entry wound indicates that the weapon was fired at close range?

Tattoo marks from powder burns

Which of the following general statements regarding gunshot wounds is correct?

The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes.

The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is:

The presence of tire skid marks at the scene.

Which of the following injury mechanisms would MOST likely result in blunt trauma?

The pressure wave caused by a blast

Which of the following injuries would MOST likely require transport to a Level I trauma center?

Two or more proximal long bone fractures

Which of the following statements regarding rollover motor vehicle crashes is correct?

Unrestrained passengers are struck with each change in direction the car makes.

A 24-year-old woman was struck by lightning. Bystanders moved the patient to an area of safety but did not provide any other care before your arrival. Your primary assessment reveals that the patient is pulseless and apneic. You begin CPR and apply the cardiac monitor, which reveals asystole. After requesting a backup paramedic unit, the MOST appropriate treatment for this patient involves:

continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary

The third phase of a motor vehicle accident involves:

deceleration of internal organs.

Sudden deceleration of a motor vehicle that is traveling at 60 mph:

dissipates tremendous forces and causes major injuries.

The majority of victims struck by lightning:

experience confusion and some degree of amnesia.

If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because:

facial edema may cause tube dislodgement 2 to 3 days after the burn

The shock wave velocity from an explosion is slower and its duration is longer if a person is:

farther away from the explosion

Compared to a handgun, a rifle:

fires at a higher velocity.

Phosphorus is found in _____________ and burns when exposed to _____________.

fireworks, air

The appropriate treatment for MOST chemical burns is:

flushing with copious amounts of water.

Following a rotational impact, the MOST severely injured patient(s. will likely be found at the point of:

greatest deceleration.

A specific attribute of a Level I trauma center is that it:

has 24-hour in-house coverage by general surgeons.

If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she:

has a known bleeding disorder.

Compared to beta radiation particles, alpha radiation particles:

have minimal penetrating energy.

The purpose of estimating a patient's total body surface area burns in the prehospital setting is to:

help the paramedic determine the most appropriate destination hospital.

After an adult victim is struck by lightning and experiences cardiac arrest:

his or her heart may resume beating spontaneously.

The MOST acute complication associated with large body surface area burns is:

hypothermia.

The secondary assessment of a severely burned patient is intended to:

identify other injuries that may have a higher priority for treatment.

Unlike blunt trauma, penetrating trauma:

involves a disruption of the skin and underlying tissues in a small, focused area.

Nasotracheal intubation of a patient with upper airway burns:

is a complicated procedure and should be avoided.

The initial point of bodily impact when an unrestrained passenger takes the "down and under" pathway during a frontal collision is the:

knees.

The peak magnitude of the pressure wave experienced by a person:

lessens as the person is farther away from the center of the explosion.

The "platinum 10 minutes" refers to the:

maximum time spent at a scene for a trauma patient.

Unlike chemical burns, radiation burns:

may appear hours or days after exposure.

A person who is exposed to cement:

may not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat

Cardiac arrest following an electrical shock:

may occur secondarily from hypoxia or as a direct result of the shock.

Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced?

mechanism of injury

A patient with full-thickness burns surrounded by areas of superficial and partial-thickness burns should be treated with all of the following, EXCEPT:

moist dressings.

A properly worn motorcycle helmet will:

not protect the cervical spine.

Many of the physiologic changes caused by acute radiation syndrome:

occur over time and will not be apparent in the prehospital setting

A full-thickness burn is considered to be critical if it:

occurs in a patient with a significant medical illness.

Damage to the kidneys following an electrical injury:

occurs when damaged muscle produces myoglobin.

Victims standing near an object that is struck by lightning:

often have burns characterized by a feathering pattern.

The second impact that occurs when an adult pedestrian is struck by a motor vehicle would MOST likely result in injuries to the:

pelvis and chest

Knowledge of kinetics can help the paramedic:

predict injury patterns found in a patient.

Structural protection afforded to a motorcycle rider during a crash comes from:

protective gear worn by the rider.

Most lightning-related injuries occur when the victim:

receives a "splash" effect after lightning strikes a nearby object.

You are transporting a conscious but confused 29-year-old man after he was electrocuted. The patient is on high-flow oxygen, has an IV line of normal saline in place, is on a cardiac monitor, and has his spine fully immobilized. During transport, it is especially important for you to:

remain alert for lethal cardiac dysrhythmias and be prepared to defibrillate.

You respond to an industrial plant for a 42-year-old man with a chemical burn. Upon arrival at the scene, you find the patient to be ambulatory. He tells you that he was moving some bags of dry lime when one of the bags broke and spilled lime all over him. After donning the appropriate personal protective equipment, you should:

remove his clothing, brush as much of the lime off of him as possible, and flush the affected areas with copious amounts of water.

During abrupt deceleration:

shearing or rupturing of internal organs can occur.

When a patient takes the "up and over" pathway during a head-on collision:

the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.

If the windshield of a wrecked vehicle is cracked or broken:

the front seat occupant has a cervical spine injury until proven otherwise.

Supraglottic damage following a burn is MOST often caused by:

the inhalation of superheated gases.

During an explosion, secondary blast injuries occur when:

the patient is struck by flying debris, such as shrapnel.

During a frontal collision, MOST pneumothoraces occur when

the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact.

During a frontal collision, MOST pneumothoraces occur when:

the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact.

The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT:

the physical size of the patient.

The severity of hyperextension injuries to the neck following a rear-end collision depends MOSTLY on:

the position of the headrest.

.The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is:

the presence of tire skid marks at the scene.

Penetrating trauma occurs when:

tissues are penetrated by single or multiple objects.

During a lateral impact collision:

trauma to the upper extremities depends on the spatial orientation of the arms upon impact.

The acute physiologic and structural change that occurs in a patient's body when an external source of energy dissipates faster than the body's ability to sustain and dissipate it is called:

trauma.

Compared to stab wounds to the posterior part of the body, stab wounds to the anterior part of the body are generally:

upward

The onset of ___________ soon after exposure to radiation is a predictor of poor outcomes

vomiting

The degree of absorption of a corrosive chemical determines

whether toxicity is local or systemic.

________ radiation is very penetrating and easily passes through the body and solid materials.

Gamma

The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph.

140, 50

The MOST significant fall occurs from a height greater than

15 feet.

The MOST significant fall occurs from a height greater than:

15 feet.

According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face, and anterior chest has burns to ____% of his total body surface area.

18

All of the following statements regarding front air bags are correct, EXCEPT:

Air bags will provide protection from both initial and secondary impacts.

What type of injuries will MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact?

Abdominal and lumbar spine

According to the Waddell triad, the second impact from a motor vehicle occurs when the:

chest and abdomen strike the grille or low on the hood of the car.

Which of the following statements regarding sodium metal chemical burns is correct?

Do not flush with water as doing so may produce heat and cause an explosion.

Which of the following statements regarding exit wounds is correct?

Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.

When a person falls from a significant height and lands on his or her feet, axial loading results in:

compression or burst fractures to the lumbar spine

If a person survives the initial trauma from a shotgun wound at close range:

contaminants that were driven into the wound can cause a severe infection

When summoning an air transport service to transport a critically injured patient, it is MOST important to:

activate the service as soon as possible

When an adult pedestrian is struck by a motor vehicle, lateral and posterior injuries are most common because:

adults tend to turn to the side or away from the impact.

Lap belts that are worn alone and too high by a pregnant woman:

allow enough forward flexion and subsequent compression to rupture the uterus.

The primary determinants of the extent of trauma a patient sustains are the:

amount of energy in the object and the mechanism by which the object is delivered to the body

The MOST common site of deceleration injury in the chest is the:

aorta

A 52-year-old man sustained superficial and partial-thickness burns to his left arm approximately 15 minutes ago when he opened the radiator cap on his car. He is conscious, alert, and in severe pain. His BP is 138/76 mm Hg, pulse is 110 beats/min and strong, respirations are 22 breaths/min and regular, and oxygen saturation is 99% on room air. He denies any other injuries. Initial management for this patient involves:

applying cool, wet dressings to the burn and elevating his arm.

Flash burns:

are usually relatively minor compared with the potential for trauma from whatever caused the flash.

Chemicals such as Lewisite and phosgene oxime:

are vesicant agents that produce cutaneous blisters rapidly.

The two MOST common causes of death from an electrical injury are:

asphyxia and cardiopulmonary arrest.

During your primary assessment of a 21-year-old man with a suspected inhalation injury, you note that he is combative and his respirations are profoundly labored and stridorous. The closest appropriate medical facility is approximately 25 miles by ground, and the local air transport service is unavailable. You should:

assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea.

Unlike deceleration injuries, crush and compression injuries occur:

at the time of impact.

A 74-year-old man experienced partial- and full-thickness burns to his arms and chest resulting from a fire that started after he fell asleep while smoking his cigar. The patient's son, who arrived at the scene shortly after you, states that his father has congestive heart failure, rheumatoid arthritis, and atrial fibrillation. In addition to administering supplemental oxygen, it is MOST important for you to:

auscultate his breath sounds before administering IV fluids.

At a minimum, a Level II trauma center should:

be able to initiate definitive care for all injured patients.

When assessing a burn patient, it is MOST important to:

be alert for occult trauma that could affect patient outcome.

Unlike adults, children who are struck by a motor vehicle are MORE likely to:

be run over by the vehicle as they are propelled to the ground.

When considering analgesia for a burn patient who is in severe pain, you must remember that

burns increase the metabolic rate, which may necessitate higher than normal doses of analgesics.

When considering analgesia for a burn patient who is in severe pain, you must remember that:

burns increase the metabolic rate, which may necessitate higher than normal doses of analgesics.

After a motorcyclist is ejected from his or her motorcycle, secondary collisions:

cause an unpredictable combination of blunt injuries.