ch. 25 trauma overview full review
Signs of a pulmonary blast injury include: A. an irregular pulse B. coughing up blood C. vomiting blood D. multiple rib fractures
B. coughing up blood
In the case of a motor vehicle crash, the energy of the speeding vehicle is converted into the work of stopping the vehicle, which is accomplished by: A. None of these answers are correct. B. crushing the vehicle's exterior. C. the friction between the car and the ground. D. collapsing the vehicle's interior.
B. crushing the vehicle's exterior.
Airbags are designed to: A. be used with or without a shoulder harness B. decrease the severity of deceleration injuries C. prevent the driver from sustaining head trauma D. prevent a second collision inside the car
B. decrease the severity of deceleration injuries
During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: Select One: A. 7 B. 8 C. 9 D. 10
A. 7
4. The energy of a moving object is called: A. latent energy. B. kinetic energy. C. potential energy. D. converted energy.
B. kinetic energy.
Approximately 25% of severe injuries to the aorta occur during: A. frontal collisions B. lateral collisions C. rollover collisions D. rear-end collisions
B. lateral collisions
37. A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A. Compression of the head against the roof B. Lateral bending of the neck during the crash C. Impact of the head against the steering wheel D. Whiplash injury to the neck during the rollover
A. Compression of the head against the roof
19. When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the ________ when the airbag deploys upon impact. A. door B. dashboard C. windshield D. steering wheel
A. door
27. When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall. B. any fall in the elderly is considered to be high-energy trauma. C. elderly patients who fall usually have secondary head injury. D. bilateral hip fractures usually occur when an elderly person falls.
A. osteoporosis can cause a fracture that may have resulted in the fall.
A patient complains of chest tightness, coughing up blood, and subcutaneous emphysema following an explosions may be suffering from a : A. pulmonary blast injury B. ruptured tympanic membrane C. myocardial blast injury D. ruptured peritoneal cavity
A. pulmonary blast injury
26. Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. speed of fall. B. surface struck. C. height of fall. D. primary impact point.
A. speed of fall.
An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: A. trauma to the pelvis. B. blunt abdominal trauma. C. a severe closed head injury. D. penetrating thoracic trauma
A. trauma to the pelvis. Impact points are often obvious from a quick inspection of the vehicle's interior. During a frontal collision, the unrestrained occupant's knees often impact the lower dashboard. With this type of impact, energy is transferred from the knees to the femurs, and then to the pelvis or hip.
3. Force acting over distance defines the concept of: A. work. B. latent energy. C. kinetic energy. D. potential energy.
A. work.
How many categories of trauma are there? A. 4 B. 2 C. 1 D. 3
B. 2
24. When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was propelled away from the vehicle. B. approximate the speed of the vehicle that struck the pedestrian. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle.
B. approximate the speed of the vehicle that struck the pedestrian.
Which of the following injuries can be used to assist in triaging patient's because they indicate risk of pressure injuries to the lungs? A. Disturbances in vision B. Subarachnoid injuries C. Tympanic membrane injuries D. Arterial air embolism
C. Tympanic membrane injuries
When treating a patient who experienced a pulmonary blast injury, you should: Select One: A. use a demand valve to ventilate the patient. B. suspect an accompanying cardiac tamponade. C. avoid giving oxygen under positive pressure. D. administer large amounts of intravenous fluid.
C. avoid giving oxygen under positive pressure.
16. Airbags are designed to: A. prevent a second collision inside the car. B. be used with or without a shoulder harness. C. decrease the severity of deceleration injuries. D. prevent the driver from sustaining head trauma.
C. decrease the severity of deceleration injuries.
Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? Head-on collision Angular collision Ejection Controlled crash
C. ejection During an ejection, the rider will travel at high speed until stopped by a stationary object, another vehicle, or road drag. Severe abrasion injuries (road rash) down to bone can occur with drag.
5. When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. triples. C. quadruples. D. is not affected.
C. quadruples.
1. Index of suspicion is MOST accurately defined as: A. the way in which traumatic injuries occur. B. a predictable pattern that leads to serious injuries. C. your awareness and concern for potentially serious underlying injuries. D. the detection of less obvious life-threatening injuries.
C. your awareness and concern for potentially serious underlying injuries.
6. Which of the following statements regarding gunshot wounds is MOST correct? A. High velocity bullets will cause less severe internal injuries. A. The size of a bullet has the greatest impact on producing injury. C. Low velocity bullets will cause the greatest amount of trauma. D. The speed of a bullet has the greatest impact on producing injury.
D. The speed of a bullet has the greatest impact on producing injury.
Significant clues to the possibility of severe injuries in motor vehicle collisions include: A. a blown-out tire B. a deployed air bag C. broken glass D. death of a passenger
D. death of a passenger
18. Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact. B. assess the severity of the third collision of the crash. C. recognize if the driver hit the brakes before impact. D. identify contact points and predict potential injuries.
D. identify contact points and predict potential injuries.
kinetic energy is a calculation of: A. weight and size. B. mass and velocity C. mass and weight. D. speed and force.
mass and velocity
During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the tertiary phase B. during the secondary phase C. during the primary phase D. as a direct result of the pressure wave
A. during the tertiary phase Primary blast injuries are caused by the pressure wave and include ruptured eardrums and hollow organ rupture. Secondary blast injuries are caused by flying debris and include impaled objects and shrapnel injuries. Tertiary blast injuries occur when the victim is thrown into a solid object, resulting in blunt trauma to virtually any part of the body. Quaternary blast injuries include other miscellaneous injuries.
9. Two of the MOST common mechanisms of injury for blunt trauma are: A. falls and motor-vehicle collisions. B. low-caliber gunshot wounds and falls. C. gunshot wounds and vehicle ejections. D. motor-vehicle collisions and stabbings.
A. falls and motor-vehicle collisions.
In contrast to a Level III trauma center, a Level I trauma center must: A. have general surgeons in-house 24 hours a day B. be able to stablilize patients before transferring them to a higher level facility C. be involved in trauma prevention programs D. have access to an emergency physician within 30 minutes
A. have general surgeons in-house 24 hours a day
20. The cervical spine is MOST protected from whiplash-type injuries when the: A. headrest is appropriately positioned. B. airbag correctly deploys upon impact. C. patient tenses up at the time of impact. D. rear end of the vehicle is initially struck.
A. headrest is appropriately positioned.
Whiplash injuries are MOST common following _________ impacts. A. rear-end B. rollover C. frontal D. lateral
A. rear-end Whiplash injuries of the neck are a common occurrence following rear-end collisions. As the vehicle is suddenly thrust forward, the occupant's head is thrust backward. Properly positioned headrests can minimize the severity of whiplash injuries.
15. If one or more occupants in the same vehicle are killed, the EMT should: A. suspect that all living occupants experienced the same serious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. rapidly assess only the survivors who have experienced obvious trauma.
A. suspect that all living occupants experienced the same serious trauma.
32. A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 MPH. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries has this patient LEAST likely experienced? A. Head injury B. Cardiac contusion C. Pulmonary contusion D. Multiple rib fractures
A. Head injury
Which of the following is NOT true regarding digital photos of a crash scene? A. Photos can be shared over social media B. Photos may need to be deleted after review by health care providers C. Photos may provide valuable information to treating physicians D. Photos may become part of the medial record
A. Photos can be shared over social media
10. What types of motor vehicle collisions present the greatest potential for multiple impacts? A. Rotational and rollover B. Rear-end and rotational C. Frontal and rotational D. Lateral and rollover
A. Rotational and rollover
A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision? A. The bike rider hitting his bike or the car B. The bike hitting the car C. The bike rider's internal organs striking the solid structures of the body D. The bike rider striking the pavement
A. The bike rider hitting his bike or the car
Death from a rollover motor vehicle crash is MOST often secondary to: A. airbag-related trauma. B. multiple collisions to the interior of the car. C. ejection of the patient from the motor vehicle. D. crushing injuries
B. multiple collisions to the interior of the car. Rollover crashes are the most unpredictable with regard to injuries sustained by the patient. An unrestrained passenger may have struck multiple points within the vehicle. However, the most life-threatening event in a rollover is ejection or partial ejection of the patient from the vehicle.
36. While en route to a major motor-vehicle crash, an on-scene police officer advises you that a 7-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the airbag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma. B. neck and facial injuries. C. blunt trauma to the head. D. lower extremity fractures.
B. neck and facial injuries.
31. A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: A. injury to the cervical spine. B. potential airway compromise. C. damage to internal structures. D. alterations in his mental status.
B. potential airway compromise.
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. early administration of oxygen B. rapid transport to a trauma center C. elevation of the lower extremities D. intravenous fluid administration
B. rapid transport to a trauma center
8. When a motor vehicle strikes a tree while traveling at 40 MPH, the unrestrained occupant: A. will most likely be thrown over the steering column. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle does. D. is thrust under the steering column onto the floorboard.
B. remains in motion until acted upon by an external force.
17. When caring for an occupant inside a motor vehicle equipped with an airbag that did not deploy upon impact, it is MOST important to: A. realize that the airbag malfunctioned at the time of impact. B. remember that it could still deploy and seriously injure you. C. suspect that the patient may have experienced serious injuries. D. recognize that the force of impact was most likely not severe.
B. remember that it could still deploy and seriously injure you.
A fall from more than ___ times the patient's height is considered to be significant. A. five B. three C. four D. two
B. three
35. The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has a few small abrasions to her left forearm. Treatment for the passenger should include: A. a focused exam of her forearm. B. transport to a trauma center C. performing a rapid trauma assessment. D. allowing a friend to drive her to a hospital.
B. transport to a trauma center
21. Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. thoracic and sacral spine. B. lumbar and coccygeal spine. C. thoracic and lumbar spine. D. lumbar and sacral spine.
C. thoracic and lumbar spine.
Which of the following destinations is most appropriate for a 41 year old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal? A. A Level IV or Level III trauma center B. Any designated trauma center is acceptable C. Only a Level I trauma center D. A Level I or Level II trauma center
D. A Level I or Level II trauma center
Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash? A. Extensive damage to the automobile B. Flail chest and lower extremity fractures C. Massive external trauma with severe bleeding D. Aortic rupture or compression injury to the brain
D. Aortic rupture or compression injury to the brain During the third collision, the body's internal organs collide with the inside of the body. These injuries are usually not as obvious, but are often the most life-threatening. Injuries that may result from this include internal injuries of the brain (compression injuries) and aortic tears, resulting in massive internal bleeding.
12. Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. Dismounted seats B. Steering wheel deformity C. Intrusion into the vehicle D. Deployment of the airbag
D. Deployment of the airbag
Which of the following is important to do when treating a patient with penetrating trauma? A. Measure the size of the tear in the tissue. B. Determine which organs would be affected. C. Look for additional trauma. D. Determine the length of the penetrating object.
D. Determine the length of the penetrating object.
7. By what mechanism is a person injured when he or she falls from a significant height? A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. B. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
28. Which of the following statements regarding low-energy penetrating injuries is MOST correct? A. Internal injuries caused by low-velocity bullets are usually easy to predict. B. Exit wounds are typically easy to locate with low-energy penetrating injuries. C. It is usually easy to differentiate between an entrance wound and an exit wound. D. The area of injury is usually close to the path the object took through the body.
D. The area of injury is usually close to the path the object took through the body.
39. A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. perform a detailed exam. B. obtain baseline vital signs. C. auscultate bowel sounds. D. assess for an exit wound.
D. assess for an exit wound.
34. A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. inspect the helmet for cracks. B. perform a detailed exam. C. obtain baseline vital signs. D. fully immobilize her spine.
D. fully immobilize her spine.
According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed B. has a systolic blood pressure of less than 110 mmHg or a heart rate greater than 110 beats/min C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury D. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma
D. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma
23. A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. is wearing only a lap belt. B. remains within the vehicle. C. experiences multiple impacts. D. is ejected or partially ejected.
D. is ejected or partially ejected.
When assessing a stab wound, it is important for the EMT to remember that: A. stabbings to an extremity are rarely associated with an exit wound. B. the majority of the internal trauma will be near the path of the knife. C. most stabbings are unintentional and cause less severe internal injury. D. more internal damage may be present than the external wound suggests.
D. more internal damage may be present than the external wound suggests. With low-velocity penetrations, injuries are caused by sharp edges of the object moving through the body and are therefore close to the object's path. Weapons such as knives, however, may have been deliberately moved around internally, causing more internal damage than the external wound suggests.
When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious B. primary blast injuries are typically the most obvious C. solid organs usually rupture from the pressure wave D. primary blast injuries are the most easily overlooked
D. primary blast injuries are the most easily overlooked
22. Twenty-five percent of severe aortic injuries occur during: A. frontal collisions. B. lateral collisions. C. rollover collisions. D. rear-end collisions.
B. lateral collisions.
2. When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion. B. mechanism of injury. C. amount of kinetic energy. D. amount of potential energy.
B. mechanism of injury.
Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8. B. 9. C. 10. D. 11.
B. 9.
14. Which of the following injuries would MOST likely occur as a direct result of the third collision of a motor-vehicle crash? A. Flail chest B. Aortic rupture C. Extremity fractures D. Forehead lacerations
B. Aortic rupture
13. Which of the following would MOST likely occur as the direct result of the second collision of a motor-vehicle crash? A. Collapsed dashboard B. Deformed steering wheel C. Caved-in passenger door D. Intrathoracic hemorrhage
B. Deformed steering wheel
38. A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A. Lateral impact to the spine B. Energy transmission to the spine C. Direct trauma to the spinal column D. Secondary fall after the initial impact.
B. Energy transmission to the spine
According to the Journal of Safety Research, which type of crash causes approximately 30% of all fatalities that occur in motor vehicle crashes? A. Rotational B. Lateral C. Rollover D. Rear-end crashes
B. Lateral
30. The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. capitation. B. cavitation. C. congruent. D. conversion.
B. cavitation.
25. Which of the following patients has experienced the MOST significant fall? A. 4'8" tall patient who fell 13 feet B. 5'0" tall patient who fell 13 feet C. 4'6" tall patient who fell 13 feet D. 5'9" tall patient who fell 14 feet
C. 4'6" tall patient who fell 13 feet
11. With regard to a motor-vehicle collision, which of the following statements regarding collision #1 is MOST correct? A. It provides the least amount of information about the mechanism of injury. B. It has a direct effect on patient care because of the obvious vehicular damage. C. It is the most dramatic part of the collision and may make extrication difficult. D. It occurs when the unrestrained occupant collides with the interior of the vehicle.
C. It is the most dramatic part of the collision and may make extrication difficult.
A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A. Deployed airbag B. Bent steering wheel C. Nonintact windshield D> Crushed instrument panel
C. Nonintact windshield The mechanism of injury and condition of the vehicle's interior suggest likely areas of injury. Head and neck injuries are likely to result when the head and face impact the windshield.
Which of the following is considered a type of motor vehicle collision? A. Crush B. Ejection C. Rollover D. Penetration
C. Rollover
If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? A. Severe burns B. Fractured bones C. Stomach rupture D. Impaled objects
C. Stomach rupture
33. While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. underlying cardiac disease. B. a lacerated coronary artery. C. bruising of the heart muscle. D. traumatic rupture of the aorta.
C. bruising of the heart muscle.
40. Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. spinal cord injury. B. airway compromise. C. intracranial bleeding. D. a fracture of the skull.
C. intracranial bleeding.
29. Internal injuries caused by gunshot wounds are difficult to predict because: A. the caliber of the bullet is frequently unknown. B. the area of damage is usually smaller than the bullet. C. the bullet may tumble or ricochet within the body. D. exit wounds caused by the bullet are usually small.
C. the bullet may tumble or ricochet within the body.
According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. the patient requires advanced life support care and stabilization, and the nearest paramedic ground ambulance is more than 5 to 10 minutes away. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C. he or she was involved in a motor-vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor. D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.
D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.