Chap 35 Chapter Test

B. Liver

A patient has been stabbed in the right upper quadrant of the abdomen. Which solid organ should the EMT be most concerned with being​ injured? A. Stomach B. Liver C. Small intestine D. Kidney

B. Occlusive dressing applied over​ saline-soaked gauze

An industrial worker has sustained a laceration to his abdomen. On closer​ inspection, you note what appears to be fat tissue and a portion of intestine protruding through the wound. Which intervention is most appropriate for treating this​ injury? A. Dry sterile dressing applied over the wound B. Occlusive dressing applied over​ saline-soaked gauze C. One attempt at replacement of the eviscerated material in the abdomen using sterile gloves D. Direct pressure using gloved palms to the injury

C. Examine the​ patient's airway

You have arrived on the scene of a stabbing. As you approach the​ patient, you note that his shirt is off and a single stab wound to the right lower quadrant of the abdomen is evident. The patient appears unresponsive as you approach. At the​ patient's side, your first action should be​ to: A. Cover the wound with a nonporous dressing B. Quickly look for additional stab wounds C. Examine the​ patient's airway D. Provide oxygen via nonrebreather face mask

D. Cover the entrance wound with a gloved hand

You have been called for a male patient who was shot with a rifle. Assessment reveals an entrance wound to the left lower quadrant of the abdomen. A hemorrhaging exit wound to the left lower back is also located. What should you do​ immediately? A. Auscultate the​ patient's breath sounds B. Cover the abdominal wounds with dry sterile gauze dressings C. Place a cervical collar on the patient D. Cover the entrance wound with a gloved hand

A. Place a moist​ compress, such as a moist sanitary​ pad, over the injury to control the bleeding

A female patient suffered a straddle injury​ (genitalia trauma) while trying to balance on top of a​ chain-link fence, after she fell with a leg on each side of the fence. At this​ time, you​ would: A. Place a moist​ compress, such as a moist sanitary​ pad, over the injury to control the bleeding B. Gently put sterile gauze dressings into the opening of the vaginal canal to stop the bleeding C. Apply an ice pack wrapped in a towel to the genital area D. Clean the area with sterile saline and apply direct pressure with a gloved hand while monitoring for ongoing bleeding

C. Check the adequacy of the​ patient's breathing

A patient has been assaulted and sustained blunt trauma to the abdomen. As you start the primary​ assessment, you note that he is vomiting blood and you begin to suction him immediately. After the airway has been​ suctioned, you​ should: A. Examine the abdomen for specific injuries B. Administer oxygen with a nonrebreather face mask C. Check the adequacy of the​ patient's breathing D. Obtain a full set of vital signs

A. ​Liver, right​ kidney, and pancreas

A patient has been shot in the abdomen. Assessment reveals that the bullet entered the body in the right upper quadrant and exited the lower right back. Given this​ finding, the EMT should assume which solid organs may have been​ injured? A. ​Liver, right​ kidney, and pancreas B. ​Liver, gallbladder, and right kidney C. Liver and gallbladder D. ​Liver, gallbladder, right​ kidney, and small intestine

B. Hemorrhage from the spleen

A patient has referred pain to her left shoulder. What should the EMT​ suspect? A. Trauma to the right kidney B. Hemorrhage from the spleen C. Damage to the gallbladder D. Rupture of the small intestine

C. Supine​ position, with knees and hips flexed

A patient has sustained a large abdominal​ evisceration, such that a large portion of intestines are now exposed. After properly managing this​ injury, you are preparing the patient for transport. You ascertain that there is no evidence of spinal injury. How should you place the patient on the stretcher for​ transport? A. ​Semi-Fowler's position, to promote adequate breathing B. Lateral recumbent position with legs extended C. Supine​ position, with knees and hips flexed D. Prone​ position, to maintain pressure on the abdomen

D. Internal hemorrhage

A patient who experienced blunt trauma to the abdomen has a lacerated liver. Given this​ information, what would represent the most immediate threat to​ life? A. Development of acute peritonitis B. Significant pain C. Liver infection D. Internal hemorrhage

B. Check the abdomen for injury

At the scene of a motor vehicle​ accident, a car has extensive​ front-end damage and a deformed steering wheel. The restrained​ driver, who was​ self-extricated, is in the care of​ EMRs, who have applied a cervical collar and continue to maintain spine motion restriction precautions. The​ patient's airway is patent and respirations adequate. His radial pulse is rapid and​ weak, and his skin is cool and diaphoretic. The EMRs report the following vital​ signs: pulse, 136​ beats/min; respirations, 20​ breaths/min; blood​ pressure, 100/68​ mmHg; and​ SpO2, 95% with supplemental O2 being administered. The right forearm is​ deformed, and the​ head, chest, and upper back are uninjured according to your assessment. Your next action would be​ to: A. Change the nonrebreather mask to a nasal cannula B. Check the abdomen for injury C. Repeat the vital signs D. Start positive pressure ventilation

B. Place cool compresses to the testicles

A​ 16-year-old male has been struck in the genitalia by a baseball. Assessment indicates a tremendous amount of edema as well as hematoma formation and bruising to his scrotum. The primary assessment reveals no​ life-threatening conditions;​ however, the patient is crying and rates the pain as​ 10/10. Which action is most appropriate for this​ patient? A. Rapid transport using lights and sirens B. Place cool compresses to the testicles C. Application of warm packs to the scrotum D. Apply direct pressure to the site of injury

D. Hypovolemic shock

A​ 45-year-old female was at a family reunion and fell off a trampoline. She hit a picnic table with the left side of her lower rib cage.​ Now, she is very anxious and confused. Her airway is open and her breathing adequate. Her radial pulse is rapid and​ weak, and her skin is cool and diaphoretic. Vital signs are​ pulse, 132​ beats/min; respirations, 20​ breaths/min; blood​ pressure, 102/78​ mmHg; and​ SpO2, 97% on ambient air. The patient has ecchymosis to the left lower rib area as well as tenderness and instability to the rib cage. She also has a superficial abrasion to her forehead. Given these​ findings, you would suspect and treat her for which​ condition? A. Closed head injury B. Hypoxia C. Spinal shock D. Hypovolemic shock

D. Initiate immediate transport and intercept with the ALS unit

A​ 74-year-old female complains of abdominal pain after falling down five stairs off her front porch and striking her abdomen and left hand on a mailbox at the bottom. The patient also reports pain in her left wrist and right​ ankle, both of which show obvious deformity. She is alert and​ oriented, and her abdomen is free of bruising but tender in the left upper and lower quadrants. Her vital signs are​ pulse, 132​ beats/min; respirations, 22​ breaths/min; blood​ pressure, 106/86​ mmHg; and initial​ SpO2, 93% on room air. Oxygen has been​ applied, and the patient has full spine motion restriction precautions in place. Advanced life support has been requested and is 12 minutes away from your current location. What is your next​ action? A. Apply ice to the wrist and ankle while awaiting arrival of the ALS unit B. Secure the wrist and ankle to board​ splints, initiate​ transport, and cancel the ALS unit C. Monitor the patient and wait for ALS assistance D. Initiate immediate transport and intercept with the ALS unit

D. The patient developed an infection

A​ middle-aged male sustained blunt force trauma to the​ abdomen, resulting in an isolated tear and perforation of the large intestine. When following up on the​ patient, what would the EMT suspect​ occurred, given the organ that was​ injured? A. The patient rapidly decompensated into shock B. The patient developed severe internal bleeding C. The patient has profound hypoxia D. The patient developed an infection

B. Provide 15 lpm through a nonrebreather mask

During a motor vehicle​ collision, a confused unrestrained male struck the steering wheel with his abdomen.​ Currently, he is confused and complains of generalized abdominal​ pain, which he rates as​ 6/10. Assessment indicates red marks across his lower abdomen caused by the steering wheel. His pulse is 140​ beats/min, respirations are 24​ breaths/min, blood pressure is​ 108/88 mmHg, and SpO2 is​ 86%. The patient looks pale and has moist skin. What is most appropriate when providing oxygen to this​ patient? A. Oxygen can be withheld due to the SpO2 reading B. Provide 15 lpm through a nonrebreather mask C. Provide 2 lpm through a nasal cannula D. Provide 8 lpm through a simple face mask

D. Kidney

If a patient has severe retroperitoneal bleeding from an organ located within this​ cavity, she has most likely injured​ her: A. Stomach B. Large intestine C. Liver D. Kidney

A. Family giving the patient water to drink since he is thirsty

On​ scene, you encounter a restless patient who has been stabbed in the right upper quadrant of the abdomen and now complains of abdominal pain and a dry mouth. Assessment reveals no immediate life threats to the airway or breathing. The radial pulse is rapid and​ weak, and the skin cool and diaphoretic. Vital signs are​ pulse, 124​ beats/min; respirations, 20​ breaths/min; blood​ pressure, 122/88​ mmHg; and​ SpO2, 90% on room air. The injury is​ isolated, with no involvement of the​ head, neck, or back. In managing the scene and the​ patient, which observation would cause you to immediately​ intervene? A. Family giving the patient water to drink since he is thirsty B. An EMR placing the patient in a lateral recumbent position with the knees flexed C. Application of supplemental oxygen D. An EMR placing his gloved hand over the injury to control the bleeding

A. ​"Blunt trauma is especially lethal because of the large number of organs that can be​ affected."

The EMT has fundamental understanding of abdominal trauma when he​ states: A. ​"Blunt trauma is especially lethal because of the large number of organs that can be​ affected." B. ​"Evisceration injuries can be recognized by​ dark-colored bruising over the top of the injury​ site." C. ​"Injuries to solid organs like the bladder tend to be more lethal than injuries to hollow​ organs." D. ​"Injuries to hollow organs tend to be worse than injuries to solid organs because of the increased potential for blood​ loss."

C. At the fifth intercostal space

The EMT recognizes that the division between the thoracic and abdominal cavities lies​ approximately: A. At the level of the umbilicus B. Below the twelfth rib C. At the fifth intercostal space D. Above the twelfth thoracic vertebra

C. Occlusive dressings should be placed over both wounds

The​ EMT's care for an open chest wound and for an abdominal evisceration are similar in​ that: A. Both wounds can cause the trapping of air in the body B. Air must be periodically released from both wounds C. Occlusive dressings should be placed over both wounds D. Moist dressings are placed over both wounds

D. Descending aorta

Which abdominal organ or​ structure, if seriously​ injured, would cause the most rapid​ death? A. Large intestine B. Spleen C. Stomach D. Descending aorta

A. Stab wound to the small intestine

Which one of these injuries is most likely to cause​ peritonitis? A. Stab wound to the small intestine B. Blunt trauma to the spleen C. Contusion to the pancreas D. Bullet injury to the liver

B. Apply direct pressure to the injury to stop the hemorrhage

While a​ 43-year-old man was cleaning a​ window, the glass broke and a sharp piece sliced his groin. Assessment shows him to have a large laceration to his left​ scrotum, with a testicle exposed and protruding through the sac. Blood is pouring from the​ laceration, and the patient rates the pain as an​ 8/10. What should the EMT do​ first? A. Call for advanced life support assistance B. Apply direct pressure to the injury to stop the hemorrhage C. Cover the exposed testicle with moist​ dressing, and dress it loosely to collect the blood that is escaping D. Provide oxygen at 15 lpm

C. Move the ambulance and wait for law enforcement to arrive

While returning from a​ call, you are flagged down by a frantic family member of a​ 12-year-old male patient. She is standing in the​ yard, and reports that the child was shot in the abdomen and is now inside the house. She states that she has already called the​ police, who have not arrived​ yet, and that the shooter is another family member who has since left the scene. What is your best course of​ action? A. Cautiously enter the house and be ready to vacate if any hazards are found B. Go to the porch and have the patient brought to you C. Move the ambulance and wait for law enforcement to arrive D. Carefully look for scene hazards and enter once you feel safe

B. ​"My left shoulder is killing​ me!"

You are assessing a young male patient who was assaulted with a baseball bat and struck once on the left upper quadrant of the abdomen. You would recognize that this patient has​ Kehr's sign when he makes which​ statement? A. ​"My belly hurts really​ bad." B. ​"My left shoulder is killing​ me!" C. ​"It really hurts for me to​ breathe." D. ​"I am having a hard time​ breathing!"

B. Heart rate increases from 116 to 140​ beats/min

You are transporting a female patient who was sexually assaulted by having a foreign body inserted deep into her vagina. You are attempting to control hemorrhage by the appropriate means. As you reassess the​ patient, which finding is of most​ concern? A. Large blood clots form at the vaginal entrance B. Heart rate increases from 116 to 140​ beats/min C. The patient informs you she has a sexually transmitted disease D. Pain increases from​ 7/10 to​ 10/10

D. Blood pressure is now​ 106/88 mmHg

You are transporting a male patient with a deep stab wound to the​ groin, with damage also noted to the genitalia following an assault by his girlfriend. The patient is alert and​ oriented, albeit restless. Vital signs on scene were​ pulse, 128​ beats/min; respirations, 20​ breaths/min; blood​ pressure, 108/64​ mmHg; and​ SpO2, 92%. Oxygen is being administered via nasal cannula. Upon​ reassessment, which sign would be most concerning to the​ EMT? A. Heart rate of 132​ beats/min B. SpO2 stabilizing at​ 96% despite O2 therapy C. ​Patient's urge to void D. Blood pressure is now​ 106/88 mmHg

B. ​High-concentration oxygen through a nonrebreather mask

You are transporting an alert and oriented male who sustained severe abdominal trauma in an assault. The primary survey indicates a patent airway with respirations of 24 breaths per minute. Breath sounds are present bilaterally. The patient has a rapid and weak radial pulse of 144 beats per​ minute, and his skin is pale and cool. The blood pressure is​ 92/64 mmHg and SpO2 is​ 92%. Best management of the respiratory and oxygenation parameters would​ include: A. Positive pressure ventilation with supplemental oxygen B. ​High-concentration oxygen through a nonrebreather mask C. Encouraging the patient to slow his respirations D. Application of a nasal cannula at 4 lpm O2

D. On his side with knees drawn to the chest

You have arrived on the scene for a patient assaulted with a baseball bat. As you​ approach, which position would seemingly indicate that he has suffered an injury to the​ abdomen? A. Standing with restless movement and pacing B. Supine with legs extended and toes pointed C. Prone with hands on the back D. On his side with knees drawn to the chest

D. Start positive pressure ventilation

You have arrived on the scene of an assault involving a knife. Assessment of the unresponsive​ 21-year-old male patient reveals him to have sustained multiple lacerations to the arms and​ abdomen, and a section of his intestine is now protruding through a large laceration in the area around the umbilicus. He has lost a significant amount of blood. His airway is open and he is breathing poorly at a rate of 28 breaths per minute. His radial pulse is​ weak, and his skin is cool and pale. What should the EMT do​ first? A. Check the blood pressure B. Secure the patient to a long spine board C. Cover the intestine with​ saline-soaked gauze D. Start positive pressure ventilation

C. Control any active bleeding that may be occurring

You have been called for a deeply disturbed psychiatric patient who has cut off the tip of his penis with a steak knife. Assessment reveals the​ 31-year-old male to be​ crying, with blood noted to his hands and pants. The primary assessment reveals no acute life threats. At this​ time, your priority is​ to: A. Prevent the patient from urinating B. Determine why the patient cut himself C. Control any active bleeding that may be occurring D. Place the amputated penis in sterile water

A. Discoloration around the umbilicus

You have been called for a​ 42-year-old male who complains of back pain. At the​ scene, the man tells you that he was lying on the floor when his​ 5-year-old son unexpectedly jumped feet first onto his back. He gives a medical history of high blood pressure and​ asthma, for which he takes medications. As you assess the​ patient, which finding provides the greatest indication that the patient has sustained an abdominal​ injury? A. Discoloration around the umbilicus B. Mild nausea C. Bruise to his back D. Shortness of breath

C. Perform a​ jaw-thrust maneuver

You have just arrived on the scene of a very serious motor vehicle collision. Emergency Medical Responders​ (EMRs) have rapidly extricated an unresponsive female from the​ driver's seat. The EMRs report that she was unrestrained and struck the steering wheel with her chest and abdomen. As you start the primary​ assessment, you note that the patient has snoring respirations and demonstrates shallow breathing at a rate of 24 breaths per minute. What should you do​ next? A. Obtain vital signs B. Start positive pressure ventilation C. Perform a​ jaw-thrust maneuver D. Secure the patient to backboard with a cervical collar placed