Chapter 30: Abdominal and Genitourinary Injuries
Abdominal pain, vomiting, and fever are most likely due to _______. Select one: A. infection B. hemorrhage C. evisceration D. hypovolemia
A
Because solid organs have a rich supply of blood, any injury can result in major: A. hemorrhaging B. damage C. pain D. guarding
A
Patients with open abdominal injures often complain of: A. pain B. nausea C. vomiting D. dyspnea
A
Suspect a possible injury of the urinary bladder in all of the following findings EXCEPT: A. bruising to the left upper quadrant B. blood at the urethral opening C. blood at the tip of the penis or a stain on the patient's underwear D. physical signs of trauma on the lower abdomen, pelvis or perineum
A
The largest organ in the abdomen is the: A. liver B. spleen C. pancreas D. kidneys
A
The major complaint of patients with abdominal injury is: A. pain B. tachycardia C. rigidity D. swelling
A
The solid organs of the urinary system include the: A. kidneys B. ureters C. bladder D. urethra
A
Which of the following is true regarding injury to the kidneys? Select one: A. Injury to the kidneys usually indicates injury to other organs. B. Only minimal force is needed to damage the kidneys. C. The kidneys are not well protected. D. Kidney injuries are rarely caused by blunt trauma.
A
While assessing a 21 year old female who struck a tree head-on with her small passenger car, you not that her air bag deployed. You should: A. life the air bag and look for deformity to the steering wheel. B. carefully assess her upper chest for seat belt-related injuries C. perform a head-to-toe assessment while she is in the car D. extricate her immediately and transport to a trauma center
A
Compression injury is most likely due to which of the following?
A. Improperly placed lab belt
Which of the following is true regarding an injury to the kidneys?
A. Injury to the kidneys usually indicates injury to other organs.
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. applying direct pressure with a dry, sterile dressing.
Your documentation on a sexual assault victim should _______.
A. be objective and factual
Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:
A. control any external bleeding, administer oxygen, and transport at once.
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:
A. diaphragm.
When a patient stiffens the muscles of the abdomen, it is known as _______.
A. guarding.
All of the following are hollow abdominal organs, EXCEPT the:
A. spleen.
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 assesment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superifical. You should: A. carefully probe the wound to determine its depth B. assume that the arrow injured an internal organ C. clean the wound and apply a dry, sterile dressing D. transport only if signs of shock begin to develop.
B
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. Do you take any over-the-counter medications? B. Have you experienced recent abdominal trauma? C. Has blood soaked through your undergarments? D. What does your blood pressure normally run?
B
Air in the abdominal cavity can cause all of the following EXCEPT: A. pain B. diarrhea C. infection D. tissue ischemia and infarction
B
Because the depth of an open abdominal wound is often difficult to determine: Select one: A. the abdomen must be vigorously palpated. B. prompt transport to the hospital is essential. C. vital signs should be monitored frequently. D. the EMT must perform a thorough exam.
B
Blunt abdominal injuries may result from: A. a stab wound B. seat belts C. a gunshot wound D. an impaled object
B
Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: A. air bag deployment B. a poorly placed lap belt C. failure to wear seat belts D. rapid vehicle deceleration
B
Following blunt abdominal trauma, a 30 year old male complains of referred pain to the left shoulder. This finding is called the: A. Grey Turner sign B. Kehr sign C. Brudzinski sign D. Cullen sign
B
In any case of trauma to a female patient, you should always determine if the patient: A. is on birth control B. is pregnant C. is currently menstruating D. has a history of ovarian cysts
B
In cases of sexual assault, which of the following is true? A. You should always examine the genitalia for any sign of injury B. Advise the patient not to wash, urinate or defecate C. In addition to recording the facts, it is important to include your personal thoughts D. You should use plastic bags when collecting items such as clothes
B
Late signs of peritonitis may include: A. soft abdomen B. nausea C. normal bowel sounds D. diarrhea
B
The most common sign of significant abdominal injury is: A. pain B. tachycardia C. rigidity D. distention
B
When treating a patient with an amputation of the penile shaft, your top priority is: A. locating the amputated part B. controlling bleeding C. keeping the remaining tissue dry D. delaying transport until bleeding is controlled
B
Which of the following is NOT a hollow organ of the abdomen? A. Stomach B. Liver C. Bladder D. Urters
B
You respond to an 18 year old high school football player who was hit in the right flank with a helmet several hours ago. He is complaining of pain in the area. He is alert and oriented. His airway is open and his respirations are within normal limits. His pulse is regular. He has a radial pulse. He tells you that he is noticing blood in his urine. Based on this information, the patient is likely to have an injury to the: A. liver B. kidney C. gallbladder D. appendix
B
Your presence is requested by law enforcement to assess a 33 year old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: A. arrange for a rape crisis center representative to speak with the patient. B. control any external bleeding, administer oxygen, and transport at once. C. visualize the vaginal area and pack the vagina with sterile dressings D. allow her to change her clothes and take a shower before you transport
B
Your primary concern when dealing with an unresponsive patient with an open abdominal injury is: A. covering the wound with a moist dressing B. maintaining the airway C. controlling the bleeding D. monitoring vital signs
B
Injuries to the external male genitalia _______.
B. are rarely life-threatening
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:
B. closely monitor him and reassess him frequently.
Abdominal pain, vomiting, and fever are most likely due to _______.
B. infection
In pediatric patients, the liver and spleen are _______.
B. larger in proportion to the abdomen
Because the depth of an open abdominal wound is often difficult to determine:
B. prompt transport to the hospital is essential.
All of the following male genitalia lie outside the pelvis cavity EXCEPT the: A. urethra B. penis C. seminal vesicles D. testes
C
Open abdominal injuries are also known as: A. blunt injuries B. eviscerations C. penetrating injuries D. peritoneal injuries
C
Signs of injury to the kidney may include any of the following EXCEPT: A. bruises or lacerations on the overlying skin B. shock C. increased urgency of urination D. hematuria
C
The presence of tachycardia following a significant abdominal injury: A. indicates a state of decompensated shock B. should be assumed to be a sign of shock C. is most commonly caused by severe pain D. is always accompanied by hypo tension
C
When treating a patient with an evisceration, you should: A. attempt to replace the abdominal contents B. cover the protruding organs with a dry, sterile dressing C. cover the protruding contents with moist, sterile gauze compresses
C
_____ takes place in the solid organs. A. digestion B. Excretion C. Energy production D. Absorption
C
Which of the following organs would MOST likely bleed profusely when injured?
C. Liver
When a hollow organ is punctured during a penetrating injury to the abdomen:
C. peritonitis may not develop for several hours.
All of the following systems contain organs that make up the contents of the abominal cavity EXCEPT: A. the digestive system B. the urinary system C. the genitourinary system D. the limbic system
D
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: Select one: A. stomach. B. aorta. C. spleen. D. diaphragm.
D
In pediatric patients, the liver and spleen are _______. Select one: A. more protected by the thorax compared to adults B. smaller in proportion to the abdomen C. less likely to bleed when injured D. larger in proportion to the abdomen
D
Injuries to the external male genitalia _______. Select one: A. usually result in permanent damage B. are often life-threatening C. frequently lead to hypovolemic shock D. are rarely life-threatening
D
Suspect kidney damage if the patient has a history or physical evidence of all of the following EXCEPT: A. an abrasion, laceration, or contusion in the flank B. a penetrating wound in the lower rib cage or the upper abdomen C. fractures on either side of the lower rib cage D. a hematoma in the umbilical region
D
The first signs of peritonitis include all of the following EXCEPT: A. severe abdominal pain B. tenderness C. muscular spasm D. nausea
D
When a patient stiffens the muscles of the abdomen, it is known as _______. Select one: A. crepitus. B. distention. C. instability. D. guarding.
D
When performing a history on a patient with abdominal trauma, which of the following questions would be appropriate regarding trauma? A. Is there any blood in your stool? B. Does your pain go anywhere? C. Do you have any nausea, vomiting or diarrhea? D. All of the above
D
Which of the following statements regarding abdominal evisceration's is correct? A. Adherent material is preferred when covering an evisceration. B. The organs should be replaced carefully to avoid heat loss. C. Most evisceration's occur to the left upper quadrant D. The protruding organs should be kept warm and moist.
D
You are called to the local bar where a fight has taken place. The police department tells you that you have a 36 year old man who has been stabbed twice in the abdomen. Upon your arrival, the patient is alert and oriented. His airway is open. His respirations are at 24 breaths/min, pulse is rapid, regular and weak. He has distal pulses. With the penetrating trauma, you should assume that the object: A. has penetrated the peritoneum B. has entered the abdominal cavity C. has possibly injured one or more organs D. all of the above
D
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. the severity of the injury is known. B. the patient is conscious. C. there are other patients involved. D. law enforcement is at the scene.
D
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: Select one: A. perform a comprehensive secondary assessment to determine why his clinical status has changed. B. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. C. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. D. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
D
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: Select one: A. begin documenting the call on the patient care form. B. perform a comprehensive secondary assessment. C. forgo the hospital radio report because of his condition. D. closely monitor him and reassess him frequently.
D
Your documentation on a sexual assault victim should _______. Select one: A. include your opinion of the nature of the incident B. describe the status of the suspect(s) C. be subjective and summarize the crime D. be objective and factual
D
When should you visually inspect the external genitalia on your patient?
D. Only when there is a complaint of severe pain or other injury
Which of the following statements regarding abdominal eviscerations is correct?
D. The protruding organs should be kept warm and moist.
You should suspect a kidney injury anytime the patient presents with _______.
D. a hematoma in the flank region
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:
D. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
Placing a pregnant patient in a supine position during the third trimester of pregnancy:
D. may decrease the amount of blood that returns to the heart.
