EMT Chapter 30

Which of the following symptoms is NOT one of the first signs of peritonitis? A. Diarrhea B. Muscle spasm C. Tenderness D. Severe abdominal pain

A. Diarrhea

Which of the following is true regarding injury to the kidneys? A. Injury to the kidneys usually indicates injury to other organs. B. The kidneys are not well protected. C. Only minimal force is needed to damage the kidneys. D. Kidney injuries are rarely caused by blunt trauma.

A. Injury to the kidneys usually indicates injury to other organs.

All of the following are common associated complaints with genitourinary injuries, EXCEPT: A. blood in the urine B. absence of the need to void C. abdominal tenderness D. nausea

C. abdominal tenderness

If the patient who was raped or assaulted will tolerate being wrapped in a sterile burn sheet, what might the investigators find left behind from the alleged offender? A. fluid B. hair C. fiber D. all of these answers are correct

D. all of these answers are correct

The region below the rib cage and above the hip

Flank

Which of the following organs would be MOST likely to bleed profusely if severely injured? A. Liver B. Kidney C. Stomach D. Gallbladder

A. Liver

Following a motorcycle accident in which a patient collided with a tree and sustained multiple injuries, you notice the presence of blood at the urethral opening. What does this suggest? A. a ruptured bladder B. massive kidney injury C. a fractured spleen D. a ruptured gallbladder

A. a ruptured bladder

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. B. requesting a paramedic to administer pain medication. C. administering 100% oxygen via a nonrebreathing mask. D. covering the avulsion with moist, sterile dressings.

A. applying direct pressure with a dry, sterile dressing.

When a patient either consciously or unintentionally stiffens the muscles of the surface of the abdomen in response to abdominal pain, it's called: A. guarding B. rebound pain C. stiffening D. rigidity

A. guarding

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: A. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM. B. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. C. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. D. perform a comprehensive secondary assessment to determine why his clinical status has changed.

A. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.

How should you place a woman who is in her her third trimester of pregnancy on a backboard? A. on her left side B. sitting up C. supine D. on her right side

A. on her left side

In which position should a patient who has sustained a blunt abdominal injury be placed on the backboard? A. supine B. lateral C. prone D. semi-fowler's

A. supine

Which of the following parts of the female genitalia is NOT contained within the pelvis? A. vulva B. cervix C. fallopian tubes D. ovaries

A. vulva

What percentage of all trauma patients have some form of genitourinary injury? A. 5% B. 10% C. 15% D. 25%

B. 10%

You should suspect a kidney injury anytime the patient presents with _______. A. nausea B. a hematoma in the flank region C. abdominal distention D. dyspnea

B. a hematoma in the flank region

Abdominal distention or swelling can sometimes be the result of ________ from the bowel or infection. A. water B. air C. blood D. pus

B. air

The term hematuria is defined as: A. blood in the stool B. blood in the urine C. vomiting up blood D. urinary bladder rupture

B. blood in the urine

In pediatric patients, the liver and spleen are _______. A. more protected by the thorax compared to adults B. larger in proportion to the abdomen C. smaller in proportion to the abdomen D. less likely to bleed when injured

B. larger in proportion to the abdomen

You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume? A. sitting up B. legs drawn up C. legs outstretched D. on his right side

B. legs drawn up

Placing a pregnant patient in a supine position during the third trimester of pregnancy: A. is recommended if the patient has severe abdominal discomfort. B. may decrease the amount of blood that returns to the heart. C. results in spontaneous urinary incontinence if the bladder is full. D. often causes hypotension secondary to cardiac compression.

B. may decrease the amount of blood that returns to the heart.

The uterus, ovaries, and fallopian tubes are: A. prone to injury, because they lie close to the surface B. rarely damaged C. part of the external genitalia D. found in the retroperitoneal space

B. rarely damaged

A common finding during assessment of patients with an injured liver is: A. the patient will want to remain upright B. referred pain to the right shoulder C. referred pain to the left shoulder D. bruises in the flank

B. referred pain to the right shoulder

According to the US Department of Justice's National Crime Victimization Survey, there are ______ victims (age 12 years or older) of rape and sexual assault each year. A. 325,415 B. 478,722 C. 293,066 D. 512,466

C. 293,066

What is another name for the distal end of the descending colon? A. Spleen B. Transverse colon C. Appendix D. Duodenum

C. Appendix

Compression injury is most likely due to which of the following? A. Hollow-organ rupture B. Stabbing C. Improperly placed lab belt D. Ejection of unrestrained driver

C. Improperly placed lab belt

What is a very common early sign of a significant abdominal injury? A. Shock B. Decreased blood pressure C. Tachycardia D. Changes in mental status.

C. Tachycardia

Which of the following statements regarding abdominal eviscerations is correct? A. The organs should be replaced carefully to avoid heat loss. B. Most eviscerations occur to the left upper quadrant. C. The protruding organs should be kept warm and moist. D. Adherent material is preferred when covering an evisceration.

C. The protruding organs should be kept warm and moist.

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: A. begin documenting the call on the patient care form. B. forgo the hospital radio report because of his condition. C. closely monitor him and reassess him frequently. D. perform a comprehensive secondary assessment.

C. closely monitor him and reassess him frequently.

When treating a patient whose foreskin has gotten caught in more than a few teeth of a zipper, you should: A. ice the area B. apply sterile saline solution C. cut the zipper out of the pants D. all of these answers are correct

C. cut the zipper out of the pants

When a patient stiffens the muscles of the abdomen, it is known as _______. A. crepitus. B. distention. C. guarding. D. instability.

C. guarding.

Which of the following is NOT something you should do when treating injuries involving external male genitalia? A. if possible, take avulsed parts to the hospital in a labeled bag. B. make the patient as comfortable as possible C. if possible, remove impaled instruments or foreign bodies from the urethra D. apply direct pressure with dry, sterile gauze dressings.

C. if possible, remove impaled instruments or foreign bodies from the urethra

Abdominal pain, vomiting, and fever are most likely due to _______. A. hypovolemia B. evisceration C. infection D. hemorrhage

C. infection

A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however he is in severe pain. you should be MOST concerned that he has injured his: A. liver B. spleen C. kidney B. bladder

C. kidney

When a hollow organ is punctured during a penetrating injury to the abdomen: A. the abdomen will become instantly distended. B. it will bleed profusely and rapidly cause shock. C. peritonitis may not develop for several hours. D. it commonly protrudes through the injury site.

C. peritonitis may not develop for several hours.

You are called to respond to a rape at a local mall parking lot. Which of the following would NOT be proper treatment in dealing with this situation? A. make sure the EMT is the same gender as the patient B. wrap the patient in a sterile burn sheet to preserve any evidence C. place the evidence in a plastic bag D. document history, assessment, and treatment in great detail, only using objective information

C. place the evidence in a plastic bag

Because the depth of an open abdominal wound is often difficult to determine: A. the EMT must perform a thorough exam. B. vital signs should be monitored frequently. C. prompt transport to the hospital is essential. D. the abdomen must be vigorously palpated.

C. prompt transport to the hospital is essential.

Which two bodily functions are controlled by the genitourinary system? A. regulation of the metabolism and circulation of blood throughout the body B. protection against disease and infection and the break down of food C. reproduction and waste discharge D. control of voluntary and involuntary actions; involved in the production of blood cells and storage of calcium.

C. reproduction and waste discharge

All of the following are hollow abdominal organs, EXCEPT the: A. ureters. B. bladder. C. spleen. D. stomach.

C. spleen.

An injury in which there is soft-tissue damage inside the body but the skin remains intact.

Closed Abdominal Injury

Which organs are at risk of injury from falls, particularly in geriatric patients? A. Stomach, pancreas, and small intestine B. Spleen, adrenal gland, and kidney C. Inferior vena cava, urinary bladder, and pancreas. D. Aorta, spleen, and liver.

D. Aorta, spleen, and liver.

Which of the following organs would MOST likely bleed profusely when injured? A. Stomach B. Bladder C. Intestine D. Liver

D. Liver

When should you visually inspect the external genitalia on your patient? A. Anytime the patient agrees to treatment and transport B. Always during the secondary assessment C. Only when ordered by medical direction D. Only when there is a complaint of severe pain or other injury

D. Only when there is a complaint of severe pain or other injury

Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include: A. placing dry towels over the open wound. B. cleaning the exposed bowel with sterile saline. C. applying the PASG to stop the associated bleeding. D. applying an occlusive dressing, secured by trauma dressings.

D. applying an occlusive dressing, secured by trauma dressings.

Injuries to the external male genitalia _______. A. frequently lead to hypovolemic shock B. usually result in permanent damage C. are often life-threatening D. are rarely life-threatening

D. are rarely life-threatening

Your documentation on a sexual assault victim should _______. A. describe the status of the suspect(s) B. be subjective and summarize the crime C. include your opinion of the nature of the incident D. be objective and factual

D. 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. visualize the vaginal area and pack the vagina with sterile dressings. B. arrange for a rape crisis center representative to speak with the patient. C. allow her to change her clothes and take a shower before you transport. D. control any external bleeding, administer oxygen, and transport at once.

D. 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. spleen. B. aorta. C. stomach. D. diaphragm.

D. diaphragm.

Which of the following organs is a solid organ? A. ureter B. urinary bladder C. urethra D. kidney

D. kidney

In the second and third trimesters of pregnancy, the incidence of injury to the _______ is increased by displacement of the uterus. A. endometrium B. urethra C. ovaries D. urinary bladder

D. urinary bladder

Contracting the stomach muscles to minimize the pain of abdominal movement; a sign of peritonitis.

Guarding

Structures through which materials pass, such as the stomach, small intestines, large intestines, ureters, and urinary bladder.

Hollow Organs

Black, tarry stools

Melena

An injury in which there is a break in the surface of the skin or mucous membrane, exposing deeper tissue to potential contamination.

Open Abdominal Injury

The abdominal cavity.

Peritoneal Cavity

Solid masses of tissue where much of the chemical work of the body takes place (eg, the liver, spleen, pancreas, and kidneys).

Solid Organs