Exam 6 Trauma
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? Select one: A. Deployment of the air bag B. Dismounted seats C. Steering wheel deformity D. Intrusion into the vehicle
A. Deployment of the air bag
Which of the following breathing patterns is MOST indicative of increased intracranial pressure? Select one: A. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea B. Increased rate and depth with the distinct odor of acetone on the patient's breath C. Increased rate with a normal inspiratory time and a prolonged expiratory time D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea
A. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? Select one: A. Rapid transport to a trauma center B. Intravenous fluid administration C. Early administration of oxygen D. Elevation of the lower extremities
A. Rapid transport to a trauma center
Which section of the heart receives deoxygenated blood? Select one: A. Right B. Atria C. Left D. Ventricles
A. Right
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: Select one: A. an air embolism. B. an ischemic stroke. C. nerve fiber damage. D. a spinal fracture.
A. an air embolism.
The five sections of the spinal column, in descending order, are the: Select one: A. cervical, thoracic, lumbar, sacral, and coccygeal. B. cervical, coccygeal, thoracic, sacral, and lumbar. C. thoracic, cervical, lumbar, coccygeal, and sacral. D. coccygeal, sacral, lumbar, thoracic, and cervical.
A. cervical, thoracic, lumbar, sacral, and coccygeal.
Gastrointestinal bleeding should be suspected if a patient presents with: Select one: A. hematemesis. B. hemoptysis. C. dyspnea. D. hematuria.
A. hematemesis.
Abdominal pain, vomiting, and fever are most likely due to _______. Select one: A. infection B. hypovolemia C. hemorrhage D. evisceration
A. infection
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: Select one: A. intra-abdominal bleeding, or bleeding from the head of the pancreas. B. a severe liver laceration. C. rupture of a hollow organ. D. a ruptured spleen.
A. intra-abdominal bleeding, or bleeding from the head of the pancreas.
A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: Select one: A. irrigate both eyes continuously for 20 minutes with plain water. B. neutralize the acid chemical in his eye with an alkaline chemical. C. mix baking soda with water and irrigate his eyes with the solution. D. flush both eyes with an alcohol-based solution and transport.
A. irrigate both eyes continuously for 20 minutes with plain water.
The upper jawbones are called the: Select one: A. maxillae. B. mastoid. C. zygoma. D. mandible.
A. maxillae.
The ________ nerves control the diaphragm. Select one: A. phrenic B. intercostal C. costal D. vagus
A. phrenic
When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: Select one: A. pupillary constriction. B. dilation of the bronchiole smooth muscle. C. increase in heart rate. D. shunting of blood to vital organs.
A. pupillary constriction.
A patient who presents with profound cyanosis following a chest injury: Select one: A. requires prompt ventilation and oxygenation. B. should be placed in Trendelenburg position. C. is most likely experiencing severe blood loss. D. has most likely experienced a ruptured aorta.
A. requires prompt ventilation and oxygenation.
During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a: Select one: A. shotgun. B. handgun. C. .357 magnum. D. .22-caliber pistol.
A. shotgun.
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. spleen. B. gallbladder. C. liver. D. pancreas.
A. spleen.
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: Select one: A. suction his oropharynx for up to 15 seconds, then evaluate his respiratory status. B. pack his nostrils to stop the drainage of blood. C. immobilize his spine and transport immediately. D. assist his ventilations with a BVM.
A. suction his oropharynx for up to 15 seconds, then evaluate his respiratory status.
When the parasympathetic nervous system is activated: Select one: A. the heart rate decreases and the blood vessels dilate. B. heart rate and blood pressure increase. C. hormones are released that prepare the body for stress. D. blood is shunted away from the digestive organs.
A. the heart rate decreases and the blood vessels dilate.
The index of suspicion is MOST accurately defined as: Select one: A. your awareness and concern for potentially serious underlying injuries. B. the way in which traumatic injuries occur. C. the detection of less obvious life-threatening injuries. D. a predictable pattern that leads to serious injuries.
A. your awareness and concern for potentially serious underlying injuries.
A patient with a head injury presents with abnormal flexion (decorticate posturing) of his extremities. What numeric value should you assign to him for motor response? Select one: A. 2 B. 3 C. 4 D. 5
B. 3
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? Select one: A. Direct trauma to the spinal column B. Energy transmission to the spine,via axial loading C. Lateral impact to the spine D. Secondary fall after the initial impact
B. Energy transmission to the spine,via axial loading
Which of the following nerves carry information from the body to the brain via the spinal cord? Select one: A. Motor B. Sensory C. Somatic D. Central
B. Sensory
Which of the following statements regarding the rule of nines is correct? Select one: A. The anterior arm in the adult is equal to 9% of the total BSA. B. The anterior trunk of an adult is equal to 18% of the BSA. C. The posterior of a child's leg is equal to 13.5% of the BSA. D. A child's head is equal to 14% of his or her total BSA.
B. The anterior trunk of an adult is equal to 18% of the BSA.
Which of the following statements regarding gunshot wounds is correct? Select one: A. The size of a bullet has the greatest impact on the injury produced. B. The speed of a bullet has the greatest impact on the injury produced. C. High-velocity bullets will cause less severe internal injuries. D. Low-velocity bullets will cause the greatest amount of trauma.
B. The speed of a bullet has the greatest impact on the injury produced.
A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: Select one: A. carefully examine her eye and remove any foreign objects if needed. B. avoid applying pressure to the globe when you are covering the eye. C. apply firm direct pressure to the injured eye and cover the opposite eye. D. ask her to move the injured eye to assess the integrity of the optic nerve.
B. avoid applying pressure to the globe when you are covering the eye.
An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): Select one: A. amputation. B. avulsion. C. incision. D. laceration.
B. avulsion.
The central nervous system (CNS) is composed of the: Select one: A. cerebrum and meninges. B. brain and spinal cord. C. meninges and spinal cord. D. cerebellum and brain.
B. brain and spinal cord.
A partial-thickness burn involves the outer layer of skin and a portion of the: Select one: A. fatty layer. B. dermal layer. C. muscle fascia. D. epidermis.
B. dermal layer.
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: Select one: A. stomach. B. diaphragm. C. spleen. D. aorta.
B. diaphragm.
The thoracic cavity is separated from the abdominal cavity by the: Select one: A. anterior rib cage. B. diaphragm. C. costovertebral angle. D. intercostal margin.
B. diaphragm.
The Glasgow Coma Scale (GCS) is used to assess: Select one: A. verbal response, eye opening, and mental status. B. eye opening, verbal response, and motor response. C. mental status, eye opening, and respiratory rate. D. sensory response, pupil reaction, and heart rate.
B. eye opening, verbal response, and motor response.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first: Select one: A. perform a rapid head-to-toe assessment. B. follow appropriate standard precautions. C. place the patient on high-flow oxygen. D. apply direct pressure to the wound.
B. follow appropriate standard precautions.
When a patient stiffens the muscles of the abdomen, it is known as _______. Select one: A. instability. B. guarding. C. distention. D. crepitus.
B. guarding.
A tight-fitting motorcycle helmet should be left in place unless: Select one: A. the helmet is equipped with a full face shield or visor. B. it interferes with your assessment of the airway. C. the patient must be placed onto a long backboard. D. the patient complains of severe neck or back pain.
B. it interferes with your assessment of the airway.
Placing a pregnant patient in a supine position during the third trimester of pregnancy: Select one: A. results in spontaneous urinary incontinence if the bladder is full. B. may decrease the amount of blood that returns to the heart. C. is recommended if the patient has severe abdominal discomfort. D. often causes hypotension secondary to cardiac compression.
B. may decrease the amount of blood that returns to the heart.
Immediately life-threatening chest injuries must be found and managed during the _______. Select one: A. secondary assessment B. primary assessment C. patient history D. scene size-up
B. primary assessment
Significant trauma to the face should increase the EMT's index of suspicion for a(n): Select one: A. airway obstruction. B. spinal column injury, and cervical spinal precautions taken. C. indication for full spinal immobilization for transport. D. displaced mandible.
B. spinal column injury, and cervical spinal precautions taken.
All of the following are hollow abdominal organs, EXCEPT the: Select one: A. ureters. B. spleen. C. stomach. D. bladder.
B. spleen.
If one or more occupants in the same vehicle are killed in a crash, the EMT should: Select one: A. rapidly assess only the survivors who have experienced obvious trauma. B. suspect that all living occupants experienced the same serious trauma. C. allow the survivors to refuse transport if they have no obvious injuries. D. transport the survivors only if they have injuries or complain of pain.
B. suspect that all living occupants experienced the same serious trauma.
Children are often "belly breathers" because _______. Select one: A. their diaphragm is not functional B. their costa are not fully ossified, and their rib cages are cartilaginous. C. they are consciously controlling ventilations D. they are routinely hypoxic
B. their costa are not fully ossified, and their rib cages are cartilaginous.
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. Select one: A. 45% B. 36% C. 18% D. 27%
C. 18%
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? Select one: A. Carefully replace the exposed bowel into the abdomen and transport. B. Cover the exposed bowel and keep his legs in a straight position. C. Cover it with moist, sterile gauze and secure with an occlusive dressing. D. Irrigate it with sterile water and cover it with a dry dressing.
C. Cover it with moist, sterile gauze and secure with an occlusive dressing.
When performing a full body scan, you should assess for ________. Select one: A. AVPU B. OPQRST C. DCAP-BTLS D. SAMPLE
C. DCAP-BTLS
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Select one: A. Brain B. Kidneys C. Gastrointestinal system D. Skeletal muscle
C. Gastrointestinal system
Which types of motor vehicle collisions present the greatest potential for multiple impacts? Select one: A. Frontal and rotational B. Rear-end and rotational C. Rotational and rollover D. Lateral and rollover
C. Rotational and rollover
Which of the following statements regarding abdominal eviscerations is correct? Select one: 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.
A flail chest occurs when: Select one: A. a segment of fractured ribs bulges during the inhalation phase. B. more than three ribs are fractured on the same side of the chest. C. a segment of the chest wall is detached from the thoracic cage. D. multiple ribs are fractured on both sides of the thoracic cage.
C. a segment of the chest wall is detached from the thoracic cage.
A reflex arc occurs when: Select one: A. the motor nerves function automatically without receiving a message from the CNS. B. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. C. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve. D. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body.
C. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Select one: A. digital pressure to a proximal artery. B. additional sterile dressings. C. a tourniquet proximal to the injury. D. a splint and elevate the extremity.
C. a tourniquet proximal to the injury.
A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of: Select one: A. distraction. B. hyperflexion. C. axial loading. D. hyperextension.
C. axial loading.
When caring for a patient whose arm is covered with a dry chemical, you should: Select one: A. deactivate the chemical with a 5% vinegar solution. B. use forceful streams of water to remove the chemical. C. brush away the chemical before flushing with water. D. quickly irrigate the arm with large amounts of water.
C. brush away the chemical before flushing with water.
The tough, fibrous outer meningeal layer is called the: Select one: A. arachnoid mater. B. pia mater. C. dura mater. D. gray mater.
C. dura mater.
In contrast to a cerebral concussion, a cerebral contusion: Select one: A. usually does not cause a loss of consciousness. B. does not cause pressure within the skull. C. involves physical injury to the brain tissue. D. results from a laceration to the brain tissue.
C. involves physical injury to the brain tissue.
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she: Select one: A. will eliminate more carbon dioxide than if he or she were breathing deeply. B. often breathes at a slower rate because of lung damage caused by the injury. C. must increase his or her respiratory rate to maintain adequate minute volume. D. will maintain adequate minute volume if his or her respiratory rate stays the same.
C. must increase his or her respiratory rate to maintain adequate minute volume
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. hemorrhage B. coagulation C. perfusion D. hypoperfusion
C. perfusion
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. packing both nostrils with gauze pads until the bleeding stops. B. having the patient pinch his own nostrils and then lie supine. C. pinching the patient's nostrils and having him lean forward. D. placing a rolled 4² × 4² dressing between his lower lip and gum.
C. pinching the patient's nostrils and having him lean forward.
You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: Select one: A. irregular. B. rapid. C. slow. D. weak.
C. slow.
A burn that is characterized by redness and pain is classified as a: Select one: A. full-thickness burn. B. partial-thickness burn. C. superficial burn. D. second-degree burn.
C. superficial burn.
Force acting over a distance is the definition of: Select one: A. latent energy. B. potential energy. C. work. D. kinetic energy.
C. work.
What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct.
D. All of these answers are correct.
Which of the following statements regarding anterior nosebleeds is correct? Select one: A. They are usually severe and require aggressive treatment to control. B. They are usually caused by a fracture of the basilar skull. C. They cause blood to drain into the posterior pharynx. D. They usually originate from the septum area and bleed slowly.
D. They usually originate from the septum area and bleed slowly.
The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. Select one: A. spinal cord B. cerebral cortex C. cerebellum D. brain stem
D. brain stem
The hormone responsible for the actions of the sympathetic nervous system is: Select one: A. thyroxine. B. insulin. C. aldosterone. D. epinephrine.
D. epinephrine.
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: Select one: A. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. B. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. C. Is conscious, alert, and oriented X4. 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.
In a patient with a head injury, hypertension, bradycardia, and Biot or Cheyne-Stokes respirations indicate: Select one: A. an underlying skull fracture. B. internal bleeding in the chest. C. decreased cerebral blood flow. D. herniation of the brain stem.
D. herniation of the brain stem.
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: Select one: A. remains within the vehicle. B. is wearing only a lap belt. C. experiences multiple impacts. D. is ejected or partially ejected.
D. is ejected or partially ejected.
With regard to the pediatric rule of nines, the: Select one: A. head is proportionately smaller than an adult's. B. thorax is proportionately larger than an adult's. C. arms are proportionately larger than an adult's. D. legs are proportionately smaller than an adult's.
D. legs are proportionately smaller than an adult's.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: Select one: A. stomach. B. spleen. C. kidney. D. liver.
D. liver.
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: Select one: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. quickly immobilizing her spinal column. D. rapidly transporting her to the hospital.
D. rapidly transporting her to the hospital.
Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. applying a tourniquet. B. keeping the patient warm. C. applying chemical ice pack. D. splinting the extremity.
D. splinting the extremity.
Patients with full-thickness (third-degree) burns generally do not complain of pain because: Select one: A. blister formation protects the burn. B. they are generally not conscious. C. subcutaneous vessels are usually clotted. D. the nerve endings have been destroyed.
D. the nerve endings have been destroyed.
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. coagulation B. hypoperfusion C. hemorrhage D. perfusion
perfusion
