BLOCK 5 FINAL (BLOCK 5 QUIZ)

A 50-year-old man was working on his car when the jacks collapsed and the car landed on his chest. Your assessment reveals profound cyanosis and swelling to his chest and face, agonal respirations, and a weak carotid pulse. This patient will benefit MOST from: Select one: A. aggressive airway management and rapid transport. B. bilateral needle thoracenteses and 100% oxygen. C. rapid IV fluid boluses en route to a trauma center. D. prompt endotracheal intubation and hyperventilation.

A. aggressive airway management and rapid transport

Sudden deceleration of a motor vehicle that is traveling at 60 mph: Select one: A. dissipates tremendous forces and causes major injuries. B. initially causes whiplash injuries to the patient's neck. C. typically generates forces of up to 10 to 20 g. D. causes the driver's body to stop moving at the same time.

A. dissipates tremendous forces and causes major injuries

A specific attribute of a Level I trauma center is that it: Select one: A. has 24-hour in-house coverage by general surgeons. B. has rapid access to an off-site anesthesiologist. C. can initiate definitive care for all injured patients. D. is involved in an injury prevention program.

A. has 24-hour in-house coverage by general surgeons

If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: Select one: A. has a known bleeding disorder. B. is older than 45 years of age. C. is emotionally upset or angry. D. takes any kind of medication.

A. has a known bleeding disorder

An epidural hematoma typically causes rapid deterioration in the head-injured patient's condition because: Select one: A. it is associated with brisk arterial bleeding. B. numerous axons are severely damaged. C. concomitant spinal cord injury is often present. D. the meningeal veins are often disrupted.

A. it is associated with brisk arterial bleeding

Knowledge of kinetics can help the paramedic: Select one: A. predict injury patterns found in a patient. B. quantify how much blood a patient has lost. C. differentiate between medical and trauma patients. D. determine which organs have been injured.

A. predict injury patterns found in a patient

During abrupt deceleration: Select one: A. shearing or rupturing of internal organs can occur. B. supporting structures of the aorta keep it attached. C. the neck commonly sustains hyperextension injuries. D. the skull provides excellent protection for the brain.

A. shearing or rupturing of internal organs can occur

The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy. Select one: A. kinetic, potential B. potential, kinetic C. barometric, kinetic D. chemical, potential

B. potential, kinetic

Proprioception is defined as: Select one: A. the loss of thermoregulatory function distal to an injury. B. the ability to perceive the position and movement of one's body. C. a person's ability to sense light touch. D. a person's awareness of pain and the ability to localize it.

B. the ability to perceive the position and movement of one's body

If the windshield of a wrecked vehicle is cracked or broken: Select one: A. the rear seat passenger was likely thrust from the seat into the windshield. B. it is likely that the vehicle was traveling at least 55 mph at the time of impact. C. the front seat occupant has a cervical spine injury until proven otherwise. D. you should assume that the driver has a severe intracerebral hemorrhage.

C. the front seat occupant has a cervical spine injury until proven otherwise.

A complete spinal cord injury to the upper cervical spine: Select one: A. is not compatible with life and results in immediate death due to cardiopulmonary failure. B. results in quadriplegia but the patient usually retains his or her ability to breathe spontaneously. C. will result in permanent loss of all cord-mediated functions below the level of the injury. D. results in neurologic dysfunction that is considered to be permanent if it lasts longer than 24 hours.

C. will result in permanent loss of all cord-mediated functions below the level of the injury

A subdural hematoma is classified as acute if clinical signs and symptoms develop: Select one: A. within 48 hours following the injury. B. within 36 hours following the injury. C. within 24 hours following the injury. D. immediately following the injury.

C. within 24 hours following the injury

A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale score is ___, and the MOST appropriate treatment for him involves: Select one: A. 6; intubation, hyperventilation at a rate of 20 breaths/min, two large-bore IV lines running wide open, keeping him warm, and maintaining his oxygen saturation at greater than 90%. B. 8; ventilation assistance with a bag-mask device, a 2-L bolus of normal saline or lactated Ringer's solution, elevating his head 12 inches, and hyperventilating him if his heart rate falls below 60 beats/min. C. 9; high-flow oxygen via nonrebreathing mask, IV fluids as needed to maintain a systolic blood pressure of at least 100 mm Hg, monitoring his oxygen saturation, and administering 1.5 mg/kg of lidocaine to decrease intracranial pressure. D. 7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 95%.

D. 7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 95%.

A patient with diaphragmatic breathing without intercostal muscle use has MOST likely experienced a spinal injury above the level of: Select one: A. C7. B. C5. C. C2. D. T2.

D. T2

After a motorcyclist is ejected from his or her motorcycle, secondary collisions: Select one: A. result in less severe injuries if the rider is wearing leather. B. most commonly involve a stationary object. C. typically cause bilateral fractures of the femurs and tibias. D. cause an unpredictable combination of blunt injuries.

D. cause an unpredictable combination of blunt injuries

General care for an eye injury involves: Select one: A. applying a cold compress to the eyeball. B. irrigating the eye with sterile saline solution. C. applying direct pressure to the globe. D. covering both eyes to minimize further injury.

D. covering both eyes to minimize further injury

Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the: Select one: A. wrists and forearms. B. chest and abdomen. C. cervical spine. D. femurs and tibias.

D. femurs and tibias

Compared to a handgun, a rifle: Select one: A. has less powerful ammunition. B. is less accurate. C. fires a single projectile. D. fires at a higher velocity.

D. fires at a higher velocity

A diffuse axonal injury: Select one: A. results in severe stretching or tearing of the portion of the nerve cell that receives sensory messages from the rest of the body. B. is generally associated with better neurologic outcomes than a cerebral concussion because permanent brain damage does not occur. C. is a specific, grossly observable brain injury that can easily be diagnosed with a computer tomography scan of the head. D. involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.

D. involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body

The "platinum 10 minutes" refers to the: Select one: A. amount of time before decompensated shock occurs. B. maximum amount of time to extricate a patient. C. amount of time taken to perform a rapid assessment. D. maximum time spent at a scene for a trauma patient.

D. maximum time spent at a scene for a trauma patient

A moderate diffuse axonal injury: Select one: A. is the most common result of blunt head trauma and is associated with temporary neuronal dysfunction. B. causes a prolonged loss of consciousness and affects axons in both cerebral hemispheres. C. is generally characterized by a brief loss of consciousness, with or without retrograde amnesia. D. produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up.

D. produces an immediate loss of consciousness and residual neurologic deficits when the patient wakes up

A full-body exam for a trauma patient with a significant mechanism of injury and signs of a spinal cord injury: Select one: A. is performed at least every 5 to 10 minutes. B. should focus specifically on the spinal region. C. is usually not practical in the prehospital setting. D. should be performed en route to the hospital.

D. should be performed en route to the hospital

Hyperventilation of the brain-injured patient: Select one: A. is only appropriate if the patient is unresponsive and has bilaterally dilated and sluggishly reactive pupils. B. has clearly demonstrated decreased mortality and morbidity in patients with a severe head injury. C. causes cerebral vasodilation with increased intracranial pressure and should be avoided. D. shunts oxygen away from the brain and may result in decreased cerebral perfusion pressure.

D. shunts oxygen away from the brain and may result in decreased cerebral perfusion pressure

A blood pressure of 100/70 mm Hg in the presence of clinical signs of a tension pneumothorax: Select one: A. should be treated with crystalloid fluid boluses to prevent hypotension. B. is likely the result of systemic vasodilation in an attempt to reduce preload. C. indicates that prehospital needle decompression likely will not be required. D. suggests adequate cardiac compensation for the diminished venous return.

D. suggests adequate cardiac compensation for the diminished venous return.

Which of the following statements regarding anisocoria is correct? Select one: A. Anisocoria is a condition characterized by bilateral pupillary dilation. B. Anisocoria is a condition in which the pupils are unequal. C. Physiologic anisocoria indicates significant intracranial pressure. D. Anisocoria is a normal finding in the majority of the population

B. Anisocoria is a condition in which the pupils are unequal.

Any normotensive patient with a sternal fracture should receive: Select one: A. IV fluid boluses. B. ECG monitoring. C. ventilation assistance. D. antiarrhythmic drugs.

B. ECG monitoring

Which of the following statements regarding exit wounds is correct? Select one: A. With low-velocity gunshot wounds, the exit wound is always a mirror image of the entrance wound. B. Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body. C. Compared to entrance wounds, exit wounds are generally much smaller and typically have regular edges. D. Despite fragmentation of the projectile, there is usually only one exit wound for each round that is fired.

B. Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.

A flail chest is characterized by: Select one: A. excessive negative intrathoracic pressure. B. a free-floating segment of fractured ribs. C. bulging of fractured ribs during inspiration. D. drawing in of fractured ribs during expiration.

B. a free-floating segment of fractured ribs

A compression or burst fracture of the cervical spine would MOST likely occur following: Select one: A. a direct blow to the occipital region of the skull. B. a significant fall in which the patient lands head first. C. axial loading after a patient falls and lands feet first. D. rapid acceleration following a motor vehicle crash.

B. a significant fall in which the patient lands head first

A 16-year-old man collapsed after being struck in the center of the chest by a line drive during a high school baseball game. Your assessment reveals that he is pulseless and apneic. As your partner initiates one-rescuer CPR, your MOST important action should be to: Select one: A. perform intubation to secure the patient's airway. B. attach the ECG leads and be prepared to defibrillate. C. start an IV line and administer an antiarrhythmic drug. D. rapidly assess the chest for signs of a sternal fracture.

B. attach the ECG leads and be prepared to defibrillate

A spinal cord concussion is: Select one: A. the result of direct trauma and is associated with spinal cord edema. B. caused by a short-duration shock or pressure wave within the cord. C. characterized by temporary dysfunction that lasts for up to 1 week. D. a condition that results in a permanent loss of neurologic function.

B. caused by a short-duration shock or pressure wave within the cord

According to the Waddell triad, the second impact from a motor vehicle occurs when the: Select one: A. child is run over by the car as he or she is propelled to the ground. B. chest and abdomen strike the grille or low on the hood of the car. C. head strikes the ground, resulting in skull and facial fractures. D. car's bumper strikes the pelvis and femurs instead of the knees.

B. chest and abdomen strike the grille or low on the hood of the car.

Spinal cord injuries that cause neurogenic shock generally produce: Select one: A. signs and symptoms that are identical to those of hypovolemic shock. B. flaccid paralysis and complete loss of sensation distal to the injury. C. reflex tachycardia due to sympathetic nervous system stimulation. D. cool, clammy skin distal to the site of the spinal cord injury.

B. flaccid paralysis and complete loss of sensation distal to the injury

The brain connects to the spinal cord through a large opening at the base of the skull called the: Select one: A. palatine bone. B. foramen magnum. C. cribriform plate. D. occipital condyle.

B. foramen magnum

The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. Select one: A. 160, 30 B. 170, 30 C. 140, 50 D. 150, 40

C. 140, 50

Which of the following statements regarding a cerebral concussion is correct? Select one: A. A concussion results in permanent dysfunction of the cerebral cortex. B. A cerebral concussion is a moderate focal brain injury. C. Concussions are usually not associated with structural brain injury. D. Prolonged loss of consciousness is common with a cerebral concussion.

C. Concussions are usually not associated with structural brain injury

Which of the following statements regarding primary blast injuries is correct? Select one: A. Primary blast injuries are the result of flying glass or shrapnel. B. Primary blast injuries are due entirely to intense heat. C. Primary blast injuries are the most easily overlooked. D. Primary blast injuries are typically the most obvious injuries.

C. Primary blast injuries are the most easily overlooked

The MOST common site of deceleration injury in the chest is the: Select one: A. heart. B. esophagus. C. aorta. D. vena cava.

C. aorta

An object increases its kinetic energy more by: Select one: A. increasing its mass than by increasing its velocity. B. decreasing its velocity than by decreasing its mass. C. increasing its velocity than by increasing its mass. D. decreasing its speed than by increasing its mass

C. increasing its velocity than by increasing its mass

Spinal shock is a condition that: Select one: A. results in permanent neurologic deficits in the majority of patients. B. typically manifests within 24 to 36 hours following a spinal injury. C. is usually temporary and results from swelling of the spinal cord. D. generally affects the sensory nerves but spares the motor nerves.

C. is usually temporary and results from swelling of the spinal cord

Hypotension that is associated with neurogenic shock is the result of: Select one: A. concomitant internal hemorrhage. B. increased peripheral vascular tone. C. loss of alpha receptor stimulation. D. profound peripheral vasoconstriction.

C. loss of alpha receptor stimulation

The respiratory centers of the brainstem lie within the: Select one: A. midbrain. B. diencephalon. C. pons and medulla. D. basal ganglia.

C. pons and medulla

During a lateral impact collision: Select one: A. properly worn seat belts protect the passenger from pelvic trauma at the time of impact. B. the patient's head moves away from the object causing the impact, resulting in stretching injuries. C. the far-side occupant, even if properly restrained, experiences double the amount of force as the driver. D. trauma to the upper extremities depends on the spatial orientation of the arms upon impact.

D. trauma to the upper extremities depends on the spatial orientation of the arms upon impact

Cerebrospinal fluid is manufactured in the __________ of the brain and serves to ______________. Select one: A. subarachnoid space, oxygenate the brain B. subdural space, prevent infection C. cortex, protect the brain from injury D. ventricles, cushion and protect the brain

D. ventricles, cushion and protect the brain

Commotio cordis is a phenomenon in which: Select one: A. penetrating thoracic trauma perforates the atria or ventricles, causing acute rupture and massive hemorrhage. B. excessive pressure within the pericardial sac impairs cardiac contractility as well as venous return to the heart. C. myocardial tissue at the cellular level is damaged by blunt or penetrating trauma, resulting in cardiac arrest. D. ventricular fibrillation is induced following blunt trauma to the chest during the heart's repolarization period.

D. ventricular fibrillation is induced following blunt trauma to the chest during the heart's repolarization period