Chapter 32

After direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: Select one: A. apply high-flow oxygen, consider spinal precautions, and transport without delay. B. hyperventilate him with a bag valve mask and monitor his oxygen saturation. C. apply high-flow oxygen, perform a detailed secondary assessment, and transport. D. focus your assessment on his scapulae and clavicles and apply high-flow oxygen.

A. apply high-flow oxygen, consider spinal precautions, and transport without delay.

During your secondary assessment of a 19-year-old female with multiple traumas, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic, and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The most appropriate treatment for this patient includes: Select one: A. immobilizing her to a backboard and rapidly transporting. B. applying a traction splint to immobilize her femur. C. carefully splinting each of her deformed extremities. D. splinting her femur fracture with padded board splints.

A. immobilizing her to a backboard and rapidly transporting.

The most common and significant complication associated with fractures or dislocations of the knee is: Select one: A. neurovascular compromise. B. internal bleeding and shock. C. ligament and cartilage damage. D. total depletion of synovial fluid.

A. neurovascular compromise.

The primary purpose for splinting a musculoskeletal injury is to: Select one: A. prevent further injury. B. maximize distal circulation. C. make the patient comfortable. D. facilitate ambulance transport.

A. prevent further injury.

Femoral shaft fractures can result in up to. mL of internal blood loss. Select one: A. 4,000 B. 1,000 C. 1,500 D. 2.000

B. 1,000

You and your partner are preparing to apply a traction splint to a patient's deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should: Select one: A. gently massage the thigh muscles to relax them. B. stop and splint the leg in the deformed position. C. assess distal pulses and continue pulling traction. D. flex the knee and place a pillow under the thigh.

B. stop and splint the leg in the deformed position.

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: Select one: A. carefully straighten the injured arm and secure it with padded board splints. B. make two or three attempts to restore distal circulation by manipulating the elbow. C. apply gentle manual traction in line with the limb and reassess for a pulse. D. splint the elbow in the position of deformity and transport immediately.

C. apply gentle manual traction in line with the limb and reassess for a pulse.

A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should: Select one: A. place a pillow under his arm and apply a sling B. perform a rapid secondary assessment. C. immobilize the injury with a sling and swathe. D. straighten his arm and apply a board splint.

C. immobilize the injury with a sling and swathe.

Bones are connected to other bones by bands of tough fibrous tissues called: Select one: A. bursa. B. cartilage. C. ligaments. D. tendons.

C. ligaments.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: Select one: A. the presence of deformity. B. distal circulation. C. the patient history. D. bruising to the shoulder.

C. the patient history.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should: Select one: A. bind the legs together and elevate them six feet to eight feet. B. flex the knee slightly and apply a formable splint. C. apply a traction splint to realign the deformity. D. apply padded board splints to both sides of the leg.

D. apply padded board splints to both sides of the leg.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: Select one: A. gently attempt to move his arm toward his body. B. place a pillow under his arm and apply a swathe. C. flex his arm at the elbow and then apply a sling. D. assess distal pulse, motor, and sensory functions.

D. assess distal pulse, motor, and sensory functions.