Chapter 50 - Abdominal Trauma (Aehlert)

Upon examining your patient, you suspect she may be developing a compartment syndrome of the lower leg. What is your best course of action when treating this patient in the field? A) A. Apply a PASG to decrease swelling and control internal bleeding. B) B. Administer RICE. C) C. Splint it with a padded splint in the position found. D) D. Transport the patient to the closest, most appropriate facility

D

Use of the PASG is indicated for what type of injury? A) A. Abdominal hemorrhage B) B. Dislocated ankle C) C. Humoral fracture D) D. Pelvic fracture

D

What type of tissue is also known as dense connective tissue and is composed of an abundant amount of collagenous fibers where one end is joined to muscle? A) A. Bursa B) B. Cartilage C) C. Ligaments D) D. Tendons

D

Which penetrating object is least likely to have a straight trajectory through the body? A) c. Glass shard B) d. Knife C) a. Arrow D) b. Bullet

D

Why are fractures in the area of the epiphyseal plate of pediatric patients considered serious? A) A. Because of their location, epiphyseal plate fractures are inherently difficult to immobilize properly. B) B. The epiphyseal plate is a very vascular area. A fracture here may result in a great deal of blood loss, especially dangerous in the pediatric population because of their smaller amount of circulating blood volume. C) C. The epiphyseal plate is located near a joint and therefore may involve nerve and vascular structures. These plates must be handled carefully to avoid permanent damage to the extremity. D) D. The epiphyseal plate is the area of the bone responsible for the growth of the bone. A fracture here may prevent proper growth of the bone and cause unusual deformity to joints or an unnatural bending.

D

Your ambulance crew is called to a scene where a 42-year-old female fell from a second-story balcony and landed on her outstretched right arm. There is gross deformity at the shoulder. The patient is unconscious. You should address immobilization of the deformed right shoulder by: A) c. Applying a traction splint B) a. Applying a sling C) b. Applying a sling and swathe D) d. Immobilizing the patient to a long backboard

D

Your crew is called to a local skating rink to treat a 42-year-old female who fell. She is complaining of severe elbow pain and is supporting the affected limb against her body. To manage this situation effectively, you should: A) b. Rotate the arm to 90 degrees and secure it with a sling and swathe B) a. Rotate the arm to 90 degrees and secure it with a rigid splint C) d. Splint the arm in the position found, using a traction splint D) c. Splint the arm in the position found, using a pillow or blanket

D

_____________muscles are involved in movement. A) a. Cardiac B) d. Smooth C) b. Involuntary D) c. Skeletal

D

You are managing a 25-year-old male patient who was involved in a gang-related fight; police have secured the scene. During your assessment, you find several stab wounds along the patient's right flank and lower back. The patient is awake and anxious, in obvious pain. While your partner obtains vital signs, appropriate management for the stab wounds includes: A) b. Covering the wounds with gauze or trauma dressings B) a. Applying wet sterile dressings over each wound and then an occlusive dressing C) d. Packing each wound with gauze to control internal bleeding D) c. Only covering them with an occlusive dressing

A

You are treating a 44-year-old female patient who was struck by a car while crossing the street and was thrown 25 feet. She is responding to verbal stimuli, does not move appropriately, and has a pulse rate of 132 beats/min, a respiratory rate of 32 breaths/min, a blood pressure of 88/68 mm Hg, and pale and clammy skin. When you remove her clothing, her upper abdominal quadrants are bruised, rigid, and tender. Appropriate care for this patient includes: A) b. Establishing a large-bore IV B) d. Providing oxygen via nasal cannula C) c. Positioning her in the left lateral recumbent position to protect her airway D) a. Administering fentanyl for pain

A

Your 33-year-old male patient is conscious and alert after falling to the ground while exiting his vehicle. He is complaining of an isolated injury to his left leg. There is tension in his muscles during relaxation, loss of distal sensation, and extreme pain on extension that seems to be out of proportion to his injury. What has most likely occurred to your patient? A) A. Compartment syndrome B) B. Dislocation of his hip C) C. Dislocation of his patella D) D. Oblique fracture

A

Your crew is called to a local nightclub for a 23-year-old male with a hand injury. The patient tells you that he hit a brick wall when he missed his intended target. The patient's knuckles and the entire back of his hand are edematous and painful. His hand has limited movement of the distal phalanges. His hand is open and his fingers are bent. To immobilize this injury, you should: A) c. Immobilize the hand in a position of function B) b. Close the hand into a fist and then immobilize the hand C) a. 'Buddy splint' the fingers together D) d. Straighten the fingers and then immobilize the hand

A

Your crew is called to an assisted-care facility for a 73-year-old female who fell while getting out of the shower. On arrival you observe that the patient is in a considerable amount of pain and complains of left proximal leg pain. The knee of the affected leg is flexed and the leg is shortened and internally rotated. This presentation is typical of what type of injury? A) a. Dislocation of the hip B) b. Dislocation of the knee C) c. Distal femur fracture D) d. Proximal femur fracture

A

Your patient is a 34-year-old female who just rear-ended another vehicle at a high rate of speed. Your patient is 23 weeks pregnant and is complaining of intense cramping, uterine pain and tenderness, occasional contractions, and an increase in vaginal bleeding. What is your patient most likely suffering from? A) A. Abruptio placentae B) B. Imminent childbirth C) C. Placental previa D) D. Preeclampsia

A

Your patient was hit in the back with a baseball bat. Shortly after the incident, he began to experience lightheadedness and blurry vision. You notice bruising around his umbilicus. What does this indicate? A) A. Cullen's sign B) B. Kehr's sign C) C. Stop sign D) D. Turner's sign

A

After consulting with medical direction, a decision has been made to attempt realignment of a badly angulated tibia-fibula fracture. While attempting to realign the bone fragments, you observe obvious anatomic resistance to your effort. You should: A) a. Administer a muscle relaxant, and reattempt realignment B) d. Pull harder C) b. Cease your efforts to realign, and transport D) c. Gently rotate the limb, reapply traction, and then splint

C

If an expectant mother improperly wears a seat belt too high and is involved in a motor vehicle crash, she could experience what condition? A) b. Placenta previa B) a. Fetal decapitation C) d. Placental abruption D) c. Preterm labor

C

Immobilization of an injured femur requires: A) a. A four-person crew B) d. Only one rescuer C) c. At least two rescuers D) b. At least three rescuers

C

Mortality secondary to solid abdominal organ injury is primarily caused by: A) c. Infection B) d. Organ death C) a. Hemorrhagic shock D) b. Ileus

C

The most common bones to receive stress fractures are: A) a. Bones of the arm B) c. Ribs C) d. Weight-bearing bones D) b. Long bones

C

Traction splints are designed specifically to be used for what type of injuries? A) d. Tibia fractures B) b. Knee dislocations C) a. Femur fractures D) c. Pelvic fractures

C

What measurement should you use to adjust the Hare traction splint before applying it to a femur fracture? A) A. Estimate the patient's height divided by 2 and add 6 to 8 inches past the end of the extremity. B) B. Measure it against the injured leg from the ischium and add 6 to 8 inches past the end of the extremity. C) C. Measure it against the uninjured leg from the ischium and add 6 to 8 inches past the end of the extremity. D) D. Start with the traction splint fully extended and apply, tightening until the patient voices relief of pain.

C

When an expectant mother experiences significant abdominal trauma, the placenta can separate from the uterine wall. This condition is known as: A) d. Uterine rupture B) c. Placenta previa C) b. Abruptio placentae D) a. Abruptio placental previa

C

When assessing musculoskeletal injuries, paramedics should: A) a. Make every attempt to diagnose the injury correctly B) b. Manage patients as though they have a sprain C) d. Not be concerned with differentiating among sprains, strains, and fractures D) c. Manage patients as though they have a strain

C

When the diaphragm ruptures: A) b. Chest cavity organs can fall into the abdominal cavity B) d. The chest wall cannot expand normally C) a. Herniation of the abdominal contents upward into the chest cavity occurs D) c. Partially digested food does not flow from the stomach into the duodenum

C

Which of the following is correct regarding the use of traction splints? A) d. Traction splints are used to reduce open, midshaft long-bone fractures. B) a. Traction splints are used for dislocations of the knee with associated femur fracture. C) b. Traction splints are used for isolated midshaft femur fractures. D) c. Traction splints are used for proximal femur fractures or hip dislocations.

C

You are evaluating a 14-year-old female patient who fell off a top bunk and onto a binder. You expose her abdomen and can see a line of demarcation from the edge of the binder across both lower quadrants. When you palpate the abdomen, it is soft and nontender in all quadrants, and she rates her pain at 3 out of 10. Her heart rate is 86 beats/min, her respiratory rate is 20 breaths/min, her blood pressure is 114/60 mm Hg, and her skin is normal. You suspect that your patient: A) d. Will likely have liver swelling B) c. May have perforated her stomach C) a. Appears to only have superficial injuries but should still be evaluated by a physician D) b. Likely has massive internal bleeding

C

You are evaluating a 33-year-old female patient who was ejected from a motorcycle when her husband lost control on a corner. After exposing her body, you observe abrasions across her right flank and abdomen and note that bruising is developing along the posterior aspect of her right flank. Based on this information, you suspect that your patient: A) a. Has fatal injuries B) c. Likely has superficial abdominal injuries only C) d. May have internal abdominal injuries D) b. Is in decompensated hemorrhagic shock

C

You are treating a 40-year-old female patient who was stabbed in the right upper quadrant with a steak knife. Oxygen has been administered, and the entry wound has been covered with a sterile dressing. Appropriate care for this patient includes: A) c. Transport to the closest emergency department for a blood transfusion B) a. Administration of IV epinephrine to help the patient compensate C) d. Transport to the closest trauma center D) b. IV fluids infusing at a KVO rate

C

Your patient is complaining of muscle spasms in the lower leg. Your choice of treatment would be to: A) d. Administer compression B) c. Apply ice C) b. Apply heat D) a. Administer medication

C

Which organ can have an 'organ fracture,' causing massive internal hemorrhage? A) d. Liver B) a. Appendix C) c. Intestine D) b. Bladder

A

Which type of fracture is more common in children because of the softness and flexibility of their bones? A) A. Greenstick fracture B) B. Oblique fracture C) C. Spiral fracture D) D. Stress fracture

A

You and your partner have splinted a possible midshaft radial-ulna fracture. After applying the splint, PMS is reevaluated, noting that the pulse is absent. Your next action would be to: A) b. Contact medical control B) a. Apply ice C) c. Loosen the splint D) d. Realign the injury

A

An elderly man complains of severe pain in his upper thigh and hip after a fall. The leg on the affected side is shortened and internally rotated. Which action would be appropriate? A) a. Apply a traction splint. B) b. Apply PASG and inflate leg segments. C) c. Attempt to reduce the dislocation. D) d. Pad behind the knee for comfort.

D

A fracture of a child's bone at the epiphyseal plate commonly leads to: A) c. Unusual deformity of the joint or an unnatural bending B) d. Torn ligaments and tendons C) b. Infection D) a. Frequent breakage of bones in the future

A

A patient injured his hand while punching someone with a closed fist. You anticipate his injury to be to the: A) a. Fifth metacarpal B) b. First carpal C) c. Second phalange D) d. Thumb

A

An easy way to remember the various components of musculoskeletal injury assessment is to recall: A) d. The six P's of musculoskeletal assessment B) b. The mnemonic ARM-LEGS C) a. The four M's of musculoskeletal assessment D) c. The mnemonic TIC

A

Before performing a reduction of a dislocated joint, which class of medication should be administered to help with muscle relaxation? A) c. Benzodiazepines B) b. Anesthetics C) d. Narcotics D) a. Analgesics

A

Death due to abdominal trauma is usually a result of: A) A. Continuing hemorrhage and delayed surgical repair B) B. Unpreventable infection C) C. Exsanguination occurring within 30 minutes of the injury D) D. Rupture of hollow organs and resulting nutritional deficiencies

A

Following recognition of a pelvic fracture, your next intervention should be to: A) a. Apply a pelvic binder B) c. Inflate the abdominal compartment only of a pneumatic antishock garment C) d. Provide pharmacologic pain management D) b. Apply a traction splint

A

How does prehospital management of solid organ injury differ from management of hollow organ injury? A) d. There is no difference in prehospital management. B) c. Solid organ injuries require treatment at a trauma center, unlike hollow organ injuries. C) b. Solid organ injuries require less fluid resuscitation. D) a. Hollow organ injuries require less fluid resuscitation.

A

One of the most common causes of vascular abdominal injuries is: A) c. Improper use of seat belts B) b. Blast injuries C) a. Bone fracture fragments D) d. Knife wounds

A

Other than hemorrhage, the major cause of mortality following a traumatic duodenal rupture is: A) d. Spillage of intraluminal contents into the peritoneum B) a. Bowel infarction from ischemia C) c. Inability to digest food/malnutrition D) b. Ileus

A

The most serious concern of a bladder rupture is: A) d. Shock and/or peritonitis B) c. Urine and blood leakage C) b. Massive hemorrhage D) a. Loss of the body's ability to eliminate urine

A

The most significant indicator of severe abdominal trauma is the presence of: A) A. Unexplained shock B) B. Bowel sounds in the chest cavity C) C. Referred pain in one or both shoulder blades D) D. Abdominal distention

A

The urinary bladder is more likely to rupture: A) A. When it is full B) B. When it is empty C) C. In women D) D. In men

A

Which hollow organ is most commonly injured as a result of blunt force trauma? A) c. Stomach B) d. Uterus C) a. Small intestine D) b. Spleen

A

Which of the following is a solid abdominal organ? A) d. Spleen B) b. Intestines C) c. Stomach D) a. Gallbladder

A

Which of the following organs is in the retroperitoneal space? A) b. Kidney B) d. Spleen C) c. Liver D) a. Bladder

A

Appropriate care for abdominal organs protruding through the abdominal wall includes: A) d. Having the patient lie supine and providing aggressive pain management B) c. Inserting the organs back into the body C) b. Covering the organs with a dry dressing D) a. Covering the organs with moist dressing

D

As a paramedic, you realize that your ability to quickly recognize and treat a musculoskeletal injury helps to limit: A) a. Disease B) c. Morbidity C) d. Mortality D) b. Loss of use

D

You are called to the ski patrol headquarters of a ski resort because there has been a skiing accident. When you arrive, you find a 23-year-old male patient immobilized and in obvious pain. He reportedly lost control on the mogul run and tumbled down the side, eventually striking a tree. During your assessment, his abdomen is slightly rigid with rebound tenderness. There is no abdominal bruising; it just appears slightly red. His pulse rate is 82 beats/min, his respiratory rate is 18 breaths/min, his blood pressure is 136/72 mm Hg, his skin is normal, and he rates his pain as a 10 out of 10. Based on these findings, you suspect: A) b. Pelvis fracture B) c. Potential intestinal rupture C) a. Massive internal hemorrhage D) d. Spleen rupture

B

As a paramedic, you recognize the greatest potential of blood loss is from a fracture of the: A) c. Rib B) a. Femur C) b. Humerus D) d. Pelvis

D

Based on your knowledge of anatomy, you would suspect a patient with a stab wound in the upper right quadrant to be at risk for: A) d. A perforated stomach, causing infection B) c. A perforated bladder, causing infection C) b. A lacerated spleen, causing internal hemorrhage D) a. A lacerated liver, causing internal hemorrhage

D

Before manipulating any injured extremity, you must: A) d. Position the patient on a long backboard B) a. Administer intravenous analgesic per medical direction C) c. Place the patient on high-flow oxygen D) b. Assess distal pulses, sensation, and motor function

D

You are evaluating a 16-year-old male patient who was playing hockey with his friends at an outdoor skating rink when he slammed against his hockey stick, driving the handle deep into his epigastric region. He believes he fell on top of the stick and it caught under his ribs. He is also in obvious respiratory distress, and his abdomen appears slightly sunken; he seems unable to take a full breath. Which of the following interventions is contraindicated in this patient? A) d. Performing rapid sequence intubation B) c. Inflating a pneumatic antishock garment C) a. Performing bag-mask ventilations without an ETT in place D) b. Having the patient lie supine

B

Ecchymosis around the umbilicus (Cullen's sign) is indicative of hemorrhage in which of the following organs? A) A. Spleen B) B. Liver C) C. Stomach D) D. Pancreas

D

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare for a rapid extrication, you are worried that she may have experienced: A) b. Femoral artery laceration B) a. Abruptio placentae C) c. Liver laceration D) d. Premature labor

B

Following a traumatic pancreatic injury, the major concern becomes: A) a. Hypersecretion of insulin B) d. Massive hemorrhage C) b. Hyposecretion of insulin D) c. Leakage of digestive enzymes into the peritoneal space

D

Following blunt abdominal trauma, the primary problem that develops for the patient is: A) b. Ileus B) c. Pain C) d. Swelling D) a. Hemorrhage

D

When should you assess circulation when splinting an elbow? A) A. After the splint B) B. Before and after the splint C) C. Before the splint D) D. Only check if there is cardiovascular compromise

B

Which abdominal organ would most likely be affected by the primary phase of a blast injury? A) A. Kidney B) B. Large intestine C) C. Liver D) D. Spleen

B

Which of the following injuries can be caused by a shearing mechanism following abdominal trauma? A) a. Bladder perforation B) d. Liver injury C) c. Kidney tearing at the ligamentum teres D) b. Intestinal tearing along the aorta

B

Hollow organ rupture is most frequently caused by which of the following mechanisms? A) a. Contact sport collisions B) b. Restrained drivers in motor vehicle crashes C) c. Skiing accidents D) d. Unrestrained drivers in motor vehicle crashes

D

In gunshot wounds, the _______ of the projectile is the most important factor in determining the amount of kinetic energy transferred to the body and therefore the amount of damage sustained by the patient. A) A. Mass B) B. Shape C) C. Tumble D) D. Velocity

D

Which of the following is true about mechanism of abdominal injury? A) A. Shootings and stabbings are the primary cause of abdominal injury. B) B. Motor vehicle trauma is involved in as much as 75% of blunt abdominal trauma. C) C. Penetrating abdominal trauma has a higher mortality rate than blunt abdominal trauma. D) D. More than 75% of patients with penetrating abdominal trauma exsanguinate on scene.

B

A bone break common in children, in which the bone is bent but only broken on the outside of the bend, is called a: A) b. Comminuted fracture B) c. Greenstick fracture C) a. Closed fracture D) d. Stress fracture

B

A grade 2 sprain usually results in: A) d. Vascular compromise B) c. Immediate pain and swelling C) a. A dislocated joint D) b. An unstable joint

B

A major risk for both an expectant mother and her fetus following a serious traumatic event is A) d. Preecclampsia B) a. Abruptio placentae C) b. HELLP syndrome D) c. Placenta previa

B

An abdominal evisceration is managed in the field by: A) A. Replacing the contents into the abdominal cavity and keeping the patient warm B) B. Covering the abdominal contents with moist dressing C) C. Cooling the patient to reduce metabolism D) D. Administering oral fluids and pain medication

B

As a rule, fractures and dislocated joints should be: A) c. Reduced in the field B) a. Immobilized in anatomic position and in a position of comfort C) b. Immobilized with a soft splint D) d. Repositioned in the field

B

If the structure identified in this scenario is severely injured, the greatest concern is: A) A. Pneumothorax B) B. Rapid and significant blood loss C) C. Spillage of digestive enzymes into the abdominal cavity D) D. Leakage of urine and uric acid into the abdominal cavity

B

If you determine the musculoskeletal injury is isolated, then you can perform a(n): A) d. Head-to-toe assessment B) a. Focused assessment C) b. Ongoing assessment D) c. Rapid trauma assessment

B

In a sprain, which of the following is injured? A) d. Tendon B) b. Ligament C) c. Muscle D) a. Bone

B

Leakage of urine into the abdominal cavity will result in a painful presentation known as: A) A. Urethritis B) B. Peritonitis C) C. Incontinence D) D. Pyelonephritis

B

Sprains are categorized according to the: A) b. Number of cartilages damaged B) a. Extent of ligament damage C) c. Type of tendons damaged D) d. Type of tissue involved

B

What borders the abdomen superiorly? A) A. Abdominal wall B) B. Diaphragm C) C. Skeletal structures D) D. Vertebral column

B

What sign, indicative of a ruptured spleen, is described as ecchymosis around the umbilicus? A) A. Battle's sign B) B. Cullen's sign C) C. Grey-Turner's sign D) D. Kehr's sign

B

What type of fracture typically happens in children because their bones are softer? A) A. Comminuted B) B. Greenstick C) C. Oblique D) D. Transverse

B

What would you expect to find during your assessment of a patient you believe may have internal abdominal traumatic injuries? A) a. A soft abdomen B) d. Tenderness C) c. Obvious external blood loss D) b. Early development of a rigid and distended abdomen

B

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare to extricate the patient, you advise everyone on scene that you are going to immobilize the patient: A) d. With padding underneath her right hip and pelvis only to elevate the right side of her pelvis B) b. On her left side on the backboard with padding in the spaces C) a. In a traditional manner D) c. With padding under her feet and legs supine on the backboard

B

You are evaluating an extremity fracture of the lower arm. You find a distal pulse; however, your patient states there is numbness below the sight of the injury. Using the 6 P's of assessment, you state this is: A) d. Pressure B) c. Paresthesia C) a. Pallor D) b. Paralysis

B

You are managing an unresponsive 50-year-old female patient who was in a car-versus-tree motor vehicle crash. She is in the driver's seat wearing a chest strap but no waist belt. Her pulse rate is 134 beats/min, her respiratory rate is 36 breaths/min, and her blood pressure is 76/52 mm Hg. The imprint of her seat belt is clearly defined across her chest and abdomen, and her abdomen is rigid and bruising. You suspect that your patient may have: A) c. A tension pneumothorax B) d. Ruptured a blood vessel C) a. A cardiac tamponade D) b. A ruptured spleen

B

You arrive at the scene of a motor vehicle accident. Your patient, who is obviously late in her pregnancy, is still in the driver's seat. She states that she was wearing her seat belt although it is not currently in place. As you expose your patient, you find she has abrasions from the seat belt in the area of her shoulder and across her abdomen approximately 1 inch below her umbilicus. What can you infer from these markings? A) A. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at a high risk for preterm labor and delivery. B) B. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at risk of abruptio placenta and uterine rupture. C) C. Your patient was indeed wearing her seat belt and was appropriately secured. D) D. Your patient was wearing her seat belt, and although the placement was not appropriate, the large amount of abdominal fat protected her and her fetus from damage.

B

You respond to a patient complaining of shoulder pain after falling from a bicycle and landing on his outstretched hand. As a paramedic, you know this type of MOI is classified as: A) a. Direct B) b. Indirect C) c. Penetrating D) d. Twisting

B

Your crew is called to a local park for a 34-year-old male who injured his shoulder while playing softball. There is swelling at the left shoulder where the clavicle meets the proximal humerus. If this is the patient's only injury, what device should you use for immobilization? A) a. Long backboard B) d. Sling and swathe C) c. Short backboard D) b. Rigid splint

B

Most retroperitoneal hemorrhages occur as a result of: A) A. Kidney laceration B) B. Pancreas injury C) C. Tear of the duodenum D) D. Pelvic fractures

D

Once the decision has been made to realign a fracture site, you should: A) a. Continue realignment attempts until distal pulses are present B) b. Continue realignment attempts until the gross deformity has been reduced C) d. Wait to perform the procedure and realign only if the patient loses distal circulation D) c. Make only one attempt at realignment

D

A mnemonic for remembering signs and symptoms of musculoskeletal injury is: A) a. AVPU B) d. SAMPLE C) b. DCAP-BTLS D) c. OPQRST

C

Paramedics play a vital role in early abdominal trauma management by: A) b. Identifying for the surgeons which organ is bleeding B) a. Controlling internal bleeding C) d. Triaging with patients who may or may not have suffered internal injuries following abdominal trauma D) c. Providing rapid response and rapid transport to a trauma center

D

. Your crew is called to the scene of a sports injury at a local park. A 43-year-old female injured her ankle while sliding into home base. There is gross deformity at the joint that appears consistent with a severe dislocation. She is in a tremendous amount of pain and has extreme difficulty when trying to wiggle her toes. Her distal pulse is absent. Proper intervention would include analgesics and: A) d. Splinting the injury in the position found, using a pillow or blanket B) c. Attempted reduction by taking the ankle through its full range of motion C) a. Attempted reduction by pulling on the talus D) b. Attempted reduction by pulling on the toes

C

A Colles fracture refers to what area of the body? A) c. Proximal tibia B) b. Mandible C) a. Distal radius D) d. Ribs

C

A PASG can be used in place of which other type of splint? A) a. Flexible B) b. Ridged C) d. Air splint D) c. Sling and swath

C

A condition where the abdominal wall is damaged and underlying abdominal structures are protruding through the abdominal wall is known as: A) c. Abdominal inversion B) d. Abdominal protrusion C) b. Abdominal evisceration D) a. Abdominal contusion

C

A fracture or dislocation should be realigned when: A) c. The patient reports extreme pain B) b. The lower leg is involved C) a. Circulation is impaired D) d. The site is bleeding

C

Prehospital management of internal genitalia or bladder injury includes: A) a. Applying a compression bandage to the genitalia B) c. Foley catheter placement C) b. Flushing saline into the genitalia with a plastic catheter D) d. Attention to the ABCs and treating hemorrhagic shock if present

D

The best indicator of bladder or internal genitalia injury in the male patient is: A) b. Swelling of the penis B) d. Scrotal swelling and bruising C) c. Prehospital Foley catheter placement to look for blood in the urine D) a. Blood at the urethral meatus

D

The greatest factor in the amount of energy causing trauma to a patient is: A) b. The angle at which an object strikes the body B) d. The insulting object's weight C) a. Patient weight D) c. The insulting object's velocity

D

'Buddy splinting' refers to a technique in which a broken: A) d. Leg is secured by holding the injury in place against a long backboard B) b. Arm is secured to a rigid splint C) a. Arm is secured to a long backboard D) c. Finger or toe is taped to an adjacent but uninjured finger or toe

D

A break that involves several breaks in the bone, causing bone fragment damage, is called a(n): A) c. Open fracture B) d. Spiral fracture C) b. Greenstick fracture D) a. Comminuted fracture

D

A critical assessment finding during your evaluation of a patient who experienced abdominal trauma is: A) d. Pain B) b. Bruising C) a. Anxiety D) c. Hypovolemic shock

D

A fracture of the femur can result in blood loss of up to: A) c. 1000 mL B) a. 250 mL C) b. 500 mL D) d. 2000 mL

D

A) A. An early sign of peritoneal irritation B) B. A late finding of peritoneal irritation C) C. A rupture or tear in the diaphragm D) D. Consistent with the hemorrhage associated with damage to a solid organ

D

After controlling the airway and any severe external bleeding in a patient with traumatic abdominal injuries, the most important treatment is to: A) b. Provide aggressive pain management B) d. Stabilize any musculoskeletal injuries C) a. Establish two large-bore IVs D) c. Provide early rapid transport to a trauma center

D

To reduce pain and swelling in the first 24 hours after a sprain, apply: A) a. Heat and ice, alternating every 3 to 4 hours B) d. Warm soaks C) b. Heat first, and then ice, once the muscles are warmed D) c. Immobilization and ice

D