Paramedic Nancy Caroline: Ch. 32/38
During the process of wound healing, hemostasis:
Temporarily stops bleeding via vasoconstriction and platelet aggregation.
Which of the following medications would MOST likely interfere with hemostasis?
Plavix
How should you remove a patient's clothing when looking for bullet entrance and exit wounds?
Preserve the clothing as evidence and cut around bullet holes.
Upon assessing a patient, you find that they have a scapular fracture. Based on this finding, you should also asess for:
Pulmonary contusions.
Common signs and symptoms of an acute pulmonary embolism include all of the following EXCEPT:
Pulmonary edema.
While palpating an extremity, you note a pulsatile expanding hematoma, diminished distal pulses, and a palpable thrill over the site of the injury that correlates with the patient's heartbeat. You recognize that these are signs of:
An arterial injury.
Which of the following interventions encourages drainage from the site of a closed wound and reduces swelling?
Elevation
Which of the following structures is NOT part of the axial skeleton?
Femoral Shaft
Systemic signs of infection secondary to a soft-tissue injury include:
Fever and chills.
Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called:
Gangrene
The upper extremity joins the shoulder girdle at the:
Glenohumeral joint.
Which of the following is the most common cause of necrotizing fasciitis?
Group A Streptococcus
A 45-year-old man was cutting down a large tree when it collapsed, pinning him at the thighs. The patient's wife found him approximately 4 hours after the incident. The patient is conscious and in severe pain. His blood pressure is 128/68 mm Hg, pulse is 120 beats/min and regular, and respirations are 22 breaths/min with adequate depth. In addition to supplemental oxygen and cardiac monitoring, which of the following treatments should you provide BEFORE the tree is removed from his legs?
IV therapy with a crystalloid fluid bolus and albuterol via nebulizer or mucosal atomizer device
A 45-year-old patient who fell off a ladder reports that they landed on their feet. Upon assessing the patient, you suspect a pelvic fracture. Which type of injury did the patient experience?
Indirect
The skin is also referred to as the:
Integument.
In contrast to osteoarthritis, rheumatoid arthritis:
Is a systemic inflammatory disease that affects joint and other body systems.
A tough, waterproof substance that further protects the underlying tissues from light, heat, microorganisms, some chemicals, and minor trauma.
Keratin
The stratum corneum are dead cells that have had their cytoplasm replaced with:
Keratin
You arrive at the scene of a motorcycle crash and find the rider lying supine approximately 20 feet from his bike; he is still wearing his helmet. As you approach him, you note that he has bilaterally deformed femurs. You should:
Manually stabilize his head and assess his airway.
The return of myoglobin to the systemic circulation following a crush injury would result in all of the following conditions, EXCEPT:
Metabolic alkalosis.
What type of fracture occurs at an angle across the bone and is typically caused by direct or twisting force?
Oblique
Which of the following is NOT one of the 6 Ps of musculoskeletal injury assessment?
Passive extension
The appendicular skeleton is composed of the:
Pectoral girdle, pelvic girdle, and bones of the extremities.
The risk of a pulmonary embolism following a musculoskeletal trauma is HIGHEST in patients with:
Pelvic and lower extremity injuries that lead to prolonged immobilization
In a closed femur fracture, blood loss may exceed _______ before enough pressure develops to tamponade the bleeding.
1,000 mL.
Closed bilateral fractured femurs cans result in internal blood loss of up to:
1,500 mL.
Heat therapy should generally be avoided how many hours after a musculoskeletal injury because it may increase pain and swelling during this period?
48 to 72 hours
Immediate pain from the heel to the calf and a sudden inability for plantar flexion of the foot is most indicative of:
Achilles tendon rupture.
In females, a decrease in bone density is accelerated:
After menopause.
When a patient has multiple open wounds to an extremity, you should consider the use of which of the following to allow for constant pressure over large areas that may not be possible using hands alone?
Air splint
Which type of fracture is unique to children and is most commonly seen in the distal radius?
Buckle
A hemostatic agent would be used to:
Control serious hemorrhage when application of a tourniquet is not possible.
A patient taking ___________ would MOST likely experience a delay in the healing of a wound.
Corticosteroids
Primary treatment in the prehospital setting for an abrasion involves:
Covering it lightly with a sterile dressing
Upon palpating the clavicle of a patient with a suspected fracture, you hear a faint grating sound. You identify this as:
Crepitus
Which of the following statements regarding crush injury is correct?
Crush syndrome can occur if the body part is entrapped for more than 4 hours.
Which of the following dressings should be used to treat an open injury to the neck?
Occlusive dressing
When muscles are crushed beyond repair, tissue necrosis develops and causes the release of harmful products. This process is called:
Rhabdomyolysis
Osteoporosis is MOST accurately defined as a(n):
Significant decrease in bone density.
A 30-year-old man presents with jaw and neck stiffness and fever. During you assessment, he tells you that he cut his hand of a piece of metal about a week ago. You should be MOST suspicious that this patient has:
Tetanus.
Which of the following medications would most likely interfere with hemostasis?
Warfarin
When a part of a patient's body is completely avulsed, what is the priority?
Wrap the part loosely in saline-moistened gauze.
Compartment syndrome occurs when:
pressure in the fascial compartment leads to impaired circulation, sensory changes, and progressive muscle death.
