Quiz 10

You have delivered your patient, a 14-year-old female with a possible femur fracture, to the emergency department. After radiographic evaluation, the physician tells you that the patient has a comminuted fracture. This means that the femur:

. has fractured into more than two fragments.

In addition to providing the framework for the human body, bones also:

. produce blood cells in the marrow.

In which of the following situations would it NOT be appropriate to splint a patient's fractures before moving him or her?

Confused patient with tachycardia and shallow breathing

When transporting a moderately hypothermic patient, you must avoid unnecessary bumps in the road. Not doing so may result in:

a cardiac arrhythmia.

When assessing a 14-year-old male with an injured arm, you note gross deformity just distal to the elbow. Distal neurovascular functions are grossly intact. You should

assume that growth plate damage has occurred

Following blunt force trauma to the elbow, a 40-year-old female complains of severe pain and the feeling that her elbow is "locked". Your assessment reveals marked deformity and swelling. This patient has MOST likely experienced a/an:

dislocation.

When assessing a patient who has fractured his or her midshaft clavicle, you should expect to find swelling, point tenderness, and:

distal neurovascular deficit.

The primary reason for applying gentle longitudinal traction to a severely angulated tibia is to:

ensure that distal pulses remain intact.

In addition to controlling bleeding and immobilizing the spine as needed, appropriate care for a patient with a penetrating abdominal wound and signs of shock includes

ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the most appropriate facility

A patient with a displaced fracture of the proximal femur typically presents with

external leg rotation, with the injured leg shorter than the opposite leg.

The energy needed for muscular contraction is derived from the metabolism of ___________ and results in the production of:

glucose; lactic acid.

A frostbitten extremity is usually

hard and waxy.

Patients with a significant abdominal injury:

have increased pain with movement.

Signs of a ruptured urinary bladder include all of the following, EXCEPT:

hematemesis.

Severe, persistent pain caused by a jellyfish sting should be treated by:

immersing the affected area in hot water for 30 minutes.

A 21-year-old male presents with a severely angulated forearm and extreme pain. Distal sensory, motor, and circulatory functions are intact. You should

splint the forearm in the position of deformity.

A 21-year-old male presents with a severely angulated forearm and extreme pain. Distal sensory, motor, and circulatory functions are intact. You should:

splint the forearm in the position of deformity.

In addition to causing local tissue destruction, the venom from a pit viper also causes:

spontaneous bleeding due to interference with the blood-clotting mechanisms

A 40-year-old female, who is conscious and alert with mild hypothermia, should receive active external rewarming. This involves:

wrapping her in blankets and applying heat packs to her groin.

A 30-year-old male fell while rollerblading and landed on his right arm. There is obvious deformity to the elbow and the patient complains of severe pain. The patient's hand is cool and pale and his radial pulse is difficult to palpate. The hospital is approximately 10 minutes away. You should:

. splint the arm in the position found and then transport immediately.

Which of the following patients has signs and symptoms that are MOST indicative of heatstroke?

A 31-year-old male with hot and moist skin, tachycardia, and confusion

Which of the following patients is LEAST prone to a local cold injury?

A 45-year-old male with hypertension

Which of the following individuals would be at GREATEST risk for developing hypothermia?

A 68-year-old female with a generalized infection

Which of the following describes an injury caused by indirect force?

A fall on an outstretched hand with a fractured wrist and a dislocated elbow

Which of the following types of medications would increase a person's risk of developing a heat-related illness?

Antihistamines

Which of the following medications or medical devices may inhibit the body's tachycardic response during shock?

Beta-blocker

Which of the following statements regarding hypothermia is correct?

Decreased thyroid gland function predisposes a person to hypothermia.

A 25-year-old male experienced blunt abdominal trauma and is developing shock. Which of the following signs would you expect to manifest late?

Hypotension

How could the mammalian diving reflex protect the hypothermic patient who was submerged in water?

It slows the metabolic rate and decreases the body's oxygen demand.

Which of the following statements regarding the brown recluse spider is correct?

Its venom is cytotoxic and causes severe local tissue destruction.

Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash?

Lifting a deployed airbag and assessing the steering wheel

Which of the following abdominal organs would cause the MOST profuse bleeding when severely injured?

Liver

Which of the following organs lie in the right upper quadrant of the abdomen?

Liver and gallbladder

Which of the following statements regarding decompression sickness is MOST correct?

Treatment at a recompression facility is a crucial treatment.

Which of the following mechanisms of injury would MOST likely cause a shearing injury of the bladder from the urethra in a male?

Motorcycle crash

When assessing a patient with multiple systems trauma, which of the following musculoskeletal injuries would pose the GREATEST threat to the patient's life?

Multiple open fractures

You are assessing a 24-year-old male who was bitten by a rattlesnake while hiking in the woods. Which of the following clinical signs would be MOST indicative of envenomation?

Progressive tissue swelling

Which of the following would be the LEAST reliable assessment parameter or treatment tool for a patient with significant hypothermia?

Pulse oximetry

Which of the following seatbelt positions will MOST likely result in severe intraabdominal injuries when a vehicle suddenly decelerates?

Shoulder harness and lap belt placed superior to the iliac crest

Which of the following muscles is attached to the skeleton and forms the bulk of tissue of the arms and legs?

Skeletal

Which of the following is the MOST effective method of immobilizing a fractured clavicle?

Sling and swathe

Which of the following injuries MOST accurately depicts an open fracture?

Swelling and deformity to the lateral humerus with an overlying abrasion

When the core body temperature falls below 95°F, the patient's:

ability to regulate body temperature is lost.

Shortly after returning to the surface of the water, a scuba diver experiences an acute onset of pleuritic chest pain and difficulty breathing. He is tachycardic and his pulse is irregular. You should suspect:

air embolism

When assessing the pelvis of a patient with multiple systems trauma, you should:

apply gentle inward pressure to the iliac crests.

When palpating an injured extremity, a patient complains of point tenderness. On the basis of this clinical finding, you:

are unable to determine the type of fracture.

If your assessment of a patient with a possible musculoskeletal injury reveals no external signs of injury, it would be appropriate to:

ask the patient to move each extremity carefully.

A 29-year-old male was struck in the upper back by a solid object. During your assessment, you note ecchymosis, pain, and crepitus to the left scapula. His blood pressure is 124/68 mm Hg, pulse is 110 and strong, and respirations are 24 breaths/min and labored. You should provide supplemental oxygen, immobilize his spine, and:

be alert for intrathoracic injuries.

You should assess a patient with systemic hypothermia for local cold injuries to the extremities because:

blood is shunted away from the extremities

The MOST accurate definition of a fracture is a:

break in the continuity of a bone

"Breath-holding syncope" commonly occurs when a swimmer:

breathes deeply and rapidly before entering the water

Breath-holding syncope" commonly occurs when a swimmer:

breathes deeply and rapidly before entering the water.

A 56-year-old male caught the foreskin of his penis in a long segment of the zipper of his pants. He is in extreme pain, his blood pressure is 150/88 mm Hg, his pulse rate is 120 beats/min and strong, and his respirations are 22 breaths/min with adequate depth. The closest hospital is 40 miles away. You should

carefully cut the zipper out of the pants, control any bleeding, and transport.

A 56-year-old male caught the foreskin of his penis in a long segment of the zipper of his pants. He is in extreme pain, his blood pressure is 150/88 mm Hg, his pulse rate is 120 beats/min and strong, and his respirations are 22 breaths/min with adequate depth. The closest hospital is 40 miles away. You should:

carefully cut the zipper out of the pants, control any bleeding, and transport.

Articular cartilage functions by:

covering the bone ends and cushioning them from damage and wear.

In the process of applying a splint on a 21-year-old female with an apparent dislocated patella, the patella spontaneously returns to its normal position. You should:

immobilize her knee with a long board splint.

A 55-year-old male fell from the roof of his house and sustained a closed, displaced femur fracture. He is restless, diaphoretic, and tachycardic. After appropriately managing his ABCs and performing a rapid head-to-toe assessment, you should:

immobilize him on a long backboard, transport, and start a large-bore IV en route.

A 38-year-old female sustained a high-velocity injury to her pelvis. Your assessment reveals severe pain and crepitation upon palpation of the iliac crests. Her blood pressure is 84/54 mm Hg, pulse is 120 and weak, and respirations are 26 breaths/min and unlabored. In addition to administering 100% oxygen, the MOST appropriate management should include:

immobilizing her spine, applying a pelvic binder device, transporting, and administering 20 mL/kg normal saline boluses en route.

Hyperthermia occurs when:

inadequate thermolysis causes reduced heat loss.

Fractures of the proximal femur MOST commonly occur at the:

intertrochanteric region of the femur.

Gangrene and subsequent amputation of a frostbitten extremity will MOST likely occur if it:

is rewarmed and then refreezes.

Lethal cardiac dysrhythmias, such as ventricular fibrillation, may occur in the hypothermic patient if he or she:

is rewarmed too quickly.

In addition to splinting the injured extremity, appropriate management for a patient with suspected compartment syndrome includes:

keeping the limb at the level of the heart, transporting, and frequently assessing distal pulses

During a football game, a 16-year-old male was "speared" in the right flank by another player. This mechanism of injury is MOST suggestive of injury to the:

kidney.

A 29-year-old male fell approximately 5 feet from a ladder and landed on his right shoulder. He is conscious and alert, denies loss of consciousness, and complains of pain to the shoulder. His vital signs are stable. You should:

manually stabilize the injury until it is splinted, perform a secondary assessment, splint the injury appropriately, and transport.

Compared to classic heatstroke, exertional heatstroke commonly presents with:

moist, pale skin

You have applied an air splint to the deformed forearm of a critically injured patient while waiting for a helicopter to arrive. When the helicopter arrives, the flight medic asks you to accompany the patient. During the flight, you should:

monitor the splint and let air out as needed.

You are dispatched to the residence of an 80-year-old female with a possible heat-related emergency. Your assessment reveals that she is semiconscious, has hot and dry skin, and signs of severe dehydration. You should:

move her to a cooler environment.

A 59-year-old male patient impacted the dashboard with his knees when his car struck a tree at 50 mph. During your primary assessment, you note bleeding from an obvious open femur fracture. After controlling the bleeding, applying oxygen, and extricating him from the car, you should:

perform a head-to-toe assessment, immobilize his spine, and transport.

The presence of gastric juices and bacteria in the abdominal cavity causes an intense inflammatory reaction called:

peritonitis.

An 80-year-old male tripped and fell and complains of pain to his left hip. Your assessment reveals that his knee is flexed and his left leg is shortened and medially rotated. Distal neurovascular functions are grossly intact. You should immobilize this patient's injury by:

placing him on a scoop stretcher and padding the injury with pillows

When assessing a 40-year-old female with an injury to her left wrist, you should recall that the MOST reliable indicator of an underlying fracture is

point tenderness

Pathologic fractures are typically caused by all of the following, EXCEPT:

previous fractures

A patient with a core body temperature of 85°F would be expected to present with:

profoundly slow respirations

Goals of in-line traction for musculoskeletal injuries in the prehospital setting include all of the following, EXCEPT:

reduction of the fracture.

Kehr sign is defined as:

referred pain to the shoulder following injury to the liver or spleen

You are dispatched to a ski resort for a 21-year-old female with a local cold injury to her hand. Upon making contact with the patient, your MOST immediate action should be to:

remove any constricting jewelry.

When assessing a patient with a scapular fracture, you should also be alert for:

ribs fractures and a pneumothorax.

Mild hypothermia is characterized by:

shivering, tachypnea, and peripheral vascular constriction

You arrive at the scene of a motor-vehicle crash in which a 30-year-old male was ejected from his truck. As you approach the patient, who is not moving, you can see that he has gross deformity to both of his femurs and an angulated left humerus. You should:

stabilize his head and open his airway

A 24-year-old male was pulled from the water following submersion for an unknown length of time. There were no witnesses to the patient's submersion. When you arrive at the scene, you determine that he is in cardiac arrest. Routine management for this patient should include all of the following, EXCEPT:

subdiaphragmatic thrusts.

Signs of an impending lightning strike include all of the following, EXCEPT:

sudden tachycardia

To align a severe deformity associated with a humeral shaft fracture, you should:

support the fracture site with one hand and apply gentle traction by grasping the humeral condyles

The two MOST effective mechanisms for thermolysis are:

sweating and peripheral vasodilation.

Joints are bathed and lubricated by:

synovial fluid.

Tough, cord-like structures that are extensions of the fascia covering all skeletal muscles are known as:

tendons

Patients who are struck by lightning rarely sustain full-thickness burns because:

the duration of the lightning strike is short.

When assessing the skin temperature of a patient with a cold-related emergency, you should feel the skin closest to the core of the body because

the patient may be hemodynamically stable even if his or her extremities are cold.

When assessing the skin temperature of a patient with a cold-related emergency, you should feel the skin closest to the core of the body because:

the patient may be hemodynamically stable even if his or her extremities are cold.

Palpating for a pulse in a near-drowning victim may be difficult to assess because:

the peripheral vessels are constricted and cardiac output is low.

Internal heat production is called:

thermogenesis.

The body loses heat to the environment through a process called:

thermolysis

Testicular torsion is a/an:

time-sensitive injury and requires rapid transport.

In the absence of obvious external trauma, an abdominal injury would be MOST difficult to assess for in a/an:

unresponsive patient.

When assessing a patient with a grossly deformed humerus, you note that the radial pulse is absent and the extremity is becoming cyanotic. You should:

use constant, gentle manual traction to align the humerus.