Volume 4 Chapter 2

Axial loading is most likely to occur in which type of​ impact? A. Frontal with an​ up-and-over pathway B. Rear with the headrest too low C. Lateral on the side of the vehicle opposite the occupant D. Frontal with a​ down-and-under pathway

A

Greater velocity of a bullet will cause a​ ________ path of travel and a​ ________ trajectory. A. Flatter; straighter B. Flatter; wavier C. Wavier; straighter D. More​ rounded; curved

A

The primary assessment of a patient with a gunshot wound to the chest should focus on detecting which of the​ following? A. Tension pneumothorax B. Peritonitis C. Cardiac contusion D. Pancreatitis

A

When a patient​ falls, which section of the spinal column is the most prone to compression​ injury? A. Lumbar B. Cervical C. Thoracic D. Sacral

A

When assessing a patient with a crush​ injury, which of the following findings would indicate that toxins have entered the central​ circulation? A. Cardiac arrhythmia B. Hot, red skin C. Central hyperventilation syndrome D. Increased urine output

A

Which of the following bullet characteristics would create the most​ damage? A. ​"Mushrooming" or flattening on impact B. A small profile C. A full metal jacket D. Lack of tumble

A

Which of the following injuries is associated with the tertiary phase of a​ blast? A. Crush injuries B. Barotrauma C. Burns D. Projectile injuries

A

Which of the following is NOT a complication of crush​ injury? A. Systemic alkalosis B. Difficult-to-control hemorrhage C. Renal failure D. Cardiac arrhythmias

A

Which of the following is TRUE of supplemental restraint​ systems? A. They may deploy during rescue​ operations, injuring the patient​ and/or EMS personnel. B. They guard against thoracic impact with the steering wheel. C. They are primarily useful in preventing injury to infants and children riding in the front seat. D. When worn​ incorrectly, they may cause spinal injury or decapitation.

A

Which of the following is TRUE of the pressure wave that accompanies​ high-velocity penetrating​ trauma? A. The pressure wave may be transmitted through​ blood, resulting in damage to blood vessels some distance from the primary wound. B. Pressure waves cause no injury to surrounding​ tissues; they only momentarily disrupt function. C. Hollow organs are less tolerant of the stress than solid organs are. D. Elastic tissues are less tolerant of the stress than​ non-elastic tissues.

A

Which of the following is TRUE of the temporary cavity formed by penetrating​ trauma? A. It is a space indirectly created by a projectile as tissue moves rapidly away from its path. B. It fills with disrupted​ tissues, some​ air, fluid, and debris. C. It is the damage that occurs when the projectile fragments. D. It heals more slowly than the permanent cavity because of the nature of the tissue damage.

A

Which of the following is TRUE regarding a motorcycle​ collision? A. Frontal impact can result in​ intraabdominal, pelvic, and femur injuries. B. The structural steel of the vehicle absorbs most of the kinetic energy in a motorcycle collision. C. A rider who​ "lays down the​ bike" will generally receive more severe injuries than a rider who stays with the bike. D. The use of helmets has drastically reduced the incidence of cervical spine injuries.

A

Which of the following is associated with assault rifle wounds but not hunting rifle​ wounds? A. Multiple wounds B. Smaller exit wounds C. Larger exit wounds D. Permanent cavitation

A

Which of the following is best described as​ "the area of contused tissue resulting from penetrating trauma that may be slow to heal due to disrupted blood flow and tissue​ damage"? A. Zone of injury B. Zone of coagulation C. Temporary cavity D. Permanent cavity

A

Which of the following is most likely to occur to the bullet when military ammunition is​ used? A. It will remain intact. B. It will​ "mushroom" or flatten. C. It will explode. D. It will fragment.

A

Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum​ teres? A. Sudden deceleration B. Gradual acceleration C. Gradual deceleration D. Sudden acceleration

A

Which of the following statements about entrance and exit wounds is​ TRUE? A. Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound. B. Entrance wounds most often appear as stellate. C. Cavitational wave energy is greatest at a​ bullet's point of entrance. D. Exit wounds are usually the size of the​ bullet's profile.

A

Which of the following statements is TRUE of the permanent cavity created by penetrating​ trauma? A. It is filled with disrupted​ tissues, some​ air, fluid, and debris. B. It is a potential​ space, not an actual space. C. It is a space created by a projectile as tissue moves rapidly away in its path. D. It is the damage done when the projectile fragments penetrate.

A

Which of the following​ "paper bag​ syndrome" injuries may occur due to sudden compression of the thorax or​ abdomen? A. Pneumothorax and diaphragmatic rupture B. Cardiac tamponade and aortic dissection C. Pneumothorax and myocardial contusion D. Pulmonary and myocardial contusions

A

You have arrived on the scene of a​ 17-year-old male patient with a gunshot wound to the thigh. Police are on the scene. There is significant ongoing hemorrhage from the wound. The patient is screaming for someone to help him. Which of the following should you do​ first? A. Ask the police if they have searched the patient for weapons yet. B. Perform a rapid trauma assessment. C. Begin​ high-concentration oxygen administration. D. Control hemorrhage with direct pressure.

A

Your patient is a construction worker who fell 15 feet and has a​ 3-foot metal concrete reinforcement bar​ (rebar) impaled in his right thigh. Which of the following is the best​ action? A. If the proper tools and personnel are​ present, have rescuers cut the rebar to a manageable length. B. Transport the patient without attempting to shorten or remove the rebar. C. If you can see both ends of the​ rebar, gently remove it and irrigate the wound with sterile saline. D. Administer sodium bicarbonate to combat acidosis resulting from the destruction of muscle tissue.

A

Your patient is a​ 30-year-old woman with a stab wound to the neck. She is sitting up and appears very anxious and short of breath. Minimal external bleeding is​ noted, but there is bubbling from the wound. Which of the following should you​ suspect, based on the mechanism of injury and assessment​ findings? A. Laceration of the trachea B. An injury to the spinal cord at the level of the stab wound C. Laceration of the ipsilateral carotid artery D. All of the above

A

Your​ patient, a​ 23-year-old woman who is 6 months​ pregnant, was the unrestrained driver of a vehicle that​ rear-ended a parked car. The air bag deployed. Considering the likelihood of organ​ collision, for which of the following injuries should you maintain a high index of​ suspicion? A. Abruptio placentae B. Anterior flail segment C. Fractured sternum D. Cardiac contusion

A

A penetrating injury to which of the following organs is LEAST likely to result in severe​ hemorrhage? A. Kidney B. Ureter C. Liver D. Spleen

B

Applying​ Newton's second law of motion to a vehicle traveling 70 miles per​ hour, crashing into which of the following would transfer the most force to the​ patient? A. Signpost B. Bridge abutment C. Shrubbery D. A body of water

B

As a bullet​ tumbles, the potential to inflict​ damage: A. is determined by the trajectory. B. increases. C. remains the same. D. decreases.

B

As the mass of an object​ increases, which of the following​ occurs? A. The amount of energy decreases. B. The amount of energy increases. C. The maximum speed it can attain increases. D. The maximum speed it can attain decreases.

B

If you were to design a bullet to have the highest energy​ exchange, what would you​ do? A. Decrease the​ bullet's trajectory. B. Design the bullet to become more unstable. C. Decrease the drag. D. Increase the caliber.

B

The path a projectile follows during a flight is called​ its: A. cavity. B. trajectory. C. ballistics. D. drag.

B

The pathway of injury left in the wake of a penetrating mechanism of injury is​ called: A. cone of injury. B. cavitation. C. trajectory. D. profile.

B

To gain an appreciation for the potential for trauma from​ high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to​ ________ times. A. 25 B. 100 C. 50 D. 80

B

Upon arriving at the scene of a​ single-vehicle collision in which the vehicle struck a utility​ pole, you note that the windshield is​ "starred," and that the driver is not restrained. Which of the following injuries is most​ likely? A. Ligamentous neck injury due to rotation beyond the range of motion B. Compression injury of the cervical spine C. Distraction injury of the cervical spine D. Whiplash injury of the neck muscles

B

When you are assessing someone with a gunshot wound from a​ rifle, which of the following is important to​ remember? A. The muzzle velocity is less than that of a handgun. B. The zone of injury is larger than that expected with other types of weapons. C. The cavitation is limited to the direct path of the bullet. D. The trajectory is​ longer, allowing more energy to be dissipated by drag before it strikes the victim.

B

Which of the following factors is NOT a consideration in the severity of injury related to​ falls? A. Landing surface B. Wind resistance C. The initial point of impact D. Distance of the fall

B

Which of the following injuries is most likely in a​ rear-end collision? A. Lumbar spine injuries B. Head and neck injuries C. Pelvic fractures D. Thoracic and abdominal injuries

B

Which of the following is NOT considered penetrating​ trauma? A. A laceration from a kitchen knife B. A laceration on the forehead as a result of being struck with a metal pipe C. Receiving a wood splinter in the foot while walking on an unfinished deck D. A superficial wound resulting from a pellet from a pellet gun being lodged under the skin

B

Which of the following is NOT one of the major types of recreational vehicles involved in​ crashes? A. Snowmobiles B. Go-karts C. Jet skis D. All-terrain vehicles

B

Which of the following is TRUE of the injuries sustained by the elderly due to​ falls? A. Only more significant falls cause fractures. B. Less-significant falls may cause fractures. C. The injuries sustained by the elderly are less likely to result in hospitalization. D. The elderly sustain injuries similar to other age groups in comparable falls.

B

Which of the following is most important when assessing the damage done by a​ gunshot? A. Whether there was an upward or a downward trajectory when the bullet was fired B. The distance from the shooter C. The type of gun used D. The size of the bullet

B

Which of the following is most likely to be fractured from a fall onto outstretched​ hands? A. Ulna B. Clavicle C. Metacarpals D. Carpals

B

Which of the following is typical of the trajectory of a knife when a female assailant stabs​ someone? A. The trajectory is​ lateral: right-to-left if she is​ right-handed and​ left-to-right if she is​ left-handed. B. The movement is​ downward, as the assailant raises the knife and swings downward. C. The movement is​ upward, as the assailant drives upward with the knife. D. The trajectory tends to be in a horizontal plane at the level of the​ assailant's shoulder.

B

Which of the following statements about lateral impact collisions is​ TRUE? A. Damage to the vehicle is a reliable indication of the seriousness of injuries. B. The degree of injury may be greater than the damage alone would indicate. C. Fatalities are rare because the upper extremities absorb the energy. D. The substantial lateral crumple zone prevents most injuries.

B

Which of the following statements about rifles is​ TRUE? A. Assault rifles do not accept domestic hunting ammunition and thus create a projectile profile that is smaller and causes less damage. B. Assault rifles generally increase the number of wounds the victim sustains. C. Assault rifles have greater velocity than hunting rifles and only operate automatically. D. Hunting rifles have larger magazines and operate semiautomatically.

B

Which of the following statements about stab wounds is​ TRUE? A. Stab wounds by female attackers are seldom lethal. B. Damage is usually limited to physical injury caused by direct contact between the blade and the​ victim's tissue. C. The size and shape of the weapon allow precise prediction of the injury. D. The presence of defense wounds decreases the likelihood of trauma to the​ neck, thorax, and abdomen.

B

Which of the following statements about the impact of motorcycle helmet usage is​ TRUE? A. Helmet use moderately decreases the incidence of cervical spine injury. B. Helmet use neither increases nor decreases the incidence of cervical spine injury. C. Helmet use substantially decreases the incidence of cervical spine injury. D. Helmet use moderately increases the incidence of cervical spine injury.

B

Which statement about ballistics is​ TRUE? A. Damage is less when the bullet does not exit the body. B. When a bullet​ yaws, it increases the damage. C. In penetrating​ trauma, the mass of a projectile is more significant than its velocity when determining kinetic energy. D. When a bullet​ tumbles, it decreases the damage.

B

You have responded to a soccer field on which two​ 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency​ department? A. Complaint of​ "getting the wind knocked out of​ me" B. Weakness in the upper extremities C. Contusion to the thigh D. Minor epistaxis

B

Your patient is a​ 50-year-old man with a gunshot wound to the right anterior chest. He is unresponsive. Which of the following should you do​ first? A. Seal the chest wound. B. Check for breathing. C. Check for a carotid pulse. D. Auscultate breath sounds.

B

As the energy from a​ medium- or​ high-velocity projectile pushes tissue from its​ path, which of the following​ occurs? A. Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound. B. No vacuum is created when there are both an entrance and an exit wound. C. Negative pressure is generated inside the​ cavity, drawing debris into the wound. D. There is negative pressure at the entrance wound and positive pressure at the exit wound.

C

Frontal impacts in which the patient takes a​ "down-and-under" pathway typically result in which of the following injury​ patterns? A. Rupture of hollow organs B. Traumatic brain injury C. Hip and femur fractures D. Rupture of the diaphragm

C

The branch of physics dealing with objects in motion and energy exchanges that occur as these objects collide is called​ what? A. Kinematics B. Inertia C. Kinetics D. Force

C

The study of the characteristics of projectiles in motion and their effects on the objects they impact is​ called: A. cavitation. B. forensics. C. ballistics. D. trajectory.

C

Vehicle supplemental restraint systems​ (air bags) are meant​ to: A. protect infants and children who ride in the front seat of the vehicle. B. prevent unrestrained occupants from taking the​ down-and-under pathway in frontal impacts. C. absorb the energy exchange of rapid deceleration. D. prevent injury from secondary impacts.

C

Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating​ trauma? A. Liver B. Spleen C. Bowel D. Kidneys

C

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier​ wall? A. The energy dissipates as sound waves. B. The energy converts to heat through friction. C. The body of the vehicle and its occupants absorb the energy. D. The​ wall's foundation absorbs the energy.

C

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a​ stop? A. The inertia of the tree increases the kinetic energy transmitted to the occupants by a factor of 10. B. Braking allows the kinetic energy to be absorbed evenly into the frame of the​ vehicle, rather than concentrating it at the point of impact. C. The energy gradually dissipates as heat due to the friction of​ braking, rather than transferring to the vehicle and its occupants. D. None of the above describes why.

C

Which of the following injuries is NOT associated with the use of vehicle restraint​ systems? A. Abdominal injury B. Lumbar spine trauma C. Traumatic brain injury D. Abrasions and contusions to the clavicle and chest area

C

Which of the following injuries is NOT commonly related to​ snowmobiling? A. Ejections B. Crush injuries C. Drowning D. Glancing blows against obstructions in the snow

C

Which of the following injuries is associated with the pressure wave produced by a​ blast? A. Lacerated liver B. Fractures C. Pneumothorax D. Ruptured spleen

C

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle​ collision? A. The vehicle strikes an object. B. The body of the occupant strikes the interior of the vehicle. C. A hubcap flies off and strikes a tree. D. The​ occupants' organs strike the interior of the body cavity.

C

Which of the following is TRUE of defense wounds in the victim of a knife​ attack? A. They rarely occur because the victim is usually taken by surprise. B. They usually occur to the shoulder as the victim attempts to turn away from the attack. C. They usually occur to the hands and arms as the victim raises them to ward off the attacker. D. They often occur to the neck and head as the victim doubles over into a protective posture.

C

Which of the following is TRUE of the differences between adult and pediatric pedestrians when struck by a​ vehicle? A. Adults tend to be thrown under the vehicle. B. Children tend to be thrown onto the hood of the vehicle. C. Children tend to be thrown under the vehicle. Your answer is correct. D. Adults tend to have injuries higher on the body.

C

Which of the following is considered a​ high-velocity weapon? A. Arrow B. Shotgun C. Rifle D. Handgun

C

Which of the following is most susceptible to damage from the pressure wave when a bullet enters​ it? A. Femoral artery B. Intestines C. Liver D. Lungs

C

Which of the following is the most important priority when caring for a patient with a​ shallow-water diving​ injury? A. Initiating rescue breathing once out of the water B. Removing the patient from the water as soon as possible C. Maintaining cervical spine stabilization while opening the airway D. Assessing the cervical spine for deformity

C

Which of the following scenarios would likely lead to the development of compartment​ syndrome? A. An excessive release of intracellular potassium B. A tennis shoe that​ doesn't fit correctly C. A crush injury to the lower leg D. A​ loose-fitting cast that covers the thigh and leg

C

Which of the following statements about bullets is​ TRUE? A. The hunting​ rifle's bullet is usually a lighter​ bullet, but it travels faster. B. A​ high-velocity bullet is three times less likely to do major harm. C. A​ small, light bullet can do significant harm. D. The larger the​ bullet, the smaller its energy.

C

Which of the following statements about​ low-velocity penetrating trauma is​ TRUE? A. Shorter knives and ice picks may be removed if they are left in the wound. B. There is no pressure shock wave with a knife wound as there is with an arrow wound. C. Knives, arrows, ice​ picks, and similar weapons cause damage only in their direct path. D. More injuries are sustained from arrows than from knives.

C

Which two factors related to kinetic energy proportionately affect the damage a projectile will​ do? A. Mass and fragmentation B. Velocity and yaw C. Velocity and mass D. Fragmentation and velocity

C

Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a​ gun? A. Friction and velocity B. Friction and distance C. Velocity and mass D. Mass and friction

C

Your patient is an​ 8-year-old boy with a pencil impaled 2 centimeters inferior to the xiphoid process. You note that the pencil is pulsating. Which of the following is the best​ action? A. Start an IV and request orders for analgesia and sedation. B. Stabilize the pencil in place and transport to the nearest medical facility. C. Stabilize the pencil in place and transport to a trauma center. D. Remove the pencil and apply direct pressure to the​ wound; transport to a trauma center if the bleeding does not stop with direct pressure.

C

A vehicle is struck in its right front as it passes through an​ intersection, resulting in an oblique impact. Which of the passengers is subjected to the greatest acceleration​ forces? A. The driver B. The​ front-seat passenger C. The​ right-rear passenger D. The​ left-rear passenger

D

During the scene​ size-up on a call for a patient with penetrating trauma due to a stab​ wound, which of the following should you​ do? A. Collect anything that could be used as evidence. B. Try to find out in which direction the assailant fled. C. Assume that the patient has no weapons if law enforcement is on the scene. D. Check for weapons on or near the patient.

D

For which of the following impacts should you maintain a higher index of suspicion because the degree of injury may be greater than the damage alone​ indicates? A. Oblique B. Rear-end C. Frontal D. Lateral

D

Infants and very small children​ (up to two years of​ age) should have their child safety seat positioned where in a​ car? A. The front seating​ area, facing backward B. The front seating​ area, facing frontward C. The rear seating​ area, facing frontward D. The rear seating​ area, facing backward

D

Penetrating trauma to the face can complicate airway management by which of the following​ mechanisms? A. Laryngotracheal edema B. Airway obstruction C. Destruction of anatomical landmarks D. Both B and C

D

People in which of the following age groups are prone to significant trauma due to​ falls? A. Pediatric population B. Teenagers C. College-aged adults D. Geriatric population

D

The two factors that refer to the rate of change of speed​ are: A. mass and weight. B. acceleration and inertia. C. deceleration and velocity. D. acceleration and deceleration.

D

When inspecting the interior of a vehicle involved in a frontal​ collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries might this​ indicate? A. Knee injury B. Femur fracture C. Fracture of the acetabulum D. All of the above

D

When the​ driver's chest strikes the steering wheel during a motor vehicle​ collision, what produces the next​ injury? A. The air bag deploys a second time. B. Unsecured objects in the vehicle become projectiles. C. The steering column shears​ off, causing penetrating trauma. D. The heart continues its forward motion until it strikes the chest wall.

D

Which of the following affects the severity of injury sustained in a motor vehicle​ collision? A. Gross vehicle weight B. Rate of acceleration or deceleration C. Vehicle speed D. All of the above

D

Which of the following best defines the term​ energy? A. The amount of heat generated through friction B. The ability to deform solid objects C. The rate of motion related to time D. The capacity to do work

D

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a​ lateral-impact motor vehicle​ collision? A. The force of​ side-impact air bag deployment B. Increased gravitational forces due to multiple changes in direction and velocity C. Taking the​ up-and-over pathway D. Lack of a crumple zone

D

Which of the following increases a​ bullet's profile? A. "Mushrooming" on impact B. The use of rifling in the barrel of the firearm C. Tumbling 180 degrees on impact D. Both A and C

D

Which of the following is TRUE about determining the pathway of the bullet when assessing a patient with a gunshot​ wound? A. It is difficult to determine the pathway of a bullet because it may not travel in a straight​ line, possibly being deflected by structures in its path or being shifted by natural movements of the diaphragm and other organs and structures of the body. B. The purpose of determining the​ bullet's pathway is to anticipate which organs may have been​ affected, which will help to guide your priorities for​ on-scene care or rapid transport. C. You should try to determine the​ bullet's pathway. D. All of the above

D

Which of the following is TRUE of body armor​ use? A. There are no reported cases of penetrating trauma among victims who were shot while wearing body armor. B. Ceramic inserts are dangerous and should not be​ used, because they generally fragment and create secondary projectiles when they are struck by a bullet. C. Blunt trauma occurs only if ceramic inserts are placed in the vest. D. Blunt trauma may be​ significant, but the potential for​ life-threatening injury is less than if armor had not been worn.

D

Which of the following is TRUE of shotgun​ ammunition? A. ​"Double ought" or​ #00 shot contains a large number of relatively small pellets. B. The closer the shooter is to the​ victim, the larger the area of visible damage. C. The shot is dispersed from the cartridge with high velocity. D. A shotgun may either fire one slug or use ammunition with multiple pellets.

D

Which of the following may result from aggressive ventilation of the blast​ patient? A. Pericardial tamponade B. Hemorrhage C. Acidosis D. Emboli

D

Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting​ motion? A. Low-velocity penetrating trauma from an ice pick B. Direct​ trauma, such as from a blow to the head C. High-velocity penetrating trauma from a gunshot wound D. Lateral-impact motor vehicle collision

D

Which of the following mechanisms may result in a conventional​ explosion? A. Fumes B. Dust C. Natural gas D. All of the above

D

Which of the following statements is NOT true of occupant ejection in motor vehicle​ collisions? A. The number of occupant impacts increases with ejection. B. Ejection accounts for 27 percent of motor vehicle fatalities. C. Ejection is most often associated with​ frontal-impact collisions. D. Ejection has not been reported with​ lateral-impact collisions.

D

Which pathway of patient travel results in higher mortality with a frontal impact​ collision? A. Down-and-under B. Straight C. Vertical D. Up-and-over

D

Which type of firearm usually limits trauma to direct​ injury? A. Automatic weapon B. Military rifle C. Hunting rifle D. Handgun

D

Which type of motor vehicle collision is most common in rural​ areas? A. Rollover B. Lateral C. Rear-end D. Frontal

D

You are called to the scene of a vehicle crash in which a car was​ rear-ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated index of suspicion for​ injuries? A. Energy can neither be created nor destroyed. B. A body in motion will remain in motion unless acted on by an outside force. C. The amount of energy transmitted to an object is inversely proportional to its rate of deceleration. D. A body at rest will remain at rest unless acted on by an outside force.

D