Ch. 29 Abdominal and Genitourinary Injuries

Which of the following abdominal organs would cause the MOST profuse bleeding when severely injured? A. Liver B. Spleen C. Pancreas D. Kidneys

A. Liver

Which of the following mechanisms of injury would MOST likely cause a shearing injury of the bladder from the urethra in a male? A. Motorcycle crash B. Blunt trauma to the flank C. Fall from a significant height D. Rear-end motor-vehicle crash

A. Motorcycle crash

Which of the following seatbelt positions will MOST likely result in severe intraabdominal injuries when a vehicle suddenly decelerates? A. Shoulder harness and lap belt placed superior to the iliac crest B. Use of the lap belt only with the shoulder harness behind the back C. Shoulder harness used and lap belt across the anterior iliac crest D. Shoulder harness not used and lap belt across the anterior iliac crest

A. Shoulder harness and lap belt placed superior to the iliac crest

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: A. ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the most appropriate facility. B. assisting ventilations, infusing normal saline to increase the systolic blood pressure, and transporting to the closest hospital. C. administering high-flow oxygen, limiting IV fluids to a maximum of 500 mL, and transporting to a regional trauma center. D. starting two large-bore IV lines, running the IVs wide open, and promptly transporting to the closest, most appropriate facility.

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

Patients with a significant abdominal injury: A. have increased pain with movement. B. develop hypotension as an early sign. C. most commonly have an injured spleen. D. become tachycardic after severe blood loss.

A. have increased pain with movement

Approximately 80% of all injuries to the genitourinary system involve the: A. kidneys. B. bladder. C. ureters.

A. kidneys

In addition to providing 100% oxygen and controlling external bleeding, the MOST appropriate management for a patient with a knife impaled in the abdomen includes: A. stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion. B. covering the knife with a protective barrier and administering 2 liters of normal saline. C. carefully removing the knife and administering 20 mL/kg boluses of normal saline. D. stabilizing the knife and increasing the blood pressure with 20 mL/kg saline boluses.

A. stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion

While transporting a pregnant trauma patient who is immobilized on a backboard, you note a sudden decrease in her blood pressure and a decrease in her mental status. You should: A. tilt the backboard to the left. B. infuse 20 mL/kg of normal saline. C. elevate the foot of the backboard. D. apply and fully inflate the PASG.

A. tilt the backboard to the left

A 25-year-old male experienced blunt abdominal trauma and is developing shock. Which of the following signs would you expect to manifest late? A. Tachycardia B. Hypotension C. Restlessness D. Pale, cool skin

B. Hypotension

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: A. attempt to unzip the pants and request a paramedic unit to give morphine. B. carefully cut the zipper out of the pants, control any bleeding, and transport. C. provide prompt transport to the hospital while providing emotional support. D. allow the patient's wife to transport him to the hospital since he is not unstable.

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

A 29-year-old male has sustained a large laceration across the lower abdomen and has a loop of bowel protruding through the wound. To minimize the amount of body heat that radiates from the open wound, you should: A. irrigate the wound with warm sterile water. B. cover the wound with moist sterile dressings. C. apply a pressure dressing to the open wound. D. cover the wound with a dry sterile dressing.

B. cover the wound with moist sterile dressings

Blunt or penetrating trauma can be especially lethal in pregnant patients because the: A. fetus can sustain serious injury. B. gravid uterus is highly vascular. C. uterus descends into the pelvis.

B. gravid uterus is highly vascular

Signs of a ruptured urinary bladder include all of the following, EXCEPT: A. hematuria. B. hematemesis. C. perineal bruising. D. urethral bleeding.

B. hematemesis

Diffuse (global) swelling of the abdomen is MOST suggestive of: A. acute bowel obstruction. B. intraabdominal bleeding. C. peritoneal inflammation.

B. intraabdominal bleeding

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: A. liver. B. kidney. C. gallbladder. D. urinary bladder.

B. kidney

The presence of gastric juices and bacteria in the abdominal cavity causes an intense inflammatory reaction called: A. gastritis. B. peritonitis. C. diverticulitis. D. appendicitis.

B. peritonitis

Kehr sign is defined as: A. the presence of flank bruising secondary to intraabdominal bleeding. B. referred pain to the shoulder following injury to the liver or spleen. C. bruising around the umbilicus secondary to intraabdominal bleeding.

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

In the absence of obvious external trauma, an abdominal injury would be MOST difficult to assess for in a/an: A. intoxicated patient. B. unresponsive patient. C. hypovolemic patient. D. patient in severe pain .

B. unresponsive patient

Which of the following medications or medical devices may inhibit the body's tachycardic response during shock? A. Aspirin B. Anticoagulant C. Beta-blocker D. Implanted defibrillator

C. Beta-blocker

Which of the following statements regarding trauma to the kidneys is correct? A. Injuries confined to the kidneys are common following blunt force trauma. B. You should suspect a ruptured aorta when the MOI suggests kidney injury. C. Kidney injury is usually associated with injury to other abdominal organs. D. The kidneys are well protected in the abdomen and rarely sustain injury.

C. Kidney injury is usually associated with injury to other abdominal organs

Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash? A. Asking the patient if he or she was wearing a seatbelt B. Noting the position of the restraint system on the patient C. Lifting a deployed airbag and assessing the steering wheel D. Determining whether or not the airbag deployed on impact

C. Lifting a deployed airbag and assessing the steering wheel

During your assessment of a 48-year-old female with localized blunt abdominal trauma, you should: A. immobilize her spinal column. B. palpate the most painful area first. C. be prepared for the patient to vomit. D. vigorously palpate the entire abdomen.

C. be prepared for the patient to vomit

Priority management for a patient with an amputated penis and stable vital signs includes: A. locating the amputated part. B. rapid transport to a trauma center. C. controlling any active hemorrhage. D. placing moist dressings on the wound.

C. controlling any active hemorrhage

After applying supplemental oxygen to a patient with blunt abdominal trauma, you should: A. fully extend the patient's legs. B. vigorously palpate the abdomen. C. obtain a set of baseline vital signs. D. start an IV and give a fluid bolus.

C. obtain a set of baseline vital signs

When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should: A. transport only and provide support and reassurance. B. limit your examination to a secondary assessment only. C. treat any injuries and provide privacy and reassurance. D. treat any injuries and question the patient about the event.

C. treat any injuries and provide privacy and reassurance

When assessing a patient who experienced blunt abdominal trauma, you note bruising around the umbilicus. This is called ____________ sign and indicates: A. Kehr sign; ruptured hollow organs. B. Grey Turner sign; injury to the liver. C. Murphy sign; gallbladder rupture. D. Cullen sign; significant internal bleeding.

D. Cullen sign; significant internal bleeding

Which of the following organs lie in the right upper quadrant of the abdomen? A. Spleen and liver B. Pancreas and liver C. Gallbladder and spleen D. Liver and gallbladder

D. Liver and gallbladder

A 29-year-old female had a glass bottle inserted into her vagina during a sexual assault. She is conscious and alert and has stable vital signs, but she is in severe pain. How should you manage this patient? A. Carefully remove the bottle, monitor her vital signs, provide emotional support, and promptly transport. B. Stabilize the bottle, place dressings in the vagina, provide emotional support, and promptly transport. C. Make one attempt to remove the bottle, start an IV of normal saline, provide emotional support, and transport promptly. D. Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly.

D. Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly

Following blunt trauma to the right flank area, a 20-year-old male presents with hematuria. Assessment of the area reveals pain to palpation, but no visible signs of trauma. His blood pressure is 120/76 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min and unlabored. Which of the following is the MOST appropriate intravenous therapy for this patient? A. One large-bore IV set at a keep vein open (KVO) rate. B. Two large-bore IVs and a 500 mL normal saline bolus. C. One large-bore IV and a 20 mL/kg normal saline bolus. D. Two large-bore IVs set at a keep vein open (KVO) rate.

D. Two large-bore IVs set at a keep vein open (KVO) rate

In an attempt to minimize the pain associated with abdominal trauma, the patient will typically: A. draw his or her knees into the abdomen and breathe deeply. B. take deep breaths to relieve pressure off of the diaphragm. C. prefer to extend his or her legs and relax the muscles of the abdomen. D. draw his or her knees into the abdomen and tense the abdominal muscles.

D. draw his or her knees into the abdomen and tense the abdominal muscles

Blunt abdominal trauma may result in tearing of the mesentery, which is/are: A. multiple bands of thick muscle that protect the abdominal organs. B. the main supporting structure of the descending abdominal aorta. C. a vascular network that provides exclusive blood supply to the liver. D. membranous folds that attach the intestines to the abdominal wall.

D. membranous folds that attach the intestines to the abdominal wall

The kidneys lie within the: A. left upper quadrant. B. right upper quadrant. C. anterior abdomen. D. retroperitoneal space.

D. retroperitoneal space

Testicular torsion is a/an: A. life-threatening injury that requires surgery. B. spontaneous event in the majority of cases. C. irreversible injury that leads to impotence. D. time-sensitive injury and requires rapid transport.

D. time-sensitive injury and requires rapid transport