EMT C28 - Abdominal and Genitourinary injuries Case studies

You should suspect a kidney injury anytime the patient presents with (A) a hematoma in the flank region (B) abdominal distention (C) nausea (D) dyspnea

(A) a hematoma in the flank

When worn properly, a seat belt should lie: (A) below the anterior superior iliac spines of the pelvis and against the hipjoints (B) across the abdominal wall at the level of the diaphragm and below the hipjoints (C) above the anterior iliac spines of the pelvis and below the hip joints (D) across the abdominal wall at the level of the umbilicus and against the hip joints

(A) below the anterior superior iliac spines of the pelvis and against the hipjoints

A sign of kidney damage following blunt trauma is: (A) hematuria (B) hemoptysis (C) hematemesis (D) hematochezia

(A) hematuria

All of the following are hollow abdominal organs but (A) liver (B) bladder (C) ureters (D) stomach

(A) liver

injuries to the external male genitalia (A) are life threatening (B) are rarely life threatening (C) usually result in permanent damage (D) frequently lead to hypovolemic shock

(B) are rarely life threatening

Abdominal pain, vomiting, and fever are most likely due to (A) hemorrhage (B) infection (C) hypovolemia (D) evisceration

(B) infection

In pediatric patients, the liver and spleen are (A) smaller in proportion to the abdomen (B) larger in proportion (C) more protected by the thorax (D) less likely to bleed when injured

(B) larger in proportion

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While enroute you should ask dispatch if: (A) the patient is conscious (B) law enforcement is at scene (C) there are other patients involved (D) the severity of injury is known

(B) law enforcement is at scene

when assessing a 21 year old female who struck a tree head on w/ her small passenger call, you note that her air bag is deployed. You should (A) perform head to toe while she is in the car (B) lift the air bag and look for deformity in steering wheel (C) carefully assess her upper chest for seatbelt related injuries (D) extricate her immediately and transport to a trauma center

(B) lift the air bag and look for deformity in steering wheel

when should you visually inspect the external genitalia on you patient? (A) always during the secondary assessment (B) only when there is a complaint of pain or other injury (C) ordered by medical direction (D) anytime the patient agrees to treatment and transport

(B) only when there is a complaint of pain or other injury

When a hollow organ is punctured during a penetrating injury in the abdomen (A) the abdomen will become visibly distended (B) peritonitis may not develop for several hours (C) it will bleed profusely and rapidly cause shock (D) it commonly protrudes through the injury site

(B) peritonitis may not develop for several hours

Which of the following statements regarding abdominal evisceration is correct? (A) most eviscerations occur to LUQ (B) the protruding organ should be kept warm and moist (C) organs should be replaced carefully to avoid heat loss (D) adherent material is preferred when covering an evisceration

(B) the protruding organ should be kept warm and moist

compression injuries to the abdomen that occur during a motor vehicle crash are typically the result (A) air bag deployment (B) failure to wear seat belt (C) a poorly placed lap belt (D) rapid vehicle deceleration

(C) a poorly placed lap belt

A 20 year old male was accidentally shot in the right upper abdominal quadrant w/ an arrow during an archery contest. Prior to your arrival, the patient removed the arrow, your assessment reveals that he is conscious and alert w/ stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should (A) transport only if signs of shock begin to develop (B) carefully probe the wound to determine depth (C) assume that the arrow injure an internal organ (D) clean the wound and apply a dry., sterile dressing

(C) assume that the arrow injure an internal organ

your documentation on a sexual assault victim should: (A) be subjective and summarize the crime (B) describe the status of the suspects (C) be objective and factual (D) include you opinion of the nature of the incidence.

(C) be objective and factual

contraction or tensing of the abdominal muscles in an effort to ease pain is called: (A) flexing (B) referring (C) guarding (D) witrhdrawing

(C) guarding

when a patient stiffens the muscle of the abdomen, it is known as: (A) distention (B) crepitus (C) guarding (D) instability

(C) guarding

Which of the following organs is most at risk for injury as a result of pelvic fracture. (A) pancreas (B) fallopian tubes (C) urinary bladder (D) liver/spleen

(C) urinary bladder

The mesentary is (A) the point of attachment between the small and large intestines (B) a layer of thick skeletal muscles that protects the abdominal organs (C) a complex network of blood vessels that supply blood to the liver (D) a membranous fold that attaches the intestines to the walls of the body

(D) a membranous fold that attaches the intestines to the walls of the body

You are assessing a 33 your female who was sexually assaulted. The patient is conscious and visibly upset. As you are talking to her, you note blood on his clothes in the groin area. Her BP is 98/58, her pulse is 130 beats/min, and her respirations are 24 breaths/min (A) visualize the vagina area, and pack the vagina w/ sterile dressing (B) allow her to change her clothes and take a shower before you transport (C) arrange for a rape crisis center rep to speak w/ her (D) control any external bleeding, administer O2, and transport at once

(D) control any external bleeding, administer O2, and transport at once

Diff. breathing and sunken appearance of anterior abdominal wall is most indicative of a ruptured (A) aorta (B) spleen (C) stomach (D) diaphragm

(D) diaphragm

A 66 year old male presents w/ dark red rectal bleeding and abdominal pain. He is conscious and alert. However, his skin is cool and clammy and his HR is elevated. Further assessment reveals that his bp is 112/60 mm HG which of the following would be most pertinent to ask? (A) what does your normal BP run? (B) did you take any over the counter medicine? (C) Has blood soaked through your undergarments? (D) have you experienced any recent abdominal trauma?

(D) have you experienced any recent abdominal trauma?

Compression injury is most likely due to which of the following? (A) stabbing (B) ejection of unrestrained driver (C) hollow organ rupture (D) improperly placed lap belt

(D) improperly placed lap belt

Which of the following is true regarding injury to the kidneys? (A) the kidneys are not well protected (B) only minimal is needed to damage the kidneys (C) kidney injuries are rarely caused by blunt trauma (D) injury to the kidneys usually indicates injury to the other organs also

(D) injury to the kidneys usually indicates injury to the other organs also

A 22 year old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His BP is 142/82, his HR is 110 beats/min and strong, and his resipirations are 22 breaths/min and regular. In addition to high flow oxygen you should (A) apply full spinal immobilization restriction precautions (B) keep him on his side but gently straightly his legs (C) place him supine but allow him to keep his legs bent (D) transport him in the position in which you found him

(D) transport him in the position in which you found him

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the: a) Kehr sign. b) Cullen sign. c) Brudzinski sign. d) Grey Turner sign.

a) Kehr sign.

Which of the following statements regarding abdominal trauma is correct? a) The absence of abdominal pain does not rule out intra-abdominal bleeding. b) The liver is well protected and is rarely injured during a traumatic event. c) Most of the vital abdominal organs lie within the retroperitoneal space. d) Hollow abdominal organs are vascular and bleed profusely when injured

a) The absence of abdominal pain does not rule out intra-abdominal bleeding.

Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when: a) hollow abdominal organs are damaged and spill their contents. b) the vessels that supply the abdominal organs become inflamed. c) solid abdominal organs bleed secondary to penetrating trauma. d) bacteria or viruses invade the walls of the gastrointestinal tract.

a) hollow abdominal organs are damaged and spill their contents.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: a) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device. b) suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. c) reassess his vital signs and then notify the receiving hospital of the change in his clinical status. d) perform a comprehensive secondary assessment to determine why his clinical status has changed.

a) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

Early bruising following abdominal trauma often manifests as: a) red areas of skin. b) gross distention. c) dark purple marks. d) localized pain.

a) red areas of skin.

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: a) forgo the hospital radio report because of his condition. b) closely monitor him and reassess him frequently. c) perform a comprehensive secondary assessment. d begin documenting the call on the patient care form.

b) closely monitor him and reassess him frequently.

The presence of tachycardia following a significant abdominal injury: a) is always accompanied by hypotension. b) should be assumed to be a sign of shock. c) indicates a state of decompensated shock. d) is most commonly caused by severe pain.

b) should be assumed to be a sign of shock.

Accumulation of blood in the abdominal cavity will MOST likely cause: a) nausea or vomiting. b) diffuse bruising. c) distention. d) referred pain.

c) distention.

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: a) kidney. b) spleen. c) liver. d) stomach.

c) liver.

Placing a pregnant patient in a supine position during the third trimester of pregnancy: a) often causes hypotension secondary to cardiac compression. b) is recommended if the patient has severe abdominal discomfort. c) may decrease the amount of blood that returns to the heart. d) results in spontaneous urinary incontinence if the bladder is full.

c) may decrease the amount of blood that returns to the heart.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: a) a ruptured spleen. b) rupture of a hollow organ. c) a severe liver laceration. d) intra-abdominal bleeding.

d) intra-abdominal bleeding.

Because the depth of an open abdominal wound is often difficult to determine: a) vital signs should be monitored frequently. b) the abdomen must be vigorously palpated. c) the EMT must perform a thorough exam. d) prompt transport to the hospital is essential.

d) prompt transport to the hospital is essential.

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: a) covering him with a warm blanket. b) giving him small sips of plain water. c) promptly transporting to the hospital. d) administering supplemental oxygen. giving him small sips of plain water.

giving him small sips of plain water.