Quiz #3 Chapter 33 & 34

general care for an eye injury involves: A: applying direct pressure to the globe B: irrigating the eye with sterile saline solution C: covering both eyes to minimize further injury D: applying a cold compress to the eyeball

C: covering both eyes to minimize further injury

spinal cord injuries that cause neurogenic shock generally produce: A: cool, clammy skin distal to the site of the spinal cord injury B: reflex tachycardia due to sympathetic nervous system stimulation C: flaccid paralysis and complete loss of sensation distal to the injury D: signs and symptoms that are identical to those of hypovolemic shock

C: flaccid paralysis and complete loss of sensation distal to the injury

a 19-year-old woman fell from a second story window and landed on her head. she is unconscious with a blood pressure of 168/104 mm Hg, heart rate of 56 beats/min, and irregular respirations of 8 breaths/min. further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. in addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves: A: hyperventilating her with a bag-mask device at a rate of 20 breaths/min, starting two large-bore IV lines, applying a cardiac monitor, administering 5 mg of Valium to prevent seizures, and transporting to a trauma center B: preoxygenating her with a bag-mask device and 100% oxygen for 2 to 3 minutes, performing nasotracheal intubation, transporting at once, starting at least one large bore IV line en route, and obtaining her Glasgow Coma Scale score C: intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments D: applying oxygen via nonrebreathing mask, covering her with blankets, starting an IV of normal saline set to keep the vein open, applying a cardiac monitor, initiating transport, and monitoring her pupils while en route to the hospital

C: intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments

when assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's: A: initial Glasgow Coma Scale score B: blood pressure C: level of consciousness D: response to verbal stimuli

C: level of consciousness

a motorcycle or football helmet should be removed if: A: the patient complaints of severe neck pain and the helmet fits snugly B: you are going to transport the patient to a medical treatment facility C: the patient is breathing shallowly and access to the airway is difficult D: you are properly trained in the technique, even if you are by yourself

C: the patient is breathing shallowly and access to the airway is difficult

beta receptor stimulation results in all of the following effects, EXCEPT: A: positive cardiac inotropy B: positive cardiac chronotropy C: vascular smooth muscle contraction D: relaxation of bronchiole smooth muscle

C: vascular smooth muscle contraction

you are caring for a man with a chemical burn to both eyes. the patient, who has contact lenses in place, is in severe pain and tells you that he can't see. proper care for this patient includes: A: carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation B: leaving his contact lenses in place to avoid further injury and transporting at once with irrigation of both eyes performed en route C: removing his contact lenses, covering both eyes with moist, sterile dressings, administering a narcotic analgesic, and transporting D: asking the patient to remove his contact lenses, irrigation both eyes for no more than 10 minutes, covering both eyes with sterile dressings, and transporting

A: carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation

you would MOST likely have to place several blankets or pillows under a patient's upper back prior to immobilization if he or she has: A: kyphosis B: osteoarthritis C: spondylosis D: osteoporosis

A: kyphosis

a flattened appearance to the face and loss of sensation over the cheek following blunt facial trauma is MOST indicative of a(n): A: zygomatic fracture B: orbital skull fracture C: Le Fort I fracture D: temporomandibular joint dislocation

A: zygomatic fracture

if you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and severe oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform: A: nasotracheal intubation B: a needle or surgical cricothyrotomy C: pharmacologically assisted intubation D: digital (tactile) intubation

B: a needle or surgical cricothyrotomy

during an explosion, a 42-year-old construction worker sustained a large laceration to the lateral aspect of his neck when he was struck by a piece of flying debris. the patient is conscious, but complains of difficulty hearing. in addition to protecting his spine, you should be MOST concerned with: A: administering high-flow oxygen via nonrebreathing mask as soon as possible B: covering the laceration with an occlusive dressing and controlling the bleeding C: carefully examining his ear to determine if his tympanic membrane is ruptured D: applying a bulky dressing to the laceration and securing it firmly with a bandage

B: covering the laceration with an occlusive dressing and controlling the bleeding

you are transporting a conscious middle-aged woman with anterior neck trauma. she is on high-flow oxygen, has spinal precautions in place, and has a large-bore IV line of normal saline in place. when you reassess her vital signs, you note that her blood pressure is 90/64 mm Hg, her pulse rate is 120 beats/min, and her respirations are 22 breaths/min with adequate depth. you should: A: begin assisting her ventilations with a bag-mask device, rapidly infuse 2 L of IV fluid and reassess B: keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion C: elevate her legs, apply a blanket, and administer IV fluid boluses until her heart rate is within a normal range D: start a second IV line and administer crystalloid IV fluids until her systolic blood pressure is at least 100 mm Hg

B: keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion

upon arriving at the scene of a motor vehicle crash, you find the driver of the car still seated in her two-door vehicle. the passenger side of the vehicle has sustained severe damage and is inaccessible. the driver is conscious and alert and complains of only lower back pain. the backseat passenger, a young child who was unrestrained, is bleeding from the head and appears to be unconscious. you should: A: ask the drive to step out of the vehicle so you can access the backseat passenger B: rapidly extricate the driver so you can gain quick access to the child in the backseat C: carefully assess the driver for the occult injuries before removing her from the vehicle D: apply a vest-type extrication device to the driver and quickly remove her from the car

B: rapidly extricate the driver so you can gain quick access to the child in the backseat

a conscious but combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. You suction her oropharynx, but her mouth quickly refills with blood. You should: A: preoxygenate the patient with a bag-mask device for 2 minutes and then perform nasotracheal intubation B: roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation C: alternate suctioning of her oropharynx for 15 seconds and assisting ventilations for 2 minutes until her airway is clear of blood D: continually suction her oropharynx until it is clear of blood, apply oxygen via nonrebreathing mask, and administer and sedative drug

B: roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation

you have intubated an unresponsive, apneic patient with a suspected spinal injury. after confirming proper ET tube placement and securing the tube, you should: A: request medical control authorization to give Solu-Medrol B: ventilate at 10 to 12 breaths/min and monitor end-tidal CO2 C: maintain an end-tidal CO2 reading of greater than 45 mm Hg D: provide mild hyperventilation in case a head injury is present

B: ventilate at 10 to 12 breaths/min and monitor end-tidal CO2

cerebrospinal fluid drainage from the ears is MOST indicative of: A: a nasal fracture B: intracerebral bleeding C: an epidural hematoma D: a skull fracture

D: a skull fracture

when managing the airway of an unresponsive patient with a serious anterior neck trauma and shallow breathing, you should: A: apply a cervical collar and perform intubation immediately B: ventilate the patient with an oxygen-powered ventilation device C: give oxygen via nonrebreathing mask and apply a pulse oximeter D: assist ventilations with a bag-mask device and prepare to intubate

D: assist ventilations with a bag-mask device and prepare to intubate

when an unrestrained passenger's head strikes the windshield of a motor vehicle following rapid deceleration: A: the anterior portion of the brain sustains stretching or tearing injuries, and the posterior portion of the brain sustains compression injuries B: the head falls back against the headrest or seat and the brain collides with the rear of the skull, resulting in direct injury to the occipital lobe C: the brain initially strikes the rear of the skull, resulting in direct bruising, and then rebounds and strikes the front part of the skull D: compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain

D: compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain

a young man was assaulted and has extensive maxillofacial injuries. your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. initial management for this patient involves: A: inserting an oropharyngeal airway, preoxygenating him with a bag-mask device for 2 minutes, and then intubating his trachea B: applying a cervical collar, performing a blind finger sweep to clear his airway, and providing ventilatory assistance with a bag-mask device C: fully immobilizing his spine, inserting a nasopharyngeal airway, and hyperventilating him with a bag-mask device at a rate of 20 breaths/min D: manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen

D: manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting with a bag-mask device and 100% oxygen

which of the following is MOST significant complication associated with a fractured nasal bone? A: facial swelling B: lateral displacement C: damage to the septum D: posterior epistaxis

D: posterior epistaxis