Quiz 6

The normal respiratory rate for a newborn should not exceed ______ breaths/min.

60

The phrenic nerves control the diaphragm and exit the spinal cord at:

C3, C4, and C5.

Which of the following statements regarding abdominal trauma is MOST correct?

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

Which of the following statements regarding a basilar skull fracture is correct?

The absence of raccoon eyes/ Battle's sign does not rule it out.

A flail chest occurs when:

a segment of the chest wall is detached from the thoracic cage.

Pneumothorax is MOST accurately defined as:

accumulation of air in the pleural space.

A normal level of consciousness in an infant or child is characterized by:

age appropriate behavior, good muscle tone, and good eye contact.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

constricted pupils (does include combative behavior, CSF leakage, and decreased sensory function).

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:

cyanosis.

The thoracic cavity is separated from the abdominal cavity by the

diaphragm.

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

guarding.

Elevation of the rib cage during inhalation occurs when:

intercostal muscles contract.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

intra-abdominal bleeding.

Atrophy is a condition that occurs when:

muscle decreases in size/function be of disease/trauma.

When assessing a patient with a hemothorax, you would MOST likely find:

signs and symptoms of shock.

Signs of vasoconstriction in the infant or child include:

weak distal pulses.

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:

2 seconds.

Hypothermia occurs when the core body temperature falls below:

90F or 32C

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:

Kehr sign.

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle.

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. During your focused exam, you note that he has diminished breath sounds over the left side of the chest. You should:

administer O2 and transport to the hospital.

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

administering blow-by O2 and transporting the child with her mother.

An open pneumothorax occurs when:

air enters the pleural space from outside the body.

Subcutaneous emphysema is an indication that:

air is escaping into the chest wall from the damaged lung.

The purpose of the pediatric assessment triangle (PAT) is to:

allow you to rapidly and visually form a general impression of the child.

The components of the PAT are:

appearance, work of breathing, and skin circulation.

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is app. 40 min. You should:

apply gentle manual traction in line w the limb and reassess for a pulse.

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:

apply high flow O2, consider spinal precautions, and transport without delay.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

applying direct pressure w a dry, sterile dressing.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to left femur. You should:

applying padded board splints to both sides of the leg.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should

assess distal pulse, motor, and sensory functions.

A 30-year old male was rescued after being lost in the woods for app. 18 hour. The outside temp is 30 F. He is immediately placed in a awarded ambulance. He is unconscious and pale. You should:

assess for a carotid pulse for up to 45 seconds.

You have applied a zippered air splint to a pt.'s left arm. During transport, the pt. complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST app. action should be to:

assess the amount of air in the splint and let are out as necessary.

You respond to a skate park where a 10year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:

assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes:

assisting ventilations at an age-appropriate rate.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume the arrow injured an internal organ.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:

at the feet.

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear- ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should:

bind his legs together on the backboard, keep him warm, and transport without delay.

An epidural hematoma is MOST accurately defined as:

bleeding bt the skill and dura mater.

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:

blunt injury to the kidney.

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):

cerebral concussion.

The MOST common and serious complication of a significant head injury is:

cerebral edema.

The five sections of the spinal column, in descending order, are the:

cervical, thoracic, lumbar, sacral, and coccygeal.

Which of the following statements regarding a pediatric patient's anatomy is correct?

children have a larger, rounder occiput compared to adults.

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:

closely monitor him and reassess him frequently.

Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:

collapsed jugular veins (includes profound cyanosis, bulging intercostal muscles, and unilaterally absent breath sounds).

You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration?

compression of the aorta and vena cava.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her BP is 98/58 mm Hg, pulse is 130 beats/min, and respirations are 24 breaths/min. You should:

control any external bleeding, administer O2, and transport at once.

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

control the bleeding and cover the wound w a sterile dressing.

Accumulation of blood in the abdominal cavity will MOST likely cause:

distention.

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport.

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

engorged jugular veins.

Before assessing the respiratory adequacy of an semiconscious infant or child, you must:

ensure that the airway is patent and clear of obstructions.

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?

epidural hematoma.

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:

giving him small sips of plain water (includes covering w blanket, promptly transport, and administering O2).

Covering a patient's _________ will significantly minimize radiation heat loss.

head

Common signs and symptoms of a chest injury include all of the following, EXCEPT:

hematemesis (includes tachypnea, localized pain, and chest wall ecchymosis).

Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when:

hollow abdominal organs are damaged and spill their contents.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam.

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should

immobilize the injury with a sling and swathe.

During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes:

immobilizing her to a backboard and rapidly transporting.

Shivering is a mechanism in which the body generates heat by:

increasing metabolic rate.

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:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

instruct him to assist her ventilations while you preform a rapid assessment.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:

laceration of the aorta.

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should:

lift the air bag and look for deformity to the steering wheel.

Bones are connected to other bones by bands of tough fibrous tissues called:

ligaments.

All of the following are hollow abdominal organs, EXCEPT for the:

liver (includes bladder, ureters, and stomach).

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

liver.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for 3 hours. his pulse is weak and heady, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:

load him on the ambulance and begin rapid cooling interventions.

A spinal cord injury at the level of C7 would MOST likely result in:

paralysis of the intercostal muscles.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing.

After using the PAT to form your general impression of a sick or injured child, you should:

perform a hands-on assessment of the ABCs.

The ________ nerves control the diaphragm.

phrenic.

Your assessment of a 23-year-old female reveals a core body temp of 93.4. She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale and respirations is rapid. In addition to monitoring her ABCs, administering oxygen, and making the ride warm. You should:

place heat packs to her groin, axillae, and behind her neck; cover her w warm blankets; and avoid rough handling.

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:

place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

The MOST reliable indicator of an underlying fracture is:

point tenderness.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

posterior hip dislocation.

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to applying 100% oxygen, you should:

prepare for immediate transport.

You are transporting a 28-year old man with frostbitten foot. The patients vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury.

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

provide some form of positive pressure ventilation.

A patient who presents with profound cyanosis following a chest injury:

requires prompt ventilation and O2.

The presence of tachycardia following a significant abdominal injury:

should be assumed to be a sign of shock.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

The spinal cord is encased in and protected by the:

spinal canal.

A 31-year old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable. You transport him to the hospital. You should:

splint the elbow in the position found and transport.

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

stabilize her head an perform a primary assessment.

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is not moving and does not appear to be conscious or breathing. You should:

stabilize his head and check for a pulse.

During your rapid trauma assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:

stabilize the chest wall w a bulky dressing.

During your rapid secondary assessment of a 30-year old male who fell 25', you note crepitus when palpating his pelvis. your partner advises you that the pt.'s blood pressure is 80/50 mm Hg and his HR is 120 beats/min and weak. You should:

stabilize the pelvis with a pelvic binder and protect the spine.

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:

stridor.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

suction his oropharynx for up to 15 seconds.

Common signs of a skull fracture include all of the following, EXCEPT:

superficial scalp lacerations (includes mastoid process bruising, ecchymosis around eyes, and noted deformity).

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 blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:

transprt him in the position in which you found him.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of

traumatic aortic rupture.

The body's natural protective mechanisms against heat loss are:

vasoconstriction and shivering.