Trauma #6

The two MOST common causes of secondary brain injury are: A. blunt trauma and cerebral edema. B. cerebral hypoxia and hypotension. C. infection and intracranial bleeding. D. increased ICP and cerebral edema.

B. cerebral hypoxia and hypotension.

When a person is exposed to cold temperatures, blood vessels in the skin: A. dilate and draw blood to the surface of the skin. B. constrict and divert blood away from the skin. C. dilate and divert blood to the core of the body. D. constrict and draw blood to the skin's surface.

B. constrict and divert blood away from the skin.

What is the function of the sternocleidomastoid muscle? A. Allows movement of the head B. Allows flexion of the neck C. Connects the scapulae together D. Facilitates chest movement

A. Allows movement of the head

When assessing a patient with multiple systems trauma, which of the following musculoskeletal injuries would pose the GREATEST threat to the patient's life? A. Multiple open fractures B. Dislocation of a major joint C. Single open long bone fracture D. Displaced fracture of the pelvis

A. Multiple open fractures

What types of motor vehicle collisions present the greatest potential for multiple impacts? A. Rotational and rollover B. Rear-end and rotational C. Frontal and rotational D. Lateral and rollover

A. Rotational and rollover

When assessing a conscious patient who experienced an electrical injury, you note irregularity in his pulse. This is MOST indicative of: A. a cardiac dysrhythmia. B. impending respiratory arrest. C. ventricular fibrillation. D. decreased perfusion.

A. a cardiac dysrhythmia.

When evaluating the mechanism of injury of a car-versus-pedestrian collision, you should first: A. approximate the speed of the vehicle that struck the pedestrian. B. determine if the patient was propelled away from the vehicle. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle.

A. approximate the speed of the vehicle that struck the pedestrian.

When palpating an injured extremity, a patient complains of point tenderness. On the basis of this clinical finding, you: A. are unable to determine the type of fracture. B. cannot identify the associated zone of injury. C. can definitively diagnose an underlying fracture. D. can conclude that gross distal motor function is intact.

A. are unable to determine the type of fracture.

Visceral injuries in the chest that occur from shearing forces, compression, or rupture, are MOST commonly seen with: A. blunt chest trauma. B. projectile injuries. C. rapid acceleration. D. penetrating chest trauma.

A. blunt chest trauma.

Unilaterally diminished or absent breath sounds, a narrowed pulse pressure, and dullness to percussion of the hemithorax are clinical findings suggestive of a: A. hemothorax. B. tension pneumothorax. C. pericardial tamponade.

A. hemothorax.

When assessing a patient with multiple gunshot wounds, you should: A. identify the number and location of all wounds. B. carefully assess the patient to predict the bullet's path. C. control the bleeding that you see and then transport.

A. identify the number and location of all wounds.

When assessing a patient who experienced a blast injury, it is important to remember that: A. primary blast injuries are the most easily overlooked. B. solid organs usually rupture from the pressure wave. C. primary blast injuries are typically the most obvious. D. secondary blast injuries are usually the least obvious.

A. primary blast injuries are the most easily overlooked.

When assessing an unresponsive 20-year-old male with a traumatic brain injury, you note that his left pupil is fully dilated and non-reactive. This indicates injury: A. to the left cerebral hemisphere. B. to the right oculomotor nerve. C. in the region of the cerebellum. D. to the inferior part of the brainstem.

A. to the left cerebral hemisphere.

When assessing a patient with a grossly deformed humerus, you note that the radial pulse is absent and the extremity is becoming cyanotic. You should: A. use constant, gentle manual traction to align the humerus. B. manipulate the humerus until distal circulation is restored. C. splint the humerus in the position found and begin transport. D. begin transport and continue attempts to restore circulation.

A. use constant, gentle manual traction to align the humerus.

When administering IV crystalloid boluses to a patient with an electrical injury, you should give enough fluid to maintain a urine output of: A. 4 mL/kg per hour. B. 1 mL/kg per hour. C. 2 mL/kg per hour. D. 3 mL/kg per hour.

B. 1 mL/kg per hour.

When assessing a 70-year-old male with suspected internal bleeding, which of the following findings would be MOST pertinent? A. A history of controlled hypertension B. Dizziness or syncope upon standing C. A history of trauma six months ago D. The patient regularly takes Tylenol.

B. Dizziness or syncope upon standing

What is the rationale for restricting IV fluid boluses in patients with a pulmonary contusion? A. Pulmonary contusions rarely cause severe hypovolemia. B. Fluids may cause pulmonary edema or increased bleeding. C. Rapidly increasing the blood pressure may inhibit hemostasis. D. Excessive fluid boluses may result in a tension pneumothorax.

B. Fluids may cause pulmonary edema or increased bleeding.

What physiologic response may occur when a head-injured patient is hyperventilated with a bag-mask device and 100% oxygen? A. Vasoconstriction and increased cerebral perfusion B. Vasoconstriction and decreased cerebral perfusion

B. Vasoconstriction and decreased cerebral perfusion

When caring for a patient with multiple abrasions, you should: A. clean the wounds with sterile water. B. be alert for underlying injuries. C. give a 500 mL crystalloid bolus. D. transport to a local trauma center.

B. be alert for underlying injuries.

Upon arriving at the scene of a motorcycle crash, you find the patient, a young male, lying supine approximately 10 feet from his bike. An emergency medical responder is manually stabilizing the patient's head. You note an obvious open injury to the patient's left lower leg with severe bleeding. Your MOST appropriate initial action should be to: A. open the patient's airway and assess respiratory rate, regularity, and depth. B. direct your partner to control the bleeding as you assess the patient's airway. C. locate and control all obvious bleeding and then perform a primary assessment. D. have your partner assume control of the patient's head as you open the airway.

B. direct your partner to control the bleeding as you assess the patient's airway.

Two of the MOST common mechanisms of injury for blunt trauma are: A. low-caliber gunshot wounds and falls. B. falls and motor vehicle collisions. C. gunshot wounds and vehicle ejections. D. motor vehicle collisions and stabbings.

B. falls and motor vehicle collisions.

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. kinetic energy. B. mechanism of injury. C. index of suspicion. D. potential energy.

B. mechanism of injury.

When assessing a patient with a mandibular fracture, you would MOST likely encounter: A. pain directly over the chin. B. misalignment of the teeth. C. impaired ocular movement. D. lateral bulging of the jaw.

B. misalignment of the teeth.

When assessing a patient with a mandibular fracture, you would MOST likely encounter: A. pain directly over the chin. B. misalignment of the teeth. C. impaired ocular movement. D. lateral bulging of the jaw.

B. misalignment of the teeth.

When assessing an elderly patient who fell, it is important to remember that: A. elderly patients who fall usually have a secondary head injury. B. osteoporosis can cause a fracture that may have resulted in the fall. C. any fall in the elderly is considered to be high-energy trauma. D. bilateral hip fractures usually occur when an elderly person falls.

B. osteoporosis can cause a fracture that may have resulted in the fall.

A trauma patient who presents with shock, jugular venous distention, and bilaterally equal breath sounds has MOST likely experienced a: A. simple pneumothorax. B. pericardial tamponade. C. pulmonary contusion. D. massive hemothorax.

B. pericardial tamponade

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. is thrust under the steering column onto the floorboard. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. will most likely be thrown over the steering column.

B. remains in motion until acted upon by an external force.

To align a severe deformity associated with a humeral shaft fracture, you should: A. place one hand above and one hand below the fracture site and apply gentle downward traction. B. support the fracture site with one hand and apply gentle traction by grasping the humeral condyles.

B. support the fracture site with one hand and apply gentle traction by grasping the humeral condyles.

Tough, cord-like structures that are extensions of the fascia covering all skeletal muscles are known as: A. menisci. B. tendons. C. ligaments. D. cartilage.

B. tendons.

When caring for a patient with significant thoracic trauma and signs of shock, it is MOST important to: A. establish two large-bore IV lines. B. transport promptly to a trauma center. C. perform a detailed secondary assessment. D. administer high-flow oxygen at all times.

B. transport promptly to a trauma center.

Under which of the following conditions would external bleeding be LEAST difficult to control? A. Lacerated antecubital vein and a BP of 130/70 mm Hg B. Lacerated carotid artery and a BP of 140/90 mm Hg C. Lacerated femoral vein and a BP of 88/60 mm Hg D. Lacerated brachial artery and a BP of 84/56 mm Hg

C. Lacerated femoral vein and a BP of 88/60 mm Hg

When stabilizing a patient's cervical spine, you should: A. support the lower jaw with your palms. B. position yourself beside the patient. C. align the patient's nose with the navel.

C. align the patient's nose with the navel.

When assessing the pelvis of a patient with multiple systems trauma, you should: A. gently rock the pelvis back and forth. B. percuss the pubic symphysis to elicit pain. C. apply gentle inward pressure to the iliac crests. D. avoid palpation due to the potential for injury.

C. apply gentle inward pressure to the iliac crests.

When caring for an open wound that has small pieces of glass and other debris inside of it, you should: A. remove the glass and debris with hemostats. B. leave the wound open unless it is bleeding. C. cover the wound with a sterile dressing. D. irrigate the wound with sterile water.

C. cover the wound with a sterile dressing.

When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A. dashboard B. steering wheel C. door D. windshield

C. door

When administering IV fluids to a patient with suspected intrathoracic bleeding, it is important to remember that: A. fluids should be restricted, even in the presence of shock. B. most patients require up to 2 liters of crystalloid solution. C. increasing the BP with fluids may increase the bleeding. D. a target systolic blood pressure of 100 should be achieved.

C. increasing the BP with fluids may increase the bleeding.

The upper jawbones are called the: A. mastoid. B. mandible. C. maxillae. D. zygoma.

C. maxillae.

When assessing a patient with blunt abdominal trauma, the severity of internal bleeding is BEST determined by: A. noting the mechanism of injury. B. frequently taking the blood pressure. C. monitoring for signs of shock. D. ascertaining the patient's medical history.

C. monitoring for signs of shock.

312. When assessing a 40-year-old female with an injury to her left wrist, you should recall that the MOST reliable indicator of an underlying fracture is: A. ecchymosis. B. gross swelling. C. point tenderness.

C. point tenderness.

When managing an adult patient with an inhalation injury, inspiratory stridor, and an altered mental status, you should: A. apply ice packs to the neck to reduce swelling. B. give humidified oxygen via a nonrebreathing mask. C. prepare for early definitive airway management. D. ventilate at a rate of 20 breaths per minute.

C. prepare for early definitive airway management.

When managing a critically-burned patient, it is important to: A. administer topical analgesia to the burned areas to afford the patient pain relief. B. break the integrity of any formed blisters as these can result in infection. C. rapidly estimate the burn's severity and then cover with dry, sterile dressings. D. perform a detailed physical exam at the scene to look for occult injuries.

C. rapidly estimate the burn's severity and then cover with dry, sterile dressings.

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. recognize that the force of impact was most likely not severe. B. realize that the air bag malfunctioned at the time of impact. C. remember that it could still deploy and seriously injure you. D. suspect that the patient may have experienced serious injuries.

C. remember that it could still deploy and seriously injure you.

When assessing a patient with a scapular fracture, you should also be alert for: A. a myocardial contusion. B. fractures of the sacral spine. C. ribs fractures and a pneumothorax. D. an associated midshaft clavicular fracture.

C. ribs fractures and a pneumothorax.

When immobilizing a patient onto a long backboard, it is important to: A. follow the commands of the AEMT at the torso. B. secure the head prior to securing the torso. C. secure the torso prior to securing the head.

C. secure the torso prior to securing the head.

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 caring for a patient with an open facial injury, the AEMT must: A. consider the mechanism of injury. B. manually stabilize the patient's head. C. wear gloves and facial protection. D. closely assess the patient's airway

C. wear gloves and facial protection.

What portion of the nervous system controls the functions of many of the body's vital organs, over which the brain has no voluntary control? A. Peripheral B. Somatic C. Adrenergic D. Autonomic

D. Autonomic

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.

What layer of the skin contains cells that are replaced with new cells that are formed in the germinal layer? A. Subcutaneous layer B. Melanin layer C. Dermis D. Epidermis

D. Epidermis

When percussing the chest of a patient who experienced blunt chest trauma, you note hyperresonance on the left side of his chest. This suggests: A. blood in the pleural space. B. alveolar hyperinflation. C. myocardial compression. D. air in the pleural space.

D. air in the pleural space.

A utility worker was trimming branches away from a high power line when he accidentally cut the power line. He is unresponsive, apneic, and pulseless. You should begin CPR and then: A. assess for an entrance and exit wound. B. establish two large-bore IV lines. C. apply full spinal motion restriction precautions. D. apply the AED as soon as possible.

D. apply the AED as soon as possible.

When assessing a 14-year-old male with an injured arm, you note gross deformity just distal to the elbow. Distal neurovascular functions are grossly intact. You should: A. apply a pediatric traction splint to the arm. B. immobilize the injury with a sling and swath. C. ensure immobilization of the hand and shoulder. D. assume that growth plate damage has occurred.

D. assume that growth plate damage has occurred.

Upon arriving at the scene of a motor-vehicle crash involving a telephone pole, you note that the driver appears unconscious and is bleeding heavily from the mouth. There is a power line across the hood and roof of the car. You should: A. carefully remove the power line with rubber gloves. B. remove the power lines with a non-conductive object. C. attempt to safely remove the patient from the car. D. ensure that the power line is not electrically active.

D. ensure that the power line is not electrically active.

When a light is shone into the pupil: A. the opposite pupil should dilate. B. it should become larger in size. C. both pupils should dilate together. D. it should become smaller in size.

D. it should become smaller in size.

Two of the meningeal layers that protect the central nervous system are the arachnoid and pia mater which: A. are avascular and thick. B. are protected by cerebrospinal fluid. C. secrete immune system chemicals. D. produce cerebrospinal fluid.

D. produce cerebrospinal fluid.

When managing a patient with severe bleeding, it is important to: A. obtain frequent vital signs. B. administer high-flow oxygen. C. control the bleeding. D. take standard precautions.

D. take standard precautions.