Volume 4 Chapter 8
How much blood loss can occur in a third-trimester pregnant female before she will show signs or symptoms of hypovolemia? A. 30 percent B. 15 percent C. 25 percent D. 40 percent
A
The liver is injured ________ percent of the time with penetrating abdominal trauma. A. 40 B. 10 C. 75 D. 25
A
Which of the following is TRUE of the epidemiology of abdominal trauma? A. Morbidity and mortality due to blunt trauma are decreasing, but morbidity and mortality due to penetrating trauma are increasing. B. Morbidity and mortality due to blunt trauma are increasing, but morbidity and mortality due to penetrating are decreasing. C. Morbidity and mortality due to blunt and penetrating trauma are both increasing. D. Mortality and morbidity due to blunt and penetrating trauma are both decreasing.
A
Which of the following is most likely to occur as a result of rapid deceleration without actual contact between the patient's body and the interior of the vehicle? A. Shearing injury of the liver B. Kidney contusion C. Rupture of the colon D. Blunt trauma to the pancreas
A
The suspicion of blunt abdominal trauma should be based primarily on: A. the presence of contusions. B. the mechanism of injury. C. the patient's complaint of abdominal pain. D. distension of the abdomen on palpation.
B
Which of the following organs is NOT part of the digestive system? A. Stomach B. Spleen C. Pancreas D. Liver
B
Which of the following patients may have trauma to abdominal organs? 1. A 30-year-old construction worker who fell from a second-story roof but managed to land on his feet 2. A 17-year-old male with a gunshot wound to the right buttock 3. A 50-year-old male with a stab wound 4 cm inferior to the right scapula 4. A 45-year-old female restrained driver of an SUV with a moderate-speed frontal impact A. 3, 4 B. 1, 2, 3, 4 C. 1, 3, 4 D. 4
B
Your patient is an 18-year-old man who was slashed across the abdomen with a machete. He has a mass of omentum and small bowel protruding from the wound. Which of the following is your primary concern with this patient? A. Immediately covering the wound with an occlusive dressing, using your gloved hand if nothing else is available B. Covering the wound with a sterile, saline-moistened dressing covered by an occlusive dressing C. Having the patient hold the omentum and placing him on the stretcher in a position of comfort to transport rapidly D. Irrigating the exposed organs with sterile saline to remove debris and gently tucking them back into the opening to keep them warm and moist and to prevent further contamination
B
Your patient is a 60-year-old female restrained driver involved in a moderate-speed frontal impact collision. When you arrive at the scene, she is sitting up in the driver's seat with a chief complaint of a burning sensation in her face. You note abrasions from deployment of the airbag. After immobilizing the patient on a long backboard, you begin transport. As you perform a detailed examination, the patient complains of developing right shoulder pain. Which of the following should you suspect? A. Exacerbation of the patient's arthritis due to immobilization on the backboard B. Intraabdominal bleeding C. Shoulder contusion or possible clavicle fracture due to restraint by the shoulder harness D. Myocardial contusion
B
The injury in which abdominal organs protrude through a large, deep laceration of the abdominal wall is best described as: A. a gutting injury. B. herniation. C. evisceration. D. disimpaction.
C
Which of the following best describes shear injuries to the abdominal organs? A. Impact of solid organs with the abdominal wall in rapid deceleration B. Sudden compression of gas-containing hollow organs, resulting in their rupture C. Tearing of the organ in which the organ is fixed at its point of attachment but free to move otherwise D. Sudden decompression of solid or hollow organs
C
Which of the following changes is NOT of concern in the pregnant trauma patient? A. Compression of the inferior vena cava B. Rupture of the urinary bladder C. The high likelihood of trauma to the uterus in the first trimester D. Disproportionate increase in vascular volume as compared to red blood cells
C
Which of the following is TRUE of abdominal trauma? A. A soft, non-tender, non-distended abdomen with intact bowel sounds reliably rules out hollow organ injury. B. Due to the vascular nature of abdominopelvic organs, the onset of signs and symptoms is abrupt and severe. C. A significant amount of blood can accumulate in the abdominal cavity before signs and symptoms of abdominal injury appear. D. A soft, non-tender, non-distended abdomen reliably rules out solid organ injury.
C
Which of the following is TRUE of the patient with a suspected penetrating injury to or rupture of the diaphragm? A. Breathing is not impaired unless abdominal organs migrate into the thoracic cavity. B. This is the only abdominal injury for which removal of an impaled object is recommended. C. Shallow respirations may be due to abdominal contents in the thorax. D. This is one of the primary indications for the use of PASG.
C
Your patient is a 17-year-old male driver of a vehicle that received a lateral impact at the driver's side door. There are no side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door. Your patient is complaining of left shoulder pain and pain "in his left side." He has a contusion on the left shoulder and deformity of the left clavicle. He has erythema over the left lateral thorax from ribs 6 through 12 with crepitus on palpation. Which of the following injuries should you suspect? 1. Blunt trauma to the spleen 2. Blunt trauma to the liver 3. Penetrating trauma to the spleen 4. Penetrating trauma to the liver 5. Left pneumothorax 6. Fracture of the left clavicle A. 1, 2, 6 B. 2, 4, 6 C. 1, 5, 6 D. 2, 5, 6
C
Damage to which of the following organs is most likely to induce severe infection in the abdominal cavity? A. Stomach B. Ureter C. Urinary bladder D. Colon
D
The __________is a double peritoneal fold containing blood vessels, lymphatic vessels, nerves, and fatty tissue. A. peritoneum B. pancreas C. retroperitoneal space D. mesentery
D
Which of the following can reduce the potential for abdominal injury? A. Side-impact airbags B. Proper placement of automobile lap belts in children C. Proper placement of automobile lap belts in adults D. All of the above
D
Which of the following describes definitive care of the patient with traumatic intraabdominal hemorrhage? A. Admission to the ICU for observation B. Aggressive oxygenation and fluid resuscitation C. Administration of blood or blood products D. Rapid surgical intervention
D
Which of the following guidelines applies to prehospital fluid resuscitation of hypotensive patients with intraabdominal hemorrhage? A. IV access is necessary only if the use of PASG fails to improve the patient's clinical condition. B. IV access should be obtained using a saline lock, but fluid resuscitation is contraindicated in the prehospital setting. C. Fluid administration rate should be titrated to maintain a systolic blood pressure of 60 mmHg. D. In most cases, fluid administration should be limited to 3 liters.
D
Which of the following is NOT part of the prehospital examination of the patient with suspected abdominal trauma? A. Checking for stability of the pelvis B. Assessment of the thorax for injury C. Asking the patient about abdominal pain first, then palpating the abdomen in all four quadrants D. Checking for blood in the urine
D
Which of the following is a special consideration when managing the pregnant trauma patient? A. She may have a 30 percent blood volume loss before experiencing signs and symptoms of shock. B. She is at increased risk for vomiting and aspiration. C. Placing her supine may decrease cardiac output. D. All of the above are special considerations.
D
Which of the following may affect the pattern of injury in abdominal trauma? A. A full-term uterus B. A full stomach C. A full bladder D. All of the above
D
Which of the following organs is LEAST likely to be injured in penetrating trauma to the abdomen? A. Kidney B. Spleen C. Small intestine D.Pancreas
D
Your patient is a 30-year-old pregnant woman at 36 weeks' gestation. She was injured in a fall from a horse and is complaining of painful contractions. Her abdomen is tender to palpation over the uterus, and the uterus becomes firm with contractions, but she denies vaginal bleeding. The patient is anxious, but her skin is warm and dry. Her blood pressure is 112/70, her heart rate is 92, and her respirations are 24. Which of the following statements best describes this situation? A. The mechanism and patient complaints are consistent with placenta previa. The mother is stable, but the fetus is in jeopardy. B. The mechanism and patient complaints are consistent with uterine rupture. Both the mother and fetus are in jeopardy. C. The mechanism and patient complaints are suspicious for abruptio placentae. The mother's condition is not life threatening, but fetal demise has most likely already occurred. D. The mechanism and patient complaints are suspicious for abruptio placentae. Both the mother and the fetus are in jeopardy.
D
