Chapter 25 face and neck injuries

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. transport her to the emergency department. B. use tweezers to try to remove the object. C. thoroughly flush her ear with sterile saline. D. remove the peanut with a cotton-tipped swab.

A

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: Select one: A. cover both of his eyes and transport to the hospital. B. remove the object with a cotton-tipped applicator. C. cover his right eye and flush the left eye with saline. D. scrape the splinter away with moist, sterile gauze.

A

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: Select one: A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. C. assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. D. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

A

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: Select one: A. irrigate both eyes continuously for 20 minutes with plain water. B. neutralize the acid chemical in his eye with an alkaline chemical. C. mix baking soda with water and irrigate his eyes with the solution. D. flush both eyes with an alcohol-based solution and transport.

A

The term "hyphema" is defined as: Select one: A. blood in the anterior chamber of the eye. B. compression of one or both optic nerves. C. inflammation of the iris, cornea, and lens. D. an acute rupture of the globe of the eye.

A

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: Select one: A. pressure dressings and chemical ice packs. B. direct pressure using dry, sterile dressings. C. digital pressure to an adjacent pulse point. D. ice packs and elevation of the patient's head.

B

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: Select one: A. cornea. B. conjunctiva. C. sclera. D. retina.

B

The mastoid process is located approximately: Select one: A. 1″ posterior to the angle of the mandible. B. 1″ posterior to the external opening of the ear. C. 1″ inferior to the external opening of the ear. D. ½″ anterior to the external opening of the ear.

B

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: Select one: A. irrigate her eyes with water to prevent mucosal drying. B. inspect her eyes and gently remove impaled objects. C. close her eyes and cover them with a moist dressing. D. secure her eyes open so you can reassess her pupils.

C

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: Select one: A. remove the contact lenses and cover his eyes with a dry, sterile dressing. B. leave the contact lenses in place and cover both eyes with a dry dressing. C. carefully remove the contact lenses and then irrigate his eyes with saline. D. leave the contact lenses in place and flush his eyes with sterile water

C

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: Select one: A. ask her to move the injured eye to assess the integrity of the optic nerve. B. carefully examine her eye and remove any foreign objects if needed. C. avoid applying pressure to the globe when you are covering the eye. D. apply firm direct pressure to the injured eye and cover the opposite eye.

C

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: Select one: A. carefully remove the glass from her eye. B. stabilize the impaled glass in her eye. C. apply direct pressure to her arm wound. D. administer 100% supplemental oxygen.

C

The lower jawbone is called the: Select one: A. zygoma. B. maxillae. C. mandible. D. mastoid.

C

What is the function of the sternocleidomastoid muscle? Select one: A. connects the scapulae together B. allows flexion of the neck C. allows movement of the head D. provides respiration

C

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: Select one: A. regularly sees a family physician. B. is allergic to any medications. C. has a history of eye surgeries. D. noticed the change during a meal.

C

Facial injuries should be identified and treated as soon as possible because: Select one: A. swelling may mask hidden injuries. B. bleeding must be controlled early. C. the spine may be injured as well. D. of the risk for airway problems

D

The skin and underlying tissues of the face: Select one: A. contain a relatively small number of nerve fibers. B. swell minimally when exposed to blunt trauma. C. are well protected by the maxillae and mandible. D. have a rich blood supply and bleed profusely

D

The superficial temporal artery can be palpated: Select one: A. at the angle of the jaw. B. over the mastoid process. C. slightly above the ear. D. just anterior to the tragus

D

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

D

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: Select one: A. alert the hospital of the situation. B. reassess his breathing adequacy. C. quickly suction his oropharynx. D. turn the backboard onto its side.

D