Chapter 29

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should: A. immediately place her on a long backboard and prepare for rapid transport. B. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. C. instruct him to assist her ventilations while you perform a rapid assessment. D. perform a focused secondary assessment of the patient's head and neck.

C. Instruct him to assist her ventilations while you perform a rapid assessment.

Bleeding within the brain tissue itself is called a(n): A subarachnoid hemorrhage B. subdural hematoma. C. intracerebral hematoma D. epidural hematoma.

C. Intracerebral hematoma

When opening the airway of a patient with a suspected spinal injury, you should use the: A head tilt-chin lift maneuver B. tongue-jaw lift maneuver. C. jaw-thrust maneuver. D. head tilt-neck lift maneuver.

C. Jaw-thrust maneuver

In contrast to a cerebral concussion, a cerebral contusion. A. usually does not cause a loss of consciousness. B involves physical injury to the brain tissue C. results from a laceration to the brain tissue. D does not cause pressure within the skull

B. Involves physical injury to the brain tissue.

The___________is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. A. cerebellum B. spinal cord C. brain stem D cerebral cortex

C. Brain stem

Coordination of balance and body movement is controlled by the. A. Brain stem. B. medulla. C. cerebellum. D. cerebrum.

C. Cerebellum

Which of the following interventions may be used to help reduce intracranial pressure? A Increasing the patient's body temperature B. Supine with the legs elevated C. Maintaining the SpO2 at 90% D. 30-degree elevation of the head

D. 30-degree elevation of the head

An epidural hematoma is most accurately defined as: A bleeding between the skull and dura mater. B an iniury caused by a damaged cerebral artery. C. venous lacerations that occur within the brain. D. bleeding between the dura mater and brain.

A. Bleeding between the skull and dura mater

The Glasgow Coma Scale (GCS) is used to assess: A eye opening, verbal response, and motor response. B. verbal response, eye opening, and mental status. C. mental status, eye opening, and respiratory rate. D. sensory response, pupil reaction, and heart rate.

A. Eye opening, verbal response, and motor response

It would be most appropriate to perform a focused secondary assessment on a patient who: A. fainted and fell to the ground from a standing position. B. was restrained during a high-speed motor vehicle crash. C. struck his or her head and is experiencing nausea or vomiting. D. has blood draining from the ears following a head injury.

A. Fainted and fell to the ground from a standing position.

When placing a patient onto a long backboard, the EMT at the patient's____________________ is in charge of all patient movements: A head B waist C. chest D lower extremities

A. Head

In the setting of a head injury, hypertension, bradycardia, and Biot respirations indicate. A. herniation of the brain stem. B. internal bleeding in the chest. C. decreased cerebral blood flow. D. an underlying skull fracture.

A. Herniation of the brain stem.

When a patient experiences a severe spinal injury, he or she: A might lose sensation below the level of the injury. B. will likely be paralyzed from the neck down. C often loses motor function on one side of the body. D most commonly has a palpable spinal deformity

A. Might loose sensation below the level of injury.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: A. rupture of the tympanic membrane following diffuse impact to the head. B. a linear skull fracture and a significant increase in intracranial pressure. C. significant pressure and bleeding in between the skull and dura mater D. fractures to the internal structures of the ear following direct trauma

A. Rapture of the tympanic membrane following diffuse impact to the head

What part of the nervous system controls the body's voluntary activities? A. Somatic 8. Central C. Autonomic D. Sensory

A. Somatic

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? Select one: A. 4 B. 3 C. 5 D. 2

B. 3

The most reliable sign of a head injury is A. an abnormally low blood pressure B. a decreased level of consciousness C. a pulse that is rapid and thready. D. decreased sensation in the extremities.

B. A decreased level of consciousness

A 45-year-old male was working on his roof when he fell approximately 12 feet, 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: A. allow him to refuse transport if his vital signs remain stable. B. immobilize his spine and perform a focused secondary exam. C. perform a rapid head-to-toe exam and immobilize his spine. D. obtain a Glasgow Coma Score value and give him oxygen.

B. Immobilize his spine and perform a focused secondary exam.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: A the patient adamantly denies neck pain. B. it causes a problem managing the airway. C. lateral immobilization has been applied. D. sensory and motor functions remain intact

B. It causes a problem managing the airway

The_________nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. A autonomic B. peripheral C. somatic D. central

B. Peripheral

The central nervous system (CNS) is composed of the: A. cerebrum and meninges. B. meninges and spinal cord. C brain and spinal cord. D. cerebellum and brain.

C. Brain and spinal cord

After your partner assumes manual in-line stabilization of the patient's head, you should: A. apply an appropriately sized rigid cervical collar. B. use four people to log roll the patient onto a backboard. C. assess distal neurovascular status in the extremities. D. thoroughly palpate the patient's head for deformities.

C. Assess distal neurovascular status in the extremities

The frontal and parietal bones of the skull are especially susceptible to: A linear skull fractures. B. nondisplaced skull fractures. C. depressed skull fractures. D. basilar skull fractures.

C. Depressed skull fractures

When assessing a conscious patient with a mechanism of injury that suggests spinal injury, you should: A. ask the patient to move his or her head to assess for pain. B. defer spinal immobilization if the patient is ambulatory. C determine if the strength in all extremities is equal. D. rule out a spinal injury if the patient denies neck pain.

C. Determine if the strength in all extremities is equal.

The tough, fibrous outer meningeal layer is called the: A. pie mater B. Arachnoid mater C. dura mater D. gray mater

C. Dura mater

When caring for a patient with a possible head injury, it is most important to monitor the patient's: A pupil size B. pulse regularity. C. level of consciousness. D. blood pressure

C. Level of consciousness

Signs and symptoms that might be found in a patient who has experienced a concussion include: A anxiety and restlessness B. hypotension and nosebleed. C. nausea and ringing in the ears. D tachycardia and diaphoresis.

C. Nausea and ringing in the ears.

The spinal cord is encased in and protected by the: A vertebral arch. B. Intervertebral disc C. spinal canal. D. vertebral body.

C. Spinal canal

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of: A. 15 B. 13 C. 12. D. 14.

D. 14

A short backboard or vest-style immobilization device is indicated for patients who: A are found supine and have stable vital signs B. require prompt extrication from an automobile. C. are sitting in their car and are clinically unstable. D. are in a sitting position and are clinically stable.

D. Are in a sitting position and are clinically stable

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another? A. Autonomic B. Connecting C. Somatic D. Peripheral

D. Connecting

Which of the following statements regarding the cranium is correct? A. The skull is a subdivision of the cranium. B. The cranium protects the structures of the face. C. Thirty percent of the cranium is occupied by blood. D. Eighty percent of the cranium is occupied by brain tissue.

D. Eighty percent of the cranium is occupied by brain tissue.

The hormone responsible for the actions of the sympathetic nervous system is. A. insulin. B. toyroxine C. aldosterone D. epinephrine

D. Epinephrine

The most important immediate treatment for patients with a head injury. regardless of severity is to: A. administer high-flow oxygen. B. transport to a trauma center: C. immobilize the entire spine, D. establish an adequate airway.

D. Establish an adequate airway.

Which of the following skull fractures would be the least likely to present with palpable deformity or other outward signs? A. Open B. Depressed C. Basilar D. Linear

D. Linear

When immobilizing a child on a long backboard, you should: A place the child's head in a slightly extended position. B. secure the head prior to securing the torso and legs. C. defer cervical collar placement to avoid discomfort. D. place padding under the child's shoulders as needed.

D. Place padding under the child's shoulders as needed.

A patient who cannot remember the events that preceded his or her head injury is experiencing: A. prograde amnesia. B. anterograde amnesia. C. posttraumatic amnesia D. retrograde amnesia.

D. Retrograde amnesia

You should be most suspicious that a patient has experienced a significant head injury if his or her pulse is: A. weak B irregular. C. rapid D slow

D. Slow

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: A pack his nostrils to stop the drainage of blood. B. assist his ventilations with a bag valve mask. C. immobilize his spine and transport immediately. D. suction his oropharynx for up to 15 seconds.

D. Suction his oropharynx for up to 15 seconds.

The ideal procedure for moving an injured patient from the ground to a backboard is A. the direct patient carry B. the clothes drag C. the use of a scoop stretcher. D. the four-person log roll.

D. The four person log roll