Chapter 31 - Head Trauma

The EMT is properly assessing for sensory function in the hands when he tells or asks the​ patient: A. "Squeeze my fingers with both​ hands." B. "Can you tell me which finger I am​ touching?" C. "Can you wiggle your​ fingers?" D. "Do you feel me touching your right​ hand?"

​"Can you tell me which finger I am​ touching?"

A young female was thrown from a horse and is now confused. Assessment findings include an open​ airway, adequate​ breathing, and a strong radial pulse. Her vital signs are normal. Which question would be the most important to ask the​ patient's mother, who was riding with the​ patient, as soon as​ possible? A. "Is she allergic to​ anything?" B. "Does she have any medical​ problems?" C. "Are all of her immunizations​ up-to-date?" D. "Did she lose​ consciousness?"

​"Did she lose​ consciousness?"

A male patient in his thirties fell 10 feet off a loading​ dock, landing on his head and back. He has deformity and depression to the back of his head and is unresponsive with snoring respirations. Vital signs are​ pulse, 132​ beats/min; respirations,​ agonal; blood​ pressure, 136/64​ mmHg, and​ SpO2, 89%. The patient responds to painful stimuli with purposeful motion. Which instruction would you provide other caregivers at the​ scene? A. "I need someone to start positive pressure ventilation at 12 breaths per​ minute." B. "Let's try a nonrebreather mask with​ high-concentration O2 to increase his oxygen​ saturation." C.​ "The patient is​ herniating; start hyperoxygenation of the patient​ immediately." D. "The airway must be manually opened with a​ head-tilt, chin-lift maneuver​ immediately!"

​"I need someone to start positive pressure ventilation at 12 breaths per​ minute."

A patient complaining of a headache states that he fell and struck the back of his head. Which statement by the patient should be of most concern to the​ EMT? A. "I take a blood thinner for my​ heart." B. "I lost my balance after stumbling on the​ rug." C. "I had my appendix out two weeks​ ago." D. "I had a​ mini-stroke (TIA) five years​ ago."

​"I take a blood thinner for my​ heart."

At an industrial​ complex, a young male was struck in the head by a large piece of steel thrown from a grinding machine. Assessment reveals a​ soft, painful depression underlying a tear in his​ scalp, which is covered with dried blood. Clear fluid is draining from his right ear. The patient is conscious but confused and exhibits the following vital​ signs: pulse, 84​ beats/min; respirations, 16​ breaths/min and​ adequate; blood​ pressure, 142/76​ mmHg; and​ SpO2, 90%. Emergency Medical Responders are on scene and are maintaining manual spine motion restriction precautions. Which instruction indicates the next step needed in this​ patient's care? A. "Let's pack his right ear with gauze to stop the loss of​ fluid." B. "Will someone administer supplemental oxygen to the​ patient? C. "Place manual, direct pressure over the injury to control​ bleeding." D. "I need someone to check the clear fluid for​ glucose."

​"Will someone administer supplemental oxygen to the​ patient?

The parameters of the Glasgow Coma Scale​ are: A. Vital signs and mental status B. Mental​ status, vital​ signs, and verbal response C. Eyes, motor, and verbal response D. Verbal and motor response

​Eyes, motor, and verbal response

Which statement about brain injury is​ CORRECT? A. A diffuse axonal injury is caused by a tearing of an artery above the dura​ mater, causing a​ space-occupying lesion. B. A cerebral contusion is the bruising of brain tissue. C. A hematoma is the collection of blood outside the skull that results in damage to the brain tissue. D. A concussion is caused by damage to arteries in the brain.

A cerebral contusion is the bruising of brain tissue.

During your trauma assessment of a patient with head​ trauma, why should you regularly assess the pupils during the reassessment​ phase? A. Dilated pupils would indicate a drug​ overdose, not a brain injury. B. A brisk response to light could indicate hyperoxia. C. A fixed and dilated pupil can indicate increasing intracranial pressure. D. Sluggishly responding pupils could indicate concurrent hyperglycemia.

A fixed and dilated pupil can indicate increasing intracranial pressure.

At a construction​ site, an​ 18-year-old male was struck in the head by a pallet of concrete blocks as it was being moved by a crane. He has a large laceration to the left side of his​ head, with noted instability to the skull beneath the wound. Moderate bleeding from the injury site is also noted. The​ patient's airway is​ open, his breathing is​ adequate, and his pulse is strong and regular. Proper care for this patient should​ include: A. Hyperventilation with​ high-concentration oxygen B. Rapid transport in an upright position C. A loose dressing over the top of the laceration D. Direct pressure to control bleeding from the injury

A loose dressing over the top of the laceration

A trauma surgeon informs you that the patient whom you transported to the emergency department earlier was diagnosed with an epidural hematoma. The patient was taken into surgery and the hematoma was​ removed, and now the patient is in critical condition. Based on this​ information, the EMT should recognize that in this​ patient: A. Blood from a ruptured vein collected between the dura mater and brain tissue B. A pocket of arterial blood collected between the skull and dura mater C. Cerebrospinal fluid accumulated in a pocket on top of the brain tissue D. Blood from a ruptured artery formed a hematoma within a section of brain tissue

A pocket of arterial blood collected between the skull and dura mater

You are caring for a patient who was trying to cross a street when he was struck by a vehicle that then threw him into the oncoming traffic​ lane, where he was struck again. The patient presents with a depressed skull​ fracture, multiple long bone​ fractures, and bruising to the chest and abdomen. In assessing this​ patient, which of the following signs or symptoms best indicates that the patient has suffered a brain​ injury? A. Heart rate​ > 110/minute B. Pulse oximeter​ < 90% C. Narrowing pulse pressure D. Altered mental status

Altered mental status

Your patient fell from a roof. He has a laceration to the forehead that is bleeding minimally. He is currently unresponsive with vital signs of BP​ 140/100, heart rate​ 72, and respiratory rate 12. Which finding may indicate that this patient has a brain​ injury? A. Laceration B. Bleeding C. Altered mental status D. Heart rate

Altered mental status

Which patient has an isolated brain injury that should be considered the most​ serious? A. A​ 53-year-old female who crashed her bicycle and who has a large laceration that is bleeding heavily on the back of her head B. A​ 62-year-old female who fell and hit her head and who is becoming more confused and combative C. A​ 31-year-old male who fell from a roof and who is now nonverbal and extends his arms and legs when you pinch the muscles on his shoulder D. A​ 21-year-old male wearing a deformed motorcycle helmet who does not respond to verbal or painful stimuli after crashing

A​ 21-year-old male wearing a deformed motorcycle helmet who does not respond to verbal or painful stimuli after crashing

A​ 40-year-old male fell 20 feet from a ledge while hiking. The park ranger is now maintaining manual spine motion restriction for the patient. The patient is combative and​ confused, but his airway is open and his breathing is adequate. The patient has a radial pulse of 112​ beats/min, blood pressure of​ 96/76 mmHg, and SpO2 of​ 91% on room air. What should the EMT do​ first? A. Place a cervical collar and secure the patient to a long board B. Check the​ patient's blood glucose level C. Perform a​ jaw-thrust maneuver or a​ head-tilt, chin-lift maneuver D. Begin administering supplemental oxygen

Begin administering supplemental oxygen

When assessing a patient with a head​ injury, which finding is most indicative of increasing pressure within the​ skull? A. Heart rate of 132​ beats/min B. Pulse oximeter reading less than​ 95% on room air C. Respirations of 24 to 28​ breaths/min D. Blood pressure of​ 192/106 mmHg

Blood pressure of​ 192/106 mmHg

Which vital sign finding should the EMT attempt to correct if the patient has a suspected brain​ injury? A. Respiratory rate of 18 per minute B. Heart rate of 102 beats per minute C. Pulse oximeter reading of 95 percent D. Blood pressure of​ 86/62

Blood pressure of​ 86/62

A patient with Cushing reflex is most likely experiencing which​ pathophysiology? A .Hypovolemia B. Shock C. Concussion D. Brain herniation

Brain herniation

A​ middle-aged male died immediately after a​ self-inflicted gunshot wound to the head. Which portion of the central nervous system was most likely damaged to cause such a rapid​ death? A. Cerebrum B. Brainstem C. Meninges D. Cerebellum

Brainstem

You have been called to a residence of a patient with diabetes who exhibits an altered mental status. A family member states she could not reach the patient by​ telephone, so she came over and found the patient awake but confused. The patient can remember his name and​ address, but cannot remember the day or year. He refuses to go to the​ hospital, but consents to an assessment. Of these physical exam findings discerned on​ assessment, which one is most​ concerning? A. SpO2 of​ 95% on room air B. Blood glucose level of 77​ mg/dL C. Heart rate of 82​ beats/min D. Bruise to the left temple

Bruise to the left temple

You have been called to the local community hospital for a​ 48-year-old male who was involved in a motor vehicle collision 2 hours prior. He has been diagnosed with a cerebral contusion and must be transported to a trauma center for specialty care. As a knowledgeable​ EMT, you recognize that a cerebral contusion​ is: A. Bruising and swelling of the brain tissue B. An open skull fracture with increased pressure in the skull C. Active bleeding between the brain and the skull D. The formation of a pocket of blood within the brain tissue

Bruising and swelling of the brain tissue

A​ 68-year-old female patient complains of a headache and generalized weakness. Her husband informs you that she was with a friend yesterday and was involved in a motor vehicle collision. She did strike her face on the​ dashboard, but refused treatment on scene. Her past medical history includes a stroke with right arm weakness and high blood​ pressure, for which she takes medications. When assessing this​ patient, which finding should concern the EMT​ most? A. Complaint of pain when she moves her jaw B. Bruising behind her left ear C. Contusion to her left cheek area D. Weakness to the​ right-hand grip

Bruising behind her left ear

Which​ finding, when considered​ individually, is most consistent with a basilar skull​ fracture? A. Altered mental status B. Bilateral constricted pupils C. A hematoma over the frontal skull bone D. Bruising behind the ear

Bruising behind the ear

A construction worker was accidentally shot with a nail gun. The nail penetrated the skull approximately​ ½ inch through the temporal region. Before your​ arrival, coworkers pulled the nail free. Based on the mechanism of​ injury, which sign provides the strongest evidence that the meningeal layers have been​ breached? A. Cerebrospinal fluid oozing from the puncture wound B. Deformity and depression at the injury site C. Blood draining from the puncture wound D. Crepitus of the skull at the injury site

Cerebrospinal fluid oozing from the puncture wound

A patient exhibits retrograde amnesia when​ she: A. Responds purposely to painful stimuli B. Is nonverbal following a head injury C. Is foggy about events occurring after the injury D. Cannot remember falling and hitting her head

Cannot remember falling and hitting her head

You are assessing a patient who has sustained blunt trauma to the head. Which sign would be most indicative of the loss of cerebrospinal​ fluid? A. Clear fluid coming from the nose B. Dark bruising on the forehead C. Light bruising around both eyes D. Red-tinged fluid in the ear canal

Clear fluid coming from the nose

You suspect that an unhelmeted male patient who was thrown from a motorcycle may have a basilar skull fracture. As you perform the secondary​ assessment, which finding would reinforce this​ suspicion? A. Clear fluid coming from the right ear and the left nostril B. Paralysis of the left arm and leg C. Dilation and sluggish response of the right pupil to light D. Blood coming from both the ears and the nose

Clear fluid coming from the right ear and the left nostril

A male soccer player was struck in the head with a soccer ball. Players state that he was dazed for several seconds following the impact and then asked the same questions over and over.​ Presently, he is conscious and oriented to​ person, but confused about place and time. He also has a reddened area to the side of his head and face. As you proceed with your​ assessment, his memory continues to improve. Based on these​ findings, the EMT should suspect which type of​ injury? A. Concussion B. Epidural hematoma C. Open head injury D. Cerebral contusion

Concussion

Which of the following would be classified as a diffuse brain​ injury? A. Decreased intracranial perfusion B. Subarachnoid bleed C. Lucid interval D. Concussion

Concussion

A patient who was involved in an altercation was struck on the side of the head with a baseball​ bat, in addition to suffering several blows to the arms and legs. When assessing this​ patient, which sign or symptom best indicates the patient has suffered a brain​ injury? A. Ecchymosis to the side of the face B. Confusion and combativeness C. Complaint of a headache D. Weakness to both arms

Confusion and combativeness

The normal response of the pupils while examined with a penlight is described​ as: A. Diplopia B. Consensual C. Conjugate D. Dilative

Consensual

A young adult male is in police custody after he crashed his car into a utility pole. There is minor​ front-end damage to the​ vehicle, and the air bags deployed. The patient was not wearing a seat belt and has an abrasion to his forehead. He is awake and oriented to​ person, time, and place. His speech is slurred and he has an odor resembling that of beer on his breath. The arresting officer states that he just wants you to check the patient before he transports him to jail. Given this​ scenario, which action seems most appropriate for the EMT to​ take? A. Have the patient sign a​ refusal-of-care form if no threats exist B. Contact medical direction with assessment findings C. Have the officer sign a​ refusal-of-care form D. Release the patient to the police since he is alert and oriented

Contact medical direction with assessment findings

The cerebellum is described as the area of the brain​ that: A. Is responsible for most conscious and sensory functions B. Consists of two​ hemispheres, each containing five distinct lobes C. Controls the body functions most essential and vital to life D. Controls reflexes and assists in maintaining body posture

Controls reflexes and assists in maintaining body posture

A young adult female was struck by a vehicle while she was riding her bicycle. She was not wearing a helmet. She is now unresponsive and has a deformity with a deep depression to the temporal area of the head. You do not see any​ bleeding, and the​ patient's scalp is intact. What is the greatest threat associated with this​ injury? A. Loss of cerebrospinal fluid B. Potential for infection C. Fracture of the temporal bone D. Damage to the brain

Damage to the brain

What type of hemorrhage involving the meningeal layers presents with the MOST acute onset of​ findings? A. Intradural B. Intracerebral C. Subdural D. Epidural

Epidural

What type of injury to the head can result in blood accumulation between the dura mater and the​ skull? A. Subdural hematoma B. Subarachnoid bleed C. Epidural hematoma D. Deceleration injury

Epidural hematoma

What would be a general characterization of the traumatic forces that would be required to cause cranial​ deformity? A. Mild B. Insignificant C. Moderate D. Extreme

Extreme

A​ 21-year-old male has a gunshot wound to the head. As you assess​ him, which finding would you recognize as a nonpurposeful response to​ pain? A. Flexing his arms across his chest when you pinch his shoulder B. Garbled and incomprehensible speech when you call his name C. Exhibiting no response to any stimuli D. Attempting to move his hand away from you as you pinch it

Flexing his arms across his chest when you pinch his shoulder

Which finding indicates that a patient who received a blow to the head is suffering from something other than a simple​ concussion? A. His heart rate is 92​ beats/min and his blood pressure is​ 144/86 mmHg B. He cannot remember what happened C. His pupils are noticeably unequal when assessed D. He asks the same questions over and over

His pupils are noticeably unequal when assessed

Head injuries can involve the​ scalp, the​ skull, and the brain itself. Which of the following is TRUE regarding these​ injuries? A. If the scalp is lacerated but the skull remains​ intact, the injury is termed an​ "open fracture." B. Because of the small number of blood vessels in the​ scalp, injuries to the scalp bleed very little. C. If bleeding occurs under intact skin of the​ scalp, it can mimic skull deformity. D. Brain damage within an intact skull will be minimal.

If bleeding occurs under intact skin of the​ scalp, it can mimic skull deformity.

A young male patient was running through a park shortly before dawn and struck his head on a​ low-hanging branch of a tree. Emergency Medical Responders have already provided spine motion restriction precautions and are providing supplemental oxygen since the patient was initially unresponsive. During​ transport, which finding obtained during your reassessment would best indicate that the patient has experienced a​ concussion? A. Persistent confusion B. Elevated blood pressure C. Improving memory D. Unequal grip strength

Improving memory

You are transporting a patient with a past medical history of a meningeal tumor. You would recognize this kind of tumor as being​ located: A. Within the bones of the skull B. In tissue composing the brainstem C. In tissue surrounding the brain D. Within the cerebrum

In tissue surrounding the brain

As brain herniation​ occurs, the body responds​ by: A. Discharging cerebrospinal fluid to decrease pressure within the skull and improve perfusion B. Decreasing blood pressure to decrease pressure within the​ skull, thereby improving blood flow C. Increasing systolic blood pressure in an attempt to maintain perfusion to the brain D. Increasing the heart rate to more rapidly circulate​ oxygen-rich blood to the brain

Increasing systolic blood pressure in an attempt to maintain perfusion to the brain

A​ 57-year-old man tripped and fell on the​ sidewalk, hitting his head on the concrete. According to​ witnesses, the patient was unresponsive for several minutes following the fall. Which bit of information would be most critical to relay to the physician in the emergency​ department? A. Knee replacement two years ago B. Position in which the patient was found C. Treatment provided by​ on-scene witnesses D. Known history of alcoholism

Known history of alcoholism

Which of the following is the most common type of skull​ fracture? A. Open B. Closed C. Linear D. Depressed

Linear

Which statement is true regarding linear skull​ fractures? A. Linear skull fractures are identifiable by a mild depression in the skull B. Linear skull fractures cannot typically be identified with palpation C. Linear skull fractures place the patient at risk for blood loss and hypoperfusion D. Linear skull fractures are rare and infrequently encountered

Linear skull fractures cannot typically be identified with palpation

A patient was ejected from a car when it overturned at a high rate of speed. The patient is unresponsive. The primary assessment is complete and you are providing positive pressure ventilation with supplemental oxygen. The patient has a significant deformity to the right side of his​ head, and both pupils are equal but slow to react to light. The patient also has deformity to the forearms. Vital signs are​ pulse, 144​ beats/min; respirations, 24​ breaths/min and​ inadequate; blood​ pressure, 90/50​ mmHg; and​ SpO2, 97%. Based on this​ presentation, the EMT​ should: A. Splint both arms and reassess the vital signs prior to departing the scene B. Check the blood glucose level and prepare for possible seizure activity C. Reassess the pupils and treat the patient for a severe head injury D. Look for evidence of bleeding in an area of the body other than the brain

Look for evidence of bleeding in an area of the body other than the brain

A young female pedestrian was hit by a car and thrown 15​ feet, striking her head against a metal guardrail. You start your secondary assessment and note a deep depression to the right parietal area of her​ head, with intact skin overlying the area. You​ should: A. Note the injury and continue assessing the patient B. Instruct your partner to hyperventilate the patient with a​ bag-valve mask C. Gently palpate the depression to determine the possibility of a skull fracture D. Apply an ice pack to the injured area

Note the injury and continue assessing the patient

A patient who fell out of a tree has an open skull injury. What would be an appropriate way to describe and document this injury on the​ PCR? A. Instability to the temporal region of the skull with no break in the overlying scalp B. Obvious deformity and instability to the right side of the skull with a laceration to the overlying scalp C. Laceration to the top of the scalp with pain to the skull when palpated D. Crepitus to the back of the skull with a hematoma overlying the unstable area

Obvious deformity and instability to the right side of the skull with a laceration to the overlying scalp

An unhelmeted​ rider, who was thrown from his motorcycle when he​ wrecked, has a large scalp avulsion with obvious skull depression to the top of his head with venous bleeding. These findings suggest which type of​ injury? A. Basilar skull fracture B. Open head injury C. Linear skull fracture D. Intracranial hematoma

Open head injury

What is the name of the paired bones that are located at the​ superior-lateral regions the​ skull? A. Occipital bones B. Frontal bones C. Parietal bones D. Temporal bones

Parietal bones

An intoxicated teenage male with a history of diabetes fell down five stairs and is now responding to a shoulder pinch with garbled speech. Manual spine motion restriction precautions are being maintained by fire department EMRs. The primary assessment reveals an open​ airway, adequate​ breathing, and strong radial pulse. Vital signs are pulse 122​ beats/min, respirations 18​ breaths/min, blood pressure​ 108/60 mmHg, and SpO2​ 97% on room air. The​ patient's skin is warm and dry. Which action would be performed​ next? A. Obtain another set of vital signs B. Administer oral glucose C. Start hyperventilation D. Perform a secondary exam

Perform a secondary exam

An unrestrained​ middle-aged female was thrown from her car as it rolled in the median of an interstate. She is​ supine, appears​ unresponsive, has blood on her​ face, and has snoring respirations. Your first action upon reaching her​ side, after taking spine motion restriction​ precautions, should be​ to: A. Find the source of bleeding and apply direct pressure B. Perform the​ jaw-thrust maneuver C. Determine the Glasgow Coma Scale score D. Insert an oropharyngeal airway

Perform the​ jaw-thrust maneuver

A​ 52-year-old male is unresponsive and has bruises and lacerations to the​ head, chest, and abdomen. Bystanders state that the patient was intoxicated and got into a fight with several patrons of a bar. They state that he was beaten with his​ opponents' fists, but not other objects or weapons. The patient has snoring​ respirations, shallow​ breathing, and a strong radial pulse. His skin is warm and dry. After providing manual spine motion​ restriction, what should be your next​ action? A. Start positive pressure ventilation B. Perform the​ jaw-thrust maneuver C. Insert a nasal or oral airway D. Apply a cervical collar

Perform the​ jaw-thrust maneuver

A young adult male has a gunshot wound to the left side of his head. He is unresponsive with snoring respirations. He is breathing 6 times per minute with a pulse rate of 52​ beats/min and a blood pressure of​ 192/104 mmHg. His radial pulse is strong and his skin is​ cool, but not diaphoretic. In addition to spine motion restriction​ precautions, the first intervention for this patient would​ be: A. Performing a​ jaw-thrust maneuver B. Administering​ high-concentration oxygen via a nonrebreather mask C. Inserting an oropharyngeal airway D. Administering positive pressure ventilation

Performing a​ jaw-thrust maneuver

A​ 14-year-old male fell 10 feet from a retaining wall and hit his head on a metal post. He is responsive to verbal stimuli with incomprehensible speech. The secondary assessment indicates blood and fluid coming from inside the​ patient's left ear. Given these assessment​ findings, the EMT​ should: A. Place a folded piece of gauze in the ear canal to stop the drainage B. Place a piece of sterile gauze over the ear to catch the fluid C. Suction the blood from the ear so you can determine the source of bleeding D. Tilt the backboard to the left to allow the ear to drain freely

Place a piece of sterile gauze over the ear to catch the fluid

You are assessing a patient who had a previous brain injury in which a portion of the cerebellum was destroyed. In relation to this specific​ injury, which finding would the EMT​ expect? A. Poor muscle coordination when signing his name to the prehospital care report B. Problems with the regulation of heart rate and blood pressure C. Inability to remember information such as past medical history D. Inability to move or feel sensations in one side of his body

Poor muscle coordination when signing his name to the prehospital care report

Your assessment of a patient who was involved in a motor vehicle collision reveals a deformity to the left side of the head underneath the hair. On further​ inspection, you note that the skin overlying the deformity is still intact. Based on these assessment​ findings, what should be the​ EMT's greatest​ concern? A. Fracture of the skull B. Soft tissue trauma to the scalp C. Potential for infection of the brain D. Possible brain injury

Possible brain injury

Which statement best describes the technique to be used when hyperventilating a patient with a head injury who shows signs of brain​ herniation? A. Provide 16 ventilations per minute B. Provide 30 ventilations per minute C. Provide 1 ventilation every 5 seconds D. Provide 1 ventilation every 3 seconds

Provide 1 ventilation every 3 seconds

The EMT arrives on the scene and finds an unconscious person who sustained head trauma from an unrestrained motor vehicle collision. As the EMT prepares to transport the patient to the emergency​ department, which reassessment finding indicates a delayed sign of a skull​ fracture? A. Presence of Cushing reflex B. Purplish discoloration around eyes C. Clear nasal drainage D. Unequal pupils with paralysis

Purplish discoloration around eyes

You are transporting a patient who experienced a​ right-sided head injury after a large refrigerator fell and pinned his head between the appliance and the floor. On​ scene, the patient was responsive to verbal stimuli with the following vital​ signs: pulse, 96​ beats/min; respirations, 16​ breaths/min; blood​ pressure, 134/66​ mmHg; and​ SpO2, 95%. During​ transport, as you reassess the​ patient, what would be the clearest sign that the head injury is​ worsening? A. Heart rate of 112​ beats/min B. Increasing edema to the right side of the head C. Blood pressure of​ 108/68 mmHg D. Responding only to painful stimuli

Responding only to painful stimuli

Which of the following terms is defined as a significant injury from​ shearing, tearing, and stretching of nerve​ fibers? A. Focal injury B. Subdural hematoma C. Severe diffuse axonal injury D. Concussion

Severe diffuse axonal injury

A woman fell from a​ second-story window onto the concrete sidewalk below. She is unresponsive and has a large depression to the back and top of her skull. Additional findings include abdominal bruising and an angulated left ankle. Your partner reports that the​ patient's vital signs are​ pulse, 68​ beats/min; respirations, 14​ breaths/min and​ irregular; blood​ pressure, 198/112​ mmHg; and​ SpO2, 91% on room air. Based on these assessment​ findings, what should the EMT suspect is​ occurring? A. Past medical history of untreated hypertension B. Shock caused by bleeding within the head C. Shock caused by​ bleeding, most likely in the abdomen D. Severe head injury with increasing pressure within the skull

Severe head injury with increasing pressure within the skull

A​ 61-year-old male fell off a roof. Your primary assessment findings include​ unresponsiveness, agonal​ breathing, and a slow and weak radial pulse. The​ patient's skin is cool and dry. Emergency Medical Responders are maintaining manual spine motion restriction procedures. What should you do​ immediately? A. Place the patient in the shock position B. Start positive pressure ventilation C. Apply oxygen via a nonrebreather mask D. Size and apply a cervical collar

Start positive pressure ventilation

A young female patient involved in a motor vehicle collision responds to painful stimuli by extending her arms and legs. Her airway is​ open, and her breathing is shallow and irregular. A radial pulse that is moderate in strength is palpated. Her pulse is 64​ beats/min, respirations are 8​ breaths/min and​ irregular, and blood pressure is​ 210/110 mmHg, with an SpO2 of​ 90% on room air. The patient has an obvious deformity to her forehead and a left pupil that is dilated and does not respond to light. Manual spine motion restriction is being maintained by Emergency Medial Responders​ (). At this​ time, the​ EMT's priority action is​ to: A. Start positive pressure ventilation at 20​ breaths/min B. Apply a nonrebreather face mask with​ high-concentration oxygen C. Apply a cervical collar and transfer the patient to the stretcher for immediate transport D. Perform the secondary assessment to identify additional injuries

Start positive pressure ventilation at 20​ breaths/min

You have been called by family members for their​ mother, who is​ "not acting​ right." At the​ scene, the family informs you that they are concerned because their​ 68-year-old mother has been complaining of a headache for two days and is now very confused. When asking about a bruise on the right side of her​ forehead, the family states she fell in church a week ago and hit her head. Since all other aspects of the assessment are​ unremarkable, you suspect a head injury. Which type of injury would you suspect given the findings and​ history? A. Subdural hematoma B. Cerebral contusion C. Epidural hematoma D. Cerebral concussion

Subdural hematoma

A​ 41-year-old male patient was struck in the head with a metal pipe during a fight with an angry neighbor. The scene is​ safe, and as you approach the​ patient, you note that he is combative and has blood on the left side of his head and​ face, and on his shirt. His breathing appears to be labored and he is incontinent of urine. Which care should you perform​ immediately? A. Check his pupils for equality and reactivity B. Take manual cervical spine motion restriction C. Expose the chest to look for possible bleeding D. Apply oxygen at 15 lpm via nonrebreather mask

Take manual cervical spine motion restriction

What is the name of the paired bones that are located on the sides of the​ head? A. Temporal bones B. Frontal bones C. Occipital bones D. Parietal bones

Temporal bones

What best describes the purpose of determining a Glasgow Coma Scale​ (GCS) score in a patient with a head​ injury? A. The GCS score helps determine whether a​ patient's mental status is improving or deteriorating B. The GCS score allows the EMT to predict the​ patient's likelihood of recovery C. The GCS score is important in guiding the​ EMT's treatment of the patient D. The GCS score gives information about the type of injury to the brain

The GCS score helps determine whether a​ patient's mental status is improving or deteriorating

When using the Glasgow Coma Scale​ (GCS), the EMT understands​ that: A. The score must be combined with vital signs B. A lower score numerically indicates less​ severity, just like the Revised Trauma Score​ (RTS) C. The score identifies the type of head injury sustained D. The higher​ score, the better the​ patient's neurologic status

The higher​ score, the better the​ patient's neurologic status

You are assessing the pupils of a patient who hit his head after falling from the top of a tractor trailer. Which pupillary finding suggests a closed head​ injury? A. Both pupils dilate when light is shielded from the eyes B. The right pupil constricts when light is shined into the left pupil C. Both the left and right pupils constrict vigorously in response to light D. The left pupil constricts to light but the right pupil does not

The left pupil constricts to light but the right pupil does not

A woman strikes her forehead against the dashboard of her car as it strikes a tree. Immediately following the​ impact, her brain shifts back and forth within her skull. Based on the anatomy and physiology of the​ skull, which statement is​ true? A. The frontal bone is the thinnest portion of the skull and will most likely be fractured B. The​ patient's brain will most likely not be damaged because the​ skull's flexibility is designed to absorb the force of the impact C. The​ patient's brain will not be injured unless an object from the dashboard penetrates her skull D. The ridges of the basilar skull can damage the brain as it moves back and forth

The ridges of the basilar skull can damage the brain as it moves back and forth

What is considered to be a normal finding when assessing a patient with a possible head​ injury? A. The right pupil dilates and the left pupil constricts when light is shined into the left eye B. The left pupil dilates when light is shined into the right pupil C. The right pupil constricts when light is shined into the left pupil D. Both the left and right pupils dilate when light is shined into them

The right pupil constricts when light is shined into the left pupil

Patients with severe traumatic brain injury will often present with the​ following: A. shortness of breath. B. altered mental status. C. hemorrhagic shock. D. drug withdrawal signs.

altered mental status.

A​ 45-year-old man fell while exiting the shower. Upon your​ arrival, he says he remembers falling but then continually asks you​ "Where am I​ now? How did I get​ here?" even after you explain that his wife called 911 and that he is still on the bathroom floor where he fell while you do your primary assessment. He is experiencing A. anterograde amnesia. B. retrograde amnesia. C. reversible amnesia. D. complete amnesia

anterograde amnesia.

You are caring for a trauma patient who was ejected from a car after it hit a tree. The EMT who is performing the physical examination states that he has found Battle sign. You know this to mean that the patient​ has: A. bruising under the eyes. B. bruising around the nose. C. bleeding from the ears. D. bruising behind the ear.

bruising behind the ear.

A nonpurposeful response by an unresponsive patient to painful stimulus may be decorticate posturing. Decorticate posturing​ is: A. the patient flexing his arms across his chest and extending his legs. B. the patient extending both arms above his head and extending his legs. C. the patient extending both arms to his​ sides, extending his​ legs, and arching his back. D. the patient bringing his knees up to his chest and grasping them with his hands.

the patient flexing his arms across his chest and extending his legs.