chapter 31 questions

Which of the following organs would most likely bleed profusely when injured? Liver Intestine Bladder Stomach

Liver

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would most likely cause an injury to the liver or spleen to be overlooked? Shoulder fracture Lumbar spine fracture Femur fracture Pelvic fracture

Shoulder fracture

Which of the following statements regarding abdominal trauma is correct? Hollow abdominal organs are vascular and bleed profusely when injured. Most of the vital abdominal organs lie within the retroperitoneal space. The absence of abdominal pain does not rule out intra-abdominal bleeding. The liver is well protected and is rarely injured during a traumatic event.

The absence of abdominal pain does not rule out intra-abdominal bleeding.

The mesentery is: a complex network of blood vessels that supply blood to the liver. the point of attachment between the small and large intestines. a membranous fold that attaches the intestines to the walls of the body. a layer of thick skeletal muscles that protects the abdominal organs.

a membranous fold that attaches the intestines to the walls of the body.

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should: apply direct pressure to the wound. open the patient's airway. apply oxygen via a nonrebreathing mask. ventilate the patient with a bag-mask device.

apply direct pressure to the wound.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes: requesting a paramedic to administer pain medication. applying direct pressure with a dry, sterile dressing. covering the avulsion with moist, sterile dressings. administering 100% oxygen via a nonrebreathing mask.

applying direct pressure with a dry, sterile dressing.

When worn properly, a seat belt should lie: across the abdominal wall at the level of the diaphragm and below the hip joints. above the anterior posterior iliac spines of the pelvis and below the hip joints. across the abdominal wall at the level of the umbilicus and against the hip joints. below the anterior superior iliac spines of the pelvis and against the hip joints.

below the anterior superior iliac spines of the pelvis and against the hip joints.

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: forgo the hospital radio report because of his condition. closely monitor him and reassess him frequently. begin documenting the call on the patient care form. perform a comprehensive secondary assessment.

closely monitor him and reassess him frequently.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: allow her to change her clothes and take a shower before you transport. visualize the vaginal area and pack the vagina with sterile dressings. control any external bleeding, administer oxygen, and transport at once. arrange for a rape crisis center representative to speak with the patient.

control any external bleeding, administer oxygen, and transport at once.

Accumulation of blood in the abdominal cavity will most likely cause: distention. referred pain. nausea or vomiting. diffuse bruising.

distention.

Contraction or tensing of the abdominal muscles to ease pain is called: withdrawing. flexing. guarding. referring.

guarding

Peritonitis usually occurs when: solid abdominal organs bleed secondary to penetrating trauma. bacteria or viruses invade the walls of the gastrointestinal tract. hollow abdominal organs are damaged and spill their contents. the vessels that supply the abdominal organs become inflamed.

hollow abdominal organs are damaged and spill their contents.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. perform a comprehensive secondary assessment to determine why his clinical status has changed.

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: a ruptured spleen. intra-abdominal bleeding. a severe liver laceration. rupture of a hollow organ.

intra-abdominal bleeding.

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if: the severity of the injury is known. the patient is conscious. law enforcement is at the scene. there are other patients involved.

law enforcement is at the scene.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should: lift the airbag and look for deformity to the steering wheel. extricate her immediately and transport to a trauma center. perform a head-to-toe assessment while she is in the car. carefully assess her upper chest for seatbelt-related injuries.

lift the airbag and look for deformity to the steering wheel.

Bruising to the right upper quadrant of the abdomen after blunt trauma is most suggestive of injury to the: liver. spleen. kidney. stomach.

liver

When a hollow organ is punctured during a penetrating injury to the abdomen: the abdomen will become instantly distended. it commonly protrudes through the injury site. peritonitis might not develop for several hours. it will bleed profusely and rapidly cause shock.

peritonitis might not develop for several hours.

All of the following are hollow abdominal organs, except the: spleen. stomach. ureters. bladder.

spleen

A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: transport him in the position in which you found him. keep him on his side but gently straighten his legs. apply full spinal motion restriction precautions. place him supine but allow him to keep his knees bent.

transport him in the position in which you found him.