Chapter 33: Eye, Face and Neck Trauma

Only attempt to remove foreign particles that are lodged in which of the following? Select one: a. Cornea b. Conjunctiva c. Globe d. Retina

b. Conjunctiva

He is responsive and supine with battery acid burns to the eyes and a deep laceration to the left side of the neck that is bleeding heavily. Your partner will maintain manual stabilization of the head and neck. Which of the following describes the best treatment for this patient's injuries? Select one: a. Once bleeding is under control and you have administered oxygen, check with medical direction to find out if you can flush the patient's eyes with saline. b. Immediately begin flushing the eyes with saline. Simultaneously, place a gloved hand over the neck wound to control bleeding and administer high-concentration oxygen. c. Immediately stop the profuse bleeding from the neck wound. Then begin flushing the eyes with saline. Administer high-concentration oxygen as soon as you can. d. Immediately begin flushing the eyes with saline. Probe the neck wound to locate and apply pressure to the carotid artery, then administer high-concentration oxygen.

b. Immediately begin flushing the eyes with saline. Simultaneously, place a gloved hand over the neck wound to control bleeding and administer high-concentration oxygen.

He is responsive and supine with battery acid burns to the eyes and a deep laceration to the left side of the neck that is bleeding heavily. Your partner will maintain manual stabilization of the head and neck. Which of the following best describes the sequence that should be followed? Select one: a. Assess the patient, provide emergency care, and wait for the paramedics. b. Transport immediately, provide emergency care, and meet the paramedics en route. c. Assess the patient, provide emergency care, and then transport. d. Provide emergency care for life-threatening injuries first, assess the patient, treat other injuries, and then transport.

b. Transport immediately, provide emergency care, and meet the paramedics en route.

Richard complained about numbness over his left eye and double vision (diplopia). These complaints are most likely the result of: Select one: a. hypoperfusion. b. an injury to the orbit of the eye. c. the injury to the neck. d. trauma to the globe of the eye.

b. an injury to the orbit of the eye.

You are assessing your patient who has an eye injury and notice blood in the anterior chamber of the eye. You know this condition as: Select one: a. bipolar. b. hyphema. c. hemophilia. d. myopia.

b. hyphema.

During the primary assessment of a patient with facial trauma, establish manual stabilization of the head and neck: Select one: a. following application of oxygen. b. on first contact with the patient. c. while examining the eyes with a penlight. d. after assessing the facial trauma.

b. on first contact with the patient.

You are treating a patient with a lacerated eyelid. Your treatment and management of this patient should include: a. covering the eye with a dry sterile dressing. b. preserving any avulsed skin and transporting with the patient. c. application of direct pressure to control bleeding. d. frequently checking for visual acuity in the uninjured eye.

b. preserving any avulsed skin and transporting with the patient.

Your patient has presented you with an avulsed tooth resulting from facial trauma. You should: a. scrub it with water, and place it in a saline solution. b. rinse it with saline, and place it in a saline solution. c. scrub it with saline, and place it in dry gauze. d. rinse it with water, and place it in an alcohol solution.

b. rinse it with saline, and place it in a saline solution.

Fluid that fills the anterior chamber of the eye

Aqueous humor

Thin covering of the inner eyelids and exposed portion of the sclera of the eye

Conjunctiva

Portion of the eye that covers the pupil and the iris

Cornea

Colored portion of the eye that surrounds the pupil

Iris

The portion of the eye that focuses light on the retina

Lens

The dark center of the eye

Pupil

Back of the eye

Retina

Outer coating of the eye; the white of the eye

Sclera

Clear jelly that fills the large chamber of the eye

Vitreous humor

You are treating a patient with a chemical burn to the eyes. The eyes should be flushed from the inside corner to the outside edge for at least: Select one: a. 20 minutes. b. 15 minutes. c. 10 minutes. d. 5 minutes.

a. 20 minutes.

When should you begin treatment of a suspected chemical burn of the eye? Select one: a. During the primary assessment b. During the reassessment c. After the secondary assessment and physical exam d. After a rapid trauma assessment

a. During the primary assessment

Your patient presents with a painful, deformed, and swollen jaw and has dentures that are still intact and in place. How should this be managed? Select one: a. Leave the dentures in place. b. Contact medical direction for instructions. c. Remove dentures if the patient requests it. d. Dentures should always be removed.

a. Leave the dentures in place.

Your patient has an impaled nail that has penetrated the cheek all the way through and is loose. What should you do? Select one: a. Pull it out in the same direction from which it entered. b. Stabilize it, and be prepared to remove it from the airway. c. Push it out in the direction opposite to the way it entered. d. Stabilize it with bulky dressings, and transport.

a. Pull it out in the same direction from which it entered.

Which of the following is considered appropriate when treating an injured eye? Select one: a. Transport the patient for evaluation covering both eyes. b. Have the patient walk to distract him from the pain. c. Remove blood clots from the sclera with a sterile dressing. d. Force the eyelids open, if necessary, to examine the pupils.

a. Transport the patient for evaluation covering both eyes.

You are preparing to treat a critically injured patient with a midfacial injury. Your initial management priorities should be to: Select one: a. establish manual spinal stabilization, ensure a patent airway, support breathing, and control life-threatening bleeding. b. ensure a patent airway, establish stabilization of the cervical spine, support breathing and obtain baseline vital signs. c. establish spinal stabilization with a cervical collar, control bleeding, ensure a patent airway, and assist breathing. d. manage life-threatening bleeding, manage the cervical spine, ensure a patent airway, and support breathing.

a. establish manual spinal stabilization, ensure a patent airway, support breathing, and control life-threatening bleeding.

Richard's neck injury: Select one: a. must be carefully observed for swelling and airway compromise. b. is not serious unless Richard has difficulty in speaking or a loss of voice. c. is not serious since the trachea remains at midline. d. is not serious since Richard is alert and oriented.

a. must be carefully observed for swelling and airway compromise.

Suspect significant damage to the eye if: Select one: a. there is unusual sensitivity to light. b. the field of vision increases. c. vision improves only after blinking. d. there is an injury to the forehead or cheek.

a. there is unusual sensitivity to light.

Your patient is suffering from facial trauma with exposed nerves and tendons. You should do which of the following? Select one: a. Apply a dry, sterile dressing to the injury. b. Cover exposed tissues with an occlusive dressing. c. Apply a moist, sterile dressing to the injury. d. Do not cover; it may damage the nerves.

c. Apply a moist, sterile dressing to the injury.

You suspect your patient has a nasal fracture. Which of the following is the most appropriate for treating this type of injury? Select one: a. Apply a pressure dressing, and transport. b. Pack the nostrils, and transport. c. Apply cold compresses, and transport. d. Gently pull to align the nose, and transport.

c. Apply cold compresses, and transport.

You are treating a patient who has sustained an eye injury and is wearing soft contacts. Which of the following is the correct way to remove a soft contact lens? Select one: a. Apply a moistened suction cup. b. Slide a fingernail under the edge of the lens and lift. c. Pinch the lens between your thumb and index finger. d. Press the lower eyelid under the bottom edge of the lens.

c. Pinch the lens between your thumb and index finger.

To prevent a patient from swallowing a dressing that is packed between the teeth and cheek, you should do which of the following? Select one: a. Have the patient hold onto one end of the dressing. b. Never place a dressing into the mouth because it may block the airway. c. Tape some of the dressing material to the outside of the mouth. d. Place a gloved index finger into the mouth to hold the dressing.

c. Tape some of the dressing material to the outside of the mouth.

Ali should have applied what kind of dressing to Richard's neck injury? Select one: a. Porous b. Self-adhering c. Gauze d. Occlusive

d. Occlusive

Which of the following best describes how to secure a figure-eight bandage over the neck wound? Select one: a. Over the dressing, around the neck, and anchored at the neck b. Over the dressing, around the neck, under the armpit on the side of the injury, and anchored at the shoulder c. Over the dressing, around the neck, under the armpit on the side of the injury, back around the neck, and anchored at the shoulder d. Over the dressing, across one shoulder, across the back, under the opposite armpit, and anchored at the shoulder

d. Over the dressing, across one shoulder, across the back, under the opposite armpit, and anchored at the shoulder

You are assessing your patient and notice a clear fluid draining from the ear. You should do which of the following? Select one: a. Pack the ear with dressings. b. Apply direct pressure. c. Apply pressure dressings. d. Place a loose dressing across the opening.

d. Place a loose dressing across the opening.

In which of the following positions would you place the patient with an impaled or extruded eye injury? Select one: a. Lateral recumbent position b. Fowler position c. Prone position d. Supine position

d. Supine position

Contact lenses: Select one: a. are always worn in both eyes. b. are never worn by people who wear glasses. c. should not be removed in chemical burns to the eye. d. can be clearly seen by using a penlight.

d. can be clearly seen by using a penlight.

Your patient who presents with double vision (diplopia), a marked decrease in vision, and loss of sensation above the eyebrow, over the cheek, or in the upper lip is most likely suffering from a(n): Select one: a. chemical eye burn. b. laceration of the globe. c. laceration to the eyelid. d. orbital fracture.

d. orbital fracture.

Your patient has a severed blood vessel of the neck. You should: Select one: a. position the patient on his left side, head up. b. use a loosely placed, moist sterile dressing. c. apply pressure to both sides of the neck at the same time. d. use a figure-eight wrap to secure the dressing.

d. use a figure-eight wrap to secure the dressing.