exam 4

Which of the following is not a peripheral pulse in the adult?

Femoral

Increased myocardial contractility secondary to stretching of the myocardial walls is called the

Frank-Starling effect.

Rewarming a patient too quickly could result in

a cardiac dysrhythmia.

When treating a patient who experienced a pulmonary blast injury, you should

avoid giving oxygen under positive pressure.

Heat cramps are typically the result of prolonged exposure to a hot environment, resulting in

electrolyte depletion and severe muscle spasms.

Upon arriving at the scene of a motor-vehicle crash involving a telephone pole, you note that the driver appears unconscious and is bleeding heavily from the mouth. There is a power line across the hood and roof of the car. You should

ensure that the power line is not electrically active.

Signs of cerebral herniation include

extensor posturing.

A person would most likely experience a compression injury of the lumbar spine when he or she

falls and lands on his or her feet.

The _______ layer is located at the base of the epidermis and continuously produces new cells that gradually rise to the surface.

germinal

The energy needed for muscular contraction is derived from the metabolism of _______ and results in the production of _______.

glucose; lactic acid

Glycogenolysis is the physiologic process in which

glycogen is converted to glucose.

The skin and underlying tissues of the face

have a rich blood supply and bleed heavily.

The cervical spine is most protected from whiplash-type injuries when the

headrest is appropriately positioned.

Unilaterally diminished or absent breath sounds, a narrowed pulse pressure, and dullness to percussion of the hemithorax are clinical findings suggestive of a

hemothorax.

A 21-year-old male presents with a severely angulated forearm and extreme pain. Distal sensory, motor, and circulatory functions are intact. You should

splint the forearm in the position of deformity.

How many pairs of ribs are attached anteriorly to the sternum?

10

A 1-year-old female sustained blunt abdominal trauma following a motor-vehicle crash in which she was not properly restrained. Significant signs and symptoms will most likely occur after as little as ____ mL of blood loss

100

A 4-year-old boy pulled a pot of boiling water from the stovetop. He has superficial and partial-thickness burns to his head, left anterior trunk, and entire left arm. On the basis of the "rule of nines," what percentage of this child's body surface area (BSA) has been burned?

30%

An individual is considered to be hypothermic when his or her core body temperature falls below

95°F.

Which of the following patients has signs and symptoms that are most indicative of heatstroke?

A 31-year-old male with hot and moist skin, tachycardia, and confusion

What is the function of the sternocleidomastoid muscle?

Allows movement of the head

Which of the following injuries would most likely occur as a direct result of the third collision in a motor vehicle crash?

Aortic rupture

Which of the following findings would be least suggestive of the presence of high-energy trauma?

Deployment of the air bag

Which of the following musculoskeletal injuries poses the greatest risk for compartment syndrome?

Humeral fracture in a child

With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct?

It is the most dramatic part of the collision and may make extrication difficult.

Which of the following is not a lymphatic organ?

Liver

Which of the following potentially lethal chest injuries would you be the least likely to detect during the primary survey?

Pulmonary contusion

Which of the following would be the least reliable assessment parameter or treatment tool for a patient with significant hypothermia?

Pulse oximetry

Which of the following statements regarding scalp lacerations is correct?

Scalp lacerations may contribute to hypovolemic shock in adult patients.

Which of the following clinical signs is a manifestation of fluid leakage into the interstitial spaces?

Stridor

Which of the following has the most impact on the severity of radiation injury or type of health effect?

The amount and duration of exposure

A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?

The patient may die several hours later due to pulmonary complications.

A 40-year-old female, unrestrained, impacted the steering wheel of her vehicle with her chest when her vehicle hit a tree while traveling at 45 mph. She is conscious and alert but is experiencing significant chest pain and shortness of breath. Given the mechanism of injury and her present condition, it is least likely that she experienced

a head injury.

When stabilizing a patient's cervical spine, you should

align the patient's nose with the navel.

The function of the 12 pairs of cranial nerves is to

allow transmission of sensations directly to and from the brain.

You are assessing a 4-year-old male who was electrocuted when he stuck a pin into an electrical socket. He is conscious and alert and complains of pain to his left hand, where you find a small entrance wound. When treating this child, you should

anticipate extensive internal injuries.

In addition to 100% oxygen, appropriate management for a patient with a suspected pelvic fracture, who is conscious and alert with stable vital signs, includes

application of a pelvic binder, immobilization on a long backboard, at least one large-bore IV set to keep the vein open, and transport.

A 28-year-old female was the unrestrained driver of a car that struck the rear end of another car while traveling at 35 mph. She is conscious and alert and complains of pain to the anterior chest. During your assessment, you note a large ecchymotic area over the superior aspect of the anterior chest. As your partner assumes manual stabilization of her head, you should

apply 100% oxygen via a nonrebreathing mask.

A 37-year-old male was struck on the driver side of his vehicle by another car traveling at 45 mph. Your primary survey reveals that the patient is semiconscious and in respiratory distress. When extricating this patient from his car, you should

apply a C-collar and rapidly remove him on a long backboard.

A patient has a severe injury to his upper thigh with massive external bleeding. The source of the bleeding is not immediately apparent. You should

apply a tourniquet as high on the thigh as you can.

Retinal injuries that are caused by exposure to extremely bright light

are typically not painful but may result in permanent damage to vision.

When palpating an injured extremity, a patient complains of point tenderness. On the basis of this clinical finding, you

are unable to determine the type of fracture.

During your primary survey of a 33-year-old male with severe hypothermia, you find that he is unresponsive and has agonal breathing. You should

assess for a carotid pulse for up to 60 seconds.

You should assess a patient with systemic hypothermia for local cold injuries to the extremities because

blood is shunted away from the extremities.

Visceral injuries in the chest that occur from shearing forces, compression, or rupture are most commonly seen with

blunt chest trauma.

Heatstroke occurs when the

body is subjected to more heat than it can remove.

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the

conjunctiva.

When a person is exposed to cold temperatures, blood vessels in the skin

constrict and divert blood away from the skin.

Immediate treatment for a patient with an open soft-tissue injury includes

control of active bleeding.

A young male is wearing lightweight clothing and is standing outside in windy winter weather. He is losing heat to the environment mostly by

convection.

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

cover both of his eyes and transport to the hospital.

All of the following are characteristic of a closed soft tissue injury, except

deformity of a short bone.

When caring for a patient with a suspected laryngeal injury, you should

discourage the patient from talking.

A young male has experienced a possible neck injury. When you attempt to place his head in a neutral in-line position, he complains of a severe spasm in his neck. You should

immobilize him in the position in which you found him.

When administering IV fluids to a patient with suspected intrathoracic bleeding, it is important to remember that

increasing the BP with fluids may increase the bleeding.

The three basic pathways by which radiation enters the body are

inhalation, ingestion, and direct exposure.

A 50-year-old male fell approximately 20 feet and landed on his side. He is conscious and alert and denies loss of consciousness. During your assessment, you note pain and crepitus when palpating the iliac crests. In addition to the potential for spinal injury, you should be most immediately concerned about

internal hemorrhage.

Fractures of the proximal femur most commonly occur at the

intertrochanteric region of the femur.

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n)

laryngeal fracture.

In addition to improving systemic perfusion following an electrical burn injury, you should administer IV crystalloid fluid boluses in order to

maintain adequate urine output.

You and your partner are applying a Hare traction splint to a patient with a deformed midshaft femur. As you expose the injured femur and assess neurovascular functions, your partner should

manually support and stabilize the injured leg.

The upper jawbones are called the

maxillae.

Blunt abdominal trauma may result in tearing of the mesentery, which is/are

membranous folds that attach the intestines to the abdominal wall.

You have applied an air splint to the deformed forearm of a critically injured patient who will be transported to a trauma center by air. During the flight, you would expect the flight paramedic to

monitor the splint and let air out as needed.

You are dispatched to a ski resort for a 21-year-old female with a local cold injury to her hand. Upon making contact with the patient, your most immediate action should be to

move her to a warmer environment.

A 34-year-old male sustained a twisting injury to his left lower leg when he stepped into a hole. Your assessment reveals ecchymosis and pain to the area but no deformity or crepitus. You should suspect a

nondisplaced fracture.

Cerebrospinal fluid flows between the

pia mater and arachnoid.

If spinal immobilization on a long backboard is clinically indicated, you should

place padding behind the occiput.

All of the following are formed components of the blood, except

plasma.

During a track and field event, a 25-year-old female sustained an injury to her left arm. She complains of severe pain and an inability to extend her elbow. Upon inspection, you note that the olecranon process is more prominent than it is on the uninjured arm. These findings are most characteristic of

posterior radius/ulna displacement

A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be most alert for

potential airway compromise.

The primary function of the antidiuretic hormone (ADH) is

promotion of water retention.

As blood enters the lungs, it enters the alveoli by passing across the

pulmonary capillary.

When managing a critically burned patient, it is important to

rapidly estimate the burn's severity and then cover with dry, sterile dressings.

Near-drowning is most accurately defined as

recovery that lasts for at least 24 hours following submersion in water.

Shock caused by a pericardial tamponade is secondary to

reduced ventricular filling.

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant

remains in motion until acted upon by an external force.

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is most important to

remember that it could still deploy and seriously injure you.

When assessing a patient with a scapular fracture, you should also be alert for

rib fractures and pneumothorax.

The presence of a scaphoid abdomen and bowel sounds in the lower hemithorax are most suggestive of a

ruptured diaphragm.

Static tension lines are present on the

scalp.

Joints are bathed and lubricated by

synovial fluid.

Patients with multiple rib fractures may develop significant hypoxia because of a ventilation/perfusion mismatch, which occurs when

the circulatory system is intact but the amount of available oxygen is diminished.

Manual C-spine stabilization should continue until

the patient is fully secured to a long backboard.

Death immediately following a burn is most commonly the result of

toxic chemical inhalation.

Common clinical findings in a patient with a suspected myocardial contusion include all of the following, except

unilaterally diminished or absent breath sounds.

An intracerebral hematoma is the result of bleeding

within the brain tissue itself.

Force acting over a distance defines the concept of

work.

A 40-year-old female, who is conscious and alert with mild hypothermia, should receive active external rewarming. This involves

wrapping her in blankets and applying heat packs to her groin.