MEDIC 2 review 3

________ has the greatest effect on kinetic energy. -Acceleration -Force -Mass -Velocity

Velocity

Which of the following is the highest risk wound? -An impaled pencil in the hand -A deep human bite wound -A crush injury to the lower leg where the patient has been trapped for 30 minutes -An abdominal hematoma

A deep human bite wound

Which of the following is the most important predictor of damage sustained from a gunshot wound? -Type of firearm -Velocity of the projectile -Distance between the person and the muzzle of the firearm -Anatomic location and structures struck

Anatomic location and structures struck

You are assessing a patient with a chest injury and suspect he is limiting his chest expansion due to pain. If the patient continues this respiratory pattern, what condition may develop? -Pulmonary contusion -Subcutaneous emphysema -Atelectasis -Cardiac contusion

Atelectasis

A hangman's fracture is an example of a ______ force. -distraction -flexion -hyperextension -vertical compression

distraction

In an explosion, _________ blast injuries are due to impact with another object. -primary -secondary -tertiary -quaternary

tertiary

The Parkland formula is used to determine ____________. -total body surface area burned. -relative percentages of body surface area affected by growth. -the approximate amount of fluid the burn patient needs. -the amount of analgesia required for pain management in a burn victim.

the approximate amount of fluid the burn patient needs.

Which of the following anatomical structures are found in zone I of the neck? -Subclavian veins -Pharynx -Salivary glands -Aortic arch

-Aortic arch -Subclavian veins

Which of the following indications would you see in a patient with moderate ICP elevation? -Cheyne-Stokes respirations -Widened pulse pressure and bradycardia -Blown pupils -Decerebrate posturing

-Decerebrate posturing -Widened pulse pressure and bradycardia

Which of the following fit into the major burn category? -An adult male with a full-thickness burn involving 8% of his TBSA -A 6-year-old girl with partial-thickness burns involving 15% of her TBSA -A 40-year-old splashed with battery acid that covers both arms -A 23-year-old woman suffering from smoke inhalation with signs of stridor

-A 40-year-old splashed with battery acid that covers both arms -A 23-year-old woman suffering from smoke inhalation with signs of stridor

Which of the following are signs of compensated shock? -Hypotension -Normal blood pressure -Weak, thready pulse -Labored/irregular breathing

-Normal blood pressure -Weak, thready pulse

How much blood does a person need to lose before significant changes in vital signs occur? -1 pint -2 pints -3 pints -5 pints

2 pints

What does a bull's-eye lesion, with a central, charred zone of full-thickness burns; a middle zone of cold, gray, dry tissue; and an outer, red zone of coagulation necrosis indicate? -Electrical burn -Lightning burn -Hydrofluoric acid burn -Scald burn

Electrical burn

What is the first thing you need to do when treating an open wound? -Expose the wound. -Dress and bandage the wound. -Treat shock. -Clean the wound surface.

Expose the wound.

You are treating a patient who weighs approximately 150 pounds (68 kg). She has lost about 1 L of blood from a femur fracture and another 500 mL from an open tibial fracture. In addition, you suspect that she has other injuries that may be causing blood loss. When you deliver fluids, what should you do? -Infuse as much fluid as possible over the shortest time possible. -Infuse enough fluid to bring the blood pressure back to normal for that patient. -Infuse enough fluid to maintain the systolic pressure at about 80 mm Hg. -Infuse enough fluid to maintain the diastolic pressure at about 80 mm Hg.

Infuse enough fluid to maintain the systolic pressure at about 80 mm Hg.

You have responded to a house fire and encounter a 35-year-old woman with partial-thickness burns on her hands and stomach. She is displaying signs of shock. What should you do? -Treat the burns immediately to counteract the shock. -Check capillary refill time. -Apply humidified oxygen. -Inspect for additional injuries.

Inspect for additional injuries.

In the instance of an adult pedestrian being struck by a vehicle, which type of energy is the patient initially hit with? -Potential energy -Thermal energy -Kinetic energy -Barometric energy

Kinetic energy

Which type of cut is caused by a sharp edge? -Contusion -Laceration -Puncture -Abrasion

Laceration

A young patient was assaulted. You note ecchymosis, orbital swelling, and malocclusion. As you continue your inspection, you sense movement in the palate. Which of the following should you suspect? -Le Fort fracture -Skull fracture -Temporomandibular joint dislocation -Zygomatic fracture

Le Fort fracture

A. Cardiac output equals the stroke volume multiplied by the pulse rate. B. Increasing afterload increases cardiac output. C. Blood pressure equals stroke volume multiplied by heart rate and divided by mean arterial pressure. D. If a typical adult loses more than 2 pints (1 L) of blood, significant changes in vital signs occur.

-True -False -False -True

There is no optimal device for spinal immobilization. Adult patients require 0.25 to 1 inch of padding behind the occiput to maintain neutral position of the cervical spine and avoid hyperextension. Because of their large occiput, pediatric patients require padding under the torso to maintain neutral position and avoid hyperflexion. Lateral movements provide better spinal alignment than do axial movements.

-True -False -True -False

What is the revised trauma score calculation for a patient with a GCS of 11, SBP of 80, and a RR of 20? -4 -3 -2 -1

3

As the air between the pleural membranes increases, what signs/symptoms should you expect? -Hyporesonance -Diminished breath sounds on the affected side -Increased preload -Hypovolemia

Diminished breath sounds on the affected side

Which of the following is the most likely to be fatal? -Ejection -Frontal or head-on impact -Lateral or side impact -Rollovers

Ejection

Which of the following should you NOT use to secure a dressing in place? -A triangular bandage -Adhesive tape -Elastic bandages -A towel

Elastic bandages

How should you move an injured patient from the ground to a backboard? -Clothes drag -Firefighter's lift -Four-person log roll -Hammock carry

Four-person log roll

Which of the following indicates upper GI bleeding? -Melena -Hematemesis -Hematuria -Hemoptysis

Hematemesis

Which of the following are indicators for Cushing triad? -Hypotension, focal neurologic deficits, and disorientation -Tachycardia, hypertension, and decorticate posturing -Abnormal behavior, pupillary abnormalities, and period of unresponsiveness -Hypertension, bradycardia, and irregular respirations

Hypertension, bradycardia, and irregular respirations

What are the components of the trauma lethal triad? -Hypercoagulation, hypothermia, and alkalosis -Hypothermia, coagulopathy, and acidosis -MOI, force of impact, and restraints -Head trauma, hypothermia, and hypovolemia

Hypothermia, coagulopathy, and acidosis

What is the primary treatment for a patient with a chemical burn to the eye? -Covering both eyes with bulky dressings -Covering both eyes with gauze pads soaked in distilled water -Irrigation with sterile saline solution -Administering 0.5% tetracaine hydrochloride drops

Irrigation with sterile saline solution

How should you manage a burn blister? -Drain it. -Seal it with a topical burn ointment. -Disinfect it. -Leave it intact and cover it loosely.

Leave it intact and cover it loosely.

You are managing an open abdominal wound. The bandage you have placed is soaked with blood. What is your next step? -Remove the blood-soaked bandage and flush the wound. -Remove the blood-soaked bandage and replace the dressing with a clean one. -Leave the bandage in place and put additional bandages over the first. -Put an occlusive dressing over the original dressing and rebandage it.

Leave the bandage in place and put additional bandages over the first.

What is the general rule for dealing with a puncture wound involving an impaled object? -Leave the object in place. -Shorten the object to help stabilize it. -Do not move the patient. -Administer pain medication and remove the object.

Leave the object in place.

You are dispatched to the scene of a 19-year-old man who has been assaulted. When you arrive, you find the patient sitting on the sidewalk. A police officer at the scene is holding pressure to the patient's right upper abdomen with a blood-soaked gym towel. You observe no other obvious trauma injuries. Based on the location of the patient's wound, you should suspect injury to which of the following? -Liver and possibly the gallbladder -Stomach and possibly the spleen -Urinary bladder -Appendix

Liver and possibly the gallbladder

What are the most commonly injured abdominal organs? -Appendix and colon -Kidney and panaceas -Large and small intestines -Liver and spleen

Liver and spleen

In which of the following organs would temporary cavitation leave fewer permanent effects? -Brain -Liver -Lungs -Spleen

Lungs

Which of the following indicates lower GI bleeding? -Hematemesis -Hematoma -Hematuria -Melena

Melena

A 16-year-old male was struck in the face by a baseball bat during practice. He presents supine on the ground and is unresponsive with blood and broken teeth in the airway. What is your next step? -Measure and apply a cervical collar. -Roll the patient onto his side and suction. -Administer high-flow oxygen using a nonrebreather mask. -Ventilate the patient with a bag-mask device and high-flow oxygen.

Roll the patient onto his side and suction.

External compression results in ______________. -shearing in the aorta -rupture of the hollow organs -crushing of the solid organs -perforation of the bladder

rupture of the hollow organs

Which of the following is a physical finding of cardiac tamponade? -Breath sounds equal on both sides -Respiratory distress as a presenting sign/symptom -Tracheal deviation -Hyperresonant chest sounds on the injured side

Breath sounds equal on both sides

You should base your suspicion of blunt abdominal trauma on _____ -rigidity of the abdomen on palpation -the location and amount of abdominal pain -physical signs such as ecchymosis or abrasions -the mechanism of injury .

the mechanism of injury

You are responding to an accident scene where a 35-year-old man has sustained a leg injury. His skin is pale and cool. Blood is oozing steadily from a tear in the right lower leg of his jeans. As you cut the jeans, you see bone protruding from the anterior lower leg. To immobilize the patient's right leg, you should -apply a tourniquet -manually support the limb -use a traction splint -do nothing except strap the patient's leg to the backboard and provide rapid transport

use a traction splint

A superficial burn is characterized by -eschar -red, swollen skin -lack of pain -blisters

red, swollen skin

What is the first thing you should do for a burn victim? -Stop the burn. -Assess the ABCDEs. -Address hypovolemic shock. -Administer fluids.

Stop the burn.

What is hemoperitoneum? -A diaphragmatic injury -Blunt trauma to the liver -A collection of blood in the abdominal cavity -A collection of blood in the retroperitoneal space

A collection of blood in the abdominal cavity

What is subcutaneous emphysema? -The presence of air in the veins, leading to cardiac arrest -A crackling sensation felt on palpation caused by the presence of air in the soft tissue -The presence of blood in subarachnoid space -The high-pitched, wheezing sound indicative of disrupted airflow

A crackling sensation felt on palpation caused by the presence of air in the soft tissue

Which of the following is the best early indicator of a significant change in tissue perfusion? -A decrease in the blood pressure -A rise in the pulse rate -A sudden change in mental status -The amount of visible blood loss

A decrease in the blood pressure

A short backboard or vest-type immobilization device is indicated for which of the following? -A patient in a sitting position who is clinically stable -A supine patient who is clinically stable -An unstable patient in need of rapid extrication -An unconscious patient in the water

A supine patient who is clinically stable

Which of the following is indicative of a diaphragmatic rupture? -Abdominal sounds in the chest -Cullen sign -Distended abdomen -Peritonitis

Abdominal sounds in the chest

What should you do for a patient whose shock is caused by vasodilation due to a spinal cord injury? -Administer alpha-adrenoceptor agonist. -Administer fluid resuscitation via IV. -Administer calcium channel blockers. -Apply ice packs to regulate body temperature.

Administer alpha-adrenoceptor agonist.

What is the MOST significant complication associated with facial injuries? -Spinal injury -Airway compromise -Altered mental status -Shock

Airway compromise

Which type of chemicals cause liquefaction necrosis? -Acids -Alkalis -Oxidizing agents -Vesicants

Alkalis

According to the American College of Surgeons Committee on Trauma classes, in a Class III blood loss, what would a patient's mental status be? -Slightly anxious -Anxious and confused -Confused and lethargic -Unresponsive

Anxious and confused

Which of the following is the correct method for rapid extrication of a patient from a motor vehicle? -Apply an extrication collar and remove the patient from the car using the direct carry method. -Apply an extrication collar, slide a long spine board under the patient's buttocks, and remove the patient from the car. -Apply a cervical collar, insert a short backboard between the patient's back and the seat, and slide the patient out of the car onto a long spine board for full immobilization. -Maintain support of the head, grasp the patient by the clothing, and rapidly remove the patient from the car.

Apply an extrication collar, slide a long spine board under the patient's buttocks, and remove the patient from the car.

What should you do if your patient has a hydrofluoric acid burn? -Continuously flush with water. -Apply calcium gluconate gel. -Use a soap and water solution. -Brush the contaminant from the skin and clothing.

Apply calcium gluconate gel.

What is the correct treatment for profuse bleeding of facial injuries? -Apply direct pressure. -Apply occlusive dressings. -Apply cold packs. -Suction the airway.

Apply direct pressure.

A rise of 20 mm Hg above the patient's normal resting blood pressure along with a history of SCI and associated signs and symptoms indicate the patient is experiencing what? -Autonomic dysreflexia -Cauda equina syndrome -Hypotensive shock -Spinal stenosis

Autonomic dysreflexia

When immobilizing a child younger than the age of 6 on a long backboard, where do you need to place padding? -Behind the occiput -Under the lumbar -Under the knees -Between the shoulder blades

Between the shoulder blades

What is the most serious problem you need to consider in a patient with an electrical burn? -Brain damage -Cardiac dysrhythmia or arrest -Hyperthermia -Shock

Cardiac dysrhythmia or arrest

You are responding to an older woman who slipped and struck her forehead on the bathtub. She is complaining of having trouble "making her arms work." Which syndrome is this patient exhibiting? -Anterior cord syndrome -Central cord syndrome -Posterior cord syndrome -Brown-Séquard syndrome

Central cord syndrome

When encountering a patient with multiple injuries who is visibly bleeding, what should you do first? -Evaluate the airway. -Monitor breathing. -Check the pulse. -Treat for shock.

Check the pulse.

Which of the following is the result of a chest wall impact directly over the heart, especially directly over the left ventricle, that results in cardiac arrest? -Commotio cordis -Open pneumothorax -Traumatic aortic disruption -Traumatic asphyxia

Commotio cordis

Your primary survey of a patient with external hemorrhage identifies rapid but weak peripheral pulses. What does this indicate? -Injuries to the arms -Decompensated shock -Compensated shock -Irreversible shock

Compensated shock

Which of the following is characterized by ecchymosis in the umbilical region caused by peritoneal bleeding? -Cullen sign -Beck's triad -Kehr sign -Grey Turner sign

Cullen sign

What happens in the third phase of a motor vehicle collision? -Deceleration of the occupant(s) -Deceleration of internal organs -Secondary collision -Additional impact

Deceleration of internal organs

What is the most reliable sign of a head injury? -Cushing triad -Decreasing level of consciousness -Dizziness -Sluggish/nonreactive pupils

Decreasing level of consciousness

You are treating a patient complaining of unrelenting nausea, vomiting, abdominal pain, constipation, dyspnea, and abdominal distention. Which of the following should you suspect? -Diaphragmatic injury -Esophageal injury -Flail chest -Hemothorax

Diaphragmatic injury

If a patient had a foreign body impaled in the globe of the eye, which type of dressing would be applied? -Bulky dressing, lightly bandaged in place for both eyes -Bulky dressing, tightly bandaged in place for the affected eye -Moist, sterile dressing and protective cup for the affected eye -Moist, sterile dressing; protective cup for the affected eye; and bandage for the unaffected eye

Moist, sterile dressing; protective cup for the affected eye; and bandage for the unaffected eye

What is anisocoria? -Naturally occurring uneven pupil size -Bleeding into the anterior chamber of the eye due to blunt trauma -A fracture of the orbit or the bones that support the floor of the orbit -A condition where the eyeball retracts posteriorly into the space created when the orbital cavity is enlarged

Naturally occurring uneven pupil size

For a patient with a penetrating injury to the neck, which type of dressing should you apply? -Bulky dressing, lightly bandaged in place -Bulky dressing, tightly bandaged in place -Occlusive dressing, sealed on three sides -Moist dressing with direct pressure and roller gauze wrapped loosely around the neck

Occlusive dressing, sealed on three sides

You are assessing a patient and note bright red blood in the anterior chamber of the eye. How should you transport this patient? -Inferior to the injury -On a backboard with the head elevated 40° -Supine -In the prone position

On a backboard with the head elevated 40°

What might you expect to see on a 12-lead EGC if myocardial contusion is present? -Persistent tachycardia -ST elevation and T wave inversion -PVCs or PACs -LBBB

PVCs or PACs

You are treating a patient with a groin wound that is bleeding profusely. What should you do? -Apply a ratcheting tourniquet. -Apply an air splint. -Pack the wound and apply direct pressure. -Apply ice to reduce the blood flow.

Pack the wound and apply direct pressure.

Which of the following is a sign of diminished perfusion? -Cyanosis -Dyspnea -Tachycardia -Pale skin

Pale skin

Which of the following is a classic finding in flail chest? -Bradycardia -Decreased cardiac output -Paradoxical motion -Pulsus paradoxus

Paradoxical motion

Which of the following signs are consistent with abdominal hemorrhage? -Tender abdomen, hypertension, and bradycardia -Distention, hypotension, tachycardia, and shock -Tachycardia, hypertension, and distention -Periumbilical ecchymosis, distention, bradycardia, and shock

Periumbilical ecchymosis, distention, bradycardia, and shock

Subcutaneous emphysema is an indication of what condition? -Aortic rupture -Cardiac tamponade -Hemothorax -Pneumothorax

Pneumothorax

You are assessing a 30-year-old patient who was struck in the chest by another player's head during a soccer game. Given this MOI, what is the most common thoracic injury? -Pulmonary contusion -Clavicle fracture -Flail chest -Penetrating trauma

Pulmonary contusion

You are assessing a young woman who was struck by flying glass in the face. The skin of her left cheek is avulsed. What should you do? -Leave the avulsed skin alone and cover the area loosely. -Detach the avulsed skin and preserve it in saline-moistened sterile gauze. -Unkink the avulsed skin and apply a moist, sterile dressing. -Put the skin back in place and apply a dry compression dressing.

Put the skin back in place and apply a dry compression dressing.

Which of the following is true about factors that affect types of injuries? -Blunt trauma is easier to diagnose than penetrating trauma. -The smaller the area of force dissipation, the more the pressure is reduced to a specific spot on the body, often without breaking the skin. -Injuries sustained when the break point of an organ is exceeded are more difficult to identify. -Rapidly applied amounts of energy are less tolerated than an identical amount of energy delivered over a longer period.

Rapidly applied amounts of energy are less tolerated than an identical amount of energy delivered over a longer period.

Which type of impact has the greatest chance of survivability? -Front end -Rear end -Lateral -Rollover

Rear end

You are treating a construction worker working with a special type of concrete ("the kind that sets real fast") and some splashed into his eyes. While irrigating his eyes, you notice that the patient has dried concrete specks on his cheeks and forehead. What should you do? -Remove them from the skin while wearing gloves and flush the skin for 30 minutes. -Leave them in place but continue to irrigate the skin for 30 minutes. -Do nothing, as they are probably harmless. -Make a note of this finding on the patient report and get to it when you can.

Remove them from the skin while wearing gloves and flush the skin for 30 minutes.

You are assessing a young woman who fell and hit her head. She is conscious but can't remember the circumstances that led up to the injury. What is this patient experiencing? -Anterograde amnesia -Retrograde amnesia -Systematized amnesia -Transient global amnesia

Retrograde amnesia

You are treating a 20-year-old patient who was kicked in the head during a soccer game. When you arrive, he is unconscious. His coach reports that after the incident, the patient "seemed a little stunned" but got up to rejoin the game before he suddenly collapsed. A teammate reports that the patient had a prior injury due to a car accident a few weeks ago. What condition does this indicate? -Cerebral concussion -Moderate diffuse axonal injury (DAI) -Postconcussion syndrome -Second impact syndrome

Second impact syndrome

Which of the following is an early sign of hypoperfusion? -Altered LOC -Dilated pupils -Tachycardia -Thirst

Tachycardia

What is fluid creep? -The intravascular volume that oozes out of the circulation and into the interstitial spaces -The fluid shifts that typically occur 6 to 8 hours after the burn -The administration of more fluid than necessary prior to the patient's arrival at a burn center -The progressive edema beneath a circumferential burn

The administration of more fluid than necessary prior to the patient's arrival at a burn center

Half of all fluid administered to a burn victim needs to be administered during what period? -The first 8 hours from the time of the injury -The first 6 hours from the time treatment begins -The first 10 hours after arrival at the ED -The first 24 hours from admission to the burn unit

The first 8 hours from the time of the injury

You are assessing a patient who has suffered several facial lacerations during an automobile accident. As you examine her eyes with your penlight, you observe a circular shadow over the patient's left iris. What does this indicate? -She has an orbital blowout. -She has a corneal abrasion. -The patient is wearing hard contact lenses. -There is glass impaled in the lens.

The patient is wearing hard contact lenses.

What is the Waddell triad? -The process by which a motorcyclist lays down the bike to avoid injury -The pattern of vehicle pedestrian injuries in children and people of short stature -The duration, direction of force, and velocity of a motor vehicle that predicts injury patterns -The speed, rate of change, and downward acceleration of an object

The pattern of vehicle pedestrian injuries in children and people of short stature

What is brisance? -The shattering effect of a shock wave and its ability to cause disruption of tissues -The phase, after the initial positive pressure wave, in which pressure is less than atmospheric -The phase of the explosion in which there is a pressure front higher than atmospheric pressure -The leading edge of an explosion pressure blast wave

The shattering effect of a shock wave and its ability to cause disruption of tissues

How many sides of the dressing should you seal when using an occlusive dressing on a chest wound? -One -Two -Three -Four

Three

What are the predominant MOIs that would you expect to find in an adult pedestrian hit by a motor vehicle? -Femur or pelvis fractures and sternal and rib fractures -Tibia-fibula fractures and coup-contrecoup traumatic brain injuries -Facial abrasions and closed head injuries -Anterior-posterior compression injuries to the pelvis

Tibia-fibula fractures and coup-contrecoup traumatic brain injuries

When applying a short spine board, what part of the body do you need to secure first? -Torso -Shoulders -Chest -Head

Torso

What is the best bleeding control for an arterial extremity wound? -Air splint -Tourniquet -Occlusive dressing -Elastic bandage

Tourniquet

You have responded to a car-pedestrian accident and find a 20-year old male on the ground. He has a deformed right lower leg and significant swelling in the right thigh, abrasions on his chest and forehead, unequal pupils, a pulse rate of 52, and is breathing at a rate of 6 breaths/min. What should you do first? -Apply an air splint to the lower leg. -Ventilate the patient at 20 breaths per minute using a bag mask device. -Administer high-flow oxygen via a nonrebreather mask. -Apply a traction split to the right thigh.

Ventilate the patient at 20 breaths per minute using a bag mask device.

________ pain results from stretching, oxygen deprivation, and swelling. -Superficial -Referred -Somatic -Visceral

Visceral

When should you remove other dressings from a bleeding wound? -Never -When applying a hemostatic dressing -When applying an nonadherent dressing -Once the wound has stopped bleeding

When applying a hemostatic dressing

The body's first response to soft tissue injury to regain hemostasis is -collagen synthesis -epithelialization -inflammation -neovascularization

inflammation

_______ lobe governs the perception of pain, temperature, and vibration. -frontal -occipital -parietal -temporal

parietal

When the thoracic trauma patient presents with air bubbles trapped below the skin, the patient is presenting with ______ -pulmonary contusion -subcutaneous emphysema -atelectasis -cardiac contusion

subcutaneous emphysema