Soft Tissue Injuries Chapter: 26

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According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA.

1%

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

14

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.

18%

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned?

30%

9. Which of the following processes occurs during the inflammation phase of the healing process? A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. B. White blood cells are forced away from the injury site, thus allowing an increase in the flow of red blood cells, resulting in increased blood flow. C. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection. D. The veins and arteries at the injury site constrict and platelets aggregate, which stops bleeding and causes a temporary increase in the size of the wound.

Answer: A Question Type: General Knowledge Page: 807

32. A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should: A. control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately. B. remove the steel rod, control the bleeding, apply an automated external defibrillator (AED), begin CPR, and transport to a trauma center. C. stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center. D. control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.

Answer: A Question Type: Critical Thinking Page: 820

51. A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. A. 18% B. 27% C. 36% D. 45%

Answer: A Question Type: Critical Thinking Page: 825

56. A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should: A. rapidly assess the patient after ensuring that the power line is not live. B. apply insulated gloves and assume manual control of his c-spine. C. quickly but carefully move the patient away from the power line. D. manually stabilize his head as your partner assesses for breathing.

Answer: A Question Type: Critical Thinking Page: 827

58. A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: A. begin CPR and apply the AED. B. begin CPR and transport at once. C. assess for entry and exit wounds. D. fully immobilize his spinal column.

Answer: A Question Type: Critical Thinking Page: 828

3. The germinal layer of the epidermis contains pigment granules that are responsible for skin: A. color. B. texture. C. moisture. D. temperature.

Answer: A Question Type: General Knowledge Page: 806

6. All of the following body structures are lined with mucous membranes, EXCEPT for the: A. lips. B. nose. C. anus. D. mouth.

Answer: A Question Type: General Knowledge Page: 806

17. In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is: A. infection. B. hypothermia. C. nerve damage. D. vessel damage.

Answer: A Question Type: General Knowledge Page: 809

22. Which of the following statements regarding penetrating injuries is correct? A. External bleeding may be minimal but internal injuries can be extensive. B. The degree of internal injury can often be estimated by the external injury. C. It is important to distinguish between entrance and exit wounds in the field. D. The depth of a penetrating injury should be thoroughly assessed by the EMT.

Answer: A Question Type: General Knowledge Page: 810

34. In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: A. an air embolism. B. a spinal fracture. C. an ischemic stroke. D. nerve fiber damage.

Answer: A Question Type: General Knowledge Page: 821

38. Burns are classified according to: A. depth and extent. B. location and pain. C. degree and location. D. extent and location.

Answer: A Question Type: General Knowledge Page: 823

39. Which of the following is a severe burn in a 35-year-old patient? A. circumferential partial-thickness burn to the chest B. full-thickness burn to 5% of the body surface area (BSA) C. partial-thickness burn to 20% of the BSA D. superficial burn covering 50% of the BSA

Answer: A Question Type: General Knowledge Page: 823

48. According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA. A. 1% B. 2% C. 4% D. 6%

Answer: A Question Type: General Knowledge Page: 825

57. Which of the following statements regarding electrical burns is correct? A. Entrance wounds are small relative to the amount of internal tissue damage. B. Respiratory or cardiac arrest following an electrical burn is very uncommon. C. The exit wound caused by electrical burns is smaller than the entrance wound. D. The size of the entry and exit wounds is a reliable indicator of internal damage.

Answer: A Question Type: General Knowledge Page: 827

61. Functions of dressings and bandages include all of the following, EXCEPT: A. immobilization of the injury. B. prevention of contamination. C. protection from further injury. D. control of external hemorrhage.

Answer: A Question Type: General Knowledge Page: 836

26. As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: A. open his airway and assess his breathing status. B. perform an immediate head-to-toe assessment. C. assess his pulse for rate, regularity, and quality. D. apply high-flow oxygen and assess his injuries.

Answer: A Question Type: Critical Thinking Page: 817

13. Which of the following statements regarding crush syndrome is correct? A. With crush syndrome, massive blood vessel damage occurs following severe soft-tissue injuries, such as amputation of an extremity. B. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. C. Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely because toxins are quickly eliminated from the body. D. Provided that a patient with a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal.

Answer: B Question Type: General Knowledge Page: 808

15. A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has: A. internal hemorrhage. B. compartment syndrome. C. a severe closed fracture. D. damage to the radial nerve.

Answer: B Question Type: Critical Thinking Page: 808

23. During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a: A. handgun. B. shotgun. C. .22-caliber pistol. D. .357 magnum.

Answer: B Question Type: Critical Thinking Page: 811

25. During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should: A. perform a focused physical exam of his abdomen. B. administer oxygen and prepare for rapid transport. C. place him in a sitting position and give him oxygen. D. conclude that he is experiencing intracranial bleeding.

Answer: B Question Type: Critical Thinking Page: 815

37. During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct? A. You should contact the police and have the patients arrested. B. The 39-year-old female is at high risk for an infection. C. The patient struck in the mouth should be immobilized. D. The 44-year-old female is at high risk for an infection.

Answer: B Question Type: Critical Thinking Page: 822

2. What layer of the skin forms a watertight, protective seal for the body? A. dermis B. epidermis C. muscular layer D. subcutaneous layer

Answer: B Question Type: General Knowledge Page: 806

4. Which of the following statements regarding the dermis is correct? A. The dermis produces a substance that provides color to the skin. B. The dermis contains hair follicles, sweat glands, and nerve endings. C. The cells of the dermis are worn away and are constantly replaced. D. The dermis lies above the germinal layer and provides protection.

Answer: B Question Type: General Knowledge Page: 806

11. A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): A. abrasion. B. contusion. C. hematoma. D. crush injury.

Answer: B Question Type: General Knowledge Page: 808

12. A hematoma develops when: A. small amounts of blood leak into the epidermis. B. large blood vessels beneath the skin are damaged. C. severe swelling compromises arterial circulation. D. cells and small vessels in the dermis are damaged.

Answer: B Question Type: General Knowledge Page: 808

18. Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? A. avulsion B. abrasion C. incision D. laceration

Answer: B Question Type: General Knowledge Page: 809

20. An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): A. incision. B. avulsion. C. laceration. D. amputation.

Answer: B Question Type: General Knowledge Page: 810

42. A burn that is characterized by redness and pain is classified as a: A. third-degree burn. B. first-degree burn. C. second-degree burn D. partial-thickness burn

Answer: B Question Type: General Knowledge Page: 824

46. Common signs and symptoms of an airway burn include all of the following, EXCEPT: A. hoarseness. B. chest pressure. C. singed nasal hair. D. soot around the mouth.

Answer: B Question Type: General Knowledge Page: 825

49. Which of the following statements regarding the rule of nines is correct? A. A child's head is equal to 14% of his or her total BSA. B. The anterior trunk of an adult is equal to 18% of the BSA. C. The posterior of a child's leg is equal to 13.5% of the BSA. D. The anterior arm in the adult is equal to 9% of the total BSA.

Answer: B Question Type: General Knowledge Page: 825

53. Which of the following is a severe burn in a 2-year-old child? A. superficial burn that covers 25% of the BSA B. any full-thickness burn, regardless of its location on the body C. partial-thickness burn that covers 10% of the BSA D. any burn that involves the arms, legs, or posterior part of the body

Answer: B Question Type: General Knowledge Page: 826

55. In order for electricity to flow through the body and cause damage: A. an insulator must exist between the electrical source and the patient. B. a complete circuit must exist between the electrical source and the ground. C. the part of the body that is in contact with the electrical source must be dry. D. the person must make direct physical contact with the source of electricity.

Answer: B Question Type: General Knowledge Page: 826

21. A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: A. carefully probe the wound to determine if the bleeding is venous or arterial. B. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. C. replace the avulsed flap to its original position and cover it with a sterile dressing. D. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.

Answer: C Question Type: Critical Thinking Page: 810

24. A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: A. perform a neurologic exam. B. palpate his radial pulses. C. administer high-flow oxygen. D. apply ice to the hematoma.

Answer: C Question Type: Critical Thinking Page: 813

28. A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should: A. place a sterile dressing over the wound and apply direct pressure. B. control the bleeding from the wound and prepare to transport at once. C. apply an occlusive dressing to the wound and continue your assessment. D. direct your partner to assist the patient's ventilations with a bag-mask device.

Answer: C Question Type: Critical Thinking Page: 818

52. A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned? A. 18% B. 27% C. 30% D. 36%

Answer: C Question Type: Critical Thinking Page: 825

62. You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: A. remove the bandage and dressing and apply another one. B. carefully manipulate her arm until the symptoms subside. C. assess distal circulation and readjust the bandage as needed. D. remove the gauze bandage and replace it with an elastic one.

Answer: C Question Type: Critical Thinking Page: 837

1. Which of the following areas of the body has the thinnest skin? A. scalp B. back C. ears D. soles of the feet

Answer: C Question Type: General Knowledge Page: 806

7. Functions of the skin include all of the following, EXCEPT: A. maintenance of water balance. B. regulation of body temperature. C. the production of key antibodies. D. sending information to the brain.

Answer: C Question Type: General Knowledge Page: 806

16. When assessing a patient with a closed soft-tissue injury, it is MOST important to: A. manipulate the injury site for signs of a fracture. B. assess circulation distal to the site of the injury. C. remain alert for more severe underlying injuries. D. recognize that the integrity of the skin is broken.

Answer: C Question Type: General Knowledge Page: 809

19. A laceration: A. is an injury that separates various layers of soft tissue. B. is a sharp, smooth cut that is made by a surgical scalpel. C. is a jagged cut caused by a sharp object or blunt force trauma. D. rarely penetrates through the subcutaneous tissue to the muscle.

Answer: C Question Type: General Knowledge Page: 809

31. In which of the following patients should you remove an impaled object? A. a semiconscious patient with an ice pick impaled in the chest B. an apneic patient with a shard of glass impaled in the abdomen C. a pulseless and apneic patient with a knife impaled in the back D. a conscious and alert patient with a fishhook impaled in the eye

Answer: C Question Type: General Knowledge Page: 820

36. In contrast to animal bites, the bite of a human: A. is usually less severe because the human mouth is cleaner. B. typically results in a minor infection that is slow-spreading. C. carries with it a wide variety of virulent bacteria and viruses. D. is associated with a much higher incidence of rabies infection.

Answer: C Question Type: General Knowledge Page: 822

40. Which of the following is a severe burn in a 65-year-old patient? A. superficial burn to 30% of the BSA B. full-thickness burn to 1% of the BSA C. partial-thickness burn to 20% of the BSA D. second-degree burn covering 10% of the BSA

Answer: C Question Type: General Knowledge Page: 823

44. Patients with full-thickness (third-degree) burns generally do not complain of pain because: A. blister formation protects the burn. B. he or she is generally not conscious. C. the nerve endings have been destroyed. D. subcutaneous vessels are usually clotted.

Answer: C Question Type: General Knowledge Page: 824

50. With regard to the pediatric rule of nines, the: A. head is proportionately smaller than an adult's. B. thorax is proportionately larger than an adult's. C. legs are proportionately smaller than an adult's. D. arms are proportionately larger than an adult's.

Answer: C Question Type: General Knowledge Page: 825

27. You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with: A. performing a detailed secondary assessment to locate all of her injuries. B. assessing the bruises that overlie major organs in the chest and abdomen. C. the fact that her clinical signs could indicate that she is bleeding internally. D. obtaining a complete set of vital signs to rule out the possibility of shock.

Answer: C Question Type: Critical Thinking Page: 817

10. During the normal wound healing process, bleeding may occur from even a minor injury because: A. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding. B. histamines released by the immune system constrict the blood vessels, which increases the pressure within them. C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. D. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding.

Answer: C Question Type: General Knowledge Page: 807

14. The hallmark sign of compartment syndrome is: A. a lack of pain despite the severity of the injury. B. extreme redness to the injury site. C. a bounding pulse distal to the injury. D. pain out of proportion to the injury.

Answer: D Question Type: General Knowledge Page: 808

30. A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? A. Irrigate it with sterile water and cover it with a dry dressing. B. Cover the exposed bowel and keep his legs in a straight position. C. Carefully replace the exposed bowel into the abdomen and transport. D. Cover it with moist, sterile gauze and secure with an occlusive dressing.

Answer: D Question Type: Critical Thinking Page: 819

33. A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to: A. remove the kickstand in a circular motion and apply a dry, sterile dressing. B. cut the kickstand off just above the skin, and stabilize it with sterile dressings. C. leave the kickstand attached to the bike until the physician can remove it safely. D. unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

Answer: D Question Type: Critical Thinking Page: 821

35. An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: A. administer oxygen via a nonrebreathing mask. B. ask the child's father to try to locate the dog. C. advise the child that he will need rabies shots. D. report the incident to the appropriate authorities.

Answer: D Question Type: Critical Thinking Page: 822

59. You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with: A. treating him for hypothermia. B. preventing the risk of infection. C. estimating the extent of his burns. D. the potential for airway swelling.

Answer: D Question Type: Critical Thinking Page: 829

5. The sebaceous glands produce sebum, a material that: A. facilitates shedding of the epidermis. B. pulls the hair erect when you are cold. C. discharges sweat onto the skin's surface. D. waterproofs the skin and keeps it supple.

Answer: D Question Type: General Knowledge Page: 806

8. When a person is exposed to a cold environment: A. sweat is produced and is warmed when the vessels constrict. B. blood vessels dilate and divert blood to the core of the body. C. the skin becomes flushed secondary to peripheral vasodilation. D. peripheral vessels constrict and divert blood away from the skin.

Answer: D Question Type: General Knowledge Page: 806

29. An abdominal evisceration: A. is most commonly the result of blunt force trauma. B. should be covered with bulky dry, sterile dressings. C. often causes severe hypothermia because of heat loss. D. occurs when organs protrude through an open wound.

Answer: D Question Type: General Knowledge Page: 819

41. Which of the following is of LEAST importance when initially assessing the severity of a burn? A. area(s) burned B. age of the patient C. past medical history D. known drug allergies

Answer: D Question Type: General Knowledge Page: 823

43. A partial-thickness burn involves the outer layer of skin and a portion of the: A. epidermis. B. fatty layer. C. muscle fascia. D. dermal layer.

Answer: D Question Type: General Knowledge Page: 824

45. Which of the following statements regarding severe burns is correct? A. Severe burns involving the airway have a 100% mortality rate. B. The majority of severe burns involve full-thickness burns only. C. Patients with severe burns are especially prone to hyperthermia. D. Severe burns are typically a combination of all degrees of burn.

Answer: D Question Type: General Knowledge Page: 824

47. Burns to pediatric patients are generally considered more serious than burns to adults because: A. pediatric patients are more prone to hyperthermia. B. most burns in children are the result of child abuse. C. pediatric patients have a proportionately larger volume of blood. D. pediatric patients have more surface area relative to total body mass.

Answer: D Question Type: General Knowledge Page: 825

54. When caring for a patient whose arm is covered with a dry chemical, you should: A. deactivate the chemical with a 5% vinegar solution. B. quickly irrigate the arm with large amounts of water. C. use forceful streams of water to remove the chemical. D. brush away the chemical before flushing with water.

Answer: D Question Type: General Knowledge Page: 826

60. When treating a partial-thickness burn, you should: A. immerse the affected part in warm water. B. rupture any blisters to prevent an infection. C. cover the burn with a moist, sterile dressing. D. avoid the use of creams, lotions, or antiseptics.

Answer: D Question Type: General Knowledge Page: 836

Which of the following statements regarding crush syndrome is correct?

Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?

Cover it with moist, sterile gauze and secure with an occlusive dressing.

Which of the following statements regarding the cranium is correct?

Eighty percent of the cranium is occupied by brain tissue.

Which of the following statements regarding electrical burns is correct?

Entrance wounds are small relative to the amount of internal tissue damage.

Which of the following statements regarding penetrating injuries is correct?

External bleeding may be minimal but internal injuries can be extensive.

Which of the following statements regarding secondary brain injury is correct?

Hypoxia and hypotension are the two most common causes of secondary brain injury.

Which of the following statements regarding severe burns is correct?

Severe burns are typically a combination of all degrees of burn.

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct?

The 39-year-old female is at high risk for an infection.

Which of the following statements regarding a basilar skull fracture is correct?

The absence of raccoon eyes or Battle's sign does not rule it out.

Which of the following statements regarding the rule of nines is correct?

The anterior trunk of an adult is equal to 18% of the BSA.

Which of the following statements regarding the dermis is correct?

The dermis contains hair follicles, sweat glands, and nerve endings.

Which of the following processes occurs during the inflammation phase of the healing process?

The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.

Which of the following statements regarding motor nerves is correct

They carry information from the CNS to the muscles.

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

In order for electricity to flow through the body and cause damage:

a complete circuit must exist between the electrical source and the ground.

The MOST reliable sign of a head injury is:

a decreased level of consciousness.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?

abrasion

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:

acting as a shock absorber for the brain and spinal cord.

A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:

administer high-flow oxygen.

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:

administer oxygen and prepare for rapid transport.

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:

after assessing distal neurovascular functions.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:

an air embolism.

Which of the following is a severe burn in a 2-year-old child?

any full-thickness burn, regardless of its location on the body

A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should:

apply an occlusive dressing to the wound and continue your assessment

A short backboard or vest-style immobilization device is indicated for patients who:

are in a sitting position and are clinically stable

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:

assess distal circulation and readjust the bandage as needed.

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities.

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes:

assisting ventilations at an age-appropriate rate.

The body's functions that occur without conscious effort are regulated by the _________ nervous system.

autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

avoid excessive pressure when applying the bandage.

When treating a partial-thickness burn, you should:

avoid the use of creams, lotions, or antiseptics.

An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):

avulsion.

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:

begin CPR and apply the AED.

An epidural hematoma is MOST accurately defined as:

bleeding between the skull and dura mater.

Which of the following sets of vital signs depicts Cushing's triad?

blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

The central nervous system (CNS) is composed of the:

brain and spinal cord.

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

brain stem

When caring for a patient whose arm is covered with a dry chemical, you should:

brush away the chemical before flushing with water.

In contrast to animal bites, the bite of a human:

carries with it a wide variety of virulent bacteria and viruses.

Coordination of balance and body movement is controlled by the:

cerebellum.

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):

cerebral concussion.

The MOST common and serious complication of a significant head injury is:

cerebral edema.

The _________ contain(s) about 75% of the brain's total volume.

cerebrum

The five sections of the spinal column, in descending order, are the:

cervical, thoracic, lumbar, sacral, and coccygeal.

Common signs and symptoms of an airway burn include all of the following, EXCEP

chest pressure.

Common signs and symptoms of an airway burn include all of the following, EXCEPT:

chest pressure.

Which of the following is a severe burn in a 35-year-old patient?

circumferential partial-thickness burn to the chest

The germinal layer of the epidermis contains pigment granules that are responsible for skin:

color

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:

compartment syndrome.

The frontal and parietal bones of the skull are especially susceptible to:

compressed skull fractures.

Rapid deceleration of the head, such as when it impacts the windshield, causes:

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?

connecting

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

constricted pupils.

A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should:

control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n)

contusion.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):

contusion.

Burns are classified according to:

depth and extent.

A partial-thickness burn involves the outer layer of skin and a portion of the:

dermal layer.

When assessing a conscious patient with an MOI that suggests spinal injury, you should:

determine if the strength in all extremities is equal.

The tough, fibrous outer meningeal layer is called the:

dura mater

Which of the following areas of the body has the thinnest skin?

ears

When immobilizing a patient on a long backboard, you should:

ensure that you secure the torso before securing the head.

What layer of the skin forms a watertight, protective seal for the body?

epidermis

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?

epidural hematoma

The hormone responsible for the actions of the sympathetic nervous system is:

epinephrine.

The MOST important treatment for patients with a head injury, regardless of severity, is

establish an adequate airway.

It would be MOST appropriate to perform a focused secondary assessment on a patient who:

fainted and fell to the ground from a standing position.

A burn that is characterized by redness and pain is classified as a:

first-degree burn.

Distraction injuries of the spine are MOST commonly the result of:

hangings.

Functions of dressings and bandages include all of the following, EXCEPT:

immobilization of the injury.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is

infection.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:

infection.

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

instruct him to assist her ventilations while you perform a rapid assessment.

Bleeding within the brain tissue itself is called a(n)

intracerebral hematoma.

Bleeding within the brain tissue itself is called a(n):

intracerebral hematoma.

In contrast to a cerebral concussion, a cerebral contusion:

involves physical injury to the brain tissue.

A laceration:

is a jagged cut caused by a sharp object or blunt force trauma.

A tight-fitting motorcycle helmet should be left in place unless:

it interferes with your assessment of the airway.

When opening the airway of a patient with a suspected spinal injury, you should use the:

jaw-thrust maneuver.

Which of the following is of LEAST importance when initially assessing the severity of a burn?

known drug allergies

A hematoma develops when:

large blood vessels beneath the skin are damaged.

With regard to the pediatric rule of nines, the:

legs are proportionately smaller than an adult's.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

level of consciousness.

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs?

linear

All of the following body structures are lined with mucous membranes, EXCEPT for the:

lips.

Lacerations to the scalp

may be an indicator of deeper, more serious injuries.

Lacerations to the scalp:

may be an indicator of deeper, more serious injuries.

When a patient experiences a severe spinal injury, he or she:

may lose sensation below level of injury

An abdominal evisceration:

occurs when organs protrude through an open wound.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status.

The hallmark sign of compartment syndrome is:

pain out of proportion to the injury.

Which of the following is a severe burn in a 65-year-old patient?

partial-thickness burn to 20% of the BSA

Burns to pediatric patients are generally considered more serious than burns to adults because:

pediatric patients have more surface area relative to total body mass.

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

peripheral

When a person is exposed to a cold environment:

peripheral vessels constrict and divert blood away from the skin.

When immobilizing a child on a long backboard, you should:

place padding under the child's shoulders as needed.

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should

rapidly assess the patient after ensuring that the power line is not live.

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should:

rapidly assess the patient after ensuring that the power line is not live.

When assessing a patient with a closed soft-tissue injury, it is MOST important to:

remain alert for more severe underlying injuries.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

replace the avulsed flap to its original position and cover it with a sterile dressing.

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:

report the incident to the appropriate authorities.

A patient who cannot remember the events that preceded his or her head injury is experiencing

retrograde amnesia

Which of the following nerves carry information from the body to the brain via the spinal cord?

sensory

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

slow.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

What part of the nervous system controls the body's voluntary activities?

somatic

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

suction his oropharynx for up to 15 seconds.

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with:

the fact that her clinical signs could indicate that she is bleeding internally.

When the parasympathetic nervous system is activated:

the heart rate decreases and the blood vessels dilate.

Patients with full-thickness (third-degree) burns generally do not complain of pain because:

the nerve endings have been destroyed.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard.

You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with:

the potential for airway swelling.

Functions of the skin include all of the following, EXCEPT:

the production of key antibodies.

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to

unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to:

unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

If you do not have the appropriate size cervical collar, you should:

use rolled towels to immobilize the patient's head.

The sebaceous glands produce sebum, a material that:

waterproofs the skin and keeps it supple


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