Chapter 26- Face and Neck Injuries

Which of the following statements regarding scalp lacerations is correct? Select one: A. Blood loss from a scalp laceration may result in hypovolemic shock, especially in children B. Patients who take antihypertensive medications bleed more severely from scalp lacerations C. Although deep scalp lacerations bleed profusely, they are rarely associated with skull fractures D. Because the scalp is highly vascular, you should always apply a tight pressure dressing to control bleeding

A. Blood loss from a scalp laceration may result in hypovolemic shock, especially in children

The term "hyphema" is defined as: Select one: A. blood in the anterior chamber of the eye. B. an acute rupture of the globe of the eye. C. inflammation of the iris, cornea, and lens. D. compression of one or both optic nerves.

A. blood in the anterior chamber of the eye.

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: Select one: A. close her eyes and cover them with a moist dressing. B. secure her eyes open so you can reassess her pupils. C. inspect her eyes and gently remove impaled objects. D. irrigate her eyes with water to prevent mucosal drying.

A. close her eyes and cover them with a moist dressing.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: Select one: A. irrigating his right eye laterally. B. flushing his eye starting laterally. C. irrigating both eyes simultaneously. D. covering both eyes and transporting.

A. irrigating his right eye laterally.

When assessing a patient with a mandibular fracture, you would MOST likely encounter: Select one: A. misalignment of the teeth. B. impaired ocular movement. C. pain directly over the chin. D. lateral bulging of the jaw.

A. misalignment of the teeth.

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: Select one: A. pupil. B. sclera. C. cornea. D. conjunctiva.

A. pupil.

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injury because: Select one: A. they must make arrangements for an ICU bed. B. a specialist may be needed to manage the injury. C. it saves time on repeat assessments at the hospital. D. most patients with facial trauma will need surgery.

B. a specialist may be needed to manage the injury.

Retinal injuries that are caused by exposure to extremely bright light: Select one: A. are intensely painful, but usually only result in temporary blindness. B. are typically not painful, but may result in permanent damage to vision. C. usually do not immediate medical attention unless vision is impaired. D. damage the motor cells of the eye, resulting in reduced eye movement.

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

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: Select one: A. carefully examine her eye and remove any foreign objects if needed. B. avoid applying pressure to the globe when you are covering her eye. C. ask her to move the injured eye to assess the integrity of the optic nerve. D. apply firm direct pressure to the injured eye and cover the opposite eye.

B. avoid applying pressure to the globe when you are covering her eye.

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: Select one: A. acute retinitis. B. conjunctivitis. C. a detached retina. D. a corneal abrasion.

B. conjunctivitis.

The eyeball itself is called the: Select one: A. orbit. B. globe. C. sclera. D. cornea.

B. globe.

You are assessing a 59-year-old male who complains of a headache and note that his pupils are asymmetrical. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: Select one: A. is allergic to any medications. B. has a history of eye surgeries. C. regularly sees a family physician. D. took any medication for his headache.

B. has a history of eye surgeries.

Clinical findings associated with a laryngeal injury include: Select one: A. pallor, a mediastinal shift, and tracheal deviation. B. hemoptysis, subcutaneous emphysema, and cyanosis. C. posterior neck deformity, Battle's sign, and a dry cough. D. hematemesis, bulging eyes, and jugular venous distention.

B. hemoptysis, subcutaneous emphysema, and cyanosis.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. If you do not have sterile saline or water, you should: Select one: A. flush both eyes with an alcohol-based solution and transport. B. irrigate both eyes continuously for 20 minutes with plain water. C. neutralize the acid chemical in his eye with an alkaline chemical. D. mix baking soda with water and irrigate his eyes with the solution.

B. irrigate both eyes continuously for 20 minutes with plain water.

The cricoid cartilage: Select one: A. lies superior to the thyroid cartilage in the neck. B. is the only complete circular cartilage of the trachea. C. is easier to see and palpate than the thyroid cartilage. D. lies superior to the cricothyroid membrane in the neck.

B. is the only complete circular cartilage of the trachea.

When a light is shone into the pupil: Select one: A. the opposite pupil should dilate. B. it should become smaller in size. C. it should become larger in size. D. both pupils should dilate together.

B. it should become smaller in size.

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: Select one: A. applying a tight pressure dressing. B. padding between the ear and the scalp. C. packing the ear with sterile gauze pads. D. covering the wound with a moist dressing.

B. padding between the ear and the scalp.

Frequent reassessments of the patient with face or neck injuries are MOST important because: Select one: A. they lend credibility to your documentation. B. such injuries can affect the respiratory system. C. hospital staff require frequent patient updates. D. rapid facial swelling may mask hidden injuries.

B. such injuries can affect the respiratory system.

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: Select one: A. conjunctivitis. B. acute hyphema. C. a blowout fracture. D. a detached retina.

C. a blowout fracture.

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with heavy bleeding. As your partner manually stabilizes the patient's head, you should: Select one: A. stabilize the impaled glass in her eye. B. administer 100% supplemental oxygen. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye.

C. apply direct pressure to her arm wound.

The lower jawbone is called the: Select one: A. zygoma. B. maxillae. C. mandible. D. mastoid.

C. mandible.

The white portion of the eye is called the: Select one: A. iris. B. retina. C. sclera. D. cornea.

C. sclera.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: Select one: A. incus. B. pinna. C. tragus. D. stapes.

C. tragus.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. use tweezers to try to remove the object. B. remove the peanut with a cotton-tipped swab. C. transport her to the emergency department. D. thoroughly flush her ear with sterile saline.

C. transport her to the emergency department.

What is the function of the sternocleidomastoid muscle? Select one: A. Allows flexion of the neck B. Facilitates chest movement C. Connects the scapulae together D. Allows movement of the head

D. Allows movement of the head

Which of the following statements regarding anterior nosebleeds is correct? Select one: A. They cause blood to drain into the posterior pharynx. B. They are usually severe and require aggressive treatment to control. C. They are usually caused by a fracture of the basilar skull. D. They usually originate from the septum area and bleed slowly

D. They usually originate from the septum area and bleed slowly

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: Select one: A. leave the contact lenses in place and flush his eyes with sterile water. B. remove the contact lenses and cover his eyes with a dry, sterile dressing. C. leave the contact lenses in place and cover both eyes with a dry dressing. D. carefully remove the contact lenses and then irrigate his eyes with saline.

D. carefully remove the contact lenses and then irrigate his eyes with saline.

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: Select one: A. sclera. B. cornea. C. retina. D. conjunctiva.

D. conjunctiva.

A 58-year-old woman fell and landed face-first on a concrete sidewalk. She is conscious, but confused. Her skin is pale, cool, and clammy; her radial pulses are weak and rapid; and her blood pressure is 72/54 mm Hg. Further assessment reveals crepitus to her left cheekbone. After administering high-flow oxygen, you should: Select one: A. apply a cervical collar only, establish two large-bore IV lines, and administer 2 liters of normal saline. B. place her in a sitting position on the stretcher, insert a saline lock, and reassess her blood pressure. C. perform a detailed secondary assessment, immobilize her entire spine, and establish IV access. D. immobilize her entire spine, establish at least one large-bore IV line, and give a 20-mL/kg crystalloid bolus.

D. immobilize her entire spine, establish at least one large-bore IV line, and give a 20-mL/kg crystalloid bolus.

A 30-year-old female was assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: Select one: A. begin immediate ventilatory assistance. B. visualize her mouth for obvious wounds. C. apply oxygen via a nonrebreathing mask. D. suction her oropharynx for 15 seconds.

D. suction her oropharynx for 15 seconds.