Chapter 28
A sign of kidney damage following blunt trauma is: A) hematuria. B) hemoptysis. C) hematemesis. D) hematochezia.
A) hematuria.
All of the following are hollow abdominal organs, EXCEPT for the: A) liver. B) bladder. C) ureters. D) stomach.
A) liver.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: A) liver. B) spleen. C) kidney. D) stomach.
A) liver.
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: A) perform a head-to-toe assessment while she is in the car. B) lift the air bag and look for deformity to the steering wheel. C) carefully assess her upper chest for seatbelt-related injuries. D) extricate her immediately and transport to a trauma center.
B) lift the air bag and look for deformity to the steering wheel.
Which of the following organs would MOST likely bleed profusely when injured? A) bladder B) liver C) stomach D) intestine
B) liver
When a hollow organ is punctured during a penetrating injury to the abdomen: A) the abdomen will become instantly distended. B) peritonitis may not develop for several hours. C) it will bleed profusely and rapidly cause shock. D) it commonly protrudes through the injury site.
B) peritonitis may not develop for several hours.
Because the depth of an open abdominal wound is often difficult to determine: A) vital signs should be monitored frequently. B) prompt transport to the hospital is essential. C) the EMT must perform a thorough exam. D) the abdomen must be vigorously palpated.
B) prompt transport to the hospital is essential.
Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: A) air bag deployment. B) failure to wear seatbelts. C) a poorly placed lap belt. D) rapid vehicle deceleration.
C) a poorly placed lap belt.
A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: A) transport only if signs of shock begin to develop. B) carefully probe the wound to determine its depth. C) assume that the arrow injured an internal organ. D) clean the wound and apply a dry, sterile dressing.
C) assume that the arrow injured an internal organ.
Contraction or tensing of the abdominal muscles in an effort to ease pain is called: A) flexing. B) referring. C) guarding. D) withdrawing.
C) guarding.
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
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: A) aorta. B) spleen. C) stomach. D) diaphragm.
D) diaphragm.
A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: A) apply full spinal motion restriction precautions. B) keep him on his side but gently straighten his legs. C) place him supine but allow him to keep his knees bent. D) transport him in the position in which you found him.
D) transport him in the position in which you found him.
All of the following are signs of a significant abdominal injury, EXCEPT: a) localized pain b) hypotension c) diffuse bruising d) tachycardia
a) localized pain
In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:
infection
It can be difficult to assess the severity of injuries to the genitourinary system following sexual assault because:
patients may be hesitant to allow you to examine them
When assessing a patient with a closed soft-tissue injury, it is MOST important to:
remain alert for more severe underlying injuries
A 30-year-old Male has a large laceration to his right lower abdominal quadrant with a loop of bowel protruding through the wound. When treating this patient, the EMT-B Should recall that the: A) protruding bowel should be kept warm and moist. B) Open abdomen rapidly draws heat into the wound. C) Wound should be covered with a dry, sterile dressing. D) bowel should be replaced in order to avoid infection.
A) protruding bowel should be kept warm and moist.
Which of the following statements regarding abdominal eviscerations is correct? A) Most eviscerations occur to the left upper quadrant. B) The protruding organs should be kept warm and moist. C) The organs should be replaced carefully to avoid heat loss D) Adherent material is preferred when covering an evisceration.
B) The protruding organs should be kept warm and moist.
A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: A) covering him with a warm blanket. B) giving him small sips of plain water. C) promptly transporting to the hospital. D) administering supplemental oxygen.
B) giving him small sips of plain water.
A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for: A) external genitalia injury. B) a lacerated liver or spleen. C) blunt injury to the kidney. D) a ruptured urinary bladder.
C) blunt injury to the kidney.
Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a: A) rollover crash. B) lateral collision. C) head on crash. D) rearend collision.
C) head on crash.
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: A) a ruptured spleen. B) a severe liver laceration. C) intra-abdominal bleeding. D) rupture of a hollow organ
C) intra-abdominal bleeding.
The presence of tachycardia following a significant abdominal injury: A) is always accompanied by hypotension. B) indicates a state of decompensated shock. C) should be assumed to be a sign of shock. D) is most commonly caused by severe pain.
C) should be assumed to be a sign of shock
Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? A) pancreas B) fallopian tubes C) urinary bladder D) liver or spleen
C) urinary bladder
When documenting a call involving a female patient who was sexually assaulted, the EMT should: A) theorize as to why the sexual assault occurred. B) include the results of his or her internal vaginal exam. C) include a description of the suspected perpetrator. D) avoid speculation and document only factual data.
D) avoid speculation and document only factual data.
Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: A) visualize the vaginal area and pack the vagina with sterile dressings. B) allow her to change her clothes and take a shower before you transport. C) arrange for a rape crisis center representative to speak with the patient. D) control any external bleeding, administer oxygen, and transport at once.
D) control any external bleeding, administer oxygen, and transport at once.
Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the: A) Kehr sign. B) Cullen sign. C) Grey Turner sign. D) Brudzinski sign.
A) Kehr sign.
A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes: A) applying direct pressure with a dry, sterile dressing. B) covering the avulsion with moist, sterile dressings. C) requesting a paramedic to administer pain medication. D) administering 100% oxygen via a nonrebreathing mask.
A) applying direct pressure with a dry, sterile dressing.
When worn properly, a seatbelt should lie: A) below the anterior superior iliac spines of the pelvis and against the hip joints. B) across the abdominal wall at the level of the diaphragm and below the hip joints. C) above the anterior posterior iliac spines of the pelvis and below the hip joints. D) across the abdominal wall at the level of the umbilicus and against the hip joints.
A) below the anterior superior iliac spines of the pelvis and against the hip joints.
You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: A) closely monitor him and reassess him frequently. B) perform a comprehensive secondary assessment. C) begin documenting the call on the patient care form. D) forgo the hospital radio report because of his condition.
A) closely monitor him and reassess him frequently.
Accumulation of blood in the abdominal cavity will MOST likely cause: A) distention. B) referred pain. C) diffuse bruising. D) nausea or vomiting.
A) distention.
Placing a pregnant patient in a supine position during the third trimester of pregnancy: A) may decrease the amount of blood that returns to the heart. B) often causes hypotension secondary to cardiac compression. C) results in spontaneous urinary incontinence if the bladder is full. D) is recommended if the patient has severe abdominal discomfort.
A) may decrease the amount of blood that returns to the heart.
Which of the following statements regarding abdominal trauma is correct? A) Most of the vital abdominal organs lie within the retroperitoneal space. B) The absence of abdominal pain does not rule out intra-abdominal bleeding. C) The liver is well protected and is rarely injured during a traumatic event. D) Hollow abdominal organs are vascular and bleed profusely when injured.
B) The absence of abdominal pain does not rule out intra-abdominal bleeding.
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: A) perform a comprehensive secondary assessment to determine why his clinical status has changed. B) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device. C) reassess his vital signs and then notify the receiving hospital of the change in his clinical status. D) suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.
B) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.
You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if: A) the patient is conscious. B) law enforcement is at the scene. C) there are other patients involved. D) the severity of the injury is known.
B) law enforcement is at the scene.
Early bruising following abdominal trauma often manifests as: A) localized pain. B) red areas of skin. C) gross distention. D) dark purple marks.
B) red areas of skin.
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him? A) What does your blood pressure normally run? B) Do you take any over-the-counter medications? C) Has blood soaked through your undergarments? D) Have you experienced recent abdominal trauma?
D) Have you experienced recent abdominal trauma?
The mesentery is: A) the point of attachment between the small and large intestines. B) a layer of thick skeletal muscles that protects the abdominal organs. C) a complex network of blood vessels that supply blood to the liver. D) a membranous fold that attaches the intestines to the walls of the body.
D) a membranous fold that attaches the intestines to the walls of the body.
Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when: A) solid abdominal organs bleed secondary to penetrating trauma. B) the vessels that supply the abdominal organs become inflamed. C) bacteria or viruses invade the walls of the gastrointestinal tract. D) hollow abdominal organs are damaged and spill their contents.
D) hollow abdominal organs are damaged and spill their contents.
