Chapter 31

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 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.

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

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

a) cover the exposed bowel with moist sterile dressing and then secure it in place with a dry bandage

Accumulation of blood in the abdominal cavity will MOST likely cause:

a) distention

A sign of kidney damage after blunt trauma is:

a) hematuria

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

a) liver

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

a) might decrease the amount of blood that returns to the heart

All of the following are hollow abdominal organs, except the:

a) spleen

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

b) apply direct pressure to the wound

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following expect:

b) giving him small sips of plain water

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:

b) insert an airway adjunct if he will tolerate it and begin assisting his ventilation with a bag valve mask

You are dispatched to a residence for young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

b) law enforcement is at the scene

While assessing a 21 year old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should:

b) lift the airbag and look for deformity to the steering wheel

Which of the following organs would most likely bleed profusely when injured?

b) liver

When a hollow organ is punctured during a penetrating injury to the abdomen:

b) peritonitis might not develop for several hours

Because the depth of an open abdominal wound is often difficult to determine:

b) prompt transport to the hospital is essential

Early bruising following abdominal trauma often manifests as:

b) red areas of skin

Which of the following statements regarding abdominal trauma is correct?

b) the absence of abdominal pain does not rule out intra-abdominal bleeding

Which of the following statements regarding abdominal evisceration is correct?

b) the protruding organs should be kept warm and moist

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

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 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:

c) assume that the arrow injured an internal organ

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 points tenderness to the area. Your assessment reveals that there is small amount of blood in his underwear. You should be most suspicious for:

c) blunt injury to the kidney

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

c) guarding

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

c) intra-abdominal bleeding

Which of the following statements regarding rebound tenderness is correct?

c) it is often discovered when the patient is jarred or moved suddenly

The presence of tachycardia following a significant abdominal injury:

c) should be assumed to be a sign of shock

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?

c) shoulder fracture

Which of the following organs is at most risk for injury as the result of pelvic fracture?

c) urinary bladder

A 66 year old male presents with dark red rectal bleeding and abdominal pain. He is conscious ad alert, however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be most pertinent to ask him?

d) Have you experienced recent abdominal trauma?

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

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:

d) control any external bleeding, administer oxygen, and transport at once

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

d) diaphragm

Peritonitis usually occurs when:

d) hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.

A 22 year old male was kicked 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/in and strong, and his respiration are 22 breaths/min and regular. In addition to administering high flow oxygen, you should:

d) transport him in the position in which you found him

The mesentery is:

d)a membranous fold that attaches the intestines to the walls of the body.