Chapter 31: Abdominal and Genitourinary Injuries

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: Select one: A. forgo the hospital radio report because of his condition. B. perform a comprehensive secondary assessment. C. closely monitor him and reassess him frequently. D. begin documenting the call on the patient care form.

C

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: Select one: A. applying direct pressure with a dry, sterile dressing. B. administering 100% oxygen via a nonrebreathing mask. C. covering the avulsion with moist, sterile dressings. D. requesting a paramedic to administer pain medication.

A

Because solid organs have a rich supply of blood , any injury can result in major: A hemorrhaging B. damage c . pain D. guarding

A

If you are treating a patient with an abdominal evisceration , you should use a ( n ) : A moist , sterile dressing B. dry , sterile dressing c . adhesive dressing D. triangular bandage

A

Patients with open abdominal injuries often complain of : A pain B. nausea C. vomiting D. dyspnea

A

Suspect a possible injury of the urinary bladder in all of the following findings EXCEPT : A bruising to the left upper quadrant B. blood at the urethral opening C. blood at the tip of the penis or a stain on the patient's underwear D. physical signs of trauma on the lower abdomen , pelvis , or perineum

A

The abdomen is divided into four : A. quadrants B. planes C. sections D. angles

A

The largest organ in the abdomen is the : A liver B. spleen c . pancreas D. kidneys

A

The major complaint of patients with abdominal injury is : A pain B. tachycardia c . rigidity D. swelling

A

The solid organs of the urinary system include the : A kidneys B. ureters c . bladder D. urethra

A

While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find: A. a deformed steering wheel. B. that the airbags deployed. C. a crushed instrument panel. D. damage to the lower dashboard

A

You have a male patient who has no immediate life threat but does have bleeding genitalia . You should bandage with a ( n ) : A. dry dressing B. moist dressing c . occlusive dressing D. adhesive dressing

A

A very common early sign of a significant abdominal injury and shock is : A. pain B. tachycardia C. rigidity D. distention

B

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should: a. apply 02 via NRM b. apply direct pressure to wound c. ventilate patient with BVM d. open patients airway

B

Any air in the peritoneal cavity seeks the most ________space or void ; thus , the location of the air can change with the positioning of the patient . A inferior B. superior C. distal D. proximal

B

Blunt abdominal injuries may result from : A. a stab wound B. seat belts C. a gunshot wound D. an impaled object

B

In any case of trauma to a female patient , you should always determine if the patient : A. is on birth control B is pregnant C. is currently menstruating D. has a history of ovarian cysts

B

In cases of sexual assault , which of the following is TRUE ? A.You should always examine the genitalia for any sign of injury . B Advise the patient not to wash , urinate , or defecate . c . In addition to recording the facts , it is important to include your personal thoughts . D. You should use plastic bags when collecting items such as clothes .

B

Late signs of abdominal injury include all of the following EXCEPT : A. distention B. increased blood pressure C. change in mental status D. pale , cool , moist skin

B

The mesentery is: Select one: A. the point of attachment between the small and large intestines. B. a membranous fold that attaches the intestines to the walls of the body. C. a layer of thick skeletal muscles that protects the abdominal organs. D. a complex network of blood vessels that supply blood to the liver.

B

The patient's pain radiating to the right shoulder is most likely referred from the: A. bladder. B. liver. C. kidney. D. intestine.

B

When treating a patient with an amputation of the penile shaft , your top priority is : A. locating the amputated part B. controlling bleeding c . keeping the remaining tissue dry D. delaying transport until bleeding is controlled

B

Which of the following is NOT a hollow organ of the abdomen ? A. Stomach B. Liver C. Bladder D. Ureters

B

Which of the following statements regarding abdominal eviscerations is correct? a) Adherent material is preferred when covering an evisceration. b) The protruding organs should be kept warm and moist. c) The organs should be replaced carefully to avoid heat loss. d) Most eviscerations occur to the left upper quadrant.

B

You are dispatched to a residence for a young female who was kicked in the abdomen. 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

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: Select one: A. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. B. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask. C. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. D. perform a comprehensive secondary assessment to determine why his clinical status has changed.

B

You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume? A. Sitting up B. Legs drawn up C. Legs outstretched D. On his right side

B

The term "hematuria" is defined as: A. blood in the stool. B. blood in the urine. C. vomiting up blood. D. urinary bladder rupture.

B (suggests injury to the urinary bladder or kidneys)

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: Select one: A. gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing. B. cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket. C. cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage. D. make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.

C

All of the following male genitalia lie outside the pelvic cavity EXCEPT : A the urethra B. the penis C. the seminal vesicles D. the testes

C

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 umbilicus and against the hip joints. c) across the abdominal wall at the level of the diaphragm and below the hip joints. d) above the anterior posterior iliac spines of the pelvis and below the hip joints.

C

Whenever possible, you should always provide the sexual assault patient with : A. a police escort B. privacy to use the restroom C. an attendant of the same gender D. the name of the assailant

C

Which of the following is NOT a solid organ of the abdomen ? A. Liver . B. Spleen C. Gallbladder D. Pancreas

C

Your primary concern when dealing with an unresponsive patient with an open abdominal injury is : A covering the wound with a moist dressing B. maintaining the airway C. controlling the bleeding D. monitoring vital signs

C

take ( s ) place in the solid organs: . A. Digestion B. Excretion C.Endocrine functions D. Absorption

C

A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his: A. liver. B. spleen. C. kidney. D. bladder.

C (The flanks are located laterally in the back and overlie the kidneys)

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

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, except: Select one: A. administering supplemental oxygen. B. promptly transporting him to the hospital. C. covering him with a warm blanket. D. giving him small sips of plain water.

D

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: Select one: a. a ruptured urinary bladder. b. a lacerated liver or spleen. c. external genitalia injury. d. blunt injury to the kidney.

D

All of the following systems contain organs that make up the contents of the abdominal cavity EXCEPT : A. the digestive system B. the urinary system C. the genitourinary system D. the limbic system

D

If the seat belt lies too high , it can do all of the following EXCEPT : A. squeeze abdominal organs . B. compress the great vessels C. fracture the lumbar spine D. rupture the appendix

D

Late signs of peritonitis may include : A. a soft abdomen B. abdominal distention . c . normal bowel sounds D. diarrhea

D

Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include: A. placing dry towels over the open wound. B. cleaning the exposed bowel with sterile saline. C. applying the PASG to stop the associated bleeding. D. applying an occlusive dressing, secured by trauma dressings.

D

Peritonitis usually occurs when: Select one: A. bacteria or viruses invade the walls of the gastrointestinal tract. B. the vessels that supply the abdominal organs become inflamed. C. solid abdominal organs bleed secondary to penetrating trauma. D. hollow abdominal organs are damaged and spill their contents.

D

Suspect kidney damage if the patient has a history or physical evidence of all of the following EXCEPT : A. an abrasion , laceration , or contusion in the flank B. a penetrating wound in the region of the lower rib cage or the upper abdomen C. fractures on either side of the lower rib cage D. a hematoma in the umbilical region

D

The first signs of peritonitis include all of the following EXCEPT : A severe abdominal pain B. tenderness C. muscular spasm D. nausea

D

What potentially injured organs are found in the left upper quadrant? A. Spleen and liver B. Spleen and ascending colon C. Spleen and gallbladder D. Spleen and stomach

D

When a hollow organ is punctured during a penetrating injury to the abdomen: Select one: A. the abdomen will become instantly distended. B. it will bleed profusely and rapidly cause shock. C. it commonly protrudes through the injury site. D. peritonitis might not develop for several hours.

D

When performing a history on a patient with abdominal trauma , all of the following questions would be appropriate regarding trauma EXCEPT : A. Is there any blood in your stool ? B. Does your pain go anywhere ? c . Do you have any nausea , vomiting , or diarrhea ? D. Are you having trouble with your hearing ?

D

When treating a patient with an evisceration , you should : A. attempt to replace the abdominal contents B. cover the protruding organs with a dry , sterile dressing c . cover the protruding organs with adherent dressings D. cover the protruding contents with moist , sterile gauze compresses

D

Which of the following are considered solid organs? A. Liver and intestines B. Kidneys and bladder C. Spleen and stomach D. Pancreas and spleen

D

Which of the following statements regarding abdominal trauma is correct? Select one: A. Hollow abdominal organs are vascular and bleed profusely when injured. B. Most of the vital abdominal organs lie within the retroperitoneal space. C. The liver is well protected and is rarely injured during a traumatic event. D. The absence of abdominal pain does not rule out intra-abdominal bleeding.

D

You have a patient with suspected kidney injury but no spinal injury . How should he be positioned ? A. Supine B. Prone C. Lateral recumbent D. Position of comfort

D

Peritonitis would MOST likely result following injury to the: A. liver. B. spleen. C. kidney. D. stomach.

D (hollow organ injuries cause peritonitis)

You respond to an 18 - year - old high school football player who was hit in the right flank with a helmet several hours ago . He is complaining of pain in the area . He is alert and oriented . His airway is open , and his respirations are within normal limits . His pulse is rapid and regular . He has a radial pulse . He tells you that he is noticing blood in his urine . Based on this information , the patient is likely to have an injury to the : A. liver B. kidney C. gallbladder D. appendix

B

Early bruising following abdominal trauma often manifests as: Select one: A. localized pain. B. gross distention. C. red areas of skin. D. dark purple marks.

C

Even when seat belts are worn properly and the airbags deploy, injury may occur to the: A. chest. B. extremities. C. iliac crests. D. lower ribcage

C

Open abdominal injuries are also known as : A. blunt injuries B. collapse injuries C. penetrating injuries D. peritoneal injuries

C

Signs of injury to the kidney may include any of the following EXCEPT: A. bruises or lacerations on the overlying skin B. shock C. vomiting D. hematuria

C

The ________is often injured during motor vehicle collisions , especially in the cases of improperly placed seat belts or impact from the steering wheel , falls from heights or onto sharp objects, bicycle and motorcycle crashes where the patient hits the handlebars on impact . A. pancreas B. heart C. spleen D. colon

C

You are dispatched to a motor vehicle collision . Your patient is a 42 - year - old restrained woman . The airbag deployed , and the woman has abrasions on her face . She is complaining of pain to both her chest and abdomen . Her airway is open , and respirations are within normal limits . Her pulse is a little rapid but strong and regular . She has distal pulses . In assessing this patient , which of the following statements is NOT true ? A. Bowel sounds may help confirm findings . B. Palpation is typically performed first with light touch . C. If light touch elicits pain , perform deep palpation to assess further injury . D. If you find an entry wound , you should always assess for an exit wound .

C

Which of the following organs would most likely bleed profusely when injured? Select one: A. Stomach B. Intestine C. Bladder D. Liver

D

You are called to the local bar where a fight has taken place . The police abdomen / min . On arrival , the department ; pulse is rapid , regular , and patient is alert tells you that you have a 36 - year - old man who has been stabbed twice in the and oriented . His airway is open . His respirations are at 24 breaths trauma , you should assume that the object has done weak . He has distal pulses . With the penetrating all of the following EXCEPT : A. has penetrated the peritoneum B. has entered the abdominal cavity c . has possibly injured one or more organs D. has damaged only the skin

D

Your patient has his penis caught in his zipper . What do you need to do to relieve the pressure ? A. Pull the pants off the patient . B. Force the zipper open . C. Remove the foreskin . D. Cut the zipper out of the pants

D