Chapter 33 Quiz

During an explosion, a 42-year-old construction worker sustained a large laceration to the lateral aspect of his neck when he was struck by a piece of flying debris. The patient is conscious, but complains of difficulty hearing. In addition to protecting his spine, you should be MOST concerned with: Select one: A.administering high-flow oxygen via nonrebreathing mask as soon as possible. B.covering the laceration with an occlusive dressing and controlling the bleeding. C.applying a bulky dressing to the laceration and securing it firmly with a bandage. D.carefully examining his ear to determine if his tympanic membrane is ruptured.

B.covering the laceration with an occlusive dressing and controlling the bleeding.

Signs and symptoms of retinal detachment include: Select one: A.paralysis of upward gaze and greater than 50% loss of central vision. B.flashing lights, specks, or floaters in the field of vision. C.immediate pain and total loss of vision following blunt eye trauma. D.double vision and partial or complete loss of peripheral vision.

B.flashing lights, specks, or floaters in the field of vision.

General care for an eye injury involves: Select one: A.covering both eyes to minimize further injury. B.applying direct pressure to the globe. C.irrigating the eye with sterile saline solution. D.applying a cold compress to the eyeball.

A.covering both eyes to minimize further injury.

A ruptured tympanic membrane: Select one: A.is extremely painful but typically heals spontaneously. B.is characterized by CSF leakage from the ears. C.commonly leads to an infection of the middle ear. D.commonly results in permanent hearing loss.

A.is extremely painful but typically heals spontaneously.

Proper treatment for an open wound to the neck includes: Select one: A.sealing the wound with an occlusive dressing. B.prompt transportation to a hyperbaric chamber. C.applying a circumferential pressure dressing. D.administering 2 L of IV crystalloid solution.

A.sealing the wound with an occlusive dressing.

Open soft-tissue facial trauma following a significant mechanism of injury: Select one: A.suggests that the patient may have a closed head injury or spinal injury. B.dictates the need for immediate intubation to protect the patient's airway. C.often requires removal of foreign bodies that are impaled in the face. D.is of most concern due to the possibility of permanent disfigurement.

A.suggests that the patient may have a closed head injury or spinal injury.

A flattened appearance to the face and loss of sensation over the cheek following blunt facial trauma is MOST indicative of a(n): Select one: A.zygomatic fracture. B.orbital skull fracture. C.temporomandibular joint dislocation. D.Le Fort I fracture.

A.zygomatic fracture.

Alkali or strong acid burns to the eye should be irrigated continuously for at least ___ minutes. Select one: A.15 B.20 C.30 D.10

B.20

Which of the following cranial nerves innervates the muscles that cause motion of the eyeballs and upper eyelids? Select one: A.Trigeminal B.Oculomotor C.Ophthalmic D.Optic

B.Oculomotor

If you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and severe oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform: Select one: A.pharmacologically assisted intubation. B.a needle or surgical cricothyrotomy. C.digital (tactile) intubation. D.nasotracheal intubation.

B.a needle or surgical cricothyrotomy.

Appropriate management for a patient with severe epistaxis, tachycardia, and diaphoresis following an injury to the face includes: Select one: A.positioning the patient supine and elevating his or her legs 12 to 18 inches. B.administering enough IV crystalloid fluids to maintain adequate perfusion. C.pinching the patient's nares together and instructing him or her to lean back. D.applying direct pressure to the bridge of the nose and keeping the patient calm.

B.administering enough IV crystalloid fluids to maintain adequate perfusion.

Following blunt trauma to the face, a 30-year-old man presents with epistaxis, double vision, and an inability to look upward. You should suspect: Select one: A.traumatic conjunctivitis. B.an orbital blowout fracture. C.traumatic retinal detachment. D.fracture of the cribriform plate.

B.an orbital blowout fracture.

Which of the following is the MOST significant complication associated with a fractured nasal bone? Select one: A.Facial swelling B.Lateral displacement C.Posterior epistaxis D.Damage to the septum

C.Posterior epistaxis

In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause: Select one: A.hemiparalysis. B.severe bradycardia. C.cerebral hypoxia. D.an air embolism.

C.cerebral hypoxia.

A fracture of all midfacial bones, separating the entire midface from the cranium: Select one: A.should be stabilized by placing bulky dressings across the fractured area. B.is almost always accompanied by multiple severe fractures of the mandible. C.is commonly associated with facial elongation and dental malocclusion. D.is referred to as a Le Fort I fracture and most commonly results from a fall.

C.is commonly associated with facial elongation and dental malocclusion.

A conscious but combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. You suction her oropharynx, but her mouth quickly refills with blood. You should: Select one: A.preoxygenate the patient with a bag-mask device for 2 minutes and then perform nasotracheal intubation. B.alternate suctioning of her oropharynx for 15 seconds and assisting ventilations for 2 minutes until her airway is clear of blood. C.roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation. D.continually suction her oropharynx until it is clear of blood, apply oxygen via nonrebreathing mask, and administer a sedative drug.

C.roll the backboard on its side, suction her oropharynx, and prepare to perform pharmacologically assisted intubation.

The primary risk associated with oral and dental injuries is: Select one: A.intraoral infection. B.permanent tooth loss. C.malocclusion. D.airway compromise.

D.airway compromise.

A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to: Select one: A.suction her oropharynx for up to 15 seconds. B.control the intraoral bleeding with sterile gauze. C.manually stabilize her head in a neutral position. D.ensure that she is sitting up and leaning forward.

D.ensure that she is sitting up and leaning forward.

Because significant force is required to fracture the mandible: Select one: A.a mandibular fracture can be ruled out in cases of minor blunt facial trauma. B.most mandibular fractures are associated with a spinal fracture. C.patients with a possible mandibular fracture should be intubated routinely. D.it is often fractured in more than one place and is unstable to palpation.

D.it is often fractured in more than one place and is unstable to palpation.

A young man was assaulted and has extensive maxillofacial injuries. Your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. Initial management for this patient involves: Select one: A.applying a cervical collar, performing a blind finger sweep to clear his airway, and providing ventilatory assistance with a bag-mask device. B.fully immobilizing his spine, inserting a nasopharyngeal airway, and hyperventilating him with a bag-mask device at a rate of 20 breaths/min. C.inserting an oropharyngeal airway, preoxygenating him with a bag-mask device for 2 minutes, and then intubating his trachea. D.manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.

D.manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.