Paramedic Chapter 36 - Abdominal and Genitourinary Trauma - Multiple Choice

Which of the following is indicative of a diaphragmatic rupture? A. Abdominal sounds in the chest B. Cullen sign C. Distended abdomen D. Peritonitis

A. Abdominal sounds in the chest

Which of the following is characterized by ecchymosis in the umbilical region caused by peritoneal bleeding? A. Cullen sign B. Beck's triad C. Kehr sign D. Grey Turner sign

A. Cullen sign

You are providing care for a 16-year-old male patient complaining of lower back pain. The patient was playing football and was tackled from behind and has been complaining of pain ever since. On closer inspection, the patient has some bruising in his right flank. Based on this information, the patient is demonstrating: A. Grey Turner sign and you should maintain a high index of suspicion for retroperitoneal injury. B. Grey Turner sign and you should maintain a high index of suspicion for abdominal injury. C. Cullen sign and you should maintain a high index of suspicion for retroperitoneal injury. D. Cullen sign and you should maintain a high index of suspicion for abdominal injury.

A. Grey Turner sign and you should maintain a high index of suspicion for retroperitoneal injury.

You are dispatched to the scene of a 19-year-old man who has been assaulted. When you arrive, you find the patient sitting on the sidewalk. A police officer at the scene is holding pressure to the patient's right upper abdomen with a blood-soaked gym towel. You observe no other obvious trauma injuries. Based on the location of the patient's wound, you should suspect injury to which of the following? A. Liver and possibly the gallbladder B. Stomach and possibly the spleen C. Urinary bladder D. Appendix

A. Liver and possibly the gallbladder

You are providing care for a 47-year-old male patient who was the front seat passenger of a car involved in a motor vehicle collision. The patient was wearing his seatbelt and the airbag did deploy. At this time, he is slightly confused and complaining of diffuse abdominal pain and tenderness. His vital signs appear within normal limits although his pulse is a little fast. Based on this information, your most appropriate action should be to: A. perform any primary interventions then rapid transport to the highest level of trauma center available. B. perform more in-depth assessment to determine the nature of organs involved then transport to the closest hospital. C. transport immediately to the closest appropriate receiving facility. D. provide rapid transport to the highest level of trauma center available.

A. perform any primary interventions then rapid transport to the highest level of trauma center available.

You are responding to a 20-year-old male patient who was assaulted a day ago. He is complaining of right flank pain. There is bruising on his right lateral abdomen and lower right back. He reports blood in his urine. Which organ do you suspect has been affected? A. Gallbladder B. Kidney C. Liver D. Urinary bladder

B. Kidney

Which of the following organs or structures lies in the retroperitoneal space? A. Spleen B. Pancreas C. Ascending colon D. Transverse colon

B. Pancreas

How should you treat a pregnant woman who you suspect has internal bleeding? A. Place her supine on a short backboard. B. Place her on her left side secured to a backboard lifted 15°. C. Place her in semi-Fowler position. D. Place her on her right side secured to a backboard lifted 15°.

B. Place her on her left side secured to a backboard lifted 15°.

Which of the following factors can decrease the potential damage caused by trauma to the abdomen? A. A seat belt that is worn above the iliac crests B. Toned abdominal muscles and an empty bladder C. Abdominal muscle tensing at the time of impact D. Air bags and being younger than 44 years old

B. Toned abdominal muscles and an empty bladder

A 39-year-old woman sustained an abdominal evisceration after she was cut in the abdomen with a machete. The patient is semiconscious and is breathing shallowly. You should: A. administer oxygen via nonrebreathing mask; cover the exposed bowel with dry, sterile dressings; start an IV and give a 500-mL fluid bolus; and transport to a trauma center. B. assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route. C. insert an oral airway, provide ventilatory assistance, cover the exposed bowel with aluminum foil, begin transport, and start two large-bore IV lines with normal saline en route. D. perform intubation to protect her airway; cover the exposed bowel with moist, sterile dressings; start an IV and give analgesia; and transport to a trauma center with fluid boluses en route.

B. assist ventilations with a bag-mask device; cover the exposed bowel with moist, sterile dressings and protect them from injury; transport at once; and initiate IV therapy en route.

With respect to penetrating injury, the most frequently injured organ is the: A. spleen. B. liver. C. diaphragm. D. small intestine.

B. liver.

You are providing care for a 22-year-old female patient who was assaulted with a knife. The patient has sustained an evisceration with a small amount of bowel exposed. The patient has sustained no other injuries and is alert. Based on this information, your most appropriate action should be to: A. irrigate with normal saline and gently place the organs back into the body, bandage, and transport to the closest appropriate hospital. B. place saline-soaked dressings on the wound and cover loosely, then transport to the closest receiving facility. C. apply a clean adhesive dressing and transport to the closest appropriate hospital. D. irrigate the wound with normal saline and transport to the closest appropriate hospital.

B. place saline-soaked dressings on the wound and cover loosely, then transport to the closest receiving facility.

External compression results in ______________. A. shearing in the aorta B. rupture of the hollow organs C. crushing of the solid organs D. perforation of the bladder

B. rupture of the hollow organs

A 24-year-old male intentionally placed a commercially manufactured constricting object around the base of his penis. He complains of moderate pain, and assessment of his penis reveals that it is cyanotic. You should: A. make one attempt to cut the constricting object away from his penis. B. transport him to the hospital and provide emotional support en route. C. apply ice to the area to reduce any swelling and then remove the object. D. administer a narcotic analgesic prior to removing the constricting object.

B. transport him to the hospital and provide emotional support en route.

What is hemoperitoneum? A. A diaphragmatic injury B. Blunt trauma to the liver C. A collection of blood in the abdominal cavity D. A collection of blood in the retroperitoneal space

C. A collection of blood in the abdominal cavity

___________ is an uncontrollable abdominal wall muscle contraction resulting from inflammation of the peritoneum. A. Guarding B. Ecchymosis C. Rigidity D. Rebound tenderness

C. Rigidity

When assessing a patient with abdominal trauma for distention, you should recall that: A. a distended abdomen is one of the earliest clinical findings in patients with abdominal trauma. B. abdominal distention is usually caused by muscle tensing rather than intraabdominal bleeding. C. a significant amount of blood volume in the abdominal cavity is required to produce distention. D. because distention is a late sign of intraabdominal bleeding, it should not be assessed for in the field.

C. a significant amount of blood volume in the abdominal cavity is required to produce distention.

A 17-year-old high school football player was struck in the abdomen by another player during a tackle. Your assessment reveals signs of shock and pain to the patient's left shoulder, which his unremarkable for trauma. Examination of the patient's abdomen is also unremarkable for obvious injury. Based on your assessment findings and the patient's clinical presentation, you should suspect: A. a lacerated liver. B. acute peritonitis. C. an injury to the spleen. D. retroperitoneal bleeding.

C. an injury to the spleen.

Gross hematuria and suprapubic pain following a pelvic injury is MOST indicative of injury to the: A. ureters. B. urethra. C. bladder. D. kidney.

C. bladder.

What are the most commonly injured abdominal organs? A. Appendix and colon B. Kidney and pancreas C. Large and small intestines D. Liver and spleen

D. Liver and spleen

Which of the following signs are consistent with abdominal hemorrhage? A. Tender abdomen, hypertension, and bradycardia B. Distention, hypotension, tachycardia, and shock C. Tachycardia, hypertension, and distention D. Periumbilical ecchymosis, distention, bradycardia, and shock

D. Periumbilical ecchymosis, distention, bradycardia, and shock

You are providing care to a 26-year-old male patient who sustained a laceration to his scrotum after a fall from some gym equipment. The laceration has moderate bleeding and the scrotal area feels spongy, and you can hear crepitus whenever the patient moves. Based on this information, which of the following statements is correct? A. The hemorrhage is minor, you should apply a clean dressing and ice pack to the wound and then transport to the closest appropriate facility. B. The hemorrhage is severe; you should apply a clean dressing and ice pack to the wound and then transport promptly to the closest appropriate facility. C. The injury is minor and you should complete your assessment and then make a transport decision. D. There are signs of pressure necrosis and the patient should be transported promptly to the closest appropriate hospital

D. There are signs of pressure necrosis and the patient should be transported promptly to the closest appropriate hospital

______________________ pain results from stretching, oxygen deprivation, and swelling. A. Superficial B. Referred C. Somatic D. Visceral

D. Visceral

During the third collision in a motor vehicle crash: A. hollow abdominal organs rupture upon impact. B. the person's abdomen collides with the steering wheel. C. rapid deceleration propels an unrestrained person forward. D. abdominal organs shear from their points of attachment.

D. abdominal organs shear from their points of attachment.

The periumbilical area refers to the: A. space behind the navel. B. external umbilical orifice. C. area lateral to the umbilicus. D. area around the umbilicus.

D. area around the umbilicus.

You are providing care for a 46-year-old female patient who was the driver of a car involved in a motor vehicle collision. The patient is awake and was wearing her seatbelt. At this time, she is complaining of pain in her right lower chest and there is bruising for her right lower ribs. Based on this information, you should also maintain a high index of suspicion for injuries to the: A. urinary bladder and intra-abdominal trauma. B. small intestine and peritonitis. C. kidneys and retroperitoneal organs. D. liver.

D. liver.

Because of its anatomic position in the retroperitoneum, it typically takes high-energy force to damage the: A. liver. B. spleen. C. stomach. D. pancreas.

D. pancreas.

You should base your suspicion of blunt abdominal trauma on ___________________. A. rigidity of the abdomen on palpation B. the location and amount of abdominal pain C. physical signs such as ecchymosis or abrasions D. the mechanism of injury

D. the mechanism of injury