Paramedic vol. 4 chapter 2

When assessing a patient with a crush​ injury, which of the following findings would indicate that toxins have entered the central​ circulation?

Cardiac arrhythmia

The pathway of injury left in the wake of a penetrating mechanism of injury is​ called:

cavitation.

As a bullet​ tumbles, the potential to inflict​ damage:

increases.

You are called to the scene of a vehicle crash in which a car was​ rear-ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated index of suspicion for​ injuries?

A body at rest will remain at rest unless acted on by an outside force.

Which of the following scenarios would likely lead to the development of compartment​ syndrome?

A crush injury to the lower leg

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle​ collision?

A hubcap flies off and strikes a tree.

Which of the following is NOT considered penetrating​ trauma?

A laceration on the forehead as a result of being struck with a metal pipe

Which of the following is TRUE of shotgun​ ammunition?

A shotgun may either fire one slug or use ammunition with multiple pellets.

Which of the following injuries is associated with the pressure wave produced by a​ blast?

Pneumothorax

Which of the following​ "paper bag​ syndrome" injuries may occur due to sudden compression of the thorax or​ abdomen?

Pneumothorax and diaphragmatic rupture

Which of the following statements about stab wounds is​ TRUE?

Damage is usually limited to physical injury caused by direct contact between the blade and the​ victim's tissue.

If you were to design a bullet to have the highest energy​ exchange, what would you​ do?

Design the bullet to become more unstable.

Which of the following is typical of the trajectory of a knife when a female assailant stabs​ someone?

The movement is​ downward, as the assailant raises the knife and swings downward.

Which of the following statements about​ low-velocity penetrating trauma is​ TRUE?

​Knives, arrows, ice​ picks, and similar weapons cause damage only in their direct path.

Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting​ motion?

​Lateral-impact motor vehicle collision

Which pathway of patient travel results in higher mortality with a frontal impact​ collision?

​Up-and-over

Which of the following is TRUE of the injuries sustained by the elderly due to​ falls?

​​Less-significant falls may cause fractures.

Infants and very small children​ (up to two years of​ age) should have their child safety seat positioned where in a​ car?

The rear seating​ area, facing backward

Which of the following is TRUE of body armor​ use?

Blunt trauma may be​ significant, but the potential for​ life-threatening injury is less than if armor had not been worn.

Which of the following increases a​ bullet's profile?

Both A and C

Penetrating trauma to the face can complicate airway management by which of the following​ mechanisms?

Both B and C

Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating​ trauma?

Bowel

Applying​ Newton's second law of motion to a vehicle traveling 70 miles per​ hour, crashing into which of the following would transfer the most force to the​ patient?

Bridge abutment

Which of the following statements about entrance and exit wounds is​ TRUE?

Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.

Which of the following is TRUE of the temporary cavity formed by penetrating​ trauma?

It is a space indirectly created by a projectile as tissue moves rapidly away from its path.

Which of the following is most susceptible to damage from the pressure wave when a bullet enters​ it?

Liver

Which of the following is considered a​ high-velocity weapon?

Rifle

To gain an appreciation for the potential for trauma from​ high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to​ ________ times.

100

Which of the following is TRUE of the pressure wave that accompanies​ high-velocity penetrating​ trauma?

The pressure wave may be transmitted through​ blood, resulting in damage to blood vessels some distance from the primary wound.

Your​ patient, a​ 23-year-old woman who is 6 months​ pregnant, was the unrestrained driver of a vehicle that​ rear-ended a parked car. The air bag deployed. Considering the likelihood of organ​ collision, for which of the following injuries should you maintain a high index of​ suspicion?

Abruptio placentae

When inspecting the interior of a vehicle involved in a frontal​ collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries might this​ indicate?

All of the above

Which of the following affects the severity of injury sustained in a motor vehicle​ collision?

All of the above

Which of the following is TRUE about determining the pathway of the bullet when assessing a patient with a gunshot​ wound?

All of the above

Which of the following mechanisms may result in a conventional​ explosion?

All of the above

You have arrived on the scene of a​ 17-year-old male patient with a gunshot wound to the thigh. Police are on the scene. There is significant ongoing hemorrhage from the wound. The patient is screaming for someone to help him. Which of the following should you do​ first?

Ask the police if they have searched the patient for weapons yet.

Which of the following statements about rifles is​ TRUE?

Assault rifles generally increase the number of wounds the victim sustains.

Which of the following statements about bullets is​ TRUE?

A​ small, light bullet can do significant harm.

Your patient is a​ 50-year-old man with a gunshot wound to the right anterior chest. He is unresponsive. Which of the following should you do​ first?

Check for breathing.

During the scene​ size-up on a call for a patient with penetrating trauma due to a stab​ wound, which of the following should you​ do?

Check for weapons on or near the patient.

Which of the following is TRUE of the differences between adult and pediatric pedestrians when struck by a​ vehicle?

Children tend to be thrown under the vehicle.

Which of the following is most likely to be fractured from a fall onto outstretched​ hands?

Clavicle

Upon arriving at the scene of a​ single-vehicle collision in which the vehicle struck a utility​ pole, you note that the windshield is​ "starred," and that the driver is not restrained. Which of the following injuries is most​ likely?

Compression injury of the cervical spine

Which of the following injuries is associated with the tertiary phase of a​ blast?

Crush injuries

Which of the following injuries is NOT commonly related to​ snowmobiling?

Drowning

Which of the following statements is NOT true of occupant ejection in motor vehicle​ collisions?

Ejection has not been reported with​ lateral-impact collisions.

Which of the following may result from aggressive ventilation of the blast​ patient?

Emboli

Which type of motor vehicle collision is most common in rural​ areas?

Frontal

Which of the following is TRUE regarding a motorcycle​ collision?

Frontal impact can result in​ intraabdominal, pelvic, and femur injuries.

Axial loading is most likely to occur in which type of​ impact?

Frontal with an​ up-and-over pathway

People in which of the following age groups are prone to significant trauma due to​ falls?

Geriatric population

Which type of firearm usually limits trauma to direct​ injury?

Handgun

Which of the following injuries is most likely in a​ rear-end collision?

Head and neck injuries

Which of the following statements about the impact of motorcycle helmet usage is​ TRUE?

Helmet use neither increases nor decreases the incidence of cervical spine injury.

Frontal impacts in which the patient takes a​ "down-and-under" pathway typically result in which of the following injury​ patterns?

Hip and femur fractures

Which of the following is associated with assault rifle wounds but not hunting rifle​ wounds?

Multiple wounds

Your patient is a construction worker who fell 15 feet and has a​ 3-foot metal concrete reinforcement bar​ (rebar) impaled in his right thigh. Which of the following is the best​ action?

If the proper tools and personnel are​ present, have rescuers cut the rebar to a manageable length.

Which of the following statements is TRUE of the permanent cavity created by penetrating​ trauma?

It is filled with disrupted​ tissues, some​ air, fluid, and debris.

Which of the following is most likely to occur to the bullet when military ammunition is​ used?

It will remain intact.

​The branch of physics dealing with objects in motion and energy exchanges that occur as these objects collide is called​ what?

Kinetics

Your patient is a​ 30-year-old woman with a stab wound to the neck. She is sitting up and appears very anxious and short of breath. Minimal external bleeding is​ noted, but there is bubbling from the wound. Which of the following should you​ suspect, based on the mechanism of injury and assessment​ findings?

Laceration of the trachea

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a​ lateral-impact motor vehicle​ collision?

Lack of a crumple zone

For which of the following impacts should you maintain a higher index of suspicion because the degree of injury may be greater than the damage alone​ indicates?

Lateral

As the energy from a​ medium- or​ high-velocity projectile pushes tissue from its​ path, which of the following​ occurs?

Negative pressure is generated inside the​ cavity, drawing debris into the wound.

When a patient​ falls, which section of the spinal column is the most prone to compression​ injury?

Lumbar

Which of the following is the most important priority when caring for a patient with a​ shallow-water diving​ injury?

Maintaining cervical spine stabilization while opening the airway

Your patient is an​ 8-year-old boy with a pencil impaled 2 centimeters inferior to the xiphoid process. You note that the pencil is pulsating. Which of the following is the best​ action?

Stabilize the pencil in place and transport to a trauma center.

Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum​ teres?

Sudden deceleration

Which of the following is NOT a complication of crush​ injury?

Systemic alkalosis

​The primary assessment of a patient with a gunshot wound to the chest should focus on detecting which of the​ following?

Tension pneumothorax

As the mass of an object​ increases, which of the following​ occurs?

The amount of energy increases.

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier​ wall?

The body of the vehicle and its occupants absorb the energy.

Which of the following best defines the term​ energy?

The capacity to do work

Which of the following statements about lateral impact collisions is​ TRUE?

The degree of injury may be greater than the damage alone would indicate.

Which of the following is most important when assessing the damage done by a​ gunshot?

The distance from the shooter

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a​ stop?

The energy gradually dissipates as heat due to the friction of​ braking, rather than transferring to the vehicle and its occupants.

When the​ driver's chest strikes the steering wheel during a motor vehicle​ collision, what produces the next​ injury?

The heart continues its forward motion until it strikes the chest wall.

When you are assessing someone with a gunshot wound from a​ rifle, which of the following is important to​ remember?

The zone of injury is larger than that expected with other types of weapons.

Which of the following is TRUE of supplemental restraint​ systems?

They may deploy during rescue​ operations, injuring the patient​ and/or EMS personnel.

Which of the following is TRUE of defense wounds in the victim of a knife​ attack?

They usually occur to the hands and arms as the victim raises them to ward off the attacker.

A vehicle is struck in its right front as it passes through an​ intersection, resulting in an oblique impact. Which of the passengers is subjected to the greatest acceleration​ forces?

The​ left-rear passenger

Which of the following injuries is NOT associated with the use of vehicle restraint​ systems?

Traumatic brain injury

A penetrating injury to which of the following organs is LEAST likely to result in severe​ hemorrhage?

Ureter

Which two factors related to kinetic energy proportionately affect the damage a projectile will​ do?

Velocity and mass

Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a​ gun?

Velocity and mass

You have responded to a soccer field on which two​ 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency​ department?

Weakness in the upper extremities

Which statement about ballistics is​ TRUE?

When a bullet​ yaws, it increases the damage.

Which of the following factors is NOT a consideration in the severity of injury related to​ falls?

Wind resistance

Which of the following is best described as​ "the area of contused tissue resulting from penetrating trauma that may be slow to heal due to disrupted blood flow and tissue​ damage"?

Zone of injury

Vehicle supplemental restraint systems​ (air bags) are meant​ to:

absorb the energy exchange of rapid deceleration.

The two factors that refer to the rate of change of speed​ are:

acceleration and deceleration.

The study of the characteristics of projectiles in motion and their effects on the objects they impact is​ called:

ballistics

The path a projectile follows during a flight is called​ its:

trajectory.

Which of the following bullet characteristics would create the most​ damage?

​"Mushrooming" or flattening on impact

Greater velocity of a bullet will cause a​ ________ path of travel and a​ ________ trajectory.

​Flatter; straighter

Which of the following is NOT one of the major types of recreational vehicles involved in​ crashes?

​Go-karts