Trauma #7
Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. Aortic rupture B. Forehead lacerations C. Flail chest D. Extremity fractures
A. Aortic rupture
Which of the following is a LATE sign of a tension pneumothorax? A. Contralateral tracheal shift B. Bulging intercostal muscles C. Narrowing pulse pressure D. Profound shortness of breath
A. Contralateral tracheal shift
Which of the following assessment findings would you expect to see in a patient with a posterior hip dislocation and sciatic nerve involvement? A. Inability to dorsiflex the foot B. Weak or absent distal pulses C. Loss of flexion of the knee D. Hyperactive tendon reflexes
A. Inability to dorsiflex the foot
Which of the following abdominal organs would cause the MOST profuse bleeding when severely injured? A. Liver B. Spleen C. Pancreas D. Kidneys
A. Liver
Which of the following is the MOST acute and serious complication associated with a break in the integrity of the skin? A. Loss of fluids B. Hyperthermia C. Severe infection D. Vasodilation
A. Loss of fluids
Which of the following mechanisms of injury would MOST likely cause a shearing injury of the bladder from the urethra in a male? A. Motorcycle crash B. Blunt trauma to the flank C. Fall from a significant height D. Rear-end motor-vehicle crash
A. Motorcycle crash
Which of the following organs or tissues requires only intermittent circulation of blood? A. Muscles B. Brain C. Lungs D. Kidneys
A. Muscles
Which of the following injuries presents the greatest risk for severe internal bleeding? A. Pelvic fractures B. Rib fractures C. Tibial fractures D. Bilateral femur fractures
A. Pelvic fractures
Which of the following seatbelt positions will MOST likely result in severe intraabdominal injuries when a vehicle suddenly decelerates? A. Shoulder harness and lap belt placed superior to the iliac crest B. Use of the lap belt only with the shoulder harness behind the back C. Shoulder harness used and lap belt across the anterior iliac crest D. Shoulder harness not used and lap belt across the anterior iliac crest
A. Shoulder harness and lap belt placed superior to the iliac crest
Which of the following is the MOST effective method of immobilizing a fractured clavicle? A. Sling and swathe B. Modified wrist sling C. Short arm rigid splint D. Pillow or other padding
A. Sling and swathe
Which of the following physiologic responses occurs initially following a burn injury? A. Vasoconstriction and decreased blood flow to the burned area B. Massive edema as the fluid shifts into the extravascular space C. An inflammatory response and increased capillary permeability D. Electrolyte derangements and significant hypovolemia
A. Vasoconstriction and decreased blood flow to the burned area
When treating a patient who experienced a pulmonary blast injury, you should: A. avoid giving oxygen under positive pressure. B. administer large amounts of intravenous fluid. C. use a demand valve to ventilate the patient. D. suspect an accompanying cardiac tamponade.
A. avoid giving oxygen under positive pressure.
When treating a patient with a suspected myocardial contusion, it is especially important to monitor the patient for: A. evidence of pulmonary edema. B. a heart rate that exceeds 90/min. C. distention of the jugular veins.
A. evidence of pulmonary edema.
When using a Sager traction splint, you should apply traction that is approximately ____% of the patient's body weight to a maximum of ____ pounds. A. 5, 10 B. 10, 15 C. 15, 20
B. 10, 15
Which of the following conditions would allow an adult patient to MOST effectively compensate for external blood loss? A. 500 mL of blood loss over 30 seconds B. 500 mL of blood loss over 15 minutes C. 1,000 mL of blood loss over 20 minutes D. 750 mL of blood loss over 10 minutes
B. 500 mL of blood loss over 15 minutes
Which of the following sets of vital signs is MOST indicative of Cushing's triad? A. BP, 170/94 mm Hg; pulse, 120 beats/min; respirations, 24 breaths/min and shallow B. BP, 190/100 mm Hg; pulse, 68 beats/min; respirations, 30 breaths/min and irregular C. BP 90/60 mm Hg; pulse, 110 beats/min; respirations, 28 breaths/min and regular D. BP 100/50 mm Hg; pulse 50 beats/min; respirations, 34 breaths/min and irregular
B. BP, 190/100 mm Hg; pulse, 68 beats/min; respirations, 30 breaths/min and irregular
Which of the following factors has the MOST significant impact on determining the severity of a burn? A. The age of the patient B. Depth and extent of the burn C. Preexisting medical conditions D. Location of the burned areas
B. Depth and extent of the burn
Which of the following is the MOST significant acute complication associated with a laceration to the forearm? A. Severe pain B. External bleeding C. Severe infection D. Internal bleeding
B. External bleeding
Which of the following musculoskeletal injuries poses the GREATEST risk for compartment syndrome? A. Ankle fracture in an adult B. Humeral fracture in a child C. Hip fracture in an older adult D. Wrist fracture in an adolescent
B. Humeral fracture in a child
Which of the following injuries or conditions would MOST likely overwhelm the body's hemostatic response and result in death? A. Bleeding within the brain B. Ruptured aortic aneurysm C. Laceration to the liver D. Laceration to the spleen
B. Ruptured aortic aneurysm
Which of the following muscles is attached to the skeleton and forms the bulk of tissue of the arms and legs? A. Smooth B. Skeletal C. Autonomic D. Involuntary
B. Skeletal
Which of the following statements regarding anterior nosebleeds is correct? A. They are usually caused by a fracture of the basilar skull. B. They usually originate from the septum area and bleed slowly. C. They are usually severe and require aggressive treatment to control. D. They cause blood to drain into the posterior pharynx.
B. They usually originate from the septum area and bleed slowly.
Which of the following head-injured patients should be hyperventilated at a rate of 20 breaths/min with a bag-mask device and 100% oxygen? A. Semiconscious 34-year-old female with deep, regular breathing, bilaterally dilated and reactive pupils, and bradycardia. B. Unresponsive 21-year-old male with slow, irregular breathing, fixed and dilated pupils, and extensor posturing. C. Semiconscious 25-year-old female with rapid, shallow breathing, dilated and sluggish pupils, and hypertension. D. Unresponsive 30-year-old male with slow, shallow breathing, equal and reactive pupils, and hypotension.
B. Unresponsive 21-year-old male with slow, irregular breathing, fixed and dilated pupils, and extensor posturing.
Which of the following signs or symptoms would you MOST likely encounter in a patient who was struck in the back of the head? A. Loss of sensory perception B. Visual disturbances C. Abnormal behavior D. Loss of motor control
B. Visual disturbances
Which of the following describes an injury caused by indirect force? A. Rupture of the stomach following the blast phase of an explosion B. Knee striking the dashboard during a car crash and fracturing the patella C. A fall on an outstretched hand with a fractured wrist and a dislocated elbow D. Being struck by a car and sustaining a pelvic fracture and a closed head trauma
C. A fall on an outstretched hand with a fractured wrist and a dislocated elbow
When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. quadruples.
B. quadruples.
Which of the following patients should be assigned a Glasgow Coma Scale (GCS) score of 8? A. 22-year-old female who opens her eyes in response to pain, is unable to recall the year, and pushes your hand away when you palpate her abdomen B. 16-year-old female who opens her eyes when you talk to her, answers your questions inappropriately, and tells you her leg hurts C. 19-year-old male who does not open his eyes, is making mumbling sounds, and pulls his arm away when you are palpating it
C. 19-year-old male who does not open his eyes, is making mumbling sounds, and pulls his arm away when you are palpating it
Which of the following patients has experienced a critical burn? A. A 50-year-old with 9% full-thickness burns involving an upper extremity B. A 10-year-old with 45% superficial burns involving the chest and back C. A 65-year-old with 18% partial-thickness burns to both upper extremities D. A 31-year-old with 27% partial-thickness burns who takes antidepressants
C. A 65-year-old with 18% partial-thickness burns to both upper extremities
Which of the following is the MOST significant complication associated with facial injuries? A. Cervical spine injury B. External hemorrhage C. Airway compromise D. Damage to the eyes
C. Airway compromise
Which of the following medications or medical devices may inhibit the body's tachycardic response during shock? A. Aspirin B. Anticoagulant C. Beta-blocker D. Implanted defibrillator
C. Beta-blocker
Which of the following findings is LEAST suggestive of a head injury? A. One pupil larger in size than the other pupil B. Failure of the eyes to move in the same direction C. Briskly constricting pupils when exposed to light D. Failure of the eyes to follow movement of an object
C. Briskly constricting pupils when exposed to light
Which of the following statements regarding cerebral perfusion pressure (CPP) is correct? A. The minimum CPP that is needed to adequately perfuse the brain is 40 mm Hg. B. The body responds to a decrease in CPP by decreasing mean arterial pressure. C. CPP is the difference between mean arterial pressure and intracranial pressure.
C. CPP is the difference between mean arterial pressure and intracranial pressure.
Which of the following statements regarding blunt chest trauma is correct? A. Blunt chest trauma usually occurs during the tertiary phase of a blast injury. B. The force from blunt chest wall trauma is usually confined to a small area. C. Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs.
C. Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs.
Which of the following statements regarding electrical burns is correct? A. The size of entrance and exits wounds provides an indicator as to the degree of internal injury. B. When exposed to electricity, the human body is an excellent insulator because it is comprised primarily of water. C. Internal injury caused by an electrical burn is usually more severe than the external burns indicate. D. Ordinary household current can cause an electrical injury, but the burns are usually not severe.
C. Internal injury caused by an electrical burn is usually more severe than the external burns indicate.
Which of the following MOST accurately describes the pathophysiology of a pneumothorax? A. Accumulation of blood or other fluid in the pleural space B. Intrapulmonary pressure secondary to pleural compression C. Intrapleural pressure with progressive pulmonary collapse
C. Intrapleural pressure with progressive pulmonary collapse
Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash? A. Asking the patient if he or she was wearing a seatbelt B. Noting the position of the restraint system on the patient C. Lifting a deployed airbag and assessing the steering wheel D. Determining whether or not the airbag deployed on impact
C. Lifting a deployed airbag and assessing the steering wheel
Which of the following injuries would pose the LEAST threat to the patient? A. Single open long bone fracture B. Displaced fracture of the pelvis C. Major sprains at a major joint
C. Major sprains at a major joint
Which of the following chest injuries would be the LEAST likely to present with jugular venous distention? A. Pericardial tamponade B. Tension pneumothorax C. Massive hemothorax
C. Massive hemothorax
Which of the following mechanisms of injury is MOST commonly associated with traumatic dissection or rupture of the aorta? A. Significant falls B. Penetrating injuries C. Motorcycle crashes
C. Motorcycle crashes
Which of the following situations dictates removal of a football or motorcycle helmet? A. The patient complains of pain to the cervical spine. B. Transport time to the hospital is greater than 30 minutes. C. Respirations of 24 breaths/min and reduced tidal volume D. The patient is conscious but has a bad headache.
C. Respirations of 24 breaths/min and reduced tidal volume
When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injury because: A. it saves time on repeat assessments at the hospital. B. most patients with facial trauma will need surgery. C. a specialist may be needed to manage the injury. D. they must make arrangements for an ICU bed.
C. a specialist may be needed to manage the injury.
When treating a patient with a suspected diaphragmatic rupture, you should: A. apply 100% oxygen with a nonrebreathing mask. B. avoid administering more than 500 mL of crystalloid. C. avoid placing the patient in a Trendelenburg position.
C. avoid placing the patient in a Trendelenburg position.
Which of the following patients has experienced the MOST significant fall? A. A 5'-0" patient who fell 13' B. A 5'-9" patient who fell 14' C. A 4'-8" patient who fell 13' D. A 4'-6" patient who fell 13'
D. A 4'-6" patient who fell 13'
Which of the following signs or symptoms would you be LEAST likely to find during your assessment of a patient with a pneumothorax? A. Progressive respiratory difficulty B. Tachypnea with reduced tidal volume C. Unilaterally diminished breath sounds D. Contralateral shifting of the trachea
D. Contralateral shifting of the trachea
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. Intrusion into the vehicle B. Dismounted seats C. Steering wheel deformity D. Deployment of the air bag
D. Deployment of the air bag
Which of the following organs lie in the right upper quadrant of the abdomen? A. Spleen and liver B. Pancreas and liver C. Gallbladder and spleen D. Liver and gallbladder
D. Liver and gallbladder
Which of the following potentially lethal chest injuries would you be the LEAST likely to detect during the primary assessment? A. Flail chest B. Cardiac tamponade C. Bronchial disruption D. Pulmonary contusion
D. Pulmonary contusion
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. Elevation of the lower extremities B. Early administration of oxygen C. Intravenous fluid administration D. Rapid transport to a trauma center
D. Rapid transport to a trauma center
Which of the following organs or systems can survive the longest without oxygen? A. Gastrointestinal system B. Central nervous system C. The myocardium D. Skeletal muscles
D. Skeletal muscles
Which of the following injuries MOST accurately depicts an open fracture? A. Deformity to the radius and ulna with an overlying healing laceration B. Swelling and deformity to the tibia with a bulge from the fractured bone C. Deformity to the midshaft femur with ecchymosis and a large hematoma D. Swelling and deformity to the lateral humerus with an overlying abrasion
D. Swelling and deformity to the lateral humerus with an overlying abrasion
Which of the following has the MOST impact on the severity of radiation injury or type of health effect? A. Type of radiation and the patient's age B. The distance between the patient and the source C. The presence of any underlying medical conditions. D. The amount and duration of exposure
D. The amount and duration of exposure
Which of the following patients would benefit MOST from the application and inflation of the pneumatic antishock garment (PASG)? A. Unilateral femur fracture with a BP of 100/60 mm Hg B. Closed head trauma with a BP of 160/90 mm Hg C. Chest trauma with a systolic BP of 60 mm Hg D. Unstable pelvis with a BP of 80/50 mm Hg
D. Unstable pelvis with a BP of 80/50 mm Hg
