Quiz 2.2

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Ritameeker
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246355
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Quiz 2.2
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2013-11-11 17:57:02
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trauma chest shock
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Quiz 2.2
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  1. Another name for an open pneumothorax is:

    A. tension pneumothorax
    B. flail chest
    C. hemopneumothorax
    D. sucking chest wound
    D. sucking chest wound
    (this multiple choice question has been scrambled)
  2. The location of the neurovascular bundles containing the intercostal arteries is best described as the bundle that runs along the:

    A. intercostal space equally distant from both associated ribs
    B. posterior surface of the associated rib
    C. superior margin of the associated rib
    D. inferior margin of the associated rib
    D. inferior margin of the associated rib
    (this multiple choice question has been scrambled)
  3. Your patient received a blow to the left lateral chest at the level of the sixth and seventh ribs.  You should suspect fractures at:

    A. the point of impact and the posterior axillary line of both ribs
    B. the point of impact on both ribs
    C. the point of impact of the sixth rib only
    D. the point of impact and the posterior axillary line of the sixth rib only
    A. the point of impact and the posterior axillary line of both ribs
    (this multiple choice question has been scrambled)
  4. Which of the following best describes the percentage of mortality from penetrating GSWs to the cranium?

    A. 35 -50
    B. 75 - 80
    C. 90 - 95
    D. 10 - 15
    B. 75 - 80
    (this multiple choice question has been scrambled)
  5. Your patient has a possible pelvic fracture from a frontal motor vehicle collision.  She has a bp of 78 by palpation, a HR of 130, and responds only to painful stimuli.  Before you arrived BLS providers immobilized the patient to a long backboard.  Which of the following should you do next?

    A. perform a rapid trauma assessment
    B. apply PASG
    C. initiate rapid transport
    D. start a large-bore IV of lactated ringer's solution
    C. initiate rapid transport
    (this multiple choice question has been scrambled)
  6. Which of the following is NOT a benefit of PASG?

    A. minimizing movement of the pelvis and lower extremities
    B. decreasing the size of the vascular container
    C. an autotransfusion of up to 2,000 ml of blood from the lower extremities
    D. increasing peripheral vascular resistance
    C. an autotransfusion of up to 2,000 ml of blood from the lower extremities
    (this multiple choice question has been scrambled)
  7. Which of the following changes is NOT of concern in the pregnant trauma patient?

    A. compression of the inferior vena cava
    B. disproportionate increase in vascular volume as compared to red blood cells
    C. the high likelihood of trauma to the uterus in the first trimester
    d. all of the above
    C. the high likelihood of trauma to the uterus in the first trimester
    (this multiple choice question has been scrambled)
  8. The morbidity associated with simple pneumothorax is primarily due to which of the following?

    A. occlusion of pulmonary circulation
    B. increased intrathoracic pressure
    C. loss of chest wall integrity
    D. ventilation/perfusion mismatch
    D. ventilation/perfusion mismatch
    (this multiple choice question has been scrambled)
  9. Which of the following early signs of shock is easily missed?

    A. tachycardia
    B. decrease in respiratory rate and volume
    C. narrowing pulse pressure
    D. decrease in blood pressure
    A. tachycardia
    (this multiple choice question has been scrambled)
  10. You have arrived on scene of a paramedic who was shot as she approached a residence on a call.  The scene has since been secured.  Your patient is a 38 yof with one GSW to the left side of the chest at the fifth intercostal space in the midaxillary line.  She is pale, cool, and awake but agitated.  She is diaphoretic and complaining of pain in her left  side and difficulty breathing.  The patient's EMT partner has applied oxygen by NRB and an occlusive dressing over the entry wound before your arrival.  As you continue your assessment, the patient's level of consciousness decreases.  She responds to verbal stimuli.  Her airway is clear, her RR is 38 and shallow, her neck veins are flat, and her breath sounds are absent on the left side.  The patient lacks a radial pulse, and the ABD is nonguarded and nontender.  Which of the following should you do first?

    A. assist ventilation with a BVM
    B. start a large-bore IV of isotonic crystalloid solution
    C. do a rapid trauma assessment
    D. do an immediate needle chest decompression
    D. do an immediate needle chest decompression
    (this multiple choice question has been scrambled)
  11. Which of the following represents the correct sequence for controlling hemorrhage from an extremity?

    A. direct pressure on the dressing and wound, finger pressure through the dressing to the leaking vessel, and, if pressure fails, application of a tourniquet
    B. direct pressure on the dressing and wound, elevation, ice
    C. direct pressure on the dressing and wound, elevation, ice, tourniquet as a last resort
    D. finger pressure through the dressing to the leaking vessel, splinting, ice, elevation
    A. direct pressure on the dressing and wound, finger pressure through the dressing to the leaking vessel, and, if pressure fails, application of a tourniquet
    (this multiple choice question has been scrambled)
  12. Your patient is a 17 yom driver of a vehicle that received a lateral impact at the driver's side door. There are no side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door.  Your patient is complaining of pain "in his left side."  He has a contusion on the left shoulder and deformity of the left clavivle.  He has erytherma over the left lateral thorax from ribs 6 through 12 with crepitus on palpation.  Which of the following injuries should you suspect?

    1. blunt trauma to the spleen
    2. bunt trauma to the liver
    3. penetrating trauma to the spleen
    4. penetrating trauma to the liver
    5. left pneumothorax
    6. fracture of the left clavicle
    7. soft tissue injury to the left shoulder

    A. 2, 5, 6
    B. 1, 3, 5, 6, 7
    C. 1, 5, 6
    D. 2, 4, 6, 7
    B. 1, 3, 5, 6, 7
    (this multiple choice question has been scrambled)
  13. Which of the following patients may have trauma to abdominal organs?

    1. a 30 year old construction worker who fell from a second-story roof but managed to land on his feet
    2. a 17 yom with a GSW to the right buttock
    3. a 50 yom with a stab wound 4 cm inferior to the right scapula
    4. a 45 yof restrained driver of an SUV with moderate-speed frontal impact

    A. 1, 3, 4
    B. 4
    C. 3, 4
    D. 1, 2, 3, 4
    D. 1, 2, 3, 4
    (this multiple choice question has been scrambled)
  14. The finding of JVD in the patient with thoracic trauma is LEAST likely to be associated with which of the following?

    A. traumatic asphyxia
    B. tension pneumothorax
    C. pericardial tamponade
    D. hemothorax
    D. hemothorax
    (this multiple choice question has been scrambled)
  15. Under normal circumstances, at any given moment most of the blood is in the _____ system.

    A. hematopoietic
    B. capillary
    C. venous
    D. arterial
    C. venous
    (this multiple choice question has been scrambled)
  16. Your patient is a 45 yom with extensive blunt trauma to the face.  He has decorticate posturing in response to pain; weak, irregular respiratory effort at 6 per minute; and a HR of 50 with a good radial pulse.  The patient appears to have nasal and mandibular fractures, and an OPA is insufficient to keep the tongue from the posterior pharynx.  Which of the following has the MOST potential to negatively impact the patient?

    A. a nonvisualized dual-lumen airway
    B. retrograde intubation
    C. oral intubation under direct laryngoscopy
    D. nasotracheal intubation
    D. nasotracheal intubation
    (this multiple choice question has been scrambled)
  17. Your patient is a 60 yof restrained driver involved  in a moderate-speed, frontal-impact collision.  When you arrive at the scene, she is sitting up in the driver's seat with a chief complaint of a burning sensation of her face.  You note abrasions from deployment of the airbag.  After immobilizing the patient on a long backboard, you begin transport.  As you perform a detailed examination, the patient complains of developing right shoulder pain.  Which of the following should you suspect?

    A. intraabdominal bleeding
    B. myocardial contusion
    C. shoulder contusion or possible clavicle fracture due to restraint by the shoulder
    D. exacerbation of the patient's arthritis due to immobilization on the backboard
    A. intraabdominal bleeding
    (this multiple choice question has been scrambled)
  18. Which of the following statements about the patient in neurogenic shock is NOT true?

    A. signs of hypovolemic shock may be masked
    B. the heart rate may be normal
    C. unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis
    D. neurogenic shock may be temporary, even if spinal cord damage is permanent
    C. unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis
    (this multiple choice question has been scrambled)
  19. Managing a laceration with arterial bleeding most often requires:

    A. direct pressure
    B. cauterization
    C. PASG
    D. a tourniquet
    A. direct pressure
    (this multiple choice question has been scrambled)
  20. Assuming all of the following patients have experienced significant blood loss and are hypotensive, in which would the use of PASG be absolutely contraindicated?

    A. 35 year-old pregnant female with bilateral femur fractures sustained in a head-on motor vehicle collision
    B. a 31 yom with a stab wound between his thoracic vertebral column and right scapula
    C. 16 yom with massive blood loss from a severed popliteal artery as a result of being struck by a piece of debris ejected by a lawn mower
    D. 19 yof with an unstable pelvis after being thrown from a horse
    B. a 31 yom with a stab wound between his thoracic vertebral column and right scapula
    (this multiple choice question has been scrambled)
  21. Which of the following can reduce the potential for abdominal injury?

    a. proper placement of automobile lap belts in adults
    b. side-impact airbags
    c. proper placement of automobile lap belts in children
    d. all of the above
    d. all of the above
  22. You have responded for an injured person at an address you know to be a motorcycle clubhouse.  Your patient was attacked by another party with a broken beer bottle.  Your patient has a large laceration on her neck with moderate bleeding.  Which property of your dressing material is most important in caring for this patient?

    A. occlusive
    B. sterile
    C. absorbent
    D. adherent
    A. occlusive
    (this multiple choice question has been scrambled)
  23. Recent research has provided evidence of which of the following regarding spinal-injury assessment?

    A. paramedics cannot reliably identify patients who are likely to have spinal injuries
    B. only trauma patients with signs and symptoms of neurological deficit need to receive spinal immobilization
    C. there are reliable criteria for determining the likelihood of spinal injury
    D. all trauma patients should be assumed to have spinal injuries
    C. there are reliable criteria for determining the likelihood of spinal injury
    (this multiple choice question has been scrambled)
  24. A laceration that is perpendicular to the tension lines of the body is more likely to:

    A. become infected
    B. be caused by blunt trauma
    C. leave a noticeable scar
    D. heal without a scar
    C. leave a noticeable scar
    (this multiple choice question has been scrambled)
  25. Which of the following indicates that a patient has transitioned from compensated to decompensated shock?

    A. increased respiratory rate
    B. peripheral vasoconstriction
    C. widening pulse pressure
    D. hypotension
    D. hypotension
    (this multiple choice question has been scrambled)

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