Quiz 4: Trauma and Trauma Systems

The purpose of determining the mechanism of injury and the index of suspicion for the trauma patient at the same time is to allow you to: A) decide whether to transport the patient. B) identify comorbid factors. C) document a complete scene size-up. D) anticipate your patient's injuries.

Which of the following accounts for the highest number of trauma deaths in the United States of America? A) Motor vehicle crashes B) Falls C) Assaults D) Firearms injuries

Which of the following acts resulted in the development of modern EMS systems? A) Ryan White Act B) Highway Safety Act of 1966 C) Good Samaritan Act D) The Trauma Care Systems Planning and Development Act of 1990

In addition to handling all types of specialty trauma, which level of trauma center provides continuing medical and public education programs? A) IV B) III C) I D) II

Upon arriving on a scene where the mechanism of injury indicates a potentially life-threatening injury, you should employ which of the following interventions to best help deliver the care that is needed? A) Reevaluate the scene size-up. B) Initiate transport immediately, delaying more extensive care until you are en route. C) Ask a surgeon to respond to the scene. D) Call immediately for air medical transport to reduce the "Golden Period."

Which of the following physical findings indicates the need for immediate transport? A) Vital signs: systolic blood pressure 80, respiratory rate 8 B) Glasgow Coma Scale score of 15 C) Second-degree burns involving 9 percent of total body surface area in an adult patient D) Fractured right femur

Which of the following requires immediate transport to a trauma center? A) A 40-year-old who fell 12 feet from a garage roof with a radius fracture B) A 36-year-old woman in a motor vehicle crash who has a blood pressure of 100/60 C) A 22-year-old soccer player with lower leg pain D) A 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

As a paramedic, your role in trauma care consists of all of the following, EXCEPT: A) providing rapid transport to appropriate facilities. B) promoting injury prevention. C) providing care to seriously injured trauma patients. D) providing surgical interventions to stop hemorrhage.

Trauma triage criteria application, field skill performance, response times, patient assessment, patient care and transport are all monitored through which of the following? A) Quality improvement B) Trauma registry C) Centers for Disease Control and Prevention D) Public healthcare model

Which of the following is the best definition of the Golden Period? A) The ideal time it takes to assess a multi-system trauma patient B) The ideal timeframe from time of injury until surgery C) The ideal time from requesting a helicopter to it landing on scene D) The ideal timeframe from call dispatch to arrival on scene

Which of the following is NOT an example of trauma? A) An abrasion to the knee B) Chest pain C) Cerebral contusion D) A stab wound to the abdomen

Establishment of educational programs and improved auto technology are examples of which part of the public health model? A) Surveillance B) Risk identification C) Intervention D) Implementation

Which level of trauma facility has minimal surgical support but can stabilize before transferring to a higher-level trauma facility? A) III B) II C) IV D) I

Which of the following statements about trauma is FALSE? A) Life-threatening injuries may exist with little external evidence. B) Dramatic-appearing extremity injuries draw the paramedic's focus away from life-threatening injuries. C) Life-threatening injury occurs in less than 10 percent of trauma patients. D) Most patients with life-threatening trauma will have sustained external injury to the extremities (arms/legs).

The leading cause of death in people under age 44 is: A) heart attack. B) trauma. C) cancer. D) cardiovascular disease.

Which of the following patients is NOT a candidate for air medical transport? A) Combative trauma patient B) Seriously injured patient with cardiac tamponade C) Patient with prolonged extrication time D) Burn patient with over 50 percent second-degree burns

Which of the following trauma patients would be classified as "stable"? A) Patient with facial burns and associated hoarseness and stridor B) Patient who is unconscious, with no ventilations and no pulse C) Patient with controlled bleeding from a laceration to the right forearm from a glass cut D) Patient with closed, bilateral femur fractures but adequate ventilations

Modern medicine treats trauma as a: A) crisis. B) disease. C) life threat. D) medical problem.

A trauma center that has surgical care capability available at all times and can handle all but the most seriously injured specialty and multisystem trauma patients is a Level ________ trauma center. A) III B) I C) IV D) II

Which of the following is the best, most cost-effective way for EMS personnel to help reduce trauma-related morbidity and mortality? A) Participate in injury prevention programs. B) Keep up to date on trauma management knowledge and skills. C) Transport all trauma patients to a trauma center. D) Provide complete patient care reports so that accurate data can be entered into the trauma registry.

Which level of trauma facility strictly stabilizes trauma patients and prepares to transport, often by helicopter, to a more distant and higher-level trauma center? A) I B) II C) IV D) III

Which of the following mechanisms would yield the greatest index of suspicion for serious injury? A) Helmeted bicyclist losing control and falling off his bike onto a grassy surface at 15 miles per hour B) Adult falling 5 feet from a ladder and landing in the mud C) Seventy-mile-per-hour motor vehicle crash with partial ejection D) Pedestrian struck by a car travelling 5 miles/hour

Which level of trauma facility can provide neurosurgery, microsurgery, and care for multisystem trauma? A) III B) II C) I D) IV

Which of the following patients does NOT require specialty-center capabilities beyond that offered by a trauma center? A) A 67-year-old with second- and third-degree burns over 50 percent of the body B) A 25-year-old with amputation of three fingers C) A 4-year-old with a closed-head injury D) A 22-year-old with bilateral open femur fractures

Which of the following best differentiates medical and trauma patient assessment? A) There is no concept for "medical load and go" patients. B) Trauma triage guidelines are not critical with medical patients. C) Scene safety is not an issue with the medical patient. D) Assessing breath sounds is not crucial to trauma assessment.

Which of the following is the only way to determine which patient care procedures benefit trauma patients? A) Surveillance B) Risk identification C) Implementation D) Evaluation

Which of the following is an acceptable way of reducing prehospital time to maximize the use of the "Golden Period" for trauma patients? A) Skip spinal immobilization in the blunt trauma patient. B) Start all IVs on the scene to allow for more rapid transport. C) Load the patients and begin transport before doing a primary assessment. D) Call for air medical transport, if indicated.

Which of the following is a "mental summation of suspected injuries based on the event analysis"? A) Index of injury B) Index of suspicion C) Newton's First Law of Motion D) Mechanism of injury

You assess a trauma patient who has an airway that cannot be maintained or secured. How should this patient be classified? A) Critical B) Unstable C) Potentially unstable D) Stable

According to the Haddon Matrix, which of the following would be a pre-event host factor affecting the risk for injury in a vehicle collision? A) Level of EMS providers responding to the scene B) Presence of crash barriers near bridge abutments C) Texting and/or talking on a cellphone while driving D) Advanced automatic collision notification

Vehicle supplemental restraint systems (air bags) are meant to: A) prevent unrestrained occupants from taking the down-and-under pathway in frontal impacts. B) protect infants and children who ride in the front seat of the vehicle. C) prevent injury from secondary impacts. D) absorb the energy exchange of rapid deceleration.

When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation? A) Hot, red skin B) Increased urine output C) Cardiac arrhythmia D) Central hyperventilation syndrome

People in which of the following age groups are prone to significant trauma due to falls? A) College-aged adults B) Geriatric population C) Pediatric population D) Teenagers

Which of the following is NOT a complication of crush injury? A) Renal failure B) Difficult-to-control hemorrhage C) Cardiac arrhythmias D) Systemic alkalosis

The two factors that refer to the rate of change of speed are: A) deceleration and velocity. B) mass and weight. C) acceleration and deceleration. D) acceleration and inertia.

Which of the following injuries is MOST likely in a rear-end collision? A) Thoracic and abdominal injuries B) Head and neck injuries C) Pelvic fractures D) Lumbar spine injuries

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) The amount of energy transmitted to an object is inversely proportional to its rate of deceleration. B) Energy can neither be created nor destroyed. C) A body at rest will remain at rest unless acted on by an outside force. D) A body in motion will remain in motion unless acted on by an outside force.

When a patient falls, which section of the spinal column is the most prone to compression injury? A) Sacral B) Cervical C) Thoracic D) Lumbar

Which of the following injuries is NOT associated with the use of vehicle restraint systems? A) Traumatic brain injury B) Abrasions and contusions to the clavicle and chest area C) Lumbar spine trauma D) Abdominal injury

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? A) Bridge abutment B) Shrubbery C) A body of water D) Signpost

Which of the following is TRUE of the differences between adult and pediatric pedestrians when struck by a vehicle? A) Adults tend to be thrown under the vehicle. B) Children tend to be thrown onto the hood of the vehicle. C) Children tend to be thrown under the vehicle. D) Adults tend to have injuries higher on the body.

Which of the following is MOST likely to be fractured from a fall onto outstretched hands? A) Carpals B) Metacarpals C) Clavicle D) Ulna

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? A) Cardiac contusion B) Anterior flail segment C) Abruptio placentae D) Fractured sternum

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? A) Braking allows the kinetic energy to be absorbed evenly into the frame of the vehicle, rather than concentrating it at the point of impact. B) The energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants. C) The inertia of the tree increases the kinetic energy transmitted to the occupants by a factor of 10. D) None of the above describes why.

Which pathway of patient travel results in higher mortality with a frontal impact collision? A) Vertical B) Straight C) Up-and-over D) Down-and-under

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? A) Whiplash injury of the neck muscles B) Compression injury of the cervical spine C) Distraction injury of the cervical spine D) Ligamentous neck injury due to rotation beyond the range of motion

Which of the following factors is NOT a consideration in the severity of injury related to falls? A) Landing surface B) Wind resistance C) The initial point of impact D) Distance of the fall

Which of the following is TRUE regarding a motorcycle collision? A) Frontal impact can result in intraabdominal, pelvic, and femur injuries. B) A rider who "lays down the bike" will generally receive more severe injuries than a rider who stays with the bike. C) The structural steel of the vehicle absorbs most of the kinetic energy in a motorcycle collision. D) The use of helmets has drastically reduced the incidence of cervical spine injuries.

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? A) Rear-end B) Oblique C) Lateral D) Frontal

Which of the following best defines the term energy? A) The ability to deform solid objects B) The rate of motion related to time C) The capacity to do work D) The amount of heat generated through friction

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision? A) Increased gravitational forces due to multiple changes in direction and velocity B) Lack of a crumple zone C) Taking the up-and-over pathway D) The force of side-impact air bag deployment

Which of the following injuries is NOT commonly related to snowmobiling? A) Ejections B) Crush injuries C) Drowning D) Glancing blows against obstructions in the snow

Which of the following is the most important priority when caring for a patient with a shallow-water diving injury? A) Assessing the cervical spine for deformity B) Maintaining cervical spine stabilization while opening the airway C) Removing the patient from the water as soon as possible D) Initiating rescue breathing once out of the water

Which of the following affects the severity of injury sustained in a motor vehicle collision? A) Gross vehicle weight B) Rate of acceleration or deceleration C) Vehicle speed D) All of the above

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle collision? A) The vehicle strikes an object. B) The occupants' organs strike the interior of the body cavity. C) The body of the occupant strikes the interior of the vehicle. D) A hubcap flies off and strikes a tree.

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? A) The energy dissipates as sound waves. B) The body of the vehicle and its occupants absorb the energy. C) The wall's foundation absorbs the energy. D) The energy converts to heat through friction.

Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a gun? A) Friction and distance B) Mass and friction C) Velocity and mass D) Friction and velocity

Which of the following injuries is associated with the pressure wave produced by a blast? A) Pneumothorax B) Lacerated liver C) Fractures D) Ruptured spleen

Axial loading is MOST likely to occur in which type of impact? A) Frontal with an up-and-over pathway B) Frontal with a down-and-under pathway C) Rear with the headrest too low D) Lateral on the side of the vehicle opposite the occupant

Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen? A) Pulmonary and myocardial contusions B) Pneumothorax and diaphragmatic rupture C) Cardiac tamponade and aortic dissection D) Pneumothorax and myocardial contusion

Which of the following statements about lateral impact collisions is TRUE? A) The substantial lateral crumple zone prevents most injuries. B) Damage to the vehicle is a reliable indication of the seriousness of injuries. C) The degree of injury may be greater than the damage alone would indicate. D) Fatalities are rare because the upper extremities absorb the energy.

Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting motion? A) Direct trauma, such as from a blow to the head B) Low-velocity penetrating trauma from an ice pick C) High-velocity penetrating trauma from a gunshot wound D) Lateral-impact motor vehicle collision

Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns? A) Traumatic brain injury B) Hip and femur fractures C) Rupture of the diaphragm D) Rupture of hollow organs

Which of the following scenarios would likely lead to the development of compartment syndrome? A) A crush injury to the lower leg B) A loose-fitting cast that covers the thigh and leg C) An excessive release of intracellular potassium D) A tennis shoe that doesn't fit correctly

Which of the following is TRUE of the injuries sustained by the elderly due to falls? A) The injuries sustained by the elderly are less likely to result in hospitalization. B) Only more significant falls cause fractures. C) Less-significant falls may cause fractures. D) The elderly sustain injuries similar to other age groups in comparable falls.

Which of the following is NOT one of the major types of recreational vehicles involved in crashes? A) Snowmobiles B) Jet skis C) All-terrain vehicles D) Go-karts

Infants and very small children (up to two years of age) should have their child safety seat positioned where in a car? A) The front seating area, facing backward B) The rear seating area, facing backward C) The front seating area, facing frontward D) The rear seating area, facing frontward

When the driver's chest strikes the steering wheel during a motor vehicle collision, what produces the next injury? A) The air bag deploys a second time. B) The steering column shears off, causing penetrating trauma. C) Unsecured objects in the vehicle become projectiles. D) The heart continues its forward motion until it strikes the chest wall.

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? A) Fracture of the acetabulum B) Femur fracture C) Knee injury D) All of the above

Which of the following injuries is associated with the tertiary phase of a blast? A) Crush injuries B) Barotrauma C) Burns D) Projectile injuries

Which of the following statements about the impact of motorcycle helmet usage is TRUE? A) Helmet use moderately increases the incidence of cervical spine injury. B) Helmet use moderately decreases the incidence of cervical spine injury. C) Helmet use substantially decreases the incidence of cervical spine injury. D) Helmet use neither increases nor decreases the incidence of cervical spine injury.

Which of the following mechanisms in a motor vehicle collision would MOST likely result in a tear of the liver at the ligamentum teres? A) Gradual deceleration B) Sudden acceleration C) Sudden deceleration D) Gradual acceleration

Which of the following statements is NOT true of occupant ejection in motor vehicle collisions? A) Ejection accounts for 27 percent of motor vehicle fatalities. B) The number of occupant impacts increases with ejection. C) Ejection has not been reported with lateral-impact collisions. D) Ejection is most often associated with frontal-impact collisions.

Which of the following may result from aggressive ventilation of the blast patient? A) Emboli B) Pericardial tamponade C) Hemorrhage D) Acidosis

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? A) The right-rear passenger B) The left-rear passenger C) The front-seat passenger D) The driver

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? A) Weakness in the upper extremities B) Complaint of "getting the wind knocked out of me" C) Contusion to the thigh D) Minor epistaxis

Which type of motor vehicle collision is most common in rural areas? A) Frontal B) Lateral C) Rollover D) Rear-end

The branch of physics dealing with objects in motion and energy exchanges that occur as these objects collide is called what? A) Kinematics B) Kinetics C) Inertia D) Force

Which of the following is TRUE of supplemental restraint systems? A) They may deploy during rescue operations, injuring the patient and/or EMS personnel. B) When worn incorrectly, they may cause spinal injury or decapitation. C) They guard against thoracic impact with the steering wheel. D) They are primarily useful in preventing injury to infants and children riding in the front seat.

Which of the following mechanisms may result in a conventional explosion? A) Fumes B) Dust C) Natural gas D) All of the above

Which of the following statements about low-velocity penetrating trauma is TRUE? A) Shorter knives and ice picks may be removed if they are left in the wound. B) There is no pressure shock wave with a knife wound as there is with an arrow wound. C) More injuries are sustained from arrows than from knives. D) Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.

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? A) Start an IV and request orders for analgesia and sedation. B) Remove the pencil and apply direct pressure to the wound; transport to a trauma center if the bleeding does not stop with direct pressure. C) Stabilize the pencil in place and transport to a trauma center. D) Stabilize the pencil in place and transport to the nearest medical facility.

The pathway of injury left in the wake of a penetrating mechanism of injury is called: A) cone of injury. B) cavitation. C) profile. D) trajectory.

Which of the following statements is TRUE of the permanent cavity created by penetrating trauma? A) It is filled with disrupted tissues, some air, fluid, and debris. B) It is the damage done when the projectile fragments penetrate. C) It is a space created by a projectile as tissue moves rapidly away in its path. D) It is a potential space, not an actual space.

Which of the following is TRUE of the pressure wave that accompanies high-velocity penetrating trauma? A) Hollow organs are less tolerant of the stress than solid organs are. B) Pressure waves cause no injury to surrounding tissues; they only momentarily disrupt function. C) Elastic tissues are less tolerant of the stress than non-elastic tissues. D) The pressure wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

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? A) Check for a carotid pulse. B) Seal the chest wound. C) Auscultate breath sounds. D) Check for breathing.

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? A) Laceration of the trachea B) An injury to the spinal cord at the level of the stab wound C) Laceration of the ipsilateral carotid artery D) All of the above

If you were to design a bullet to have the highest energy exchange, what would you do? A) Decrease the drag. B) Increase the caliber. C) Decrease the bullet's trajectory. D) Design the bullet to become more unstable.

Which of the following is most important when assessing the damage done by a gunshot? A) The type of gun used B) The size of the bullet C) The distance from the shooter D) Whether there was an upward or a downward trajectory when the bullet was fired

A penetrating injury to which of the following organs is LEAST likely to result in severe hemorrhage? A) Liver B) Kidney C) Spleen D) Ureter

Which of the following is TRUE of shotgun ammunition? A) A shotgun may either fire one slug or use ammunition with multiple pellets. B) The shot is dispersed from the cartridge with high velocity. C) The closer the shooter is to the victim, the larger the area of visible damage. D) "Double ought" or #00 shot contains a large number of relatively small pellets.

Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating trauma? A) Spleen B) Bowel C) Kidneys D) Liver

The study of the characteristics of projectiles in motion and their effects on the objects they impact is called: A) trajectory. B) cavitation. C) ballistics. D) forensics.

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? A) Control hemorrhage with direct pressure. B) Perform a rapid trauma assessment. C) Ask the police if they have searched the patient for weapons yet. D) Begin high-concentration oxygen administration.

As a bullet tumbles, the potential to inflict damage: A) increases. B) remains the same. C) is determined by the trajectory. D) decreases.

The path a projectile follows during a flight is called its: A) cavity. B) ballistics. C) trajectory. D) drag.

Which of the following is TRUE of body armor use? A) There are no reported cases of penetrating trauma among victims who were shot while wearing body armor. B) Blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn. C) Blunt trauma occurs only if ceramic inserts are placed in the vest. D) Ceramic inserts are dangerous and should not be used, because they generally fragment and create secondary projectiles when they are struck by a bullet.

Which of the following is most susceptible to damage from the pressure wave when a bullet enters it? A) Intestines B) Femoral artery C) Liver D) Lungs

Which of the following is TRUE about determining the pathway of the bullet when assessing a patient with a gunshot wound? A) You should try to determine the bullet's pathway. B) The purpose of determining the bullet's pathway is to anticipate which organs may have been affected, which will help to guide your priorities for on-scene care or rapid transport. C) It is difficult to determine the pathway of a bullet because it may not travel in a straight line, possibly being deflected by structures in its path or being shifted by natural movements of the diaphragm and other organs and structures of the body. D) All of the above

Which statement about ballistics is TRUE? A) Damage is less when the bullet does not exit the body. B) When a bullet tumbles, it decreases the damage. C) In penetrating trauma, the mass of a projectile is more significant than its velocity when determining kinetic energy. D) When a bullet yaws, it increases the damage.

When you are assessing someone with a gunshot wound from a rifle, which of the following is important to remember? A) The zone of injury is larger than that expected with other types of weapons. B) The muzzle velocity is less than that of a handgun. C) The trajectory is longer, allowing more energy to be dissipated by drag before it strikes the victim. D) The cavitation is limited to the direct path of the bullet.

Which of the following is typical of the trajectory of a knife when a female assailant stabs someone? A) The trajectory is lateral: right-to-left if she is right-handed and left-to-right if she is left-handed. B) The movement is downward, as the assailant raises the knife and swings downward. C) The movement is upward, as the assailant drives upward with the knife. D) The trajectory tends to be in a horizontal plane at the level of the assailant's shoulder.

Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory. A) wavier; straighter B) flatter; wavier C) more rounded; curved D) flatter; straighter

Which of the following is TRUE of the temporary cavity formed by penetrating trauma? A) It heals more slowly than the permanent cavity because of the nature of the tissue damage. B) It fills with disrupted tissues, some air, fluid, and debris. C) It is a space indirectly created by a projectile as tissue moves rapidly away from its path. D) It is the damage that occurs when the projectile fragments.

Which of the following is TRUE of defense wounds in the victim of a knife attack? A) They usually occur to the shoulder as the victim attempts to turn away from the attack. B) They often occur to the neck and head as the victim doubles over into a protective posture. C) They usually occur to the hands and arms as the victim raises them to ward off the attacker. D) They rarely occur because the victim is usually taken by surprise.

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. A) 25 B) 100 C) 50 D) 80

Which of the following is associated with assault rifle wounds but not hunting rifle wounds? A) Permanent cavitation B) Multiple wounds C) Smaller exit wounds D) Larger exit wounds

Which of the following statements about bullets is TRUE? A) A high-velocity bullet is three times less likely to do major harm. B) The larger the bullet, the smaller its energy. C) A small, light bullet can do significant harm. D) The hunting rifle's bullet is usually a lighter bullet, but it travels faster.

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? A) Collect anything that could be used as evidence. B) Check for weapons on or near the patient. C) Try to find out in which direction the assailant fled. D) Assume that the patient has no weapons if law enforcement is on the scene.

Which of the following statements about stab wounds is TRUE? A) The presence of defense wounds decreases the likelihood of trauma to the neck, thorax, and abdomen. B) Damage is usually limited to physical injury caused by direct contact between the blade and the victim's tissue. C) The size and shape of the weapon allow precise prediction of the injury. D) Stab wounds by female attackers are seldom lethal.

Which of the following statements about entrance and exit wounds is TRUE? A) Exit wounds are usually the size of the bullet's profile. B) Entrance wounds most often appear as stellate. C) Cavitational wave energy is greatest at a bullet's point of entrance. D) 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 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"? A) Temporary cavity B) Zone of injury C) Zone of coagulation D) Permanent cavity

Penetrating trauma to the face can complicate airway management by which of the following mechanisms? A) Laryngotracheal edema B) Airway obstruction C) Destruction of anatomical landmarks D) Both B and C

The primary assessment of a patient with a gunshot wound to the chest should focus on detecting which of the following? A) Pancreatitis B) Tension pneumothorax C) Cardiac contusion D) Peritonitis

Which two factors related to kinetic energy proportionately affect the damage a projectile will do? A) Velocity and yaw B) Velocity and mass C) Mass and fragmentation D) Fragmentation and velocity

Which type of firearm usually limits trauma to direct injury? A) Hunting rifle B) Military rifle C) Automatic weapon D) Handgun

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? A) Administer sodium bicarbonate to combat acidosis resulting from the destruction of muscle tissue. B) If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length. C) If you can see both ends of the rebar, gently remove it and irrigate the wound with sterile saline. D) Transport the patient without attempting to shorten or remove the rebar.

Which of the following bullet characteristics would create the most damage? A) Lack of tumble B) A small profile C) A full metal jacket D) "Mushrooming" or flattening on impact

As the mass of an object increases, which of the following occurs? A) The maximum speed it can attain increases. B) The amount of energy decreases. C) The maximum speed it can attain decreases. D) The amount of energy increases.

Which of the following statements about rifles is TRUE? A) Assault rifles generally increase the number of wounds the victim sustains. B) Hunting rifles have larger magazines and operate semiautomatically. C) Assault rifles do not accept domestic hunting ammunition and thus create a projectile profile that is smaller and causes less damage. D) Assault rifles have greater velocity than hunting rifles and only operate automatically.

Which of the following is NOT considered penetrating trauma? A) Receiving a wood splinter in the foot while walking on an unfinished deck B) A superficial wound resulting from a pellet from a pellet gun being lodged under the skin C) A laceration from a kitchen knife D) A laceration on the forehead as a result of being struck with a metal pipe

Which of the following increases a bullet's profile? A) "Mushrooming" on impact B) The use of rifling in the barrel of the firearm C) Tumbling 180 degrees on impact D) Both A and C

As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs? A) Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound. B) No vacuum is created when there are both an entrance and an exit wound. C) Negative pressure is generated inside the cavity, drawing debris into the wound. D) There is negative pressure at the entrance wound and positive pressure at the exit wound.

Which of the following is MOST likely to occur to the bullet when military ammunition is used? A) It will "mushroom" or flatten. B) It will remain intact. C) It will fragment. D) It will explode.

Which of the following is considered a high-velocity weapon? A) Shotgun B) Arrow C) Handgun D) Rifle

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic shock? A) Administer hypertonic saline solution or colloids at a keep-open rate. B) Administer synthetic oxygen-carrying fluids as necessary to increase the level of consciousness. C) Begin with a 2,000 mL bolus of isotonic crystalloid solution infused under pressure. D) Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Your patient is a 23-year-old man with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal stimuli; has pale, cool, diaphoretic skin; and has a heart rate of 128, respirations at 24, and a blood pressure of 82/60. These findings indicate which of the following kind of shock? A) Compensated B) Irreversible C) Decompensated D) Neurogenic

As a patient with hemorrhagic blood loss becomes more acidotic, what homeostatic process is usually impaired? A) Coagulation B) Hemoptysis C) Vascular phase D) Aerobic metabolism

Your patient is a 42-year-old man with multiple lacerations on his arms, head, and torso after falling through a plate-glass window. On your arrival, he appears to be unresponsive, lying prone on the sidewalk. Which of the following is the correct sequence of actions in caring for this patient? 1. Control major hemorrhage. 2) Take Standard Precautions. 3) Check the area for broken glass before kneeling next to the patient. 4) Turn him to a supine position. 5) Open his airway. A) 2, 3, 1, 4, 5 B) 2, 5, 1, 3, 4 C) 2, 3, 4, 1, 5 D) 2, 3, 4, 5, 1

Managing a laceration with arterial bleeding most often requires: A) cauterization. B) a tourniquet. C) PASG. D) direct pressure.

Which of the following patients with hemorrhagic shock is likely to be internally bleeding, solely? A) A 50-year-old man with a stab wound to the neck B) A 45-year-old woman with a suspected ruptured ectopic pregnancy C) A 38-year-old man with an open femur fracture D) A 26-year-old man with a gunshot wound involving the popliteal artery

When a patient has lost 2 liters or more of blood from hemorrhage, which classification is that? A) I B) III C) IV D) II

Which of the following is defined as the volume of blood ejected from the heart with each beat? A) Stroke volume B) Ventricular capacitance C) Cardiac output D) Afterload

A fracture of the femur may result in a hematoma that contains enough blood to make it a class ________ hemorrhage. A) I B) III C) IV D) II

Your patient is a 45-year-old man who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and confused, pale, diaphoretic, and cool to the touch. He lacks a radial pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this patient? A) He is in irreversible shock. B) He is in decompensated shock. C) He is in compensated shock. D) None of the above is certain.

Peripheral vascular resistance is measured as which of the following? A) Pulse pressure B) Mean arterial pressure C) Hydrostatic pressure D) Oncotic pressure

Which of the following is the preferred in-hospital fluid for resuscitation in hemorrhagic shock? A) Fresh frozen plasma B) Lactated Ringer's C) Whole blood D) Normal saline

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the ________ phase. A) hemolytic B) hemostatic C) vascular D) ischemic

Which of the following findings indicates a progression from compensated shock to decompensated shock? A) Narrowing pulse pressure B) Tachycardia C) Altered mental status D) Diaphoresis

When assessing the chest during a rapid trauma assessment, what is MOST likely to indicate major internal hemorrhage? A) Hyporesonance to percussion B) Increased respiratory rate C) Distended neck veins D) Muffled heart tones

Which type of wound facilitates the effectiveness of normal blood clotting mechanisms? A) Vessels torn by stretching, such as when a limb is caught in farm machinery B) Transverse laceration of the vessel C) Longitudinal laceration of the vessel D) Crushing injuries

Which of the following mechanisms is responsible for accumulating lactic acid in shock? A) The citric acid cycle B) Gluconeogenesis C) Hemostasis D) Anaerobic metabolism

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a class ________ hemorrhage. A) II B) IV C) III D) I

Which of the following does NOT indicate compensated shock? A) Anxiety B) Altered mental status C) Weakness D) Thirst

What is the best course of action in the case of hemorrhage from either the nose or ear canal? A) Cover the area with a soft, porous dressing B) Apply direct pressure to the upper face C) Squeeze the nostrils closed D) Apply pressure to the forehead

Even with intervention, survival is unlikely with blood loss over ________ percent of the total blood volume. A) 25 B) 15 C) 50 D) 35

Which of the following indicates that a patient has transitioned from compensated to decompensated shock? A) Widening pulse pressure B) Increased respiratory rate C) Hypotension D) Peripheral vasoconstriction

Red blood cells make up approximately ________ percent of whole blood volume. A) 45 B) 60 C) 30 D) 15

Which of the following is a manifestation of orthostatic hypotension? A) Your patient's pulse is 76 when he is supine but 88 when he sits up. B) Your patient's blood pressure is 142/90 when she is supine but 116/88 when she sits up. C) Your patient's blood pressure is 150/100 when he is supine but 134/90 when he sits up. D) Your patient's pulse is 80 when she is supine but 96 when she sits up.

What method of controlling hemmorage should be done as a last resort? A) Elevation B) Direct pressure C) Tourniquet D) Packing the wound with bandages and dressings

The blood flowing to the heart best describes: A) contractility. B) afterload. C) preload. D) vascular phase.

Under normal circumstances, at any given moment most of the blood is in the ________ system. A) venous B) capillary C) hematopoietic D) arterial

Which of the following best describes definitive care for the trauma patient with ongoing, significant hemorrhage? A) Administration of blood or blood products B) Administration of hypertonic crystalloid or colloid solution C) Invasive hemodynamic monitoring and serial hematocrits D) Immediate surgery

Which of the following impairs blood clotting? A) Hypothermia B) Administration of IV fluids C) Use of nonsteroidal, anti-inflammatory medications D) All of the above

The rapid trauma exam focuses on finding injuries that may cause shock by quickly assessing which of the following body areas? 1. Head 2) Neck 3) Chest 4) Abdomen 5) Pelvis 6) Proximal extremities 7) Distal extremities A) 1, 2, 3, 4, and 5 B) 1, 4, 5, and 6 C) 1, 2, 3, 4, 5, 6, and 7 D) 3, 4, 5, and 6

Which of the following statements about the patient in neurogenic shock is FALSE? A) Signs of hypovolemic shock may be masked. B) Unopposed sympathetic nervous stimulation results in systemic pallor and diaphoresis. C) Can present with neck and/or back pain. D) Neurogenic shock may require IV fluid resuscitation.

Your patient is an obese 39-year-old woman involved in a lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this patient? A) Relative to body size, this patient can tolerate a larger amount of hemorrhage before showing signs of shock. B) This patient will tolerate blood loss well, as only non-vital tissues will become ischemic. C) Relative to body weight, a smaller amount of hemorrhage may result in shock. D) Blood volume increases proportionally with body weight, and the patient will experience signs of shock consistent with the classic stages of hemorrhage.

Which of the following fluids is appropriate for the prehospital management of hypovolemic shock? A) Five percent dextrose in water B) Lactated Ringer's C) A 0.2% sodium chloride solution D) A 0.45% sodium chloride solution

Which of the following would be the MOST likely cause of neurogenic shock? A) Pericardial tamponade B) Spinal cord injury C) Systemic infection D) Massive histamine release

Rapid volume replacement is best achieved under which of the following conditions? A) Use of a long catheter with a large internal diameter B) Use of a long catheter with a small internal diameter C) Use of a short catheter with a small internal diameter D) Use of a short catheter with a large internal diameter

Which of the following vessels has the greatest ability to change diameter? A) Arteriole B) Capillary C) Systemic artery D) Aorta

Your patient is a 29-year-old man who works in a meat-processing plant. He received a knife wound in the proximal anteromedial thigh, which is continuing to bleed on your arrival. He is restless and thirsty and has pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of 118/88 mmHg. This patient is exhibiting signs and symptoms consistent with a class ________ hemorrhage. A) III B) II C) IV D) I

Which of the following early signs of shock is easily missed? A) Tachycardia B) Decrease in respiratory rate and volume C) Decrease in blood pressure D) Narrowing pulse pressure

Which of the following is TRUE of the elderly trauma patient? A) The elderly trauma patient is more likely to experience myocardial ischemia as a result of hemorrhage. B) Medications like beta-blockers may interfere with normal compensatory mechanisms. C) Hemorrhage may not result in tachycardia as expected. D) All of the above are true.

Which of the following is NOT a characteristic of arterial bleeding? A) Rapid blood loss B) Spurting or pumping as it leaves the body C) Clots quickly on its own D) Bright red

In responding to a trauma patient at the scene of a motor vehicle crash, which of the following is an early sign or signs of shock you might encounter during the primary assessment? A) Rapid heart rate and anxiety B) Rapidly dropping blood pressure C) Rapid breathing and air hunger D) Rapidly dropping level of responsiveness

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) Finger pressure through the dressing to the leaking vessel, splinting, ice, elevation D) Direct pressure on the dressing and wound, elevation, ice, tourniquet as a last resort

Which of the following terms is best described as the loss of blood from the vascular space? A) Hypovolemia B) Hemorrhage C) Hemostasis D) Shock

Brighter red, slow, oozing blood flow is characteristic of which type of hemorrhage? A) Arterial B) Venous C) Capillary D) Arteriole

Which of the following may move more slowly through the early stages of hemorrhage with greater loss percentages needed to transition from one stage class to another? A) Elderly patients B) Infants C) Alcoholics D) Athletes

In which stage of shock are the body's cells are so badly injured and die in such quantities that organs no longer are able to function normally? A) Decompensated B) Irreversible C) Compensated D) Class I

Which of the following findings is NOT likely with a patient in cardiogenic shock? A) Pulmonary edema B) Excessive urination C) Arrhythmias D) Jugular vein distention

What is the mechanism of TXA? A) Antifibrinolytic B) Coagulopathy C) Thrombocytopenia D) Development of metabolic acidosis

Which of the following vessels does NOT make up the microcirculation in the circulatory system? A) Arterioles B) Capillaries C) Venules D) Veins

Blood present in the stool of a patient is known as: A) hemoptysis. B) hematemesis. C) hematochezia. D) hemorrhage.

You are called to a commercial creamery, where an employee got his arm trapped in the ice cream mixing machinery. You note that the skin has been pulled off his hand and arm from the mid forearm down. The patient's muscles, tendons, and bones are exposed. This type of injury is a(n): A) amputation. B) skinning injury. C) degloving injury. D) crush injury.

You are assessing an assault victim and note a contusion over the abdomen. Which of the following should you remember while caring for this patient? A) Unless the contusion is over a critical area, such as the spleen or liver, the likelihood of serious injury is minimal. B) A contusion to the abdomen should always increase your index of suspicion for underlying injury. C) If there is no rigidity or distension of the abdomen, serious injury is unlikely. D) The significance of the trauma is related to the amount of pain the patient experiences on palpation.

A nonpenetrating injury caused by blunt trauma that damages blood vessels, causing pain and discoloration, is a(n): A) ecchymosis. B) strain. C) abrasion. D) contusion.

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

The tough, fibrous sheaths that bundle skeletal muscle are called: A) tendons. B) fibers. C) sarcolemma. D) fascia.

Which of the following statements about crush injuries is most accurate? A) Only closed injuries can be classified as crush injuries. B) The actual source of bleeding in crush injuries may be hard to identify. C) A spongy sensation on palpation of the injured area indicates crush injury. D) Crush injuries are easily identifiable because they invariably result in deformity.

Which of the following is best described as the accumulation of a pocket of blood in the tissues? A) Hematoma B) Abrasion C) Compartment syndrome D) Contusion

The acute breakdown of muscle fibers in crushing injury is called: A) myoglobinemia. B) sarcoidosis. C) rouleaux formation. D) rhabdomyolysis.

When caring for an amputated part, which of the following principles apply? 1. Place the unwrapped part in a dry plastic bag, and seal it. 2) Place the part in a plastic bag with the part wrapped in gauze moistened with lactated Ringer's solution or normal saline, and seal it. 3) Always transport the part with the patient. 4) Keep the part moist, and place it in a container of cold water. 5) Keep the part dry, and place it in an ice-filled container. A) 2, 4 B) 2, 3, 4 C) 1, 3, 5 D) 2, 5

You arrive on the scene of a patient with severe blunt trauma to the face. You hear gurgling as you approach the patient. After opening the airway with a manual maneuver, what should your next action be? A) Ventilate B) Apply a cervical collar C) Control the source of hemorrhage D) Suction

Which of the following are likely to accumulate in the bloodstream following a large crush injury? A) Myoglobin B) Potassium C) Lactic acid D) All of the above

Your patient is an 18-year-old man who stepped on a nail in the barnyard. The nail penetrated his tennis shoe and punctured his foot. On your arrival, the patient has removed the nail and the shoe. The wound is about 2 mm in diameter with minor bleeding that has been controlled. The skin around the wound is red. The patient does not want to be transported but asks if you can give him "some ointment and a Band-Aid." You should explain to the patient that this type of injury is associated with an increased risk of: A) infection. B) delayed bleeding. C) scarring. D) nerve damage.

In which of the following ways does the integumentary system prevent pathogens from entering the body? A) Via humoral immunity B) Via cell-mediated immunity C) By secreting chemotactic factors D) By providing a barrier to the environment

In which type of soft tissue injury is the skin cut or torn, leaving a flap of skin attached? A) Avulsion B) Laceration C) Amputation D) Abrasion

Your patient is a 35-year-old man who has his leg trapped under a section of concrete from an industrial accident. While awaiting removal of the concrete, which type of IV fluid is indicated for administration to this patient? A) Five percent dextrose in water B) Normal saline C) Lactated Ringer's D) Whole blood

The layer of skin that contains adipose tissue is the ________ layer. A) dermal B) connective C) epidermal D) subcutaneous

Which of the following medications may be indicated in the treatment of a patient with a crush injury? A) Sodium bicarbonate B) Potassium chloride C) Lactated Ringer's D) Furosemide

For most open soft tissue wounds managed by the paramedic in the prehospital setting, which of the following is a desirable characteristic of the dressing applied? A) Occlusive B) Dry C) Adherent D) Nonabsorbent

Your patient is a 19-year-old man who received a penetrating knife wound to his chest. On your arrival, he is lying supine with a visible chest wound that is bleeding slightly. You can hear the sucking sound of air moving in and out of the wound. This wound is best managed with: A) a bulky dressing held in place with adhesive strips. B) an occlusive bandage sealed on three sides and open on the fourth side. C) a dry dressing covered by an adherent bandage. D) a sterile, wet dressing held in place with an elastic bandage.

The first stage of wound healing is: A) hemostasis. B) neovascularization. C) inflammation. D) epithelialization.

A laceration that is perpendicular to the tension lines of the body is more likely to: A) become infected. B) heal without a scar. C) be caused by blunt trauma. D) gape open.

Your patient is a 30-year-old machinist who had his right hand caught in a press. Upon extrication, there is no evidence of significant trauma. You should: A) splint the hand in the position found, elevate above the heart, apply ice. B) splint in position of function, start an IV of normal saline, consider morphine for analgesia. C) wrap the hand in a bulky dressing held in place by an elastic bandage. D) apply oxygen by nonrebreather, splint using a sling and swath, insert a large-bore IV of lactated Ringer's.

Which of the following most accurately describes the injury that removes the epidermis and the upper portion of the dermis? A) Avulsion B) Incision C) Laceration D) Abrasion

Which of the following is a principle that should be used when considering application of a tourniquet to control bleeding? A) A tourniquet should be used for severe bleeding that cannot be controlled by any other means. B) Every 15 minutes, the tourniquet will need to be removed for 5 minutes, then reapplied. C) A narrow, nonelastic material is best for generating the pressure needed to stop bleeding. D) A blood pressure cuff used as a tourniquet will maintain its pressure if it has been properly applied.

Your patient is a 15-year-old soccer player who was kicked in the calf by another player. She has a contusion on her calf, but the amount of pain she is experiencing seems out of proportion to the apparent injury. You note that although you can palpate a pedal pulse, there is swelling in the foot and ankle, and the skin is cool to the touch. You should suspect which of the following at this time? A) Compartment syndrome B) Volkmann's ischemic contracture C) Crush syndrome D) Degloving injury

The bacteria most often associated with infection of open soft tissue injury is: A) Pasteurella multocida. B) Pseudomonas aeruginosa. C) Staphylococcus. D) Clostridium tetani.

Your patient is a three-year-old boy who has struck his head on a concrete patio. He has a linear wound that penetrates the dermis and is approximately 2 cm long. This wound would be best described as a(n): A) contusion. B) puncture. C) avulsion. D) laceration.

Your patient is a 45-year-old type 2 diabetic man who has a non-healing wound on his right foot. You note that the right leg is discolored and edematous and has subcutaneous emphysema and a foul odor. Which of the following should you suspect? A) MRSA B) Gangrene C) Tetanus D) Compartment syndrome

One in ________ open wounds becomes infected. A) 5 B) 10 C) 15 D) 20

You are reassessing the distal circulation on a patient's forearm you have bandaged. The distal hand and wrist are cool to the touch and turning pale. The patient complains of numbness and tingling in that hand. What is your next course of action? A) Loosen the bandage and see if that relieves the signs and symptoms. B) Keep the dressing and bandage in place and expedite transport. C) Administer pain medication to help relieve the symptoms. D) Sling and swathe the arm to the chest and reassess the distal circulation.

The three primary factors that determine the severity of radiation are: A) distance, shielding, and symptoms. B) duration, shielding, and dose. C) duration, distance, and shielding. D) dose, symptoms, and shielding.

Which of the following has contributed most significantly to the decline in U.S. burn mortality? A) Public service announcements on radio, television, and billboards B) Paramedic involvement in public education C) Visits to elementary schools by firefighters D) Improved building codes and construction and sprinkler and smoke detector use

Which classification of burn is characterized mainly by blisters? A) Full thickness B) Superficial C) Partial thickness D) Minor

Based on total body surface area and burn depth, you have determined that an 88-year-old woman has a moderate burn. Considering the age of the patient, this burn is classified as: A) critical. B) significant. C) fatal. D) moderate.

An area of burned tissue that is not painful is MOST likely a ________ burn injury. A) second-degree B) full thickness C) superficial D) partial thickness

You have been dispatched to a call for a burn patient. Upon arriving, you find a 23-year-old woman who was sunbathing and fell asleep. She is alert and oriented and in moderate pain. She has blisters covering her extremities, abdomen, face, and chest. This patient's burns fall into which one of the following categories? A) Superficial B) Critical C) Minor D) Moderate

Which of the following stages of burn injury is best described as including a pain response, an outpouring of catecholamines, tachycardia, tachypnea, mild hypertension, and anxiety? A) Resolution B) Emergent C) Fluid shift D) Hypermetabolic

Which tissue layer(s) is (are) affected by partial thickness burns? 1. Epidermis 2) Dermis 3) Subcutaneous 4) Muscle A) 1, 2, 3, and 4 B) 1 and 2 C) 1, 2, and 3 D) 1

Contact with strong alkalis results in burns involving ________ necrosis of the tissue. A) coagulation B) liquefaction C) thermal D) ischemic

Your patient has circumferential full thickness burns of the thorax. He is intubated, and you have noticed an increase in resistance as you bag him. His skin is very tight and inflexible as you try to ventilate. Which of the following is required to improve this patient's ventilatory status? A) IV sedation B) Needle thoracostomy C) Escharotomy D) Fasciotomy

Which of the following body areas warrant special attention when burned? A) Legs B) Arms C) Abdomen D) Feet

Which of the following patient factors increases the criticality of the patient's burn injuries? A) Taking antidepressants B) Male gender C) Prior history of burns D) Being in the geriatric age group

You are dispatched to a structure fire at which there is a report of a burned person. Your patient is a 32-year-old man with blisters on his anterior chest and circumferential superficial burns to both lower extremities. Using the "rule of nines," the percentage of burn is: A) 54. B) 27. C) 36. D) 45.

Which of the following agents is the best choice for analgesia in a patient with 9 percent partial thickness burns involving the right lower extremity? A) Naproxen sodium B) Ketorolac C) Acetaminophen D) Fentanyl

The type of electricity supplied to homes is ________ current. Contact with this type of current may result in ________. A) indirect; rhabdomyolysis B) direct; rhabdomyolysis C) direct; muscle tetany D) alternating; muscle immobolization

You are caring for a patient with 30 percent full and partial thickness burns. He is an 80 kg man. According to the Parkland formula, he should receive ________ liters of fluid over 24 hours, with ________ liters infused in the first 8 hours. A) 9.6; 4.8 B) 5; 3 C) 8.2; 2 D) 4.5; 1.25

According to Jackson's theory of thermal wounds, which of the following zones has suffered the greatest damage? A) Coagulation B) Hyperemia C) Stasis D) Disintegration

Which type of radiation particle can travel through 6 to 10 feet of air, penetrate a few layers of clothing, and cause external and internal injuries? A) Gamma B) Alpha C) Neutron D) Beta

Which of the following accounts for the most severe thermal burns of the airway? A) Inhalation of toxic gases B) Inhalation of radioactive particles in smoke C) Inhalation of superheated steam D) Inhalation of superheated air

Which of the following may occur from watching arc welding without proper protection? A) Hyphema B) Retinal detachment C) Ultraviolet keratitis D) Radial keratotomy

For which of the following burn patients could you use local cooling? A) An 18-month-old child with partial and full thickness scald burns on the lower extremities, buttocks, genitalia, and lower abdomen B) A 19-year-old woman with approximately 40 percent superficial and 45 percent partial thickness burns from sunbathing C) A 15-year-old man with partial thickness burns of his left upper extremity, anterior chest, and neck resulting from playing with gasoline and matches D) A 52-year-old man with a 1-inch-wide full thickness burn across the entire width of the palm of his right hand resulting from picking up a hot grate from a barbecue grill

A burn patient who has signs and symptoms of inhalation injury with associated respiratory compromise should be classified as: A) serious. B) moderate. C) critical. D) minor.

You are assessing a 17-year-old male patient with a burn on the lateral aspect of his thigh. Which of the following guidelines is most helpful when estimating the percentage of total body surface area involved? A) The rule of palms B) The Parkland formula C) The rule of nines D) The modified pediatric rule of nines

Which of the following is TRUE of the heat generated when electricity flows through the body? A) Dry skin offers less resistance to electricity, generating more heat. B) Wet skin offers less resistance to electricity, generating more heat. C) Wet skin offers greater resistance to electricity, generating more heat. D) Dry skin offers more resistance to electricity, generating more heat.

Cool-water immersion of a burned part effectively reduces burning only when done within which of the following time frames? A) The first 24 hours B) The first 10 to 15 minutes C) The first 1 to 2 minutes D) The first hour

Paralysis of the muscles of respiration may occur when there is body contact with electrical currents as low as ________ mA. A) 60 B) 100 C) 20 D) 5

The first step for treating a patient who has been contaminated with dry lime is to: A) neutralize the lime with a mild acidic solution, such as vinegar and water. B) brush away as much of the powder as possible. C) flush the skin with large amounts of isopropyl alcohol. D) flush with copious amounts of tepid water.

Which of the following best describes the pathophysiology of most burns to the human body? A) Heat causes evaporation of water and denatures protein. B) Radiation, including solar radiation and radiant heat, alters cell structures. C) Chemicals cause an endothermic reaction that destroys tissue. D) The skin, and sometimes deeper tissues, are destroyed through combustion.

Which of the following represents the modified body surface area percentages in the "rule of nines" for pediatric patients? A) Posterior chest is 7 percent. B) Upper extremities are 13.5 percent each. C) External genitalia is 1 percent. D) Lower extremities are 13.5 percent each.

The voltage of a bolt of lightning may be as much as ________ volts, and its temperature may reach ________ degrees Fahrenheit. A) 5,000; 150,000 B) 150,000; 5,000 C) 50,000; 100,000 D) 100,000; 50,000

Most inhalation injuries in burn patients are due to which of the following? A) Toxic inhalation B) Radiation burns of the airway C) Thermal burns of the lower airway D) Thermal burns of the upper airway

During which phase of a burn injury does extravasation of proteins, water, and electrolytes occur, resulting in edema and potential hypovolemia? A) Emergent B) Hyperemia C) Hypermetabolic D) Fluid shift

Your patient is a 23-year-old woman who was rescued from a burning house. She was asleep in a back bedroom when the fire started, and there was no smoke alarm. She has a pulse oximetry reading of 99 percent after receiving oxygen by nonrebreather mask. What is the most appropriate interpretation of this finding? A) Effects of smoke inhalation have been resolved by oxygen administration. B) You cannot rely on this alone to assess oxygenation. C) There was minimal smoke inhalation. D) Carboxyhemoglobin is less than 1 percent.

Which of the following body structures is the best electricity conductor? A) Bones B) Nerves C) Muscle D) Skin

Which of the following burns would be classified as moderate? A) Superficial < 50 percent BSA B) Full thickness < 2 percent BSA C) Partial thickness < 30 percent BSA D) Partial thickness > 30 percent BSA

Patients who survive the first several days of a moderate to critical burn are MOST likely to die from which of the following complications? A) Hypovolemia B) Organ failure C) Infection D) Hypothermia

Flash burns associated with electricity occur because: A) air is a moderately good conductor of electricity, generating moderate heat. B) air is an excellent conductor of electricity, generating moderate heat. C) air is mildly resistant to the passage of electricity, generating only enough heat to cause superficial burns. D) air is highly resistant to the passage of electricity, generating intense heat.

You are assessing a 37-year-old woman who was rescued from an apartment fire. She has a harsh, stridorous, "brassy"-sounding cough productive of sooty sputum. Her eyebrows and the hair around her face are singed. Respirations = 28, heart rate = 108, and blood pressure = 124/84. You have a 30-minute transport time. Which of the following is the best intervention for this patient? A) One hundred percent oxygen by nonrebreather mask B) Sedation and cricothyrotomy C) A nebulized albuterol treatment D) Rapid sequence intubation and endotracheal intubation

The seriousness of burns in the pediatric population is put into perspective by realizing that burns are the ________ leading cause of death in children under age 12 years. A) first B) second C) third D) fourth

Which of the following chemicals must be brushed off the skin, then covered with oil? A) Phenol B) Sodium metal C) Oleoresin capsicum D) Dry lime

Which of the following best describes the effect of hyperventilation in the brain-injured patient? A) It is beneficial, because vasodilation results in increased cerebral blood flow. B) It is detrimental, because vasodilation causes an increase in tissue edema. C) It is beneficial, because vasoconstriction results in decreased tissue edema. D) It is detrimental, because vasoconstriction results in decreased cerebral perfusion.

Your patient is a 45-year-old man 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 heart rate of 50 with a good radial pulse. The patient appears to have nasal and mandibular fractures, and an oropharyngeal airway is insufficient to keep the tongue from the posterior pharynx. Which of the following has the most potential to negatively impact the patient? A) Retrograde intubation B) Oral intubation under direct laryngoscopy C) Nasotracheal intubation D) A non-visualized dual-lumen airway

Which of the following medications may be indicated in the prehospital management of the patient with traumatic brain injury? A) Methylprednisolone B) Diazoxide C) Mannitol D) Furosemide

Circulation to the face is provided by the ________ artery. A) external carotid B) internal carotid C) midfacial D) mandibular

Which of the following correctly describes the impact of motorcycle helmet use? A) Helmet usage is associated with a 10 percent reduction in serious head injuries. B) There have been no reported fatalities from motorcycle collisions in which the riders were wearing helmets. C) Helmet usage decreases the risk of serious head injuries but increases the risk of cervical-spine injuries. D) Helmet usage results in a more than 50 percent reduction in serious head injuries.

Which of the following parameters should be used to guide the oxygenation and ventilation of the patient with a traumatic brain injury? A) Maintain an oxygen saturation level of at least 96 percent and a capnography reading between 35 and 40 mmHg. B) Maintain an oxygen saturation level of at least 90 percent and a capnography level < 45 mmHg. C) Maintain an oxygen saturation level of at least 98 percent and a capnography reading > 45 mmHg. D) Maintain an oxygen saturation level of at least 90 percent and a capnography reading < 35 mmHg.

You are caring for a 22-year-old amateur boxer who complained of a sudden obstruction of part of his visual field. This complaint is most consistent with which of the following conditions? A) Extrusion of the eyeball B) Subconjunctival hemorrhage C) Hyphema D) Retinal detachment

Regarding the primary assessment of the patient with suspected traumatic brain injury, which of the following describes the best approach to assessing the patient's neurological functioning? A) The use of AVPU B) Assessing the patient for level of consciousness and orientation to person, place, and time C) Assessing a revised trauma score D) Assessing a Champion trauma scale score

Which of the following best describes the percentage of mortality from penetrating gunshot wounds to the cranium? A) 35 to 50 B) 75 to 80 C) 90 to 95 D) 10 to 15

Your patient has received blunt facial trauma due to an assault. For which of the following injuries should you maintain a high index of suspicion? A) Airway obstruction B) Hypoxia due to aspiration of blood C) Basilar skull fracture D) Lumbar spine trauma

The ________ is one of the thinnest and most frequently fractured cranial bones. A) temporal B) ethmoid C) parietal D) occipital

Which of the following patients fit the criteria for application of spinal precautions in the prehospital setting? A) An 85-year-old man who has fallen down three steps and has a large laceration to the occipital region of the skull, but no complaints of pain B) A 21-year-old man who was diving into a pool and states he hit his head, but is out of the pool and ambulatory upon your arrival with no complaint of neck or back pain C) A 36-year-old woman who was involved in a minor motor vehicle crash with an obvious closed tibia fracture D) None of the above

During the early care for a patient with a basilar skull fracture in the prehospital setting, which of the following would be an unexpected finding? A) Periorbital ecchymoses or "raccoon eyes" B) CSF otorrhea C) Blood mixed with cerebral spinal fluid flowing from the mouth D) CSF rhinorrhea

Which of the following skull fractures is most common? A) Linear B) Basilar C) Depressed D) Comminuted

Which of the following features of the cranium exacerbates the severity of intracranial trauma? A) It is rigid. B) It is formed of dense, heavy bone. C) It is relatively thin in the frontal region. D) The sutures allow for separation of the bones.

Your patient is a 7-year-old male pedestrian who was struck by a vehicle. Your assessment reveals bleeding from the right auditory canal. Which of the following describes the most appropriate way to manage this? A) Determining the presence or absence of cerebrospinal fluid is a low priority. Pack the auditory canal with sterile gauze to control bleeding. B) Use a "halo" test to determine whether cerebrospinal fluid is in the blood. If it is, loosely cover the ear with a sterile dressing to prevent contamination while allowing blood to flow freely from the ear. If cerebrospinal fluid is not present, pack the ear canal with sterile gauze to control bleeding. C) Determining the presence or absence of cerebrospinal fluid in the blood is a low priority. Loosely cover the ear with a sterile dressing to prevent contamination while allowing blood to flow freely from the ear. D) Check the glucose level in the blood draining from the ear. If it is less than the patient's blood glucose level, there is cerebrospinal fluid present. Cover the ear loosely with a sterile dressing to prevent contamination while allowing blood to flow freely from the ear. If the glucose level of the blood from the ear is the same as the patient's blood glucose level, pack the auditory canal with sterile gauze to control bleeding.

When developing a spinal clearance policy, age: A) should never be considered, as age does not matter. B) should be considered only when the patient is a man between the ages of 21 and 35. C) should be considered, as the very old may not be able to describe their symptoms accurately. D) should be considered only if the patient is a minor.

Your patient is a 22-year-old female assault victim. She has blunt trauma to the face with swelling around the right eye and zygomatic area. Upon assessing her eye movement, you note that the right eye cannot follow your finger and does not move. Which of the following MOST likely explains this finding? A) She has a fracture of the orbit that has trapped the optic nerve, thereby paralyzing her gaze. B) She has direct trauma to the eyeball that has damaged the intrinsic muscles of the eye. C) She has a fracture of the orbit that has trapped the extrinsic eye muscles. D) She has direct trauma to the eyeball that has damaged the optic nerve, thereby paralyzing her gaze.

Which of the following groups is NOT among those with the highest incidence of serious head trauma? A) The elderly B) Young men C) Middle-aged men D) Infants

For the head injury patient without signs of herniation, adjust ventilation rates to maintain a capnography reading of between: A) 15 and 20 mmHg. B) 25 and 30 mmHg. C) 45 and 50 mmHg. D) 35 and 40 mmHg.

Your patient is a 37-year-old male unrestrained driver of a vehicle. You find him with his upper body across the console and his head hanging down into the passenger's side floorboard area. You note pooled blood from a scalp wound. After immobilizing him and loading him into the ambulance, where you have more light for your examination, you note that he has a large, full-thickness avulsion of the scalp. The patient's heart rate is 112, respirations are 20, and blood pressure is 82/50. Which of the following statements about this patient are TRUE? 1. The scalp wound itself cannot account for the patient's vital signs. 2) The scalp wound itself may account for the patient's vital signs. 3) The patient's vital signs are consistent with increasing intracranial pressure. 4) Nothing about the vital signs indicates increased intracranial pressure. A) 1 and 4 B) 2 and 3 C) 1 and 3 D) 2 and 4

When palpating the spine of a patient during your assessment, you are feeling the: A) spinous processes. B) vertebral bodies. C) transverse vertebral processes. D) vertebral pedicles.

A patient who has dived into a shallow pool and hit his head on the bottom is MOST likely to have which of the following types of injuries? A) Cervical hyperextension B) Cervical hyperflexion C) Axial distraction D) Axial loading

Recent research has provided evidence of which of the following regarding spinal injury assessment? A) Only trauma patients with signs and symptoms of neurological deficit need to receive spinal immobilization. B) Paramedics cannot reliably identify patients who are likely to have spinal injuries. C) All trauma patients should be assumed to have spinal injuries. D) There are reliable criteria for determining the likelihood of spinal injury.

Which of the following is a common mechanism of injury associated with spinal cord injuries? A) Falls greater than 20 feet B) Bungee jumping C) Shallow water diving D) All of the above

Which of the following best describes the goals of manual cervical spine stabilization? A) Preventing movement of the head in any direction; prevent any flexion/extension, rotation, or lateral bending B) Keeping the head in an "eyes forward" position; applying enough traction to cause axial unloading, which is 18 to 22 pounds in the average adult C) Preventing rotation of the head; avoiding any upward lifting or downward pressure on the cervical spine D) Preventing movement of the head in any direction; applying gentle axial pressure to stabilize the vertebral column

Which of the following statements about the administration of dextrose to the patient with a traumatic brain injury is TRUE? A) Hypoglycemia is associated with a poorer neurologic outcome; if the blood glucose level is less than 60 mg/dL, administer 25 grams of dextrose. B) Hypoglycemia is inconsequential to neurologic outcome; assessing the blood glucose level is not a priority. C) Hyperglycemia is associated with a poorer neurologic outcome; never administer dextrose to a patient with traumatic brain injury. D) Hypoglycemia is associated with a poorer neurologic outcome. All patients with suspected traumatic brain injury who have an altered mental status should receive 25 grams of dextrose intravenously.

You are caring for a 20-year-old skateboarder who crashed into a brick retaining wall at the bottom of a steep hill. He has blunt trauma to his face with nose deformity, loose teeth, and bleeding from the nose and mouth. Although you have answered him several times, he keeps repeating to you, "What happened? It seems like I'm having a bad day." This is most indicative of which of the following? A) Aphasia B) Retrograde amnesia C) Decorticate disorientation D) Anterograde amnesia

Which of the following are the two most important prehospital considerations for head injury patients? A) Cervical spine immobilization and ventilation B) ICP monitoring and administering corticosteroids C) Ventilation and administering corticosteroids D) Ventilation and maintaining adequate blood pressure

Your patient states that he had a traumatic brain injury from a motorcycle collision three years ago. You notice that his gait is unsteady and his movements are a bit jerky. You suspect that he has damage to which of the following structures? A) Falx cerebri B) Reticular activating system C) Third cranial nerve D) Cerebellum

Which of the following is NOT a component of the Glasgow Coma Scale? A) Eye opening B) Motor ability C) Pupillary reaction D) Verbal response

Which of the following is the largest element of the nervous system? A) Cerebellum B) Pons C) Medulla oblongata D) Cerebrum

Which of the following Glasgow Coma Scale scores indicates serious brain injury? A) < 3 B) Between 12 and 15 C) < 8 D) < 15

The cerebral perfusion pressure is represented by which of the following equations? A) CPP = MAP - CVP B) CPP = CVP - ICP C) CPP = MAP - ICP D) CPP = ICP - MAP

Which of the following mechanisms causes indirect brain injury? A) Coup/contrecoup injuries B) Systemic hypotension combined with increasing intracranial pressure C) Cushing's reflex D) Acceleration/deceleration forces without a direct blow to the cranium

Which of the following best describes consensual reactivity of the pupils? A) It is a pathological phenomenon. When a penlight is shone into one eye, both pupils constrict. B) It is a normal phenomenon. When a penlight is shone into one eye, only that pupil will constrict, while the other pupil is unaffected. C) It is a normal phenomenon. When a penlight is shone into one eye, both pupils constrict. D) It is a pathological phenomenon. When a penlight is shone into one eye, only that pupil constricts, while the other pupil is unaffected.

Your patient is a 12-year-old boy who was struck in the right temporal area of the head with a baseball. He had a brief loss of consciousness and is alert on your arrival. You note that he is becoming drowsy and has a strong radial pulse of 60, a blood pressure of 140/70, and a respiratory rate of 12. Which of the following best describes this patient's condition? A) He is stable, and he most likely has a subarachnoid hemorrhage with no increase in intracranial pressure. B) He is critical, and he most likely has an epidural hematoma with rapidly increasing intracranial pressure. C) He is stable, and he most likely has a mild diffuse axonal injury with no increase in intracranial pressure. D) He is serious, and he most likely has a subdural hematoma with an increase in intracranial pressure.

The shearing, stretching, and tearing associated with rapid acceleration/deceleration forces acting on the brain result in which of the following types of brain injury? A) Direct, diffuse B) Indirect, diffuse C) Indirect, focal D) Direct, focal

A concussion is best described as which of the following types of brain injuries? A) Indirect, diffuse B) Indirect, focal C) Direct, focal D) Direct, diffuse

For the patient with suspected traumatic brain injury, the ideal positioning of the patient for transport is: A) in a left lateral recumbent position on the backboard. B) on a long backboard with the foot of the backboard in a 15-degree Trendelenburg position. C) on a long backboard with the patient's feet elevated on pillows to achieve a 15-degree angle. D) on a long backboard with the head of the backboard elevated 15 to 30 degrees.

When CPP falls below the critical level of 50 mmHG, autoregulation does which of the following to maintain CPP and cerebral perfusion? A) Decreases blood pressure B) Increases blood pressure C) Decreases intracranial pressure D) Increases intracranial pressure

Which of the following about the use of prehospital fluid resuscitation in the patient with a traumatic brain injury is TRUE? A) Administer fluids aggressively regardless of the patient's blood pressure. B) Do not administer fluids unless the patient's blood pressure drops below 60 mmHg, because the administration of fluids leads to increased cerebral edema. C) Administer fluids as needed to maintain a systolic blood pressure above 90 mmHg. D) The use of hypertonic fluids is indicated to maintain vascular volume while reducing tissue edema.

Which of the following best describes the role of rapid sequence intubation (RSI) in the prehospital management of patients with traumatic brain injury? A) It is beneficial and should be used for all patients with traumatic brain injury who are experiencing trismus or who have an intact gag reflex. B) It is supported by anecdotal evidence, but no studies have been done to determine its feasibility or usefulness. C) It is controversial because of conflicting study results. D) It is detrimental, resulting in poorer neurological outcomes than in patients who received standard airway management.

Which of the following statements about the patient in neurogenic shock is NOT true? A) The patient's heart rate may be slow. B) The patient's blood pressure is decreasing. C) Signs of hypovolemic shock may be masked. D) Unopposed sympathetic nervous system stimulation results in generalized pallor and diaphoresis.

Coup injuries commonly occur in which region of the brain? A) Frontal region B) Occipital region C) Temporal region D) Neuronal region

Anterior cord syndrome is caused by which of the following mechanisms? A) Tearing of the anterior cord due to hyperextension mechanisms B) Disruption of arterial blood supply to the anterior cord C) Laceration of the anterior cord caused by bone fragments D) Contusion of the anterior cord caused by blunt trauma

The diaphragm is controlled by peripheral nerve roots ________ through ________. A) C-3; C-7 B) C-3; C-5 C) C-1; C-7 D) C-1; C-5

The spinal cord is continuous from the brain to the level of: A) T-12 or T-13. B) L-5 or L-6. C) the coccyx. D) L-1 or L-2.

You are treating a 16-year-old male patient who fell while practicing a new move on his skateboard. Bystanders relate that the patient was not wearing a helmet. The bystanders also relate that the patient was alert and oriented following the fall; however, while waiting for you to arrive, the patient became unconscious. While performing your physical exam, you note that the patient has a hematoma to the right temporal area. Your assessment leads you to believe that your patient has an epidural hematoma. You know that an epidural hematoma is caused by what type of bleeding? A) Venous bleeding B) Capillary bleeding C) Arterial bleeding D) Venous and capillary bleeding

You have intubated a 5-year-old girl with a suspected head injury. You note that the patient is exhibiting signs of herniation. What is the desired range for this patient's end-tidal CO₂? A) 35 to 40 B) 30 to 35 C) 25 to 30 D) 40 to 45

The phrenic nerve consists of peripheral nerve roots ________ through ________. A) C-1; C-3 B) C-5; C-8 C) C-3; C-5 D) C-1; C-8

Your patient is a 17-year-old female who fell from a horse. She is complaining of being unable to move. During your assessment, you have placed her arms at her sides, but her arms keeping returning to a "stick-up" or "hold-up" position. Based on this, which of the following is MOST likely? A) The patient has a spinal-cord injury at T-1. B) The patient has Brown-Séquard syndrome. C) The patient is feigning the injury. D) The patient has a spinal cord injury in the midcervical region.

All the following are seen in Cushing's triad, EXCEPT: A) increased blood pressure. B) irregular respirations. C) tachycardia. D) All of the above are seen in Cushing's triad.

Which of the following spinal cord injuries is LEAST likely to result in residual neurologic deficit? A) Compression B) Transection C) Contusion D) Laceration

Pediatric patients are ________ likely to become hypovolemic from head injuries than adult patients. A) more B) less C) equally D) Pediatric patients always become hypovolemic due to the movable fontanels.

A spinal cord lesion may result in paralysis of both lower extremities. This condition is known as: A) hemiplegia. B) hemiparesis. C) quadriplegia. D) paraplegia.

When assessing an individual who has lost sensation below the umbilicus, at what level do you suspect injury? A) T-10 B) T-4 C) L-1 D) T-8

Which of the following is a function of the sympathetic nervous system? A) Digestion B) Sexual functioning C) Constriction of the pupils D) Increased heart rate

All of the following are used in the sedation of patients for rapid sequence intubation, EXCEPT: A) Valium. B) Romazicon. C) etomidate. D) ketamine.

A patient unable to extend the leg or flex the hip is MOST likely to have incurred an injury in which nerve plexus? A) Cervical B) Lumbar C) Brachial D) Sacral

Which of the following is noted in the patient with a positive Babinski's sign? A) Fanning of the toes with plantar flexion of the great toe B) Dorsiflexion of the second to fifth toes with plantar flexion of the great toe C) Fanning of the toes with dorsiflexion of the great toe D) Plantar flexion of the second to fifth toes with dorsiflexion of the great toe

The cerebrum, cerebellum, and brainstem account for what percentage of the cranial volume? A) 60 percent B) 80 percent C) 50 percent D) 75 percent

A patient who had a spinal cord T4 injury two years ago calls 911 for a pounding headache, blurred vision, and flushing. On your arrival, her vital signs include a blood pressure of 240/120 and pulse of 58. What is this condition called? A) Autonomic hyperreflexia syndrome B) Spinal shock C) Malignant hypertension D) Brown-Séquard syndrome

You are on the scene of a domestic assault in which the female victim defended herself against further attack by stabbing her attacker. Your patient is a 36-year-old man who has been stabbed in the posterior thorax about 1 centimeter to the right of the spinous process of T6. Your assessment reveals loss of motor and sensory function on the right side distal to T6 but intact motor function with some loss of sensation on the left side distal to T6. Which of the following best explains this patient's presentation? A) "Pseudoneurologic" deficit to avoid being arrested B) Brown-Séquard syndrome C) Central cord syndrome D) Autonomic hyperreflexia

In a subdural hematoma, the vessel most commonly involved is the: A) superior sagittal sinus. B) inferior sagittal sinus. C) middle meningeal artery. D) superior meningeal artery.

Concussion is a(n) ________ injury. A) direct. B) indirect. C) diffuse. D) delayed.

Which of the following mechanisms are involved in neurogenic shock? 1. Unopposed vasodilation 2) Loss of innervation to the adrenal medulla 3) Decreased preload 4) Unopposed sympathetic tone A) 1, 2, 3 B) 1, 3, 4 C) 1, 2, 3, 4 D) 1, 3

When providing fluid resuscitation for a 1-year-old child with hypovolemia from a head injury, the goal is to maintain a systolic blood pressure of: A) 90 mmHg. B) 85 mmHg. C) 75 mmHg. D) 65 mmHg.

Which syndrome causes motor weakness that affects the upper extremities and usually occurs in patients older than 50 years of age? A) Central cord B) Anterior cord C) Brown-Séquard D) Cauda equina

A ________ fracture characteristically involves the entire facial region below the brow ridge, including the zygoma, nasal bone, and maxilla. A) Le Fort I B) Le Fort II C) Le Fort III D) Le Fort IV

Intracranial Volume = Brain Volume + CSF Volume + Blood Volume is the basis behind which of the following? A) Cerebral perfusion pressure B) Monroe-Kellie doctrine C) Mean arterial pressure D) Traumatic brain injury

Which of the following trauma patients is MOST likely to have SCIWORA when examined in the hospital? A) 5-year-old male B) 80-year-old female C) 21-year-old male D) 45-year-old female