Chapter 26 - Head & Spine Injuries

Question 1

A patient who cannot remember the events that preceded his or her head injury is experiencing:
Select one:
A. perigrade amnesia.
B. retrograde amnesia.
C. posttraumatic amnesia.
D. anterograde amnesia.

Answer 1

B. retrograde amnesia.

Question 2

After your partner assumes manual in-line stabilization of the patient’s head, you should:
Select one:
A. use four people to log roll the patient onto a backboard.
B. apply an appropriately sized rigid cervical collar.
C. assess distal neurovascular status in the extremities.
D. thoroughly palpate the patient’s head for deformities.

Answer 2

C. assess distal neurovascular status in the extremities.

Question 3

An epidural hematoma is MOST accurately defined as:
Select one:
A. bleeding between the skull and dura mater.
B. bleeding between the dura mater and brain.
C. an injury caused by a damaged cerebral artery.
D. venous lacerations that occur within the brain.

Answer 3

A. bleeding between the skull and dura mater.

Question 4

uring your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:
Select one:
A. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs.
B. perform a focused secondary assessment of the patient’s head and neck.
C. immediately place her on a long backboard and prepare for rapid transport.
D. instruct him to assist her ventilations while you perform a rapid assessment.

Answer 4

D. instruct him to assist her ventilations while you perform a rapid assessment.

Question 5

It would be MOST appropriate to perform a focused secondary assessment on a patient who:
Select one:
A. fainted and fell to the ground from a standing position.
B. has blood draining from the ears following a head injury.
C. struck his or her head and is experiencing nausea or vomiting.
D. was restrained during a high-speed motor vehicle crash.

Answer 5

A. fainted and fell to the ground from a standing position.

Question 6

Lacerations to the scalp:
Select one:
A. are most commonly associated with skull fractures.
B. may be an indicator of deeper, more serious injuries.
C. bleed minimally because the scalp has few vessels.
D. uncommonly cause hypovolemic shock in children.

Answer 6

B. may be an indicator of deeper, more serious injuries.

Question 7

The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by:
Select one:
A. a neurosurgeon or emergency department physician.
B. noting a decrease in the heart rate during ventilations.
C. reassessing the patient’s blood pressure after at least 10 minutes.
D. immediate reassessment following the intervention.

Answer 7

D. immediate reassessment following the intervention.

Question 8

The Glasgow Coma Scale (GCS) is used to assess:
Select one:
A. eye opening, verbal response, and motor response.
B. sensory response, pupil reaction, and heart rate.
C. mental status, eye opening, and respiratory rate.
D. verbal response, eye opening, and mental status.

Answer 8

A. eye opening, verbal response, and motor response.

Question 9

The MOST important treatment for patients with a head injury, regardless of severity, is to:
Select one:
A. transport to a trauma center.
B. administer 100% oxygen.
C. establish an adequate airway.
D. immobilize the spine.

Answer 9

C. establish an adequate airway.

Question 10

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
Select one:
A. pupillary constriction.
B. increase in heart rate.
C. shunting of blood to vital organs.
D. dilation of the bronchiole smooth muscle.

Answer 10

A. pupillary constriction.

Question 11

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
Select one:
A. fractures to the internal structures of the ear following direct trauma.
B. significant pressure and bleeding in between the skull and dura mater.
C. a linear skull fracture and a significant increase in intracranial pressure.
D. rupture of the tympanic membrane following diffuse impact to the head.

Answer 11

D. rupture of the tympanic membrane following diffuse impact to the head.

Question 12

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:
Select one:
A. before manually stabilizing the patient’s head.
B. after moving the patient to a long backboard.
C. after assessing distal neurovascular functions.
D. after the torso has been adequately secured.

Answer 12

C. after assessing distal neurovascular functions.

Question 13

Which of the following nerves carry information from the body to the brain via the spinal cord?
Select one:
A. sensory
B. motor
C. somatic
D. central

Answer 13

A. sensory

Question 14

Which of the following statements regarding secondary brain injury is correct?
Select one:
A. Because cerebral edema develops quickly, it is considered to be a primary brain injury.
B. It results from direct brain trauma following an impact to the head.
C. Hypoxia and hypotension are the two most common causes of secondary brain injury.
D. Signs are often present immediately after an impact to the head.

Answer 14

C. Hypoxia and hypotension are the two most common causes of secondary brain injury.