Chapter 31

Question 1

Which of the following injuries may produce distended neck veins?

Answer 1

Cardiac tamponade
Traumatic asphyxia
Tension pneumothorax

Question 2

Which of the following is an unreliable sign for determining the presence of a tension pneumothorax?

Answer 2

Trachea that shifts to the side opposite the injury

Question 3

Which of the following describes the proper application of an occlusive dressing for an open chest wound?

Answer 3

Apply an occlusive dressing to each penetrating wound.

Question 4

Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being “hit in the face and kicked and punched in his ribs and stomach.” Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient?

Answer 4

The potential for serious internal damage

Question 5

You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you’re making the decision to transport. Which of the following best encapsulates the correct strategy for transport?

Answer 5

Transport the patient emergently because of the high index of suspicion for a serious injury.

Question 6

The mechanism of injury in which a patient’s chest has struck an immovable object, such as a steering wheel, may most accurately be described as a(n):

Answer 6

compression injury

Question 7

Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered?

Answer 7

Traumatic asphyxia

Question 8

You find a middle-aged male sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should:

Answer 8

place your gloved hand over the wound.

Question 9

Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma?

Answer 9

Liver

Question 10

Common signs and symptoms following an injury to a hollow abdominal organ include:

Answer 10

irritation and peritonitis

Question 11

You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsating mass. You should:

Answer 11

Defer further abdominal palpations

Question 12

Which of the following is a strategy to maintain adherence of an occlusive dressing to bloody or diaphoretic skin?

Answer 12

manually maintain pressure

Question 13

Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques?

Answer 13

apply direct pressure to the wound

Question 14

On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration, and the bleeding is controlled. Which of the following is the best approach toward managing the exposed intestines?

Answer 14

moisten a sterile dressing with saline solution and cover abdominal contents

Question 15

You are treating a patient with paradoxical motion on the left side of the chest. He is breathing is shallow at a rate of 4 breaths per minute. You should:

Answer 15

begin positive pressure ventilation

Question 16

Your patient is a 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should:

Answer 16

begin chest compressions

Question 17

Which of the following is an accurate definition of a flail chest?

Answer 17

Section of the chest wall that is unstable, leading to breathing problems

Question 18

A patient with jugular vein distention is most likely suffering from which of the following injuries?

Answer 18

tension pneumothorax

Question 19

The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss.

Answer 19

3

Question 20

What is a drawback to using sterile aluminum foil as an occlusive dressing?

Answer 20

the foil may lacerate the eviscerated organs