test 7 Flashcards
In shock states, what general principle can be observed regarding perfusion?
Perfusion in some areas is inadequate because the circulatory system malfunctions.
Hypoperfusion is:
inadequate blood flow to the tissues.
You have been called to a nursing home, where you find an 88-year-old female patient who is confused and combative. The staff states that this is not her normal behavior but that she has been bedridden from a previous stroke. They also report that she has had a recent urinary tract infection from an indwelling catheter. You note that her skin is flushed and warm, her pulse is 108, and her blood pressure is 80/44. You should suspect:
septic shock.
As you approach a patient with severe hemorrhaging from one arm, what should you do first?
Don Standard Precautions before touching the patient
Your patient presents with signs and symptoms of shock after a motor vehicle crash. Which of the following would be one such sign?
Apparent agitation
In all forms of shock, what is the greatest consequence to the body?
Inadequate delivery of oxygen to the cells
You are treating a 42-year-old male complaining of chest pain and shortness of breath. You notice that he appears pale, cool, and sweaty. What is the most likely reason for these findings?
Blood vessels constrict in response to sympathetic stimulation, causing a decrease in blood flow to the skin.
If a patient in shock is able to maintain perfusion, then this is:
compensated shock.
You are managing a 27-year-old female with severe hemorrhage from her right ankle after a motor vehicle collision. You are unable to stop the hemorrhage with direct pressure. What intervention should you try next?
Apply a tourniquet proximal to the wound on the patient’s femur.
This is the correct answer.
You suspect that your patient has a GI bleed. She presents with tachycardia, hypotension, and pale skin. What stage of shock is she most likely in?
Decompensated shock
In neurogenic shock, what mechanism causes hypoperfusion?
Arteries that are under continuous nervous control lose their ability to maintain contraction and dilate fully, causing a drop in blood pressure.
Which of the following would be the best approach for a patient who was in shock secondary to internal bleeding?
Provide necessary care while transporting the patient to a hospital that can provide surgical intervention.
During severe external bleeding, the brain may suffer a lack of oxygen. Which of the following contributes most to that lack of oxygen?
A reduction in the number of red blood cells and blood pressure
The problem of blood vessels dilating in compensation for trauma is primarily related to:
vascular capacity that is too great.
When assessing a patient, consider the possibility of closed soft-tissue injuries whenever there is swelling, pain, or deformity, as well as:
a mechanism of blunt trauma.
Your patient suffered a severe electrical burn injury. In your emergency care, you should always:
assess for an entrance and an exit wound.
Generally, when providing emergency care of open wounds, the first thing you would do is:
expose the wound.
All burns are to be treated as more serious if:
accompanied by other injuries or medical problems.
For a young child with isolated genital injuries, you should:
consider the possibility of abuse, and treat the child with sensitivity.
The layer of skin that is rich with blood vessels, nerves, and specialized structures is the:
dermis.
Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is this?
Hematoma
In caring for an amputated part, it is important to:
wrap the part in sterile gauze and keep it cool.
What is the resulting injury called when the burn penetrates all the way to the bottom layer of skin?
Full-thickness
Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso (chest and abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface burned?
22.5%
Damage to which of the following organs is least likely in the case of abdominal bruising?
Lungs
Which layer of the skin provides shock absorption and insulation?
Subcutaneous
What is the purpose of a flutter-valve occlusive dressing?
To allow air to escape but not enter
Injury to which of the following organs would be most likely to cause peritonitis?
Small intestine
When air is present in the chest cavity, the injury is called a:
pneumothorax.
Your patient was just involved in a motor vehicle collision. She is breathing very fast and shallowly. You auscultate her lung sounds and find diminished breath sounds on the right side. You suspect that the patient is most likely suffering from:
simple pneumothorax.
A fracture that results in multiple bone pieces at the fracture site is termed a:
comminuted fracture.
To realign an extremity, an EMT grasps the distal extremity while a partner places one hand above and one hand below the injury site, and then:
the partner supports the site while the first EMT creates gentle manual traction in the direction of the long axis of the extremity.
To stabilize a hip fracture, how should you bind the legs together?
Place a folded blanket between the patient’s legs and bind the legs together with wide straps, Velcro-equipped straps, or wide cravats.
For a high-priority, unstable patient with musculoskeletal injuries, you should:
immobilize the whole body on a long spine board and “load and go.”
The first effects of a bone injury are swelling of soft tissue and:
the formation of a blood clot in the area of the fracture.
The humerus is an example of a(n):
appendicular bone.
A 22-year-old female patient slipped running down stairs, and has injured her right tibia and fibula. You have used an air splint to splint the injury. To test the splint, you can:
see if you can cause a slight dent in the plastic with fingertip pressure.
The first step in the progression of compartment syndrome is that:
a fracture or crush injury causes bleeding or swelling in an extremity
When treating a patient with an open musculoskeletal injury to the thigh, how would you best treat the open wound?
Cover the open wound with a sterile dressing, elevate the extremity, and apply a cold pack to the area to help reduce swelling.
An injury to the cranium would directly affect:
the bony structure making up the forehead and top, back, and upper sides of the skull.
You just arrived at the scene of a motor vehicle crash involving two cars. The passenger of one car is sitting in the front seat, unconscious, with her chin to her chest. She is having snoring respirations, so you carefully position her head in a neutral position to clear her airway. In doing so, you notice that her nose is bleeding, there is a reddened area on her forehead at the hairline, and the windshield is starred, with some hair stuck in the fractured glass. What type of cervical injury should you suspect?
Extension or flexion injury
Which of the following describes shock following spinal injury?
Dilation of the blood vessels, resulting in reduction of perfusion to tissues
The catcher at a baseball game is struck on the front of his head by a thrown bat. He sustains a cerebral bruise on the front of his brain but also has a contusion on the back of his brain. The bruise on the back of his brain is called a(n):
contrecoup injury.
You find out that one of your patients from an earlier car wreck suffered bleeding that caused the blood to collect and pool within the patient’s skull. Based on this information, you know that the patient most likely suffered which type of brain injury?
Hematoma
A 22-year-old male patient was involved in a physical altercation at a bar. He has no evidence of head trauma, and reportedly did not fall or lose consciousness at any time. His only complaint is pain upon deep inspiration along the front of his left rib cage. Given the mechanism of injury and his presentation, should this patient be immobilized?
Probably not, because he does not have the mechanism of injury or the symptoms to suggest the need
When you are stabilizing an impaled object in the head, always:
use bulky and rigid support.
The region where the jaw articulates with the remainder of the head is termed the:
temporomandibular joint.
You are treating a 6-year-old car crash victim, and have decided to immobilize him. You should refrain from doing which of the following?
Securing the patient in his child safety seat
You are caring for a 19-year-old female patient who was involved in a motor vehicle crash. She sustained blunt-force trauma to her face with contusions, swelling, and minor bleeding throughout her facial region. Which of the following findings most strongly suggests a fractured mandible?
Lower teeth that are out of alignment in the front
Manual cervical stabilization should be provided to all patients with a significant mechanism of injury until:
completion of the assessment.
The regions on the surface of the body that individually are innervated by a single spinal nerve are called:
dermatomes.
A brain injury is classified as nontraumatic if it is:
not attributable to an external cause.
You have established manual in-line cervical spine stabilization of an unconscious trauma patient. You may release manual stabilization:
when the patient is fully immobilized and secured to the backboard.
When crushed, the liver and spleen:
bleed profusely and cause shock.
A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can talk, and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the highest priority in this patient’s assessment and treatment?
Care for spine injuries, head injuries, and severe fractures.
The problem of blood vessels dilating in compensation for trauma is primarily related to:
vascular capacity that is too great.
Which of the following is the best indicator of perfusion in the adult?
Mental state and alertness
When a patient has significant blood loss, which of the following clinical findings would you expect to find that signifies the presence of shock?
rapid heart rate
