Ch. 17-25 Quiz Questions

Front 1

The second impact that occurs when an adult pedestrian is struck by a motor vehicle would MOST likely result in injuries to the:

Back 1

pelvis and chest

Front 2

When a patient takes the “up and over” pathway during a head-on collision:

Back 2

the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx

Front 3

Sudden deceleration of a motor vehicle that is traveling at 60 mph:

Back 3

dissipates tremendous forces and causes major injuries

Front 4

The greatest amount of kinetic energy would be created if a ___ pound driver struck a tree while traveling at ___ mph.

Back 4

150, 40

Front 5

Which of the following injuries would MOST likely require transport to a level 1 trauma center?

Back 5

Two or more proximal long bone fractures

Front 6

The most significant fall occurs from a height greater than:

Back 6

15 feet

Front 7

During an explosion, secondary blast injuries occur when:

Back 7

the patient is struck by flying debris, such as shrapnel

Front 8

Which of the following general statements regarding trauma is MOST correct?

Back 8

Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma

Front 9

Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced?

Back 9

Mechanism of injury

Front 10

The shock wave velocity from an explosion is slower and its duration is longer if a person is:

Back 10

farther from the explosion

Front 11

A properly worn motorcycle helmet will:

Back 11

not protect the cervical spine

Front 12

Lap belts that are worn alone and high by a pregnant woman:

Back 12

allow enough forward flexion and subsequent compression to rupture the uterus

Front 13

If a person survives the initial trauma from a shotgun wound at a close range:

Back 13

contaminants that were driven into the wound can cause a severe infection

Front 14

When a person falls from a significant height and lands on his or her feet, axial loading results in:

Back 14

compression or burst fractures to the lumbar spine

Front 15

Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the:

Back 15

femurs and tibias

Front 16

If a level 1 trauma center is 30 miles away, and a level 2 trauma center is 10 miles away, it would be MOST appropriate to transport the patient with a severe traumatic brain injury:

Back 16

via air transport to the level 1 trauma center

Front 17

The peak magnitude of the pressure wave experienced by a person:

Back 17

lessens as the person is farther away from the center of the explosion

Front 18

If the windshield of a wrecked vehicle is cracked or broken:

Back 18

the front seat occupant has a cervical injury until proven otherwise

Front 19

The MOST common site of deceleration injury in the chest is the:

Back 19

aorta

Front 20

Unlike decoration injuries, crush and compression injuries occur:

Back 20

at the time of impact

Front 21

The primary determinants of the extent of trauma a patient sustains are the:

Back 21

amount of energy in the object and the mechanism by which the object is delivered to the body

Front 22

At a minimum, a level 2 trauma center should:

Back 22

be able to initiate definitive care for all injured patients

Front 23

When summoning an air transport service to transport a critically injured patient, it is MOST important to:

Back 23

activate the service as soon as possible

Front 24

Structural protection afforded to a motorcycle rider during a crash comes from:

Back 24

protective gear worn by the rider

Front 25

What type of injuries would MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact?

Back 25

Abdominal and lumbar spine

Front 26

Routine pre-hospital treatment for a patient with internal hemorrhage and shock includes all of the following, EXCEPT:

Back 26

analgesia if the systolic BP is greater than 70 mmHg

Front 27

During shock, norepinephrine release causes:

Back 27

the body to shunt blood from areas of lesser need to areas of greater need

Front 28

What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation:

Back 28

platelets

Front 29

During the irreversible (terminal) phase of shock:

Back 29

the body attempts to shunt blood from the liver, kidneys, and lungs to keep the heart and brain perfused

Front 30

If you suspect internal bleeding during the initial assessment, you should:

Back 30

keep the patient warm and administer oxygen

Front 31

Anaerobic metabolism:

Back 31

is less efficient than aerobic metabolism and leads to systemic acidosis

Front 32

The MOST significant factor that determines how well the body compensates for blood loss is:

Back 32

the period of time over which the blood is lost

Front 33

Widespread dilation of the resistance vessels, capacitance vessels, or both, leads to:

Back 33

distributive shock

Front 34

Which of the following conditions would result in obstructive shock?

Back 34

Tension pneumothorax

Front 35

During compensated shock:

Back 35

an increase in respiratory rate and depth creates a compensatory respiratory alkalosis to offset the metabolic acidosis

Front 36

A weak radial pulse in a patient with shock indicates:

Back 36

vascular dilation and decreased blood flow

Front 37

A woman finds her 50-year-old husband unresponsive on the couch. When you arrive and begin your assessment, the wife tells you that her husband experienced an episode of chest discomfort 2 days prior, but refused to seek medical attention. The patient is unconscious and unresponsive; is breathing with a marked reduction in tidal volume; and has rapid, thready radial pulses. Your partner reports that the patient’s systolic BP is 70 mmHg. The MOST appropriate treatment for this patient involves:

Back 37

assisting his ventilations, applying a cardiac monitor, intubating if necessary, auscultating his lungs, transporting at once, establishing vascular access en route, administering a 200-mL crystalloid bolus if his lungs are clear, and considering a dopamine infusion.

Front 38

The goal of volume replacement for a patient with hemorrhagic shock is to:

Back 38

maintain perfusion without increasing internal or uncontrollable external bleeding

Front 39

Care for a patient with profound shock begins by:

Back 39

following BSI precautions

Front 40

Which of the following statements regarding hypotension and shock is MOST correct?

Back 40

Hypotension is a classic sign of shock, but it occurs late

Front 41

External bleeding would be the LEAST difficult to control in a patient with a large laceration to the ___ and a BP of ___ mmHg.

Back 41

Brachial artery, 68/46

Front 42

You are dispatched to a restaurant for a patient that is choking. Upon arrival, you find the patient, a 30-year-old man, in obvious respiratory distress. His face is flushed and his arms are covered with hives. You are unable to obtain a blood pressure because the patient is restless; however, you are able to palpate his pulse, which is rapid and weak. In addition to ensuring adequate oxygenation and ventilation, the MOST important treatment for this patient involves:

Back 42

administering epinephrine as soon as possible

Front 43

An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because:

Back 43

the body’s metabolic rate is slower

Front 44

Hemoglobin functions by:

Back 44

binding to oxygen that is absorbed in the lungs and transporting it to the tissues

Front 45

Failure of the body’s compensatory mechanisms to preserve perfusion results in all of the following, EXCEPT:

Back 45

an increase in preload

Front 46

When a certain level of tissue hypoperfusion is reached:

Back 46

the cells convert to anaerobic metabolism, the byproduct of which is lactic acid

Front 47

You are administering a normal saline bolus to a patient in hypovolemic shock secondary to severe external blood loss. How much saline will remain in the patient’s intravascular space after 20 minutes if you have infused a total of 500 mL?

Back 47

200 mL

Front 48

When noncolloid solutions are used in the treatment of shock:

Back 48

you should give two to three times the volume of blood lost

Front 49

Which of the following factors would have the MOST negative effect on the body’s process of hemostasis?

Back 49

Anticoagulant use

Front 50

Cardiogenic shock would MOST likely develop following:

Back 50

decompensated congestive heart failure

Front 51

Which of the following bandages is associated with the HIGHEST risk of blood flow compromise?

Back 51

Elastic bandages

Front 52

Which of the following wounds usually requires substantial irrigation and debridement prior to closure?

Back 52

Degloving injuries

Front 53

The skin is also referred to as the:

Back 53

integument

Front 54

Which of the following medications would MOST likely interfere with homeostasis?

Back 54

Plavix

Front 55

A patient taking ___ would MOST likely experience a delay in the healing of a wound.

Back 55

Corticosteroids

Front 56

You are the first unit to arrive at the scene of a small building collapse. As you exit the ambulance, you can see a man pinned under a large metal beam. You should:

Back 56

immediately request a special rescue team

Front 57

A patient with nerve compromise following an open injury to the hand:

Back 57

requires prompt transport to the hospital

Front 58

The FIRST aspect to address in any patient with a soft-tissue injury is:

Back 58

your safety

Front 59

Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called:

Back 59

gangrene

Front 60

During the inflammation phase of the healing process:

Back 60

histamine causes vasodilation and increased blood flow to the injury

Front 61

When caring for an amputated body part:

Back 61

early notification of the hospital is important

Front 62

All of the following are functions of the skin, EXCEPT:

Back 62

providing the immune system response for the body

Front 63

When a patient’s leg is entrapped under a crushing object for a prolonged period of time, toxic metabolic waste products are released into the systemic circulation:

Back 63

after the patient’s leg is freed from entrapment

Front 64

The skin helps regulate body temperature through:

Back 64

the production of sweat, which is evaporated from the surface of the skin

Front 65

Compared to the bleeding from an open wound, bleeding from a closed wound:

Back 65

is limited because the skin is unbroken

Front 66

A wound is at HIGHEST risk for infection if:

Back 66

it is caused by a human or animal bite

Front 67

Signs and symptoms of compartment syndrome include all of the following, EXCEPT:

Back 67

erythema

Front 68

The MOST significant immediate threat to a patient with a soft-tissue injury is:

Back 68

hemorrhage

Front 69

In addition to bleeding and contamination, the MOST immediate danger associated with an avulsion is:

Back 69

a loss of blood supply to the avulsed flap

Front 70

The use of wet dressings in the field is limited because:

Back 70

they provide a medium for pathogens to grow

Front 71

You are dispatched to a residence for a man who cut his hand with a chainsaw. Upon arriving at the scene, your first action should be to:

Back 71

carefully assess the scene for safety hazards

Front 72

Which of the following interventions encourages drainage from the site of a closed wound and reduces swelling?

Back 72

Elevation

Front 73

Which of the following statements regarding compartment syndrome is MOST correct?

Back 73

Compartment syndrome is more likely to occur with closed injuries

Front 74

A crushing or tearing amputation:

Back 74

can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly

Front 75

When managing a patient who is entrapped by a crushing object, it is MOST important to:

Back 75

make every effort to treat the patient before removing the crushing object

Front 76

Full-thickness circumferential burns to the chest:

Back 76

may cause significant restriction of respiratory excursion

Front 77

The LEAST common cause of death from fires is:

Back 77

integument burns

Front 78

Nasotracheal intubation of a patient with upper airway burns:

Back 78

is a complicated procedure and should be avoided

Front 79

Which of the following chemicals corrode the skin and cause massive protein denaturing?

Back 79

Ammonium

Front 80

Which of the following statements regarding carbon monoxide (CO) poisoning is MOST correct?

Back 80

Never rule out CO poisoning because of the absence of cherry red skin

Front 81

A 4-year-old boy pulled a pot of boiling water off the stove and experienced partial-thickness splash burns to his neck, anterior trunk, and both anterior arms. During your assessment, you note that the child is conscious, but is not crying. He is tachypneic and tachycardic and his skin is cool and moist. Other than the burns, there are no other gross injuries. Which of the following statements regarding this scenario is MOST correct?

Back 81

The child may be hypoglycemic and requires assessment of his blood glucose level

Front 82

According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face and anterior chest has burns to ___% of his total body surface area (TBSA).

Back 82

18

Front 83

The outer zone of an entrance or exit wound caused by a contact electrical burn is:

Back 83

the red zone of coagulation necrosis

Front 84

A burn patient with a history of chronic obstructive pulmonary disease:

Back 84

may be triaged as a critically burned patient, even if the burn injury is small

Front 85

Damage to the kidneys following an electrical injury:

Back 85

occurs when damaged muscle produces myoglobin

Front 86

A patient with full-thickness burns surrounded by areas of superficial and partial-thickness burns should be treated with all of the following, EXCEPT:

Back 86

moist dressings

Front 87

The skin sheds excess heat from the body through:

Back 87

the evaporation of sweat

Front 88

Specific treatment for a hydrofluoric acid burn is:

Back 88

calcium chloride

Front 89

With regard to a thermal burn injury, the zone of coagulation:

Back 89

is the central part of the burn and suffers the most damage

Front 90

If a burn patient presents with a hoarse voice and states, “I’m cold,” your MOST immediate concern should be:

Back 90

inhalation injury

Front 91

The purpose of estimating a patient’s total body surface area (TBSA) burns in the prehospital setting is to:

Back 91

help the paramedic determine the most appropriate destination hospital

Front 92

A partial-thickness burn is considered to be critical if it:

Back 92

involves more than 30% of the body surface area

Front 93

You are transporting a conscious but confused 29-year-old man after he was electrocuted. The patient is on high-flow oxygen, has an IV line of normal saline in place, is on a cardiac monitor, and has his spine fully immobilized. During transport, it is especially important for you to:

Back 93

remain alert for lethal cardiac dysrhythmias and to be prepared to defibrillate

Front 94

Unlike chemical burns, radiation burns:

Back 94

may appear hours or days after exposure

Front 95

A 74-year-old man experienced partial- and full-thickness burns to his arms and chest resulting from a fire that started after he fell asleep while smoking his cigar. The patient’s son, who arrived at the scene shortly after you, states that his father has congestive heart failure, rheumatoid arthritis, and atrial fibrillation. In addition to administering supplemental oxygen, it is MOST important for you to:

Back 95

auscultate his breath sounds before administering IV fluids

Front 96

Burn shock is caused by:

Back 96

fluid loss across damaged skin and volume shifts within the rest of the body

Front 97

After an adult victim is struck by lightning and experiences cardiac arrest:

Back 97

his or her heart may resume beating spontaneously

Front 98

If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because:

Back 98

facial edema may cause tube dislodgement 2 to 3 days after the burn

Front 99

Which of the following statements regarding pre-hospital vascular access and fluid therapy in the severely burned patient is MOST correct?

Back 99

At least one large-bore IV should be started while en route to the hospital

Front 100

Which of the following burn injuries would MOST likely require transport to a burn specialty center?

Back 100

Burns that involve the hands, feet, or major joints

Front 101

A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to:

Back 101

ensure that she is sitting up and leaning forward

Front 102

A 19-year-old woman fell from a second story window and landed on her head. She is unconscious with a blood pressure of 148/94 mmHg, heart rate of 58 beats/min, and irregular respirations of 8 breaths/min. Further assessment reveals blood draining from her nose and bilaterally dilated pupils that are slow to react. In addition to employing full spinal precautions, the MOST appropriate treatment for this patient involves:

Back 102

intubating her trachea after preoxygenating her for 2 to 3 minutes with a bag-mask device, transporting immediately, starting at least one large-bore IV en route, applying a cardiac monitor, and performing frequent neurologic assessments.

Front 103

Bleeding from a scalp laceration with an underlying skull deformity:

Back 103

may contribute to hypovolemia in adults

Front 104

You are en route to the hospital with a conscious middle-aged man who experienced trauma to the anterior neck during an assault. He is on supplemental oxygen, has spinal precautions in place, and has a large-bore IV line of normal saline in place. When you obtain a repeat set of vital signs, you note that his blood pressure is 90/64 mmHg, his pulse rate is 120 beats/min, and his respirations are 22 breaths/min with adequate depth. You should:

Back 104

keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion

Front 105

Which of the following bones is part of the cranial vault AND the face?

Back 105

Ethmoid

Front 106

In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause:

Back 106

cerebral hypoxia

Front 107

When managing the airway of an unresponsive patient with serious anterior neck trauma and inadequate breathing, you should:

Back 107

assist ventilations with a bag-mask device and prepare to intubate

Front 108

The ___ are cone-shaped fossae that enclose and protect the eyes.

Back 108

Orbits

Front 109

The hyoid bone:

Back 109

floats in the superior aspect of the neck just below the mandible

Front 110

A diffuse axonal injury (DIA):

Back 110

involves stretching, shearing, or tearing of the extension of the neuron that conducts electrical impulses away from the cell body.

Front 111

If a knife is impaled in the neck:

Back 111

a cricothyrotomy may be required to establish a patent airway

Front 112

A young man was assaulted and has extensive maxillofacial injuries. Your initial assessment reveals that he is semiconscious, has poor respiratory effort, and has blood draining from the corner of his mouth. Initial management for this patient involves:

Back 112

manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen

Front 113

Pupils that are slow (sluggish) to react to light:

Back 113

are a sign of cerebral hypoxia

Front 114

A moderate diffuse axonal injury:

Back 114

produces an immediate loss of consciousness and residual neuorologic deficits when the patient wakes up

Front 115

The parietal lobe of the brain:

Back 115

controls somatic functions for the contralateral side of the body

Front 116

Open fractures of the cranial vault:

Back 116

are associated with a high risk of bacterial meningitis

Front 117

A subdural hematoma is classified as being acute if clinical signs and symptoms develop:

Back 117

within 24 hours following the injury

Front 118

A ruptured tympanic membrane:

Back 118

is extremely painful but typically heals spontaneously

Front 119

The respiratory centers of the brain stem lie within the:

Back 119

pons and medulla

Front 120

The crista galli:

Back 120

is the anatomic point of attachment of the meninges

Front 121

Following a traumatic brain injury, initial swelling of the brain occurs due to:

Back 121

cerebral vasodilation

Front 122

Significant blunt injuries to the larynx or trachea pose an IMMEDIATE risk of:

Back 122

airway compromise

Front 123

Unlike a cerebral concussion, a cerebral contusion is:

Back 123

associated with physical brain damage and more pronounced neurologic deficits

Front 124

When treating a patient with an ocular injury, what should you do to avoid an increase in intraocular pressure (IOP)?

Back 124

Discourage the patient from coughing

Front 125

Which of the following types of skull fracture would be the LEAST likely to present with gross physical signs?

Back 125

Linear fracture

Front 126

Prehospital treatment of the patient with a traumatic brain injury must focus primarily on:

Back 126

maintaining cerebral perfusion pressure

Front 127

Early signs and symptoms of increased intracranial pressure include:

Back 127

headache and vomiting

Front 128

The occipital condyles are the:

Back 128

points of articulation between the skull and vertebral column

Front 129

Which of the following statements regarding anisocoria is MOST correct?

Back 129

Anisocoria is a condition in which the pupils are unequal

Front 130

Which of the following statements regarding a closed head injury is MOST correct?

Back 130

In a closed head injury, the dura mater remains intact.

Front 131

Proper treatment for an open wound to the neck includes:

Back 131

sealing the wound with an occlusive dressing

Front 132

Vascular injury following trauma to the anterior neck would MOST likely present with:

Back 132

pulse deficits

Front 133

Because significant force is required to fracture the mandible:

Back 133

it is often fractured in more than one place and is unstable to palpation

Front 134

What two major nerves provide sensory and motor control to the face?

Back 134

Facial and trigeminal

Front 135

You are caring for a man with a chemical burn to both eyes. The patient, who has contact lenses in place, is in severe pain and tells you that he can’t see. Proper care for this patient includes:

Back 135

carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation

Front 136

The primary risk associated with oral and dental injuries is:

Back 136

airway compromise

Front 137

The ___ conducts signals to the brain via the optic nerve and interprets them as vision.

Back 137

Retina

Front 138

A patient with a loss of peripheral vision MOST likely has damage to the:

Back 138

retina

Front 139

When assessing the severity of a traumatic brain injury, the single most important assessment parameter is the patient’s:

Back 139

level of consciousness

Front 140

The MOST disastrous consequence of a severe traumatic brain injury is:

Back 140

a decrease in cerebral perfusion pressure

Front 141

Death following a head injury is almost always the result of:

Back 141

trauma to the brain

Front 142

What portion of the eye may become icteric in patients with hepatitis?

Back 142

Sclera

Front 143

Open soft-tissue facial trauma following a significant mechanism of injury:

Back 143

suggests that the patient may have a closed head injury or spinal injury

Front 144

A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale (GCS) score is ___, and the MOST appropriate treatment for him involves:

Back 144

7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic BP of at least 90 mmHg, and maintaining his oxygen saturation at greater than 95%

Front 145

The galea aponeurotica is:

Back 145

a tendon expansion that connects the frontal and occipital muscles of the cranium

Front 146

Which of the following statements regarding the hypothalamus is MOST correct?

Back 146

The hypothalamus is the most inferior portion of the diencephalon and controls functions such as hunger, sleep, and vomiting.

Front 147

A flattened appearance to the face and loss of sensation over the chest following blunt facial trauma is MOST indicative of a/an:

Back 147

zygomatic fracture

Front 148

What portion of the brain stem is responsible for maintenance of consciousness, specifically one’s level of arousal?

Back 148

Reticular activating system

Front 149

Signs and symptoms of retinal detachment include:

Back 149

flashing lights, specks or floaters in the field of vision

Front 150

The ONLY indication for removing contact lenses in the prehospital setting is:

Back 150

chemical eye burns

Front 151

A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130 mmHg, heart rate is 48 beats/min, and respirations are 22 breaths/min. This patient’s clinical presentation is MOST consistent with:

Back 151

autonomic dysreflexia

Front 152

A motorcycle or football helmet should be removed if:

Back 152

the patient is breathing shallowly and access to the airway is difficult

Front 153

A compression or burst fracture of the cervical spine would MOST likely occur following:

Back 153

a significant fall in which the patient lands head first

Front 154

A skier wiped out while skiing down a large hill. He is conscious and alert and complains of being very cold; he also complains of neck stiffness and numbness and tingling in all of his extremities. A quick assessment reveals that his airway is patent and his breathing is adequate. You should:

Back 154

immobilize his spine and quickly move him to a warmer environment

Front 155

Herniation of an intervertebral disc occurs when:

Back 155

stress on the vertebral column forces a disc into the spinal canal

Front 156

You would MOST likely have to place several blankets or pillows under a patient’s upper back prior to immobilization if he or she has:

Back 156

kyphosis

Front 157

A patient with diaphragmatic breathing without intercostal muscle use has MOST likely experienced a spinal injury above the level of:

Back 157

T-2

Front 158

The spine:

Back 158

is a major structural component of the axial skeleton

Front 159

In addition to the supporting muscles and ligaments found in the vertebral column, the thoracic spine is further stabilized by the:

Back 159

rib attachments

Front 160

When assessing a Glasgow Coma Scale (GCS) score to a patient who has limb paralysis due to a spinal cord injury, you should:

Back 160

ask the patient to blink or move a facial muscle

Front 161

When moving an injured patient from the ground onto a long backboard, it is generally preferred that you:

Back 161

use the four-person log roll technique

Front 162

The anterior weight bearing structure of the vertrebra is the:

Back 162

vertebral body

Front 163

An unconscious trauma patient whose head and neck are passively rotated to one side:

Back 163

should be maintained in this position unless breathing is compromised

Front 164

Patients with evidence of trauma above the ___ should be considered at risk for an associated spine injury.

Back 164

Clavicles

Front 165

A positive Babinski reflex is observed when the:

Back 165

toes move upward in response to stimulation of the sole of the foot

Front 166

If methylprednisolone (Solu-Medrol) is administered to a patient with a spinal cord injury, it should be given:

Back 166

less then 3 hours after the injury

Front 167

What spinal nerve tract carries information regarding pain and temperature?

Back 167

Lateral spinothalamic

Front 168

Modification of your physical examination of a patient with a suspected spinal cord injury following a two-car motor vehicle crash is based on all of the following factors, EXCEPT:

Back 168

injuries to patients in the other vehicle

Front 169

Proprioception is MOST accurately defined as:

Back 169

the ability to perceive the position and movement of one’s body

Front 170

A 40-year-old unrestrained man was ejected from his small truck when it struck a tree. He patient is found approximately 20 feet from the wreckage. Your initial actions should include:

Back 170

manually stabilizing his head and opening his airway with the jaw-thrust maneuver.

Front 171

When performing a cranial nerve assessment of a patient with a suspected spinal injury, you note that the patient’s pupil is constricted and the upper eyelid droops. This indicates an injury to:

Back 171

C3

Front 172

When immobilizing a sitting patient with a vest-type extrication device, you should manually stabilize his or her head and then:

Back 172

assess distal pulse and sensory and motor fuctions

Front 173

A 21-year-old woman was thrown from a horse and landed on her head. Upon arrival at the scene, you find the patient lying supine. She is conscious and has her head turned to the side. As you attempt to move her head to a neutral in-line position, she screams in pain. You should:

Back 173

maintain her head in the position found and continue with your assessment

Front 174

An injured patient’s head should be secured to the long backboard only after:

Back 174

his or her torso has been secured adequately

Front 175

Hypotension that is associated with neurogenic shock is the result of:

Back 175

loss of alpha receptor stimulation

Front 176

The main disadvantage of using a scoop stretcher to transfer a patient to the long backboard is:

Back 176

inability to conduct a visual exam of the back for injuries

Front 177

When performing the standing takedown technique to immobilize a patient’s spine, the patient is secured to the long backboard with straps:

Back 177

after he or she is lowered to the ground

Front 178

Upon arriving at the scene of a motor vehicle crash, you find the driver of the car still seated in her two-door vehicle. The passenger side of the vehicle has sustained severe damage and is inaccessible. The driver is conscious and alert and complains only of lower back pain. The backseat passenger, a young child who was unrestrained, is bleeding from the head and appears to be unconscious. You should:

Back 178

rapidly extricate the driver so you can gain quick access to the child in the backseat

Front 179

What spinal cord injury is characterized by motor loss on the same side as the injury, but below the lesion:

Back 179

Brown-Sequard syndrome

Front 180

The only area of the spine that allows for significant rotation is:

Back 180

C1-C2

Front 181

Which of the following statements regarding central cord syndrome is MOST correct?

Back 181

The patient typically presents with greater loss of function in the upper extremities than in the lower extremities

Front 182

In which of the following situations would spinal motion restriction precautions likely NOT be necessary?

Back 182

Syncopal episode in which the patient was already seated or supine

Front 183

Which of the following statements regarding the brain stem is MOST correct?

Back 183

The brain stem connects the spinal cord to the brain

Front 184

Which of the following statements regarding the hangman’s fracture is MOST correct?

Back 184

It is a fracture of C2 that is secondary to significant distraction of the neck

Front 185

When applying a vest-type extrication device to a seated patient, his or her head should be secured to the device:

Back 185

only after the torso is fastened securely

Front 186

Although extremely painful, injuries to the ___ spine are typically the LEAST significant:

Back 186

coccygeal

Front 187

Vagal tone remains intact following a spine injury because:

Back 187

the vagus nerve originates outside the medulla and regulates the heart via the carotid arteries

Front 188

Displacement of bony fragments in the anterior portion of the spinal cord results in:

Back 188

anterior cord syndrome

Front 189

The upper thoracic spinal nerves:

Back 189

innervate the muscles of the chest that help in breathing and coughing

Front 190

A spinal cord contusion is:

Back 190

caused by a short-duration shock or pressure wave within the cord

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The MOST significant complication associated with prolonged immobilization of a patient on a long backboard is:

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pressure lesion development

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Any motor or sensory deficits noted during the neurologic examination of a patient with a possible spinal cord injury:

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should be documented and monitored

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In which of the following situations would it be MOST appropriate to apply a vest-type extrication device to a patient who is seated in his or her crashed motor vehicle?

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Conscious with neck pain and stable vital signs

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Following a spinal injury, a patient presents with abdominal breathing and use of the accessory muscles in the neck. This suggests injury at or above:

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C3-C4

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The innermost meningeal layer that rests directly on the spinal cord is the:

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pia mater

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If the mechanism of injury indicates that your patient may have sustained a spinal cord injury:

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assume that a spine injury exists, regardless of neurologic findings

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The MOST effective method of decreasing morbidity and mortality associated with spinal cord injury (SCI) is:

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public education and prevention strategies

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You are dispatched to a senor citizen’s center where an elderly woman apparently fainted. When you arrive, you find the patient sitting in a chair. An employee of the center tells you that he caught the patient before she fell to the ground. Your initial assessment reveals that the patient is conscious and alert and is breathing adequately. You should:

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obtain vital signs and assess her blood glucose level

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The ___ is the largest component of the central nervous system and contains billions of neurons that serve a variety of functions.

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Brain

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You are assessing a patient who sustained blunt trauma to the center of his back. He is conscious, but is unable to feel or move his lower extremities. His blood pressure is 80/50 mmHg, pulse is 40 beats/min and weak, and respirations are 24 breaths/min and shallow. If IV fluids do not adequately improve perfusion, you should:

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give 0.5 mg of atropine and consider a dopamine infusion