CH 33

Question 1

Which of the following is a function of the autonomic nervous​ system?

Answer 1

Constriction of blood vessels

Question 2

Your patient is a​ 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to​ him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following best describes his level of​ consciousness?

Answer 2

painful

Question 3

When blood accumulates between the brain and the dura​ mater, what is the​ result?

Answer 3

subdural hematoma

Question 4

Your patient is pregnant at 30​ weeks’ gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her​ spine?

Answer 4

Place the patient supine on the​ backboard, then put a pillow under the right side of the backboard.

Question 5

Your patient is a​ 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of​ 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate​ intervention?

Answer 5

Provide cervical spine immobilization.

Question 6

Which of the following is controlled by the left side of the​ brain?

Answer 6

sensation of the right leg

Question 7

A​ 36-year-old male was accidentally shot with a nail gun into the head. You see the​ nail, which protrudes about 2 to 3 centimeters from the​ skull, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury​ site?

Answer 7

none

Question 8

Which of the following describes the proper position of the​ patient’s head for spinal​ immobilization?

Answer 8

​Neutral, inline position

Question 9

Which of the following is used to calculate a​ patient’s GCS?

Answer 9

Eye movement
Verbal response
motor response

Question 10

Which of the following may be a hazard of an improperly fitting cervical​ collar?

Answer 10

Prevents the patient from opening his mouth
B.
Allows hyperextension of the neck
C.
Allows flexion of the neck

Question 11

Which of the following signs is least likely to indicate a traumatic brain​ injury?

Answer 11

low blood pressure

Question 12

In which of the following circumstances should a helmet be​ removed?

Answer 12

If the helmet interferes with airway management

Question 13

While assessing a patient with a laceration to the​ neck, the EMT must be aware that which of the following conditions may​ develop?

Answer 13

air embolus

Question 14

Which of the following is a potential complication of hyperventilating a patient with a brain​ injury?

Answer 14

Decreasing blood flow to the brain

Question 15

Your patient is a​ 30-year-old construction worker who fell from scaffolding and has been impaled through the right orbit by a​ 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the best course of​ action?

Answer 15

Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

Question 16

Your patient is a​ 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you​ suspect?

Answer 16

Cervical spine injury

Question 17

Which of the following is the underlying cause of neurogenic​ shock?

Answer 17

Failure of the nervous system to control the diameter of blood vessels

Question 18

A​ 65-year-old man was doing some work on his roof when he lost his footing and fell to the​ ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head​ injury?

Answer 18

increased blood pressure

Question 19

The bony bumps you feel along the center of a​ person’s back are known as which of the​ following?

Answer 19

Spinous process

Question 20

Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long spine​ board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You​ should:

Answer 20

remove the helmet to better manage proper alignment.

Question 21

In most​ cases, which of the following is the correct way to provide initial management of a suspected cervical spine​ injury?

Answer 21

Hold the​ patient’s head still in a​ neutral, “eyes​ forward” position.

Question 22

You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale​ (GCS) per your protocols. Which of the following will you​ check?

Answer 22

Eye​ opening, motor​ response, and verbal response

Question 23

What is another name for the zygomatic​ bone?

Answer 23

malar

Question 24

Your patient has had his throat slashed during a robbery attempt. You are concerned because it is apparent that the vessels in his neck have been lacerated. A breach in which of the following vessels would be most likely to lead to an air​ embolism?

Answer 24

veins

Question 25

What is the Glasgow Coma Scale​ (GCS) of your adult male patient who has fallen off a​ horse, has his eyes​ open, and can follow your commands to squeeze his​ hands, but is confused about what happened and his​ whereabouts?

Answer 25

14

Question 26

Which of the following is classified as an open head​ injury?

Answer 26

Laceration with a skull fracture

Question 27

At which point may manual stabilization of the cervical spine be​ terminated?

Answer 27

When the patient is secured to a long backboard

Question 28

Which of the following is not a common field finding in spinal​ injuries?

Answer 28

deformity

Question 29

Messages from the body to the brain are carried by which of the following types of​ nerves?

Answer 29

sensory

Question 30

A​ 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to​ treat?

Answer 30

Airway obstruction B. Brain injury C. Cervical spine trauma

Question 31

Which of the following is the opening at the base of the​ skull?

Answer 31

Foramen magnum

Question 32

When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment​ building?

Answer 32

En route to the hospital

Question 33

Your patient is a​ 16-year-old male who was ejected from an​ all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with​ shallow, irregular​ respirations; a blood pressure of​ 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be most​ appropriate?

Answer 33

Insert an oropharyngeal airway and ventilate via​ bag-valve mask at 10 to 12 breaths per minute.

Question 34

Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of​ vertebrae?

Answer 34

Peripheral nervous system

Question 35

Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You immobilize him on a long spine board with a cervical collar on his neck as a precaution because you know that​ the:

Answer 35

cervical spine is not supported by other bony structures.

Question 36

You are called for a man who is not acting right. His wife says he was outside working in the garden but​ didn't come in for lunch when he was called. She went to check on him and found him sitting next to a​ stump, confused. You assessment shows a pulse rate of​ 58, blood pressure of​ 186/82, respirations of​ 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you​ don't see any obvious indication that he has fallen. You should suspect​ a(n):

Answer 36

nontraumatic brain injury.

Question 37

The maxillae form which of the following​ structures?

Answer 37

upper jaw

Question 38

Which of the following may result from the application of a cervical collar that is too large for the​ patient?

Answer 38

Hyperextension of the neck

Question 39

When using a short spine immobilization​ device, which part of the body is secured last​?

Answer 39

head

Question 40

Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine​ injuries?

Answer 40

Rigid cervical collars

Question 41

How many cervical vertebrae are​ there?

Answer 41

7

Question 42

Your patient is a​ 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is sitting in the​ driver's seat and conscious and​ alert, he has some abrasions on his​ forehead, his skin is warm and​ dry, and he has a strong radial pulse and no difficulty breathing. After applying a cervical​ collar, which of the following actions represents the most appropriate way for removing the patient from the​ vehicle?

Answer 42

Place a long spine board under the​ patient's buttocks and then carefully lower the patient to the board in a supine position.

Question 43

Which of the following injuries is considered an indirect brain​ injury?

Answer 43

Concussion

Question 44

When​ log-rolling a patient with a suspected spinal​ injury, which of the following EMTs directs the​ move?

Answer 44

EMT at the head of the patient

Question 45

EMT at the head of the patient

Answer 45

Cervical and lumbar

Question 46

Which of the following causes worsening of the damage in a brain​ injury?

Answer 46

Improper management of airway and ventilation

Question 47

Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of​ blood, and you are considering how you will control the bleeding. Your primary treatment should be​ to

Answer 47

place your gloved hand over the wound before placing an occlusive dressing.

Question 48

You are treating a​ 35-year-old male patient who has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of​ 60/40, a pulse of 66 beats per​ minute, and respirations of 18 breaths per minute. The​ patient's skin is flushed and warm. The​ patient's presentation is most likely caused by which of the​ following?

Answer 48

Neurogenic shock

Question 49

Which of the following is not used to calculate a​ patient's GCS?

Answer 49

Work of breathing

Question 50

Which of the following causes worsening of the damage in a brain​ injury?

Answer 50

Improper management of airway and ventilation

Question 51

You are treating an unresponsive homeless patient found in an alley. During your assessment you notice the Battle​ sign, which is​ bruising:

Answer 51

behind the ear.

Question 52

Your​ 38-year-old male patient has been injured in an assault. He has several facial lacerations and a large knot on his head. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As part of your scene​ size-up and primary​ assessment, you​ should:

Answer 52

immobilize his cervical spine.

Question 53

Which of the following statements concerning a concussion is true​?

Answer 53

The patient may not have any symptoms of the injury.

Question 54

Which of the following is defined as an area of the body surface that is innervated by a single spinal​ nerve?

Answer 54

Dermatome

Question 55

Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of​ vertebrae?

Answer 55

Peripheral nervous system

Question 56

Your patient is a​ 35-year-old woman who was driving a minivan that was struck in the​ driver's side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles she extends her legs and flexes her arms and wrists. When giving your radio​ report, which of the following terms should you use to describe​ this?

Answer 56

Posturing

Question 57

As pressure within the cranium​ increases, which of the following is the​ result?

Answer 57

Increased blood​ pressure, decreased pulse

Question 58

A fracture of which of the following bones would be considered a skull​ fracture?

Answer 58

Temporal bone B. Nasal bones C. Maxilla

Question 59

A​ 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained​ a(n):

Answer 59

whiplash injury.

Question 60

To which of the following sections of the spine are the ribs​ attached?

Answer 60

thoracic

Question 61

A young female was injured in an automobile​ wreck, striking her head on the windshield. She is unconscious and her breathing is irregular. She is bleeding from a scalp​ wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68 and blood pressure​ 148/90, and her pupils are unequal. You should suspect​ a(n):

Answer 61

closed head injury.

Question 62

Of the following​ patients, which injury is the highest priority to receive​ bag-valve mask​ ventilations?

Answer 62

​15-year-old female who was ejected from a​ vehicle, struck her head on a​ tree, and displays decerebrate movements in response to painful stimuli

Question 63

You are treating a​ 54-year-old female patient who was involved in a domestic​ dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of​ 200/110, a pulse of 60 beats per​ minute, and slightly irregular breathing. The​ patient's presentation is most likely caused by which of the​ following?

Answer 63

Increased intracranial pressure

Question 64

When a patient has a serious open wound to the​ neck, you are concerned about the possibility of an air embolism. The reason an air embolism can occur is because​ of:

Answer 64

pressure in the large neck veins that is lower than atmospheric pressure.

Question 65

Which of the following is a sign of possible brain​ injury?

Answer 65

A. Projectile vomiting B. Deep laceration of the scalp C. Irregular breathing patterns

Question 66

Your patient is a​ 16-year-old centerfielder on his high school baseball team. He was injured when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to tell you what happened. His vital signs are pulse​ 88, blood pressure​ 132/86, respiratory rate​ 16, and pupils equal. As you assess his​ head, you do not see any cuts or​ bleeding, but you feel a​ spongy, depressed area over his left ear. You should suspect​ a(n):

Answer 66

open head injury.