A patient is involved in a MVA and suffers multiorgan trauma. He is brought to the ER by
F F F F F F F F F F F F F F F F F F
EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
F F F F F F F F F F F F F
He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
F F F F F F F F F F F F F F F F F F
thready. His CVP is 9 his HR is 42 and his BP is 80/40. What is the most likely cause of his
F F F F F F F F F F F F F F F F F F F F F F
shock state? F
A. Closed head injury F F
B. Ongoing intra-abdominal hemorrhage F F
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock F F F F F
Which one of the following findings in an adult is most likely to require immediate
F F F F F F F F F F F F F F F
management during the primary survey? F F F F
A. distended abdomen F
B. Glasgow Coma Scale score of 11 F F F F F
C. temperature of 36.5°C (97.8°F) F F F
D. deforming of the right thigh F F F F
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
F F F F F F F F F F F F F
breaths per minute F F
Which one of the following statements regarding abdominal trauma in the pregnant
F F F F F F F F F F F F
patient is TRUE? F F
A. The fetus is in jeopardy only with major abdominal trauma.
F F F F F F F F F
B. Leakage of amniotic fluid is an indication for hospital admission.
F F F F F F F F F
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
F F F F F F F F F F F
,D. With penetrating trauma injury to the mother's abdominal hollow viscus is more
F F F F F F F F F F F F
common in late than in early pregnancy.
F F F F F F
E. The secondary survey follows a different pattern from that of the nonpregnant
F F F F F F F F F F F F
patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
F F F F F F F F F F F F
The most important immediate step in the management of an open pneumothorax is:
F F F F F F F F F F F F
A. endotracheal intubation F
B. operation to close the wound F F F F
C. placing a chest tube through the chest wound
F F F F F F F
D. placement of an occlusive dressing over the wound F F F F F F F
E. initiation of 2 large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of
F F F F F F F F F F F F
an occlusive dressing over the wound
F F F F F
The following are contraindications for tetanus toxoid administration:
F F F F F F F
A. history of neurological reaction or severe hypersensitivity to the product
F F F F F F F F F
B. local side effectsF F
C. muscular spasms F
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
F F F F F F F F F F F F
hypersensitivity to the product F F F
A 56-year-old man is thrown violently against the steering wheel of his truck during a
F F F F F F F F F F F F F F F
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
F F F F F F F F F F F F F
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40
F F F F F F F F F F F F F F F F F
breaths per minute. Which of the following best differentiates cardiac tamponade from
F F F F F F F F F F F F
tension pneumothorax as the cause of his hypotension?
F F F F F F F
A. Tachycardia
,B. pulse volume F
C. breath sounds F
D. pulse pressure F
E. jugular venous pressure - ANSWER>>C. breath sounds
F F F F F F
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
F F F F F F F F F F F F F F
endotracheal intubation because: F F
A. The trachea is relatively short.
F F F F
B. The distance from the lips to the larynx is relatively short.
F F F F F F F F F F
C. The use of cuffed endotracehal tubes eliminates this issue.
F F F F F F F F
D. The mainstem bronchi are less angulated in their relation to the trachea.
F F F F F F F F F F F
E. So little friction exists between the endotracheal tube and the wall of the trachea. -
F F F F F F F F F F F F F F F
ANSWER>>A. The trachea is relatively short. F F F F F
Which one of the following is the most effective method for initially treating frostbite?
F F F F F F F F F F F F F
A. moist heat F
B. early amputation
F
C. padding and elevation F F
D. vasodilators and heparin F F
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
F F F F F F F F
Which one of the following statements concerning intraosseous infusion is TRUE?A. Only
F F F F F F F F F F F F
crystalloid solutions may be safely infused through the needle.
F F F F F F F F
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
F F F F F F F F F
C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
F F F F F F F F F F F
, D. Intraosseous infusion may be utilized indefinitely. F F F F F
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
F F F F F F F F F F F F F F F
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
F F F F F F F F F F F
the needle.
F
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the
F F F F F F F F F F F F F F F F F F
emergency department her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
F F F F F F F F F F F F F F F F
rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
F F F F F F F F F F F F F F F F
mm in size and equally reactive to light. There is no other apparent injury. The most
F F F F F F F F F F F F F F F F
important principle to follow in the early management of her head injury is to:
F F F F F F F F F F F F F
A. avoid hypotension F
B. administer an osmotic diuretic F F F
C. aggressively treat systemic hypertension F F F
D. reduce metabolic requirements of the brain F F F F F
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
F F F F F F F F F F
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III
F F F F F F F F F F F F F
(moderately severe) splenic injury has been confirmed by computed tomography (CT).
F F F F F F F F F F F
Which of the following mandates prompt celiotomy (laparotomy)?
F F F F F F F
A. a serum amylase of 200
F F F F F
B. a leukocyte count of 14,000
F F F F
C. evidence of retroperitoneal hematoma on CT scan F F F F F F
D. development of peritonitis on physical exam F F F F F
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
F F F F F F F F F F F F F F F F F
development of peritonitis on physical exam F F F F F
F F F F F F F F F F F F F F F F F F
EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
F F F F F F F F F F F F F
He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
F F F F F F F F F F F F F F F F F F
thready. His CVP is 9 his HR is 42 and his BP is 80/40. What is the most likely cause of his
F F F F F F F F F F F F F F F F F F F F F F
shock state? F
A. Closed head injury F F
B. Ongoing intra-abdominal hemorrhage F F
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock F F F F F
Which one of the following findings in an adult is most likely to require immediate
F F F F F F F F F F F F F F F
management during the primary survey? F F F F
A. distended abdomen F
B. Glasgow Coma Scale score of 11 F F F F F
C. temperature of 36.5°C (97.8°F) F F F
D. deforming of the right thigh F F F F
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
F F F F F F F F F F F F F
breaths per minute F F
Which one of the following statements regarding abdominal trauma in the pregnant
F F F F F F F F F F F F
patient is TRUE? F F
A. The fetus is in jeopardy only with major abdominal trauma.
F F F F F F F F F
B. Leakage of amniotic fluid is an indication for hospital admission.
F F F F F F F F F
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
F F F F F F F F F F F
,D. With penetrating trauma injury to the mother's abdominal hollow viscus is more
F F F F F F F F F F F F
common in late than in early pregnancy.
F F F F F F
E. The secondary survey follows a different pattern from that of the nonpregnant
F F F F F F F F F F F F
patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
F F F F F F F F F F F F
The most important immediate step in the management of an open pneumothorax is:
F F F F F F F F F F F F
A. endotracheal intubation F
B. operation to close the wound F F F F
C. placing a chest tube through the chest wound
F F F F F F F
D. placement of an occlusive dressing over the wound F F F F F F F
E. initiation of 2 large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of
F F F F F F F F F F F F
an occlusive dressing over the wound
F F F F F
The following are contraindications for tetanus toxoid administration:
F F F F F F F
A. history of neurological reaction or severe hypersensitivity to the product
F F F F F F F F F
B. local side effectsF F
C. muscular spasms F
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
F F F F F F F F F F F F
hypersensitivity to the product F F F
A 56-year-old man is thrown violently against the steering wheel of his truck during a
F F F F F F F F F F F F F F F
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
F F F F F F F F F F F F F
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40
F F F F F F F F F F F F F F F F F
breaths per minute. Which of the following best differentiates cardiac tamponade from
F F F F F F F F F F F F
tension pneumothorax as the cause of his hypotension?
F F F F F F F
A. Tachycardia
,B. pulse volume F
C. breath sounds F
D. pulse pressure F
E. jugular venous pressure - ANSWER>>C. breath sounds
F F F F F F
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
F F F F F F F F F F F F F F
endotracheal intubation because: F F
A. The trachea is relatively short.
F F F F
B. The distance from the lips to the larynx is relatively short.
F F F F F F F F F F
C. The use of cuffed endotracehal tubes eliminates this issue.
F F F F F F F F
D. The mainstem bronchi are less angulated in their relation to the trachea.
F F F F F F F F F F F
E. So little friction exists between the endotracheal tube and the wall of the trachea. -
F F F F F F F F F F F F F F F
ANSWER>>A. The trachea is relatively short. F F F F F
Which one of the following is the most effective method for initially treating frostbite?
F F F F F F F F F F F F F
A. moist heat F
B. early amputation
F
C. padding and elevation F F
D. vasodilators and heparin F F
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
F F F F F F F F
Which one of the following statements concerning intraosseous infusion is TRUE?A. Only
F F F F F F F F F F F F
crystalloid solutions may be safely infused through the needle.
F F F F F F F F
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
F F F F F F F F F
C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
F F F F F F F F F F F
, D. Intraosseous infusion may be utilized indefinitely. F F F F F
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
F F F F F F F F F F F F F F F
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
F F F F F F F F F F F
the needle.
F
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the
F F F F F F F F F F F F F F F F F F
emergency department her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
F F F F F F F F F F F F F F F F
rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
F F F F F F F F F F F F F F F F
mm in size and equally reactive to light. There is no other apparent injury. The most
F F F F F F F F F F F F F F F F
important principle to follow in the early management of her head injury is to:
F F F F F F F F F F F F F
A. avoid hypotension F
B. administer an osmotic diuretic F F F
C. aggressively treat systemic hypertension F F F
D. reduce metabolic requirements of the brain F F F F F
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
F F F F F F F F F F
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III
F F F F F F F F F F F F F
(moderately severe) splenic injury has been confirmed by computed tomography (CT).
F F F F F F F F F F F
Which of the following mandates prompt celiotomy (laparotomy)?
F F F F F F F
A. a serum amylase of 200
F F F F F
B. a leukocyte count of 14,000
F F F F
C. evidence of retroperitoneal hematoma on CT scan F F F F F F
D. development of peritonitis on physical exam F F F F F
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
F F F F F F F F F F F F F F F F F
development of peritonitis on physical exam F F F F F
