Deck 27: Emergency or Life-Threatening Situations

Question 1

The deepest level of coma determined by the Glasgow Coma Scale is a value of

A)0.
B)1.
C)2.
D)3.
E) 4.

Answer 1

3.

Question 2

Respiratory distress may be evidenced by

A)retractions of accessory muscles.
B)oliguria.
C)flushed skin.
D)decreased capillary refill time.
E)bradycardia.

Answer 2

retractions of accessory muscles.

Question 3

Cushing triad includes

A)hypotension.
B)irregular respirations.
C)tachypnea.
D)constricted pupils.
E)tachycardia.

Answer 3

irregular respirations.

Question 4

A life-threatening condition is recognized with the assessment of

A)pain with downward pressure on both anterior superior iliac spines.
B)guarding and intense pain with deep palpation of the abdomen.
C)distant and muffled heart sounds with distended neck veins.
D)severe throbbing pain in one eye with photophobia.
E)painful blunt sternal pressure.

Question 5

Pulsus paradoxus greater than 20 mm Hg, tachycardia greater than 130 beats/min, and increasing dyspnea are signs of

A)intracranial pressure.
B)pulmonary hypertension.
C)status asthmaticus.
D)tetanic contractions.
E)drug overdose.

Question 6

Until stabilized, trauma patients require reevaluation every

A)2 minutes.
B)5 minutes.
C)10 minutes.
D)15 minutes.
E)hour.

Question 7

Delayed capillary refill may alert you to

A)hypovolemic shock.
B)moderate hypoxemia.
C)epiglottitis.
D)upper respiratory infection.
E)subnormal intracranial pressure.

Question 8

Capillary refill can be assessed by applying pressure over a nail bed or a(n)

A)bony prominence.
B)ear.
C)mucous membrane.
D)femoral vein.
E)eyelid.

Question 9

The application of blunt sternal pressure is used to detect

A)fracture of attached ribs.
B)motor function of T7 dermatome.
C)cardiac tamponade.
D)cardiac contusion.
E)pneumothorax.

Question 10

If trauma above the clavicle is suspected, it is important to

A)perform endotracheal intubation.
B)test range of motion of the neck.
C)arrange for neck extension x-ray studies.
D)stabilize the neck in a neutral position.
E)remove any headgear.

Question 11

Paradoxic chest movement suggest a

A)spontaneous pneumothorax.
B)status asthmaticus.
C)clavicle fracture.
D)pulmonary contusion.
E)flail chest.

Question 12

Blood, vomitus, or foreign bodies are removed from the oropharynx of the unconscious patient by

A)stimulating the cough reflex.
B)placing the patient prone.
C)performing a back thrust.
D)using suction.
E)hyperextending the neck.

Question 13

Clear or amber drainage from the nose or ears of a patient who has sustained blunt trauma may indicate

A)epiglottitis.
B)aspiration.
C)basilar skull fracture.
D)perforated tympanic membrane.
E)retropharyngeal abscess.

Question 14

Raccoon eyes and Battle sign are associated with

A)a ruptured spleen.
B)orbital fractures.
C)basilar skull fractures.
D)subdural hematoma.
E)ectopic pregnancy.

Question 15

You arrive by ambulance at a construction site, where a man is lying on the street. The only information you have is that he fell three stories. His neck is immobilized with sacks of concrete mix on either side. Your first action should be to determine

A)airway patency.
B)bleeding sites.
C)cranial nerve function.
D)limb position.
E)peripheral pulses.

Question 16

You would complete a Glasgow Coma Scale rating during the

A)health history.
B)physical examination.
C)primary survey.
D)secondary survey.
E)patient transport.

Question 17

Upon palpating the chest wall of a trauma patient, you feel subcutaneous crepitus (emphysema), which is a sign that

A)there is a flail chest.
B)a fracture underlies the injury.
C)a foreign body is present.
D)there is vascular obstruction.
E)air has leaked into soft tissue.

Question 18

The ABCs of the advanced cardiac life support survey would be interrupted to

A)obtain further historical data.
B)manage life-threatening conditions.
C)reassess the patient's temperature.
D)transport the patient via airlift.
E)complete the assessment record.

Question 19

While you are performing the primary survey on a trauma victim, the patient is answering your questions. You may assume that during the time of the questioning

A)his airway is open.
B)he is alert and oriented.
C)no head injury has occurred.
D)there is no respiratory compromise.
E)he is not hypovolemic.

Question 20

Status epilepticus is defined as

A)seizures with intermittent recovery of consciousness.
B)nonconvulsive brain wave disturbance with psychomotor dysfunction.
C)protracted convulsions with unresponsiveness lasting up to an hour.
D)seizures that result in hypotension, pallor, and prolonged diaphoresis.
E)convulsive activity uncontrolled by medication.

Question 21

Which injury is the most common precipitator of severe blunt trauma?

A)Age-related falls
B)Motor vehicle accidents
C)Work-related injuries
D)Childhood play injuries
E)Sports-related injuries

Question 22

The approximate expected systolic blood pressure for a child older than 1 year of age is _____ the child's age in years.

A)100 +
B)80 +
C)120 -
D)80 + 2 $\times$
E)120 +

Question 23

During injury assessment, one of the most crucial historical components is

A)number of siblings.
B)history of prior fractures.
C)mechanism of injury.
D)past and current occupational exposures.
E)personal and social history.

Question 24

In life-threatening emergencies, consent for treatment

A)is obtained before treatment to protect the facility from liability.
B)must be obtained within an hour after beginning treatment.
C)occurs after treatment is administered.
D)is not valid because the patient is not competent.
E)is not necessary.

Question 25

Adults and children display different physiologic responses to injury and acute illness. An important concept to remember when assessing infants and children is that they

A)experience lethal arrhythmias first, progressing to respiratory failure.
B)are smaller, so they are less prone to hypothermia than adults.
C)usually experience respiratory arrest before circulatory failure.
D)tolerate greater volume changes with less severe consequences.
E)usually experience cardiac arrest before respiratory failure.

Question 26

The mnemonic AMPLE is used to assess

A)level of responsiveness.
B)respiratory status.
C)secondary assessment of a trauma patient.
D)level of coma.
E)an abbreviated history in an emergency condition.