Question 1

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

Accepted Answer

Low blood pressure is not typically associated with traumatic brain injury. The other options are more commonly seen in individuals with a traumatic brain injury.

Question 2

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

Accepted Answer

All of the options listed can be signs of possible brain injury. A deep laceration of the scalp can indicate that there was force or trauma to the head, which could lead to brain injury. Projectile vomiting can be a sign of increased pressure within the skull, which could be due to swelling or bleeding in the brain. An irregular breathing pattern can also be a sign of brain injury, as the brain plays a critical role in regulating breathing. Therefore, all of the above are possible signs of brain injury.

Question 3

You respond to a patient who was hit in the face with a chair.Upon arrival,you notice a patient leaning in the corner and bleeding profusely from the mouth and nose.Your first action should be which of the following?

Accepted Answer

Ensuring scene safety is always the first step in emergency response to protect both the responder and the patient from further harm.

Question 4

Your patient is a 21-year-old male who slid head-first down a water slide at his fraternity house and impacted the bales of straw that his fraternity brothers had erected as a barrier to keep participants from sliding onto the adjacent highway.The patient is conscious and complaining of neck pain.Which of the following should be included in your assessment?

Accepted Answer

In cases of potential neck injury, it's crucial to minimize movement to avoid exacerbating any spinal injuries. Asking the patient to grasp and squeeze your hands is a non-invasive way to assess motor function without risking further injury. Options A, B, and C involve movements that could potentially harm a patient with a spinal injury.

Question 5

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

Accepted Answer

Hyperventilating a patient with a brain injury can cause vasoconstriction of the blood vessels in the brain, leading to decreased blood flow to the brain. This can worsen the patient's condition and lead to further brain damage. It is important to monitor the patient's oxygen saturation and carbon dioxide levels carefully and adjust ventilation accordingly.

Question 6

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):

Accepted Answer

The man's presentation with confusion, dilated pupil, and no signs of trauma suggests a nontraumatic brain injury as the cause. The other options are less likely given the absence of corresponding symptoms or indications.

Question 7

Your patient has been involved in a motor vehicle collision.He has a contusion on his forehead,is confused,and is bleeding from his nose.His heart rate is 90 beats per minute,blood pressure is 80/58 mmHg,respirations are 20 breaths per minute,and his skin is cool and clammy.Which of the following sets of injuries should you suspect?

Accepted Answer

The patient's symptoms suggest a head injury (contusion on the forehead, confusion, and nosebleed), potential spine injury (due to the mechanism of injury in a motor vehicle collision), and signs of shock (heart rate of 90 beats per minute, low blood pressure of 80/58 mmHg, respirations of 20 breaths per minute, and cool, clammy skin) which could indicate internal bleeding.

Question 8

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?

Accepted Answer

A high-speed collision resulting in the patient striking the windshield with their face would likely cause significant trauma to multiple body systems. Cervical spine trauma must be considered because of the force of the impact. A brain injury is also a possibility due to the back-and-forth motion of the brain inside the skull upon impact. Airway obstruction may also occur due to swelling or trauma to the face and neck. Therefore, all of the above injuries should be prepared for and treated accordingly.

Question 9

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):

Accepted Answer

The answer of Your patient is a 16-year-old centerfielder on...

Question 10

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

Accepted Answer

The GCS is calculated by assessing eye response (4), verbal response (4 for confused), and motor response (6 for obeying commands), totaling 14.

Question 11

Hyperventilation of a patient with a severe brain injury due to an impaled object means that bag-valve-mask ventilations are provided at a rate of ________ per minute.

Accepted Answer

Hyperventilation in a patient with a severe brain injury is typically done at a rate of 20 breaths per minute to help reduce intracranial pressure by causing vasoconstriction of cerebral blood vessels.

Question 12

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

Accepted Answer

The priority for bag-valve-mask ventilation is the patient who is displaying decerebrate movements in response to painful stimuli, as this indicates a severe brain injury and potential airway compromise. The other patients may also require medical attention but do not have as severe of an immediate need for ventilatory support.

Question 13

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?

Accepted Answer

The patient's response to painful stimuli (pressing knuckles on sternum) indicates a level of consciousness of painful, which is between verbal and unresponsive.

Question 14

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

Accepted Answer

Improper management of airway and ventilation can lead to inadequate oxygenation and increased carbon dioxide levels, both of which can exacerbate brain injury by increasing intracranial pressure and causing further damage to brain tissue.

Question 15

You are treating an unresponsive homeless patient found in an alley.During your assessment you notice bruising behind both ears,which is known as which of the following?

Accepted Answer

Bruising behind the ears is known as Battle's signs, and it is a sign of a basilar skull fracture. This type of fracture can be caused by head trauma and can have serious implications for the patient's health. As such, it is important to recognize this sign and seek appropriate medical care for the patient. Options A, B, and C are not applicable to this scenario.

Question 16

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?

Accepted Answer

Based on the patient's presentation, he has a severe head injury with shallow, irregular respirations and bradycardia. The priority intervention is to secure his airway with an oropharyngeal airway and provide adequate ventilation with a bag-valve mask. The rate of ventilation should be 20 breaths per minute to avoid hyperventilation, which can worsen intracranial pressure. Giving oxygen by nonrebreather mask at 10-15 LPM is also important to maintain adequate oxygen saturation. Inserting a nasopharyngeal airway may worsen any potential spinal injury and is not recommended until cervical spine clearance has been performed.

Question 17

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?

Accepted Answer

The answer of Your patient is a 30-year-old construction worker...

Question 18

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,blood pressure 148/90,and her pupils are unequal.You should suspect a(n):

Accepted Answer

The combination of unconsciousness, irregular breathing, scalp bleeding, and unequal pupils suggests a closed head injury. The intact cranium indicates that the bleeding is likely occurring within the brain itself, leading to increased pressure and potential brain damage. A concussion would not typically cause bleeding, while a contusion or open head injury would usually involve visible damage to the skull. The vital signs may indicate increased intracranial pressure. Immediate medical attention is necessary in this case.

Question 19

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?

Accepted Answer

The patient's unresponsiveness, high blood pressure, and irregular breathing suggests increased intracranial pressure, which can be caused by traumatic brain injury or bleeding in the brain. The abrasion on the side of the head may indicate a head injury.

Question 20

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?

Accepted Answer

In an emergency setting, it is not advisable to remove a foreign object, such as a nail, from a wound site. The nail may be preventing further bleeding and removing it may increase the risk of significant bleeding. Furthermore, removing the nail may cause further injury, especially if the nail has penetrated deep into the brain tissue. Only a trained medical professional, in a controlled environment such as an operating room, should attempt to remove the nail. Shortness of breath or excessive ICP are not indications for urgent removal of the nail.

Quiz 29: Trauma to the Head, neck, and Spine