Home Medical QuizzesEmergency Quizzes The Quizzes about Trauma, Shock, and Resuscitation – Part 1 (20 test)

The Quizzes about Trauma, Shock, and Resuscitation – Part 1 (20 test)

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Trauma, Shock, and Resuscitation

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See all quizzes of  the Trauma, Shock, and Resuscitation  at here:

Part 1 (20 test) | Part 2 (20 test) | Part 3 (18 test – end)

II. Preview all questions below

1. A 58-year-old woman is brought to the emergency department (ED) by emergency medical service (EMS) after slipping on a patch of ice while walking to work and hitting her head on the cement Bystanders acknowledged that the patient was unconscious for approximately 1 minute. On arrival, her vital signs are blood pressure (BP) 155/75 mm Hg, heart rate (HR) 89 beats per minute, respiratory rate (RR) 18 breaths per minute, and pulse oxygenation 98% on room air. She has a 5-cm laceration to the back of her head that is actively bleeding. You ask the patient what hap- pened but she cannot remember. You inform her that she is in the hospital as a result of a fall. Over the next 10 minutes she asks you repeatedly what happened and where she is. You do not find any focal neurologic deficits. As you bring the patient to the CT scanner, she vomits once. CT results show a normal brain scan. Which of the following is the most likely diag-nosis?

  1. Cerebral concussion
  2. Diffuse axonal injury
  3. Cerebral contusion
  4. Posttraumatic epilepsy
  5. Trauma-induced Alzheimer disease

 

2. A 41-year-old man, the restrained driver in a high-speed motor vehicle collision, is brought to the ED by The patient is breathing without difficulty with bilateral and equal breaths sounds. He has strong pulses peripherally indicating a BP of at least 90 mm Hg. The HR is 121 beats per minute. His Glasgow coma scale (GCS) is 14. A secondary survey reveals chest wall bruising. You suspect a cardiac injury. Which of the fol- lowing locations most commonly involve cardiac contusions?

  1. Right atrium
  2. Right ventricle
  3. Left atrium
  4. Left ventricle
  5. Septum

3. A 25-year-old man is brought into the trauma resuscitation room after his motorcycle is struck by another EMS reports that the patient was found 20 ft away from his motorcycle, which was badly damaged. His vital signs include a BP of 90/60 mm Hg, HR 115 beats per minute, RR 22 breaths per minute, and pulse oxygenation of 100% on facemask. Which of the following is the smallest amount of blood loss that produces a decrease in the systolic BP in adults?

  1. Loss of 5% of blood volume
  2. Loss of 10% of blood volume
  3. Loss of 15% to 30% of blood volume
  4. Loss of 30% to 40% of blood volume
  5. Loss of greater than 40% of blood volume

 

4. You are notified by the EMS dispatcher that there is a multiple-car collision on the local highway with many He states that there are two people dead at the scene, one person is critically injured and hypoten- sive, and three people have significant injuries but with stable vital signs. Which of the following is the leading cause of death and disability in trauma victims?

  1. Abdominal injury
  2. Thoracic injury
  3. Back injury
  4. Cervical injury
  5. Head injury

 

5. Paramedics bring a 17-year-old high school football player to the ED on a backboard and with a cervical During a football game, the patient “speared” another player with his helmet and subsequently expe- rienced severe neck pain. He denies paresthesias and is able to move all of his extremities. A cervical spine CT scan reveals multiple fractures of the first cervical vertebra. Which of the following best describes this fracture?

  1. Odontoid fracture
  2. Hangman’s fracture
  3. Jefferson fracture
  4. Clay shoveler’s fracture
  5. Teardrop fracture

 

6. A 20-year-old man presents to the ED with multiple stab wounds to his His BP is 85/50 mm Hg and HR is 123 beats per minute. Two large-bore IVs (intravenous) are established and running wide open. On examination, the patient is mumbling incomprehensibly, has good air entry on lung examination, and you notice jugular venous distension (JVD). As you are listening to his heart, the nurse calls out that the patient has lost his pulse and that she cannot get a BP reading. Which of the following is the most appropriate next step in management?

  1. Atropine
  2. Epinephrine
  3. Bilateral chest tubes
  4. ED thoracotomy
  5. Pericardiocentesis

 

7. A 22-year-old man calls the ED from a local bar stating that he was punched in the face 10 minutes ago and is holding his front incisor tooth in his He wants to know what the best way is to preserve the tooth. Which of the following is the most appropriate advice to give the caller?

  1. Place the tooth in a napkin and bring it to the ED.
  2. Place the tooth in a glass of water and bring it to the ED.
  3. Place the tooth in a glass of beer and bring it to the ED.
  4. Pour some water over the tooth and place it immediately back into the socket.
  5. Place the tooth in a glass of milk and bring it to the ED.

 

8. A 19-year-old man is brought into the trauma room by EMS after a head-on cycling The patient was not wearing a helmet. Upon presentation his BP is 125/75 mm Hg, HR is 105 beats per minute, RR is 19 breaths per minute, and oxygen saturation is 100% on mask. His eyes are closed but open to command. He can move his arms and legs on com- mand. When you ask him questions, he is disoriented but able to converse. What is this patient’s GCS score?

  1. 11
  2. 12
  3. 13
  4. 14
  5. 15

9. An 18-year-old man presents to the ED after getting stabbed in his His HR is 140 beats per minute and BP is 90/40 mm Hg. He is yelling that he is in pain. Two large-bore IVs are inserted into his antecu- bital fossa and fluids are running wide open. After 2 L of fluids, his BP does not improve. Which of the following is the most common organ injured in stab wounds?

  1. Liver
  2. Small bowel
  3. Stomach
  4. Colon
  5. Spleen

 

10. A 61-year-old man presents to the ED with chest wall pain after a motor vehicle He is speaking full sentences, breath sounds are equal bilat- erally, and his extremities are well-perfused. His BP is 150/75 mm Hg, HR is 92 beats per minute, and oxygen saturation is 97% on room air. Chest radi- ography reveals fractures of the seventh and eighth ribs of the right antero- lateral chest. He has no other identifiable injuries. Which of the following is the most appropriate treatment for this patient’s rib fractures?

  1. Apply adhesive tape on the chest wall perpendicular to the rib fractures.
  2. Insert a chest tube into the right thorax.
  3. Bring the patient to the OR for surgical fixation.
  4. Analgesia and incentive  spirometry.
  5. Observation.

 

11. A 27-year-old man brought to the ED by paramedics after a motor vehicle His RR is 45 breaths per minute, oxygen saturation is 89%, HR is 112 beats per minute, and BP is 115/75 mm Hg. You auscultate his chest and hear decreased breath sounds on the left. Which of the fol- lowing is the most appropriate next step in management?

  1. Order a stat chest radiograph.
  2. Perform a pericardiocentesis.
  3. Perform a diagnostic peritoneal lavage (DPL).
  4. Perform an ED thoracotomy.
  5. Perform a tube thoracostomy.

 

12. A 29-year-old man is brought to the ED by EMS after being stabbed in the left side of his His BP is 120/80 mm Hg, HR is 105 beats per minute, RR is 16 breaths per minute, and oxygen saturation is 98% on room air. On the secondary survey, you note motor weakness of his left lower extremity and the loss of pain sensation in the right lower extremity. Which of the following is the most likely diagnosis?

  1. Spinal shock
  2. Central cord syndrome
  3. Anterior cord syndrome
  4. Brown-Séquard syndrome
  5. Cauda equina syndrome

 

13. A 33-year-old man, who was drinking heavily at a bar, presents to the ED after getting into a A bystander tells paramedics that the patient was punched and kicked multiple times and sustained multiple blows to his head with a stool. In the ED, his BP is 150/75 mm Hg, HR is 90 beats per minute, RR is 13 breaths per minute, and oxygen saturation is 100% on non-rebreather. On examination, he opens his eyes to pain and his pupils are equal and reactive. There is a laceration on the right side of his head. He withdraws his arm to pain but otherwise does not move. You ask him questions, but he just moans. Which of the following is the most appropri- ate next step in management?

  1. Prepare for intubation.
  2. Suture repair of head laceration.
  3. Administer mannitol.
  4. Bilateral burr holes.
  5. Neurosurgical  intervention.

 

14. A 74-year-old man presents to the ED after being involved in a motor vehicle He states he was wearing his seat belt in the driver’s seat when a car hit him from behind. He thinks his chest hit the steering wheel and now complains of pain with breathing. His RR is 20 breaths per minute, oxygen saturation is 98% on room air, BP is 145/75 mm Hg, and HR is 90 beats per minute. On examination, you notice paradoxical respirations. Which of the following best describes a flail chest?

  1. One rib with three fracture sites
  2. Two adjacent ribs, each with two fracture sites
  3. Three adjacent ribs, each with two fracture sites
  4. One fractured right-sided rib and one fractured left-sided rib
  5. Two fractured right-sided ribs and two fractured left-sided ribs

 

15. A 29-year-old man presents to the ED after being stabbed in his The patient is speaking in full sentences. His breath sounds are equal bilat- erally. His BP is 130/75 mm Hg, HR is 95 beats per minute, RR is 16 breaths per minute, and oxygen saturation is 99% on room air. The stab wound is located between the angle of the mandible and the cricoid cartilage and violates the platysma. There is blood oozing from the site although there is no expanding hematoma. Which of the following is the most appropriate next step in management?

  1. Explore the wound and blind clamp any bleeding site.
  2. Probe the wound looking for injured vessels.
  3. Apply direct pressure and bring the patient immediately to the OR to explore the zone I injury.
  4. Apply direct pressure and bring the patient immediately to the OR to explore the zone II injury.
  5. Apply direct pressure and bring the patient immediately to the OR to explore the zone III injury.

 

16. A 45-year-old man is brought to the ED after a head-on motor vehicle colli- Paramedics at the scene tell you that the front end of the car is smashed. The patient’s BP is 130/80 mm Hg, HR is 100 beats per minute, RR is 15 breaths per minute, and oxygen saturation is 98% on room air. Radiographs of the cervical spine reveal bilateral fractures of the C2 vertebra. The patient’s neurologic exami- nation is unremarkable. Which of the following best describes this fracture?

  1. Colles fracture
  2. Boxer’s fracture
  3. Jefferson fracture
  4. Hangman’s fracture
  5. Clay shoveler’s fracture

 

17. A 71-year-old man is found lying on the ground one story below the balcony of his Paramedics bring the patient into the ED. He is cool to touch with a core body temperature of 96°F. His HR is 119 beats per minute and BP is 90/70 mm Hg. His eyes are closed, but they open when you call his name. His limbs move to stimuli, and he answers your questions but is confused. On examination, you note clear fluid dripping from his left ear canal and an area of ecchymosis around the mastoid bone. Which of the following is the most likely diagnosis?

  1. Le Fort fracture
  2. Basilar skull fracture
  3. Otitis interna
  4. Otitis externa
  5. Tripod fracture

 

18. A 34-year-old construction worker is brought to the ED by EMS after falling 30 ft from a His vital signs are HR 124 beats per minute, BP 80/40 mm Hg, and oxygen saturation 93% on 100% oxygen. He has obvious head trauma with a scalp laceration overlying a skull fracture on his occiput. He does not speak when asked his name, his respirations are poor, and you hear gurgling with each attempted breath. Auscultation of the chest reveals diminished breath sounds on the right. There is no JVD or anterior chest wall crepitus. His pelvis is unstable with movement laterally to medially and you note blood at the urethral meatus. His right leg is grossly deformed at the knee and there is an obvious fracture of his left arm. Which of the following is the most appropriate next step in management?

  1. Insert a 32F chest tube into the right thoracic cavity.
  2. Perform a DPL to rule out intra-abdominal hemorrhage.
  3. Create two Burr holes into the cranial vault to treat a potential epidural hematoma.
  4. Immediately reduce the extremity injuries and place in a splint until the patient is stabilized.
  5. Plan for endotracheal intubation of the airway with in-line stabilization of the cervical spine.

 

19. A 20-year-old man was found on the ground next to his car after it hit a tree on the side of the Bystanders state that the man got out of his car after the collision but collapsed within a few minutes. Paramedics sub- sequently found the man unconscious on the side of the road. In the ED, his BP is 175/90 mm Hg, HR is 65 beats per minute, temperature is 99.2°F, RR is 12 breaths per minute, and oxygen saturation is 97% on room air. Physical examination reveals a right-sided fixed and dilated pupil. A head CT is shown below. Which of the following is the most likely diagnosis?

(Reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB. Atlas of Emergency Medicine. New York, NY: McGraw-Hill, 2002: 162.)

  1. Epidural hematoma
  2. Subdural hematoma
  3. Subarachnoid  hemorrhage (SAH)
  4. Intracerebral hematoma
  5. Cerebral contusion

 

20. An 81-year-old woman presents to the ED after tripping over the sidewalk curb and landing on her chin causing a hyperextension of her She was placed in a cervical collar by paramedics. On examination, she has no sensorimotor function of her upper extremities. She cannot wiggle her toes, has 1/5 motor function of her quadriceps, and only patchy lower extremity sensation. Rectal examination reveals decreased rectal tone. Which of the following is the most likely diagnosis?

  1. Central cord syndrome
  2. Anterior cord syndrome
  3. Brown-Séquard syndrome
  4. Transverse myelitis
  5. Exacerbation of Parkinson disease

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