Ch 29 - Trauma Systems and Mechanism of Injury Part 1

Chapter: Ch 29 - Trauma Systems and Mechanism of Injury Multiple Choice 1. The acute physiologic and structural change that occurs in a patient's body when an external source of energy dissipates faster than the body's ability to sustain and dissipate it is called: A) injury. B) trauma. C) deceleration. D) kinematics. Ans: B Page: 1483 Type: General Knowledge 2. The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy. A) kinetic, potential B) barometric, kinetic C) potential, kinetic D) chemical, potential Ans: C Page: 1484 Type: General Knowledge 3. Knowledge of kinetics can help the paramedic: A) predict injury patterns found in a patient. B) determine which organs have been injured. C) quantify how much blood a patient has lost. D) differentiate between medical and trauma patients. Ans: A Page: 1484 Type: General Knowledge 4. The primary determinants of the extent of trauma a patient sustains are the: A) type of object that strikes a patient and the part of the body that sustains the most impact. B) amount of energy in the object and the mechanism by which the object is delivered to the body. C) size of the object that strikes the body and any secondary injuries that occur if the patient falls. D) physical size of the patient and the part of the body that sustains direct impact from an object. Ans: B Page: 1484 Type: General Knowledge 5. Which of the following general statements regarding trauma is correct? A) Bullet impact is less if the energy in the bullet is applied to a small area. B) The position of the patient at the time of the event is considered to be an internal factor. C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. D) Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period. Ans: C Page: 1484 Type: General Knowledge 6. Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A) Index of suspicion B) Past medical history C) Age of the patient D) Mechanism of injury Ans: D Page: 1484-1485 Type: General Knowledge 7. According to the American College of Surgeons, an injured patient should be transported to a Level I trauma center if his or her: A) heart rate is greater than 100 beats/min. B) systolic blood pressure is less than 90 mm Hg. C) respiratory rate is less than 14 breaths/min. D) Glasgow Coma Scale score is less than 15. Ans: B Page: 1507-1508 Type: General Knowledge 8. Which of the following mechanisms of injury poses the LEAST threat for significant injury? A) Rear-end collision with restrained driver B) Death of an occupant in the same vehicle C) Motorcycle crash at greater than 20 mph D) Vehicular intrusion of greater than 12 inches Ans: A Page: 1509 Type: General Knowledge 9. Which of the following injuries would MOST likely require transport to a Level I trauma center? A) Two or more proximal long bone fractures B) Superficial burns to an entire lower extremity C) Lateral neck pain following a motor vehicle crash D) Penetrating injury that is distal to the elbow or knee Ans: A Page: 1507 Type: General Knowledge 10. If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: A) is older than 45 years of age. B) takes any kind of medication. C) is emotionally upset or angry. D) has a known bleeding disorder. Ans: D Page: 1509 Type: General Knowledge 11. A) B) C) D) A specific attribute of a Level I trauma center is that it: is involved in an injury prevention program. can initiate definitive care for all injured patients. has 24-hour in-house coverage by general surgeons. has rapid access to an off-site anesthesiologist. Ans: C Page: 1510 Type: General Knowledge 12. At a minimum, a Level II trauma center should: A) have an in-house neurosurgeon 24 hours a day. B) be able to initiate definitive care for all injured patients. C) have access to an emergency physician within 20 minutes. D) provide total care for every aspect of a patient's injuries. Ans: B Page: 1510 Type: General Knowledge 13. If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury: A) by ground to the Level I trauma center. B) to the closest hospital for stabilization. C) via air transport to the Level I trauma center. D) by ground to the Level II trauma center. Ans: C Page: 1509-1511 Type: General Knowledge 14. Which of the following is NOT a factor when considering transport of a trauma patient via helicopter? A) The need for definitive airway management B) Distance from the scene to the landing zone C) Time it will take the aircraft to reach the scene D) Type of terrain on which the helicopter will land Ans: A Page: 1511 Type: General Knowledge 15. When summoning an air transport service to transport a critically injured patient, it is MOST important to: A) determine the flight crew's credentials. B) ensure that the fire department is present. C) predetermine the destination facility. D) activate the service as soon as possible. Ans: D Page: 1511 Type: General Knowledge 16. The Òplatinum 10 minutesÓ refers to the: A) maximum amount of time to extricate a patient. B) maximum time spent at a scene for a trauma patient. C) amount of time before decompensated shock occurs. D) amount of time taken to perform a rapid assessment. Ans: B Page: 1505 Type: General Knowledge 17. An object increases its kinetic energy more by: A) decreasing its speed than by increasing its mass. B) increasing its velocity than by increasing its mass. C) decreasing its velocity than by decreasing its mass. D) increasing its mass than by increasing its velocity. Ans: B Page: 1485 Type: General Knowledge 18. The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. A) 140, 50 B) 160, 30 C) 150, 40 D) 170, 30 Ans: A Page: 1484-1486 Type: General Knowledge 19. The law of conservation of energy states that: A) kinetic energy can be converted only to thermal or chemical energy. B) the force that an object can exert is the product of its mass multiplied by its acceleration. C) energy can be neither created nor destroyed; it can only change form. D) a body at rest will remain at rest unless acted upon by an outside force. Ans: C Page: 1486 Type: General Knowledge 20. Sudden deceleration of a motor vehicle that is traveling at 60 mph: A) typically generates forces of up to 10 to 20 g. B) initially causes whiplash injuries to the patient's neck. C) dissipates tremendous forces and causes major injuries. D) causes the driver's body to stop moving at the same time. Ans: C Page: 1486 Type: General Knowledge 21. Which of the following injury mechanisms would MOST likely result in blunt trauma? A) Small-caliber gunshot wound B) Explosion involving shards of glass C) Falling from a tree onto a fence D) The pressure wave caused by a blast Ans: D Page: 1486 Type: General Knowledge 22. Penetrating trauma occurs when: A) internal organs are lacerated and bleed profusely. B) tissues are penetrated by single or multiple objects. C) blunt force trauma causes explosive open injuries. D) a fractured rib perforates the parenchyma of a lung. Ans: B Page: 1497 Type: General Knowledge 23. During abrupt deceleration: A) shearing or rupturing of internal organs can occur. B) the neck commonly sustains hyperextension injuries. C) the skull provides excellent protection for the brain. D) supporting structures of the aorta keep it attached. Ans: A Page: 1487, 1489 Type: General Knowledge 24. Unlike deceleration injuries, crush and compression injuries occur: A) at the time of impact. B) before impact occurs. C) after the initial impact. D) from penetrating mechanisms. Ans: A Page: 1489 Type: General Knowledge 25. The MOST common site of deceleration injury in the chest is the: A) heart. B) esophagus. C) aorta. D) vena cava. Ans: C Page: 1489 Type: General Knowledge 26. The third phase of a motor vehicle accident involves: A) crush injuries to the body. B) impact by another vehicle. C) deceleration of internal organs. D) injuries caused by flying debris. Ans: C Page: 1487 Type: General Knowledge 27. If the windshield of a wrecked vehicle is cracked or broken: A) you should assume that the driver has a severe intracerebral hemorrhage. B) the front seat occupant has a cervical spine injury until proven otherwise. C) the rear seat passenger was likely thrust from the seat into the windshield. D) it is likely that the vehicle was traveling at least 55 mph at the time of impact. Ans: B Page: 1488 Type: General Knowledge 28. The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is: A) deformity to the driver's brake pedal. B) severe damage to the front rims of the tires. C) a trail of debris leading to the site of impact. D) the presence of tire skid marks at the scene. Ans: D Page: 1488-1489 Type: General Knowledge 29. The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT: A) objects inside the vehicle. B) the physical size of the patient. C) the design of the motor vehicle. D) safety features of the motor vehicle. Ans: B Page: 1489 Type: General Knowledge 30. The initial point of bodily impact when an unrestrained passenger takes the Òdown and underÓ pathway during a frontal collision is the: A) knees. B) pelvis. C) femurs. D) abdomen. Ans: A Page: 1489-1490 Type: General Knowledge 31. When a patient takes the Òup and overÓ pathway during a head-on collision: A) the head takes a higher trajectory, striking the windshield and causing stretching injuries to the neck. B) secondary injuries as the patient is ejected are often less severe than the primary injuries. C) the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx. D) injuries to the parietal aspect of the skull are common as the head strikes the side window. Ans: C Page: 1490 Type: General Knowledge 32. During a frontal collision, MOST pneumothoraces occur when: A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact. B) the diaphragm rapidly ascends into the chest cavity during impact, causing an increase in intrathoracic pressure. C) the chest strikes the steering wheel, which fractures one or more ribs and causes a perforation injury to one of the lungs. D) the patient is ejected through the windshield, and his or her chest collides with a secondary object outside the vehicle. Ans: A Page: 1490-1491 Type: General Knowledge 33. During a lateral impact collision: A) the far-side occupant, even if properly restrained, experiences double the amount of force as the driver. B) the patient's head moves away from the object causing the impact, resulting in stretching injuries. C) properly worn seat belts protect the passenger from pelvic trauma at the time of impact. D) trauma to the upper extremities depends on the spatial orientation of the arms upon impact. Ans: D Page: 1490-1491 Type: General Knowledge 34. The severity of hyperextension injuries to the neck following a rear-end collision depends MOSTLY on: A) the proper use of seat belts. B) the position of the headrest. C) proper deployment of the air bags. D) whether the driver tenses up. Ans: B Page: 1492 Type: General Knowledge 35. Following a rotational impact, the MOST severely injured patient(s. will likely be found at the point of: A) least deceleration. B) greatest deceleration. C) secondary impact. D) greatest acceleration. Ans: B Page: 1492 Type: General Knowledge 36. Which of the following statements regarding rollover motor vehicle crashes is correct? A) Injuries to the passengers are usually not serious if seat belts are worn properly. B) Ejection of the patient from the vehicle increases the chance of death by 5 times. C) Unrestrained passengers are struck with each change in direction the car makes. D) The restrained occupant's head and neck usually remain stationary during a rollover. Ans: C Page: 1492-1493 Type: General Knowledge 37. Which of the following is NOT a benefit of a properly worn seat belt? A) Minimal risk of whiplash injuries after a rear-end collision B) Prevention of partial or complete ejection from the vehicle C) Prevention of occupants from violently contacting each other D) Distribution of deceleration energy over a greater surface area Ans: A Page: 1493 Type: General Knowledge 38. What type of injuries will MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact? A) Pelvic and lumbar spine B) Femur and thoracic spine C) Kidney and thoracic spine D) Abdominal and lumbar spine Ans: D Page: 1493 Type: General Knowledge