SOLVED

21) Which of the following best describes definitive care for the pregnant trauma patient with ongoing, significant hemorrhage? A) Invasive hemodynamic monitoring and serial hematocrits B) Administration of hypertonic crystalloid or colloid solution C) Immediate surgery D) Administration of blood or blood products 22) Which of the following groups has the highest trauma morbidity and mortality rates? A) Males aged 13 to 35 years B) Males aged 45 to 70 C) Both genders aged 60 to 75 years D) Children aged 1 to 12 years 23) During which part of your assessment would you note the need for additional resources? A) Scene size-up B) Primary assessment C) Secondary assessment D) None of the above 24) In which type of vehicle impact are patients afforded the most protection? A) Frontal impacts B) Side impacts C) Lateral impacts D) None of the above 25) All of the following are components of the revised trauma score except: A) Glasgow Coma Scale B) Systolic blood pressure C) Pulse rate D) Respiratory rate 26) Which of the following best explains the importance of determining the trauma patient’s level of consciousness and orientation in the initial assessment? A) It determines whether the patient requires further assessment. B) It provides immediate information about the severity of the patient’s injury. C) It immediately rules in or out the need for spinal immobilization. D) It serves as a baseline for determining improvement or deterioration in the patient’s condition. 27) Which of the following patients’ mechanisms of injury meets trauma triage criteria for transport to a trauma center? A) A 17-year-old male with a gunshot wound to the arm B) A 31-year-old male involved in a medium-velocity motor vehicle collision C) A ten-year-old male soccer player with a laceration over his right eye after colliding with another player’s head D) A nine-year-old female who fell 15 feet from grandstand bleachers at a baseball game 28) Your patient is a 19-year-old male who was thrown from a horse while riding in a rodeo. After throwing the patient off, the horse stepped on the patient’s abdomen. When you reach the patient, you note that his face, neck, and shoulders are pale, cool, and diaphoretic but that the patient’s skin is otherwise warm and dry. The patient has some movement and sensation in his forearms and hands but otherwise no movement or sensation below the shoulders. He is anxious and has a respiratory rate of 24, a heart rate of 68, and a blood pressure of 106/66. Which of the following should be the primary concern when determining this patient’s transport priority? A) The potential for neurologic shock, requiring immediate surgery B) The potential for intraabdominal hemorrhage that may be masked by loss of sympathetic nervous function C) The potential for traumatic brain injury D) The potential for respiratory failure secondary to paralysis of the diaphragm 29) Your patient is a 45-year-male who was found sitting in a chair in a residence. He responds to painful stimuli with incoherent speech and has an odor of alcohol on his clothing and breath. There is an empty bottle of tricyclic antidepressants next to the patient, as well as a nearly empty bottle of liquor. Because there is no electricity in the residence and light is insufficient, you move the patient to your stretcher so you can perform your examination in a better environment. The patient has a blood pressure of 130/70, a heart rate of 124, and respirations of 8 per minute. There were no obvious signs of trauma, but your detailed examination reveals a fresh laceration to the right parietal area of the head. The laceration has been cleaned and appears to be several hours old. Which of the following is the best course of action? A) Transport the patient on the assumption that his condition is more consistent with a tricyclic overdose than with trauma. His reported history of alcoholism probably accounts for the laceration on his head. B) Right now the patient’s condition seems more consistent with tricyclic overdose, but because a history of the head laceration cannot be obtained, the patient should be monitored closely for signs of increased intracranial pressure. C) Place a cervical collar on the patient and secure him to a long backboard before transport. The empty medication bottle was likely an incidental finding. Intubate, using RSI if necessary. Begin transport to a trauma center, and start a large-bore IV of lactated Ringer’s solution infusing at a wide-open rate. D) Place a cervical collar on the patient and secure him to a long backboard before transport. His level of consciousness does not allow for better assessment of the mechanism of injury. His signs and symptoms are consistent with a tricyclic overdose and alcohol abuse, but his reported history of alcohol abuse puts him at increased risk of intracranial bleeding due to fairly minor trauma. 30) When administering fluid to a multisystem trauma patient with no signs of head injury but with signs of hypoperfusion, the paramedic should only administer fluid to maintain a systolic blood pressure equal to _____ mmHg. A) 70 B) 80 C) 60 D) 100