SOLVED

11) Your patient is a 12-year-old male who was struck in the right temporal area of the head with a baseball. He had a brief loss of consciousness and is alert on your arrival. You note that he is becoming drowsy and has a strong radial pulse of 60, a blood pressure of 140/70, and a respiratory rate of 12. Which of the following best describes this patient’s condition? A) He is stable, and he most likely has a subarachnoid hemorrhage with no increase in intracranial pressure. B) He is critical, and he most likely has an epidural hematoma with rapidly increasing intracranial pressure. C) He is stable, and he most likely has a mild diffuse axonal injury with no increase in intracranial pressure. D) He is serious, and he most likely has a subdural hematoma with an increase in intracranial pressure. 12) The shearing, stretching, and tearing associated with rapid acceleration/deceleration forces acting on the brain result in which of the following types of brain injury? A) Direct, diffuse B) Indirect, diffuse C) Indirect, focal D) Direct, focal 13) A concussion is best described as which of the following types of brain injuries? A) Indirect, diffuse B) Indirect, focal C) Direct, focal D) Direct, diffuse 14) For the patient with suspected traumatic brain injury, the ideal positioning of the patient for transport is: A) In a left lateral recumbent position on the backboard B) On a long backboard with the foot of the backboard in a 15-degree Trendelenburg position C) On a long backboard with the patient’s feet elevated on pillows to achieve a 15-degree angle D) On a long backboard with the head of the backboard elevated 15 to 30 degrees 15) When CPP falls below the critical level of 50 mmHG, autoregulation does which of the following to maintain CPP and cerebral perfusion? A) Decreases blood pressure B) Increases blood pressure C) Decreases intracranial pressure D) Increases intracranial pressure 16) Which of the following would explain tachycardia and hypotension in the patient with a closed traumatic brain injury? 1. An undiscovered source of hemorrhage resulting in shock 2. Cushing’s reflex 3. Massive blood loss due to tearing of the middle meningeal artery 4. Loss of compensatory mechanisms maintaining CPP A) 1, 3, 4 B) 1 C) 1, 4 D) 1, 2, 3, 4 17) Which of the following about the use of prehospital fluid resuscitation in the patient with a traumatic brain injury is TRUE? A) Administer fluids aggressively regardless of the patient’s blood pressure. B) Do not administer fluids unless the patient’s blood pressure drops below 60 mmHg, because the administration of fluids leads to increased cerebral edema. C) Administer fluids as needed to maintain a systolic blood pressure above 90 mmHg. D) The use of hypertonic fluids is indicated to maintain vascular volume while reducing tissue edema. 18) Which of the following best describes the role of rapid sequence intubation (RSI) in the prehospital management of patients with traumatic brain injury? A) It is beneficial and should be used for all patients with traumatic brain injury who are experiencing trismus or who have an intact gag reflex. B) It is supported by anecdotal evidence, but no studies have been done to determine its feasibility or usefulness. C) It is controversial because of conflicting study results. D) It is detrimental, resulting in poorer neurological outcomes than in patients who received standard airway management. 19) Which of the following statements about the patient in neurogenic shock is NOT true? A) The patient’s heart rate may be normal. B) Neurogenic shock may be temporary, even if spinal-cord injury is permanent. C) Signs of hypovolemic shock may be masked. D) Unopposed sympathetic nervous system stimulation results in generalized pallor and diaphoresis. 20) Coup injuries commonly occur in which region of the brain? A) Frontal region B) Occipital region C) Temporal region D) Neuronal region