Burn and Trauma Management in Emergency Care, Exams of Nursing

Download Burn and Trauma Management in Emergency Care and more Exams Nursing in PDF only on Docsity! CFRN Practice Test Which of the following is the MOST commonly injured organ in the abdominal cavity? A. Pancreas B. Spleen C. Liver D. Kidneys - ANS B. Spleen Liver injuries will cause pain in the right upper quadrant along with right shoulder pain as blood accumulates around the diaphragm. The pain in the right shoulder is called: A. Gourd's sign B. Kehr's sign C. Vagal's sign D. Hobb's sign - ANS B. Kehr's sign The phrenic nerve that arises from cervical vertebrae 3, 4, and 5 controls the _______. A. Liver B. Diaphragm C. Stomach D. Pancreas - ANS B. Diaphragm The _______ is the largest solid organ in the human body. A. Brain B. Pancreas C. Spleen D. Liver - ANS D. Liver A root cause of esophageal varices is/are: A. Mallory-Weiss syndrome B. Reactive gastritis C. Cirrhosis D. Peptic ulcers - ANS C. Cirrhosis The most common cause of lower GI bleeding is: A. Ulcerative colitis B. Diverticulosis C. Inflammatory bowel disease (IBD) D. Angiodysplasia - ANS B. Diverticulosis A. 1 mL/kg/hr. B. 2 mL/kg/hr. C. 3 mL/kg/hr. D. 4 mL/kg/hr. - ANS B. 2 mL/kg/hr Which of the following is a major factor that makes children susceptible to hypothermia? A. The inability to shiver B. Fewer glycogen stores C. A larger proportion of body fat D. All of the above - ANS A. The inability to shiver All pediatric assessments should begin with forming a general impression using the Pediatric: A. Trauma score B. Assessment triangle C. Perfusion score D. Faces scale - ANS B. Assessment triangle Due to the relatively large tongue of a child in proportion to his or her mouth, successful intubation requires: proper blade size, proper positioning, and proper: A. Suctioning B. Sedation C. Sweeping of the tongue D. Cricoid pressure - ANS C. Sweeping of the tongue Physical assessment of a child's cardiovascular system begins with: A. Observing the child's general appearance and level of consciousness B. Checking the child's central pulse rate C. Feeling the child's skin temperature D. Placing the child on a cardiac monitor - ANS A. Observing the child's general appearance and level of consciousness An increase in _______ is the chief compensatory mechanism in children to increase end-organ perfusion and to maintain blood pressure. A. Heart rate B. Stroke volume C. Contractility D. Peripheral vasoconstriction - ANS A. Heart rate Epiglottitis is a medical emergency in the pediatric population. Remember the four Ds, which stand for: A. Dysphagia, dysphonia, drooling, and distress B. Diaphoresis, diplopia, diarrhea, and distress C. Dilated (pupils), drooling, distress, and diaphoresis D. Drooling, dysphagia, distant lung sounds, and distress - ANS A. Dysphagia, dysphonia, drooling, and distress Options to relieve a foreign body airway obstruction in a pediatric includes: A. Abdominal thrusts only B. One attempt at nasotracheal intubation C. Carotid massage D. Chest thrusts, Heimlich maneuver, and laryngoscopy with Magill forceps - ANS D. Chest thrusts, Heimlich maneuver, and laryngoscopy with Magill forceps A child in shock will fail quickly when the child's compensatory systems: A. Are in overdrive B. Fail C. Thrive D. Are functioning normally - ANS B. Fail In a child in shock, the heart rate is the: C. Obstructed venous disorders D. Lateral renal disorders - ANS A. Postrenal disorders Head injuries are the leading cause of ______________________ in the pediatric population. A. Pneumonia B. Degenerate spinal disease C. Death D. All of the above - ANS C. Death Which of the following statements about congenital heart defects is TRUE? A. The term infant is at the highest risk for an undiagnosed congenital heart defect. B. Congenital heart defects are classified as either cyanotic or acyanotic. C. A child with a relatively small lesion may go on to age 8 to 12 months before it is detected. D. The pattern of cyanosis, decreased mental status, and lethargy may mimic hypoglycemia. - ANS B. Congenital heart defects are classified as either cyanotic or acyanotic. While caring for a critical patient with profound hypoxia, you recall that changes in the V/Q ratio is one of the most common causes of hypoxemia. Which of the following best describes the V/Q ratio? A. A marker for inflammation when a blood clot may be present B. A measure of the coaguability of the pulmonary blood flow C. A measurement of how much blood flow must be present at the alveolar capillary membrane for perfusion to take place D. A serologic measurement of pulmonary injury - ANS C. A measurement of how much blood flow must be present at the alveolar capillary membrane for perfusion to take place In the presence of midface trauma with instability, which airway maneuver would be contraindicated? A. Digital intubation B. Oropharyngeal suctioning of foreign bodies C. Oral intubation D. Nasotracheal intubation - ANS D. Nasotracheal intubation You are on scene with a 37 year-old male involved in an MVC, combative and confused on-scene. Patient was intubated with a 8.0 ETT, 24 cm at the lips. Quantitative ETCO2 monitoring shows a ETCO2 of 50. Which action should be undertaken by the flight/transport nurse? A. Slightly hyperventile the patient B. Switch to a litmus paper ETCO2 detector C. Advance ETT 1 cm, then reassess D. Continue ventilating at 12 bpm with 100% FiO2 - ANS A. Slightly hyperventile the patient When assessing your patient's airway prior to intubation, you use the Mallampati classification. Your physical assessment reveals that the posterior pharynx is partially exposed. Based on your knowledge of this classification, you know that this is a Mallampati grade class of: A. I. B. II. C. III. D. IV. - ANS B. II. During intubation, the operator may use the BURP technique. This acronym stands for: A. Bag the patient, use pressure, reverse, placement B. Bilateral, upwards, replace, position C. Backward, upward, rightward, pressure D. Beneath, under, rearward, posterior - ANS C. Backward, upward, rightward, pressure You have just orally intubated your patient. When listening to breath sounds, you note that there are air sounds over the epigastrium. It is difficult to determine the presence of lung sounds. There is no significant chest rise or fall with revelations. The most appropriate action at this point is to: A. Deflate the cuff and pull back the tube 2 to 3 cm. B. Deflate the cuff and advance the tube 1 to 2 cm. C. Continue to ventilate for another minute and then reassess. D. Deflate the cuff, remove the tube, and repeat the steps for oral intubation. - ANS D. Deflate the cuff, remove the tube, and repeat the steps for oral After several failed intubation attempts, your patient still requires an advanced airway. There is a significant chance your patient has an airway obstruction as well. You are considering doing a surgical cricothyrotomy. Which of the following is a TRUE statement regarding this procedure? Distension of the external jugular veins is indicative of: A. Right-sided heart failure B. Left-sided heart failure C. Hypotension D. Myocardial infarction - ANS A. Right-sided heart failure Chemoreceptors respond to changes in which of the following indicators in blood? A. pH, glucose, and PCO2 B. Glucose, PO2, and PCO2 C. pH, PCO2, and HCO3 D. pH, PCO2, and PO2 - ANS D. pH, PCO2, and PO2 Cardiac output (CO) equals: A. Stroke volume x heart rate B. Stroke volume ÷ systemic resistance C. Heart rate - mean arterial pressure D. Heart rate ÷ stroke - ANS A. Stroke volume x heart rate On a 12-lead ECG, the augmented leads are: A. I, II, and III B. V1 to V6 C. aVR, aVL, and aVF D. RA, LA, LL, and RL - ANS C. aVR, aVL, and aVF When evaluating a chest pain patient's 12-lead ECG, you note that lead aVR is positively deflected. This is indicative of: A. Posterior wall MI B. Lead misplacement C. The patient in the left lateral recumbent position D. Septal wall MI - ANS B. Lead misplacement Extreme right axis deviation (RAD) can be seen in: A. SA node failure B. Ventricular tachycardia (VT) C. Septal wall MI D. A left bundle branch block - ANS B. Ventricular tachycardia (VT) A left axis deviation is normally seen: A. In children B. In pregnant women C. Due to dextrocardia D. Due to hypokalemia - ANS B. In pregnant women Your patient is short of breath and complaining of chest pain. He is seated in a tripod position, which he says improves his condition. When analyzing his 12-lead ECG, you note that all complexes are low- voltage, with ST segment elevation and T-wave inversion in all leads. You suspect: A. Improper lead placement B. A global MI C. Pericarditis D. WPW syndrome - ANS C. Pericarditis Shock, sepsis, and multi-organ dysfunction syndrome (MODS) share which of the following common denominators? A. Dilation of great vessels B. Inability of oxygen supply to meet demand C. Cellular function D. A carbon dioxide deficit - ANS C. Cellular function Glycolysis, the citric acid cycle, and the electron transport chain are the three essential components of which of the following processes? A. Aerobic metabolism B. Hypermetabolic output C. Hyperdynamic balance D. Anaerobic metabolism - ANS D. Anaerobic metabolism A patient in compensatory shock will increase his or her respiratory rate to bring about which of the following changes? A. A decrease in pH and an increase in minute volume B. Increased oxygen intake to blow off excess carbon dioxide C. A decrease in minute volume and an increase in pH D. Dilation of the capillary bed and diffusion gradient - ANS B. Increased oxygen intake to blow off excess carbon dioxide Your patient's lab states the current lactate level is 5.3mmol/L. This value suggests: A. Nothing B. Aerobic metabolism is occurring C. Anaerobic metabolism is occurring and is a biomarker for morbidity and mortality D. Metabolic acidosis - ANS C. Anaerobic metabolism is occurring and is a biomarker for morbidity and mortality Which of the following information about burns is FALSE? A. There are approximately 1 million burn injuries every year in the United States. B. Two percent of burn center admissions do not survive. C. Serious burns occur most often in males. D. The first 24 hours of burn care are crucial. - ANS B. Two percent of burn B. Two percent of burn center admissions do not survive A systemic inflammatory response is initiated in burns greater than: A. 5% B. 10% C. 15% D. 25% - ANS D. 25% Major burn injuries include all of the following EXCEPT: A. Partial-thickness burns of 15% to 25% in adults B. High-voltage electrical injury C. Full-thickness burns involving more than 10% of body surface area (BSA) D. Burns caused by caustic chemicals - ANS A. Partial-thickness burns of 15% to 25% in adults Inhalation should always be expected in all of the following EXCEPT: A. Facial burns B. High-voltage electrical shock C. Carbonaceous sputum D. Stridor or progressive hoarseness - ANS B. High-voltage electrical shock A variety of causes are thought to result in decreased cardiac output in burned patients, including all of the following EXCEPT: A. The inflammatory response and its mediators B. Cyanide poisoning C. Carbon monoxide poisoning D. Constrictive cardiomyopathy - ANS D. Constrictive cardiomyopathy Although succinylcholine (Anectine) is the drug of choice in rapid sequence intubation (RSI), it is contraindicated in patients with burn injuries greater than _______ hours old. A. 24 B. 48 C. 72 D. 96 - ANS B. 48 In a failed intubation attempt with a burn patient, the CCTP should be prepared to: A. Perform a surgical airway intervention B. A localized reaction C. Anaphylaxis D. A toxicity reaction - ANS C. Anaphylaxis _______ occurs when one or more of the components of the immune system is damaged or non- functioning. A. Infection B. Immunocompromise C. Immunodeficiency D. Hypersensitivity - ANS C. Immunodeficiency The prevention of colonization by pathogenic bacteria is attributed to: A. Broad-spectrum antibiotics B. Antifungal soaps and creams C. Adequate hand washing D. The presence of normal flora - ANS D. The presence of normal flora Microorganisms capable of causing disease are called: A. Pathogens B. Fomites C. Vectors D. Hosts - ANS A. Pathogens Properties of microbes that influence their virulence include all of the following EXCEPT: A. Invasion of host tissues B. Evasion of host defenses C. Toxicity D. Fomitic class of invader - ANS D. Fomitic class of invader All of the following are typical portals of entry EXCEPT the: A. Skin B. Hair follicles C. Conjunctiva of the eye D. Mucous membranes of the genitourinary tract - ANS A. Skin What are the two types of toxins produced by bacteria? A. Endogenous and exogenous B. Mild and fulminating C. Exotoxins and endotoxins D. Pyrogenic and exogenic - ANS C. Exotoxins and endotoxins Which of the following lactate (lactic acid) levels would be indicative of a septic shock? A. 4 mg/dl B. 9 mg/dl C. >18 mg/dl D. 2 mg/dl - ANS C. >18 mg/dl Which of the following is NOT a risk factor that predisposes people to environmental emergencies? A. Being in a poor state of health B. Being a thrill seeker C. Extremes of age D. Taking certain medications - ANS B. Being a thrill seeker The body's ability to ensure and maintain a balance between heat production and heat elimination is known as: A. Homogenesis B. Thermogenesis C. Thermolysis D. Thermoregulation - ANS D. Thermoregulation A. Impaired thermogenesis B. Excessive thermolysis C. Excessive environmental cold stress D. Hyperdynamic cardiac states - ANS D. Hyperdynamic cardiac states Passive external rewarming can be accomplished through the use of all EXCEPT: A. Removal of wet clothing B. Use of blankets C. Use of heat packs D. Infusion of cold saline - ANS D. Infusion of cold saline The MOST common critical care transport crew configuration is: A. Nurse and paramedic B. Two Nurses C. Nurse and physician D. Paramedic and EMT - ANS Patients with acute myocardial infarction, cerebrovascular accident, severe traumatic brain injury, and abdominal aneurysm are all examples of patients who: A. Will not tolerate the altitude changes associated with air medical transport B. Will require a respiratory therapist during transport C. Are good candidates for rotor-wing transportation D. Are too critical to transport - ANS C. Are good candidates for rotor-wing transportation _______ requires the use of specialized equipment and specialized training for paramedics and nurses. A. Advanced life support B. Fixed-wing air medical evacuation C. Specialty care transport, as defined by CMS D. Interfacility transport - ANS C. Specialty care transport, as defined by CMS The percentage of oxygen in the atmosphere at 250,000' (76 km) is: A. 16% B. 18% C. 21% D. 25% - ANS C. 21% A patient's pneumothorax increasing in size as altitude increases is an example of _______ Law. A. Charles' B. Boyle's C. Dalton's D. Fick's - ANS B. Boyle's The primary gas law dealing with diffusion of gasses across the alveolar membrane is: A. Graham's Law B. Boyle's Law C. Dalton's Law D. Fick's Law - ANS D. Fick's Law Reduced atmospheric pressure causing a reduced alveolar PO2 is an example of _______ hypoxia. A. Hypoxic B. Histotoxic C. Stagnant D. Hypemic - ANS A. Hypoxic 8. You are preparing a trauma patient with a closed head injury and blunt chest trauma for a 2-hour, fixed-wing transport. The patient is intubated, paralyzed, and sedated. Vital signs are: blood pressure, 110/76 mm Hg; respirations, 16 breaths/minute by ventilator; heart rate, 118 beats/minute and showing sinus tachycardia on the monitor; and an SaO2 of 96% with 0.5 FIO2. The CT scan shows a moderate subarachnoid bleed and chest x-ray reveals a 25% pneumothorax on the right. You are currently at 500' (152 m) above sea level, and the aircraft will reach a cabin pressure of 8,000' (2.4 km) en route to the tertiary care facility. Which of the following is your best option during this flight? B. Angina C. Polyphagia D. Hydrocele - ANS What potentially fatal diagnosis must be ruled out as cause of lower abdominal / pelvic pain in the fertile female? A. Ectopic pregnancy B. Gastroenteritis C. Cholelithiasis D. None of the above - ANS A. Ectopic pregnancy A prolonged erection of the penis, which typically occurs in male patients with a spinal cord injury, sickle cell anemia, penile vessel spasm or clot formation is called a: A. Polyuria B. Priapism C. Kehr's sign D. None of the above - ANS B. Priapism Three risk factors that predispose a patient for a hematology emergency include all of the following EXCEPT: A. Glaucoma B. Genetic predisposition C. Environmental exposures D. Infectious exposures - ANS A. Glaucoma A patient presenting with a viral infection would typically demonstrate a / an ______________________ number of lymphocytes. A. Unchanged B. Varied C. Increased D. Decreased - ANS D. Decreased A patient presenting with a bacterial infection would typically demonstrate a / an ______________________ number of lymphocytes. A. Unchanged B. Decreased C. Increased D. Varied - ANS C. Increased The three primary categories of common anemias include all of the following EXCEPT: A. Increased RBC destruction B. Increased RBC production C. Decreased RBC production D. Acute / chronic blood loss - ANS B. Increased RBC production The MOST important part of responding to a scene involving man-made disasters is: A. Speed of response B. Crew and Patient Safety C. Treatment delivery D. Crew integration to the scene - ANS B. Crew and Patient Safety Universal organizational structure for scene responses is known as: A. NIMS/ICS B. Incident management C. Resource management D. People skills - ANS A. NIMS/ICS What is the best resource available to responders at the awareness level to determine any hazardous materials present at scene? A. Regional response book B. Protocol book C. Emergency Response Guidebook (ERG) D. Eye movement, Secretions, Hazardous materials, Patient mentation - ANS B. Ability to walk (ambulation), Respirations, Perfusion, Mental Status Biological warfare agents such as bacteria, viruses, and fungi are used to: A. Kill or incapacitate B. Spread over large areas C. Strengthen and awaken D. Conduct wartime research - ANS A. Kill or incapacitate The dicrotic notch on an arterial pressure waveform is caused by the: A. Pulmonic valve closing B. Tricuspid valve opening C. Aortic valve closing D. Pulmonic valve opening - ANS C. Aortic valve closing An increase in heart rate will: A. Increase coronary perfusion pressures B. Decrease coronary perfusion time C. Increase coronary perfusion time D. Decrease myocardial oxygen consumption - ANS B. Decrease coronary perfusion time The intra-aortic balloon pump (IABP) catheter offers a mechanical means of balancing _______ and _______. A. Heart rate; stroke volume (SV) B. Ventricular ejection; ventricular filling C. Myocardial oxygen supply; oxygen demand D. Blood pressure (BP); heart rate - ANS C. Myocardial oxygen supply; oxygen demand Correct IABP timing inflates the balloon when: A. The ventricles are contracting B. The coronary arteries are filling C. Systole is occurring D. The aortic valve is open - ANS B. The coronary arteries are filling The counterpulsation balloon deflates at the end of _______ just prior to _______. A. Systole; ventricular relaxation B. Diastole; atrial relaxation C. Diastole; ventricular ejection D. Systole; ventricular contraction - ANS C. Diastole; ventricular ejection The most reliable trigger of IABP inflation and deflation is the: A. Electrocardiogram (ECG) B. Arterial pressure C. Pacemaker D. Internally programmed rate - ANS A. Electrocardiogram (ECG) _______ is maintained when the supply of oxygen is sufficient to meet the cellular demands of the body. A. pH balance B. Homeostasis C. Hemostasis D. Lactic acid - ANS B. Homeostasis Intra-aortic balloon pump tubing ______________ for transport. A. Can be coiled up B. Should always be taped together C. Should never be taped together D. A. & B. - ANS C. Should never be taped together If significant movement of the intra-aortic balloon pump occurs during transport, consider ______________ IABP therapy after consultation with medical control. D. Pulse oximetry readings may be affected in the patient with peripheral vascular disease due to reduced blood flow to the extremities. - ANS D. Pulse oximetry readings may be affected in the patient with peripheral vascular disease due to reduced blood flow to the extremities. During transport of a mechanically ventilated patient the ventilator goes off with a high pressure alarm. To trouble shoot the high pressure alarm, you recall the DOPE mnemonic. What does the P in DOPE stand for ? A. Pressure B. Pneumothorax C. Puncture D. Pulmonary obstruction - ANS B. Pneumothorax When utilizing the SIMV mode of ventilation, what adjunct features should be utilized in conjunction with SIMV ? A. Volume B. Pressure Support C. Pressure Control D. No other features needed - ANS B. Pressure Support Potential hazards of positive-pressure mechanical ventilation are pneumothorax, subcutaneous emphysema, and which of the following? A. Over-oxygenation B. Cardiac tamponade C. Decreased cardiac output D. Widening pulse pressures - ANS C. Decreased cardiac output When considering which type of ventilation is most appropriate for the patient, the use of noninvasive ventilation methods such as bilevel positive airway pressure (BiPAP) may be an option. Which of the following statements is TRUE regarding BiPAP ventilation? A. It maintains a constant airway pressure throughout the entire breathing cycle. B. It is not considered traditional "life support." C. It delivers a preset pressure to the lungs during nonspontaneous breathing. D. It decreases the functional residual capacity (FRC). - ANS B. It is not considered traditional "life support." Your patient has been mechanically ventilated for several days following respiratory failure. The current therapy is aimed at weaning the patient off the ventilator. The ventilator has a set respiratory rate and tidal volume that is delivered in synchrony with each patient-initiated breath. The machine will deliver a certain number of mandatory breaths regardless. All other breaths are spontaneous and the patient's own rate and depth. Which of the following ventilator modes best fits this description? A. Synchronized intermittent mandatory ventilation (SIMV) B. Continuous positive airway pressure (CPAP) C. Assist/control mode D. Pressure-control volume (PCV) - ANS A. Synchronized intermittent mandatory ventilation (SIMV) You are preparing to transport a patient who is being mechanically ventilated. You are reviewing the ventilator mode, settings, and parameters. You note that the patient is receiving a tidal volume of 500 mL. Which of the following statements is TRUE regarding tidal volume? A. It is the peak pressure generated during ventilation. B. It is the pressure applied in volume ventilation to the small airways. C. It is the volume of gas delivered with each machine breath. D. It is the percentage of inhaled oxygen delivered. - ANS C. It is the volume of gas delivered with each machine breath The thyroid gland secretes calcitonin directly into the bloodstream when serum calcium levels are: A. Above normal B. Below normal C. Normal D. Either high or normal - ANS A. Above normal Endogenous catecholamines (sympathetic stimulation) are involved in regulating all of the following autonomic functions EXCEPT: A. Increasing the heart rate B. Decreasing the respiratory rate C. Increasing the respiratory rate D. Increasing blood pressure - ANS B. Decreasing the respiratory rate A. Acute myocardial infarction B. Congestive heart failure C. Cerebrovascular accident D. Gastrointestinal bleeding - ANS D. Gastrointestinal bleeding Which of the following is NOT a sign or symptom of hypothyroidism? A. Weight gain B. Lethargy C. An increase in body temperature D. Muscle aches and weakness - ANS C. An increase in body temperature Which of the following is NOT a disadvantage of Spinal Immobilization? A. Airway Compromise B. Risk of Aspiration C. Pressure Ulcers D. Pain Reduction - ANS D. Pain Reduction Which of these is NOT considered a positive finding on the NEXUS Criteria? A. Intoxication B. Distracting Injury C. GCS of 15 D. Focal Neurological Deficit - ANS C. GCS of 15 All of these are possible causes of Seizures EXCEPT: A. Fever B. MI C. Glucose Imbalance D. Head Injury - ANS B. MI Which of the following questions is NOT an example of a questions you would want to ask first, in regards to a seizure patient? A. How long was the seizure? B. Has the patient ever had a seizure before? C. Is the patient postictal? D. Did the patient eat breakfast? - ANS D. Did the patient eat breakfast? Which is the most common seizure we deal with in emergency medicine? A. Complex Partial Seizures B. Petit Mal Seizures C. Tonic/Clonic Seizures D. Psuedoseizures - ANS C. Tonic/Clonic Seizures Cerebral Edema occurs in approximately what percentage of ischemic stroke patients? A. 10% to 20% B. 15% to 25% C. 20% to 30% D. Over 30% - ANS A. 10% to 20% Signs and Symptoms of Duchenne Muscular Dystrophy include all of the following EXCEPT: A. Waddling Gait B. Heel Walking C. Frequent Falls D. Dilated Cardiomyopathy - ANS B. Heel Walking Los Angeles Prehospital Stroke Scale Include all of the following EXCEPT: A. Age > 45 D. Secondary brain injury - ANS C. Contrecoup injury The pathophysiology of traumatic brain injury (TBI) emphasizes the importance of which two types of injury? A. Direct and indirect B. Hypoxia and ischemia C. P derangement and loss of consciousness D. Swelling and vasospasm - ANS A. Direct and indirect All of the following are possible causes of secondary brain injury EXCEPT: A. Hypoxia B. Hypercarbia C. Hyponatremia D. Hematoma - ANS D. Hematoma Current guidelines identify the ideal cerebral perfusion pressure (CPP) to be: A. 15 to 25 mm Hg B. 30 to 40mm Hg C. 45 to 60 mm Hg D. 50 to 70 mm Hg - ANS D. 50 to 70 mm Hg An epidural hematoma is often the result of a blow to the temporal region of the skull that involves the: A. Bridging veins of the skull B. Middle meningeal artery C. Anterior fossae artery D. Vertebral artery - ANS B. Middle meningeal artery The Monroe-Kellie doctrine describes the contents of the cranial vault as: A. Brain, neurons and blood B. Brain, blood and cerebrospinal fluid C. Cerebrospinal fluid, air and blood D. Brain, blood and air - ANS B. Brain, blood and cerebrospinal fluid As ICP rises to the level of arterial pressure, the cascade of events know as Cushing's triad begins. Cushing's triad is BEST described as: A. Widened pulse pressure, bradycardia, and abnormal respiratory pattern B. MAP greater that 120 mm Hg, tachycardia, and abnormal respiratory pattern C. Tachypnea, widened pulse pressure, and tachycardia D. Apnea, bradycardia, and systolic blood pressure greater than 180 mm Hg - ANS A. Widened pulse pressure, bradycardia, and abnormal respiratory pattern Bilateral closed femur fractures could result in a blood loss of: A. 500 ml B. 1,000 ml C. 1,500 ml D. 2,000 ml - ANS D. 2,000 ml The following statements about compartment syndrome are correct EXCEPT for: A. Can be caused by burns, external compression and crushing injury B. Pain from compartment syndrome can be described as easily relieved by medication C. Can affect any extremity and the buttocks D. Can develop over a period of hours - ANS B. Pain from compartment syndrome can be described as easily relieved by medication The vertebrae are stabilized by both: A. Fat and connective tissue B. Spinal cord and nerves C. Cranial plate and foramen magnum D. Ligaments and muscles - ANS D. Ligaments and muscles A. Stabilization B. Reducing swelling C. Escharotomy D. Pain management - ANS C. Escharotomy The differential diagnosis is best described as: A. The most likely diagnosis for a patient's condition. B. The least likely diagnosis for a patient's condition. C. A list of possible diagnostic considerations for a patient's possible condition. D. Including the projected diagnosis. - ANS C. A list of possible diagnostic considerations for a patient's possible condition. Which of the following is associated with assessment prior to scene transport? A. Copies of radiologic films B. Copies of lab tests C. Care provided before the CCTP arrival D. Patient history - ANS C. Care provided before the CCTP arrival Which of the following are part of the cardiovascular assessment? A. Skin color, edema, central venous pressure (CVP) monitoring, and reactivity of pupils B. Nail beds, edema, ECG tracing, and deep tendon reflexes C. ECG tracing, hepatojugular reflex, nail beds, and peripheral pulses D. Edema, ECG tracing, CVP monitoring, and presence of thyromegaly - ANS C. ECG tracing, hepatojugular reflex, nail beds, and peripheral pulses Which of the following is TRUE regarding work of breathing? A. Palpation of the accessory muscles can identify increased work of breathing. B. Intercostal retractions and nasal flaring may indicate increased work of breathing. C. Due to higher energy levels, children can tolerate an increased work of breathing better than adults. D. The fatigue associated with increased work of breathing results in a decreased metabolism. - ANS B. Intercostal retractions and nasal flaring may indicate increased work of breathing. The Glasgow Coma Scale (GCS) measures the patient's: A. Clarity of speech, clear thought process, and vibratory sense. B. Best eye opening, best gait, and best speech. C. Gait, balance, and proprioception. D. Best verbal effort, best motor response, and best eye opening. - ANS D. Best verbal effort, best motor response, and best eye opening. Decerebrate posturing is characterized by which of the following? A. Hyperextension of the neck and stiff, extended extremities B. Hyperflexion of the neck and flexed extremities C. Hyperextension of the neck and clenched extremities D. Hyperflexion of the neck and extension of the upper extremities - ANS A. Hyperextension of the neck and stiff, extended extremities You are caring for a patient who has sustained a significant head injury. During a routine neurologic assessment, you pay close attention to the patient's GCS. During the examination, you note that the previous GCS score was 13 and now it is 9. Based on this finding, you might suspect which of the following? A. This is a normal response. B. You have calculated the GCS incorrectly. C. The intracranial pressure is increasing. D. Hypertension is increasing. - ANS C. The intracranial pressure is increasing Which of the following is most consistent with a pathology of upper gastrointestinal bleeding? A. Dark, melanotic stool B. Dark stool with bright red blood C. Passage of blood clots per rectum D. Hematochezia - ANS A. Dark, melanotic stool A standard and key assessment of the critical care musculoskeletal system is: A. Obtain IV Access B. Stop any major bleeding C. Use the PASG D. Obtain a 12 Lead ECG - ANS B. Stop any major bleeding What causes hypotension in neurogenic shock? A. Loss of fluid B. Decreased contractility in the heart C. Decrease in systemic vascular resistance D. Decreased heart rate - ANS C. Decrease in systemic vascular resistance You have a 68 year- old diabetic patient who is complaining of general weakness and shortness of breath. Upon exam you determine the patient is hypotensive, diaphoretic, tachycardic with pulmonary edema. What type of shock are you suspecting? A. Hypovolemic B. Cardiogenic C. Anaphylactic D. Septic - ANS B. Cardiogenic What is the first line pharmacologic treatment for the patient suffering from an anaphylactic reaction? A. Diphenhydramine B. Decadron C. Albuterol D. Epinephrine - ANS D. Epinephrine The quickSOFA (qSOFA) score is a diagnostic tool used to help diagnosis Sepsis in your patient's. Which of these would NOT qualify as warning signs of a Sepsis patient: A. Altered Mental Status B. Respiratory Rate 28 C. Heart Rate 104 D. Systolic BP 86 - ANS C. Heart Rate 104 Common treatment modalities for all sepsis patients would include all of the following EXCEPT: A. Normal saline or Lactated Ringers infusion for volume expansion B. Vasopressor medication C. Antibiotics D. ET Intubation - ANS D. ET Intubation In a critically ill pregnant patient, the key to a viable fetus is: A. Early delivery if gestation is over 20 weeks B. Maintaining adequate perfusion of the mother C. Getting a neonatal consult as soon as possible D. Having the labor and delivery team on standby - ANS B. Maintaining adequate perfusion of the mother The umbilical cord contains: A. One vein and one artery B. Two veins and one artery C. One vein and two arteries D. Two veins and two arteries - ANS C. One vein and two arteries During an abdominal exam of a known pregnant patient, the CCTP palpates the top of the uterus just above the symphisis pubis. Based on this finding, the pregnancy is at least _______ weeks' gestation. A. 8 B. 12 C. 20 D. 24 - ANS B. 12 Compared with the pregnant mother, the oxygen content of the fetus is: