Chapter 28- Head and Spine Injuries Practice Questions

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Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
Select one:
A. decerebrate posturing.
B. widening pulse pressure.
C. a rapid, thready pulse.
D. CSF leakage from the ears.

C

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:
Select one:
A. acute unilateral paralysis following the injury.
B. a rapid deterioration of neurologic signs.
C. an acute increase in the patient’s pulse rate.
D. a progressively lowering blood pressure.

B

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
Select one:
A. significant pressure and bleeding in between the skull and dura mater.
B. rupture of the tympanic membrane following diffuse impact to the head.
C. fractures to the internal structures of the ear following direct trauma.
D. a linear skull fracture and a significant increase in intracranial pressure.

B

When immobilizing a trauma patient’s spine, the EMT manually stabilizing the head should not let go until:
Select one:
A. the head has been stabilized with lateral immobilization.
B. the patient has been secured to the ambulance stretcher.
C. the patient has been completely secured to the backboard.
D. an appropriately sized cervical collar has been applied.

C

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
Select one:
A. shunting of blood to vital organs.
B. pupillary constriction.
C. increase in heart rate.
D. dilation of the bronchiole smooth muscle.

B

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?
Select one:
A. 4
B. 5
C. 2
D. 3

D

The ideal procedure for moving an injured patient from the ground to a backboard is:
Select one:
A. the use of a scoop stretcher.
B. the four-person log roll.
C. the direct patient carry.
D. the clothes drag.

B

The Glasgow Coma Scale (GCS) is used to assess:
Select one:
A. eye opening, verbal response, and motor response.
B. sensory response, pupil reaction, and heart rate.
C. mental status, eye opening, and respiratory rate.
D. verbal response, eye opening, and mental status.

A

In contrast to a cerebral concussion, a cerebral contusion:
Select one:
A. involves physical injury to the brain tissue.
B. does not cause pressure within the skull.
C. results from a laceration to the brain tissue.
D. usually does not cause a loss of consciousness.

A

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:
Select one:
A. slow.
B. weak.
C. irregular.
D. rapid.

A

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
Select one:
A. the patient adamantly denies neck pain.
B. it causes a problem managing the airway.
C. sensory and motor functions remain intact.
D. lateral immobilization has been applied.

B

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
Select one:
A. suction his oropharynx for up to 15 seconds.
B. pack his nostrils to stop the drainage of blood.
C. immobilize his spine and transport immediately.
D. assist his ventilations with a BVM.

A

The central nervous system (CNS) is composed of the:
Select one:
A. meninges and spinal cord.
B. brain and spinal cord.
C. cerebellum and brain.
D. cerebrum and meninges.

B

Which of the following statements regarding secondary brain injury is correct?
Select one:
A. It results from direct brain trauma following an impact to the head.
B. Hypoxia and hypotension are the two most common causes of secondary brain injury.
C. Signs are often present immediately after an impact to the head.
D. Because cerebral edema develops quickly, it is considered to be a primary brain injury.

B

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Select one:
A. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
B. Increased rate and depth with the distinct odor of acetone on the patient’s breath
C. Slow, shallow, occasional gasps that progress to prolonged periods of apnea
D. Increased rate with a normal inspiratory time and a prolonged expiratory time

A

Hyperextension injuries of the spine are MOST commonly the result of:
Select one:
A. hangings.
B. compression.
C. diving.
D. falls.

A

A tight-fitting motorcycle helmet should be left in place unless:
Select one:
A. it interferes with your assessment of the airway.
B. the helmet is equipped with a full face shield or visor.
C. the patient must be placed onto a long backboard.
D. the patient complains of severe neck or back pain.

A

The five sections of the spinal column, in descending order, are the:
Select one:
A. thoracic, cervical, lumbar, coccygeal, and sacral.
B. coccygeal, sacral, lumbar, thoracic, and cervical.
C. cervical, coccygeal, thoracic, sacral, and lumbar.
D. cervical, thoracic, lumbar, sacral, and coccygeal.

D

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:
Select one:
A. hyperflexion.
B. hyperextension.
C. distraction.
D. axial loading.

D

What part of the nervous system controls the body’s voluntary activities?
Select one:
A. Central
B. Sensory
C. Autonomic
D. Somatic

D

The tough, fibrous outer meningeal layer is called the:
Select one:
A. pia mater
B. arachnoid space
C. gray mater
D. dura mater

D

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:
A. increased blood pressure, bradycardia, reactive pupils, and rapid respirations.
B. sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.
C. ataxic respirations, unequal pupils, no response to pain, and an irregular pulse.
D. fixed and dilated pupils, decreased blood pressure, and irregular respirations.

B

Which of the following statements regarding a basilar skull fracture is correct?
A. Bloody CSF commonly leaks from the nose.
B. In most cases, mastoid bruising occurs.
C. The absence of raccoon eyes or Battle’s sign does not rule it out.
D. They are typically the result of local, low-energy trauma to the head.

C

An epidural hematoma is MOST accurately defined as:
A. bleeding between the skull and dura mater.
B. bleeding between the dura mater and brain.
C. venous lacerations that occur within the brain.
D. an injury caused by a damaged cerebral artery.

A

When immobilizing a patient on a long backboard, you should:
A. have the patient exhale before fastening the torso straps.
B. secure the torso and then center the patient on the board.
C. follow the commands of the person at the patient’s torso.
D. ensure that you secure the torso before securing the head.

D

The _________ contain(s) about 75% of the brain’s total volume.
A. cerebrum
B. cerebellum
C. brain stem
D. meninges

A

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:
A. regenerating brain cells after they have been damaged.
B. acting as a shock absorber for the brain and spinal cord.
C. delivering oxygen directly to the CNS.
D. producing leukocytes that protect the brain from infection.

B

Bleeding within the brain tissue itself is called a(n):
A. epidural hematoma.
B. intracerebral hematoma.
C. subdural hematoma.
D. intracranial hematoma.

B

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:
A. after the torso has been adequately secured.
B. after moving the patient to a long backboard.
C. after assessing distal neurovascular functions.
D. before manually stabilizing the patient’s head.

C

Which of the following head injuries would cause the patient’s condition to deteriorate MOST rapidly?
A. cerebral contusion
B. subdural hematoma
C. cerebral concussion
D. epidural hematoma

D

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