SOLVED

1) Which of the following best describes the effect of hyperventilation in the brain-injured patient? A) It is beneficial, because vasodilation results in increased cerebral blood flow. B) It is detrimental, because vasodilation causes an increase in tissue edema. C) It is beneficial, because vasoconstriction results in decreased tissue edema. D) It is detrimental, because vasoconstriction results in decreased cerebral perfusion. 2) Your patient is a 45-year-old male with extensive blunt trauma to the face. He has decorticate posturing in response to pain; weak, irregular respiratory effort at 6 per minute; and a heart rate of 50 with a good radial pulse. The patient appears to have nasal and mandibular fractures, and an oropharyngeal airway is insufficient to keep the tongue from the posterior pharynx. Which of the following has the MOST potential to negatively impact the patient? A) Retrograde intubation B) Oral intubation under direct laryngoscopy C) Nasotracheal intubation D) A nonvisualized dual-lumen airway 3) Which of the following medications may be indicated in the prehospital management of the patient with traumatic brain injury? A) Methylprednisolone B) Diazoxide C) Mannitol D) Furosemide 4) Circulation to the face is provided by the ________ artery A) External carotid artery B) Internal carotid artery C) Midfacial artery D) Mandibular artery 5) Which of the following correctly describes the impact of motorcycle helmet use? A) Helmet usage is associated with a 10 percent reduction in serious head injuries. B) There have been no reported fatalities from motorcycle collisions in which the riders were wearing helmets. C) Helmet usage decreases the risk of serious head injuries but increases the risk of cervical-spine injuries. D) Helmet usage results in a more than 50 percent reduction in serious head injuries. 6) Which of the following parameters should be used to guide the oxygenation and ventilation of the patient with a traumatic brain injury? A) Maintain an oxygen saturation level of at least 96 percent and a capnography reading between 35 and 40 mmHg. B) Maintain an oxygen saturation level of at least 90 percent and a capnography level < 45 mmHg. C) Maintain an oxygen saturation level of at least 98 percent and a capnography reading > 45 mmHg. D) Maintain an oxygen saturation level of at least 90 percent and a capnography reading < 35 mmHg. 7) You are caring for a 22-year-old amateur boxer who complained of a sudden obstruction of part of his visual field. This complaint is most consistent with which of the following conditions? A) Extrusion of the eyeball B) Subconjunctival hemorrhage C) Hyphema D) Retinal detachment 8) Regarding the primary assessment of the patient with suspected traumatic brain injury, which of the following describes the best approach to assessing the patient’s neurological functioning? A) The use of AVPU B) Assessing the patient for level of consciousness and orientation to person, place, and time C) Assessing a revised trauma score D) Assessing a Champion trauma scale score 9) Your patient is a 26-year-old male who suffered a shotgun wound to the neck and face. Your assessment reveals obstruction of the upper airway because of extensive soft-tissue damage and fractures of the mandible, maxilla, and hard palate. The patient has a bubbling open wound to the anterior neck about 1 centimeter inferior to the cricoid cartilage, opening the trachea to the environment. Which of the following describes the best way to manage this patient’s airway? A) Control bleeding around the neck wound, using suction if necessary to prevent aspiration. Assess whether it is possible to introduce an endotracheal tube into the trachea through the wound. B) Control bleeding around the neck wound, apply an occlusive dressing over it, and attempt nasotracheal intubation. C) Control bleeding from the wound, and apply an occlusive dressing over it. Perform a percutaneous cricothyrotomy, and use transtracheal jet insufflation to ventilate. D) Control bleeding around the neck wound, and apply an occlusive dressing over it. Insert a nonvisualized dual-lumen airway (e.g., CombiTube) for ventilation. 10) Which of the following may confound the assessment of the patient who has a mechanism of injury consistent with significant brain injury? A) Slow development of the brain-injury process B) The patient’s use of alcohol, marijuana, or other drugs C) The nature of the patient’s injuries D) All of the above 1