Test 1 25 multiple choice questions 1 It is best to avoid low risk evacuations for high risk problems allowing the weather to influence your evacuation decisions any use of helicopters high risk evacuations for low risk problems ID: 705458
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Slide1
Wilderness and Rescue Medicine
Test 1
25 multiple choice questionsSlide2
1
It is best to avoid:
low risk evacuations for high risk problems.
allowing the weather to influence your evacuation decisions.
any use of helicopters.
high risk evacuations for low risk problems.
Multiple choiceSlide3
2
As you approach the scene of a climbing accident you observe an injured climber hanging five meters above the ground. The belay rope disappears over the top of the cliff 20 meters above. Your first action should be to:
check the climber’s circulatory, respiratory, and nervous systems.
conduct a focused history and physical exam.
survey the scene for dangers, numbers of patients and available resources.
stand under the climber in case the belay rope is cut.
Multiple choiceSlide4
3
The technical team has secured the belay and lowered the injured climber to the ground. Your
Initial Assessment
includes:
a quick sweep for severe external bleeding.
evaluation of respiratory status.
splinting of fractures. a and b only.
Multiple choiceSlide5
4
The injured climber is A on AVPU and able to describe the accident in detail. This finding confirms that there is
no significant:
spine injury.
traumatic brain injury.
internal bleeding.
skull fracture.
Multiple choiceSlide6
5
Your examination reveals a deformed, tender and very swollen left thigh. Your problem list now includes:
internal bleeding.
unstable fracture.
a critical body system injury.
all of the above.
Multiple choiceSlide7
6
Vital signs on your injured climber measure as follows: P - 136, R - 24, BP - 110/72, Skin – c/d/pale, C - Awake and oriented. This pattern best fits the assessment of:
decompensated volume shock.
compensated volume shock.
traumatic brain injury with increased ICP.
parasympathetic acute stress reaction.
Multiple choiceSlide8
7
What would be appropriate in your plan for the injured climber?
Spine stabilization.
Packaging to prevent hypothermia.
Request a paramedic for IV fluids and pain control.
All of the above.
Multiple choiceSlide9
8
Fortunately, you find no tenderness or bruising of the chest or abdomen. Why might blunt injury to the chest and abdomen be a positive mechanism for volume shock?
Parasympathetic acute stress reactions are common.
The pain can cause the patient to go into shock.
Solid organs like the spleen and liver can rupture and bleed.
Rib fracture can cause problems with breathing.
Multiple choiceSlide10
9
From a medical perspective, which statement best describes
shock
?
A potentially fatal reaction to fear, grief, pain or other serious psychological stress.
Inadequate pressure in the circulatory system resulting in inadequate perfusion and oxygenation of body cells.
The damage caused by electric current passing through the body and into the ground. Any condition resulting in elevated pulse and respiratory rate accompanied by pale and cool skin.
Multiple choiceSlide11
10
You are hiking with friends on a fine summer day. One of your party is lagging behind. You return to find him lying by the trail. There has been no trauma. Your exam reveals an ill appearing man with vital signs: P: 122, R: 22, Skin: flushed and sweaty, C: Awake and oriented. He reveals that he has not produced urine for the past 5 hours, and has been drinking little because he forgot his water bottle. The most likely problem is:
compensated volume shock from dehydration.
exertional hyponatremia from dehydration.
heat stroke and dehydration.
decompensated shock from dehydration.
Multiple choiceSlide12
11
The most appropriate field treatment for the patient in the previous question is:
immediate cooling.
immediate descent.
salt tablets.
rest and hydration.
Multiple choiceSlide13
12
As a ski patroller, you are called to evaluate a young man behaving abnormally. He is carrying a snowboard and wandering around the base area. He seems confused and scared and is unable to tell you what he is doing or how he came to be there. Possible problems include:
traumatic brain injury.
low blood sugar.
drug use (intoxication).
all of the above.
Multiple choiceSlide14
13
When you arrived on scene at a mountain bike accident the injured rider was standing up examining her broken helmet. You could safely conclude that:
there is no spine injury.
there is no internal bleeding.
there is no traumatic brain injury.
the patient can stand.
Multiple choiceSlide15
14
You conduct a focused history and physical exam on the injured rider. What finding leads you to include traumatic brain injury on your problem list?
The large scalp laceration.
The swelling of the scalp and the bloody nose.
The patient cannot remember the accident.
The broken helmet.
Multiple choiceSlide16
15
Assuming that the scene is stable, the most appropriate plan for the mountain bike rider in the previous questions includes:
a spine assessment exam to determine if spine stabilization is necessary.
immediate stabilization on a backboard based on the mechanism of injury.
a
ssuming the
spine is clear based on her ability to walk. asking the patient to ride her bike down the trail to where the backboard is waiting.
Multiple choiceSlide17
16
The problem of “traumatic brain injury” carries the
anticipated
problem of:
Volume shock.
Severe scalp swelling.
Increased intracranial pressure. Skull fracture.
Multiple choiceSlide18
17
Why is increased intracranial pressure a major Critical System problem?
It can cause severe swelling of the scalp and cranium (skull).
Loss of blood into the cranium can cause volume shock.
Pressure inside the cranium can cause the bone to fracture.
Pressure inside the cranium can prevent adequate perfusion of brain tissue.
Multiple choiceSlide19
18
Why is spine assessment and protection important in the management of the trauma patient?
Further trauma to an unstable spinal column could cause spinal cord injury.
Emergency personnel are frequently sued for causing spinal cord injury.
Immobilization is
the ideal treatment for any trauma patient.
Spine stabilization makes it easier to manage other critical system problems.
Multiple choiceSlide20
19
Which history, signs or symptoms would indicate that a patient is not reliable enough to clear the spine?
Now oriented x 4, but was unconscious for 3 minutes.
Patient has a history of two previous traumatic brain injuries.
Pain from a wrist injury that keeps distracting the patient from your exam.
Patient cannot remember exactly what caused the accident.
Multiple choiceSlide21
20
Your hot-shot crew is running from a rapidly advancing wildfire. One of your crew tumbles over a 3 meter high ledge. He complains of neck pain. An appropriate plan for this environment includes:
Pronounce his spine “clear” and keep running.
Maintain hands-on spine stabilization and wait for a medical team to bring a backboard.
Assist him in running from the fire and evaluate the spine when a safe zone is reached.
Fashion a short backboard from a tree branch and urge him to run with it in place.
Multiple choiceSlide22
21
A patient with a dislocated thumb exhibits symptoms including elevated pulse, elevated respiratory rate, shell/core effect, and mental status changes. The most likely problem is:
shock caused by pain.
sympathetic acute stress reaction.
shock from blood loss into the thumb.
parasympathetic acute stress reaction.
Multiple choiceSlide23
22
In the wilderness and rescue context why is it useful to distinguish between acute stress reaction (ASR) and shock?
Shock is not life-threatening while acute stress reaction can be fatal.
The distinction is not important because both are treated as emergencies.
ASR can be effectively treated with epinephrine and diphenhydramine.
Shock might justify a high-risk evacuation while acute stress reaction does not.
Multiple choiceSlide24
23
Which problem carries the anticipated problem of respiratory distress?
Open fracture of the forearm with sympathetic ASR and rapid respiration.
Rapid respiration with volume shock from sweating and dehydration.
Traumatic brain injury with increased ICP and vomiting.
Parasympathetic ASR after suffering a crushed foot in a climbing accident.
Multiple choiceSlide25
24
Which statement best describes
respiratory failure
?
Increased respiratory rate in response to shock, anaphylaxis, infection, or asthma.
The respiratory system is unable to adequately oxygenate the blood.
The accumulation of fluid in the alveoli resulting in crackles in the lungs and coughing. Lower airway constriction resulting in wheezing.
Multiple choiceSlide26
25
You respond to a jeep rollover on a backcountry road. On which patient would you use your only oxygen system?
The bystander having an asthma attack; P 132, R 32, wheezing,
A and disoriented.
The driver with fractured ribs, P 100, R 20, A and oriented.
The passenger with TBI; P 80, R 16, A and disoriented.
The passenger with the fractured femur; P 112, R 22, A and oriented.
Multiple choice