MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

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1 EPC, Ch 2 Quiz w-key Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) The pain associated with skeletal fractures is transmitted by nerves in the. A) periosteum B) osteoclasts C) yellow bone marrow D) epiphysis 1) 2) The ability of bone to maintain its structure begins to decrease around age. A) 40 B) 18 to 20 C) 70 D) 55 2) 3) Your patient is a 27-year-old male ice skater whose left skate was planted when he was struck and knocked down by another skater. He is agitated and complaining of severe pain in his leg. Your examination reveals an open fracture 6 inches proximal to the ankle joint. Which of the following describes the most appropriate management of this patient? A) Focused exam, cover the open wound, apply a lower extremity traction splint, begin transport, start an IV, and request orders for analgesia. B) Rapid trauma exam, high-flow oxygen, cervical spine immobilization, cover the open wound, use the long backboard for initial splinting, initiate transport, start two large-bore IVs, perform a detailed examination, use padded board splints to immobilize from the ankle to above the knee, and reassess the patient every 5 minutes. C) Focused exam, oxygen, spinal immobilization, splint from the foot to above the knee, begin transport, start two large-bore IVs, and request orders for analgesia. D) Focused exam, cover the open wound, splint from the foot to above the knee, begin transport, start an IV, and request orders for analgesia. 3) 4) One of the earliest indications that compartment syndrome is developing in an injured extremity is: A) loss of distal pulses. B) increased pain. C) tension in the limb. D) ecchymosis. 4) 5) Your patient is a 60-year-old female driver of a vehicle involved in a moderate-speed frontal collision. She was unrestrained, but airbags deployed. There is no damage to the windshield, but the bottom of the steering wheel ring is deformed. On your initial approach to the vehicle, an EMT is in the back seat with manual cervical spine stabilization. The patient is anxious and complaining of pain "in her legs." She appears pale, her skin is cool but dry, she as a thready radial pulse of 116, respirations of 24, and clear, equal bilateral breath sounds. Her abdomen is soft and nontender, and there is no pain or instability on assessment of the pelvis. Which of the following is the best management of this patient? A) Oxygen, c-collar, placement of a seated-spinal immobilization device, extrication onto a long backboard, apply bilateral traction splints, begin transport, start two large-bore IVs of lactated Ringer's solution, and request orders for analgesia. B) Oxygen, c-collar, rapid extrication onto a long backboard, rapid trauma exam, placement of bilateral traction splints, begin transport, and start two large-bore IVs of isotonic crystalloid solution. C) Oxygen, c-collar, rapid extrication onto a long backboard, rapid trauma exam, application of PASG, begin transport, and start two large-bore IVs of isotonic crystalloid solution. D) Oxygen, c-collar, placement of a seated-spinal immobilization device, extrication onto a long backboard, use the long board to immobilize the lower extremities, begin transport, start two large-bore IVs of lactated Ringer's solution, and request orders for analgesia. 5) 1

2 6) Which of the following best describes the percentage of musculoskeletal trauma in multisystems trauma patients? A) 50 B) 80 C) 90 D) 30 6) 7) Tendons connect to. A) bones, bones B) muscles, fascia C) cartilage, bones D) muscles, bones 7) 8) A dislocated knee is most likely to damage which of the following vascular structures? A) Great saphenous vein B) Femoral artery C) Popliteal artery D) Femoral vein 8) 9) Your patient is a 50-year-old motorcyclist who received a lateral impact from an automobile as he went through an intersection. He has a deformity of the right midthigh and an open right tibia/fibula fracture. He also has a fracture of his left forearm and some abrasions. He was wearing a helmet and suffered no loss of consciousness. He currently has a strong radial pulse of 100, his skin is warm and moist, and he has adequate respirations at 20 per minute. Which of the following is the best way to manage this patient's lower-extremity trauma? A) Perform a rapid trauma assessment and, if nothing significant is noted, assess distal neurovascular status, apply a traction splint, ensure spinal immobilization, begin transport, start two large-bore IVs of isotonic crystalloid, perform a detailed examination, and consult with medical control for pain management. B) Apply high-flow oxygen, perform a rapid trauma assessment, ensure spinal immobilization using the long backboard to splint the lower extremity, and avoid analgesia due to multisystems trauma potential. C) Apply high-flow oxygen, perform a rapid trauma assessment, apply PASG, ensure spinal immobilization, start two large-bore IVs of isotonic crystalloid solution, infuse wide open, and begin transport but avoid analgesia due to multisystems trauma potential. D) Perform a rapid trauma assessment and, if nothing significant is noted, assess distal neurovascular status, apply and secure padded long board splints laterally and medially, ensure spinal immobilization, begin transport, start two large-bore IVs of isotonic crystalloid, perform a detailed examination, and consult with medical control for pain management. 9) 10) Your patient is a football player who had his right foot planted and was tackled from the left rear, causing his body to rotate around the axis of his right lower extremity. This mechanism is most consistent with which of the following types of fractures? A) Spiral B) Comminuted C) Impacted D) Oblique 10) 11) A sprain is an injury best defined as which of the following? A) Muscle fibers that are stretched and torn B) A violent muscle spasm that tears away a small piece of bone C) Complete displacement of bone ends from their normal position, causing noticeable deformity D) Partial or complete tearing of the ligaments of the joint capsule 11) 12) Which of the following is the highest priority when managing a patient with bilateral closed femur fractures? A) Anticipating hypovolemic shock B) Providing intravenous analgesia C) Preventing infection D) Assessing the potential for rehabilitation 12) 13) Musculoskeletal trauma is best described as life threatening. A) frequently B) moderately C) rarely D) always 13) 2

3 14) The use of PASG is indicated in the treatment of which of the following musculoskeletal injuries? A) Bilateral tibia/fibula fractures B) Pelvic fracture C) Knee dislocation D) Lumbar vertebral compression fracture 14) 15) Which of the following best describes the function of cancellous bone? A) It reduces the weight of bones while allowing for support. B) Its dense, compact structure is well adapted to weight bearing. C) It contains yellow bone marrow. D) It acts as a growth plate in long bones. 15) 16) Not considering other injuries, which of the following musculosketal findings warrants immediate transport of your patient? A) Open fracture of the tibia and fibula B) Posterior shoulder dislocation C) Femur fracture D) Unstable pelvis 16) 17) The most commonly fractured bone(s) in the human body is/are the: A) cervical vertebrae. B) femur. C) fifth metacarpal. D) clavicle. 17) 18) Your patient is a 7-year-old male with a fracture of the proximal tibia. Which of the following is the most likely and serious complication of this injury? A) Fat embolism B) Juvenile onset arthritis C) Disruption of bone growth from the epiphyseal plate D) Formation of a bone callus 18) 19) When assessing a long bone injury, you should assume you are dealing with a joint injury when the site of injury is within inch(es) from the joint? A) 3 B) 1 C) 6 D) 2 19) 20) Which of the following types of fractures occurs in pediatric age groups but not in adults? A) Oblique B) Greenstick C) Transverse D) Impacted 20) 3

4 Answer Key Testname: EPC, CH 22 QUIZ W-KEY 1) A Diff: 1 Page Ref: 929 2) A Diff: 1 Page Ref: 931 3) D 4) C Diff: 1 Page Ref: 926 5) C 6) B Diff: 1 Page Ref: 925 7) D Diff: 1 Page Ref: 926 8) C Diff: 1 Page Ref: 949 9) D 10) A Diff: 2 Page Ref: ) D Diff: 1 Page Ref: 928 Objective: 4 12) A Diff: 1 Page Ref: ) C Diff: 1 Page Ref: ) B Diff: 2 Page Ref: ) A Diff: 1 Page Ref: ) D Diff: 1 Page Ref: ) D Diff: 1 Page Ref: ) C Diff: 2 Page Ref: ) A Diff: 1 Page Ref: ) B Diff: 1 Page Ref: 931 Objective: 4 4

5 EPC, Ch 2 Quiz w-key Name 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 5

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