Question # 1 (Multiple Choice) Signs and symptoms of a basilar skull fracture may include:

A) 1-Cerebrospinal fluid draining from the nose. 2-Ecchymosis in the mastoid region 3-Periorbital ecchymosis
B) 1, 2 only.
C) 1, 3 only.
D) 2, 3 only.
E) 1, 2, 3

Question # 2 (Multiple Choice) A 27-year-old man has suffered a blow to the right side of the head. His injury may cause compression of the oculomotor cranial nerve resulting in:

A) dilation of the ipsilateral pupil
B) dilation of the contralateral pupil
C) constriction of the ipsilateral pupil
D) constriction of the contralateral pupil

Question # 3 (Multiple Choice) You are called for an unconscious man. On arrival you find an unresponsive male, approximately 20 years of age, lying supine in a parking lot. Bystanders state he was the victim of a gang fight and has been struck in the head and shoulders with a baseball bat. Examination reveals contusions to the left temporal area and over the shoulders. There is a small amount of bleeding from the left nostril. The patient's blood pressure is 118/74, pulse 90 and regular, respiratory rate 12/min. Which of the following represents the MOST IMPORTANT intervention you can perform for this patient to help minimize cerebral edema?

A) Hyperventilate (super oxygenate) the patient
B) Apply the pneumatic antishock garment
C) Placing the patient in Trendelenburg position
D) Establish two large-bore IVs of normal saline and infuse wide open

Question # 4 (Multiple Choice) A 46-year-old man is the victim of a motor vehicle crash. Examination of the patient reveals an abrasion on the forehead, bruising of the center of the chest, and a rigid abdomen. The patient was the unrestrained driver of a small car that was struck head-on by a late model sports utility vehicle. The patient is able to state his name but does not know where he is or today's date. His blood pressure is 80/60, pulse 114, respiratory rate 16. Breath sounds are equal bilaterally. The patient's skin is pale, cool, and diaphoretic. You suspect this patient's hypotension is most likely due to:

A) hypoxia
B) hypovolemia
C) a tension pneumothorax
D) increased intracranial pressure

Question # 5 (Multiple Answer) A middle-aged man is the victim of a car-pedestrian crash. Bystanders state he was crossing the street when he was struck by a car traveling approximately 30 miles per hour. The patient is lying prone on the pavement and appears unconscious. Your first action will be to: (two answers could be considered correct)

A) examine the patient's neck, back, and lower extremities for injuries
B) logroll the patient to a supine position to assess airway, breathing, and circulation
C) assess the patient's ABCs, back, and extremities in his present position, then logroll him to a supine position
D) apply a cervical collar in his present position, position the pneumatic antishock garment on a long backboard, and logroll the patient onto the board

Question # 6 (Multiple Choice) The Glasgow Coma Scale evaluates:

A) motor response, gag reflex, verbal response
B) eye opening, motor response, verbal response
C) eye opening, pupillary response, motor response
D) verbal response, pupillary response, motor response

Question # 7 (Multiple Choice) A patient who opens his eyes in response to pain, makes no verbal response, but withdraws from pain has a Glasgow Coma Score

A) 3
B) 5
C) 7
D) 11

Question # 8 (Multiple Choice) A 30-year-old female was thrown from her horse, striking her head on a concrete bench before she hit the ground. She is unconscious with a blood pressure of 74/44, pulse 58 and regular, respirations 14. Her skin is warm and dry. The physical examination is unremarkable except for an abrasion to the chin and right side of the forehead. You suspect:

A) subdural hematoma
B) hypovolemic shock
C) drug overdose
D) neurogenic shock

Question # 9 (Multiple Choice) A 33-year-old man is the victim of a motorcycle crash. Examination reveals a possible fracture of the right humerus, distended abdomen, and an unstable pelvis. The patient's vital signs are: BP 68/40, P 124, R 18. You are preparing to establish two large-bore IVs. The first IV is successfully placed in the left antecubital fossa. The second IV should be placed in the:

A) right hand.
B) there is no need to establish a second IV line
C) right antecubital fossa or external jugular vein
D) external jugular vein or a second IV in the left upper extremity

Question # 10 (Multiple Choice) Cushing's triad is associated with

A) cardiac tamponade
B) tension pneumothorax
C) massive hemothorax
D) increased intracranial pressure

Question # 11 (Multiple Choice) Select the correct statement regarding the Glasgow Coma Scale

A) A score of 3 is normal
B) A score of 7 represents coma
C) A score of 12 accompanies brain death
D) A score of 15 is indicative of a poor prognosis

Question # 12 (Multiple Choice) Which of the following signs are associated with Cushing's triad?

A) decreasing blood pressure, decreasing pulse rate, change in respiratory pattern
B) increasing blood pressure, decreasing pulse rate, change in respiratory pattern
C) increasing blood pressure, increasing pulse rate, change in respiratory pattern
D) decreasing blood pressure, increasing pulse rate, change in respiratory pattern.

Question # 13 (Multiple Choice) A 19-year-old male has suffered a blow to the head. Examination reveals fluid draining from the patient's left ear. You should:

A) firmly pack the left ear with sterile gauze
B) apply a loose sterile dressing to the left ear
C) apply direct pressure to the left ear with a gloved finger
D) transport the patient on the right side to slow the flow of fluid

Question # 14 (Multiple Choice) The MOST important sign in the evaluation of a head-injured patient is

A) tachycardia.
B) blood pressure
C) tachypnea.
D) level of consciousness

Question # 15 (Multiple Choice) All of the following patients are victims involved in a motor vehicle crash. Which patient should be rapidly extricated?

A) . 26-year-old female front seat passenger complaining of a headache. Laceration present on right forehead. BP 138/80, P 92, R 16
B) 19-year-old male back seat passenger complaining of pain in right femur. Swelling and discoloration noted over right thigh. BP 128/74, P 88, R 14.
C) 30-year-old male driver complaining of difficulty breathing. Unable to palpate radial pulse, carotid weak, rate 120. Respiratory rate 44 and labored
D) 24-year-old female back seat passenger complaining of abdominal pain. Seatbelt markings noted over chest and abdomen. BP 118/82, P 76, R 16

Question # 16 (Multiple Choice) A patient has suffered an open skull fracture with profuse bleeding. Management should include:

A) applying a constricting band to the forehead
B) applying direct pressure to both carotid arteries
C) applying direct pressure to both carotid arteries
D) administering oxygen by NR mask and transporting rapidly to the hospital

Question # 17 (Multiple Choice) You are on the scene of a car-pedestrian crash. A 63-year-old woman was crossing the street when she was struck by a car traveling approximately 45 miles per hour. The patient was thrown approximately 20 feet. The decision to "load-and-go" or continue stabilization at the scene will be primarily based on:

A) local triage protocols
B) national trauma guidelines.
C) employer policies & physical findings
D) mechanism of injury & physical findings.

Question # 18 (Multiple Choice) You are called for an assault victim. You arrive to find a man approximately 20 years of age lying on his side in an alley. Examination reveals the patient has blood oozing from the right side of his nose. The patient's right cheek appears flattened and there is discoloration around his eyes. The patient states his cheek and nose feel numb. You suspect:

A) mandibular fracture
B) basilar skull fracture
C) parotid fracture
D) zygomatic fracture

Question # 19 (Multiple Choice) Select the correct statement regarding an epidural hematoma.

A) In an epidural hematoma, bleeding occurs between the dura and arachnoid mater.
B) An epidural hematoma develops slowly, producing symptoms hours or days after the injury.
C) In an epidural hematoma, bleeding occurs between the cranium and the dura
D) An epidural hematoma is most often associated with venous bleeding

Question # 20 (Multiple Choice) A "Halo" test is a check for

A) cervical injury
B) CSF leaks
C) Priapism
D) Brain damage