Question # 1 (Multiple Choice) Signs and symptoms of a basilar skull fracture may include: 1. Cerebrospinal fluid draining from the nose. 2. Ecchymosis in the mastoid region. 3. Periorbital ecchymosis.

A) a. 1, 2 only.
B) b. 1, 3 only.
C) c. 2, 3 only.
D) d. 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 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) 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 # 5 (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 of:

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

Question # 6 (Multiple Choice) Cushing's triad is associated with

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

Question # 7 (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 # 8 (Multiple Choice) Select the most appropriate statement that should be used to describe a patient's level of consciousness

A) The patient is obtunded
B) The patient appears drowsy
C) The patient is semiconscious
D) The patient withdraws from a painful stimulus

Question # 9 (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 # 10 (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 # 11 (Multiple Choice) LORAZAPAM (ATIVAN) is classified as an

A) benzodiazepine
B) vasodilator
C) anit-inflammatory agent
D) anticholinergic

Question # 12 (Multiple Choice) The patient in the "I Feel So Ejected" case was given ATIVAN at the hospital for

A) reducing brain swelling
B) reducing hypotenison
C) reducing seizure activity
D) reducing PVC's

Question # 13 (Multiple Choice) The correct adult dosage of ATIVAN is

A) 0.5 - 2.0 mg IV
B) 1-2 g diluted in 10 ml of D5W
C) 2-4 g IV
D) 1.5 -2.0 g/kg IV

Question # 14 (Multiple Choice) The Mannitol dose for an adult is

A) 1.5 -2.0 g/kg IV
B) 25-50 mg IV
C) 0.5 mg/lb to 0.8 mg/lb IM, SQ
D) 0.2 ml in 2.5 ml saline

Question # 15 (Multiple Choice) MANNITOL (OSMOTROL) is an osmotic diuretic that inhibits sodium and water absorption in the kidneys. It would most likely be used for

A) GI bleeds
B) acute cerebral edema
C) kidney injury
D) Loop of Henley dysfunction

Question # 16 (Multiple Choice) Select the correct statement regarding an epidural hematoma.

A) In an epidural hematoma, bleeding occurs between the dura and arachnoid mater.
B) n 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.