Prehospital Emergency Care, 11e (Mistovich et al.)
Chapter 36 Multisystem Trauma and Trauma in Special Patient
Population
1.B: You are by the side of an 88-year-old male who fell. He has a hematoma to his
forehead as well as deformity to his left forearm. His daughter informs you that her father
has severe dementia and she cares for him at home. As you assess him, he continually
screams out, "Mary, help me. I need help!" At this time, which question is most
appropriate to ask the daughter?
A) "Was Mary his wife?"
B) "Is this how he normally is?"
C) "Do you know what he means by this?"
D) "My mother suffers from dementia; it is a terrible disease, isn't it?"
2.D: An 83-year-old female fell down the basement stairs. Once at her side, she tells you
that her left hip hurts and rates it as 10/10. Since the patient is downstairs, you recognize
the need for assistance in extricating her from the residence. As you start the primary
assessment, you note a dog at the top of the stairs starts growling at you. At this time, what
is your primary concern?
A) Airway
B) Pain
C) Need for additional help
D) Dog
3.C: A car swerved to miss a deer in the road and hit a utility pole at a low rate of speed.
Damage to the car is minimal, but the 82-year-old male passenger was not wearing a seat
belt and hit his head on the dashboard. He presents as confused and diaphoretic. His
daughter, the driver, states that he has a history of dementia, high blood pressure, and
diabetes, as well as coronary artery disease. She adds that he took his insulin about 2 hours
ago. Which question to the daughter would be most important at this time?
A) "How far along is the dementia?"
B) "He seems sweaty. Was he feeling okay this morning?"
C) "Did he eat anything today?"
D) "Does he take medication for the high blood pressure?"
4.A: A 78-year-old male pedestrian was struck by a car at a convenience store. The
patient is conscious but confused, and has sustained multisystem trauma. What would
represent the best sequence of care for this patient?
A) Primary assessment, oxygen, secondary assessment, spine motion restriction
precautions, and all other care en route to the hospital
B) Primary assessment, spine motion restriction, and all other care en route to the hospital
C) Primary assessment, oxygen, secondary assessment, and all other care en route to the
hospital
, Prehospital Emergency Care, 11e (Mistovich et al.)
Chapter 36 Multisystem Trauma and Trauma in Special Patient
Population
D) Primary assessment, oxygen, secondary assessment, cervical collar, and all other
care en route to the hospital
5.B: A 62-year-old female with severe kyphosis fell and hit the back of her head, which is
now oozing blood from a small laceration. Family members state that she suddenly
complained of a "very bad headache" before collapsing to the kitchen floor. She has snoring
respirations and cyanosis in the extremities. Which intervention should you perform first?
A) Apply a cervical collar
B) Use a jaw-thrust maneuver
C) Start positive pressure ventilation
D) Cover the laceration
6.C: You are transporting an elderly female who fell in a nursing home and displays
outward rotation of her left leg. She has a lengthy medical history, including de- mentia.
Currently, she is very quiet and receiving oxygen through a nasal cannula at 6 liters per
minute. She also is secured to a long spine board. During your reassessment, you note her
to be alert but confused, with slightly accelerated respirations and a strong radial pulse.
You also note that her SpO2 has dropped from 97% on scene to 91%. You should:
A) Perform a head-tilt, chin-lift maneuver
B) Request ALS assistance
C) Apply supplemental oxygen
D) Start positive pressure ventilation
7.A: An unresponsive 10-year-old male was struck by a car while riding his bike. He
has blood on his face and presents with snoring respirations. Respirations are
approximately 10 breaths per minute, with cyanosis noted to his extremities. Manual
spine motion restriction to the neck is being held by Emergency Medical Responders.
What should you do next?
A) Perform a jaw-thrust maneuver
B) Start positive pressure ventilation
C) Suction the airway
D) Quickly assess for life-threatening injuries
8.D: An elderly female fell and is now very confused. You are having a problem getting
her past medical history. Her daughter states that she is typically alert and very well
oriented. What is your next best action?
A) Transport the patient without delay
B) Contact the patient's doctor for the history
C) Transport her to a hospital that has cared for her before
D) Ask the patient's daughter for the history
Chapter 36 Multisystem Trauma and Trauma in Special Patient
Population
1.B: You are by the side of an 88-year-old male who fell. He has a hematoma to his
forehead as well as deformity to his left forearm. His daughter informs you that her father
has severe dementia and she cares for him at home. As you assess him, he continually
screams out, "Mary, help me. I need help!" At this time, which question is most
appropriate to ask the daughter?
A) "Was Mary his wife?"
B) "Is this how he normally is?"
C) "Do you know what he means by this?"
D) "My mother suffers from dementia; it is a terrible disease, isn't it?"
2.D: An 83-year-old female fell down the basement stairs. Once at her side, she tells you
that her left hip hurts and rates it as 10/10. Since the patient is downstairs, you recognize
the need for assistance in extricating her from the residence. As you start the primary
assessment, you note a dog at the top of the stairs starts growling at you. At this time, what
is your primary concern?
A) Airway
B) Pain
C) Need for additional help
D) Dog
3.C: A car swerved to miss a deer in the road and hit a utility pole at a low rate of speed.
Damage to the car is minimal, but the 82-year-old male passenger was not wearing a seat
belt and hit his head on the dashboard. He presents as confused and diaphoretic. His
daughter, the driver, states that he has a history of dementia, high blood pressure, and
diabetes, as well as coronary artery disease. She adds that he took his insulin about 2 hours
ago. Which question to the daughter would be most important at this time?
A) "How far along is the dementia?"
B) "He seems sweaty. Was he feeling okay this morning?"
C) "Did he eat anything today?"
D) "Does he take medication for the high blood pressure?"
4.A: A 78-year-old male pedestrian was struck by a car at a convenience store. The
patient is conscious but confused, and has sustained multisystem trauma. What would
represent the best sequence of care for this patient?
A) Primary assessment, oxygen, secondary assessment, spine motion restriction
precautions, and all other care en route to the hospital
B) Primary assessment, spine motion restriction, and all other care en route to the hospital
C) Primary assessment, oxygen, secondary assessment, and all other care en route to the
hospital
, Prehospital Emergency Care, 11e (Mistovich et al.)
Chapter 36 Multisystem Trauma and Trauma in Special Patient
Population
D) Primary assessment, oxygen, secondary assessment, cervical collar, and all other
care en route to the hospital
5.B: A 62-year-old female with severe kyphosis fell and hit the back of her head, which is
now oozing blood from a small laceration. Family members state that she suddenly
complained of a "very bad headache" before collapsing to the kitchen floor. She has snoring
respirations and cyanosis in the extremities. Which intervention should you perform first?
A) Apply a cervical collar
B) Use a jaw-thrust maneuver
C) Start positive pressure ventilation
D) Cover the laceration
6.C: You are transporting an elderly female who fell in a nursing home and displays
outward rotation of her left leg. She has a lengthy medical history, including de- mentia.
Currently, she is very quiet and receiving oxygen through a nasal cannula at 6 liters per
minute. She also is secured to a long spine board. During your reassessment, you note her
to be alert but confused, with slightly accelerated respirations and a strong radial pulse.
You also note that her SpO2 has dropped from 97% on scene to 91%. You should:
A) Perform a head-tilt, chin-lift maneuver
B) Request ALS assistance
C) Apply supplemental oxygen
D) Start positive pressure ventilation
7.A: An unresponsive 10-year-old male was struck by a car while riding his bike. He
has blood on his face and presents with snoring respirations. Respirations are
approximately 10 breaths per minute, with cyanosis noted to his extremities. Manual
spine motion restriction to the neck is being held by Emergency Medical Responders.
What should you do next?
A) Perform a jaw-thrust maneuver
B) Start positive pressure ventilation
C) Suction the airway
D) Quickly assess for life-threatening injuries
8.D: An elderly female fell and is now very confused. You are having a problem getting
her past medical history. Her daughter states that she is typically alert and very well
oriented. What is your next best action?
A) Transport the patient without delay
B) Contact the patient's doctor for the history
C) Transport her to a hospital that has cared for her before
D) Ask the patient's daughter for the history
