GNK 285 - Emergency Medicine Exam | Complete Solutions (Verified)

GNK 285 - Emergency Medicine Exam | Complete Solutions (Verified) You are called to assist a boy who sustained a head injury while performing stunts with his bicycle. The first thing you would consider checking is whether: A. There are obvious wounds or deformities B. He is responsive C. He has sustained a neck injury too D. He is breathing adequately When caring for a victim who has an object impaled in their hand, you should... A. Remove the object, flush with cool water and transport to hospital B. None of the above C. Immobilize the object by placing several dressings around it D. Break the object off where it sticks out and bandage the injury Your uncle staggers into the house from his garage. He has a large avulsion injury of his forearm, with a piece of metal protruding from it. What would be the primary aim of your treatment at this stage? A. To prevent further injury B. To prevent pain C. To prevent hypovolemic shock D. To prevent infection Which if the following conditions cause hot, red and dry skin? A. Cold exposure B. Fever C. Shock D. Head stroke The three most common causes of seizures in adults include: A. Hyperglycemia, hypoxia and stroke B. Infections, emotional trauma and head injures C. Head trauma, stroke and infections such as meningitis D. Fever, hypoxia and hyperglycemia What is the blueish discoloration around the eyes called? A. Beck's triad B. Cushing sign C. Racoon eyes D. Battle sign You are performing a secondary survey on a trauma case. For which of these conditions will you immediately seek emergency treatment by qualified staff? A. Significant bleeding B. All of the above C. Multiple musculoskeletal injuries D. Head, neck or back injury A woman was injured in a bus accident. No wounds are found on inspection but she complains of severe backache. Indicate the priority of her injuries. A. Priority 1 (Red) B. Priority 2 (Yellow) C. Priority 3 (Green) D. Priority 4 (Black) Your assessment of the scene suggests that a victim has suffered an electrical shock. The first thing to do: A. Cover all the burns with a loose dry dressing B. Place the victim on one side with the head down (recovery position) C. Ask a bystander to help move the patient D. Make sure the power is turned off You are walking your dog and pass a house with a fish pond. You notice a child in the water. Upon investigation, you find the child unresponsive. You should for help and determine that the child is not breathing and has no pulse. No one responds to your call for assistance but fortunately you have your cellphone at hand. At what stage should you call the emergency services? A. After you gave five slow ventilations B. Immediately before you start CPR. C. After you have performed CPR for two minutes. Which of the following factors will contribute to the extend of the injury from a fall? (Multiple responses) A. Whether he or she hit anything else during the fall B. Victim's weight C. What the victim fell onto D. Height of the fall What injury most likely cased the discoloration around the patient's ears? (Battle signs) A. Perforated tympanic membrane B. Facial fractures C. Fracture of the jaw D. Base of skull fracture The first step in the primary survey is to assess a scene for safety. Which of the following are examples of a scene that can be considered unsafe? A. A 2 year old child with a leg injury sustained from slipping in a fish pond. B. A 45 year old male in a lift with difficulty in breathing. C. A 22 year old female with abdominal pain. D. An 18 year old adolescent with a gunshot wound to the chest. Which of the following conditions cause a victim's skin to become cold, pale and clammy? A. Heat stroke B. Cold exposure C. Shock D. Fever You decide to dress the large avulsion injury of your uncle's forearm - with a piece of metal protruding from the wound in question. Indicate which dressing should be applied to stabilize the impaled object. A. Doughnut dressing B. Support sling C. Pressure bandage D. Baguette dressing Following a tennis match, your 57 year old father complains of a sudden pressure sensation in chis chest with come pain in his jaw. He adds that he feels dizzy and nauseous. What should you do? A. Give him some water to drink to treat the symptoms of dehydration B. Administer 325mg of aspirin and have him rest an hour C. Have him rest in the shade and call for immediate emergency assistance A child was bitten by a black mamba snake in KZN. What is the most common clinical problem associated with black mamba envenomation? A. Coagulopathy B. Tissue necrosis C. Neurotoxicity D. Kidney failure Select the applicable diagnostic significance of a crackling sensation under the chin over the chest area, following performing a physical examination on a person following a motor vehicle accident: A. Fracture of the mandible B. Overdose C. Fracture of the base of the skull D. Rib fracture A 10 year old girl was stung several times by a swarm of bees. The areas where she was stung are red and swollen, and several stingers are still embedded in her arms and legs. She is crying, complains of pain and has a rapid pulse. The parents state that she is not allergic. What is the appropriate action to take? A. Use tweezers to remove the stingers and then apply a warm compress B. Squeeze the stingers to remove the venom and apply cold packs C. Wash the area and apply warm compress to relieve pain D. Scrape off the stingers with the edge of a plastic card and wash the area with water The correct sequence when performing CPR on an adult is: A. Hazards, Hello, Help, Airway, Breathing, Compressions B. Hazards, Hello, Help, Chest rise, Airway, Breathing C. Hazards, Hello, Help, Airway, Breathing, Circulation D. Hazards, Hello, Help, Compressions, Airway, Breathing After a birthday party at a friend's house, you find a confused partygoer on the bathroom floor. What can his small or pinpoint pupils be indicative of? A. Rib fracture B. Fracture of the base of the skull C. Drug overdose D. Fractures of the mandible You are assisting at an emergency child birth. Following the delivery of the baby, your best course of action is? A. Drying the baby and skin-to-skin contact between the mother and baby B. Examine the perineum for lacerations C. Placing the mother in left lateral position and head down D. Continuous uterine massage You are the first responder to arrive at the scene of an unconscious child. You determine that the child does not have a pulse and is not breathing. The next step you should take is: A. Leave the child and phone for help B. Do not start CPR because the child is not breathing and has no pulse C. Phone or look for help before starting CPR D. Attempts five cycles of CPR before phoning for help A 2 year old pulled a pan of boiling liquid off the stove and burned his entire head and anterior portion of his torso. Calculate the percentage of the child's body surface that has been burned. A. 30% B. 36% C. 18% D. 42% You are called to help an injured person at a collapsed construction site. Upon examination of the victim he complains of severe shortness of breath and severe chest pain. Which of the following conditions might he have? A. Fracture of the mandible B. Flail chest C. Overdose D. Fracture of the base of the skull Which of these is not a symptom of shock? A. Thirst, nausea, vomiting B. Restlessness, irritability C. Rapid breathing, rapid pulse D. Fever, warm and dry skin What is the cause of angina (chest pain)? A. Insufficient blood reaching the lungs B. Insufficient blood reaching the leg muscles C. Insufficient blood reaching the brain D. Insufficient blood reaching the heart Which of the following describe capillary refill correctly: A. Time taken for color to return to an external capillary bed after pressure was applied to cause blanching B. Color that returns within 5 seconds after the application of pressure is considered a normal capillary refill time C. None of the above D. All of the above Which one of the following steps should be taken when caring for a victim with a penetrating abdominal injury? A. Cover the wound with a folded dry towel B. Cover the wound with a water soaked towel C. Attempt to push protruding organs back into the bowel D. Apply direct pressure to stop the bleeding You should suspect that a victim has a head and or spine injuries in: A. An incident involving a lightening strike B. A person is found unconscious for unknown reasons C. A fall from a height greater than a victim's height D. All of the above Ecchymosis around the eyes can be indicative of? A. Rib fracture B. Fracture of the back of the skull C. Drug overdose D. Fracture of the mandible Which of the following is the most appropriate first step in the management of a suspected MI case? A. Obtain a full medical history B. Activate the emergency medical services C. Put the person at ease D. Aim to relieve the tightness in his chest by loosening the clothing You are at the scene of a motorcycle accident involving a young man. He is conscious, standing next to his motorcycle and complains of severe neck pain with tingling in his hands and feet. What would be your next step? A. Help him lie down on his back and remove his helmet B. Ask him to remove his helmet and carefully lie down on his back C. Assist him to remove his helmet and help him lie down on his back D. Help him lie down on his back while stabilizing his neck without removing his helmet A 35 year old man has collapsed in the lobby of the movie theatre. When you arrive at the scene you determine that the patient does not have a pulse and is not breathing. Management of the cinema states that they have an AED. When the AED first arrives, you should: A. Finish the cycle of CPR and then apply the AED B. Do not use the AED if the patient still has no pulse C. Stop CPR and wait for paramedics to arrive to apply the AED D. Immediately turn the AED on and follow the voice prompts How can you reduce the risk of disease transmission when caring for open and bleeding wounds? A. Avoid direct contact with blood B. Use protective barriers such as gloves C. Wash your hands immediately after giving care D. All of the above A visitor to your house suddenly complains of dizziness and starts talking incoherently. His hands feel cols and clammy and you see a medic alert bracelet that indicates that he is diabetic. What would be the best action to take after checking his "CAB"? A. Carry him to your car and rush him to hospital B. Have him lie down C. Apply a teaspoon of honey to the inside of the cheeks D. Give him some water to drink Which of the following options for the management of shock may increase a patient's chances of bleeding? A. Maintaining body temperature by covering the patient with a blanket B. Transporting the patient to an emergency facility as soon as possible C. Raising the patient's legs above the level of the torso D. Dressing bleeding wounds with appropriate bandages Which one of the following signs is most consistent with a stroke? A. Chest pain B. Ear pain C. Nausea D. Facial droop A victim of a car accident has just vomited and now appears to be coughing up blood. He is breathing very quickly and his pulse is weak and fast. What is most likely wrong? A. He is having a seizure B. He is having a heart attack C. He has internal bleeding D. He is having a diabetic emergency The three tell-tale signs of a stroke include? A. Sluggish pupils, unresponsiveness and high BP B. Facial drooping, arm drifting and abnormal speech C. Facial drooping, loss of consciousness and low BP D. Sudden loss of consciousness, variation in pulse rate and low BP You find a 60 year old male lying on the floor of his home. Your first step in the care of this person should be: A. Maintain an open airway B. Begin chest compressions C. Assess his level of responsiveness D. Asses for a pulse Which is the recommended artery for obtaining a pulse in an unresponsive 2 year old? A. Radial B. Femoral C. Brachial D. Carotid A 54 year old man suddenly experiences discomfort in his chest while playing golf. He complains of feeling faint and says that it feels as if his heart is skipping beats. He is sweating and pale. Which is the most likely diagnosis? A. Acute left heart failure B. Acute asthma attack C. Stroke D. Acute MI A first degree burn: A. Is the most serious burn B. Involves only the top layer of skin or epidermis C. Requires surgery for treatment D. Is red and blistered and very painful A 19 year old was shot in the chest during a hijacking of his car. there is minimal bleeding from the wound but you can hear a sucking noise with each breath. What should you immediately do? A. Assess his breathing by having a long conversation B. Prevent air from getting sucked in through his wound C. Elevate his legs to counteract shock and rapidly transport him to the hospital D. Splint the victim's arm to his chest on the injured side You are dining in a restaurant when a women next to you suddenly cries out. Her six month old baby is turning blue around his mouth, appears to be gagging but is not able to breathe or cry. What is your next step? A. Deliver back blows and chest thrusts B. Begin CPR C. Do a blind finger sweep of the baby's mouth so that you can open the airway effectively D. Assist the baby with rescue breaths On an infant where do you check the pulse? A. Brachial B. Carotid C. Behind the knee cap D. Radial In general a splint should be: A. Snug but not so tight that it slows circulation B. None of the above C. Loose so that the victim can still move the injured limb D. Tied with a piece of sting over the injured area Which of the following symptoms will indicate an internal bleeding with signs of decompensated sock: A. All of the above B. A skin that feels cool and appears pale C. A rapid and weak peripheral pulse D. A tender, swollen and bruised abdomen The drowning process is a continuum that begins when a person's airway lies below the surface of liquid, at which time a person voluntarily holds his breath. This is followed by an involuntary period of laryngospasm secondary to the presence of liquid in the larynx. As a first aider, the most important steps in the initial management of the patient include: A. Ensuring the first aider's safety, recovering the person from the water and immediately B. Covering the person with a blanket to prevent hypthermia C. Immediately comment with rescue breaths and draining water from the lungs Classify a physiologically stable patient with backache: A. Priority I (Red) B. Priority II (Yellow) C. Priority III (Green) D. Priority IV (Black) Closest respiratory rate of a boy: (per minute) A. 56 B. 48 C. 3 D. 100 Fruity Smell A. Asthma/Diabetes B. Cyanide C. Organophosphates Almond Smell A. Asthma/Diabetes B. Cyanide C. Organophosphates Garlic Smell A. Asthma/Diabetes B. Cyanide C. Organophosphates Small or pinpoint pupils? A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Trachea dislocation A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Fluid leakage from ear A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Bulging jugular vein A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Sucking of air on inspiration A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Subcutaneous Emphysema A. Nicotine overdose B. Pneumothorax C. Skull fracture D. Tension pneumothorax Skin red, hot and dry A. heat stroke B. cold exposure C. fever D. shock Skin cold, pallor, dry A. heat stroke B. cold exposure C. fever D. shock Skin hot, red and clammy A. heat stroke B. cold exposure C. fever D. shock Skin cold, pale and clammy A. heat stroke B. cold exposure C. fever D. shock How to deal with a hysterical patient? A. Converse with B. Isolate C. Engage with D. Sedate Respiratory rate of an adult at rest? A. 12 B. 24 C. 48 Respiratory rate of a child at rest? A. 12 B. 24 C. 48 Respiratory rate of an infant at rest? A. 12 B. 24 C. 48 Pulse rate of an adult: A. 60-80 B. 80-100 C. 100-120 D. 120-140 E. 50 Pulse rate of a child: A. 60-80 B. 80-100 C. 100-120 D. 120-140 E. 50 Pulse rate of an infant: A. 60-80 B. 80-100 C. 100-120 D. 120-140 E. 50 Pulse rate of a newborn: A. 60-80 B. 80-100 C. 100-120 D. 120-140 E. 50 Pulse rate of a fit athlete: A. 60-80 B. 80-100 C. 100-120 D. 120-140 E. 50 SAMPLE - What does it stand for? S: Signs and symptoms A: Allergies M: Medications P: Past medical and surgical history L: Last oral intake E: Events leading to the injury AVPU - What does it stand for? Alert: Able to respond to questions Verbal: Responds appropriately to verbal stimuli Painful: Responds only to painful stimuli Unresponsive: Does not respond Person was hurt. Was lying down with closed eyes, however upon conversing he would moan and grumble back some words. Moreover he pinched back when pinched. What range of AVPU system is he? V and P Cherry red skin A. CO poisoning B. Atropine, poison C. Organophosphate poison D. Systemic effect of poison Red hot dry skin A. CO poisoning B. Atropine, poison C. Organophosphate poison D. Systemic effect of poison Profuse sweating A. CO poisoning B. Atropine, poison C. Organophosphate poison D. Systemic effect of poison Vital sign change A. CO poisoning B. Atropine, poison C. Organophosphate poison D. Systemic effect of poison Cytotoxic snakes: - Spitting cobra - Puff adder Neurotoxic snakes: - Mamba - Non-spitting cobra - Rinkhals Hemotoxic snake Boomslang What question not to ask when obtaining history? Yes/No questions How much blood can you lose in a pelvic injury? A.1 L B. 2 L C. 3 L D. 4 L 7 year old kid was taken out from the bottom of a pool. 2 Breaths were applied (1s per breath) and 15 chest compressions. What was done wrong? - Not enough time provided to exhale - Too fast in breaths applied. Person was shot in his left arm and left chest. What action to take? Sling his arms to the same side of the chest Three signs of a base of skull fracture - Racoon eyes - Battle sign - Fluid or blood from ears Flail chest indicative of which fracture Ribs or sternum fracture Crackling under skin indicative of which fracture Ribs Priority 1: Red patients - Stretcher case and physiologically unstable - Cardiac arrest - Obstructed airway or not breathing - Facial or inhalation burns - Amputated limbs - Severe bleeding - Open thoracic injuries - Serious head injuries Priority 2: Yellow patients - Stretcher case and physiologically stable - Multiple and major fractures - Head injuries without localized signs - Back and neck injuries Priority 3: Green patients - Walking, wounded or ill - Burns without shock - Minor fractures and wounds - Hysteria