TRAUMA FISDAP [2026] | STEP-BY-STEP ANSWER GUIDE |
UPDATED ACTUAL | COMPLETE EXAM PREPARATION
• Patients with significant closed head injuries often have pupillary abnormalities
and:
A) paralysis.
B) paresthesia.
C) hypertension.
D) tachycardia. -✓✓ANSWER: C) hypertension.
Closed head injuries can cause a variety of signs and symptoms. In addition to
pupillary abnormalities (ie, unequal pupils, sluggishly reactive pupils), a classic
finding that indicates a significant increase in intracranial pressure is Cushing's
triad. This trio of findings includes hypertension; bradycardia; and abnormal
breathing, which can vary from slow and irregular to rapid and deep.
• In contrast to an incision, a laceration:
A) is a jagged cut.
B) is a superficial injury.
C) bleeds more severely.
D) usually involves an artery. -✓✓ANSWER: A) is a jagged cut.
A laceration is a jagged cut caused by a sharp object or a blunt force that tears the
tissue, whereas an incision is a sharp, smooth cut. The depth of the injury
can vary; it can extend through the skin and subcutaneous tissue or into the
underlying muscles and adjacent nerves and blood vessels. Lacerations and
,incisions can involve arteries, veins, or both, potentially resulting in severe
bleeding.
• Which of the following clinical findings is consistent with decompensated
shock?
A) Diaphoresis and pallor
B) Falling blood pressure
C) Restlessness and anxiety
D) Tachycardia and tachypnea -✓✓ANSWER: B) Falling blood pressure
During shock, the compensatory mechanisms of the body attempt to maintain the
blood pressure. This is accomplished by increasing the heart rate, shunting
blood from the skin to more vital organs, and increasing the respiratory rate to
increase the oxygen content of the blood. Once these compensatory
mechanisms fail, the blood pressure will fall (hypotension). Hypotension signifies
a state of decompensated shock. You must not rely on the patient's blood
pressure as an indicator of overall perfusion. Restlessness, anxiety, tachycardia,
tachypnea, and cool, clammy skin (diaphoresis) are earlier signs of shock and do
not necessarily indicate a decompensated state.
• Which of the following injury mechanisms involves axial loading?
A) skater slips and falls, landing on her outstretched arm.
B) A construction worker falls off a roof and lands feet first.
C) A woman's knees impact the dash during a frontal collision.
D) A man's neck is forced laterally during a side impact collision. -✓✓ANSWER: B)
A construction worker falls off a roof and lands feet first.
,Axial loading injuries occur when a sudden, excessive compression force drives
the long axis of the body toward the head, or the head toward the feet.
Common injuries that involve axial loading are heavy objects falling on a patient's
head, diving head first into shallow water, and falls in which the patient lands
feet first. All of these mechanisms cause compression of the spine, potentially
resulting in serious injury. None of the other injury mechanisms described are
consistent with axial loading.
• A man was stabbed in the cheek with a dinner fork, and the fork is still impaled
in his cheek. He is conscious and alert, breathing adequately,
and has blood in his oropharynx. You should:
A) apply high-flow oxygen via a nonrebreathing mask, carefully remove the fork,
and control any external bleeding.
B) suction his oropharynx, control any external bleeding, stabilize the fork in
place, and protect it with bulky dressings.
C) carefully remove the fork, suction his oropharynx as needed, and pack the
inside of his cheek with sterile gauze pads.
D) suction his oropharynx, carefully cut the fork to make it shorter, control any
external bleeding, and secure the fork in place. -✓✓ANSWER: B) suction his
oropharynx, control any external bleeding, stabilize the fork in place, and protect
it with bulky dressings.
An impaled object in the cheek should be removed if it interferes with your ability
to manage the patient's airway. In this case, however, the patient is
breathing adequately and does not require aggressive airway care (eg, ventilatory
assistance). The most practical approach is to suction the blood from his
oropharynx, which will prevent him from swallowing it, vomiting it, or aspirating
it. Stabilize the fork in place and protect it with bulky dressings; removing
, an impaled object from the cheek in the opposite direction it entered would
clearly cause further soft-tissue injury and bleeding. Transport the patient in a
sitting position and suction his oropharynx en route as needed. There is no reason
to cut the fork to make it shorter; this will only unnecessarily manipulate
it, potentially causing further soft tissue damage and increased bleeding.
• A 40-year-old man was hit in the nose during a fight. He has bruising under his
left eye and a nosebleed. What should you do?
A) Place a chemical ice pack over his nose.
B) Determine if he has any visual disturbances.
C) Ensure that he is sitting up and leaning forward.
D) Apply direct pressure by pinching his nostrils together. -✓✓ANSWER: C) Ensure
that he is sitting up and leaning forward.
During a nosebleed (epistaxis), much of the blood may pass down the throat into
the stomach as the patient swallows; this is especially true if the patient is
lying supine. Blood is a gastric irritant; a person who swallows a large amount of
blood may become nauseated and vomit, which increases the risk of
aspiration. Therefore, your first action should be to ensure that the patient is
sitting up and leaning forward. This will prevent blood from draining down the
back of the throat. Next, apply direct pressure by pinching the fleshy part of the
nostrils together; you or the patient may do this. Placing a chemical ice pack
over the nose may further help control the bleeding by constricting the nasal
vasculature. After controlling the nosebleed, continue your assessment, which
includes assessing for facial deformities and visual disturbances.
UPDATED ACTUAL | COMPLETE EXAM PREPARATION
• Patients with significant closed head injuries often have pupillary abnormalities
and:
A) paralysis.
B) paresthesia.
C) hypertension.
D) tachycardia. -✓✓ANSWER: C) hypertension.
Closed head injuries can cause a variety of signs and symptoms. In addition to
pupillary abnormalities (ie, unequal pupils, sluggishly reactive pupils), a classic
finding that indicates a significant increase in intracranial pressure is Cushing's
triad. This trio of findings includes hypertension; bradycardia; and abnormal
breathing, which can vary from slow and irregular to rapid and deep.
• In contrast to an incision, a laceration:
A) is a jagged cut.
B) is a superficial injury.
C) bleeds more severely.
D) usually involves an artery. -✓✓ANSWER: A) is a jagged cut.
A laceration is a jagged cut caused by a sharp object or a blunt force that tears the
tissue, whereas an incision is a sharp, smooth cut. The depth of the injury
can vary; it can extend through the skin and subcutaneous tissue or into the
underlying muscles and adjacent nerves and blood vessels. Lacerations and
,incisions can involve arteries, veins, or both, potentially resulting in severe
bleeding.
• Which of the following clinical findings is consistent with decompensated
shock?
A) Diaphoresis and pallor
B) Falling blood pressure
C) Restlessness and anxiety
D) Tachycardia and tachypnea -✓✓ANSWER: B) Falling blood pressure
During shock, the compensatory mechanisms of the body attempt to maintain the
blood pressure. This is accomplished by increasing the heart rate, shunting
blood from the skin to more vital organs, and increasing the respiratory rate to
increase the oxygen content of the blood. Once these compensatory
mechanisms fail, the blood pressure will fall (hypotension). Hypotension signifies
a state of decompensated shock. You must not rely on the patient's blood
pressure as an indicator of overall perfusion. Restlessness, anxiety, tachycardia,
tachypnea, and cool, clammy skin (diaphoresis) are earlier signs of shock and do
not necessarily indicate a decompensated state.
• Which of the following injury mechanisms involves axial loading?
A) skater slips and falls, landing on her outstretched arm.
B) A construction worker falls off a roof and lands feet first.
C) A woman's knees impact the dash during a frontal collision.
D) A man's neck is forced laterally during a side impact collision. -✓✓ANSWER: B)
A construction worker falls off a roof and lands feet first.
,Axial loading injuries occur when a sudden, excessive compression force drives
the long axis of the body toward the head, or the head toward the feet.
Common injuries that involve axial loading are heavy objects falling on a patient's
head, diving head first into shallow water, and falls in which the patient lands
feet first. All of these mechanisms cause compression of the spine, potentially
resulting in serious injury. None of the other injury mechanisms described are
consistent with axial loading.
• A man was stabbed in the cheek with a dinner fork, and the fork is still impaled
in his cheek. He is conscious and alert, breathing adequately,
and has blood in his oropharynx. You should:
A) apply high-flow oxygen via a nonrebreathing mask, carefully remove the fork,
and control any external bleeding.
B) suction his oropharynx, control any external bleeding, stabilize the fork in
place, and protect it with bulky dressings.
C) carefully remove the fork, suction his oropharynx as needed, and pack the
inside of his cheek with sterile gauze pads.
D) suction his oropharynx, carefully cut the fork to make it shorter, control any
external bleeding, and secure the fork in place. -✓✓ANSWER: B) suction his
oropharynx, control any external bleeding, stabilize the fork in place, and protect
it with bulky dressings.
An impaled object in the cheek should be removed if it interferes with your ability
to manage the patient's airway. In this case, however, the patient is
breathing adequately and does not require aggressive airway care (eg, ventilatory
assistance). The most practical approach is to suction the blood from his
oropharynx, which will prevent him from swallowing it, vomiting it, or aspirating
it. Stabilize the fork in place and protect it with bulky dressings; removing
, an impaled object from the cheek in the opposite direction it entered would
clearly cause further soft-tissue injury and bleeding. Transport the patient in a
sitting position and suction his oropharynx en route as needed. There is no reason
to cut the fork to make it shorter; this will only unnecessarily manipulate
it, potentially causing further soft tissue damage and increased bleeding.
• A 40-year-old man was hit in the nose during a fight. He has bruising under his
left eye and a nosebleed. What should you do?
A) Place a chemical ice pack over his nose.
B) Determine if he has any visual disturbances.
C) Ensure that he is sitting up and leaning forward.
D) Apply direct pressure by pinching his nostrils together. -✓✓ANSWER: C) Ensure
that he is sitting up and leaning forward.
During a nosebleed (epistaxis), much of the blood may pass down the throat into
the stomach as the patient swallows; this is especially true if the patient is
lying supine. Blood is a gastric irritant; a person who swallows a large amount of
blood may become nauseated and vomit, which increases the risk of
aspiration. Therefore, your first action should be to ensure that the patient is
sitting up and leaning forward. This will prevent blood from draining down the
back of the throat. Next, apply direct pressure by pinching the fleshy part of the
nostrils together; you or the patient may do this. Placing a chemical ice pack
over the nose may further help control the bleeding by constricting the nasal
vasculature. After controlling the nosebleed, continue your assessment, which
includes assessing for facial deformities and visual disturbances.
