FISDAP TRAUMA 2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES

FISDAP TRAUMA 2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Patients with significant closed head injuries often have pupillary abnormalities and : A) paralysis. B) paresthesia. C) hypertension. D) tachycardia. Correct Answer C) hypertension. Rationale: Closed head injuries can cause a variety of signs and symptoms. In addition to pupillary abnormalities (ie, unequal pupils, sluggishly reactive pupils), a cla ssic 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 i ncision, a laceration: A) is a jagged cut. B) is a superficial injury. C) bleeds more severely. D) usually involves an artery. Correct Answer A) is a jagged cut. Rationale: 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 muscle s 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 Correct Answer B) Falling blood pressure Rationale: 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 st ate 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 indicat e 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. Correct Answer B) A construction worker falls off a roof and lands feet first. Rationale: Axial loading injuries occur when a sudden, excessive compression force drives the lon g 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 m echanisms 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 remo ve 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. Correct 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 aggress ive 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 c ut 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. Wh at 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. Correct 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 swall ows 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 contr olling the nosebleed, continue your assessment, which