Deck 15: Disorders and Conditions Resulting From Trauma

Question 1

Physical patterns observed in child abuse include

A) bruising and burns.
B) observable injuries such as teeth marks.
C) welts and fractures.
D) all of the above.

Answer 1

D
Often children who are victims of child abuse are identified as such by teachers, daycare providers, or health care providers. The injuries to the child encompass many forms, including bruises, fractures, burns, bites, and welts. The injuries can even be fatal (see Figure 15-29).
Bruising can exhibit many telltale appearances, such as finger marks, which wrap around the child's limb and may show evidence of rings worn by the perpetrator; imprints of electrical cords or hangers; and horizontal wraparound marks left by belts or straps, and possibly buckle marks. These bruises appear on soft tissue and not over bony prominences where normal falls would have caused them to be. The bruising is often seen in areas normally covered by clothing and the bruises are in various stages of healing.
Burns from cigarettes appear as small circles (the diameter of a cigarette), often on hands, feet, buttocks, or genitals. These are at various stages of healing. Another form of burn is the scald burn with the pattern of "dipping," straight lines with no splash marks, a result of the child's being held in scalding water (see Figure 15-30, A and B).
Other observable injuries include teeth marks, with bruising caused by human bites, and raised areas or welts caused by spankings with sticks, paddles, or belts on the buttocks or legs. A fracture, usually greenstick in nature, of a long bone may be noted.
Often the child is withdrawn, avoids eye contact, and does not respond appropriately to painful stimuli. When asked how the injury happened, the child denies any abuse and protects the abuser. In other cases, the child exhibits unusually aggressive behavior and has a neglected appearance.
Neglect is often also considered to be a form of child abuse. When children are not provided with food or shelter, the caretaker is considered to be neglectful. Leaving young children unattended, thus endangering their well-being is also a form of neglect. Child abuse or neglect is a reportable crime in all states, and the health care giver caring for the child victim can be found liable if the case is not reported to the appropriate agency.
Physical, psychological, or sexual injury to a child is considered child abuse. The most commonly observed form is physical abuse because the resulting injuries are usually apparent. Signs of psychological abuse may be evidenced in the actions of the child. Sexual abuse may be discovered collaterally when complaints by the child of discomfort in the genital region are investigated or the child reports the abuse.

Question 2

Complications of survivors of lightning strikes include

A) cataracts.
B) cervical spine injuries.
C) ruptured tympanic membranes.
D) all of the above.

Answer 2

D
Prognosis varies according to the extent of the insult. When respiratory efforts are maintained, survival may be possible. Cardiac dysrhythmias are a potential lethal complication of lighting injuries. Prompt institution of cardiopulmonary resuscitation (CPR) when respiratory efforts are found absent may also result in survival of the victim. Those who do not have respiratory or cardiac activity cessation usually survive, but require follow-up examinations of eyes and ears for late-onset problems. Burn treatment of points of entry and exit, as well as treatment of any other skin burns, is required.
The patient should be entered into the EMS without delay. Treatment consists of restoring or maintaining the patient's respiratory effort. If the person is apneic, cardiac function ceases in a few minutes. If the person is in cardiac arrest, CPR must be initiated and continued for an extended period. Cardiac monitoring is indicated, along with observation for cerebral edema and respiratory insult. Fractures and lacerations, burns, and other injuries need to be treated according to facility protocol. Tetanus prophylaxis must be confirmed or administered if necessary. Follow-up eye examinations should be conducted because cataracts may develop in the year after the lightning strike. Treatment of ruptured tympanic membranes should be instituted.

Question 3

_____ is a severe systemic infection, transmitted by a tick, and characterized by a maculopapular rash, small hemorrhages under the skin, and involvement of vital organs.

A) Rocky Mountain spotted fever
B) Rabies
C) Acquired immunodeficiency syndrome (AIDS)
D) Malaria

Answer 3

A
The patient may recall being bitten by a tick, typically during outdoor activity, such as camping and hiking. Patients are frequently unaware of the insects because they are flat and small and may be hidden in an area covered in hair. Several days to 2 weeks later, a sudden onset of fever, severe headache, vomiting, malaise, and myalgia occur. Four days after the onset of fever, a characteristic maculopapular rash is noted, which spreads over the body. Small hemorrhages appear under the skin, the characteristic sign that gives the disease its name. Inflammation of blood vessels (vasculitis) affects the skin and other organs, leading to systemic manifestations in the heart, lungs, kidneys, and nervous system. After 2-3 weeks, the skin begins to peel (see Figure 15-20).

Question 4

FBs in the ear may include

A) bugs and insects.
B) cereal, peas, beans, grapes, and pebbles.
C) cotton.
D) all of the above.

Question 5

The legal responsibilities of the health care provider in battered spouse syndrome

A) are not in the scope of concern.
B) vary from facility to facility.
C) vary by state but should be known.
D) all of the above.

Question 6

The soft-tissue injury that occurs when a body part becomes entangled or entrapped, resulting in skin, tissue, and bone being pulled from the body is a(n)

A) laceration.
B) avulsion.
C) incision.
D) abrasion.

Question 7

Cumulative trauma disorders include

A) carpal tunnel syndrome.
B) white finger.
C) synovitis.
D) all of the above.

Question 8

Compression of the brachial plexus nerves may also be called

A) tendinitis.
B) thoracic outlet syndrome.
C) tennis elbow.
D) trigger finger.

Question 9

All incidents of open trauma have a commonality in

A) the risk of infection.
B) pain.
C) risk of tetanus.
D) all of the above.

Question 10

A soft-tissue injury in which the outer layer of the skin has been scraped away is an

A) avulsion.
B) abrasion.
C) amputation.
D) incision.

Question 11

Treatment of a laceration includes

A) gentle cleansing and approximation and securing the edges.
B) debridement, suturing, and sterile dressing application.
C) the use of tissue glue.
D) all of the above.

Question 12

The best way to remove the "stinger" from the site of an insect sting is

A) pulling it out using tweezers.
B) squeezing it out.
C) scraping across it with a credit card.
D) cutting it out with a pocket knife.

Question 13

A burn that involves destruction of the skin and underlying tissue is termed

A) superficial.
B) partial thickness.
C) full thickness.
D) radiation.

Question 14

Tetanus toxoid prophylaxis is important in any person who has sustained open trauma because

A) boosters are required throughout life.
B) tetanus toxoid is a broad-spectrum antibiotic.
C) organisms that cause tetanus enter the body directly into the bloodstream through wounds.
D) all of the above.

Question 15

Treatment of a puncture wound includes

A) brisk scrubbing of the area with a brush.
B) copious irrigation of the wound.
C) approximation of the wound edges for suturing.
D) all of the above.

Question 16

The individual who has a body temperature above 105° F; red, hot, and dry skin; headache; dizziness; and shortness of breath is experiencing

A) heat exhaustion.
B) heat stroke.
C) hypothermia.
D) all of the above.

Question 17

In electrical shock, the current

A) follows the path of least resistance.
B) always enters the heart.
C) destroys the brain tissue.
D) always destroys lung tissue.

Question 18

The rule of nines is used to calculate

A) cardiac or respiratory failure.
B) the percentage of body surface affected by burns.
C) the type of thermal trauma.
D) all of the above.

Question 19

Treatment of snakebite includes

A) keeping the victim quiet and transporting to an emergency facility.
B) putting a tourniquet around the limb.
C) applying ice.
D) all of the above.

Question 20

The person suffering from hypothermia experiences

A) shivering.
B) disorientation.
C) fatigue.
D) all of the above.

Question 21

There are no specific tests or documentation procedures available for the rape victim.

Question 22

Only women are victims of intimate partner violence (IPV).

Question 23

An easy way to remove a live bug from an ear is

A) grasp with tweezers.
B) turn off light and shine a flash light in the ear.
C) pull on ear lobe.
D) have patient stand in shower.

Question 24

Radiation exposure may affect the hemopoietic system.

Question 25

Another name for "trigger finger" is stenosing tenosynovitis.

Question 26

The most common symptom of tendonitis is acute pain.

Question 27

Treatment of frostbite includes vigorous massage of the affected area.

Question 28

Treatment for altitude sickness includes

A) drinking alcohol.
B) moving to a lower altitude.
C) climbing until symptoms cease.
D) taking salt pills.

Question 29

Health care providers are at risk for puncture wounds from contaminated needle sticks. It is not necessary for health care providers to follow United States Occupational Safety and Health Administration (OSHA) guidelines concerning puncture wounds from contaminated needle sticks.

Question 30

Lateral humeral epicondylitis is

A) trigger finger.
B) tennis elbow.
C) carpal tunnel syndrome.
D) thoracic outlet syndrome.

Question 31

In shaken infant syndrome, there is no outward indication of physical trauma most of the time.

Question 32

Physical trauma is a leading cause of death in the United States for persons age 1 year old to approximately age 44.

Question 33

Rust rings on the cornea may be the result of an FB in the eye.

Question 34

Victims of elder abuse are eager to admit to being victims.

Question 35

Sun protection factors (SPFs) of at least 6 are recommended by the Skin Cancer Foundation as a protection against the sun's harmful rays or ultraviolet B (UVB).

Question 36

Carpal tunnel syndrome involves entrapment of the median nerve.

Question 37

Deoxyribonucleic acid (DNA)-parentage testing is conclusive in determining genetic profiles of the mother, child, and father.

Question 38

An easy way to remove a FB from the nose of a child is to

A) grasp it with tweezers.
B) irrigate
C) have child blow his/her nose.
D) shine a light in nares.