Question 1

Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a gun?

Accepted Answer

A)  Friction and distance 
B)  Mass and friction 
C)  Velocity and mass 
D)  Friction and velocity

Question 2

Axial loading is MOST likely to occur in which type of impact?

Accepted Answer

A)  Frontal with an up-and-over pathway 
B)  Frontal with a down-and-under pathway 
C)  Rear with the headrest too low 
D)  Lateral on the side of the vehicle opposite the occupant

Question 3

Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting motion?

Accepted Answer

A)  Direct trauma, such as from a blow to the head 
B)  Low-velocity penetrating trauma from an ice pick 
C)  High-velocity penetrating trauma from a gunshot wound 
D)  Lateral-impact motor vehicle collision

Question 4

People in which of the following age groups are prone to significant trauma due to falls?

Accepted Answer

A)  College-aged adults 
B)  Geriatric population 
C)  Pediatric population 
D)  Teenagers

Question 5

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "starred," and that the driver is not restrained. Which of the following injuries is MOST likely?

Accepted Answer

A)  Whiplash injury of the neck muscles 
B)  Compression injury of the cervical spine 
C)  Distraction injury of the cervical spine 
D)  Ligamentous neck injury due to rotation beyond the range of motion

Question 6

Which of the following injuries is associated with the tertiary phase of a blast?

Accepted Answer

A)  Crush injuries 
B)  Barotrauma 
C)  Burns 
D)  Projectile injuries

Question 7

Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The air bag deployed. Considering the likelihood of organ collision, for which of the following injuries should you maintain a high index of suspicion?

Accepted Answer

A)  Cardiac contusion 
B)  Anterior flail segment 
C)  Abruptio placentae 
D)  Fractured sternum

Question 8

Which of the following is TRUE of shotgun ammunition?

Accepted Answer

A)  A shotgun may either fire one slug or use ammunition with multiple pellets. 
B)  The shot is dispersed from the cartridge with high velocity. 
C)  The closer the shooter is to the victim, the larger the area of visible damage. 
D)  "Double ought" or #00 shot contains a large number of relatively small pellets.

Question 9

Which of the following is TRUE of the pressure wave that accompanies high-velocity penetrating trauma?

Accepted Answer

A)  Hollow organs are less tolerant of the stress than solid organs are. 
B)  Pressure waves cause no injury to surrounding tissues; they only momentarily disrupt function. 
C)  Elastic tissues are less tolerant of the stress than non-elastic tissues. 
D)  The pressure wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

Question 10

As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs?

Accepted Answer

A)  Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound. 
B)  No vacuum is created when there are both an entrance and an exit wound. 
C)  Negative pressure is generated inside the cavity, drawing debris into the wound. 
D)  There is negative pressure at the entrance wound and positive pressure at the exit wound.

Question 11

Which of the following affects the severity of injury sustained in a motor vehicle collision?

Accepted Answer

A)  Gross vehicle weight 
B)  Rate of acceleration or deceleration 
C)  Vehicle speed 
D)  All of the above

Question 12

Which statement about ballistics is TRUE?

Accepted Answer

A)  Damage is less when the bullet does not exit the body. 
B)  When a bullet tumbles, it decreases the damage. 
C)  In penetrating trauma, the mass of a projectile is more significant than its velocity when determining kinetic energy. 
D)  When a bullet yaws, it increases the damage.

Question 13

When the driver's chest strikes the steering wheel during a motor vehicle collision, what produces the next injury?

Accepted Answer

A)  The air bag deploys a second time. 
B)  The steering column shears off, causing penetrating trauma. 
C)  Unsecured objects in the vehicle become projectiles. 
D)  The heart continues its forward motion until it strikes the chest wall.

Question 14

Which of the following is best described as "the area of contused tissue resulting from penetrating trauma that may be slow to heal due to disrupted blood flow and tissue damage"?

Accepted Answer

A)  Temporary cavity 
B)  Zone of injury 
C)  Zone of coagulation 
D)  Permanent cavity

Question 15

You have responded to a soccer field on which two 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency department?

Accepted Answer

A)  Weakness in the upper extremities 
B)  Complaint of "getting the wind knocked out of me" 
C)  Contusion to the thigh 
D)  Minor epistaxis

Question 16

Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient?

Accepted Answer

A)  Bridge abutment 
B)  Shrubbery 
C)  A body of water 
D)  Signpost

Question 17

Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating trauma?

Accepted Answer

A)  Spleen 
B)  Bowel 
C)  Kidneys 
D)  Liver

Question 18

Which of the following is associated with assault rifle wounds but not hunting rifle wounds?

Accepted Answer

A)  Permanent cavitation 
B)  Multiple wounds 
C)  Smaller exit wounds 
D)  Larger exit wounds

Question 19

Which of the following is most important when assessing the damage done by a gunshot?

Accepted Answer

A)  The type of gun used 
B)  The size of the bullet 
C)  The distance from the shooter 
D)  Whether there was an upward or a downward trajectory when the bullet was fired

Question 20

A vehicle is struck in its right front as it passes through an intersection, resulting in an oblique impact. Which of the passengers is subjected to the greatest acceleration forces?

Accepted Answer

A)  The right-rear passenger 
B)  The left-rear passenger 
C)  The front-seat passenger 
D)  The driver

Exam 2: Mechanism of Injury