Chapter 19.

Emergency Problems

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental
status changes, absent sweat, and tachypnea?
a. Heat cramps
b. Heat syncope
c. Heat exhaustion
d. Heat stroke

____ 2. What percentage of burns is involved using the rule of nines if both front legs are burned?
a. 9%

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b. 18%

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c. 24%

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d. 36%

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____ 3. Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens

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and is the most frequently used agent for partial- and full-thickness thermal injuries?
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a. Clotrimazole cream (Lotrimin)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
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d. Silver sulfadiazine (Silvadene)

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____ 4. A sunscreen with a sun-protection factor of at least what number will block most harmful ultraviolet
radiation?
a. 4
b. 8
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c. 10
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d. 15

____ 5. Which clinical feature is the first to be affected in increased intracranial pressure?
a. Decrease in level of consciousness
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b. Headache
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c. Nausea
d. Widening pulse pressure

____ 6. What is the normal number for the Glasgow Coma Scale?
sh

a. 7
b. 9
c. 10
d. 15

____ 7. Which diagnostic test is the best to diagnose a subdural hematoma?

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 a. History
b. Positron emission tomography
c. Magnetic resonance imaging (MRI)
d. Computed tomography (CT) scan

____ 8. Patients with a spontaneous pneumothorax should be counseled that up to what percentage may
experience a reoccurrence at some point?
a. 10%
b. 20%
c. 30%
d. 50%

____ 9. Most adult poisonings are:

a. Intentional and self-inflicted
b. Accidental
c. Caused by someone wishing to do harm to the person

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d. Not attributed to any reason

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____ 10. Which method is used to remove heavy metals, such as lead, that are ingested as poisons?

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a. Chelation

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b. Dialysis
c. Gastric lavage rs e
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d. Bowel irrigation

____ 11. If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?
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a. Permanent tissue damage may occur, resulting in necrosis to that body part.
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b. The area will be super sensitive.

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c. The area is prone to a repeat frostbite.

d. The area is as susceptible as any other area.

____ 12. What percentage of all visits to the emergency department (ED) are related to wounds?
ed d

a. 5%
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b. 12%
c. 18%
d. 24%
is

____ 13. Which solution should be used when irrigating lacerated tissue over a wound on the arm?
Th

a. Dilute povidone-iodine solution

b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water
sh

____ 14. Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the
epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns

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 d. Full-thickness burns

____ 15. Which carboxyhemoglobin (COHb) level correlates with the clinical symptoms of confusion,
lethargy, and ST-segment depression on the electrocardiogram?
a. Less than 10%
b. 20% COHb
c. 30% COHb
d. 40% to 60% COHb

____ 16. Which causes the greatest percentage of mammalian bites?

a. Dogs
b. Cats
c. Humans
d. Rodents

____ 17. Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue?

m
a. Tick

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b. Brown recluse spider

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c. Wasp

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d. Stinging caterpillar

o.
rs e
____ 18. Which of the following characteristics separates anaphylaxis from a vasovagal reaction?
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a. Bradycardia
b. Extreme diaphoresis
c. Severe bronchoconstriction
o

d. Hypotension
aC s
vi y re

____ 19. Delayed serum sickness–type reactions in response to multiple bee, wasp, or fire ant stings can be
managed with which of the following?
a. A corticosteroid such as prednisone (Deltasone), 60 to 100 mg, tapered over 2
weeks
ed d

b. An oral antihistamine, such as hydroxyzine, for 2 weeks

ar stu

c. An H2 blocker such as cimetidine for 1 week

d. 0.1 mg (1 mL of 1:10,000 solution epinephrine) in 10 mL of normal saline and
administer as a slow intravenous push over 10 minutes
is

____ 20. After a head injury, what is it called when air enters into the cerebrospinal fluid (CSF)–filled spaces
Th

within the head?

a. Pneumocephalus
b. Hemotympanum
sh

c. Battle’s sign
d. Raccoon sign

____ 21. Cerebrospinal fluid (CSF) may leak through the cribriform plate region of the skull following a head
injury and cause which of the following?
a. Ear CSF otorrhea

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 b. Leakage of CSF from the eye
c. Nasal CSF rhinorrhea
d. Leakage of CSF from the mouth

____ 22. Which classic feature of an epidural hematoma may distinguish it from other skull hematomas?
a. Unilateral hemiparesis
b. Loss of speech
c. Temporary hearing loss
d. A brief loss of consciousness, then a brief “lucid” moment, followed by momentary
unconsciousness minutes after the injury

____ 23. A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from
which affected cranial nerve?
a. CN II
b. CN III
c. CN IV

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d. CN V

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____ 24. A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a

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joint, is more likely related to which musculoskeletal injury?

o.
a. A sprain
b. A strain rs e
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c. A partial fracture
d. A fracture
o

____ 25. In a healthy adult, the process of remodeling after a fracture of the humerus takes how long?
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a. Approximately 4 weeks
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b. 2 months
c. 3 months
d. 4 months
ed d

____ 26. A patient who sustains blunt chest trauma and/or penetrating chest trauma must have which of the
ar stu

following imaging examinations?

a. Upright chest x-ray film
b. Supine chest x-ray
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c. Lateral chest x-ray

d. MRI
Th

____ 27. Josie, age 30, has a pneumothorax. It may be treated conservatively without a chest tube if it is
deflated by what percentage?
sh

a. 30%
b. 45%
c. 60%
d. All pneumothoraxes require a chest tube.

____ 28. Hepatic necrosis with jaundice may occur after ingesting massive doses of which medication?

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 a. Phenobarbital
b. Diazepam
c. Ritalin
d. Acetaminophen

____ 29. Pink, cherry red tissues and skin may result from which type of poisoning?
a. Arsenic
b. Lead
c. Carbon monoxide
d. Strychnine

____ 30. In which type of burn is the injury more extensive than it appears, and the cardiac conduction system
may be affected, leading to sudden death or arrhythmias?
a. Chemical burns
b. Electrical burns
c. Radiation burns

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d. Thermal burns

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____ 31. Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress.

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What should be your first step?

o.
a. Remove the insect with tweezers.
rs e
b. Immobilize the insect with 2% lidocaine.
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c. Sedate Eddie with diazepam.
d. Shine a light in the ear for the insect to “find its way out.”
o

____ 32. When giving discharge instructions to a patient with a laceration injury to his lower leg, which is the
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most important one?

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a. Recommend isometric exercises to prevent a deep vein thrombosis (DVT).

b. Recommend cleansing the wound every 4 hours to prevent an infection.
c. Keep the leg elevated at waist level to prevent any edema.
d. Keep the leg completely immobile to prevent extension of the laceration.
ed d
ar stu

____ 33. Cerebellar function may be assessed by performing which examination/test?

a. Gag reflex
b. Pupillary response
is

c. Romberg’s test
d. Apley’s test
Th

____ 34. In the epithelialization phase of wound healing, the wound will have only what percent of its normal
tensile strength at 3 weeks?
sh

a. Less than 15%

b. 15% to 20%
c. 25% to 40%
d. Greater than 50%

____ 35. Which of the following statements is true about antibiotic prophylaxis for most wounds?

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 a. It is not indicated for most wounds and does not affect the infection rate.
b. Antibiotics should always be ordered for a wound.
c. Antibiotics need to be ordered for at least 2 weeks.
d. Antibiotics should be ordered only if sutures are in place.

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ed d
ar stu
is
Th
sh

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 Chapter 19. Emergency Problems
Answer Section

MULTIPLE CHOICE

1. ANS: D PTS: 1
2. ANS: B PTS: 1
3. ANS: D PTS: 1
4. ANS: D PTS: 1
5. ANS: A PTS: 1
6. ANS: D PTS: 1
7. ANS: C PTS: 1
8. ANS: C PTS: 1

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9. ANS: A PTS: 1

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10. ANS: A PTS: 1

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11. ANS: A PTS: 1

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12. ANS: B PTS: 1

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13. ANS: D PTS: 1
14. ANS: C rs e
PTS: 1
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15. ANS: C PTS: 1
16. ANS: A PTS: 1
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17. ANS: B PTS: 1

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18. ANS: C PTS: 1

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19. ANS: A PTS: 1

20. ANS: A PTS: 1
21. ANS: C PTS: 1
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22. ANS: D PTS: 1

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23. ANS: C PTS: 1

24. ANS: B PTS: 1
25. ANS: B PTS: 1
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26. ANS: A PTS: 1

27. ANS: A PTS: 1
Th

28. ANS: D PTS: 1

29. ANS: C PTS: 1
30. ANS: B PTS: 1
sh

31. ANS: B PTS: 1

32. ANS: A PTS: 1
33. ANS: C PTS: 1
34. ANS: B PTS: 1
35. ANS: A PTS: 1

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