Ch 29 Head and Spine Injuries

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Last updated 3:47 AM on 7/22/26

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1. The central nervous system (CNS) is composed of the:

A) cerebellum and brain.

B) brain and spinal cord.

C) cerebrum and meninges.

D) meninges and spinal cord.

ANS: B

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1040

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-1 Describe the anatomy and physiology of the nervous system, including its divisions into the central nervous system (CNS) and peripheral nervous system (PNS) and the structures and functions of each.

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2. The _________ contain(s) about 75% of the brain's total volume.

A) cerebrum

B) cerebellum

C) brain stem

D) meninges

ANS: A

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1041

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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3. Coordination of balance and body movement is controlled by the:

A) medulla.

B) cerebrum.

C) cerebellum.

D) brain stem.

ANS: C

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1041

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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4. The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.

A) brain stem

B) cerebellum

C) spinal cord

D) cerebral cortex

ANS: A

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1042

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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5. The tough, fibrous outer meningeal layer is called the:

A) pia mater.

B) arachnoid mater.

C) gray mater.

D) dura mater.

ANS: D

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1042

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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6. The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:

A) regenerating brain cells after they have been damaged.

B) acting as a shock absorber for the brain and spinal cord.

C) delivering oxygen directly to the CNS.

D) producing leukocytes that protect the brain from infection.

ANS: B

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1042

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Application

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7. The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves.

A) central

B) somatic

C) autonomic

D) peripheral

ANS: D

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1042

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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8. Which of the following nerves carries information from the body to the brain via the spinal cord?

A) Motor

B) Central

C) Somatic

D) Sensory

ANS: D

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1043

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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9. Which of the following statements regarding motor nerves is correct?

A) They carry information from the CNS to the muscles.

B) They perform special functions such as sight, smell, and hearing.

C) They transmit information from the body to the brain via the spinal cord.

D) They are part of the CNS and control reflexes.

ANS: A

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1043

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Application

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10. Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?

A) Somatic

B) Connecting

C) Peripheral

D) Autonomic

ANS: B

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1043

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

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11. A reflex arc occurs when:

A) the motor nerves function automatically without receiving a message from the CNS.

B) a sensory nerve sends a message to the brain, but the motor nerve fails to send the appropriate response to the body.

C) the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles.

D) a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

ANS: D

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1043

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Application

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12. What part of the nervous system controls the body's voluntary activities?

A) Central

B) Sensory

C) Somatic

D) Autonomic

ANS: C

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-2 Explain the functions of the somatic and autonomic nervous systems.

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13. The body's functions that occur without conscious effort are regulated by the _________ nervous system.

A) sensory

B) somatic

C) autonomic

D) voluntary

ANS: C

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-2 Explain the functions of the somatic and autonomic nervous systems.

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14. When activated, the sympathetic nervous system produces all of the following effects, except:

A) pupillary constriction.

B) increase in heart rate.

C) shunting of blood to vital organs.

D) dilation of the bronchiole smooth muscle.

ANS: A

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-2 Explain the functions of the somatic and autonomic nervous systems.

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15. The hormone responsible for the actions of the sympathetic nervous system is:

A) insulin.

B) thyroxine.

C) epinephrine.

D) aldosterone.

ANS: C

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-2 Explain the functions of the somatic and autonomic nervous systems.

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16. When the parasympathetic nervous system is activated:

A) blood is shunted away from the digestive organs.

B) the heart rate decreases and the blood vessels dilate.

C) hormones are released that prepare the body for stress.

D) heart rate and blood pressure increase.

ANS: B

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Application

Objective: 29-2 Explain the functions of the somatic and autonomic nervous systems.

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17. Which of the following statements regarding the cranium is correct?

A) The skull is a subdivision of the cranium.

B) Thirty percent of the cranium is occupied by blood.

C) The cranium protects the structures of the face.

D) Eighty percent of the cranium is occupied by brain tissue.

ANS: D

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1044

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-3 List the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system.

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18. The five sections of the spinal column, in descending order, are the:

A) thoracic, cervical, lumbar, coccygeal, and sacral.

B) cervical, thoracic, lumbar, sacral, and coccygeal.

C) coccygeal, sacral, lumbar, thoracic, and cervical.

D) cervical, coccygeal, thoracic, sacral, and lumbar.

ANS: B

Complexity: Difficult

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1045

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-3 List the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system.

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19. The spinal cord is encased in and protected by the:

A) spinal canal.

B) vertebral body.

C) vertebral arch.

D) intervertebral disc.

ANS: A

Complexity: Easy

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1045

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-3 List the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system.

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20. The cervical spine is composed of _____ vertebrae.

A) 5

B) 6

C) 7

D) 8

ANS: C

Complexity: Moderate

Ahead: Anatomy and Physiology

Subject: Chapter 29, Page 1045

Title: Head and Spine Injuries

Feedback: See Anatomy and Physiology

Taxonomy: Recall

Objective: 29-3 List the major bones of the skull and spinal column and their related structures; include their functions as they relate to the nervous system.

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21. Common signs and symptoms of a serious head injury include all of the following, except:

A) a rapid, thready pulse.

B) widening pulse pressure.

C) cerebrospinal fluid leakage from the ears.

D) decerebrate posturing.

ANS: A

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1046

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

Objective: 29-4 Explain the different types of head injuries, their potential mechanism of injury (MOI), and general signs and symptoms of a head injury that EMTs should consider when performing a patient assessment.

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22. Lacerations to the scalp:

A) bleed minimally because the scalp has few vessels.

B) uncommonly cause hypovolemic shock in the elderly.

C) might be an indicator of deeper, more serious injuries.

D) are most commonly associated with skull fractures.

ANS: C

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1046

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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23. Common signs of a skull fracture include all of the following, except:

A) mastoid process bruising.

B) ecchymosis around the eyes.

C) noted deformity to the skull.

D) superficial scalp lacerations.

ANS: D

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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24. Which of the following skull fractures would be the least likely to present with palpable deformity or other outward signs?

A) Linear

B) Basilar

C) Open

D) Depressed

ANS: A

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Application

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25. The frontal and parietal bones of the skull are especially susceptible to:

A) basilar skull fractures.

B) depressed skull fractures.

C) linear skull fractures.

D) nondisplaced skull fractures.

ANS: B

Complexity: Easy

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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26. When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

A) fractures to the internal structures of the ear following direct trauma.

B) a linear skull fracture and a significant increase in intracranial pressure.

C) significant pressure and bleeding in between the skull and dura mater.

D) rupture of the tympanic membrane following diffuse impact to the head.

ANS: D

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Application

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27. Which of the following statements regarding a basilar skull fracture is correct?

A) Bloody cerebrospinal fluid commonly leaks from the nose.

B) In most cases, mastoid bruising occurs.

C) The absence of raccoon eyes or Battle sign does not rule it out.

D) They are typically the result of local, low-energy trauma to the head.

ANS: C

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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28. Which of the following statements regarding secondary brain injury is correct?

A) It results from direct brain trauma following an impact to the head.

B) Because cerebral edema develops quickly, it is considered to be a primary brain injury.

C) Hypoxia and hypotension are the two most common causes of secondary brain injury.

D) Signs are often present immediately after an impact to the head.

ANS: C

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1048

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

Objective: 29-6 Explain the difference between a primary (direct) injury and a secondary (indirect) injury; include examples of possible MOIs that may cause each one.

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29. Rapid deceleration of the head, such as when it impacts the windshield, causes:

A) compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain.

B) primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels.

C) stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain.

D) compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

ANS: D

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1048

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Application

Objective: 29-7 Describe the different types of brain injuries and their corresponding signs and symptoms, including increased intracranial pressure (ICP), concussion, contusion, and injuries caused by medical conditions.

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30. An injured brain begins to swell initially due to:

A) intracranial pressure.

B) cerebral edema.

C) an epidural hematoma.

D) a coup-contrecoup injury.

ANS: B

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1049

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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31. Which of the following breathing patterns is most indicative of increased intracranial pressure?

A) Increased rate with a normal inspiratory time and a prolonged expiratory time

B) Irregular rate, pattern, and volume of breathing with intermittent periods of apnea

C) Increased rate and depth with the distinct odor of acetone on the patient's breath

D) Slow, shallow occasional gasps that progress to prolonged periods of apnea

ANS: B

Complexity: Difficult

Ahead: Head Injuries

Subject: Chapter 29, Page 1049

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Application

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32. An epidural hematoma is most accurately defined as:

A) bleeding between the skull and dura mater.

B) bleeding between the dura mater and brain.

C) venous lacerations that occur within the brain.

D) an injury caused by a damaged cerebral artery.

ANS: A

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1049

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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33. Which of the following head injuries would cause the patient's condition to deteriorate most rapidly?

A) Cerebral contusion

B) Subdural hematoma

C) Cerebral concussion

D) Intracerebral hematoma

ANS: D

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1050

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Analysis

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34. Bleeding within the brain tissue itself is called a(n):

A) epidural hematoma.

B) intracerebral hematoma.

C) subdural hematoma.

D) subarachnoid hemorrhage.

ANS: B

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1050

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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35. Signs and symptoms that might be found in a patient who has experienced a concussion include:

A) anxiety and restlessness.

B) nausea and ringing in the ears.

C) tachycardia and diaphoresis.

D) hypotension and nosebleed.

ANS: B

Complexity: Easy

Ahead: Head Injuries

Subject: Chapter 29, Page 1051

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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36. A patient who cannot remember the events that preceded his or her head injury is experiencing:

A) retrograde amnesia.

B) anterograde amnesia.

C) prograde amnesia.

D) posttraumatic amnesia.

ANS: A

Complexity: Difficult

Ahead: Head Injuries

Subject: Chapter 29, Page 1051

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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37. In contrast to a cerebral concussion, a cerebral contusion:

A) does not cause pressure within the skull.

B) results from a laceration to the brain tissue.

C) involves physical injury to the brain tissue.

D) usually does not cause a loss of consciousness.

ANS: C

Complexity: Easy

Ahead: Head Injuries

Subject: Chapter 29, Page 1051

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Recall

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38. Hyperextension injuries of the spine are most commonly the result of:

A) falls.

B) diving.

C) hangings.

D) compression.

ANS: C

Complexity: Easy

Ahead: Spine Injuries

Subject: Chapter 29, Page 1052

Title: Head and Spine Injuries

Feedback: See Spine Injuries

Taxonomy: Recall

Objective: 29-8 Describe the different types of injuries that may damage the cervical, thoracic, or lumbar spine; include examples of possible MOIs that may cause each one.

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39. When caring for a patient with a possible head injury, it is most important to monitor the patient's:

A) pupil size.

B) blood pressure.

C) pulse regularity.

D) level of consciousness.

ANS: D

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1053

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

Objective: 29-9 Explain the steps in the patient assessment process for a person who has a suspected head or spine injury; include specific variations that may be required as related to the type of injury.

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40. A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

A) distraction.

B) axial loading.

C) hyperextension.

D) hyperflexion.

ANS: B

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1053

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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41. When opening the airway of a patient with a suspected spinal injury, you should use the:

A) tongue-jaw lift maneuver.

B) head tilt-neck lift maneuver.

C) head tilt-chin lift maneuver.

D) jaw-thrust maneuver.

ANS: D

Complexity: Easy

Ahead: Patient Assessment

Subject: Chapter 29, Page 1055

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Recall

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42. During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

A) perform a focused secondary assessment of the patient's head and neck.

B) instruct him to assist her ventilations while you perform a rapid assessment.

C) apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs.

D) immediately place her on a long backboard and prepare for rapid transport.

ANS: B

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1055

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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43. Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

A) the patient adamantly denies neck pain.

B) lateral immobilization has been applied.

C) it causes a problem managing the airway.

D) sensory and motor functions remain intact.

ANS: C

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1055

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Recall

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44. A female patient with a suspected head injury has slow, shallow breathing. The most appropriate treatment for her includes:

A) hyperventilating her at 30 breaths/min.

B) administering oxygen via a nonrebreathing mask.

C) ventilation assistance to maintain an oxygen saturation of 90%.

D) ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.

ANS: D

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1056

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

Objective: 29-11 Explain emergency medical care of a patient with a head injury; include the three general principles designed to protect and maintain the critical functions of the CNS and ways to determine if the patient has a TBI.

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45. You should be most suspicious that a patient has experienced a significant head injury if his or her pulse is:

A) slow.

B) weak.

C) rapid.

D) irregular.

ANS: A

Complexity: Easy

Ahead: Patient Assessment

Subject: Chapter 29, Page 1057

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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46. It would be most appropriate to perform a focused secondary assessment on a patient who:

A) fainted and fell to the ground from a standing position.

B) was restrained during a high-speed motor vehicle crash.

C) has blood draining from the ears following a head injury.

D) struck his or her head and is experiencing nausea or vomiting.

ANS: A

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1057

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Analysis

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47. A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

A) obtain a Glasgow Coma Score value and give him oxygen.

B) immobilize his spine and perform a focused secondary exam.

C) allow him to refuse transport if his vital signs remain stable.

D) perform a rapid head-to-toe exam and immobilize his spine.

ANS: B

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1057

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

Objective: 29-12 Explain emergency medical care of a patient with a spinal injury; include the implications of not properly caring for patients with injuries of this nature, the steps for performing manual in-line stabilization, implications for sizing and using a cervical collar, and key symptoms that contraindicate in-line stabilization.

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48. When assessing a conscious patient with a mechanism of injury that suggests spinal injury, you should:

A) determine if the strength in all extremities is equal.

B) rule out a spinal injury if the patient denies neck pain.

C) defer spinal immobilization if the patient is ambulatory.

D) ask the patient to move his or her head to assess for pain.

ANS: A

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1057

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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49. The most reliable sign of a head injury is:

A) a pulse that is rapid and thready.

B) a decreased level of consciousness.

C) an abnormally low blood pressure.

D) decreased sensation in the extremities.

ANS: B

Complexity: Easy

Ahead: Patient Assessment

Subject: Chapter 29, Page 1058

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Recall

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50. The Glasgow Coma Scale (GCS) is used to assess:

A) mental status, eye opening, and respiratory rate.

B) sensory response, pupil reaction, and heart rate.

C) verbal response, eye opening, and mental status.

D) eye opening, verbal response, and motor response.

ANS: D

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1058

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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51. Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

A) 12.

B) 13.

C) 14.

D) 15.

ANS: C

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1058

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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52. A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

A) 2

B) 3

C) 4

D) 5

ANS: B

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1058

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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53. When a patient experiences a severe spinal injury, he or she:

A) will likely be paralyzed from the neck down.

B) might lose sensation below the level of the injury.

C) most commonly has a palpable spinal deformity.

D) often loses motor function on one side of the body.

ANS: B

Complexity: Easy

Ahead: Patient Assessment

Subject: Chapter 29, Page 1060

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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54. The effectiveness of positive pressure ventilations when treating a head-injured patient can only be determined by:

A) immediate reassessment after the intervention.

B) a neurosurgeon or emergency department physician.

C) reassessing the patient's blood pressure after 10 minutes.

D) noting a decrease in the heart rate during ventilations.

ANS: A

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1060

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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55. An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

A) rapid deterioration of neurologic signs.

B) a progressively lowering blood pressure.

C) an acute increase in the patient's pulse rate.

D) acute unilateral paralysis following the injury.

ANS: A

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Pages 1060-1061

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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56. The most important immediate treatment for patients with a head injury, regardless of severity, is to:

A) immobilize the entire spine.

B) administer high-flow oxygen.

C) establish an adequate airway.

D) transport to a trauma center.

ANS: C

Complexity: Moderate

Ahead: Emergency Medical Care of Head Injuries

Subject: Chapter 29, Page 1061

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Head Injuries

Taxonomy: Application

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57. During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

A) assist his ventilations with a bag valve mask.

B) suction his oropharynx for up to 15 seconds.

C) immobilize his spine and transport immediately.

D) pack his nostrils to stop the drainage of blood.

ANS: B

Complexity: Difficult

Ahead: Emergency Medical Care of Head Injuries

Subject: Chapter 29, Page 1062

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Head Injuries

Taxonomy: Application

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58. When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

A) elevate the patient's head and apply an ice pack.

B) apply manual pressure and avoid applying a bandage.

C) avoid excessive pressure when applying the bandage.

D) apply firm compression for no longer than five minutes.

ANS: C

Complexity: Moderate

Ahead: Emergency Medical Care of Head Injuries

Subject: Chapter 29, Page 1063

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Head Injuries

Taxonomy: Application

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59. Which of the following sets of vital signs depicts Cushing triad?

A) Blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

B) Blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min

C) Blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min

D) Blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min

ANS: A

Complexity: Moderate

Ahead: Emergency Medical Care of Head Injuries

Subject: Chapter 29, Page 1063

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Head Injuries

Taxonomy: Application

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60. When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

A) an appropriately sized cervical collar has been applied.

B) the patient has been secured to the ambulance stretcher.

C) the head has been stabilized with lateral immobilization.

D) the patient has been completely secured to the backboard.

ANS: D

Complexity: Moderate

Ahead: Emergency Medical Care of Spinal Injuries

Subject: Chapter 29, Page 1064

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Spinal Injuries

Taxonomy: Application

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61. The ideal procedure for moving an injured patient from the ground to a backboard is:

A) the clothes drag.

B) the four-person log roll.

C) the use of a scoop stretcher.

D) the direct patient carry.

ANS: B

Complexity: Easy

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1067

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Recall

Objective: 29-13 Explain the process of preparing patients who have suspected head or spinal injuries for transport; include the use and functions of a long backboard, vacuum mattress, short backboard, and other short spinal extrication devices to immobilize the patient's cervical and thoracic spine.

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62. When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

A) head

B) chest

C) waist

D) lower extremities

ANS: A

Complexity: Easy

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1070

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Recall

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63. When immobilizing a patient on a long backboard, you should:

A) have the patient exhale before fastening the torso straps.

B) secure the torso and then center the patient on the board.

C) follow the commands of the person at the patient's torso.

D) ensure that you secure the torso before securing the head.

ANS: D

Complexity: Moderate

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1070

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Application

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64. After your partner assumes manual in-line stabilization of the patient's head, you should:

A) apply an appropriately sized rigid cervical collar.

B) assess distal neurovascular status in the extremities.

C) thoroughly palpate the patient's head for deformities.

D) use four people to log roll the patient onto a backboard.

ANS: B

Complexity: Moderate

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1068

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Recall

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65. A short backboard or vest-style immobilization device is indicated for patients who:

A) are found supine and have stable vital signs.

B) are in a sitting position and are clinically stable.

C) require prompt extrication from an automobile.

D) are sitting in their car and are clinically unstable.

ANS: B

Complexity: Easy

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1078

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Application

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66. When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:

A) after the torso has been adequately secured.

B) after moving the patient to a long backboard.

C) after assessing distal neurovascular functions.

D) before manually stabilizing the patient's head.

ANS: C

Complexity: Moderate

Ahead: Preparation for Transport

Subject: Chapter 29, Page 1078

Title: Head and Spine Injuries

Feedback: See Preparation for Transport

Taxonomy: Recall

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67. Which of the following statements regarding cervical collars is correct?

A) Once a cervical collar is applied, you can cease manual head stabilization.

B) A cervical collar is used in addition to, not instead of, manual immobilization.

C) Cervical collars are contraindicated in patients with numbness to the extremities.

D) The patient's head should be forced into a neutral position to apply a cervical collar.

ANS: B

Complexity: Moderate

Ahead: Emergency Medical Care of Spinal Injuries

Subject: Chapter 29, Page 1065

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Spinal Injuries

Taxonomy: Recall

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68. If you do not have the appropriate-size cervical collar, you should:

A) use rolled towels to immobilize the patient's head.

B) place sandbags on either side of the patient's head.

C) ask the patient to keep his or her head in a neutral position.

D) defer cervical immobilization and apply lateral head blocks.

ANS: A

Complexity: Moderate

Ahead: Emergency Medical Care of Spinal Injuries

Subject: Chapter 29, Page 1070

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Spinal Injuries

Taxonomy: Recall

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69. A tight-fitting motorcycle helmet should be left in place unless:

A) it interferes with your assessment of the airway.

B) the patient must be placed onto a long backboard.

C) the patient complains of severe neck or back pain.

D) the helmet is equipped with a full face shield or visor.

ANS: A

Complexity: Moderate

Ahead: Helmet Removal

Subject: Chapter 29, Page 1079

Title: Head and Spine Injuries

Feedback: See Helmet Removal

Taxonomy: Recall

Objective: 29-14 Explain the different circumstances in which a helmet should be left on or taken off a patient with a possible head or spinal injury.

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70. When immobilizing a child on a long backboard, you should:

A) secure the head prior to securing the torso and legs.

B) defer cervical collar placement to avoid discomfort.

C) place the child's head in a slightly extended position.

D) place padding under the child's shoulders as needed.

ANS: D

Complexity: Moderate

Ahead: Emergency Medical Care of Spinal Injuries

Subject: Chapter 29, Page 1083

Title: Head and Spine Injuries

Feedback: See Emergency Medical Care of Spinal Injuries

Taxonomy: Recall

Objective: 29-16 Discuss age-related variations that are required when providing emergency care to a pediatric patient who has a suspected head or spine injury.

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71. In which of the following situations would the EMT be the least likely to immobilize a patient's spine?

A) No spinal pain, but tingling in the extremities

B) No distracting injuries or evidence of intoxication

C) Unresponsive, but moving all extremities equally

D) Pain to the c-spine, but no numbness or tingling.

ANS: B

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1054

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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72. Which of the following interventions may be used to help reduce intracranial pressure?

A) Supine with the legs elevated

B) Maintaining the SpO2 at 90%

C) 30-degree elevation of the head

D) Increasing the patient's body temperature

ANS: C

Complexity: Moderate

Ahead: Patient Assessment

Subject: Chapter 29, Page 1054

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Application

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73. A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should:

A) remove his helmet and shoulder pads.

B) leave his helmet and shoulder pads in place.

C) remove his helmet, but leave his shoulder pads in place.

D) leave his helmet in place, but remove his shoulder pads.

ANS: B

Complexity: Moderate

Ahead: Helmet Removal

Subject: Chapter 29, Page 1079

Title: Head and Spine Injuries

Feedback: See Helmet Removal

Taxonomy: Application

Objective: 29-16 Discuss age-related variations that are required when providing emergency care to a pediatric patient who has a suspected head or spine injury.

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74. In the setting of a head injury, hypertension, bradycardia, and Biot respirations indicate:

A) decreased cerebral blood flow.

B) internal bleeding in the chest.

C) an underlying skull fracture.

D) herniation of the brain stem.

ANS: D

Complexity: Difficult

Ahead: Patient Assessment

Subject: Chapter 29, Page 1056

Title: Head and Spine Injuries

Feedback: See Patient Assessment

Taxonomy: Analysis

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75. You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:

A) bacterial meningitis.

B) hypovolemic shock.

C) sudden hypotension.

D) permanent hearing loss.

ANS: A

Complexity: Moderate

Ahead: Head Injuries

Subject: Chapter 29, Page 1047

Title: Head and Spine Injuries

Feedback: See Head Injuries

Taxonomy: Application