All trauma quizzes review Flashcards
1
Q
Your patient has a Glasgow coma scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths / min. His revised trauma score (RTS) is: A. 9 B. 8 C.11 D.10
A
A.9
2
Q
Which of the following injuries would most likely occur as a direct result of a third collision in a motor vehicle crash? A. Forehead lacerations B. Extremity fractures C. Flail Chest D. Aortic rupture
A
D. Aortic rupture
3
Q
Following a blunt injury to the head, a 22 year old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. a fracture of the skull B. Spinal cord injury C. airway compromise D. intracranial bleeding
A
D. intracranial bleeding
4
Q
Which types of motor vehicle collisions present the greatest potential for multiple impacts? A. Rotational and Rollover B.Lateral and Rollover C. Frontal and rotational D. Rear end and rotational
A
A. Rotational and rollover
5
Q
Which of the following findings would be LEAST suggestive of the presence of high energy trauma? A. Intrusion into the vehicle B. Dismounted Seats C. Steering wheel deformity D. Deployment of air bag
A
D. Deployment of air bag
6
Q
When assessing an elderly patient who fell, it is important to remember that:
A. any fall in the elderly is considered to be high - energy trauma
B. bilateral hip fractures usually occur when an elderly persons falls
C. osteoporosis can cause a fracture as a result of a fall from a standing position
D. elderly patients who fall usually have a secondary head injury
A
C. osteoporosis can cause a fracture as a result of a fall from a standing position
7
Q
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. Rapid transport to a trauma center B. Early administration of oxygen C. Intravenous fluid administration D. Elevation of the lower extremities
A
A. Rapid transport to a trauma center
8
Q
A 15 year old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In additional to managing problems associated with airway, breathing, and circulation. It is MOST important for you to: A. stabilize her entire spine B. leave her bicycle helmet on C. inspect the helmet for cracks D. obtain baseline vital signs
A
A. stabilize her entire spine
9
Q
Which of the following destinations is most appropriate for a 41 year old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming the travel times to each is equal?
A. Only a level 1 trauma center
B. A level I or level II trauma center
C. Any designated trauma center is acceptable
D. A level IV or level III trauma center
A
B. A level I or level II trauma center
10
Q
When assessing a patient who experienced a blast injury, it is important to remember that:
A. primary blast injuries are typically the most obvious
B. secondary blast injuries are usually the least obvious
C. solid organs usually rupture from the pressure wave
D. primary blast injuries are the most easily overlooked
A
D. primary blast injuries are the most easily overlooked
11
Q
A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. assess for an exit wound B. apply a cervical collar C. Auscultate bowel sounds D. obtain baseline vital signs
A
A. Asses for an exit wound
12
Q
When en route to a major motor vehicle crash, an on scene police officer advises you that a 6 year old male who was riding in the front seat is involved. He is further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be most suspicious that the child has experienced: A. neck and facial injuries B. blunt trauma to the head C. open abdominal trauma D. lower extremity fractures
A
A. neck and facial injuries
13
Q
A 12 year old male jumped 12 feet from a tree and landed on his feet. He complains of pain in his lower back. What injury mechanism is MOST likely responsible for his back pain?
A. Secondary fall after the initial impact
B. energy transmission to the spine
C. Direct trauma to the spinal column
D. Lateral impact to the spine
A
B. Energy transmission to the spine
14
Q
Approximately 25% of severe injuries to the aorta occur during: A. Lateral collisions B. Frontal Collisions C. Rollover collisions D. Rear end collisions
A
A. Lateral collisions
15
Q
When the speed of a motor vehicle doubles, the amount of kinetic energy: A. is not affected B. quadruples C. triples D. doubles
A
B. quadruples
16
Q
Which of the following statements regarding gunshot wounds is correct?
A. High velocity bullets will cause less severe internal injuries
B. The size of a bullet has the greatest impact on the injury produced
C. The speed of a bullet has the greatest impact on the injury produced
D. Low - velocity bullets will cause the greatest amount of trauma
A
C. The speed of a bullet has the greatest impact on the injury produced.
17
Q
Force acting over a distance is the definition of: A. Kinetic energy B. Work C. Latent energy D. Potential energy
A
B. Work
18
Q
According to the american college of surgeons committee on trauma, an adult trauma patient should be transported to the highest level of trauma center if he or she:
A. Has a GCS score of less than or equal to 13 with a mechanism attributed to trauma
B. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury
C. was involved in a motor vehicle crash in which another patient in the same vehicle was killed
D. has a systolic blood pressure of less than 110mm hg or a heart rate greater than 110 beats / min
A
A. Has a GCS score of less than or equal to 13 with a mechanism attributed to trauma
19
Q
The index of suspicion is the MOST accurately defined as:
A. The way in which traumatic injuries occur
B. a predictable pattern that leads to serious injuries
D. your awareness and concern for potentially serious underlying injuries
A
D. your awareness and concern for potentially serious underlying injuries
20
Q
According to the association of air medical services, you should consider air medical transport of a trauma patient if:
A. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patients injuries
B. the patient requires advanced life support care and stabilization and the nearest ALS ground ambulance is more than 5 to 10 minutes away
C. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome
D. He or she involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient’s injuries are minor
A
C. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome
21
Q
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed \_\_\_\_\_\_\_. Select one: A. hypoperfusion B. hemorrhage C. coagulation D. perfusion
A
D. perfusion
22
Q
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:
Select one:
A. placing a rolled 4² × 4² dressing between his lower lip and gum.
B. having the patient pinch his own nostrils and then lie supine.
C. pinching the patient’s nostrils and having him lean forward.
D. packing both nostrils with gauze pads until the bleeding stops.
A
C. pinching the patient’s nostrils and having him lean forward.
23
Q
Hypovolemic shock occurs when:
Select one:
A. the patient’s systolic blood pressure is less than 100 mm Hg.
B. the body cannot compensate for rapid blood loss.
C. at least 10% of the patient’s blood volume is lost.
D. the clotting ability of the blood is enhanced.
A
B. the body cannot compensate for rapid blood loss.
24
Q
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. spleen. B. gallbladder. C. pancreas. D. liver.
A
A. spleen
25
```
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
Select one:
A. apply a nonrebreathing mask.
B. assist the patient's ventilations.
C. obtain baseline vital signs.
D. perform a secondary assessment.
```
B. assist the patient's ventilations.
26
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:
Select one:
A. a splint and elevate the extremity.
B. additional sterile dressings.
C. a tourniquet proximal to the injury.
D. digital pressure to a proximal artery.
C. a tourniquet proximal to the injury.
27
```
Internal bleeding into a fractured extremity is MOST often controlled by:
Select one:
A. splinting the extremity.
B. applying a tourniquet.
C. keeping the patient warm.
D. applying chemical ice pack.
```
A. splinting the extremity.
28
```
In older patients, the first indicator of nontraumatic internal bleeding may be:
Select one:
A. a low blood pressure.
B. weakness or dizziness.
C. diaphoresis and pale skin.
D. a heart rate over 120 beats/min.
```
B. weakness or dizziness.
29
```
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
Select one:
A. 5%
B. 15%
C. 10%
D. 20%
```
D. 20%
30
```
What mechanism(s) does the body use to control bleeding?
Select one:
A. Clotting
B. Coagulation
C. Vasoconstriction
D. All of these answers are correct.
```
D. All of these answers are correct.
31
If applying a dressing to control the bleeding of a patient's arm, the EMT should ________.
Select one:
A. apply direct pressure first
B. use large or small gauze pads or dressings depending upon the size of the wound
C. cover the entire wound, above and below, with the dressing
D. All of these answers are correct.
D. All of these answers are correct.
32
Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?
Select one:
A. The patient has not eaten in 24 hours.
B. The patient had a stroke 5 years prior.
C. The patient takes rivaroxaban (Xeralto).
D. The patient has a history of hypertension.
C. The patient takes rivaroxaban (Xeralto).
33
```
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
Select one:
A. Sling and swathe
B. Vacuum splint
C. Cardboard splint
D. Air splint
```
D. Air splint
34
Which of the following statements regarding hemophilia is correct?
Select one:
A. Hemophiliacs take aspirin to enhance blood clotting.
B. Approximately 25% of the population has hemophilia.
C. Hemophilia is defined as a total lack of platelets.
D. Patients with hemophilia may bleed spontaneously.
D. Patients with hemophilia may bleed spontaneously.
35
```
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?
Select one:
A. Brain
B. Kidneys
C. Gastrointestinal system
D. Skeletal muscle
```
C. Gastrointestinal system
36
```
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
Select one:
A. acute appendicitis.
B. an aortic aneurysm.
C. gastrointestinal bleeding.
D. intrathoracic hemorrhaging.
```
C. gastrointestinal bleeding.
37
```
Which portion of the blood carries oxygen to and wastes away from body tissues?
Select one:
A. White blood cells
B. Red blood cells
C. Platelets
D. Plasma
```
B. Red blood cells
38
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:
Select one:
A. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
B. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding.
C. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first.
D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.
A. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
39
```
The severity of bleeding should be based on all of the following findings, EXCEPT:
Select one:
A. clinical signs and symptoms.
B. the mechanism of injury.
C. systolic blood pressure.
D. poor general appearance.
```
C. systolic blood pressure.
40
```
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:
Select one:
A. spleen.
B. gallbladder.
C. pancreas.
D. liver.
```
A. spleen.
41
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?
Select one:
A. Carefully replace the exposed bowel into the abdomen and transport.
B. Cover it with moist, sterile gauze and secure with an occlusive dressing.
C. Irrigate it with sterile water and cover it with a dry dressing.
D. Cover the exposed bowel and keep his legs in a straight position.
B. Cover it with moist, sterile gauze and secure with an occlusive dressing.
42
```
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.
Select one:
A. 45%
B. 27%
C. 18%
D. 36%
```
C. 18%
43
```
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
Select one:
A. crush injury.
B. contusion.
C. hematoma.
D. abrasion.
```
B. contusion.
44
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
Select one:
A. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing.
B. replace the avulsed flap to its original position and cover it with a sterile dressing.
C. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.
D. carefully probe the wound to determine if the bleeding is venous or arterial.
B. replace the avulsed flap to its original position and cover it with a sterile dressing
45
As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:
Select one:
A. open his airway and assess his breathing status.
B. perform an immediate head-to-toe assessment.
C. assess his pulse for rate, regularity, and quality.
D. apply high-flow oxygen and assess his injuries.
A. open his airway and assess his breathing status.
46
```
A burn that is characterized by redness and pain is classified as a:
Select one:
A. partial-thickness burn.
B. second-degree burn.
C. full-thickness burn.
D. superficial burn.
```
D. superficial burn
47
```
A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:
Select one:
A. administer high-flow oxygen.
B. apply ice to the hematoma.
C. perform a neurologic exam.
D. palpate his radial pulses.
```
A. administer high-flow oxygen.
48
```
During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a:
Select one:
A. handgun.
B. .22-caliber pistol.
C. .357 magnum.
D. shotgun.
```
D. shotgun.
49
Burns to pediatric patients are generally considered more serious than burns to adults because:
Select one:
A. most burns in children are the result of child abuse.
B. pediatric patients have a proportionately larger volume of blood.
C. pediatric patients are more prone to hyperthermia.
D. pediatric patients have more surface area relative to total body mass.
D. pediatric patients have more surface area relative to total body mass.
50
In which of the following patients should you remove an impaled object?
Select one:
A. A pulseless and apneic patient with a knife impaled in the back
B. A semiconscious patient with an ice pick impaled in the chest
C. An apneic patient with a shard of glass impaled in the abdomen
D. A conscious and alert patient with a fishhook impaled in the eye
A. A pulseless and apneic patient with a knife impaled in the back
51
```
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:
Select one:
A. a spinal fracture.
B. an ischemic stroke.
C. nerve fiber damage.
D. an air embolism.
```
D. an air embolism
52
When caring for a patient whose arm is covered with a dry chemical, you should:
Select one:
A. brush away the chemical before flushing with water.
B. quickly irrigate the arm with large amounts of water.
C. use forceful streams of water to remove the chemical.
D. deactivate the chemical with a 5% vinegar solution.
A. brush away the chemical before flushing with water.
53
Which of the following is a severe burn in a 65-year-old patient?
Select one:
A. Superficial burn to 30% of the BSA
B. Second-degree burn covering 10% of the BSA
C. Full-thickness burn to 1% of the BSA
D. Partial-thickness burn to 20% of the BSA
D. Partial-thickness burn to 20% of the BSA
54
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
Select one:
A. advise the child that he will need rabies shots.
B. ask the child's father to try to locate the dog.
C. report the incident to the appropriate authorities.
D. administer oxygen via a nonrebreathing mask.
C. report the incident to the appropriate authorities.
55
The sebaceous glands produce sebum, a material that:
Select one:
A. waterproofs the skin and keeps it supple.
B. facilitates shedding of the epidermis.
C. discharges sweat onto the skin's surface.
D. pulls the hair erect when you are cold.
A. waterproofs the skin and keeps it supple.
56
```
Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?
Select one:
A. Avulsion
B. Incision
C. Laceration
D. Abrasion
```
D. Abrasion
57
Which of the following statements regarding crush syndrome is correct?
Select one:
A. With crush syndrome, massive blood vessel damage occurs following severe soft-tissue injuries, such as amputation of an extremity.
B. Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely because toxins are quickly eliminated from the body.
C. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.
D. Provided that a patient with a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal.
C. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.
58
```
Which of the following areas of the body has the thinnest skin?
Select one:
A. Soles of the feet
B. Back
C. Scalp
D. Ears
```
D. Ears
59
You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:
Select one:
A. carefully manipulate her arm until the symptoms subside.
B. remove the gauze bandage and replace it with an elastic one.
C. assess distal circulation and readjust the bandage as needed.
D. remove the bandage and dressing and apply another one.
C. assess distal circulation and readjust the bandage as needed.
60
C. assess distal circulation and readjust the bandage as needed.
D. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
61
A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:
Select one:
A. transport her to the emergency department.
B. thoroughly flush her ear with sterile saline.
C. remove the peanut with a cotton-tipped swab.
D. use tweezers to try to remove the object.
A. transport her to the emergency department.
62
```
A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:
Select one:
A. a detached retina.
B. conjunctivitis.
C. a corneal abrasion.
D. acute retinitis.
```
B. conjunctivitis.
63
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
Select one:
A. careful monitoring her vital signs.
B. rapidly transporting her to the hospital.
C. quickly immobilizing her spinal column.
D. requesting a paramedic ambulance.
B. rapidly transporting her to the hospital.
64
A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:
Select one:
A. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
B. fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport.
C. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.
D. assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport.
A. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
65
A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should:
Select one:
A. irrigate both eyes continuously for 20 minutes with plain water.
B. flush both eyes with an alcohol-based solution and transport.
C. neutralize the acid chemical in his eye with an alkaline chemical.
D. mix baking soda with water and irrigate his eyes with the solution.
A. irrigate both eyes continuously for 20 minutes with plain water.
66
```
If your patient swallows blood following facial trauma, there is an increased risk of ________.
Select one:
A. altered LOC
B. GI trauma
C. hypotension
D. vomiting
```
D. vomiting
67
The Adam's apple is:
Select one:
A. below the thyroid cartilage and forms the upper part of the trachea.
B. the lower part of the larynx that is formed by the cricoid cartilage.
C. the small indentation in between the thyroid and cricoid cartilages.
D. the upper part of the larynx that is formed by the thyroid cartilage.
D. the upper part of the larynx that is formed by the thyroid cartilage.
68
```
Significant trauma to the face should increase the EMT's index of suspicion for a(n):
Select one:
A. airway obstruction.
B. basilar skull fracture.
C. displaced mandible.
D. spinal column injury.
```
D. spinal column injury.
69
```
Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:
Select one:
A. a blowout fracture.
B. optic vessel compression.
C. a ruptured eyeball.
D. a lacerated globe.
```
A. a blowout fracture.
70
```
The upper jawbones are called the:
Select one:
A. maxillae.
B. zygoma.
C. mastoid.
D. mandible.
```
A. maxillae.
71
Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:
Select one:
A. direct pressure using dry, sterile dressings.
B. pressure dressings and chemical ice packs.
C. ice packs and elevation of the patient's head.
D. digital pressure to an adjacent pulse point.
A. direct pressure using dry, sterile dressings
72
```
When a light is shone into the pupil:
Select one:
A. the opposite pupil should dilate.
B. both pupils should dilate together.
C. it should become smaller in size.
D. it should become larger in size.
```
C. it should become smaller in size.
73
When caring for a patient with an open facial injury, the EMT's immediate priority should be to:
Select one:
A. manually stabilize the patient's head.
B. wear gloves and facial protection.
C. consider the mechanism of injury.
D. closely assess the patient's airway.
B. wear gloves and facial protection.
74
```
The MOST significant complication associated with facial injuries is:
Select one:
A. damage to the eyes.
B. mandibular immobility.
C. cervical spine injury.
D. airway compromise.
```
D. airway compromise.
75
```
The superficial temporal artery can be palpated:
Select one:
A. at the angle of the jaw.
B. just anterior to the tragus.
C. over the mastoid process.
D. slightly above the ear.
```
B. just anterior to the tragus.
76
When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because:
Select one:
A. it saves time on repeat assessments at the hospital.
B. they must make arrangements for an ICU bed.
C. most patients with facial trauma will need surgery.
D. they may need to call a specialist to see the patient.
D. they may need to call a specialist to see the patient.
77
Which of the following statements regarding anterior nosebleeds is correct?
Select one:
A. They usually originate from the septum area and bleed slowly.
B. They cause blood to drain into the posterior pharynx.
C. They are usually caused by a fracture of the basilar skull.
D. They are usually severe and require aggressive treatment to control.
A. They usually originate from the septum area and bleed slowly.
78
Which of the following statements regarding the vitreous humor is correct?
Select one:
A. It is a clear, watery fluid surrounding the eye and can be replaced if it is lost.
B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.
C. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost.
D. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost.
B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.
79
```
You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:
Select one:
A. has a history of eye surgeries.
B. regularly sees a family physician.
C. noticed the change during a meal.
D. is allergic to any medications.
```
A. has a history of eye surgeries.
80
```
When performing a full body scan, you should assess for ________.
Select one:
A. SAMPLE
B. DCAP-BTLS
C. OPQRST
D. AVPU
```
B. DCAP-BTLS
81
A tight-fitting motorcycle helmet should be left in place unless:
Select one:
A. the patient must be placed onto a long backboard.
B. the patient complains of severe neck or back pain.
C. the helmet is equipped with a full face shield or visor.
D. it interferes with your assessment of the airway.
D. it interferes with your assessment of the airway.
82
An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:
Select one:
A. a rapid deterioration of neurologic signs.
B. an acute increase in the patient's pulse rate.
C. acute unilateral paralysis following the injury.
D. a progressively lowering blood pressure.
A. a rapid deterioration of neurologic signs.
83
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:
Select one:
A. assist his ventilations with a BVM.
B. immobilize his spine and transport immediately.
C. pack his nostrils to stop the drainage of blood.
D. suction his oropharynx for up to 15 seconds.
D. suction his oropharynx for up to 15 seconds.
84
```
Hyperextension injuries of the spine are MOST commonly the result of:
Select one:
A. compression.
B. falls.
C. diving.
D. hangings.
```
D. hangings
85
```
A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?
Select one:
A. 2
B. 4
C. 3
D. 5
```
C. 3
86
In contrast to a cerebral concussion, a cerebral contusion:
Select one:
A. does not cause pressure within the skull.
B. involves physical injury to the brain tissue.
C. usually does not cause a loss of consciousness.
D. results from a laceration to the brain tissue.
B. involves physical injury to the brain tissue.
87
```
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:
Select one:
A. hyperflexion.
B. axial loading.
C. hyperextension.
D. distraction.
```
B. axial loading.
88
The five sections of the spinal column, in descending order, are the:
Select one:
A. thoracic, cervical, lumbar, coccygeal, and sacral.
B. cervical, coccygeal, thoracic, sacral, and lumbar.
C. cervical, thoracic, lumbar, sacral, and coccygeal.
D. coccygeal, sacral, lumbar, thoracic, and cervical.
C. cervical, thoracic, lumbar, sacral, and coccygeal.
89
The Glasgow Coma Scale (GCS) is used to assess:
Select one:
A. sensory response, pupil reaction, and heart rate.
B. eye opening, verbal response, and motor response.
C. mental status, eye opening, and respiratory rate.
D. verbal response, eye opening, and mental status.
B. eye opening, verbal response, and motor response.
90
```
The ideal procedure for moving an injured patient from the ground to a backboard is:
Select one:
A. the use of a scoop stretcher.
B. the clothes drag.
C. the direct patient carry.
D. the four-person log roll.
```
D. the four-person log roll.
91
```
What part of the nervous system controls the body's voluntary activities?
Select one:
A. Central
B. Sensory
C. Somatic
D. Autonomic
```
C. Somatic
92
```
The central nervous system (CNS) is composed of the:
Select one:
A. cerebrum and meninges.
B. cerebellum and brain.
C. brain and spinal cord.
D. meninges and spinal cord.
```
C. brain and spinal cord.
93
When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
Select one:
A. dilation of the bronchiole smooth muscle.
B. increase in heart rate.
C. pupillary constriction.
D. shunting of blood to vital organs.
C. pupillary constriction.
94
Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
Select one:
A. sensory and motor functions remain intact.
B. the patient adamantly denies neck pain.
C. lateral immobilization has been applied.
D. it causes a problem managing the airway.
D. it causes a problem managing the airway.
95
```
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
Select one:
A. widening pulse pressure.
B. a rapid, thready pulse.
C. decerebrate posturing.
D. CSF leakage from the ears.
```
B. a rapid, thready pulse.
96
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:
Select one:
A. the patient has been secured to the ambulance stretcher.
B. the patient has been completely secured to the backboard.
C. an appropriately sized cervical collar has been applied.
D. the head has been stabilized with lateral immobilization.
B. the patient has been completely secured to the backboard.
97
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Select one:
A. Increased rate with a normal inspiratory time and a prolonged expiratory time
B. Increased rate and depth with the distinct odor of acetone on the patient's breath
C. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea
C. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
98
```
You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:
Select one:
A. rapid.
B. weak.
C. slow.
D. irregular.
```
C. slow.
99
Which of the following statements regarding secondary brain injury is correct?
Select one:
A. Because cerebral edema develops quickly, it is considered to be a primary brain injury.
B. Hypoxia and hypotension are the two most common causes of secondary brain injury.
C. It results from direct brain trauma following an impact to the head.
D. Signs are often present immediately after an impact to the head.
B. Hypoxia and hypotension are the two most common causes of secondary brain injury.
100
```
A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:
Select one:
A. prepare for immediate transport.
B. apply bulky dressings to the sternum.
C. determine if he has cardiac problems.
D. apply an AED and assess his BP.
```
A. prepare for immediate transport.
101
A flail chest occurs when:
Select one:
A. more than three ribs are fractured on the same side of the chest.
B. a segment of fractured ribs bulges during the inhalation phase.
C. multiple ribs are fractured on both sides of the thoracic cage.
D. a segment of the chest wall is detached from the thoracic cage.
D. a segment of the chest wall is detached from the thoracic cage.
102
```
A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
Select one:
A. massive hemothorax.
B. traumatic asphyxia.
C. pulmonary contusion.
D. tension pneumothorax.
```
C. pulmonary contusion.
103
A simple pneumothorax:
Select one:
A. is commonly caused by blunt chest trauma.
B. heals on its own without any treatment.
C. often has a nontraumatic cause.
D. is caused by penetrating chest trauma.
A. is commonly caused by blunt chest trauma.
104
A spinal cord injury at the level of C7 would MOST likely result in:
Select one:
A. paralysis of all the respiratory muscles.
B. paralysis of the diaphragm.
C. immediate cardiac arrest.
D. paralysis of the intercostal muscles.
D. paralysis of the intercostal muscles.
105
An open pneumothorax occurs when:
Select one:
A. air enters the pleural space from outside the body.
B. a fractured rib perforates the tissue of the lung.
C. extreme pleural pressure causes the lung to rupture.
D. air enters the pleural space from a perforated lung.
A. air enters the pleural space from outside the body.
106
Children are often “belly breathers” because _______.
Select one:
A. they are consciously controlling ventilations
B. their diaphragm is not functional
C. their intercostal muscles are not developed
D. they are routinely hypoxic
C. their intercostal muscles are not developed
107
```
Closed chest injuries are typically caused by _______.
Select one:
A. flying debris
B. high-velocity weapons
C. penetrating trauma
D. blunt trauma
```
D. blunt trauma
108
```
Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?
Select one:
A. Diminished breath sounds
B. Widening pulse pressure
C. A rapid, irregular pulse
D. Engorged jugular veins
```
D. Engorged jugular veins
109
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:
Select one:
A. often breathes at a slower rate because of lung damage caused by the injury.
B. will eliminate more carbon dioxide than if he or she were breathing deeply.
C. will maintain adequate minute volume if his or her respiratory rate stays the same.
D. must increase his or her respiratory rate to maintain adequate minute volume.
D. must increase his or her respiratory rate to maintain adequate minute volume.
110
```
Immediately life-threatening chest injuries must be found and managed during the _______.
Select one:
A. scene size-up
B. primary assessment
C. secondary assessment
D. patient history
```
B. primary assessment
111
```
In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:
Select one:
A. cardiac tamponade.
B. myocardial contusion.
C. flail chest.
D. pneumothorax.
```
D. pneumothorax.
112
```
Patients with chest injuries will often present with _______.
Select one:
A. tachypnea
B. agonal respirations
C. Cheyne-Stokes respirations
D. Kussmaul respirations
```
A. tachypnea
113
```
The thoracic cavity is separated from the abdominal cavity by the:
Select one:
A. diaphragm.
B. costovertebral angle.
C. anterior rib cage.
D. intercostal margin.
```
A. diaphragm.
114
When a person is lying supine at the end of exhalation, the diaphragm:
Select one:
A. is less prone to penetrating trauma.
B. descends below the level of the navel.
C. contracts and flattens inferiorly.
D. may rise as high as the nipple line.
D. may rise as high as the nipple line
115
```
Which of the following is most likely to cause immediate death?
Select one:
A. Aortic rupture
B. Aortic dissection
C. Myocardial contusion
D. Pulmonary contusion
```
A. Aortic rupture
116
While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:
Select one:
A. administer oxygen and transport to the hospital.
B. circumferentially tape a dressing around his chest.
C. immediately perform a rapid head-to-toe exam.
D. recognize that he needs a needle decompression.
A. administer oxygen and transport to the hospital.
117
```
You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:
Select one:
A. massive hemothorax.
B. tension pneumothorax.
C. pericardial tamponade.
D. laceration of the aorta.
```
D. laceration of the aorta.
118
```
You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:
Select one:
A. partially remove the dressing.
B. begin rapid transport at once.
C. begin ventilatory assistance.
D. call for a paramedic ambulance.
```
A. partially remove the dressing.
119
```
You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:
Select one:
A. insert an oropharyngeal airway.
B. obtain a set of baseline vital signs.
C. immediately request ALS support.
D. perform a focused secondary exam.
```
C. immediately request ALS support.
120
A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:
Select one:
A. requesting a paramedic to administer pain medication.
B. covering the avulsion with moist, sterile dressings.
C. administering 100% oxygen via a nonrebreathing mask.
D. applying direct pressure with a dry, sterile dressing.
D. applying direct pressure with a dry, sterile dressing.
121
```
Abdominal pain, vomiting, and fever are most likely due to _______.
Select one:
A. hemorrhage
B. evisceration
C. infection
D. hypovolemia
```
C. infection
122
```
All of the following are hollow abdominal organs, EXCEPT the:
Select one:
A. ureters.
B. stomach.
C. spleen.
D. bladder.
```
C. spleen.
123
Because the depth of an open abdominal wound is often difficult to determine:
Select one:
A. prompt transport to the hospital is essential.
B. the EMT must perform a thorough exam.
C. the abdomen must be vigorously palpated.
D. vital signs should be monitored frequently.
A. prompt transport to the hospital is essential.
124
```
Compression injury is most likely due to which of the following?
Select one:
A. Improperly placed lab belt
B. Hollow-organ rupture
C. Ejection of unrestrained driver
D. Stabbing
```
A. Improperly placed lab belt
125
```
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:
Select one:
A. stomach.
B. aorta.
C. diaphragm.
D. spleen.
```
C. diaphragm.
126
In pediatric patients, the liver and spleen are _______.
Select one:
A. less likely to bleed when injured
B. smaller in proportion to the abdomen
C. more protected by the thorax compared to adults
D. larger in proportion to the abdomen
D. larger in proportion to the abdomen
127
```
Injuries to the external male genitalia _______.
Select one:
A. are often life-threatening
B. usually result in permanent damage
C. frequently lead to hypovolemic shock
D. are rarely life-threatening
```
D. are rarely life-threatening
128
Placing a pregnant patient in a supine position during the third trimester of pregnancy:
Select one:
A. results in spontaneous urinary incontinence if the bladder is full.
B. is recommended if the patient has severe abdominal discomfort.
C. often causes hypotension secondary to cardiac compression.
D. may decrease the amount of blood that returns to the heart.
D. may decrease the amount of blood that returns to the heart.
129
When a hollow organ is punctured during a penetrating injury to the abdomen:
Select one:
A. the abdomen will become instantly distended.
B. it commonly protrudes through the injury site.
C. peritonitis may not develop for several hours.
D. it will bleed profusely and rapidly cause shock.
C. peritonitis may not develop for several hours.
130
```
When a patient stiffens the muscles of the abdomen, it is known as _______.
Select one:
A. instability.
B. distention.
C. crepitus.
D. guarding.
```
D. guarding.
131
When should you visually inspect the external genitalia on your patient?
Select one:
A. Only when ordered by medical direction
B. Anytime the patient agrees to treatment and transport
C. Always during the secondary assessment
D. Only when there is a complaint of severe pain or other injury
D. Only when there is a complaint of severe pain or other injury
132
Which of the following is true regarding injury to the kidneys?
Select one:
A. The kidneys are not well protected.
B. Kidney injuries are rarely caused by blunt trauma.
C. Injury to the kidneys usually indicates injury to other organs.
D. Only minimal force is needed to damage the kidneys.
C. Injury to the kidneys usually indicates injury to other organs.
133
```
Which of the following organs would MOST likely bleed profusely when injured?
Select one:
A. Bladder
B. Liver
C. Stomach
D. Intestine
```
B. Liver
134
Which of the following statements regarding abdominal eviscerations is correct?
Select one:
A. The protruding organs should be kept warm and moist.
B. Adherent material is preferred when covering an evisceration.
C. The organs should be replaced carefully to avoid heat loss.
D. Most eviscerations occur to the left upper quadrant.
A. The protruding organs should be kept warm and moist.
135
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
Select one:
A. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.
B. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
C. perform a comprehensive secondary assessment to determine why his clinical status has changed.
D. reassess his vital signs and then notify the receiving hospital of the change in his clinical status.
B. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
136
You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:
Select one:
A. perform a comprehensive secondary assessment.
B. forgo the hospital radio report because of his condition.
C. begin documenting the call on the patient care form.
D. closely monitor him and reassess him frequently.
D. closely monitor him and reassess him frequently.
137
```
You should suspect a kidney injury anytime the patient presents with _______.
Select one:
A. abdominal distention
B. dyspnea
C. a hematoma in the flank region
D. nausea
```
C. a hematoma in the flank region
138
Your documentation on a sexual assault victim should _______.
Select one:
A. be subjective and summarize the crime
B. be objective and factual
C. include your opinion of the nature of the incident
D. describe the status of the suspect(s)
B. be objective and factual
139
Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:
Select one:
A. allow her to change her clothes and take a shower before you transport.
B. arrange for a rape crisis center representative to speak with the patient.
C. visualize the vaginal area and pack the vagina with sterile dressings.
D. control any external bleeding, administer oxygen, and transport at once.
D. control any external bleeding, administer oxygen, and transport at once.
140
Because the depth of an open abdominal wound is often difficult to determine:
Select one:
A. prompt transport to the hospital is essential.
B. the EMT must perform a thorough exam.
C. the abdomen must be vigorously palpated.
D. vital signs should be monitored frequently.
A. prompt transport to the hospital is essential.
141
```
A “hip” fracture is actually a fracture of the:
Select one:
A. pelvic girdle.
B. femoral shaft.
C. proximal femur.
D. pubic symphysis.
```
C. proximal femur.
142
A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should:
Select one:
A. make one attempt to return the patella to its normal position.
B. gently straighten her knee and apply a padded board splint.
C. keep her knee flexed and secure it with padded board splints.
D. flex her knee slightly more and assess for distal circulation.
C. keep her knee flexed and secure it with padded board splints.
143
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
Select one:
A. stabilize her head and perform a primary assessment.
B. assess for a carotid pulse and assist her ventilations.
C. apply manual stabilization to both of her femurs.
D. administer oxygen and perform a rapid assessment.
A. stabilize her head and perform a primary assessment.
144
A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:
Select one:
A. gently manipulate the injured leg until the numbness dissipates.
B. control the bleeding and cover the wound with a sterile dressing.
C. assess distal pulses as well as sensory and motor functions.
D. manually stabilize the leg above and below the site of injury.
B. control the bleeding and cover the wound with a sterile dressing.
145
A fracture is MOST accurately defined as a(n):
Select one:
A. break in the continuity of the bone.
B. total loss of function in a bone.
C. abnormality in the structure of a bone.
D. disruption in the midshaft of a bone.
A. break in the continuity of the bone.
146
```
A supracondylar or intercondylar fracture is also known as a fracture of the:
Select one:
A. proximal radius.
B. distal humerus.
C. olecranon process.
D. radial head.
```
B. distal humerus
147
An open fracture is MOST accurately defined as a fracture in which:
Select one:
A. a bullet shatters the underlying bone.
B. bone ends protrude through the skin.
C. a large laceration overlies the fracture.
D. the overlying skin is no longer intact.
D. the overlying skin is no longer intact.
148
```
Crepitus and false motion are:
Select one:
A. most common with dislocations.
B. positive indicators of a fracture.
C. indicators of a severe sprain.
D. only seen with open fractures.
```
B. positive indicators of a fracture.
149
During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:
Select one:
A. apply gentle manual traction in line with the limb and reassess for a pulse.
B. make two or three attempts to restore distal circulation by manipulating the elbow.
C. splint the elbow in the position of deformity and transport immediately.
D. carefully straighten the injured arm and secure it with padded board splints.
A. apply gentle manual traction in line with the limb and reassess for a pulse.
150
During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
Select one:
A. stabilize the pelvis with a pelvic binder and protect the spine.
B. perform a focused physical exam with emphasis on the pelvis.
C. log roll the patient onto a long backboard and transport at once.
D. defer spinal immobilization and transport to a trauma center.
A. stabilize the pelvis with a pelvic binder and protect the spine.
151
In general, musculoskeletal injuries should be splinted before moving the patient unless:
Select one:
A. transport time is less than 15 minutes.
B. the patient is clinically unstable.
C. deformity and swelling are present.
D. the patient is in severe pain.
B. the patient is clinically unstable.
152
In which of the following situations should the EMT splint an injured limb in the position of deformity?
Select one:
A. When distal circulation and neurological functions are absent
B. If resistance is encountered or the patient experiences severe pain
C. If transport time to the hospital is greater than 20 to 30 minutes
D. If a traction splint will be used to immobilize the injured extremity
B. If resistance is encountered or the patient experiences severe pain
153
```
Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:
Select one:
A. fascia.
B. tendons.
C. ligaments.
D. cartilage.
```
B. tendons.
154
The MOST significant hazard associated with splinting is:
Select one:
A. compression of nerves, tissues, and vasculature.
B. reduction in circulation distal to the injury site.
C. aggravation of the injury or worsened pain.
D. delaying transport of a critically injured patient.
D. delaying transport of a critically injured patient.
155
The musculoskeletal system refers to the:
Select one:
A. involuntary muscles of the nervous system.
B. nervous system's control over the muscles.
C. bones and voluntary muscles of the body.
D. connective tissue that supports the skeleton.
C. bones and voluntary muscles of the body.
156
When caring for a patient with a possible fracture of the scapula, the EMT should:
Select one:
A. apply rigid board splints across the chest and back.
B. assume that minimal force was applied to the back.
C. recognize that scapular fractures are life threatening.
D. carefully assess the patient for breathing problems.
D. carefully assess the patient for breathing problems.
157
```
Which of the following musculoskeletal injuries would MOST likely result in deformity?
Select one:
A. Severe strain
B. Moderate sprain
C. Displaced fracture
D. Hairline fracture
```
C. Displaced fracture
158
```
Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?
Select one:
A. Pelvic fracture with hypotension
B. Bilateral femur fractures
C. An amputated extremity
D. Nondisplaced long bone fractures
```
A. Pelvic fracture with hypotension
159
Which of the following statements regarding compartment syndrome is correct?
Select one:
A. Compartment syndrome occurs because of increased pressure within the bone cavity.
B. Most cases of compartment syndrome occur following a severe fracture of the pelvis.
C. In most cases, compartment syndrome develops within a few minutes after an injury.
D. Compartment syndrome typically develops within 6 to 12 hours after an injury.
D. Compartment syndrome typically develops within 6 to 12 hours after an injury
160
With regard to musculoskeletal injuries, the zone of injury is defined as the:
Select one:
A. part of the body that sustained secondary injury.
B. area of obvious deformity over the site of impact.
C. area of soft-tissue damage surrounding the injury.
D. exact part of the bone or joint that was disrupted.
C. area of soft-tissue damage surrounding the injury.
161
A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (–1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:
Select one:
A. apply an AED and assess his cardiac rhythm.
B. assess for a carotid pulse for up to 60 seconds.
C. apply chemical heat packs to his groin and axillae.
D. open his airway and give two rescue breaths.
B. assess for a carotid pulse for up to 60 seconds.
162
A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
Select one:
A. elevating the lower extremities and giving antivenin.
B. supine positioning, splinting the leg, and transporting.
C. applying ice to the wound and transporting quickly.
D. transporting only with close, continuous monitoring.
B. supine positioning, splinting the leg, and transporting.
163
```
All of the following terms refer to a body part that is cold but not frozen, EXCEPT:
Select one:
A. immersion foot.
B. trench foot.
C. frostnip.
D. frostbite.
```
D. frostbite.
164
```
Burns associated with lightning strikes are typically:
Select one:
A. third-degree.
B. superficial.
C. full-thickness.
D. partial-thickness.
```
B. superficial.
165
```
Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:
Select one:
A. nausea.
B. tachycardia.
C. hot, dry skin.
D. headache.
```
C. hot, dry skin.
166
Drowning is MOST accurately defined as:
Select one:
A. temporary survival after submersion in water.
B. water in the lungs following submersion in water.
C. death beyond 24 hours after submersion in water.
D. death from suffocation after submersion in water.
D. death from suffocation after submersion in water.
167
```
Hypothermia occurs when the core body temperature falls below:
Select one:
A. 90°F (32°C).
B. 95°F (35°C).
C. 88°F (31°C).
D. 98°F (37°C).
```
B. 95°F (35°C).
168
In contrast to Lyme disease, Rocky Mountain spotted fever:
Select one:
A. causes painful joint swelling after a few days or weeks.
B. can cause paralysis and cardiorespiratory collapse.
C. may be confused with rheumatoid arthritis.
D. presents with flu-like symptoms and a bull's-eye rash.
B. can cause paralysis and cardiorespiratory collapse.
169
```
Most of the serious injuries associated with scuba diving are caused by:
Select one:
A. cold water temperature.
B. alcohol consumption.
C. too rapid of a descent.
D. too rapid of an ascent.
```
D. too rapid of an ascent.
170
```
The body's natural cooling mechanism, in which sweat is converted to a gas, is called:
Select one:
A. convection.
B. conduction.
C. evaporation.
D. radiation.
```
C. evaporation
171
```
The EMT must assume that any unwitnessed water-related incident is accompanied by:
Select one:
A. cold-water immersion.
B. an air embolism.
C. possible spinal injury.
D. alcohol intoxication.
```
C. possible spinal injury.
172
```
The MOST prominent symptom of decompression sickness is:
Select one:
A. dizziness and nausea.
B. abdominal or joint pain.
C. difficulty with vision.
D. tightness in the chest.
```
B. abdominal or joint pain.
173
```
The venom of a black widow spider is toxic to the:
Select one:
A. nervous system.
B. cardiovascular system.
C. respiratory system.
D. renal system.
```
A. nervous system
174
```
When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
Select one:
A. conduction.
B. evaporation.
C. convection.
D. radiation.
```
A. conduction.
175
```
Which of the following is an early sign of pit viper envenomation?
Select one:
A. Syncope and bleeding at distal sites
B. Signs and symptoms of hypoperfusion
C. Local swelling and ecchymosis
D. General weakness and diaphoresis
```
C. Local swelling and ecchymosis
176
Which of the following MOST accurately describes hyperthermia?
Select one:
A. Heat evaporates a significant amount of body water.
B. The body eliminates more heat than it can generate.
C. The body is exposed to more heat than it can lose.
D. The core body temperature exceeds 99.5°F (37°C).
C. The body is exposed to more heat than it can lose.
177
You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
Select one:
A. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.
B. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.
C. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.
D. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
D. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
178
You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:
Select one:
A. cover his foot with chemical heat compresses.
B. protect the affected part from further injury.
C. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water.
D. administer oxygen via a nonrebreathing mask.
B. protect the affected part from further injury.
179
You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:
Select one:
A. administer one tube of oral glucose and reassess his mental status.
B. load him into the ambulance and begin rapid cooling interventions.
C. perform a head-to-toe assessment and look for signs of trauma.
D. place him in a sitting position and have him drink 1 L of water.
B. load him into the ambulance and begin rapid cooling interventions.
180
ou respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:
Select one:
A. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department.
B. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber.
C. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.
D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance.
C. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.
181
You are triaging victims of a train derailment. Patient A has significant bleeding from an abdominal injury. Patient B has several simple fractures of the femur and ulna. Patient C is conscious and complaining of head and neck pain. Patient D is in cardiac arrest. How would you prioritize these patients?
A-red; B-green; C-yellow; D-black
