CH 30 Soft Tissue Trauma

Question 1

H-1) Lacerations are cuts that​ are:
A. penetrating or perforating.
B. a tearing away or off.
C. smooth or jagged.
D. crushing or fracturing.

Answer 1

C. smooth or jagged

Question 2

H-2) A puncture wound that is shallow or deep is​ a:
A. fracturing puncture wound.
B. penetrating puncture wound.
C. crushing puncture wound.
D. perforating puncture wound.

Answer 2

B. penetrating puncture wound

A penetrating puncture wound is an open wound that tears through the skin and destroys underlying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit wound

Question 3

H-3) Which of the following is a function of the​ skin?
A. Digestion
B. Circulation
C. Sensation
D. Respiration

Answer 3

C. Sensation

It is important to remember that the skin plays a fundamental role in our interactions each day. Nerve endings provide us with sensory input in the form of tactile​ (touch) stimulation. We sense temperature and pleasurable and painful stimuli.

Question 4

H-4) The structures within the dermis​ include:
A. muscle cells.
B. sweat glands.
C. periosteum.
D. adipose tissue.

Answer 4

B. sweat glands

Question 5

H-5) A wound under the skin that involves the collection of blood from injury to a large blood vessel is called​ a:
A. contusion.
B. crush injury.
C. hematoma.
D. concussion.

Answer 5

C. hematoma

A hematoma is similar to a contusion except that hematomas involve a larger amount of tissue​ damage, including damage to larger blood vessels with greater internal blood loss. Whereas a contusion may cause some minor injury to small blood​ vessels, a hematoma is characterized by much more severe internal bleeding and the collection of a larger volume of blood beneath the skin.

Question 6

H-6) Crush injuries often can be identified by​ what?
A. Finding of bleeding from the nose or ears
B. Swelling or deformity
C. Mechanism of injury
D. Palpation of the wound

Answer 6

B. Swelling or deformity

Crush injuries may be difficult or impossible to identify during​ assessment, so you must rely on the MOI. Patients with a significant MOI should be considered to have internal bleeding and shock until they are ruled out in the emergency department.

Question 7

H-7) Possible injury to the cervical spine or brain could be indicated by​ a(n):
A. contusion to the trunk.
B. avulsion of an extremity.
C. penetration of the sternum.
D. bruise on the head or neck.

Answer 7

D. bruise on the head or neck

Question 8

H-8) Abdominal bruising should be considered a sign of​ possible:
A. internal organ damage.
B. pneumothorax.
C. pelvic fracture.
D. head injury.

Answer 8

A. internal organ damage

Question 9

H-9) A simple scratch or scrape of the outer layer of the skin is called​ a(n):
A. contusion.
B. abrasion.
C. laceration.
D. avulsion.

Answer 9

B. abrasion

The classification of abrasion includes simple scrapes and scratches in which the outer layer of the skin is damaged but not all the layers are penetrated. Even though an abrasion is considered a superficial​ injury, it often is extremely painful because of the presence of exposed nerve endings. In most​ cases, blood will ooze from the wound​ (capillary bleeding), which can be controlled easily with direct pressure.

Question 10

H-10) A degloving injury is an example of​ a(n):
A. amputation.
B. avulsion.
C. bite.
D. hand fracture.

Answer 10

B. avulsion

A special type of avulsion is the degloving injury. In this​ wound, the mechanism of injury tears the skin off the underlying​ muscle, connective​ tissue, blood​ vessels, and bone.

Question 11

H-11) Your​ 24-year-old patient was riding an ATV through the woods and impaled herself on a dead tree branch. The​ one-inch diameter branch went in through her mouth and out her right cheek before breaking from the tree. You can see both ends of the penetrating branch. On your​ arrival, the patient is bleeding heavily into her mouth and is struggling to breathe unless she is leaning forward. To gain control of the​ patient’s bleeding and thereby her​ airway, you​ should:
A. sacrifice spinal immobilization and transport the patient in a sitting​ position, leaning forward.
B. insert a nasopharyngeal airway.
C. pack the​ patient’s mouth full of gauze and tell her to breathe through her nose.
D. attempt to remove the object.

Answer 11

D. attempt to remove the object

You may remove an object that is impaled in the cheek if you find perforation and you can see both ends of the object. Pull it out in the direction it entered the cheek. If this cannot be easily​ done, leave the object in place

Question 12

H-12) To stabilize an object impaled in an​ eye, you​ should:
A. place a roll of​ 3-inch gauze bandage or folded 4x4s on either side of the​ object, along the vertical axis of the​ head, in a manner that will stabilize the object.
B. place a paper cup over the impaled object and secure in place with a​ self-adherent roller bandage.
C. snap off as much of the object as you can and then seal the eye with an occlusive dressing before bandaging it with a​ self-adherent roller bandage.
D. wrap a roll of​ 3-inch gauze bandage around the entirety of the​ patient’s head along the horizontal​ axis, covering the eyes.

Answer 12

A. place a roll of​ 3-inch gauze bandage or folded 4x4s on either side of the​ object, along the vertical axis of the​ head, in a manner that will stabilize the object

Question 13

H-13) The emotional and psychological damage from burn​ injuries:
A. usually occurs only with the most severe injuries.
B. begins at the emergency scene.
C. typically is not​ long-lasting.
D. is not a concern for EMTs.

Answer 13

B. begins at the emergency scene.

In addition to the physical damage caused by​ burns, patients often suffer emotional and psychological problems that begin at the emergency scene and may last a lifetime.

Question 14

H-14) Singed nasal hairs in a burned patient are an ominous sign​ because:
A. the smell can be overpowering.
B. they are very painful.
C. they could indicate airway damage.
D. they make it difficult to administer oxygen.

Answer 14

C. they could indicate airway damage.

Question 15

H-15) A way of identifying the seriousness of a burn is by its degree. Which of the following statements is​ true?
A. A​ first-degree burn is the most serious and the deepest.
B. A​ second-degree burn is characterized by​ red, dry, smooth skin.
C. A superficial burn is also called a​ second-degree burn.
D. A​ full-thickness burn is also known as a​ third-degree burn

Answer 15

D. A​ full-thickness burn is also known as a​ third-degree burn

The older description of burns was by degrees. In that classification​ system, a​ third-degree burn has the same characteristics as a​ full-thickness burn, as both represent injuries that involve all three layers of the skin.

Question 16

H-16) Which of the following statements about a​ partial-thickness burn is​ true?
A. The formation of blisters is common.
B. ​Partial-thickness burns are not very​ painful, because of the nerve ending damage.
C. A​ partial-thickness burn involves only the epidermis.
D. The damaged skin of a​ partial-thickness burn is called eschar.

Answer 16

A. The formation of blisters is common.

A​ partial-thickness burn involves not only the epidermis but also portions of the dermis. Blisters are an indication of a​ partial-thickness burn.

Question 17

H-17) If a child pulled a pot of boiling water off the stove and was burned by​ it, this burn would​ be:
A. an electrical burn.
B. a delayed burn.
C. a thermal burn.
D. a flash burn.

Answer 17

C. a thermal burn.

Question 18

H-18) What is the first step in removing dry chemicals from the​ body?
A. Brush off the excess material.
B. Vacuum off excess material.
C. Pour water on the body.
D. Neutralize the chemical with vinegar.

Answer 18

A. Brush off the excess material.

The first step with dry chemicals on the body is to brush off any excess chemical​ first, then flush with copious amounts of water.

Question 19

H-19) Chemical burns to the eyes should​ be:
A. bandaged shut.
B. left alone.
C. flushed with water.
D. rinsed with a neutralizing solution.

Answer 19

C. flushed with water.

Flush the eyes with​ water, being careful not to flush the chemical into the other eye.

Question 20

H-20) A patient with an electrical injury is least likely to present with which of the following signs and​ symptoms?
A. Hypotension
B. Muscle tenderness
C. Visual difficulties
D. Restlessness or irritability

Answer 20

A. Hypotension

Hypotension is not a common sign of an electrical​ injury, but visual​ difficulties, restlessness or​ irritability, and muscle tenderness are common signs and symptoms.

Question 21

H-21) Your patient was involved in a serious industrial​ accident, and sustained critical electrical burns to both his hands when he accidentally grabbed a live wire. Despite the severity of his​ burns, the patient says he​ doesn’t feel that bad. This patient will need​ to:
A. have his wounds flushed with​ hot, sterilized water immediately.
B. be administered​ bag-valve-mask ventilations.
C. be transported as soon as possible.
D. have his wounds wrapped loosely in sterile bandages with no dressings.

Answer 21

C. be transported as soon as possible.

This patient should be transported as soon as possible. Some problems with electrical injuries have a slow onset. If there are​ burns, there also may be more serious hidden problems. In any case of electrical​ shock, heart problems may develop. The other treatments are​ inappropriate, and this patient should be administered​ high-concentration oxygen but should not be administered​ bag-valve-mask ventilations, because there are no signs of inadequate breathing.

Question 22

H-22) After treating an actively bleeding head laceration with a sterile dressing and​ bandage, you notice that the dressing has become​ blood-soaked and that blood is seeping through the bandage. You​ should:
A. remove the​ blood-soaked dressing and replace it with​ new, sterile dressing.
B. reapply pressure and place additional sterile dressings over the​ blood-soaked dressing.
C. apply direct pressure to the​ patient’s neck with both hands.
D. remove the bandage and reposition the​ dressing, being sure to rewrap it tightly.

Answer 22

B. reapply pressure and place additional sterile dressings over the​ blood-soaked dressing.

Do not remove dressings. Once a dressing has been applied to a​ wound, it must remain in place. Bleeding may restart and tissues at the wound site may be injured if the dressing is removed. If the bleeding​ continues, reapply​ pressure, apply additional hemostatic​ agent, and put new dressings over the​ blood-soaked one.

Question 23

H-23) It is characteristic of hemostatic dressings​ to:
A. form an airtight seal.
B. stop or slow bleeding.
C. be bulky.
D. control bleeding through pressure.

Answer 23

B. stop or slow bleeding.

Many EMS systems now carry hemostatic dressings used to stop bleeding. Hemostatic dressings facilitate clotting through a chemical process.

Question 24

PT-1)  When a flap of tissue is traumatically​ removed, this condition is called​ a(n):
A. puncture.
B. avulsion.
C. incision.
D. laceration.

Answer 24

B. avulsion.

Question 25

PT-2) The layer of skin that is rich with blood​ vessels, nerves, and specialized structures is​ the:
A. subcutaneous.
B. fascia.
C. dermis.
D. epidermis.

Answer 25

C. dermis.

Question 26

PT-3) A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can​ talk, and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the highest priority in this​ patient’s assessment and​ treatment?
A. Care for spine​ injuries, head​ injuries, and severe fractures.
B. Transport as soon as possible.
C. Evaluate the electrical burns.
D. Apply sterile dressings to the burn sites.

Answer 26

A. Care for spine​ injuries, head​ injuries, and severe fractures.

(Page 858)

Question 27

PT-4) What is the resulting injury called when the burn penetrates all the way to the bottom layer of​ skin?
A. Superficial​ partial-thickness
B. ​Partial-thickness
C. ​Full-thickness
D. Superficial

Answer 27

C. ​Full-thickness

Question 28

PT-5) You are called to the scene of a patient who was burned by an electrical shock while installing a washing machine. On your​ arrival, the patient is lying beside the washing machine on which he was working. What is your first consideration for this​ patient?
A. Place an AED on the patient.
B. Assume the source of electricity is still active.
C. Establish baseline vital signs on the patient.
D. Establish an​ airway, because he may have suffered burns to the mouth.

Answer 28

B. Assume the source of electricity is still active.

Question 29

PT-6) You are caring for a​ 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be most preferred in managing this​ wound?
A. Gloves and a gown
B. Gloves and a face shield
C. Gown and mask
D. Gloves only

Answer 29

B. Gloves and a face shield

Question 30

PT-7) Which layer of the skin provides shock absorption and​ insulation?
A. Epidermis
B. Adipose
C. Subcutaneous
D. Dermis

Answer 30

C. Subcutaneous

Question 31

PT-8) For a young child with isolated genital​ injuries, you​ should:
A. consider the possibility of​ abuse, and treat the child with sensitivity.
B. withhold care until law enforcement arrives.
C. avoid questioning the child about the cause of the​ injuries, so as not to embarrass the child.
D. challenge the parents directly about the possibility of child abuse.

Answer 31

A. consider the possibility of​ abuse, and treat the child with sensitivity.

Question 32

PT-9) When​ crushed, the liver and​ spleen:
A. cause​ muscle, nerve, and tissue damage.
B. cause contusions on the surface of the skin.
C. cause severe inflammation and sepsis.
D. bleed profusely and cause shock.

Answer 32

D. bleed profusely and cause shock.

Page 829

Question 33

PT-10) You are called to the scene of a metal fabrication​ plant, where you are presented with a​ 30-year-old male patient complaining of bilateral severe eye pain. Upon​ examination, you notice both eyes are red and irritated. Patient states that one of the dyes he was working with splashed into his eyes. How would you manage this​ patient’s injury?
A. Cover both eyes with a​ moist, sterile dressing.
B. Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.
C. Cover both eyes with​ dry, sterile dressing and transport immediately to the nearest appropriate facility.
D. Neutralize the acid immediately with vinegar or baking soda.

Answer 33

B. Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.

(Page 855)

Question 34

PT-11) Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso​ (chest and​ abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface​ burned?
A. ​18%
B. ​22.5%
C. ​27%
D. ​13.5%

Answer 34

B. ​22.5%

Question 35

PT-12) Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is​ this?
A. Stellate
B. Crush injury
C. Contusion
D. Hematoma

Answer 35

D. Hematoma

Question 36

PT-13) You are performing a secondary assessment on your​ 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point​ to?
A. Injury to abdominal organs
B. A punctured lung
C. Damage to the cervical spine
D. Damage to the brain

Answer 36

B. A punctured lung

Question 37

PT-14) How does the skin provide temperature​ regulation?
A. By increasing or decreasing the metabolism within the skin structures
B. By altering the blood flow to the skin and by controlling perspiration
C. By opening temperature pores in the skin
D. By thickening or thinning the layers of the skin

Answer 37

B. By altering the blood flow to the skin and by controlling perspiration

Question 38

PT-15) ​Generally, when providing emergency care of open​ wounds, the first thing you would do​ is:
A. clean the wound surface.
B. bandage a dressing in place.
C. control the bleeding.
D. expose the wound.

Answer 38

D. expose the wound.

Question 39

PT-16) Burns involving the airway often lead​ to:
A. bradycardia.
B. respiratory compromise.
C. hypoglycemia.
D. hypertensive crisis.

Answer 39

B. respiratory compromise.

Question 40

PT-17) In caring for an amputated​ part, it is important​ to:
A. place the part in ice water.
B. wrap the part in sterile gauze and pack it in ice.
C. wrap the part in sterile gauze and keep it cool.
D. place the part in milk.

Answer 40

C. wrap the part in sterile gauze and keep it cool.

Question 41

PT-18) Damage to which of the following organs is least likely in the case of abdominal​ bruising?
A. Spleen
B. Kidneys
C. Lungs
D. Liver

Answer 41

C. Lungs

Question 42

PT-19) All burns are to be treated as more serious​ if:
A. accompanied by other injuries or medical problems.
B. they are from a thermal source.
C. they involve the epidermis.
D. they are accompanied by reddening of the skin.

Answer 42

A. accompanied by other injuries or medical problems.

Question 43

PT-20) Your patient suffered a severe electrical burn injury. In your emergency​ care, you should​ always:
A. assess for an entrance and an exit wound.
B. hose the patient​ down, to stop the burning reaction.
C. pull the patient off the electrical source as soon as possible.
D. treat the patient in the same area where the burn injury occurred.

Answer 43

A. assess for an entrance and an exit wound.

Question 44

PT-21) You are caring for a victim who was rescued from a burning building by the fire department. The patient is alert and oriented with superficial burns to the​ arms, chest,​ neck, and face. He complains that he cannot breathe well. What is this​ patient's most critical​ injury?
A. Burns to the face
B. Burns to the neck
C. Burns to the arms
D. Burns to the chest

Answer 44

A. Burns to the face

Question 45

PT-22) You are caring for a​ 46-year-old female who accidentally sustained burns to her left hand up to the wrist from boiling water. You arrive moments after the incident. Of the​ following, which should you do​ first?
A. Check the​ patient’s pulse and blood pressure in the affected extremity.
B. Remove any rings or other jewelry from the​ patient’s hand and wrist.
C. Cool the burned area to stop the burning process.
D. Apply a topical analgesic ointment to the burn area to reduce the pain.

Answer 45

C. Cool the burned area to stop the burning process.

Question 46

PT-23) Which of the following statements about puncture wounds is​ correct?
A. Puncture wounds carry a much lower risk of infection than do other open wounds.
B. If there is little external evidence of​ bleeding, internal bleeding is unlikely.
C. Even​ insignificant-looking puncture wounds can cause devastating injuries.
D. A puncture wound is not serious unless it is deep.

Answer 46

C. Even​ insignificant-looking puncture wounds can cause devastating injuries.

Question 47

PT-24) In bandaging a hand​ wound, what important consideration is​ necessary?
A. Bandage the lower​ arm, wrist, and​ hand, including the fingertips.
B. Bandage the hand in the position of function.
C. The dressing does not need to be​ sterile, because the hand is typically not clean.
D. The arm should be wrapped with elastic gauze from the elbow toward the fingertips

Answer 47

B. Bandage the hand in the position of function.

Question 48

CT-1) You are dispatched to an industrial plant for a burn. You arrive and find a​ 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you​ do?
A. Care for the burn and do a complete patient​ assessment, including cervical spine precautions.
B. Before doing​ treatment, call the local burn center for instruction.
C. Call for air transport and continue to pour water on the burns until transport arrives.
D. Because of his​ age, immediately put him in your ambulance and transport him to a burn center.

Answer 48

A. Care for the burn and do a complete patient​ assessment, including cervical spine precautions.

Question 49

CT-2) Which of the following is a description of the rule of nines for an​ adult?
A. The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, and the lower back and​ buttocks; 8 percent to the front of each lower​ extremity; and 10 percent for the back of each lower​ extremity, then 1 percent to the genital region.
B. The rule of nines assigns 9 percent to the head and​ neck, as well as each upper​ extremity; 10 percent to the​ chest, the​ abdomen, and the upper​ back; 8 percent to the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region.
C. The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region.
D. The rule of nines assigns 9 percent to the head and​ neck; 6 percent to each upper​ extremity; 12 percent to the chest and​ abdomen; 9 percent to the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region.

Answer 49

C. The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region.

Question 50

CT-3) Which of the following is a desirable characteristic of dressings used in the prehospital management of most open​ wounds?
A. Occlusive
B. Absorbent
C. Adherent
D. Sterile

Answer 50

D. Sterile

Question 51

CT-4) Which of the following is required in the management of all open​ soft-tissue injuries?
A. Use of Standard Precautions by the EMT
B. Provision of​ high-concentration oxygen
C. Application of a disinfectant solution
D. Cervical spine precautions

Answer 51

A. Use of Standard Precautions by the EMT

Question 52

CT-5) You are dispatched to the local elementary school for an injured student. Upon​ arrival, you find that two​ 7-year-olds got into a fight and one of them jabbed a pencil in the​ other’s cheek. The pencil is still sticking out of the​ child’s cheek. When you examine the​ patient, you cannot see the end of the pencil that went through the​ cheek, as it appears to be stuck in the palate. There is not significant​ bleeding, and the child is not having any difficulty breathing. The child is very upset and wants you to pull the pencil out. What should you​ do?
A. Call the parents and see what they want you to do.
B. Remove the object and put a bandage on the outside of the cheek.
C. Let the child carefully pull the object out.
D. Stabilize the​ object, but do not try to remove it.

Answer 52

D. Stabilize the​ object, but do not try to remove it.

Question 53

CT-6) You are examining a​ 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this​ mean?
A. The palm of the​ patient’s hand equals​ 9% of the​ body’s surface area.
B. The palm of your hand represents​ 1% of the​ body’s surface area.
C. The palm of the​ patient’s hand equals about​ 1% of the​ body’s surface area.
D. You can only use the rule of palm for​ children, so you would use the rule of nines instead.

Answer 53

C. The palm of the​ patient’s hand equals about​ 1% of the​ body’s surface area.

Question 54

CT-7) Which of the following is not an open tissue​ injury?
A. Laceration
B. Abrasion
C. Contusion
D. Avulsion

Answer 54

C. Contusion

Question 55

CT-8) Which of the following statements is not true concerning the proper transport of an avulsed​ ear?
A. It should not be immersed in cooled water or saline.
B. It should be labeled with the​ patient’s name, as well as the date and time it was bagged.
C. It should be in a dry sterile dressing.
D. It should be kept as cool as possible.

Answer 55

C. It should be in a dry sterile dressing.

Question 56

CT-9) Which of the following is not an open tissue​ injury?
A. Contusion
B. Amputation
C. Abrasion
D. Avulsion

Answer 56

A. Contusion

Question 57

CT-10) Your patient is a​ 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and​ painful, but without blisters. When caring for this injury in the prehospital​ setting, which of the following is​ appropriate?
A. Apply a lotion containing a topical anesthetic and aloe vera.
B. Apply a plastic bag full of ice to the skin.
C. Apply an antibiotic ointment.
D. Apply a dry sterile dressing.

Answer 57

D. Apply a dry sterile dressing.

Question 58

CT-11) Which of the following is not true concerning​ lacerations?
A. They may involve degloving injuries to the skin or tissue.
B. They may indicate deeper underlying tissue damage.
C. They may be caused by penetrating trauma.
D. They may be caused by blunt trauma.

Answer 58

A. They may involve degloving injuries to the skin or tissue.

Question 59

CT-12) Your patient is a​ 14-year-old male who crashed his​ bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his​ hands, arms,​ chest, and knees. The patient has small pieces of​ gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine​ immobilization?
A. Use your fingers to pick embedded debris from the​ wound, bandage with moist saline dressings in​ place, and transport.
B. Do not attempt to remove any​ debris, apply pressure dressings over the embedded material if​ necessary, apply​ high-concentration oxygen, and transport.
C. Assess for additional​ injuries, flush away large pieces of debris with a sterile​ dressing, place dressings on the​ abrasions, bandage them in​ place, and transport.
D. Use a tongue depressor to scrape large pieces of debris out of the​ wounds, place the patient on​ high-concentration oxygen, and transport.

Answer 59

C. Assess for additional​ injuries, flush away large pieces of debris with a sterile​ dressing, place dressings on the​ abrasions, bandage them in​ place, and transport.

Question 60

CT-13) Which of the following layers of the skin is the most important in insulating the body against heat​ loss?
A. Parietal layer
B. Epidermis
C. Subdural layer
D. Subcutaneous layer

Answer 60

D. Subcutaneous layer

Question 61

CT-14) A wound in which the epidermis is scraped away with minimal​ bleeding, such as commonly occurs when a child falls on his knees on a​ sidewalk, is called​ a(n):
A. avulsion.
B. abrasion.
C. contusion.
D. laceration.

Answer 61

B. abrasion.

Question 62

CT-15) Your patient is a​ 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital​ setting?
A. Push the hook through the wound to avoid further damage from the barbed end.
B. Pull the hook out from the same direction in which it entered the hand.
C. Apply a pressure dressing over the hook.
D. Leave the hook in place and try not to disturb it.

Answer 62

D. Leave the hook in place and try not to disturb it.

Question 63

CT-16) While assessing a patient with partial thickness burns to his chest and​ neck, what should be your highest priority​ (even if there are no symptoms​ presently)?
A. Airway
B. Bleeding
C. Blood pressure
D. Hypothermia

Answer 63

A. Airway

Question 64

CT-17) You are dispatched to the local high school for a​ “person struck with a​ baseball.” You arrive on the scene and find a​ 16-year-old male sitting on the bench. Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next​ step?
A. Tell the coach the patient is okay and he can go back into the ball game.
B. Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes.
C. Have the patient walk to the ambulance and take him to the ED. No other care needs to be​ provided, as there is really no significant sign of any injury.
D. Take appropriate Standard​ Precautions, apply​ high-concentration oxygen by nonrebreather​ mask, and transport the patient​ ASAP, carefully monitoring the patient during transport.

Answer 64

D. Take appropriate Standard​ Precautions, apply​ high-concentration oxygen by nonrebreather​ mask, and transport the patient​ ASAP, carefully monitoring the patient during transport.

Question 65

CT-18) Which of the following injuries requires the use of an occlusive​ dressing?
A. Open wound to the abdomen from which a loop of intestine is protruding
B. Open wound to the chest
C. Open wound to the neck
D. All of the above

Answer 65

D. All of the above

Question 66

CT-19) Which of the following best describes a partial thickness​ burn?
A. The skin is white and dry with no sensation of pain.
B. The skin is charred or blackened and lacks sensation.
C. The skin is red and moist with blister formation.
D. The skin is​ red, but dry and painful.

Answer 66

C. The skin is red and moist with blister formation.

Question 67

CT-20) Your patient is a​ 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his​ knees, and circumferentially around both legs. Using the rule of​ nines, which of the following most accurately represents the extent of body surface area​ burned?
A. 36 percent
B. 4.5 percent
C. 18 percent
D. 9 percent

Answer 67

C. 18 percent

Question 68

CT-21) The meatus​ is:
A. the external opening of the urethra.
B. the tube that carries urine from the kidney to the bladder.
C. the canal through which urine is discharged from the bladder to the exterior of the body.
D. in a​ male, the area between the scrotum and the anus.

Answer 68

A. the external opening of the urethra

Question 69

CT-22) Which type of wound has a small opening into the​ skin, but may be quite​ deep, and is often caused by instruments such as​ nails, ice​ picks, or​ pencils?
A. Incision
B. Puncture
C. Laceration
D. Avulsion

Answer 69

B. Puncture

Question 70

CT-23) In caring for a​ 27-year-old male who has a large laceration on his anterior​ forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do​ next?
A. Apply a tourniquet.
B. Apply additional dressing material over the top of the original dressing and bandage it in place.
C. Apply an ice pack over the original dressing.
D. Remove the saturated dressings and apply a large trauma dressing.

Answer 70

B. Apply additional dressing material over the top of the original dressing and bandage it in place.

Question 71

CT-24) You are dispatched to a local industrial plant for an​ “electrical injury.” You arrive​ on-scene and find a​ 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious​ person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next​ step?
A. While on the​ scene, rapidly do a complete​ assessment, provide​ oxygen, provide care for potential spine​ injuries, and transport as soon as possible after the exam.
B. Load and go conduct any other care in the ambulance en route due to the potential seriousness of the burns.
C. Stay with the patient​ awhile, and if he does not appear to be in​ distress, encourage him to refuse care.
D. Put the patient on oxygen and help him into your ambulance.

Answer 71

A. While on the​ scene, rapidly do a complete​ assessment, provide​ oxygen, provide care for potential spine​ injuries, and transport as soon as possible after the exam.

Question 72

CT-25) When managing an electrical​ burn, the EMT​ should:
A. always attempt to remove the patient from the electrical source.
B. never attempt CPR unless it is within 4 minutes of contact.
C. check for a source and ground burn injury.
D. quickly check the​ pulse, even if the patient is still in contact with the electrical source.

Answer 72

C. check for a source and ground burn injury.`

Question 73

CT-26) Your patient is a​ 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his​ hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the best way to manage this​ situation?
A. Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands.
B. Brush away the powder and bandage the hands in a position of function.
C. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
D. Have the fire department connect to a hydrant and spray down the patient from head to toe.

Answer 73

C. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.

Question 74

CT-27) You are treating the amputation of three fingers on a​ 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated​ fingers?
A. Place the fingers directly on ice or use cold​ packs, as they must be kept very cold.
B. Wrap them in a sterile​ dressing, put them in a plastic​ bag, and keep them cool.
C. Fingers cannot be reattached so you can discard them in a biohazard bag.
D. Because it is cold​ out, you merely need to wrap them in a 5 x 9 dressing and give them to the staff at the ED.

Answer 74

B. Wrap them in a sterile​ dressing, put them in a plastic​ bag, and keep them cool.

Question 75

CT-28) You are treating a​ 5-year-old for extensive burns. You know that burns pose a greater risk to infants and children. The reason for this​ is:
A. their body surface area is greater in relation to their total body size.
B. the​ parents’ interference with your assessment and treatment can delay your response.
C. the child will likely be upset and crying and therefore hard to evaluate.
D. child abuse is usually the reason for the burns.

Answer 75

A. their body surface area is greater in relation to their total body size.

Question 76

CT-29) Which of the following is the outermost layer of the​ skin?
A. Fascia
B. Epidermis
C. Adipose tissue
D. Dermis

Answer 76

B. Epidermis

Layers = Epidermis
Dermis
Subcutaneous

Question 77

CT-30) You assess a​ 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the​ burn, you notice a white powder on the burn. What should be your next​ step?
A. Brush off the​ powder, bandage the​ arm, and transport the patient to the closest trauma center.
B. Flush the arm and hand with copious amounts of water.
C. Transport the patient immediately to the closest burn center.
D. Brush the powder off the​ patient’s arm and​ hand, and then flush with copious amounts of water.

Answer 77

D. Brush the powder off the​ patient’s arm and​ hand, and then flush with copious amounts of water.

Question 78

CT-31) A​ 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury​ site?
A. Bleeding from the wound is minimal.
B. The​ patient’s distal​ pulse, motor​ function, and sensation are intact.
C. The nail is less than 2 inches in length.
D. None of the above

Answer 78

D. None of the above

Question 79

CT-32) Which of the following is recommended when caring for an amputated​ part?
A. Rinse away debris with saline solution and place the part in a container of ice.
B. Wrap the part in aluminum foil to preserve body temperature.
C. Care for the amputated part before worrying about the patient bleeding.
D. Seal the part in a plastic bag and keep it cool.

Answer 79

D. Seal the part in a plastic bag and keep it cool.

Question 80

CT-33) Which of the following is appropriate in caring for a patient with closed​ soft-tissue injuries and a significant mechanism of injury​ (MOI)?
A. Treat for shock if you think there are internal injuries even if the​ patient’s vital signs are normal.
B. Anticipate vomiting.
C. Splint any​ swollen, deformed extremities.
D. All of the above

Answer 80

D. All of the above

Question 81

CT-34) You are dispatched to an auto repair shop for an​ “accident.” You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a​ high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you​ do?
A. Tell the patient that if it does not get better within the next few days he should consult his own doctor.
B. Remove the ice from the​ wound, then elevate and splint the limb. Transport the patient high priority.
C. The patient is correct. This type of wound will heal on its own and he can go back to work.
D. Continue to apply​ cold, elevate and splint the​ limb, and transport the patient high priority.

Answer 81

B. Remove the ice from the​ wound, then elevate and splint the limb. Transport the patient high priority.

Question 82

CT-35) Which of the following is true concerning​ lacerations?
A. They may be caused by blunt trauma.
B. They may be caused by penetrating trauma.
C. They may indicate deeper underlying tissue damage.
D. All of the above

Answer 82

D. All of the above

Question 83

CT-36) Your patient is a​ 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this​ wound?
A. Application of antibiotic ointment
B. Removing rings
C. Application of a dry sterile dressing
D. Keeping the site clean

Answer 83

A. Application of antibiotic ointment

Question 84

CT-37) Which of the following patients has the greatest likelihood of being cared for in a burn​ center?
A. ​30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
B. ​45-year-old man who has a partial thickness burn about 3 inches long by​ 1/2 inch wide on his posterior arm from backing into a barbecue grill
C. ​16-year-old female who came into contact with a motorcycle exhaust pipe and has a superficial burn on her leg about 2 inches in diameter
D. ​12-year-old male with a partial thickness burn involving his forearm as a result of making a torch by lighting aerosol from a can of hairspray

Answer 84

A. ​30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself

Question 85

CT-38) Burns pose a greater risk to infants and children for which of the following​ reasons?
A. Infants and children have a greater risk of infection from the burn.
B. Pediatric patients have a greater risk of shock from the burn.
C. Pediatric patients have a greater risk of heart problems associated with the burn.
D. None of the above

Answer 85

B. Pediatric patients have a greater risk of shock from the burn.

Question 86

CT-39) You are caring for a​ 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are​ torn, and you can see most of the wound. What is the next​ step?
A. You need to make sure the wound is very clean before trying to control bleeding by exposing the wound completely and cleaning it with alcohol.
B. You need to expose the wound completely because you need to clear away any embedded particles and debris from the wound.
C. You need to expose the wound​ completely, control​ bleeding, clean the surface by simply removing large pieces of foreign matter if​ any, and dress and bandage the wound.
D. You can treat the wound without total exposure as exposing a wound in that area of the body could be embarrassing.

Answer 86

C. You need to expose the wound​ completely, control​ bleeding, clean the surface by simply removing large pieces of foreign matter if​ any, and dress and bandage the wound.

Question 87

CT-40) Which of the following is not considered soft​ tissue?
A. The skin
B. Cartilage
C. Membranes
D. Muscles

Answer 87

B. Cartilage

Question 88

CT-41) An injury in which the epidermis remains​ intact, but blood vessels and cells in the dermis are​ injured, is called​ a(n):
A. avulsion.
B. hematoma.
C. contusion.
D. abrasion.

Answer 88

C. contusion.

Question 89

CT-42) For which of the following patients should the EMT carefully continue to monitor the​ patient’s ventilatory status throughout treatment and transport due to the greatest risk of respiratory​ failure?
A. ​34-year-old male who opened the radiator of his car and had hot fluid spray on his​ chest, resulting in redness and pain in an area about the size of the​ patient’s hand
B. ​28-year-old male who spilled a strong industrial acid on his legs
C. ​17-year-old male with a blistering sunburn on his face
D. ​16-year-old male whose shirt caught on​ fire, resulting in circumferential burns of his chest

Answer 89

D. ​16-year-old male whose shirt caught on​ fire, resulting in circumferential burns of his chest

Question 90

CT-43) Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical​ wire?
A. The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity.
B. Toxic gases were inhaled.
C. The burning will continue for​ hours, perhaps days.
D. The extent of tissue damage may be much greater than it appears on the surface.

Answer 90

D. The extent of tissue damage may be much greater than it appears on the surface.

Question 91

CT-44) Which of the following is of concern with a puncture​ wound?
A. An object that remains impaled in the body
B. Hidden internal bleeding with minimal external bleeding
C. Strong possibility of contamination
D. All of the above

Answer 91

D. All of the above

Question 92

CT-45) A burn extending into the subcutaneous fat would be classified as which type of​ burn?
A. Superficial partial thickness
B. Superficial
C. Full thickness
D. Deep partial thickness

Answer 92

C. Full thickness

Question 93

CT-46) You are assessing a​ 30-year-old male patient that had his arm caught in a piece of machinery. By the time you​ arrive, he has been freed. The patient tells you that he does not understand why you were​ called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspicion of which of the following​ injuries?
A. ​High-pressure injection
B. Crush injury
C. Chemical burn
D. Puncture

Answer 93

A. ​High-pressure injection

Question 94

CT-47) Which of the following best describes an​ avulsion?
A. Accumulation of blood beneath the​ skin, resulting in swelling
B. Flap of skin that is partially or completely torn away from the underlying tissue
C. Epidermis that is scraped away by a rough surface
D. An injury caused by a​ sharp, pointed object

Answer 94

B. Flap of skin that is partially or completely torn away from the underlying tissue

Question 95

CT-48) While assessing a​ 78-year-old male patient who escaped an apartment fire with partial thickness burns to both​ arms, the EMT must be aware of which of the​ following?
A. Being involved in a crime makes the patient part of the chain of​ evidence, requiring a police officer to ride with you to the hospital.
B. Medical conditions may be aggravated by the burn.
C. The patient may need to be questioned by police and fire officials about the cause of the fire.
D. The burn is the most serious injury to the patient.

Answer 95

B. Medical conditions may be aggravated by the burn.

Question 96

CT-49) When using the rule of palm to estimate the approximate body surface area​ burned, the​ patient's palm equals about what percentage of the​ body's surface area​ (BSA)?
A. 3 percent
B. 5 percent
C. 1 percent
D. 2 percent

Answer 96

C. 1 percent

Question 97

CT-50) An injury caused by heavy pressure to the​ tissues, such as when an extremity is trapped under a fallen​ tree, that results in damage to underlying​ structures, bleeding, and inflammation is called​ a(n):
A. contusion.
B. abrasion.
C. crush injury.
D. avulsion.

Answer 97

C. crush injury

Question 98

CT-51) Bleeding from​ soft-tissue injuries should initially be controlled with which one of the following​ techniques?
A. Application of an ice pack or chemical cold pack
B. Direct pressure
C. Running cold water over the wound
D. Elevation of the injured part

Answer 98

B. Direct pressure

Question 99

CT-52) Which of the following is not a type of​ avulsion?
A. The skin is stripped off the​ hand, like removing a glove.
B. An ear is partially torn away from the head.
C. The skin is partially torn away from the foot.
D. A finger is cut off with a​ butcher’s saw.

Answer 99

D. A finger is cut off with a​ butcher’s saw

Question 100

CT-53) Which of the following is a consideration in determining a​ burn’s severity?
A. Body surface area​ (BSA) involved in the burn
B. The type of agent that caused the burn
C. Other illnesses or injuries the patient may have
D. All of the above

Answer 100

D. All of the above

Question 101

CT-54) A​ 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you​ do?
A. Immediately apply a tourniquet to control bleeding.
B. Because of the seriousness of the​ injury, wait for ALS before providing any care.
C. Apply a pressure dressing to control​ bleeding, stabilize the foot by​ splinting, apply​ oxygen, and transport as a priority patient.
D. Complete the amputation. It will make the injury much easier to handle.

Answer 101

C. Apply a pressure dressing to control​ bleeding, stabilize the foot by​ splinting, apply​ oxygen, and transport as a priority patient.

Question 102

CT-55) Your patient is a​ 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being​ “hit in the face and kicked and punched in my ribs and​ stomach.” Your examination reveals contusions and swelling around both​ eyes, bleeding from the​ nose, a laceration of his upper​ lip, and multiple contusions of the​ chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this​ patient?
A. The presence of any defensive wounds the patient may have sustained
B. Getting a description of the assailants
C. Potential internal injuries
D. The swelling around his​ eyes, which may be reduced by applying a cold pack

Answer 102

C. Potential internal injuries

Question 103

CT-56) According to the rule of nines for infants and young​ children, the​ patient's head and neck account for what percentage of the total body surface​ area?
A. 14 percent
B. 1 percent
C. 18 percent
D. 9 percent

Answer 103

C. 18 percent

Question 104

CT-57) Which of the following is not a major function of the​ skin?
A. Temperature regulation
B. Regulates the pH balance of the body
C. Excretion of wastes
D. Protection from the environment

Answer 104

B. Regulates the pH balance of the body

Question 105

CT-58) Which of the following statements is false regarding an electrical​ injury?
A. Injury is usually limited to the area around the source and ground burns.
B. Patients with electrical burns may be treated with the automated external defibrillator​ (AED) and CPR.
C. Patients with burns that appear insignificant are treated as having critical injuries.
D. Treatment of a source burn is the same as for other thermal burns.

Answer 105

A. Injury is usually limited to the area around the source and ground burns.