Ch. 32

Question 1

An open fracture is MOST accurately defined as a fracture in which:

a) the overlying skin is no longer intact.
b) bone ends protrude through the skin.
c) a bullet shatters the underlying bone.
d) a large laceration overlies the fracture.

Answer 1

a) the overlying skin is no longer intact.

Question 2

A “hip” fracture is actually a fracture of the:

a) pelvic girdle.
b) femoral shaft.
c) pubic symphysis.
d) proximal femur.

Answer 2

d) proximal femur.

Question 3

Which of the following statements regarding compartment syndrome is correct?

a) Compartment syndrome occurs because of increased pressure within the bone cavity.
b) Compartment syndrome typically develops within 6 to 12 hours after an injury.
c) In most cases, compartment syndrome develops within a few minutes after an injury.
d) Most cases of compartment syndrome occur following a severe fracture of the pelvis.

Answer 3

b) Compartment syndrome typically develops within 6 to 12 hours after an injury.

Question 4

Applying ice to and elevating an injured extremity are performed in order to:

a) reduce pain and swelling.
b) maintain extremity perfusion.
c) prevent further injury.
d) enhance tissue circulation.

Answer 4

a) reduce pain and swelling.

Question 5

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.

a) comminuted
b) transverse
c) greenstick
d) pathologic

Answer 5

d) pathologic

Question 6

Which of the following musculoskeletal injuries would MOST likely result in deformity?

a) moderate sprain
b) severe strain
c) displaced fracture
d) hairline fracture

Answer 6

c) displaced fracture

Question 7

Which of the following types of muscle is under direct voluntary control of the brain?

a) smooth
b) cardiac
c) skeletal
d) autonomic

Answer 7

c) skeletal

Question 8

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger’s side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

a) a thoracic spine fracture.
b) anterior hip dislocation.
c) posterior hip dislocation.
d) fracture of the tibia or fibula.

Answer 8

c) posterior hip dislocation.

Question 9

A fracture is MOST accurately defined as a(n):

a) abnormality in the structure of a bone.
b) disruption in the midshaft of a bone.
c) break in the continuity of the bone.
d) total loss of function in a bone.

Answer 9

c) break in the continuity of the bone.

Question 10

The MOST significant hazard associated with splinting is:

a) delaying transport of a critically injured patient.
b) reduction in circulation distal to the injury site.
c) aggravation of the injury or worsened pain.
d) compression of nerves, tissues, and vasculature.
delaying transport of a critically injured patient.

Answer 10

a) delaying transport of a critically injured patient.

Question 11

Atrophy is a condition that occurs when:

a) carbon dioxide, lactic acid, and other wastes accumulate in the muscle.
b) muscle decreases in size and function because of disease or trauma.
c) the tendons that attach muscle to bone become stretched or injured.
d) increased use of skeletal muscle causes an increase in its strength.

Answer 11

b) muscle decreases in size and function because of disease or trauma.

Question 12

Which of the following statements regarding shoulder dislocations is MOST correct?

a) Posterior dislocations are most common.
b) They are caused by forced arm adduction.
c) They involve the acromion process and humerus.
d) Most shoulder dislocations occur anteriorly.

Answer 12

d) Most shoulder dislocations occur anteriorly.

Question 13

The musculoskeletal system refers to the:

a) nervous system’s control over the muscles.
b) bones and voluntary muscles of the body.
c) connective tissue that supports the skeleton.
d) involuntary muscles of the nervous system.

Answer 13

b) bones and voluntary muscles of the body.

Question 14

The MOST reliable indicator of an underlying fracture is:

a) obvious bruising.
b) guarding.
c) severe swelling.
d) point tenderness.

Answer 14

d) point tenderness.

Question 15

Skeletal muscle is also referred to as __________ muscle.

a) striated
b) smooth
c) connective
d) involuntary

Answer 15

a) striated

Question 16

Bone marrow produces:

a) electrolytes.
b) lymphocytes.
c) blood cells.
d) platelets.

Answer 16

c) blood cells.

Question 17

Crepitus and false motion are:

a) most common with dislocations.
b) positive indicators of a fracture.
c) only seen with open fractures.
d) indicators of a severe sprain.

Answer 17

b) positive indicators of a fracture.

Question 18

In moving joints, the ends of the bones are covered with:

a) gliding cartilage.
b) synovial tendons.
c) articular cartilage.
d) muscular fascia.

Answer 18

c) articular cartilage.

Question 19

A(n) __________ fracture occurs in the growth section of a child’s bone and may lead to bone growth abnormalities.

a) diaphyseal
b) greenstick
c) epiphyseal
d) metaphyseal

Answer 19

c) epiphyseal

Question 20

Bones are connected to other bones by bands of tough fibrous tissues called:

a) ligaments.
b) tendons.
c) bursa.
d) cartilage.

Answer 20

a) ligaments.

Question 21

Femoral shaft fractures can result in up to _____ mL of internal blood loss.

a) 2,000
b) 1,500
c) 4,000
d) 1,000

Answer 21

d) 1,000

Question 22

Of the following musculoskeletal injuries, which is considered to be the LEAST severe?

a) open fractures of a long bone
b) nondisplaced pelvic fracture
c) an amputation of an extremity
d) multiple closed long bone fractures

Answer 22

b) nondisplaced pelvic fracture

Question 23

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should:

a) gently straighten the elbow and apply an air splint.
b) splint the elbow in the position found and transport.
c) apply a heat pack to the elbow to reduce swelling.
d) gently manipulate the elbow to improve circulation.

Answer 23

b) splint the elbow in the position found and transport.

Question 24

A subluxation occurs when:

a) a joint is incompletely dislocated.
b) a fracture and a dislocation exist.
c) a bone develops a hairline fracture.
d) ligaments are partially severed.

Answer 24

a) a joint is incompletely dislocated.

Question 25

In general, musculoskeletal injuries should be splinted before moving the patient unless:

a) the patient is clinically unstable.
b) deformity and swelling are present.
c) the patient is in severe pain.
d) transport time is less than 15 minutes.

Answer 25

a) the patient is clinically unstable.

Question 26

Which of the following musculoskeletal injuries would pose the greatest threat to a patient’s life?

a) an amputated extremity
b) pelvic fracture with hypotension
c) bilateral femur fractures
d) nondisplaced long bone fractures

Answer 26

b) pelvic fracture with hypotension

Question 27

Which of the following statements regarding striated muscle is correct?

a) Most of the body’s striated muscle is found within the walls of the blood vessels.
b) It forms the major muscle mass of the body and usually crosses at least one joint.
c) Striated muscle tissue is attached directly to the bones by tough bands of cartilage.
d) Striated muscle is involuntary because you have no conscious control over it.

Answer 27

b) It forms the major muscle mass of the body and usually crosses at least one joint.

Question 28

The MOST commonly fractured bone(s) in the body is the:

a) radius and ulna.
b) scapula.
c) clavicle.
d) midshaft femur.

Answer 28

c) clavicle.

Question 29

The act of pulling on a body structure in the direction of its normal alignment is called:

a) immobilization.
b) reduction.
c) traction.
d) stabilization.

Answer 29

c) traction.

Question 30

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger’s side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

a) a thoracic spine fracture.
b) posterior hip dislocation.
c) fracture of the tibia or fibula.
d) anterior hip dislocation.

Answer 30

b) posterior hip dislocation.

Question 31

The primary purpose for splinting a musculoskeletal injury is to:

a) facilitate ambulance transport.
b) prevent further injury.
c) make the patient comfortable.
d) maximize distal circulation.

Answer 31

b) prevent further injury.

Question 32

What type of muscle contracts and relaxes to control the movement of the contents within its structures?

a) smooth
b) striated
c) cardiac
d) skeletal

Answer 32

a) smooth

Question 33

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:

a) cartilage.
b) ligaments.
c) tendons.
d) fascia.

Answer 33

c) tendons.

Question 34

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments.

a) sprain
b) strain
c) dislocation
d) fracture

Answer 34

a) sprain

Question 35

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:

a) splint the elbow in the position of deformity and transport immediately.
b) carefully straighten the injured arm and secure it with padded board splints.
c) apply gentle manual traction in line with the limb and reassess for a pulse.
d) make two or three attempts to restore distal circulation by manipulating the elbow.

Answer 35

c) apply gentle manual traction in line with the limb and reassess for a pulse.

Question 36

When assessing a patient with a possible fracture of the leg, the EMT should:

a) assess proximal circulation.
b) ask the patient to move the injured leg.
c) carefully move it to elicit crepitus.
d) compare it to the uninjured leg.

Answer 36

d) compare it to the uninjured leg.

Question 37

During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes:

A. carefully splinting each of her deformed extremities.
B. immobilizing her to a backboard and rapidly transporting.
C. applying and inflating the pneumatic antishock garment (PASG) and transporting.
D. applying a traction splint to immobilize her femur.

Answer 37

B. immobilizing her to a backboard and rapidly transporting.

Question 38

When splinting an injury of the wrist, the hand should be placed:

A. in a straight position.
B. into a fist.
C. in a functional position.
D. in an extended position.

Answer 38

C. in a functional position.

Question 39

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should:

A. gently straighten the elbow and apply an air splint.
B. gently manipulate the elbow to improve circulation.
C. apply a heat pack to the elbow to reduce swelling.
D. splint the elbow in the position found and transport.

Answer 39

D. splint the elbow in the position found and transport.

Question 40

The pectoral girdle consists of the:

A. clavicles and rib cage.
B. sternum and scapulae.
C. acromion and clavicles.
D. scapulae and clavicles

Answer 40

D. scapulae and clavicles

Question 41

Common signs and symptoms of a sprain include all of the following, EXCEPT:

A. point tenderness.
B. ecchymosis.
C. swelling.
D. deformity.

Answer 41

D. deformity.

Question 42

Which of the following scenarios is an example of a direct injury?

A. A child dislocates his elbow after falling on his outstretched arm.
B. A skier dislocates his knee after a twisting injury to the ankle.
C. A passenger fractures her patella after it strikes the dashboard.
D. A person lands on his or her feet and fractures the lumbar spine.

Answer 42

C. A passenger fractures her patella after it strikes the dashboard.

Question 43

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:

A. control the bleeding and cover the wound with a sterile dressing.
B. gently manipulate the injured leg until the numbness dissipates.
C. assess distal pulses as well as sensory and motor functions.
D. manually stabilize the leg above and below the site of injury.

Answer 43

A. control the bleeding and cover the wound with a sterile dressing.

Question 44

When splinting a possible fracture of the foot, it is MOST important for the EMT to:

A. observe for tissue swelling.
B. use a pillow as a splint.
C. apply a pneumatic splint.
D. leave the toes exposed

Answer 44

D. leave the toes exposed

Question 45

Deformity caused by a fracture would MOST likely be masked by:

A. guarding.
B. crepitus.
C. swelling.
D. ecchymosis.

Answer 45

C. swelling.

Question 46

A patient has sustained a possible arm fracture. He has swelling, bruising, and deformity to the lateral bone of his right forearm. Which of the following is most likely fractured?

A. Ulna
B. Tibia
C. Radius
D. Humerus

Answer 46

C. Radius

Question 47

Ligaments are fibrous connective tissue that connect ______ to ______ and serve to hold structures together.

A. muscles to muscles
B. muscles to bones
C. bones to bones
D. muscles to joints

Answer 47

C. bones to bones

Question 48

Tendons are fibrous connective tissue that attach ______ to ______ or other body structures.

A. muscles to muscles
B. muscles to bones
C. bones to bones
D. muscles to joints

Answer 48

B. muscles to bones

Question 49

A pelvic fracture has a great risk for shock due to blood loss because each femur has up to __ liter of blood.

A. 1
B. 1.5
C. 2
D. 3

Answer 49

A. 1