Exam 4: Questions Flashcards
Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except:
A. it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound.
B. it will reduce pain
C. it should not be used alone but rather in conjunction with other manual techniques
D. it should not be left in place for more than 20 minutes
A. it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound.
Which of the following BEST describes the delivery of oxygen and nutrients at the body’s cellular level?
perfusion
Which of the following is a characteristic of arterial bleeding?
spurting under pressure
When deciding where to transport a patient who is in hypovolemic shock or who has the potential for developing hypovolemic shock, which of the following is the MOST important service to be provided by the receiving hospital?
Immediate surgical capabilities
Which of the following must be kept in mind when considering the severity of external bleeding?
Signs of shock do not appear until a large amount of blood has been lost.
Which of the following is NOT recommended when controlling epistaxis?
A. Having the patient tilt the head backward to elevate the nose
B. Placing the unconscious patient in the recovery position
C. Pinching the nostrils together
D. Keeping the patient calm and quiet
A. Having the patient tilt the head backward to elevate the nose
If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute?
blood pressure cuff
Which of the following types of vessels have valves to maintain one-way blood flow?
veins
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?
Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.
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?
18%
An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n):
contusion
Burns pose a greater risk to infants and children for which of the following reasons?
Pediatric patients have a greater risk of shock from the burn.
Which of the following is required in the management of all open soft-tissue injuries?
Use of Standard Precautions by the EMT
Which of the following is NOT considered soft tissue? A. cartilage B. the skin C. membranes D. muscles
cartilage
Which of the following is NOT a major function of the skin? A. Protection from the environment B. Temperature regulation C. excretion of wastes D. regulates the pH balance of the body
D. regulates the pH balance of the body
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?
Stabilize the object, but do not try to remove it.
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 his 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?
Potential internal injuries
Which of the following statements is incorrect regarding an electrical injury?
A. Patients with burns that appear insignificant are treated as having critical injuries.
B. Patients with electrical burns may be treated with the automated external defibrillator (AED) and CPR.
C. Treatment of a source burn is the same as for other thermal burns.
D. Injury is usually limited to the area around the source and ground burns.
D. Injury is usually limited to the area around the source and ground burns.
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?
The palm of the patient’s hand equals about 1% of the body’s surface area.
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?
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.
Which of the following statements is NOT true concerning the proper transport of an avulsed ear?
A. it should be kept as cool as possible
B. It should not be immersed in cooled water or saline.
C. It should be labeled with the patient’s name, as well as the date and time it was bagged.
D. It should be in a dry sterile dressing.
D. It should be in a dry sterile dressing.
A teenage male has fallen onto a railing while skateboarding. He complains of right- sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. You should:
begin positive pressure ventilation.
The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fill adequately, usually secondary to trauma.
cardiac tamponade
What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax with each breath?
Sucking chest wound
What is the underlying cause of bluish or reddish facial discoloration following traumatic asphyxiation?
High pressure on the chest leads to blood being forced from the right atrium into the face and neck.
Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma?
Liver
The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss.
3
Which of the following is the least reliable sign for determining the presence of a tension pneumothorax?
A. Trachea that shifts to the side opposite of the injury
B. Signs and symptoms of shock
C. Shortness of breath
D. Distended neck veins
B. Signs and symptoms of shock
Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and transport?
Tension pneumothorax
You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you’re making the decision to transport. Which of the following BEST encapsulates the correct strategy for transport?
Transport the patient emergently because of the high index of suspicion for a serious injury
Your patient has an open abdominal wound with intestines protruding. You should:
cover the organs with moist sterile dressings.
A traction splint may be used on which of the following musculoskeletal injuries?
Possible fracture of the femur
Which one of the following definitions is NOT true?
A. Joints are places where bones articulate.
B. A sprain is the stretching and tearing of ligaments.
C. Another name for manual traction is tension.
D. Tendons connect muscles to ligaments.
D. Tendons connect muscles to ligaments.
There are general rules that apply to all types of splinting. Which of the following is NOT a general rule of splinting?
A. Exposure the injury
B. Assess distal CSM
C. In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.
D. Align long-bone injuries to anatomical position.
C. In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.
The sound or feeling of the ends of broken bones rubbing together is called:
crepitus
Which of the following BEST describes compartment syndrome?
A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure
Which of the following is NOT a mechanism of musculoskeletal injury?
Extensive force
Although it can be difficult to definitively determine hip dislocation in the field, certain signs and symptoms are usually there. Which of the following statements is false?
A. Often there is lack of sensation in the limb.
B. A posterior hip dislocation presents with a bent knee and the foot may hang loose.
C. An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed.
D. The posterior hip dislocation is the most common.
C. An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed.
Your patient is a 3-year-old girl who is unable to move her elbow after her mother picked her up by the forearm. Proper splinting of this injury would be to immobilize from the ________ to the ________.
forearm; humerus
Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of action?
Gently attempt to straighten the leg to regain a pulse before splinting.
Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?
Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X- rayed at the emergency department, then splint the ankle.
A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n):
whiplash injury.
In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury?
Hold the patient’s head still in a neutral, “eyes forward” position.
In which of the following circumstances should a helmet be removed?
If the helmet interferes with airway management
Which of the following is controlled by the left side of the brain?
The sensation of the right leg
Which of the following is a potential complication of hyperventilating a patient with a brain injury?
Decreasing blood flow to the brain
When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building?
En route to the hospital
A 65-year-old man was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury?
Increased blood pressure
You are called for a young man who was diving head first off a dock into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been performing rescue breathing for him. He is awake, but he is unable to breathe on his own. What type of damage or injury does this indicate?
Damage to C- 3, C- 4, or C5
Which of the following is the correct sequence for securing the straps on a long spine board?
Torso, legs, head
Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood and you are considering how you will control the bleeding. Your primary treatment should be to place a(n):
occlusive dressing.
Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?
Peripheral nervous system
Which portions of the spine are the most vulnerable to injury?
Cervical and lumbar
Which of the following statements concerning a concussion is true?
A. The patient may not have any symptoms of the injury.
B. It is accompanied by recurrent episodes of unconsciousness.
C. It is a bruising of the brain tissue.
D. All of the above
A. The patient may not have any symptoms of the injury.
Your patient is a 35-year-old woman who was driving a minivan that was struck in the driver’s side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles she extends her legs and flexes her arms and wrists. When giving your radio report, which of the following terms should you use to describe this?
Posturing
What is the highest Glasgow Coma Score (GCS) measurement of altered mental status, which according to CDC guidelines necessitates transport to a trauma center?
13
Which of the following is the most significant mechanism of injury for a driver in a vehicle accident?
Death of a passenger in the same vehicle
What is the definition of multiple trauma?
A trauma in which the patient has more than one serious injury.
What is the most important intervention an EMT can perform for an unstable multisystem trauma patient?
Rapid Transport
Which patient is the most unstable?
A. Patient who only responds to verbal stimuli
B. Patient responsive to painful stimuli only
C. Unresponsive patient with tachycardia
D. Unresponsive patient with hypotension
D. Unresponsive patient with hypotension
What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) released in order to guide the most injured patients into trauma centers?
Physiological determinants, anatomic criteria, and mechanism of injury
Which of the following choices is NOT a justifiable reason for delaying the transport of a critical trauma patient?
A. Immobilizing the patient to a long spine board
B. Suctioning the airway
C. Awaiting arrival of the patient’s parents on- scene
D. Ventilating a patient in respiratory distress
C. Awaiting arrival of the patient’s parents on- scene
You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient’s body?
Head, chest, and torso
You are on the scene of a 50-year-old male who lacerated his arm on a sheet of plate glass. He is pale, diaphoretic, and mumbling incoherently. You have controlled an arterial bleed with direct pressure. His blood pressure is 70/40, pulse 120, and respiratory rate of 28. Which of the following signs is the most concerning?
Blood pressure
A patient who is lying on cold ground is losing the most amount of heat by what mechanism?
conduction
In a hypothermic patient the coldest blood is found in what part of the patient’s body?
Extremities
Applying an external source of heat to the patient’s body to rewarm him is called ________ rewarming.
active
For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups?
Poor ability to regulate body temperature
The technique for central rewarming requires the application of heat to which of the following areas of the patient’s body?
Lateral chest, neck, armpits, and groin
Where should a constricting band be placed to reduce lymphatic flow after a venomous snake bite?
2 inches above and 2 inches below the bite
In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long?
30-45 seconds
Which of the following describes the condition of having an abnormally high body temperature?
Hyperthermia
You arrive on the scene to find a scuba diver on board a boat slumped over in the captain’s chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?
air embolism
Which of the following signs would you NOT expect to see in a patient suffering from severe hypothermia? A. skin cool to touch B. numbness C. drowsiness D. Shivering
D. Shivering
You respond to a construction site on a very hot summer day for a person “not acting right.” You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started “speaking gibberish” and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient’s skin is cool to the touch and dry, but his shirt is wet with visible salt rings. You suspect:
heat exhaustion
You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient’s friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first action?
suction the airway
