Exam 5- Ch. 25-30 Flashcards
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mmHg and her pulse is 130 beats/min and thready. You should:
a. Apply 100% oxygen and immediately transport
b. Place her supine and elevate her lower extremities
c. Perform a rapid head-to-toe physical assessment
d. Provide some form of positive-pressure ventilation
d. Provide some form of positive-pressure ventilation
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 applying 100% oxygen, you should:
a. Apply an automated external defibrillator (AED) and take his blood pressure
b. Prepare for immediate transport
c. Determine if he has cardiac problems
d. Apply bulky dressings to the sternum
b. Prepare for immediate transport
During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:
a. Assess the quality of her pulse
b. Repeat the primary assessment
c. Begin assisting her ventilations
d. Perform a secondary assessment
b. Repeat the primary assessment
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20’ and is lying unconscious on the ground; the power line is lying across his chest. You should:
a. Rapidly assess the patient after ensuring that the power line is not live
b. Apply insulated gloves and assume manual control of his c-spine
c. Quickly but carefully move the patient away from the power line
d. Manually stabilizing his head as your partner assesses for breathing
a. Rapidly assess the patient after ensuring that the power line is not live
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
a. Assist his ventilations with a bag-mask device
b. Suction his oropharynx for up to 15 seconds
c. Immobilize his spine and transport immediately
d. Pack his nostrils to stop the drainage of blood
b. Suction his oropharynx for up to 15 seconds
What is melena?
Dark tarry stool with or without visible blood
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 mmHg and his pulse is 120 beats/min and thready. Your should be MOST suspicious that this patient is experiencing:
a. An aortic aneurysm
b. Acute appendicitis
c. Gastrointestinal bleeding
d. Intrathoracic hemorrhaging
c. Gastrointestinal bleeding
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 mmHg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:
a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport
b. Assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport
c. Fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport
d. Apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport
a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport
A 45-year-old male was working on his roof when he fell approximately 12’, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:
a. Obtaining a Glasgow Coma Score value and give him oxygen
b. Immobilize his spine and perform a focused secondary exam
c. Allow him to refuse transport if his vital signs remain stable
d. Perform a rapid head-to-toe exam and immobilize his spine
b. Immobilize his spine and perform a focused secondary exam
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 mmHg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:
a. Visualize the vaginal area and pack the vagina with sterile dressings
b. Allow her to change her clothes and take a shower before you transport
c. Arrange for a rape crisis center representative to speak with the patient
d. Control any external bleeding, administer oxygen, and transport at once
d. Control any external bleeding, administer oxygen, and transport at once
A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:
a. Manually stabilize her left leg, apply a traction split, and then secure her to a long backboard or a scoop
b. Carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg
c. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps
d. Bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher
c. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps
While 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 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. Open abdominal trauma
b. Neck and facial fractures
c. Blunt trauma to the head
d. Lower extremity fractures
b. Neck and facial fractures
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:
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
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:
a. Requesting a paramedic ambulance
b. Carefully monitoring her vital signs
c. Rapidly transporting her to the hospital
d. Quickly immobilizing her spinal column
c. Rapidly transporting her to the hospital
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:
a. Transport to a trauma center.
b. A focused exam of her forearm.
c. Transport to a community hospital.
d. A secondary assessment at the scene.
a. Transport to a trauma center.
Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred 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 the injury to the:
a. Liver
b. Spleen
c. Pancreas
d. Gallbladder
b. Spleen
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient’s condition?
a. Compression of the head against the roof
b. Lateral bending of the neck during the crash
c. Impact of the head against the steering wheel
d. Whiplash injury to the neck during the rollover
a. Compression of the head against the roof
A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned?
a. 36%
b. 30%
c. 27%
d. 18%
b. 30%
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:
a. Administer oxygen via a nonrebreathing mask
b. Advise the child that he will need rabies shots
c. Ask the child’s father to try to locate the dog
d. Report the incident to the appropriate authorities
d. Report the incident to the appropriate authorities
A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:
a. Place a pillow under his arm and apply a sling
b. Straighten his arm and apply a board splint
c. Perform a rapid secondary assessment
d. Immobilize the injury with a sling and swathe
d. Immobilize the injury with a sling and swathe
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
a. Carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing.
b. Thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.
c. Replace the avulsed flap to its original position and cover it with a sterile dressing.
d. Carefully probe the wound to determine if the bleeding is venous or arterial.
c. Replace the avulsed flap to its original position and cover it with a sterile dressing.
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
a. Is wearing only a lap belt.
b. Remains within the vehicle.
c. Is ejected or partially ejected.
d. Experiences multiple impacts.
c. Is ejected or partially ejected.
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:
a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
b. Assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport.
c. Fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport.
d. Apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.
a. Apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:
a. Cover both of his eyes and transport to the hospital.
b. Cover his right eye and flush the left eye with saline.
c. Scrape the splinter away with moist, sterile gauze.
d. Remove the object with a cotton-tipped applicator.
a. Cover both of his eyes and transport to the hospital.
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:
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.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash.
a. thoracic and sacral
b. lumbar and coccygeal
c. thoracic and lumbar
d. lumbar and sacral
c. thoracic and lumbar
The energy of a moving object is called:
a. latent energy.
b. kinetic energy.
c. potential energy.
d. converted energy.
b. kinetic energy.
Two of the MOST common mechanisms of injury for blunt trauma are:
a. falls and motor vehicle collisions.
b. low-caliber gunshot wounds and falls.
c. gunshot wounds and vehicle ejections.
d. motor vehicle collisions and stabbings
a. falls and motor vehicle collisions.
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:
a. determine the vehicle’s speed at the time of impact.
b. assess the severity of the third collision of the crash.
c. recognize if the driver hit the brakes before impact.
d. identify contact points and predict potential injuries.
d. identify contact points and predict potential injuries.
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for:
a. injury to the cervical spine.
b. potential airway compromise.
c. damage to internal structures.
d. alterations in his mental status.
b. potential airway compromise.
Which of the following statements regarding low-energy penetrating injuries is correct?
a. Internal injuries caused by low-velocity bullets are usually easy to predict.
b. Exit wounds are typically easy to locate with low-energy penetrating injuries.
c. It is usually easy to differentiate between an entrance wound and an exit wound.
d. The area of injury is usually close to the path the object took through the body.
d. The area of injury is usually close to the path the object took through the body.
Which of the following patients has experienced the MOST significant fall?
a. a 4′8″ patient who fell 12 feet
b. a 5′0″ patient who fell 13 feet
c. a 4′6″ patient who fell 13 feet
d. a 5′9″ patient who fell 14 feet
a. a 4′8″ patient who fell 12 feet
When treating a patient who experienced a pulmonary blast injury, you should:
a. use a demand valve to ventilate the patient.
b. suspect an accompanying cardiac tamponade.
c. avoid giving oxygen under positive pressure.
d. administer large amounts of intravenous fluid.
c. avoid giving oxygen under positive pressure.
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
a. the speed of the fall.
b. the surface struck.
c. the height of the fall.
d. the primary impact point.
a. the speed of the fall.
In contrast to a Level III trauma center, a Level I trauma center must:
a. be involved in trauma prevention programs.
b. have general surgeons who are in-house 24 hours a day.
c. have access to an emergency physician within 30 minutes.
d. be able to stabilize patients before transferring to a higher level facility.
b. have general surgeons who are in-house 24 hours a day.
Internal injuries caused by gunshot wounds are difficult to predict because:
a. the caliber of the bullet is frequently unknown.
b. the area of damage is usually smaller than the bullet.
c. the bullet may tumble or ricochet within the body.
d. exit wounds caused by the bullet are usually small.
c. the bullet may tumble or ricochet within the body.
When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the:
A. index of suspicion.
B. mechanism of injury.
C. kinetic energy.
D. potential energy
B. mechanism of injury.
The function of the blood is to _______ all of the body’s cells and tissues
A. Remove oxygen from
B. Deliver nutrients to
C. Carry waste products to
D. All of the above
B. Deliver nutrients to
The cardiovascular system consists of
A. A pump
B. A container
C. Fluid
D. All of the above
D. All of the above
Blood leaves each chamber of a normal heart through a
A. Vein
B. Artery
C. One way valve
D. Capillary
C. One way valve
Blood enters the right atrium from the
A. Coronary arteries
B. Lungs
C. Vena cava
D. Coronary veins
C. Vena cava
Blood enters the left atrium from the
A. Coronary arteries
B. Lungs
C. Vena cava
D. Coronary veins
B. Lungs
The only arteries of the body that carry deoxygenated blood are the
A. Pulmonary arteries
B. Coronary arteries
C. Femoral arteries
D. Subclavian arteries
A. Pulmonary arteries
