Paramedic Phase2 Test Flashcards
- During an explosion, secondary blast injuries occur when:
A) hollow organs rupture due to the pressure wave.
B) the patient is thrown against a stationary object.
C) the patient sustains severe burns from the intense heat.
D) the patient is struck by flying debris, such as shrapnel.
d
64. Which of the following organs is LEAST susceptible to pressure changes caused by an explosion? A) Liver B) Lungs C) Tympanic membrane D) Gastrointestinal tract
a
2. The energy stored in an object, such as a bridge pillar, is called \_\_\_\_\_\_\_\_\_\_ energy, and the energy from motion is called \_\_\_\_\_\_\_\_\_\_ energy. A) kinetic, potential B) barometric, kinetic C) potential, kinetic D) chemical, potential
c
. Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A) Index of suspicion B) Past medical history C) Age of the patient D) Mechanism of injury
d
The primary determinants of the extent of trauma a patient sustains are the:
A) type of object that strikes a patient and the part of the body that sustains the most impact.
B) amount of energy in the object and the mechanism by which the object is delivered to the body.
C) size of the object that strikes the body and any secondary injuries that occur if the patient falls.
D) physical size of the patient and the part of the body that sustains direct impact from an object.
b
- After a motorcyclist is ejected from his or her motorcycle, secondary collisions:
A) most commonly involve a stationary object.
B) cause an unpredictable combination of blunt injuries.
C) typically cause bilateral fractures of the femurs and tibias.
D) result in less severe injuries if the rider is wearing leather.
b
caused by inflammation of the peritoneum (membrane lining the abdominal organs and cavity).
peritonitis
. When an adult pedestrian is struck by a motor vehicle, lateral and posterior injuries are most common because:
A) the patient is thrust onto the hood of the vehicle.
B) adults tend to turn to the side or away from the impact.
C) the patient is thrown and lands on his or her side or back.
D) the initial impact by the bumper spins the patient to the side.
b
- Unlike adults, children who are struck by a motor vehicle are MORE likely to:
A) be run over by the vehicle as they are propelled to the ground.
B) experience injuries to the lower extremities from the initial impact.
C) be propelled onto the hood of the vehicle during the second impact.
D) turn away from the oncoming vehicle, resulting in posterior trauma.
a
- The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT:
A) objects inside the vehicle.
B) the physical size of the patient.
C) the design of the motor vehicle.
D) safety features of the motor vehicle.
b
26. The third phase of a motor vehicle accident involves: A) crush injuries to the body. B) impact by another vehicle. C) deceleration of internal organs. D) injuries caused by flying debris.
c
A patient with hemorrhagic shock would be expected to have: A) warm, flushed skin. B) flattened jugular veins. C) a widened pulse pressure. D) an increased hematocrit.
b
28. Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burns
d
. You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should:
A) administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route.
B) administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route.
C) apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.
D) control the bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport.
c
When applying a tourniquet to control major external hemorrhage from an extremity injury, you should:
A) apply the tourniquet over a joint, as this will further help compress blood vessels.
B) maintain direct pressure to the wound until the tourniquet has been fully applied.
C) secure the tourniquet in place until the pulses distal to the injury have weakened.
D) apply a pressure dressing over the tourniquet to further help control the bleeding.
b
33. A healthy adult can tolerate blood loss of up to \_\_\_\_ mL over a period of 15 to 20 minutes without any negative effects. A) 500 B) 750 C) 1,000 D) 1,500
a
The MOST significant factor that determines how well the body compensates for blood loss is:
A) the patient’s pulse rate at the time of the injury.
B) the period of time over which the blood is lost.
C) whether the bleeding is internal or external.
D) whether the bleeding is venous or arterial.
b
44. A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation? A) Closed head injury B) Bilateral femur fractures C) Proximal upper extremity fractures D) Sympathetic nervous system failure
b
. Much of the bleeding associated with unsplinted fractures continues because:
A) most fractures are unstable and usually lacerate major blood vessels.
B) swelling associated with such fractures prevents platelet aggregation.
C) bone ends will continue to move and destroy partially formed clots.
D) patient anxiety increases the blood pressure, which exacerbates bleeding.
c
In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with: A) polyuria and weak pulses. B) bounding radial pulses. C) mottled skin and dilated pupils. D) restlessness and pale cool skin.
c
. Decompensated shock in the adult is characterized by: A) increased tidal volume. B) bounding radial pulses. C) 15% blood loss or more. D) a falling blood pressure.
d
External bleeding would be the MOST difficult to control in a patient with a large laceration to the \_\_\_\_\_\_\_\_\_\_\_\_\_ and a blood pressure of \_\_\_\_\_\_ mm Hg. A) jugular vein, 96/62 B) brachial artery, 68/46 C) femoral vein, 114/60 D) carotid artery, 100/70
d
- Afterload is defined as the:
A) pressure in the aorta against which the left ventricle must pump.
B) amount of resistance to blood flow offered by the heart valves.
C) amount of blood ejected from the ventricle with each contraction.
D) volume of blood remaining in the ventricles following contraction.
a
Which of the following statements regarding blood flow is correct?
A) Ejection fraction is the percentage of blood that the heart pumps per contraction.
B) If more blood returns to the heart, stroke volume decreases and cardiac output falls.
C) As more blood is pumped with each contraction, the ejection fraction increases.
D) The amount of blood that returns to the atrium remains fixed from minute to minute.
a
The swelling that occurs in conjunction with a contusion is caused by:
A) inflammation of the injured blood vessels.
B) rupture of large blood vessels in the dermis.
C) aggregation of platelets to the injured site.
D) leakage of fluid into spaces between the cells.
d
In contrast to a contusion, a hematoma is: A) accompanied by ecchymosis. B) caused by large vessel damage. C) rarely accompanied by a bruise. D) a less significant closed injury.
b
. You should splint an open soft-tissue injury to an extremity because:
A) most patients do not keep the extremity still when asked to do so.
B) most open soft-tissue injuries are associated with a fracture.
C) splinting is an excellent means of providing relief from pain.
D) motion of the extremity may disrupt the blood-clotting process.
d
Your MAIN concern when caring for a patient with a soft-tissue injury to the face should be: A) airway compromise. B) hypovolemic shock. C) injuries to the eyes. D) preventing contamination.
a
. Which of the following statements regarding soft-tissue injuries is correct?
A) Most soft-tissue injuries require immediate care to prevent blood loss.
B) They are often the most obvious, but are seldom the most life threatening.
C) Soft-tissue injuries should be covered immediately upon patient contact.
D) Most soft-tissue injuries are hidden and require a systematic assessment.
b
When the ambient temperature is high:
A) the dermis produces less collagen, which temporarily decreases the skin’s ability to retain warmth.
B) blood vessels in the dermis dilate, which increases blood flow to the skin and allows heat to dissipate.
C) sweat glands in the epidermis produce sweat, which is evaporated from the skin surface by the air.
D) constriction of the vessels in the dermis brings warm blood to the surface of the skin, where it is eliminated.
b
The skin helps regulate body temperature through:
A) peripheral vasodilation, which shunts cool blood to the core of the body.
B) the production of sweat, which is evaporated from the surface of the skin.
C) increased elastin production, which provides insulation to the epidermis.
D) cutaneous vasoconstriction, which brings warm blood to the skin’s surface.
b
A 41-year-old man was assaulted during a robbery attempt. Your primary assessment reveals that the patient is semiconscious. He has massive soft-tissue trauma to the face, inadequate breathing, and oropharyngeal bleeding. You should:
A) apply direct pressure to his facial wounds and promptly intubate him.
B) suction the blood from his mouth and assist ventilations with a bag-mask device.
C) insert a nasal airway, apply oxygen via nonrebreathing mask, and transport.
D) suction his oropharynx for 30 seconds and then perform endotracheal intubation.
b
A 22-year-old man was struck in the forehead by a softball. He is conscious and alert, but complains of a severe headache. Your assessment reveals a large hematoma to his forehead. His vital signs are stable and his breathing is adequate. You should:
A) apply firm manual pressure to the hematoma to reduce internal bleeding.
B) place him in a sitting position and apply a chemical heat pack to his head.
C) apply an icepack to the hematoma and monitor his level of consciousness.
D) start an IV of normal saline and administer 2 mg of morphine for the pain.
c
Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called: A) tetanus. B) gangrene. C) fasciitis. D) lymphedema.
b
- Which of the following statements regarding crush injury is correct?
A) A crush injury can occur if the PASG is left in place for greater than 1 hour.
B) Gangrene often sets in if a body part is entrapped for longer than 30 minutes.
C) Crush syndrome can occur if the body part is entrapped for more than 4 hours.
D) In a crush injury, the external appearance is a good predictor of internal damage.
c
You and your partner are transferring a severely burned patient from a community hospital to a burn specialty center. The patient, a 110-pound woman, has partial- and full-thickness burns that cover approximately 55% of her body. She has two large-bore IV lines in place, is intubated, and is on a cardiac monitor. According to the Parkland formula, how much normal saline should she receive in 30 minutes? A) 340 mL B) 355 mL C) 370 mL D) 395 mL
a
- A superficial burn is:
A) usually painless because the nerve endings are not exposed.
B) characterized by reddened skin with varying degrees of pain.
C) painful, but will heal spontaneously, often with scar formation.
D) a second-degree burn that is characterized by blister formation.
b
Which of the following burn injuries would MOST likely require transport to a burn specialty center?
A) Superficial burns to more than 40% of the body
B) Burns that involve the hands, feet, or genitalia
C) Partial-thickness burns to more than 5% of the body
D) Any burn that occurs in a child under 5 years of age
b
You and your partner are transferring a severely burned patient from a community hospital to a burn specialty center. The patient, a 110-pound woman, has partial- and full-thickness burns that cover approximately 55% of her body. She has two large-bore IV lines in place, is intubated, and is on a cardiac monitor. According to the Parkland formula, how much normal saline should she receive in 30 minutes? A) 340 mL B) 355 mL C) 370 mL D) 395 mL
a
According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face, and anterior chest has burns to \_\_\_\_% of his total body surface area. A) 18 B) 27 C) 36 D) 45
a
Which of the following statements regarding the rule of palms is correct?
A) The patient’s palm, excluding the fingers, represents 1% of his or her total body surface area.
B) The rule of palms is not an accurate estimator of total body surface area burned in pediatric patients.
C) The patient’s palm, including the fingers, represents 1% of his or her total body surface area.
D) The rule of palms is most accurate when a patient has experienced burns to less than 20% of his or her total body surface area.
a
When assessing a patient with maxillofacial trauma, it is MOST important to:
A) gently palpate the maxilla, mandible, and zygoma to elicit crepitus.
B) protect the cervical spine and monitor the patient’s neurologic status.
C) apply a cervical collar and determine if the patient has visual disturbances.
D) have the patient open his or her mouth and assess for dental malocclusion.
b
- If you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and severe oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform:
A) nasotracheal intubation.
B) a needle or surgical cricothyrotomy.
C) pharmacologically assisted intubation.
D) digital (tactile) intubation.
b
A young man was assaulted and has extensive maxillofacial injuries. Your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. Initial management for this patient involves:
A) inserting an oropharyngeal airway, preoxygenating him with a bag-mask device for 2 minutes, and then intubating his trachea.
B) applying a cervical collar, performing a blind finger sweep to clear his airway, and providing ventilatory assistance with a bag-mask device.
C) fully immobilizing his spine, inserting a nasopharyngeal airway, and hyperventilating him with a bag-mask device at a rate of 20 breaths/min.
D) manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen.
d
Hyphema is defined as:
A) severe ecchymosis to the orbital region.
B) blood in the anterior chamber of the eye.
C) marked swelling of the globe of the eye.
D) double vision following blunt eye trauma.
b
A fracture of all midfacial bones, separating the entire midface from the cranium:
A) is commonly associated with facial elongation and dental malocclusion.
B) should be stabilized by placing bulky dressings across the fractured area.
C) is almost always accompanied by multiple severe fractures of the mandible.
D) is referred to as a Le Fort I fracture and most commonly results from a fall.
a
Because significant force is required to fracture the mandible:
A) most mandibular fractures are associated with a spinal fracture.
B) it is often fractured in more than one place and is unstable to palpation.
C) patients with a possible mandibular fracture should be intubated routinely.
D) a mandibular fracture can be ruled out in cases of minor blunt facial trauma.
b
Because significant force is required to fracture the mandible:
A) most mandibular fractures are associated with a spinal fracture.
B) it is often fractured in more than one place and is unstable to palpation.
C) patients with a possible mandibular fracture should be intubated routinely.
D) a mandibular fracture can be ruled out in cases of minor blunt facial trauma.
b
. If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be MOST suspicious for a(n): A) Le Fort II fracture. B) nasal bone fracture. C) orbital skull fracture. D) basilar skull fracture.
c
A flattened appearance to the face and loss of sensation over the cheek following blunt facial trauma is MOST indicative of a(n): A) zygomatic fracture. B) orbital skull fracture. C) Le Fort I fracture. D) temporomandibular joint dislocation.
a
. Early signs and symptoms of increased intracranial pressure include: A) headache and vomiting. B) hypertension and bradycardia. C) widening of the pulse pressure. D) arm flexion and leg extension.
a
- Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT:
A) rapidly increasing intracranial pressure.
B) an underlying skull fracture.
C) a fluctuating level of consciousness.
D) unilateral hemiparesis or slurred speech.
a
What type of intracranial hemorrhage would MOST likely be caused by a penetrating head injury? A) Subdural hematoma B) Intracerebral hematoma C) Epidural hematoma D) Subarachnoid hemorrhage
b
Cerebrospinal fluid drainage from the ears is MOST indicative of: A) a nasal fracture. B) intracerebral bleeding. C) an epidural hematoma. D) a skull fracture.
d
A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include:
A) applying a cervical collar and assisting his ventilations with a bag-mask device.
B) rolling the patient onto his side as a unit and suctioning his mouth for 15 seconds.
C) performing a tongue-jaw lift and looking in his mouth for any obvious obstructions.
D) manually stabilizing his head and opening his airway with the jaw-thrust maneuver.
d
- Upon arriving at the scene of a motor vehicle crash, you find the driver of the car still seated in her two-door vehicle. The passenger side of the vehicle has sustained severe damage and is inaccessible. The driver is conscious and alert and complains only of lower back pain. The backseat passenger, a young child who was unrestrained, is bleeding from the head and appears to be unconscious. You should:
A) ask the driver to step out of the vehicle so you can access the backseat passenger.
B) rapidly extricate the driver so you can gain quick access to the child in the backseat.
C) carefully assess the driver for occult injuries before removing her from the vehicle.
D) apply a vest-type extrication device to the driver and quickly remove her from the car.
b
A 39-year-old man crashed his vehicle into a wooded area and was not found for approximately 8 hours. When you arrive at the scene and assess him, you note that he is conscious but anxious. He is unable to feel or move below his mid-thoracic area and complains of a severe headache. His blood pressure is 210/130 mm Hg, heart rate is 44 beats/min, and respirations are 22 breaths/min. This patient's clinical presentation is MOST consistent with: A) neurogenic shock. B) intracranial pressure. C) autonomic dysreflexia. D) symptomatic bradycardia.
c
Most head injuries are the result of: A) assault or abuse. B) motor vehicle crashes. C) sports-related incidents. D) falls from a significant height.
b
When an unrestrained passenger’s head strikes the windshield of a motor vehicle following rapid deceleration:
A) the anterior portion of the brain sustains stretching or tearing injuries, and the posterior portion of the brain sustains compression injuries.
B) the head falls back against the headrest or seat and the brain collides with the rear of the skull, resulting in direct injury to the occipital lobe.
C) the brain initially strikes the rear of the skull, resulting in direct bruising, and then rebounds and strikes the front part of the skull.
D) compression injuries occur to the anterior portion of the brain, and stretching or tearing injuries occur to the posterior portion of the brain.
d
According to the National Spinal Cord Injury Database, MOST spinal cord injuries are caused by: A) acts of violence. B) athletic activities. C) falls in the elderly. D) motor vehicle crashes.
d
