Quiz 15

Question 1

When a person is lying supine at the end of exhalation, the diaphragm:

1 contracts and flattens inferiorly.

2 may rise as high as the nipple line.

3 is less prone to penetrating trauma.

4 descends below the level of the navel.

Answer 1

2

Question 2

Which of the following is not a sign of a chest wall injury?

1 tachypnea.

2 hematemesis.

3 localized pain.

4 chest wall ecchymosis.

Answer 2

2

Question 3

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

1 insert an oropharyngeal airway.

2 obtain a set of baseline vital signs.

3 perform a focused secondary exam.

4 immediately request ALS support.

Answer 3

4

Question 4

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

1 ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

2 asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta

3 fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia

4 collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest

Answer 4

1

Question 5

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:

1 massive hemothorax.

2 tension pneumothorax.

3 pericardial tamponade.

4 laceration of the aorta.

Answer 5

4

Question 6

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:

1 Kehr sign.

2 Cullen sign.

3 Grey Turner sign.

4 Brudzinski sign.

Answer 6

1

Question 7

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

1 transport only if signs of shock begin to develop.

2 carefully probe the wound to determine its depth.

3 assume that the arrow injured an internal organ.

4 clean the wound, apply a dry, sterile dressing, and sign a refusal form.

Answer 7

3

Question 8

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

1 perform a comprehensive secondary assessment to determine why his clinical status has changed.

2 insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

3 reassess his vital signs and then notify the receiving hospital of the change in his clinical status.

4 suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

Answer 8

2

Question 9

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

1 applying direct pressure with a dry, sterile dressing.

2 covering the avulsion with moist, sterile dressings.

3 requesting a paramedic to administer pain medication.

4 administering 100% oxygen via a nonrebreathing mask.

Answer 9

1

Question 10

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

1 What does your blood pressure normally run?

2 Do you take any over-the-counter medications?

3 Has blood soaked through your undergarments?

4 Have you experienced recent abdominal trauma?

Answer 10

4

Question 11

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

1 theorize as to why the sexual assault occurred.

2 include the results of his or her internal vaginal exam.

3 include a description of the suspected perpetrator.

4 avoid speculation and document only factual data.

Answer 11

4

Question 12

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 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

1 visualize the vaginal area and pack the vagina with sterile dressings.

2 allow her to change her clothes and take a shower before you transport.

3 arrange for a rape crisis center representative to speak with the patient.

4 control any external bleeding, administer oxygen, and transport at once.

Answer 12

4

Question 13

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

1 radiation.

2 conduction.

3 convection.

4 evaporation.

Answer 13

2

Question 14

The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:

1 radiation.

2 conduction.

3 convection.

4 evaporation.

Answer 14

3

Question 15

The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:

1 radiation.

2 convection.

3 conduction.

4 evaporation.

Answer 15

4

Question 16

The body’s natural protective mechanisms against heat loss are:

1 shivering and vasodilation.

2 vasodilation and respiration.

3 respiration and vasoconstriction.

4 vasoconstriction and shivering.

Answer 16

4

Question 17

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

1 blood is shunted away from the extremities to the body’s core.

2 peripheral vasodilation brings warm blood to the skin’s surface.

3 the major muscles of the body become rigid during hypothermia.

4 the patient is usually unable to escape the cold ambient temperature.

Answer 17

1

Question 18

A frostbitten foot can be identified by the presence of:

1 gross deformity.

2 soft, smooth skin.

3 mottling and blisters.

4 blanching of the skin.

Answer 18

3

Question 19

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:

1 apply an AED and assess his cardiac rhythm.

2 assess for a carotid pulse for more than 15 seconds.

3 open his airway and give two rescue breaths.

4 apply chemical heat packs to his groin and axillae.

Answer 19

2

Question 20

The two MOST efficient ways for the body to eliminate excess heat are:

1 respiration and bradycardia.

2 perspiration and tachycardia.

3 sweating and dilation of skin blood vessels.

4 hyperventilation and tachycardia.

Answer 20

3

Question 21

In order for sweating to be an effective cooling mechanism:

1 several layers of clothing must be worn.

2 it must be able to evaporate from the body.

3 the relative humidity must be above 90%.

4 the body must produce at least 1 L per hour.

Answer 21

2

Question 22

High humidity reduces the body’s ability to lose heat through:

1 radiation.

2 convection.

3 conduction.

4 evaporation.

Answer 22

4

Question 23

Heatstroke occurs when:

1 a person’s core body temperature rises above 103°F (39°C).

2 the body’s heat-eliminating mechanisms are overwhelmed.

3 a person becomes dehydrated secondary to excess water loss.

4 the ambient temperature exceeds 90°F (32°C) and the humidity is high.

Answer 23

2

Question 24

The EMT must assume that any unwitnessed water-related incident is accompanied by:

1 an air embolism.

2 alcohol intoxication.

3 possible spinal injury.

4 cold water immersion.

Answer 24

3

Question 25

Which of the following statements regarding drowning is correct?

1 Hypoxia in the drowning victim initially occurs due to water in the lungs.

2 Artificial ventilations can easily be performed in patients with a laryngospasm.

3 Large amounts of water enter the lungs in a small number of drowning victims.

4 Laryngospasm following submersion in water makes rescue breathing difficult.

Answer 25

4

Question 26

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

1 suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once.

2 initiate CPR, apply a cervical collar, remove his wet clothing, and transport rapidly.

3 provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.

4 apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.

Answer 26

3

Question 27

An air embolism associated with diving occurs when:

1 the diver hyperventilates prior to entering the water.

2 the diver holds his or her breath during a rapid ascent.

3 the alveoli completely collapse due to high pressure.

4 high water pressure forces air into the mediastinum.

Answer 27

2

Question 28

Which of the following is not a signs and symptoms of an air embolism:

1 dysphasia.

2 pale skin.

3 dizziness.

4 joint pain.

Answer 28

2

Question 29

The MOST prominent symptom of decompression sickness is:

1 tightness in the chest.

2 difficulty with vision.

3 dizziness and nausea.

4 abdominal or joint pain.

Answer 29

4

Question 30

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

1 suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.

2 place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department.

3 suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber.

4 position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-mask device, and contact medical control for further guidance.

Answer 30

1

Question 31

In contrast to the brown recluse spider, the black widow spider:

1 is very small and has a violin-shaped marking on its back.

2 is large and has a red-orange hourglass mark on its abdomen.

3 has a bite that is typically painless until a blister develops.

4 has a bite that usually produces local pain but no systemic signs or symptoms.

Answer 31

2

Question 32

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient’s abdomen is rigid and painful to palpation. You should suspect:

1 a black widow spider bite.

2 envenomation from a pit viper.

3 a brown recluse spider bite.

4 Rocky Mountain spotted fever.

Answer 32

1

Question 33

All of the following snakes are pit vipers, EXCEPT for the:

1 copperhead.

2 rattlesnake.

3 coral snake.

4 cottonmouth

Answer 33

3