Take Home Test 4 Flashcards
What is the definition of multiple trauma?
A) A trauma that requires the response of multiple agencies
B) A trauma in which the patient has more than one serious injury
C) A trauma in which there are multiple casualties
D) Multiple injuries that affect more than one body system
B) A trauma in which the patient has more than one serious injury
According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a
patient should be transported to a trauma center patient should be transported to a trauma center.
A) 110
B) 90
C) 100
D) 80
B) 90
What is the highest Glasgow Coma Scale (GCS) measurement indicating altered mental status
according to CDC guidelines?
A) 12
B) 14
C) 8
D) 13
D) 13
You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make
note that the occupants of both vehicles are outside, and you request additional units to proceed
non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During
secondary assessment of past medical history, you make note of several important details: the
patient is on high blood pressure medications and has had a heart attack in the past. He is
complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may
have been from the seat belt, but is refusing care and transport. The patient did not lose
consciousness. Based on this information, which transport decision would be most appropriate for
this patient?
A) Have the patient to sign a refusal form.
B) Take the patient to a trauma center.
C) Explain to the patient the need for transport to a local community hospital.
D) Call for ALS intercept.
C) Explain to the patient the need for transport to a local community hospital.
What are some of the most important critical decisions an EMT can make on the scene of a serious
trauma?
A) Determining patient severity, amount of time on scene, and transport destination
B) Deciding whether to treat life-threatening injuries on scene or to load and go
C) Diagnosing the causes for a patient’s presentation and identifying a course of definitive care
D) Determining the potential liability involved in performing life-saving interventions
A) Determining patient severity, amount of time on scene, and transport destination
Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has
abrasions on both knees and the palms of both hands, which are oozing blood. This is an example
of bleeding from which of the following types of vessels?
A) Capillaries
B) Venules
C) Veins
D) Arteries
A) Capillaries
The most common form of hemostatic agent is:
A) discs.
B) granules.
C) powders.
D) gauze or dressings.
D) gauze or dressings.
External bleeding may be classified according to types. Which of the following is one of those
types?
A) Liver bleeding
B) Capillary bleeding
C) Cardiac bleeding
D) Brain bleeding
B) Capillary bleeding
In which of the following vessels does the vital exchange of oxygen, nutrients, and wastes take
place?
A) Capillaries
B) Veins
C) Arterioles
D) Venules
A) Capillaries
Which of the following vessels contain blood under the highest amount of pressure?
A) Veins
B) Venules
C) Capillaries
D) Arteries
D) Arteries
Which of the following is responsible for most of the early signs and symptoms of shock?
A) Constriction of the peripheral blood vessels
B) Increased respirations of the patient
C) Dilation of the peripheral blood vessels
D) The body’s attempts at compensation for blood loss
D) The body’s attempts at compensation for blood loss
Which of the following signifies a failure in the patient’s compensatory response to blood loss?
A) Tachycardia
B) Tachypnea
C) Pale, cool skin
D) Hypotension
D) Hypotension
Which of the following statements about treating a patient who appears to be in shock is false?
A) The patient should be promptly put on high-concentration oxygen.
B) Prompt transportation is a very high priority.
C) Airway management is a top priority.
D) Spend time on scene to correct the causes of the shock so it does not worsen.
D) Spend time on scene to correct the causes of the shock so it does not worsen.
Which of the following is the most important reason for controlling external bleeding?
A) To prevent and manage hypoperfusion
B) To make clean-up of the ambulance and your equipment easier after the call
C) To prevent the patient from becoming upset at the sight of blood
D) To prevent the spread of infectious diseases
A) To prevent and manage hypoperfusion
Which of the following statements about the application of a tourniquet is incorrect?
A) If possible, the tourniquet should be placed on a joint.
B) The tourniquet should be placed approximately 2 to 3 inches above the bleeding.
C) Commercial tourniquets are preferable to improvised tourniquets.
D) The tourniquet should be at least 2 inches wide.
A) If possible, the tourniquet should be placed on a joint.
Which of the following is not a consequence of hypoperfusion?
A) Cells are not supplied with oxygen.
B) Acid buildup decreases and body pH increases.
C) Cells are not supplied with nutrients.
D) Cellular waste products are not removed.
B) Acid buildup decreases and body pH increases.
Shock is the circulatory system’s failure to provide sufficient blood and oxygen to all the body’s
tissues. Which of the following is not a major type of shock?
A) Hemorrhagic
B) Hypovolemic
C) Hypervolemic
D) Cardiogenic
C) Hypervolemic
Which of the following best explains the reason for minimizing scene time for the trauma patient
with significant hemorrhage or the potential for significant hemorrhage?
A) It gives the EMT less opportunity to make mistakes in the patient’s care.
B) It is essential to get the shock patient to more definitive care.
C) The clock for the “golden hour” of trauma begins at the time of your arrival.
D) There is nothing the EMT can do for a patient in shock
B) It is essential to get the shock patient to more definitive care.
Which of the following blood vessels cannot stop bleeding by constricting?
A) Arterioles
B) Capillaries
C) Veins
D) Arteries
B) Capillaries
Which of the following is not recommended when controlling epistaxis?
A) Placing the unconscious patient in the recovery position
B) Keeping the patient calm and quiet
C) Having the patient tilt the head backward to elevate the nose
D) Pinching the nostrils together
C) Having the patient tilt the head backward to elevate the nose
Which of the following is of concern in a patient who received burns to his hand when he grabbed
a live electrical wire?
A) The patient remains an electrocution hazard to rescuers for several minutes after being
removed from the source of electricity.
B) Toxic gases were inhaled.
C) The extent of tissue damage may be much greater than it appears on the surface.
D) The burning will continue for hours, perhaps days
C) The extent of tissue damage may be much greater than it appears on the surface.
An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a
fallen tree, that results in damage to underlying structures, bleeding, and inflammation is called
a(n):
A) abrasion.
B) avulsion.
C) contusion.
D) crush injury.
D) crush injury.
A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site?
A) Bleeding from the wound is minimal.
B) The patient’s distal pulse, motor function, and sensation are intact.
C) The nail is less than 2 inches in length.
D) None of the above
D) None of the above
Which of the following is a consideration in determining a burn’s severity?
A) Body surface area (BSA) involved in the burn
B) The type of agent that caused the burn
C) Other illnesses or injuries the patient may have
D) All of the above
D) All of the above
You are dispatched to a local industrial plant for an “electrical injury.” You arrive on-scene and find a 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next step?
A) Stay with the patient awhile, and if he does not appear to be in distress, encourage him to refuse care.
B) Load and go–conduct any other care in the ambulance en route due to the potential seriousness of the burns.
C) Put the patient on oxygen and help him into your ambulance. D) While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.
D) While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.
You are dispatched to an industrial plant for a burn. You arrive and find a 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you do?
A) Before doing treatment, call the local burn center for instruction.
B) Care for the burn and do a complete patient assessment, including cervical spine precautions.
C) Call for air transport and continue to pour water on the burns until transport arrives.
D) Because of his age, immediately put him in your ambulance and transport him to a burn center.
B) Care for the burn and do a complete patient assessment, including cervical spine precautions.
Which of the following is not considered soft tissue?
A) Muscles
B) Membranes
C) Cartilage
D) The skin
C) Cartilage
You are dispatched to the local high school for a “person struck with a baseball.” You arrive on the scene and find a 16-year-old male sitting on the bench. Apparently he was the pitcher and was
struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the
ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are
normal. What is the next step?
A) Tell the coach the patient is okay and he can go back into the ball game.
B) Have the patient walk to the ambulance and take him to the ED. No other care needs to be provided, as there is really no significant sign of any injury.
C) Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes.
D) Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport.
D) Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport.
Your patient is a 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the
prehospital setting?
A) Push the hook through the wound to avoid further damage from the barbed end.
B) Pull the hook out from the same direction in which it entered the hand.
C) Leave the hook in place and try not to disturb it.
D) Apply a pressure dressing over the hook.
C) Leave the hook in place and try not to disturb it.
Which of the following is the outermost layer of the skin?
A) Dermis
B) Epidermis
C) Fascia
D) Adipose tissue
B) Epidermis
Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?
A) Central nervous system
B) Peripheral nervous system
C) Autonomic nervous system
D) All of the above
B) Peripheral nervous system
Which of the following causes worsening of the damage in a brain injury?
A) Improper management of airway and ventilation
B) Allowing seepage of cerebrospinal fluid (CSF) from the ears or
nose
C) Administration of 100% oxygen
D) Failure to keep the patient awake and talking
A) Improper management of airway and ventilation
When using a short spine immobilization device, which part of the body is secured last?
A) Legs
B) Head
C) Torso
D) Arms
B) Head
Which of the following is a sign of possible brain injury?
A) Projectile vomiting
B) Deep laceration of the scalp
C) Irregular breathing patterns
D) All of the above
D) All of the above
Your patient has had his throat slashed during a robbery attempt. You are concerned because it is apparent that the vessels in his neck have been lacerated. A breach in which of the following
vessels would be most likely to lead to an air embolism?
A) Arteries
B) Capillaries
C) Veins
D) Arterioles
C) Veins
Messages from the body to the brain are carried by which of the following types of nerves?
A) Cranial
B) Sensory
C) Skeletal
D) Motor
B) Sensory
You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a
pulse of 60 beats per minute, and slightly irregular breathing. The patient’s presentation is most likely caused by which of the following?
A) Increased arterial pressure
B) Coup-contrecoup injury
C) Increased intracranial pressure
D) Closed head injury
C) Increased intracranial pressure
Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You immobilize him on a long spine board with a cervical collar
on his neck as a precaution because you know that the:
A) coccyx is easily dislocated.
B) cervical spine is not supported by other bony structures.
C) thoracic spine is especially vulnerable to injury.
D) lumbar area is rarely injured due to the rib support.
B) cervical spine is not supported by other bony structures.
The bony bumps you feel along the center of a person’s back are known as which of the following?
A) Dermatome
B) Foramen magnum
C) Vertebrae
D) Spinous process
D) Spinous process
Your patient is a 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate intervention?
A) Carefully rotate the patient’s head to check for trauma.
B) Hyperventilate at a rate of 24 breaths per minute using
supplemental oxygen.
C) Provide cervical spine immobilization.
D) Log-roll the patient onto a short spine board.
C) Provide cervical spine immobilization.
You are treating a 35-year-old male patient who has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient’s skin is flushed and warm. The patient’s presentation is most likely caused by which of the following?
A) Neurogenic shock
B) Priapism
C) Air embolism
D) Increased intracranial pressure
A) Neurogenic shock
While assessing a patient with a laceration to the neck, the EMT must be aware that which of the
following conditions may develop?
A) Contusion
B) Concussion
C) Increasing intracranial pressure
D) Air embolus
D) Air embolus
Which of the following is not a common field finding in spinal injuries?
A) Pain with movement
B) Deformity
C) Impaired breathing
D) Tenderness
B) Deformity
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?
A) Increased pulse rate
B) Glasgow Coma Scale (GCS) of 15
C) Constricted pupils
D) Increased blood pressure
D) Increased blood pressure
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?
A) Battle sign
B) Cushing reflex
C) Tonic-clonic activity
D) Posturing
D) Posturing
Your 38-year-old male patient has been injured in an assault. He has several facial lacerations and a large knot on his head. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As part of your scene size-up and primary assessment, you should:
A) immobilize his cervical spine.
B) complete an initial set of vital signs.
C) wait for ALS to treat the patient.
D) splint any other bone or joint injuries.
A) immobilize his cervical spine.
Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long
spine board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You should:
A) place towels on either side of the helmet to stabilize it.
B) remove the helmet to better manage proper alignment.
C) tip his head back to gain neutral alignment.
D) pad under his shoulders to straighten his neck.
B) remove the helmet to better manage proper alignment.
How many cervical vertebrae are there?
A) 5
B) 7
C) 4
D) 12
B) 7
A young female was injured in an automobile wreck, striking her head on the windshield. She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68 and blood pressure 148/90, and her pupils are unequal. You should suspect a(n):
A) concussion.
B) open head injury.
C) contusion.
D) closed head injury.
D) closed head injury.
Which of the following describes the proper position of the patient’s head for spinal immobilization?
A) Neutral, inline position
B) The “sniffing” position
C) Chin tilted upward for airway maintenance
D) Stabilized in position found
A) Neutral, inline position
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?
A) Transport the patient non-emergently because he’s complaint free.
B) Begin transport non-emergently and upgrade if the patient’s condition deteriorates.
C) Transport the patient emergently because of the high index of suspicion for a serious injury.
D) The patient does not necessarily need transport, so allow him to refuse if he wants.
C) Transport the patient emergently because of the high index of suspicion for a serious injury.
Which of the following structures connect bone ends and allow for a stable range of motion?
A) Cartilage
B) Tendons
C) Periosteum
D) Ligaments
D) Ligaments
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) A posterior hip dislocation presents with a bent knee and the
foot may hang loose.
B) The posterior hip dislocation is the most common.
C) Often there is lack of sensation in the limb.
D) An anterior hip dislocation would probably present with the
entire lower limb rotated inward.
D) An anterior hip dislocation would probably present with the
entire lower limb rotated inward.
Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is not true?
A) You should always check for a distal pulse.
B) In a knee dislocation, the tibia is forced anteriorly or posteriorly in relation to the distal femur.
C) The lack of a distal pulse could be a signal of a real emergency.
D) In a patellar dislocation, the knee will be stuck in flexion but the
knee cap will not be displaced.
D) In a patellar dislocation, the knee will be stuck in flexion but the
knee cap will not be displaced.
Which of the following hazards may arise from properly splinting an injured extremity?
A) Converting a closed fracture to an open one
B) Ignoring life-threatening problems while focusing on an extremity injury
C) Compromising circulation to the extremity
D) All of the above
B) Ignoring life-threatening problems while focusing on an extremity injury
A new EMT who is treating a suspected femur injury asks his partner, “How much traction should I pull?” The partner’s best reply is which of the following?
A) The amount of traction applied should be 15 pounds.
B) No traction splint applied in the field pulls true traction; they must pull 20 pounds of countertraction.
C) The amount of traction applied should be roughly 10% of the patient’s body weight and not exceed 15 pounds.
D) Pull enough traction to give the patient some relief from the pain.
C) The amount of traction applied should be roughly 10% of the patient’s body weight and not exceed 15 pounds.
Which one of the following statements is not true concerning a knee injury?
A) There could be pain and tenderness.
B) Fractures can occur to the proximal tibia and fibula.
C) Fractures can occur to the patella.
D) Fractures can occur to the proximal femur.
D) Fractures can occur to the proximal femur.
The sound or feeling of the ends of broken bones rubbing together is called:
A) paresthesia.
B) angulation.
C) Crepitus
D) deformity.
C) Crepitus
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 ________.
A) wrist; elbow
B) fingertips; shoulder
C) wrist; shoulder
D) forearm; humerus
D) forearm; humerus
Which of the following describes an open extremity injury?
A) Bone ends have lacerated the soft tissues and skin from the inside.
B) A gunshot wound has penetrated the skin and then fractured the bone.
C) The joint capsule has been torn open during a dislocation.
D) Both A and B
D) Both A and B
A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder, it “pops back into place.” What should your next step be?
A) Contact medical control for input into the best treatment for this patient.
B) Report the popping sound to the receiving physician when you arrive at the hospital.
C) Check distal CSM, apply a sling and swathe, and transport the patient.
D) Check distal CSM, apply a traction splint, and transport the patient.
C) Check distal CSM, apply a sling and swathe, and transport the patient.
Which of the following statements is not true concerning a pelvic wrap?
A) It should not be used unless the patient shows signs of shock. B) It can be used if the pelvis shows instability.
C) It can be used if the pelvis shows deformity.
D) You can consider its use based on mechanism of injury (MOI)
A) It should not be used unless the patient shows signs of shock.
One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling
caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional
swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called?
A) Compartment syndrome
B) Fracture syndrome
C) Crushing syndrome
D) Perfusing syndrome
A) Compartment syndrome
Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the best way to immobilize this patient’s extremities prior to transport?
A) Use padded board splints for the upper extremities and a PASG for the lower extremities.
B) Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize
the fractures.
C) Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard.
D) Immobilize the patient to a long backboard without splinting the extremities individually.
D) Immobilize the patient to a long backboard without splinting the extremities individually.
Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms?
A) Direct force
B) Sudden acceleration
C) Twisting motion
D) Indirect force
D) Indirect force
Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient?
A) Seeing if you can elicit crepitus on palpation
B) Gently attempting to flex the mid-portion of the bone to check for angulation
C) Asking the patient to see if he can bear weight on the extremity
D) Comparing the injured side to the uninjured side
D) Comparing the injured side to the uninjured side
Which of the following allows for smooth movement of bone surfaces against one another at joints?
A) Smooth muscle
B) Tendons
C) Ligaments
D) Cartilage
D) Cartilage
Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following signs and symptoms
should you anticipate?
A) Patient demonstrates signs of shock
B) Patient feels the need to empty his bladder.
C) Patient cannot lift legs when lying supine.
D) All of the above.
D) All of the above.
Which of the following is a muscle injury caused by overstretching or overexertion of the muscle?
A) Strain
B) Sprain
C) Fracture
D) Luxation
A) Strain
Blood at the meatus of the penis (opening of the urethra) is a sign of:
A) pelvic trauma/fracture.
B) priapism.
C) pelvic dislocation syndrome.
D) spinal fracture or injury.
A) pelvic trauma/fracture.
The strong white fibrous material called the periosteum:
A) protects the perineum.
B) surrounds the abdominal cavity.
C) surrounds the heart.
D) covers the bones.
D) covers the bones.
Which of the following is not a benefit of splinting an injury to bones and connective tissues?
A) It may prevent a closed injury from becoming an open injury.
B) It prevents neurological damage due to movement of bone ends or fragments.
C) It restricts blood flow to the site of the injury to prevent swelling.
D) It reduces pain.
C) It restricts blood flow to the site of the injury to prevent swelling.
When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the
EMT should initially check what “six Ps”?
A) Pain, pallor, position, pulses, placement, and pressure
B) Pain, pallor, paresthesia, pulses, paralysis, and pressure
C) Pain, pallor, position, pulses, placement, and pad
D) Pain, pallor, paresthesia, pulses, placement, and pressure
B) Pain, pallor, paresthesia, pulses, paralysis, and pressure
A traction splint may be used on which of the following musculoskeletal injuries?
A) Suspected multiple fractures of the femur, tibia, and fibula
B) Possible fracture of the femur
C) Possible fracture of the humerus
D) Possible fracture of the cervical spine
B) Possible fracture of the femur
Which one of the following statements is not true?
A) Ligaments are connective tissues that connect bone to bone.
B) Muscles are the tissues or fibers that cause movement of body parts or organs.
C) Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for
articulation.
D) Tendons are bands of connective tissue that bind the ligaments to muscles.
D) Tendons are bands of connective tissue that bind the ligaments to muscles.
Your patient is an 11-year-old male who has a swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the
immobilization of his injured extremity?
A) Check pulse, movement, and sensation distal to the injury before and after splinting.
B) Use an upper extremity traction splint.
C) Immobilize from the shoulder to the wrist.
D) Do not attempt to realign the extremity before splinting
A) Check pulse, movement, and sensation distal to the injury
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?
A) Kidneys
B) Liver
C) Intestines
D) Pancreas
B) Liver
You are treating a patient with paradoxical motion on the left side of the chest. He is breathing is shallow at a rate of 4 breaths per minute. You should:
A) administer 15 lpm oxygen via mask.
B) roll the patient onto his left side.
C) tape the chest to restrict movement.
D) begin positive pressure ventilation.
D) begin positive pressure ventilation.
Your patient is a 21-year-old male who has a sucking gunshot wound to the chest. Which of the following is the highest priority in managing this patient?
A) Performing a rapid trauma assessment
B) Placing an occlusive dressing over the wound
C) Placing a pressure dressing over the wound to control bleeding
D) Placing the patient in the shock position
B) Placing an occlusive dressing over the wound
You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and high-category trauma; however, due to the mechanism of injury,
it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient?
A) Verifying trauma center ER bed availability
B) Examining the patient for entrance and exit wounds
C) Performing a distal neurological assessment
D) Searching for presence of diaphoresis, tachycardia, and hypotension
B) Examining the patient for entrance and exit wounds
You’re an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off an isolated county road. It appears the patient was not wearing a seat belt and struck the steering wheel with his chest. On assessment, you notice a paradoxical motion to the patient’s chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include?
A) The patient is showing signs of abdominal bleeding.
B) The patient may have an abdominal evisceration.
C) The patient may have a flail chest.
D) The patient is showing signs of an open chest injury
C) The patient may have a flail chest.
You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsating mass. You should:
A) defer further abdominal palpation.
B) apply cold packs to the abdomen.
C) ask your partner to verify your findings.
D) bind the abdomen with an elastic bandage.
A) defer further abdominal palpation.
The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point
that the chambers of the heart no longer fill adequately, usually secondary to trauma.
A) cardiac tamponade
B) hemopneumothorax
C) pericardial effusion
D) commotio cordis
A) cardiac tamponade
Which of the following injuries may produce distended neck veins?
A) Traumatic asphyxia
B) Cardiac tamponade
C) Tension pneumothorax
D) All of the above
D) All of the above
Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient
most likely suffered?
A) Pneumothorax
B) Traumatic asphyxia
C) Hemothorax
D) Flail chest
B) Traumatic asphyxia
Which of the following best describes an evisceration?
A) A penetrating chest wound in which air is “sucked” into the chest cavity
B) Open wound of the abdomen from which organs protrude
C) Fracture of two or more adjacent ribs in two or more places
D) Movement of ribs opposite to the direction of movement of the rest of the chest wall
B) Open wound of the abdomen from which organs protrude
Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques?
A) Packing the wound with rolled gauze
B) Applying direct pressure to the wound
C) Applying an ice pack or chemical cold pack
D) Applying a sterile dressing
B) Applying direct pressure to the wound
Which of the following best describes the potential benefit of a three-sided occlusive dressing over a four-sided occlusive dressing for an open chest wound?
A) It prevents the development of a hemothorax by allowing blood to escape.
B) It allows easy access for reexamination of the wound en route to the hospital.
C) It eliminates the need to continue monitoring the patient’s respiratory status.
D) It may reduce the chances of developing a tension pneumothorax.
D) It may reduce the chances of developing a tension pneumothorax.
What is the underlying cause of bluish or reddish facial discoloration following traumatic asphyxia?
A) The bluish or reddish facial discoloration is not associated with traumatic asphyxia; a pale discoloration is usually present.
B) High pressure on the chest leads to blood being forced from the right atrium into the face and
neck.
C) The patient has become hypoxic due to a chest injury, and the finding suggests central
cyanosis.
D) The physiological strain of the body results in a flushed appearance and increased risk of a
hypertensive event.
B) High pressure on the chest leads to blood being forced from the right atrium into the face and
neck.
Which of the following is an accurate definition of a flail chest?
A) Fracture of one rib in two or more consecutive places
B) Section of the chest wall that is unstable, leading to breathing problems
C) Fracture of at least four ribs in two or more places
D) Lung that has been punctured by a fractured rib, resulting in a buildup of air
B) Section of the chest wall that is unstable, leading to breathing problems
What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax through a penetration of the chest wall with each breath?
A) Paradoxical motion
B) Sucking chest wound
C) Closed tension pneumothorax
D) Open chest wound
B) Sucking chest wound
Which of the following is an unreliable sign for determining the presence of a tension pneumothorax?
A) Trachea that shifts to the side opposite the injury
B) Signs and symptoms of shock
C) Distended neck veins
D) Shortness of breath
A) Trachea that shifts to the side opposite the injury
While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be
associated with:
A) flail chest.
B) commotio cordis.
C) aortic dissection.
D) tension pneumothorax.
C) aortic dissection.
You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive
dressing on the site and begun emergent transport to the closest trauma center. However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform next?
A) Call dispatch for an ALS intercept en route to the hospital.
B) Free a corner or edge of the dressing to release pressure buildup.
C) Begin providing CPR to the patient.
D) Begin providing BVM-assisted ventilations to the patient
B) Free a corner or edge of the dressing to release pressure buildup.
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.
A) 5
B) 0.5
C) 1
D) 3
D) 3
For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline?
A) Gunshot wound to the abdomen from which a loop of intestine is protruding
B) Stab wound to the chest
C) A hemothorax from an object impaled into the chest
D) Laceration to the neck
A) Gunshot wound to the abdomen from which a loop of intestine is protruding
Which of the following is a strategy to maintain adherence of an occlusive dressing to bloody or diaphoretic skin?
A) Do not use adhesive tape.
B) Wrap the dressing circumferentially with gauze.
C) Manually maintain pressure.
D) Do not use occlusive dressings in this case.
C) Manually maintain pressure.
A patient with jugular vein distention is most likely suffering from which of the following injuries?
A) Hemopneumothorax
B) Tension pneumothorax
C) Pneumothorax
D) Hemothorax
B) Tension pneumothorax
You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1- to 2-minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions?
A) Cardiac tamponade
B) Tension pneumothorax
C) Commotio cordis
D) Aortic dissection
C) Commotio cordis
A 36-year-old male was accidentally shot with a nail gun into the chest. You see the nail, which protrudes about 2 to 3 centimeters from the thorax, when you visualize the injury site. Under which
of the following circumstances should you remove the nail from the injury site?
A) The patient develops a tension pneumothorax.
B) The patient begins to complain of shortness of breath.
C) Bleeding from the patient’s wound is minimal.
D) None of the above
D) None of the above
