Test 30,31 Flashcards
50 y/o, mall, 5 mins away from hospital goes into cardiac arrest
tell the driver to stop, analyze the cardiac rhythm and deliver shock
which of the following ppl is allowed to be “cleared”
none of the above
66 y/o regained pulse after shock but remains unresponsive
ventilate patient w high concentration oxygen, transport
early indicator of hypoperfusion
mental status
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 may have an abdominal evisceration.
B) The patient is showing signs of an open chest injury.
C) The patient may have a flail chest.
D) The patient is showing signs of abdominal bleeding.
C) The patient may have a flail chest.
22) Which of the following injuries may produce distended neck veins?
A) Tension pneumothorax
B) Traumatic asphyxia
C) Cardiac tamponade
D) All of the above
D) All of the above
23) Which of the following describes the proper application of an occlusive dressing for an open chest wound?
A) Apply an occlusive dressing to each penetrating wound.
B) Trim the dressing so that it is the exact size of the wound.
C) Traditional gauze dressings create the best seal over open wounds.
D) Use a porous material such as a 4” by 4” gauze pad.
A) Apply an occlusive dressing to each penetrating wound.
24) 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) pericardial effusion
C) commotio cordis
D) hemopneumothorax
A) cardiac tamponade
25) 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) Aortic dissection
B) Cardiac tamponade
C) Tension pneumothorax
D) Commotio cordis
D) Commotio cordis
26) 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
A) aortic dissection
B) commotio cordis.
C) tension pneumothorax.
D) flail chest.
A) aortic dissection
27) 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?
A) Reducing the swelling around his eyes by applying a cold pack
B) The potential for serious internal damage
C) The possibility of commotio cordis
D) The presence of any defensive wounds the patient may have sustained
B) The potential for serious internal damage
What is the underlying cause of bluish or reddich facial discoloration following traumatic
A) The patient has become hypoxic due to a chest injury, and the finding suggests central
B) The physiological strain of the body resulls in a flushed appearance and increased risk of a hypertensive event.
& The bluish or reddish facial discoloration is not associated with traumatic asphyxia; a pale discoloration is usually present.
(D) High pressure on the chest leads to blood being forced from the right atrium into the face and neck
(D) High pressure on the chest leads to blood being forced from the right atrium into the face and neck
29) 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) The patient does not necessarily need transport, so allow him to refuse if he wants.
C) Begin transport non-emergently and upgrade if the patient’s condition deteriorates.
D) Transport the patient emergently because of the high index of suspicion for a serious injury.
D) Transport the patient emergently because of the high index of suspicion for a serious injury.
30) 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) Hemothorax
B) Flail chest
C) Traumatic asphyxia
D) Pneumothorax
C) Traumatic asphyxia
31) You find a middle-aged male sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should:
A cover the wound with an occlusive dressing.
B) place a trauma dressing over the wound.
C) place the patient on high-concentration oxygen.
D) place your gloved hand over the wound.
D) place your gloved hand over the wound.
32) When deciding where to transport a patient who has internal bleeding or who has the potential for internal bleeding, which of the following is the most important service to be provided by the receiving hospital?
A) Immediate surgical capabilities
Critical-care nursing
C) Rehabilitation services
D) Availability of a chaplain
A) Immediate surgical capabilities
33) Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now?
A) Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic
B) Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.
C) Apply additional dressing material, bandage it in place, and apply pressure to the brachial
artery.
D) Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.
A) Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic
34) Which of the following is recommended in situations in which a tourniquet must be used?
A) Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb
B) Use a material that is wide and thick.
C) Apply the tourniquet over the elbow or knee,
D) Apply a bulky dressing and bandage over the tourniquet.
B) Use a material that is wide and thick.
35) Which of the following bent explains the reason for minimizing scene time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?
A) It is essential to get the shock patient to more definitive care.
B) The clock for the “golden hour” of trauma begins at the time of your arrival.
C) It gives the EMT less opportunity to make mistakes in the patient’s care,
D) There is nothing the EMT can do for a patient in shock,
A) It is essential to get the shock patient to more definitive care.
36) If you do not have a commereial tourniquet avallable, what common supply found on the ambulance can be used as a substitute?
A) Cold pack
B) Air splint
C) Rope tie-down
D) Triangle bandage
D) Triangle bandage
37) Which of the following statements about treating a patient who appears to be in shock in false?
A) The patient should be promptly put on high-concentration oxygen.
B) Airway management is a top priority,
C) Prompt transportation is a very high 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.
38) 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 and will not be effective if anything is between the cold agent and 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 and will not be effective if anything is between the cold agent and wound
39) Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the best sequence of steps in the management of this patient?
A) Direct pressure, high-concentration oxygen, and splinting the leg
B) Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
C) High-concentration oxygen, elevation of the extremity, and application of ice
D) High-concentration oxygen, tourniquet, PASC, and elevation of the extremity
A) Direct pressure, high-concentration oxygen, and splinting the leg
40) 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 follewing in a general term used to refer to a problem with the heart?
A) Congestive heart failure
B) Myocardial infarction
C) Cardiac dysrithmia
D) Cardiac compromise
D) Cardiac compromise
Which of the following may be a sign of symptom of a problem with the heart?
A) Fainting or near fainting
B) Nausea, with or without vomiting
C) Chest discomfort
D) All of the above
D) All of the above
10) What stimulates a mechanical contraction of the cells of the heart, creating a mechanical squeeze used to push blood?
A) Electrical energy
B) Left ventricle
C) Left and right atria
D) Right ventricle
A) Electrical energy
11) You are on-scene with a 48-year-old unresponsive male patient. Bystanders state he complained of 11) chest pain and then suddenly collapsed. Vital signs are blood pressure 68/42, pulse 36, and respiratory rate 3. He is unresponsive to painful stimuli. After performing the primary assessment and treating ALL LIFE THREATS what is your next intervention
A) administer high concentrations oxygen
B) Apply the AED.
C) Insert an oral airway.
D) Package the patient for rapid transport.
D) Package the patient for rapid transport.
12) Assuming your protocol allows the administration of nitroglycerin when certain conditions exist, what is the maximum number of tablets to be administered in the prehospital setting?
A) 4
B) 2
C)3
D) 1
C) 3
13) Which of the following statements regarding the administration of nitroglycerin tablets is true?
A) An increase in blood pressure should be expected.
B) The patient may complain of a headache following administration.
C) It takes 20 to 30 minutes for nitroglycerin to have an effect.
D)If a patient’s pulse rate changes following nitroglycerin administration, it indicates an allergic
B) The patient may complain of a headache following administration.
14) In which of the following situations would the administration of aspirin to a cardiac patient be
prohibited?
(A) The patient has a gastrointestinal ulcer.
B) The patient feels dizzy.
C) The patient has a diastolic blood pressure greater than 90 mmHg.
D) The patient does not currently take aspirin.
(A) The patient has a gastrointestinal ulcer.
15) You are treating a male patient with chest pain caused by the complete ecclusion of one of the coronary arteries. What would you most likely expect with this patient?
A) His pain will be reduced with aspirin.
B) His pain will go away with oxygen.
C) His pain will be alleviated with nitroglycerin.
D) His pain will not be alleviated with any of the above medications.
D) His pain will not be alleviated with any of the above medications.
16) A weakened area of an artery that balloons out and may rupture, causing catastrophic bleeding, is called:
A) asystole.
B) angina.
C) angioplasty.
D) an aneurysm.
D) an aneurysm.
17) You suspect that your patient is suffering from angina pectoris. What signs or symptoms would
you expect to see with this condition?
A) Chest pain that is relieved with nitroglycerin
B) Chest pain that radiates to the leg
C Chest pain that is not relieved with rest
D) Chest pain that is not relieved with nitroglycerin
A) Chest pain that is relieved with nitroglycerin
18) Which of the following is the beneficial action of a beta blocker medication?
A) Causes vasoconstriction, increasing the blood pressure
B) Increases the amount of oxygen needed by the myocardium
C) Increases the strength of myocardial contraction
D) Slows the heart rate
D) Slows the heart rate
19) When assessing a 14-year-old male patient that has been involved in a bicycle accident, you notice 19) that he has a small amount of blood coming from his left forearm. This observation is known as which of the following?
A) Symptom
B) Indication
C) Sign
D) Clue
C) Sign
20) The patient was a driver in a lateral impact motor vehicle collision. During the assessment of his chest, the EMT notes a segment of the chest wall moving in the opposite direction from the rest of the chest. Which of the following best describes this finding?
A) Flutter segment
B) Paradoxical motion
C) Tension pneumothorax
D) Intercostal retractions
B) Paradoxical motion
21) When assessing a patient who has been stabbed, which of the following information should the EMT gain first?
A) Owner of the knife
B) Make and model of the knife
C) Angle at which the knife entered the patient
D) Size and type of the knife
D) Size and type of the knife
22) In which of the following patients should you check for the possibility of spinal injury?
A An unresponsive diabetic who appears to have fallen down
B) An unresponsive patient found in her bed with no obvious injury
CA responsive patient with no history of injury who is complaining of a headache and neck
D) All of the above
A An unresponsive diabetic who appears to have fallen down
23) For which of the following patients is a focused physical examination appropriate?
(A) A 25-year-old female with a history of asthma and who is complaining of difficulty breathing
Patient is an unresponsive 40 y/o woman. what should you do first
A) immediatly request advanced life support
B) perform a rapid physical exam
C) ask her husband if she has any allergies
D) take BP
B) perform a rapid physical exam
how would you obtain the history of the present illness of a patient with a complain of chest pain?
A) has your family ever had pain like this?
B) How would you describe the way the pain feels?
B) How would you describe the way the pain feels?
31) Your patient in a 66-year-old female wh however, she remains unresponsive and should be done next?
after a shock with an AEt%
adequately. Which of the following
A) Remove the AED, assist the patient’s ventilations with a bag-valve mask and supplemental oxygen, and keep reassessing the pulse
B) Ventilate the patient with high-concentration oxygen and transport immediately,
C) Deliver a fourth shock to improve the patient’s respiratory status.
D) Apply a nonrebreather mask with high-concentration oxygen and keep reassessing the pulse.
B) Ventilate the patient with high-concentration oxygen and transport immediately,
32) In which of the following ways does cardiac arrest in children differ from cardiac arrest in adults?
A) Cardiac arrest in children is more likely to be due to respiratory failure.
B) Ventricular fibrillation is common in children.
C) Cardiac arrest in adults is more likely to be due to respiratory failure.
D) Ventricular fibrillation is not common in adults.
A) Cardiac arrest in children is more likely to be due to respiratory failure.
33) Which of the following patients should have an automated external defibrillator applied?
A) A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic
B) A 67-year-old man with severe, crushing chest pain that is not relieved by nitroglyceri
C) A 6-month-old in severe respiratory distress
D) A 40-year-old female in cardiac arrest due to chest injuries sustained in a motor
A) A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic
34) You are preparing a patient in cardiac arrest for an AED when you palpate a small lump below the patient’s right clavicle. How should this modify your placement of the AED?
A) Place the AED pads over the patient’s abdomen.
B) Place the AED as you would for any patient.
Do not place the AED but transport the patient immediately.
D) While placing the pads in the general area you need them, keep them several inches away
D) While placing the pads in the general area you need them, keep them several inches away
35) Mechanical CPR devices are used by EMS agencies in order to provide:
A) a 100% success rate.
B) better quality of care with less training.
C) high-quality compressions.
D) a faster response time to the scene.
C) high-quality compressions.
36) 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) Cardiogenic
D) Hypervolemic
D) Hypervolemic
37) Which of the following types of vessels have valves to maintain one-way blood flow?
A)Arteries
B) Veins
C) Capillaries
D) Arterioles
B) Veins
38) Which of the following is not part of the circulatory system?
A) Blood
B) Blood vessels
C) Heart
D) Brain
D) Brain
39) In which of the following vessels does the vital exchange of oxygen, nutrients, and wastes take place?
A) Arterioles
B) Capillaries
C) Veins
D) Venules
B) Capillaries
12 y/o boy who ran his arm through a glass window and has 8 inch laceration on his anterior forearm. what should you do now
elevate the arm and prepare to apply a touriquet or consider administering a hemostatic agent
2a) Which of the following should increase the EMTs suspicion of internal bleeding?
A) Penetrating trauma to the chest or abdomen
C) High-speed motor vehicle collision
B) Fall from a height two or more times the patient’s height
D) All of the above
D) all the above
15) AS an ET; your best clue indicating the possibility of intemal bleeding may be the presence of:
A) the mechanism of injury.
B)bruising, swelling, or pain over vital organs.
C) painful, swollen, or deformed extremities.
D) a tender, rigid, or distended abdomen.
A) the mechanism of injury.
failure in patients compensatory response to blood loss
hypotension
major cause of chock that the emt will see
hemorrhage
lung collapse without injury
spontaneous pneumothorax
6 y/o, anxious, fever, skin warm, dry
epiglottitis
nearest hospital
cardiac catherization
not a reason no shock advised
patient is in ventricular fibrillation or ventricular tachycardia
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?
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.
In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next?
Apply additional dressing material over the top of the original dressing and bandage it in place.
Which of the following statements is false regarding an electrical injury?
Injury is usually limited to the area around the source and ground burns.
Which of the following is true concerning lacerations?
all of the above (may be caused by blunt trauma, may be caused by penetrating trauma, may indicate deeper underlying tissue damage)
While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms, the EMT must be aware of which of the following?
Medical conditions may be aggravated by the burn.
Which of the following is not an open tissue injury?
contusion
You are assessing a 30-year-old male patient that had his arm caught in a piece of machinery. By the time you arrive, he has been freed. The patient tells you that he does not understand why you were called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspicion of which of the following injuries?
High-pressure injection
When managing an electrical burn, the EMT should:
check for a source and ground burn injury.
Which of the following layers of the skin is the most important in insulating the body against heat loss?
subcutaneous layer
Which of the following patients has the greatest likelihood of being cared for in a burn center?
A 30-year-old woman who has deep partial thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
Which of the following is appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury (MOI)?
all of the above (treat for shock, anticipate vomiting, splint swollen, deformed extremities)
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?
none of the above
Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization?
Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.
Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils?
puncture
Which of the following is not considered soft tissue?
cartilage
While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)?
airway
Bleeding from soft-tissue injuries should initially be controlled with which one of the following techniques?
direct pressure
burn extending into the subcutaneous fat would be classified as which type of burn?
full thickness
Which of the following best describes an avulsion?
A flap of skin that is partially or completely torn away from the underlying tissue
Which of the following injuries requires the use of an occlusive dressing?
all the above
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%
Your patient is a 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and painful, but without blisters. When caring for this injury in the prehospital setting, which of the following is appropriate?
Apply a dry sterile dressing.
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?
Care for the burn and do a complete patient assessment, including cervical spine precautions.
Which of the following is a description of the rule of nines for an adult?
The rule of nines assigns 9 percent to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1 percent to the genital region.
Which of the following is not a type of avulsion?
A finger is cut off with a butcher’s saw.
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 of concern with a puncture wound?
An object that remains impaled in the body, hidden internal bleeding with minimal external bleeding, and the strong possibility of contamination.(all of the above)
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 a major function of the skin?
Regulates the pH balance of the body
The meatus is:
external opening of the urethra
Which of the following best describes a partial thickness burn?
The skin is red and moist with blister formation.
For which of the following patients should the EMT carefully continue to monitor the patient’s ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure?
A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest
Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound?
Application of antibiotic ointment
Which of the following is not true concerning lacerations?
They may involve degloving injuries to the skin or tissue.
Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned?
18%
You are dispatched to an auto repair shop for an “accident.” You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you do?
Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.
Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds?
sterile
You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step?
You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.
Which of the following is recommended when caring for an amputated part?
Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.
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.
Which of the following statements is not true concerning the proper transport of an avulsed ear?
It should be in a dry sterile dressing.
You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?
Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.
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.
