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