Trauma - Review questions Flashcards
1
Q
Kinetic energy is a calculation of: A. weight and size. B. weight and speed. C. mass and weight. D. speed and force.
A
B. weight and speed.
2
Q
A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A. Deployed airbag B. Bent steering wheel C. Non-intact windshield D. Crushed instrument panel
A
C. Non-intact windshield
3
Q
Which of the following would MOST likely result from the third collision in the “three-collision” effect that occurs during a high-speed, frontal impact motor vehicle crash?
A. Extensive damage to the automobile
B. Flail chest and lower extremity fractures
C. Massive external trauma with severe bleeding
D. Aortic rupture or compression injury to the brain
A
D. Aortic rupture or compression injury to the brain
4
Q
A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A. deployed airbags. B. steering wheel deformity. C. starring of the windshield. D. a crushed instrument panel.
A
A. deployed airbags.
5
Q
An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: A. trauma to the pelvis. B. blunt abdominal trauma. C. a severe closed head injury. D. penetrating thoracic trauma.
A
A. trauma to the pelvis
6
Q
Whiplash injuries are MOST common following \_\_\_\_\_\_\_\_\_ impacts. A. rear-end B. rollover C. frontal D. lateral
A
A. rear-end
7
Q
Death from a rollover motor vehicle crash is MOST often secondary to:
A. crushing injuries.
B. airbag-related trauma.
C. multiple collisions to the interior of the car.
D. ejection of the patient from the motor vehicle.
A
D. ejection of the patient from the motor vehicle.
8
Q
Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? A. Head-on collision B.Angular collision C. Ejection D. Controlled crash
A
C. Ejection
9
Q
When assessing a stab wound, it is important for the EMT to remember that:
A. stabbings to an extremity are rarely associated with an exit wound.
B. the majority of the internal trauma will be near the path of the knife.
C. most stabbings are unintentional and cause less severe internal injury.
D. more internal damage may be present than the external wound suggests.
A
D. more internal damage may be present than the external wound suggests.
10
Q
A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury was MOST likely caused by \_\_\_\_\_\_\_\_\_\_\_ , blast injuries. A. primary B. secondary C. tertiary D. quaternary
A
C. tertiary
11
Q
Which of the following is NOT a component of the cardiovascular system? A. Heart B. Lungs C. Venules D. Plasma
A
B. Lungs
12
Q
Perfusion is MOST accurately defined as:
A. the removal of adequate amounts of carbon dioxide during exhalation.
B. the intake of adequate amounts of oxygen during the inhalation phase.
C. circulation of blood within an organ with sufficient amounts of oxygen.
D. the production of carbon dioxide, which accumulates at the cellular level.
A
C. circulation of blood within an organ with sufficient amounts of oxygen.
13
Q
A man involved in a motorcycle crash has multiple abrasions and lacerations. Which of the following injuries has the HIGHEST treatment priority?
A. Widespread abrasions to the back with pinkish ooze
B. 3” laceration to the forehead with dark red, flowing blood
C. Laceration to the forearm with obvious debris in the wound
D. 1” laceration to the thigh with spurting, bright red blood
A
D. 1” laceration to the thigh with spurting, bright red blood
14
Q
Which of the following sets of vital signs is LEAST indicative of internal bleeding?
A. BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min
B. BP, 100/50 mm Hg; pulse rate, 120 beats/min; respirations, 24 breaths/min
C. BP, 98/60 mm Hg; pulse rate, 110 beats/min; respirations, 28 breaths/min
D. BP, 102/48 mm Hg; pulse rate, 100 beats/min; respirations, 22 breaths/min
A
A. BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min
15
Q
When caring for a patient with internal bleeding, the EMT must first: A. ensure a patent airway. B. obtain baseline vital signs. C. control any external bleeding. D. take appropriate standard precaution
A
D. take appropriate standard precaution
16
Q
The quickest and MOST effective way to control external bleeding from an extremity is: A. a pressure bandage. B. direct pressure. C. a splint. D. a tourniquet.
A
B. direct pressure.
17
Q
When applying a tourniquet to an amputated arm, the EMT should:
A. use the narrowest bandage possible.
B. avoid applying the tourniquet over a joint.
C. cover the tourniquet with a sterile bandage.
D. use rope to ensure that the tourniquet is tight.
A
B. avoid applying the tourniquet over a joint.
18
Q
A 70-year-old man is experiencing a severe nosebleed. When you arrive, you find him leaning over a basin, which contains an impressive amount of blood. He has a history of coronary artery disease, diabetes, and migraine headaches. His BP is 180/100 and his heart rate is 100 beats/min. Which of the following is the MOST likely contributing factor to his nosebleed? A. His blood pressure B. His history of diabetes C. The fact that he is elderly D. His heart rate of 100 beats/min
A
A. His blood pressure
19
Q
When caring for a patient with severe epistaxis, the MOST effective way to prevent aspiration of blood is to:
A. insert a nasopharyngeal airway and lean the patient back.
B. tilt the patient’s head forward while he or she is leaning forward.
C. place the patient supine with his or her head in the flexed position.
D. tilt the patient’s head forward while he or she is leaning backward.
A
B. tilt the patient’s head forward while he or she is leaning forward.
20
Q
Controlling internal bleeding requires:
A. applying a tourniquet.
B. surgery in a hospital.
C. positioning the patient in the sitting position.
D. providing slow and considerate transport.
A
B. surgery in a hospital.
21
Q
A young male was struck in the forearm with a baseball and complains of pain to the area. Slight swelling and ecchymosis are present, but no external bleeding. Which type of injury does this describe? A. Abrasion B. Contusion C. Hematoma D. Avulsion
A
B. Contusion
22
Q
A compression injury that is severe enough to cut off blood flow below the injury is called: A. a contusion. B. a hematoma. C. a local thrombus. D. compartment syndrome.
A
D. compartment syndrome.
23
Q
A 45-year-old convenience store clerk was shot in the right anterior chest during a robbery. Your assessment reveals that the wound has blood bubbling from it every time the patient breathes. Your MOST immediate action should be to:
A. prevent air from entering the wound.
B. cover the wound with a bulky dressing.
C. assess the patient’s back for an exit wound.
D. transport the patient promptly to the closest trauma center.
A
A. prevent air from entering the wound.
24
Q
Which effects will the application of an ice pack have on a hematoma?
A. Vasodilation and increased pain
B. Vasodilation and decreased bleeding
C. Vasoconstriction and increased swelling
D. Vasoconstriction and decreased bleeding
A
D. Vasoconstriction and decreased bleeding
25
```
The primary reason for applying a sterile dressing to an open injury is to:
A. prevent contamination.
B. control external bleeding.
C. reduce the risk of infection.
D. minimize any internal bleeding.
```
B. control external bleeding.
26
The MOST appropriate way to dress and bandage an open abdominal wound with a loop of bowel protruding from it is to:
A. cover the wound with a dry, sterile dressing and apply firm pressure.
B. apply a moist, sterile dressing to the wound and apply firm pressure.
C. apply a moist, sterile dressing to the wound and secure it with an occlusive dressing.
D. carefully replace the protruding bowel into the abdomen and cover the wound.
C. apply a moist, sterile dressing to the wound and secure it with an occlusive dressing.
27
A 22-year-old male was attacked by a rival gang and has a large knife impaled in the center of his chest. Your assessment reveals that he is apneic and pulseless. You should:
A. carefully remove the knife, control any bleeding, begin CPR, and transport.
B. stabilize the knife in place, provide rescue breathing, and transport at once.
C. remove the knife and control any bleeding, apply the AED, and analyze his rhythm.
D. begin CPR, control any external bleeding, and transport rapidly to a trauma center.
A. carefully remove the knife, control any bleeding, begin CPR, and transport.
28
Which of the following is considered a severe burn?
A. Any full-thickness burn
B. 20% partial-thickness burn
C. 10% full-thickness burn with abrasions
D. 5% full-thickness burn with a fracture
D. 5% full-thickness burn with a fracture
29
```
A 5-year-old boy was burned when he pulled a barbecue grill over on himself. He has partial- and full-thickness burns to his anterior chest and circumferentially on both arms. What percentage of his body surface area has been burned?
A. 18%
B. 27%
C. 36%
D. 45%
```
B. 27%
30
Which of the following statements regarding chemical burns is FALSE?
A. Most chemical burns are caused by strong acids or alkalis.
B. Fumes of strong chemicals can cause burns to the respiratory tract.
C. Prior to removing a dry chemical, flush the area with sterile water.
D. Do not attempt to neutralize an acid burn with an alkaline chemical.
C. Prior to removing a dry chemical, flush the area with sterile water.
31
Which of the following statements regarding the “Adam’s apple” is FALSE?
A. It is inferior to the cricoid cartilage.
B. It is formed by the thyroid cartilage.
C. It is the uppermost part of the larynx.
D. It is more prominent in men than in women.
A. It is inferior to the cricoid cartilage.
32
```
The globe of the eye is also called the:
A. lens.
B. orbit.
C. retina.
D. eyeball.
```
D. eyeball.
33
```
When a person is looking at an object up close, the pupils should:
A. dilate.
B. constrict.
C. remain the same size.
D. dilate, and then constrict.
```
A. dilate.
34
When caring for a chemical burn to the eye, the EMT should:
A. prevent contamination of the opposite eye.
B. immediately cover the injured eye with a sterile dressing.
C.avoid irrigating the eye, as this may cause further injury.
D. irrigate both eyes simultaneously, even if only one eye is injured.
A. prevent contamination of the opposite eye.
35
Which of the following signs is least indicative of a head injury?
A. Asymmetrical pupils
B. Pupillary constriction to bright light
C. Both eyes moving in opposite directions
D. Inability to look upward when instructed to
B. Pupillary constriction to bright light
36
The purpose of the eustachian tube is to:
A. move in response to sound waves.
B. transmit impulses from the brain to the ear.
C. equalize pressure in the middle ear when external pressure changes.
D. house fluid within the inner chamber of the ear and support balance.
C. equalize pressure in the middle ear when external pressure changes.
37
```
When caring for a patient with facial trauma, the EMT should be MOST concerned with:
A. spinal trauma.
B. airway compromise.
C. associated eye injuries.
D. severe external bleeding.
```
B. airway compromise.
38
```
The presence of subcutaneous emphysema following trauma to the face and throat is MOST
A. suggestive of:
esophageal injury.
B. cervical spine fracture.
C. crushing tracheal injury.
D. carotid artery laceration.
```
C. crushing tracheal injury.
39
A 21-year-old male has a large laceration to his neck. When you assess him, you note that bright red blood is spurting from the left side of his neck. You should immediately:
A. apply a pressure dressing to his neck.
B. sit the patient up to slow the bleeding.
C. place your gloved hand over the wound.
D. apply 100% oxygen via nonrebreathing mask
C. place your gloved hand over the wound
40
Which of the following mechanisms of injury would MOST likely cause a crushing injury of the larynx and/or trachea?
A. Attempted suicide by hanging
B. Gunshot wound to the lateral neck
C. Car crash involving lateral impact
D. Patient whose head hits the windshield
A. Attempted suicide by hanging
41
The brain, a part of the central nervous system (CNS), is divided into the:
A. cerebrum, cerebellum, and brain stem.
B. cerebrum, brain stem, and spinal cord.
C. cerebellum, cerebrum, and spinal cord.
D. spinal cord, cerebrum, and cerebral cortex
A. cerebrum, cerebellum, and brain stem.
42
As you are assessing a 24-year-old man with a large laceration to the top of his head, you should recall that:
A. the scalp, unlike other parts of the body, has relatively fewer blood vessels.
B. blood loss from a scalp laceration may contribute to hypovolemic shock in adults.
C. any avulsed portions of the scalp should be carefully cut away to facilitate bandaging.
D. most scalp injuries are superficial and are rarely associated with more serious injuries.
B. blood loss from a scalp laceration may contribute to hypovolemic shock in adults.
43
```
A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n):
A. epidural hematoma.
B. subdural hematoma.
C. concussion.
D. contusion.
```
A. epidural hematoma
44
```
A 44-year-old man was struck in the back of the head and was reportedly unconscious for approximately 30 seconds. He complains of a severe headache and “seeing stars,” and states that he regained his memory shortly before your arrival. His presentation is MOST consistent with a(n):
A. contusion.
B. concussion.
C. subdural hematoma.
D. intracerebral hemorrhage.
```
B. concussion.
45
```
A young male was involved in a motor vehicle accident and experienced a closed head injury. He has no memory of the events leading up to the accident, but remembers that he was going to a birthday party. What is the correct term to use when documenting his memory loss?
A. Concussion
B. Cerebral contusion
C. Retrograde amnesia
D. Anterograde amnesia
```
C. Retrograde amnesia
46
```
A distraction injury to the cervical spine would MOST likely occur following:
A. a diving accident.
B. blunt neck trauma.
C. hyperextension of the neck.
D. hanging-type mechanisms.
```
D. hanging-type mechanisms.
47
During immobilization of a patient with a possible spinal injury, manual stabilization of the head must be maintained until:
A. an appropriate-size extrication collar has been placed.
B. the patient is fully immobilized on a long backboard.
C. a range of motion test of the neck has been completed.
D. pulse, motor, and sensory functions are found to be intact.
B. the patient is fully immobilized on a long backboard.
48
Your patient is a 21-year-old male who has massive face and head trauma after being assaulted. He is lying supine, is semiconscious, and has blood in his mouth. You should:
A. insert a nasal airway, assess his respirations, and give 100% oxygen.
B. suction his airway and apply high-flow oxygen via a nonrebreathing mask.
C. manually stabilize his head, log roll him onto his side, and suction his mouth.
D. apply a cervical collar, suction his airway, and begin assisting his ventilations.
C. manually stabilize his head, log roll him onto his side, and suction his mouth.
49
A man is found slumped over the steering wheel, unconscious and making snoring sounds, after an automobile accident. His head is turned to the side and his neck is flexed. You should:
A. gently rotate his head to correct the deformity.
B. carefully hyperextend his neck to open his airway.
C. apply an extrication collar with his head in the position found.
D. manually stabilize his head and move it to a neutral, in-line position.
D. manually stabilize his head and move it to a neutral, in-line position.
50
You should NOT remove an injured football player’s helmet if:
A. a cervical spine injury is suspected, even if the helmet fits loosely.
B. the patient has a patent airway, even if he has breathing difficulty.
C. he has broken teeth, but only if the helmet does not fit snugly in place.
D. the face guard can easily be removed and there is no airway compromise.
D. the face guard can easily be removed and there is no airway compromise.
51
```
When the chest impacts the steering wheel during a motor vehicle crash with rapid deceleration, the resulting injury, which often kills patients, usually within seconds, is:
A. a hemothorax.
B. aortic shearing.
C. a pneumothorax.
D. a ruptured myocardium.
```
B. aortic shearing.
52
```
Signs and symptoms of a chest injury include all of the following, EXCEPT:
A. hemoptysis.
B. hematemesis.
C. asymmetrical chest movement.
D. increased pain with breathing.
```
B. hematemesis.
53
During your assessment of a patient who was stabbed, you see an open wound to the left anterior chest. Your MOST immediate action should be to:
A. position the patient on the affected side.
B. transport immediately.
C. assess the patient for a tension pneumothorax.
D. cover the wound with an occlusive dressing.
D. cover the wound with an occlusive dressing.
54
```
When caring for a patient with signs of a pneumothorax, your MOST immediate concern should be:
A. hypovolemia.
B. intrathoracic bleeding.
C. ventilatory inadequacy.
D. associated myocardial injury
```
C. ventilatory inadequacy.
55
What purpose does a one-way “flutter valve” serve when used on a patient with an open pneumothorax?
A. It prevents air escape from within the chest cavity.
B. It allows a release of air trapped in the pleural space.
C. It only prevents air from entering an open chest wound.
D. It allows air to freely move in and out of the chest cavity.
B. It allows a release of air trapped in the pleural space.
56
```
Signs of a cardiac tamponade include all of the following, EXCEPT:
A. muffled heart tones.
B. a weak, rapid pulse.
C. collapsed jugular veins.
D. narrowing pulse pressure
```
C. collapsed jugular veins
57
```
A patient experienced a severe compression to the chest when trapped between a vehicle and a brick wall. You suspect traumatic asphyxia due to the hemorrhage into the sclera of his eyes and which other sign?
A. Flat neck veins
B. Cyanosis in the face and neck
C. Asymmetrical chest movement
D. Irregular heart rate
```
B. Cyanosis in the face and neck
58
```
A 14-year-old baseball player was hit in the chest with a line drive. He is in cardiac arrest. Which of the following is the most likely explanation?
A. Myocardial contusion
B. Traumatic asphyxia
C. Commotio cordis
D. Hemothorax
```
C. Commotio cordis
59
```
Paradoxical chest movement is typically seen in patients with:
A. a flail chest.
B. a pneumothorax.
C. isolated rib fractures.
D. a ruptured diaphragm.
```
A. a flail chest.
60
A 40-year-old man, who was the unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. You should be MOST concerned that he:
A. has injured his myocardium.
B. has a collapsed lung and severe hypoxia.
C. has extensive bleeding into the pericardial sac.
D. is at extremely high risk for ventricular fibrillation.
A. has injured his myocardium.
61
```
Peritonitis would MOST likely result following injury to the:
A. liver.
B. spleen.
C. kidney.
D. stomach.
```
D. stomach.
62
```
Which of the following organs would be the MOST likely to bleed profusely if severely injured?
A. Liver
B. Kidney
C. Stomach
D. Gallbladder
```
A. Liver
63
Which of the following statements regarding intra-abdominal bleeding is FALSE?
A. Intra-abdominal bleeding often causes abdominal distention.
B. Intra-abdominal bleeding is common following blunt force trauma.
C. The absence of pain and tenderness rules out intra-abdominal bleeding.
D. Bruising may not occur immediately following blunt abdominal trauma.
C. The absence of pain and tenderness rules out intra-abdominal bleeding.
64
```
Even when seatbelts are worn properly and the airbags deploy, injury may occur to the:
A. chest.
B. extremities.
C. iliac crests.
D. lower ribcage
```
C. iliac crests.
65
```
While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find:
A. a deformed steering wheel.
B. that the airbags deployed.
C. a crushed instrument panel.
D. damage to the lower dashboard.
```
A. a deformed steering wheel.
66
Other than applying a moist, sterile dressing covered with a dry dressing to treat an abdominal evisceration, an alternative form of management may include:
A. placing dry towels over the open wound.
B. cleaning the exposed bowel with sterile saline.
C. applying the PASG to stop the associated bleeding.
D. applying an occlusive dressing, secured by trauma dressings.
D. applying an occlusive dressing, secured by trauma dressings.
67
```
You are transporting a patient with possible peritonitis following trauma to the abdomen. Which position will he MOST likely prefer to assume?
A. Sitting up
B. Legs drawn up
C. Legs outstretched
D. On his right side
```
B. Legs drawn up
68
```
A 16-year-old boy was playing football and was struck in the left flank during a tackle. His vital signs are stable; however, he is in severe pain. You should be MOST concerned that he has injured his:
A. liver.
B. spleen.
C. kidney.
D. bladder.
```
C. kidney.
69
```
The term “hematuria” is defined as:
A. blood in the stool.
B. blood in the urine.
C. vomiting up blood.
D. urinary bladder rupture.
```
B. blood in the urine
70
When caring for a female with trauma to the external genitalia, the EMT should:
A. use local pressure to control bleeding.
B. carefully pack the vagina to reduce bleeding.
C. remove any impaled objects from the vagina.
D. cover any open wounds with moist, sterile dressings.
A. use local pressure to control bleeding
71
```
Skeletal muscle is also referred to as:
A. smooth muscle.
B. striated muscle.
C. autonomic muscle.
D. involuntary muscle.
```
B. striated muscle.
72
You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that:
A. there is a disruption of the joint and the bone ends are no longer in contact.
B. the patient has an incomplete fracture that passes only partway through the bone.
C. stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred.
D. the muscles of the ankle have been severely stretched, resulting in displacement of the bones from the joint.
C. stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred.
73
```
A young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess:
A. false motion.
B. distal pulses.
C. capillary refill.
D. sensory and motor functions.
```
D. sensory and motor functions.
74
The purpose of splinting a fracture is to:
A. reduce the fracture if possible.
B. prevent motion of bony fragments.
C. reduce swelling in adjacent soft tissues.
D. force the bony fragments back into anatomic alignment.
B. prevent motion of bony fragments.
75
A motorcyclist crashed his bike and has closed deformities to both of his midshaft femurs. He is conscious, but restless; his skin is cool and clammy; and his radial pulses are rapid and weak. The MOST appropriate splinting technique for this patient involves:
A. applying rigid board splints.
B. applying two traction splints.
C. securing him to a long backboard.
D. immobilizing his femurs with air splints.
C. securing him to a long backboard.
76
To effectively immobilize a fractured clavicle, you should apply a(n):
A. sling and swathe.
B. air splint over the entire arm.
C. rigid splint to the upper arm, then a sling.
D. traction splint to the arm of the injured side
A. sling and swathe.
77
```
A patient tripped, fell, and landed on her elbow. She is in severe pain and has obvious deformity to her elbow. You should:
A. assess distal pulses.
B. manually stabilize her injury.
C. assess her elbow for crepitus.
D. apply rigid board splints to her arm.
```
B. manually stabilize her injury.
78
When treating an open extremity fracture, you should:
A. apply a splint and then dress the wound.
B. dress the wound before applying a splint.
C. irrigate the wound before applying a dressing.
D. allow the material that secures the splint to serve as the dressing
B. dress the wound before applying a splint.
79
```
Which of the following musculoskeletal injuries has the GREATEST risk for shock due to blood loss?
A. Pelvic fracture
B. Posterior hip dislocation
C. Unilateral femur fracture
D. Proximal humerus fracture
```
A. Pelvic fracture
80
A patient injured her knee while riding a bicycle. She is lying on the ground, has her left leg flexed, is in severe pain, and cannot move her leg. Your assessment reveals obvious deformity to her left knee. Distal pulses are present and strong. The MOST appropriate treatment for her injury involves:
A. wrapping her entire knee area with a pillow.
B. splinting the leg in the position in which it was found.
C. straightening her leg and applying two rigid board splints.
D. straightening her leg and applying and inflating an air splint.
B. splinting the leg in the position in which it was found.
