Unit 33, 34 Flashcards
1) The maxillae form which of the following structures?
A) Lower jaw B) Upper jaw C) Cheek bones D) Forehead
B) Upper jaw
2) What is another name for the zygomatic bone?
A) Malar B) Maxillae C) Temporal D) Mandible
A) Malar
3) The bony bumps you feel along the center of a person’s back are known as which of the following?
A) Vertebrae B) Foramen magnum C) Spinous process D) Dermatome
C) Spinous process
4) Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve?
A) Spinous process B) Maxillae C) Malar D) Dermatome
D) Dermatome
5) Messages from the body to the brain are carried by which of the following types of nerves?
A) Sensory B) Skeletal C) Motor D) Cranial
A) Sensory
6) Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae? A) Peripheral nervous system B) Central nervous system
C) Autonomic nervous system D) All of the above
A) Peripheral nervous system
7) Which of the following is a function of the autonomic nervous system?
A) Speaking B) Running or walking
C) Constriction of blood vessels D) Solving complex math problems
C) Constriction of blood vessels
8) Which of the following is controlled by the left side of the brain?
A) Sensation in the left arm B) Sensation of the right leg
C) Movement of both lower extremities D) Movement of the left arm
B) Sensation of the right leg
9) To which of the following sections of the spine are the ribs attached?
A) Thoracic B) Sacral C) Cervical D) Lumbar
A) Thoracic
10) Which portions of the spine are the most vulnerable to injury?
A) Thoracic and lumbar B) Cervical and lumbar C) Cervical and sacra D) Thoracic and sacra
B) Cervical and lumbar
11) Which of the following is the opening at the base of the skull?
A) Foramen magnum B) Orbits C) Spinous process D) Temporomandibular joint
A) Foramen magnum
12) How many cervical vertebrae are there? A) 7 B) 12 C) 5 D) 4
A) 7
13) 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 blood pressure B) Glasgow Coma Scale (GCS) of 15
C) Constricted pupils D) Increased pulse rate
A) Increased blood pressure
14) As pressure within the cranium increases, which of the following is the result?
A) Decreased blood pressure, decreased pulse B) Increased blood pressure, decreased pulse
C) Decreased blood pressure, increased pulse D) Increased blood pressure, increased pulse
B) Increased blood pressure, decreased pulse
15) A fracture of which of the following bones would be considered a skull fracture?
A) Temporal bone B) Nasal bones C) Maxilla D) Any of the above
D) Any of the above
16) Which of the following injuries is considered an indirect brain injury?
A) Cerebral laceration B) Depressed skull fracture with cerebral penetration by bone fragments
C) Gunshot wound to the head D) Concussion
D) Concussion
17) Which of the following is classified as an open head injury?
A) Contusion without a skull fracture B) Laceration with a skull fracture
C) Laceration without a skull fracture D) Both A and B
B) Laceration with a skull fracture
18) Which of the following statements concerning a concussion is true?
A) It is a bruising of the brain tissue. B) The patient may not have any symptoms of the injury.
C) It is accompanied by recurrent episodes of unconsciousness. D) All of the above
B) The patient may not have any symptoms of the injury.
19) When blood accumulates between the brain and the dura mater, what is the result?
A) Epidural contusion B) Subdural contusion C) Epidural hematoma D) Subdural hematoma
D) Subdural hematoma
20) 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) Tonic-clonic activity B) Posturing C) Cushing reflex D) Battle sign
B) Posturing
21) 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 intracranial pressure B) Coup-contrecoup injury
C) Closed head injury D) Increased arterial pressure
A) Increased intracranial pressure
22) Which of the following is a sign of possible brain injury?
A) Deep laceration of the scalp B) Projectile vomiting C) Irregular breathing patterns D) All of the above
D) All of the above
23) Which of the following is a potential complication of hyperventilating a patient with a brain injury?
A) Increasing the amount of carbon dioxide in the blood B) Increasing blood flow to the brain
C) Decreasing blood flow to the brain D) Decreasing the patient’s blood pressure
C) Decreasing blood flow to the brain D
24) Which of the following causes worsening of the damage in a brain injury?
A) Allowing seepage of cerebrospinal fluid (CSF) from the ears or nose B) Administration of 100% oxygen
C) Failure to keep the patient awake and talking D) Improper management of airway and ventilation
D) Improper management of airway and ventilation
25) Which of the following signs is least likely to indicate a traumatic brain injury?
A) Low blood pressure B) Irregular breathing pattern C) Vomiting D) Irrational behavior
A) Low blood pressure
26) Of the following patients, which injury is the highest priority to receive bag-valve mask ventilations?
A) 25-year-old female victim of battery who is awake but complains of a headache and has bloody fluid draining from her nose and left ear
B) 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli
C) 25-year-old male who regained consciousness one or two minutes after being struck on the head by a baseball bat and is now asking repetitive questions
D) 70-year-old male who struck his head when he fell in the parking lot, has a large laceration on his forehead, and is disoriented
B) 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli
27) You are treating an unresponsive homeless patient found in an alley. During your assessment you notice the Battle sign, which is bruising:
A) between the eyes. B) on the back of the head. C) on the back of the neck. D) behind the ear.
D) behind the ear.
28) A 36-year-old male was accidentally shot with a nail gun into the head. You see the nail, which protrudes about 2 to 3 centimeters from the skull, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site?
A) Bleeding from the patient’s wound is minimal. B) The patient develops excessive intracranial pressure (ICP).
C) The patient begins to complain of shortness of breath. D) None of the above.
D) None of the above.
29) Your patient is a 30-year-old construction worker who fell from scaffolding and has been impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the best course of action?
A) Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the scene time under 10 minutes.
B) Transport with the reinforcement bar in place to prevent delay at the scene.
C) Test the reinforcement bar for stability and remove it only if it is loose enough to be easily pulled from the wound.
D) Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.
D) Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.
30) A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat?
A) Cervical spine trauma B) Brain injury C) Airway obstruction D) All of the above
D) All of the above
31) Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be most appropriate?
A) Insert an oropharyngeal airway (OPA) and ventilate via bag-valve mask (BVM) at 30 breaths per minute.
B) Insert a nasopharyngeal airway and give oxygen by nonrebreather mask (NRB) at 15 lpm.
C) Insert an oropharyngeal airway and give oxygen by nonrebreather mask at 10 lpm.
D) Insert an oropharyngeal airway and ventilate via bag-valve mask at 10 to 12 breaths per minute.
D) Insert an oropharyngeal airway and ventilate via bag-valve mask at 10 to 12 breaths per minute.
32) Your patient is a 16-year-old centerfielder on his high school baseball team. He was injured when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to tell you what happened. His vital signs are pulse 88, blood pressure 132/86, respiratory rate 16, and pupils equal. As you assess his head, you do not see any cuts or bleeding, but you feel a spongy, depressed area over his left ear. You should suspect a(n):
A) closed head injury. B) laceration injury. C) open head injury. D) indirect injury.
C) open head injury
33) 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) closed head injury. C) contusion. D) open head injury.
B) closed head injury
34) You are called for a man who is not acting right. His wife says he was outside working in the garden but didn’t come in for lunch when he was called. She went to check on him and found him sitting next to a stump, confused. You assessment shows a pulse rate of 58, blood pressure of 186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you don’t see any obvious indication that he has fallen. You should suspect a(n):
A) closed head injury. B) open head injury. C) insecticide poisoning. D) nontraumatic brain injury.
D) nontraumatic brain injury.
35) Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following best describes his level of consciousness?
A) Alert B) Verbal C) Painful D) Unresponsive
C) Painful
36) What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, and can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts?
A) 12 B) 14 C) 15 D) 13
B) 14
37) When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building? A) At the hospital before writing the care report B) En route to the hospital
C) As he approaches the patient D) Before departing from the scene
B) En route to the hospital
38) Which of the following is not used to calculate a patient’s GCS?
A) Eye movement B) Verbal response C) Work of breathing D) Motor response
C) Work of breathing
39) Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the following?
A) Eye opening, verbal response, and motor response B) Grip strength, verbal response, and eye opening
C) Verbal response, motor response, and AVPU D) Motor response, arm movement, and speech
A) Eye opening, verbal response, and motor response
40) You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check?
A) Eye opening, motor response, and verbal response B) Motor response, verbal response, and attentiveness
C) Speech patterns, motor patterns, and mental status D) Verbal responses, motor skills, and mental status
A) Eye opening, motor response, and verbal response
41) While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop? A) Concussion B) Air embolus C) Contusion D) Increasing intracranial pressure
B) Air embolus
42) Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood, and you are considering how you will control the bleeding. Your primary treatment should be to:
A) transport the patient immediately in the supine position.
B) place your gloved hand over the wound before placing an occlusive dressing.
C) apply a dry, sterile dressing to the wound and then wrap with gauze.
D) pack the wound with bulky dressings while avoiding placing pressure on the wound.
B) place your gloved hand over the wound before placing an occlusive dressing.
43) When a patient has a serious open wound to the neck, you are concerned about the possibility of an air embolism. The reason an air embolism can occur is because of:
A) the higher pressure in the vessels of the neck. B) the negative pressure in the chest.
C) pressure in the large neck veins that is lower than atmospheric pressure. D) damage to the trachea.
C) pressure in the large neck veins that is lower than atmospheric pressure.
44) 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) Capillaries B) Arterioles C) Arteries D) Veins
D) Veins
45) Your patient is a 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you suspect?
A) Cervical spine injury B) Lumbar spine injury
C) Soft-tissue injury of the neck only D) Thoracic spine injury
A) Cervical spine injury
46) A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n):
A) distraction injury. B) compression fracture. C) extension injury. D) whiplash injury.
D) whiplash injury.
47) 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) Priapism B) Air embolism C) Increased intracranial pressure D) Neurogenic shock
D) Neurogenic shock
48) In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury?
A) Hold the patient’s head still in a neutral, “eyes forward” position.
B) Gently apply pressure to the top of the patient’s head.
C) Maintain the patient’s head and neck in the position they are found.
D) Provide approximately 15 pounds of upward cervical traction.
A) Hold the patient’s head still in a neutral, “eyes forward” position.
49) Which of the following is not a common field finding in spinal injuries?
A) Deformity B) Impaired breathing C) Tenderness D) Pain with movement
A) Deformity
50) Which of the following is the underlying cause of neurogenic shock?
A) Blood loss from damaged spinal blood vessels B) Failure of the heart to adequately pump blood
C) Extreme emotional response to paralysis D) Failure of the nervous system to control the diameter of blood vessels
D) Failure of the nervous system to control the diameter of blood vessels
51) Which of the following may result from the application of a cervical collar that is too large for the patient?
A) Rotation of the head and neck B) Hyperflexion of the neck
C) Hyperextension of the neck D) Excessive lateral movement of the mandible
C) Hyperextension of the neck
52) Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine injuries?
A) Soft cervical collars B) Pair of pillows C) Rigid cervical collars D) Long spine board
C) Rigid cervical collars
53) Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is sitting in the driver’s seat and conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. After applying a cervical collar, which of the following actions represents the most appropriate way for removing the patient from the vehicle?
A) Perform rapid extrication onto a long spine board.
B) Have the patient stand up and then do a standing takedown onto a long backboard.
C) Place the backboard on the stretcher and have the patient stand, turn, and lie down on the backboard while you maintain manual inline stabilization of the cervical spine.
D) Place a long spine board under the patient’s buttocks and then carefully lower the patient to the board in a supine position.
D) Place a long spine board under the patient’s buttocks and then carefully lower the patient to the board in a supine position.
54) When using a short spine immobilization device, which part of the body is secured last?
A) Arms B) Torso C) Head D) Legs
C) Head
55) 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) Provide cervical spine immobilization.
C) Hyperventilate at a rate of 24 breaths per minute using supplemental oxygen.
D) Log-roll the patient onto a short spine board
B) Provide cervical spine immobilization.
56) Your patient is pregnant at 30 weeks’ gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine?
A) Use a short immobilization device and transport the patient in a sitting position.
B) Place the patient supine on the backboard.
C) Place the patient on her left side on the backboard.
D) Place the patient supine on the backboard, then put a pillow under the right side of the backboard.
D) Place the patient supine on the backboard, then put a pillow under the right side of the backboard.
57) When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move?
A) EMT at the head of the patient B) EMT with the highest level of training
C) EMT with the most seniority D) EMT at the heaviest portion of the patient
A) EMT at the head of the patient
58) 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) pad under his shoulders to straighten his neck. B) tip his head back to gain neutral alignment.
C) place towels on either side of the helmet to stabilize it. D) remove the helmet to better manage proper alignment.
D) remove the helmet to better manage proper alignment.
59) In which of the following circumstances should a helmet be removed?
A) If you suspect a skull fracture and need to palpate the head
B) If you want to place a nasal cannula on the patient but cannot because his ears are covered by the helmet
C) If the helmet interferes with airway management
D) If the helmet fits so snugly that you cannot inspect the ears for the presence of blood or fluid
C) If the helmet interferes with airway management
60) At which point may manual stabilization of the cervical spine be terminated?
A) Only when directed to do so by medical control B) When the patient is secured to a long backboard
C) After a short immobilization device has been applied D) After a cervical collar has been applied
B) When the patient is secured to a long backboard
61) Which of the following describes the proper position of the patient’s head for spinal immobilization?
A) Chin tilted upward for airway maintenance B) Neutral, inline position
C) Stabilized in position found D) The “sniffing” position
B) Neutral, inline position
62) Which of the following may be a hazard of an improperly fitting cervical collar?
A) Allows hyperextension of the neck B) Prevents the patient from opening his mouth
C) Allows flexion of the neck D) All of the above
D) All of the above
63) 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) wait for ALS to treat the patient. B) immobilize his cervical spine.
C) splint any other bone or joint injuries. D) complete an initial set of vital signs.
B) immobilize his cervical spine.
64) 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) cervical spine is not supported by other bony structures. B) lumbar area is rarely injured due to the rib support.
C) thoracic spine is especially vulnerable to injury. D) coccyx is easily dislocated.
A) cervical spine is not supported by other bony structures.
1) What is the definition of multiple trauma?
A) A trauma in which the patient has more than one serious injury
B) A trauma in which there are multiple casualties
C) A trauma that requires the response of multiple agencies
D) Multiple injuries that affect more than one body system
A) A trauma in which the patient has more than one serious injury
2) What is the definition of multisystem trauma?
A) One or more injuries that affect more than one body system
B) Trauma in which the patient has more than one serious injury
C) A trauma in which there are multiple casualties
D) A trauma that requires the response of multiple agencies
A) One or more injuries that affect more than one body system
3) Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following?
A) Make decisions beyond what is usually called for.
B) Provide the best quality care possible, including definitive care on scene.
C) Respond above and beyond the call of duty.
D) Practice outside the scope of practice in order to provide the greatest good.
A) Make decisions beyond what is usually called for.
4) Which one of the following is not a key decision for the EMT when faced with a multisystem or multiple trauma patient?
A) Should I transport to a trauma center? B) Do I need to minimize on-scene time?
C) Should I allow police to interview the patient on scene? D) Is the patient seriously injured?
C) Should I allow police to interview the patient on scene?
5) What are three elements of successful trauma care that field practitioners can use that will ultimately translate into greater rates of survival?
A) Teamwork, timing, and transport B) Ground ambulances, air helicopters, and trauma centers
C) Lights, sirens, and diesel D) Physiological determinants, anatomic criteria, and mechanism of injury
A) Teamwork, timing, and transport
6) You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has Glasgow Coma Scale scores of 3, 4, and 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient?
A) The nearest community facility B) Level I Trauma Center
C) Level II Trauma Center D) Nowhere, because the patient is an adult and refusing care
C) Level II Trauma Center
7) Based on the following presentations of patient injuries, which one would be considered most severe according to the anatomic criteria of the CDC trauma triage guidelines, justifying immediate transportation to a trauma center?
A) Midline cervical spine pain B) Open (compound) midshaft femur fracture
C) Closed head injury D) Flail chest
D) Flail chest
8) 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) Diagnosing the causes for a patient’s presentation and identifying a course of definitive care
C) Deciding whether to treat life-threatening injuries on scene or to load and go
D) Determining the potential liability involved in performing life-saving interventions
A) Determining patient severity, amount of time on scene, and transport destination
9) What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers?
A) Teamwork, timing, and transport
B) Physiological determinants, anatomic criteria, and mechanism of injury
C) Patient priority, amount of time on scene, and transport destination D) Lights, sirens, and diesel
B) Physiological determinants, anatomic criteria, and mechanism of injury
10) What is the highest Glasgow Coma Scale (GCS) measurement indicating altered mental status according to CDC guidelines? A) 12 B) 13 C) 8 D) 14
B) 13
11) An adult fall meets trauma triage criteria set forth by the CDC if it is greater than:
A) 10 feet. B) 25 feet. C) 20 feet. D) 15 feet.
C) 20 feet.
12) A respiratory rate of less than ________ or greater than ________ in cases of trauma is a criterion for immediate transportation to a trauma center according to the CDC physiologic guidelines.
A) 8; 32 B) 10; 29 C) 12; 20 D) 5; 45
B) 10; 29
13) Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations?
A) An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt
B) An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS response
C) A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC
D) An elderly patient who slipped out of her wheelchair and is complaining of pelvic pain
C) A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC
14) What type of trauma triage criteria regarding transport would a finger amputation receive?
A) Any hospital, as long as on-line medical direction approves the facility’s capabilities
B) Any hospital with surgical facilities C) Trauma center D) Patient’s choice of destination
B) Any hospital with surgical facilities
15) Which patient requires transport to a trauma center?
A) Unresponsive patient with hypotension B) Patient who responds to verbal stimuli
C) Responsive patient with tachycardia D) Patient responsive with a respiratory rate of 10
A) Unresponsive patient with hypotension
16) You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is the best approach regarding transport of this patient?
A) Dispatch and await the medical helicopter, which is 20 minutes away.
B) Transport to a local community hospital approximately 15 minutes away via ground.
C) Begin transport to the trauma center on the ground, which is 1.5 hours’ driving time.
D) Contact the community hospital to ask them if they think they can take this patient.
A) Dispatch and await the medical helicopter, which is 20 minutes away.
17) A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient who should be immediately transported to a trauma center if secondary to trauma.
A) 20 B) 25 C) 18 D) 30
A) 20
18) What criterion based on the CDC guidelines allows a discretionary approach to trauma triage?
A) Fall greater than 20 feet B) Partial ejection from automobile
C) Motorcycle crash greater than 20 mph D) EMS provider judgment
D) EMS provider judgment
19) Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone?
A) Vehicle rollover B) Vehicle crash-generated telemetry data
C) Intrusion into the occupant area greater than 8 inches D) Auto versus pedestrian
D) Auto versus pedestrian
20) You are dispatched to a motorcycle crash with one patient involved. What on-scene intervention is inappropriate for this patient?
A) Begin chest compressions. B) Extensively splint the patient’s injuries.
C) Suction vomit and secretions from the airway. D) Manually stabilizing the cervical spine.
B) Extensively splint the patient’s injuries.
21) Which of the following choices is not a justifiable reason for delaying transport of a critical trauma patient?
A) Suctioning the airway B) Awaiting arrival of police on scene
C) Ventilating a patient in respiratory distress D) Immobilizing the patient to a long spine board
B) Awaiting arrival of police on scene
22) Which of the following is not a significant mechanism of injury for a driver in a vehicle accident according to CDC guidelines?
A) Spidering of the windshield B) Encroachment greater than 12 inches of the driver’s compartment
C) Death of a passenger in the same vehicle D) Ejection from the vehicle
A) Spidering of the windshield
23) You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority?
A) Arterial bleed B) Snoring respirations C) Broken wrist D) Femur fracture
A) Arterial bleed
24) 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) Take the patient to a trauma center. B) Have the patient to sign a refusal form.
C) Call for ALS intercept. D) Explain to the patient the need for transport to a local community hospital.
D) Explain to the patient the need for transport to a local community hospital.
25) You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the best transport decision?
A) Call medical control for advice from the trauma center.
B) Divert to the trauma center because the patient is becoming symptomatic.
C) Continue transporting to the local hospital because you’ve already given your report and they accepted the patient.
D) Continue transporting to the local hospital because it’s the closest facility.
B) Divert to the trauma center because the patient is becoming symptomatic.
26) According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a patient should be transported to a trauma center. A) 90 B) 100 C) 110 D) 80
A) 90
27) What are the three elements of the Revised Trauma Score?
A) GCS, pulse rate, and respiratory rate B) GCS, systolic blood pressure, and pulse rate
C) GCS, systolic blood pressure, and respiratory rate
D) Level of consciousness, systolic blood pressure, and pulse rate
C) GCS, systolic blood pressure, and respiratory rate
28) Which patient is the highest priority?
A) Patient with a Glasgow Coma Scale of 15 B) Patient with a Revised Trauma Score of 12
C) Patient with a penetrating chest injury D) Patient with a broken femur
C) Patient with a penetrating chest injury
