Unit 5 Trauma Part 2 Chapters 31-34

Question 1

A 37-year-old male sustained blunt trauma to the left anterolateral chest. He is conscious, but confused, and complains of pain during inspiration; his respirations are shallow. Your assessment reveals crepitus to the area of impact. Breath sounds, although weakly audible, are bilaterally equal. The pulse oximeter reads 89% on room air. You should:
Select one:
a. encourage him to breathe shallowly to reduce his pain.
b. assist his ventilations with a bag-mask device.
c. circumferentially wrap his chest for support.
d. apply high-flow oxygen via a nonrebreathing mask.

Answer 1

b. assist his ventilations with a bag-mask device.

Question 2

Which of the following mechanisms of injury is most commonly associated with traumatic dissection or rupture of the aorta?
Select one:
a. Motorcycle crashes
b. Penetrating injuries
c. Significant falls 
d. Lateral chest wall trauma

Answer 2

c. Significant falls

Question 3

Any injury at the nipple line should be considered a thoracic and abdominal injury because:
Select one:
a. the diaphragm may elevate as high as the nipple line upon exhalation.
b. the diaphragm ascends into the chest cavity during the inspiration phase.
c. the liver, spleen, and stomach are completely protected by the ribs.
d. penetrating injuries to the upper chest often result in liver lacerations.

Answer 3

a. the diaphragm may elevate as high as the nipple line upon exhalation.

Question 4

A 22-year-old male with blunt thoracic trauma presents with severely labored respirations. His level of consciousness is decreased, and his heart rate is 140 beats/min and thready. Further assessment reveals absent breath sounds on the entire left side of his chest and jugular venous distention. After appropriately managing his airway and immobilizing his spine, you should:
Select one:
a. transport immediately, start a large-bore IV en route, and request a paramedic rendezvous.
b. insert a supraglottic airway device, start a large-bore IV, and transport to a trauma center.
c. perform a secondary assessment, transport at once, and establish vascular access en route.
d. start a large-bore IV, administer 20 mL/kg normal saline boluses, reassess his vital signs, and transport.

Answer 4

a. transport immediately, start a large-bore IV en route, and request a paramedic rendezvous.

Question 5

Regardless of the cause, hyperventilation causes:
Select one:
a. metabolic alkalosis.
b. respiratory alkalosis.
c. metabolic acidosis.
d. respiratory acidosis.

Answer 5

b. respiratory alkalosis.

Question 6

The primary muscle(s) of respiration is/are the:
Select one:
a. intercostal muscles and latissimus dorsi.
b. pectoralis major and diaphragm.
c. diaphragm and intercostal muscles.
d. sternocleidomastoid muscle.

Answer 6

c. diaphragm and intercostal muscles.

Question 7

In contrast to paradoxical chest motion, asymmetrical chest movement occurs when:
Select one:
a. both sides of the chest wall move in unison during deep inspiration.
b. one side of the chest fails to move normally during inspiration.
c. both sides of the chest move shallowly during normal breathing.
d. one segment of the chest wall moves opposite the remainder of the chest.

Answer 7

b. one side of the chest fails to move normally during inspiration.

Question 8

A construction worker is pinned between a truck and a loading dock. He is conscious and in respiratory distress. Further assessment reveals upper torso and facial cyanosis and bilateral conjunctival hemorrhages. When treating this patient, you must:
Select one:
a. administer 3 L of normal saline before he is freed.
b. be prepared for severe hypotension once he is freed.
c. suspect that he will experience metabolic alkalosis.
d. avoid fluid boluses because this may cause pulmonary edema.

Answer 8

b. be prepared for severe hypotension once he is freed.

Question 9

A trauma patient who presents with shock, jugular venous distention, and bilaterally equal breath sounds has most likely experienced a:
Select one:
a. pericardial tamponade.
b. pulmonary contusion.
c. massive hemothorax.
d. simple pneumothorax.

Answer 9

a. pericardial tamponade.

Question 10

Which of the following is a late sign of a tension pneumothorax?
Select one:
a. Profound shortness of breath
b. Contralateral tracheal shift
c. Narrowing pulse pressure
d. Bulging intercostal muscles

Answer 10

b. Contralateral tracheal shift

Question 11

Commotio cordis is a condition in which:
Select one:
a. shearing forces tear the aorta from its point of attachment, resulting in profound intrathoracic hemorrhage.
b. immediate cardiac arrest occurs when the chest is impacted during the heart’s repolarization period.
c. increased intrathoracic pressure causes the intercostal muscles to bulge from in between the ribs.
d. a patient takes a deep breath just before blunt trauma to the chest, resulting in rupture of one or both lungs.

Answer 11

b. immediate cardiac arrest occurs when the chest is impacted during the heart’s repolarization period.

Question 12

A 40-year-old male experienced penetrating trauma to the left anterior chest. During inhalation, you note that his radial pulses become barely palpable. You should suspect:
Select one:
a. aortic disruption.
b. cardiac tamponade.
c. hemopneumothorax.
d. myocardial contusion.

Answer 12

b. cardiac tamponade.

Question 13

Chest trauma is a common cause of respiratory acidosis and rapidly leads to death because the:
Select one:
a. kidneys fail and are unable to normalize the blood’s pH.
b. pH level of the blood increases precipitously.
c. renal system cannot compensate quickly enough.
d. body eliminates CO2 more rapidly than it is produced.

Answer 13

c. renal system cannot compensate quickly enough.

Question 14

Which of the following statements regarding the parietal pericardium is correct?
Select one:
a. It forms the pericardium and is in direct contact with the myocardium and vena cava.
b. It cannot distend acutely but can slowly distend with as much as 1,000 mL of blood.
c. It acutely distends with as little as 500 mL of blood or excess pericardial fluid.
d. It is a thin fibrous sac that encases the heart and normally contains 200 mL of fluid.

Answer 14

b. It cannot distend acutely but can slowly distend with as much as 1,000 mL of blood.

Question 15

Common clinical findings in a patient with a suspected myocardial contusion include all of the following, except:
Select one:
a. ecchymosis to the sternum and surrounding area.
b. unilaterally diminished or absent breath sounds.
c. tachycardia and a pulse that may be irregular.
d. retrosternal chest pain and shortness of breath.

Answer 15

b. unilaterally diminished or absent breath sounds.

Question 16

Central chemoreceptors are located in the:
Select one:
a. aortic bodies.
b. diaphragm.
c. medulla.
d. carotid bodies.

Answer 16

c. medulla.

Question 17

When treating a patient with a suspected myocardial contusion, it is especially important to monitor the patient for:
Select one:
a. signs of right-sided heart failure.
b. evidence of pulmonary edema.
c. distention of the jugular veins.
d. a heart rate that exceeds 90 beats/min.

Answer 17

b. evidence of pulmonary edema.

Question 18

You are performing a rapid assessment on a 30-year-old male who was involved in a motor-vehicle crash. The patient is conscious, but restless. He complains of difficulty breathing and chest pain. Your assessment reveals diminished breath sounds in the left hemithorax and normal jugular veins. His blood pressure is 124/64 mm Hg, heart rate is 120 and regular, and respirations are 26 breaths/min and shallow. Which of the following injuries should you suspect?
Select one:
a. Simple pneumothorax
b. Moderate hemothorax
c. Tension pneumothorax
d. Myocardial contusion

Answer 18

a. Simple pneumothorax

Question 19

Common signs of a chest injury include all of the following, except:
Select one:
a. hypotension.
b. hemoptysis.
c. hyperpnea.
d. tachycardia.

Answer 19

c. hyperpnea.

Question 20

Fracture of the first and second ribs following severe blunt trauma would most likely result in a:
Select one:
a. myocardial contusion.
b. massive hemothorax.
c. tracheobronchial injury.
d. pericardial tamponade.

Answer 20

c. tracheobronchial injury.

Question 21

When percussing the chest of a patient who experienced blunt chest trauma, you note hyperresonance on the left side of his chest. This suggests:
Select one:
a. blood in the pleural space.
b. alveolar hyperinflation.
c. myocardial compression.
d. air in the pleural space.

Answer 21

d. air in the pleural space.

Question 22

When administering IV fluids to a patient with suspected intrathoracic bleeding, it is important to remember that:
Select one:
a. most patients require up to 2 L of crystalloid solution.
b. a target systolic blood pressure of 100 should be achieved.
c. fluids should be restricted, even in the presence of shock.
d. increasing the BP with fluids may increase the bleeding.

Answer 22

d. increasing the BP with fluids may increase the bleeding.

Question 23

Shortly after arriving home from the airport, a 19-year-old male experienced an acute onset of sharp chest pain and difficulty breathing. He denies a history of trauma. Your assessment reveals that he is in moderate distress and is tachycardic. Breath sounds are diminished over the apex of the right lung. You should suspect a:
Select one:
a. acute onset of pneumonia.
b. developing tension pneumothorax.
c. spontaneous pneumothorax.
d. localized hemothorax.

Answer 23

c. spontaneous pneumothorax.

Question 24

You are performing a rapid assessment on a 30-year-old male who was involved in a motor-vehicle crash. The patient is conscious, but restless. He complains of difficulty breathing and chest pain. Your assessment reveals diminished breath sounds in the left hemithorax and normal jugular veins. His blood pressure is 124/64 mm Hg, heart rate is 120 and regular, and respirations are 26 breaths/min and shallow. Which of the following injuries should you suspect?
Select one:
a. Myocardial contusion
b. Moderate hemothorax
c. Simple pneumothorax 
d. Tension pneumothorax

Answer 24

c. Simple pneumothorax

Question 25

A 25-year-old male experienced blunt abdominal trauma and is developing shock. Which of the following signs would you expect to manifest late?
Select one:
a. Restlessness
b. Pale, cool skin
c. Hypotension
d. Tachycardia

Answer 25

c. Hypotension

Question 26

A 56-year-old male caught the foreskin of his penis in a long segment of the zipper of his pants. He is in extreme pain, his blood pressure is 150/88 mm Hg, his pulse rate is 120 beats/min and strong, and his respirations are 22 breaths/min with adequate depth. The closest hospital is 40 miles away. You should:
Select one:
a. carefully cut the zipper out of the pants, control any bleeding, and transport.
b. allow the patient’s wife to transport him to the hospital because he is not unstable.
c. provide prompt transport to the hospital while providing emotional support.
d. attempt to unzip the pants and request a paramedic unit to give morphine.

Answer 26

a. carefully cut the zipper out of the pants, control any bleeding, and transport.

Question 27

Which of the following organs lie in the right upper quadrant of the abdomen?
Select one:
a. Gallbladder and spleen
b. Pancreas and liver
c. Liver and gallbladder
d. Spleen and liver

Answer 27

c. Liver and gallbladder

Question 28

Blunt or penetrating trauma can be especially lethal in pregnant patients because the:
Select one:
a. gravid uterus is highly vascular. 
b. uterus descends into the pelvis.
c. fetus can sustain serious injury.
d. vital signs usually remain normal.

Answer 28

a. gravid uterus is highly vascular.

Question 29

The absence of pain when palpating a trauma patient’s abdomen does not rule out the possibility of intraabdominal bleeding because:
Select one:
a. the strong abdominal musculature becomes tense following blunt trauma.
b. most cases of intraabdominal hemorrhage occur in the retroperitoneal space.
c. the liver and spleen are both well protected by the lower ribcage.
d. blood within the peritoneal cavity does not provoke an inflammatory response.

Answer 29

d. blood within the peritoneal cavity does not provoke an inflammatory response.

Question 30

Blunt abdominal trauma may result in tearing of the mesentery, which is/are:
Select one:
a. the main supporting structure of the descending abdominal aorta.
b. a vascular network that provides exclusive blood supply to the liver.
c. multiple bands of thick muscle that protect the abdominal organs.
d. membranous folds that attach the intestines to the abdominal wall.

Answer 30

d. membranous folds that attach the intestines to the abdominal wall.

Question 31

When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should:
Select one:
a. treat any injuries and question the patient about the event.
b. treat any injuries and provide privacy and reassurance.
c. transport only and provide support and reassurance.
d. limit your examination to a secondary assessment only.

Answer 31

b. treat any injuries and provide privacy and reassurance.

Question 32

Patients with a significant abdominal injury:
Select one:
a. most commonly have an injured spleen.
b. have increased pain with movement.
c. develop hypotension as an early sign.
d. become tachycardic after severe blood loss.

Answer 32

b. have increased pain with movement.

Question 33

During your assessment of a 48-year-old female with localized blunt abdominal trauma, you should:
Select one:
a. vigorously palpate the entire abdomen.
b. palpate the most painful area first.
c. be prepared for the patient to vomit.
d. immobilize her spinal column.

Answer 33

c. be prepared for the patient to vomit.

Question 34

The presence of gastric juices and bacteria in the abdominal cavity causes an intense inflammatory reaction called:
Select one:
a. gastritis.
b. appendicitis.
c. diverticulitis.
d. peritonitis.

Answer 34

d. peritonitis.

Question 35

In the absence of obvious external trauma, an abdominal injury would be most difficult to assess for in a:
Select one:
a. hypovolemic patient.
b. unresponsive patient. 
c. intoxicated patient.
d. patient in severe pain.

Answer 35

b. unresponsive patient.

Question 36

In an attempt to minimize the pain associated with abdominal trauma, the patient will typically:
Select one:
a. take deep breaths to relieve pressure off of the diaphragm.
b. draw his or her knees into the abdomen and tense the abdominal muscles.
c. prefer to extend his or her legs and relax the muscles of the abdomen.
d. draw his or her knees into the abdomen and breathe deeply.

Answer 36

b. draw his or her knees into the abdomen and tense the abdominal muscles.

Question 37

The kidneys lie within the:
Select one:
a. retroperitoneal space.
b. right upper quadrant.
c. anterior abdomen.
d. left upper quadrant.

Answer 37

a. retroperitoneal space.

Question 38

In addition to controlling bleeding and immobilizing the spine as needed, appropriate care for a patient with a penetrating abdominal wound and signs of shock includes:
Select one:
a. starting two large-bore IV lines, running the IVs wide open, and promptly transporting to the closest, most appropriate facility.
b. assisting ventilations, infusing normal saline to increase the systolic blood pressure, and transporting to the closest hospital.
c. administering high-flow oxygen, limiting IV fluids to a maximum of 500 mL, and transporting to a regional trauma center.
d. ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the most appropriate facility.

Answer 38

d. ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the most appropriate facility.

Question 39

Which of the following seatbelt positions will most likely result in severe intraabdominal injuries when a vehicle suddenly decelerates?
Select one:
a. Use of the lap belt only with the shoulder harness behind the back
b. Shoulder harness and lap belt placed superior to the iliac crest
c. Shoulder harness not used and lap belt across the anterior iliac crest
d. Shoulder harness used and lap belt across the anterior iliac crest

Answer 39

b. Shoulder harness and lap belt placed superior to the iliac crest

Question 40

Which of the following would be the least reliable assessment parameter when determining the neurovascular status of a patient with a possible extremity fracture?
Select one:
a. Distal sensory function
b. Quality of distal pulses
c. Ability to move the extremity
d. Distal motor function

Answer 40

c. Ability to move the extremity

Question 41

You have applied an air splint to the deformed forearm of a critically injured patient while waiting for a helicopter to arrive. When the helicopter arrives, the flight medic asks you to accompany the patient. During the flight, you should:
Select one:
a. monitor the splint and let air out as needed.
b. deflate the air splint by approximately 50%.
c. remove the air splint and apply a rigid splint.
d. inflate the air splint by approximately 50%.

Answer 41

a. monitor the splint and let air out as needed.

Question 42

In an average-sized adult male, a closed unilateral femur fracture can result in internal blood loss of up to:
Select one:
a. 2,500 mL.
b. 1,000 mL.
c. 500 mL.
d. 2,000 mL.

Answer 42

b. 1,000 mL.

Question 43

Which of the following describes an injury caused by indirect force?
Select one:
a. Rupture of the stomach following the blast phase of an explosion
b. A fall on an outstretched hand with a fractured wrist and a dislocated elbow
c. Knee striking the dashboard during a car crash and fracturing the patella
d. Being struck by a car and sustaining a pelvic fracture and a closed head trauma

Answer 43

b. A fall on an outstretched hand with a fractured wrist and a dislocated elbow

Question 44

A 34-year-old male twisted his lower leg and ankle while skiing. He complains of severe pain and swelling to the area. When assessing for deformity, you should:
Select one:
a. place heat on his leg to force blood away from the area.
b. gently manipulate the injured limb to elicit crepitus.
c. apply an icepack and reassess after the swelling subsides.
d. compare the injured extremity to the uninjured extremity.

Answer 44

d. compare the injured extremity to the uninjured extremity.

Question 45

An elderly female with a history of osteoarthritis has sustained an apparent dislocation of her left knee. She is conscious and in severe pain. Her knee is flexed and distal neurovascular functions are grossly intact. When splinting her injury, you should:
Select one:
a. gently straighten her knee to facilitate placement of a zippered air splint.
b. keep her knee flexed and apply board splints secured at the hip and ankle.
c. carefully straighten her knee and apply a Hare or Sager traction splint.
d. keep her knee flexed and apply two short board splints to stabilize the knee.

Answer 45

b. keep her knee flexed and apply board splints secured at the hip and ankle.

Question 46

When assessing a patient with multiple systems trauma, which of the following musculoskeletal injuries would pose the greatest threat to the patient's life?
Select one:
a. Displaced fracture of the pelvis
b. Single open long bone fracture
c. Multiple open fractures 
d. Dislocation of a major joint

Answer 46

c. Multiple open fractures

Question 47

Which of the following is the most effective method of immobilizing a fractured clavicle?
Select one:
a. Pillow or other padding
b. Short arm rigid splint
c. Sling and swathe
d. Modified wrist sling

Answer 47

c. Sling and swathe

Question 48

A 70-year-old female slipped on a throw rug, but grabbed an adjacent table before she fell to the ground. When assessing her, you should recall that:
Select one:
a. most mishaps in the elderly patient occur as a result of near syncope.
b. even minor mechanisms of injury can result in fractures in the elderly.
c. this mechanism of injury has most likely resulted in a hip dislocation.
d. osteoporosis is the most common cause of falls in the elderly population.

Answer 48

b. even minor mechanisms of injury can result in fractures in the elderly.

Question 49

Articular cartilage functions by:
Select one:
a. covering the bone ends and cushioning them from damage and wear.
b. connecting the two bone ends of a joint together and allowing range of motion.
c. strengthening the articulation point of immovable joints and providing support.
d. preventing joints from extending beyond their normal range of motion.

Answer 49

a. covering the bone ends and cushioning them from damage and wear.

Question 50

A major benefit of using a Sager traction splint is that it:
Select one:
a. allows you to pull traction before applying the splint.
b. can be applied effectively by one AEMT if necessary.
c. immobilizes the limb by producing countertraction.
d. allows you to bind the injured leg to the uninjured leg.

Answer 50

b. can be applied effectively by one AEMT if necessary.

Question 51

A 38-year-old female sustained a high-velocity injury to her pelvis. Your assessment reveals severe pain and crepitation upon palpation of the iliac crests. Her blood pressure is 84/54 mm Hg, pulse is 120 and weak, and respirations are 26 breaths/min and unlabored. In addition to administering 100% oxygen, the most appropriate management should include:
Select one:
a. immobilizing her spine, applying a pelvic binder device, transporting, and administering 20-mL/kg normal saline boluses en route.
b. immobilizing her spine, applying and inflating the abdominal compartment of the PASG, and promptly transporting.
c. logrolling the patient onto a long backboard, immobilizing her spine, starting a large-bore IV to keep the vein open, and rapidly transporting.
d. immobilizing the patient with a scoop stretcher, administering a 20-mL/kg bolus of normal saline, and rapidly transporting.

Answer 51

a. immobilizing her spine, applying a pelvic binder device, transporting, and administering 20-mL/kg normal saline boluses en route.

Question 52

During a track and field event, a 25-year-old female sustained an injury to her left arm. She complains of severe pain and an inability to extend her elbow. Upon inspection, you note that the olecranon process is more prominent than it is on the uninjured arm. These findings are most characteristic of:
Select one:
a. posterior radius/ulna displacement.
b. a distal fracture of the humerus.
c. anterior radius/ulna displacement.
d. a proximal fracture of the radius.

Answer 52

a. posterior radius/ulna displacement.

Question 53

In addition to 100% oxygen, appropriate management for a patient with a suspected pelvic fracture, who is conscious and alert with stable vital signs, includes:
Select one:
a. immobilization with a scoop stretcher, the PASG applied and inflated, at least one large-bore IV, a 20-mL/kg fluid bolus, and transport.
b. application of a pelvic binder, immobilization on a long backboard, at least one large-bore IV set to keep the vein open, and transport.
c. application of a pelvic binder, immobilization on a long backboard, two large-bore IVs, a 500-mL crystalloid bolus, and transport.
d. immobilization with a scoop stretcher, the PASG applied but not inflated, at least one large-bore IV, several 20-mL/kg fluid boluses, and transport.

Answer 53

b. application of a pelvic binder, immobilization on a long backboard, at least one large-bore IV set to keep the vein open, and transport.

Question 54

A 29-year-old male was involved in a rollover motor-vehicle crash. The patient was removed from his vehicle prior to your arrival. During your general impression, you note that he is conscious, yelling in pain, and has an actively bleeding open fracture of his left leg. As your partner assumes manual stabilization of the patient's head and communicates with him, you should:
Select one:
a. determine if his airway is patent.
b. apply a splint to his injured leg.
c. apply direct pressure to his leg.
d. administer supplemental oxygen.

Answer 54

c. apply direct pressure to his leg.

Question 55

A 59-year-old male patient impacted the dashboard with his knees when his car struck a tree at 50 mph. During your primary assessment, you note bleeding from an obvious open femur fracture. After controlling the bleeding, applying oxygen, and extricating him from the car, you should:
Select one:
a. perform a head-to-toe assessment, immobilize his spine, and transport.
b. perform a detailed secondary assessment, immobilize his spine, and transport.
c. immobilize his spine with a vest-style device and transport immediately.
d. apply a traction splint, immobilize his spine, and transport.

Answer 55

a. perform a head-to-toe assessment, immobilize his spine, and transport.

Question 56

When assessing a 40-year-old female with an injury to her left wrist, you should recall that the most reliable indicator of an underlying fracture is:
Select one:
a. ecchymosis.
b. extremity guarding.
c. gross swelling.
d. point tenderness.

Answer 56

d. point tenderness.

Question 57

You have applied an air splint to the deformed forearm of a critically injured patient while waiting for a helicopter to arrive. When the helicopter arrives, the flight medic asks you to accompany the patient. During the flight, you should:
Select one:
a. monitor the splint and let air out as needed.
b. deflate the air splint by approximately 50%.
c. remove the air splint and apply a rigid splint.
d. inflate the air splint by approximately 50%.

Answer 57

a. monitor the splint and let air out as needed.

Question 58

Following blunt force trauma to the elbow, a 40-year-old female complains of severe pain and the feeling that her elbow is “locked.” Your assessment reveals marked deformity and swelling. This patient has most likely experienced a:
Select one:
a. epiphyseal injury.
b. severe sprain.
c. fracture.
d. dislocation.

Answer 58

d. dislocation.

Question 59

Which of the following statements regarding skeletal muscle is correct?
Select one:
a. Skeletal muscle is highly vascular and bleeds significantly when injured.
b. Most of the body’s skeletal muscle is not under voluntary control.
c. Skeletal muscle can only survive for up to 10 minutes without oxygen.
d. Skeletal muscle is composed of the same tissue as cardiac muscle.

Answer 59

a. Skeletal muscle is highly vascular and bleeds significantly when injured.

Question 60

During a hockey game, a 19-year-old male player was pushed and he landed on his left shoulder. He complains of pain and point tenderness to the area. Your assessment reveals an anterior bulge of the lateral clavicle. This patient has most likely experienced a:
Select one:
a. acromioclavicular separation. 
b. sternoclavicular joint fracture.
c. dislocation of the left shoulder.
d. fracture of the lateral clavicle.

Answer 60

a. acromioclavicular separation.

Question 61

Near-drowning is most accurately defined as:
Select one:
a. immediate recovery at the scene and minor secondary complications.
b. recovery that lasts for at least 24 hours following submersion in water.
c. death beyond 24 hours as a result of intrapulmonary complications.
d. recovery that lasts for more than 36 hours following water submersion.

Answer 61

b. recovery that lasts for at least 24 hours following submersion in water.

Question 62

Patients who are struck by lightning rarely sustain full-thickness burns because:
Select one:
a. the duration of the lightning strike is short.
b. the skin is an effective barrier to electricity.
c. damage occurs through the skin and not across it.
d. most lightning strikes are caused by indirect injury.

Answer 62

a. the duration of the lightning strike is short.

Question 63

Heat cramps are typically the result of prolonged exposure to a hot environment, resulting in:
Select one:
a. significant volume depletion and hypovolemia.
b. electrolyte depletion and severe muscle spasms.
c. hypothalamic failure and decreased thermolysis.
d. painful spasms in the muscles of the upper body.

Answer 63

b. electrolyte depletion and severe muscle spasms.

Question 64

You should assess a patient with systemic hypothermia for local cold injuries to the extremities because:
Select one:
a. blood is shunted away from the extremities.
b. lactic acid tends to accumulate in the periphery.
c. cold blood is shunted to the body’s periphery.
d. hypothermia causes peripheral vasodilation.

Answer 64

a. blood is shunted away from the extremities.

Question 65

Which of the following patients has signs and symptoms that are most indicative of heatstroke?
Select one:
a. A 50-year-old female with an axillary temperature of 100.5°F and warm, dry skin
b. A 40-year-old female with severe cramps in her legs, tachycardia, and nausea
c. A 44-year-old male with weakness, cool and clammy skin, and a syncopal episode
d. A 31-year-old male with hot and moist skin, tachycardia, and confusion

Answer 65

d. A 31-year-old male with hot and moist skin, tachycardia, and confusion

Question 66

Which of the following patients is least prone to a local cold injury?
Select one:
a. A 52-year-old male with alcoholism
b. A 60-year-old female with diabetes
c. A 49-year-old female with fatigue
d. A 45-year-old male with hypertension

Answer 66

d. A 45-year-old male with hypertension

Question 67

Because heat always travels from a warm object to a cooler one, a person standing in a cold room will lose heat by:
Select one:
a. constriction.
b. evaporation.
c. conduction.
d. radiation.

Answer 67

d. radiation.

Question 68

You are assessing a 24-year-old male who was bitten by a rattlesnake while hiking in the woods. Which of the following clinical signs would be most indicative of envenomation?
Select one:
a. Redness surrounding the bite
b. Moderate pain at the site
c. Progressive tissue swelling 
d. Severe patient anxiety

Answer 68

c. Progressive tissue swelling

Question 69

In addition to supplemental oxygen, the most appropriate treatment for a nauseated patient with heat exhaustion includes:
Select one:
a. oral fluid administration and transport.
b. 20-mL/kg saline boluses and transport.
c. semi-Fowler’s position and transport.
d. IV set to keep the vein open and transport.

Answer 69

b. 20-mL/kg saline boluses and transport.

Question 70

A 40-year-old female, who is conscious and alert with mild hypothermia, should receive active external rewarming. This involves:
Select one:
a. infusing an isotonic crystalloid that is warmed to 115°F.
b. wrapping her in blankets and lavaging her urinary bladder.
c. immersing her in water that is between 106°F and 110°F.
d. wrapping her in blankets and applying heat packs to her groin.

Answer 70

d. wrapping her in blankets and applying heat packs to her groin.

Question 71

When treating a patient who is severely hypothermic, unresponsive, and wearing wet clothes, the AEMT should:
Select one:
a. perform CPR if a pulse cannot be felt after 5–10 seconds.
b. leave the clothing on, but cover the patient with blankets.
c. avoid placing chemical heat packs anywhere on the body.
d. avoid using the AED because it will not be effective.

Answer 71

c. avoid placing chemical heat packs anywhere on the body.

Question 72

Patients with diabetes are especially prone to heat illnesses because:
Select one:
a. diabetes is associated with hypothalamic deterioration.
b. they cannot readily produce large amounts of glucose.
c. autonomic neuropathy interferes with vasodilation.
d. they usually have concomitant heart disease.

Answer 72

c. autonomic neuropathy interferes with vasodilation.

Question 73

While stacking wood on a woodpile, a 60-year-old male experienced immediate, severe pain on the back of his hand. He complains of abdominal pain, nausea, and dizziness. Your assessment reveals that he is conscious and alert, but has an extremely rigid abdomen. You should suspect:
Select one:
a. a black widow spider bite. 
b. severe acute peritonitis.
c. an envenomated pit viper bite.
d. a brown recluse spider bite.

Answer 73

a. a black widow spider bite.

Question 74

A 19-year-old male was struck by lightning. He is unresponsive and apneic, but has a pulse. He also has widespread superficial burns. You should:
Select one:
a. provide mouth-to-mask rescue breathing, apply dry dressings to his burns, and transport without delay.
b. ventilate him with a bag-mask device, call for a paramedic unit to intubate him, cover his burns, and start an IV.
c. quickly insert a multilumen airway device, provide mild hyperventilation, and administer 2 L of IV fluid.
d. manually stabilize his head, ventilate him with a bag-mask device, and establish at least one-large bore IV.

Answer 74

d. manually stabilize his head, ventilate him with a bag-mask device, and establish at least one-large bore IV.

Question 75

During your primary survey of a 33-year-old male with severe hypothermia, you find that he is unresponsive and has agonal breathing. You should:
Select one:
a. begin CPR and apply the AED as soon as possible.
b. give two rescue breaths and assess for a pulse.
c. apply chemical heat packs to his groin and neck.
d. assess for a carotid pulse for up to 60 seconds.

Answer 75

d. assess for a carotid pulse for up to 60 seconds.

Question 76

When a warm hand touches a cold object, heat passes directly from the body to the colder object. This is an example of:
Select one:
a. conduction.
b. radiation.
c. convection.
d. evaporation.

Answer 76

a. conduction.

Question 77

When treating a diver who complains of severe pain to his joints and abdomen after returning to the surface of the water, you should manage his airway accordingly and position him:
Select one:
a. on his right side with his head elevated.
b. on his left side with his head down.
c. in a supine position with his legs elevated.
d. in a semi-Fowler’s position.

Answer 77

b. on his left side with his head down.

Question 78

When treating a diver who complains of severe pain to his joints and abdomen after returning to the surface of the water, you should manage his airway accordingly and position him:
Select one:
a. on his right side with his head elevated.
b. in a supine position with his legs elevated.
c. on his left side with his head down.
d. in a semi-Fowler’s position.

Answer 78

c. on his left side with his head down.

Question 79

Treatment for a patient with a pit viper bite to an extremity and no signs of envenomation includes oxygen, as well as:
Select one:
a. covering the area with a sterile dressing, splinting the extremity, and transporting.
b. splinting the extremity, keeping it above the level of the heart, and transporting.
c. covering the area with a sterile dressing and requesting immediate paramedic backup.
d. starting an IV and administering at least one 20-mL/kg normal saline bolus.

Answer 79

a. covering the area with a sterile dressing, splinting the extremity, and transporting.

Question 80

When treating a diver who complains of severe pain to his joints and abdomen after returning to the surface of the water, you should manage his airway accordingly and position him:
Select one:
a. in a semi-Fowler’s position.
b. on his left side with his head down.
c. in a supine position with his legs elevated.
d. on his right side with his head elevated.

Answer 80

b. on his left side with his head down.

Question 81

When assessing a 14-year-old male with an injured arm, you note gross deformity just distal to the elbow. Distal neurovascular functions are grossly intact. You should:
Select one:
a. immobilize the injury with a sling and swathe.
b. assume that growth plate damage has occurred.
c. ensure immobilization of the hand and shoulder.
d. apply a pediatric traction splint to the arm.

Answer 81

b. assume that growth plate damage has occurred.

Question 82

When assessing a 40-year-old female with an injury to her left wrist, you should recall that the most reliable indicator of an underlying fracture is:
Select one:
a. gross swelling.
b. extremity guarding.
c. point tenderness. 
d. ecchymosis.

Answer 82

c. point tenderness.

Question 83

Compartment syndrome is caused by:
Select one:
a. excessive synovial fluid inside a joint capsule.
b. lactic acid release in the region of a fracture.
c. increased pressure in the fascial compartment.
d. hyperperfusion to a fractured upper extremity.

Answer 83

c. increased pressure in the fascial compartment.

Question 84

When using a Sager traction splint, you should apply traction that is approximately \_\_\_\_% of the patient's body weight to a maximum of \_\_\_\_ pounds.
Select one:
a. 5, 10
b. 10, 15
c. 20, 30
d. 15, 20`

Answer 84

b. 10, 15