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455 Cards in this Set
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When assessing a patient who experienced a blast injury, it is important to remember that:
A. primary blast injuries are the most easily overlooked. B. solid organs usually rupture from the pressure wave. C. primary blast injuries are typically the most obvious. D. secondary blast injuries are usually the least obvious. |
A. primary blast injuries are the most easily overlooked
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The cervical spine is MOST protected from whiplash-type injuries when the:
A. headrest is appropriately positioned. B. air bag correctly deploys upon impact. C. rear end of the vehicle is initially struck. D. patient tenses up at the time of impact. |
A. headrest is appropriately positioned
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The energy contained in a moving object is called:
A. potential energy. B. latent energy. C. converted energy. D. kinetic energy. |
D. kinetic energy
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When assessing an elderly patient who fell, it is important to remember that:
A. elderly patients who fall usually have a secondary head injury. B. osteoporosis can cause a fracture that may have resulted in the fall. C. any fall in the elderly is considered to be high-energy trauma. D. bilateral hip fractures usually occur when an elderly person falls. |
B. osteoporosis can cause a fracture that may have resulted in the fall
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With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct?
A. It has a direct effect on patient care because of the obvious vehicular damage. B. It occurs when the unrestrained occupant collides with the interior of the vehicle. C. It is the most dramatic part of the collision and may make extrication difficult. D. It provides the least amount of information about the mechanism of injury. |
C. It is the most dramatic part of the collision and may make extrication difficult
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Signs of a pulmonary blast injury include:
A. coughing up blood. B. an irregular pulse. C. multiple rib fractures. D. vomiting blood. |
A. coughing up blood
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Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?
A. Aortic rupture B. Forehead lacerations C. Flail chest D. Extremity fractures |
A. Aortic rupture
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While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:
A. lower-extremity fractures. B. blunt trauma to the head. C. neck and facial injuries. D. open abdominal trauma. |
C. neck and facial injuries
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The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
A. capitation. B. conversion. C. cavitation. D. congruent. |
C. cavitation
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A 40-year-old female, unrestrained, impacted the steering wheel of her vehicle with her chest when her vehicle hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Given the mechanism of injury and her present condition, it is LEAST likely that she experienced:
A. a cardiac contusion. B. a pulmonary contusion. C. multiple rib fractures. D. a head injury. |
D. a head injury
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A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?
A. Lateral bending of the neck during the crash B. Impact of the head against the steering wheel C. Compression of the head against the roof D. Whiplash injury to the neck during the rollover |
C. Compression of the head against the roof
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Which of the following statements regarding low-energy penetrating injuries is correct?
A. Exit wounds are typically easy to locate with low-energy penetrating injuries. B. Internal injuries caused by low-velocity bullets are usually easy to predict. C. It is usually easy to differentiate between an entrance wound and an exit wound. D. The area of injury is usually close to the path the object took through the body. |
D. The area of injury is usually close to the path the object took through the body.
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Internal injuries caused by gunshot wounds are difficult to predict because:
A. exit wounds caused by the bullet are usually small. B. the caliber of the bullet is frequently unknown. C. the area of damage is usually smaller than the bullet. D. the bullet may tumble or ricochet within the body. |
D. the bullet may tumble or ricochet within the body.
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If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave?
A. Fractured bones B. Severe burns C. Impaled objects D. Stomach rupture |
D. Stomach rupture
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A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
A. experiences multiple impacts. B. remains within the vehicle. C. is wearing only a lap belt. D. is ejected or partially ejected. |
D. is ejected or partially ejected
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Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?
A. Elevation of the lower extremities B. Early administration of oxygen C. Intravenous fluid administration D. Rapid transport to a trauma center |
D. Rapid transport to a trauma center
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A 12-year-old male jumped approximately 12' from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?
A. Lateral impact to the spine B. Direct trauma to the spinal column C. Energy transmission to the spine D. Secondary fall after the initial impact |
C. Energy transmission to the spine
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In contrast to a Level III trauma center, a Level I trauma center must:
A. be able to stabilize patients before transferring to a higher level facility. B. be involved in trauma prevention programs. C. have general surgeons that are in-house 24 hours a day. D. have access to an emergency physician within 30 minutes. |
C. have general surgeons that are in-house 24 hours a day
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Which of the following statements regarding gunshot wounds is correct?
A. The speed of a bullet has a greater impact on causing injury than the mass. B. The size of a bullet has the greatest impact on producing injury. C. High-velocity bullets will cause less severe internal injuries. D. Low-velocity bullets will cause the greatest amount of internal injury. |
A. The speed of a bullet has a greater impact on causing injury than the mass
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Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
A. the speed of the fall. B. the primary impact point. C. the surface struck. |
A. the speed of the fall
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When evaluating the mechanism of injury of a car-versus-pedestrian collision, you should first:
A. approximate the speed of the vehicle that struck the pedestrian. B. determine if the patient was propelled away from the vehicle. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle. |
A. approximate the speed of the vehicle that struck the pedestrian
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If one or more occupants in the same vehicle are killed in a crash, the AEMT should:
A. rapidly assess only the survivors who have experienced obvious trauma. B. allow the survivors to refuse transport if they have no obvious injuries. C. suspect that all living occupants experienced the same serious trauma. D. transport the survivors only if they have injuries or complain of pain. |
C. suspect that all living occupants experienced the same serious trauma
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By what mechanism is a person injured when he or she falls from a significant height?
A. As the person falls, the amount of kinetic energy is converted into work, work is then converted to kinetic energy upon impact. B. Kinetic energy is converted to potential energy, the potential energy is then converted into the work of bringing the body to a stop. C. Potential energy is created as the person is falling, the potential energy is then converted into kinetic energy upon impact. D. Potential energy is converted to kinetic energy, the kinetic energy is then converted into the work of bringing the body to a stop. |
D. Potential energy is converted to kinetic energy, the kinetic energy is then converted into the work of bringing the body to a stop |
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The index of suspicion is MOST accurately defined as:
A. a predictable pattern that leads to serious injuries. B. your concern for potentially serious underlying injuries. |
B. your concern for potentially serious underlying injuries
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Your patient has a Glasgow Coma Scale (GCS) score of 11, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is:
A. 8. B. 11. C. 9. D. 10. |
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When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the:
A. kinetic energy. B. mechanism of injury. C. index of suspicion. D. potential energy. |
B. mechanism of injury
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Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:
A. airway compromise. B. spinal cord injury. C. a fracture of the skull. D. intracranial bleeding. |
D. intracranial bleeding
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According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she:
A. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. B. was involved in a motor-vehicle crash in which another patient in the same vehicle was killed. C. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma. D. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. |
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According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if:
A. the patient requires advanced life support care and stabilization, and the nearest paramedic ground ambulance is more than 5 to 10 minutes away. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C. he or she was involved in a motor-vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor. D. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. |
C. he or she was involved in a motor-vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor
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When treating a patient who experienced a pulmonary blast injury, you should:
A. avoid giving oxygen under positive pressure. B. administer large amounts of intravenous fluid. C. use a demand valve to ventilate the patient. D. suspect an accompanying cardiac tamponade. |
A. avoid giving oxygen under positive pressure
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Two of the MOST common mechanisms of injury for blunt trauma are:
A. low-caliber gunshot wounds and falls. B. falls and motor vehicle collisions. C. gunshot wounds and vehicle ejections. D. motor vehicle collisions and stabbings. |
B. falls and motor vehicle collisions
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While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for:
A. underlying cardiac disease. B. bruising of the heart muscle. C. a lacerated coronary artery. D. traumatic rupture of the aorta. |
B. bruising of the heart muscle
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When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to:
A. recognize that the force of impact was most likely not severe. B. realize that the air bag malfunctioned at the time of impact. C. remember that it could still deploy and seriously injure you. D. suspect that the patient may have experienced serious injuries. |
C. remember that it could still deploy and seriously injure you
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During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:
A. 7. B. 9. C. 8. D. 10. |
A. 7
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A sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:
A. a focused exam of her forearm. B. transport to a community hospital. C. transport to a trauma center. D. a secondary assessment at the scene. |
C. transport to a trauma center
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Air bags are designed to:
A. be used with or without a shoulder harness. B. prevent a second collision inside the car. C. prevent the driver from sustaining head trauma. D. decrease the severity of deceleration injuries. |
D. decrease the severity of deceleration injuries
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Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the:
A. thoracic and lumbar spine. B. lumbar and coccygeal spine. C. thoracic and sacral spine. D. lumbar and sacral spine. |
A. thoracic and lumbar spine
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When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant:
A. is thrust under the steering column onto the floorboard. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. will most likely be thrown over the steering column. |
B. remains in motion until acted upon by an external force
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When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact.
A. dashboard B. steering wheel C. door D. windshield |
C. door
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Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?
A. Collapsed dashboard B. Intrathoracic hemorrhage C. Deformed steering wheel D. Caved-in passenger door |
C. Deformed steering wheel
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Evaluation of the interior of a crashed motor vehicle during extrication will allow the AEMT to:
A. determine the vehicle's speed at the time of impact. B. identify contact points and predict potential injuries. C. assess the severity of the third collision of the crash. D. recognize if the driver hit the brakes before impact. |
B. identify contact points and predict potential injuries
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Force acting over a distance defines the concept of:
A. kinetic energy. B. potential energy. C. latent energy. D. work. |
D. work
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What types of motor vehicle collisions present the greatest potential for multiple impacts?
A. Rotational and rollover B. Rear-end and rotational C. Frontal and rotational D. Lateral and rollover |
A. Rotational and rollover
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A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:
A. obtain baseline vital signs. B. leave her bicycle helmet on. C. inspect the helmet for cracks. D. stabilize her entire spine. |
D. stabilize her entire spine
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Which of the following patients has experienced the MOST significant fall?
A. A 5'-0" patient who fell 13' B. A 5'-9" patient who fell 14' C. A 4'-8" patient who fell 13' D. A 4'-6" patient who fell 13' |
D. A 4'-6" patient who fell 13'
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When the speed of a motor vehicle doubles, the amount of kinetic energy:
A. doubles. B. quadruples. |
B. quadruples
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Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?
A. Intrusion into the vehicle B. Dismounted seats C. Steering wheel deformity D. Deployment of the air bag |
D. Deployment of the air bag
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Approximately 25% of severe injuries to the aorta occur during:
A. rollover collisions. B. rear-end collisions. C. frontal collisions. D. lateral collisions. |
D. lateral collisions
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A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for:
A. alterations in his mental status. B. potential airway compromise. C. injury to the cervical spine. D. damage to internal structures. |
B. potential airway compromise
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A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control any obvious bleeding and then:
A. auscultate bowel sounds. B. apply a cervical collar. C. assess for an exit wound. D. obtain baseline vital signs. |
C. assess for an exit wound
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During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred:
A. as a direct result of the pressure wave. B. during the tertiary phase. |
B. during the tertiary phase
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Which of the following injuries or conditions would MOST likely overwhelm the body's hemostatic response and result in death?
A. Bleeding within the brain B. Ruptured aortic aneurysm C. Laceration to the liver D. Laceration to the spleen |
B. Ruptured aortic aneurysm
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Which of the following patients would benefit MOST from the application and inflation of the pneumatic antishock garment (PASG)?
A. Unilateral femur fracture with a BP of 100/60 mm Hg B. Closed head trauma with a BP of 160/90 mm Hg C. Chest trauma with a systolic BP of 60 mm Hg D. Unstable pelvis with a BP of 80/50 mm Hg |
D. Unstable pelvis with a BP of 80/50 mm Hg
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The LEAST desirable method of bleeding control in the prehospital setting is:
A. clamping a bleeding artery with hemostats. B. applying a tourniquet proximal to the injury. C. applying a pressure dressing and bandage. D. maintaining manual pressure over the injury. |
A. clamping a bleeding artery with hemostats
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Under which of the following conditions would external bleeding be LEAST difficult to control?
A. Lacerated antecubital vein and a BP of 130/70 mm Hg B. Lacerated carotid artery and a BP of 140/90 mm Hg C. Lacerated femoral vein and a BP of 88/60 mm Hg D. Lacerated brachial artery and a BP of 84/56 mm Hg |
C. Lacerated femoral vein and a BP of 88/60 mm Hg
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During your rapid assessment of an unconscious 67-year-old female, you note signs of shock and the presence of hematochezia. You should be MOST suspicious for:
A. bleeding within the retroperitoneum. B. lower gastrointestinal bleeding. C. a leaking abdominal aortic aneurysm. D. upper gastrointestinal bleeding. |
B. lower gastrointestinal bleeding
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Which of the following organs or systems can survive the longest without oxygen?
A. Gastrointestinal system B. Central nervous system C. The myocardium D. Skeletal muscles |
D. Skeletal muscles
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When assessing a 70-year-old male with suspected internal bleeding, which of the following findings would be MOST pertinent?
A. A history of controlled hypertension B. Dizziness or syncope upon standing C. A history of trauma six months ago D. The patient regularly takes Tylenol. |
B. Dizziness or syncope upon standing
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A 32-year-old male was involved in a motorcycle crash and sustained bilateral femur fractures as he was ejected over the handlebars of his bike. He is experiencing signs and symptoms of shock. On the basis of his injury, what is the approximate volume of blood that he has lost?
A. 3 L B. 2 L C. 4 L D. 1 L |
B. 2 L
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Hemostasis is a natural response of the body in which:
A. bleeding spontaneously clots through vasoconstriction and platelet aggregation. B. all body systems work together to maintain stability of the internal environment. C. blood is diverted away from the skin to areas where it is needed the most. D. platelets lose their ability to aggregate due to severe internal bleeding. |
A. bleeding spontaneously clots through vasoconstriction and platelet aggregation
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If a patient is hemorrhaging, he or she is:
A. bleeding. B. bleeding externally. C. bleeding internally. D. in severe shock. |
A. bleeding
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During times of decreased perfusion, the autonomic nervous system:
A. causes vasodilation to increase venous capacitance. B. redirects blood to the most vital organs of the body. C. decreases the heart rate so as to decrease oxygen demand. D. diverts all available blood flow to the kidneys. |
B. redirects blood to the most vital organs of the body
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If used, inflation of the pneumatic antishock garment (PASG) should continue until the:
A. systolic BP reaches 120 mm Hg. B. carotid pulse is stronger. C. radial pulses return. D. patient develops dyspnea. |
C. radial pulses return
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During your initial attempt to control severe external bleeding from an extremity, you should:
A. apply a tourniquet proximal to the wound. B. digitally compress a proximal pressure point. C. apply direct pressure with a sterile dressing. D. apply a pressure dressing to the wound. |
C. apply direct pressure with a sterile dressing
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Prior to applying and inflating the pneumatic antishock garment (PASG), you should:
A. auscultate bilateral breath sounds. B. palpate the pelvis at least two times. C. palpate the abdomen for rigidity. D. perform a secondary assessment. |
A. auscultate bilateral breath sounds
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A 1-year-old female sustained blunt abdominal trauma following a motor-vehicle crash in which she was not properly restrained. Significant signs and symptoms will MOST likely occur after as little as _____ of blood loss.
A. 250 mL B. 300 mL C. 50 mL D. 100 mL |
D. 100 mL
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Perfusion is MOST accurately defined as:
A. circulation of blood within an organ or tissue. B. adequate supplies of glucose within the brain. C. removal of carbon dioxide from the body. D. oxygen and carbon dioxide exchange in the lungs. |
A. circulation of blood within an organ or tissue
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You are dispatched to a local nightclub for a patient who has been stabbed. After arriving at the scene and ensuring you and your partner's safety, you find the patient sitting on the ground. He is conscious, screaming in pain, and attempting to control bright red blood that is spurting from his groin area. After taking standard precautions, you should:
A. ensure that the patient's airway is patent. B. apply direct pressure to control the bleeding. C. apply 100% oxygen via a nonrebreathing mask. D. obtain baseline vital signs and treat for shock. |
B. apply direct pressure to control the bleeding
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Prior to applying a tourniquet to a profusely bleeding injury, you should take standard precautions and then:
A. apply oxygen via a nonrebreathing mask. B. elevate the patient's legs 6" to 12". C. hold direct pressure over the bleeding site. D. apply pressure over a proximal artery. |
C. hold direct pressure over the bleeding site
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Following severe maxillofacial trauma, a 16-year-old male presents with oropharyngeal bleeding and poor respiratory effort. You should:
A. suction the oropharynx. B. pack the mouth with sterile gauze. C. assist his ventilations at once. D. insert a nasopharyngeal airway. |
A. suction the oropharynx
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During Stage 1 hemorrhage, the body compensates primarily by:
A. increasing systolic blood pressure. B. narrowing the pulse pressure. C. constriction of the vascular bed. D. increasing the respiratory rate. |
C. constriction of the vascular bed
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Which of the following conditions would allow an adult patient to MOST effectively compensate for external blood loss?
A. 500 mL of blood loss over 30 seconds B. 500 mL of blood loss over 15 minutes C. 1,000 mL of blood loss over 20 minutes D. 750 mL of blood loss over 10 minutes |
B. 500 mL of blood loss over 15 minutes
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Blood leaves the capillary beds and is returned to the right side of the heart by the:
A. venules and veins. B. pulmonary capillary vessels. C. cellular capillary vessels. D. arterioles and arteries. |
A. venules and veins
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Which of the following medications would interfere with the body's hemostatic effect?
A. Antihypertensives B. Antianginals C. Anticoagulants D. Antidepressants |
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After blood diffuses across the capillary membrane and perfuses the cells, it:
A. drops off carbon dioxide and returns oxygenated blood to the heart. B. returns carbon dioxide to the left side of the heart, starting with the veins. C. forms lactic and pyruvic acids, which are used by the cells to form energy. D. returns waste products to the right side of the heart, starting with the venules. |
D. returns waste products to the right side of the heart, starting with the venules
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A 21-year-old male has lost approximately 35% of his blood volume following a penetrating injury to the chest. Which of the following signs or symptoms would you NOT expect to see?
A. Widened pulse pressure B. Marked tachypnea C. Diaphoresis and pallor D. Decreased systolic BP |
A. Widened pulse pressure
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The ability of a person to effectively compensate for acute blood loss is MOST directly related to the:
A. patient's weight. B. location of the injury. C. patient's total blood volume. D. rate of blood loss. |
D. rate of blood loss
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An 80-kg patient has a lacerated brachial artery with severe bleeding. Based on his weight, what is the maximum amount of blood loss that his body can tolerate without developing severe shock?
A. 500 mL B. 1,100 mL C. 950 mL D. 1,250 mL |
B. 1,100 mL
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Which of the following organs or tissues requires only intermittent circulation of blood?
A. Muscles B. Brain C. Lungs D. Kidneys |
A. Muscles
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A patient has severe bleeding from a large laceration to the anterior forearm. Direct pressure and a pressure dressing are not immediately effective in controlling the bleeding. You should:
A. apply a tourniquet above the level of the bleeding. B. elevate the arm and apply ice to the injury. C. apply additional dressings and elevate the arm. D. locate and apply digital pressure to the brachial artery. |
A. apply a tourniquet above the level of the bleeding
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Which of the following injuries presents the greatest risk for severe internal bleeding?
A. Pelvic fractures B. Rib fractures C. Tibial fractures D. Bilateral femur fractures |
A. Pelvic fractures
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A 22-year-old female was involved in a traumatic incident. She is exhibiting signs of shock, but there are no obvious external signs of trauma. You should suspect bleeding within the:
A. abdominal cavity. B. lower extremities. C. cranial vault. D. thoracic cavity. |
A. abdominal cavity
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A 33-year-old male was shot in the abdomen during an altercation at a bar. He is semiconscious, his heart rate is 160 beats/min and thready, and his respirations are 38 breaths/min and shallow. On the basis of this patient's clinical presentation, you should suspect that he is experiencing stage ____ hemorrhage.
A. 1 B. 4 C. 3 D. 2 |
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A 19-year-old male sustained major head trauma following a motorcycle crash. During your assessment, you note the presence of blood draining from his left ear. What is the MOST important reason for not attempting to control the flow of this bleeding?
A. An increase in intracranial pressure may occur. B. The patient may develop a life-threatening infection. C. It would likely skew the physician's assessment. D. Its origin is from a location that you cannot access. |
A. An increase in intracranial pressure may occur
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When assessing a patient with blunt abdominal trauma, the severity of internal bleeding is BEST determined by:
A. noting the mechanism of injury. B. frequently taking the blood pressure. C. monitoring for signs of shock. D. ascertaining the patient's medical history. |
C. monitoring for signs of shock
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You are caring for a 59-year-old male involved in a motor-vehicle crash. During your assessment, you note that his pelvis is unstable, he is pale and diaphoretic, and his blood pressure is 80/50 mm Hg. Use of the pneumatic antishock garment (PASG) would be absolutely contraindicated if further assessment of this patient revealed:
A. coarse crackles in the lungs B. collapsed jugular veins. C. bilateral femur fractures D. a rigid, distended abdomen. |
A. coarse crackles in the lungs
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When managing a patient with severe bleeding, it is important to:
A. obtain frequent vital signs. B. administer high-flow oxygen. C. control the bleeding. D. take standard precautions. |
D. take standard precautions
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Patients with internal bleeding are in MOST need of:
A. IV fluid boluses. B. surgical intervention. C. high-flow oxygen. D. thermal management. |
B. surgical intervention
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Significant vital signs changes, including increased heart and respiratory rates and a decreasing blood pressure, would likely occur if an 80-kg adult patient acutely loses as little as _____ L of blood.
A. 1 B. 2 C. 0.5 D. 2.5 |
A. 1
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You should be MOST suspicious for serious bleeding when:
A. the MOI suggests injury to the lower extremities. B. the typical signs of shock are not present. C. a patient has a poor general appearance. D. a patient has a normal BP for his or her age |
C. a patient has a poor general appearance
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A full-thickness burn is typically characterized by all of the following, EXCEPT:
A. intense pain. B. muscle involvement. C. eschar. D. leathery skin. |
A. intense pain
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During a lengthy transport of a 120-lb 29-year-old female with partial- and full-thickness burns to 45% of her BSA, medical control orders you to begin IV fluid replacement based on the Parkland formula. What volume of IV crystalloid should you administer per hour?
A. 690 mL B. 620 mL C. 720 mL D. 780 mL |
B. 620 mL
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Which of the following types of burns is characterized by intense pain and destruction of a portion of the dermis?
A. First-degree B. Partial-thickness C. Third-degree D. Full-thickness |
B. Partial-thickness
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Appropriate management of a patient with an abdominal evisceration includes:
A. covering the exposed organs with a moist, sterile dressing and securing the dressing in place with a dry, sterile dressing. B. applying and inflating all compartments of the PASG to protect the exposed organs and treat for shock. C. carefully irrigating the exposed organs with sterile saline and replacing them back into the abdomen. D. avoiding flexion of the patient's knees as this may exacerbate bleeding and enlarge the evisceration. |
A. covering the exposed organs with a moist, sterile dressing and securing the dressing in place with a dry, sterile dressing
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You arrive at the scene of a residential fire where the occupant, a 48-year-old male, has sustained partial- and full-thickness burns to his lower extremities and lower torso. Firefighters removed the patient's smoldering clothing and stopped the burning process prior to your arrival. The patient is conscious, but restless, and complains of intense pain to the burned areas. After taking the standard precautions, you should:
A. rapidly estimate the extent of the patient's burns. B. perform a secondary assessment and start an IV. C. immerse the burned areas in sterile water. D. apply supplemental oxygen and monitor his airway. |
D. apply supplemental oxygen and monitor his airway
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Common signs and symptoms of radiation sickness include:
A. hair loss and skin burns. B. hyperactive organ function. C. thickening of the skin. D. increased visual acuity. |
A. hair loss and skin burns
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Which of the following statements regarding severe burns is correct?
A. Significant hypovolemia may not occur for several hours following the burn injury. B. Immediately following the burn, fluid shifts to the injured area and creates edema. C. Sodium is shunted away from the burned area as the body attempts to compensate. D. Following the burn, there is an immediate shift of fluid out of the vascular space. |
A. Significant hypovolemia may not occur for several hours following the burn injury
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You are dispatched to an industrial plant for a worker who was exposed to an unknown chemical. Upon arrival, you find the patient sitting outside of the plant. He has a white, dry powder covering his right arm. Care for this patient's exposure includes:
A. immediately flushing the area with sterile saline to stop the burning process. B. brushing the chemical from the patient's arm and then irrigating with water. C. removing the patient's clothing and immersing his arm in a container of water. D. removing the patient's clothing and flushing with copious amounts of water. |
B. brushing the chemical from the patient's arm and then irrigating with water
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Small muscles within the dermis that pull the hair into an erect position when you are cold or frightened are called the:
A. erector ducts. B. hair follicles. C. erector pili. D. sebum muscles. |
C. erector pili
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When managing a critically-burned patient, it is important to:
A. administer topical analgesia to the burned areas to afford the patient pain relief. B. break the integrity of any formed blisters as these can result in infection. C. rapidly estimate the burn's severity and then cover with dry, sterile dressings. D. perform a detailed physical exam at the scene to look for occult injuries. |
C. rapidly estimate the burn's severity and then cover with dry, sterile dressings
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Which of the following is the MOST acute and serious complication associated with a break in the integrity of the skin?
A. Loss of fluids B. Hyperthermia C. Severe infection D. Vasodilation |
A. Loss of fluids
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On the basis of the Parkland formula, how much crystalloid should you administer per hour to a 70-kg patient with severe burns to 50% of his BSA?
A. 900-1,000 mL B. 700-800 mL C. 1,000-1,100 mL D. 800-900 mL |
D. 800-900 mL
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You respond to a domestic dispute, where a middle-aged male was stabbed in the chest by his wife. Your assessment reveals that the patient is pulseless and apneic. The knife is impaled in the center of his chest. You should:
A. turn the patient onto his side, stabilize the knife, and begin CPR. B. carefully remove the knife, control the bleeding, and perform CPR. C. stabilize the knife with bulky dressing, initiate CPR, and transport. D. leave the knife in place, control the bleeding, and initiate CPR. |
B. carefully remove the knife, control the bleeding, and perform CPR
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A 4-year-old boy pulled a pot of boiling water from the stovetop. He has superficial and partial-thickness burns to his head, left anterior trunk, and entire left arm. On the basis of the "rule of nines," what percentage of this child's body surface area (BSA) has been burned?
A. 36% B. 27% C. 30% D. 45% |
C. 30%
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Compartment syndrome is caused by:
A. severe increased intracranial pressure following blunt head trauma. B. excessive blood or fluid collection within the abdominal musculature. C. tissue compression and damage due to fluid trapped in a confined space. D. permanent nerve and tissue damage proximal to an injury site. |
C. tissue compression and damage due to fluid trapped in a confined space
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In addition to improving systemic perfusion following an electrical burn injury, you should administer IV crystalloid fluid boluses in order to:
A. abruptly increase the blood pressure. B. concentrate myoglobin in the renal tubules. C. maintain adequate urine output. D. prevent the occurrence of dysrhythmias. |
C. maintain adequate urine output
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Upon arriving at the scene of a motor-vehicle crash involving a telephone pole, you note that the driver appears unconscious and is bleeding heavily from the mouth. There is a power line across the hood and roof of the car. You should:
A. carefully remove the power line with rubber gloves. B. remove the power lines with a non-conductive object. C. attempt to safely remove the patient from the car. D. ensure that the power line is not electrically active. |
D. ensure that the power line is not electrically active
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Melanin granules, which are contained within the deeper cells in the germinal layer, are responsible for:
A. texture of the skin. B. color of the skin. C. sweat production. D. heat production. |
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The layer of the skin that plays a key role in the cooling of the body is the:
A. dermis. B. epidermis. C. sebaceous layer. D. germinal layer. |
A. dermis
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A thermal burn involving the epidermis that is characterized by redness and pain is classified as a:
A. moderate burn. B. second-degree burn. C. superficial burn. D. full-thickness burn. |
C. superficial burn
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You are assessing a 4-year-old male who was electrocuted when he stuck a pin into an electrical socket. He is conscious and alert and complains of pain to his left hand, where you find a small entrance wound. When treating this child, you should:
A. apply an AED and monitor the child. B. fully immobilize his spinal column. C. flush the wound with sterile saline. D. anticipate extensive internal injuries. |
D. anticipate extensive internal injuries
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The layer of skin that lies below the germinal layer and contains nerves, sebaceous glands, and blood vessels is called the:
A. dermis. B. melanin layer. C. subcutaneous layer. D. epidermis. |
A. dermis
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The mouth, nose, and other body orifices are lined with ___________________, which secrete a watery substance and provide a protective barrier against harmful agents.
A. germinal cells B. melanin granules C. mucus membranes D. sebaceous glands |
C. mucus membranes
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A 59-year-old male has a partial amputation of his left arm, just proximal to the elbow. Bleeding has been controlled and you note that the arm is attached by only a few strands of tissue. You should:
A. cover the arm with a bulky dressing and carefully splint it. B. splint the arm but do not cover it so you can assess for bleeding. C. carefully detach the arm and wrap it in a moist sterile dressing. D. immerse the arm, still attached, in a container of cool water. |
A. cover the arm with a bulky dressing and carefully splint it
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A 40-year-old patient has sustained circumferential burns to the chest. The MOST serious complication associated with this type of burn injury is:
A. increased chest excursion. B. cardiac dysrhythmias. C. ventilatory insufficiency. D. compartment syndrome. |
C. ventilatory insufficiency
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Which of the following statements regarding electrical burns is correct?
A. The size of entrance and exits wounds provides an indicator as to the degree of internal injury. B. When exposed to electricity, the human body is an excellent insulator because it is comprised primarily of water. C. Internal injury caused by an electrical burn is usually more severe than the external burns indicate. D. Ordinary household current can cause an electrical injury, but the burns are usually not severe. |
C. Internal injury caused by an electrical burn is usually more severe than the external burns indicate
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An elderly male was removed from his burning house by firefighters. He has extensive full-thickness burns is semiconscious and has shallow, stridorous respirations. The firefighters have already stopped the burning process. After ensuring an open airway, you should:
A. insert a multilumen airway device to protect the patient's airway. B. assist his ventilations with a bag-mask device and 100% oxygen. C. apply 100% oxygen via a nonrebreathing mask and keep him warm. D. estimate the severity of his burns and begin IV fluid replacement. |
B. assist his ventilations with a bag-mask device and 100% oxygen |
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A 34-year-old male was involved in a motor-vehicle crash. During the crash, his vehicle caught fire. Bystanders removed the patient from his vehicle prior to your arrival. The patient is conscious with adequate breathing. He has partial-thickness burns to his face and neck, and an open femur fracture with severe bleeding. Immediate management for this patient should include:
A. performing a secondary assessment. B. providing assisted ventilation. C. maintaining body temperature. D. controlling the bleeding from his leg. |
D. controlling the bleeding from his leg
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A 62-year-old female with a history of type 2 diabetes has sustained partial-thickness burns to 27% of her body surface area (BSA). This burn should be classified as a:
A. first-degree burn. B. critical burn. C. minor burn. D. moderate burn. |
B. critical burn
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The skin sends messages to the brain to regulate various functions via:
A. efferent nerves. B. sensory nerves. C. motor nerves. D. axonal nerves. |
B. sensory nerves
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The "rule of palms" for estimating the extent of the body surface area (BSA) burned is especially useful with:
A. partial-thickness burns. B. irregularly-shaped burns. C. circumferential burns. D. burns to multiple body sites. |
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Which of the following weapons would MOST likely result in the largest surface area of tissue damage?
A. .22 caliber handgun B. 12-gauge shotgun C. 357 magnum D. 9.0 mm handgun |
B. 12-gauge shotgun
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When a person is exposed to cold temperatures, blood vessels in the skin:
A. dilate and draw blood to the surface of the skin. B. constrict and divert blood away from the skin. C. dilate and divert blood to the core of the body. D. constrict and draw blood to the skin's surface. |
B. constrict and divert blood away from the skin
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Appropriate management for a patient with a serious closed injury and signs of shock includes all of the following, EXCEPT:
A. 15" to 20" elevation of the lower extremities. B. IV fluid boluses to maintain perfusion. C. prompt transport to a local trauma center. D. high-flow oxygen or assisted ventilation. |
A. 15" to 20" elevation of the lower extremities
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Upon arriving at the scene of a motorcycle crash, you find the patient, a young male, lying supine approximately 10 feet from his bike. An emergency medical responder is manually stabilizing the patient's head. You note an obvious open injury to the patient's left lower leg with severe bleeding. Your MOST appropriate initial action should be to:
A. open the patient's airway and assess respiratory rate, regularity, and depth. B. direct your partner to control the bleeding as you assess the patient's airway. C. locate and control all obvious bleeding and then perform a primary assessment. D. have your partner assume control of the patient's head as you open the airway. |
B. direct your partner to control the bleeding as you assess the patient's airway
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How much IV fluid (per bolus) should you administer to a 65-kg patient with extensive burns and severe shock?
A. 1,435 mL B. 1,300 mL C. 1,410 mL D. 1,350 mL |
B. 1,300 mL
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Which of the following has the MOST impact on the severity of radiation injury or type of health effect?
A. Type of radiation and the patient's age B. The distance between the patient and the source C. The presence of any underlying medical conditions. D. The amount and duration of exposure |
D. The amount and duration of exposure
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When assessing a conscious patient who experienced an electrical injury, you note irregularity in his pulse. This is MOST indicative of:
A. a cardiac dysrhythmia. B. impending respiratory arrest. C. ventricular fibrillation. D. decreased perfusion. |
A. a cardiac dysrhythmia
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Why does the skin become flushed or red when a person is exposed to a hot environment?
A. Sweat glands produce sebum, resulting in heat evaporation. B. Vasoconstriction shunts blood to the surface of the skin. C. The blood is hyperoxygenated and assumes a bright color. D. Blood vessels dilate and heat radiates to the skin surface. |
D. Blood vessels dilate and heat radiates to the skin surface
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Which of the following factors has the MOST significant impact on determining the severity of a burn?
A. The age of the patient B. Depth and extent of the burn C. Preexisting medical conditions D. Location of the burned areas |
B. Depth and extent of the burn
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When managing an adult patient with an inhalation injury, inspiratory stridor, and an altered mental status, you should:
A. apply ice packs to the neck to reduce swelling. B. give humidified oxygen via a nonrebreathing mask. C. prepare for early definitive airway management. D. ventilate at a rate of 20 breaths per minute. |
C. prepare for early definitive airway management
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Which of the following physiologic responses occurs initially following a burn injury?
A. Vasoconstriction and decreased blood flow to the burned area B. Massive edema as the fluid shifts into the extravascular space C. An inflammatory response and increased capillary permeability D. Electrolyte derangements and significant hypovolemia |
A. Vasoconstriction and decreased blood flow to the burned area
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Which of the following patients has experienced a critical burn?
A. A 50-year-old with 9% full-thickness burns involving an upper extremity B. A 10-year-old with 45% superficial burns involving the chest and back C. A 65-year-old with 18% partial-thickness burns to both upper extremities D. A 31-year-old with 27% partial-thickness burns who takes antidepressants |
C. A 65-year-old with 18% partial-thickness burns to both upper extremities
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Heat that is generated by an electrical injury can cause coagulation and vascular occlusion, resulting in:
A. massive infection. B. compartment syndrome. C. spinal cord inflammation. D. spontaneous hemorrhage. |
B. compartment syndrome
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An industrial-plant worker was splashed in the left eye with a strong acid chemical. The MOST appropriate initial care for this patient's injury is to:
A. neutralize the substance with a strong alkaline solution. B. irrigate the eye laterally, away from the unaffected eye. C. cover the affected eye with a sterile dressing or eye patch. D. limit irrigation of the affected eye to a maximum of 5 minutes. |
B. irrigate the eye laterally, away from the unaffected eye
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In which of the following circumstances should you remove an impaled object?
A. Metal rod in the thigh with severe arterial hemorrhage B. Knife in the abdomen of a pulseless and apneic patient C. Ice pick in the chest of an unconscious breathing patient D. Metal shard in the cheek and inadequate respiratory effort |
D. Metal shard in the cheek and inadequate respiratory effort
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Cardiac arrest following an electrical burn would MOST likely occur if:
A. there is an entrance and an exit wound. B. the patient is exposed to direct current. C. the patient is older than 50 years of age. D. the electricity flows from arm to arm. |
D. the electricity flows from arm to arm
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When assessing a patient with multiple gunshot wounds, you should:
A. identify the number and location of all wounds. B. carefully assess the patient to predict the bullet's path. C. control the bleeding that you see and then transport. D. distinguish between entrance and exit wounds. |
A. identify the number and location of all wounds
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What layer of the skin contains cells that are replaced with new cells that are formed in the germinal layer?
A. Subcutaneous layer B. Melanin layer C. Dermis D. Epidermis |
D. Epidermis
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After ensuring you and your partner's safety, the next step in caring for a patient with any burn is to:
A. ensure the burning process has stopped. B. perform a rapid head-to-toe assessment. C. open and maintain the patient's airway. D. move the patient to a place of safety. |
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Which of the following statements regarding the dermal layer of the skin is correct?
A. Blood vessels in the dermis do not penetrate into the epidermis. B. The dermis forms a watertight covering for the body. C. Cells of the dermis are constantly worn away and replaced. D. Most of the skin's melanin granules are contained in the dermis. |
A. Blood vessels in the dermis do not penetrate into the epidermis
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A young male tripped on a garden hose, fell, and struck his head on a concrete sidewalk. He is unresponsive and has a large hematoma to his forehead. His respirations are slow and shallow. You should:
A. apply ice to the injury to reduce bleeding. B. assist his ventilations with 100% oxygen. C. administer oxygen via nonrebreathing mask. D. start an IV and administer a 20 mL/kg bolus. |
B. assist his ventilations with 100% oxygen
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A 20-year-old male was shot multiple times during a drive-by shooting. You arrive at the scene, which has been secured by law enforcement, and approach the patient. He is semiconscious and is bleeding heavily from the chest. You should:
A. follow proper standard precautions. B. ensure the patient's airway is patent. C. perform a primary assessment. D. immediately control all bleeding. |
A. follow proper standard precautions
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You are dispatched to the scene of a shooting. Upon arrival, you are directed by law enforcement to the patient, a 44-year-old male, who is unconscious. He is lying in an impressive pool of blood and you can hear gurgling from his mouth when he breathes. After your partner assumes C-spine control and opens the patient's airway, you should:
A. suction the patient's oropharynx. B. perform a secondary assessment. C. assess respiratory rate and quality. D. locate the source of the bleeding. |
A. suction the patient's oropharynx
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When caring for a patient with multiple abrasions, you should:
A. clean the wounds with sterile water. B. be alert for underlying injuries. C. give a 500 mL crystalloid bolus. D. transport to a local trauma center. |
B. be alert for underlying injuries
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You and your partner are caring for a 30-year-old female who sustained extensive partial- and full-thickness burns when she was near a gas heater that exploded. Your primary assessment reveals that the patient is semiconscious with profoundly labored and stridorous respirations. Immediate management of this patient should include:
A. assisting her breathing with a bag-mask device and oxygen. B. covering her with dry, sterile dressings and applying oxygen. C. insertion of a multilumen airway to protect her from aspiration. D. 100% oxygen via a nonrebreathing mask and rapid transport. |
A. assisting her breathing with a bag-mask device and oxygen
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A 22-year-old male has sustained full-thickness burns to approximately 55% of his BSA. You are appropriately managing his airway and are administering 100% oxygen. You note that the patient's heart rate is 140 beats/min and thready and his blood pressure is 78/58 mm Hg. You should:
A. deliver several 500 mL boluses of normal saline solution. B. administer 20 mL/kg crystalloid boluses to maintain perfusion. C. administer IV fluids based on the Parkland formula. D. withhold IV fluid therapy until you have contacted medical control. |
B. administer 20 mL/kg crystalloid boluses to maintain perfusion
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A burn occurs when the soft tissue of the skin:
A. is severely damaged by thermal or friction heat. B. receives more energy than it can absorb without injury. C. degrades due to exposure to radioactive substances. D. is exposed to caustic or corrosive chemicals. |
B. receives more energy than it can absorb without injury
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High-voltage burn injuries occur MOST frequently in:
A. utility workers. B. adults in the workplace. C. industrial plant workers. D. children in the home. |
A. utility workers
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A 28-year-old female was the unrestrained driver of a car that struck the rear end of another car while traveling at 35 mph. She is conscious and alert and complains of pain to the anterior chest. During your assessment, you note a large ecchymotic area over the superior aspect of the anterior chest. As your partner assumes manual stabilization of her head, you should:
A. rapidly extricate her from the car and transport. B. open her airway with the jaw-thrust maneuver. C. obtain vital signs to assess for signs of shock. D. apply 100% oxygen via a nonrebreathing mask. |
D. apply 100% oxygen via a nonrebreathing mask
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Which of the following is the MOST significant acute complication associated with a laceration to the forearm?
A. Severe pain B. External bleeding C. Severe infection D. Internal bleeding |
B. External bleeding
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When administering IV crystalloid boluses to a patient with an electrical injury, you should give enough fluid to maintain a urine output of:
A. 4 mL/kg per hour. B. 1 mL/kg per hour. C. 2 mL/kg per hour. D. 3 mL/kg per hour. |
B. 1 mL/kg per hour.
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All of the follow deformity of a short bonea closed soft tissue injury, EXCEPT:
A. swelling beneath the skin. B. a history of blunt trauma. C. pain at the site of injury. D. deformity of a short bone. |
D. deformity of a short bone
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A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty, but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?
A. The patient may die several hours later due to pulmonary complications. B. Signs and symptoms of upper airway swelling are rapidly progressing. C. It is likely that this patient has not experienced a serious airway burn. D. You should encourage this patient to drive himself to the hospital. |
A. The patient may die several hours later due to pulmonary complications
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In order for electricity to flow through the body and cause injury:
A. there must be an insulator in between the patient and the electrical source. B. the source of the electricity must be high voltage, such as a high power line. C. there must be a complete circuit between the electrical source and the ground. D. a patient must be in direct contact with the electrical source for at least 30 seconds. |
C. there must be a complete circuit between the electrical source and the ground
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Which of the following is NOT a function of the skin?
A. Protection from harmful agents B. Temperature regulation C. Maintenance of water balance D. Destruction of sebum |
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Following an electrical burn, estimating the extent of the BSA involved is:
A. not possible in the prehospital setting and can only be determined by a physician. B. difficult because the degree and depth may be greater internally than externally. C. easy because the external wound is often more dramatic than any internal injury. D. extremely difficult and should not be assessed in the field by the AEMT. |
B. difficult because the degree and depth may be greater internally than externally
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Priority treatment for a patient with an open soft-tissue injury includes:
A. wound decontamination. B. control of active bleeding. C. prevention of hypothermia. D. IV crystalloid fluid boluses. |
B. control of active bleeding
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When caring for an open wound that has small pieces of glass and other debris inside of it, you should:
A. remove the glass and debris with hemostats. B. leave the wound open unless it is bleeding. C. cover the wound with a sterile dressing. D. irrigate the wound with sterile water. |
C. cover the wound with a sterile dressing
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Death immediately following a burn is MOST commonly the result of:
A. massive bacterial infection. B. severe hypovolemic shock. C. incineration of the patient. D. toxic chemical inhalation. |
D. toxic chemical inhalation
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During your assessment of a patient with blunt chest trauma, you note the presence of ecchymosis to the area of impact. This finding is MOST characteristic of a/an:
A. crush injury. B. contusion. C. abrasion. D. hematoma. |
B. contusion
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Radiation is released into the atmosphere when:
A. atoms lose their charge and increase their production of energy. B. unstable atoms emit excess energy in an attempt to stabilize. C. stable atoms become unstable and produce excess energy. D. it becomes ionized and its atoms become stable in their charge. |
B. unstable atoms emit excess energy in an attempt to stabilize
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During an explosion, a metal worker sustained a large laceration to the left side of his neck by flying debris. He is conscious, but restless the wound is moderately bleeding. Appropriate care for this patient's injury includes:
A. circumferentially wrapping the neck with gauze to secure a dressing in place. B. preventing air from entering the wound and applying a pressure dressing. C. controlling the bleeding by applying direct pressure to both carotid arteries. D. applying a pressure dressing to the wound and then apply a cervical collar. |
B. preventing air from entering the wound and applying a pressure dressing |
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A 60-year-old male has sustained partial- and full-thickness burns to his anterior chest, head, and both anterior arms. On the basis of the "Rule of Nines," what percentage of his body surface area (BSA) has been burned?
A. 45% B. 18% C. 27% D. 36% |
D. 36%
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All of the following signs are indicative of upper airway burns due to an inhalation injury, EXCEPT:
A. carbonaceous sputum. B. dyspnea and hypoxia. C. an altered mental status. D. wheezing or rhonchi. |
D. wheezing or rhonchi
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All patients with closed soft-tissue injuries should be assessed for:
A. intra-abdominal bleeding. B. trauma to the spinal cord. C. signs of impending infection. D. serious hidden injuries. |
D. serious hidden injuries
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A 55-year-old male sustained partial-thickness burns to his face and neck when he opened the hot radiator cap on his car. He is conscious and alert, but complains of dyspnea and difficulty swallowing. His oxygen saturation is 96% on room air. You should be MOST concerned about the:
A. possibility of blindness. B. degree of burns. C. risk of infection. D. status of his airway. |
D. status of his airway
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A utility worker was trimming branches away from a high power line when he accidentally cut the power line. He is unresponsive, apneic, and pulseless. You should begin CPR and then:
A. assess for an entrance and exit wound. B. establish two large-bore IV lines. C. apply full spinal motion restriction precautions. D. apply the AED as soon as possible. |
D. apply the AED as soon as possible
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The three basic pathways by which radiation enters the body are:
A. inhalation, absorption and direct exposure. B. ingestion, direct exposure, and injection. C. inhalation, ingestion, and direct exposure. D. absorption, inhalation, and injection. |
C. inhalation, ingestion, and direct exposure
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In contrast to upper-airway injury following a burn, lower-airway injury is usually the result of:
A. inhalation of superheated gases. B. diffuse collapsing of the alveoli. C. inhalation of chemicals and particulate matter. D. interstitial fluid shifts and pulmonary edema. |
C. inhalation of chemicals and particulate matter
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Common prehospital treatment for patients with severe burns includes all of the following, EXCEPT:
A. advanced airway care. B. tetanus prophylaxis. C. crystalloid fluid boluses. D. contamination prevention. |
B. tetanus prophylaxis
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Which of the following would be classified as a moderate burn in an infant or child?
A. Superficial burns covering 30% of the BSA B. Partial-thickness burns to the hands, face, or genitalia C. Partial-thickness burns covering 15% of the BSA D. Full-thickness burns covering 1% of the BSA |
C. Partial-thickness burns covering 15% of the BSA
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What is the function of the sternocleidomastoid muscle?
A. Allows movement of the head B. Allows flexion of the neck C. Connects the scapulae together D. Facilitates chest movement |
A. Allows movement of the head
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When assessing a patient with a mandibular fracture, you would MOST likely encounter:
A. pain directly over the chin. B. misalignment of the teeth. C. impaired ocular movement. D. lateral bulging of the jaw. |
B. misalignment of the teeth
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A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
A. requesting a paramedic ambulance. B. rapidly transporting her to the hospital. C. quickly immobilizing her spinal column. D. careful monitoring of her vital signs. |
B. rapidly transporting her to the hospital
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A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with heavy bleeding. As your partner manually stabilizes the patient's head, you should:
A. administer 100% supplemental oxygen. B. stabilize the impaled glass in her eye. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye. |
C. apply direct pressure to her arm wound
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Clinical findings associated with a laryngeal injury include:
A. hematemesis, bulging eyes, and jugular venous distention. B. pallor, a mediastinal shift, and tracheal deviation. C. posterior neck deformity, Battle's sign, and a dry cough. D. hemoptysis, subcutaneous emphysema, and cyanosis. |
D. hemoptysis, subcutaneous emphysema, and cyanosis
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Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:
A. a blowout fracture. B. acute hyphema. C. conjunctivitis. D. a detached retina. |
A. a blowout fracture. |
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The eyeball itself is called the:
A. globe. B. sclera. C. orbit. D. cornea. |
A. globe
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You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should:
A. alert the hospital of the situation. B. reassess his breathing adequacy. C. turn the backboard onto its side. D. quickly suction his oropharynx. |
C. turn the backboard onto its side
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When caring for a patient with an open facial injury, the AEMT must:
A. consider the mechanism of injury. B. manually stabilize the patient's head. C. wear gloves and facial protection. D. closely assess the patient's airway. |
C. wear gloves and facial protection
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The upper jawbones are called the:
A. mastoid. B. mandible. C. maxillae. D. zygoma. |
C. maxillae
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A 30-year-old female was assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
A. apply oxygen via a nonrebreathing mask. B. visualize her mouth for obvious wounds. C. begin immediate ventilatory assistance. D. suction her oropharynx for 15 seconds. |
D. suction her oropharynx for 15 seconds
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The skin and underlying tissues of the face:
A. have a rich blood supply and bleed heavily. B. swell minimally when exposed to blunt trauma. C. contain a relatively small number of nerve fibers. D. are well protected by the maxillae and mandible. |
A. have a rich blood supply and bleed heavily
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Frequent reassessments of the patient with face or neck injuries are MOST important because:
A. such injuries can affect the respiratory system. B. hospital staff require frequent patient updates. C. rapid facial swelling may mask hidden injuries. D. they lend credibility to your documentation. |
A. such injuries can affect the respiratory system
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The opening in the center of the iris, which allows light to move to the back of the eye, is called the:
A. sclera. B. pupil. C. cornea. D. conjunctiva. |
B. pupil
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A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should:
A. leave the contact lenses in place and cover both eyes with a dry dressing. B. carefully remove the contact lenses and then irrigate his eyes with saline. C. leave the contact lenses in place and flush his eyes with sterile water. D. remove the contact lenses and cover his eyes with a dry, sterile dressing. |
B. carefully remove the contact lenses and then irrigate his eyes with saline
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The AEMT should be MOST suspicious of a Le Fort fracture if a patient who experienced massive blunt force trauma to the face presents with:
A. misalignment of the teeth. B. mobility of the facial bones. C. numbness of the chin. D. flattening of the cheekbones. |
B. mobility of the facial bones
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A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate depth. You should:
A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. D. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport. |
A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport
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The superficial temporal artery can be palpated:
A. just anterior to the tragus. B. at the angle of the jaw. C. slightly above the ear. D. over the mastoid process. |
A. just anterior to the tragus
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Which of the following statements regarding scalp lacerations is correct?
A. Because the scalp is highly vascular, you should always apply a tight pressure dressing to control bleeding B. Patients who take antihypertensive medications bleed more severely from scalp lacerations C. Although deep scalp lacerations bleed profusely, they are rarely associated with skull fractures D. Blood loss from a scalp laceration may result in hypovolemic shock, especially in children |
D. Blood loss from a scalp laceration may result in hypovolemic shock, especially in children
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Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a/an:
A. esophageal tear. B. laryngeal fracture. C. crushed cricoid. D. collapsed trachea. |
B. laryngeal fracture
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The term "hyphema" is defined as:
A. an acute rupture of the globe of the eye. B. inflammation of the iris, cornea, and lens. C. compression of one or both optic nerves. D. blood in the anterior chamber of the eye. |
D. blood in the anterior chamber of the eye
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When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injury because:
A. it saves time on repeat assessments at the hospital. B. most patients with facial trauma will need surgery. C. a specialist may be needed to manage the injury. D. they must make arrangements for an ICU bed. |
C. a specialist may be needed to manage the injury
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A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:
A. acute retinitis. B. a detached retina. C. conjunctivitis. D. a corneal abrasion. |
? |
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Which of the following statements regarding the vitreous humor is correct?
A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost. D. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost. |
B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. |
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A 58-year-old woman fell and landed face-first on a concrete sidewalk. She is conscious, but confused. Her skin is pale, cool, and clammy, her radial pulses are weak and rapid, and her blood pressure is 72/54 mm Hg. Further assessment reveals crepitus to her left cheekbone. After administering high-flow oxygen, you should:
A. perform a detailed secondary assessment, immobilize her entire spine, and establish IV access. B. place her in a sitting position on the stretcher, insert a saline lock, and reassess her blood pressure. C. apply a cervical collar only, establish two large-bore IV lines, and administer 2 liters of normal saline. D. immobilize her entire spine, establish at least one large-bore IV line, and give a 20-mL/kg crystalloid bolus. |
D. immobilize her entire spine, establish at least one large-bore IV line, and give a 20-mL/kg crystalloid bolus |
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The conjunctiva are kept moist by fluid produced by the:
A. posterior orbit. B. corneal ducts. C. lacrimal glands. D. optic chiasma. |
C. lacrimal glands
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The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the:
A. retina. B. cornea. C. conjunctiva. D. sclera. |
C. conjunctiva
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You are assessing a 59-year-old male who complains of a headache and note that his pupils are asymmetrical. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:
A. regularly sees a family physician. B. has a history of eye surgeries. C. took any medication for his headache. D. is allergic to any medications. |
B. has a history of eye surgeries
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The optic nerve endings are located within the:
A. cornea. B. retina. C. pupil. D. sclera. |
B. retina
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A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open, her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should:
A. secure her eyes open so you can reassess her pupils. B. inspect her eyes and gently remove impaled objects. C. irrigate her eyes with water to prevent mucosal drying. D. close her eyes and cover them with a moist dressing. |
D. close her eyes and cover them with a moist dressing |
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Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:
A. digital pressure to an adjacent pulse point. B. ice packs and elevation of the patient's head. C. pressure dressings and chemical ice packs. D. direct pressure using dry, sterile dressings. |
D. direct pressure using dry, sterile dressings
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You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:
A. circumferentially wrap a dressing around his neck. B. apply direct pressure below the lacerated vessel. C. apply direct pressure above and below the wound. D. apply pressure to the closest arterial pressure point. |
C. apply direct pressure above and below the wound
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Which of the following findings is LEAST suggestive of a head injury?
A. One pupil larger in size than the other pupil B. Failure of the eyes to move in the same direction C. Briskly constricting pupils when exposed to light D. Failure of the eyes to follow movement of an object |
C. Briskly constricting pupils when exposed to light
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A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should:
A. avoid applying pressure to the globe when you are covering her eye. B. apply firm direct pressure to the injured eye and cover the opposite eye. C. carefully examine her eye and remove any foreign objects if needed. D. ask her to move the injured eye to assess the integrity of the optic nerve. |
A. avoid applying pressure to the globe when you are covering her eye
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The Adam's apple is:
A. the upper part of the larynx that is formed by the thyroid cartilage. B. the lower part of the larynx that is formed by the cricoid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. below the thyroid cartilage and forms the upper part of the trachea. |
A. the upper part of the larynx that is formed by the thyroid cartilage
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The lower jawbone is called the:
A. maxillae. B. zygoma. C. mandible. D. mastoid. |
C. mandible
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A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:
A. remove the object with a cotton-tipped applicator. B. scrape the splinter away with moist, sterile gauze. C. cover both of his eyes and transport to the hospital. D. cover his right eye and flush the left eye with saline. |
C. cover both of his eyes and transport to the hospital
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The cricoid cartilage:
A. is the only complete circular cartilage of the trachea. B. is easier to see and palpate than the thyroid cartilage. C. lies superior to the thyroid cartilage in the neck. D. lies superior to the cricothyroid membrane in the neck. |
A. is the only complete circular cartilage of the trachea
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A fracture involving the nasal bone and inferior maxilla, which separates the nasal bone and lower maxilla from the facial skull and remainder of the cranial bones describes:
A. a Le Fort III fracture. B. a Le Fort II fracture. C. a Le Fort I fracture. D. craniofacial disjunction. |
B. a Le Fort II fracture
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A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes:
A. applying a gauze pad in between his lower lip and gum. B. packing the nasopharynx with moist, sterile dressings. C. placing him supine and pinching his nostrils together. D. leaning him forward and pinching his nostrils together. |
D. leaning him forward and pinching his nostrils together
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Retinal injuries that are caused by exposure to extremely bright light:
A. are typically not painful, but may result in permanent damage to vision. B. are intensely painful, but usually only result in temporary blindness. C. usually do not immediate medical attention unless vision is impaired. D. damage the motor cells of the eye, resulting in reduced eye movement. |
A. are typically not painful, but may result in permanent damage to vision
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Significant trauma to the face should increase the AEMT's index of suspicion for a/an:
A. displaced mandible. B. airway obstruction. C. basilar skull fracture. D. spinal cord injury. |
D. spinal cord injury
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When a light is shone into the pupil:
A. the opposite pupil should dilate. B. it should become larger in size. C. both pupils should dilate together. D. it should become smaller in size. |
D. it should become smaller in size. |
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The white portion of the eye is called the:
A. iris. B. retina. C. sclera. D. cornea. |
C. sclera
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A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes:
A. padding between the ear and the scalp. B. covering the wound with a moist dressing. C. applying a tight pressure dressing. D. packing the ear with sterile gauze pads. |
A. padding between the ear and the scalp
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The small, rounded, fleshy bulge immediately anterior to the ear canal is called the:
A. tragus. B. stapes. C. pinna. D. incus. |
A. tragus
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Which of the following is the MOST significant complication associated with facial injuries?
A. Cervical spine injury B. External hemorrhage C. Airway compromise D. Damage to the eyes |
C. Airway compromise
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Which of the following statements regarding anterior nosebleeds is correct?
A. They are usually caused by a fracture of the basilar skull. B. They usually originate from the septum area and bleed slowly. C. They are usually severe and require aggressive treatment to control. D. They cause blood to drain into the posterior pharynx. |
B. They usually originate from the septum area and bleed slowly
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The mastoid process is located approximately:
A. ½" anterior to the external opening of the ear. B. 1" inferior to the external opening of the ear. C. 1" posterior to the external opening of the ear. D. 1" posterior to the angle of the mandible. |
C. 1" posterior to the external opening of the ear
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Facial injuries must be identified and treated as soon as possible because:
A. bleeding must be controlled early. B. swelling may mask hidden injuries. C. the spine may be injured as well. D. of the risk for airway problems. |
D. of the risk for airway problems
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A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include:
A. covering both eyes and transporting. B. irrigating his right eye laterally. C. irrigating both eyes simultaneously. D. flushing his eye starting laterally. |
B. irrigating his right eye laterally
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An 82-year-old man experienced a minor facial injury when he tripped and fell. He is conscious and alert and complains of slight pain to his cheekbones. His medical history includes hypertension, blood clots in his legs, hypothyroidism, and type 2 diabetes. During your assessment, it is important to remember that:
A. his blood glucose level should be assessed immediately. B. patients with hypothyroidism are especially prone to falls. C. he is at an increased risk for severe posterior epistaxis. D. any patient who falls should have their spine immobilized. |
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A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. If you do not have sterile saline or water, you should:
A. irrigate both eyes continuously for 20 minutes with plain water. B. neutralize the acid chemical in his eye with an alkaline chemical. C. mix baking soda with water and irrigate his eyes with the solution. D. flush both eyes with an alcohol-based solution and transport. |
A. irrigate both eyes continuously for 20 minutes with plain water
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Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with:
A. conjunctivitis. B. contact lenses. C. retinitis. D. a brain injury. |
D. a brain injury
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A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:
A. thoroughly flush her ear with sterile saline. B. remove the peanut with a cotton-tipped swab. C. use tweezers to try to remove the object. D. transport her to the emergency department. |
D. transport her to the emergency department
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The complex network of spinal nerves that controls the lower extremities is called the:
A. lumbosacral plexus. B. coccygeal plexus. C. brachial plexus. D. solar plexus. |
A. lumbosacral plexus
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Following a severe closed head injury, a 23-year-old female develops cardiac dysrhythmias and an irregular pattern of breathing. The area of her brain MOST likely injured is the:
A. cerebellum. B. cerebrum. C. cerebral cortex. D. brainstem. |
D. brainstem
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When assessing an unresponsive 20-year-old male with a traumatic brain injury, you note that his left pupil is fully dilated and non-reactive. This indicates injury:
A. to the left cerebral hemisphere. B. to the right oculomotor nerve. C. in the region of the cerebellum. D. to the inferior part of the brainstem. |
A. to the left cerebral hemisphere
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A 40-year-old man was struck in the head with a steel pipe. He opens his eyes when you ask him a question, but cannot recall the date or events prior to the injury. When you ask him if he is injured anywhere else, he tells you no. You should assign him a Glasgow Coma Scale (GCS) score of:
A. 13 B. 10 C. 11 D. 12 |
D. 12
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Manual C-spine stabilization should continue until:
A. the patient has been loaded into the ambulance. B. motor and sensory functions have been assessed. C. the patient is fully secured to a long backboard. D. an appropriately-sized C-collar has been applied. |
C. the patient is fully secured to a long backboard
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If a person places his or her hand on a hot stove:
A. the connecting nerves in the spinal cord will detect the painful stimulus and send a sensory message to the brain. B. the sensory nerve will form a reflex arc and send a message to the brain to elicit a motor response. C. the sensory nerve will bypass the brain and send a message directly to the motor nerve. D. the motor nerve will bypass the spinal cord and send a sensory message directly to the brain. |
C. the sensory nerve will bypass the brain and send a message directly to the motor nerve
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Which of the following head-injured patients should be hyperventilated at a rate of 20 breaths/min with a bag-mask device and 100% oxygen?
A. Semiconscious 34-year-old female with deep, regular breathing, bilaterally dilated and reactive pupils, and bradycardia. B. Unresponsive 21-year-old male with slow, irregular breathing, fixed and dilated pupils, and extensor posturing. C. Semiconscious 25-year-old female with rapid, shallow breathing, dilated and sluggish pupils, and hypertension. D. Unresponsive 30-year-old male with slow, shallow breathing, equal and reactive pupils, and hypotension. |
B. Unresponsive 21-year-old male with slow, irregular breathing, fixed and dilated pupils, and extensor posturing
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Which of the following is an important aspect in the care of a patient with a significant head injury?
A. Taking measures to prevent hyperthermia. B. Maintaining a SBP of at least 110 mm Hg. |
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Following blunt head trauma, a 44-year-old male presents with clear, watery fluid draining from his nose. You should suspect:
A. early herniation of the brainstem. B. damage to all of the meningeal layers. C. rapidly increasing intracranial pressure. D. fracture of the basilar region of the skull. |
B. damage to all of the meningeal layers
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A 38-year-old male committed suicide by hanging himself. This mechanism of injury MOST likely resulted in:
A. distraction of the upper cervical spine. B. complete spinal cord transection. C. separation of the lower cervical vertebrae. D. brainstem separation from the spinal cord. |
A. distraction of the upper cervical spine
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The presence of posturing following severe head trauma is a sign of:
A. mastoid injury. B. brainstem injury. C. spinal injury. D. cerebellar injury. |
B. brainstem injury
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Of the following clinical findings, which one would you MOST likely encounter during the early phase following a fracture of the basilar skull?
A. Altered mental status B. Mastoid ecchymosis C. Periorbital ecchymosis D. CSF draining from the nose |
A. Altered mental status
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What physiologic response may occur when a head-injured patient is hyperventilated with a bag-mask device and 100% oxygen?
A. Vasoconstriction and increased cerebral perfusion B. Vasoconstriction and decreased cerebral perfusion |
B. Vasoconstriction and decreased cerebral perfusion
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Which of the following signs or symptoms would you MOST likely encounter in a patient who was struck in the back of the head?
A. Loss of sensory perception B. Visual disturbances C. Abnormal behavior D. Loss of motor control |
B. Visual disturbances
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Which portion of the central nervous system is afforded the BEST protection by the cranium?
A. Meninges B. Brainstem C. Cerebrum D. Cerebellum |
B. Brainstem
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The MOST significant complication associated with a severe closed head injury is:
A. injury to the lower cervical spine. B. hypertension and bradycardia. C. decreased level of consciousness. D. increased intracranial pressure. |
D. increased intracranial pressure
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A 48-year-old male fell approximately 20' from his roof. As you approach him, you note that his eyes are closed and that he is not moving. His respirations are gurgling and you see blood draining from his mouth. You should
A. immediately suction his airway. B. take proper standard precautions. |
B. take proper standard precautions
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You are transporting a semiconscious 30-year-old female with an isolated head injury to a local trauma center. When you reassess her, you note that her BP is 78/56 mm Hg and her radial pulses are no longer palpable. You should:
A. allow her to remain hypotensive as this will decrease intracranial pressure. B. infuse 20 mL/kg of normal saline as needed to maintain her BP at 90 mm Hg. C. rapidly increase her systolic blood pressure with 1 to 2 liters of normal saline. |
B. infuse 20 mL/kg of normal saline as needed to maintain her BP at 90 mm Hg
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A linear skull fracture:
A. usually does not present with deformity of the skull. B. results from extension of a basilar skull fracture. C. typically occurs following diffuse impact to the head. D. causes severe displacement of the cranial bones. |
A. usually does not present with deformity of the skull
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The 31 pairs of spinal nerves serve all of the following functions EXCEPT:
A. conducting sensory impulses to the spinal cord. B. controlling movement of the upper and lower extremities. C. transmitting sensations directly to and from the brain. D. conducting motor impulses to the muscles. |
C. transmitting sensations directly to and from the brain
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A 23-year-old male was involved in a motor-vehicle crash and has an obviously depressed skull fracture. His pulse is rapid and weak, his skin is cool and clammy, and his blood pressure is low. You should:
A. recognize that his clinical presentation is consistent with brain herniation. B. hyperventilate him at 20 breaths/min with a bag-mask device and 100% oxygen. C. start a large-bore IV, but restrict fluids to avoid an increase in intracranial pressure. D. suspect that he has internal bleeding and administer crystalloid fluid boluses. |
D. suspect that he has internal bleeding and administer crystalloid fluid boluses
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Two of the meningeal layers that protect the central nervous system are the arachnoid and pia mater which:
A. are avascular and thick. B. are protected by cerebrospinal fluid. C. secrete immune system chemicals. D. produce cerebrospinal fluid. |
D. produce cerebrospinal fluid
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Of the following, which is the LEAST common sign or symptom of a head injury?
A. An irregular respiratory pattern B. Combative or abnormal behavior C. A cardiac rhythm disturbance D. CSF drainage from a scalp wound |
C. A cardiac rhythm disturbance
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A 37-year-old male was struck on the driver side of his vehicle by another car traveling at 45 mph. Your primary assessment reveals that the patient is semiconscious and in respiratory distress. When extricating this patient from his car, you should:
A. apply a C-collar and rapidly remove him on a long backboard. B. apply a vest-style extrication device and remove him from the car. C. manually stabilize his head and quickly pull him from the car. |
A. apply a C-collar and rapidly remove him on a long backboard
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Cerebral edema is aggravated by:
A. low CO2 levels in the blood. B. increased pH of the CSF. C. high O2 levels in the blood. D. low O2 levels in the blood. |
D. low O2 levels in the blood
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A patient with neurogenic shock would be expected to present with:
A. hyperthermia and tachycardia. B. pallor and profuse diaphoresis. C. bradycardia and hypothermia. D. unilateral paralysis and tachycardia. |
C. bradycardia and hypothermia
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The two MOST common causes of secondary brain injury are:
A. blunt trauma and cerebral edema. B. cerebral hypoxia and hypotension. C. infection and intracranial bleeding. D. increased ICP and cerebral edema. |
B. cerebral hypoxia and hypotension
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Which of the following clinical presentations is MOST indicative of a subdural hematoma?
A.. Progressive deterioration of mental status and other neurologic functions 2 days following a head injury. B. No loss of consciousness immediately following a head injury and a frontal headache that is increasing in intensity. |
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While assessing a patient with blunt head trauma, you note an unstable segment of the skull and a large laceration to the scalp. You should control active bleeding, administer 100% oxygen, and:
A. be alert for increased intracranial pressure. B. apply a tight pressure dressing to the scalp. C. administer 1-2 liters of isotonic crystalloid D. immobilize the patient's head prior to the torso. |
A. be alert for increased intracranial pressure
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A person would MOST likely experience a compression injury of the lumbar spine when he or she:
A. hyperextends the lower back. B. dives head first into a pool. C. laterally bends the lumbar spine. D. falls and lands on his or her feet. |
D. falls and lands on his or her feet
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Which of the following MOST accurately describes the position of the cerebellum within the skull?
A. Inferoposterior to the cerebrum B. Inferolateral to the brain stem |
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A subdural hematoma is an accumulation of blood:
A. beneath the dura mater but outside the brain. B. above all of the meningeal layers. C. between the dura mater and the skull. |
A. beneath the dura mater but outside the brain
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Decerebrate posturing is characterized by:
A. flexion of the arms and flexion of the legs. B. extension of the arms and extension of the legs. |
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You are caring for an 11-month-old male who fell from a second-story window and landed on his head. While assessing him, it is important to remember that:
A. the size of his head will not allow you to perform a jaw-thrust. B. he could develop hypovolemic shock from intracranial bleeding. C. children with head injuries rarely develop hypovolemic shock. D. the fontanelles are still open and should be assessed for bulging. |
B. he could develop hypovolemic shock from intracranial bleeding
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Mastoid bruising is also referred to as:
A. Cullen's sign. B. Gray-Turner's sign. C. Battle's sign. D. raccoon eyes. |
C. Battle's sign
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A young female was involved in a motor-vehicle crash and complains of neck pain. When assessing her, you should NOT:
A. assess gross motor function. B. ask her to move her hands or feet. C. ask her to point to the area of pain. D. determine cervical range of motion. |
D. determine cervical range of motion
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An appropriately sized cervical collar should:
A. rest on the shoulder and provide support under the mandible. B. fit loosely underneath the chin to minimize patient discomfort. |
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A middle-aged male is found unconscious at the base of the steps to his house. There is no evidence of trauma and there were no witnesses to the event. You should:
A. stabilize his head and open his airway with the jaw-thrust maneuver. B. apply a cervical collar and open his airway with the tongue-jaw lift. C. apply manual stabilization of his C-spine and gently tilt his head back. D. assess his airway after performing a head-tilt chin-lift maneuver. |
A. stabilize his head and open his airway with the jaw-thrust maneuver
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Which of the following sets of vital signs is MOST indicative of Cushing's triad?
A. BP, 170/94 mm Hg, pulse, 120 beats/min respirations, 24 breaths/min and shallow B. BP, 190/100 mm Hg, pulse, 68 beats/min, respirations, 30 breaths/min and irregular C. BP 90/60 mm Hg, pulse, 110 beats/min, respirations, 28 breaths/min and regular D. BP 100/50 mm Hg, pulse 50 beats/min respirations, 34 breaths/min and irregular |
B. BP, 190/100 mm Hg, pulse, 68 beats/min, respirations, 30 breaths/min and irregular |
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A young male has experienced a possible neck injury. When you attempt to place his head in a neutral in-line position, he complains of a severe spasm in his neck. You should:
A. apply a chemical ice pack to his neck for pain relief. B. carefully continue to move his head into a neutral position. C. immobilize him in the position in which you found him. D. monitor neurological functions as you gently move his head. |
C. immobilize him in the position in which you found him
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Which of the following situations dictates removal of a football or motorcycle helmet?
A. The patient complains of pain to the cervical spine. B. Transport time to the hospital is greater than 30 minutes. C. Respirations of 24 breaths/min and reduced tidal volume D. The patient is conscious but has a bad headache. |
C. Respirations of 24 breaths/min and reduced tidal volume
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Following a minor head injury, which of the following occurs more commonly in children than adults?
A. Convulsions B. Vomiting C. Aspiration |
B. Vomiting
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Hypotension in an adult patient with an isolated brain injury and no external bleeding is MOST likely the result of:
A. dilation of the cerebral vessels. . B. decreased cerebral perfusion. |
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An intracerebral hematoma is the result of bleeding:
A. above the surface of the cerebrum. B. within the brain tissue itself. |
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The physiologic response that occurs when a person is exposed to a stressful stimulus is initiated by the:
A. involuntary nervous system. B. sympathetic nervous system. |
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The central nervous system (CNS) is:
A. composed of the cerebrum, cerebellum, brainstem, and spinal cord. B. composed of fibers that link nerve cells to the body's vital organs. C. protected and cushioned by two meningeal layers. |
A. composed of the cerebrum, cerebellum, brainstem, and spinal cord
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A 57-year-old male was struck in the head by a falling object. He opens his eyes when you pinch his trapezius muscle, is using inappropriate words, and withdraws from painful stimuli. His Glasgow Coma Scale (GCS) score is:
A. 12. B. 10. C. 9. D. 11. |
C. 9
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During your assessment of a 29-year-old female with a severe head injury, you note that her left pupil is dilated and unreactive to light. This suggests pressure on the:
A. oculomotor nerve. B. abducens nerve. C. glossopharyngeal nerve. D. hypoglossal nerve. |
A. oculomotor nerve
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Following a traumatic brain injury, a patient presents with Cushing's triad, which consists of:
A. hypertension, bradycardia, and irregular respirations. B. hypotension, tachycardia, and rapid respirations. C. hypotension, bradycardia, and shallow respirations. D. hypertension, tachycardia, and abnormal respirations. |
A. hypertension, bradycardia, and irregular respirations
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Which of the following statements regarding scalp lacerations is correct?
A. Children are less susceptible to hypovolemia from scalp lacerations. B. Scalp lacerations may contribute to hypovolemic shock in adult patients. |
B. Scalp lacerations may contribute to hypovolemic shock in adult patients
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A 19-year-old male was struck by a baseball in the occipital region of the skull. Witnesses report that the patient was briefly unconscious following the incident. He is now conscious and alert, but cannot remember the events immediately following the injury. He is breathing without difficulty and his vital signs are stable. This patient's clinical presentation is MOST consistent with a/an:
A. intracerebral hematoma. B. cerebral concussion. C. epidural hematoma. D. cerebral contusion. |
B. cerebral concussion
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Which of the following statements regarding cerebral perfusion pressure (CPP) is correct?
A. The minimum CPP that is needed to adequately perfuse the brain is 40 mm Hg. B. The body responds to a decrease in CPP by decreasing mean arterial pressure. C. CPP is the difference between mean arterial pressure and intracranial pressure. |
C. CPP is the difference between mean arterial pressure and intracranial pressure
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In contrast to a cerebral concussion, diffuse axonal injury (DAI):
A. involves stretching, shearing, or tearing of cerebral nerve fibers. B. is generally associated with better clinical outcomes. |
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You are dispatched to a construction site, where a 30-year-old male fell approximately 30 feet and landed on his head. He is unresponsive, has respirations of 38 breaths/min and irregular, and decerebrate posturing. Further assessment reveals that his pupils are fixed and dilated and his blood pressure is 190/120 mm Hg. In addition to spinal immobilization, the MOST appropriate treatment for this patient includes:
A. assisted ventilations at a rate of 10 breaths/min with a bag-mask device and 100% oxygen, followed by insertion of a King LT airway. B. hyperventilation at a rate of 20 breaths/min with a bag-mask device and 100% oxygen, followed by insertion of an advanced airway device. C. 100% supplemental oxygen via a nonrebreathing mask and a 20 mL/kg bolus of normal saline to maintain adequate cerebral perfusion. |
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When stabilizing a patient's cervical spine, you should:
A. support the lower jaw with your palms. B. position yourself beside the patient. C. align the patient's nose with the navel. |
C. align the patient's nose with the navel
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What portion of the nervous system controls the functions of many of the body's vital organs, over which the brain has no voluntary control?
A. Peripheral B. Somatic C. Adrenergic D. Autonomic |
D. Autonomic
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A 39-year-old female struck a tree while traveling approximately 40 mph. When you arrive at the scene, the patient is out of her vehicle and walking around. You should:
A. have her walk to the ambulance and then immobilize her. B. immobilize her spine only if she complains of neck pain. C. immobilize her in a standing position to a long backboard. |
C. immobilize her in a standing position to a long backboard
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The function of the 12 pairs of cranial nerves is to:
A. conduct sensory impulses from the skin to the spinal cord. B. allow transmission of sensations directly to and from the brain. C. perform specialized functions in the neck and thoracic cavity. |
B. allow transmission of sensations directly to and from the brain
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You are transporting a 37-year-old male with a head injury to a local trauma center. When performing your reassessment, which of the following clinical findings would be the earliest indicator of increasing intracranial pressure?
A. A decreasing level of consciousness B. An acute decrease in systolic blood pressure C. The presence of decorticate posturing D. A progressive narrowing of the pulse pressure |
A. A decreasing level of consciousness
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Which of the following patients should be assigned a Glasgow Coma Scale (GCS) score of 8?
A. 22-year-old female who opens her eyes in response to pain, is unable to recall the year, and pushes your hand away when you palpate her abdomen B. 16-year-old female who opens her eyes when you talk to her, answers your questions inappropriately, and tells you her leg hurts C. 19-year-old male who does not open his eyes, is making mumbling sounds, and pulls his arm away when you are palpating it |
C. 19-year-old male who does not open his eyes, is making mumbling sounds, and pulls his arm away when you are palpating it
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When immobilizing a patient onto a long backboard, it is important to:
A. follow the commands of the AEMT at the torso. B. secure the head prior to securing the torso. C. secure the torso prior to securing the head. |
C. secure the torso prior to securing the head
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A football player sustained a possible spinal injury when he was tackled. He is conscious and alert, complains of pain to the mid-cervical spine region, and has stable vital signs. You should:
A. cut the facemask portion of the helmet off to monitor his airway. B. remove the helmet and immobilize him in the usual fashion. C. immobilize him with his helmet on unless it is not tight-fitting. D. gently move the helmet to ensure that it is tight-fitting. |
C. immobilize him with his helmet on unless it is not tight-fitting
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Subluxation of the spine occurs when:
A. compression causes a burst fracture. B. the vertebrae are no longer aligned. |
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You are caring for a young female who experienced blunt head trauma and is unresponsive. You have inserted a King LT airway and are providing mild hyperventilation because she has signs of brain herniation. In doing this, you should:
A. utilize capnography and ensure that her end-tidal CO2 does not fall below 30 mm Hg. B. continue to hyperventilate her, even if her clinical status begins to improve. |
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You are transporting a 40-year-old male who experienced blunt trauma to the side of his head. At the scene, he was conscious and alert and refused oxygen
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however, you note that his mental status has deteriorated and his respirations have become irregular and shallow. You should:
A. start a large-bore IV and deliver a 20 mL/kg fluid bolus. B. assist his ventilations with a bag-mask device. C. insert an advanced airway device immediately. D. apply a nonrebreathing mask set at 15 L/min. |
B. assist his ventilations with a bag-mask device
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The largest portion of the brain, which controls a wide variety of functions, is the:
A. cerebellum. B. cerebrum. C. brain stem. |
B. cerebrum
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During a motor-vehicle crash, a 3-year-old female, who was properly restrained in her car seat, is crying and asking for her mommy. There is no obvious injury to the child and she is breathing without difficulty. You should:
A. remove her from the car seat and immobilize her on a long backboard. B. immobilize her in the car seat and apply padding as needed. C. leave her in the car seat but avoid immobilization to decrease anxiety. |
B. immobilize her in the car seat and apply padding as needed
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A 40-year-old female is semiconscious following blunt head trauma. Your assessment reveals that her respirations are slow and shallow, her pulse is slow, and her blood pressure is elevated. Her pupils are bilaterally dilated and sluggishly reactive. Appropriate management for this patient includes:
A. hyperventilation at a rate of 20 breaths/min. B. 20 mL/kg boluses of a crystalloid solution. C. preoxygenation and insertion of a Combitube. D. assisted ventilation at a rate of 10 breaths/min. |
D. assisted ventilation at a rate of 10 breaths/min
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A patient with closed head trauma would MOST likely deteriorate rapidly following a/an:
A. cerebral concussion. B. epidural hematoma. C. cerebral contusion. D. subdural hemorrhage. |
B. epidural hematoma
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The ability to consciously flex a muscle in an extremity is a function of the:
B. somatic nervous system. C. autonomic nervous system |
B. somatic nervous system. |
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Just before striking a tree with her car, a 17-year-old female suddenly gasps and holds her breath. What type of injury will she MOST likely experience?
A. Disruption of the great vessels B. Compression of the myocardium C. Rupture of the lung parenchyma D. Multiple pulmonary contusions |
C. Rupture of the lung parenchyma
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A 54-year-old male impacted the steering wheel with his chest when his truck struck another vehicle head-on. He complains of retrosternal chest pain, dysphagia, and dyspnea. Although his blood pressure is 160/90, his femoral pulses are weakly palpable. You should suspect:
A. vena cava compression. B. ruptured aortic aneurysm. C. traumatic aortic disruption. |
C. traumatic aortic disruption
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Which of the following is a LATE sign of a tension pneumothorax?
A. Contralateral tracheal shift B. Bulging intercostal muscles C. Narrowing pulse pressure D. Profound shortness of breath |
A. Contralateral tracheal shift
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As the aorta exits the left ventricle, it immediately branches into the:
A. carotid arteries. B. innominate artery. C. subclavian arteries. D. coronary arteries. |
D. coronary arteries
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The mediastinum encompasses all of the structures within the thoracic cavity, EXCEPT for the:
A. aorta. B. heart. C. lungs. D. vena cavae. |
C. lungs
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Common clinical findings in a patient with a suspected myocardial contusion include all of the following, EXCEPT:
A. unilaterally diminished or absent breath sounds. B. tachycardia and a pulse that may be irregular. C. ecchymosis to the sternum and surrounding area. |
A. unilaterally diminished or absent breath sounds
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Commotio cordis is a condition in which:
A. immediate cardiac arrest occurs when the chest is impacted during the heart's repolarization period. B. shearing forces tear the aorta from its point of attachment, resulting in profound intrathoracic hemorrhage. C. a patient takes a deep breath just before blunt trauma to the chest, resulting in rupture of one or both lungs. D. increased intrathoracic pressure causes the intercostal muscles to bulge from in between the ribs. |
A. immediate cardiac arrest occurs when the chest is impacted during the heart's repolarization period
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Which of the following signs or symptoms would you be LEAST likely to find during your assessment of a patient with a pneumothorax?
A. Progressive respiratory difficulty B. Tachypnea with reduced tidal volume C. Unilaterally diminished breath sounds D. Contralateral shifting of the trachea |
D. Contralateral shifting of the trachea
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Any injury at the nipple line should be considered a thoracic and abdominal injury because:
A. the liver, spleen, and stomach are completely protected by the ribs. B. the diaphragm may elevate as high as the nipple line upon exhalation. C. penetrating injuries to the upper chest often result in liver lacerations. D. the diaphragm ascends into the chest cavity during the inspiration phase. |
B. the diaphragm may elevate as high as the nipple line upon exhalation
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When administering IV fluids to a patient with suspected intrathoracic bleeding, it is important to remember that:
A. fluids should be restricted, even in the presence of shock. B. most patients require up to 2 liters of crystalloid solution. C. increasing the BP with fluids may increase the bleeding. D. a target systolic blood pressure of 100 should be achieved. |
C. increasing the BP with fluids may increase the bleeding
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Which of the following mechanisms of injury is MOST commonly associated with traumatic dissection or rupture of the aorta?
A. Significant falls B. Penetrating injuries C. Motorcycle crashes |
C. Motorcycle crashes
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The primary muscle(s) of respiration is/are the:
A. sternocleidomastoid muscle. B. pectoralis major and diaphragm. C. diaphragm and intercostal muscles. D. intercostal muscles and latissimus dorsi. |
C. diaphragm and intercostal muscles
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Which of the following statements regarding the parietal pericardium is correct?
A. It acutely distends with as little as 500 mL of blood or excess pericardial fluid. B. It cannot distend acutely but can slowly distend with as much as 1,000 mL of blood. C. 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
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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:
A. circumferentially wrap his chest for support. B. assist his ventilations with a bag-mask device. C. apply high-flow oxygen via a nonrebreathing mask. D. encourage him to breathe shallowly to reduce his pain. |
B. assist his ventilations with a bag-mask device |
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A construction worker is pinned in 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:
A. be prepared for severe hypotension once he is freed. B. administer 3 liters of normal saline before he is freed. C. avoid fluid boluses as this may cause pulmonary edema. |
A. be prepared for severe hypotension once he is freed
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Which of the following chest injuries would be the LEAST likely to present with jugular venous distention?
A. Pericardial tamponade B. Tension pneumothorax C. Massive hemothorax |
C. Massive hemothorax
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A trauma patient who presents with shock, jugular venous distention, and bilaterally equal breath sounds has MOST likely experienced a:
A. simple pneumothorax. B. pericardial tamponade. C. pulmonary contusion. D. massive hemothorax. |
B. pericardial tamponade
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Chest trauma is a common cause of respiratory acidosis, and rapidly leads to death because the:
A. pH level of the blood increases precipitously. B. renal system cannot compensate quickly enough. C. body eliminates CO2 more rapidly than it is produced. D. kidneys fail and are unable to normalize the blood's pH |
B. renal system cannot compensate quickly enough
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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/an:
A. localized hemothorax. B. spontaneous pneumothorax. C. acute onset of pneumonia. D. developing tension pneumothorax. |
B. spontaneous pneumothorax
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What is the rationale for restricting IV fluid boluses in patients with a pulmonary contusion?
A. Pulmonary contusions rarely cause severe hypovolemia. B. Fluids may cause pulmonary edema or increased bleeding. C. Rapidly increasing the blood pressure may inhibit hemostasis. D. Excessive fluid boluses may result in a tension pneumothorax. |
B. Fluids may cause pulmonary edema or increased bleeding
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A 34-year-old male is in late shock secondary to blunt chest trauma. His respirations of 6 breaths/min and shallow will initially result in:
A. oxygen deficiency and alkalosis. B. carbon dioxide retention and acidosis. C. carbon dioxide elimination and decreased pH. |
B. carbon dioxide retention and acidosis
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A 54-year-old male convenience store clerk was shot in the left anterior chest during an attempted robbery. After ensuring that the scene is safe, you enter the store and perform a primary assessment. The patient is semiconscious, is in severe respiratory distress, and is pale. Further assessment reveals absent breath sounds on the left side of his chest, collapsed jugular veins, and a blood pressure of 70/44 mm Hg. In addition to managing his airway, you should:
A. ventilate the patient at a rate of 20-24 breaths per minute. B. transport immediately and perform invasive procedures en route. C. start two large-bore IVs and give a 20 mL/kg bolus of normal saline. D. perform a detailed secondary assessment and then transport rapidly. |
B. transport immediately and perform invasive procedures en route
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Of the following injuries, which would MOST likely present with muffled heart tones?
A. Myocardial contusion B. Tension pneumothorax C. Diaphragmatic injury |
B. Tension pneumothorax
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When percussing the chest of a patient who experienced blunt chest trauma, you note hyperresonance on the left side of his chest. This suggests:
A. blood in the pleural space. B. alveolar hyperinflation. C. myocardial compression. D. air in the pleural space. |
D. air in the pleural space
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During your rapid assessment of a patient with a gunshot wound to the chest, you located an open wound to the right anterior chest and sealed it with the appropriate dressing. A few minutes later, the patient's respirations are increasingly labored and his heart rate has significantly increased. You should:
A. request a paramedic to perform a needle decompression. B. relieve pleural tension by lifting a corner of the dressing. C. transport the patient to a trauma center for definitive care. |
B. relieve pleural tension by lifting a corner of the dressing
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Visceral injuries in the chest that occur from shearing forces, compression, or rupture, are MOST commonly seen with:
A. blunt chest trauma. B. projectile injuries. C. rapid acceleration. D. penetrating chest trauma. |
A. blunt chest trauma
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A 37-year-old semiconscious male sustained a stab wound lateral to the left side of the sternum. He presents with signs of shock, engorged jugular veins, and a weakened radial pulse during inspiration. After administering 100% supplemental oxygen, you should:
A. administer 20 mL/kg boluses of an isotonic crystalloid. B. apply and fully inflate the pneumatic antishock garment (PASG). C. call for a paramedic unit to perform a needle chest decompression. |
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Patients with multiple rib fractures may develop significant hypoxia because of a ventilation/perfusion mismatch, which occurs when:
A. vascular disruption severely inhibits the adequate exchange of gases in the lungs. B. the circulatory system is intact but the amount of available oxygen is diminished. C. alveolar surface area is greatly increased and the pulmonary capillaries are dilated. |
A. vascular disruption severely inhibits the adequate exchange of gases in the lungs
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During your rapid assessment of a semiconscious 44-year-old female with blunt thoracic trauma, you detect an area on the left anterior chest that bulges during exhalation. Your partner is assisting her ventilations with a bag-mask device and 100% oxygen. You should:
A. advise your partner to increase the rate and depth of ventilations. B. stabilize the chest wall deformity and continue your assessment. C. call for a paramedic crew to perform a needle chest decompression. D. place a sandbag over the deformed area and auscultate breath sounds. |
B. stabilize the chest wall deformity and continue your assessment
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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:
A. perform a secondary assessment, transport immediately, and establish vascular access en route. B. insert a multilumen airway device, start a large-bore IV, and transport to a trauma center. C. transport immediately, start a large-bore IV en route, and request a paramedic rendezvous. |
C. transport immediately, start a large-bore IV en route, and request a paramedic rendezvous
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Patients with a tension pneumothorax experience a decreased cardiac output and shock secondary to:
A. myocardial compression and decreased preload. B. massive blood accumulation in the pleural space. C. decreased intrathoracic pressure and increased preload. |
myocardial compression and decreased preload
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Which of the following MOST accurately describes the pathophysiology of a pneumothorax?
A. Accumulation of blood or other fluid in the pleural space B. Intrapulmonary pressure secondary to pleural compression C. Intrapleural pressure with progressive pulmonary collapse |
C. Intrapleural pressure with progressive pulmonary collapse
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Which of the following statements regarding the lung parenchyma is correct?
A. It is covered by the visceral pleura. B. It is encased in the parietal pleura. C. It is composed of three lobes on the left. |
A. It is covered by the visceral pleura
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In contrast to paradoxical chest motion, asymmetrical chest movement occurs when:
A. both sides of the chest move shallowly during normal breathing. B. one side of the chest fails to move normally during inspiration. C. both sides of the chest wall move in unison during deep inspiration. |
B. one side of the chest fails to move normally during inspiration
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Which of the following potentially lethal chest injuries would you be the LEAST likely to detect during the primary assessment?
A. Flail chest B. Cardiac tamponade C. Bronchial disruption D. Pulmonary contusion |
D. Pulmonary contusion
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Regardless of the cause, hyperventilation causes:
A. respiratory alkalosis. B. metabolic acidosis. C. metabolic alkalosis. |
A. respiratory alkalosis
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Following a motor-vehicle crash in which his truck struck a utility pole, a 56-year-old male complains of pain to the mid-chest and difficulty breathing. Your assessment reveals an ecchymotic area over the mid-sternum. His blood pressure is 110/70 mm Hg, pulse is 120 and irregular, and respirations are 24 breaths/min with adequate depth. In addition to spinal immobilization, appropriate treatment for this patient includes:
A. supplemental oxygen and a large-bore IV set to keep the vein open. B. assisted ventilation, two large-bore IVs, and a 20 mL/kg fluid bolus. C. supplemental oxygen and stabilization of the sternum with a sandbag. D. supplemental oxygen and application of an AED in case of cardiac arrest. |
A. supplemental oxygen and a large-bore IV set to keep the vein open
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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:
A. aortic disruption. B. cardiac tamponade. C. myocardial contusion. |
B. cardiac tamponade
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When caring for a patient with significant thoracic trauma and signs of shock, it is MOST important to:
A. establish two large-bore IV lines. B. transport promptly to a trauma center. C. perform a detailed secondary assessment. D. administer high-flow oxygen at all times. |
B. transport promptly to a trauma center
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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, normal jugular veins, and a midline trachea. 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?
A. Moderate hemothorax B. Simple pneumothorax C. Myocardial contusion D. Tension pneumothorax |
B. Simple pneumothorax
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Which of the following statements regarding blunt chest trauma is correct?
A. Blunt chest trauma usually occurs during the tertiary phase of a blast injury. B. The force from blunt chest wall trauma is usually confined to a small area. C. Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs. |
C. Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs
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A 29-year-old male was robbed and struck in the chest by an assailant with a steel pipe. Your assessment reveals severe pain and crepitus to the right upper chest, at and below the clavicle. What is MOST significant about the location of this patient's injury?
A. The patient will instinctively hyperventilate in an attempt to increase chest excursion and minute volume. B. This type of injury is associated with a high incidence of widespread alveolar destruction due to intrapulmonary bleeding. C. Because they are protected by the bony girdle of the clavicle and scapula, upper rib fractures may indicate severe internal injuries. |
C. Because they are protected by the bony girdle of the clavicle and scapula, upper rib fractures may indicate severe internal injuries
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The presence of a scaphoid abdomen and bowel sounds in the lower hemithorax are MOST suggestive of a:
A. pneumothorax. B. perforated lung. C. perforated bowel. D. ruptured diaphragm. |
D. ruptured diaphragm
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Common signs of a chest injury include all of the following, EXCEPT:
A. hyperpnea. B. tachycardia. C. hemoptysis. D. hypotension. |
A. hyperpnea
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Unilaterally diminished or absent breath sounds, a narrowed pulse pressure, and dullness to percussion of the hemithorax are clinical findings suggestive of a:
A. hemothorax. B. tension pneumothorax. C. pericardial tamponade. |
A. hemothorax
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When treating a patient with a suspected myocardial contusion, it is especially important to monitor the patient for:
A. evidence of pulmonary edema. B. a heart rate that exceeds 90/min. C. distention of the jugular veins. |
A. evidence of pulmonary edema
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When treating a patient with a suspected diaphragmatic rupture, you should:
A. apply 100% oxygen with a nonrebreathing mask. B. avoid administering more than 500 mL of crystalloid. C. avoid placing the patient in a Trendelenburg position. |
C. avoid placing the patient in a Trendelenburg position
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Fracture of the first and second ribs following severe blunt trauma would MOST likely result in a:
A. massive hemothorax. B. myocardial contusion. C. tracheobronchial injury. D. pericardial tamponade. |
C. tracheobronchial injury
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The esophagus enters the thorax via the thoracic inlet and travels:
A. through the anterior thorax. B. through the posterior thorax. C. lateral to the lung parenchyma. |
B. through the posterior thorax
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A 31-year-old man was stabbed in the chest during an altercation at a bar. He is semiconscious and has shallow breathing. As your partner assists the patient's ventilations, you perform a rapid assessment and find a single stab wound to the left anterior chest with minimal bleeding. Breath sounds on the side of the injury are markedly diminished. You should:
A. request a paramedic unit to perform a needle chest decompression. B. cover the wound with an occlusive dressing and continue your assessment. C. advise your partner to ventilate the patient with a manually-triggered device. D. reassess the status of the patient's airway and the adequacy of his breathing. |
B. cover the wound with an occlusive dressing and continue your assessment
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In the absence of obvious external trauma, an abdominal injury would be MOST difficult to assess for in a/an:
A. intoxicated patient. B. unresponsive patient. C. hypovolemic patient. D. patient in severe pain . |
B. unresponsive patient
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The absence of pain when palpating a trauma patient's abdomen does not rule out the possibility of intraabdominal bleeding because:
A. the strong abdominal musculature becomes tense following blunt trauma. B. most cases of intraabdominal hemorrhage occur in the retroperitoneal space. C. blood within the peritoneal cavity does not provoke an inflammatory response. |
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Signs of a ruptured urinary bladder include all of the following, EXCEPT:
A. hematuria. B. hematemesis. C. perineal bruising. D. urethral bleeding. |
B. hematemesis
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Approximately 80% of all injuries to the genitourinary system involve the:
A. kidneys. B. bladder. C. ureters. |
A. kidneys
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A 29-year-old female had a glass bottle inserted into her vagina during a sexual assault. She is conscious and alert and has stable vital signs, but she is in severe pain. How should you manage this patient?
A. Carefully remove the bottle, monitor her vital signs, provide emotional support, and promptly transport. B. Stabilize the bottle, place dressings in the vagina, provide emotional support, and promptly transport. C. Make one attempt to remove the bottle, start an IV of normal saline, provide emotional support, and transport promptly. D. Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly. |
D. Stabilize the bottle with bulky dressings, monitor her vital signs, provide emotional support, and transport promptly
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When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should:
A. transport only and provide support and reassurance. B. limit your examination to a secondary assessment only. C. treat any injuries and provide privacy and reassurance. D. treat any injuries and question the patient about the event. |
C. treat any injuries and provide privacy and reassurance
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Which of the following organs lie in the right upper quadrant of the abdomen?
A. Spleen and liver B. Pancreas and liver C. Gallbladder and spleen D. Liver and gallbladder |
D. Liver and gallbladder
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Which of the following abdominal organs would cause the MOST profuse bleeding when severely injured?
A. Liver B. Spleen C. Pancreas D. Kidneys |
A. Liver
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Following blunt trauma to the right flank area, a 20-year-old male presents with hematuria. Assessment of the area reveals pain to palpation, but no visible signs of trauma. His blood pressure is 120/76 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min and unlabored. Which of the following is the MOST appropriate intravenous therapy for this patient?
A. One large-bore IV set at a keep vein open (KVO) rate. B. Two large-bore IVs and a 500 mL normal saline bolus. C. One large-bore IV and a 20 mL/kg normal saline bolus. D. Two large-bore IVs set at a keep vein open (KVO) rate. |
D. Two large-bore IVs set at a keep vein open (KVO) rate
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Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash?
A. Asking the patient if he or she was wearing a seatbelt B. Noting the position of the restraint system on the patient C. Lifting a deployed airbag and assessing the steering wheel D. Determining whether or not the airbag deployed on impact |
C. Lifting a deployed airbag and assessing the steering wheel
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The kidneys lie within the:
A. left upper quadrant. B. right upper quadrant. C. anterior abdomen. D. retroperitoneal space. |
D. retroperitoneal space
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A 25-year-old male experienced blunt abdominal trauma and is developing shock. Which of the following signs would you expect to manifest late?
A. Tachycardia B. Hypotension C. Restlessness D. Pale, cool skin |
B. Hypotension
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Which of the following statements regarding trauma to the kidneys is correct?
A. Injuries confined to the kidneys are common following blunt force trauma. B. You should suspect a ruptured aorta when the MOI suggests kidney injury. C. Kidney injury is usually associated with injury to other abdominal organs. D. The kidneys are well protected in the abdomen and rarely sustain injury. |
C. Kidney injury is usually associated with injury to other abdominal organs
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Blunt or penetrating trauma can be especially lethal in pregnant patients because the:
A. fetus can sustain serious injury. B. gravid uterus is highly vascular. C. uterus descends into the pelvis. |
B. gravid uterus is highly vascular
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Which of the following mechanisms of injury would MOST likely cause a shearing injury of the bladder from the urethra in a male?
A. Motorcycle crash B. Blunt trauma to the flank C. Fall from a significant height D. Rear-end motor-vehicle crash |
A. Motorcycle crash
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When assessing a patient who experienced blunt abdominal trauma, you note bruising around the umbilicus. This is called ____________ sign and indicates:
A. Kehr sign ruptured hollow organs. B. Grey Turner sign injury to the liver. C. Murphy sign gallbladder rupture. D. Cullen sign significant internal bleeding. |
D. Cullen sign significant internal bleeding |
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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:
A. attempt to unzip the pants and request a paramedic unit to give morphine. B. carefully cut the zipper out of the pants, control any bleeding, and transport. C. provide prompt transport to the hospital while providing emotional support. D. allow the patient's wife to transport him to the hospital since he is not unstable. |
B. carefully cut the zipper out of the pants, control any bleeding, and transport
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While transporting a pregnant trauma patient who is immobilized on a backboard, you note a sudden decrease in her blood pressure and a decrease in her mental status. You should:
A. tilt the backboard to the left. B. infuse 20 mL/kg of normal saline. C. elevate the foot of the backboard. D. apply and fully inflate the PASG. |
A. tilt the backboard to the left
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During your assessment of a 48-year-old female with localized blunt abdominal trauma, you should:
A. immobilize her spinal column. B. palpate the most painful area first. C. be prepared for the patient to vomit. D. vigorously palpate the entire abdomen. |
C. be prepared for the patient to vomit
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After applying supplemental oxygen to a patient with blunt abdominal trauma, you should:
A. fully extend the patient's legs. B. vigorously palpate the abdomen. C. obtain a set of baseline vital signs. D. start an IV and give a fluid bolus. |
C. obtain a set of baseline vital signs
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Kehr sign is defined as:
A. the presence of flank bruising secondary to intraabdominal bleeding. B. referred pain to the shoulder following injury to the liver or spleen. C. bruising around the umbilicus secondary to intraabdominal bleeding. |
B. referred pain to the shoulder following injury to the liver or spleen
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Which of the following seatbelt positions will MOST likely result in severe intraabdominal injuries when a vehicle suddenly decelerates?
A. Shoulder harness and lap belt placed superior to the iliac crest B. Use of the lap belt only with the shoulder harness behind the back C. Shoulder harness used and lap belt across the anterior iliac crest D. Shoulder harness not used and lap belt across the anterior iliac crest |
A. Shoulder harness and lap belt placed superior to the iliac crest
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In an attempt to minimize the pain associated with abdominal trauma, the patient will typically:
A. draw his or her knees into the abdomen and breathe deeply. B. take deep breaths to relieve pressure off of the diaphragm. 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 tense the abdominal muscles. |
D. draw his or her knees into the abdomen and tense the abdominal muscles
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Diffuse (global) swelling of the abdomen is MOST suggestive of:
A. acute bowel obstruction. B. intraabdominal bleeding. C. peritoneal inflammation. |
B. intraabdominal bleeding
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In addition to providing 100% oxygen and controlling external bleeding, the MOST appropriate management for a patient with a knife impaled in the abdomen includes:
A. stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion. B. covering the knife with a protective barrier and administering 2 liters of normal saline. C. carefully removing the knife and administering 20 mL/kg boluses of normal saline. D. stabilizing the knife and increasing the blood pressure with 20 mL/kg saline boluses. |
A. stabilizing the knife in place and infusing crystalloids to maintain adequate perfusion
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Testicular torsion is a/an:
A. life-threatening injury that requires surgery. B. spontaneous event in the majority of cases. C. irreversible injury that leads to impotence. D. time-sensitive injury and requires rapid transport. |
D. time-sensitive injury and requires rapid transport
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Patients with a significant abdominal injury:
A. have increased pain with movement. B. develop hypotension as an early sign. C. most commonly have an injured spleen. D. become tachycardic after severe blood loss. |
A. have increased pain with movement
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Priority management for a patient with an amputated penis and stable vital signs includes:
A. locating the amputated part. B. rapid transport to a trauma center. C. controlling any active hemorrhage. D. placing moist dressings on the wound. |
C. controlling any active hemorrhage
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Blunt abdominal trauma may result in tearing of the mesentery, which is/are:
A. multiple bands of thick muscle that protect the abdominal organs. B. the main supporting structure of the descending abdominal aorta. C. a vascular network that provides exclusive blood supply to the liver. D. membranous folds that attach the intestines to the abdominal wall. |
D. membranous folds that attach the intestines to the abdominal wall
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During a football game, a 16-year-old male was "speared" in the right flank by another player. This mechanism of injury is MOST suggestive of injury to the:
A. liver. B. kidney. C. gallbladder. D. urinary bladder. |
B. kidney
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Which of the following medications or medical devices may inhibit the body's tachycardic response during shock?
A. Aspirin B. Anticoagulant C. Beta-blocker D. Implanted defibrillator |
C. Beta-blocker
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A 29-year-old male has sustained a large laceration across the lower abdomen and has a loop of bowel protruding through the wound. To minimize the amount of body heat that radiates from the open wound, you should:
A. irrigate the wound with warm sterile water. B. cover the wound with moist sterile dressings. C. apply a pressure dressing to the open wound. D. cover the wound with a dry sterile dressing. |
B. cover the wound with moist sterile dressings
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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:
A. ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the 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. starting two large-bore IV lines, running the IVs wide open, and promptly transporting to the closest, most appropriate facility. |
A. ensuring adequate ventilation, maintaining adequate perfusion with IV fluids, and transporting to the most appropriate facility
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Increasing the blood pressure with IV crystalloids in a patient with intraabdominal bleeding would MOST likely:
A. result in clinical improvement. B. exacerbate the internal bleeding. C. facilitate the hemostatic process. D. improve perfusion to vital organs. |
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The presence of gastric juices and bacteria in the abdominal cavity causes an intense inflammatory reaction called:
A. gastritis. B. peritonitis. C. diverticulitis. D. appendicitis. |
B. peritonitis
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You and your partner are applying a Hare traction splint to a patient with a deformed midshaft femur. As you expose the injured femur and assess neurovascular functions, your partner should:
A. elevate the leg and apply an ankle hitch. B. measure the splint beside the uninjured leg. C. manually support and stabilize the injured leg. D. apply gentle in-line traction to the injured leg. |
C. manually support and stabilize the injured leg
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When assessing the pelvis of a patient with multiple systems trauma, you should:
A. gently rock the pelvis back and forth. B. percuss the pubic symphysis to elicit pain. C. apply gentle inward pressure to the iliac crests. D. avoid palpation due to the potential for injury. |
C. apply gentle inward pressure to the iliac crests
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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:
A. remove the air splint and apply a rigid splint. B. inflate the air splint by approximately 50%. C. deflate the air splint by approximately 50%. D. monitor the splint and let air out as needed. |
D. monitor the splint and let air out as needed
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A major benefit of using a Sager traction splint is that it:
A. immobilizes the limb by producing countertraction. B. can be applied effectively by one AEMT if necessary. C. allows you to bind the injured leg to the uninjured leg. |
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In the process of applying a splint on a 21-year-old female with an apparent dislocated patella, the patella spontaneously returns to its normal position. You should:
A. allow her to drive herself to the hospital. B. apply the PASG and inflate the leg section. C. immobilize her knee with a long board splint. |
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On which of the following injuries would it be MOST appropriate to apply a traction splint?
A. Pain and crepitus upon palpation of the pelvis B. Posterior bulge of the hip with intact circulation C. Swelling and ecchymosis to the midshaft femur D. Deformity and swelling just proximal to the knee |
C. Swelling and ecchymosis to the midshaft femur
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Tough, cord-like structures that are extensions of the fascia covering all skeletal muscles are known as:
A. menisci. B. tendons. C. ligaments. D. cartilage. |
B. tendons
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A 29-year-old male was struck in the upper back by a solid object. During your assessment, you note ecchymosis, pain, and crepitus to the left scapula. His blood pressure is 124/68 mm Hg, pulse is 110 and strong, and respirations are 24 breaths/min and labored. You should provide supplemental oxygen, immobilize his spine, and:
A. be alert for intrathoracic injuries. B. pad under the scapula with a pillow. C. give a crystalloid bolus of 20 mL/kg. D. transport to a local community hospital. |
A. be alert for intrathoracic injuries
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You arrive at the scene of a motor-vehicle crash in which a 30-year-old male was ejected from his truck. As you approach the patient, who is not moving, you can see that he has gross deformity to both of his femurs and an angulated left humerus. You should:
A. perform a rapid secondary assessment. B. assess the adequacy of his respirations. C. stabilize his head and open his airway. D. assess his femurs for gross bleeding. |
C. stabilize his head and open his airway
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You have delivered your patient, a 14-year-old female with a possible femur fracture, to the emergency department. After radiographic evaluation, the physician tells you that the patient has a comminuted fracture. This means that the femur:
A. has fractured into more than two fragments. B. fractured as a result of an osteopathic condition. C. will prematurely stop developing and growing. D. was fractured as a result of an impacting injury. |
A. has fractured into more than two fragments
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When assessing a patient with multiple systems trauma, which of the following musculoskeletal injuries would pose the GREATEST threat to the patient's life?
A. Multiple open fractures B. Dislocation of a major joint C. Single open long bone fracture D. Displaced fracture of the pelvis |
A. Multiple open fractures
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A fracture that occurs in the growth section of a child's bone, which may lead to bone growth abnormalities, is called a/an __________________ fracture.
A. diaphyseal B. metaphyseal C. epiphyseal |
C. epiphyseal
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Proximal humeral fractures MOST commonly occur:
A. as a result of minor trauma. B. in the pediatric population. C. in the elderly population. D. during stretching injuries. |
C. in the elderly population
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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:
A. application of a pelvic binder, immobilization on a long backboard, at least one large-bore IV set to keep the vein open, and transport. B. immobilization with a scoop stretcher, the PASG applied and inflated, at least one large-bore IV, a 20 mL/kg fluid bolus, and transport. C. application of a pelvic binder, immobilization on a long backboard, two large-bore IVs, a 500 mL crystalloid bolus, and transport. |
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A 50-year-old male fell approximately 20 feet and landed on his side. He is conscious and alert and denies loss of consciousness. During your assessment, you note pain and crepitus when palpating the iliac crests. In addition to the potential for spinal injury, you should be MOST concerned about:
A. internal hemorrhaging. B. retroperitoneal injuries. C. neurovascular compromise. D. the cause of the patient's fall. |
A. internal hemorrhaging
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Which of the following is the MOST effective method of immobilizing a fractured clavicle?
A. Sling and swathe B. Modified wrist sling C. Short arm rigid splint D. Pillow or other padding |
A. Sling and swathe
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An injury that may result in complete separation of a joint due to stretching or tearing of the supporting ligaments is called a:
A. sprain. B. strain. C. dislocation. D. subluxation. |
A. sprain
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Decrease in the size of a muscle and its inherent ability to function is called:
A. atrophy. B. myalgia. C. cephalgia. D. hypertrophy. |
A. atrophy
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A 29-year-old male fell approximately 5 feet from a ladder and landed on his right shoulder. He is conscious and alert, denies loss of consciousness, and complains of pain to the shoulder. His vital signs are stable. You should:
A. perform a rapid scan of the body, start and IV of normal saline, transport, and splint the injury en route to the hospital. B. manually stabilize the injury until it is splinted, perform a secondary assessment, splint the injury appropriately, and transport. C. allow the patient to stabilize his shoulder with his opposite hand, perform a secondary assessment, and transport. D. start an IV of normal saline, appropriately splint his shoulder, transport, and perform a secondary assessment en route. |
B. manually stabilize the injury until it is splinted, perform a secondary assessment, splint the injury appropriately, and transport
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Which of the following statements regarding skeletal muscle is correct?
A. Most of the body's skeletal muscle is not under voluntary control. B. Skeletal muscle is highly vascular and bleeds significantly when injured. C. Skeletal muscle can only survive for up to 10 minutes without oxygen. |
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Pathologic fractures are typically caused by all of the following, EXCEPT:
A. osteoporosis. B. bone cancer. C. previous fractures. D. minor injury force. |
C. previous fractures
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A Colles fracture is caused by injury to the:
A. carpal bones. B. distal radius. C. proximal ulna. D. midshaft forearm. |
B. distal radius
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An 80-year-old male tripped and fell and complains of pain to his left hip. Your assessment reveals that his knee is flexed and his left leg is shortened and medially rotated. Distal neurovascular functions are grossly intact. You should immobilize this patient's injury by:
A. straightening his leg and immobilizing him with a scoop stretcher. B. applying a Hare traction splint and immobilizing him on a longboard. C. placing him on a scoop stretcher and padding the injury with pillows. D. attempting to reduce the injury and immobilizing him on a longboard. |
C. placing him on a scoop stretcher and padding the injury with pillows
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Goals of in-line traction for musculoskeletal injuries in the prehospital setting include all of the following, EXCEPT:
A. reduction of the fracture. Correct B. stabilization of the fracture site. C. alignment of the injured extremity. D. avoiding neurovascular compromise. |
D. avoiding neurovascular compromise
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In addition to splinting the injured extremity, appropriate management for a patient with suspected compartment syndrome includes:
A. applying traction to the extremity, keeping it at the level of the heart, and transporting. B. lowering the limb below the level of the heart, transporting, and frequently assessing pulses. C. elevating the limb above the level of the heart, transporting, and reassessing distal pulses. D. keeping the limb at the level of the heart, transporting, and frequently assessing distal pulses. |
D. keeping the limb at the level of the heart, transporting, and frequently assessing distal pulses
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General principles of splinting an injured extremity include:
A. immobilizing the joint below a suspected fracture. B. frequently assessing gross neurovascular functions. C. immobilizing the bone above a suspected dislocation. D. splinting all extremity injuries en route to the hospital. |
B. frequently assessing gross neurovascular functions
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A 55-year-old male fell from the roof of his house and sustained a closed, displaced femur fracture. He is restless, diaphoretic, and tachycardic. After appropriately managing his ABCs and performing a rapid head-to-toe assessment, you should:
A. apply a traction splint, immobilize him on a long backboard, and begin transport. B. immobilize him on a long backboard, transport, and start a large-bore IV en route. |
B. immobilize him on a long backboard, transport, and start a large-bore IV en route
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Which of the following statements regarding hip dislocations is correct?
A. Most hip dislocations are caused by posterior displacement of the femoral head. B. Most hip dislocations are caused by anterior displacement of the femoral head. C. Anterior hip dislocations are characterized by lateral rotation of the lower extremity. D. Posterior hip dislocations are characterized by medial rotation of the lower extremity. |
A. Most hip dislocations are caused by posterior displacement of the femoral head
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A 21-year-old male presents with a severely angulated forearm and extreme pain. Distal sensory, motor, and circulatory functions are intact. You should:
A. apply a zippered air splint to relieve the pain. B. splint the forearm in the position of deformity. C. apply chemical heat packs to help reduce swelling. D. carefully straighten the forearm and apply a splint. |
B. splint the forearm in the position of deformity
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Which of the following musculoskeletal injuries poses the GREATEST risk for compartment syndrome?
A. Ankle fracture in an adult B. Humeral fracture in a child C. Hip fracture in an older adult D. Wrist fracture in an adolescent |
B. Humeral fracture in a child
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Which of the following injuries would pose the LEAST threat to the patient?
A. Single open long bone fracture B. Displaced fracture of the pelvis C. Major sprains at a major joint |
C. Major sprains at a major joint
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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/an:
A. fracture. B. dislocation. C. severe sprain. D. epiphyseal injury. |
B. dislocation
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A 34-year-old male sustained a twisting injury to his left lower leg when he stepped into a hole. Your assessment reveals ecchymosis and pain to the area, but no deformity or crepitus. You should suspect a:
A. displaced fracture. B. nondisplaced fracture. C. comminuted fracture. D. transverse fracture. |
B. nondisplaced fracture
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A young female has a closed, unstable deformity to her left femur. In this situation, the primary reason for applying a splint is to:
A. relieve the patient's pain and anxiety. B. prevent conversion to an open fracture. C. minimize any bleeding within the thigh. D. prevent severe spasms of the thigh muscle. |
B. prevent conversion to an open fracture
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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:
A. apply a pediatric traction splint to the arm. B. immobilize the injury with a sling and swath. C. ensure immobilization of the hand and shoulder. D. assume that growth plate damage has occurred. |
D. assume that growth plate damage has occurred
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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:
A. apply a traction splint, immobilize his spine, and transport. B. perform a head-to-toe assessment, immobilize his spine, and transport. C. immobilize his spine with a vest-style device and transport immediately. D. perform a detailed secondary assessment, immobilize his spine, and transport. |
B. perform a head-to-toe assessment, immobilize his spine, and transport
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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:
A. determine if his airway is patent. B. apply direct pressure to his leg. C. administer supplemental oxygen. D. apply a splint to his injured leg. |
B. apply direct pressure to his leg
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A patient with developing compartment syndrome following a fracture typically complains of or presents with:
A. tension or pressure in the affected extremity. B. extreme cyanosis to the affected extremity. C. increased sensation distal to site of the injury. D. a lesser degree of pain than would be expected. |
A. tension or pressure in the affected extremity
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Fractures of the proximal femur MOST commonly occur at the:
A. acetabular region of the pelvis. B. superior aspect of the femoral head. C. intertrochanteric region of the femur. D. epiphyseal region of the femoral head. |
C. intertrochanteric region of the femur
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In which of the following situations would it NOT be appropriate to splint a patient's fractures before moving him or her?
A. Upset patient with abrasions and capillary bleeding B. Conscious patient in severe pain with stable vital signs C. Alert patient with a history of uncontrolled hypertension D. Confused patient with tachycardia and shallow breathing |
D. Confused patient with tachycardia and shallow breathing
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A 30-year-old male fell while rollerblading and landed on his right arm. There is obvious deformity to the elbow and the patient complains of severe pain. The patient's hand is cool and pale and his radial pulse is difficult to palpate. The hospital is approximately 10 minutes away. You should:
A. gently flex the elbow so that you can apply a sling and swathe. B. align the arm and apply a padded board splint and then transport. C. make one attempt to restore distal circulation and then transport. D. splint the arm in the position found and then transport immediately. |
D. splint the arm in the position found and then transport immediately
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Which of the following muscles is attached to the skeleton and forms the bulk of tissue of the arms and legs?
A. Smooth B. Skeletal C. Autonomic D. Involuntary |
B. Skeletal
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Which of the following injuries MOST accurately depicts an open fracture?
A. Deformity to the radius and ulna with an overlying healing laceration B. Swelling and deformity to the tibia with a bulge from the fractured bone C. Deformity to the midshaft femur with ecchymosis and a large hematoma D. Swelling and deformity to the lateral humerus with an overlying abrasion |
D. Swelling and deformity to the lateral humerus with an overlying abrasion
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The primary reason for applying gentle longitudinal traction to a severely angulated tibia is to:
A. determine if there is any crepitation. B. relieve the muscle spasms that cause pain. C. facilitate the placement of a standard splint. |
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When palpating an injured extremity, a patient complains of point tenderness. On the basis of this clinical finding, you:
A. are unable to determine the type of fracture. B. cannot identify the associated zone of injury. C. can definitively diagnose an underlying fracture. D. can conclude that gross distal motor function is intact. |
A. are unable to determine the type of fracture
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The energy needed for muscular contraction is derived from the metabolism of ___________ and results in the production of:
A. oxygen, pyruvic acid. B. glucose, lactic acid. C. calcium pyruvic acid. D. oxygen carbon dioxide. |
B. glucose, lactic acid |
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Which of the following describes an injury caused by indirect force?
A. Rupture of the stomach following the blast phase of an explosion B. Knee striking the dashboard during a car crash and fracturing the patella C. A fall on an outstretched hand with a fractured wrist and a dislocated elbow D. Being struck by a car and sustaining a pelvic fracture and a closed head trauma |
C. A fall on an outstretched hand with a fractured wrist and a dislocated elbow
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When assessing a patient who has fractured his or her midshaft clavicle, you should expect to find swelling, point tenderness, and:
A. abduction of the arm. B. a localized zone of injury. C. tenting over the fracture site. |
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Which of the following would be the LEAST reliable assessment parameter when determining the neurovascular status of a patient with a possible extremity fracture?
A. Distal motor function B. Quality of distal pulses C. Ability to move the extremity |
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Appropriate stabilization of an anterior shoulder dislocation includes:
A. pillow or towel under the arm and a sling and swathe. B. adducting the arm and applying a sling and swathe. C. internally rotating the arm and applying two swathes. D. bulky dressing under the arm and a modified wrist sling. |
A. pillow or towel under the arm and a sling and swathe
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Articular cartilage functions by:
A. preventing joints from extending beyond their normal range of motion. B. covering the bone ends and cushioning them from damage and wear. C. connecting the two bone ends of a joint together and allowing range of motion. D. strengthening the articulation point of immovable joints and providing support. |
B. covering the bone ends and cushioning them from damage and wear
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To align a severe deformity associated with a humeral shaft fracture, you should:
A. place one hand above and one hand below the fracture site and apply gentle downward traction. B. support the fracture site with one hand and apply gentle traction by grasping the humeral condyles. |
B. support the fracture site with one hand and apply gentle traction by grasping the humeral co
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___________ muscle is a component of body systems, including the digestive and cardiovascular systems.
A. Smooth B. Striated C. Voluntary |
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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:
A. keep her knee flexed and apply board splints secured at the hip and ankle. B. gently straighten her knee to facilitate placement of a zippered air splint. C. keep her knee flexed and apply two short board splints to stabilize the knee. |
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In addition to providing the framework for the human body, bones also:
A. allow the muscles to contract. B. produce electrolytes for the body. C. destroy nonfunctional erythrocytes. D. produce blood cells in the marrow. |
D. produce blood cells in the marrow
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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:
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. |
B. even minor mechanisms of injury can result in fractures in the elderly
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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/an:
A. fracture of the lateral clavicle. B. acromioclavicular separation. C. dislocation of the left shoulder. D. sternoclavicular joint fracture. |
B. acromioclavicular separation
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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:
A. a distal fracture of the humerus. B. posterior radius/ulna displacement. C. a proximal fracture of the radius. |
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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:
A. ecchymosis. B. gross swelling. C. point tenderness. |
C. point tenderness
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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:
A. gently manipulate the injured limb to elicit crepitus. B. place heat on his leg to force blood away from the area. C. apply an icepack and reassess after the swelling subsides. D. compare the injured extremity to the uninjured extremity. |
D. compare the injured extremity to the uninjured extremity
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The MOST accurate definition of a fracture is a:
A. crack on the surface of a bone. B. break in the continuity of a bone. |
B. break in the continuity of a bone
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When assessing a patient with a scapular fracture, you should also be alert for:
A. a myocardial contusion. B. fractures of the sacral spine. C. ribs fractures and a pneumothorax. D. an associated midshaft clavicular fracture. |
C. ribs fractures and a pneumothorax.
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When assessing a patient with a grossly deformed humerus, you note that the radial pulse is absent and the extremity is becoming cyanotic. You should:
A. use constant, gentle manual traction to align the humerus. B. manipulate the humerus until distal circulation is restored. C. splint the humerus in the position found and begin transport. D. begin transport and continue attempts to restore circulation. |
A. use constant, gentle manual traction to align the humerus
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Which of the following assessment findings would you expect to see in a patient with a posterior hip dislocation and sciatic nerve involvement?
A. Inability to dorsiflex the foot B. Weak or absent distal pulses C. Loss of flexion of the knee D. Hyperactive tendon reflexes |
A. Inability to dorsiflex the foot
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If your assessment of a patient with a possible musculoskeletal injury reveals no external signs of injury, it would be appropriate to:
A. allow the patient to walk to the ambulance. B. forgo complete immobilization of the spine. C. skip your assessment of distal neurologic function. D. ask the patient to move each extremity carefully. |
D. ask the patient to move each extremity carefully
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Joints are bathed and lubricated by:
A. synovial fluid. B. articular fluid. C. viscous fluid. D. sebaceous fluid. |
A. synovial fluid
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In an average-sized adult male, a closed unilateral femur fracture can result in internal blood loss of up to:
A. 500 mL. B. 1,000 mL. |
B. 1,000 mL
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A 34-year-old male experienced an abduction injury to his right arm. He is found in extreme pain, holding his injured arm in a fixed position away from the chest wall. Your assessment reveals a bulge through the pectoralis major muscle and a squared off appearance of the shoulder. What has MOST likely occurred?
A. Fracture-dislocation of the glenoid fossa B. Posterior dislocation of the humeral head C. Anterior dislocation of the humeral head |
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Compartment syndrome is caused by:
A. increased pressure in the fascial compartment. B. excessive synovial fluid inside a joint capsule. C. hyperperfusion to a fractured upper extremity. D. lactic acid release in the region of a fracture. |
A. increased pressure in the fascial compartment
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A patient with a displaced fracture of the proximal femur typically presents with:
A. internal leg rotation, with the injured leg longer than the opposite leg. B. external leg rotation, with the injured leg shorter than the opposite leg. C. internal leg rotation, with the injured leg shorter than the opposite leg. D. external leg rotation, with the injured leg longer than the opposite leg. |
B. external leg rotation, with the injured leg shorter than the opposite leg
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When using a Sager traction splint, you should apply traction that is approximately ____% of the patient's body weight to a maximum of ____ pounds.
A. 5, 10 B. 10, 15 C. 15, 20 |
B. 10, 15
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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:
A. immobilizing the patient with a scoop stretcher, administering a 20 mL/kg bolus of normal saline, and rapidly transporting. 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 her spine, applying a pelvic binder device, transporting, and administering 20 mL/kg normal saline boluses en route. |
D. immobilizing her spine, applying a pelvic binder device, transporting, and administering 20 mL/kg normal saline boluses en route
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