Quiz 5 - EMT 104 - Ch 29-35

Which of the following BEST describes the function of blood?

a. It flows from the heart with the vital gases and nutrients to maintain lack of perfusion.

b. It transports gases along with nutrients, aids in excretion, and provides protection and regulation.

c. It clots, flows, transports, protects, and excretes on a daily basis.

d. It is a life-giving liquid that supports all the body's functions to maintain hypoperfusion.

b. It transports gases along with nutrients, aids in excretion, and provides protection and regulation.

Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels?

a. Arteries

b. Veins

c. Lymphatic vessels

d. Capillaries

d. Capillaries

Care for a femur fracture

a. Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression

b. High-concentration oxygen, tourniquet, PASG, and elevation of the extremity

c. Direct pressure, high-concentration oxygen, and splinting the leg

d. High-concentration oxygen, elevation of the extremity, and application of ice

c. Direct pressure, high-concentration oxygen, and splinting the leg

Your patient has attempted suicide by slitting his wrists. You notice that he has run the knife across his wrist; perpendicular to the arm, and that the wound is not deep. Which of the following statements is TRUE regarding the likelihood for serious blood loss?

a. You should expect severe blood loss.

b. Blood loss is probably not life threatening.

c. A tourniquet will probably be necessary.

d. There is most likely tremendous internal blood loss.

b. Blood loss is probably not life threatening.

Which one of the following is incorrect in the application of a tourniquet?

a. The tourniquet should be 2 to 4 inches wide.

b. A blood pressure cuff can be used as a tourniquet.

c. If possible, the tourniquet should be placed on a joint.

d. The tourniquet should be placed approximately 2 inches above the bleeding.

c. If possible, the tourniquet should be placed on a joint.

Your patient is a 28-year-old male who cut his thigh with a chain saw. Bleeding is significant and difficult to control. Which of the following is NOT part of the proper management of this patient?

a. Use of a tourniquet

b. Administering oxygen

c. Using direct pressure to control the bleeding

d. Replacement of fluid level by giving the patient adequate amounts of water

d. Replacement of fluid level by giving the patient adequate amounts of water

Which of the following should increase the EMT's suspicion of internal bleeding?

a. Fall from a height three or more times the patient's height

b. Penetrating trauma to the chest or abdomen

c. High-speed motor vehicle collision

d. All of the statements are true

d. All of the statements are true

Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now?

a. Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.

b. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.

c. Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic agent.

d. Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.

c. Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic agent.

Which of the following distinguishes decompensated shock from compensated stage of shock?

a. Delayed capillary refill time

b. Tachycardia

c. Low blood pressure

d. Altered mental status

c. Low blood pressure

Which of the following BEST explains the reason for minimizing scene-time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?

a. It gives the EMT less opportunity to make mistakes in the patient's care.

b. There is nothing the EMT can do for a patient in shock.

c. Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.

d. The clock for the "golden hour" of trauma begins at the time of your arrival.

c. Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.

Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned?

a. 18 percent

b. 36 percent

c. 4.5 percent

d. 9 percent

a. 18 percent

You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step?

a. You need to expose the wound completely because you need to clear away any embedded particles and debris from the wound.

b. You can treat the wound without total exposure as exposing a wound in that area of the body could be embarrassing.

c. You need to make sure the wound is very clean before trying to control bleeding by exposing the wound completely and cleaning it with alcohol.

d. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.

d. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.

You are dispatched to the local elementary school for an injured student. Upon arrival, you find that two 7-year-olds got into a fight and one of them jabbed a pencil in the other's cheek. The pencil is still sticking out of the child's cheek. When you examine the patient, you cannot see the end of the pencil that went through the cheek, as it appears to be stuck in the palate. There is not significant bleeding, and the child is not having any difficulty breathing. The child is very upset and wants you to pull the pencil out. What should you do?

a. Stabilize the object, but do not try to remove it.

b. Remove the object and put a bandage on the outside of the cheek.

c. Call the parents and see what they want you to do.

d. Let the child carefully pull the object out.

a. Stabilize the object, but do not try to remove it.

Which of the following injuries requires the use of an occlusive dressing?

a. Open wound to the abdomen from which a loop of intestine is protruding

b. Open wound to the chest

c. All of the statements are true

d. Open wound to the neck

c. All of the statements are true

You are dispatched to an auto repair shop for an "accident." You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you do?

a. Tell the patient that if it does not get better within the next few days he should consult his own doctor.

b. The patient is correct. This type of wound will heal on its own and he can go back to work.

c. Continue to apply cold, elevate and splint the limb, and transport the patient high priority.

d. Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.

d. Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.

A 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you do?

a. Because of the seriousness of the injury, wait for ALS before providing any care.

b. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.

c. Immediately apply a tourniquet to control bleeding.

d. Complete the amputation. It will make the injury much easier to handle.

b. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.

You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?

a. Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.

b. Fingers cannot be reattached so you can discard them in a biohazard bag.

c. Place the fingers directly on ice or use cold packs, as they must be kept very cold.

d. Because it is cold out, you merely need to wrap them in a 5×9 dressing and give them to the staff at the ED.

a. Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.

You are treating a 5-year-old for extensive burns. You know that burns pose a greater risk to infants and children. The reason for this is:

a. child abuse is usually the reason for the burns.

b. their body surface area is greater in relation to their total body size.

c. the parents' interference with your assessment and treatment can delay your response.

d. the child will likely be upset and crying and therefore hard to evaluate.

b. their body surface area is greater in relation to their total body size.

You assess a 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the burn, you notice a white powder on the burn. What should be your next step?

a. Transport the patient immediately to the closest burn center.

b. Brush off the powder, bandage the arm, and transport the patient to the closest trauma center.

c. Flush the arm and hand with copious amounts of water.

d. Brush the powder off the patient's arm and hand, and then flush with copious amounts of water.

d. Brush the powder off the patient's arm and hand, and then flush with copious amounts of water.

You are dispatched to a local industrial plant for an "electrical injury." You arrive on-scene and find a 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious person, breathing adequately. What is the next step?

a. Stay with the patient awhile, and if he does not appear to be in distress, encourage him to refuse care.

b. Load and go - conduct any other care in the ambulance enroute due to the potential seriousness of the burns.

c. While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.

d. Put the patient on oxygen and help him into your ambulance.

c. While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.

Your patient is a 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should:

a. attach the AED and analyze.

b. begin chest compressions.

c. elevate the patient's legs.

d. place him on a backboard.

b. begin chest compressions.

You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center. However, while enroute the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform next?

a. Begin providing CPR to the patient.

b. Call dispatch for an ALS intercept enroute to the hospital.

c. Begin providing BVM-assisted ventilations to the patient.

d. Free a corner or edge of the dressing and have the patient exhale to release pressure buildup.

d. Free a corner or edge of the dressing and have the patient exhale to release pressure buildup.

On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration, and the bleeding is controlled. Which of the following is the BEST approach toward managing the exposed intestines?

a. Leave the abdominal contents in the place in which they were found and transport immediately.

b. Gently replace the intestines after moistening with sterile saline solution.

c. Moisten a sterile dressing with saline solution, cover the abdominal contents and apply an occlusive dressing.

d. Cover the abdomen with an occlusive dressing of aluminum foil.

c. Moisten a sterile dressing with saline solution, cover the abdominal contents and apply an occlusive dressing.

The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss.

a. 5

b. 1

c. 3

d. 0.5

c. 3

The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fill adequately, usually secondary to trauma.

a. commotio cordis

b. hemopneumothorax

c. cardiac tamponade

d. pericardial effusion

c. cardiac tamponade

You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1 to 2-minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions?

a. Aortic dissection

b. Tension pneumothorax

c. Commotio cordis

d. Cardiac tamponade

d. Cardiac tamponade

What is the underlying cause of bluish or reddish facial discoloration following a traumatic asphyxiation?

a. The physiological strain of the body results in a flushed appearance and increased risk of a hypertensive event.

b. High pressure on the chest leads to blood being forced from the right atrium into the face and neck.

c. The patient has become hypoxic due to a chest injury and the finding suggests central cyanosis.

d. Bluish or reddish facial discoloration is not associated with traumatic asphyxiation; a pale discoloration is usually present.

b. High pressure on the chest leads to blood being forced from the right atrium into the face and neck.

Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered?

a. Flail chest

b. Hemothorax

c. Pneumothorax

d. Traumatic asphyxia

d. Traumatic asphyxia

Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being "hit in the face and kicked and punched in his ribs and stomach." Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient?

a. The presence of any defensive wounds the patient may have sustained

b. Potential internal injuries

c. Getting a description of the assailants

d. The swelling around his eyes, which may be reduced by applying a cold pack

b. Potential internal injuries

You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and a high-category trauma; however, due to the mechanism of injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient?

a. Searching for presence of diaphoresis, tachycardia, and hypotension

b. Verifying trauma center ER bed availability

c. Performing a distal neurological assessment

d. Examining the patient for entrance and exit wounds

d. Examining the patient for entrance and exit wounds

The sound or feeling of the ends of broken bones rubbing together is called:

a. breakilation.

b. crapilation.

c. crepitus.

d. painful.

c. crepitus.

Which one of the following statements is NOT true?

a. Muscles are the tissues or fibers that cause movement of body parts or organs.

b. Tendons are bands of connective tissue that bind the ligaments to muscles.

c. Ligaments are connective tissues that connect bone to bone.

d. Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for articulation.

b. Tendons are bands of connective tissue that bind the ligaments to muscles.

Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you anticipate?

a. Shock

b. All of the statements are true

c. Damage to the nerves of the lower extremities

d. Damage to internal organs

b. All of the statements are true

Which of the following statements is NOT true?

a. An angulated break is when the broken bone is bent at an angle.

b. A greenstick break is an incomplete break in a bone.

c. A comminuted break is when a bone is broken in only one place.

d. A fracture is any break in a bone.

c. A comminuted break is when a bone is broken in only one place.

Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?

a. Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a pillow and a cold pack applied to the injury.

b. Explain to the patient that her ankle is fractured, and you must splint her ankle to prevent further injury and reduce pain.

c. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.

d. Transport the patient immediately to a trauma center, applying high-concentration oxygen enroute.

c. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.

Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of action?

a. Gently attempt to straighten the leg to regain a pulse before splinting.

b. Transport rapidly to the nearest trauma center.

c. Explain to the patient that, because you cannot detect circulation in his foot, his leg will most likely have to be amputated above the site of the injury.

d. Splint the leg in the position in which it was found and transport without delay.

a. Gently attempt to straighten the leg to regain a pulse before splinting.

When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what "six Ps"?

a. Pain, pallor, position, pulses, placement, and pad

b. Pain, pallor, paresthesia, pulses, paralysis, and pressure

c. Pain, pallor, position, pulses, placement, and pressure

d. Pain, pallor, paresthesia, pulses, placement, and pressure

b. Pain, pallor, paresthesia, pulses, paralysis, and pressure

One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called?

a. Perfusing syndrome

b. Fracture syndrome

c. Crushing syndrome

d. Compartment syndrome

d. Compartment syndrome

Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the BEST way to immobilize this patient's extremities prior to transport?

a. Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard.

b. Immobilize the patient to a long backboard without splinting the extremities individually.

c. Use padded board splints for the upper extremities and PASG for the lower extremities.

d. Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize the fractures.

b. Immobilize the patient to a long backboard without splinting the extremities individually.

Your patient is a 20-year-old college student who has fallen from a third-level balcony onto a wooden deck below. The patient responds to verbal stimuli, is pale in color with moist skin, and has a very obvious deformity with protruding bone ends of his right forearm. Which?

a. Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity enroute if time and resources allow.

b. Provide immediate manual in-line stabilization of the cervical spine;

c. Open the airway; assess breathing; check the carotid pulse; splint the forearm injury; immobilize the patient to a long backboard;

d. Provide manual in-line stabilization of the cervical spine along with assessment of breathing,

a. Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity enroute if time and resources allow.

A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat?

a. Cervical spine trauma

b. Brain injury

c. All of the statements are true

d. Airway obstruction

c. All of the statements are true

Your patient is a 35-year-old woman who was driving a minivan that was struck in the driver's side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles, she extends her legs and flexes her arms and wrists. When giving your radio report, which of the following terms should you use to describe this?

a. Posturing

b. Cushing reflex

c. Battle sign

d. Tonic-clonic activity

a. Posturing

You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a pulse of 60 beats per minute, and slightly irregular breathing. The patient's presentation is most likely caused by which of the following?

a. Increased intracranial pressure

b. Increased arterial pressure

c. Coup-contrecoup injury

d. Closed head injury

a. Increased intracranial pressure

You are called for a man who is not acting right. His wife says he was outside working in the garden but didn't come in for lunch when he was called. She went to check on him and found him sitting next to a stump, confused. Your assessment shows a pulse rate of 58, blood pressure of 186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you don't see any obvious indication that he has fallen. You should suspect a(n):

a. non-traumatic brain injury.

b. insecticide poisoning.

c. open head injury.

d. closed head injury.

a. non-traumatic brain injury.

Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood, and you are considering how you will control the bleeding. Your primary treatment should be to:

a. transport the patient immediately in the supine position.

b. place your gloved hand over the wound before placing an occlusive dressing.

c. pack the wound with bulky dressings while avoiding placing pressure on the wound.

d. apply a dry, sterile dressing to the wound and then wrap with gauze.

b. place your gloved hand over the wound before placing an occlusive dressing.

You have determined the bar is too long to adequately secure during patient transport. Which of the following is your best course of action?

a. Transport with the reinforcement bar in place to prevent delay at the scene.

b. Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

c. Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the scene time under 10 minutes.

d. Test the reinforcement bar for stability and remove it only if it is loose enough to be easily pulled from the wound.

b. Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

You are enroute to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check?

a. Verbal responses, motor skills, and mental status

b. Eye-opening, motor response, and verbal response

c. Speech patterns, motor patterns, and mental status

d. Motor response, verbal response, and attentiveness

b. Eye-opening, motor response, and verbal response

Your patient has a suspected cervical spine injury from falling from a rope swing. His vital signs are pulse 62, respirations 20, and blood pressure 90/56. He has no feeling below his mid-chest area but is able to breathe on his own. You should suspect:

a. cardiogenic shock.

b. psychogenic shock.

c. neurogenic shock.

d. hypovolemic shock.

c. neurogenic shock.

Your patient is pregnant at 20 weeks' gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine?

a. Place the patient supine on the backboard, then put a pillow under the right side of the backboard.

b. Place the patient supine on the backboard.

c. Place the patient on her left side on the backboard.

d. Use a short immobilization device and transport the patient in a sitting position.

a. Place the patient supine on the backboard, then put a pillow under the right side of the backboard.

You are called for a young man who was diving head first off a dock into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been performing rescue breathing for him. He is awake, but he is unable to breathe on his own. What type of damage or injury does this indicate?

a. Open head injury

b. Closed head injury

c. Damage to his thoracic spine

d. Damage to C-3, C-4, or C5

d. Damage to C-3, C-4, or C5

You are caring for a multisystem trauma patient. Which of the following EMT interventions is most important?

a. Trend vital signs

b. Rapid transport

c. Splint all suspected musculoskeletal injuries

d. Complete a complete secondary physical exam

b. Rapid transport

What are some of the most important critical decisions an EMT can make on the scene of a serious trauma?

a. Determining patient severity, amount of time on scene, and transport destination

b. Determining the potential liability involved in performing life-saving interventions

c. Deciding whether to treat life-threatening injuries on scene or to load and go

d. Diagnosing the causes for a patient's presentation and identifying a course of definitive care

a. Determining patient severity, amount of time on scene, and transport destination

You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew-members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient's body?

a. Head, posterior torso, and lower extremities

b. Head, chest, and upper extremities

c. Head, chest, and torso

d. Torso, pelvis, and lower extremities

c. Head, chest, and torso

What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers?

a. Patient priority, amount of time on scene, and transport destination

b. Teamwork, timing, and transport

c. Lights, sirens, and diesel

d. Physiological determinants, anatomic criteria, and mechanism of injury

d. Physiological determinants, anatomic criteria, and mechanism of injury

A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient who should be immediately transported to a trauma center if secondary to trauma.

a. 20

b. 18

c. 30

d. 25

a. 20

Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations?

a. An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt

b. An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of pelvic pain

c. A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC

d. An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4-minute EMS response

c. A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC

Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone?

a. Vehicle rollover

b. Intrusion into the occupant area greater than 8 inches

c. Auto versus pedestrian

d. Vehicle crash-generated telemetry data

c. Auto versus pedestrian

You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority?

a. Femur fracture

b. Arterial bleed

c. Snoring respirations

d. Broken wrist

b. Arterial bleed

You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop-in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away.

a. Continue transporting to the local hospital since it's the closest facility.

b. Call the trauma center for advice.

c. Divert to the trauma center because the patient is becoming symptomatic.

d. Continue transporting to the local hospital because you've already given report and they accepted the patient.

c. Divert to the trauma center because the patient is becoming symptomatic.

Which of the following is the most significant mechanism of injury for a driver in a vehicle accident?

a. Encroachment greater than 12 inches of the driver's compartment

b. Spidering of the windshield

c. Rear-end collision

d. Death of a passenger in the same vehicle

d. Death of a passenger in the same vehicle

You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search-and-rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is:

a. keep the digits frozen on ice until they can be properly rewarmed at the hospital.

b. gently warm the digits by slowly massaging them.

c. actively rewarm the digits.

d. gently bandage the digits.

d. gently bandage the digits.

In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?

a. Contact medical control for input into the best treatment for this patient.

b. Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

c. Check distal CSM, apply warming packs to the extremities, and transport the patient.

d. Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death.

b. Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?

a. Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by non-rebreather mask.

b. Have the patient stand outside the ambulance and slowly drink an electrolyte solution or sports drink.

c. Give oxygen by non-rebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

d. Give oxygen by non-rebreather mask and have the patient rest, monitoring the patient's improvement over time at the scene.

c. Give oxygen by non-rebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Regarding drowning in adults, which of the following statements is TRUE?

a. Colder water improves survival chances in saltwater drowning but not in freshwater drowning.

b. The colder the water, the better the chances of survival in either saltwater or freshwater drowning.

c. Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.

d. The warmer the water, the better the chances of survival in saltwater drowning.

b. The colder the water, the better the chances of survival in either saltwater or freshwater drowning.

Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following?

a. Gasoline or kerosene

b. Vinegar

c. Sterile saline solution

d. Cold water

b. Vinegar

You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and moist, and his shirt is wet with visible salt rings. You suspect:

a. heat exhaustion.

b. heat cramps.

c. heat stroke.

d. myocardial infarction.

a. heat exhaustion.

You respond to a boat dock for a scuba diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect?

a. Myocardial infarction

b. Air embolism

c. Near drowning

d. Decompression sickness

b. Air embolism

You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do NOT know how to swim or consider yourself a poor swimmer, which of the following should you do first?

a. Use the buoy to float out to the swimmer.

b. Row the boat out to the swimmer.

c. Find someone who can swim to try to swim out and save the swimmer.

d. Call for help and try to throw the buoy to the swimmer.

d. Call for help and try to throw the buoy to the swimmer.

You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states the patient is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the BEST treatment plan?

a. Treat the patient for shock and transport.

b. Assist the patient in administering her epinephrine auto-injector.

c. Place a constricting band around the arm to minimize the spread of the venom.

d. Place the patient in the Trendelenburg position.

a. Treat the patient for shock and transport.

You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is "really sick." As you approach, you notice that the patient appears to be in obvious distress and is diaphoretic and holding his right wrist. Which of the following is your highest priority?

a. Immediately apply a constricting band to minimize the spread of the venom.

b. Confirm the location and status of the snake.

c. Confirm the type of snake and contact medical control for specific instructions.

d. Perform a primary assessment and identify any potential life threats.

b. Confirm the location and status of the snake.