EMT Chp 24 & 25

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease?

A. Vaginal passage of blood clots

B. Bright red blood in the urine

C. A history of ectopic pregnancy

D. A shuffling gait when walking

D. a shuffling gait when walking

The physical examination of a sexual assault victim should be:

A. limited to a brief survey for life-threatening injuries.

B. deferred until the patient can be evaluated by a physician.

C. performed in the presence of at least two police officers.

D. as detailed as possible so all injuries can be documented.

A. limited to a brief survey for life-threatening injuries

During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:

A. perform a visual assessment of her vaginal area.

B. perform a rapid secondary assessment.

C. assess her blood pressure and elevate her legs.

D. assist her ventilations with a bag-mask device.

D. assist her ventilations with a bag-mask device

Which of the following statements regarding rape is correct?

A. Only a licensed physician can make a diagnosis of rape.

B. Rape is a legal term, not a medical diagnosis.

C. Rape causes more physical than emotional harm.

D. The EMT should try to determine if rape occurred.

B. Rape is a legal term, not a medical diagnosis

A 24-year-old woman complains of an ache in her abdomen that gets worse when she walks. She has a fever and chills and tells you that it burns when she urinates. Which of the following should you suspect?

A. Chlamydia

B. Gonorrhea

C. Ectopic pregnancy

D. Pelvic inflammatory disease

D. Pelvic inflammatory disease

When caring for a female patient who has been sexually assaulted, you should:

A. ask the patient for a concise, detailed report of what happened to her.

B. advise her that she will not be allowed to shower or change her clothes.

C. allow law enforcement to take her statement before you begin treatment.

D. place any bloodstained clothing or other articles in separate paper bags.

D. place any bloodstained clothing or other articles in separate paper bags

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she:

A. ascertains if the patient was ever pregnant.

B. has obtained a complete set of vital signs.

C. has gathered patient history information.

D. has formed a general impression of the patient.

C. has gathered patient history information

Whenever possible, a female sexual assault victim should be:

A. thoroughly assessed, even if no signs of injury exist.

B. encouraged to take a shower and change her clothes.

C. asked to provide a brief description of the perpetrator.

D. given the option of being treated by a female EMT.

D. given the option of being treated by a female EMT

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?

A. Chlamydia

B. Genital herpes

C. Ectopic pregnancy

D. Ovarian cysts

A. Chlamydia

Pelvic inflammatory disease (PID) typically does NOT affect the:

A. uterus.

B. fallopian tubes.

C. urinary bladder.

D. ovaries.

C. urinary bladder

When documenting a call in which a female was sexually assaulted, you should:

A. only use quotation marks when recording any statements made by witnesses.

B. keep the report concise and record only what the patient stated in her own words.

C. record your opinion only if you have reasonable proof to justify the statement.

D. translate the patient's words or statements using proper medical terminology.

B. keep the report concise and record only what the patient stated in her own words

When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to:

A. ask questions related to her gynecologic history.

B. maintain her ABCs and transport without delay.

C. determine the underlying cause of her problem.

D. keep assessment and treatment to a minimum.

B. maintain her ABCs and transport without delay

Pregnant women with bacterial vaginosis might have:

A. babies that deliver after 42 weeks.

B. secondary cervical cancer.

C. hypertension later in life.

D. low birth weight babies.

D. low birth weight babies

As a woman approaches menopause:

A. she cannot become pregnant because of fluctuating hormone levels.

B. her risk of developing pelvic inflammatory disease lowers significantly.

C. she usually experiences abdominal cramping without vaginal bleeding.

D. her menstrual periods may become irregular and vary in severity.

D. her menstrual periods may become irregular and vary in severity

The onset of menstruation usually occurs in females who are:

A. between 8 and 10 years of age.

B. between 18 and 23 years of age.

C. between 11 and 16 years of age.

D. between 25 and 28 years of age.

C. between 11 and 16 years of age

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:

A. provide emotional support and visually assess her for obvious trauma.

B. ask her if there is anyone you can contact, such as a friend or relative.

C. advise her that she cannot clean herself up because this will destroy evidence.

D. defer any physical assessment so that you do not destroy potential evidence.

A. provide emotional support and visually assess her for obvious trauma

Bacterial vaginosis is a condition that occurs when:

A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

B. numerous bacteria enter the uterus through the cervix and cause severe tissue damage.

C. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes.

D. abnormal bacteria enter the vagina and cause damage without causing any symptoms.

A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

A. often presents with acute pain.

B. is typically not as severe.

C. can be controlled in the field.

D. may be relatively painless.

D. may be relatively painless

Which of the following statements regarding gonorrhea is correct?

A. Symptoms of gonorrhea usually appear within 3 months after being infected.

B. Painful urination is a common symptom of gonorrhea in men and women.

C. Most men who are infected with gonorrhea do not experience symptoms.

D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

B. painful urination is a common symptoms of gonorrhea in men and women

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include:

A. ovarian cysts and gonorrhea.

B. ovarian abscess and ectopic pregnancy.

C. bacterial vaginosis and chlamydia.

D. uterine rupture with severe bleeding.

B. ovarian abscess and ectopic pregnancy

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I can't remember anything, but I know I was raped." The EMTs should suspect that:

A. an underlying head injury is causing her amnesia.

B. the patient was given a drug prior to the incident.

C. the traumatic experience has created a mental block.

D. the patient knew her attacker, but is afraid to say.

B. the patient was given a drug prior to the incident

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

A. The most common presenting symptom of PID is generalized upper abdominal pain.

B. PID most commonly affects women who have had an ectopic pregnancy in the past.

C. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

D. The most severe cases of PID occur in women who are not sexually active.

C. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy

The most frequently used date rape drug is:

A. Xanax.

B. Ecstasy.

C. alcohol.

D. ketamine.

C. alcohol

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:

A. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.

B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

D. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

A. becomes engorged with blood.

B. thins and begins to separate.

C. sheds and is expelled externally.

D. diverts blood flow to the vagina.

A. becomes engorged with blood

If a woman with vaginal bleeding reports syncope, the EMT should assume that she:

A. is in shock.

B. has an infection.

C. has an ectopic pregnancy.

D. is pregnant.

A. is in shock

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT:

A. carefully removing any foreign bodies from the vagina.

B. supplemental oxygen and keeping the patient supine.

C. treating external lacerations with sterile compresses.

D. refraining from placing any dressings into the vagina.

A. carefully removing any foreign bodies from the vagina

The outermost cavity of a woman's reproductive system, which forms the lowest part of the birth canal, is called the:

A. cervix.

B. vagina.

C. uterus.

D. perineum.

B. vagina

When a female has reached menarche:

A. she is capable of becoming pregnant.

B. she can no longer produce an ovum.

C. she usually requires hormone therapy.

D. menstrual periods become less frequent.

A. she is capable of becoming pregnant

It is common for young females who experience their first menstrual period to:

A. have a false positive home pregnancy test result.

B. experience abdominal cramping, which may be misinterpreted.

C. become so emotionally distraught that they contemplate suicide.

D. lose up to 500 mL of blood within the first 24 hours.

B. experience abdominal cramping, which may be misinterpreted

Injury to the labia would most likely occur following:

A. sexual abuse.

B. a motor-vehicle crash.

C. strenuous exercise.

D. a significant fall

A. sexual abuse

Injuries to the vagina and external genitalia are serious because:

A. external injury is always associated with internal injury.

B. severe infection occurs in nearly all cases of external injury.

C. most injuries to these areas are unnoticed by the patient.

D. these areas are rich with blood vessels and nerves.

D. these areas are rich with blood vessels and nerves

During your assessment of a 30-year-old woman with abdominal pain, she tells you that she has been experiencing vaginal bleeding. Her vital signs are stable, and there are no signs of shock. What should you do?

A. Carefully pack her vagina with a sterile multi-trauma dressing.

B. Position her supine, elevate her legs, and keep her warm.

C. Visualize her vaginal area to assess the degree of bleeding.

D. Defer the vaginal examination until she is at the hospital.

D. defer the vaginal examination until she is at the hospital

Which of the following findings should make the EMT especially suspicious that a woman was sexually assaulted?

A. The odor of alcohol on her breath

B. A prescription for alprazolam (Xanax)

C. Inability to remember the event

D. Signs of shock on assessment

C. inability to remember the event

The most common presenting sign of pelvic inflammatory disease (PID) is:

A. vomiting.

B. generalized lower abdominal pain.

C. foul-smelling vaginal discharge

D. nausea.

B. generalized lower abdominal pain

Which of the following drugs is commonly referred to as "roofies"?

A. Ketamine

B. MDMA

C. GHB

D. Rohypnol

D. Rohypnol

Each ovary produces an ovum in alternating months and releases it into the:

A. uterus.

B. fallopian tube.

C. vagina.

D. cervical os.

B. fallopian tube

Which of the following statements regarding pelvic inflammatory disease (PID) is correct?

A. PID is a life-threatening condition that is associated with shock.

B. PID is an infection of the lower female reproductive organs.

C. The majority of women with PID never develop symptoms.

D. Untreated PID can lead to an ectopic pregnancy or an abscess.

D. untreated PID can lead to an ectopic pregnancy or abscess

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)?

A. Pain around the umbilicus, low-grade fever, and generalized weakness

B. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

C. Upper abdominal cramping, severe headache, and heavy vaginal bleeding

D. Left lower quadrant pain, referred pain to the left shoulder, and fever

B. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

When caring for a female patient who has been sexually assaulted, you should:

A. place any bloodstained clothing or other articles in separate paper bags.

B. allow law enforcement to take her statement before you begin treatment.

C. advise her that she will not be allowed to shower or change her clothes.

D. ask the patient for a concise, detailed report of what happened to her.

A. place any bloodstained clothing or other articles in separate paper bags

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries is the LEAST likely?

A. Head injury

B. Pulmonary contusion

C. Multiple rib fractures

D. Cardiac contusion

A. Head injury

When caring for an occupant inside a motor vehicle equipped with an airbag that did not deploy upon impact, you should:

A. remember that it could still deploy and seriously injure you.

B. realize that the airbag malfunctioned at the time of impact.

C. suspect that the patient may have experienced serious injuries.

D. recognize that the force of impact was most likely not severe.

A. remember that it could still deploy and seriously injure you

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. injury to the cervical spine.

B. potential airway compromise.

C. damage to internal structures.

D. alterations in his mental status

B. potential airway compromise

Which of the following statements regarding gunshot wounds is correct?

A. Low-velocity bullets will cause the greatest amount of trauma.

B. The speed of a bullet has the greatest impact on the injury produced.

C. The size of a bullet has the greatest impact on the injury produced.

D. High-velocity bullets will cause less severe internal injuries.

B. the speed of a bullet has the greatest impact on the injury proceeded

The cervical spine is MOST protected from whiplash-type injuries when the:

A. rear end of the vehicle is initially struck.

B. headrest is appropriately positioned.

C. patient tenses up at the time of impact.

D. airbag correctly deploys upon impact.

B. headrest is appropraitely positioned

Approximately 25% of severe injuries to the aorta occur during:

A. rear-end collisions.

B. rollover collisions.

C. lateral collisions.

D. frontal collisions

C. lateral collisions

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:

A. determine the vehicle's speed at the time of impact.

B. identify contact points and predict potential injuries.

C. recognize if the driver hit the brakes before impact.

D. assess the severity of the third collision of the crash.

B. identify contact points and predict potential injuries

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. Intravenous fluid administration

C. Early administration of oxygen

D. Rapid transport to a trauma center

D. rapid transport to a trauma center

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first:

A. determine if the patient was propelled away from the vehicle.

B. approximate the speed of the vehicle that struck the pedestrian.

C. determine if the patient was struck and pulled under the vehicle.

D. evaluate the vehicle that struck the patient for structural damage.

B. approximate the speed of the vehicle that struck the pedestrian

If one or more occupants in the same vehicle are killed in a crash, the EMT should:

A. transport the survivors only if they have injuries or complain of pain.

B. suspect that all living occupants experienced the same serious trauma.

C. allow the survivors to refuse transport if they have no obvious injuries.

D. rapidly assess only the survivors who have experienced obvious trauma.

B. suspect that all living occupants experienced the same serious trauma

When the speed of a motor vehicle doubles, the amount of kinetic energy:

A. quadruples.

B. doubles.

C. triples.

D. is not affected.

A. quadruples

The driver of 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. transport to a trauma center.

B. a secondary assessment at the scene.

C. transport to a community hospital.

D. a focused exam of her forearm.

A. transport to a trauma center

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. is ejected or partially ejected.

C. is wearing only a lap belt.

D. remains within the vehicle.

B. is ejected or partially ejected

When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the airbag deploys upon impact.

A. windshield

B. dashboard

C. steering wheel

D. door

D. door

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His revised trauma score (RTS) is:

A. 10.

B. 9.

C. 8.

D. 11.

B. 9

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?

A. Dismounted seats

B. Intrusion into the vehicle

C. Steering wheel collapse

D. Deployment of the airbag

D. deployment of the airbag

Force acting over a distance is the definition of:

A. potential energy.

B. work.

C. kinetic energy.

D. latent energy.

B. work

When assessing an elderly patient who fell, it is important to remember that:

A. bilateral hip fractures usually occur when an elderly person falls.

B. elderly patients who fall usually have a secondary head injury.

C. osteoporosis can cause a fracture as a result of a fall from a standing position.

D. any fall in the elderly is considered to be high-energy trauma.

C. osteoporosis can cause a fracture as a result of a fall from a standing position

When treating a patient who experienced a pulmonary blast injury, you should:

A. use a demand valve to ventilate the patient.

B. suspect an accompanying cardiac tamponade.

C. avoid giving oxygen under positive pressure.

D. administer large amounts of intravenous fluid.

C. avoid giving oxygen under positive pressure

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. Eardrum rupture

B. Fractured bones

C. Impaled objects

D. Severe burns

A. eardrum rupture

By what mechanism is a person injured when he or she falls from a significant height?

A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop.

B. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact.

D. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.

B. potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop

What types of motor vehicle collisions present the greatest potential for multiple impacts?

A. Rear-end and rotational

B. Rotational and rollover

C. Lateral and rollover

D. Frontal and rotational

B. rotational and rollover

The index of suspicion is MOST accurately defined as:

A. a predictable pattern that leads to serious injuries.

B. your awareness and concern for potentially serious underlying injuries.

C. the way in which traumatic injuries occur.

D. the detection of less obvious life-threatening injuries.

B. your awareness and concern for potentially serious underlying injuries

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?

A. Extremity fractures

B. Flail chest

C. Aortic rupture

D. Forehead lacerations

C. aortic rupture

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:

A. congruent.

B. cavitation.

C. conversion.

D. capitation.

B. cavitation

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 airbag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:

A. neck and facial injuries.

B. lower extremity fractures.

C. open abdominal trauma.

D. blunt trauma to the head.

A. neck and facial injuries

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. potential energy.

D. index of suspicion.

B. mechanism of injury

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. Compression of the head against the roof

B. Impact of the head against the steering wheel

C. Whiplash injury to the neck during the rollover

D. Lateral bending of the neck during the crash

A. Compression of the head against the roof

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash.

A. thoracic and lumbar

B. thoracic and sacral

C. lumbar and coccygeal

D. lumbar and sacral

A. thoracic and lumbar

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:

A. the height of the fall.

B. the primary impact point.

C. the surface struck.

D. the speed of the fall.

D. the speed of the fall

In contrast to a Level III trauma center, a Level I trauma center must:

A. have general surgeons in-house 24 hours a day.

B. have access to an emergency physician within 30 minutes.

C. be able to stabilize patients before transferring to a higher level facility.

D. be involved in trauma prevention programs.

A. have general surgeons in-house 24 hours a day

Which of the following statements regarding low-energy penetrating injuries is correct?

A. Internal injuries caused by low-velocity bullets are usually easy to predict.

B. The area of injury is usually close to the path the object took through the body.

C. It is usually easy to differentiate between an entrance wound and an exit wound.

D. Exit wounds are typically easy to locate with low-energy penetrating injuries.

B. the area of injury is usually close to the path the object took through the body

A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:

A. obtain baseline vital signs.

B. apply a cervical collar.

C. auscultate bowel sounds.

D. assess for an exit wound.

D. assess for an exit wound

When assessing a patient who experienced a blast injury, it is important to remember that:

A. solid organs usually rupture from the pressure wave.

B. primary blast injuries are typically the most obvious.

C. secondary blast injuries are usually the least obvious.

D. primary blast injuries are the most easily overlooked.

D. primary blast injuries are the most easily overlooked

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. inspect the helmet for cracks.

B. leave her bicycle helmet on.

C. stabilize her entire spine.

D. obtain baseline vital signs.

C. stabilize her entire spine

Signs of a pulmonary blast injury include:

A. multiple rib fractures.

B. vomiting blood.

C. an irregular pulse.

D. coughing up blood.

D. coughing up blood

The energy of a moving object is called:

A. latent energy.

B. potential energy.

C. kinetic energy.

D. converted energy.

C. kinetic energy

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is rapid and irregular. You should be MOST suspicious for:

A. traumatic rupture of the aorta.

B. bruising of the heart muscle.

C. a lacerated coronary artery.

D. underlying cardiac disease.

B. bruising of the heart muscle

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?

A. Deformed steering wheel

B. Collapsed dashboard

C. Intrathoracic hemorrhage

D. Caved-in passenger door

A. deformed steering wheel

Which of the following is NOT one of the three types of collisions in a typical impact in a motor vehicular crash?

A. Collision of the internal organs against the body's solid structures

B. Collision of a car against another car, a tree, or another object

C. Collision of two passenger bodies within the same vehicle

D. Collision of the passenger against the interior of the car

C. collision of two passenger bodies within the same vehicles