Chapter 30 Test EMT

Which of the following is a consideration in determining a​ burn's severity?

a) Body surface area​ (BSA) involved in the burn

b) The type of agent that caused the burn

c) Other illnesses or injuries the patient may have

d) All of the above

d) All of the above

Which of the following is not an open tissue​ injury?

a) Avulsion

b) Contusion

c) Laceration

d) Abrasion

b) Contusion

You are assessing a​ 30-year-old male patient that had his arm caught in a piece of machinery. By the time you​ arrive, he has been freed. The patient tells you that he does not understand why you were​ called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspicion of which of the following​ injuries?

a) Chemical burn

b) Puncture

c) ​High-pressure injection

d) Crush injury

c) ​High-pressure injection

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) 4.5 percent

b) 18 percent

c) 9 percent

d) 36 percent

b) 18 percent

You are dispatched to an industrial plant for a burn. You arrive and find a​ 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you​ do?

a) Care for the burn and do a complete patient​ assessment, including cervical spine precautions

b) Before doing​ treatment, call the local burn center for instruction

c) Call for air transport and continue to pour water on the burns until transport arrives

d) Because of his​ age, immediately put him in your ambulance and transport him to a burn center

a) Care for the burn and do a complete patient​ assessment, including cervical spine precautions

Bleeding from​ soft-tissue injuries should initially be controlled with which one of the following​ techniques?

a) Direct pressure

b) Application of an ice pack or chemical cold pack

c) Running cold water over the wound

d) Elevation of the injured part

a) Direct pressure

Your patient is a​ 14-year-old male who crashed his​ bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his​ hands, arms,​ chest, and knees. The patient has small pieces of​ gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine​ immobilization?

a) Assess for additional​ injuries, flush away large pieces of debris with a sterile​ dressing, place dressings on the​ abrasions, bandage them in​ place, and transport

b) Use a tongue depressor to scrape large pieces of debris out of the​ wounds, place the patient on​ high-concentration oxygen, and transport

c) Use your fingers to pick embedded debris from the​ wound, bandage with moist saline dressings in​ place, and transport

d) Do not attempt to remove any​ debris, apply pressure dressings over the embedded material if​ necessary, apply​ high-concentration oxygen, and transport

a) Assess for additional​ injuries, flush away large pieces of debris with a sterile​ dressing, place dressings on the​ abrasions, bandage them in​ place, and transport

While assessing a patient with partial thickness burns to his chest and​ neck, what should be your highest priority​ (even if there are no symptoms​ presently)?

a) Blood Pressure

b) Hypothermia

c) Bleeding

d) Airway

d) Airway

When managing an electrical​ burn, the EMT​ should:

a) check for a source and ground burn injury

b) quickly check the​ pulse, even if the patient is still in contact with the electrical source

c) never attempt CPR unless it is within 4 minutes of contact

d) always attempt to remove the patient from the electrical source

a) check for a source and ground burn injury

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) 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

c) child abuse is usually the reason for the burns

d) the​ parents' interference with your assessment and treatment can delay your response

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

Which of the following best describes a partial thickness​ burn?

a) The skin is charred or blackened and lacks sensation

b) The skin is red and moist with blister formation

c) The skin is white and dry with no sensation of pain

d) The skin is​ red, but dry and painful

b) The skin is red and moist with blister formation

Which of the following is appropriate in caring for a patient with closed​ soft-tissue injuries and a significant mechanism of injury​ (MOI)?

a) Treat for shock if you think there are internal injuries even if the​ patient's vital signs are normal

b) Splint any​ swollen, deformed extremities

c) Anticipate vomiting

d) All of the above

d) All of the above

You are examining a​ 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this​ mean?

a) The palm of your hand represents​ 1% of the​ body's surface area

b) You can only use the rule of palm for​ children, so you would use the rule of nines instead

c) The palm of the​ patient's hand equals about​ 1% of the​ body's surface area

d) The palm of the​ patient's hand equals​ 9% of the​ body's surface area

c) The palm of the​ patient's hand equals about​ 1% of the​ body's surface area

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

b) 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

c) Wrap them in a sterile​ dressing, put them in a plastic​ bag, and keep them cool

d) Place the fingers directly on ice or use cold​ packs, as they must be kept very cold

c) Wrap them in a sterile​ dressing, put them in a plastic​ bag, and keep them cool

A wound in which the epidermis is scraped away with minimal​ bleeding, such as commonly occurs when a child falls on his knees on a​ sidewalk, is called​ a(n):

a) contusion

b) laceration

c) abrasion

d) avulsion

c) abrasion

Which of the following is not true concerning​ lacerations?

a) They may involve degloving injuries to the skin or tissue

b) They may be caused by blunt trauma

c) They may indicate deeper underlying tissue damage

d) They may be caused by penetrating trauma

a) They may involve degloving injuries to the skin or tissue

Which of the following is required in the management of all open​ soft-tissue injuries?

a) Application of a disinfectant solution

b) Provision of​ high-concentration oxygen

c) Use of Standard Precautions by the EMT

d) Cervical spine precautions

c) Use of Standard Precautions by the EMT

Which type of wound has a small opening into the​ skin, but may be quite​ deep, and is often caused by instruments such as​ nails, ice​ picks, or​ pencils?

a) Laceration

b) Avulsion

c) Incision

d) Puncture

d) Puncture

Which of the following is not an open tissue​ injury?

a) Abrasion

b) Avulsion

c) Contusion

d) Amputation

c) Contusion

Which of the following is a description of the rule of nines for an​ adult?

a) The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region

b) The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, and the lower back and​ buttocks; 8 percent to the front of each lower​ extremity; and 10 percent for the back of each lower​ extremity, then 1 percent to the genital region

c) The rule of nines assigns 9 percent to the head and​ neck, as well as each upper​ extremity; 10 percent to the​ chest, the​ abdomen, and the upper​ back; 8 percent to the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region

d) The rule of nines assigns 9 percent to the head and​ neck; 6 percent to each upper​ extremity; 12 percent to the chest and​ abdomen; 9 percent to the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region

a) The rule of nines assigns 9 percent to the head and​ neck, each upper​ extremity, the​ chest, the​ abdomen, the upper​ back, the lower back and​ buttocks, the front of each lower​ extremity, and the back of each lower​ extremity, then 1 percent to the genital region

For which of the following patients should the EMT carefully continue to monitor the​ patient's ventilatory status throughout treatment and transport due to the greatest risk of respiratory​ failure?

a) ​34-year-old male who opened the radiator of his car and had hot fluid spray on his​ chest, resulting in redness and pain in an area about the size of the​ patient's hand

b) 17-year-old male with a blistering sunburn on his face

c) ​16-year-old male whose shirt caught on​ fire, resulting in circumferential burns of his chest

d) ​28-year-old male who spilled a strong industrial acid on his legs

c) ​16-year-old male whose shirt caught on​ fire, resulting in circumferential burns of his chest

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) Continue to apply​ cold, elevate and splint the​ limb, and transport the patient high priority

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

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

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

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

b) 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

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

d) 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

b) 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

Which of the following is recommended when caring for an amputated​ part?

a) Wrap the part in aluminum foil to preserve body temperature

b) Rinse away debris with saline solution and place the part in a container of ice

c) Seal the part in a plastic bag and keep it cool

d) Care for the amputated part before worrying about the patient bleeding

c) Seal the part in a plastic bag and keep it cool

Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical​ wire?

a) The burning will continue for​ hours, perhaps days

b) The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity

c) The extent of tissue damage may be much greater than it appears on the surface

d) Toxic gases were inhaled

c) The extent of tissue damage may be much greater than it appears on the surface

Burns pose a greater risk to infants and children for which of the following​ reasons?

a) Infants and children have a greater risk of infection from the burn

b) Pediatric patients have a greater risk of shock from the burn

c) Pediatric patients have a greater risk of heart problems associated with the burn

d) None of the above

b) Pediatric patients have a greater risk of shock from the burn

An injury in which the epidermis remains​ intact, but blood vessels and cells in the dermis are​ injured, is called​ a(n):

a) contusion

b) avulsion

c) hematoma

d) abrasion

a) contusion

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 my 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

In caring for a​ 27-year-old male who has a large laceration on his anterior​ forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do​ next?

a) Apply an ice pack over the original dressing

b) Apply a tourniquet

c) Apply additional dressing material over the top of the original dressing and bandage it in place

d) Remove the saturated dressings and apply a large trauma dressing

c) Apply additional dressing material over the top of the original dressing and bandage it in place

When using the rule of palm to estimate the approximate body surface area​ burned, the​ patient's palm equals about what percentage of the​ body's surface area​ (BSA)?

a) 1 percent

b) 2 percent

c) 3 percent

d) 5 percent

a) 1 percent

Which of the following is not considered soft​ tissue?

a) Membranes

b) The skin

c) Cartilage

d) Muscles

c) Cartilage

Which of the following is not a major function of the​ skin?

a) Protection from the environment

b) Regulates the pH balance of the body

c) Excretion of wastes

d) Temperature regulation

b) Regulates the pH balance of the body

Which of the following is the outermost layer of the​ skin?

a) Epidermis

b) Dermis

c) Fascia

d) Adipose tissue

a) Epidermis

Your patient is a​ 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this​ wound?

a) Removing rings

b) Application of antibiotic ointment

c) Application of a dry sterile dressing

d) Keeping the site clean

b) Application of antibiotic ointment

The meatus​ is:

a) the tube that carries urine from the kidney to the bladder

b) in a​ male, the area between the scrotum and the anus

c) the external opening of the urethra

d) the canal through which urine is discharged from the bladder to the exterior of the body

c) the external opening of the urethra

Which of the following is true concerning​ lacerations?

a) They may be caused by blunt trauma

b) They may be caused by penetrating trauma

c) They may indicate deeper underlying tissue damage

d) All answers are correct

d) All answers are correct

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) Open wound to the neck

d) All of the above

d) All of the above

Which of the following best describes an​ avulsion?

a) Accumulation of blood beneath the​ skin, resulting in swelling

b) An injury caused by a​ sharp, pointed object

c) Flap of skin that is partially or completely torn away from the underlying tissue

d) Epidermis that is scraped away by a rough surface

c) Flap of skin that is partially or completely torn away from the underlying tissue

Which of the following statements is not true concerning the proper transport of an avulsed​ ear?

a) It should be labeled with the​ patient's name, as well as the date and time it was bagged

b) It should not be immersed in cooled water or saline

c) It should be kept as cool as possible

d) It should be in a dry sterile dressing

d) It should be in a dry sterile dressing

While assessing a​ 78-year-old male patient who escaped an apartment fire with partial thickness burns to both​ arms, the EMT must be aware of which of the​ following?

a) The burn is the most serious injury to the patient

b) The patient may need to be questioned by police and fire officials about the cause of the fire

c) Being involved in a crime makes the patient part of the chain of​ evidence, requiring a police officer to ride with you to the hospital

d) Medical conditions may be aggravated by the burn

d) Medical conditions may be aggravated by the burn

An injury caused by heavy pressure to the​ tissues, such as when an extremity is trapped under a fallen​ tree, that results in damage to underlying​ structures, bleeding, and inflammation is called​ a(n):

a) avulsion

b) crush injury

c) abrasion

d) contusion

b) crush injury

Your patient is a​ 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital​ setting?

a) Push the hook through the wound to avoid further damage from the barbed end

b) Pull the hook out from the same direction in which it entered the hand

c) Leave the hook in place and try not to disturb it

d) Apply a pressure dressing over the hook

c) Leave the hook in place and try not to disturb it

According to the rule of nines for infants and young​ children, the​ patient's head and neck account for what percentage of the total body surface​ area?

a) 1 percent

b) 14 percent

c) 9 percent

d) 18 percent

d) 18 percent

Which of the following is not a type of​ avulsion?

a) The skin is partially torn away from the foot

b) An ear is partially torn away from the head

c) The skin is stripped off the​ hand, like removing a glove

d) A finger is cut off with a​ butcher's saw

d) A finger is cut off with a​ butcher's saw

Which of the following is a desirable characteristic of dressings used in the prehospital management of most open​ wounds?

a) Sterile

b) Adherent

c) Occlusive

d) Absorbent

a) Sterile

Which of the following statements is false regarding an electrical​ injury?

a) Treatment of a source burn is the same as for other thermal burns

b) Patients with burns that appear insignificant are treated as having critical injuries

c) Injury is usually limited to the area around the source and ground burns

d) Patients with electrical burns may be treated with the automated external defibrillator​ (AED) and CPR

c) Injury is usually limited to the area around the source and ground burns

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. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next​ step?

a) Load and go-conduct any other care in the ambulance en route due to the potential seriousness of the burns

b) 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

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

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

b) 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

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) Call the parents and see what they want you to do

c) Remove the object and put a bandage on the outside of the cheek

d) Let the child carefully pull the object out

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

Which of the following patients has the greatest likelihood of being cared for in a burn​ center?

a) 12-year-old male with a partial thickness burn involving his forearm as a result of making a torch by lighting aerosol from a can of hairspray

b) ​16-year-old female who came into contact with a motorcycle exhaust pipe and has a superficial burn on her leg about 2 inches in diameter

c) 45-year-old man who has a partial thickness burn about 3 inches long by​ 1/2 inch wide on his posterior arm from backing into a barbecue grill

d) ​30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself

d) ​30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself

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

c) Immediately apply a tourniquet to control bleeding

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

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

Your patient is a​ 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his​ hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the best way to manage this​ situation?

a) Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose

b) Have the fire department connect to a hydrant and spray down the patient from head to toe

c) Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands

d) Brush away the powder and bandage the hands in a position of function

a) Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose

A burn extending into the subcutaneous fat would be classified as which type of​ burn?

a) Deep partial thickness

b) Superficial

c) Full thickness

d) Superficial partial thickness

c) Full thickness

A​ 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury​ site?

a) Bleeding from the wound is minimal

b) The​ patient's distal​ pulse, motor​ function, and sensation are intact

c) The nail is less than 2 inches in length

d) None of the above

d) None of the above

Which of the following layers of the skin is the most important in insulating the body against heat​ loss?

a) Subdural layer

b) Subcutaneous layer

c) Parietal layer

d) Epidermis

b) Subcutaneous layer

You are dispatched to the local high school for a​ "person struck with a​ baseball." You arrive on the scene and find a​ 16-year-old male sitting on the bench. Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next​ step?

a) Have the patient walk to the ambulance and take him to the ED. No other care needs to be​ provided, as there is really no significant sign of any injury

b) Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes

c) Take appropriate Standard​ Precautions, apply​ high-concentration oxygen by nonrebreather​ mask, and transport the patient​ ASAP, carefully monitoring the patient during transport

d) Tell the coach the patient is okay and he can go back into the ball game

c) Take appropriate Standard​ Precautions, apply​ high-concentration oxygen by nonrebreather​ mask, and transport the patient​ ASAP, carefully monitoring the patient during transport

Which of the following is of concern with a puncture​ wound?

a) Strong possibility of contamination

b) An object that remains impaled in the body

c) Hidden internal bleeding with minimal external bleeding

d) All of the above

d) All of the above

Your patient is a​ 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and​ painful, but without blisters. When caring for this injury in the prehospital​ setting, which of the following is​ appropriate?

a) Apply an antibiotic ointment

b) Apply a plastic bag full of ice to the skin

c) Apply a dry sterile dressing

d) Apply a lotion containing a topical anesthetic and aloe vera

c) Apply a dry sterile dressing