Emt test Chapters 25 - 32

Q1: A 34-year-old male has a deep forearm laceration from a band saw with bright red, spurting blood. He is pale and sweaty with a weak pulse.

A) Apply sterile pressure dressing

B) Apply direct pressure

C) Apply a tourniquet

D) Elevate the arm

B) Apply direct pressure.

Explanation: Direct pressure is the first and most effective primary intervention for controlling external hemorrhage.

Q2: While assessing a patient with suspected internal bleeding, which of the following is considered a LATE sign of hypovolemic shock?

A) Hypotension

B) Tachycardia

C) Pale, cool, clammy skin

D) Tachypnea

A) Decreased blood pressure (hypotension).

Explanation: Hypotension is a late sign of shock, indicating that compensatory mechanisms are failing.

Q3: What is the average total blood volume in a healthy, 70 kg adult?

A) 9-10 liters

B) 7-8 liters

C) 5-6 liters

D)3-4 liters

C) 5 to 6 liters.

Explanation: An adult weighing 70 kg has a blood volume of approximately 7% to 8% of total body weight.

Q4: A 45-year-old female in a head-on MVC has abdominal pain, cold clammy skin, HR 124, and seatbelt bruising. Management?

A) Sips of water

B) Abdominal binder

C) O2, warmth, supine, rapid transport

D) Secondary assessment on-scene

C) Administer high-flow oxygen, keep her warm, place her supine, and transport rapidly.

Explanation: Internal bleeding requires supportive care and rapid transport to a trauma center.

Q5: You applied a tourniquet and bleeding stopped, but a distal pulse is still weakly palpable. Next step?

A) Loosen it

B) Apply a second tourniquet proximal

C) Apply a second tourniquet distal

D) Leave it

B) Apply a second tourniquet proximal to the first one.

Explanation: If one tourniquet fails to eliminate the distal pulse, a second should be placed immediately proximal.

Q6: Modern hemostatic gauze like QuikClot often uses what mineral derived from volcanic ash?

A) Chitosan

B) Kaolin

C) Thrombin

D) Alginate

B) Kaolin.

Explanation: Kaolin is an inorganic mineral that triggers the intrinsic clotting cascade.

Q7: A 19-year-old had acid sprayed in his eyes and is in pain. Immediate priority?

A) Dry dressings

B) Neutralize with baking soda

C) Flush with water/saline

D) Cover and transport

C) Flush the face and eyes continuously with clean water or saline.

Explanation: Chemical burns require immediate irrigation for at least 20 minutes.

Q8: Using the Rule of Palms, the patient's palm (including fingers) represents what percentage of BSA?

A) 0.5%

B) 1%

C) 2%

D) 3.5%

B) 1%.

Explanation: The patient's hand (palm and fingers) is roughly equal to 1% of their total body surface area.

Q9: A cook spilled hot grease on his anterior torso and the entire front of his left leg. What is the BSA?

A) 18%

B) 27%

C) 36%

D) 45%

B) 27%.

Explanation: Anterior torso (18%) + Anterior left leg (9%) = 27%.

Q10: What is the medical term for the outermost layer of skin containing no blood vessels?

A) Dermis

B) Epidermis

C) Subcutaneous

D) Fascia

B) Epidermis.

Explanation: The epidermis is the superficial, avascular layer of the skin.

Q11: How do you manage an abdominal evisceration?

A) Push bowel back in

B) Dry sterile occlusive dressing

C) Moist sterile dressing + occlusive dressing

D) Pressure dressing

C) Apply a moist, sterile dressing, cover it with an occlusive dressing, and keep the patient warm.

Explanation: Never replace organs; keep them moist and warm.

Q12: Why is an occlusive dressing applied to an open neck wound?

A) Hemorrhage control

B) Prevent air embolism

C) Prevent bacteria

D) Prevent hypothermia

B) Air entering the wound (air embolism).

Explanation: Occlusive dressings prevent air from being sucked into the venous system through neck lacerations.

Q13: Which animal bite carries the highest risk of deep infection due to "needle-like" teeth?

A) Dog

B) Cat

C) Human

D) Raccoon

B) Cat bites.

Explanation: Cat teeth are sharp and slender, injecting bacteria deep into tissues.

Q14: A patient hit with a softball has double vision and cannot look upward; the eye sits lower. Diagnosis?

A) Retinal detachment

B) Blowout fracture

C) Mandibular fracture

D) Ruptured globe

B) Blowout fracture of the orbit.

Explanation: Blunt force fractures the orbital floor, trapping muscles and causing characteristic gaze issues.

Q15: Primary intervention for a jugular vein laceration?

A) Antiseptic

B) Hemostatic gauze + C-collar

C) Occlusive dressing sealed 4 sides

D) Coughing

C) Apply direct pressure with an occlusive dressing sealed on all four sides.

Explanation: This prevents atmospheric air from entering the circulatory system.

Q16: Jelly-like fluid in the posterior cavity of the eye?

A) Aqueous humor

B) Vitreous humor

C) Lacrimal fluid

D) Scleral fluid

B) Vitreous humor.

Explanation: Vitreous humor maintains the eye's shape and is not reproduced by the body.

Q17: Best way to preserve an avulsed permanent tooth?

A) Scrub and dry

B) Dry gauze

C) Milk or Hanks' solution

D) Isopropyl alcohol

C) Place the tooth in a cup of cold milk or Hanks' Balanced Salt Solution.

Explanation: Keeping the tooth moist in a pH-balanced medium preserves the periodontal ligament cells.

Q18: Correct management for non-traumatic epistaxis?

A) Lean back and pinch

B) Lean forward and pinch fleshy part

C) Cotton balls + lie flat

D) Warm compress

B) Have the patient lean forward and pinch the fleshy part of the nostrils.

Explanation: This controls bleeding while preventing blood from entering the airway or stomach.

Q19: Strongest and only movable bone of the skull?

A) Maxilla

B) Zygoma

C) Mandible

D) Sphenoid

C) Mandible.

Explanation: The mandible is the lower jaw bone.

Q20: BP 180/90, HR 54, RR 8 (irregular) in a head injury patient indicates:

A) Beck’s Triad

B) Cushing’s Triad

C) Virchow’s Triad

D) Trauma Triad of Death

B) Cushing’s Triad.

Explanation: This indicates significantly increased intracranial pressure (ICP).

Q21: How do you handle CSF leaking from the ears?

A) Pack with gauze

B) Pressure dressing

C) Loose sterile dressing

D) Flush with saline

C) Cover the ears loosely with a sterile dressing.

Explanation: CSF should be allowed to drain to avoid increasing ICP.

Q22: The tough, fibrous outer layer of the meninges?

A) Pia mater

B) Arachnoid mater

C) Dura mater

D) Subarachnoid

C) Dura mater.

Explanation: The dura mater is the "tough mother" or outermost membrane.

Q23: Soccer player knocked out for 2 mins, now confused with retrograde amnesia. Likely injury?

A) Epidural hematoma

B) Subdural hematoma

C) Concussion

D) Intracerebral hemorrhage

C) Concussion.

Explanation: A temporary disturbance of brain function without structural damage visible on imaging.

Q24: When can you release manual C-spine stabilization?

A) After C-collar is on

B) When secured to the transport device

C) When pain stops

D) After secondary assessment

B) Once the patient is fully secured to a backboard or stretcher.

Explanation: A collar alone does not provide adequate immobilization.

Q25: Diving victim cannot move arms or legs and is numb below the collarbones. Injury level?

A) Cervical

B) Thoracic

C) Lumbar

D) Sacral

A) Cervical spine.

Explanation: Quadriplegia indicates a high spinal cord injury in the cervical region.

Q26: A "Hangman’s fracture" involves a bilateral fracture of which vertebra?

A) C1

B) C2

C) C5

D) C7

B) C2 (Axis).

Explanation: The C2 vertebra is specifically known as the Axis.

Q27: Sucking chest wound treatment?

A) Pressure dressing

B) Three-sided occlusive dressing

C) Wet-to-dry dressing

D) Bulky pad

B) A three-sided occlusive dressing.

Explanation: This creates a one-way valve to allow air out but not in.

Q28: Sign of tension pneumothorax?

A) Bradycardia/Hypertension

B) Diminished breath sounds, JVD, Hypotension

C) Wheezing

D) Paradoxical motion

B) Decreased breath sounds on one side, JVD, and progressive hypotension.

Explanation: This indicates obstructive shock from mediastinal shift.

Q29: How many pairs of ribs do humans have?

A) 10

B) 12

C) 14

D) 16

B) 12.

Explanation: Humans have 12 pairs of ribs (7 true, 3 false, 2 floating).

Q30: Paradoxical chest wall movement indicates:

A) Tension pneumo

B) Flail chest

C) Hemothorax

D) Traumatic asphyxia

B) Flail chest.

Explanation: Caused by 2+ ribs broken in 2+ places.

Q31: What makes up Beck's Triad for Cardiac Tamponade?

A) Hypotension, JVD, Muffled heart sounds

B) Hypertension, Bradycardia, Irregular RR

C) Tachycardia, Tachypnea, Pinpoint pupils

D) Tracheal deviation

A) Hypotension, JVD, and muffled heart sounds.

Explanation: These indicate fluid accumulation in the pericardial sac.

Q32: Sudden V-Fib after a blunt blow to the chest during the T-wave?

A) Myocardial contusion

B) Commotio cordis

C) Tamponade

D) Aortic dissection

B) Commotio cordis.

Explanation: This is an electrically-induced arrest from blunt trauma.

Q33: LUQ pain radiating to the left shoulder (Kehr's sign) indicates injury to the:

A) Liver

B) Spleen

C) Kidney

D) Appendix

B) Spleen.

Explanation: Irritation of the diaphragm by blood from the spleen causes referred left shoulder pain.

Q34: Which organ rupture is most likely to cause peritonitis?

A) Spleen

B) Liver

C) Urinary bladder

D) Kidney

C) Urinary bladder.

Explanation: Hollow organs leak contents (urine/waste) causing chemical/bacterial inflammation.

Q35: Membrane lining the abdominal cavity?

A) Pleura

B) Pericardium

C) Peritoneum

D) Meninges

C) Peritoneum.

Explanation: The peritoneum wraps the abdominal organs and lines the cavity.

Q36: Management for blood at the urethral meatus?

A) Catheter

B) Direct pressure to urethra

C) Cold pack and transport

D) Push tissue back in

C) Apply a cold pack to the perineum to reduce swelling and transport.

Explanation: Never insert anything into the urethra when trauma is suspected.

Q37: Primary role in sexual assault care?

A) Wash wounds

B) Plastic bags for clothes

C) Support, paper bags for clothes

D) Confession statement

C) Provide medical care, emotional support, and preserve evidence using paper bags.

Explanation: Paper bags prevent moisture from destroying DNA evidence.

Q38: Largest internal organ in the RUQ?

A) Pancreas

B) Spleen

C) Liver

D) Gallbladder

C) Liver.

Explanation: The liver is the largest solid internal organ.

Q39: Deformed wrist with weak pulse and cold fingers. Management?

A) Splint as is

B) Gentle manual traction to restore pulse

C) Move fingers

D) Tourniquet

B) Apply gentle manual traction in line with the long axis to restore pulse before splinting.

Explanation: Realigning a pulseless limb is appropriate to restore circulation.

Q40: Sign of a hip fracture?

A) Lengthened/Internal rotation

B) Shortened/External rotation

C) Locked knees

D) Sensation loss

B) The affected leg is shortened and rotated outward (externally rotated).

Explanation: Muscle spasms pull the proximal femur into this position.

Q41: Strongest bone in the body?

A) Tibia

B) Humerus

C) Femur

D) Pelvis

C) Femur.

Explanation: The thigh bone is the largest and strongest.

Q42: Tense/hard calf, pain out of proportion, pain with passive stretch. Suspect:

A) Osteomyelitis

B) Compartment syndrome

C) DVT

D) Dislocation

B) Compartment syndrome.

Explanation: High pressure within muscle compartments compromises circulation.

Q43: When splinting a long bone, immobilize:

A) Fracture site only

B) Joint above and below

C) Entire body

D) Joint below only

B) The joint above and the joint below the injury.

Explanation: This prevents movement of the bone fragments.

Q44: Partial break/bending fracture in children?

A) Comminuted

B) Greenstick

C) Spiral

D) Pathologic

B) Greenstick fracture.

Explanation: Occurs because pediatric bones are more flexible.

Q45: Core temp 93 degrees F (33.9 degrees C) with shivering and slurred speech:

A) Mild hypothermia

B) Moderate

C) Severe

D) Profound

A) Mild hypothermia.

Explanation: Mild is defined as 90 degrees F to 95 degrees F (32 degrees C to 35 degrees C).

Q46: Why handle severe hypothermia patients gently?

A) Bruising

B) Prevent V-Fib

C) Prevent hyperthermia

D) Blood sugar

B) Rough handling can precipitate ventricular fibrillation (VF).

Explanation: The cold heart is extremely irritable.

Q47: Sitting on cold concrete loses heat via:

A) Radiation

B) Conduction

C) Convection

D) Evaporation

B) Conduction.

Explanation: Direct transfer of heat via physical contact.

Q48: Heat exhaustion management?

A) Ice bath

B) Cool environment, remove clothes, oral fluids

C) Epi-pen

D) Salt tablets

B) Move him to a cool environment, remove excess clothing, and offer oral fluids. Explanation: Ice baths are generally reserved for heatstroke.

Q49: Divers getting "the bends" have:

A) Nitrogen narcosis

B) Decompression sickness

C) Arterial gas embolism

D) CO_2 retention

B) Decompression sickness.

Explanation: Nitrogen bubbles form in tissues due to rapid ascent.

Q50: Spider with neurotoxic venom causing muscle spasms:

A) Brown recluse

B) Black widow

C) Yellow sac

D) Wolf

B) Black widow spider.

Explanation: The black widow's neurotoxin causes systemic muscle rigidity and pain.