Mt. SAC EMT Exam #3 (Ch. 19,25,26,30,31)

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

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would most likely cause an injury to the liver or spleen to be overlooked?

A. Lumbar spine fracture

B. Pelvic fracture

C. Femur fracture

D. Shoulder fracture

D. shoulder fracture

The mesentery is:

A. a membranous fold that attaches the intestines to the walls of the body.

B. a layer of thick skeletal muscles that protects the abdominal organs.

C. the point of attachment between the small and large intestines.

D. a complex network of blood vessels that supply blood to the liver.

A. a membranous fold that attaches the intestines to the walls of the body

Peritonitis usually occurs when:

A. hollow abdominal organs are damaged and spill their contents.

B. solid abdominal organs bleed secondary to penetrating trauma.

C. bacteria or viruses invade the walls of the gastrointestinal tract.

D. the vessels that supply the abdominal organs become inflamed.

A. hollow abdominal organs are damaged and spill their contents

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should:

A. extricate her immediately and transport to a trauma center.

B. perform a head-to-toe assessment while she is in the car.

C. carefully assess her upper chest for seatbelt-related injuries.

D. lift the airbag and look for deformity to the steering wheel.

D. lift the airbag and look for deformity to the steering wheel

A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:

A. apply full spinal motion restriction precautions.

B. place him supine but allow him to keep his knees bent.

C. keep him on his side but gently straighten his legs.

D. transport him in the position in which you found him.

D. transport him in the position in which you found him

Which of the following statements regarding rebound tenderness is correct?

A. It should be assessed for by vigorously palpating the abdomen.

B. The absence of rebound tenderness rules out intra-abdominal injury.

C. Rebound tenderness is a specific sign found with a spleen injury.

D. It is often discovered when the patient is jarred or moved suddenly.

D. it is often discovered when the patient is jarred or moved suddenly

Bruising to the right upper quadrant of the abdomen after blunt trauma is most suggestive of injury to the:

A. liver.

B. kidney.

C. spleen.

D. stomach.

A. liver

Contraction or tensing of the abdominal muscles to ease pain is called:

A. referring.

B. withdrawing.

C. flexing.

D. guarding.

D. guarding

Which of the following organs is at most risk for injury as the result of a pelvic fracture?

A. Urinary bladder

B. Liver or spleen

C. Fallopian tubes

D. Pancreas

A. urinary bladder

Difficulty breathing and a sunken appearance of the anterior abdominal wall is mostindicative of a ruptured:

A. aorta.

B. stomach.

C. spleen.

D. diaphragm.

D. diaphragm

Which of the following organs would most likely bleed profusely when injured?

A. Liver

B. Stomach

C. Bladder

D. Intestine

A. liver

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

A. arrange for a rape crisis center representative to speak with the patient.

B. allow her to change her clothes and take a shower before you transport.

C. visualize the vaginal area and pack the vagina with sterile dressings.

D. control any external bleeding, administer oxygen, and transport at once.

D. control any external bleeding, administer oxygen, and transport at once

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

A. closely monitor him and reassess him frequently.

B. forgo the hospital radio report because of his condition.

C. begin documenting the call on the patient care form.

D. perform a comprehensive secondary assessment.

A. closely monitor him and reasses him frequently

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

A. a poorly placed lap belt.

B. airbag deployment.

C. rapid vehicle deceleration.

D. failure to wear seat belts.

A. a poorly placed lap belt

The presence of tachycardia following a significant abdominal injury:

A. indicates a state of decompensated shock.

B. is most commonly caused by severe pain.

C. should be assumed to be a sign of shock.

D. is always accompanied by hypotension.

C. should be assumed to be a sign of shock

Accumulation of blood in the abdominal cavity will most likely cause:

A. distention.

B. referred pain.

C. nausea or vomiting.

D. diffuse bruising.

A. distention

Early bruising following abdominal trauma often manifests as:

A. dark purple marks.

B. red areas of skin.

C. localized pain.

D. gross distention.

B. red areas of skin

When worn properly, a seat belt should lie:

A. below the anterior superior iliac spines of the pelvis and against the hip joints.

B. above the anterior posterior iliac spines of the pelvis and below the hip joints.

C. across the abdominal wall at the level of the umbilicus and against the hip joints.

D. across the abdominal wall at the level of the diaphragm and below the hip joints.

A. below the anterior superior iliac spines of the pelvis and agains the hip joints

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except:

A. giving him small sips of plain water.

B. promptly transporting him to the hospital.

C. covering him with a warm blanket.

D. administering supplemental oxygen.

A. giving him small sips of plain water

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

A. clean the wound and apply a dry, sterile dressing.

B. assume that the arrow injured an internal organ.

C. carefully probe the wound to determine its depth.

D. transport only if signs of shock begin to develop.

B. assume that the arrow injured the internal organ

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

Select one:

A. open the patient's airway.

B. apply oxygen via a nonrebreathing mask.

C. ventilate the patient with a bag-mask device.

D. apply direct pressure to the wound.

d apply direct pressure to the wound

Which of the following statements regarding abdominal trauma is correct?

Select one:

A. The absence of abdominal pain does not rule out intra-abdominal bleeding.

B. The liver is well protected and is rarely injured during a traumatic event.

C. Hollow abdominal organs are vascular and bleed profusely when injured.

D. Most of the vital abdominal organs lie within the retroperitoneal space.

a the absence of abdominal pain does not rule out intra-abomdinal bleeding

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

Select one:

A. there are other patients involved.

B. the severity of the injury is known.

C. the patient is conscious.

D. law enforcement is at the scene.

d law enforcement is at the scene

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be most suspicious for:

Select one:

A. external genitalia injury.

B. blunt injury to the kidney.

C. a ruptured urinary bladder.

D. a lacerated liver or spleen.

b blunt injury to the kidney

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

Select one:

A. cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

B. gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing.

C. make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.

D. cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket.

A. cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

When a hollow organ is punctured during a penetrating injury to the abdomen:

Select one:

A. peritonitis might not develop for several hours.

B. it commonly protrudes through the injury site.

C. the abdomen will become instantly distended.

D. it will bleed profusely and rapidly cause shock.

A. peritonitis might not develop for several hours

All of the following are hollow abdominal organs, except the:

Select one:

A. bladder.

B. spleen.

C. stomach.

D. ureters.

B. spleen.

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be most pertinent to ask him?

Select one:

A. Has blood soaked through your undergarments?

B. Have you experienced recent abdominal trauma?

C. What does your blood pressure normally run?

D. Do you take any over-the-counter medications?

B. Have you experienced recent abdominal trauma?

A sign of kidney damage after blunt trauma is:

Select one:

A. hemoptysis.

B. hematuria.

C. hematochezia.

D. hematemesis.

B. hematuria.

Which of the following statements regarding abdominal eviscerations is correct?

Select one:

A. The organs should be replaced carefully to avoid heat loss.

B. Most eviscerations occur to the left upper quadrant.

C. The protruding organs should be kept warm and moist.

D. Adherent material is preferred when covering an evisceration.

C. The protruding organs should be kept warm and moist.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes:

Select one:

A. requesting a paramedic to administer pain medication.

B. covering the avulsion with moist, sterile dressings.

C. applying direct pressure with a dry, sterile dressing.

D. administering 100% oxygen via a nonrebreathing mask.

C. applying direct pressure with a dry, sterile dressing.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

Select one:

A. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

B. reassess his vital signs and then notify the receiving hospital of the change in his clinical status.

C. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

D. perform a comprehensive secondary assessment to determine why his clinical status has changed.

A. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

Select one:

A. rupture of a hollow organ.

B. a ruptured spleen.

C. intra-abdominal bleeding.

D. a severe liver laceration.

C. intra-abdominal bleeding.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

Select one:

A. avoid speculation and document only factual data.

B. theorize as to why the sexual assault occurred.

C. include a description of the suspected perpetrator.

D. include the results of the internal vaginal exam.

A. avoid speculation and document only factual data.

Because the depth of an open abdominal wound is often difficult to determine:

Select one:

A. prompt transport to the hospital is essential.

B. vital signs should be monitored frequently.

C. the EMT must perform a thorough exam.

D. the abdomen must be vigorously palpated.

A. prompt transport to the hospital is essential.

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

Select one:

A. might decrease the amount of blood that returns to the heart.

B. often causes hypotension secondary to cardiac compression.

C. is recommended if the patient has severe abdominal discomfort.

D. results in spontaneous urinary incontinence if the bladder is full.

A. might decrease the amount of blood that returns to the heart.

Which of the following organs is at most risk for injury as the result of a pelvic fracture?

Select one:

A. Pancreas

B. Fallopian tubes

C. Urinary bladder

D. Liver or spleen

C. Urinary bladder

Which of the following statements regarding rebound tenderness is correct?

Select one:

A. The absence of rebound tenderness rules out intra-abdominal injury.

B. It should be assessed for by vigorously palpating the abdomen.

C. It is often discovered when the patient is jarred or moved suddenly.

D. Rebound tenderness is a specific sign found with a spleen injury.

C. It is often discovered when the patient is jarred or moved suddenly.

The mesentery is:

Select one:

A. the point of attachment between the small and large intestines.

B. a layer of thick skeletal muscles that protects the abdominal organs.

C. a complex network of blood vessels that supply blood to the liver.

D. a membranous fold that attaches the intestines to the walls of the body.

D. a membranous fold that attaches the intestines to the walls of the body.

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except:

Select one:

A. promptly transporting him to the hospital.

B. giving him small sips of plain water.

C. administering supplemental oxygen.

D. covering him with a warm blanket.

B. giving him small sips of plain water.

Solid abdominal organs include the:

A. urinary bladder, colon, and ureters.

B. gallbladder and large intestine.

C. stomach and small intestine.

D. spleen, kidneys, and pancreas.

D. spleen, kidneys, and pancreas

Most patients with abdominal pain prefer to:

A. sit fully upright because it helps relax the abdominal muscles.

B. lie in a supine position with their knees in a flexed position.

C. lie on their side with their knees drawn into the abdomen.

D. sit in a semi-Fowler position with their knees slightly bent.

C. lie on their side with their knees drawn into the abdomen

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:

A. esophageal varices.

B. esophagitis.

C. acute pancreatitis.

D. Mallory-Weiss tear.

D. Mallory-Weiss tear

The kidneys help to regulate blood pressure by:

A. accommodating a large amount of blood volume.

B. eliminating toxic waste products from the body.

C. retaining key electrolytes, such as potassium.

D. removing sodium and water from the body.

D. removing sodium and water from the body

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

A. treat for shock and request a paramedic unit to respond to the scene and assist you.

B. perform a detailed secondary assessment and then transport him to a dialysis center.

C. leave him in a sitting position, keep him warm, and prepare for immediate transport.

D. place him in a supine position, elevate his lower extremities, and transport at once.

C. leave him in a sitting position, keep him warm, and prepare for immediate transport

Which of the following statements regarding the acute abdomen is correct?

A. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.

B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated.

C. The initial pain associated with an acute abdomen tends to be vague and poorly localized.

D. The most common cause of an acute abdomen is inflammation of the gallbladder and liver.

C. The initial pain associated with an acute abdomen tends to be vague and poorly localized

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

A. visceral pain.

B. remote pain.

C. radiating pain.

D. referred pain.

D. referred pain

In the presence of ileus, the only way the stomach can empty itself is by:

A. diarrhea.

B. muscular contraction.

C. spontaneous rupture.

D. vomiting.

D. vomiting

The principal symptom in both infectious and noninfectious gastroenteritis is:

A. dysuria.

B. high fever.

C. vomiting.

D. diarrhea.

D. diarrhea

Functions of the liver include:

A. secretion of bile and filtration of toxic substances.

B. absorption of nutrients and toxins.

C. release of amylase, which breaks down starches into sugar.

D. production of hormones that regulate blood sugar levels.

A. secretion of bile and filtration of toxic substances

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

A. request a paramedic unit to give the patient pain medication.

B. administer oxygen and prepare for immediate transport.

C. place the patient in a sitting position and transport at once.

D. vigorously palpate the abdomen to establish pain severity.

B. administer oxygen and prepare for immediate transport

Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:

A. progressive deterioration of abdominal organ function.

B. chronic dementia, which inhibits communication.

C. age-related deterioration of their sensory systems.

D. interactions of the numerous medications they take.

C. age-related deterioration of their sensory systems

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:

A. immediately perform a rapid physical examination.

B. consider requesting a rendezvous with an ALS unit.

C. continue transporting and alert the receiving hospital.

D. assist his ventilations with a bag-valve mask.

B. consider requesting a rendezvous with an ALS unit

Which of the following statements regarding gastrointestinal bleeding is correct?

A. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

B. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome.

C. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

D. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe.

C. bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself

Which of the following is characteristic of peptic ulcer disease (PUD)?

A. Sharp pain that is typically located in both lower abdominal quadrants

B. Burning or gnawing stomach pain that subsides immediately after eating

C. Symptom relief after taking nonsteroidal anti-inflammatory drugs

D. The passage of bright red blood in the stool or coughing up blood

B. burning or gnawing stomach pain that subsides immediately after eating

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies?

A. Spleen

B. Kidneys

C. Pancreas

D. Liver

A. spleen

A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:

A. pancreatitis.

B. appendicitis.

C. acute cholecystitis.

D. acute cystitis.

C. acute cholecystitis

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of:

A. an aortic aneurysm.

B. a kidney infection.

C. acute pancreatitis.

D. acute appendicitis.

A. an aortic aneurysm

Which of the following statements regarding dialysis is correct?

A. Hemodialysis is effective but carries a high risk of peritonitis.

B. Acute hypertension is a common adverse effect of dialysis.

C. The purpose of dialysis is to help the kidneys retain salt and water.

D. Patients who miss a dialysis treatment often present with weakness.

D. Patients who miss a dialysis treatment often present with weakness

An important aspect in the treatment of a patient with severe abdominal pain is to:

A. give 100% oxygen only if signs of shock are present.

B. provide emotional support en route to the hospital.

C. encourage the patient to remain in a supine position.

D. administer analgesic medications to alleviate pain.

B. provide emotional support en route to the hospital