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A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:
apply a tourniquet proximal to the wrist.
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
Rapid transport to a trauma center
As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?
Control the bleeding.
Distributive shock occurs when:
widespread dilation of the blood vessels causes blood to pool in the vascular beds.
Foods, medications, and insects are common causes of ________.
anaphylactic shock
Hypovolemic shock caused by severe burns is the result of a loss of:
plasma.
In an acute injury setting, neurogenic shock is commonly accompanied by:
hypothermia.
Inadequate circulation of blood throughout the body is called ________.
shock
Pulmonary edema and impaired ventilation occur during:
cardiogenic shock.
Shock due to severe infection is called ________.
septic shock
To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:
the skin.
What are the three components of the "perfusion triangle"?
Heart, blood vessels, blood
When assessing a patient with signs and symptoms of shock, it is important to remember that:
blood pressure may be the last measurable factor to change in shock.
When should nonlifesaving interventions be performed for your multisystem trauma patient?
En route to the hospital
When treating an 80-year-old patient who is in shock, it is important to remember that:
changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.
Which of the following injuries would MOST likely cause obstructive shock?
Cardiac tamponade
Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?
Decompression of the injured side of the chest
You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________.
peripheral vasoconstriction
Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.
cardiogenic shock
Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________.
compensated shock
A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?
Energy transmission to the spine
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:
stabilize her entire spine.
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:
assess for an exit wound.
According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she:
has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.
According to the Association of Air Medical Services, you should consider air medical transport of a trauma patient if:
traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.
Approximately 25% of severe injuries to the aorta occur during:
lateral collisions.
Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:
intracranial bleeding.
Force acting over a distance is the definition of:
work.
The index of suspicion is MOST accurately defined as:
your awareness and concern for potentially serious underlying injuries.
When assessing a patient who experienced a blast injury, it is important to remember that:
primary blast injuries are the most easily overlooked.
When assessing an elderly patient who fell, it is important to remember that:
osteoporosis can cause a fracture as a result of a fall from a standing position.
When the speed of a motor vehicle doubles, the amount of kinetic energy
quadruples.
Which of the following destinations is most appropriate for a 41-year-old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal?
A Level I or Level II trauma center
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?
Deployment of the air bag
Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?
Aortic rupture
Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?
Rapid transport to a trauma center
Which of the following statements regarding gunshot wounds is correct?
The speed of a bullet has the greatest impact on the injury produced.
Which types of motor vehicle collisions present the greatest potential for multiple impacts?
Rotational and rollover
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 air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:
neck and facial injuries.
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:
9.
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:
pinching the patient's nostrils and having him lean forward.
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
gastrointestinal bleeding.
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
assist the patient's ventilations.
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______.
perfusion
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:
spleen.
Hypovolemic shock occurs when:
the body cannot compensate for rapid blood loss.
If applying a dressing to control the bleeding of a patient's arm, the EMT should ________.
A. apply direct pressure first
B. use large or small gauze pads or dressings depending upon the size of the wound
C. cover the entire wound, above and below, with the dressing
D. All of these answers are correct.
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:
a tourniquet proximal to the injury.
In older patients, the first indicator of nontraumatic internal bleeding may be:
weakness or dizziness.
Internal bleeding into a fractured extremity is MOST often controlled by:
splinting the extremity.
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
20%
The severity of bleeding should be based on all of the following findings, EXCEPT:
systolic blood pressure.
What mechanism(s) does the body use to control bleeding?
A. Clotting
B. Coagulation
C. Vasoconstriction
D. All of these answers are correct.
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?
The patient takes rivaroxaban (Xeralto).
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
Air splint
Which of the following statements regarding hemophilia is correct?
Patients with hemophilia may bleed spontaneously.
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?
Gastrointestinal system
Which portion of the blood carries oxygen to and wastes away from body tissues?
Red blood cells
Which section of the heart receives deoxygenated blood?
Right
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.
18%
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound?
Cover it with moist, sterile gauze and secure with an occlusive dressing.
A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:
administer high-flow oxygen.
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
replace the avulsed flap to its original position and cover it with a sterile dressing.
A burn that is characterized by redness and pain is classified as a:
superficial burn.
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
contusion.
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
report the incident to the appropriate authorities.
As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:
open his airway and assess his breathing status.
Burns to pediatric patients are generally considered more serious than burns to adults because:
pediatric patients have more surface area relative to total body mass.
During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a:
shotgun.
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:
an air embolism.
In which of the following patients should you remove an impaled object?
A pulseless and apneic patient with a knife impaled in the back
The sebaceous glands produce sebum, a material that:
waterproofs the skin and keeps it supple.
When caring for a patient whose arm is covered with a dry chemical, you should:
brush away the chemical before flushing with water.
Which of the following areas of the body has the thinnest skin?
Ears
Which of the following is a severe burn in a 65-year-old patient?
Partial-thickness burn to 20% of the BSA
Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?
Abrasion
Which of the following processes occurs during the inflammation phase of the healing process?
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
Which of the following statements regarding crush syndrome is correct?
Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.
You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:
assess distal circulation and readjust the bandage as needed.
A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:
conjunctivitis.
A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:
transport her to the emergency department.
A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:
fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:
rapidly transporting her to the hospital.
A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should:
irrigate both eyes continuously for 20 minutes with plain water.
Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:
direct pressure using dry, sterile dressings.
Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:
a blowout fracture.
If your patient swallows blood following facial trauma, there is an increased risk of ________.
vomiting
Significant trauma to the face should increase the EMT's index of suspicion for a(n):
spinal column injury.
The Adam's apple is:
the upper part of the larynx that is formed by the thyroid cartilage.
The MOST significant complication associated with facial injuries is:
airway compromise.
The superficial temporal artery can be palpated:
just anterior to the tragus.
The upper jawbones are called the:
maxillae
When a light is shone into the pupil:
it should become smaller in size.
When caring for a patient with an open facial injury, the EMT's immediate priority should be to:
wear gloves and facial protection.
When performing a full body scan, you should assess for ________.
DCAP-BTLS
When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because:
they may need to call a specialist to see the patient.
Which of the following statements regarding anterior nosebleeds is correct?
They usually originate from the septum area and bleed slowly.
Which of the following statements regarding the vitreous humor is correct?
It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.
You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:
has a history of eye surgeries.