EMT Exam 4: Ch 29-35
You suspect that your patient has a GI bleed. She presents with tachycardia, hypotension, and pale skin. What stage of shock is she most likely in?
decompensated shock
The layer of skin that is rich with blood vessels, nerves, and specialized structures is the:
dermis
In a contusion, what remains intact?
epidermis
The skin is the largest organ of the body. It is composed of three layers, including the:
epidermis
Which patient most likely has an abdominal injury?
Patient tries to lie still with legs drawn up.
Which of the following statements is true?
Pediatric and geriatric patients are especially at risk for hypothermia.
You are assessing a victim of a gunshot wound to the head. Her eyes are open, but she does not follow or track any movement. There is no eye blink, and her pupils are fixed and dilated. Her motor response score is a 1, and her verbal response is a 1 as well. What is her eye-opening score?
1
Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso (chest and abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface burned?
22.5%
Which of the following patients is the most critical, based on trauma triage guidelines?
31-year-old male construction-site fall victim who fell approximately two stories and who demonstrates signs and symptoms of shock
You are assessing a patient who is unconscious but who responds to painful stimuli by attempting to push away the painful stimulus (for instance, a pinch on the leg) with his hand. How would you score his motor response according to the Glasgow Coma Scale?
5
How many vertebrae make up the cervical spine?
7
During severe external bleeding, the brain may suffer a lack of oxygen. Which of the following contributes most to that lack of oxygen?
A reduction in the number of red blood cells and blood pressure
In cold weather, which of the following persons is most susceptible to a cold emergency?
A warmly dressed person lying flat on the cold ground
Which of the following patients at the scene of an accident is most likely developing shock?
An elderly female is vomiting on her hands and knees.
The humerus is an example of a(n):
Appendicular bone
Which of the following statements is true? (arteries)
Arteries carry blood from the heart.
In neurogenic shock, what mechanism causes hypoperfusion?
Arteries that are under continuous nervous control lose their ability to maintain contraction and dilate fully, causing a drop in blood pressure.
You are treating a 42-year-old male complaining of chest pain and shortness of breath. You notice that he appears pale, cool, and sweaty. What is the most likely reason for these findings?
Blood vessels constrict in response to sympathetic stimulation, causing a decrease in blood flow to the skin.
Which of the following statements is true? (trauma)
Bullet wounds are a type of penetrating trauma, and involve both internal and external injuries.
How does the skin provide temperature regulation?
By altering the blood flow to the skin and by controlling perspiration
When treating a patient with an open musculoskeletal injury to the thigh, how would you best treat the open wound?
Cover the open wound with a sterile dressing, elevate the extremity, and apply a cold pack to the area to help reduce swelling.
Which of the following describes shock following spinal injury?
Dilation of the blood vessels, resulting in reduction of perfusion to tissues
Which of the following statements about puncture wounds is correct?
Even insignificant-looking puncture wounds can cause devastating injuries.
In all forms of shock, what is the greatest consequence to the body?
Inadequate delivery of oxygen to the cells
You are treating a 29-year-old motorcycle crash victim who appears pale, cool, and diaphoretic. You suspect he sustained a traumatic brain injury based on decreased pupillary response. Based on these findings and the mechanism of injury, which of the following is the most appropriate method to manage this patient?
Limit on-scene time and promptly transport the patient to the hospital.
You are caring for a 19-year-old female patient who was involved in a motor vehicle crash. She sustained blunt-force trauma to her face with contusions, swelling, and minor bleeding throughout her facial region. Which of the following findings most strongly suggests a fractured mandible?
Lower teeth that are out of alignment in the front
Which of the following is the best sign of a pelvic injury?
Pain in the pelvis, significant mechanism of injury, obvious deformity
To stabilize a hip fracture, how should you bind the legs together?
Place a folded blanket between the patient's legs and bind the legs together with wide straps, Velcro-equipped straps, or wide cravats.
You are treating a 22-year-old male who was stabbed in the neck during a bar fight. What is an important part of the treatment of this injury?
Sealing the wound with an occlusive dressing
Which of the following statements about the body's response to heat loss is true?
Shivering stops when the patient becomes severely hypothermic.
You arrive on scene to a patient with an arterial bleed from his right lower leg. The patient is lethargic, and has many other injuries. What should you do first?
Stop the hemorrhage with direct pressure
The region where the jaw articulates with the remainder of the head is termed the:
TMJ (temporomandibular joint)
What is the purpose of a flutter-valve occlusive dressing?
To allow air to escape but not enter
In caring for an open neck wound, it is important to avoid compressing both carotid arteries at the same time. Why?
To prevent a dangerous reduction of blood flow to the brain
You suspect that your patient has a deep local cold injury. Which of the following signs or symptoms would you expect?
White, waxy-appearing skin
If you see angulation when assessing a patient, then:
a bone or bones are out of anatomical position.
The first step in the progression of compartment syndrome is that:
a fracture or crush injury causes bleeding or swelling in an extremity.
Which of the following statements is true of a compression injury?
a mechanism of injury involving a compression injury could be a driver striking his chest on a steering column.
A GCS of 8 indicates:
a significant likelihood of head injury.
All burns are to be treated as more serious if:
accompanied by other injuries or medical problems.
Which of the following may be dangerous if done incorrectly or used when not indicated?
active rewarming
Timing in multisystem trauma management involves:
an awareness that time on scene must be efficiently managed in order to expedite transport
When caring for the victim of a motor vehicle collision, the EMT should suspect critical injuries if:
another occupant was killed
Your patient presents with signs and symptoms of shock after a motor vehicle crash. Which of the following would be one such sign?
apparent agitation
You have a patient with a long laceration to his thigh after falling through a roof on which he was working. The bleeding is bright red and spurting, and the patient is becoming increasingly pale and disoriented. How would you characterize this bleeding?
arterial
You suspect that your patient is suffering from severe hypothermia. When checking for a pulse, you should check for:
at least 60 seconds
When a flap of tissue is traumatically removed, this condition is called a(n):
avulsion
When crushed, the liver and spleen:
bleed profusely and cause shock.
Which of the following is a common cause of nontraumatic brain injury?
blood clot
What type of injury is likely to produce a flail segment?
blunt trauma
In the case of a large evisceration, you should place layers of:
bulky dressings over a dressing moistened with saline.
You are caring for a victim who was rescued from a burning building by the fire department. The patient is alert and oriented with superficial burns to the arms, chest, neck, and face. He complains that he cannot breathe well. What is this patient's most critical injury?
burns to the face
Microscopically small structures in the circulatory system that supply every cell in the body are:
capillaries
For a patient at what stage of shock are the efforts of EMTs likely to be most successful and have the greatest impact on a positive outcome?
compensated shock
You respond to the scene of a 27-year-old female who was working on her car when she "snagged her hand on a sharp edge." She has napkins around her hand covering the wound. You uncover it and note that the bleeding is slow and dark red in color. Direct pressure easily stops the bleeding. Based on this information, what is the source of her bleeding?
cephalic vein
An internal injury with no open pathway from the outside is called:
closed
A fracture that results in multiple bone pieces at the fracture site is termed a:
comminuted fracture
You are dispatched to the local park, where a 15-year-old male is in sudden cardiac arrest after being struck in the chest by a ball. As you arrive at the patient, you should immediately do which of the following?
confirm pulseless arrest and begin cpr
For a young child with isolated genital injuries, you should:
consider the possibility of abuse, and treat the child with sensitivity.
You and your partner disagree on the best destination for a trauma patient. In this situation, you should:
consult your protocols or medical direction
The catcher at a baseball game is struck on the front of his head by a thrown bat. He sustains a cerebral bruise on the front of his brain but also has a contusion on the back of his brain. The bruise on the back of his brain is called a(n):
contrecoup injury
when palpating a fracture site on a patient's mid-thigh, you notice a grating sensation. This is known as:
crepitus
Which of the following statements should you use as a guideline in managing patients with a local cold injury?
do not re-expose the patient to cold.
Generally, when providing emergency care of open wounds, the first thing you would do is:
expose the wound
You just arrived at the scene of a motor vehicle crash involving two cars. The passenger of one car is sitting in the front seat, unconscious, with her chin to her chest. She is having snoring respirations, so you carefully position her head in a neutral position to clear her airway. In doing so, you notice that her nose is bleeding, there is a reddened area on her forehead at the hairline, and the windshield is starred, with some hair stuck in the fractured glass. What type of cervical injury should you suspect?
extension or flexion injury
Which of the following blood vessels do you believe will cause the most significant hemorrhage if injured?
femoral artery
A fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment is called a:
flail chest
During transport of a hypothermic patient who is alert and responding appropriately, and whom local protocols dictate you may actively rewarm, you should:
gently apply heat to the patient's body.
You are caring for a 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be most preferred in managing this wound?
gloves and a face shield
Which of the following components is not used during the evaluation of the Revised Trauma Score?
heart rate
A swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel is a(n):
hematoma
You find out that one of your patients from an earlier car wreck suffered bleeding that caused the blood to collect and pool within the patient's skull. Based on this information, you know that the patient most likely suffered which type of brain injury?
hematoma
Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is this?
hematoma
An open wound to the chest, if an occlusive dressing is not available, should be sealed:
immediately with a gloved hand
For a high-priority, unstable patient with musculoskeletal injuries, you should:
immobilize the whole body on a long spine board and "load and go."
Hypoperfusion is:
inadequate blood flow to the tissues.
What is the primary concern about a splint that is applied too loosely?
it could allow the bone fragments to move, which could cause further damage.
In a dislocation, what structures other than the joint capsule are likely to be injured?
ligaments
Damage to which of the following organs is least likely in the case of abdominal bruising?
lungs
Your patient is unable to move his lower jaw or speak. You should suspect an injury to the:
mandible
For an older trauma patient, what is LEAST important to determining the patient's priority for triage to a higher level of care?
medications for chronic conditions
Which of the following is the best indicator of perfusion in the adult?
mental state and alertness
In your care of a patient suffering from shock due to a motor vehicle crash, which of the following is most critical?
minimizing your scene time
Blunt trauma is:
more common in rural and suburban areas
A brain injury is classified as nontraumatic if it is:
not attributable to an external cause.
A fracture may be classified as:
open or closed
A movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is called:
paradoxical motion
Which of the following types of patients typically have an ineffective shivering response to cold?
pediatric patients
The term used for the delivery of oxygen and nutrients from the blood through the thin capillary walls into the cells and the removal of carbon dioxide and other waste products from the cells is:
perfusion
When air is present in the chest cavity, the injury is called a:
pneumothorax
Which pregnant trauma patient is the highest priority for transport to a trauma center?
pregnant for 24 weeks
The skin serves which of the following functions?
protection
For a patient with severe hypothermia, you:
provide passive rewarming but do not actively rewarm the patient
You are performing a secondary assessment on your 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point to?
punctured lung
Burns involving the airway often lead to:
respiratory compromise
A 22-year-old female patient slipped running down stairs, and has injured her right tibia and fibula. You have used an air splint to splint the injury. To test the splint, you can:
see if you can cause a slight dent in the plastic with fingertip pressure.
You have been called to a nursing home, where you find an 88-year-old female patient who is confused and combative. The staff states that this is not her normal behavior but that she has been bedridden from a previous stroke. They also report that she has had a recent urinary tract infection from an indwelling catheter. You note that her skin is flushed and warm, her pulse is 108, and her blood pressure is 80/44. You should suspect:
septic shock
Your patient was just involved in a motor vehicle collision. She is breathing very fast and shallowly. You auscultate her lung sounds and find diminished breath sounds on the right side. You suspect that the patient is most likely suffering from:
simple pneumothorax
Injury to which of the following organs would be most likely to cause peritonitis?
small intestine
You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which of the following additional injuries should you have a high level of suspicion?
spinal injury
While assessing the abdomen of a 25-year-old female, you note that she has a large piece of glass sticking out of her right upper quadrant. What should you do?
stabilize the glass
Which layer of the skin provides shock absorption and insulation?
subcutaneous
If an individual sustains a head injury, and blood has accumulated on top of the brain but beneath the dura, this type of injury is termed a(n):
subdural hematoma
An open chest wound that pulls air into the thoracic cavity is known as what type of injury?
sucking
Which of the following is most clearly an example of an open chest injury?
sucking chest wound
Knowing what you will do on scene and how that relates to what your partner will do is part of:
teamwork
You respond to the scene of a 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his chest, where you notice a puncture wound. From what is this patient most likely suffering?
tension pneumothorax
To see the effect of direct force, you would look at:
the area of the point of impact.
The first effects of a bone injury are swelling of soft tissue and:
the formation of a blood clot in the area of the fracture.
To realign an extremity, an EMT grasps the distal extremity while a partner places one hand above and one hand below the injury site, and then:
the partner supports the site while the first EMT creates gentle manual traction in the direction of the long axis of the extremity.
If your trauma patient had an initial GCS score of 13 and now has a score of 10, this implies that:
the patient is deteriorating
You respond to the scene of a 34-year-old male whose left lower arm is bleeding profusely after an accidental amputation at the wrist while cutting planks with a circular saw. Direct pressure does not stop the bleeding, so you decide to place a tourniquet on the patient's limb. Which of the following statements is the most accurate?
the tourniquet should be applied proximal to the wound, but not over a joint.
A 14-year-old girl has fallen from her bicycle. She sustained injuries when she landed with her arm extended to catch her fall. According to the principles of indirect mechanisms of injury, which of the following bones is least likely to have been injured in this fall?
thoracic vertebra
Which of the following would most likely be used to determine whether a patient would be transported to a trauma center?
trauma score
You are evaluating a 45-year-old male car wreck victim. Your evaluation of this patient is based on specific characteristics that will be assigned a specific score. What is this score known as?
trauma score
You are treating a 42-year-old male assault victim who presents with nausea, vomiting, and sharp abdominal pain. While inspecting his abdomen, you note redness to his right upper quadrant. Based on your assessment findings, the patient is most likely suffering from which of the following?
traumatic hemorrhage of the liver
When you are stabilizing an impaled object in the head, always:
use bulky and rigid support
The problem of blood vessels dilating in compensation for trauma is primarily related to:
vascular capacity that is too great
Rough handling of a hypothermic patient may lead to:
ventricular fibrillation
In caring for an amputated part, it is important to:
wrap the part in sterile gauze and keep it cool.