emt exam 5

Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the BEST way to immobilize this patient's extremities prior to transport?

Immobilize the patient to a long backboard without splinting the extremities individually. CORRECT. The best course of action is to immobilize the patient to a long backboard without splinting the extremities individually.

Which of the following causes worsening of the damage in a brain injury?

Improper management of airway and ventilation CORRECT. Improper management of airway and ventilation may potentially worsen the damage in a brain injury patient.

Which of the following would you expect to see in a patient with severe hypothermia?

Irrational behavior CORRECT. Irrational behavior is a hallmark sign of severe hypothermia in a patient.

Which of the following is an appropriate question to ask while evaluating a woman in labor?

Is this your first pregnancy? CORRECT. Determining the number of pregnancies that the patient has had is an appropriate question to determine during active labor.

What is the most important intervention an EMT can perform for an unstable multisystem trauma patient

Rapid transport CORRECT. Although oxygen, airway management, and cervical spine precautions are important interventions, the only things that will save the patient's life are blood transfusions and/or surgery as soon as possible. Therefore, rapid transport with a scene time of less than 10 minutes is the best intervention.

In which of the following ways does the body produce heat in response to being cold?

Shivering CORRECT. In response to being cold the body will shiver to produce heat.

Which of the following signs would you NOT expect to see in a patient suffering from severe hypothermia?

Shivering CORRECT. Shivering would not be expected in a patient suffering severe hypothermia.

If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done?

Try to slip the cord over the baby's head and shoulder. CORRECT. If there is a nuchal cord, the first step is to try to slip the cord over the baby's head and shoulder.

A young female was injured in an automobile wreck, striking her head on the windshield. She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68, blood pressure 148/90, and her pupils are unequal. You should suspect a(n):

closed head injury. CORRECT. Since her cranium is intact, all swelling and bleeding occurs inside the cranial vault, which increases the pressure on the respiratory center in the brain. Her increasing blood pressure, decreasing pulse, unequal pupils, and irregular respirations point to a possible closed head injury.

You are the first on the scene of a two-car vehicle collision. Your patient is a front passenger who is unresponsive inside the vehicle. The patient is trapped and the vehicle is on fire. The fire department is still en route. You should:

have the fire department rescue the patient. CORRECT. Vehicles on fire are at high risk for explosion. Rescue of persons inside trapped vehicles should only be performed by trained personnel with the appropriate protective clothing and equipment. You will be in danger if you try to move the patient or put out the fire with a fire extinguisher. You do not have the protective gear or training to do it safely. A fire extinguisher is usually inadequate to extinguish a vehicle fire.

You have delivered a newborn and wrapped the baby in a dry blanket. During your reassessment of the mother, you note continued moderate vaginal bleeding. Care for this bleeding may involve all of the following except:

having the mother squeeze her legs together to provide direct pressure. CORRECT. The mother does not need to squeeze her legs together to control the bleeding.

You have been called for a young female in labor. She is lying on the floor in obvious distress from the labor pains. While you are assessing her for crowning, your partner is getting a set of vital signs. She tells you that she is getting dizzy and nauseated. Vital signs are pulse rate 120, respiratory rate 22, and blood pressure 98/62. You should be concerned that she has:

supine hypotensive syndrome. CORRECT. When the mother is in a supine position, the pregnancy will tend to compress the inferior vena cava, reducing return of blood to the heart, thereby reducing cardiac output. The resulting dizziness and drop in blood pressure point to supine hypotensive syndrome.

A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n):

whiplash injury. CORRECT. When a vehicle is struck from behind or is struck head on, the neck can whip quickly back and forth violently. This causes the neck to exceed the normal range of motion. A distraction injury occurs when the spine is pulled excessively as with a hanging.

When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ °F.

. 100 to 105 CORRECT. When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below 100 to 105 °F.

A respiratory rate of less than ________ and greater than ________ in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines.

. 10; 29 CORRECT. A respiratory rate of less than 10 and greater than 29 in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines.

What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts?

. 14 CORRECT. The GCS is 14 since the patient has confusion on the verbal scale.

The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss.

. 3 CORRECT. Since the blood vessels that run through the chest are the largest in the body, injury to these vessels is often fatal. In fact, the chest can hold over 3 liters of blood. It is possible to bleed to death within the chest cavity and never spill a drop outside the body.

What are some of the most important critical decisions an EMT can make on the scene of a serious trauma?

. Determining patient priority, amount of time on-scene, and hospital transport decision CORRECT. Some of the most important critical decisions an EMT can make on the scene of a serious trauma include determining patient priority, amount of time on-scene, and hospital transport decision.

Based on the following presentations of patient injuries, which one would be considered MOST severe, justifying immediate transportation to a trauma center?

. Flail chest CORRECT. A flail chest is the most severe injury listed and justifies transportation to a trauma center.

Which of the following is classified as an open head injury?

. Laceration with a skull fracture

A 36-year-old male was accidentally shot with a nail gun into the head. You see the nail, which protrudes about 2 to 3 centimeters from the skull, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site?

. None of the above CORRECT. An impaled object should not be removed from the skull.

The bony bumps you feel along the center of a person's back are known as which of the following?

. Spinous process CORRECT. The spinous process is the bony bump on a vertebra in the center.

Traditionally an APGAR score is taken at what time intervals after birth?

1 and 5 minutes CORRECT. APGAR scores are taken at 1 and 5 minute intervals.

When performing chest compressions on a pregnant patient that has gone into cardiac arrest, what change do you need to make in the placement of your hands?

1 to 2 inches higher on the sternum CORRECT. When performing cardiac arrest on a pregnancy patient the EMT should place his hands 1 to 2 inches higher on the sternum to make up for shifting of the heart by the large uterus.

Of the following patients, which injury is the highest priority to receive bag-valve-mask ventilations?

15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli CORRECT. This patient has altered mental status (AMS) due to the head trauma and should receive ventilations via a bag-valve mask (BVM) in a controlled fashion.

Where should a constricting band be placed to reduce lymphatic flow after a venomous snake bite?

2 inches above and 2 inches below the bite CORRECT. The constricting band should be placed 2 inches below and 2 inches above the bite.

A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient, who should be immediately transported to a trauma center if secondary to trauma.

20 CORRECT. A respiratory rate of less than 20 in infants is a significant finding and indicates a critical patient, who should be immediately transported to a trauma center if secondary to trauma.

Hyperventilation of a patient with a severe brain injury due to an impaled object means that bag-valve-mask ventilations are provided at a rate of ________ per minute.

20 CORRECT. Hyperventilation of a severe brain injury patient is 20 ventilations per minute.

What is the height from which an adult fall would meet trauma triage criteria set forth by the CDC?

20 feet CORRECT. The height from which an adult fall would meet trauma triage criteria set forth by the CDC would be 20 feet.

Who is the most susceptible to hypothermia?

21-year-old near-drowning patient on a warm spring day CORRECT. Even though it is a warm spring day, the water temperature can still be very cold. Any patient submerged in water is at the highest risk for hypothermia because his clothes can no longer keep him warm, and the cold water rapidly drops his body temperature to dangerously low levels.

When the body is in water, how many times faster does it lose heat than when it is in still air?

25 CORRECT. When the body is in water it loses heat 25 times faster than when in still air.

In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long?

30 to 45 seconds CORRECT. The patient with extreme hypothermia who appears to be in cardiac arrest should have the pulse should be checked for 30 to 45 seconds.

By definition, a premature infant is one who is born before how many weeks of the pregnancy?

37 CORRECT. By definition a premature infant is one born before 37 weeks of pregnancy.

An infant's birth weight is considered low if it is less than ________ pounds.

5.5 CORRECT. An infant's birth weight is considered low if it is less than 5.5 pounds.

Normal maternal blood loss during delivery of an infant usually does not exceed how much?

500 cc CORRECT. Normal maternal blood loss during delivery of an infant usually does not exceed the amount of 500 cc.

For which of the following patients would the use of a short spine immobilization device be appropriate?

52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain CORRECT. Since this patient is hemodynamically stable, the short spine board may be used to extricate the patient for transfer to a long spine board (LSB) for transport to an ED.

How many cervical vertebrae are there?

7 CORRECT. There are 7 cervical vertebrae.

When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body.

7 CORRECT. When clamping the umbilical cord, the clamp closest to the baby should be approximately 7 inches from the infant's body.

When submerged in water, biological death may be delayed if the water temperature is below ________°F.

70 CORRECT. When submerged in water, biological death may be delayed if the water temperature is below 70°F.

You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities. What is the newborn's APGAR score?

9 CORRECT. An infant that has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities would have an APGAR score of 9.

Which of the following statements is NOT true?

A comminuted break is when a bone is broken in only one place. CORRECT. A comminuted broken bone is when the bone is broken in many places.

Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations?

A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC CORRECT. A pregnant female with vaginal bleeding due to trauma is a priority patient for a transport to a trauma center.

Which of the following BEST describes the compartment syndrome?

A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure CORRECT. Compartment syndrome is a serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure.

What is the definition of multiple trauma?

A trauma in which the patient has more than one serious injury. CORRECT. Multiple trauma is trauma in which the patient has more than one serious injury.

While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop?

Air embolus CORRECT. It is possible for air to be sucked into a neck blood vessel lacerated and cause an air embolism (air bubble).

To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body?

Abdomen CORRECT. The EMT should place the back of his hand on the abdomen since it is in the central core.

The condition in which the placenta separates from the uterine wall is known as which of the following?

Abruptio placentae CORRECT. The condition in which the placenta separates from the uterine wall is known as abruptio placentae.

You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks you to wait because she feels the need to use the bathroom first. Which of the following is the BEST course of action?

Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible. CORRECT. The best course of action is to advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible.

You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect?

Air embolism CORRECT. Because the patient was scuba diving, both decompression sickness and air embolism must be ruled out. Both of these conditions can present with chest pains or diminished lung sounds; however, the air embolism presents with frothy blood in the mouth and a sudden lapse into unconsciousness.

You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?

Air embolism CORRECT. Since it is not a deep dive, the most likely scenario is the air embolism instead of decompression sickness.

Which of the following is NOT appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury?

All of the above

A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat?

All of the above CORRECT. A patient that has struck the windshield of a vehicle with his face may have cervical spine trauma, brain injury, and/or an airway obstruction.

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

All of the above CORRECT. A puncture wound has a strong possibility of contamination. In a puncture wound there may be hidden internal bleeding with minimal external bleeding. Another concern with a puncture wound is the object that remains impaled in the body.

Which of the following may be a hazard of an improperly fitting cervical collar?

All of the above CORRECT. An improperly fitting cervical collar allows for hyperextension and flexion of the neck as well as preventing the patient from opening their mouth.

Which of the following may result from a woman in her third trimester of pregnancy lying in a supine position?

All of the above CORRECT. Fetal compromise, maternal hypotension, and the mother's body attempting to compensate for shock are all conditions that may be experienced by a third trimester mother placed in a supine position.

Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you anticipate?

All of the above CORRECT. For an overturned tractor, the EMT should expect the nerves of the lower extremities to be damaged, the patient to have sustained internal injuries to the organs, and the patient will present as in shock.

Which of the following is often associated with water-related emergencies?

All of the above CORRECT. Hypothermia, cardiac arrest, and alcohol use are all associated with water-related emergencies.

Which of the following is true concerning lacerations?

All of the above CORRECT. Lacerations may be caused by blunt force trauma, penetrating trauma, and may indicate deeper underlying tissue damage.

Which of the following is a complication of bone fractures?

All of the above CORRECT. Nerve damage, swelling, and hemorrhage are all potential complications of bone fractures.

Which of the following injuries requires the use of an occlusive dressing?

All of the above CORRECT. Open neck wounds, abdominal eviscerations, and chest wounds require the use of occlusive dressing so that air from the atmosphere is not entrained into the body through the open wound.

Which of the following is true of premature infants?

All of the above CORRECT. Premature infants are at risk for respiratory difficulty, susceptible to infection, and may develop hypothermia.

Which of the following is a sign of possible brain injury?

All of the above CORRECT. Signs of a possible brain injury are deep lacerations, projectile vomiting, and irregular breathing patterns.

Which of the following is a cause of gynecological emergencies?

All of the above CORRECT. Soft-tissue trauma, sexual assault, and disorders of the female reproductive organs are all causes of gynecological emergencies.

You are called for a women who is about to deliver. During the labor process, your patient's water breaks. She experiences a rush of warm water and an increase in uterine contractions. The purpose of the amniotic fluid is to:

All of the above CORRECT. The amniotic fluid provides lubrication during delivery, maintains a constant fetal temperature, and allows the fetus to float during development. All of these are important functions of amniotic fluid. Amniotic fluid also provides a cushion between the fetus and minor injuries.

Which of the following should be done when the infant's head has been delivered?

All of the above CORRECT. The cord should be checked to make sure it is not wrapped around the head and suctioning of the mouth and nose is done while the head is being delivered.

Which of the following should the EMT do to control maternal bleeding after delivery of the baby?

All of the above CORRECT. To control maternal bleeding the EMT may use direct pressure with a sanitary napkin, massage the uterus, and allow the infant to nurse if possible.

Which of the following conditions should be present before the umbilical cord is cut?

All of the above CORRECT. To cut the umbilical cord the infant should be breathing on his or her own, the cord should not be pulsating, and the cord should be clamped in two places.

Which of the following injuries may produce distended neck veins (JVD)?

All of the above CORRECT. Traumatic asphyxia, tension pneumothorax, and cardiac tamponade may all cause distended neck veins (jugular vein distension - JVD).

In which of the following situations should the mother be transported immediately?

All of the above CORRECT. Uterine rupture, limb presentation, and bleeding from placenta previa would all be situations that warrant immediate transport.

You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and that he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient?

Allow the patient to warm up inside the ambulance by passive rewarming measures. CORRECT. The patient is suffering from a superficial cold injury. The correct treatment is to get the patient out of the cold environment and warm the affected area with passive rewarming measures.

Which of the following terms describes the temperature of the surrounding air?

Ambient temperature CORRECT. Ambient temperature describes the temperature of the surrounding air.

Although it can be difficult to definitively determine hip dislocation in the field, certain signs and symptoms are usually there. Which of the following statements is false?

An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed. CORRECT. An anterior hip dislocation would present with the entire lower limb being rotated outward and the hip would be flexed. A posterior hip dislocation, which is the most common, would present with the patient's leg rotated inward, the hip flexed, and the knee bent. The patient would be unable to flex the foot or lift the toes. The foot may hang loose. Often, there is a lack of sensation in the limb.

Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following

Anticipate and treat problems with a greater level of complexity than usual. CORRECT. The EMT is expected in multiple trauma and multisystem trauma patients to anticipate and treat problems with a greater level of complexity than usual.

What type of trauma triage criteria regarding transport would a finger amputation receive?

Any hospital with surgical facilities CORRECT. Any hospital with surgical capabilities would be able to handle a finger amputation.

A fracture of which of the following bones would be considered a skull fracture?

Any of the above CORRECT. In a fracture any of the bones of the skull (temporal, frontal, nasal, maxillae, and others) would constitute a skull fracture.

Which of the following traumatic chest injuries may result in massive, often fatal internal hemorrhage?

Aortic dissection CORRECT. An aortic dissection results in massive, often fatal internal hemorrhage. The reason is so little time that elapses from dissection until the patient bleeds out internally away from the surgery suite of a trauma hospital.

Which of the following could worsen the effects of a snake bite?

Application of ice CORRECT. Ice will cause the venom to collect in an area and cause tissue necrosis.

Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. Which of the following descriptions represents the MOST appropriate way for removing the patient from the vehicle?

Apply a cervical collar and short spine immobilization device before removing to a long backboard. CORRECT. The patient is hemodynamically stable so the patient can be packaged with a cervical collar, short spine board before being moved to a long backboard.

When assisting with a delivery in the field, which of the following should be done as the head begins to emerge from the vagina?

Apply gentle pressure to the head with your gloved hand. CORRECT. Gentle pressure should be applied to the infant's head with a gloved hand.

You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry but his shirt is wet with visible salt rings. Which is the best treatment for the patient?

Apply high-concentration oxygen and rapidly transport to the nearest medical facility. CORRECT. The patient is in decompensated shock and needs high-concentration oxygen and rapid transport where he can get the appropriate definitive treatment.

Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques?

Applying direct pressure to the wound CORRECT. Direct pressure is the initial way to control bleeding from a wound.

Which of the following is acceptable when actively rewarming a hypothermic patient?

Applying humidified oxygen CORRECT. Applying humidified oxygen is an acceptable method to use with active rewarming.

You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority?

Arterial bleed CORRECT. The patient will die the fastest from the uncontrolled arterial bleed. New advances in battlefield medicine have reaffirmed the importance of immediate bleeding control. Military medics are now taught to treat ABCs simultaneously with an emphasis on bleeding control rather than in a sequential A, B, C order.

Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream?

Arterial gas embolism CORRECT. When gases leave a damaged lung in a diving accident and enter the bloodstream, an arterial gas embolism occurs.

Your patient is a 21-year-old male who slid head-first down a water slide at his fraternity house and impacted the bales of straw that his fraternity brothers had erected as a barrier to keep participants from sliding onto the adjacent highway. The patient is conscious and complaining of neck pain. Which of the following should be included in your assessment?

Ask the patient to grasp and squeeze your hands. CORRECT. A proper assessment technique is to get the patient to grasp and squeeze your hands.

In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?

Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED. CORRECT. The best course of action is to assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone?

Auto versus pedestrian CORRECT. Auto versus pedestrian is a trauma triage criteria that justifies transportation to a trauma center based on mechanism of injury (MOI).

Which of the following choices is NOT a justifiable reason for delaying transport of a critical trauma patient?

Awaiting arrival of the patient's parents on-scene CORRECT. Awaiting a patient's parents is NOT a justifiable reason to delay transport.

You are treating an unresponsive homeless patient found in an alley. During your assessment you notice bruising behind both ears, which is known as which of the following?

Battle's signs CORRECT. Battle's signs, a bruise behind the ear (late sign), may be present in head trauma patients.

Why is it important to remove constricting items such as rings before thawing a frozen extremity?

Because thawed areas often swell CORRECT. Thawed areas often swell so it is important to remove constructing items.

Which of the following is the highest priority to the EMT in delivery of an infant with meconium-stained amniotic fluid?

Being prepared to suction the infant immediately before he takes a breath CORRECT. The most important action to take in a meconium delivered infant is to suction immediately before the infant takes a breath.

Which of the following describes an open extremity injury?

Both A and B CORRECT. A gunshot wound and bone ends that have lacerated the soft tissues from the inside are considered open extremity injuries.

Which of the following describes a breech presentation?

Both A and B CORRECT. Feet first or buttocks first presentation is considered a breech delivery.

The purpose of a constricting band after a venomous snake bite is to impede the flow of which of the following?

Both A and C

Which of the following spiders can cause a characteristic wound with a bite that is often painless?

Brown recluse spider CORRECT. The brown recluse spider bite is often painless.

You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do NOT know how to swim or consider yourself a poor swimmer, which of the following should you do first?

Call for help and try to throw the buoy to the swimmer. CORRECT. The correct sequence should be reach, throw, row, then go. Throwing the buoy is the best measure for rescue.

Which of the following allows for smooth movement of bone surfaces against one another at joints?

Cartilage CORRECT. Cartilage serves as an area for articulation of the joint making it smoother in movement.

Which portions of the spine are the most vulnerable to injury?

Cervical and lumbar CORRECT. Some parts of the spine are more susceptible to injury than others. The cervical and lumbar vertebrae are susceptible to injury because they are not supported by other bony structures.

Your patient is a 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you suspect?

Cervical spine injury CORRECT. Due the patient being hung by the hood, the EMT should suspect a cervical spine injury.

A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder, it "pops back into place." What should your next step be?

Check distal CSM, apply a sling and swathe, and transport the patient. CORRECT. The best course of action is to check PMS, apply a sling and swath, and transport.

Your patient is an 11-year-old male who has a swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the immobilization of his injured extremity?

Check pulse, movement, and sensation distal to the injury before and after splinting. CORRECT. An immobilization consideration is to check pulse, movement, and sensation (PMS) distal to the injury before and after splinting.

You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt, but does not have pants on. His skin feels cold to the touch. The week's temperatures have not been above 50°F. Which of the following should you do immediately after ensuring the patient has an adequate airway?

Check the pulse. CORRECT. After assuring the patient has an adequate airway, then the pulse must be checked.

Which of the following describes the normal appearance of amniotic fluid?

Clear and colorless fluid CORRECT. Amniotic fluid is normally clear and colorless.

You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions?

Commotio cordis CORRECT. In commotio cordis the impact occurs just when the heart is vulnerable. There are several hundredths of a second during each heartbeat when the heart, if sufficiently stimulated, will go into ventricular fibrillation (VF). The patient sustained a blow strong enough at just the right time to go into cardiac arrest.

One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called?

Compartment syndrome CORRECT. A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment becomes so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. This is the description of compartment syndrome.

Which of the following injuries is considered an indirect brain injury?

Concussion CORRECT. Indirect injuries to the brain include concussions and contusions.

A patient who is lying on cold ground is losing the most amount of heat by what mechanism?

Conduction CORRECT. Since the patient is in contact with the cold ground, heat loss is by conduction.

You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is "really sick." As you approach, you notice that the patient appears in obvious distress, diaphoretic, and holding his right wrist. Which of the following is your highest priority?

Confirm the type of snake and contact medical control for specific instructions.

Which of the following is a function of the autonomic nervous system?

Constriction of blood vessels CORRECT. Constriction of the blood vessels is controlled by the automatic (autonomic) nervous system.

In addition to lacerations, blunt trauma resulting in a closed chest injury creates the potential for which of the following internal injuries?

Contusion CORRECT. A contusion (bruising) is a closed soft tissue injury caused by blunt force trauma.

Which of the following is NOT an open tissue injury?

Contusion CORRECT. A contusion (bruising) is a closed soft tissue injury caused by blunt force trauma.

Which of the following is the process in which heat is lost from the body as wind passes over it?

Convection CORRECT. Convection is the process in which heat is lost from the body as wind passes over it.

Which of the following types of snake is NOT a pit viper?

Coral snake CORRECT. The coral snake is not a pit viper but instead is referred to as an elaphid (rear-teeth biters).

Of the following venomous snakes, which one usually has the highest incidence of a "dry bite?"

Coral snake CORRECT. The coral snake will have the highest incidence of dry bites.

Which of the following is the correct technique to check for crowning in the assessment of a woman in labor?

Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening. CORRECT. The correct way to check for crowning is to cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening.

You are called for a young man who was diving head first off a dock into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been performing rescue breathing for him. He is awake, but he is unable to breathe on his own. What type of damage or injury does this indicate?

Damage to C-3, C-4, or C5 CORRECT. Injury to the phrenic nerve originating at the 4th cervical vertebra may interfere with breathing. Injuries high in the cervical spine (C-1 through C-5) will often leave the patient unable to breathe on his own if he survives the injury at all.

Which of the following is the most significant mechanism of injury for a driver in a vehicle accident?

Death of a passenger in the same vehicle CORRECT. The fact that a person died in the same vehicle is the most significant issue because the living passengers in the same car received the identical force. They are at the highest risk to die as well.

Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive?

Decompression sickness CORRECT. Decompression sickness is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive.

Which of the following is a potential complication of hyperventilating a patient with a brain injury?

Decreasing blood flow to the brain CORRECT. Hyperventilation of a patient will potentially decrease blood flow to the brain.

Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve?

Dermatome CORRECT. A dermatome is an area of the body surface that is innervated by a single spinal nerve.

You are called to assess a pregnant woman who is approximately 7 months pregnant. She states that her pregnancy has been uneventful but she is experiencing intermittent headaches. Her vital signs are pulse 118, respirations 22, blood pressure 138/88, and blood sugar 148. Which of the following is true regarding a pregnant woman?

Diabetes may be made worse during pregnancy. CORRECT. It is normal for the pulse rate and respiratory rate to rise slightly and the blood pressure should drop slightly. The stress of the pregnancy often exacerbates preexisting conditions such as asthma and diabetes.

By which of the following means does the fetus's blood pick up nourishment from the mother?

Diffusion CORRECT. Diffusion is the movement of substances down a concentration gradient from high to low and accounts for how fetal blood picks up nutrients.

Which of the following is the underlying cause of neurogenic shock?

Dilation of blood vessels CORRECT. The underlying cause of neurogenic shock is dilation of the blood vessels.

You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is considered the BEST approach regarding transport of this patient?

Dispatch and await the medical helicopter, which is 20 minutes away. CORRECT. The medical helicopter is a good choice for transport even at 20 minutes away as they can dramatically cut down the 1.5 hour ground transport time in flight time.

You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the BEST transport decision?

Divert to the trauma center because the patient is becoming symptomatic. CORRECT. Diversion to the trauma center is the best course of action for the patient that is starting to decline.

You are treating a 16-year-old skateboarder who has fallen at the skate park. She has an angulated left forearm that she has in a guarded position. When do you splint this injury?

During the secondary exam CORRECT. The splinting of this injury is done during the secondary exam.

When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move?

EMT at the head of the patient CORRECT. The EMT at the head of the patient directs the move in a log roll of a spinal patient.

Which of the following BEST describes a localized cold injury with a clear line of demarcation of its limits?

Early frostnip CORRECT. A superficial localized cold injury with a clear line of demarcation of its limits is known as early frostnip.

When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building?

En route to the hospital CORRECT. En route to the hospital is the best time and place to conduct the GCS taking into account how the interventions are working for the patient.

You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and a high-category trauma; however, due to the mechanism of injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient?

Examining the patient for entrance and exit wounds CORRECT. Part of the primary assessment of the patient that has been shot is to look for the presence of entrance and exit wounds to effectively manage them.

Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?

Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle. CORRECT. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.

Which of the following is NOT a mechanism of musculoskeletal injury?

Extensive force CORRECT. Extensive force is not one of the three types of mechanisms that cause musculoskeletal injuries.

In a hypothermic patient the coldest blood is found in what part of the patient's body?

Extremities CORRECT. The coldest blood is found in the extremities.

Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the following?

Eye opening, verbal response, and motor response CORRECT. GCS is neurological assessment based on eye opening, verbal response, and motor response.

You are en route to the trauma center with a patient who was injured when he was thrown from a horse. You suspect multiple trauma injuries including a closed head injury. You will monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the following will you check?

Eye-opening, motor response, and verbal response CORRECT. GCS is neurological assessment based on eye opening, verbal response, and motor response.

Heat stroke is caused by which of the following mechanisms?

Failure of temperature regulation mechanisms CORRECT. Heat stroke is caused by the failure of temperature regulation mechanisms of the body.

Your patient is a 30-year-old construction worker who fell from scaffolding and has been impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the BEST course of action?

Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short. CORRECT. The rebar must be stabilized so that the rescue crew can cut it down from 36 inches to a more manageable size for transport of the patient.

You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds with increasing pain. The patient states that she feels the urge to push. These signs indicate which stage of delivery?

First and second stage CORRECT. The first stage of labor is from the start of contractions until the cervix is fully dilated at 10 cm. The second stage of labor is from the full dilation of the cervix until the baby is delivered.

To rescue someone who has fallen through the ice, which of the following is the safest device to use?

Flat-bottomed aluminum boat CORRECT. A flat-bottom aluminum boat is the safest to attempt ice rescue in case the ice breaks leaving the rescuers in a boat to float. The victim can be placed in the boat by the rescuers.

Which of the following increases a scuba diver's risk of decompression sickness?

Flying within several hours after a dive CORRECT. A major risk for decompression sickness is flying several hours after a dive.

Which of the following is the opening at the base of the skull?

Foramen magnum CORRECT. The foramen magnum is the opening at the base of the skull.

The PASG may be used as a splinting device for patients with which of the following suspected injuries?

Fractured pelvis CORRECT. The PASG may be used to stabilize a fractured pelvis.

Which one of the following statements is NOT true concerning a knee injury?

Fractures can occur to the proximal femur. CORRECT. The knee is a joint and not a single bone. Fractures can occur to the distal femur, to the proximal tibia and fibula, and to the patella (not the proximal femur where it attaches to the pelvis at the hip). There could be pain, tenderness, and swelling.

You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center. However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform next?

Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. And re-seal the wound CORRECT. An open chest wound covered with an occlusive that begins to develop pressure should have the corner lifted to release the built up pressure.

Which of the following is the correct way to time the frequency of contractions in the pregnant woman?

From the beginning of one contraction to the beginning of the next CORRECT. The correct way to time the contractions is from the beginning of one contraction to the beginning of the next.

What are the three elements of the Revised Trauma Score?

GCS, systolic blood pressure, and respiratory rate CORRECT. The three elements of the Revised Trauma Score are GCS, systolic blood pressure, and respiratory rate.

Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of action?

Gently attempt to straighten the leg to regain a pulse before splinting. CORRECT. The best course of action is to gently attempt to straighten the leg to regain a pulse before splinting.

Which of the following is NOT a principle of splinting that must be considered by the EMT?

Gently replace protruding bone ends back beneath the skin to prevent further contamination. CORRECT. Never push protruding bone ends back beneath the skin.

Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?

Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin. CORRECT. Since the patient is suffering from heat stroke, give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Your patient is a 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this patient?

Gradually rewarm both feet. CORRECT. The feet should be gradually rewarmed in deep local cold injuries.

Which of the following should the EMT do during the treatment of localized cold injury?

Gradually warm the affected area. CORRECT. For treatment of localized cold injury, the area should be gradually warmed.

For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline and then cover it with an occlusive dressing?

Gunshot wound (GSW) to the abdomen from which a loop of intestine is protruding CORRECT. A GSW to the abdomen with an evisceration should have the organs covered with an absorbent dressing moistened with saline and then covered by an occlusive dressing.

Where could you find the phalange bones?

Hands and feet CORRECT. You would find the phalanges in the hands and feet (fingers and toes).

Most radiant heat is lost through which part of the body?

Head CORRECT. Most radiant heat is lost through the head and neck.

When using a short spine immobilization device, which part of the body is secured last?

Head CORRECT. The correct sequence for securing the straps is the torso, legs, and then the head.

Your patient has been involved in a motor vehicle collision. He has a contusion on his forehead, is confused, and is bleeding from his nose. His heart rate is 90 beats per minute, blood pressure is 80/58 mmHg, respirations are 20 breaths per minute, and his skin is cool and clammy. Which of the following sets of injuries should you suspect?

Head injury, spine injury, and internal bleeding

You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient's body?

Head, chest, and torso CORRECT. The correct priority of assessment in the patient that must be extricated is to focus on the central core of the head, chest, and torso for life-threatening injuries.

The greatest danger to the pregnant woman and her fetus involved in trauma is which of the following?

Hemorrhagic shock CORRECT. The greatest danger to the mother and fetus from trauma is hemorrhagic shock caused from massive bleeding and associated shock. The bleeding may be caused by blunt or penetrating trauma.

What is the underlying cause of bluish or reddish facial discoloration following a traumatic asphyxiation?

High pressure on the chest leads to blood being forced from the right atrium into the face and neck. CORRECT. In traumatic asphyxiation the high pressure on the chest leads to blood being forced from the right atrium into the face and neck.

Which of the following is NOT advisable following complete birth of the infant?

Hold the infant by the ankles to allow the airway to drain. CORRECT. The infant is not held by the ankles at any time during the delivery.

In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury?

Hold the patient's head still in a neutral, "eyes forward" position. CORRECT. The patient's head should be kept still in a neutral position.

Which of the following may result from the application of a cervical collar that is too large for the patient?

Hyperextension of the neck CORRECT. If a cervical collar is too large, hyperextension of the neck may occur.

Which of the following describes the condition of having an abnormally high body temperature?

Hyperthermia CORRECT. Hyperthermia is the condition of having an abnormally high body temperature.

Which of the following is NOT a classification of localized cold injury?

Hypothermia CORRECT. Hypothermia is considered generalized cold injury.

Which of the following complications may arise from properly splinting an injured extremity?

Ignoring life-threatening problems while focusing on an extremity injury CORRECT. An EMT may ignore life-threatening problems due to the grotesque nature of some extremity injuries.

Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is NOT true?

In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced. CORRECT. The patella can become displaced when the lower leg and knee are twisted. In a patellar dislocation, the knee will be stuck in flexion and the knee cap will be displaced and be palpable laterally. A knee dislocation occurs when the tibia itself is forced either anteriorly or posteriorly in relation to the distal femur. Always check for a distal pulse, since the dislocated knee joint can compress the popliteal artery and stop the major blood supply to the lower leg. If there is no pulse, this is a true emergency.

A 65-year-old man was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury

Increased blood pressure CORRECT. Signs of a head injury include increasing blood pressure, decreasing pulse, and irregular respirations. Altered mental status, including memory loss or combativeness, is also a sign of a brain injury.

As pressure within the cranium increases, which of the following is the result?

Increased blood pressure, decreased pulse CORRECT. As pressure increases within the cranium the blood pressure (BP) increases and the HR decreases.

You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a pulse of 60 beats per minute, and slightly irregular breathing. The patient's presentation is most likely caused by which of the following?

Increased intracranial pressure CORRECT. The body responds to rising intracranial pressure in a predictable manner. The body's highest priority is to perfuse the brain with oxygen. When intracranial pressure increases, the body must increase the blood pressure to overcome the resistance to blood flow in the cranium. Increased blood pressure is necessary to pump blood into the brain and to perfuse brain tissue. This is why you will see increasing blood pressure in patients with increased intracranial pressure. The remainder of the body does not need this increase in blood pressure and responds to the hypertension by slowing the heart rate. As a result you will frequently see a slowing heart rate paired with rising blood pressure in response to rising intracranial pressure. You will also see the irregular breathing patterns.

Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms?

Indirect force CORRECT. Since the break occurred away from the point of contact (the hands), the forearm injury is caused by the indirect force.

Which of the following does NOT make infants and children more prone to hypothermia?

Inefficient metabolism CORRECT. An infant and child will have a higher metabolism than an adult.

Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be MOST appropriate?

Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute. CORRECT. The correct procedure is to insert an OPA and use a BVM for ventilations delivered at 20 breaths per minute.

You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find the 16-year-old patient unresponsive with agonal respirations and a weak carotid pulse. What is your first action?

Insert an oropharyngeal airway. CORRECT. The patient has agonal respirations and must therefore be ventilated with a bag-valve mask. However, the first step is to secure the airway to ensure adequate ventilation with a bag-valve mask. The oropharyngeal airway is inserted first. Only after ventilating the patient for at least 30 seconds can a dual lumen airway (Combitube) be inserted.

Which of the following BEST describes the benefit of a three-sided occlusive dressing over a four-sided occlusive dressing for an open chest wound?

It reduces the chances of developing a tension pneumothorax. CORRECT. The three-sided taped occlusive dressing would allow for easier relief of pressure build up by the EMT. The EMT would simply lift the un-taped side and lift to create a relief valve for the pressure. A four-sided taped occlusive dressing must have one side of the tape removed to relieve the pressure from a tension pneumothorax.

Which of the following is NOT a benefit of splinting an injury to bones and connective tissues?

It restricts blood flow to the site of the injury to prevent swelling. CORRECT. Splinting allows blood to flow to the site of injury. Swelling may occur regardless of splinting or not, but splinting may reduce the swelling process.

Which of the following statements is NOT true concerning a pelvic wrap?

It should not be used unless the patient shows signs of shock. CORRECT. The pelvic wrap reduces internal bleeding and pain while providing stabilization to the pelvis. It may also prevent further injury. It should be used on patients who have pelvic deformity or instability whether or not signs of shock are present. A positive MOI could also indicate that it should be used.

Seizures due to complications of pregnancy generally occur during which of the following time periods?

Late in pregnancy CORRECT. Seizures as a complication of pregnancy are usually later in the pregnancy.

The technique for central rewarming requires the application of heat to which of the following areas of the patient's body?

Lateral chest, neck, armpits, and groin CORRECT. The technique for central rewarming requires the application of heat to the lateral chest, neck, armpits, and groin.

You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has a Glasgow Coma Scale of 3, 4, 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient?

Level II Trauma Center CORRECT. The patient has an altered mental status and a Glasgow Coma Scale of 13. He is unable to give informed consent. Therefore, under implied consent, the patient must be transported. It is impossible to determine in the field if the patient's condition is a result of intoxication or a head injury; therefore, the patient needs to be transported to the nearest facility that can handle a potential head injury. This is the Level II Trauma Center.

Which of the following structures connect bone ends, making joints more stable?

Ligaments CORRECT. Ligaments attach bone to bone at the ends, making the joint more stable.

Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma?

Liver CORRECT. The liver is a very vascular organ that can cause blood loss quickly resulting in life-threatening hemorrhage.

Which of the following signs is LEAST likely to indicate a traumatic brain injury?

Low blood pressure CORRECT. Low blood pressure is not usually associated with traumatic brain injury, but is more indicative of internal or external bleeding that is severe.

Supine hypotensive syndrome is easily prevented by transporting the pregnant female into which of the following positions?

Lying on her left side CORRECT. The pregnant female should be transported lying on her left side so as to prevent supine hypotension.

While treating a patient of sexual assault, your treatment should follow which of the following sequences?

Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence. CORRECT. When treating a patient of sexual assault it is important to maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence.

What is another name for the zygomatic bone?

Malar CORRECT. The malar is the cheek bone, also called the zygomatic bone.

Which of the following is a strategy to maintain an occlusive dressing to bloody or diaphoretic skin?

Manually maintain pressure. CORRECT. To help hold an occlusive dressing to blood or sweaty skin, the EMT may have to maintain constant pressure over the dressing so as to hold it in place.

You are dispatched to a motorcycle crash with one patient involved. What is the most important intervention to perform first?

Manually stabilize the cervical spine. CORRECT. Manual stabilization of the cervical spine is the most important intervention on a motorcycle crash.

What is the first step in a rapid takedown of a standing patient ?

Manually stabilize the patient's head and neck CORRECT. Manually stabilizing the patient's head and neck is the first step in a rapid takedown of a standing patient.

On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration and the bleeding is controlled. Which of the following is the BEST approach toward managing the exposed intestines?

Moisten a sterile dressing with saline solution and cover the abdominal contents. CORRECT. For an evisceration it is important to moisten a sterile dressing with saline solution and cover the abdominal contents with an occlusive dressing.

You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states she is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment plan?

Monitor the patient for shock and transport. CORRECT. The correct treatment plan is to monitor the patient for signs of shock and transport for evaluation by a physician.

Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding?

Monitoring for hypovolemic shock CORRECT. The most important concern for the EMT is to monitor the patient for hypovolemic shock.

What is the definition of multisystem trauma?

Multiple injuries that affect more than one body system CORRECT. Multiple injuries that affect more than one body system is the definition of multisystem trauma.

A 36-year-old male was accidentally shot with a nail gun into the chest. You see the nail, which protrudes about 2 to 3 centimeters from the thorax, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site?

None of the above CORRECT. An impaled object should not be removed from the chest.

Which of the following BEST describes an evisceration?

Open wound of the abdomen from which organs protrude CORRECT. An evisceration is an open wound of the abdomen from which the organs protrude.

Which of the following is NOT part of a basic obstetrics kit?

Packet of suture material CORRECT. Suture material is not part of the obstetrics kit as an EMT does not do sutures.

When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what "six Ps"?

Pain, pallor, paresthesia, pulses, paralysis, and pressure CORRECT. The six Ps are: Pain or tenderness; pallor (pale skin or poor capillary refill); paresthesia, or the sensation of "pins and needles"; pulses diminished or absent in the injured extremity; paralysis, or the inability to move; and pressure

Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following BEST describes his level of consciousness?

Painful CORRECT. The patient responds to deep painful stimuli so he is painful on the AVPU scale.

If assisting in a prehospital delivery while off-duty, which of the following would be the BEST choice for tying or clamping the umbilical cord?

Pair of shoelaces CORRECT. A pair of shoelaces is an excellent makeshift clamp that can be used for clamping the cord.

A method of assessing compromise to an extremity when a musculoskeletal injury is suspected is to learn and follow the six Ps. Which of the items below is NOT one of the six Ps?

Parenthesis CORRECT. The six Ps are: pain or tenderness; pallor (pale skin or poor capillary refill); paresthesia, or the sensation of "pins and needles"; pulses diminished or absent in the injured extremity; paralysis, or the inability to move; and pressure. Parenthesis is not one of the six Ps.

Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following?

Passive rewarming CORRECT. Allowing a patient's body temperature to increase by preventing further heat loss is referred to as passive rewarming.

You respond to the scene of a 14-year-old patient. He is unresponsive and hypothermic. Emergency Medical Responders have moved the patient inside and secured the airway prior to your arrival. What is your next action?

Passively rewarm the patient. CORRECT. It is more important to implement passive rewarming techniques first as the hypothermia is the life-threatening condition for the patient, not any potential frostbite.

Which patient is the highest priority?

Patient with a penetrating chest injury CORRECT. A patient with a chest injury has a much greater chance of dying due to the location of the heart, lungs, and great vessels than a patient with a femur fracture. The mortality rate for thoracic trauma is much higher than for a femur fracture.

Which trauma patient is the most critical?

Patient with decerebrate posturing CORRECT. The patient with the lowest Glasgow Coma Scale score is the most critical. This is the patient with decerebrate posturing (GCS = 4). The decorticate posturing patient has a GCS of 5 and the patient who withdraws to painful stimuli has a GCS of 6.

Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?

Peripheral nervous system CORRECT. The peripheral nervous system includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae.

Which of the following is the most significant way in which the body cools itself?

Perspiration CORRECT. Perspiration (entire body) is the most significant way in which the body cools itself.

Which of the following is NOT relevant in determining whether or not delivery is imminent for a woman in labor?

Phoning the patient's obstetrician for advice CORRECT. Phoning the patient's obstetrician for advice will do little to determine that delivery is imminent.

What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers?

Physiological determinants, anatomic criteria, and mechanism of injury CORRECT. The CDC trauma guidelines include physiological determinants, anatomic criteria, and mechanism of injury.

Your patient is an infant who has just been delivered 3 weeks before her due date. She is breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and chest. Which of the following interventions should be done first?

Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute. CORRECT. This is a normal delivery so this infant only needs blow-by oxygen for stabilization.

Which of the following is indicated in the prehospital management of a prolapsed umbilical cord?

Place the mother in a head-down position with pillows under her hips. CORRECT. For a prolapsed cord, the mother should be placed in a head-down position with pillows under her hips.

Your patient is pregnant at 20 weeks' gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine?

Place the patient supine on the backboard, then put a pillow under the right side of the backboard. CORRECT. The patient that is pregnant should be immobilized to a long spine board with elevation of the right side of the board to displace the uterus and prevent supine hypotension.

What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients?

Placenta CORRECT. The placenta is the temporary organ that attaches to the uterus and supplies the fetus with oxygen and nutrients from the mother.

Your patient is a 21-year-old male who has a gunshot wound to the chest. Which of the following is the highest priority in managing this patient?

Placing an occlusive dressing over the wound CORRECT. The most important first step for this patient is to place an occlusive dressing over the sucking chest wound.

A suspected musculoskeletal injury of the shoulder is BEST managed by which of the following techniques?

Placing the arm in a sling and using a triangular bandage to secure it to the body CORRECT. A sling and swathe made from a triangular bandage to secure the arm to the body is the best way to immobilize a shoulder injury.

For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups?

Poor ability to regulate body temperature CORRECT. Infants and elderly patients have a poor ability to regulate body temperature.

A traction splint may be used on which of the following musculoskeletal injuries?

Possible fracture of the femur CORRECT. The traction splint is used on the mid-shaft femur fracture.

Your patient is a 35-year-old woman who was driving a minivan that was struck in the driver's side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles she extends her legs and flexes her arms and wrists. When giving your radio report, which of the following terms should you use to describe this?

Posturing CORRECT. The patient is displaying posturing due to her injuries.

Which of the following BEST describes the term crowning?

Presenting part of the baby being visible at the vaginal opening CORRECT. Crowning occurs when the presenting part of the baby first bulges from the vaginal opening.

Your patient is a 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate intervention?

Provide cervical spine immobilization. CORRECT. In a motorcycle crash victim it is important to provide cervical spine immobilization.

Your patient is a 20-year-old college student who has fallen from a third-level balcony onto a wooden deck below. The patient responds to verbal stimuli, is pale in color with moist skin, and has a very obvious deformity with protruding bone ends of his right forearm. Which of the following is the BEST sequence of intervention for this patient?

Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow. CORRECT. The best course of action is to provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow.

Which of the following is acceptable in the management of a patient stung by a honey bee?

Remove jewelry from any affected limbs. CORRECT. The most appropriate action is to remove jewelry from the affected limbs before the swelling starts.

Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine injuries?

Rigid cervical collars CORRECT. Rigid cervical collars are used for prehospital stabilization of cervical injuries.

You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as the head was delivered and again following complete delivery. The infant is not yet breathing. Which of the following is the correct sequence of interventions?

Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse. CORRECT. Tactile stimulating is warranted in this patient along with full resuscitative procedures.

Heat cramps occur due to loss of which of the following substances?

Salt CORRECT. Heat cramps occur as the result of the loss of salt.

During which stage of labor is the baby born?

Second CORRECT. The second stage of labor is the one in which the baby is born. It starts from full dilation of the cervix until the baby is born.

Which of the following is an accurate definition of a flail chest?

Section of the chest wall that is unstable, leading to breathing problems CORRECT. Closed chest injuries may cause a condition known as flail chest. This condition is defined as a fracture of two or more consecutive ribs in two or more places. (Some sources say three or more ribs in two or more places.) The most important factor to remember-even more than the number of broken ribs-is that flail chest leaves a portion of the chest wall unstable, which affects breathing and reduces lung expansion.

Which of the following is controlled by the left side of the brain?

Sensation of the right leg CORRECT. As the nerves exit the brain, prior to traveling down the spinal cord, they cross over to the opposite side of the body. This is why an injury to the left side of the brain may produce effects such as weakness or lack of sensation on the right side of the body.

Messages from the body to the brain are carried by which of the following types of nerves?

Sensory CORRECT. Messages from the body to the brain are carried by sensory nerves.

Which of the following is true concerning trauma in the pregnant woman?

She may lose up to 35% of her blood volume before exhibiting signs of shock. CORRECT. A mother may lose up to 35% of her blood volume before exhibiting signs of shock.

Which one of the following is NOT a key decision for the EMT when faced with a multisystem or multiple trauma patient?

Should I allow police to interview the patient on-scene? CORRECT. Whether or not the police are able to interview a patient on scene is not a key decision in patient care that an EMT must make.

Why is it important to keep patients at rest when they are hypothermic?

Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature. CORRECT. Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.

In which of the following situations would a person lose heat by conduction?

Sitting on cold metal bleachers at a football game CORRECT. Conduction is losing heat by direct contact with an object, in this case cold metal bleachers.

What is the term for when the fetus and placenta deliver before the 28th week of pregnancy?

Spontaneous abortion CORRECT. A spontaneous abortion is when the fetus and placenta deliver before the 28th week of pregnancy. It is more commonly known as a miscarriage.

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

Sterile CORRECT. Most open wounds are treated with dry, sterile dressings.

Which of the following bones is found in the chest?

Sternum CORRECT. The sternum is also called the breastbone and is found in the chest.

Which of the following is an injury to the musculature of an extremity?

Strain CORRECT. A strain is an injury to the musculature of an extremity.

What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax with each breath?

Sucking chest wound CORRECT. A sucking chest wound is an open chest wound in which air is "sucked" into the chest cavity with each breath.

You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first action?

Suction the airway. CORRECT. This patient needs an oral airway because he is unresponsive, as well as high-concentration oxygen by bag-valve mask because of his respiratory status; however, the first priority is to suction out the blood in the airway in order to clear it for adequate ventilation and to minimize the chances of aspiration.

You respond to a professional volleyball tournament for a potential heatstroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping?

Sweating too much CORRECT. The patient is suffering from heat cramps and not heatstroke. The muscles are cramping because the body has lost too many essential electrolytes (salts) by profuse sweating.

You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make note that the occupants of both vehicles are outside, and you request additional units to proceed non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During secondary assessment of past medical history, you make note of several important details: the patient is on high blood pressure medications, and has had a heart attack in the past. He is complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may have been from the seat belt, but is refusing care and transport. The patient did not lose consciousness. Based on this information, which transport decision would be most appropriate for this patient?

Take the patient to a local community hospital. CORRECT. This patient is hemodynamically stable and can go to a local community hospital for soreness.

Which of the following describes the proper application of an occlusive dressing for an open chest wound?

Tape the dressing securely on three sides. CORRECT. An occlusive dressing should be taped on 3 sides securely to seal the chest.

What are three elements of successful trauma care that field practitioners can use which will ultimately translate into greater rates of survival?

Teamwork, timing, and transport CORRECT. Greater rates of survival are improved with teamwork, timing, and transport.

Which one of the following definitions is NOT true?

Tendons connect muscles to ligaments. CORRECT. Tendons are tissues that connect muscle to bone, not muscles to ligaments.

A patient with jugular vein distention (JVD) is most likely suffering from which of the following injuries?

Tension pneumothorax

Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and transport?

Tension pneumothorax CORRECT. Due the chest cavity being filled with air under pressure, the patient with a tension pneumothorax is at the greatest risk for going into respiratory failure as a result of the injury.

A new EMT who is treating a suspected femur injury asks his partner, "How much traction should I pull?" The partner's BEST reply is which of the following?

The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds. CORRECT. The correct response to the new EMT is the amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds.

Regarding drowning in adults, which of the following statements is true?

The colder the water, the better the chances of survival in either saltwater or freshwater drowning. CORRECT. The colder the water, the better for survival, regardless of whether salt or fresh water.

Which of the following is true concerning a stillborn baby?

The death may occur weeks before delivery. CORRECT. The death of a stillborn baby may have occurred weeks before delivery.

Your patient is a 26-year-old female with a history of ectopic pregnancies. She has called 911 for extreme abdominal pain and she is concerned that she has another ectopic pregnancy. Her vital signs are pulse 118, respirations 20, and blood pressure 100/76. Which of the following is true regarding ectopic pregnancies?

The fallopian tubes cannot stretch to accommodate a fetus. CORRECT. Unlike the uterus, fallopian tubes cannot expand with development of the fetus and are vulnerable to rupture and severe bleeding. Ectopic pregnancies usually occur very early in the pregnancy, often before the woman knows she is pregnant. Normal development occurs when the fertilized egg implants in the uterus.

You have just delivered a full-term baby girl and she is doing well. You have dried her off and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the following is normally true regarding cutting the umbilical cord?

The infant must be breathing on his or her own before you cut the cord. CORRECT. Normally, the infant begins crying immediately after birth and the cord is cut after you dry the baby off, usually within the first minute after birth. If the baby does not begin crying and is not breathing, you may have to expedite cutting the cord so you can perform resuscitation.

Which of the following is true concerning prehospital delivery of twins?

The infants will probably be smaller than a single infant and need attention in keeping them warm. CORRECT. In a twin delivery the infants will probably be smaller than a single infant and care must be taken to maintain warmth of the twins.

You're an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated county road. It appears the patient was unrestrained, or not wearing a seat belt, and struck the steering wheel with his chest. On assessment, you notice a paradoxical motion to the patient's chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include?

The patient may have a flail chest.

You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find a 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are cervical spine precautions necessary?

The patient may have suffered a spinal injury by jumping in shallow water. CORRECT. Cervical spine injury is a potential concern with any drowning, especially in adults. Since the patient is unresponsive, cervical spine precautions must be undertaken. The patient is more likely to suffer a spinal injury jumping or diving in shallow water versus deep water.

Which of the following statements concerning a concussion is true?

The patient may not have any symptoms of the injury. CORRECT. In a concussion, the patient may have no symptoms of the injury.

Which of the following BEST describes placenta previa?

The placenta is implanted over the opening of the cervix. CORRECT. When the placenta is implanted over the opening of the cervix, it is deemed placenta previa.

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 his 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?

The possibility of a pneumothorax CORRECT. Due to the mechanism of injury, the potential of internal injuries like a pneumothorax is the greatest concern.

Which of the following is a true statement regarding the skin's status in the case of a closed chest injury?

The skin is not penetrated. CORRECT. In a closed chest injury, the skin is not penetrated.

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

The use of Standard Precautions by the EMT CORRECT. All open soft-tissue injuries should alert the EMT to use standard body substance isolation (BSI) precautions such as gloves.

Which of the following observations may the EMT use to rule out a spinal injury in a trauma patient?

There is a lack of mechanism of injury. CORRECT. The mechanism of injury (MOI) is a reliable indicator of spinal injury in the trauma patient.

Which of the following is a common sign of a pre-delivery emergency?

There is profuse vaginal bleeding. CORRECT. Profuse vaginal bleeding is not normal and is a sure sign of a pre-delivery emergency.

Why are infants and young children more prone to hypothermia than adults?

They have less fat than adults. CORRECT. Infants and young children have less muscle mass and body fat in relation to their overall skin surface area. This lack of insulation makes them more prone to hypothermia.

Which of the following BEST describes the events that occur during the first stage of labor?

Thinning and dilation of the cervix CORRECT. The thinning and dilation of the cervix is during the first stage of labor.

To which of the following sections of the spine are the ribs attached?

Thoracic CORRECT. There are 12 thoracic spinal vertebrae (to which the ribs attach).

Which of the following is the correct sequence for securing the straps on a long spine board?

Torso, legs, head CORRECT. The correct sequence for securing the straps is the torso, legs, and then the head.

Which of the following types of bandages should NOT be used by the EMT providing wound care?

Tourniquet CORRECT. A tourniquet is not a type of bandage and is only used as a last resort to stop bleeding if direct pressure and pressure bandaging does not work.

Which of the following is an unreliable sign for determining the presence of a tension pneumothorax?

Trachea that shifts to the side opposite the injury CORRECT. In a tension pneumothorax the trachea may shift to the opposite side, but this is a very late sign and one which is difficult to detect, making it an unreliable sign.

You respond to a boat dock for a diving injury. You find a 22-year-old female patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when she unexpectedly came out of the water complaining of chest pains and then collapsed. The nearest hospital is 25 minutes away and the nearest specialty resource center with a hyperbaric chamber is 30 minutes away. What is the best decision when determining transport?

Transport the patient by ground to the specialty center. CORRECT. The patient needs definitive treatment at a specialty center that can provide advanced services such as hyperbaric treatment. The need for the specialty treatment outweighs the 5 minutes saved by going to the nearest facility.

You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you're making the decision to transport. Which of the following BEST encapsulates the correct strategy for transport?

Transport the patient emergently because of the high index of suspicion for a serious injury. CORRECT. The patient should be transported emergently because of the high index of suspicion of serious injury.

Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered?

Traumatic asphyxia CORRECT. The bluish appearance and bloodshot eyes suggest the increased pressure build up in the chest causing the blood to back up from the right atrium into the head, neck, and face.

Which of the following measures is NOT appropriate for a patient with a significant isolated head injury?

Treat for shock by elevating the foot of the backboard. CORRECT. The raising of the foot of the backboard is no longer accepted as a means for treating shock in a head trauma patient.

While treating a pregnant trauma patient, which of the following is the BEST way to keep the fetus alive?

Treat the patient as any other trauma patient. CORRECT. The patient must be treated the same as any other trauma patient since the mother must survive for the fetus to have any chance of surviving.

Which patient is the most unstable?

Unresponsive patient with hypotension CORRECT. All of the patients would be categorized as unstable and triaged red based on their altered level of consciousness. Tachycardia is the body's way to compensate for injury and shock. The unresponsive patient who is hypotensive cannot protect his or her airway and is no longer able to compensate for the traumatic injuries. He or she is now in decompensated shock and is the most unstable.

The maxillae form which of the following structures?

Upper jaw CORRECT. The upper jaw is referred to as the maxillae.

Your patient is a 16-year-old male who ran his truck off of the road and into a ditch. He was driving just fast enough to cause the air bag to deploy when he hit the ditch. He is complaining of some neck and shoulder pain. His vital signs are respirations 20, pulse 110, blood pressure 116/80, and pupils equal and reactive. How should you manage this patient?

Use a short spine board or vest device, then transfer him to a long spine board. CORRECT. This patient is stable enough for you to use an extrication vest or short spine board to immobilize him before moving him to a long spine board. There doesn't appear to be anything urgent requiring you to perform a rapid extrication.

If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first?

Use your fingers to tear the sac away from the baby's face. CORRECT. If the sac is delivered intact, the EMT should use the fingers to tear the sac away from the baby's face.

Your patient has had his throat slashed during a robbery attempt. You are concerned since it is apparent that the vessels in his neck have been lacerated. A breach in which of the following vessels would be most likely to lead to an air embolism?

Veins CORRECT. In this scenario, your biggest concern is for the carotid veins since they may have pressure that is lower than atmospheric pressure.

Rough handling of a patient with severe hypothermia may result in which of the following?

Ventricular fibrillation CORRECT. Rough handling of a patient with severe hypothermia may result in ventricular fibrillation.

Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following?

Vinegar CORRECT. Vinegar will reduce the pain of a marine animal sting through rinsing of the area.

At which point may manual stabilization of the cervical spine be terminated?

When the patient is secured to a long backboard CORRECT. Termination of cervical spine immobilization may be terminated when the patient is secured to a long backboard.

The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors?

White or lighter CORRECT. Blanching means the skin turns white or lighter.

Which of the following is NOT used to calculate a patient's GCS?

Work of breathing CORRECT. Work of breathing is not part of the calculation of the GCS scale.

Which of the following is appropriate when caring for a premature baby?

Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F CORRECT. When caring for a premature baby it is important to wrap the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F.

You respond to a patient who was hit in the face with a chair. Upon arrival, you notice a patient leaning in the corner and bleeding profusely from the mouth and nose. Your first action should be which of the following?

You respond to a patient who was hit in the face with a chair. Upon arrival, you notice a patient leaning in the corner and bleeding profusely from the mouth and nose. Your first action should be which of the following?

You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is in your estimation about 8 months pregnant. She tells you that she has been hiding her pregnancy. You are especially concerned about problems she might have during the delivery. Which of the following are findings that may indicate the need for neonatal resuscitation?

Young mother who has not had prenatal care CORRECT. A mother who has not seen an obstetrician and has no idea regarding her health or the health of her unborn baby is at an increased risk. Additionally, she probably has not been taking prenatal vitamins or managing any preexisting medical conditions. Very young women and older women are at higher risk of delivering distressed newborns.

Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming.

active CORRECT. Applying an external source of heat to the patient's body to rewarm him is called active rewarming.

While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated with:

aortic dissection. CORRECT. Aortic dissection may cause blood pressures and pulse pressures that are different bilaterally and also from upper and lower extremities.

A teenage male has fallen onto a railing while skateboarding. He complains of right-sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. You should:

apply a bulky dressing over the section. CORRECT. This patient probably has a flail segment. The appropriate management for a patient with a flail segment that is breathing adequately is to apply a bulky dressing and secure it with tape. Positive pressure ventilation is difficult in a conscious patient who is breathing adequately, and an occlusive dressing would not help this patient.

The part of the skeleton that is made up from the skull and spinal column is called the:

axial skeleton. CORRECT. The axial skeleton is made up of the skull and the spinal column.

When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has:

been rewarmed. CORRECT. When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has been rewarmed.

You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search and rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is to:

bandage the digits. CORRECT. Bandaging the digits gently will protect them and minimize handling until they can be treated by a physician.

Your patient is a 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should:

begin chest compressions. CORRECT. The scenario suggests that this patient has suffered commotio cordis. The appropriate treatment for this patient is the same as any other pulseless arrest where the patient has been down for over 5 minutes. Chest compressions should begin immediately followed by application of the AED. Elevation of the patient's legs and backboarding prior to chest compressions will delay lifesaving care.

You are treating a patient with paradoxical motion on the left side of the chest. He is breathing shallow at a rate of 4 breaths per minute. You should:

begin positive pressure ventilation. CORRECT. This patient is not breathing adequately and needs to be ventilated. The presence of paradoxical motion indicates that he could have a flail segment, which would be treated with a bulky dressing if the patient were breathing adequately.

The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fill adequately, usually secondary to trauma.

cardiac tamponade CORRECT. When an injury to the heart causes blood to flow into the surrounding pericardial sac, the condition produced is cardiac tamponade. The heart's unyielding sac fills with blood and compresses the chambers of the heart to a point where they will no longer adequately fill, backing up blood into the veins.

Your patient has been injured by a fall down a flight of steps. He is alert and oriented but complains of back and neck pain. You spinal immobilize him on a long spine board with a cervical collar on his neck as a precaution because you know that the:

cervical spine is the most vulnerable part of the spine. CORRECT. The cervical spine is the most vulnerable part of the spine. The cervical and lumbar vertebrae are susceptible to injury because they are not supported by other bony structures, whereas the thoracic spine is protected somewhat by the ribs. The coccyx is fused and is less prone to injury except with a direct blow.

The mechanism of injury in which a patient's chest has struck an immovable object, such as a steering wheel, may most accurately be described as a(n):

compression injury. CORRECT. Compression injuries develop from severe blunt trauma in which the chest is rapidly compressed, such as when a driver strikes his chest on the steering column or when a person is trapped in a trench-wall collapse. The key is the internal chest organs are compressed between the sternum, ribs, and vertebra.

Your patient has an open abdominal wound with intestines protruding. You should:

cover the organs with moist sterile dressings. CORRECT. Abdominal organs that are protruding from an open wound should be covered with moist sterile dressings and then an occlusive dressing. It is important to keep the organs moist and clean. EMTs should never manipulate eviscerated abdominal organs. Blankets are good for keeping abdominal organs warm after the initial care is given.

You have covered an open chest wound with your gloved hand and the patient's breathing has improved. In order to free your hand to provide further care, you should:

cover the wound with an occlusive dressing. CORRECT. Open chest wounds should be covered with an occlusive dressing to prevent air from being drawn into the chest. In an emergency, a gloved hand may be used temporarily to close the wound. However, eventually a dressing must be applied to free the EMT to provide further care. Although it is important for the dressing to be sterile, it is essential that the dressing does not allow air to pass through the wound. A bulky dressing will probably not be needed to control bleeding and it will not prevent air from being sucked into the chest. Even if the wound has closed on its own, you should still apply an occlusive dressing in case the wound opens again.

The strong white fibrous material called the periosteum:

covers the bones. CORRECT. The strong white fibrous material covering the bone is called the periosteum.

The sound or feeling of the ends of broken bones rubbing together is called:

crepitus. CORRECT. Grating or crepitus is a sound or feeling caused by broken bone ends rubbing together.

The term gangrene means tissue:

death. CORRECT. Gangrene means tissue death.

You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsing mass. You should:

defer further abdominal palpation. CORRECT. A pulsing mass in the abdomen may indicate an aortic injury. Once it is palpated initially, it should not be reassessed again in the field. This patient needs to be transported to a trauma center immediately.

You are called for a woman with severe abdominal pain. During your assessment and interview, she tells you that she is sexually active and there is a chance she could be pregnant. Her vital signs are pulse 122, respirations 22, blood pressure 96/62, and skin cool and pale. You should immediately suspect:

ectopic pregnancy. CORRECT. As the saying goes, "Any woman of childbearing age with abdominal pain has an ectopic pregnancy until proven otherwise by the physician in the emergency department." Yes, the woman is likely suffering from internal bleeding, but the best answer is ectopic pregnancy as the cause of the internal bleeding. With this patient, the other causes of internal bleeding are unlikely.

The term for a baby developing inside the mother's womb after week 8 is:

fetus. CORRECT. The fetus is the term for the baby after 8 weeks of development until delivery.

Your pregnant patient is in active labor. You note that her contractions are getting closer together and much stronger as the baby moves deeper into the birth canal. The muscle contraction mechanism that moves the baby toward birth is the same mechanism that moves:

food from the esophagus to the stomach. CORRECT. Peristalsis moves the egg through the fallopian tubes to the uterus. It also moves the baby out of the uterus into the birth canal, culminating in childbirth.

You have been called for a 32-year-old female who is in active labor. During your assessment and interview, you note that she is 37 weeks along, this is her first child, and her contractions are 5 minutes apart. She also tells you that her pregnancy is considered "high risk." Your first concern should be:

getting to the hospital. CORRECT. Much of your assessment of a woman in labor will be geared toward making a decision on whether to transport her or to prepare for an immediate delivery. This is her first child and contractions are 5 minutes apart, so it may be some time before she delivers. If at all possible, you want this high-risk pregnancy to deliver in a hospital.

You are getting ready to transport an unresponsive 25-year-old female patient. She was hit by a vehicle while crossing the street. She is 26 weeks pregnant. You are 10 minutes away from the nearest facility, 15 minutes away from a Level I Trauma Center, and 15 minutes away from a hospital that specializes in high-risk obstetrics. You should transport the patient to which hospital?

he trauma center: the patient will need specialized trauma surgeons CORRECT. The patient is pregnant and the victim of a multisystem trauma. She and her unborn child need specialized experts. The extra 5 minutes to get to a specialized hospital that can handle her multiple issues far outweigh any benefits she may gain by getting to a hospital that cannot adequately treat her. The number one cause of death of the fetus is the death of the mother; therefore, the mother is the priority. Level I Trauma Centers are equipped to not only deal with the mother's issues but her unborn child's as well.

You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry, but his shirt is wet with visible salt rings. You suspect:

heat exhaustion. CORRECT. The patient is not experiencing any cramping at this time, so heat cramps is not the correct answer. The salt rings on the shirt indicate that the patient may be hyponatremic, not hypernatremic. The patient's vital signs and physical exam indicate that the patient is in decompensated hypovolemic shock. Although a myocardial infarction is a possibility, it would not cause the patient to be in hypovolemic shock. Heat exhaustion will cause decompensated hypovolemic shock when the body sweats out too much fluid in an attempt to cool the body.

Localized cold injury occurs due to vasoconstriction and:

ice crystal formation in the tissues. CORRECT. Localized cold injury occurs due to vasoconstriction and ice crystal formation in the tissues.

Your 38-year-old male patient has been injured in an assault. He has several facial lacerations and a large knot on his head. Bystanders say that he was thrown over a large table and landed on his head and shoulder. As part of your scene size-up and primary assessment, you should:

immobilize his cervical spine. CORRECT. Since the patient has sustained a probable head injury after landing on his head and shoulder, you should immobilize his cervical spine as a precaution. Any blunt trauma above the clavicles may damage the cervical spine. Manual stabilization is taken during the scene size-up and full immobilization applied as soon as practical.

Common signs and symptoms following an injury to a hollow abdominal organ include:

irritation and peritonitis. CORRECT. A ruptured hollow organ would cause irritation and peritonitis.

You respond for an imminent delivery of a baby in the breech position. As you examine the mother, you see that the umbilical cord is protruding from the opening of the cervix. You realize that the most important care you can provide for this baby is to:

keep the baby off of the cord. CORRECT. Insert several fingers of your gloved hand into the mother's vagina so that you can gently push up on the baby's head or buttocks to keep pressure off of the cord. You will be pushing up through the cervix. This may be the only chance that the baby has for survival.

You are treating a 35-year-old male patient that has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient's presentation is most likely caused by which of the following?

neurogenic shock CORRECT. The hypotension and lack of bradycardia and tachycardia in this scenario may point to neurogenic shock rather than increased intracranial pressure and blood loss due to trauma.

Your patient has a suspected cervical spine injury from falling from a rope swing. His vital signs are pulse 62, respirations 20, and blood pressure 90/56. He has no feeling below his mid-chest area but is able to breathe on his own. You should suspect:

neurogenic shock. CORRECT. With a low spine injury, the body loses control over the smooth muscle that regulates the size of blood vessels. The vessels increase in size as they lose muscle tone, but the amount of blood inside the vessels remains the same, so the patient's blood pressure plummets. The nerve impulses that send the message to the brain to constrict the blood vessels are unable to get past the injured area.

Your patient is a 16-year-old centerfielder on his high school baseball team. He was injured when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to tell you what happened. His vital signs are pulse 88, blood pressure 132/86, respiratory rate 16, and pupils equal. As you assess his head, you do not see any cuts or bleeding, but you feel a spongy, depressed area over his left ear. You should suspect a(n):

open head injury. CORRECT. It appears that the boy has an open head injury evidenced by the spongy, depressed area of the skull. The broken area allows for a little more external swelling, which may lessen the immediate signs of a brain injury.

Blood at the meatus of the penis (opening of the urethra) is a sign of:

pelvic trauma/fracture. CORRECT. Blood from the male urethra is a sign of pelvic trauma/fracture.

Your pregnant patient is in active labor. She has been lying on her back throughout her labor and is experiencing signs and symptoms of shock. Her vital signs are pulse rate 118, respirations 22, blood pressure 96/62, and skin cool and diaphoretic. The BEST way to treat her is to:

place a rolled blanket under her left hip to displace the uterus. CORRECT. The drop in blood pressure and her skin signs signal shock, but traditional methods of treating shock (hypoperfusion) will not be effective in this instance. Her shock has developed because of her body positioning. Correct that problem and the shock should be self-correcting.

When delivering a baby, you should do all of the following except:

place your fingers in the armpit to assist with delivery of the shoulders. CORRECT. The EMT should not place their hands in the infant's shoulders to assist with delivery of the shoulders.

You find a middle-aged male is sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should:

place your gloved hand over the wound. CORRECT. This patient has a wound that is immediately life threatening, making quick action vital. Placing your gloved hand over the wound will stop air from entering the chest. An occlusive dressing is appropriate but it takes time to apply. A trauma dressing would not stop air from entering the chest. Supplemental oxygen will be needed in this patient, but his ventilation must be attended to first.

You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8 months pregnant and has moderate, bright red bleeding. She says that her doctor was concerned about the location of the placenta. This condition is known as:

placenta previa. CORRECT. In placenta previa, the placenta has attached very low in the uterus near or over the cervix. When the cervix begins stretching and moving, it may disrupt the placenta, causing bleeding.

You respond to a call for a patient in active labor with her second child. Your interview with the patient shows that she is 40 weeks pregnant and has been in active labor for several hours. You determine that her vital signs are all within normal limits. After your physical exam, you determine the baby is crowning. You should next:

prepare to deliver the baby on-scene. CORRECT. With obvious crowning, you should immediately prepare to deliver the baby on-scene. The baby will deliver with or without you, so get your equipment ready.

All of the following are signs of adequate breathing and circulation in the newborn except:

relaxation of the extremities. CORRECT. Relaxation of the extremities is a sign that adequate circulation and breathing is not occurring in the infant.

Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long spine board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You should:

remove the helmet to better manage proper alignment. CORRECT. Anytime you are unable to secure the airway or maintain proper cervical alignment, you should carefully remove the patient's helmet. If the helmet allows for excessive movement or the patient is in the presence of cardiac arrest, you should remove the helmet.

Some drawbacks to using sterile aluminum foil as an occlusive dressing include:

skin lacerations may occur from the sharp edges. CORRECT. Aluminum foil may cause skin lacerations from the sharp edges when used as an occlusive dressing.

Which one of the following statements is NOT true?

tendons are bands of connective tissue that bind the ligaments to muscles. CORRECT. Tendons are bands of connective tissue that bind the muscles to bones.

You have responded to a woman who has possible premature labor. She is 8 months pregnant and is experiencing labor pains. During your assessment, you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You should next:

time her contractions. CORRECT. You should time her contractions. When her contractions last 30 seconds to 1 minute and are 2 to 3 minutes apart, delivery of the baby may be imminent. If delivery is imminent, in most cases, you will stay on-scene and deliver the baby.

The muscular organ in which a baby develops during pregnancy is called the:

uterus. CORRECT. The uterus is the muscular organ in which the baby develops during pregnancy.

When a patient has a serious open wound to the neck, you are concerned about the possibility of an air embolism. The reason an air embolism can occur is because of:

vessel pressure that is lower than atmospheric pressure. CORRECT. When vessels in the neck are damaged and bleeding, the lower pressure in the vessel may allow air from the outside to be sucked into the vessel. This can lead to a dangerous air embolism, which may migrate to the heart or lungs.

A pillow is frequently used to splint an ankle or foot injury. It is effective, rapid, and can be used for most patients. Its main weakness is:

you are not immobilizing the knee and the joint adjacent to the ankle. CORRECT. Soft splinting an ankle or foot is effective and rapid. A pillow is a standard piece of equipment on most ambulances. It requires only two people to apply. Most splints require only two people. Pulses are accessible after application. However, a commercial splint with a foot and leg that extends above the knee may be better than a pillow since it will also immobilize the knee, the joint adjacent to the ankle.