MOD 4 Exam

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ___ of blood is lost.

100 mL

A 21 year old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover ___ of his BSA.

18%

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

The phrenic nerves control the diaphragm and exit the spinal cord at:

C3, C4, and C5

Which of the following statements regarding compartment syndrome is correct?

Compartment syndrome typically develops within 6 to 12 hours after an injury but can begin in as little as 4 hours.

Which of the following statements regarding secondary brain injury is correct?

Hypoxia and hypotension are the two most common causes of secondary brain injury

Following blunt trauma to the face, a 21 year old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:

a blowout fracture

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced:

a detached retina

The mesentary is:

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

In which of the following patients should you remove an impaled object?

a pulseless and apneic patient with a knife impaled in the back

A flail chest occurs when:

a segment of the chest wall is detached from the thoracic cage

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:

a tourniquet proximal to the injury

Blood stasis, changes in the vessel wall, and certain medications affect the:

ability of the blood to effectively clot

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?

abrasion

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by:

acting as a shock absorber for the brain and spinal cord

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:

administer oxygen and transport to the hospital

A 37 year old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway

An open pneumothorax occurs when:

air enters the pleural space from outside the body.

The MOST significant complication associated with facial injuries is:

airway compromise

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:

an air embolism

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?

aortic rupture

Which of the following is most likely to cause immediate death?

aortic rupture

If applying a dressing to control the bleeding of a patient's arm, the EMT should:

apply direct pressure first, use large or small gauze pads or dressings depending upon the size of the would, and cover the entire wound, above and below, with the dressing

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound

Most cases of external bleeding from an extremity can be controlled by:

applying local direct pressure

Injuries to the external male genitalia:

are rarely life-threatening

With regard to musculoskeletal injuries, the zone of injury is defined as the:

area of soft-tissue damage surrounding the injury

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:

arterioles

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:

assess distal circulation and readjust the bandage as needed

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17 year old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of the injury. You should:

assess distal pulse, motor, and sensory functions

A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:

assess for an exit wound

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As you partner is assessing and managing his airway, you should control the obvious bleeding and then:

assess for any additional penetrating wounds

During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should:

assist ventilations with a bag-valve mask

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

assume that the arrow injured an internal organ

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

avoid excessive pressure when applying the bandage

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:

axial loading

Which of the following MOST accurately describes septic shock?

bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Your documentation on a sexual assault victim should:

be objective and factual

When worn properly, a seatbelt should lie:

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

Bone marrow produces

blood cells

When assessing a patient with signs and symptoms of shock, it is important to remember that:

blood pressure may be the last measurable factor to change in shock

An organ or tissue may be better able to resist damage from hypoperfusion if the:

body's temperature is considerably less than 98.6*F (37.0*C)

The ___ is the best-protected part of the CNS and controls the function of the cardiac and respiratory systems.

brain stem

A fracture is MOST accurately defined as a(n):

break in the continuity of the bone

When caring for a patient whose arm is covered with a dry chemical, you should:

brush away the chemical before flushing with water

A 56 year old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

cardiogenic hypoperfusion

A 56 year old man is found semiconscious by his wife. Your assessment reveals respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

cardiogenic hypoperfusion

Pulmonary edema and impaired ventilation occur during:

cardiogenic shock

When caring for a patient with a possible fracture of the scapula, the EMT should:

carefully assess the patient for breathing problems

Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:

check her airway for obstructions

Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT:

collapsed jugular veins

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called:

compensated shock

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the:

conjunctiva

A 30 year old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

conjunctivitis

A 54 year old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance would to the medical aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

control the bleeding and cover the wound with a sterile dressing

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):

contusion

A 33 year old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how should you care for his wound?

cover it with moist, sterile gauze and secure with an occlusive dressing

Air bags are designed to:

decrease the severity of deceleration injuries

The MOST significant hazard associated with splinting is:

delaying transport of a critically injured patient

You are dispatched to a residence for a 40 year old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted

The thoracic cavity is separated from the abdominal cavity by the :

diaphragm

Bleeding form soft-tissue injuries to the face is MOST effectively controlled with:

direct pressure using dry, sterile dressings

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

distention

The tough, fibrous outer meningeal layer is called the:

dura mater

Which of the following areas of the body has the thinnest skin?

ears

When should nonlifesaving interventions be performed for your multisystem trauma patient?

en route to the hospital

A 12 year old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back, What injury mechanism is MOST likely responsible for his back pain?

energy transmission to the spine

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

engorged jugular veins

Following blunt force trauma to the left anterior chest, a 25 year old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

engorged jugular veins

Which of the following statements regarding electrical burns is correct?

entrance wounds are small relative to the amount of internal tissue damage

What layer of the skin forms a watertight, protective seal for the body?

epidermis

A(n) ___ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.

epiphyseal

The Glasgow Coma Scale (GCS) is used to assess:

eye opening, verbal response, and motor response

Neurogenic shock occurs when:

failure of the nervous system causes widespread vasodilation

Two of the MOST common mechanisms of injury for blunt trauma are:

falls and motor vehicle collisions

In which of the following situations would external bleeding be the MOST difficult to control?

femoral artery laceration and a blood pressure of 140/90 mm Hg

A 39 year old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first:

follow appropriate standard precautions

A 27 year old man was stabbed in the chest during a disagreement at a poker game. As you approach him, you see a knife impaled in his chest. Before you begin treatment, it is MOST important to:

follow standard precautions

A 52 year old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:

fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport

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

guarding

When a patient stiffens the muscles of the abdomen, it is known as:

guarding

The cervical spine is MOST protected from whiplash-type injuries when the:

headrest is appropriately positioned

Gastrointestinal bleeding should be suspected if a patient presents with:

hematemesis

A sign of kidney damage following blunt trauma is:

hematuria

In a patient with a head injury, hypertension, bradycardia, and Biot respirations indicate:

herniation of the brain stem

A 70 year old man presents with a severe nosebleed. His medical history includes COPD, depression and a hemorrhagic stoke 3 years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today?

high blood pressure

In an acute injury setting, neurogenic shock is commonly accompanied by:

hypothermia

In which of the following situations should the EMT splint an injured limb in the position of deformity?

if resistance is encountered or the patient experiences severe pain

Compression injury is most likely due to which of the following?

improperly placed lab belt

When splinting an injury of the wrist, the hand should be placed:

in a functional position

Which of the following is true regarding injury to the kidneys?

injury to the kidneys usually indicated injury to other organs

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

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

instruct him to assist her ventilations while you perform a rapid assessment

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

intra-abdominal bleeding

Bleeding within the brain tissue itself is called a(n):

intracerebral hematoma

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

irregular rate, pattern, and volume of breathing with intermittent periods of apnea

Bleeding from the nose following head trauma:

is a sign of a skull fracture and should not be stopped

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:

is ejected or partially ejected

The cricoid cartilage:

is the only complete circular cartilage of the trachea

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

it causes a problem managing the airway

A tight-fitting motorcycle helmet should be left in place unless:

it interferes with your assessment of the airway

Which of the following statements regarding the vitreous humor is correct?

it is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost

When a light is shone into the pupil:

it should become smaller in size

Which of the following is of LEAST importance when initially assessing the severity of a burn?

known drug allergies

In pediatric patients, the liver and spleen are:

larger in proportion to the abdomen

Approximately 25% of severe injuries to the aorta occur during:

lateral collisions

A 29 year old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes:

leaning him forward and pinching his nostrils together

bones are connected to other bones by bands of tough fibrous tissues called:

ligaments

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

liver

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

liver

Which of the following organs or structures does NOT reside within the mediastinum?

lungs

The lower jawbone is called the:

mandible

The upper jawbones are called the:

maxillae

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the:

mechanism of injury

Atrophy is a condition that occurs when?

muscle decreases in size and function

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:

neck and facial injuries

Of the following muscoloskeletal injuries, which is considered to be the LEAST severe?

nondisplaced pelvic fracture

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status

Early signs and symptoms of intra-abdominal bleeding include:

pain and distention

You have sealed the open chest wound of a 40 year old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a ___ fracture

pathologic

The circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed:

perfusion

You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to:

peripheral vasocontriction

When a person is exposed to a cold environment:

peripheral vessels constrict and divert blood away from the skin

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

peritonitis may not develop for several hours

A 43 year old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:

pinching the patient's nostrils and having him lean forward

By what mechanism is a person injured when he or she falls from a significant height?

potential energy is converted to kinetic injury; the kinetic energy is then converted into the work of bringing the body to a stop

A 28 year old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:

prepare for immediate transport

Immediately life-threatening chest injuries must be found and managed during the:

primary assessment

A "hip" fracture is actually a fracture of the:

proximal femur

The opening in the center of the iris, which allows light to move to the back of the eye, is called the:

pupil

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:

pupillary constriction

When the speed of a motor vehicle doubles, the amount of kinetic energy:

quadruples

A 25 year old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival

rapid transport to a trauma center

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should:

rapidly assess the patient after ensuring that the power line is not live

A 6 year old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:

rapidly transporting her to the hospital

You are transporting a 33 year old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:

reassess his condition every 5 minutes

Early bruising following abdominal wall trauma often manifests as:

red areas of skin

When assessing a patient with a closed soft-tissue injury, it is MOST important to:

remain alert for more severe underlying injuries

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, you should:

remember that it could still deploy and seriously injure you

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:

report the incident to the appropriate authorities

A patient who presents with profound cyanosis following a chest injury:

requires prompt ventilation and oxygenation

The optic nerve endings are located within the:

retina

Which section of the heart receives deoxygenated blood?

right

Inadequate circulation of blood throughout the body is called:

shock

The presence of tachycardia following a significant abdominal injury:

should be assumes to be a sign of shock

Which of the following types of muscle is under direct voluntary control of the brain?

skeletal

Which of the following organs can tolerate inadequate perfusion for 2 to 3 hours?

skeletal muscle

What part of the nervous system controls the body's voluntary activities?

somatic

Significant trauma to the neck should increase the EMT's index of suspicion for a(n):

spinal column injury

Following blunt trauma to the abdomen, a 21 year old female complains of left upper quadrant abdominal pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:

spleen

When treating a trauma patient who is in shock, LOWEST priority should be given to:

splinting fractures

Internal bleeding into a fractured extremity is MOST often controlled by:

splinting the extremity

A 22 year old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

stabilize the head and perform a primary assessment

Which of the following statements regarding anaphylactic shock is correct?

subsequent exposure after sensitization often produces a more severe reaction

A burn that is characterized by redness and pain is classified as a:

superficial or first-degree burn

The severity of bleeding should be based on all of the following findings, EXCEPT:

systolic blood pressure

Patients with chest injuries will often present with:

tachypnea

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:

tendons

Which of the following statements regarding the dermis is correct?

the dermis contains hair follicles, sweat glands, and nerve endings

The ideal procedure for moving an injured patient from the ground to a backboard is:

the four-person log roll

An open fracture is MOST accurately defined as a fracture in which:

the overlying skin is no longer intact

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard

You arrive at the home of a 50 year old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration

Which of the following statements regarding abdominal eviscerations is correct?

the protruding organs should be kept warm and moist

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:

the skin

Which of the following statements regarding gunshot wounds is correct?

the speed of a bullet has the greatest impact on the injury produced

Which of the following statements regarding motor nerves is correct?

they carry information from the CNS to the muscles

Which of the following statements regarding anterior nosebleeds is correct?

they usually originate from the septum area and bleed slowly

The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:

transport to a trauma center

Anaphylactic shock is typically associated with:

urticaria

If your patient swallows blood following facial trauma, there is an increased risk of ________.

vomiting

Signs of compensated shock include all of the following, EXCEPT:

weak and absent peripheral pulses

When caring for a patient with an open facial injury, the EMT's immediate priority should be to:

wear gloves and facial protection

The index of suspicion is MOST accurately defined as:

your awareness and concern for potentially serious underlying injuries