PHS EMT Block 3 Exam

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

14

You arrive at a residence approximately 20 minutes after a 7-year-old boy, who weighs 22 kg, ingested a bottle of Advil. He is conscious and alert and has stable vital signs. Medical control orders you to administer activated charcoal and oxygen and then transport the child at once. The appropriate maximum dose of activated charcoal for this child is:

44 g

Which of the following patients has experienced the MOST significant fall?

4′6″ patient who fell 13′

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:

7

Which of the following statements regarding agonal respirations is correct?

Agonal respirations are ineffective and need to be assisted.

Which of the following statements regarding crush syndrome is correct?

Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

Which of the following statements regarding glucose is correct?

Glucose is a simple sugar that is readily absorbed by the bloodstream.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:

Identify contact points and predict potential injuries

Which of the following statements regarding abdominal trauma is correct?

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

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

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.

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

a poorly placed lap belt

A flail chest occurs when:

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

Pneumothorax is defined as:

accumulation of air in the pleural space.

A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:

administer high-flow oxygen.

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.

Patients develop septic shock secondary to:

an infection that weakens cardiac contractions.

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:

apply direct pressure over the wound.

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

apply direct pressure to the wound

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

arterioles

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:

assess for a carotid pulse for up to 45 seconds. ??

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. 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 was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:

assist the patient's ventilations

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

assisted ventilation, thermal management, and elevation of the lower extremities

An EMT may administer aspirin to a patient if:

authorization from medical control has been obtained.

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should:

avoid applying pressure to the globe when you are covering the eye.

When worn properly, a seatbelt should lie

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

Which of the following sets of vital signs depicts Cushing's triad?

blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

The central nervous system (CNS) is composed of the:

brain and spinal cord.

The _________ contain(s) about 75% of the brain's total volume.

cerebrum

The five sections of the spinal column, in descending order, are the:

cervical, thoracic, lumbar, sacral, and coccygeal.

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:

clean the wound and apply a dry, sterile dressing.

The germinal layer of the epidermis contains pigment granules that are responsible for skin:

color

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:

compartment syndrome.

Rapid deceleration of the head, such as when it impacts the windshield, causes:

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?

compression of the head against the roof

A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should:

control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.

All of the following snakes are pit vipers, EXCEPT for the:

coral snake

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:

cover both of his eyes and transport to the hospital.

Drowning is MOST accurately defined as:

death from suffocation after submersion in water

Burns are classified according to:

depth and extent

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

direct pressure using dry, sterile dressings

The disruption of a joint in which the bone ends are no longer in contact is called a:

dislocation

Which of the following musculoskeletal injuries would MOST likely result in deformity?

displaced fracture

A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the:

distal forearm.

The tough, fibrous outer meningeal layer is called the:

dura mater

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

A spontaneous pneumothorax would MOST likely occur as the result of:

exertion of a person with a congenital lung defect.

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

As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells

fibrinogen

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:

follow appropriate 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.

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:

hot, dry skin.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a non-rebreathing 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 bag-mask device.

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.

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:

intracranial bleeding

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

leaning him forward and pinching his nostrils together.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

level of consciousness.

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

liver

A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect:

liver dysfunction

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:

load him into the ambulance and begin rapid cooling interventions

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

lungs

When a patient experiences a severe spinal injury, he or she:

may lose sensation below the level of the injury.

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

move him as a unit to a supine position.

An abdominal evisceration

occurs when organs protrude through an open wound.

Early signs and symptoms of intra-abdominal bleeding include:

pain and distention.

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. Appropriate treatment for this patient includes:

pinching the patient's nostrils and having him lean forward.

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:

place additional dressings over the wound

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

When immobilizing a child on a long backboard, you should:

place padding under the child's shoulders as needed.

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 applying 100% oxygen, you should:

prepare for immediate transport

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:

preparing for immediate transport

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

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant:

remains in motion until acted upon by an external force.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

replace the avulsed flap to its original position and cover it with a sterile dressing

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

requires prompt ventilation and oxygenation.

Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients?

seesaw breathing

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

slow

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

During your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:

stabilize the chest wall with a bulky dressing.

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should:

stop twisting the stick when the bleeding stops

Frequent reassessments of the patient with face or neck injuries are MOST important because:

such injuries can affect the respiratory system.

A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should

suction her oropharynx for 15 seconds.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

suction his oropharynx for up to 15 seconds.

Common signs of a skull fracture include all of the following, EXCEPT:

superficial scalp lacerations

If one or more occupants in the same vehicle are killed in a crash, the EMT should:

suspect that all living occupants experienced the same serious trauma

Deformity caused by a fracture would MOST likely be masked by:

swelling

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with:

the fact that her clinical signs could indicate that she is bleeding internally.

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.

Functions of the skin include all of the following, EXCEPT:

the production of key antibodies.

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:

traumatic aortic rupture

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

When caring for a patient with an open facial injury, the EMT must:

wear gloves and facial protection

Force acting over a distance defines the concept of:

work.

The index of suspicion is MOST accurately defined as:

your concern for potentially serious underlying injuries.