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1st trauma exam

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The expectation that certain injuries or patterns of injuries have resulted to a body part, organ, or system based on the mechanism of injury and the force of impact to the patient is known as: A) c. Index of suspicion B) d. Mechanism of action C) a. Energy-related injury D) b. Index of energy transfer

The most critical factor in the survival of any severely injured patient is the: A) c. Time from incident to definitive care B) d. Type of protective factors employed C) b. Skills of trauma surgeons at the receiving hospital D) a. Presence of ALS providers at the scene

The patient was in a fight and sustained a laceration to his forearm. A bystander placed a tourniquet to the patient's forearm before the paramedic unit arrived. The patient does not have a pulse distal of the tourniquet. The best treatment for this patient is to: A) A. Leave the tourniquet in place. B) B. Loosen the tourniquet until a pulse is felt. C) C. Remove the tourniquet. D) D. Remove the tourniquet and then replace the tourniquet on a different area of the arm.

The pediatric assessment triangle consists of _________, ________, and _________. A) A. Appearance, breathing, circulation B) B. Appearance, breathing, color C) C. Appearance, breathing, mental statusc D) D. Body position, breathing, circulation

The release of which of the following substances starts the inflammatory phase of healing by dilating the capillaries? A) c. Histamine B) a. Fibrin C) d. Hydroxylysine D) b. Fibroblasts

There are currently four types of restraint systems used in motor vehicles in the United States. These systems include: A) b. Lap belt, shoulder restraints, air bags, and child safety seats B) c. Lap belt, shoulder restraints, head restraints, and air bags C) d. Lap belt, air bags, head restraints, and child safety seats D) a. Lap belt, shoulder restraints, head restraints, and child safety seats

To minimize the possibility of sound transmission from one side of the chest to the other, which of the following is the best location to assess the breath sounds of an infant? A) b. Axillary region B) c. Midclavicular region C) d. Posterior region D) a. Anterior region

Which of the following is a life-threatening injury in which the thorax is severely crushed, preventing ventilation? A) d. Traumatic asphyxia B) a. Hemopneumothorax C) c. Tension pneumothorax D) b. Pericardial tamponade

Which of the following is a normal compensatory response to the need for increased cardiac output or oxygen delivery? A) d. Tachycardia B) a. Atrial fibrillation C) b. Atrial flutter D) c. Bradycardia

Which of the following is considered tertiary prevention? A) d. Rehabilitation B) b. Public education C) c. Quality assurance D) a. A prehospital report

Which of the following is considered the most appropriate way to transport a stable 2-year-old child to the hospital? A) a. In a child safety seat B) c. On the stretcher with the attached belts C) b. On a backboard D) d. Sitting in his or her parent's lap

Which of the following is crucial in the treatment of the patient with a significant head injury? A) d. Repeat assessments B) b. Hyperventilation C) c. Intubation D) a. Administration of valium

Which of the following is one of the biggest concerns for the paramedic while caring for a victim with soft tissue injury? A) d. Exposure to bloodborne pathogens B) c. Disfigurement C) b. Debilitation from the injury D) a. Blood loss

Which of the following is the leading cause of death in children after infancy? A) d. Trauma B) b. Dysrhythmias C) a. Drowning D) c. Seizures

Which of the following is the least common type of trauma in the pediatric population? A) c. Penetration B) a. Blunt force trauma C) b. Cavitation D) d. Suffocation

Which of the following is true regarding the use of nasal airways in an infant or small pediatric patient? A) a. It does not allow adequate airflow. B) c. It is the preferred airway adjunct. C) b. It is placed in the left nares. D) d. It provides adequate airflow.

Which of the following methods of obtaining a temperature is considered the most accurate reflection of the patient's core body temperature? A) c. Rectal B) d. Tympanic C) a. Axillary D) b. Oral

Which of the following mnemonics is most useful in determining the possible causes of an altered mental status? A) d. TICLS B) a. AEIOU-TIPPS C) b. DCAP-BTLS D) c. SAMPLE

Which of the following processes is occurring when cells from the basal layer of the epidermis migrate across the damaged area of tissue, resulting in the regeneration of the epidermis? A) b. Epithelialization B) c. Hemostasis C) a. Coagulation D) d. Neovascularization

Which of the following should the paramedic consider regarding a projectile that fragments? A) a. Each piece of the fragmented projectile crushes its own path into the body. B) d. The fragments cause a temporary cavity that is considerably smaller. C) c. Low-velocity projectiles tend to fragment easier than high-velocity fragments. D) b. Exit wounds are very common with projectiles that break into fragments.

Which of the following would be considered part of the breathing assessment in the patient assessment triangle? A) a. Body position B) d. Skin color C) c. Muscle tone D) b. Mental status

Why is an occlusive dressing used for lacerations/wounds of the neck? A) c. Risk of developing an air embolus B) d. Risk of suffocation C) b. Risk of contamination D) a. Risk for an increase in infection

Within 3 days of injury, new blood vessels have begun to form through which of the following processes? A) d. Neovascularization B) b. Epithelialization C) a. Coagulation D) c. Hemostasis

You are assessing a 4-year-old patient who has been in a motor vehicle crash. Which of the following is considered a normal rate of breathing for this patient? A) c. 22 to 34 breaths/min B) a. 12 to 30 breaths/min C) d. 24 to 40 breaths/min D) b. 18 to 30 breaths/min

A patient was cut by several large shards of glass that blew out from a window during an explosion. This is an example of a: A) d. Tertiary blast injury B) c. Secondary blast injury C) b. Quaternary blast injury D) a. Primary blast injury

An example of a high-order explosive includes: A) a. Gun powder B) c. Nitroglycerin C) b. Molotov cocktail D) d. Pipe bomb

An injury victim with which of the following conditions would be at the highest risk for infection and complications? A) a. Chiari's malformation B) c. Rheumatoid arthritis C) b. Osteogenesis imperfecta D) d. Sickle cell anemia

Cavitation is: A) b. The breaking apart of a projectile as it passes through the body B) a. An opening produced by a force that pushes body tissue laterally away from the path of a projectile C) c. The end-over-end motion of a projectile D) d. Wind resistance experienced by a projectile

Children with special healthcare needs are particularly susceptible to which of the following medical problems? A) c. Lower extremity contractures B) a. Airway, breathing, and circulation C) b. Gastronomy tube complications D) d. Upper extremity contractures

During a lateral impact, if the damaged vehicle moves away from the impact: A) c. The victim sustains an up-and-over injury pathway B) d. The victim sustains torsion to the head, neck, and torso C) b. The victim sustains a down-and-under injury pathway D) a. The victim absorbs most of the impact from the collision

During the initial assessment of the patient described in question 79, you notice a penetrating chest wound. This wound was most likely the result of the _____ blast injury. A) a. Miscellaneous B) c. Secondary C) b. Primary D) d. Tertiary

In a frontal motorcycle collision, injuries to the driver are caused by: A) d. Rearward movement of the motorcycle after impact B) b. The driver being propelled over the handlebars C) a. Hyperflexion of the torso D) c. Rapid acceleration and twisting of the torso

In a trauma system, prehospital care is divided into three aspects that include: A) d. Triage, treatment, and injury prevention B) b. Treatment, transportation, and triage guidelines C) a. Staging, triage guidelines, and treatment D) c. Triage, staging, and rapid transportation

In which of the following areas would a wound have the highest risk for infection? A) b. Elbow B) c. Feet C) a. Cheek D) d. Knee

Increased pressure precedes muscle death in what soft tissue injury? A) d. Crush syndrome B) b. Compartment syndrome C) a. Compartment injury D) c. Crush injury

Low-velocity falls in the elderly: A) a. Are likely to cause only minor injuries B) b. Can cause severe head and spinal injury C) d. May pose a threat of disability to the older patient D) c. Are inconsequential and usually result in no injury

Medium-energy weapons would include: A) A. Civilian hunting rifles, military-style rifles, and assault rifles B) B. Guns with short barrels that have less power, such as handguns and some rifles C) C. Knives, needles, ice picks, tree branches falling onto rebar at a construction site, and fence posts in a motor vehicle collision that cause tissue damage as a result of their sharp, cutting edges D) D. Rocket launchers, grenades, and landmines

Of the following treatments, which is the most correct first treatment to be rendered to a patient with suspected internal bleeding? A) b. Provide IV access before any other care. B) a. Provide airway and ventilatory support. C) d. Provide supportive care, and do not transport. D) c. Provide only rapid transport.

Paramedics are treating a patient who fell through a glass coffee table. The patient presents with multiple lacerations and avulsions to the lower leg. What is the most appropriate treatment for the avulsed areas? A) a. Cover the avulsed areas with moist, sterile dressing. B) d. Return tissue to its normal position and cover the avulsed areas. C) b. Irrigate and apply ice to the avulsed areas. D) c. Irrigate and cover the avulsed areas with dry dressing.

Prolonged expiration suggests what type of airway obstruction? A) a. Complete B) b. Lower C) d. Upper D) c. Partial

Small children who have larger heads and occipital regions must have what elevated to keep the head/airway in the neutral position? A) a. Chest B) d. Torso C) b. Head D) c. Legs

The major difference between the adult and child when involved in a pedestrian versus motor vehicle collision is that: A) A. The adult tends to face the threat, whereas the child will turn away. B) B. The child tends to face the threat, whereas the adult will turn away. C) C. Both will face the threat. D) D. Both will turn away from the threat.

The paramedic should consider transporting the trauma patient by air ambulance when: A) a. Critical care needs are met by ground ambulance crews B) b. Road conditions may delay reaching the trauma center C) d. Time delays are inconsequential to patient care D) c. The weather plays no factor in transportation

The patient was involved in an motor vehicle collision and is showing signs and symptoms of internal bleeding. The best initial treatment for this patient is: A) A. Bilateral IVs and rapidly infusing fluids B) B. High-flow oxygen C) C. Placing the patient supine with the legs elevated D) D. Using the PASG, all compartments

The phase of trauma care in which the paramedic delivers direct patient care is known as: A) d. Preplanning B) b. Postevent C) a. Incident D) c. Preevent

The proper steps to control external hemorrhage are to: A) A. Add a tourniquet immediately. B) B. Apply a direct pressure dressing, add more dressing if hemorrhage is not controlled, and apply a tourniquet. C) C. Apply a direct pressure dressing, add more dressing if hemorrhage is not controlled, raise the extremity and apply pressure point, and apply a tourniquet. D) D. Apply direct pressure, apply pressure point, and never apply a tourniquet.

Trauma care is divided into three phases: preevent, event, and postevent. Which of the following best describes the postevent phase? A) c. Reducing injuries through injury-prevention programs B) b. Lowering morbidity and mortality through optimum care C) d. Wearing appropriate personal protective equipment D) a. Conducting safety awareness training after the incident

Vasoconstriction that allows the clotting process to stop continues for how long? A) d. Up to 60 minutes B) c. Up to 30 minutes C) a. Up to 10 minutes D) b. Up to 20 minutes

What are the most appropriate actions to deal with a wound dressing that has become saturated with blood? A) b. Place the saturated dressing in a biohazard bag. B) a. Add additional dressing material over the saturated dressing. C) d. Remove the saturated dressing to apply new dressing material. D) c. Reconsider the use of direct pressure to the wound.

What disease is characterized by inflammation and infection of the lower airway and lungs caused by a viral, bacterial, parasitic, or fungal organism? A) b. Bronchiolitis B) d. Pneumonia C) a. Asthma D) c. Croup

What pediatric dysrhythmia can be caused by suctioning, increased intracranial pressure, hypothermia, hyperkalemia, and ingestion of calcium channel blockers? A) b. Atrial flutter B) c. Secondary bradycardia C) a. Atrial fibrillation D) d. Sinus tachycardia

What size bag-mask device is most appropriate for a 13-year-old adolescent? A) c. 1000 mL B) d. 1200 mL C) a. 450 mL D) b. 500 mL

What term is associated with cuts, bruises, and scars attributed to the child's fragile skin? A) d. von Willebrand's disease B) a. Ehlers-Danlos syndrome C) b. Hemophilia D) c. Mongolian spots

When a joint is forced beyond its normal range of motion and results in excessive stretching of the ligaments that form the joint, this is called: A) A. A hematoma B) B. A sprain C) C. A strain D) D. Tendonitis

When arriving on scene of an EMS call, what is the first action you should take? A) b. Primary survey B) c. Scene size-up C) d. Secondary survey D) a. Body substance isolation

When assessing the skin surface on a pediatric, you grasp the skin of the abdomen between your thumb and index finger, pull the skin taut and quickly release, and notice 'tenting.' This is a sign of: A) A. Abdominal trauma B) B. Dehydration C) C. Evisceration D) D. Meningitis

Which area is most commonly affected in a patient who has epiglottitis? A) b. Below the trachea B) d. Supraglottic C) a. Below the glottis D) c. Subglottic

Which disease is described as edema below the area of the glottis, with inflamed mucosa that is associated with inspiratory stridor? A) a. Asthma B) c. Croup C) b. Bacterial tracheitis D) d. Epiglottitis

Which is the correct statement regarding laying a motorcycle down to avoid impact with an object? A) b. Abrasions and fractures will be on the opposite side of the body. B) a. Abrasions and fractures will be on the affected side of the body. C) d. The rider slides on the back and may sustain head injuries. D) c. The injuries can be more severe than striking the object.

Which of the following best describes kinetic energy? A) c. Kinetic energy = Mass × Acceleration B) b. Kinetic energy = 1/2 mass × Velocity2 C) a. Kinetic energy = 1/2 mass × Acceleration D) d. Kinetic energy = Mass × Deceleration

Which of the following head injuries is the most common cause of death in sports-related head injuries? A) b. Acute epidural B) d. Acute subdural C) a. Acute arachnoid D) c. Acute subarachnoid

Which of the following is a primary pharmacologic intervention in the treatment of the pediatric seizure? A) d. Succinimides B) c. Benzodiazepines C) a. Amphetamines D) b. Barbiturates

Which of the following is considered a form of closed soft tissue trauma? A) c. Pneumothorax B) b. Contusion C) d. Traumatic asphyxia D) a. Avulsion

Which of the following is considered a normal heart rate for an infant (1 to 12 months old)? A) b. 80 to 140 beats/min B) d. 100 to 160 beats/min C) a. 70 to 120 beats/min D) c. 90 to 150 beats/min

Which of the following is considered to be an open soft tissue trauma? A) b. Hematoma B) c. Sucking chest wound C) d. Traumatic asphyxia D) a. Contusion

Which of the following is the final process of wound healing? A) b. Potentiation B) d. Remodeling C) c. Reconstruction D) a. Inflammation

Which of the following is the most common type of skull fracture in a child? A) c. Displaced B) d. Linear C) b. Depressed D) a. Comminuted

Which of the following most accurately defines epiglottitis? A) A. Bacterial infection, affects the lower airway, can occur at any age B) B. Bacterial infection, affects the upper airway, can occur at any age C) C. Viral infection, affects the lower airway, affects patients younger than 3 years old D) D. Viral infection, affects the upper airway, affects patients older than7 years of age

Which of the following statements most accurately describes how a paramedic should obtain intravenous (IV) access for the patient with a large blood loss? A) b. One small-gauge IV is needed. B) d. Patient transport should not be delayed to start an IV line. C) a. No IV access is needed. D) c. Patient transport should be delayed for IV access.

Which of the following statements most accurately describes the proper treatment to be rendered to a patient with internal bleeding? A) a. Provide rapid transport to any care facility. B) b. Provide rapid transport to the nearest facility with emergency surgical capability. C) d. Transport to the facility that the patient requests. D) c. Transport only after establishing IV access.

Which procedure can be used to minimize gastric distention? A) c. Positive-pressure ventilation B) a. Cricoid pressure C) d. Suctioning D) b. Intubation

Within which layer are the sebaceous glands? A) b. Epidermis B) a. Dermis C) d. Stratum corneum D) c. Germinativum

You are assessing a 12-month-old infant who is the victim of suffocation. He has a tiny pinpoint rash on the upper area of the neck and face. What is the correct name for this particular rash? A) c. Purpura B) b. Petechiae C) a. Macular D) d. Vesicular

You are assessing a 2-year-old. Which of the following is considered a normal heart rate for this patient? A) a. 70 to 120 beats/min B) c. 90 to 150 beats/min C) d. 100 to 160 beats/min D) b. 80 to 140 beats/min

You are on scene to treat a 6-year-old patient who is in severe respiratory distress. The patient is lethargic with urticaria, stridor, retractions, and hypotension. What is the most appropriate primary pharmacologic intervention? A) d. Methylprednisolone B) c. Epinephrine C) b. Diphenhydramine D) a. Albuterol

You are treating a 12-month-old patient who is febrile and lethargic, has grunting respirations, and is tachypneic at a rate of 52 breaths/min. Scattered crackles are heard throughout all lobes, with a significant decrease in the right lower lobe. What would be the most appropriate primary intervention? A) a. Administer albuterol. B) b. Administer bag-mask ventilation. C) c. Administer epinephrine. D) d. Administer O2 via simple face mask.

Determining whether additional resources are necessary, including law enforcement, special rescue services, additional medical personnel, or special transport services, is part of which of the following? A) d. Secondary survey B) b. Primary survey C) c. Scene size-up D) a. Patient assessment

During the crushing phase of injury, blood flow to the extremity is obstructed, which results in hypoxia at the cellular level. This, in turn, results in a decrease of: A) d. Myoglobin B) b. Creatinine C) a. Adenosine triphosphate D) c. Creatine kinase

During the crushing phase of injury, flow to the extremity is obstructed, resulting in: A) c. Tissue asphyxia B) a. Lipid peroxidation C) d. Tissue ischemia D) b. Oxygen superoxide

How often should an IO site be reassessed? A) c. Every 10 to 15 minutes B) d. Every 15 to 20 minutes C) b. Every 5 to 10 minutes D) a. Every 2 to 5 minutes

In a pedestrian versus motor vehicle crash, in what region of the body would the pediatric patient sustain the majority of his or her injuries? A) d. Posterior B) c. Cephalic C) a. Anterior D) b. Caudal

In children, at what age do subdural hematomas most commonly occur? A) b. Older than 5 years old B) d. Younger than 5 years old C) c. Younger than 2 years old D) a. Older than 2 years old

In what year did the U.S. Congress enact the legislation authorizing federal funds for Emergency Medical Services for Children? A) d. 1995 B) b. 1987 C) a. 1984 D) c. 1990

In which of the following situations is an analgesic more appropriate than a sedative? A) c. Head injury B) a. Abdominal injury C) d. Long bone fracture D) b. Cardioversion

In which of the following situations would cervical spinal immobilization be contraindicated and manual stabilization used instead? A) d. Tracheal deviation B) c. Massive cervical swelling C) a. Cervical tenderness D) b. Jugular vein distention

Injuries to the lung that are the result of trauma similar to a crash scenario include lung rupture known as the: A) d. Pressure effect B) a. Balloon effect C) c. Paper bag effect D) b. Blow-out effect

Integrating emergency care for children, developing pediatric equipment, and providing injury/illness prevention for children are the goals of which organization? A) b. EMSP B) d. NREMT C) a. EMSC D) c. NAEMT

Medium-energy weapons include: A) a. AK 47s B) c. Knives and picks C) b. Handguns D) d. M-16s

Name the four elements to the CUPS assessment. A) A. C-spine, unstable, pulses, stable B) B. Circulation, unstable, potentially unstable, stable C) C. Critical, unstable, potentially unstable, stable D) D. Critical, unstable, pulses, stable

Not padding under the torso of a child who is being immobilized would result in which position of the neck? A) d. Flexed B) b. Adducted C) c. Extended D) a. Abducted

Paramedics are treating a construction worker who has amputated his left arm with a circular saw. After wrapping the amputated part in a sterile dressing, what is the next most appropriate step? A) a. Place the amputated part directly on ice. B) c. Seal the amputated part in a bag, and place it on ice. C) b. Seal the amputated part in a bag, and place it in cool water. D) d. Submerse the amputated part in cold sterile water.

Paramedics have been dispatched to a construction site where a worker has fallen and been impaled by a piece of rebar. Of which type of trauma should the paramedics be most suspicious? A) c. Crush B) a. Blast C) d. Open D) b. Closed

Possible complications of an IO infusion include which of the following? A) d. Inability to aspirate blood B) c. Inability to administer fluids by gravity C) b. Penetration of the posterior cortex D) a. Penetration of the bone marrow

Shoulder restraints act to: A) b. Allow up-and-over movement in a frontal crash B) a. Allow hyperflexion of the torso in the event of a collision C) c. Prevent folding of the body at the waist during a crash D) d. Prevent lateral twisting of the head, neck, and chest

Typically, do patients suffering from asthma have a history of a low-grade fever?

No, unless trigger is an infection.

Does a patient suffering from croup present with drooling?

No.

Typically, do patients suffering from bronchiolitis have a history of allergies?

No.

Pain level of patient suffering from croup?

None or very mild.

What drug is always used first in the management of symptomatic bradycardia in pediatric patients?

Oxygen. Second line drug is epinephrine.

Why is it important to determine the medications taken by an asthmatic patient before beginning any therapy?

Patients may have abused their MDIs and may be suffering from an overdose of beta2 agonists. Some patients who overuse their MDIs develop a resistance to the effects of their usual bronchodilator. Trying a different agent may be useful.

Why should skin turgor be checked on any pediatric patient who is experiencing an asthma attack?

Patients will have increased respiratory water loss and decreased fluid intake. Dehydration will worsen the attack by thickening mucus in lower airways, causing plug formation.

Cardiogenic

Pericardial tamponade would most likely result in which of the following types of shock?

How can seizures result in death of a pediatric patient?

The principle cause is loss of airway resulting in hypoxia.

D. anticipate your patient's injuries.

The purpose of determining the mechanism of injury and the index of suspicion for the trauma patient at the same time is to allow you to:

C. Posterior for minor abrasions or lacerations.

The rapid trauma exam focuses on finding injuries that may cause shock. Components of the rapid trauma assessment include all of the following EXCEPT:

What is a fontanelle?

The soft spots in the infants skull that allow for rapid growth of the brain during the first year of life.

acceleration and deceleration.

The two factors that refer to the rate of change of speed are:

What change occurs in the fontanelles of a dehydrated infant?

They become sunken below the surrounding skull.

100

To gain an appreciation for the potential for trauma from high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to ________ times.

Does a patient suffering from epiglottitis present with a fever?

Typically high-grade.

Does a patient suffering from croup present with a fever?

Typically low-grade.

venous

Under normal circumstances, at any given moment, most of the blood is in the ________ system.

Compression injury of the cervical spine

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "spidered," or "starred," and that the driver was not restrained. Which of the following injuries is most likely?

C. Call immediately for air medical transport to reduce the "Golden Hour."

Upon arriving on a scene where the mechanism of injury indicates a potentially life-threatening injury, which of the following interventions will BEST help deliver the care that is needed?

Etiology of croup?

Viral

All of these

When inspecting the interior of a vehicle involved in a frontal collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries does this indicate?

Dropping level of consciousness

Which of the following does NOT indicate compensated shock?

Tachycardia

Which of the following early signs of shock is easily missed?

The assessment of breathing in a pediatric patient should take no longer than which of the following? A) b. 20 seconds B) c. 30 seconds C) a. 10 seconds D) d. 60 seconds

The dermis primarily consists of: A) c. Deep fascia B) d. Ligaments C) b. Collagen D) a. Cartilage

The destruction of the muscle tissues that results in a release of cellular material and acidosis and can lead to acute renal failure is called: A) A. Compartment syndrome B) B. Peritonitis C) C. Rhabdomyolysis (Crush syndrome) D) D. Traumatic asphyxia

The patient from question 79 also has 20% third-degree burns to the anterior thorax. This injury can be classified as the _____ blast injury. A) a. Primary B) d. Tertiary C) b. Quaternary (miscellaneous) D) c. Secondary

The preferred site for IO infusion on a pediatric patient is the: A) A. Anterior lateral surface of the distal tibia B) B. Anterior lateral surface of the proximal tibia C) C. Anterior medial surface of the proximal tibia D) D. Posterior medial surface of the proximal tibia

The typical third impact in an auto-pedestrian collision is the: A) d. Vehicle hitting the body B) c. Vehicle hitting a stationary object C) a. Pedestrian striking the ground D) b. Pedestrian striking the hood of the vehicle

To open the airway in an infant or small child and maintain the head and cervical spine in a neutral position, you should: A) A. Hyperflex the patient's neck B) B. Insert an endotracheal tube immediately C) C. Place padding under the patient's torso D) D. Place the patient in the supine position on a flat surface

What can result when widespread tissue hypoxia and cellular damage causes leakage of contents from damaged muscle cells? A) c. Traumatic asphyxia B) a. Lipid peroxidation C) b. Rhabdomyolysis D) d. Thromboplastin

What disease is described as a bacterial infection of the subglottic area, complicated with copious thick, pus-filled secretions? A) a. Asthma B) c. Croup C) b. Bacterial tracheitis D) d. Epiglottitis

What does a decrease by 2 points on the Glasgow Coma Scale suggest in a child with a head injury? A) a. Mild deterioration B) b. Moderate deterioration C) d. Significant deterioration D) c. No deterioration

What is it called when measures are applied in advance to reduce the likelihood that an injury will occur? A) c. Primary prevention B) d. Secondary prevention C) b. Injury prevention D) a. Illness prevention

What is the appropriate dose for the initial fluid bolus of a 4-day-old trauma patient who weighs 8 pounds? A) c. 80 mL B) d. 160 mL C) b. 72 mL D) a. 36 mL

You are treating a 2-year-old, 24-lb patient. Upon assessment, the patient is unconscious, with the following vital signs: BP, 64/42 mm Hg; R, 26 breaths/min; P, 48 beats/min. Once the patient's airway is secured, what is the most appropriate pharmacologic intervention? A) b. Atropine 0.48 mg B) a. Atropine 0.22 mg C) c. Epinephrine 0.11 mg D) d. Epinephrine 0.24 mg

In a motor vehicle crash, a frontal or head-on impact can result in an up-and-over injury pathway. This means: A) c. The victim moves laterally and strikes the window and door B) a. The impact is at an angle with less trauma to the victim C) b. The victim moves downward in the seat and strikes the dashboard D) d. The victim moves upward and ultimately strikes the windshield or roof

In assessment tool TICLS, what does the 'L' stand for? A) A. Lacrimation B) B. Lethargic C) C. Lividity D) D. Look or gaze

In blast injuries, what phase results when a victim is propelled through space by the explosion and then strikes a stationary object. A) A. Primary blast injury B) B. Propellius missilus C) C. Secondary blast injury D) D. Tertiary blast injury

In children, what is usually the cause of cardiac arrest? A) d. Trauma B) c. Seizures C) a. Congenital heart disease D) b. Respiratory failure

It is recommended that patients with penetrating trauma receive a tetanus vaccine if they have not had one in _____ years. A) a. 3 B) c. 10 C) d. 15 D) b. 5

Muscle death precedes increased pressures in what soft tissue injury? A) a. Compartment injury B) c. Crush injury C) d. Crush syndrome D) b. Compartment syndrome

National standards concerning the use of ground ambulance transportation define the 'reasonable amount of time' that it takes severe trauma patients to reach definitive care after their injuries as being within: A) d. 120 minutes B) c. 90 minutes C) a. 10 minutes D) b. 60 minutes

Paramedics are on the scene of an industrial accident where a 34-year-old male has been entrapped between two pieces of sheet metal for more than 5 hours. Before calling medical direction, what can the paramedics anticipate will be ordered? A) d. NS with magnesium and furosemide B) b. D50 with potassium and mannitol C) c. LR with sodium bicarbonate and furosemide D) a. D5 1/2NS with sodium bicarbonate and mannitol

Paramedics are treating a patient who is experiencing pain and swelling to the lower extremity after a fall. After assessing the need for spinal immobilization, what is the next most appropriate treatment for this patient? A) a. Apply a cold pack. B) b. Apply manual traction. C) d. Splint above and below the injury. D) c. Check for pulse, motor, and sensory responses.

Synovial joints are composed of the bones' ends, which are held together by: A) d. Tendons B) a. Cartilage C) c. Synovial fluid D) b. Ligaments

You are assessing a 2-year-old patient who is irritable and restless, has audible wheezes with retractions, and has see-saw respirations. What do these signs and symptoms indicate? A) a. Congestive heart failure B) c. Respiratory failure C) b. Pulmonary edema D) d. Respiratory distress

You are assessing an infant who has spontaneous eye opening, cries only to pain, and withdraws from touch. Which rating on the pediatric Glasgow scale would this patient receive? A) a. 10 B) c. 13 C) d. 15 D) b. 12

You are called to the scene to assist a 2-year-old male who has fallen approximately 3 feet onto a concrete surface. On your arrival, the child is breathing but unconscious. You suspect trauma to which area of the body? A) b. The feet B) a. The buttocks C) d. The upper extremities D) c. The head

You are responding to the scene of the possible drowning of a 2-year-old. Which of the following is considered a normal respiratory rate for this patient? A) a. 12 to 20 breaths/min B) b. 18 to 30 breaths/min C) c. 22 to 34 breaths/min D) d. 24 to 40 breaths/min

You are treating a patient with a rapid onset of stridor, drooling, and a high fever. What is the most appropriate intervention for this patient? A) d. Intubate immediately. B) c. Examine the oropharynx. C) b. Assist ventilations. D) a. Administer oxygen.

What is the prehospital treatment for croup?

Humidified oxygen and nebulized racemic epinephrine.

What are the most common causes of shock in pediatric patients?

Hypovplemic and sepsis.

What routes are available for drug administration to children during cardiopulmonary arrest?

IV, IO and endotracheal tube.

Design the bullet to become more unstable

If you were to design a bullet to have the highest energy exchange, what would you do?

The heart continues its forward motion until it strikes the chest wall.

In a motor vehicle collision, when the driver's chest strikes the steering wheel, what produces injury next?

Neurogenic

In a previously healthy individual, which of the following types of shock may NOT result in the typical signs of cool, pale, moist skin; tachycardia; and narrowed pulse pressure?

A. I

In addition to handling all types of specialty trauma, which level of trauma center provides continuing medical and public education programs?

up and over

In frontal impact collisions, which pathway of patient travel results in higher mortality?

B. A 26-year-old male with a gunshot wound involving the popliteal artery

In which of the following patients with hemorrhagic shock can you employ aggressive fluid resuscitation?

What is cardiac output most dependent upon in pediatric patients?

heart rate

Late signs of shock in the pediatric patient include:

hypotension and bradycardia

Which dysrhythmia is a normal compensatory response in pediatric patients?

sinus tachycardia

What would be a likely initial skin color finding in a child with compensated shock?

pallor

What is the suggested initial setting for defibrillation of pediatric patients? What energy is used on subsequent shocks?

2 J/kg then 4J/kg

In which age group is fever the most common cause of seizures?

3 months to 5 years old

Epiglottitis typically affects this age group.

3 to 7 years old

Croup typically affects this age group.

6 months to 6 years old

A patient has an impaled object through the cheek that is obstructing the airway. What is the correct treatment for this injury? A) A. Apply a tourniquet to control bleeding. B) B. Carefully remove the object. C) C. Do not remove the object. D) D. Stabilize the object by placing bulky dressing around it to prevent lateral movement.

A patient with a rapid onset of difficulty swallowing, drooling, stridor, and a high fever is most likely suffering from which disease? A) d. Epiglottitis B) a. Asthma C) b. Bacterial tracheitis D) c. Croup

A pediatric epidural hematoma may occasionally be the result of which type of bleeding? A) d. Venous B) b. Capillary C) c. Meningeal D) a. Arterial

A rash with reddish-purple, nonblanchable discolorations greater than 0.5 cm in diameter is called: A) b. Petechiae B) c. Purpura C) a. Macular D) d. Vesicular

A subcutaneous infection of the pulp space of the finger pad that is characterized by throbbing pain and a red, tense finger pad is called: A) A. Felon B) B. Flexor tenosynovitis C) C. Folliculitits D) D. Paronchia

What size bag-mask device is most appropriate for a 3-day-old infant? A) b. 350 to 400 mL B) d. 500 to 1000 mL C) a. 250 to 300 mL D) c. 450 to 500 mL

What would be the minimum systolic blood pressure for a 5-year-old? A) b. 70 mm Hg B) d. 90 mm Hg C) a. 60 mm Hg D) c. 80 mm Hg

When paramedics are called to assist with a public education event to inform children about the importance of wearing bicycle helmets, which form of prevention would they be teaching? A) b. Primary B) c. Secondary C) d. Trauma D) a. Injury

Which of the following conditions is considered to be an upper airway disease? A) d. Pneumonia B) a. Asthma C) b. Bronchiolitis D) c. Epiglottitis

Which of the following dressings enhances healing by creating a wound environment that is supportive of the movement of cells across the membranes? A) b. Occlusive B) a. Dry C) c. Sterile D) d. Wet

Which of the following dressings is commonly used after wound closure to allow for drainage away from the wound? A) c. Nonocclusive B) d. Nonsterile C) a. Nonabsorbent D) b. Nonadherent

The average circulating blood volume in an adult is: A) A. 55 to 75 ml/kg B) B. 75 ml/kg C) C. 85 ml/kg D) D. 90 to 105 ml/kg

Which of the following is a possible cause of bleeding from the nose, ears, or mouth? A) c. Liver laceration B) b. Kidney contusion C) a. Femur fracture D) d. Skull fracture

Which of the following is an uncommon dysrhythmia in children? A) a. Sinus bradycardia B) b. Sinus tachycardia C) c. Ventricular fibrillation D) d. Ventricular tachycardia

Which of the following is considered a form of closed soft tissue trauma? A) d. Traumatic asphyxia B) c. Pneumothorax C) a. Avulsion D) b. Hematoma

Which of the following is considered a type of soft tissue trauma that lies somewhere between the two broad categories of open and closed? A) d. Penetrating B) a. Blast C) c. Crush D) b. Blunt

Which of the following is the correct statement regarding a rollover crash? A) d. The injuries are predictable because of the mechanism. B) b. The greater the speed, the less severe the injuries. C) a. Shear forces do not apply to rollover collisions. D) c. The greater the speed, the more severe the injuries.

Which of the following most accurately defines croup? A) A. Bacterial infection, affects the lower airway, affects patients younger than 6 months old B) B. Bacterial infection, affects the upper airway, affects patients 6 months to 6 years old C) C. Viral infection, affects the lower airway, affects patients older than 6 years of age D) D. Viral infection, affects the upper airway, affects patients 6 months to 6 years old

Which of the following plays a significant role in allergic reactions and the inflammatory response to injury? A) a. Fibroblasts B) d. Neutrophils C) b. Macrophages D) c. Mast cells

Which of the following statements is correct when comparing penetrating and blunt trauma? A) c. Penetrating trauma causes more severe tissue damage than blunt trauma. B) a. Blunt trauma does not have the same force as penetrating trauma. C) d. Because blunt trauma does not penetrate the skin, it does not cause cavitation. D) b. Both blunt trauma and penetrating trauma can cause cavitation.

Which of the following statements most accurately describes the presentation of signs and symptoms of internal bleeding? A) c. Signs and symptoms of internal bleeding may mimic a heart attack. B) b. Signs and symptoms of internal bleeding may be masked by an illness. C) a. Signs and symptoms of internal bleeding are readily apparent in all cases. D) d. Signs and symptoms of internal bleeding may not develop for a significant period of time.

Which of the following statements pertaining to data collection and analysis of trauma patients is correct? A) d. It is conducted by the public health department or EMS agency. B) c. It is a less important administrative aspect of a trauma system. C) b. It has little value in assessing trauma treatment of overall care. D) a. It analyzes injury patterns, treatment, and overall care.

Which of the following would be considered part of the appearance assessment in the pediatric assessment triangle? A) a. Body position B) d. Work of breathing C) c. Skin color D) b. Mental status

Which of the following would be considered part of the circulation assessment in the patient assessment triangle? A) a. Body position B) b. Mental status C) c. Muscle tone D) d. Skin color

Which of the following would have a greater risk for severe complications after a lower extremity injury? A) a. A 25-year-old female with a spinal cord injury B) c. A 45-year-old female with hypertension C) b. A 35-year-old male with a head injury D) d. A 55-year-old male with diabetes

Which open soft tissue wound is described as flaps of skin or other tissue that are pulled partially or completely off of the patient? A) c. Evisceration B) a. Amputation C) d. Laceration D) b. Avulsion

Which soft tissue injury occurs when large veins or arteries are ruptured beneath intact skin? A) d. Tamponade B) b. Ecchymosis C) a. Contusion D) c. Hematoma

Why is the use of alcohol, Betadine, and hydrogen peroxide contraindicated in the cleansing of wounds? A) d. Suppresses the immune system B) c. Inhibits the action of neutrophils C) b. Increases inflammation D) a. Destroys healing cells

Within how many days of injury do fibroblasts begin to divide and produce collagen? A) b. 6 to 9 B) c. 8 to 12 C) d. 10 to 15 D) a. 3 to 5

Wounds that involve the large arteries of the neck or those that open into the chest cavity require which type of dressing? A) c. Nonocclusive B) b. Nonadherent C) a. Adherent D) d. Occlusive

How would you determine the appropriate size endotrachial tube to use when intubating a pediatric patient?

(Age of the child + 4) / 4. If the age is unknown, use the an endotracheal tube closest in size to the child's little finger.

What is the IV dose of epinephrine in pediatric cardiac arrest?

0.01 mg/kg (0.1 mL/kg) of the 1:10,000 solution.

What is the minimum dose of atropine for pediatric patients? Why?

0.02 mg/kg. The minimum dose must be 0.1 mg. Anything less will result in slowing of the heart rate (paradoxical bradycardia).

A young woman and her 2-year-old daughter sustained minor to moderate injuries in a motor vehicle crash. Both mother and daughter are visibly upset. Which statement describes what the paramedic should do when transporting the woman and her daughter? A) b. Be sure to secure each patient separately using a stretcher or child seat as needed. B) d. The paramedic should hold the child to reassure both the mother and daughter. C) a. Allow the woman to hold her daughter because it will calm the distressed child. D) c. It is permissible to transport the mother and daughter on the same stretcher.

Any damage to tissue will alter the normal anatomy, which causes the release of tissue factors. This is the beginning of which process? A) a. Coagulation B) d. Neovascularization C) c. Histamine release D) b. Hemostasis

At what point is the patient assessment triangle performed? A) c. Before approaching the patient B) b. After the initial assessment C) d. During the initial assessment D) a. After approaching the patient

Exit wounds differ from entrance wounds in that the exit wound is: A) b. Ragged and torn tissue with a stellate appearance B) d. Usually smaller than the entrance wound C) a. Burned around the edges of the skin D) c. Round with a smooth edge

Gastric distention is a complication caused by which of the following? A) c. Positive-pressure ventilation B) d. Vomiting C) b. Cardiac compressions D) a. Aspiration

How long does a complicated febrile seizure last? A) d. Longer than 15 minutes B) c. 7 to 10 minutes C) a. Less than 3 minutes D) b. 4 to 6 minutes

In frontal collisions, the lap belt: A) c. Keeps the torso from moving forward B) d. Prevents the body from moving backward C) b. Allows the body to move with the vehicle D) a. Allows room for the torso to reach the dashboard

In which of the following situations is a sedative more appropriate than an analgesic? A) b. Cardioversion B) c. Degloving injury C) a. Burns D) d. Long bone fracture

Kinematics may be defined as: A) b. The process of predicting injury patterns B) a. The process of investigating the causes of motor vehicle crashes C) d. The study of forces and motion D) c. The study of fatal injury patterns

Paramedics are treating a patient whose arm has been entrapped in a compressor for more than 6 hours. What can the paramedics anticipate will be ordered by medical control? A) d. 1500-mL bolus of NS B) b. 500-mL bolus of LR C) c. 1500-mL bolus of D5 0.25% NS D) a. 500-mL bolus of D5 0.9% NS

Paramedics are treating a patient with an obvious deformity to the right elbow. After assessing the need for spinal immobilization and obtaining a neurovascular assessment, which of the following is the next most appropriate step? A) d. Splint the bone above and below the joint. B) b. Apply manual traction. C) c. Begin transport to a trauma center. D) a. Apply a cold pack.

Paramedics have been dispatched to a residence where the homeowner has fallen off of the roof. Of which type of trauma should the paramedics be most suspicious? A) b. Closed B) d. Open C) a. Blast D) c. Crush

Using the '20-10-20' rule as a guide in determining a positive test result for orthostatic vital signs, what does each number represent? A) A. Decrease in systolic blood pressure up to 20 mm Hg, an increase in the diastolic blood pressure of 10 mm Hg, an increase of the heart rate by 20 beats/min B) B. Decrease in systolic blood pressure up to 20 mm Hg, an increase the heart rate by 10 beats/min, an increase in the diastolic blood pressure of 20 mg Hg C) C. Increase in systolic blood pressure up to 20 mm Hg, an increase in the diastolic blood pressure by 10 mm Hg, and an increase in the heart rate by 20 beats/min D) D. No changes in orthostatic vitals when the patient stands up

What disease is characterized by thick mucus and inflammation and swelling of the smaller air passages? A) b. Bronchiolitis B) d. Pneumonia C) c. Croup D) a. Asthma

What is the initial fluid bolus for a 6-year-old trauma patient who weighs 42 pounds? A) b. 380 mL B) c. 420 mL C) a. 190 mL D) d. 840 mL

What is the most appropriate way to determine the proper size of a nasal airway? A) d. From the tip of the nose to the tip of the ear B) c. From the tip of the jaw to the tip of the ear C) b. From the corner of the mouth to the tip of the ear D) a. From the corner of the mouth to the angle of the jaw

When a vehicle collides with another vehicle or strikes an object on the side of the vehicle, this is called: A) A. Lateral impact B) B. Rear-end impact C) C. Rollover impact D) D. Rotational impact

When an adult pedestrian is struck by a car, the injuries on initial impact are usually: A) a. Fractures to the legs B) d. Abdominal injuries C) b. Head and neck injuries D) c. Arm and shoulder injuries

When assessing the eyes of a pediatric patient, you find blood in the anterior chamber of the eye. What term is used for this condition? A) b. Hyphema B) c. Periorbital ecchymosis C) d. Raccoon eyes D) a. Battle's sign

When assessing/treating the stable pediatric patient, what is the most appropriate location/action for the caregiver? A) a. Involved with the patient and the patient's care B) c. Separated from the child C) b. Out of the child's sight D) d. With the patient, uninvolved with the patient's care

When energy is applied to an object, there is a corresponding movement of particles within that object. This describes the concept of: A) b. Energy exchange B) d. Kinetic energy C) c. Inertia D) a. Conservation of energy

When is it appropriate to use the child's safety seat as a means of spinal immobilization? A) c. When the child is stable B) b. At all times C) d. Never D) a. When the airway is compromised

When obtaining a blood pressure, how much of the upper arm should the width of the cuff cover? A) b. one-half to two-thirds B) c. one-fourth to three-fourths C) d. one-fourth to two-thirds D) a. one-half to three-fourths

Where are the constantly developing cells of the epidermis formed? A) a. Germinativum B) c. Sebaceous gland C) d. Stratum corneum D) b. Papillary dermis

Where is the best location to assess the skin turgor of an infant? A) c. The abdomen B) b. Side of the cheek C) d. The thigh D) a. Back of the hand

Which area is most commonly affected in a patient who has croup? A) a. Below the glottis B) c. Supraglottic C) d. Tracheal D) b. Below the trachea

Which closed soft tissue injury involves the stretching of the ligaments that form the joint? A) c. Sprain B) b. Fracture C) d. Strain D) a. Contusion

Which of the following answers most accurately defines hyperpnea? A) A. Increased depth of breathing B) B. Increased heart rate C) C. Increased respiratory rate D) D. Increased tidal volume

Which of the following best describes a level 2 trauma center? A) d. Usually a nonteaching or community hospital B) a. Created with rural and remote areas in mind C) c. Most are found in large university-based hospitals D) b. May not be a hospital but rather a clinic-type facility

Which of the following first-impression findings is associated with an altered mental status? A) a. Abnormal work of breathing B) d. Hypotension C) b. Bradycardia D) c. Fever

You are assessing an 11-month-old infant. Which of the following is considered a normal heart rate for this patient? A) d. 100 to 160 beats/min B) b. 80 to 140 beats/min C) c. 90 to 150 beats/min D) a. 70 to 120 beats/min

You are on scene with a child who has multiple injuries that lead to suspicions of abuse. What is the most appropriate action to take in this situation? A) d. Report the abuse. B) a. Confront the parents. C) c. Inspect the home. D) b. Do nothing.

You are transporting a patient who is intubated and is now becoming bradycardic. What is the most appropriate intervention to perform first? A) b. Reassess and confirm tube placement. B) d. Turn up the oxygen. C) c. Suction the endotracheal tube. D) a. Immediately remove tube and reintubate.

You are treating a 3-year-old patient who is unconscious, tachycardic, hypotensive, and bradypneic, and has a diffuse, nonblanchable, reddish-purple rash throughout the trunk and face. Which of the following is the first action you should complete? A) c. Don a face mask. B) b. Begin cardiac compressions. C) a. Assist ventilations. D) d. Transport immediately.

A patient you would perform a surgical cricothyrotomy:

A 14 year old with an obstructed airway who does not respond to abdominal thrusts.

A fracture of the femur may result in a hematoma that contains enough blood to make it a Stage ________ hemorrhage.

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a Stage ________ hemorrhage.

What is status epilepticus?

A patient has two or more seizures without regaining consciousness.

What is status asthmaticus?

A severe asthma attack that will not respond to treatment with beta2-adrenergic agonists.

C. III

A trauma center that is committed to special emergency department training and has a degree of surgical capability but that usually stabilizes and transfers seriously injured patients is a Level ________ trauma center.

D. surgical

A trauma system is based on the principle that serious trauma is a ________ disease.

The left-rear passenger

A vehicle is struck in its right front as it passes through an intersection, resulting in a rotational impact. Which of the passengers is subjected to the greatest acceleration forces?

D. Bronchiolar smooth muscle relaxation.

All of the following result from the Beta-1 actions of epinephrine in response to shock EXCEPT:

What is the cause of sudden infant death syndrome (SIDS)?

An unknown disease process with no identifiable cause of death.

distributive

Anaphylactic shock is a form of ________ shock.

Bridge abutment

Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient?

increases.

As a bullet tumbles, its potential to inflict damage:

D. providing surgical interventions to stop hemorrhage.

As a paramedic, your role in trauma care consists of all of the following EXCEPT:

Negative pressure is generated inside the cavity, drawing debris into the wound.

As the energy from a medium or high-velocity projectile pushes tissue from its path, which of the following occurs?

The amount of energy increases.

As the mass of an object increases, which of the following occurs?

Frontal with an up-and-over pathway

Axial loading is most likely to occur in which type of impact?

A body in motion will stay in motion until acted on by some external force. This statement best defines: A) d. Principles of kinetic energy B) b. Newton's first law of motion C) a. Conservation of energy D) c. Newton's laws on force

Etiology of epiglottitis?

Bacterial

What class of medications are used for managing status epilepticus in the prehospital setting?

Benzodiazepines. Diazepam (Valium) or lorazepam (Ativan) are the drugs most commonly used.

In which age group does the majority of SIDS deaths occur?

Birth to 6 months.

A car strikes a tree at 50 miles per hour. Newton's first law of motion states that the: A) b. Energy of the body inside the vehicle cannot be destroyed, but the form can be changed B) c. Force on the body equals the mass times acceleration C) a. Body inside the car will travel at 50 miles an hour until acted on by an outside force D) d. Kinetic energy of the body will be determined primarily by the velocity

A shotgun is a low-velocity, short-range weapon. Which of the following statements is correct pertaining to wounds caused by shotguns? A) b. If fired at a distance, the pellets are spread out and may cause severe injury. B) a. If fired at a close range, the pellets are compact and cause little damage. C) d. The wad, if it enters the skin, increases the potential for infection from the injury. D) c. The pellets enter the body at the same time and tend to fragment quickly.

After securing the airway of a pediatric seizure patient, which of the following would be the most appropriate intervention? A) b. Administer midazolam. B) d. Obtain an ECG reading. C) c. Treat hypoglycemia if present. D) a. Administer fosphenytoin.

What is the correct management for avulsions? A) A. Apply direct pressure. If hemorrhage not controlled, apply more dressing. If hemorrhage continues, apply a tourniquet. B) B. Apply splints to immobilize the bones above and below the affected joint. Periodically reassess the injury to ensure that there has been no nerve or vascular compromise. C) C. Place the tissue in its normal position. Then dress and bandage the injury. Do not remove avulsed tissue. D) D. Place the tissue in the position found. Then dress and bandage the injury. Remove avulsed tissue.

What is the most correct location for the application of direct pressure? A) a. Between the wound and the heart B) d. One inch superior to the wound C) b. Directly over the wound D) c. One inch distal from the wound

What is the normal respiratory rate for an infant (1 to 12 months old)? A) c. 24 to 40 breaths/min B) a. 18 to 30 breaths/min C) d. 30 to 60 breaths/min D) b. 22 to 34 breaths/min

When a caregiver of an ill child responds in an angry and fearful manner, what should you as the paramedic do? A) d. Respond in a condescending manner. B) b. Ignore the caregiver's concerns. C) a. Accept the caregiver's feelings as normal. D) c. Remove the child from the home.

When is it considered appropriate to use the scalp vein as a means of peripheral venous access in an infant? A) b. For medication administration only B) c. Only as a last effort C) a. For both fluid and medication administration after patient stabilization D) d. Only during resuscitation

Where is the most appropriate place to assess the skin color of children with darker skin tones? A) a. Conjunctiva B) d. Mucosa C) c. Lips D) b. Fingernails

Which condition is characterized by a loss of peripheral vascular tone and results in widespread vasodilation? A) d. Septic shock B) b. Hypovolemic shock C) c. Neurogenic shock D) a. Anaphylactic shock

Which of the following areas is composed of large, dense collagen fibers and provides much of the skin's elasticity? A) d. Superficial fascia B) b. Papillary dermis C) c. Reticular dermis D) a. Deep fascia

Which of the following best describes the effect of body armor on medium- and high-energy projectiles? A) b. High-energy projectiles cannot pierce body armor. B) d. Most high-energy projectiles can penetrate body armor. C) c. Injuries to the heart and lungs can occur because of blunt force. D) a. Few medium-energy projectiles can penetrate body armor.

Which of the following dressings allows the wound to drain exudate but does not incorporate the dressing into the scab or clot? A) d. Occlusive B) a. Adherent C) b. Nonadherent D) c. Nonocclusive

Which of the following dressings is typically used when infection is a concern or for direct application to an open wound? A) a. Adherent B) d. Wet C) c. Sterile D) b. Occlusive

Which of the following dysrhythmias is rare in children and could indicate a myocardial heart disease? A) b. Pulseless electrical activity B) a. Bradycardia C) d. Ventricular tachycardia D) c. Supraventricular tachycardia

Which of the following is characterized by chronic inflammation, hyperreactive airways, and episodes of bronchospasm? A) b. Bronchiolitis B) a. Asthma C) d. Pneumonia D) c. Croup

Which of the following is considered to be an open soft tissue injury? A) d. Traumatic asphyxia B) a. Contusion C) c. Avulsion D) b. Hematoma

Which of the following is the most common type of shock in children? A) c. Neurogenic B) a. Anaphylactic C) b. Hypovolemic D) d. Septic

Which of the following may indicate a cerebrospinal fluid shunt malfunction? A) d. Tachycardia B) a. Calmness C) c. Irritability D) b. Hypotension

Which of the following patients would be more susceptible to sudden infant death syndrome? A) b. Asian male B) d. Native American female C) a. African American male D) c. Caucasian female

Which of the following statements most accurately describes the pressure within an artery? A) c. It is moderate pressure. B) b. It is low pressure. C) a. It is high pressure. D) d. There is no pressure.

Which thick, dense layer of fibrous connective tissue provides the final layer of the skin's defense? A) d. Superficial fascia B) c. Reticular dermis C) a. Deep fascia D) b. Papillary dermis

You arrive on scene to find a father administering rescue breaths to his 3-year-old child. He tells you that she was chewing on a piece of candy and began to choke. He tried but could not clear her throat, and she collapsed several minutes ago. The child appears ashen. You cannot ventilate the child's lungs; your partner completes an assessment while you perform laryngoscopy and remove the candy with Magill forceps. As you remove the candy, your partner tells you there is no pulse. You should immediately: A) b. Declare the patient dead B) c. Intubate the patient because the laryngoscope is already in the mouth C) a. Begin resuscitation D) d. Perform 30 seconds of bag-mask ventilations

You have been called to evaluate a 19-month-old boy in respiratory distress. His parents tell you that he seems to be having trouble breathing and appears subdued. On examination, you observe thick mucus in the nose and back of the mouth and hear rhonchi throughout his lungs. His temperature is 101° F. As you administer oxygen, you suspect this patient likely has: A) d. Respiratory syncytial virus B) b. New-onset asthma C) a. Bronchitis D) c. Pneumonia

Your pediatric patient is 3 years old and has an elevated temperature of less than 102.2, loud stridor that is 'seal like,' cough, and nasal flaring. These are typically signs and symptoms of: A) A. Anaphylaxis B) B. Bronchiolitis C) C. Croup D) D. Epiglottitis

What is the principle danger facing a patient with epiglottitis?

Complete airway obstruction.

A healthy adult will usually tolerate a blood loss of what percentage? A) d. 25% to 30% B) b. 15% to 20% C) c. 20% to 25% D) a. 10% to 15%

A patient has bleeding from a laceration on the right forearm. What is the most often used and most effective method to control this bleeding? A) d. Volume infusion B) b. Elevation of the extremity C) c. Pressure point D) a. Direct pressure

A patient who presents for 2 to 3 days with loud stridor, nasal flaring, retractions, and a temperature of 99° F is most likely suffering from which disease? A) b. Bacterial tracheitis B) d. Epiglottitis C) a. Asthma D) c. Croup

According to the trauma center categories, a level III trauma center is: A) A. A regional resource center that offers a full spectrum of services from prevention programs to patient rehabilitation, serves as the leader in trauma care for a geographic area, and can be mostly found in large, university-based hospitals because of the requirements for the patient care, education and teaching programs, and research. B) B. Able to provide evaluation, resuscitation, and operative intervention for stabilization. (usually a community hospital). C) C. Created with rural and remote areas in mind, provides initial stabilization, and may be a clinic-type facility rather than a hospital. D) D. Provides comprehensive trauma care, does not include research as an essential component, and is usually a nonteaching or community hospital.

After a crushing injury, restoration of blood flow brings oxygen in contact with the cells, but it also brings an oxygen free radical known as: A) c. Lipid peroxidase B) b. Lactic acid C) a. Creatine kinase D) d. Oxygen superoxide

Among children 5 to 9 years of age, which of the following is the most common cause of death from trauma? A) c. Motor vehicle crash B) a. Bicycle injuries C) b. Drowning D) d. Pedestrian crash

At which point should the blood pressure be obtained during the assessment of a pediatric patient? A) d. During the airway assessment B) c. During the breathing assessment C) a. After the breathing assessment D) b. After the rest of the circulatory assessment

Blood from an artery is generally what color? A) c. Pink B) a. Black C) b. Blue D) d. Red

Damage can occur when one organ or structure moves either faster or slower relative to other objects in the portion of the body or body system. This best describes the concept known as: A) c. Kinetic energy B) d. Shear C) b. Inertia D) a. Compressive force

Deaths caused by penetrating trauma: A) b. Are increasing yearly B) c. Have been steadily declining since 1990 C) d. Have no predictable patterns, making prevention difficult D) a. Are generally not preventable

During a frontal crash, the center of gravity of a motorcycle typically causes the rider to be: A) d. Trapped under the bike when it falls to the side B) b. Thrown backward from the bike C) a. Rolled forward with the bike D) c. Thrown over the handlebars

During a vertical fall, a child typically falls: A) b. Face down and could have abdominal trauma B) a. Arms first and may have broken arms C) c. Feet first and could sustain ankle fractures D) d. Head first and may have severe head injuries

Ejection from vehicles: A) d. Never occurs when occupants are restrained B) c. Is becoming more common as fewer people are wearing seat belts C) b. Decreases the risk for spinal trauma but increases the risk for head trauma D) a. Creates a sixfold increase in the risk for death

If no trauma is suspected, which position would be appropriate for assessing the anterior and posterior fontanelles of an infant? A) b. Prone B) a. Lying on side C) d. Supine D) c. Sitting up

In a motor vehicle crash, a frontal or head-on impact can result in a down-and-under injury pathway. This means: A) c. The victim moves laterally and strikes the window and door B) d. The victim moves upward and ultimately strikes the windshield C) a. The impact is at an angle with less trauma to the victim D) b. The victim continues forward toward the steering wheel and moves downward in the seat

The leading cause of death in children under 9 years of age is injuries sustained from: A) c. Pedestrian injuries B) d. Bicycle crashes C) a. Falls D) b. Motor vehicle crashes

The patient is a 28-year-old male involved in a knife fight. He sustained a stab wound to the flank just above the area parallel to the navel. The paramedic should consider that: A) d. Damage may be minimal, as there are few structures in the area B) b. Damage can include the liver or stomach C) c. Damage can include the spleen and lung tissue D) a. Damage can include the kidney and hollow organs of the abdomen

The patient shows bleeding that presents in a steady, slow flow that is dark and red. This type of hemorrhage is called a(n): A) A. Arterial bleed B) B. Capillary bleed C) C. Coagulation D) D. Venous bleed

The signs of external bleeding are dependent on which of the following? A) a. The patient's age B) c. The size of the patient C) b. The patient's temperature D) d. The source of the bleeding

The type of tissue involved in the impact of a projectile determines the severity of the damage. Which of the following sustains the most severe damage as a result of a penetrating projectile? A) c. Liver B) d. Lungs C) a. Bone D) b. Intestines

There are four types of child car seats, including: A) c. Highback booster seat, safety belt seat, rear facing, and side facing B) a. Backless safety seat, rear facing, front facing, and side facing C) b. Front facing, rear facing, side facing, and highback booster seat D) d. Rear facing, front facing, highback booster seat, and safety belt seat

There are three mechanisms of injury when a pedestrian is struck by a motor vehicle. These three mechanisms include: A) a. Striking the bumper, striking the ground, and secondary strike by vehicle B) d. Striking the bumper, striking the windshield, and striking another pedestrian C) b. Striking the bumper, striking the hood, and run over by another vehicle D) c. Striking the bumper, striking the hood, and striking the ground

What is described as renal failure after crush injuries? A) a. Compartment injury B) b. Compartment syndrome C) c. Crush injury D) d. Crush syndrome

What is the most appropriate action to take if hemorrhage control has not been achieved with direct pressure? A) a. Apply a bulky dressing. B) c. Apply pressure to a pressure point. C) b. Apply a tourniquet. D) d. Use elevation of the limb.

What is the most appropriate treatment plan for the patient with a cerebrospinal fluid shunt malfunction? A) b. Hyperventilate. B) a. Administer oxygen. C) c. Intubate. D) d. Tap the shunt reservoir.

What is the typical goal for the administration of IV fluids for the patient with signs and symptoms of shock? A) c. A systolic pressure between 70 and 80 mm Hg B) a. A systolic pressure between 50 and 60 mm Hg C) b. A systolic pressure between 60 and 70 mm Hg D) d. A systolic pressure between 80 and 90 mm Hg

What possible condition should be considered when a patient reports a 'ripping' or 'tearing' pain in the back or abdomen? A) c. Pancreatic cancer B) d. Pelvic inflammatory disease C) b. Liver disease D) a. Aortic aneurysm

What should be done to decrease the flexion of the cervical region of a pediatric patient? A) b. Place a towel under the head. B) a. Place a towel under the chest. C) c. Place a towel under the shoulders. D) d. Place padding under the shoulders to the hips.

You arrive on scene to treat an 'unresponsive infant.' Two very anxious parents direct you to a bedroom where a baby is lying face down in the crib and is not moving. You lift the infant to assess the airway, and the infant's extremities stay fixed in position. The infant feels cold to the touch, and its face and chest are purple; there is no breathing and no pulse. The infant's mother tells you she put him down for a nap 2.5 hours ago and thought he was just sleeping until she went to check on him. What should you do? A) d. Immediately begin CPR. B) b. Attempt intubation, and if the airway cannot be established declare the patient dead. C) a. Accuse the parents of neglecting the baby. D) c. Complete your assessment, and declare this patient dead following established protocols.

Even with intervention, survival is unlikely with blood loss over ________ percent of the total blood volume.

Frontal-impact motor vehicle collision at 45 miles per hour

For which of the following mechanisms of injury should you maintain the highest index of suspicion for hemorrhagic shock?

Hip and femur fractures

Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns?

You are dispatched to an elementary school for a 5-year-old, 42-lb male with a history of diabetes. He is confused, diaphoretic, and tachycardic. When you attempt to get a BGL, the glucometer malfunctions. The next appropriate therapy following management of ABCs and IV access is:

Give D50W at a dose of 2 mL/kg.

Speed of onset of croup.

Gradual, typically several days.

flatter, straighter

Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory.

lateral

In which of the following types of impact should you have a higher index of suspicion because the degree of injury may be greater than the damage alone indicates?

Typical signs and symptoms of a patient suffering from epiglottitis:

Inspiratory stridor, pain on swallowing, high fever, and drooling.

How is hypovolemic shock corrected in pediatric patients?

It is treated using boluses of IV fluid.

Why should oxygen be humidified when administering to a pediatric patient experiencing an asthma attack?

It will reduce the chance of mucus drying up in the lower airways and causing a plug formation.

What is a treatment plan for status asthmaticus is the pediatric patient?

Managed with oxygen, continued administration of nebulized beta2-adrenergic agonists, assisted ventilations, correction of dehydration and acidosis, possible subcutaneous administration of beta2-adrenergic agonists, and possible endotracheal intubation. Medical direction may include aminophylline, magnesium sulfate, and terbutaline by continous infusion.

direct pressure.

Managing a laceration with arterial bleeding most often requires:

C. Mast cells release histamine, resulting in dilation of capillary sphincters and an increase in tissue perfusion.

When cells become hypoxic and the amount of carbon dioxide in them increases, reducing tissue pH, which of the following occurs to restore homeostasis?

B. Use of a short catheter with a large internal diameter

Rapid volume replacement is best achieved under which of the following conditions?

Speed of onset of epiglottits.

Rapid, typically hours.

Pain level of patient suffering from epiglottitis?

Severe, cannot swallow.

Likely findings in a pediatric patient with early septic shock?

Tachycardia with bounding pulses; warm, flushed skin; slow capillary refill; and irritability.

Why are children and infants suffering from burn injuries more likely to have more significant fluid loss than adults?

The body surface area is larger in proportion to the body volume.

Frank-Starling law of the heart.

The increase in myocardial contraction as a result of increased blood return to the heart BEST describes:

trajectory

The path a projectile follows during a flight is called its:

cavity

The pathway of injury left in the wake of a penetrating mechanism of injury is called the:

vascular

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the ________ phase.

Lumbar

When a patient falls and lands on his or her feet, which section of the spinal column is the most prone to compression injury?

What are your considerations when deciding to use a cuffed or uncuffed endotracheal tube in patients younger than 8 years old?

When an endotrachela tube of proper size is inserted, the cricoid cartilage (narrowest point of the airway in children under 8) forms a functional cuff, sealing the airway, making a cuff unnecessary. Placing a cuff on a pediatric endotracheal tube would decrease the lumen of the tube to a point where it would be difficult to adequately ventilate.

A large exit wound

When assessing a patient with a gunshot wound to the chest, which of the following findings would tell you the most about the amount of damage?

The zone of injury is larger than that expected with other types of weapons.

When assessing someone with a gunshot wound from a rifle, which of the following is important to remember?

B. Dullness to percussion

When assessing the chest during rapid trauma survey, what would indicate major internal hemorrhage?

The capacity to do work

Which of the following best defines the term energy?

B. Tunica media

Which layer of the arteries controls the diameter of the vessel?

B. II

Which level of trauma facility can handle the most common trauma emergencies but for more specialized care will have to transfer the patient to a regional trauma center?

C. III

Which level of trauma facility has minimal surgical support but can stabilize before transferring to a higher-level trauma facility?

D. IV

Which level of trauma facility stabilizes and prepares to transport trauma patients to a higher-level facility but does NOT necessarily have surgical capabilities?

Pneumothorax, ruptured bowel

Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen?

Bowel

Which of the following abdominal organs is the least affected by the pressure wave associated with penetrating trauma?

C. Highway Safety Act of 1966

Which of the following acts resulted in the development of modern EMS systems?

B. Immediate surgery

Which of the following best describes definitive care for the trauma patient with ongoing, significant hemorrhage?

B. It prevents pyruvic acid from being converted to lactic acid.

Which of the following best describes the importance of oxygen in cellular metabolism?

The body of the vehicle and its occupants absorb the energy.

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier wall?

The energy gradually dissipates as heat due to the friction of braking, rather than transfers to the vehicle and its occupants.

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a stop?

"Mushrooming" or flattening on impact

Which of the following bullet characteristics would create the most damage?

The victims usually have defensive wounds on their forearms.

Which of the following characteristics of stab wounds is associated with a male attacker?

Lack of a crumple zone

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision?

It will remain intact.

Which of the following is most likely to occur when military ammunition is used?

Wind resistance

Which of the following factors is NOT a consideration in the severity of injury related to falls?

Dropping level of consciousness

Which of the following findings indicates a progression from compensated shock to decompensated shock?

A. Lactated Ringer's

Which of the following fluids is appropriate for the prehospital management of hypovolemic shock?

Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic shock?

D. All of these

Which of the following impairs blood clotting?

"Mushrooming" on impact and tumbling 180 degrees upon impact

Which of the following increases a bullet's profile?

Hypotension

Which of the following indicates that a patient has transitioned from compensated to decompensated shock?

Pneumothorax

Which of the following injuries is associated with the pressure wave produced by a blast?

Entrapment

Which of the following injuries is associated with the tertiary phase of a blast?

Head and neck injuries

Which of the following injuries is most likely to occur to the occupants of a vehicle struck from behind?

A. An autotransfusion of up to 2000 ml of blood from the lower extremities

Which of the following is NOT a benefit of PASG?

Tertiary impact

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle collision?

B. Fall of less than 5 feet

Which of the following is NOT considered a significant mechanism of injury in pediatric patients?

A laceration on the forehead as a result of being struck with a metal pipe

Which of the following is NOT considered penetrating trauma?

B. When patients meet any of the trauma triage criteria, you should transport the patients to the closest facility, because they do not meet all the criteria for immediate transport.

Which of the following is NOT true of trauma triage criteria?

A small, light bullet does the most harm.

Which of the following statements about bullets is true?

D. Your patient's blood pressure is 142/90 when she is supine, but 116/88 when she sits up.

Which of the following is a manifestation of orthostatic hypotension?

Multiple wounds

Which of the following is associated with assault rifle wounds but not hunting rifle wounds?

Rifle

Which of the following is considered a high-velocity weapon?

The distance from the shooter

Which of the following is most important when assessing the damage done by a gunshot?

Clavicle

Which of the following is most likely to be fractured due to a fall onto outstretched hands?

Maintaining cervical spine stabilization while opening the airway

Which of the following is the most important priority when caring for a patient with a shallow-water diving injury?

D. Whole blood

Which of the following is the preferred fluid for resuscitation in hemorrhagic shock?

A shotgun may either fire one slug or use ammunition with multiple pellets.

Which of the following is true of shotgun ammunition?

They may deploy during rescue operations, injuring the patient and/or EMS personnel.

Which of the following is true of supplemental restraint systems?

Children tend to turn toward the vehicle.

Which of the following is true of the differences between adult and pediatric pedestrians when struck by a vehicle?

D. All of these.

Which of the following is true of the elderly trauma patient?

The shock wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

Which of the following is true of the shock wave that accompanies high-velocity penetrating trauma?

It is a space indirectly created by a projectile as tissue moves rapidly away from its path.

Which of the following is true of the temporary cavity formed by penetrating trauma?

The movement is downward as the assailant raises the knife and swings downward.

Which of the following is typical of the trajectory of a knife when a female assailant stabs someone?

Does a patient suffering from epiglottitis present with drooling?

Yes.

Typically, do patients suffering from asthma have a history of allergies?

Yes.

Typically, do patients suffering from bronchiolitis have a history of a low-grade fever?

Yes.

C. Index of suspicion

Which of the following means "the anticipation of injury to a body region or organ"?

Surgery

Which of the following measures effectively controls bleeding in body cavities?

Sudden deceleration

Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum teres?

Sudden acceleration from a lateral-impact motor vehicle collision

Which of the following mechanisms is most consistent with diffuse axonal injury?

Anaerobic metabolism

Which of the following mechanisms is responsible for accumulating lactic acid in shock?

A. Motor vehicle crash with a 20-miles-per-hour impact

Which of the following mechanisms of injury does NOT call for immediate transport to a trauma center?

D. Fifty miles per hour motor vehicle crash with partial ejection

Which of the following mechanisms would yield the greatest index of suspicion for injury?

Handgun

Which of the following organs is most susceptible to damage from the pressure wave when a bullet enters it?

Liver, diaphragm, lung, kidney

Which of the following organs would most likely be injured by a stab wound to the 6th intercostal space in the midaxillary line on the right side?

A. 22-year-old with bilateral open femur fractures

Which of the following patients does NOT require specialty center capabilities beyond that offered by a trauma center?

A. Combative trauma patient

Which of the following patients is NOT a candidate for air medical transport?

C. Vital signs: blood pressure 80 by palpation, heart rate 130, and respiratory rate 12

Which of the following physical findings indicates the need for immediate transport?

Direct pressure, elevation, pressure point compression

Which of the following represents the correct sequence for controlling hemorrhage from an extremity?

A. 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

Which of the following requires immediate transport to a trauma center?

Metabolic acidosis

Which of the following results from anaerobic metabolism in shock?

"Washout" of microemboli and lactic acid

Which of the following results from relaxation of the postcapillary sphincters in shock?

Exit wounds reflect the potential for damage more accurately than entrance wounds.

Which of the following statements about entrance and exit wounds is true?

The degree of injury may be greater than the damage alone would indicate.

Which of the following statements about lateral impact collisions is true?

Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.

Which of the following statements about low-velocity penetrating trauma is true?

Assault rifles generally increase the number of wounds the victim sustains.

Which of the following statements about rifles is true?

Male attackers usually strike with an overhand and inward strike.

Which of the following statements about stab wounds is true?

Helmet use neither increases nor decreases the incidence of spinal trauma.

Which of the following statements about the impact of motorcycle helmet usage is true?

Unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis.

Which of the following statements about the patient in neurogenic shock is NOT true?

It fills with disrupted tissues, some air, fluid, and debris.

Which of the following statements is true of the permanent cavity created by penetrating trauma?

Catecholamines

Which of the following substances has the most rapid effect when compensating for hemorrhage?

Hemorrhage

Which of the following terms is best described as the loss of blood from the vascular space?

C. Transverse laceration of the vessel

Which of the following types of wound facilitates the effectiveness of normal blood-clotting mechanisms?

arterioles

Which of the following vessels has the greatest ability to change diameter?

Baroreceptors

Which of the following, located in the aortic arch, monitor blood pressure and send feedback to the medulla oblingata to maintain homeostasis?

Velocity and mass

Which of the two following factors proportionately affect the kinetic energy of a bullet fired from a gun?

When a bullet yaws, it increases the damage.

Which statement about ballistics is true?

Velocity and mass

Which two factors related to kinetic energy proportionately affect the damage a projectile will do?

Handgun

Which type of firearm usually limits trauma to direct injury?

A body at rest will remain at rest unless acted on by an outside force.

You are called to the scene of a vehicle crash in which a car was rear ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated suspicion of index for injuries?

C. Initiate rapid transport.

Your patient has a possible pelvic fracture from a frontal motor vehicle collision. She has a blood pressure of 78 by palpation, a heart rate of 130, and responds only to painful stimuli. Before you arrived, BLS providers immobilized the patient to a long backboard. Which of the following should you do next?

C. Obstructive and respiratory

Your patient is a 23-year-old male cyclist who was impaled in the chest by a small tree branch as he was riding on a trail. The branch has been removed on your arrival. You note a 1 cm wound in the third intercostal space in the midclavicular line on the right. There is minimal bleeding. You note air being sucked into the wound when the patient inhales, but air does not exit the wound on exhalation. The patient is anxious and has a weak radial pulse of 116 that disappears on inhalation. The patient's respiratory rate is 28, and breath sounds are absent on the right side. The patient is sitting against a tree and refuses to lie down. You note jugular venous distention, but no tracheal deviation. Which types of shock should you suspect in this patient?

Decompensated

Your patient is a 23-year-old male with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal stimuli; has pale, cool, diaphoretic skin; a heart rate of 128; respirations at 24; and a blood pressure of 82/60. These findings indicate which of the following kind of shock?

Your patient is a 29-year-old male who works in a meat-processing plant. He received a knife wound in the proximal antero-medial thigh, which is continuing to bleed on your arrival. He is restless, thirsty, and has pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of 118/88. This patient is exhibiting signs and symptoms consistent with a Stage ________ hemorrhage.

B. He is in decompensated shock.

Your patient is a 45-year-old male who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and confused, pale, diaphoretic, and cool to the touch. He lacks a radial pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this patient?

C. Relative to body weight, a smaller amount of hemorrhage may result in shock.

Your patient is an obese 39-year-old woman involved in a lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this patient?

Abruptio placentae

Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The airbag deployed. For which of the following injuries should you maintain a high index of suspicion?

Observations of a child from across the room before initial contact should include:

muscle tone, interaction, skin color, respiratory effort and rate

Management of a child with moderate croup would include oxygen and:

nebulized saline and nebulized racemic or levo-epinephrine

The first-line medication for all pediatric resuscitations?

oxygen

What are the most common causes of cardiac arrest in children?

respiratory failure

Common nontraumatic causes of shock in the pediatric patient include:

sepsis and hypovolemia

"Jitteriness" and trembling in a pediatric patient with hypoglycemia are caused by the body's activation of the:

sympathetic nervous system, resulting in the liver releasing additional glucose.

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