AEMTexam 4

When assessing a patient who experienced blunt abdominal trauma, you note bruising around the umbilicus. This is called ____________ sign and indicates: A) Cullen sign; significant internal bleeding. B) Murphy sign; gallbladder rupture. C) Grey Turner sign; injury to the liver. D) Kehr sign; ruptured hollow organs.

A) Cullen sign; significant internal bleeding.

Which of the following statements regarding the lung parenchyma is correct? A) It is covered by the visceral pleura. B) It occupies the entire mediastinal space. C) It is encased in the parietal pleura. D) It is composed of three lobes on the left.

A) It is covered by the visceral pleura.

Which of the following statements regarding anterior nosebleeds is correct? A) They usually originate from the septum area and bleed slowly. B) They cause blood to drain into the posterior pharynx. C) They are usually caused by a fracture of the basilar skull. D) They are usually severe and require aggressive treatment to control.

A) They usually originate from the septum area and bleed slowly.

Retinal injuries that are caused by exposure to extremely bright light: A) are typically not painful, but may result in permanent damage to vision. B) damage the motor cells of the eye, resulting in reduced eye movement. C) are intensely painful, but usually only result in temporary blindness. D) usually do not immediate medical attention unless vision is impaired.

A) are typically not painful, but may result in permanent damage to vision.

During your primary assessment of a 33-year-old male with severe hypothermia, you find that he is unresponsive and has agonal breathing. You should: A) assess his carotid pulse for 30 to 45 seconds. B) give two rescue breaths and assess for a pulse. C) apply chemical heat packs to his groin and neck. D) begin CPR and apply the AED as soon as possible.

A) assess his carotid pulse for 30 to 45 seconds.

You should assess a patient with systemic hypothermia for local cold injuries to the extremities because: A) blood is shunted away from the extremities. B) cold blood is shunted to the body's periphery. C) hypothermia causes peripheral vasodilation. D) lactic acid tends to accumulate in the periphery.

A) blood is shunted away from the extremities.

"Breath-holding syncope" commonly occurs when a swimmer: A) breathes deeply and rapidly before entering the water. B) rapidly ascends while holding his or her breath. C) holds his or her breath too long while under water. D) holds his or her breath before entering the water.

A) breathes deeply and rapidly before entering the water.

You are treating a 55-year-old male with heatstroke when he suddenly becomes unresponsive and stops breathing. Assessment of his carotid pulse reveals that it is weak and rapid. You should: A) continue cooling measures, maintain his airway, ventilate him with a bag-mask device, transport, and request a paramedic intercept. B) insert an oral airway, ventilate him with a bag-mask device, cease rapid cooling measures, and transport to the closest hospital. C) ventilate him with a bag-mask device, continue cooling measures, apply the AED in case he develops cardiac arrest, and transport. D) cease cooling measures, insert an oral airway, hyperventilate him with a bag-mask device, transport, and give a 2 liter IV fluid bolus.

A) continue cooling measures, maintain his airway, ventilate him with a bag-mask device, transport, and request a paramedic intercept.

During a football game, a 16-year-old male was "speared" in the right flank by another player. This mechanism of injury is MOST suggestive of injury to the: A) kidney. B) gallbladder. C) liver. D) urinary bladder.

A) kidney.

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a/an: A) laryngeal fracture. B) collapsed trachea. C) crushed cricoid. D) esophageal tear.

A) laryngeal fracture.

The presence of gastric juices and bacteria in the abdominal cavity causes an intense inflammatory reaction called: A) peritonitis. B) diverticulitis. C) appendicitis. D) gastritis.

A) peritonitis.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: A) rapidly transporting her to the hospital. B) requesting a paramedic ambulance. C) careful monitoring of her vital signs. D) quickly immobilizing her spinal column.

A) rapidly transporting her to the hospital.

A 54-year-old male impacted the steering wheel with his chest when his truck struck another vehicle head-on. He complains of retrosternal chest pain, dysphagia, and dyspnea. Although his blood pressure is 160/90, his femoral pulses are weakly palpable. You should suspect: A) traumatic aortic disruption. B) vena cava compression. C) ruptured aortic aneurysm. D) myocardial contusion.

A) traumatic aortic disruption.

Clinical findings associated with a laryngeal injury include: A) hemoptysis, subcutaneous emphysema, and cyanosis. B) hematemesis, bulging eyes, and jugular venous distention. C) pallor, a mediastinal shift, and tracheal deviation. D) posterior neck deformity, Battle's sign, and a dry cough.

A) hemoptysis, subcutaneous emphysema, and cyanosis.

What is the function of the sternocleidomastoid muscle? A) Facilitates chest movement B) Allows movement of the head C) Allows flexion of the neck D) Connects the scapulae together

B) Allows movement of the head

Which of the following types of medications would increase a person's risk of developing a heat-related illness? A) Antihypertensives B) Antihistamines C) Antiarrhythmics D) Antihyperlipidemics

B) Antihistamines

Which of the following would be the LEAST reliable assessment parameter or treatment tool for a patient with significant hypothermia? A) AED B) Pulse oximetry C) Pulse rate D) Respiratory rate

B) Pulse oximetry

Which of the following seatbelt positions will MOST likely result in severe intraabdominal injuries when a vehicle suddenly decelerates? A) Shoulder harness used and lap belt across the anterior iliac crest B) Shoulder harness and lap belt placed superior to the iliac crest C) Shoulder harness not used and lap belt across the anterior iliac crest D) Use of the lap belt only with the shoulder harness behind the back

B) Shoulder harness and lap belt placed superior to the iliac crest

You are performing a rapid assessment on a 30-year-old male who was involved in a motor-vehicle crash. The patient is conscious, but restless. He complains of difficulty breathing and chest pain. Your assessment reveals diminished breath sounds in the left hemithorax, normal jugular veins, and a midline trachea. His blood pressure is 124/64 mm Hg, heart rate is 120 and regular, and respirations are 26 breaths/min and shallow. Which of the following injuries should you suspect? A) Moderate hemothorax B) Simple pneumothorax C) Myocardial contusion D) Tension pneumothorax

B) Simple pneumothorax

When the core body temperature falls below 95°F, the patient's: A) heart rate slows in order to produce body heat. B) ability to regulate body temperature is lost. C) blood vessels dilate in order to conserve heat. D) shivering mechanism is markedly diminished.

B) ability to regulate body temperature is lost.

A 37-year-old semiconscious male sustained a stab wound lateral to the left side of the sternum. He presents with signs of shock, engorged jugular veins, and a weakened radial pulse during inspiration. After administering 100% supplemental oxygen, you should: A) insert a multilumen airway device and begin ventilating him. B) administer 20 mL/kg boluses of an isotonic crystalloid. C) call for a paramedic unit to perform a needle chest decompression. D) apply and fully inflate the pneumatic antishock garment (PASG).

B) administer 20 mL/kg boluses of an isotonic crystalloid.

Patients with diabetes are especially prone to heat illnesses because: A) they usually have concomitant heart disease. B) autonomic neuropathy interferes with vasodilation. C) diabetes is associated with hypothalamic deterioration. D) they cannot readily produce large amounts of glucose.

B) autonomic neuropathy interferes with vasodilation.

Visceral injuries in the chest that occur from shearing forces, compression, or rupture, are MOST commonly seen with: A) penetrating chest trauma. B) blunt chest trauma. C) projectile injuries. D) rapid acceleration.

B) blunt chest trauma.

A 34-year-old male is in late shock secondary to blunt chest trauma. His respirations of 6 breaths/min and shallow will initially result in: A) carbon dioxide elimination and decreased pH. B) carbon dioxide retention and acidosis. C) oxygen deficiency and an increased pH. D) oxygen deficiency and alkalosis.

B) carbon dioxide retention and acidosis.

A 44-year-old male was bitten by a black widow spider. He is conscious and alert, complains of nausea, and has a tense, painful abdomen. His blood pressure is 150/94 mm Hg, pulse is 110 beats/min and strong, and respirations are 24 breaths/min and unlabored. After administering 100% oxygen, you should: A) start a large-bore IV line and administer a 20 mL/kg fluid bolus. B) clean the bite with soap and water, apply ice to the area, and transport. C) request a paramedic unit to respond and administer an antihistamine. D) apply a chemical heat pack to the area to reduce the pain and transport.

B) clean the bite with soap and water, apply ice to the area, and transport.

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A) inspect her eyes and gently remove impaled objects. B) close her eyes and cover them with a moist dressing. C) secure her eyes open so you can reassess her pupils. D) irrigate her eyes with water to prevent mucosal drying.

B) close her eyes and cover them with a moist dressing.

A young male is wearing lightweight clothing and is standing outside in windy winter weather. He is losing heat to the environment mostly by: A) evaporation. B) convection. C) conduction. D) radiation.

B) convection.

An 82-year-old man experienced a minor facial injury when he tripped and fell. He is conscious and alert and complains of slight pain to his cheekbones. His medical history includes hypertension, blood clots in his legs, hypothyroidism, and type 2 diabetes. During your assessment, it is important to remember that: A) patients with hypothyroidism are especially prone to falls. B) he is at an increased risk for severe posterior epistaxis. C) any patient who falls should have their spine immobilized. D) his blood glucose level should be assessed immediately.

B) he is at an increased risk for severe posterior epistaxis.

Signs of a ruptured urinary bladder include all of the following, EXCEPT: A) hematuria. B) hematemesis. C) urethral bleeding. D) perineal bruising

B) hematemesis.

Unilaterally diminished or absent breath sounds, a narrowed pulse pressure, and dullness to percussion of the hemithorax are clinical findings suggestive of a: A) tension pneumothorax. B) hemothorax. C) pericardial tamponade. D) pneumothorax.

B) hemothorax.

Commotio cordis is a condition in which: A) shearing forces tear the aorta from its point of attachment, resulting in profound intrathoracic hemorrhage. B) immediate cardiac arrest occurs when the chest is impacted during the heart's repolarization period. C) increased intrathoracic pressure causes the intercostal muscles to bulge from in between the ribs. D) a patient takes a deep breath just before blunt trauma to the chest, resulting in rupture of one or both lungs.

B) immediate cardiac arrest occurs when the chest is impacted during the heart's repolarization period.

Hyperthermia occurs when: A) a person is briefly exposed to high temperatures. B) inadequate thermolysis causes reduced heat loss. C) the core body temperature rises above 100°F. D) vasodilation shunts warm blood to the body's core.

B) inadequate thermolysis causes reduced heat loss.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: A) covering both eyes and transporting. B) irrigating his right eye laterally. C) flushing his eye starting laterally. D) irrigating both eyes simultaneously

B) irrigating his right eye laterally.

The superficial temporal artery can be palpated: A) at the angle of the jaw. B) just anterior to the tragus. C) slightly above the ear. D) over the mastoid process.

B) just anterior to the tragus

Compared to classic heatstroke, exertional heatstroke commonly presents with: A) hot, dry skin. B) moist, pale skin. C) a weak, rapid pulse. D) altered behavior.

B) moist, pale skin.

A 24-year-old male was pulled from the water following submersion for an unknown length of time. There were no witnesses to the patient's submersion. When you arrive at the scene, you determine that he is in cardiac arrest. Routine management for this patient should include all of the following, EXCEPT: A) oropharyngeal suctioning. B) subdiaphragmatic thrusts. C) defibrillation as needed. D) full spinal precautions.

B) subdiaphragmatic thrusts.

Patients with multiple rib fractures may develop significant hypoxia because of a ventilation/perfusion mismatch, which occurs when: A) vascular disruption severely inhibits the adequate exchange of gases in the lungs. B) the circulatory system is intact but the amount of available oxygen is diminished. C) the circulatory system is unable to transfer adequate oxygen to the body's tissues. D) alveolar surface area is greatly increased and the pulmonary capillaries are dilated.

B) the circulatory system is intact but the amount of available oxygen is diminished.

A 54-year-old male convenience store clerk was shot in the left anterior chest during an attempted robbery. After ensuring that the scene is safe, you enter the store and perform a primary assessment. The patient is semiconscious, is in severe respiratory distress, and is pale. Further assessment reveals absent breath sounds on the left side of his chest, collapsed jugular veins, and a blood pressure of 70/44 mm Hg. In addition to managing his airway, you should: A) perform a detailed secondary assessment and then transport rapidly. B) transport immediately and perform invasive procedures en route. C) start two large-bore IVs and give a 20 mL/kg bolus of normal saline. D) ventilate the patient at a rate of 20-24 breaths per minute.

B) transport immediately and perform invasive procedures en route.

When caring for any patient who was sexually assaulted and experienced injury to the external genitalia, you should: A) treat any injuries and question the patient about the event. B) treat any injuries and provide privacy and reassurance. C) limit your examination to a secondary assessment only. D) transport only and provide support and reassurance.

B) treat any injuries and provide privacy and reassurance.

When treating an unconscious, breathing patient with moderate to severe hypothermia, you must avoid rough handling in order to avoid inducing: A) paradoxical hyperthermia. B) ventricular fibrillation. C) respiratory arrest. D) asystole.

B) ventricular fibrillation.

Which of the following findings is LEAST suggestive of a head injury? A) Failure of the eyes to follow movement of an object B) One pupil larger in size than the other pupil C) Briskly constricting pupils when exposed to light D) Failure of the eyes to move in the same direction

C) Briskly constricting pupils when exposed to light

Which of the following MOST accurately describes the pathophysiology of a pneumothorax? A) Accumulation of blood or other fluid in the pleural space B) Intrapulmonary pressure secondary to pleural compression C) Intrapleural pressure with progressive pulmonary collapse D) Air trapping in the mediastinum from a punctured lung

C) Intrapleural pressure with progressive pulmonary collapse

A fracture involving the nasal bone and inferior maxilla, which separates the nasal bone and lower maxilla from the facial skull and remainder of the cranial bones describes: A) a Le Fort I fracture. B) a Le Fort III fracture. C) a Le Fort II fracture. D) craniofacial disjunction.

C) a Le Fort II fracture.

When percussing the chest of a patient who experienced blunt chest trauma, you note hyperresonance on the left side of his chest. This suggests: A) alveolar hyperinflation. B) myocardial compression. C) air in the pleural space. D) blood in the pleural space.

C) air in the pleural space.

Prior to initiating CPR on an apneic, hypothermic patient, you should: A) analyze the patient's cardiac rhythm with an AED. B) administer a 20 mL/kg bolus of isotonic crystalloid. C) assess the carotid pulse for up to 60 seconds. D) provide two minutes of rescue breathing.

C) assess the carotid pulse for up to 60 seconds.

uring your assessment of a 48-year-old female with localized blunt abdominal trauma, you should: A) immobilize her spinal column. B) vigorously palpate the entire abdomen. C) be prepared for the patient to vomit. D) palpate the most painful area first.

C) be prepared for the patient to vomit.

When a warm hand touches a cold object, heat passes directly from the body to the colder object. This is an example of: A) convection. B) radiation. C) conduction. D) evaporation.

C) conduction.

Blunt abdominal trauma may result in tearing of the mesentery, which is/are: A) the main supporting structure of the descending abdominal aorta. B) a vascular network that provides exclusive blood supply to the liver. C) membranous folds that attach the intestines to the abdominal wall. D) multiple bands of thick muscle that protect the abdominal organs.

C) membranous folds that attach the intestines to the abdominal wall.

In contrast to paradoxical chest motion, asymmetrical chest movement occurs when: A) one segment of the chest wall moves opposite the remainder of the chest. B) both sides of the chest wall move in unison during deep inspiration. C) one side of the chest fails to move normally during inspiration. D) both sides of the chest move shallowly during normal breathing.

C) one side of the chest fails to move normally during inspiration.

Which of the following statements regarding blunt chest trauma is correct? A) Shearing of vital intrathoracic organs is uncommon with blunt chest trauma. B) Blunt chest trauma usually occurs during the tertiary phase of a blast injury. C) The force from blunt chest wall trauma is usually confined to a small area. Which of the following statements regarding blunt chest trauma is correct? D) Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs.

D) Fractured ribs can tear the lung parenchyma or other vital intrathoracic organs.

Which of the following is the MOST reliable means of assessing the potential for abdominal injuries following a motor-vehicle crash? A) Determining whether or not the airbag deployed on impact B) Asking the patient if he or she was wearing a seatbelt C) Noting the position of the restraint system on the patient D) Lifting a deployed airbag and assessing the steering wheel

D) Lifting a deployed airbag and assessing the steering wheel

Which of the following organs lie in the right upper quadrant of the abdomen? A) Pancreas and liver B) Gallbladder and spleen C) Spleen and liver D) Liver and gallbladder

D) Liver and gallbladder

Which of the following potentially lethal chest injuries would you be the LEAST likely to detect during the primary assessment? A) Cardiac tamponade B) Bronchial disruption C) Flail chest D) Pulmonary contusion

D) Pulmonary contusion

Of the following injuries, which would MOST likely present with muffled heart tones? A) Myocardial contusion B) Sternal fracture C) Diaphragmatic injury D) Tension pneumothorax

D) Tension pneumothorax

Following blunt trauma to the right flank area, a 20-year-old male presents with hematuria. Assessment of the area reveals pain to palpation, but no visible signs of trauma. His blood pressure is 120/76 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min and unlabored. Which of the following is the MOST appropriate intravenous therapy for this patient? A) One large-bore IV and a 20 mL/kg normal saline bolus. B) Two large-bore IVs and a 500 mL normal saline bolus. C) One large-bore IV set at a keep vein open (KVO) rate. D) Two large-bore IVs set at a keep vein open (KVO) rate.

D) Two large-bore IVs set at a keep vein open (KVO) rate.

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with heavy bleeding. As your partner manually stabilizes the patient's head, you should: A) administer 100% supplemental oxygen. B) stabilize the impaled glass in her eye. C) carefully remove the glass from her eye. D) apply direct pressure to her arm wound.

D) apply direct pressure to her arm wound.

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 depth. You should: A) assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. B) apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport. C) fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. D) apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

D) apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

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: A) ask her to move the injured eye to assess the integrity of the optic nerve. B) apply firm direct pressure to the injured eye and cover the opposite eye. C) carefully examine her eye and remove any foreign objects if needed. D) avoid applying pressure to the globe when you are covering her eye.

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

When treating a patient with a suspected diaphragmatic rupture, you should: A) avoid administering more than 500 mL of crystalloid. B) apply 100% oxygen with a nonrebreathing mask. C) assist ventilations with a bag-mask device if needed. D) avoid placing the patient in a Trendelenburg position.

D) avoid placing the patient in a Trendelenburg position

A construction worker is pinned in between a truck and a loading dock. He is conscious and in respiratory distress. Further assessment reveals upper torso and facial cyanosis and bilateral conjunctival hemorrhages. When treating this patient, you must: A) suspect that he will experience metabolic alkalosis. B) administer 3 liters of normal saline before he is freed. C) avoid fluid boluses as this may cause pulmonary edema. D) be prepared for severe hypotension once he is freed.

D) be prepared for severe hypotension once he is freed.

The term "hyphema" is defined as: A) an acute rupture of the globe of the eye. B) inflammation of the iris, cornea, and lens. C) compression of one or both optic nerves. D) blood in the anterior chamber of the eye.

D) blood in the anterior chamber of the eye.

The absence of pain when palpating a trauma patient's abdomen does not rule out the possibility of intraabdominal bleeding because: A) most cases of intraabdominal hemorrhage occur in the retroperitoneal space. B) the strong abdominal musculature becomes tense following blunt trauma. C) the liver and spleen are both well protected by the lower ribcage. D) blood within the peritoneal cavity does not provoke an inflammatory response.

D) blood within the peritoneal cavity does not provoke an inflammatory response.

When treating a patient with a suspected myocardial contusion, it is especially important to monitor the patient for: A) signs of right-sided heart failure. B) distention of the jugular veins. C) a heart rate that exceeds 90/min. D) evidence of pulmonary edema.

D) evidence of pulmonary edema.

A patient with a core body temperature of 85°F would be expected to present with: A) confusion or lethargy. B) deep, rapid respirations. C) uncontrolled shivering. D) profoundly slow respirations.

D) profoundly slow respirations.

Chest trauma is a common cause of respiratory acidosis, and rapidly leads to death because the: A) body eliminates CO2 more rapidly than it is produced. B) kidneys fail and are unable to normalize the blood's pH. C) pH level of the blood increases precipitously. D) renal system cannot compensate quickly enough.

D) renal system cannot compensate quickly enough.

Murphy sign;

gallbladder rupture.

Grey Turner sign;

injury to the liver.

Kehr sign;

ruptured hollow organs.

Cullen sign;

significant internal bleeding.