Chapter 24
67.Optimally, on-scene time for critically injured patients should be less than _____ minutes.
10
77.A young boy was riding his bicycle down the street when he hit a parked car. How many collisions took place? A. 1B. 2C. 3D. 4
3
23.During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of A.7.B.8.C.9.D.10.
7.
18. Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His Revised Trauma Score (RTS) is A. 8.B. 9.C. 10.D. 11.
9.
42.Which of the following patients has experienced the MOST significant fall? A.a 4′8″ patient who fell 13′B.a 5′0″ patient who fell 13′C.a 4′6″ patient who fell 13′D.a 5′9″ patient who fell 14′
A 4'6" patient who fell 13 feet
94.Which of the following patients has experienced the MOST significant fall?
A 4'6" patient who fell 13'
6. Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A.flail chestB.aortic ruptureC.extremity fracturesD.forehead lacerations
Aortic rupture
83.Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash? -Extensive damage to the automobile -Flail chest and lower extremity fractures -Massive external trauma with severe bleeding -Aortic rupture or compression injury to the brain
Aortic rupture or compression injury to the brain
95.Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash?
Aortic rupture or compression injury to the brain
29.A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A.compression of the head against the roofB.lateral bending of the neck during the crashC.impact of the head against the steering wheelD.whiplash injury to the neck during the rollover
Compression of the head against the roof
32.Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A.collapsed dashboardB.deformed steering wheelC.caved-in passenger doorD.intrathoracic hemorrhage
Deformed steering wheel
14. Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A.dismounted seatsB.steering wheel deformityC.intrusion into the vehicleD.deployment of the air bag
Deployment of the air bag
88.Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? - Head-on collision - Angular collision - Ejection - Controlled crash
Ejection
12. A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A.lateral impact to the spineB.energy transmission to the spineC.direct trauma to the spinal columnD.secondary fall after the initial impact
Energy transmission to the spine
50.A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience? A.head injuryB.cardiac contusionC.pulmonary contusionD.multiple rib fractures
Head injury
35.With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A.It provides the least amount of information about the mechanism of injury.B.It has a direct effect on patient care because of the obvious vehicular damage.C.It is the most dramatic part of the collision and may make extrication difficult.D.It occurs when the unrestrained occupant collides with the interior of the vehicle.
It is the most dramatic part of the collision and may make extrication difficult.
68._____ impacts are probably the number one cause of death associated with motor vehicle collisions. A. FrontalB. LateralC. rear endD. Rollover
Lateral
72.A comprehensive regional resource capable of providing every aspect of trauma care from prevention through rehabilitation is the definition of a _____ trauma center. A. Level 1B. Level 2C. Level 3D. Level 4
Level I
74.Burns from hot gases and respiratory injuries from inhaling toxic gas are associated with which type of blast injury?
Miscellaneous
71."For every action, there is an equal and opposite reaction" is
Newton's third law.
82.20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A. Deployed airbagB. Bent steering wheelC. Non-intact windshieldD. Crushed instrument panel
Nonintact windshield
36.By what mechanism is a person injured when he or she falls from a significant height? A.Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop.B.Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.C.As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact.D.Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.
9. Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A.intravenous fluid administrationB.early administration of oxygenC.elevation of the lower extremitiesD.rapid transport to a trauma center
Rapid transport to a trauma center
56.Which of the following is considered a type of impact from a motor vehicle collision? A. EjectionB. RolloverC. CrushD. Penetration
Rollover
73.Which of the following is not considered a type of impact associated with a motorcycle crash? A. Head onB. RotationalC. ControlledD. Ejection
Rotational
3. Which types of motor vehicle collisions present the greatest potential for multiple impacts? A. Lateral and rolloverB. Frontal and rotationalC. Rear-end and rotationalD. Rotational and rollover
Rotational and rollover
38.Which of the following statements regarding low-energy penetrating injuries is correct? A.Internal injuries caused by low-velocity bullets are usually easy to predict.B.Exit wounds are typically easy to locate with low-energy penetrating injuries.C.It is usually easy to differentiate between an entrance wound and an exit wound.D.The area of injury is usually close to the path the object took through the body.
The area of injury is usually close to the path the object took through the body.
78.A young boy was riding his bicycle down the street when he hit a parked car. What was the first collision? A. The bike hitting the carB. The bike rider hitting his bike or the carC. The bike rider's internal organs striking the solid structures of the bodyD. The bike rider striking the pavement
The bike hitting the car.
79.A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision?
The bike rider hitting his bike or the car.
58.Which of the following is NOT considered appropriate use of air medical services? A. Head onB. RotationalC. ControlledD. Ejection
The closest trauma center is 10 minutes away by ground transport.
80.A young boy was riding his bicycle down the street when he hit a parked car. What will rate your index of suspicion for this collision?
The mechanism of injury
4. Which of the following statements regarding gunshot wounds is correct? A.High-velocity bullets will cause less severe internal injuries.B.The size of a bullet has the greatest impact on producing injury.C.Low-velocity bullets will cause the greatest amount of trauma.D.The speed of a bullet has the greatest impact on producing injury.
The speed of a bullet has the greatest impact on the injury produced.
57.The three collisions in a frontal impact include all of the following EXCEPT
air bag striking passenger.
44.When evaluating the mechanism of injury of a car versus pedestrian collision, you should first A.determine if the patient was propelled away from the vehicle.B.approximate the speed of the vehicle that struck the pedestrian.C.evaluate the vehicle that struck the patient for structural damage.D.determine if the patient was struck and pulled under the vehicle
approximate the speed of the vehicle that struck the pedestrian.
11. A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then A.apply a cervical collar.B.obtain baseline vital signs.C.auscultate bowel sounds.D.assess for an exit wound.
assess for an exit wound.
28.When treating a patient who experienced a pulmonary blast injury, you should A.use a demand valve to ventilate the patient.B.suspect an accompanying cardiac tamponade.C.avoid giving oxygen under positive pressure.D.administer large amounts of intravenous fluid
avoid giving oxygen under positive pressure.
62.A contusion to a patient's forehead along with a spider-webbed windshield suggests possible injury to the
brain
46.While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for A.underlying cardiac disease.B.a lacerated coronary artery.C.bruising of the heart muscle.D.traumatic rupture of the aorta.
bruising of the heart muscle.
40.The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as A.capitation.B.cavitation.C.congruent.D.conversion.
cavitation.
60.In a motor vehicle collision, as the passenger's head hits the windshield, the brain continues to move forward until it strikes the inside of the skull, resulting in a _____ injury. A. CompressionB. LacerationC. LateralD. Motion
compression
91.Index of suspicion is MOST accurately defined as A.the way in which traumatic injuries occur. B.a predictable pattern that leads to serious injuries. C.your concern for potentially serious underlying injuries. D.the detection of less obvious life-threatening injuries.
concern for potentially serious underlying injuries.
53.Energy can be
converted.
20.Signs of a pulmonary blast injury include A.vomiting blood.B.coughing up blood.C.an irregular pulse.D.multiple rib fractures.
coughing up blood.
64.Significant clues to the possibility of severe injuries in motor vehicle collisions include A. death of a passenger.B. a blown-out tire.C. broken glass.D. a deployed air bag.
death of a passenger
37.Air bags are designed to A.prevent a second collision inside the car.B.be used with or without a shoulder harness.C.decrease the severity of deceleration injuries.D.prevent the driver from sustaining head trauma.
decrease the severity of deceleration injuries.
25.When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A.doorB.dashboardC.windshieldD.steering wheel
door
49.During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred A.during the tertiary phase.B.during the secondary phase.C.during the primary phase.D.as a direct result of the pressure wave.
during the tertiary phase.
69.The most common life-threatening event in a rollover is ____ or partial ejection of the passenger from the vehicle.
ejection
87.Death from a rollover motor vehicle crash is MOST often secondary to - crushing injuries. - airbag-related trauma. - multiple collisions to the interior of the car. - ejection of the patient from the motor vehicle.
ejection of the patient from the motor vehicle.
45.Two of the MOST common mechanisms of injury for blunt trauma are a. falls and motor vehicle collisions.b. low-caliber gunshot wounds and falls.c. gunshot wounds and vehicle ejections.d. motor vehicle collisions and stabbings
falls and motor vehicle collisions.
59.Medium-velocity penetrating injuries may be caused by a
handgun.
7. According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she A.was involved in a motor vehicle crash in which another patient in the same vehicle was killed .B.has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C.has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D.has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.
has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.
48.In contrast to a Level III trauma center, a Level I trauma center must a. be involved in trauma prevention programs.b. have general surgeons who are in-house 24 hours a day.c. have access to an emergency physician within 30 minutes.d. be able to stabilize patients before transferring to a higher level facility.
have general surgeons that are in-house 24 hours a day.
63.Which of the following is the MOST common cause of death from a blast injury? A. AmputationB. BurnsC. Chest traumaD. Head injury
head trauma
21.The cervical spine is MOST protected from whiplash-type injuries when the A. headrest is appropriately positioned.B. air bag correctly deploys upon impact.C. rear end of the vehicle is initially struck.D. patient tenses up at the time of impact.
headrest is appropriately positioned.
66.Air bags decrease injury to all of the following EXCEPT A. ChestB. HeartC. FaceD. Head
heart
27.Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to A.determine the vehicle's speed at the time of impact.B.assess the severity of the third collision of the crash.C.recognize if the driver hit the brakes before impact.D.identify contact points and predict potential injuries.
identify contact points and predict potential injuries.
51.Your awareness and concern for potentially serious obvious and underlying injuries is referred to as the
index of suspicion.
17. Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of A.spinal cord injury. B.airway compromise. C.intracranial bleeding. D.a fracture of the skull.
intracranial bleeding.
22.A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she A.is wearing only a lap belt.B.remains within the vehicle.C.experiences multiple impacts.D.is ejected or partially ejected
is ejected or partially ejected.
52.The energy of a moving object is called a. latent energy.b. kinetic energy.c. potential energy.d. converted energy.
kinetic energy.
15. Approximately 25% of severe injuries to the aorta occur during A.frontal collisions. B.lateral collisions. C.rollover collisions. D.rear-end collisions.
lateral collisions.
61.Your quick primary assessment of the patient and evaluation of the _____ can help to direct lifesaving care and provide critical information to the hospital staff. A. EnvironmentB. Index of suspicionC. Mechanism of injuryD. Abdominal area
mechanism of injury
26.When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the A.index of suspicion.B.mechanism of injury.C.kinetic energy.D.potential energy.
mechanism of injury.
89.When assessing a stab wound, it is important for the EMT to remember that - stabbings to an extremity are rarely associated with an exit wound. - the majority of the internal trauma will be near the path of the knife - most stabbings are unintentional and cause less severe internal injury. - more internal damage may be present than the external wound suggests.
more internal damage may be present than the external wound suggests.
10. While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced A.open abdominal trauma.B.neck and facial injuries.C.blunt trauma to the head.D.lower extremity fractures.
neck and facial injuries.
5. When assessing an elderly patient who fell, it is important to remember that A. osteoporosis can cause a fracture as a result of a fall from a standing position.B. any fall in the elderly is considered to be high-energy trauma.C. elderly patients who fall usually have a secondary head injury.D. bilateral hip fractures usually occur when an elderly person falls.
osteoporosis can cause a fracture as a result of a fall from a standing position.
93.The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has a few small abrasions to her left forearm. Treatment for the passenger should include a. transport to a trauma center.b. a focused exam of her forearm.c. transport to a community hospital.d. a secondary assessment at the scene.
performing a rapid trauma assessment.
43.A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for A.injury to the cervical spine.B.potential airway compromise.C.damage to internal structures.D.alterations in his mental status.
potential airway compromise.
65.Damage to the body that resulted from a pressure wave generated by an explosion is found in what type of blast
primary
19. When assessing a patient who experienced a blast injury, it is important to remember that A.secondary blast injuries are usually the least obvious.B.primary blast injuries are typically the most obvious.C.solid organs usually rupture from the pressure wave.D.primary blast injuries are the most easily overlooked
primary blast injuries are the most easily overlooked.
75.A patient complaining of chest tightness, coughing up blood, and subcutaneous emphysema following an explosion may be suffering from a A. myocardial blast injury.B. ruptured tympanic membrane.C. ruptured peritoneal cavity.D. pulmonary blast injury.
pulmonary blast injury.
13. When the speed of a motor vehicle doubles, the amount of kinetic energy A.doubles.B.triples.C.quadruples.D.is not affected
quadruples.
55.All of the following are considered types of motorcycle impacts EXCEPT A. Head on collisionB. Angular collisionC. Controlled collisionD. Rear collision
rear collision.
86.Whiplash injuries are MOST common following _________ impacts. - rear-end - rollover - frontal - lateral
rear-end
30.When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant A. is thrust under the steering column onto the floorboard.B. remains in motion until acted upon by an external force.C. will decelerate at the same rate as the motor vehicle.D. will most likely be thrown over the steering column.
remains in motion until acted upon by an external force.
41.When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to A.realize that the air bag malfunctioned at the time of impact.B.remember that it could still deploy and seriously injure you.C.suspect that the patient may have experienced serious injuries.D.recognize that the force of impact was most likely not severe.
remember that it could still deploy and seriously injure you.
54.The amount of kinetic energy that is converted to do work on the body dictates the _____ of the injury.
severity
16. A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to A.stabilize her entire spine. B.obtain baseline vital signs. C.inspect the helmet for cracks. D.leave her bicycle helmet on.
stabilize her entire spine.
84.A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find - deployed airbags. - steering wheel deformity. - starring of the windshield .- a crushed instrument panel.
steering wheel deformity.
33.If one or more occupants in the same vehicle are killed in a crash, the EMT should A.suspect that all living occupants experienced the same serious trauma.B.transport the survivors only if they have injuries or complain of pain.C.allow the survivors to refuse transport if they have no obvious injuries.D.rapidly assess only the survivors who have experienced obvious trauma.
suspect that all living occupants experienced the same serious trauma.
76.Patients suffering from an open wound to the neck may suffer from all of the following EXCEPT A. Significant bleedingB. Air embolismC. Tension pneumothoraxD. Subcutaneous crepitation
tension pneumothorax.
90.A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury MOST likely occurred during the ___________ phase of the explosion. - primary- secondary- tertiary- quaternary
tertiary
31.Internal injuries caused by gunshot wounds are difficult to predict because A.the caliber of the bullet is frequently unknown.B.the area of damage is usually smaller than the bullet.C.the bullet may tumble or ricochet within the body.D.exit wounds caused by the bullet are usually small
the bullet may tumble or ricochet within the body.
47.Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT a. the speed of the fall.b. the surface struck.c. the height of the fall.d. the primary impact point.
the speed of the fall.
34.Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the A.thoracic and sacral spine.B.lumbar and coccygeal spine.C.thoracic and lumbar spine.D.lumbar and sacral spine
thoracic and lumbar spine.
70.A fall from more than _____ times the patient's height is considered to be significant. A. twoB. threeC. fourD. five
three
1. According to the Association of Air Medical Services, you should consider air medical transport of a trauma patient if A.traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. B.ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C.the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. D.he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.
traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.
24.The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include A.transport to a trauma center.B.a focused exam of her forearm.C.transport to a community hospital.D.a secondary assessment at the scene.
transport to a trauma center.
85.An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter - trauma to the pelvis .- blunt abdominal trauma. - a severe closed head injury. - penetrating thoracic trauma.
trauma to the pelvis.
81.Kinetic energy is a calculation of A. weight and size.B. weight and speed.C. mass and weight.D. speed and force.
weight and speed.
2. Force acting over a distance is the definition of A.work.B.latent energy.C.kinetic energy.D.potential energy.
work.
8. The index of suspicion is MOST accurately defined as
your awareness and concern for potentially serious underlying injuries.