Chapter 28

How much blood loss can femur fractures account​ for? A. 750 mL B. 3 L C. ​1,500 mL D. 500 mL

1,500 mL

Hemostatic gauze has been used to control hemorrhage. What is the minimum amount of time that pressure should be maintained after packing the wound with hemostatic​ gauze? A. 1 minute B. 10 minutes C. 3 minutes D. 5 minutes

3 minutes

A​ 35-year-old female patient states that she was shot in the abdomen. Her vital signs are P​ 110, R​ 22, BP​ 86/50, and SpO2 is 90 percent on room air. Oxygen should be administered via​ a: A. simple mask at 8 lpm. B. nonrebreather mask at 15 lpm. C. nasal cannula at 3 lpm. D. ​bag-valve mask at 15 lpm.

NRB at 15lpm

Severe external bleeding should be controlled during which phase of the patient​ assessment? A. Reassessment B. Scene​ size-up C. Secondary assessment D. Primary assessment

PRIMARY assessmetnm

Which statement is TRUE about​ dressings? A. Both the dressing and the bandage should be sterile to prevent contamination. B. Aluminum foil makes an excellent occlusive​ dressing, especially for eviscerations. C. A dressing covers an open wound to control bleeding and prevent contamination. D. A dressing is applied over a bandage to secure the bandage in place.

a dressing covers an open wound to control bleeding and prevent contamination

Which item should NEVER be removed in the​ field? A. A pencil that is stuck in your​ patient's cheek B. A knife that is lodged in your​ patient's chest C. A screwdriver that is impaled through your​ patient's trachea D. A pen that is stuck in your​ patient's hard palate

a knife that is lodged in your patient's chest

Which of these patients would the EMT recognize as suffering from an evisceration​ injury? A. A male patient with a knife impaled in his right upper abdomen B. A female shot in the chest with​ "bubbling" coming from the wound as the patient breathes C. A female with a large flap of skin that has been torn loose from her scalp D. A male patient with a loop of intestine protruding from an open surgical wound

a male patient with a loop of intestine protruding from an open surgical wound

​Scraping, rubbing, or shearing away of the outermost layer of the skin is called​ a/an: A. avulsion. B. laceration. C. abrasion. D. contusion.

abrasion

A patient presents with an arrow impaled in the right lower quadrant of his abdomen. He is in excruciating pain and states that he was accidentally shot by a friend while hunting. While there is no external bleeding coming from the​ injury, the surrounding skin is ecchymotic. Other assessment​ findings, such as the vital​ signs, indicate the patient is in early shock. Which action should the EMT perform​ first? A. Stabilize the arrow with an occlusive dressing B. Establish manual cervical spine motion restriction C. Carefully remove the arrow D. Administer supplemental oxygen

administer supplemental oxygen

Which choice is of special consideration in preventing when treating a​ large, open neck​ injury? A. Jugular perforation B. Pulmonary embolism C. Pericardial edema D. Air embolism

air embolism

You are treating a​ 43-year-old female patient who was hunting with a pistol. When she sat down in the​ outhouse, her gun went​ off, and the bullet created a large hole in her right​ thigh, which is now severely spurting blood. What is the MOST appropriate method of bleeding control for this injury if direct pressure​ fails? A. Application of a tourniquet B. Looking for a pressure point to apply C. Direct pressure and elevation D. Application of ice on the wound

application of a tourniquet

Once a dressing has been applied to a​ wound, you​ should: A. apply a hot pack. B. wash the area around the wound. C. apply a bandage. D. place the injury lower than the heart.

apply a bandage

Your​ 35-year-old female patient has accidentally cut her forearm with a kitchen knife. Because the blood is bright red and​ spurting, you consider the bleeding to be from​ a/an: A. capillary. B. venule. C. artery. D. vein.

artery

You have just applied a pressure dressing to the leg of a woman who suffered a deep laceration to her calf from a piece of broken glass. What should you do​ next? A. Obtain a​ follow-up blood pressure B. Apply a tourniquet above the laceration C. Assess the blood glucose level to determine if hypoglycemia contributed to the accident D. Assess for a pedal pulse

assess for a pedal pulse

Bleeding from the​ nose, ears, or mouth is a cause for concern. Keep in mind​ that: A. treatment for nosebleeds consists of having the patient pinch the fleshy part of the nostrils together and lean backward. B. if your patient has a head​ injury, you should attempt to stop the flow of​ blood, since the bleeding will decrease blood flow to the brain. C. attempting to stop bleeding from the ears if the patient has a head injury could increase pressure inside the skull. D. hyperglycemia can increase intracranial​ pressure, resulting in the bleeding.

attempting to stop bleeding from the ears if the patient has a head injury could increase the pressure inside the skull

Your patient was slashed with a knife and has a flap of skin hanging from his arm. This is known as​ a/n: A. laceration. B. puncture. C. avulsion. D. abrasion.

avulsion

A blood vessel that is cut along its length​ will: A. retract and clot off. B. bleed uncontrollably. C. cause hypoperfusion within 2 to 3 minutes. D. immediately seal itself with reticular fibers.

bleed uncontrollably

Which statement regarding contusions is​ true? A. Blood vessels in the epidermis have broken but the skin is intact B. The epidermis is open and actively bleeding C. Blood vessels in the subcutaneous layer have been broken D. Blood vessels in the dermal layer have ruptured

blood vessels in the dermal layer have ruptured

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she initially cut​ herself, blood spurted from the​ wound; then, within a second or​ two, it subsided to a mere trickle. She asks why this would happen. What is the correct​ response? A. ​"Red blood cells will quickly repair the injury to the blood​ vessel." B. ​"Blood has the ability to clot within a second or two of​ injury." C. ​"The skin around the injured blood vessels quickly swells and stops​ bleeding." D. ​"Blood vessels tend to constrict quickly once they are​ injured."

blood vessels tend to constrict quickly once they are injured

Your​ 14-year-old female patient has fallen off her bike and scraped her arm. The bleeding is dark red and slowly oozing. This type of bleeding is usually from​ damaged: A. veins. B. arteries. C. capillaries. D. venules.

capillaries

Slow oozing blood that is dark in color is MOST likely what​ type? A. Capillary B. Arterial C. Venous D. Significant

capillary

Soft tissue wounds of the skin are classified​ as: A. closed or open. B. simple or compound. C. partial thickness or full thickness. D. ​first, second, or third degree.

closed or open

You are treating a​ 32-year-old male patient who struck a large tree with his car. On your​ arrival, law enforcement tells you that the patient was wandering around the accident scene. You locate the patient sitting on the ground next to his​ car, conscious and alert. He is unable to speak because of an avulsion of his left​ cheek, leaving a​ full-thickness section that was severed and is heavily​ bleeding, just below his zygomatic​ arch, flipped down onto his lower jaw. You also note that he is missing several of his now exposed teeth. Your partner immediately begins control of the​ patient's cervical​ spine, and you note that his respirations are 16 and easy and his radial pulse is 92. After the airway has been​ secured, what is your NEXT​ priority? A. Applying​ high-flow oxygen B. Locating the missing teeth C. Controlling the bleeding D. Immobilizing the spine

controlling the bleeding

Some wounds lie beneath unbroken skin. An example of this type of wound is​ a/an: A. contusion. B. avulsion. C. abrasion. D. penetration.

contusion

Which of the following is a closed soft tissue​ injury? A. Avulsion B. Contusion C. Abrasion D. Laceration

contusion

The use of which medicine by the patient may make bleeding the patient sustains more severe because the medication causes inhibition of​ clotting? A. Lasix B. Coumadin C. Albuterol D. Plavix

coumadin

A patient was building a bomb in his garage when it accidentally detonated. Assessment findings from the rapid secondary assessment reveal part of the intestines and a portion of the liver protruding from the right side of the abdomen. Proper care of this injury would​ include: A. Careful replacement of the organs back into the abdominal cavity B. Direct but gentle pressure applied to the exposed organs to hold them in place C. Application of a dry sterile dressing covered with an occlusive dressing taped on three sides D. Covering the exposed organs with a large sterile dressing soaked with sterile water

covering the exposed organs with a large sterile dressing soaked with sterile water

A​ 24-year-old male patient cut his thigh with a chainsaw and has severe bleeding. You should immediately​ apply: A. hemostatic gauze. B. a tourniquet. C. a pressure dressing. D. direct pressure.

direct pressure

A​ 24-year-old male patient cut his thigh with a chainsaw and has severe bleeding. You should immediately​ apply: A. hemostatic gauze. B. direct pressure. C. a tourniquet. D. a pressure dressing.

direct pressure

The method of bleeding control that is the FIRST and MOST successful method you will try​ is: A. a tourniquet. B. direct pressure. C. the use of a pressure point. D. the application of cold.

direct pressure

Which set of​ steps, in​ order, is BEST for controlling​ bleeding? A. Direct​ pressure, pressure​ dressing, and tourniquet B. ​Elevation, pressure​ points, and direct pressure C. Pressure​ points, direct​ pressure, and elevation D. ​Tourniquets, direct​ pressure, and pressure points

direct pressure, pressure dressing, and touniquet

In preparing to transport a patient and her recently amputated​ foot, what is the MOST important thing to​ remember? A. Keep the amputated part cool. B. Wrap the part in a dry sterile dressing. C. Remove any gross contamination by flushing the part with sterile water or saline. D. Do not allow the part to freeze.

do not allow the part to freeze

What is one of the general principles of dressing and​ bandaging? A. Dressings and bandages should be sterile. B. Do not bandage a dressing in place until bleeding has stopped. C. Cover as small an area as possible in bandaging a wound on an extremity. D. Pressure bandages should be tight enough that a distal pulse cannot be felt.

do not bandage a dressing in place until bleeding has stopped

Which characteristic is specific to dressings but NOT to bandages that are used on soft tissue trauma and​ bleeding? A. Bandages should not be absorbent. B. Dressings are sterile. C. Dressings do not need to be sterile. D. Bandages are smaller than dressings.

dressings are sterile

When performing your scene​ size-up and initial assessment of a patient with an open soft tissue​ injury, remember​ that: A. you should use a pressure point if bleeding is not controlled by direct pressure. B. ensuring an open airway and verifying breathing should be done immediately after severe external bleeding has been controlled. C. if tissue has been torn​ away, you should pack the wound with sterile gauze. D. you should scrub the wound with a disinfectant to prevent contamination and infection.

ensuring an open airway and verifying breathing should be done immediately after severe external bleeding has been controlled

Which catecholamines cause the MOST rapid response to hemorrhage and cardiovascular​ insufficiency? A. Norepinephrine and angiotensin B. Antidiuretic hormone and angiotensin C. Epinephrine and norepinephrine D. Epinephrine and arginine vasopressin​ (AVP)

epinephrine and norepinephrine

The EMT removes the shirt of a patient in a motor vehicle collision and notices the abdominal organs are protruding from the skin. After stabilizing the​ patient, which term should the EMT include in the medical​ record? A. Pneumothorax B. Amputation C. Evisceration D. Laceration

evisceration

External venous hemorrhage can almost always​ be, and is preferred to​ be, controlled​ by: A. applying direct digital pressure to the appropriate proximal pressure point. B. splinting the limb and applying a cold pack. C. using pressure points. D. firmly bandaging a dressing in place.

firmly bandaging a dressing in place

Which of the following is the proper positioning for a patient suffering from​ epistaxis? A. Head forward B. Head backward C. Supine D. Reclined

head forward

A wound under the skin that involves a large blood vessel and is characterized by a large lump with bluish discoloration is called​ a: A. crush injury. B. concussion. C. hematoma. D. contusion.

hematoma

The patient presents to the emergency room after tripping and falling on the sidewalk. The paramedic notices a large lump on the base of the skull that is bluish in color and is elevated. Which term should the paramedic document in the​ patient's record? A. Hematoma B. Laceration C. Abrasion D. Avulsion

hematoma

Emergency care for soft tissue injuries generally consists​ of: A. laceration closure. B. fluid replacement. C. wound irrigation D. hemorrhage control.

hemorrhage control

Which of the following is a late sign of​ shock? A. Hypotension B. ​Weak, thready pulse C. Altered mental status D. Tachycardia

hypotension

Which of the following can slow the clotting​ process? A. Hypothermia B. Tachycardia C. Hyperthermia D. Bradycardia

hypothermia

Emergency medical care for internal bleeding​ includes: A. immediate transport for patients with signs and symptoms of shock. B. applying direct manual pressure to the areas of internal bleeding. C. placing the patient with head and torso elevated to better perfuse the brain. D. applying supplemental oxygen only by nasal cannula so that the circulatory system is not overwhelmed.

immediate transport for patients with signs and symptoms of shock

Which statement is TRUE about crush​ injuries? A. Because crush injuries are internal​ wounds, there is not enough blood lost to cause hypoperfusion. B. Because of the protective muscle and fat of the​ body, a crush injury does not usually cause serious damage. C. Because of the mechanism of​ injury, crush injuries show no external bleeding. D. Internal organs can actually rupture if a severe crush injury is sustained.

internal organs can actually rupture if a severe crush injury is sustained

Which of the following can cause increased​ bleeding? A. Splinting B. Direct pressure C. Bradycardia D. Intravenous fluids

intravenous fluids

Why would blood loss from the ear of a patient with a head injury be of special​ concern? A. It tells you that the patient has also suffered a temporal skull fracture. B. It may be indicative of a skull fracture. C. Ears do not have blood vessels and therefore cannot​ bleed; this means that the blood is coming from the brain. D. It means that the ear canal itself is injured

it may be indicative of a skull fracture

One reason to NOT allow the​ patient's blood pressure to rise too high after hemorrhagic shock from soft tissue trauma is​ because: A. it may cause worsening of the bleed. B. it will put the heart under too much strain. C. the sudden increase in pressure may cause a stroke to the brain. D. it will cause the lungs to fail.

it may cause worsening of the bleed

Your​ 11-year-old patient was riding his bike without a helmet when he wrecked and hit the back of his head. You now see bleeding from his nose. Why is this of special​ concern, given his mechanism of​ injury? A. It may indicate that a skull fracture has occurred. B. It means that a contrecoup injury has occurred. C. It means that he is probably lying about what happened. D. This is most likely a child abuse case.

it may indicate that a skull fracture has occurred

The paramedic arrives on the scene and finds a patient unresponsive. The paramedic determines the patient has an open​ airway, is​ breathing, and has very​ cool, clammy, and mottled skin. The paramedic believes the patient has internal bleeding with hemorrhagic shock. Which additional assessment finding supports this​ suspicion? A. Capillary refill of less than 2 seconds B. Increased systolic blood pressure C. Pulse oximetry level of​ 95% D. Lack of radial pulses

lack of radial pulses

Prior to your arrival on the scene of a motorcycle​ crash, an Emergency Medical Responder contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable​ EMT, which kind of injury should you​ anticipate? A. Bruised skin with a portion of bone protruding B. Long and deep laceration with moderate bleeding C. Torn skin with an underlying fracture D. Loose flap of skin torn on the​ patient's left arm

loose flap of skin torn on the patient's left arm

Which of the following signs and symptoms indicate​ shock? A. Wide pulse pressure B. Nausea C. Bradycardia D. Constricted pupils

nausea

The EMT is caring for a patient with external bleeding from injuries sustained in an accident. The EMT documents the patient has lost about​ 25% of his total blood volume. Which clinical manifestations would support this​ finding? A. Low blood​ pressure, normal pulse​ pressure, and cool skin with normal color B. Normal blood​ pressure, narrow pulse​ pressure, and​ pale, cool, and clammy skin C. Low blood​ pressure, very narrow pulse​ pressure, and​ pale, cold, and mottled skin D. High blood​ pressure, widened pulse​ pressure, and​ pale, cool, and clammy skin

normal blood pressure, narrow pulse pressure, and pale, cool, and clammy skin

A​ 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which dressing is best for this​ injury? A. ​Self-adhering roller gauze B. Sterile gauze C. Moist sterile gauze D. Occlusive dressing

occlusive dressing

You should cover an open chest wound with​ a/n: A. sterile dressing. B. dry dressing. C. moist dressing. D. occlusive dressing.

occlusive dressing

A​ 45-year-old male patient has been ejected during a motor vehicle accident. After donning standard​ precautions, you should​ next: A. place the patient in a supine position. B. cover the patient with a blanket. C. open the airway. D. control external bleeding.

open the airway

Your patient sustained an injury that amputated his left foot. What action is NOT an appropriate step in treatment of this type of​ injury? A. Flushing the foot with sterile water B. Bagging the foot in plastic C. Wrapping the foot in a dry sterile dressing D. Placing the foot directly into a cooler full of ice

placing the foot directly into a cooler full of ice

Your patient severed his right hand in an industrial accident. All of the steps are appropriate to take in the treatment of an amputated hand​ EXCEPT: A. removing any gross contamination by flushing the hand with sterile water or saline. B. bagging the hand in plastic. C. wrapping the hand in a dry sterile gauze dressing. D. placing the hand in a bag full of ice water.

placing the hand in a bag full of ice water

A​ 43-year-old male patient has a circular shaped entrance wound to his stomach after being stabbed with a screwdriver. This is known as​ a/an: A. abrasion. B. laceration. C. avulsion. D. puncture.

puncture

Which wound type has the greatest tendency to conceal the actual extent of​ injury? A. Degloving B. Parallel laceration C. Incision D. Puncture

puncture

The use of an occlusive dressing would be preferred on all of the injuries EXCEPT​ a/n: A. gunshot wound to the right thorax. B. puncture wound lateral to the femoral artery. C. open neck injury. D. knife wound to the posterior​ surface, above the scapula.

puncture would lateral to the femoral artery

A man has been bitten in his arm by his dog. He states that the bite occurred several hours​ earlier, when he accidentally stepped on the​ dog's paw. When​ asked, he tells you that the dog is​ up-to-date on all her​ shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment​ findings, what is the primary reason this patient should be seen in the emergency​ department? A. Possible shock from blood loss B. Prevent formation of a contusion C. Need to complete a police report D. Risk for infection

risk for infection

Assessment findings for a driver who was ejected from his vehicle in a​ rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic​ areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute with absent alveolar breath sounds. His skin is cool and​ diaphoretic; the radial pulses are weak. Manual cervical spine motion restriction is being maintained. The​ EMT's next action would be​ to: A. Apply an appropriately sized cervical collar B. Obtain a heart rate and blood pressure C. Examine the fracture site more closely D. Start positive pressure ventilation

start PPV

Lacerations are either linear​ or: A. subjugated. B. stellate. C. angular. D. eccentric.

stellate

When covering various​ wounds, you should always use​ a/n: A. occlusive dressing. B. wet dressing. C. dry dressing. D. sterile dressing.

sterile dressing

You and your partner arrive at the scene of a construction accident. The​ patient, a​ 43-year-old finish​ carpenter, was cutting the edge off a trim board when the knife​ slipped, avulsing a large section of his anterior lower​ arm, including underlying musculature and veins. He is currently alert and​ oriented, and a​ co-worker is successfully applying direct pressure over the avulsed flap to control bleeding. The​ patient's respirations are​ 12, and his right radial pulse is 84. Which form of bleeding control would you initially attempt to​ utilize? A. An absorbent dressing with a loosely applied circumferential bandage B. Tourniquet C. Sterile dressing with a circumferential​ bandage, moderately wrapped to provide pressure D. Digital pressure

sterile dressing with a circumferential bandage, moderately wrapped to provide pressure

What are the three main layers of the​ skin? A. ​Dermis, subcutaneous, muscle B. ​Dermis, muscle, epidermis C. ​Epidermis, subcutaneous, muscle D. ​Subcutaneous, epidermis, dermis

subcutaneous, epidermis, dermis

How should a patient suffering from hemorrhagic shock be​ positioned? A. ​Fowler's B. Supine C. Trendelenburg D. Left lateral recumbent

supine

You are called for a​ 78-year-old female who fell earlier in the day. As you enter her​ kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be blood on her pants. She is on home oxygen for COPD and is breathing in a moderately labored manner. The patient states that she fell a few hours​ ago, and now the pain and swelling in her arm are unbearable. She has also developed significant lower neck pain. What should you do​ first? A. Check her SpO2 level B. Place a cold pack to her cheek C. Examine her arm for deformity D. Take manual spinal motion restriction precautions

take manual spine restriction precautions

The paramedic arrives on scene of a​ multi-vehicle motor collision and finds a patient who has suspected internal bleeding. Which additional assessment should the paramedic expect to​ find? A. ​Cherry-red skin coloration B. Tender abdomen C. Decreased respirations D. Bleeding from the nasal passages

tender abdomen

You are called for a​ 2-year-old boy who has a nosebleed. While you are en route to the​ call, the dispatcher informs you that the patient has hemophilia. As an​ EMT, you should recognize​ that: A. The​ patient's blood is infectious B. A mask will need to be worn C. The patient requires oxygen D. The bleeding may be significant

the bleeding may be significant

Which of the following is a sign or symptom of hemorrhagic​ shock? A. Bradycardia B. Thirst C. Hypertension D. Rapid capillary refill

thirst

The EMT is providing care to a patient who sustained an injury to the hand with exposure of tendons and muscle. After assessing the​ wound, which intervention should the EMT perform to prevent​ infection? A. Expose the wound. B. Remove embedded debris. C. Apply direct pressure. D. Wipe the wound.

wipe the wound

A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when​ he: A. Places the thumb in ice water B. Keeps the thumb warm during transport C. Places the thumb in sterile saline D. Wraps it in a dry sterile dressing

wraps it in a dry sterile dressing