Chapter 31-35

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?

"have you had a sonogram?"

Femoral shaft fractures can result in up to _____ mL of internal blood loss.

1,000

If a baby is born at 7:52, the second Apgar score should be calculated at:

7:57

A person ability to shiver is lost when his or her body temperature falls below:

90F (32C)

Hypothermia occurs when the core body temperature falls below:

95 F (35C)

During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do?

Apply gentle pressure to the baby's head as it delivers.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is a an obvious anterior bulge to the area of injury. You should:

Assess distal pulse, motor, and sensory functions.

Hypothermia can worsen internal bleeding secondary to:

Blood-clotting abnormalities

When caring for a patient with a possible fracture of the scapula, the EMT should:

Carefully assess the patient for breathing problems.

Which of the following statements regarding compartment syndrome is correct?

Compartment syndrome typically develops within 6 to 12 hours after an injury.

You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient's is reluctant to explain what happened and becomes very quiet. Based on information, you should:

Continue your care in a private area, document any details regarding scene and the incident, and reassure her as you provide care.

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

Control the bleeding and cover the wound with a sterile dressing.

The MOST significant hazard associated with splinting is:

Delaying transport of a critically injured patient.

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

Displaced fracture

Which of the following medications increases a person's risk of a heat-related emergency?

Diuretics

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

Hyperglycemia

Which of the following statements regarding striated muscle is correct?

It forms the major muscle mass of the body and usually crosses and least one joint.

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should:

Keep her knee flexed and secure it with padded board splints.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?

Pelvic fracture with hypotension

A 77-year-old women slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:

Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

The EMT must assume that any unwitnessed water-related incident is accompanied by:

Possible spinal injury

What type of the muscle contracts and relaxes to control the movement of the contents within tis structures?

Smooth

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

Suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Which of the following MOST accurately describes hyperthermia?

The body is exposed to more heat than it can lose.

Most of serious injures associated with scuba diving are caused by:

Too rapid of an ascent

From what internal female organ is the fetus expelled during delivery?

Uterus

Compared to adults, infections and children are at higher risk for hyperthermia for all of the following reasons, EXCEPT:

a relatively small surface area

To assess a patient's body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen

The MOST prominent symptom of decompression sickness is:

abdominal or joint pain

During you assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:

apply gentle manual traction in line with the limb and reassess for a pulse.

With regard to musculoskeletal injuries, the zone of injury is defined as the:

area of soft-tissue damage surrounding the injury.

In moving joints, the ends of the bones are covered with:

articular cartilage

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

assess for carotid pulse for up to 60 seconds

Bone marrow produces:

blood cells

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

blood is shunted away from the extremities to the body's core.

The musculoskeletal system refers to the:

bones and voluntary muscles of the body.

A fracture is MOST accurately defined a(n):

break in the continuity of the bone.

in contrast to Lyme disease, Rocky mountain spotted fever:

can cause paralysis and cardiorespiratory collapse

The MOST commonly fractured bone(s) in the body is/are the:

clavicle

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

conduction

Drowning is MOST accurately defined as:

death from suffocation after submersion in water.

Common signs and symptoms of a sprain include all of the following, EXCEPT

deformity

A supracondylar or intercondylar fracture is also known as a fracture of the:

distal humerus

A colles fractures involves a fracture of the:

distal radius

When the body loses sweat, it also loses:

electrolytes

High humidity reduces the body's ability to lose heat through:

evaporation

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

evaporation

Traction splints are used primarily to immobilize and secure fractures of the:

femur

Covering a patients___will significantly minimize radiation heat loss.

head

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

hot, dry skin

When splinting an injury of the wrist, the hand should be placed:

in a functional positon

The amniotic fluid serves to:

insulate and protect the fetus.

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

into the patient's rectum

In contrast to the brown recluse spider, the black widow spider:

is large and has a red-orange hourglass mark on its abdomen.

A nuchal cord is defined as an umbilical cord that:

is wrapped around the baby's neck.

In order for sweating to be an effective cooling mechanism:

it must be able to evaporate from the body.

Bones are connected to other bands by bands of tough fibrous tissues called:

ligaments

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

load him into the ambulance and begin rapid cooling intervention

Which of the following is an early sign of put viper envenomation?

local swelling and ecchymosis

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the:

lumbar spine

Atrophy is a condition that occurs when:

muscle decreases in size and function

The venom of a black widow spider is toxic to the:

nervous system

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a _____fractures.

pathologic

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes

placing the mother supine with her head down and pelvis elevated.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

posterior hip dislocation

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because

pregnant patients have an overall increase in blood volume

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect with affected part from further injury

A "hip" fracture is actually a fracture of the:

proximal femur

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect:

pulmonary embolism

High air temperature reduces the body's ability to lose heat by:

radiation

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:

secondary to decreased perfusion in the extremities

A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment revelas that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect:

separation of the acromioclavicular joint.

Which of the following types of muscle is under direct voluntary control of the brain?

skeletal

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

stabilize her head and perform a primary assessment.

Burns associated with lightning strikes are typically:

superficial

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture makes with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

The two MOST efficient ways for the body to eliminate excess heat are:

sweating and vasodilation

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

swelling

Which of the following would be LEAST likely to occur in a patient with a core body temperature of between 89 F (32C) and 92F (33C)

tachycardia

Skeletal muscle is attached to the bone by tough, rope-like, fibrous structures called:

tendons

The presence of meconium in the amniotic fluid indicates

that the baby's airway may be obstructed

Heat stroke occurs when:

the body's heat-eliminating mechanisms are overwhelmed.

An air embolism associated with diving occurs when:

the diver holds his or her breath during a rapid ascent

An open fracture is MOST accurately defined as a fracture in which:

the overlying skin is no longer intact

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:

the patient history

The act of pulling on a body structure in the direction of its normal alignment is called:

traction

The body's natural protective mechanisms against heat loss are:

vasoconstriction and shivering

Heat loss form the body through respiration occurs when:

warm air is exhaled into the atmosphere.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:

Asses the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:

Stabilize the pelvis with a pelvic binder and protect the spine.

You and your partner are preparing to apply a traction splint to a patient's deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should:

Stop and splint the leg in the deformed position.

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:

apply high-flow oxygen, consider spinal precautions, and transport without delay.

A(n)_________fractures occurs in the growth section of s child's bone and may lead to bone growth abnormalities.

epiphyseal

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

frostbite

In which of the following situations should the EMT splint an injured limb in the position of deformity?

if resistance is encountered or the patient experiences severe pain

Care for a patient with a fractures tibia and suspected compartment syndrome includes:

keeping the leg at the level of the heart

The MOST common and significant complication associated with fractures or dislocations of the knee is:

neuromuscular compromise

Crepitus and false motion are:

positive indicators of a fracture.

Which of the following joints allows no motion

skull sutures

In general, musculoskeletal injuries should be splinted before moving the patient unless:

the patient is clinically unstable