Chapter 31 questions

Compartment syndrome usually appears within ______ hours after injury. A. 6 to 9 B. 6 to 12 C. 7 to 10 D. 2 to 8

A

Crepitus and false motion are: A. positive indicators of a fracture. B. indicators of a severe sprain C. only seen with open fractures D. most common with dislocations

A

During your 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: A. apply gentle manual traction in line with the limb and reassess for a pulse. B. carefully straighten the injured arm and secure it with padded board splints C. splint the elbow in the position of deformity and transport immediately D. make two or three attempts to restore distal circulation by manipulating the elbow

A

The hip bone is also called the: A. innominate bone B. pubic symphysis C. ischium D. sacrum

A

The pectoral girdle consists of the: A. scapulae and clavicles. B. clavicles and rib cage. C. sternum and scapulae. D. acromion and clavicles.

A

The primary purpose for splinting a musculoskeletal injury is to: A. prevent further injury. B. maximize distal circulation. C. make the patient comfortable. D. facilitate ambulance transport.

A

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. A. strain B. sprain C. fracture D. dislocation

B

One of the functions of the bones of the skeleton is to serve as a reservoir for important minerals and ______. A. oxygen B. electrolytes C. water D. simple sugars

B

Skeletal muscle is also referred to as __________ muscle. A. smooth B. striated C . connective D. involuntary

B

What is the name of a generalized bone disease that weakens bones and is common among postmenopausal women? A. osteomyelitis B. osteoporosis C. crepitus D. arthritis

B

When assessing a patient with a possible fracture of the leg, the EMT should: A. assess proximal circulation. B. compare it to the uninjured leg. C. carefully move it to elicit crepitus. D. ask the patient to move the injured leg.

B

In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel? A. moderate B. critical C. serious D. severe

C

Which of the following structures is regulated by smooth muscle? A. Heart B. Skeleton C. Blood vessels D. Diaphragm

C

How many EMTs does it take to apply a rigid splint? A. 1 B. 2 C. 4 D. 3

D

Patients with which type of injury lie with the leg externally rotated, with the injured leg usually shorter than the opposite, uninjured limb? A. dislocation of the knee B. displaced fractures of the proximal femurs C. femoral shaft fractures D. injuries of the tibia and fibula

D

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should: A. splint the elbow in the position found and transport. B. gently manipulate the elbow to improve circulation. C. gently straighten the elbow and apply an air splint. D. apply a heat pack to the elbow to reduce swelling

A

A disruption of a joint in which the bone ends are no longer in contact is known as what? A. dislocation B. sprain C. fracture D. strain

A

A supracondylar or intercondylar fracture is also known as a fracture of the: A. distal humerus. B. olecranon process C. radial head D. proximal radius

A

For which injury may patients report numbness in the hand because of nervous or circulatory compromise? A. fracture of the humerus B. shoulder dislocation C. dislocation of the elbow D. acromioclavicular separation

A

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A. Nondisplaced pelvic fracture B. Open fractures of a long bone C. An amputation of an extremity D. Multiple closed long bone fractures

A

Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called: A. tendons B. ligaments C. fascia D. cartilage

A

Skiing injuries often happen because of: A. twisting forces B. direct blows C. high-energy forces D. indirect forces

A

The purpose of splinting a fracture is to: A. reduce swelling in adjacent soft tissues B. reduce the fracture, if possible C. force the bony fragments back into anatomic alignment D. protect and maintain the position go an uninjured extremity

A

What is the added advantage of using an air splint? A. you can use a hand pump to pull the air out through a valve B. it is the most effective way to realign a fracture of the shaft of a long bone C. the air splint applied firm pressure to a bleeding wound D. the air pressure in the splint can adjust to the environment

A

What is the primary goal of in-line traction? A. avoid further neurovascular compromise B. prevent permanent disability C. reduce swelling D. minimize pain

A

When assessing distal circulation in a patient's lower extremities, which pulse should you palpate? A. popliteal B. femoral C. iliac D. dorsalis pedis

A

Which of the following is a drawback of an air splint? A. temperature changes affects air pressure in the splint B. it does not provide uniform contact, so bone movement is possible C. it is complicated to use and requires multiple EMTs D. it restricts distal blood flow

A

Which of the following scenarios is an example of a direct injury? A. A passenger fractures her patella after it strikes the dashboard. B. A skier dislocates his knee after a twisting injury to the ankle. C. A person lands on his or her feet and fractures the lumbar spine. D. A child dislocates his elbow after falling on his outstretched arm.

A

Which of the following would you use to stabilize an AC separation? A. sling and swathe B. rigid splint C. zippered air splint D. traction splint

A

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. area of soft-tissue damage surrounding the injury. B. part of the body that sustained secondary injury C. exact part of the bone or joint that was disrupted D. area of obvious deformity over the site of impact

A

skeletal muscle is also referred to as: A. striated muscle B. smooth muscle C. autonomic muscle D. involuntary mjuscle

A

Which of the following are goals of in-line traction? A. align the limb for splinting B. stabilize the fragments to prevent movement C. stop bleeding D. avoid neuromuscular compromise

A, B, and C

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should A. gently straighten her knee and apply a padded board splint B. keep her knee flexed and secure it with padded board splints. C. flex her knee slightly more and assess for distal circulation D. make one attempt to return the patella to its normal position

B

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: A. administer oxygen and perform a rapid assessment B. stabilize her head and perform a primary assessment. C. apply manual stabilization to both femurs D. assess for a carotid pulse and assist her ventilations

B

An open fracture is MOST accurately defined as a fracture in which: A. a large laceration overlies the fracture B. the overlying skin is no longer intact. C. bone ends protrude through the skin D. a bullet shatters the underlying bone

B

Applying ice to and elevating an injured extremity are performed in order to: A. prevent further injury. B. reduce pain and swelling C. enhance tissue circulation. D. maintain extremity perfusion.

B

Compartment syndrome most commonly occurs with a fractured tibia in adults or _______ in children. A. ankle B. forearm C. femur D. fibula

B

During your secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes: A. splinting her femur fracture with padded board splints. B. immobilizing her to a backboard and rapidly transporting. C. applying a traction splint to immobilize her femur. D. carefully splinting each of her deformed extremities.

B

During your secondary assessment, which of the following symptoms might alert you to an open fracture? A. contusions B. puncture wounds C. tenderness D. abrasions

B

Splinting can prevent all of the following, EXCEPT: A. paralysis of extremities B. restriction of distal blood flow C. further damage to muscles, spinal cord, peripheral nerves, and blood vessels D. compromised distal functions

B

When splinting a possible fracture of the foot, it is MOST important for the EMT to: A. use a pillow as a splint. B. leave the toes exposed C. apply a pneumatic splint. D. observe for tissue swelling.

B

Which MOI causes a fracture or dislocation at a distant point? A. high-impact injury B. indirect force C. direct blow D. twisting force

B

Which of the following should you do when your patient has bilateral fractures of the humerus, femur, or tibia? A. assess the patient and stabilize his or her condition prior to transport B. use your long backboard as a splinting device C. all are correct D. be sure to include the joint above and the joint below the splint

B

Which sign/symptom would give you a high index of suspicion that a patient may have compartment syndrome? A. hypersensation B. disproportionate pain C. limb deformity D. referred pain

B

In which situations should you splint the limb in the position of deformity? A. When distal pulses are absent B. When the deformity is the result of a dislocation and is severe C. When you encounter resistance or extreme pain when applying traction D. When the fracture is an open fracture

B and C

A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should: A. perform a rapid secondary assessment. B. straighten his arm and apply a board splint. C. immobilize the injury with a sling and swathe. D. place a pillow under his arm and apply a sling.

C

A 30-year-old man complains of severe pain to his right tibia following an injury that occurred the day before. The patient's leg is pale and he is unable to move his foot. The EMT should suspect that: A. the nerves behind the knee are compromised. B. a severe infection has developed in the muscle. C. pressure in the fascial compartment is elevated. D. the nerves supplying the foot have been severed.

C

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 A. manually stabilize the leg above and below the injury B. assess distal pulses as well as sensory and motor functions C. control the bleeding and cover the wound with a sterile dressing. D. gently manipulate the injured leg until the numbness dissipates

C

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should: A. apply a traction splint to realign the deformity. B. flex the knee slightly and apply a formable splint. C. apply padded board splints to both sides of the leg. D. bind the legs together and elevate them 6 to 8 inches.

C

A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should: A. administer high-flow oxygen to the patient. B. remove the towel and inspect the wound. C. apply a tourniquet just below the shoulder. D. wrap the severed arm in a sterile dressing.

C

A fracture is MOST accurately defined as a(n): A. total loss of function in a bone B. disruption in the mid shaft of a bone C. break in the continuity of the bone D. abnormality in the structure of a bone

C

A fracture that occurs straight across the bone that is usually the result of a direct blow injury is referred to as: A. epiphyseal B. pathologic C. transverse D. incomplete

C

A young male has a musculoskeletal injury and is unresponsive. You will NOT be able to assess: A. distal pulses B. capillary refill C. sensory and motor functions D. false motion

C

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: A. perform a focused physical exam with emphasis on the pelvis B. log roll the patient onto a long backboard and transport at once C. stabilize the pelvis with a pelvic binder and protect the spine. D. defer spinal immobilization and transport to a trauma center

C

It would be appropriate to use a traction splint on which of the following injuries? A. injuries of the upper extremity B. lower leg, foot, or ankle injuries C. fractures of the shaft of the femur D. injuries of the pelvis

C

The ________ is an important anchor for ligaments surrounding the knee joint, and it forms the lateral side of the ankle joint. A. calcaneus B. patella C. fibula D. tibia

C

The musculoskeletal system refers to the: A. connective tissue that supports the skeleton B. involuntary muscles of the nervous system C. bones and voluntary muscles of the body D. nervous system's control over the muscles

C

What is the most reliable indicator of an underlying fracture? A. deformity B. guarding C. point tenderness D. crepitus

C

When should you provide details such as mandated reporting of situations involving elder or child abuse? A. initial radio report B. en route to the hospital C. verbal report at the hospital D. all of these are correct

C

Which kind of muscle performs much of the automatic work of the body? A. skeletal muscle B. all of these C. smooth muscle D. cardiac muscle

C

Which of the following fractures has the greatest potential for internal blood loss and shock? A. Hip B. Femur C. Pelvis D. Humerus

C

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. severe strain B. hairline fracture C. displaced fracture D. moderate sprain

C

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. non displaced long bone fractures B. an amputated extremity C. pelvic fracture with hypotension D. bilateral femur fractures

C

Which of the following statements regarding compartment syndrome is correct? A. most cases of compartment syndrome occur following a severe fracture of the pelvis B. in most cases, compartment syndrome develops within 6-12 hours after an injury C. compartment syndrome typically develops within 6 to 12 hours after an injury. D. compartment syndrome occurs because of increased pressure within the bone cavity

C

Which of the following statements regarding shoulder dislocations is correct? A. Posterior dislocations are most common. B. They are caused by forced arm adduction. C. Most shoulder dislocations occur anteriorly. D. They involve the acromion process and humerus.

C

You have applied a zippered air splint to a patient's left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to: A. elevate the injured arm and reassess distal sensory function. B. inflate the splint with more air until the patient is comfortable. C. assess the amount of air in the splint and let air out as necessary. D. remove the air splint and reimmobilize with padded board splints.

C

A "hip" fracture is actually a fracture of the: A. femoral shaft B. pubic symphysis C. pelvic girdle D. proximal femur.

D

How would you treat a patient with an elbow injury who has a cold, pale hand; weak pulse; and poor capillary refill? A. splint the elbow injury in the position in which you found it B. notify medical control immediately C. apply gentle manual traction in line with the long axis of the limb D. all of these

D

In general, musculoskeletal injuries should be splinted before moving the patient unless: A. the patient is in severe pain B. transport time is less than 15 min C. deformity and swelling are present D. the patient is clinically unstable.

D

In which of the following situations should the EMT splint an injured limb in the position of deformity? A. If transport time to the hospital is greater than 20-30 min B. if a traction splint will be used to immobilize the injured extremity C. when distal circulation and neurological functions are absent D. If resistance is encountered or the patient experiences severe pain

D

Supracondylar or intercondylar fractures are common in which population? A. men B. women C. elders D. children

D

The MOST reliable indicator of an underlying fracture is: A. guarding. B. severe swelling. C. obvious bruising. D. point tenderness.

D

The MOST significant hazard associated with splinting is: A. compression of nerves, tissues, and vasculature B. aggravation of the injury or worsened pain C. reduction in circulation distal to the injury site D. delaying transport of a critically injured patient.

D

When caring for a patient with a possible fracture of the scapula, the EMT should: A. recognize that scapular fractures are life threatening B. apply rigid board splints across the chest and back C. assume that minimal force was applied to the back D. carefully assess the patient for breathing problems

D

Which of the following is NOT true about fractures? A. it is important to look for differences between the injured limb and the opposite, uninjured limb B. fractures are classified as either closed or open C. radiograph examinations are required for physicians to diagnose a nondisplaced fracture D. the difference between a broken bone and a fractured bone depends on the severity of the break

D

You are attending to a patient with a nondisplaced elbow fracture. She has a strong pulse and good capillary refill. How should you address this type of injury? A. Apply a Sager traction splint to stabilize the joint. B. Apply ice to reduce swelling. C. Apply a sling and swathe to reduce pain. D. Splint from the shoulder joint to the wrist joint to stabilize the entire arm.

D

You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that: A. the patient has an incomplete fracture that passes only partway through the bone B. there is a disruption of the joint, and the bone ends are no longer in contact C. the muscles of the ankle have been severely stretched, resulting in displacement of the bones from the joint D. stretching or tearing of the ligaments with partial or temporary dislocation or the bone ends has occurred.

D

Fractures of the proximal femur usually involve the hip joint. True False

False

If you are unable to restore the distal pulse on scene, you should splint the limb in a straight position and provide prompt transport to the hospital. True False

False

A fracture of the femoral shaft is best stabilized with a traction splint, such as a Sager splint. True False

True

Lateral and medial dislocations to the knee are less common than posterior dislocations and are less likely to injure the popliteal artery. True False

True