EMT CHapters 26-33

A fractured femur can result in the loss of _______ or more blood into the soft tissues of the thigh

1 L

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover ________ of his body surface area.

18%

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head, face, and anterior trunk. What percentage of her body surface area has been burned?

30%

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first:

Apply direct pressure on the wound

All of the following should be addressed during the primary assessment except:

Capillary bleeding

A female patient with a suspected head injury has slow, shallow breathing. The most appropriate treatment for her includes:

ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

If a patient with a chest injury only inhales small amounts of air per breath, he or she:

must increase his or her respiratory rate to maintain adequate minute volume.

A patient with a chest injury has a blood pressure of 100/60 mm Hg and a pulse rate of 120 beats/min. Which of the following additional findings should make you suspect a pericardial tamponade?

Repeat BP of 90/68 mm Hg

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?

Shoulder fracture

A 30-year-old female was robbed and assaulted as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partnér manually stabilizes her head, you should:

Suction her oropharynx

A spinal cord injury at the level of C7 would most likely result in:

paralysis of the intercostal muscles.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT:

a rapid, thready pulse.

A flail chest occurs when:

a segment of the chest wall is detached from the thoracic cage.

A reflex arc occurs when:

a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway.

An open pneumothorax is:

an open chest wound through which air moves during breathing

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:

apply a compression device around his pelvis.

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:

apply a tourniquet just below the shoulder.

A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should:

apply an occlusive dressing to the wound and continue your assessment.

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 active venous bleeding. As your partner manually stabilizes the patient's head, you should:

apply direct pressure to her arm wound.

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:

apply padded board splints to both sides of the leg.

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities.

A 43-vear-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:

pinching the patient's nostrils and having him lean forward.

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:

place additional dressings over the wound.

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life- threatening injuries, how should you care for his woUnd?

Cover it with moist, sterile gauze and secure with an occlusive dressing.

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding fröm the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

Cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes:

preparing for immediate transport.

A 30-year-old man complains of severe pain to his right tibia after 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:

pressure in the fascial compartment is elevated.

Because the depth of an open abdominal wound is often difficult to determine:

prompt transport to the hospital is essential.

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should:

carefully remove the contact lenses and then irrigate his eyes with saline.

An injured brain begins to swell initially due to:

cerebral edema

A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be most concerned that this patient has:

compartment syndrome

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

conjunctivitis

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:

control the bleeding with direct pressure.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):

contusion

A patient who presents with profound cyanosis following a chest injury:

requires prompt ventilation and oxygenation.

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

separation of the acromioclavicular joint.

All of the following are hollow abdominal organs, except the:

spleen

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:

splint the elbow in the position found and transport.

Burns are classified according to:

depth and extent

A partial-thickness burn involves the outer layer of skin and a portion of the:

dermal layer

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has most likely experienced:

detached retina

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm

A Colles fracture involves a fracture of the:

distal radius

Accumulation of blood in the abdominal cavity will MOST likely cause:

distention

A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing:

gastrointestinal bleeding

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except:

giving him small sips of plain water.

Contraction or tensing of the abdominal muscles to ease pain is called:

guarding

Common signs and symptoms of a chest injury include all of the following, except:

hematemesis

A 70-year-old man presents with a severe nosebleed. His medical history includes chronic obstructive pulmonary disease, depression, and a hemorrhagic stroke three years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is most likely causing his nosebleed today?

high blood pressure

A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam.

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(n):

laryngeal fracture.

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The most appropriate care for this patient includes:

leaning him forward and pinching his nostrils together.

A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should:

leave his helmet and shoulder pads in place.

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.

A burn that is characterized by redness and pain is classified as a:

superficial burn

The Adam's apple is:

the upper part of the larynx that is formed by the thyroid cartilage.

The conjunctiva are kept moist by fluid produced by the:

lacrimal gland

A(n)_______ fracture occurs in the growth section of a child's bone and might lead to bone growth abnormalities

Epiphyseal

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ.

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:

begin CPR and apply the AED.

An epidural hematoma is MOST accurately defined as:

bleeding between the skull and dura mater.

Bone marrow produces:

blood cells

Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with:

brain injury

Bleeding within the brain tissue itself is called a(n):

intracerebral hematoma

A simple pneumothorax: Select one:

is commonly caused by blunt chest trauma.

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.