EMT II Trauma Emergencies Part I
1. The term "hyphema" is defined as: A. blood in the anterior chamber of the eye. B. an acute rupture of the globe of the eye. C. inflammation of the iris, cornea, and lens. D. compression of one or both optic nerves.
A
12. In addition to external bleeding, the most significant risk that an open soft-tissue injury exposes a patient to is: A. infection. B. hypothermia. C. nerve damage. D. vessel damage
A
16. According to the Association of Air Medical Services (AAMS), 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.
A
18. The mastoid process is located approximately: A. 1 posterior to the external opening of the ear. B. ½ anterior to the external opening of the ear. C. 1 inferior to the external opening of the ear. D. 1 posterior to the angle of the mandible.
A
24. Factors that should be considered when assessing a patient who has fallen do not include: A. the speed of the fall. B. the surface struck. C. the height of the fall. D. the primary impact point.
A
25. A flail chest occurs when: A. a segment of the chest wall is detached from the thoracic cage. B. more than three ribs are fractured on the same side of the chest. C. multiple ribs are fractured on both sides of the thoracic cage. D. a segment of fractured ribs bulges during the inhalation phase.
A
29. 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.
A
30. Which set of vital signs depicts Cushing's triad? A. Blood pressure, mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min B. Blood pressure, mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min C. Blood pressure, mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min D. Blood pressure, mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min
A
35. A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes: A. preparing him for immediate transport. B. applying oxygen via a nasal cannula. C. performing a focused physical exam. D. making a detailed assessment of his abdomen.
A
36. Which is a severe burn in a 35-year-old patient? A. Circumferential partial-thickness burn to the chest B. Full-thickness burn to 5% of the body surface area (BSA) C. Partial-thickness burn to 20% of the BSA D. Superficial burn covering 50% of the BSA
A
37. The optic nerve endings are located within the: A. retina. B. sclera. C. pupil. D. cornea.
A
47. 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.
A
5. Common signs and symptoms of a serious head injury do not include: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function
A
58. Which statement regarding electrical burns is correct? A. Entrance wounds are small relative to the amount of internal tissue damage. B. Respiratory or cardiac arrest following an electrical burn is very uncommon. C. The exit wound caused by electrical burns is smaller than the entrance wound. D. The size of the entry and exit wounds is a reliable indicator of internal damage.
A
60. The musculoskeletal system refers to the: A. bones and voluntary muscles of the body. B. nervous system's control over the muscles. C. connective tissue that supports the skeleton. D. involuntary muscles of the nervous system.
A
64. 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
72. A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: A. perform abdominal thrusts. B. visualize the child's airway. C. perform a blind finger sweep. D. give oxygen and transport at once.
A
74. Early signs of respiratory distress in the pediatric patient do not include: A. cyanosis. B. tachypnea. C. retractions. D. abnormal airway noise.
A
79. Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: A. older than 8 to 10 years. B. complaining of severe back pain. C. immobilized on a long backboard. D. experiencing cardiopulmonary arrest.
A
9. Which process occurs during the inflammation phase of the healing process? A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. B. White blood cells are forced away from the injury site, thus allowing an increase in the flow of red blood cells, resulting in increased blood flow. C. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection. D. The veins and arteries at the injury site constrict and platelets aggregate, which stops bleeding and causes a temporary increase in the size of the wound.
A
13. During an altercation in a bar, two patrons got into a fistfight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which statement regarding this scenario is most accurate? A. You should contact the police and have the patients arrested. B. The 39-year-old female is at high risk for an infection. C. The patient struck in the mouth should be immobilized. D. The 44-year-old female is at high risk for an infection.
B
15. A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. A. greenstick B. pathologic C. transverse D. comminuted
B
17. When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. will most likely be thrown over the steering column. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. is thrust under the steering column onto the floorboard.
B
20. Signs of a pulmonary blast injury include: A. vomiting blood. B. coughing up blood. C. an irregular pulse. D. multiple rib fractures.
B
21. An organ or tissue may be better able to resist damage from hypoperfusion if the: A. body's demand for oxygen is markedly increased. B. body's temperature is considerably less than 98.6°F (37.0°C). C. systolic arterial blood pressure is at least 60 mm Hg. D. heart rate is maintained at more than 100 beats/min.
B
23. A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: A. flush both eyes with an alcohol-based solution and transport. B. irrigate both eyes continuously for 20 minutes with plain water. C. neutralize the acid chemical in his eyes with an alkaline chemical. D. mix baking soda with water and irrigate his eyes with the solution.
B
27. Bone marrow produces: A. platelets. B. blood cells. C. lymphocytes. D. electrolytes.
B
28. 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
4. Which would most likely occur as the direct result of the second collision in a motor vehicle crash? A. Collapsed dashboard B. Deformed steering wheel C. Caved-in passenger door D. Intrathoracic hemorrhage
B
41. A fracture is most accurately defined as a/an: A. total loss of function in a bone. B. break in the continuity of the bone. C. disruption in the midshaft of a bone. D. abnormality in the structure of a bone.
B
51. 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.
B
52. An open pneumothorax occurs when: A. a fractured rib perforates the tissue of the lung. B. air enters the pleural space from outside the body. C. extreme pleural pressure causes the lung to rupture. D. air enters the pleural space from a perforated lung.
B
53. The cricoid cartilage: A. lies superior to the thyroid cartilage in the neck. B. is the only complete circular cartilage of the trachea. C. is easier to see and palpate than the thyroid cartilage. D. lies superior to the cricothyroid membrane in the neck.
B
6. 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.
B
65. The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. brain and spinal cord. C. cerebrum and meninges. D. meninges and spinal cord.
B
66. When a child experiences a blunt chest injury: A. the flexible rib cage protects the vital thoracic organs. B. the flexible ribs can be compressed without breaking. C. the sudden force against the ribs causes them to fracture. D. there is usually obvious injury to the external chest wall.
B
69. When caring for a female child who has possibly been sexually abused, you should: A. encourage the child to urinate and take a shower. B. have a female EMT remain with her if possible. C. carefully examine the genitalia for signs of injury. D. immediately report your suspicions to the parents.
B
73. A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect: A. mild dehydration. B. moderate dehydration. C. severe dehydration. D. hypovolemic shock.
B
75. The normal respiratory rate for a newborn should not exceed ______ breaths/min. A. 50 B. 60 C. 70 D. 80
B
77. Capillary refill time is most reliable as an indicator of end-organ perfusion in children younger than: A. 4 years. B. 6 years. C. 8 years. D. 10 years.
B
78. Which group of people is associated with the lowest risk of meningitis? A. Newborns B. Females C. Geriatrics D. Children with shunts
B
8. The frontal and parietal bones of the skull are especially susceptible to: A. basilar skull fractures. B. compressed skull fractures. C. linear skull fractures. D. nondisplaced skull fractures.
B
11. Atrophy is a condition that occurs when: A. increased use of skeletal muscle causes an increase in its strength. B. the tendons that attach muscle to bone become stretched or injured. C. muscle decreases in size and function because of disease or trauma. D. carbon dioxide, lactic acid, and other wastes accumulate in the muscle.
C
14. A subluxation occurs when: A. ligaments are partially severed. B. a fracture and a dislocation exist. C. a joint is incompletely dislocated. D. a bone develops a hairline fracture.
C
19. 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.
C
33. Which area of the body has the thinnest skin? A. Scalp B. Back C. Ears D. Soles of the feet
C
38. Which statement regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. It is typically the result of local, low-energy trauma to the head.
C
39. 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.
C
40. The body's functions that occur without conscious effort are regulated by the _________ nervous system. A. sensory B. somatic C. autonomic D. voluntary
C
44. The 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.
C
46. A laceration: A. typically is an injury that separates various layers of soft tissue. B. is a sharp, smooth cut that is made by a surgical scalpel. C. is a jagged cut caused by a sharp object or blunt force trauma. D. rarely penetrates through the subcutaneous tissue to the muscle.
C
49. As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells. A. fibrin B. plasma C. fibrinogen D. plasminogen
C
50. The ability of a person's cardiovascular system to compensate for blood loss is most related to: A. his or her baseline blood pressure. B. the part of the body injured. C. how rapidly he or she bleeds. D. how fast his or her heart beats.
C
54. The white portion of the eye is called the: A. iris. B. retina. C. sclera. D. cornea.
C
61. Which statement regarding shoulder dislocations is most accurate? 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
63. 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. The most appropriate method of splinting this injury involves: A. treating with a traction splint to realign the deformity. B. applying and fully inflating the pneumatic antishock garment (PASG). C. applying padded board splints to both sides of the leg. D. binding the legs together and elevating them 6 to 8 inches.
C
68. Early signs of respiratory distress in a child include: A. cyanosis. B. bradycardia. C. restlessness. D. decreased LOC.
C
7. Bleeding from soft-tissue injuries to the face is most effectively controlled with: A. pressure dressings and chemical ice packs. B. digital pressure to an adjacent pulse point. C. direct pressure using dry, sterile dressings. D. ice packs and elevation of the patient's head.
C
71. Which child would benefit the least from a nonrebreathing mask? A. A conscious 4-year-old male with adequate tidal volume B. A responsive 6-year-old male who responds appropriately C. An unresponsive 5-year-old male with shallow respirations D. A semiconscious 7-year-old female with normal ventilation
C
10. A reflex arc occurs when: A. the motor nerves function automatically without receiving a message from the CNS. B. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body. C. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. D. a sensory nerve detects an irritating stimulus and
D
2. Which body system or component is the least critical for supplying and maintaining adequate blood flow to the body? A. An effectively pumping heart B. An intact system of blood vessels C. Adequate blood in the vasculature D. The filtering of blood cells in the spleen
D
22. The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. sclera. B. cornea. C. retina. D. conjunctiva.
D
26. The most reliable indicator of an underlying fracture is: A. guarding. B. severe swelling. C. obvious bruising. D. point tenderness.
D
3. Which statement regarding anterior nosebleeds is correct? A. They usually cause blood to drain into the posterior pharynx. B. They are usually severe and require aggressive treatment to control. C. They are usually caused by a fracture of the basilar skull. D. They usually originate from the septum area and bleed slowly.
D
31. Which statement 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.
D
32. Bones are connected to other bones by bands of tough fibrous tissues called: A. bursa. B. tendons. C. cartilage. D. ligaments
D
34. According to the American College of Surgeons, an adult trauma patient meets Level I criteria 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.
D
42. Elevation of the rib cage during inhalation occurs when: A. the diaphragm descends. B. abdominal contents descend. C. intrathoracic pressure decreases. D. the intercostal muscles contract.
D
43. The tough, fibrous outer meningeal layer is called the: A. pia mater. B. arachnoid. C. gray mater. D. dura mater.
D
45. Burns to pediatric patients are generally considered more serious than burns to adults because: A. pediatric patients are more prone to hyperthermia. B. most burns in children are the result of child abuse. C. pediatric patients have a proportionately larger volume of blood. D. pediatric patients have more surface area relative to total body mass.
D
48. 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. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.
D
55. 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.
D
56. Which intervention is the most critical to the outcome of a patient with multisystem trauma? A. Intravenous fluid administration B. Early administration of oxygen C. Elevation of the lower extremities D. Rapid transport to a trauma center
D
57. Which musculoskeletal injury would pose the greatest threat to a patient's life? A. An amputated extremity B. Bilateral femur fractures C. Nondisplaced long bone fractures D. Pelvic fracture with hypotension
D
59. The upper jawbones are called the: A. mandible. B. mastoid. C. zygoma. D. maxillae.
D
62. When splinting an injury of the wrist, the hand should be placed: A. in a fist. B. in a straight position. C. in an extended position. D. in a functional position.
D
67. The most ominous sign of impending cardiopulmonary arrest in infants and children is: A. pallor. B. retractions. C. nasal flaring. D. bradycardia.
D
70. The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age. A. 2, 4 B. 6, 12 C. 12, 4 D. 18, 6
D
76. An infant with severe dehydration would be expected to present with: A. excessive tearing. B. moist oral mucosa. C. bulging fontanelles. D. absent urine output.
D
80. Hyperthermia differs from fever in that it is an increase in body temperature: A. of more than 2°F to 3°F per hour. B. secondary to a severe bacterial infection. C. caused by inflammation of the spinal cord. D. caused by the inability of the body to cool itself.
D