EXAM 3 TRAUMA

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

3

A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would most likely to control the bleeding?

Apply a topical hemostatic agent with direct pressure

You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is most likely causing this patient's deterioration?

Compression of the aorta and vena ceva

Which of the following statements regarding crush syndrome is correct?

Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than four hours

Which of the following would be LEAST suggestive of the presence of high energy trauma?

Deployment of the airbag

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?

Engorged jugular veins

Which of the following would be the least likely cause an altered level of consciousness in a patient with a burn?

Hypertension

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the

Mechanism of injury

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?

Rapid transport to a trauma center

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is most consistent with

a blow-out fracture

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

a brain injury

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

a rapid, thready pulse

Signs of late heatstroke include:

a weak, rapid pulse.

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 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and the avulsion is bleeding moderately. The most appropriate treatment for this patient includes

applying direct pressure with a dry, sterile dressing

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:

assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible

A young male was shot in the abdomen by an unknown type of gun. Law enforcement personnel have ensured that the scene is safe. The patient is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should

assist the patient's ventilations

During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should

assist ventilations with a bag valve mask

When treating a patient who experienced a pulmonary blast injury, you should:

avoid giving oxygen under positive pressure

You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for

bacterial meningitis

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as

cavitation

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

Signs of a pulmonary blast injury include

coughing up blood

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from 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

Airbags are designed to

decrease the severity of deceleration injuries.

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?

deformed steering wheel

Burns are classified according to:

depth and extent

The Glasgow Coma Scale (GCS) is used to assess

eye opening, verbal response, motor response

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

According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she:

has a GCS score of less than or equal to 13 with a mechanism attributed to trauma

In contrast to a Level III trauma center, a Level I trauma center must

have a general surgeons in-house 24 hours a day

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:

identify contact points and predict potential injuries

The effectiveness of positive pressure ventilations when treating a head-injured patient can only be determined by

immediate reassessment after the intervention

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

immobilize the injury with a sling and swathe

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she

is ejected or partially ejected

The energy of a moving object is called

kinetic energy

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be most suspicious that this patient has experienced a

laceration of the aorta

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

Regarding the pediatric rule of nines, the,

legs are proportionately smaller than an adult's legs.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

lift the airbag and look for deformity to the steering wheel

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

ligaments

When assessing an elderly patient who fell, it is important to remember that

osteoporosis can cause a fracture as result from a standing position

Signs and symptoms of an air embolism include all of the following, except

pale skin

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing

The most reliable indicator of an underlying fracture is

point tenderness

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 of 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

When the speed of a motor vehicle doubles, the amount of kinetic energy

quadruples

If one or more occupants in the same vehicle are killed in a crash, the EMT should:

rapidly assess only the survivors who have experienced obvious trauma

A 56-year-old male has an incomplete avulsion to right forearm. After controlling any bleeding from the wound, you should

replace the avulsed flap to its original position and cover it with a sterile dressing

After blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the:

spleen

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

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 partner manually stabilizes her head, you should

suction her oropharnyx

Heatstroke occurs when

the body's heat-eliminating mechanisms are overwhelmed.

Internal injuries caused by gunshot wounds are difficult to predict because:

the bullet may tumble or ricochet within the body

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT

the speed of the fall

Rough handling of a hypothermic patient with a pulse may cause:

ventricular fibrillation

Force acting over a distance is the definition of:

work

The index of suspicion is MOST accurately defined as:

your awareness and concern for potentially serious underlying injuries