Paramedic Trauma quizzes 1-3

Which of the following is TRUE of shotgun ammunition? Select one: a. A shotgun may either fire one slug or use ammunition with multiple pellets. b. The shot is dispersed from the cartridge with high velocity. c. The closer the shooter is to the victim, the larger the area of visible damage. d. "Double ought" or #00 shot contains a large number of relatively small pellets.

a. a shotgun may either fire one slug or use ammunition with multiple pellets.

Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient? Select one: a. Bridge abutment b. Shrubbery c. A body of water d. Signpost

a. bridge abutment

Which of the following patients is NOT a candidate for air medical transport? Select one: a. Combative trauma patient b. Seriously injured patient with cardiac tamponade c. Patient with prolonged extrication time d. Burn patient with over 50 percent second-degree burns

a. combative trauma patient

Your patient is a 23-year-old male with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal stimuli; has pale, cool, diaphoretic skin; and has a heart rate of 128, respirations at 24, and a blood pressure of 82/60. These findings indicate which of the following kind of shock? a. Compensated b. Irreversible c. Decompensated d. Neurogenic

a. compensated

You assess a trauma patient who has an airway that cannot be maintained or secured. How should this patient be classified? Select one: a. Critical b. Unstable c. Potentially unstable d. Stable

a. critical

Which of the following injuries is associated with the tertiary phase of a blast? Select one: a. Crush injuries b. Barotrauma c. Burns d. Projectile injuries

a. crush injuries

Which of the following scenarios would likely lead to the development of compartment syndrome? Select one: a. A crush injury to the lower leg b. A loose-fitting cast that covers the thigh and leg c. An excessive release of intracellular potassium d. A tennis shoe that doesn't fit correctly

a. crush injury to the lower leg

Which of the following may result from aggressive ventilation of the blast patient? Select one: a. Emboli b. Pericardial tamponade c. Hemorrhage d. Acidosis

a. emboli

Which of the following is TRUE regarding a motorcycle collision? Select one: a. Frontal impact can result in intraabdominal, pelvic, and femur injuries. b. A rider who "lays down the bike" will generally receive more severe injuries than a rider who stays with the bike. c. The structural steel of the vehicle absorbs most of the kinetic energy in a motorcycle collision. d. The use of helmets has drastically reduced the incidence of cervical spine injuries.

a. frontal impact can result in intraabdominal, pelvic, and femur injuries.

Which of the following best describes the importance of oxygen in cellular metabolism? a. It prevents pyruvic acid from being converted to lactic acid. b. It prevents the formation of pyruvic acid in the Krebs cycle. c. It is necessary for glycolysis. d. It limits the overproduction of energy in the citric acid cycle.

a. it prevents pyruvic acid from being converted to lactic acid.

Which of the following results from anaerobic metabolism in shock? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory alkalosis d. Respiratory acidosis

a. metabolic acidosis

Which of the following accounts for the highest number of trauma deaths in the United States of America? Select one: a. Motor vehicle crashes b. Falls c. Assaults d. Firearms injuries

a. motor vehicle crashes

In a previously healthy individual, which of the following types of shock may NOT result in the typical signs of cool, pale, moist skin; tachycardia; and narrowed pulse pressure? a. Neurogenic b. Cardiogenic c. Hypovolemic d. Hemorrhagic

a. neurogenic

Which of the following is the best, most cost-effective way for EMS personnel to help reduce trauma-related morbidity and mortality? Select one: a. Participate in injury prevention programs. b. Keep up to date on trauma management knowledge and skills. c. Transport all trauma patients to a trauma center. d. Provide complete patient care reports so that accurate data can be entered into the trauma registry.

a. participate in injury prevention programs

Which of the following injuries is associated with the pressure wave produced by a blast? Select one: a. Pneumothorax b. Lacerated liver c. Fractures d. Ruptured spleen

a. pneumothorax

Trauma triage criteria application, field skill performance, response times, patient assessment, patient care and transport are all monitored through which of the following? Select one: a. Quality improvement b. Trauma registry c. Centers for Disease Control and Prevention d. Public healthcare model

a. quality improvement

In responding to a trauma patient at the scene of a motor vehicle crash, which of the following is an early sign or signs of shock you might encounter during the primary assessment? a. Rapid heart rate and anxiety b. Rapidly dropping blood pressure c. Rapid breathing and air hunger d. Rapidly dropping level of responsiveness

a. rapid heart rate and anxiety

Which of the following early signs of shock is easily missed? a. Tachycardia b. Decrease in respiratory rate and volume c. Decrease in blood pressure d. Narrowing pulse pressure

a. tachycardia

Septic shock results from massive infection releasing what substances into the vascular system? a. Toxins b. Lactic acid c. Catecholamines d. Aldosterone

a. toxins

Under normal circumstances, at any given moment most of the blood is in the ________ system. a. Venous b. Capillary c. Hematopoietic d. Arterial

a. venous

Which of the following physical findings indicates the need for immediate transport? Select one: a. Vital signs: systolic blood pressure 80, respiratory rate 8 b. Glasgow Coma Scale score of 15 c. Second-degree burns involving 9 percent of total body surface area in an adult patient d. Fractured right femur

a. vital signs: systolic bp 80, resp rate 8

You have responded to a soccer field on which two 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency department? Select one: a. Weakness in the upper extremities b. Complaint of "getting the wind knocked out of me" c. Contusion to the thigh d. Minor epistaxis

a. weakness in the upper extremities

Which of the following does NOT indicate compensated shock? a. Anxiety b. Altered mental status c. Weakness d. Thirst

b. AMS

Which of the following acts resulted in the development of modern EMS systems? Select one: a. Ryan White Act b. Highway Safety Act of 1966 c. Good Samaritan Act d. The Trauma Care Systems Planning and Development Act of 1990

b. Highway safety Act of 1966

Your patient is a 29-year-old male who works in a meat-processing plant. He received a knife wound in the proximal anteromedial thigh, which is continuing to bleed on your arrival. He is restless and thirsty and has pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of 118/88. This patient is exhibiting signs and symptoms consistent with a Class ________ hemorrhage. a. III b. II c. IV d. I

b. II

Upon arriving on a scene where the mechanism of injury indicates a potentially life-threatening injury, you should employ which of the following interventions to best help deliver the care that is needed? Select one: a. Reevaluate the scene size-up. b. Initiate transport immediately, delaying more extensive care until you are en route. c. Ask a surgeon to respond to the scene. d. Call immediately for air medical transport to reduce the "Golden Period."

b. initiate transport immediately, delaying more extensive care until you are en route

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision? Select one: a. Increased gravitational forces due to multiple changes in direction and velocity b. Lack of a crumple zone c. Taking the up-and-over pathway d. The force of side-impact air bag deployment

b. lack of a crumple zone

Which of the following fluids is appropriate for the prehospital management of hypovolemic shock? a. Five percent dextrose in water b. Lactated Ringer's c. A 0.2% sodium chloride solution d. A 0.45% sodium chloride solution

b. lactated ringer's

Which of the following is the most important priority when caring for a patient with a shallow-water diving injury? Select one: a. Assessing the cervical spine for deformity b. Maintaining cervical spine stabilization while opening the airway c. Removing the patient from the water as soon as possible d. Initiating rescue breathing once out of the water

b. maintaining cervical spine stabilization while opening the airway.

Which of the following is typical of the trajectory of a knife when a female assailant stabs someone? Select one: a. The trajectory is lateral: right-to-left if she is right-handed and left-to-right if she is left-handed. b. The movement is downward, as the assailant raises the knife and swings downward. c. The movement is upward, as the assailant drives upward with the knife. d. The trajectory tends to be in a horizontal plane at the level of the assailant's shoulder.

b. movement is downward, as the assailant raises the knife and swings downward.

Which of the following is associated with assault rifle wounds but not hunting rifle wounds? Select one: a. Permanent cavitation b. Multiple wounds c. Smaller exit wounds d. Larger exit wounds

b. multiple wounds

Which of the following is a manifestation of orthostatic hypotension? a. Your patient's pulse is 76 when he is supine but 88 when he sits up. b. Your patient's blood pressure is 142/90 when she is supine but 116/88 when she sits up. c. Your patient's blood pressure is 150/100 when he is supine but 134/90 when he sits up. d. Your patient's pulse is 80 when she is supine but 96 when she sits up.

b. patient's bp is 142/90 when she is supine but 116/88 when she sits up.

Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen? Select one: a. Pulmonary and myocardial contusions b. Pneumothorax and diaphragmatic rupture c. Cardiac tamponade and aortic dissection d. Pneumothorax and myocardial contusion

b. pneumothorax and diaphragmatic rupture

Which of the following would be the most likely cause of neurogenic shock? a. Pericardial tamponade b. Spinal cord injury c. Systemic infection d. Massive histamine release

b. spinal cord injury

The primary assessment of a patient with a gunshot wound to the chest should focus on detecting which of the following? Select one: a. Pancreatitis b. Tension pneumothorax c. Cardiac contusion d. Peritonitis

b. tension pneumothorax

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier wall? Select one: a. The energy dissipates as sound waves. b. The body of the vehicle and its occupants absorb the energy. c. The wall's foundation absorbs the energy. d. The energy converts to heat through friction.

b. the body of the vehicle and its occupants absorb the energy.

You have arrived on the scene of a 17-year-old male patient with a gunshot wound to the thigh. Police are on the scene. There is significant ongoing hemorrhage from the wound. The patient is screaming for someone to help him. Which of the following should you do first? Select one: a. Control hemorrhage with direct pressure. b. Perform a rapid trauma assessment. c. Ask the police if they have searched the patient for weapons yet. d. Begin high-concentration oxygen administration.

c. ask the police if they have searched the patient for weapons yet.

The study of the characteristics of projectiles in motion and their effects on the objects they impact is called: Select one: a. trajectory. b. cavitation. c. ballistics. d. forensics.

c. ballistics

When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation? Select one: a. Hot, red skin b. Increased urine output c. Cardiac arrhythmia d. Central hyperventilation syndrome

c. cardiac arrhythmia

Which of the following is TRUE of the differences between adult and pediatric pedestrians when struck by a vehicle? Select one: a. Adults tend to be thrown under the vehicle. b. Children tend to be thrown onto the hood of the vehicle. c. Children tend to be thrown under the vehicle. d. Adults tend to have injuries higher on the body.

c. children tend to be thrown under the vehicle

Which of the following is NOT a characteristic of arterial bleeding? a. Rapid blood loss b. Spurting or pumping as it leaves the body c. Clots quickly on its own d. Bright red

c. clots quickly on its own

In anaphylactic shock, a massive _______ release causes general vasodilation, precapillary sphincter dilation, capillary engoregement, and fluid movement into the interstitial compartment. a. norepinephrine b. epinephrine c. histamine d. insulin

c. histamine

Which of the following indicates that a patient has transitioned from compensated to decompensated shock? a. Widening pulse pressure b. Increased respiratory rate c. Hypotension d. Peripheral vasoconstriction

c. hypotension

Establishment of educational programs and improved auto technology are examples of which part of the public health model? Select one: a. Surveillance b. Risk identification c. Intervention d. Implementation

c. intervention

Which of the following is TRUE of the temporary cavity formed by penetrating trauma? Select one: a. It heals more slowly than the permanent cavity because of the nature of the tissue damage. b. It fills with disrupted tissues, some air, fluid, and debris. c. It is a space indirectly created by a projectile as tissue moves rapidly away from its path. d. It is the damage that occurs when the projectile fragments.

c. it is a space indirectly created by a projectile as tissue moves rapidly away from its path.

Which of the following is TRUE of the injuries sustained by the elderly due to falls? Select one: a. The injuries sustained by the elderly are less likely to result in hospitalization. b. Only more significant falls cause fractures. c. Less-significant falls may cause fractures. d. The elderly sustain injuries similar to other age groups in comparable falls.

c. less-significant falls may cause fractures.

Which of the following is most susceptible to damage from the pressure wave when a bullet enters it? Select one: a. Intestines b. Femoral artery c. Liver d. Lungs

c. liver

As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs? Select one: a. Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound. b. No vacuum is created when there are both an entrance and an exit wound. c. Negative pressure is generated inside the cavity, drawing debris into the wound. d. There is negative pressure at the entrance wound and positive pressure at the exit wound.

c. negative pressure is generated inside the cavity, drawing debris into the wound.

Which of the following trauma patients would be classified as "stable"? Select one: a. Patient with facial burns and associated hoarseness and stridor b. Patient who is unconscious, with no ventilations and no pulse c. Patient with controlled bleeding from a laceration to the right forearm from a glass cut d. Patient with closed, bilateral femur fractures but adequate ventilations

c. patient with controlled bleeding from a laceration to right forearm from a glass cut

The blood flowing to the heart best describes: a. Contractility b. Afterload c. Preload d. Vascular phase

c. preload

Which of the following measures effectively controls bleeding in body cavities? a. PASG b. Administration of platelets and clotting factors c. Surgery d. Therapeutic hypotension

c. surgery

According to the Haddon Matrix, which of the following would be a pre-event host factor affecting the risk for injury in a vehicle collision? Select one: a. Level of EMS providers responding to the scene b. Presence of crash barriers near bridge abutments c. Texting and/or talking on a cellphone while driving d. Advanced automatic collision notification

c. texting and/or talking on a cellphone while driving.

Which of the following best defines the term energy? Select one: a. The ability to deform solid objects b. The rate of motion related to time c. The capacity to do work d. The amount of heat generated through friction

c. the capacity to do work

Which of the following is TRUE of defense wounds in the victim of a knife attack? Select one: a. They usually occur to the shoulder as the victim attempts to turn away from the attack. b. They often occur to the neck and head as the victim doubles over into a protective posture. c. They usually occur to the hands and arms as the victim raises them to ward off the attacker. d. They rarely occur because the victim is usually taken by surprise.

c. they usually occur to the hands and arms as the victim raises them to ward off the attacker.

The path a projectile follows during a flight is called its: Select one: a. cavity. b. ballistics. c. trajectory. d. drag.

c. trajectory

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the ________ phase. a. Hemolytic b. Hemostatic c. Vascular d. Ischemic

c. vascular

Which of the following is the preferred in-hospital fluid for resuscitation in hemorrhagic shock? a. Fresh frozen plasma b. Lactated Ringer's c. Whole blood d. Normal saline

c. whole blood

Which of the following patients does NOT require specialty-center capabilities beyond that offered by a trauma center? Select one: a. A 67-year-old with second- and third-degree burns over 50 percent of the body b. A 25-year-old with amputation of three fingers c. A 4-year-old with a closed-head injury d. A 22-year-old with bilateral open femur fractures

d. 2 y/o with b/l open femur fractures

Your patient is a 42-year-old male with multiple lacerations on his arms, head, and torso after falling through a plate-glass window. On your arrival he appears to be unresponsive, lying prone on the sidewalk. Which of the following is the correct sequence of actions in caring for this patient? Control major hemorrhage. Take body-substance-isolation precautions. Check the area for broken glass before kneeling next to the patient. Turn him to a supine position. Open his airway. Select one: a. 2, 3, 1, 4, 5 b. 2, 5, 1, 3, 4 c. 3, 2, 4, 1, 5 d. 2, 3, 4, 5, 1

d. 2,3,4,5,1

Even with intervention, survival is unlikely with blood loss over ________ percent of the total blood volume. a. 25 b. 15 c. 50 d. 35

d. 35

In which of the following patients with hemorrhagic shock can you employ aggressive fluid resuscitation? a. A 50-year-old male with a stab wound to the right upper quadrant of the abdomen b. A 45-year-old woman with a suspected ruptured ectopic pregnancy c. A 38-year-old male with an open femur fracture and a developing bruise beneath the right scapula following an assault d. A 26-year-old male with a gunshot wound involving the popliteal artery

d. A 26-year-old male with a gunshot wound involving the popliteal artery

Which of the following requires immediate transport to a trauma center? Select one: a. A 40-year-old who fell 12 feet from a garage roof with a radius fracture b. A 36-year-old woman in a motor vehicle crash who has a blood pressure of 100/60 c. A 22-year-old soccer player with lower leg pain d. A 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

d. A 47 y/o involved in a motor vehicle crash that resulted in the death of his passenger

Which of the following mechanisms is responsible for accumulating lactic acid in shock? a. The citric acid cycle b. Gluconeogenesis c. Hemostasis d. Anaerobic metabolism

d. Anaerobic metabolism

Which of the following statements about the impact of motorcycle helmet usage is TRUE? Select one: a. Helmet use moderately increases the incidence of cervical spine injury. b. Helmet use moderately decreases the incidence of cervical spine injury. c. Helmet use substantially decreases the incidence of cervical spine injury. d. Helmet use neither increases nor decreases the incidence of cervical spine injury.

d. Helmet use neither increases nor decreases the incidence of cervical spine injury.

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a Class ________ hemorrhage. a. II2 b. IV c. III d. I

d. I

A fracture of the femur may result in a hematoma that contains enough blood to make it a Class ________ hemorrhage. a. I b. III c. IV d. II

d. II

Select one: a. III b. I c. IV d. II

d. II

Which of the following statements about trauma is FALSE? Select one: a. Life-threatening injuries may exist with little external evidence. b. Dramatic-appearing extremity injuries draw the paramedic's focus away from life-threatening injuries. c. Life-threatening injury occurs in less than 10 percent of trauma patients. d. Most patients with life-threatening trauma will have sustained external injury to the extremities (arms/legs).

d. Most patients with life-threatening trauma will have sustained external injury to the extremities (arms/legs).

Which of the following statements about entrance and exit wounds is TRUE? Select one: a. Exit wounds are usually the size of the bullet's profile. b. Entrance wounds most often appear as stellate. c. Cavitational wave energy is greatest at a bullet's point of entrance. d. Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.

d. Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.

The two factors that refer to the rate of change of speed are: Select one: a. deceleration and velocity. b. mass and weight. c. acceleration and deceleration. d. acceleration and inertia.

c. acceleration and deceleration

Which of the following findings indicates a progression from compensated shock to decompensated shock? a. Narrowing pulse pressure b. Tachycardia c. Altered mental status d. Diaphoresis

c. altered mental status

Red blood cells make up approximately ________ percent of whole blood volume. a. 45 b. 60 c. 30 d. 15

a. 45

Which of the following vessels has the greatest ability to change diameter? a. Arterioles b. Capillaries c. Systemic arteries d. Aorta

a. Arterioles

Which of the following represents the correct sequence for controlling hemorrhage from an extremity? a. Direct pressure on the dressing and wound, finger pressure through the dressing to the leaking vessel, and, if pressure fails, application of a tourniquet b. Direct pressure on the dressing and wound, elevation, ice c. Finger pressure through the dressing to the leaking vessel, splinting, ice, elevation d. Direct pressure on the dressing and wound , elevation, ice, tourniquet as a last resort

a. Direct pressure on the dressing and wound, finger pressure through the dressing to the leaking vessel, and, if pressure fails, application of a tourniquet

Which level of trauma facility has minimal surgical support but can stabilize before transferring to a higher-level trauma facility? Select one: a. III b. II c. IV d. I

a. III

Which of the following is defined as the volume of blood ejected from the heart with each beat? a. Stroke volume b. Ventricular capacitance c. Cardiac output d. Afterload

a. Stroke volume

Your patient is a construction worker who fell 15 feet and has a 3-foot metal concrete reinforcement bar (rebar) impaled in his right thigh. Which of the following is the best action? Select one: a. Administer sodium bicarbonate to combat acidosis resulting from the destruction of muscle tissue. b. If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length. c. If you can see both ends of the rebar, gently remove it and irrigate the wound with sterile saline. d. Transport the patient without attempting to shorten or remove the rebar.

b. If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length.

When cells become hypoxic and the amount of carbon dioxide in them increases, reducing tissue pH, which of the following occurs to restore homeostasis? a. Mast cells release serotonin, resulting in dilation of the capillary sphincters and an increase in tissue perfusion. b. Mast cells release histamine, resulting in dilation of capillary sphincters and an increase in tissue perfusion. c. The sympathetic nervous system constricts the capillary sphincters to prevent washout of the accumulated lactic acid. d. The precapillary sphincters open, increasing blood flow to the tissues. The postcapillary sphincters remain closed so that increased hydrostatic pressure forces lactic acid into the interstitial fluid, where it is buffered.

b. Mast cells release histamine, resulting in dilation of capillary sphincters and an increase in tissue perfusion.

Which of the following statements about the patient in neurogenic shock is NOT true? a. Signs of hypovolemic shock may be masked. b. Unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis. c. The heart rate may be normal. d. Neurogenic shock may be temporary, even if spinal cord damage is permanent.

b. Unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis.

Which of the following is TRUE of body armor use? Select one: a. There are no reported cases of penetrating trauma among victims who were shot while wearing body armor. b. Blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn. c. Blunt trauma occurs only if ceramic inserts are placed in the vest. d. Ceramic inserts are dangerous and should not be used, because they generally fragment and create secondary projectiles when they are struck by a bullet.

b. blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn

Which of the following abdominal organs is the LEAST affected by the pressure wave associated with penetrating trauma? Select one: a. Spleen b. Bowel c. Kidneys d. Liver

b. bowel

Which of the following substances has the most rapid effect when compensating for hemorrhage? a. Glucocorticoids b. Catecholamines c. Antidiuretic hormone d. Angiotensin II

b. catecholamines

During the scene size-up on a call for a patient with penetrating trauma due to a stab wound, which of the following should you do? Select one: a. Collect anything that could be used as evidence. b. Check for weapons on or near the patient. c. Try to find out in which direction the assailant fled. d. Assume that the patient has no weapons if law enforcement is on the scene.

b. check for weapons on or near the patient

Which of the following is NOT an example of trauma? Select one: a. An abrasion to the knee b. Chest pain c. Cerebral contusion d. A stab wound to the abdomen

b. chest pain

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "starred," and that the driver is not restrained. Which of the following injuries is MOST likely? Select one: a. Whiplash injury of the neck muscles b. Compression injury of the cervical spine c. Distraction injury of the cervical spine d. Ligamentous neck injury due to rotation beyond the range of motion

b. compression injury of the cervical spine

Modern medicine treats trauma as a: Select one: a. crisis. b. disease. c. life threat. d. medical problem.

b. disease

For which of the following mechanisms of injury should you maintain the highest index of suspicion for hemorrhagic shock? a. Ten-foot fall from a ladder b. Frontal-impact motor vehicle collision at 45 miles per hour c. Gunshot wound resulting in an open tibia fracture d. Blunt trauma to the head, resulting in a full-thickness laceration to the forehead

b. frontal-impact MVC at 45 mph

Your patient is a 45-year-old male who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and confused, pale, diaphoretic, and cool to the touch. He lacks a radial pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this patient? a. He is in irreversible shock. b. He is in decompensated shock. c. He is in compensated shock. d. None of the above is certain.

b. he is in decompensated shock

Which of the following terms is best described as the loss of blood from the vascular space? a. Hypovolemia b. Hemorrhage c. Hemostasis d. Shock

b. hemorrhage

Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns? Select one: a. Traumatic brain injury b. Hip and femur fractures c. Rupture of the diaphragm d. Rupture of hollow organs

b. hip and femur fractures

Which of the following is a "mental summation of suspected injuries based on the event analysis"? Select one: a. Index of injury b. Index of suspicion c. Newton's First Law of Motion d. Mechanism of injury

b. index of suspicion

Your patient has a possible pelvic fracture from a frontal motor vehicle collision. She has a blood pressure of 78 by palpation, has a heart rate of 130, and responds only to painful stimuli. Before you arrived BLS providers immobilized the patient to a long backboard. Which of the following should you do next? a. Apply PASG b. Initiate rapid transport c. Perform a rapid trauma assessment d. Start a large-bore IV of lactated Ringer's solution

b. initiate rapid transport

Rapid volume replacement is best achieved under which of the following conditions? a. Use of a long catheter with a large internal diameter b. Use of a long catheter with a small internal diameter c. Use of a short catheter with a small internal diameter d. Use of a short catheter with a large internal diameter

d. use of a short catheter with a large internal diameter

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree, but not when it brakes to a stop? Select one: a. Braking allows the kinetic energy to be absorbed evenly into the frame of the vehicle, rather than concentrating it at the point of impact. b. The energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants. c. The inertia of the tree increases the kinetic energy transmitted to the occupants by a factor of 10. d. None of these describes why. Feedback

b. the energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants

Which of the following is the best definition of the Golden Period? Select one: a. The ideal time it takes to assess a multi-system trauma patient b. The ideal timeframe from time of injury until surgery c. The ideal time from requesting a helicopter to it landing on scene d. The ideal timeframe from call dispatch to arrival on scene

b. the ideal time frame from time of injury until surgery

Infants and very small children (up to two years of age) should have their child safety seat positioned where in a car? Select one: a. The front seating area, facing backward b. The rear seating area, facing backward c. The front seating area, facing frontward d. The rear seating area, facing frontward

b. the rear seating area, facing backwards

Which of the following types of wound facilitates the effectiveness of normal blood-clotting mechanisms? a. Vessels torn by stretching, such as when a limb is caught in farm machinery b. Transverse laceration of the vessel c. Longitudinal laceration of the vessel d. Crushing injuries

b. transverse laceration of the vessel

The leading cause of death in people under age 44 is: Select one: a. heart attack. b. trauma. c. cancer. d. cardiovascular disease.

b. trauma

Which of the following best differentiates medical and trauma patient assessment? Select one: a. There is no concept for "medical load and go" patients. b. Trauma triage guidelines are not critical with medical patients. c. Scene safety is not an issue with the medical patient. d. Assessing breath sounds is not crucial to trauma assessment.

b. trauma triage guidelines are not critical with medical patients.

Which two factors related to kinetic energy proportionately affect the damage a projectile will do? Select one: a. Velocity and yaw b. Velocity and mass c. Mass and fragmentation d. Fragmentation and velocity

b. velocity and mass

Which statement about ballistics is TRUE? Select one: a. Damage is less when the bullet does not exit the body. b. When a bullet tumbles, it decreases the damage. c. In penetrating trauma, the mass of a projectile is more significant than its velocity when determining kinetic energy. d. When a bullet yaws, it increases the damage.

b. when a bullet tumbles, it decreases the damage

Which of the following results from relaxation of the postcapillary sphincters in shock? a. Diffuse intravascular coagulation b. Melena c. "Washout" of microemboli and lactic acid d. Septicemia

c. "washout" of microemboli and lactic acid

The rapid trauma exam focuses on finding injuries that may cause shock by quickly assessing which of the following body areas? 1. Head 2. Neck 3. Chest 4. Abdomen 5. Pelvis 6. Proximal extremities 7. Distal extremities a. 1, 2, 3, 4, and 5 b. 1, 4, 5, and 6 c. 1, 2, 3, 4, 5, 6, and 7 d. 3, 4, 5, and 6

c. 1, 2, 3, 4, 5, 6, and 7

Which of the following mechanisms would yield the greatest index of suspicion for serious injury? Select one: a. Helmeted bicyclist losing control and falling off his bike onto a grassy surface at 15 miles per hour b. Adult falling 5 feet from a ladder and landing in the mud c. Seventy-mile-per-hour motor vehicle crash with partial ejection d. Pedestrian struck by a car travelling 5 miles/hour

c. 70 mph MVC with partial ejection

Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The air bag deployed. Considering the likelihood of organ collision, for which of the following injuries should you maintain a high index of suspicion? Select one: a. Cardiac contusion b. Anterior flail segment c. Abruptio placentae d. Fractured sternum

c. Abruptio placentae

Which of the following, located in the aortic arch, monitor blood pressure and send feedback to the medulla oblongata to maintain homeostasis? a. Volume receptors b. Proprioceptors c. Baroreceptors d. Chemoreceptors

c. Baroreceptors

In addition to handling all types of specialty trauma, which level of trauma center provides continuing medical and public education programs? Select one: a. IV b. III c. I d. II

c. I

Which level of trauma facility can provide neurosurgery, microsurgery, and care for multisystem trauma? Select one: a. III b. II c. I d. IV

c. I

Which level of trauma facility strictly stabilizes trauma patients and prepares to transport, often by helicopter, to a more distant and higher-level trauma center? Select one: a. I b. II c. IV d. III

c. IV

Your patient is an 8-year-old boy with a pencil impaled 2 centimeters inferior to the xiphoid process. You note that the pencil is pulsating. Which of the following is the best action? Select one: a. Start an IV and request orders for analgesia and sedation. b. Remove the pencil and apply direct pressure to the wound; transport to a trauma center if the bleeding does not stop with direct pressure. c. Stabilize the pencil in place and transport to a trauma center. d. Stabilize the pencil in place and transport to the nearest medical facility.

c. Stabilize the pencil in place and transport to a trauma center.

You are called to the scene of a vehicle crash in which a car was rear-ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated index of suspicion for injuries? Select one: a. The amount of energy transmitted to an object is inversely proportional to its rate of deceleration. b. Energy can neither be created nor destroyed. c. A body at rest will remain at rest unless acted on by an outside force. d. A body in motion will remain in motion unless acted on by an outside force.

c. a body at rest will remain at rest unless acted on by an outside force.

Your patient is a 24-year-old male who was struck just below the left scapula with a 3-inch diameter metal pipe. He is awake but having difficulty breathing. His pulse is 112 at the radial artery, and his respiratory rate is 28 per minute and shallow. His breath sounds are present bilaterally but diminished on the left. He has a blood pressure of 108/68. The patient is coughing up some bloody sputum. He has no other complaints, and a rapid trauma survey reveals no additional life-threatening injuries. Which of the following represents the best sequence of intervention for this patient? a. Begin transport immediately, oxygen 15 lpm by nonrebreathing mask, a large-bore IV of isotonic solution to maintain a systolic blood pressure of 120 mmHg or greater b. Oxygen 10-12 lpm by nonrebreathing mask, a large-bore IV of normal saline solution at a keep-open rate, transport c. Oxygen, 15 lpm by nonrebreathing mask, begin transport, a 14-gauge IV of lactated Ringer's solution, wide open d. Oxygen 10-12 lpm by nonrebreathing mask, begin transport, 16-gauge IV at a keep-open rate

d. Oxygen 10-12 lpm by nonrebreathing mask, begin transport, 16-gauge IV at a keep-open rate

Vehicle supplemental restraint systems (air bags) are meant to: Select one: a. prevent unrestrained occupants from taking the down-and-under pathway in frontal impacts. b. protect infants and children who ride in the front seat of the vehicle. c. prevent injury from secondary impacts. d. absorb the energy exchange of rapid deceleration.

d. absorb the energy exchange of rapid deceleration

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic shock? a. Administer hypertonic saline solution or colloids at a keep-open rate. b. Administer synthetic oxygen-carrying fluids as necessary to increase the level of consciousness. c. Begin with a 2,000 ml bolus of isotonic crystalloid solution infused under pressure. d. Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

d. administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Which of the following impairs blood clotting? a. Hypothermia b. Administration of IV fluids c. Use of nonsteroidal, anti-inflammatory medications d. All of the above

d. all of the above

Which of the following is TRUE of the elderly trauma patient? a. The elderly trauma patient is more likely to experience myocardial ischemia as a result of hemorrhage. b. Medications like beta-blockers may interfere with normal compensatory mechanisms. c. Hemorrhage may not result in tachycardia as expected. d. All of the above are true

d. all of the above are true

When inspecting the interior of a vehicle involved in a frontal collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries might this indicate? Select one: a. Fracture of the acetabulum b. Femur fracture c. Knee injury d. All of these

d. all of these

The purpose of determining the mechanism of injury and the index of suspicion for the trauma patient at the same time is to allow you to: Select one: a. decide whether to transport the patient. b. identify comorbid factors. c. document a complete scene size-up. d. anticipate your patient's injuries.

d. anticipate your patient's injuries.

Which of the following increases a bullet's profile? Select one: a. "Mushrooming" on impact b. The use of rifling in the barrel of the firearm c. Tumbling 180 degrees on impact d. Both "Mushrooming" on impact and Tumbling 180 degrees on impact

d. both "mushrooming" on impact and tumbling 180 degrees on impact

Which of the following is an acceptable way of reducing prehospital time to maximize the use of the "Golden Period" for trauma patients? Select one: a. Skip spinal immobilization in the blunt trauma patient. b. Start all IVs on the scene to allow for more rapid transport. c. Load the patients and begin transport before doing a primary assessment. d. Call for air medical transport, if indicated.

d. call for air medical transport, if indicated.

Managing a laceration with arterial bleeding most often requires: a. Cauterization b. A tourniquet c. PASG d. Direct pressure

d. direct pressure

When assessing the chest during rapid trauma survey, what is most likely to indicate major internal hemorrhage? a. Hyperresonance to percussion b. Increased respiratory rate c. Distended neck veins d. Dullness to percussion

d. dullness to percussion

Which of the following is the only way to determine which patient care procedures benefit trauma patients? Select one: a. Surveillance b. Risk identification c. Implementation d. Evaluation

d. evaluation

Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory. Select one: a. wavier; straighter b. flatter; wavier c. more rounded; curved d. flatter; straighter

d. flatter; straighter

Which of the following best describes definitive care for the trauma patient with ongoing, significant hemorrhage? a. Administration of blood or blood products b. Administration of hypertonic crystalloid or colloid solution c. Invasive hemodynamic monitoring and serial hematocrits d. Immediate surgery

d. immediate surgery

When a patient falls, which section of the spinal column is the most prone to compression injury? Select one: a. Sacral b. Cervical c. Thoracic d. Lumbar

d. lumbar

As a paramedic, your role in trauma care consists of all of the following, EXCEPT: Select one: a. providing rapid transport to appropriate facilities. b. promoting injury prevention. c. providing care to seriously injured trauma patients. d. providing surgical interventions to stop hemorrhage.

d. providing surgical interventions to stop hemorrhage.

Which of the following is considered a high-velocity weapon? Select one: a. Shotgun b. Arrow c. Handgun d. Rifle

d. rifle

As the mass of an object increases, which of the following occurs? Select one: a. The maximum speed it can attain increases. b. The amount of energy decreases. c. The maximum speed it can attain decreases. d. The amount of energy increases.

d. the amount of energy increases

A penetrating injury to which of the following organs is LEAST likely to result in severe hemorrhage? Select one: a. Liver b. Kidney c. Spleen d. Ureter

d. ureter