Trauma

During a soccer game, an 18-year-old woman injured her knee. Her knee is in a flexed position and is obviously deformed. You should: A:assess circulatory function distal to her injury. B:immobilize the knee in the position in which it was found. C:manually stabilize the leg above and below the knee. D:straighten the knee to facilitate immobilization.

C:manually stabilize the leg above and below the knee.

The pneumatic antishock garment may be indicated for patients with: A:any severe injury above the nipple line. B:blunt chest trauma and hypotension. C:pelvic instability and signs of shock. D:femur fractures and crackles in the lungs.

C:pelvic instability and signs of shock.

You are performing a secondary assessment on a severely injured patient while en route to a trauma center. During the assessment, you note that the patient's respiratory rate has increased. You should: A:assess his oxygen saturation with a pulse oximeter. B:immediately notify the receiving facility. C:repeat the primary assessment and treat as needed. D:count the number of respirations per minute.

C:repeat the primary assessment and treat as needed.

Displaced fractures of the proximal femur are characterized by: A:lengthening and internal rotation of the leg. B:a flexed hip joint and inward thigh rotation. C:shortening and external rotation of the leg. D:hip joint extension and external leg rotation.

C:shortening and external rotation of the leg.

During your rapid assessment of a critically-injured patient, you should assess the chest for: A:crepitus and distention. B:distention and guarding. C:symmetry and pain. D:rigidity and guarding.

C:symmetry and pain.

When caring for a trauma patient with signs of intraabdominal bleeding, it is MOST important for the EMT to: A:apply and inflate the pneumatic antishock garment. B:perform an in-depth abdominal assessment. C:transport rapidly to an appropriate medical facility. D:auscultate bowel sounds for at least 2 minutes.

C:transport rapidly to an appropriate medical facility.

Following a head injury, a young female is semiconscious and is bleeding from the nose and left ear. You should: A:control the bleeding from her nose by pinching her nostrils closed. B:place a pressure dressing over her ear to prevent blood loss. C:insert a nasal airway to keep her tongue from blocking the airway. D:cover her ear and nose with a loose gauze pad to collect the blood.

D:cover her ear and nose with a loose gauze pad to collect the blood.

A 44-year-old man has a traumatic leg amputation just below the knee. He is unresponsive; is breathing rapidly and shallowly; and has pale, cool, clammy skin. He is lying in a large pool of blood and the wound is bleeding profusely. To control this bleeding, you should: A:apply a pressure dressing and elevate the injured extremity at least 12 inches. B:locate the femoral artery and apply pressure to it until the bleeding stops. C:apply an icepack to the wound to constrict the vessels and stop the bleeding. D:cover the wound with a trauma dressing and apply a proximal tourniquet.

D:cover the wound with a trauma dressing and apply a proximal tourniquet.

Shock following major trauma is MOST often the result of: A:long bone fractures. B:head injury. C:spinal injury. D:hemorrhage.

D:hemorrhage.

A 22-year-old female woman was shot by her husband. Law enforcement is at the scene and has the husband in custody. The patient is conscious, but extremely restless, and is pale and diaphoretic. As your partner administers high-flow oxygen, you should: A:look for and control any bleeding. B:take her BP to detect hypotension. C:keep her warm by applying blankets. D:compare her carotid and radial pulses.

A:look for and control any bleeding.

Which of the following is MOST indicative of decompensated shock in a trauma patient with internal bleeding? A:Hypotension B:Clammy skin C:Restlessness D:Tachycardia

A:Hypotension

A young man fell and landed on his outstretched hand, resulting in pain and deformity to the left midshaft forearm. Distal circulation should be assessed at which of the following pulse locations? A:Radial B:Popliteal C:Pedal D:Brachial

A:Radial

Which of the following signs would you expect to see in the early stages of shock? A:Restlessness B:Hypotension C:Unconsciousness D:Thready pulses

A:Restlessness;

An adult patient opens his eyes in response to a painful stimulus, moans when you ask him questions, and pulls his arm away when you palpate it. What is his Glasgow Coma Scale (GCS) score? A:8 B:9 C:7 D:6

A:8

Which of the following patients would be MOST in need of a rapid head-to-toe assessment? A:A responsive 22-year-old man with a small caliber gunshot wound to the abdomen B:A responsive 25-year-old woman who fell 9 feet from a roof and landed on her side C:A 60-year-old man who fell from a standing position and has small abrasions on his cheek D:A 43-year-old woman with a unilaterally swollen, painful deformity of the midshaft femur

A:A responsive 22-year-old man with a small caliber gunshot wound to the abdomen

During a soccer game, a 20-year-old man collided shoulder-to-shoulder with another player. He has pain and a noticeable anterior bulge to the left shoulder. Which of the following is the MOST effective method of immobilizing this injury? A:A sling to support the left arm and swathes to secure the arm to the body B:An air-inflatable splint with the left arm immobilized in the flexed position C:A sling to support the left arm and swathes to maintain downward traction D:A long board splint with the left arm immobilized in the extended position

A:A sling to support the left arm and swathes to secure the arm to the body

Which of the following injury mechanisms is associated with hangings? A:Distraction B:Hyperextension C:Axial loading D:Subluxation

A:Distraction

A 33-year-old male struck a parked car with his motorcycle and was ejected from the motorcycle. He was not wearing a helmet. He is unresponsive, has a depressed area to his forehead, bilaterally deformed femurs, and widespread abrasions with capillary bleeding. Which of the following statements regarding this patient is false? A:You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock. B:You should suspect that the patient has a skull fracture and increased intracranial pressure. C:Internal hemorrhage cannot be controlled in the field and requires prompt surgical intervention. D:Femur fractures are a common injury when a motorcyclist is ejected from his or her motorcycle.

A:You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock.

A 23-year-old male was struck across the face with a baseball bat. His eyes are swollen shut, he has massive facial bruising and deformities, and has blood in his mouth. Your MOST immediate concern should be: A:airway compromise. B:spinal trauma. C:permanent vision loss. D:intracranial bleeding.

A:airway compromise.

A young male has an open abdominal wound through which a small loop of bowel is protruding. There is minimal bleeding. The BEST way to treat his injury is to: A:apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing. B:gently clean the exposed loop of bowel with warm sterile saline, carefully replace it back into the wound, and cover it with a dry sterile dressing. C:apply dry sterile gauze pads to the wound and then keep them continuously moist by pouring sterile saline or water on them throughout transport. D:cover the wound with a dry sterile trauma dressing and tightly secure it in place by circumferentially wrapping roller gauze around the abdomen.

A:apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing.

Despite direct pressure, a large laceration continues to spurt large amounts of bright red blood. You should: A:apply a tourniquet proximal to the injury until the bleeding stops. B:place additional dressings on the wound until the bleeding stops. C:elevate the extremity and apply a tight pressure dressing. D:apply pressure to the pulse point that is proximal to the injury.

A:apply a tourniquet proximal to the injury until the bleeding stops.

A 21-year-old man partially amputated his right arm when the chainsaw he was using to trim trees slipped. You can feel a weak radial pulse and his arm is cool to the touch. Dark red blood is flowing heavily from the wound. You should: A:apply bulky compression dressings to the wound and splint the extremity. B:control the bleeding, manipulate the arm to improve circulation, and apply a splint. C:carefully pack sterile dressings into the wound and fully splint the extremity. D:apply a tourniquet proximal to the injury and tighten it until the bleeding stops.

A:apply bulky compression dressings to the wound and splint the extremity.

A patient with a spinal injury may still be able to use his or her diaphragm to breathe, but would lose control of the intercostal muscles, if the spinal cord is injured: A:below the C5 level. B:above the C3 level. C:above the C5 level. D:between C1 and C2.

A:below the C5 level.

A 42-year-old man has a large knife impaled in the center of his chest. He is unresponsive, pulseless, and apneic. You should: A:carefully remove the knife, control the bleeding, and begin CPR. B:stabilize the knife with bulky dressings, begin CPR, and transport at once. C:secure the knife in place with a bulky dressing and transport immediately. D:carefully remove the knife, control the bleeding, and apply the AED.

A:carefully remove the knife, control the bleeding, and begin CPR.

An elderly woman, who was removed from her burning house by firefighters, has full-thickness burns to approximately 50% of her body. Appropriate treatment for this patient should include: A:covering the burns with dry, sterile dressings and preventing further loss of body heat. B:peeling burned clothing from the skin and removing all rings, necklaces, and bracelets. C:applying moist, sterile dressings to the burned areas and preventing hypothermia. D:cooling the burns with sterile saline and covering them with dry, sterile burn pads.

A:covering the burns with dry, sterile dressings and preventing further loss of body heat.

A patient experienced blunt chest trauma and has asymmetrical chest wall movement. This MOST likely indicates: A:decreased air movement into one lung. B:accumulation of blood in both of the lungs. C:shallow breathing secondary to severe pain. D:several ribs broken in numerous places.

A:decreased air movement into one lung.

In addition to high-flow oxygen, the MOST appropriate treatment for a patient with widespread full-thickness burns should include: A:dry, sterile dressings; warmth; and rapid transport. B:moist; sterile dressings; burn ointment; and rapid transport. C:moist; sterile dressings; warmth; and rapid transport. D:dry; sterile dressings; burn ointment; and rapid transport.

A:dry, sterile dressings; warmth; and rapid transport.

Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. These are signs of a/an: A:flail chest. B:pulmonary contusion. C:pneumothorax. D:isolated rib fracture.

A:flail chest

After stopping the burning process, emergency care for a 68-year-old male with partial- and full-thickness burns to his chest and upper extremities includes all of the following, EXCEPT: A:flushing the burns with cool water for 10 minutes. B:preparing to assist the patient's ventilations. C:avoiding the use of burn ointments or antiseptics. D:covering the burns with dry, sterile dressings.

A:flushing the burns with cool water for 10 minutes.

You arrive at a residence where you find a man lying unresponsive in his front yard. There were no witnesses to the event. In assessing this man, you should assume that he: A:has sustained an injury. B:has a heat-related emergency. C:is having a diabetic reaction. D:is having a heart attack.

A:has sustained an injury.

You are assessing a young male who was stabbed in the right lower chest. He is semiconscious and has labored breathing, collapsed jugular veins, and absent breath sounds on the right side of his chest. This patient MOST likely has a: A:hemothorax. B:liver laceration. C:pneumothorax. D:ruptured spleen.

A:hemothorax.

A 19-year-old female has a closed, swollen deformity to her left forearm. You are unable to palpate a radial pulse and the skin distal to the injury is cold and pale. Several attempts to contact medical control have failed and you are approximately 45 miles away from the closest hospital. You should: A:make one attempt to restore distal circulation by applying gentle manual traction in line with the long axis of the limb. B:apply an air splint to her forearm, keep her arm below the level of her heart, place an icepack over the injury, and transport. C:begin transport at once, gently manipulate her arm en route until distal circulation is restored, and apply an air splint. D:splint her entire arm with rigid board splints, elevate the limb above the level of her heart, and transport immediately.

A:make one attempt to restore distal circulation by applying gentle manual traction in line with the long axis of the limb.

A 42-year-old man was ejected from his car after it struck a bridge pillar at a high rate of speed. You find him in a prone position approximately 50 feet from his car. He is not moving and does not appear to be breathing. You should: A:manually stabilize his head. B:assess his breathing effort. C:use the jaw-thrust maneuver. D:administer high-flow oxygen.

A:manually stabilize his head.

A football player complains of severe neck pain and tingling in his arms and legs after being tackled. He is conscious and alert, has a patent airway, and is breathing adequately. He is in a supine position and is still wearing his helmet, which is tight-fitting. The MOST appropriate treatment for this patient includes: A:manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. B:manually stabilizing his head, leaving his helmet on, applying a vest-style spinal immobilization device, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. C:carefully removing his helmet, manually stabilizing his head, applying a cervical collar, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. D:manually stabilizing his head, carefully removing his helmet, administering high-flow oxygen, applying a cervical collar, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.

A:manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.

A 33-year-old factory worker was pinned between two pieces of machinery. When you arrive at the scene, you find him lying supine on the ground complaining of severe pain to his pelvis. He is restless, diaphoretic, and tachycardic. After performing a rapid head-to-toe assessment, you should: A:prepare for immediate transport. B:palpate his pelvis to assess for crepitus. C:carefully log roll him to check his back. D:perform a detailed secondary exam.

A:prepare for immediate transport.

Upon discovering an open chest wound, you should: A:prevent air from entering the open wound. B:quickly cover the wound with a porous trauma dressing. C:immediately reassess the patient's ventilatory status. D:begin assisted ventilation and prepare for transport.

A:prevent air from entering the open wound.

During the rapid head-to-toe assessment of a patient with multiple injuries, you expose the chest and find an open wound with blood bubbling from it. You should: A:prevent air from entering the wound. B:apply high-flow supplemental oxygen. C:place a porous dressing over the wound. D:stop your assessment and transport.

A:prevent air from entering the wound.

A 21-year-old male was bitten on the left forearm by a dog. He is conscious and alert and denies any other injuries. An animal control officer is at the scene and has contained the dog. Your assessment of the patient's arm reveals a large avulsion with a peeled back flap of skin. Distal circulation is adequate and the patient is able to feel and move his fingers. In addition to bleeding control, you should: A:replace the avulsed flap to its original position. B:perform a rapid head-to-toe assessment. C:apply oxygen via a nonrebreathing mask. D:irrigate the wound for at least 15 minutes.

A:replace the avulsed flap to its original position.

When caring for a critically injured patient, it is MOST appropriate to perform your secondary assessment: A:while you are en route to the hospital. B:immediately following the primary assessment. C:immediately after taking baseline vital signs. D:after all life threats have been ruled out.

A:while you are en route to the hospital.

The presence of subcutaneous emphysema following blunt trauma to the anterior neck should make you MOST suspicious for a: A:carotid artery injury. B:pneumothorax. C:fractured larynx. D:ruptured esophagus.

C:fractured larynx.

A young male has a large laceration to his lateral neck, directly over his jugular vein. His airway is patent and his breathing is adequate. Your MOST immediate priority should be to: A:obtain vital signs to determine if he is hypotensive. B:keep air out of the wound and control the bleeding. C:apply high-flow oxygen via a nonrebreathing mask. D:perform a rapid assessment to detect other injuries.

B:keep air out of the wound and control the bleeding.

Firefighters have rescued a man from his burning house. He is conscious and alert, but is experiencing significant respiratory distress. He has a brassy cough and singed nasal hairs. The MOST immediate threat to this patient's life is: A:hypothermia. B:airway swelling. C:severe infection. D:severe burns.

B:airway swelling.

Basic shock treatment includes: A:applying and inflating the PASG, applying oxygen, and thermal management. B:applying oxygen, elevating the lower extremities per protocol, and providing warmth. C:applying oxygen, elevating the upper body, and taking measures to prevent hypothermia. D:elevating the lower extremities, applying and inflating the PASG, and applying oxygen.

B:applying oxygen, elevating the lower extremities per protocol, and providing warmth.

You are called to a local nightclub for an injured patient. Law enforcement personnel have secured the scene. Upon arrival, you see a young man who is lying on the ground screaming in pain; bright red blood is spurting from an apparent stab wound to his groin area. You should: A:apply 100% oxygen. B:control the bleeding. C:ensure an open airway. D:prevent hypothermia.

B:control the bleeding.

A gang member was cut on the left side of the neck during a fight and is bleeding heavily from the wound. His airway is patent and his breathing is adequate. You should immediately: A:apply a tight pressure dressing and secure it in place with tape. B:cover the wound with an occlusive dressing and apply direct pressure. C:apply high-flow oxygen via a nonrebreathing mask at 15 L/min. D:perform a head-to-toe assessment to find and treat other injuries.

B:cover the wound with an occlusive dressing and apply direct pressure.

A man was struck in the side of the head with a steel pipe. Blood-tinged fluid is draining from the ear and bruising appears behind the ear. The MOST appropriate treatment for this patient includes: A:elevating the lower extremities and providing immediate transport. B:immobilizing the spine, administering oxygen, and monitoring for vomiting. C:controlling the drainage from the ear and immobilizing the entire spine. D:applying high-flow oxygen and packing the ear with sterile gauze pads.

B:immobilizing the spine, administering oxygen, and monitoring for vomiting.

In contrast to an incision, a laceration: A:bleeds more severely. B:is a jagged cut. C:usually involves an artery. D:is a superficial injury.

B:is a jagged cut.

Factors that affect a person's ability to compensate for internal or external blood loss include all of the following, EXCEPT: A:advanced age. B:the rate of blood loss. C:high cholesterol in the blood. D:blood-thinning medications.

C:high cholesterol in the blood.

Initial treatment for a patient with external blood loss depends upon: A:whether or not hypotension is present. B:the amount of estimated blood loss. C:his or her signs and symptoms. D:his or her past medical history.

C:his or her signs and symptoms.

A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and severely deformed. Her leg is cold to the touch and you are unable to palpate a distal pulse. You should: A:apply gentle longitudinal traction as you straighten her leg and then apply a traction splint. B:manually stabilize her injury and contact medical control for further stabilization instructions. C:carefully straighten her leg until you restore a distal pulse and then apply padded board splints. D:place a pillow behind her knee and stabilize the injury by applying padded board splints.

B:manually stabilize her injury and contact medical control for further stabilization instructions.

When assessing distal circulation in a patient with a swollen deformed femur, you should: A:ask the patient to wiggle his toes. B:palpate for a dorsalis pedis pulse. C:touch his foot with a blunt object. D:assess the pulse behind the knee.

B:palpate for a dorsalis pedis pulse.

A 19-year-old male was assaulted and has trauma to multiple body systems. After performing your primary assessment and treating any immediate life-threatening injuries, you should: A:fully immobilize his spine and transport. B:perform a rapid head-to-toe assessment. C:obtain a full set of baseline vital signs. D:transport at once and intercept with ALS.

B:perform a rapid head-to-toe assessment.

Despite direct pressure, a large laceration to the medial aspect of the arm continues to bleed profusely. You should: A:locate and apply pressure to the brachial artery. B:quickly apply a tourniquet proximal to the injury. C:pack the inside of the laceration with sterile gauze. D:continue direct pressure and elevate the extremity.

B:quickly apply a tourniquet proximal to the injury.

A patient presents with a swollen, painful deformity to the lateral bone of the left forearm. You should recognize that he has injured his: A:clavicle. B:radius. C:ulna. D:humerus.

B:radius.

A young male has trauma to multiple body systems after he fell approximately 35 feet. He is semiconscious, has an unstable chest wall, numerous long bone fractures, and a large hematoma to his head. He will have the GREATEST chance for survival if you: A:request an ALS ambulance. B:rapidly transport him to a trauma center. C:keep him warm and elevate his legs. D:give him high-flow oxygen early.

B:rapidly transport him to a trauma center.

Prior to your arrival at the scene, a young female was removed from the water after being submerged for an unknown period of time. You should manage her airway appropriately while considering the possibility of: A:hyperthermia. B:spinal injury. C:airway obstruction. D:internal bleeding.

B:spinal injury.

A woman stabbed her boyfriend in the cheek with a dinner fork during an argument. Police have the woman in custody. The patient still has the fork impaled in his cheek. He is conscious and alert, breathing adequately, and has blood in his oropharynx. You should: A:apply high-flow oxygen via a nonrebreathing mask, carefully remove the fork, and control any external bleeding. B:suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings. C:suction his oropharynx, carefully cut the fork to make it shorter, control any external bleeding, and secure the fork in place. D:carefully remove the fork, suction his oropharynx as needed, and pack the inside of his cheek with sterile gauze pads.

B:suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings.

Internal or external bleeding would be especially severe in a patient: A:with heart disease. B:with hemophilia. C:who is hypotensive. D:who takes aspirin.

B:with hemophilia.

Patients with significant closed head injuries often have pupillary abnormalities and: A:paralysis. B:tachycardia. C:hypertension. D:paresthesia.

C:hypertension.

Which of the following assessment parameters is the MOST reliable when determining if a patient with a head injury is improving or deteriorating? A:pupillary reaction. B:rate and depth of breathing. C:level of consciousness. D:systolic blood pressure.

C:level of consciousness.

When assessing and treating a patient with a gunshot wound, you should routinely: A:apply ice directly to the wound. B:evaluate the pulses proximal to the wound. C:look for the presence of an exit wound. D:determine why the patient was shot

C:look for the presence of an exit wound.

A 30-year-old man sustained partial-thickness burns to the anterior chest and both anterior arms. Based on the Rule of Nines, what percentage of his body surface area has been burned? A:9% B:36% C:18% D:27%

C:18%

Following penetrating trauma to the abdomen, a 50-year-old woman has a large laceration with a loop of protruding bowel. How should you manage this injury? A:Carefully replace the bowel and apply an occlusive dressing. B:Apply a tight pressure dressing to control any external bleeding. C:Apply a moist, sterile dressing covered by a dry, sterile dressing. D:Apply a dry, sterile dressing covered by an occlusive dressing.

C:Apply a moist, sterile dressing covered by a dry, sterile dressing.

In which of the following situations would external bleeding be the MOST difficult to control? A:Carotid artery laceration, BP of 70/50 mm Hg B:Scalp laceration, BP of 130/70 mm Hg C:Femoral artery laceration, BP of 140/90 mm Hg D:Jugular vein laceration, BP of 104/60 mm Hg

C:Femoral artery laceration, BP of 140/90 mm Hg

A 56-year-old man was the unrestrained driver of a small passenger car that rolled over twice after he rounded a corner too fast. He is unresponsive; has rapid, shallow respirations; and has a rapid, weak pulse. His left arm is completely amputated just below the elbow. As you and your partner are treating the patient, other responders are trying to find the amputated arm. Which of the following statements regarding this scenario is correct? A:Quickly move the patient to the ambulance, continue treatment, and wait for the other responders to recover his arm. B:You should transport the patient immediately, even if the other responders recover his arm before you depart the scene. C:If the patient's arm has not been recovered by the time you are ready to transport, you should transport without delay. D:Your priority should be to recover the man's arm because a vascular surgeon may be able to successfully reattach it.

C:If the patient's arm has not been recovered by the time you are ready to transport, you should transport without delay.

During transport of a patient with a head injury, which of the following will provide you with the MOST information regarding the patient's condition? A:Blood pressure B:Pupil size C:Mental status D:Heart rate

C:Mental status

During which part of your assessment would you MOST likely discover a small caliber gunshot wound to the back with minimal bleeding? A:General impression B:Detailed secondary assessment C:Rapid head-to-toe assessment D:Primary assessment

C:Rapid head-to-toe assessment

Which of the following is MOST indicative of compensated shock in an adult? A:Unresponsive, pallor, absent radial pulses, tachypnea B:Confusion, mottling, tachycardia, BP of 88/60 mm Hg C:Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg D:Weak carotid pulse, cool skin, increased respiratory rate

C:Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg

Which of the following actions is MOST important when immobilizing a patient with a suspected spinal injury? A:A vest-style immobilization device should routinely be used. B:Secure the patient's head prior to immobilizing the torso. C:Select and apply the appropriate size of extrication collar. D:Check range of motion by asking the patient to move the head.

C:Select and apply the appropriate size of extrication collar.

You respond to a shooting at a local bar. Law enforcement is present and the scene has been secured. Your patient is a young male, who is sitting against the wall screaming in pain. Bright red blood is spurting from a wound near his groin. You should: A:ensure an open airway. B:transport the patient at once. C:apply pressure to the wound. D:administer high-flow oxygen.

C:apply pressure to the wound.

Following blunt injury to the anterior torso, a patient is coughing up bright red blood. You should be MOST suspicious of: A:severe myocardial damage. B:intraabdominal bleeding. C:bleeding within the lungs. D:gastrointestinal bleeding.

C:bleeding within the lungs.

A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow, and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-flow oxygen, you should: A:control the bleeding from the stab wound with a sterile porous dressing and reassess his vital signs. B:suspect that the patient has a tension pneumothorax and notify the trauma center as soon as possible. C:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly. D:perform a detailed physical exam at the scene to ensure that you locate and treat less obvious injuries.

C:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly.

During your assessment of a patient with a gunshot wound to the chest, you note that his skin is pale. This finding is the result of: A:peripheral dilation of the vasculature. B:a critically low blood pressure. C:decreased blood flow to the skin. D:a significantly elevated heart rate.

C:decreased blood flow to the skin.

During your assessment of a patient who experienced blunt facial trauma, you note the presence of a hyphema. This indicates: A:a fracture of the nasal bone. B:that the pupils are unequal. C:direct trauma to the eyeball. D:an orbital blowout fracture.

C:direct trauma to the eyeball.

Damaged small blood vessels beneath the skin following blunt trauma causes: A:mottling. B:cyanosis. C:ecchymosis. D:hematoma.

C:ecchymosis.

A 40-year-old man was hit in the nose during a fight. He has bruising under his left eye and a nosebleed. After taking standard precautions, you should: A:place a chemical icepack over his nose. B:apply direct pressure by pinching his nostrils together. C:ensure that he is sitting up and leaning forward. D:determine if he has any visual disturbances.

C:ensure that he is sitting up and leaning forward.

A high-school student was splashed in the eyes with a strong acid chemical during a lab experiment. He is in severe pain and is unable to open his eyes. You should: A:cover both of his eyes with sterile gauze and transport at once. B:force his eyes open and assess for the presence of severe burns. C:flush both eyes with sterile water for no more than 5 minutes. D:continuously flush his eyes with saline for at least 20 minutes.

D:continuously flush his eyes with saline for at least 20 minutes.

Priority treatment for a large avulsion includes: A:cleaning the wound. B:immobilizing the injured area. C:assessing distal circulation. D:controlling any bleeding.

D:controlling any bleeding.

Which of the following is the MOST reliable indicator of a fracture to a spinal vertebra? A:Lack of pain at the site of the injury B:Decreased movement on one side of the body C:Decreased grip strength in the upper extremities D:Palpable pain at the site of the injury

D:Palpable pain at the site of the injury (Of the options listed, the presence of palpable pain (specifically, point tenderness directly over the injury site), is the most reliable indicator of an underlying vertebral fracture. In fact, point tenderness, second only to gross deformity, is the most reliable indicator of an underlying fracture to any bone).

Which of the following BEST describes the mechanism of injury? A:Your concern for potentially serious injuries B:The energy of an object in motion C:The product of mass, force of gravity, and height D:The way in which traumatic injuries occur

D:The way in which traumatic injuries occur

A 30-year-old woman has an open deformity to her left leg and is in severe pain. She is conscious and alert, has a patent airway, and is breathing adequately. Your primary concern should be: A:administering high-flow oxygen. B:covering the wound to prevent infection. C:assessing pulses distal to the injury. D:controlling any external bleeding.

D:controlling any external bleeding.

Rapid extrication of a patient from an automobile should be performed by: A:applying a cervical collar and removing the patient from the car using the direct carry method. B:applying a vest-style extrication device and sliding the patient out of the car onto a long spine board for full immobilization. C:maintaining support of the head, grasping the patient by the clothing, and rapidly removing the patient from the car. D:applying a cervical collar, sliding a long spine board under the patient's buttocks, and removing the patient from the car.

D:applying a cervical collar, sliding a long spine board under the patient's buttocks, and removing the patient from the car.

An unresponsive patient with multi-systems trauma has slow, shallow breathing; weak radial pulses; and severe bleeding from a lower extremity wound. You should direct your partner to: A:apply oxygen via nonrebreathing mask while you control the bleeding. B:prepare the long spine board and straps for rapid spinal immobilization. C:radio for a paramedic ambulance to respond to the scene. D:assist the patient's ventilations while you control the bleeding.

D:assist the patient's ventilations while you control the bleeding.

A 40-year-old man has burns to the entire head, anterior chest, and both anterior upper extremities. Using the adult Rule of Nines, what percentage of his total body surface area has been burned? A:45% B:36% C:18% D:27%

D:27%

A patient with a closed head injury opens his eyes in response to pain, is mumbling words that you cannot understand, and pushes your hand away when you apply a painful stimulus. His Glasgow Coma Scale (GCS) score is: A:8 B:6 C:9 D:7

D:7

Which of the following mechanisms of injury would necessitate performing a rapid head-to-toe assessment? A:An impaled object in the patient's lower extremity with minimal venous bleeding B:A 5 foot, 9 inch tall adult who fell 12 feet from a roof and landed on his side C:Amputation of three toes from the patient's left foot with controlled bleeding D:A stable patient involved in a motor-vehicle crash, whose passenger was killed

D:A stable patient involved in a motor-vehicle crash, whose passenger was killed

Which of the following sets of vital signs is MOST suggestive of increased intracranial pressure in a patient who has experienced a traumatic brain injury? A:BP, 92/60 mm Hg; pulse, 120 beats/min; respirations, 24 breaths/min B:BP, 84/42 mm Hg; pulse, 60 beats/min; respirations, 32 breaths/min C:BP, 160/72 mm Hg; pulse, 100 beats/min; respirations, 12 breaths/min D:BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min

D:BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min

Which of the following indicates that a patient is in decompensated shock? A:Tachycardia and tachypnea B:Diaphoresis and pallor C:Restlessness and anxiety D:Falling blood pressure

D:Falling blood pressure

Which of the following questions is of LEAST pertinence initially when assessing a responsive 40-year-old woman who fell from a standing position? A:Can you move your hands and feet? B:Did you hit your head? C:Did you faint before you fell? D:Have you fallen before?

D:Have you fallen before?

In which of the following circumstances would external bleeding be the LEAST difficult to control? A:Lacerated jugular vein; BP of 100/60 mm Hg B:Lacerated carotid artery; BP of 90/50 mm Hg C:Lacerated brachial artery; BP of 140/90 mm Hg D:Lacerated femoral vein; BP of 70/40 mm Hg

D:Lacerated femoral vein; BP of 70/40 mm Hg

A soft-tissue injury that results in a flap of torn skin is called a/an: A:incision. B:abrasion. C:laceration. D:avulsion.

D:avulsion.

A 23-year-old unrestrained female struck the steering wheel with her chest when her passenger car collided with a tree at a high rate of speed. Your assessment reveals that she is conscious, but has signs of shock and an irregular pulse. The MOST appropriate treatment for this patient includes: A:applying an AED in case she develops cardiac arrest, high-flow oxygen, full spinal precautions, and rapid transport. B:insertion of an oral airway, assisted ventilations with a bag-mask device, full spinal precautions, and rapid transport. C:high-flow oxygen, summoning a paramedic unit to the scene to assess her cardiac rhythm, a cervical collar, and transport as soon as possible. D:high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport.

D:high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport.

A 44-year-old male experienced burns to his anterior trunk and both arms. He is conscious and alert, but is in extreme pain. Assessment of the burns reveals reddening and blisters. This patient has ________________ burns that cover _____ of his total body surface area. A:first-degree, 27% B:second-degree, 45% C:full-thickness, 18% D:partial-thickness, 36%

D:partial-thickness, 36%

Appropriate care for an amputated body part includes all of the following, EXCEPT: A:laying the wrapped body part on a bed of ice. B:wrapping it in a sterile dressing and placing it in a plastic bag. C:keeping the part cool, but not allowing it to freeze. D:placing it directly on ice to prevent tissue damage.

D:placing it directly on ice to prevent tissue damage.

A 22-year-old man was stabbed in the chest with a large knife. The patient is pulseless and apneic, and the knife is impaled in the center of his chest. Treatment should include: A:stabilizing the knife, applying an occlusive dressing, and providing rapid transport. B:stabilizing the knife, starting CPR, and providing rapid transport. C:removing the knife, applying an occlusive dressing, and providing rapid transport. D:removing the knife, starting CPR, and providing rapid transport.

D:removing the knife, starting CPR, and providing rapid transport.

When applying a vest-style spinal immobilization device to a patient with traumatic neck pain, you should: A:ask the patient to fully exhale as you secure the torso. B:immobilize the head prior to securing the torso straps. C:gently flex the head forward as you position the device. D:secure the torso section prior to immobilizing the head.

D:secure the torso section prior to immobilizing the head.

You are dispatched to the scene of a motorcycle crash. Upon arrival, you find the patient lying facedown approximately 25 feet from his bike. He is not wearing a helmet and is moaning. You should: A:apply a cervical collar. B:log roll him to a supine position. C:evaluate the status of his airway. D:stabilize his head manually.

D:stabilize his head manually.

If a passenger strikes his or her head on the windshield during a motor-vehicle crash: A:he or she will likely experience a hyperflexion injury, resulting in fractures of the vertebrae in the cervical spine. B:you will always see a starburst fracture of the windshield at the location where the patient struck his or her head. C:the posterior portion of the brain will receive the initial impact, resulting in severe intracerebral hemorrhage. D:the anterior part of the brain sustains a compression injury, while the posterior part sustains a stretching injury.

D:the anterior part of the brain sustains a compression injury, while the posterior part sustains a stretching injury.

If a vehicle strikes a tree at 60 MPH, the unrestrained driver would likely experience the MOST severe injuries during the: A:second collision. B:fourth collision. C:first collision. D:third collision.

D:third collision.

General care for an amputated body part includes: A:immersing the amputated part in ice cold water to prevent further damage. B:wrapping the amputated part in a moist, sterile dressing and keeping it warm. C:thoroughly cleaning the amputated part and wrapping it in a sterile dressing. D:wrapping the amputated part in a moist, sterile dressing and placing it on ice.

D:wrapping the amputated part in a moist, sterile dressing and placing it on ice.