Ch. 42 Questions AEMT
Roughly about how much volume remains in the vascular space about one hour after the initiation of an isotonic IV fluid bolus? A. The entire fluid bolus B. About three fourths C. About one third D. About one half
About one third
A 39-year-old male was ejected from his vehicle following a rollover, sustaining the injuries listed below. Which of the following will MOST likely increase the incidence of morbidity and mortality in this patient? A. An open femur fracture B. A tension pneumothorax C. A depressed skull fracture D. All of the above
All of the above
Which of the following is a potential pitfall when managing a multisystem trauma patient? A. Managing just one injury when there are multiple injuries B. Not managing an individual injury that is contributing to the patient's condition C. Failing to recognize multisystem trauma D. All of the above
All of the above
Your patient has sustained multisystem trauma. Which of the following patient conditions would lead you to suspect an increased susceptibility to mortality? A. Age of 75 years B. Medical history of end-stage renal disease C. Anticoagulation and bleeding disorders D. All of the above
All of the above
Why does multisystem trauma lead to increased incidence of morbidity and mortality? A. The provider cannot only focus on life-threatening injuries. B. The combination of two or more life-threatening conditions in the same patient increases risk of death substantially. C. Multisystem trauma leads to increased scene management times. D. More significant mechanism of injury is required for multisystem trauma to occur.
The combination of two or more life-threatening conditions in the same patient increases risk of death substantially.
Which element is evaluated when considering the special patient or system considerations when applying the CDC's field triage decision scheme? A. The presence of burn injury B. Vehicle telemetry data C. The presence of an amputation D. The Glasgow coma scale
The presence of burn injury
Clotting disorders, also known as bleeding disorders, are collectively known as: A. coagulopathies. B. hemostasis. C. platelet aggregators. D. anemia.
coagulopathies.
A drop in core body temperature to<95°F significantly reduces the body's blood-clotting mechanism. This decrease in the blood's ability to clot is referred to as: A. coagulopathy. B. compensated shock. C. multisystem trauma. D. decompensated shock.
coagulopathy.
As a member of the emergency medical services team, an AEMT role includes all of the following EXCEPT to: A. provide rapid assessment. B. transport patients to the appropriate hospital. C. dispatch equipment. D. triage trauma patients.
dispatch equipment.
You respond to a patient who has sustained a fall. In assessing the scene, you MUST include the surface the patient landed on and the __________________ to identify the need for specialty trauma care. A. path of the patient's body over the course of the fall. B. transport time. C. direction in which kinetic energy is transmitted through the body. D. distance of the fall.
distance of the fall
You respond to a call of an explosion at a local chemical company. Upon arrival, the company's hazmat team is decontaminating patients so you can easily treat them. The team extricates a 35-year-old man who is experiencing slight respiratory distress. The care that you should provide FIRST for this patient is: A. insertion of a supraglottic airway. B. high-flow oxygen. C. an immediate head-to-toe trauma assessment. D. transport to the local trauma center.
high-flow oxygen
The combination of two or more life-threatening conditions in the same patient: A. causes the AEMT is focus on only the most serious condition. B. increases risk of death substantially. C. indicates the mechanism of injury was not serious. D. decreases the possibility the patient will be transported to a Level I trauma center.
increases risk of death substantially.
During the primary assessment: A. manage life threats as soon as they are identified. B. approach assessment and management linearly. C. address all injuries at the same time. D. perform aspects of assessment separately from aspects of treatment, patient packaging, and transport.
manage life threats as soon as they are identified
An AEMT surveys an accident scene and identifies the ______________ to determine the forces applied to the patient. A. plan of action B. mechanism of injury C. transport resources D. index of suspicion
mechanism of injury
To reduce morbidity and mortality associated with multisystem trauma, your goal is to: A. ignore immediately life-threatening conditions for the sake of a quick transport. B. minimize your time on scene and initiate transport as soon as possible. C. omit a primary assessment whenever possible. D. work independently, excluding other rescuers.
minimize your time on scene and initiate transport as soon as possible.
Managing patients with multisystem trauma requires: A. the ability to understand both specific and multiple injuries. B. permitting one type of injury to divert you from managing the patient's overall condition. C. ignoring all but one individual injury that is contributing to the patient's condition. D. the ability to focus only on the assessment of the patient.
the ability to understand both specific and multiple injuries.
Spinal injury care steps performed during the primary assessment include: A. perform a rapid rollout independent of manual spinal stabilization. B. apply a cervical collar and secure the patient to the stretcher. C. administer medications to prevent further paralysis. D. apply a cervical collar independent of spinal stabilization.
apply a cervical collar and secure the patient to the stretcher.
Your 18-year-old patient was involved in an altercation and has a puncture wound to his right mid-thorax. You should: A. apply an occlusive dressing and seal on all four sides. B. apply a moist dressing and seal on only three sides. C. apply an occlusive dressing and seal on only three sides. D. apply a moist dressing and seal on all four sides.
apply an occlusive dressing and seal on only three sides.
Immediate stabilization of life-threatening conditions must be balanced with the need for: A. waiting for air medical transport. B. psychological interventions. C. transport to any medical facility. D. specialized diagnostic tests and surgical interventions.
specialized diagnostic tests and surgical interventions.
In patients with internal hemorrhage, the bleeding is inaccessible except through: A. isotonic fluids. B. surgery. C. tourniquet. D. IV fluids.
surgery.
Your patient is a 19-year-old college student who slammed into a brick wall as he skateboarded down a loading ramp behind a building on campus. He has swelling and abrasions to his face, deformity to his nasal bones, and epistaxis. He responds only to painful stimulus by attempting to withdraw from it. His pupils are equal and reactive. He snores without continuous use of a manual airway maneuver and has respirations of eight breaths per minute with slightly decreased tidal volume. His SpO2 is 93 percent on room air. He has a strong, regular radial pulse of 76 beats per minute. His skin is warm and dry. Blood pressure is 122/80 mmHg. You have suctioned the patient's airway and are beginning bag-valve-mask ventilations. You should assist this patient's respirations at a rate of _______ breaths per minute. A. 16 B. 24 C. 20 D. 10
10
According to the National Trauma Triage Protocol, a MVC is considered to involve high-energy impact beginning with cabin intrusion of ________ inches or more at the site where the occupant was located. A. eight B. 10 C. 12 D. six
12
Because it is NOT practical for an AEMT to always calculate a MAP in the field, use a systolic blood pressure (SBP) of ________ as a sign of adequate perfusion. A. 100 mmHg B. 90 mmHg C. 60 mmHg D. 120 mmHg
90 mmHg\
Your patient is a 29-year-old female who was stabbed in the anterior right chest at the sixth intercostal space. She is awake but agitated, cool, pale, and diaphoretic. She is complaining of pain in the right chest and right upper quadrant of the abdomen. As you continue your assessment, her level of responsiveness diminishes. She now responds to verbal stimuli with eye opening, giving her a GCS of 14. The airway is clear, respirations are 32 breaths per minute and shallow, neck veins are flat, breath sounds are diminished on the right, and the patient has a weak, rapid radial pulse. There is tenderness to palpation of the right upper quadrant of the abdomen. Which of the following is the highest priority for this patient? A. Request a paramedic for immediate needle chest decompression of the right chest B. Assist ventilations with a bag-valve-mask and supplemental oxygen C. Initiate two large-bore IVs of isotonic crystalloid solution D. Use percussion to differentiate between hemothorax and pneumothorax
Assist ventilations with a bag-valve-mask and supplemental oxygen
Defects in blood clotting with either inadequate or excessive blood clotting are known as: A. coagulopathies. B. anemia. C. hemostasis. D. platelet aggregators.
Coagulopathies
Which of the following is NOT an action taken during reassessment of a critical trauma patient? A. Look for trends in patient responsiveness and condition, and adjust your interventions accordingly B. Determine the mechanism of injury C. Measure vital signs every five minutes D. Advise the receiving facility of significant improvement or deterioration in the patient's condition
Determine the mechanism of injury
An 83-year-old woman has fallen down the basement stairs. She complains of left hip pain and rates it 10/10. Since the patient is downstairs, you immediately recognize the need for assistance in extricating her to the ambulance. As you start the primary assessment, you note a large dog at the top of the stairs growling. At this time, what is your primary concern? A. Need for additional help B. Pain C. Airway D. Dog
Dog
Coagulopathy can result from: A. An increase in the body's temperature B. Hypothermia C. An extrication time of less than 20 minutes. D. Hyperthermia
Hypothermia
Which of the following BEST describes definitive care for the trauma patient with significant internal hemorrhage? A. Immediate surgical intervention at a Level I trauma center B. Administration of blood C. Transport to the closest hospital D. Administration of isotonic crystalloid IV solutions
Immediate surgical intervention at a Level I trauma center
In order to reduce morbidity and mortality, critical trauma patients are BEST cared for by transporting without delay to: A. a Level II trauma center. B. a Level III trauma center. C. a Level I trauma center. D. the closest emergency department.
a Level I trauma center
What is the result of hypothermia causing coagulopathy? A. Decreased production of RBCs B. Decreased blood loss C. Increased blood loss D. Increased production of RBCs
Increased blood loss
Which of the following is TRUE regarding multisystem trauma? A. It increases morbidity and decreases mortality. B. It decreases morbidity and increases mortality. C. It decreases morbidity and mortality. D. It increases morbidity and mortality.
It increases morbidity and mortality.
A 42-year-old female was involved in a head-on collision resulting in multisystem trauma. She is now in hypovolemic shock. What is the goal in managing this patient to prevent morbidity and mortality? A. Maintaining adequate cellular perfusion B. Administering high volumes of fluid C. Immediate extrication from the vehicle D. Preventing metabolic alkalosis
Maintaining adequate cellular perfusion
A condition in which more than one body system has been injured is known as: A. systemic trauma. B. multisystem trauma. C. multi-organ dysfunction syndrome. D. all of the above
Multisystem trauma
The mother of a four-year-old boy states that he fell off the top bunk bed and hit his head. After falling, he appeared to seize for approximately 30 seconds. Presently he has non-purposeful movement to painful stimuli, with a patent airway and slow respirations. His radial pulse is intact, and his skin is warm and dry. You note urinary incontinence. After taking manual inline spinal stabilization, which one of the following should you do immediately? A. Apply oxygen, fully immobilize the patient, and then initiate rapid transport. B. Perform a head-tilt/chin-lift and administer high-concentration oxygen. C. Insert an oropharyngeal airway and provide high-concentration oxygen. D. Perform a jaw-thrust maneuver and start positive pressure ventilation.
Perform a jaw-thrust maneuver and start positive pressure ventilation.
A 17-year-old male received blunt trauma to his face and neck when he struck a low tree branch while riding a snowmobile. He is awake and anxious, with no neurologic deficit. His voice is hoarse, and there is diffuse swelling over the anterior neck and chest, which crackles on palpation. Vital signs are: heart rate, 88 beats per minute; blood pressure, 118/78 mmHg; respiratory rate, 28 breaths per minute; and SpO2, 95 percent on room air. Which of the following is the highest priority in the care of this patient? A. Placing the patient in a position to maintain airway patency B. Placing an advanced airway C. Assisting ventilations D. Immobilizing the spine
Placing the patient in a position to maintain airway patency
A 78-year-old male pedestrian was struck by a car at a convenience store. The patient is conscious but confused and is suffering from multisystem trauma. Which one of the following represents the BEST sequence of care that can be provided? A. Primary assessment, oxygen, secondary assessment, cervical collar, and all other care en route to the hospital B. Primary assessment, immobilization, and all other care en route to the hospital C. Primary assessment, oxygen, secondary assessment, and all other care en route to the hospital D. Primary assessment, oxygen, secondary assessment, proper patient packaging and all other care en route to the hospital
Primary assessment, oxygen, secondary assessment, proper patient packaging and all other care en route to the hospital
The trauma care you provide to a patient includes: A. selecting the best method of transporting the patient to that facility. B. communicating with the receiving facility as early as possible so that the necessary personnel can prepare for the patient's arrival. C. selecting the best hospital destination for the patient's circumstances. D. all of the above.
all of the above
With a patient who exhibits inadequate ventilations, the cause could include: A. traumatic brain injury. B. injuries of the chest wall or lungs. C. spinal cord injury. D. all of the above.
all of the above
After being assaulted by her boyfriend, an 18-year-old woman who is 33 weeks pregnant is found unresponsive in her bedroom. She appears to have been beaten in the head and abdomen as evidenced by multiple hematomas and lacerations to these areas. Which assessment finding should concern the AEMT most and be addressed FIRST? A. Abdominal contusions B. Rapid heart rate C. Room air SpO2 at 93 percent D. Vaginal bleeding
Room air SpO2 at 93 percent
Which of the following BEST demonstrates adequate breathing in the trauma patient? A. Spontaneous breathing B. Increased ventilatory rate C. SpO2 of 95 percent D. Tripod position
SpO2 of 95 percent
Which of the following is a trauma triage criterion indicating the need for immediate transport of an adult trauma patient to a trauma center? A. Two or more proximal long-bone fractures B. Full-thickness burns to five percent of the total body surface area C. A fall from a distance 1.5 times the patient's height D. Penetrating trauma to the distal extremities
Two or more proximal long-bone fractures
Which of the following physical assessment findings would make your patient a candidate for rapid transport to a trauma center? A. Pulse rate of 110 B. Systolic blood pressure of 100 C. Unstable pelvic girdle D. Respiratory rate of 24
Unstable pelvic girdle
Which of the following physical assessment findings would constitute transportation to a Level I trauma center? A. GCS of 14 B. Respiratory rate of 20 breaths per minute C. Unstable pelvis D. Heart rate of 100 beats per minute
Unstable pelvis
A 62-year-old woman with severe kyphosis has fallen and hit her head, which is oozing blood. Family members state that she suddenly complained of a "very bad headache" before collapsing to the kitchen floor. She has snoring respirations and appears cyanotic in the extremities. Of the following interventions, which one should you do FIRST? A. Apply a cervical collar. B. Cover the laceration. C. Use a jaw-thrust maneuver. D. Start positive pressure ventilation.
Use a jaw-thrust maneuver.
A mechanism of injury that can lead to multisystem trauma includes: A. motorcycle and rider separation in an MVC. B. multiple penetrating trauma injuries (especially to the head, neck, and torso). C. motor vehicle crash impact at greater than 40 mph. D. all of the above
all of the above
Adequate cellular perfusion means that the patient must have: A. adequate mass of red blood cells. B. adequate cardiac output and blood pressure. C. adequate blood volume. D. all of the above.
all of the above
Patients with which life-threatening condition are considered critical? A. Dyspnea B. Suspected pneumothorax C. Flail chest D. All of the above
all of the above
Patients who are in shock are susceptible to hypothermia due to significant blood loss because: A. if the environment is warm, the rate of heat loss is accelerated. B. hypothermia increases the effectiveness of the body's blood clotting mechanisms. C. improved cellular energy production prevents the patient from increasing body temperature through metabolism. D. blood carries body heat with it when it leaves the body.
blood carries body heat with it when it leaves the body.
You are dispatched to an auto collision. Because of very heavy traffic, your response time is 25 minutes. The closest hospital is 40 miles from the accident site. You should: A. have state law enforcement stop traffic while you transport. B. request that law enforcement escort you to a hospital. C. request additional ground units. D. call for air transport.
call for air transport
Once hemorrhage is controlled, intravenous fluids can __________. A. replace red blood cells B. replace proteins needed for oncotic pressure C. replace platelets D. play a role in restoring vascular volume
play a role in restoring vascular volume
According to the CDC's field triage decision scheme, the first element(s) assessed is/are the: A. mechanism of injury. B. vital signs. C. special patient considerations. D. anatomy of injury.
vital signs.
When providing fluid resuscitation in the prehospital setting on a trauma patient, ideally what gauge catheter should you select? A. 18- or 20-gauge B. 14- or 16-gauge C. 22- or 24 gauge D. 25- or 27 gauge
14- or 16-gauge