EMT 27, 28, 29, 30 Trauma: Bleeding, Burns, Musculoskeletal philip_olcese

29 For which patient would the palm method be best to estimate the body surface area affected by a burn? Select one: a. 27-year-old with full thickness burns to the backs of the legs and arms b. 49-year-old with a partial thickness burn to the inner thigh c. 3-year-old with partial thickness burns to the anterior chest and abdomen d. 21-year-old with superficial thickness burns to the entire back and neck

49-year-old with a partial thickness burn to the inner thigh

27 After assessing the following patients, which would the EMT identify as suffering from multi-systems trauma? Select one: a. 31-year-old female; large laceration to her leg from a hunting knife; bleeding controlled b. 89-year-old female fell in a nursing home; hematoma to the back of her head c. 61-year-old male; became dizzy and fell down five stairs; laceration to the head; open fracture to the left lower leg d. 24-year-old male; slipped on ice; tenderness to the right shoulder

61-year-old male; became dizzy and fell down five stairs; laceration to the head; open fracture to the left lower leg

27 Two cars have collided head on. One car was traveling 55 mph and the other 35 mph. The total speed of impact would be: Select one: a. 55 mph. b. 90 mph. c. 35 mph. d. 20 mph.

90 mph.

28 Which one of the following statements shows that the EMT understands the application of a tourniquet? Select one: a. Since arteries run close to the body's surface in a joint, the best place to apply a tourniquet is over the joint just above the site of hemorrhage. b. If the tourniquet appears to have stopped the bleeding, the EMT should loosen it slightly to allow a small amount of blood to perfuse the tissues. c. If a blood pressure cuff is used as a tourniquet, the EMT should inflate it approximately 50 mmHg above the patient's systolic blood pressure. d. A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely stopped.

A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely stopped.

28 Which one of the following types of injuries is most likely to result in capillary bleeding only? Select one: a. Abrasion b. Penetration c. Avulsion d. Laceration

Abrasion

28 A patient was assaulted and sustained various and multiple injuries. Which injury does the EMT recognize as presenting the greatest risk for infection? Select one: a. Hematoma to the left foot b. Closed crush injury to the knee c. Abrasion to the right side of the face d. Contusion to the chin

Abrasion to the right side of the face

28 You arrive at a meat packing plant to find a 30-year-old male cut in the wrist with a sharp knife. The patient appears pale and blood is spurting from the laceration. Which one of the following should you do immediately? Select one: a. Apply 15 lpm of oxygen via nonrebreather face mask. b. Obtain a blood pressure. c. Assess and manage the airway. d. Apply direct pressure to the laceration.

Apply direct pressure to the laceration.

30 Your patient is a young man who fell down a flight of stairs and is now restless and confused. His airway is open, and he is breathing adequately at 18 times per minute. He has a radial pulse of 92 beats per minute that is moderate in strength. Which one of the following should you do next? Select one: a. Immobilize the patient with a cervical collar and long back board. b. Apply oxygen at 15 liters per minute via nonrebreather face mask. c. Insert an oral airway and start positive pressure ventilation with oxygen. d. Check the blood pressure and assess for injuries causing blood loss.

Apply oxygen at 15 liters per minute via nonrebreather face mask.

28 You have just applied a pressure dressing to the leg of a woman who suffered a deep laceration to her calf from a piece of broken glass. Which one of the following should you do next? Select one: a. Determine if the bleeding has stopped. b. Assess for a pedal pulse. c. Obtain a follow-up blood pressure. d. Apply a tourniquet above the laceration.

Assess for a pedal pulse.

29 Firefighters have pulled a middle-age male from a burning bedroom. The patient is unresponsive and has obvious deformity to his left ankle. His respirations are rapid, stridorous and shallow. Your partner inserts an oropharyngeal airway and begins ventilating the patient with a bag-valve-mask. Which one of the following actions would you perform next? Select one: a. Find out how long the patient was in the burning structure. b. Instruct your partner to hyperventilate the patient. c. Assess the patient's carotid pulse. d. Check the patient's breath sounds.

Assess the patient's carotid pulse.

28 Which one of the following statements about dressings and bandages is true? Select one: a. All dressings must be airtight to prevent contamination. b. Bandages should not be applied until bleeding is controlled. c. Dressings are placed over bandages. d. Dressings should be placed into open wounds.

Bandages should not be applied until bleeding is controlled.

28 A patient has fallen and suffers a contusion to her arm. Which one of the following statements about contusions is true? Select one: a. The epidermis is open and actively bleeding. b. Blood vessels in the subcutaneous layer have been broken. c. Blood vessels in the dermal layer have ruptured. d. Blood vessels in the epidermis have broken but the skin is intact.

Blood vessels in the dermal layer have ruptured.

29 You are assessing a patient involved in a motorcycle accident. He states that he saw an oncoming car and laid the bike down to avoid an outright collision. He was wearing a helmet. Which of the following injuries would make sense given the action of the motorcyclist? Select one: a. Road rash to the entire body b. Bilateral broken forearms c. Angulation to both femurs d. Burn to the inside of the leg

Burn to the inside of the leg

29 Your patient is a 27-year-old male who fell down a full flight of stairs while escaping his burning apartment. Which one of the following findings should be your most immediate concern? Select one: a. Tenderness to the right upper abdominal quadrant b. Deformity of the left wrist c. Full thickness burn on the hands d. Burns on the face

Burns on the face

27 A bullet fired from a gun at close range passes through the patient's liver. However, on autopsy, the coroner discovers that the man's pancreas, stomach, and gall bladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which of the following is responsible for injury to these additional organs? Select one: a. Profile impact b. Drag force c. Blunt injury d. Cavitation

Cavitation

29 Your patient is a diabetic male who spilled a pot of hot water on himself while he was cooking. He has a partial thickness burn of the right anterior leg. He is awake but confused. Following the primary survey, which one of the following actions is the highest priority? Select one: a. Determine the percent of body surface area affected by the burn. b. Perform a detailed secondary assessment. c. Apply sterile dressings to the burn. d. Check the patient's blood glucose level.

Check the patient's blood glucose level.

29 Firefighters have just pulled a young woman from a house fire and have laid her on the lawn. She is conscious and badly burned to the chest, abdomen, and legs. Her clothes are smoldering. Which one of the following actions should the EMT take immediately? Select one: a. Apply oxygen via nonrebreather face mask. b. Cool the burn with water. c. Determine the body surface area burned. d. Place an oropharyngeal airway.

Cool the burn with water.

29 A patient has suffered partial and full thickness thermal burns to the anterior chest, abdomen, and arms in an industrial accident. Which one of the following would be appropriate in the care of this patient? Select one: a. Cool the burns on scene and apply ice packs to the burned areas for transport to the emergency department. b. Cool the burns with water on scene and during rapid transport to the emergency department. c. Cool the burns with water for 90 seconds and cover the burns with a sterile, dry burn sheet. d. Cool the burns with water for 2 minutes and cover the burns with dressing soaked in sterile water.

Cool the burns with water for 90 seconds and cover the burns with a sterile, dry burn sheet.

29 You are assessing an elderly patient who was entrapped in a burning trailer. Which one of the following findings would be most indicative of a patient suffering an inhalation injury? Select one: a. Patient complaint of extreme thirst b. Partial thickness burn to the left side of the head c. Heart rate of 116 beats per minute d. Coughing of black sputum

Coughing of black sputum

27 A patient involved in a motor vehicle collision is complaining of neck pain. Which of the following pieces of information should cause the EMT to have a high index of suspicion that the patient may have suffered more significant injuries beyond the complaint of neck pain? Select one: a. History of heart problems b. No airbags in the car c. Complaint of head and neck pain d. Death of the car's driver

Death of the car's driver

29 A patient was entrapped in a burning apartment before being rescued by firefighters. As you approach him, you note that his legs and arms appear to be burned. He is screaming in pain, but is not actively burning. Given this information, which one of the following interventions would you perform first? Select one: a. Decide whether to administer oxygen with a nonrebreather face mask or with bag-valve mask. b. Perform a secondary assessment to determine if nonburn injuries are present. c. Estimate the percentage of the patient's body that has been burned. d. Determine if the patient has suffered partial or deep thickness burns.

Decide whether to administer oxygen with a nonrebreather face mask or with bag-valve mask.

27 You are responding to a call for a 4-year-old child hit by a car. When assessing this child, which of the following injury patterns would you recognize as typical based on the child's age and mechanism of injury? Select one: a. Head injury with deformity to both upper arms b. Deformed femurs, bruises to the chest and abdomen c. Bilateral ankle deformity, contusions to the back d. Left arm and leg deformity, head injury

Deformed femurs, bruises to the chest and abdomen

28 30 Which one of following assessment findings would contraindicate the use of the traction splint? Select one: a. Decreased pedal pulses b. Open fracture c. Deformity to the hip d. Numbness to the foot

Deformity to the hip

27 A young female wears her lap belt low, over her upper thighs, because the belt is uncomfortable when worn properly. If involved in a head-on up and over type collision, to what injury is she most prone, given the position of her lap belt? Select one: a. Dislocated hips b. Bilateral arm fractures c. Internal abdominal injury d. Tibia-fibula fractures

Dislocated hips

28 Which one of the following instructions is appropriate when helping a new EMT care for a male patient with a laceration to his left arm? Select one: a. Do not cut away his sleeve over the top of the laceration as it will help control the bleeding. b. It is best to let the wound bleed some. This is the body's natural way of cleaning the wound. c. When you are done cleaning the laceration, apply some sterile gauze soaked in sterile saline. d. Don't worry about removing embedded dirt from the wound, just the dirt around the laceration.

Don't worry about removing embedded dirt from the wound, just the dirt around the laceration.

27 Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another car at a high rate of speed. The patient was unrestrained and his car did not have airbags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury pattern, the EMT would recognize what type of injury mechanism? Select one: a. Up and over b. Lateral impact c. Down and under d. High velocity

Down and under

28 Which one of the following best describes a topical hemostatic agent? Select one: a. Dressing especially designed to stop bleeding b. Rapid acting pill that promotes clotting in the body c. Topical medication that reduces chances of infection d. Liquid that stops bleeding by gluing the edges of a laceration together

Dressing especially designed to stop bleeding

27 30 During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly describe the platinum 10 minutes. Which of the following indicates the best response? Select one: a. EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene. b. EMS should spend a total of 10 minutes assessing the patient for life-threatening injuries prior to initiating transport to a trauma center. c. If the transport to a trauma center is going to exceed 10 minutes, EMS should strongly consider the use of an aeromedical helicopter. d. EMS systems should be designed so that it takes an ambulance no longer than 10 minutes to respond to a trauma call.

EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene.

27 A teenage female patient has been ejected from a car as it rolled down a hill. She is responsive, but with signs of early shock. She has bruising to her anterior abdomen, a laceration to her left temple, and deformity to he left wrist. At what point should the wrist injury be splinted? Select one: a. Prior to immobilizing the patient b. En-route to the hospital c. Just before leaving the scene d. Before transferring to the stretcher

En-route to the hospital

27 As part of your service to the community, you are certified as a car seat specialist and provide monthly classes on the safe transport of infants and children. Several cars have pulled into your station and asked you to look at their car seats. Which of the following car seat positions would indicate that the parent is safely transporting his or her infant (less than one year old)? Select one: a. Facing backward in the back seat in an upright position b. Facing backward in the back seat in a reclined position c. Facing backward in an upright position in the front seat d. Facing forward in the back seat in a reclined position

Facing backward in the back seat in an upright position

30 A 23-year-old roofer has fallen 20 feet from the roof of a house into shrubs below. Aside from superficial abrasions and complaint of soreness, you detect no obvious injuries. Consequently, the patient states that as long as his legs are not broken, he does not see the need to go to the hospital. As a knowledgeable EMT, your best response would be: Select one: a. Since you did not lose consciousness, I feel better about having you refuse. Just keep an eye on your feet and watch for swelling. b. From a fall of this height, you may have hurt some internal organs. You really need to be examined. c. Although you feel okay now, you will most likely be sore later on. Why don't we go to the hospital and ask about some medications for pain? d. Since this is a work-related injury, you should really be evaluated in the hospital. Workman's comp may not cover you if you do not.

From a fall of this height, you may have hurt some internal organs. You really need to be examined.

27 Which of the following best describes the goal of a trauma system? Select one: a. Providing the highest level of care possible within a 10-minute transport time for all patients b. Getting the right patient to the right facility in the right amount of time c. Providing all trauma patients with a complete battery of diagnostic tests and access to specialists d. Transporting as many patients as possible by air medical transportation

Getting the right patient to the right facility in the right amount of time

30 A vacuum splint has just been applied to the arm of a patient who fell backward from a chair while hanging drapes. Which one of the following statements or questions should the EMT make or ask next? Select one: a. Can you rate your pain for me? b. I am wrapping the splint with roller gauze to secure it. c. I am going to feel your wrist for a pulse now. d. I need to feel your arm for tenderness.

I am going to feel your wrist for a pulse now.

28 You are having a difficult time controlling bleeding from a small skin avulsion to a patient's ankle. Which one of the following statements made by the patient best explains why control has been difficult to achieve? Select one: a. I take steroids for my lung disease. b. I take Coumadin for my irregular heartbeat. c. I drank a lot of alcohol last night. d. My blood pressure sometimes runs a little high.

I take Coumadin for my irregular heartbeat.

28 Of the statements that follow, which one describes the best way to determine the severity of a patient's blood loss? Select one: a. I use the patient's signs and symptoms to judge the severity of the blood loss. b. I estimate the blood loss based on the fact that one cup of blood is about 250 ml. c. I look at the blood pressure, and if it is less than 100 systolic, the patient has lost 500 ml of blood. d. If the pulse rate is over 100 beats per minute, the patient has lost at least 200 ml of blood.

I use the patient's signs and symptoms to judge the severity of the blood loss.

28 You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On scene the patient was alert and oriented with a patent airway and adequate respirations. There was minimal hemorrhage from the stab wound, which was covered with a sterile dressing. Oxygen was applied and transport was initiated. During the reassessment, which one of the following assessment findings should the EMT consider of most concern? Select one: a. Statement that the pain at the injury is increasing b. Increase in heart rate and restlessness c. Observation that blood is beginning to ooze from the injury d. Increased redness and edema to area surrounding stab wound

Increase in heart rate and restlessness

30 Which of the following injuries is most serious, warranting immediate and rapid transport to the hospital? Select one: a. Large, deep laceration to the arm with bleeding controlled b. Instability and crepitus to the left lateral chest wall c. Deformity to the right ankle with pain rated as a 10/10 d. Open fracture to the left lower leg

Instability and crepitus to the left lateral chest wall

29 You have been called for a 44-year-old male who was burned on the right hand and arm after falling against the hot door of an industrial incinerator. As you arrive on the scene, a nurse employed by the company informs you that he sustained a partial thickness burn. Based on this information, the EMT should expect what characteristics at the burn site? Select one: a. Decreased pain but significant edema b. Leathery skin that remains hot to the touch c. Intense pain and blister formation d. Reddened skin with decreased pain sensation

Intense pain and blister formation

28 The rapid secondary assessment of a male patient who was ejected from a motorcycle indicates instability and pain on palpation to the pelvic area. What is the EMT's primary concern related to this injury? Select one: a. Severe pain b. Risk for infection c. Internal blood loss d. Swelling in the pelvic cavity

Internal blood loss

27 You are transporting a patient who was shocked by an electrical current while installing a residential electrical service panel. He has partial thickness burns to the hand and foot where the electricity entered and exited his body respectively. During the reassessment, which one of the following signs or symptoms would be of most concern to the EMT? Select one: a. Complaint of a headache b. Edema to the foot c. Pain at burn sites d. Irregular heartbeat

Irregular heartbeat

29 A 24-year-old man was shocked while working on his house's electrical system. Assessment reveals him to have a minor burn to the fingers on his left hand. Aside from being slightly shaky, he states he feels fine and does not see the need to be treated further or transported to the hospital. Which one of the following statements should you make to him before allowing him to refuse additional care and transport? Select one: a. You need to get the burn site cleaned to avoid infection. This can be done in the hospital emergency department. b. It would be best to let the emergency physician check you out. Electrical shocks can damage the heart. c. You really need to be evaluated in the hospital emergency department. The shock puts you at high risk for a stroke within the next 48 hours. d. Electrical burns typically increase in pain as time goes on. The hospital emergency department can give you pain medication.

It would be best to let the emergency physician check you out. Electrical shocks can damage the heart.

30 A young female patient was walking on a seven-foot-high retaining wall when she stumbled and fell. She impacted a concrete sidewalk surface with her left foot and left hand. Your assessment reveals ecchymosis, deformity, and edema to both the left foot and left hand. Based on the concept of injury caused by indirect force, where else should the EMT look for injury? Select one: a. Left toes b. Left ankle c. Left fingers d. Left hip

Left hip

27 30 An alert and oriented worker had his right thigh pinned between the bumpers of two trucks. Assessment findings include deformity and swelling to the right hip area and mid thigh, along with ecchymosis and swelling to the right knee. The patient complains of excruciating pain to the right leg. Which one of the following instructions given to other EMTs on the scene would be appropriate? Select one: a. Check for a pedal pulse and then carefully move him to the stretcher for transport. b. Let's immobilize him to the long spinal board and then transport him to the hospital. c. Let's put his leg in the traction splint to help align the femur and reduce pain. d. We need to wrap the right leg in a pressure dressing and then elevate it for transport.

Let's immobilize him to the long spinal board and then transport him to the hospital.

28 Which one of the following patients would the EMT recognize as suffering from an evisceration injury? Select one: a. Female with a large flap of skin that has been torn loose from her scalp b. Male patient with a knife impaled in this right upper abdomen c. Female shot in the chest with bubbling coming from the wound as the patient breathes d. Male patient with a loop of intestine protruding from an open surgical wound

Male patient with a loop of intestine protruding from an open surgical wound

30 A lifeguard has fallen 10 feet from his chair and has deformity, swelling, and ecchymosis to her right lower leg. The leg also is rotated medially. Another lifeguard has taken and is maintaining manual in-line spinal stabilization. As your partner conducts the primary assessment, you should take which one of the following actions? Select one: a. Manually stabilize the lower right leg. b. Align the leg in a neutral position. c. Check the right foot for pulses and motor ability. d. Ready the traction splint for application.

Manually stabilize the lower right leg.

30 Which one of the following statements about traction splints is true? Select one: a. Once the mechanical traction has been applied, the ischial strap must be released to promote circulation into the affected leg. b. Mechanical traction should be applied until the affected leg is approximately one to two inches longer than the unaffected leg. c. Once the traction splint has been positioned under the leg, and the ankle hitch is applied, manual traction can be released. d. Mechanical traction should be applied until the mechanical traction is equal to the manual traction and the patient experiences a reduction in pain.

Mechanical traction should be applied until the mechanical traction is equal to the manual traction and the patient experiences a reduction in pain.

27 You are hosting a discussion on injury prevention when a participant asks you if you believe that helmets for motorcyclists will truly make a difference. You would respond by saying: Select one: a. Wearing a helmet decreases the chance of being ejected from a motorcycle. b. A motorcycle helmet decreases the chance of permanent spinal injury. c. Helmets have been shown to prevent motorcycle accidents. d. Motorcycle helmets decrease the risk of death when involved in a collision.

Motorcycle helmets decrease the risk of death when involved in a collision.

27 Which of the following statements concerning trauma is true? Select one: a. Multi-system trauma has a higher mortality rate than single-system injuries. b. Mechanism of injury is the best predictor of patient outcome. c. A spider web or star pattern of cracks on the windshield means the patient impacted the windshield with his head. d. Falls are the leading cause of trauma deaths.

Multi-system trauma has a higher mortality rate than single-system injuries.

30 A patient you transported several days ago stops by your station to thank you. He reports that he was diagnosed with a strain to the lower right leg. Which one of the following is the primary structure affected by that injury? Select one: a. Ligament b. Bone c. Joint d. Muscle

Muscle

28 A 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which one of the following dressings is best for this injury? Select one: a. Occlusive dressing b. Moist sterile gauze c. Self-adhering roller gauze d. Sterile gauze

Occlusive dressing

30 The secondary assessment of a patient complaining of right leg pain after falling down several stairs reveals a break in the skin where a fractured tibia bone broke through and then retreated back into the leg. The EMT should recognize this as which one of the following injuries? Select one: a. Closed fracture b. Open fracture c. Laceration d. Partial fracture

Open fracture

27 An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion (bruise) to his heart. The EMT would recognize that this injury occurred during which impact of the collision? Select one: a. Vehicle collision b. Organ collision c. Physiologic collision d. Body collision

Organ collision

29 A patient was burned when he accidentally ignited gasoline while working on his car. When performing the secondary assessment, which one of the following findings would indicate that the patient has suffered a partial thickness burn? Select one: a. Pink skin that is dry and painful to the touch on the left lower leg b. Painful skin that is moist and contains blisters to the abdomen c. Intact skin on the wrist that is red and dry and extremely painful when touched d. Leathery skin on the thigh that exhibits little pain when touched

Painful skin that is moist and contains blisters to the abdomen

29 A 21-year-old male has experienced a severe burn to the left leg while working on an industrial furnace. His coworkers immediately douse his flaming pants and remove them. Your primary assessment reveals no threats to the airway, breathing, or circulation. When conducting the secondary assessment of the leg, which finding would be the most critical? Select one: a. Blisters on the lower leg have broken and are leaking fluid. b. Skin on the posterior lower leg is sloughing off. c. Partial thickness burn completely encircles the knee. d. Pain is described as the worst I have ever felt.

Partial thickness burn completely encircles the knee.

27 Your patient is a 48-year-old male who is in shock from injuries sustained in a motor-vehicle collision. Which one of the following assessment findings is an indication for the use of the pneumatic anti-shock garment (PASG)? Select one: a. Evisceration of abdominal contents b. Patient response to painful stimuli with a moan c. Heart rate of 148 beats per minute d. Pelvic instability with a BP of 78/48 mmHg

Pelvic instability with a BP of 78/48 mmHg

28 While cleaning a gun, a 44-year-old man accidentally shot himself in the abdomen. On arrival the patient is responsive to painful stimuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following shows the correct sequence of events for caring for this patient? Select one: a. Transfer to the ambulance, perform the primary assessment, provide oxygen therapy, and provide rapid transport. b. Perform a primary and rapid secondary assessment, move to the stretcher for immediate transport, and start positive pressure ventilation en route to the hospital. c. Transfer to the ambulance, provide rapid transport, perform primary and secondary assessments, and administer oxygen therapy en route to the hospital. d. Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.

Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.

28 A young male was riding a motorcycle when he lost control and was ejected. The patient is unresponsive and receiving positive pressure ventilation. The rapid secondary assessment reveals bright blood flowing from both nostrils. Management of this bleeding would include which one of the following interventions? Select one: a. Careful place a nasopharyngeal airway. b. Gently place rolled sterile gauze into the nostrils. c. Place a loose dressing under the nose. d. Lightly pinch the patient's nostrils shut.

Place a loose dressing under the nose.

28 While riding a bike, a young boy fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhage has clotted off and manual in-line spinal stabilization is being maintained. Which one of the following instructions should you provide to the other EMTs on scene? Select one: a. Do not worry about covering the wound, just place a cervical collar on him and carefully transfer him to the long board. b. Place an occlusive dressing over the wound and tape on all four sides. c. Take some sterile gauze and carefully place it inside the open wound to prevent potential bleeding. d. Apply a sterile dressing over the wound and hold it in place by wrapping roller gauze around his neck.

Place an occlusive dressing over the wound and tape on all four sides.

28 Severe external bleeding should be controlled during what phase of the patient assessment? Select one: a. Rapid secondary assessment b. Reassessment c. Scene size-up d. Primary assessment

Primary assessment

27 You arrive on the scene of a motorcycle accident and find an unresponsive male patient lying in the middle of the road with blood coming from his ears and nose. He was not wearing a helmet and has snoring respirations. Which of the following would be most appropriate in the care of this patient? Select one: a. Primary assessment, oxygen administration, transfer to stretcher, transport within 5 minutes of arriving on scene with immobilization done enroute b. Primary assessment, immobilization, transfer to the ambulance after 8 minutes of scene time, all other care provided enroute c. Primary assessment, airway management, oxygen administration, immobilization, transport within 10 minutes of arriving on scene d. Immobilization, transfer to the ambulance with all assessment and care done enroute to the hospital with total scene time of 7 minutes

Primary assessment, airway management, oxygen administration, immobilization, transport within 10 minutes of arriving on scene

27 You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A paramedic, who has already triaged the nine patients involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this presentation, the EMT would recognize which of the following? Select one: a. Ear damage caused by exposure to superheated air b. Inner ear damage caused by the noise of the explosion c. Secondary blast injury to the inner ear d. Primary phase blast injury to the inner ear

Primary phase blast injury to the inner ear

27 A whiplash type neck injury is most often observed with what type of collision? Select one: a. Rollover b. Ejection c. Rear-end impact d. Frontal impacts

Rear-end impact

27 A patient, who was constructing a bomb in his basement, has sustained a secondary phase blast injury. Which of the following presentations would the EMT most likely observe? Select one: a. Headache and shortness of breath b. Complaint of nausea after inhaling fumes c. Screwdriver impaled in the arm d. Burns to the head, neck, and chest

Screwdriver impaled in the arm

29 A female who had hot coffee thrown at her has a superficial burn to the right side of her face. After transferring the patient to the hospital emergency department for continued care, a new EMT asks you if the patient will have a permanent scar on her face. Which one of the following is your best reply? Select one: a. She will probably have some degree of scarring, but it will not be very noticeable. b. Since only the outer layer of skin was burned, there is little chance of scarring. c. It depends; if the skin peels, she will probably be left with some degree of scarring. d. Since the burn was superficial, a small skin graft can be used to hide any and all scars.

Since only the outer layer of skin was burned, there is little chance of scarring.

27 Which one of the following statements shows an understanding of the EMT's prehospital role in caring for the patient in shock? Select one: a. The job of the EMT is to assume a trauma patient is in shock and get him or her to the hospital as quickly as possible. b. If shock is in its early stage, it is not yet life-threatening and the EMT can take his time in assessing and treating the patient. c. Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport. d. Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so proper care can be given.

Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport.

27 A patient has been critically hurt in a nighttime motor vehicle collision. She was wearing a seatbelt and hit a tree at 70 mph. The car she was driving weighed two tons and was equipped with airbags that did deploy. Which of the following had the greatest impact on her being injured? Select one: a. Nighttime conditions b. Speed of the vehicle at impact c. Deployment of airbags d. Weight of the vehicle

Speed of the vehicle at impact

30 A football player injured his knee during practice and is in pain. His left knee is swollen, ecchymotic, and flexed in an upward position. Your partner reports that the distal skin is warm, and he has located a weak pedal pulse. Which one of the following should you perform immediately? Select one: a. Realign and straighten the injured knee and then immobilize it by binding it to the other leg. b. Place the patient on a long spine board and apply the traction splint en route to the hospital. c. Apply a traction splint and straighten the knee until the pain is decreased. d. Splint the knee in the position found prior to providing transport to the hospital.

Splint the knee in the position found prior to providing transport to the hospital.

27As you pull up to a motor vehicle collision, you quickly scan the scene for clues as to the type and severity of injuries. Which of the following scene clues would best indicate that a patient may have a head injury? Select one: a. Frontal-type collision b. Starring of a windshield c. Airbag deployment d. Blood on a patient's clothing

Starring of a windshield

27 A young man riding a motorcycle was hit head on and ejected from the bike. Your scene size-up reveals him to be lying supine in the roadway with obvious deformity to his right thigh and left ankle, with blood noted to his pants in these areas. Patient assessment reveals he is unresponsive with snoring respirations and is breathing 16 times per minute. His radial pulse is moderate in strength, and his skin is warm and dry. Which one of the following actions should be performed first? Select one: a. Expose and splint both legs to prevent further injury. b. Take and maintain manual in-line spinal stabilization. c. Check for distal pulses in both lower extremities. d. Open the airway using the head tilt-chin lift.

Take and maintain manual in-line spinal stabilization.

27 30 You are called for a 78-year-old female who fell earlier in the day. As you enter her kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be some blood on her pants. She is on oxygen and appears to have slightly labored respirations. She states that she fell a few hours ago and now the pain and swelling in her arm are unbearable. Which one of the following should you do first? Select one: a. Assess her respiratory status. b. Take manual in-line spinal stabilization. c. Examine her arm for deformity. d. Place a cold pack to her cheek.

Take manual in-line spinal stabilization.

27 When teaching Emergency Medical Responders about airbags, which of the following points would you emphasize? Select one: a. Airbags are effective in decreasing injury in a rollover-type collision. b. The benefit of airbags is decreased in multiple collisions. c. Properly placed airbags eliminate the need for seatbelts. d. Airbags prevent broken glass from striking the occupant.

The benefit of airbags is decreased in multiple collisions.

30 A female patient with osteoporosis stepped sideways on her foot and has suffered an open tibial fracture to the distal portion of her right leg. Which one of the following interventions indicates that appropriate care is being given for this injury? Select one: a. The bone end and soft tissue wounds are covered with a sterile dressing. b. A pressure dressing is tightly applied to the open wound prior to splinting. c. The protruding bone is gently replaced back under the skin. d. The EMT cleans dirt from within the wound and off the bone prior to splinting.

The bone end and soft tissue wounds are covered with a sterile dressing.

30 Which one of the following statements shows that an EMT understands field care of a patient with a possible joint dislocation? Select one: a. If a joint injury is suspected, ice packs and not splints are indicated. b. The care for a patient with a joint injury is identical to that of a fracture. c. Warm packs, not cold packs, are indicated for a patient with a possible joint injury. d. If a distal pulse is absent, three attempts to straighten the joint can be made.

The care for a patient with a joint injury is identical to that of a fracture.

27 Which of the statements below best characterizes the capabilities of a Level III Trauma Center? Select one: a. The hospital will provide surgical services to a trauma patient and then transfer them once stable. b. The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and transfer them. c. The hospital can manage all trauma patients, 24 hours a day, 7 days a week. d. The hospital can handle most trauma patients, but will transfer those who require specialty care for specific injuries.

The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and transfer them.

29 An intoxicated patient has suffered a burn to his left lateral thigh after passing out with his leg touching the side of a kerosene heater. Close examination of the burn reveals tough leathery tissue in the center of the burn and surrounding it, red skin with blisters. Regarding the burn, which one of the following is true? Select one: a. The inner portion of the burn is full thickness and the outer portion partial thickness. b. The blister formation indicates that portion of the burn can be classified as full thickness. c. The pain is originating from the more severely burned center of the injury. d. The outer skin surrounding the burn can be medically described as eschar.

The inner portion of the burn is full thickness and the outer portion partial thickness.

27 If a car strikes a utility pole at 35 mph, which of the following is true? Select one: a. The energy transferred to the body is increased by a factor of 2. b. The utility pole absorbed half of the kinetic energy making the body collision 17.5 mph. c. The patient struck the steering wheel at a combined speed of 70 mph. d. The internal organs struck the inside of the body at 35 mph.

The internal organs struck the inside of the body at 35 mph.

27 The EMT understands the importance of evaluating the mechanism of injury when he states: Select one: a. The mechanism of injury is a useful tool in determining if the patient's outcome will be good or bad. b. The mechanism of injury can be used to guide your assessment and treatment of the patient. c. The mechanism of injury is useful in determining the exact injuries the patient has sustained. d. Evaluating the mechanism of injury is important since it determines whether emergency transport to the hospital is needed.

The mechanism of injury can be used to guide your assessment and treatment of the patient.

28 Which one of the following assessment findings best shows that the patient's injury should be classified as an abrasion? Select one: a. Irregular break in the skin; bleeding moderate but controllable b. Intact skin with large accumulation of dark blood underneath c. Intact skin with ecchymosis noted; patient states minor pain d. The skin is scraped and red; blood oozing from the injury site

The skin is scraped and red; blood oozing from the injury site

27 30? Which of the following describes the platinum 10 minutes as it applied to care of the trauma patient? Select one: a. The time it should take the transporting ambulance to get the trauma patient to the closest medical facility b. The amount of time EMS should spend on scene with any patient suffering a traumatic injury(s) c. The target scene time for EMS as it applies to the seriously injured trauma patient d. The goal for total amount of time from the actual injury to arrival of EMS at the scene

The target scene time for EMS as it applies to the seriously injured trauma patient

27 An unrestrained female driving a small car is involved in a rollover-type collision. Why is her risk for serious injury and death significantly increased? Select one: a. Smaller and lighter cars tend to roll over. b. Rollovers are the result of high speeds. c. The risk for ejection is lessened, increasing injuries suffered in the car. d. There are more impacts in a roll over.

There are more impacts in a roll over.

29 A patient, who is coughing, has sustained a superficial burn to the chest, arms, and face after pouring gasoline on a smoldering campfire. Which one of the following statements indicates that the EMT is properly caring for him? Select one: a. We are going to put ice packs to your chest to cool the burn. b. I need to clean the dirt from the burned area to prevent an infection. c. Throughout transport, I am going to listen to your lungs quite frequently. d. I am going to apply a special antibiotic lotion to the burned areas to prevent scarring.

Throughout transport, I am going to listen to your lungs quite frequently.

28 A patient has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the wound. As an EMT, you should recognize this as what type of bleeding? Select one: a. Capillary b. Lymphatic c. Arterial d. Venous

Venous

27 A 44-year-old electrician has been shocked. He is responsive to verbal stimuli and has garbled speech. His airway is open and he is breathing shallowly at a rate of 8 times per minute. His pulse is slow and irregular. Which one of the following actions should the EMT perform next? Select one: a. Insert an oral airway and apply 15 lpm oxygen with a nonrebreather face mask. b. Ventilate with a bag-valve mask at 12 breaths per minute. c. Obtain the patient's pulse, blood pressure, and pulse oximetry reading. d. Attach but do not turn on the automated external defibrillator.

Ventilate with a bag-valve mask at 12 breaths per minute.

30 A patient with a closed fracture to the forearm has been properly splinted when which of the following are immobilized? Select one: a. Wrist and forearm b. Wrist, forearm, and elbow c. Shoulder, elbow, and forearm d. Elbow and forearm

Wrist, forearm, and elbow

28 Which one of the following patients requires the EMT to remove an impaled object in the field? Select one: a. Male patient with a six-inch knife to his left upper quadrant; there is active bleeding around the injury site b. Male patient who fell on a screwdriver, which is impaled through his hand; the patient is in pain and requesting that you remove the screwdriver c. Female with a knife to the right side of her chest; she is short of breath and coughing up blood d. Young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is trickling into her airway

Young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is trickling into her airway

28 As you approach a patient, you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient should be to: Select one: a. apply oxygen. b. elevate his leg. c. assess his airway. d. cut his pants.

assess his airway.

27 You are first on the scene of a two-car motor vehicle collision. In one car there are two patients entrapped in the vehicle, while in the other, there is a male driver complaining of chest pain. At this time, your primary concern is: Select one: a. assuring personal safety. b. calling for additional help. c. triaging the patients. d. determining severity of injuries.

assuring personal safety.

27 A patient is involved in an altercation and was struck in the ribs with a baseball bat. Your assessment reveals intact skin with significant bruising to the right lateral chest. When palpating this area, you note instability and crepitus to the rib cage. The patient is also complaining of difficulty breathing. The EMT would recognize: Select one: a. thoracic injury secondary to penetrating trauma. b. chest injury caused by blunt trauma. c. pulmonary injury caused by penetrating trauma. d. chest wall injury cause by acceleration forces.

chest injury caused by blunt trauma.

30 The EMT recognizes that a benefit of applying a traction splint to a deformed femur and thigh is that it: Select one: a. contracts the thigh muscles. b. decreases pain. c. corrects the fracture. d. increases perfusion to the muscle.

decreases pain.

29 A burn patient has blisters to his left arm. The EMT should recognize that: Select one: a. the burn is superficial in nature. b. sensory nerve endings remain intact. c. fluid has collected between the layers of skin. d. large blood vessels have ruptured.

fluid has collected between the layers of skin.

29A student in a science lab has had an unknown chemical splashed into her eye. After assessing the airway, breathing, and circulation, the EMT should immediately: Select one: a. cover both eyes with sterile dressing and provide rapid transport to the hospital. b. flush the eye with copious amounts of tap water. c. examine the pupils and structures of the eye for damage. d. identify the chemical and whether or not a neutralizing solution can be used.

flush the eye with copious amounts of tap water.

27 A patient with severe head and neck pain states that he was properly wearing his seatbelt when another car struck him from behind. As a knowledgeable EMT, you would realize that the complaint of: Select one: a. head pain suggests that he was not wearing the seatbelt properly. b. head and neck pain indicates that he was not wearing his seatbelt. c. head and neck pain indicates that the lap belt was worn without the shoulder harness. d. head and neck pain could occur when the seatbelt is properly worn.

head and neck pain could occur when the seatbelt is properly worn.

27 A car has been hit head-on by another vehicle at a moderate rate of speed. Seatbelts were in place and the airbags deployed. The patient is complaining of chest pain. Quick observation reveals a bruise to his sternum. The EMT would immediately: Select one: a. lift the airbag and check the steering wheel. b. suspect an injury related to the airbag. c. check the windshield for starring. d. deflate the airbag to get breath sounds.

lift the airbag and check the steering wheel.

27 An 8-year-old boy fell forward off of a swing onto outstretched arms. He did not hit his head or lose consciousness and is complaining of left forearm pain. There is deformity to the left wrist, but no other injuries or life threats. His vital signs are pulse 132, respirations 20, blood pressure 108/62, and SpO2 100%. The proper care of this patient would be: Select one: a. immediately load and transport, splinting the injury en-route. b. apply high-flow oxygen, anatomically splint the forearm when the patient is immobilized to a long backboard. c. call ALS so that the patient can be given intravenous pain medications before splinting the forearm. d. splint the forearm and apply a cold pack before transporting non-emergently.

splint the forearm and apply a cold pack before transporting non-emergently.

27 A 49-year-old male has been stabbed in the lower right chest. Police on scene report that the patient got into an argument with an unidentified man, who then stabbed him before fleeing the scene. After assessing the patient, you are suspicious that the knife punctured the lung and is causing internal bleeding. In this situation, the mechanism of injury would be: Select one: a. blunt trauma to the lungs. b. stab wound to the right chest. c. assailant with a knife. d. internal hemorrhage.

stab wound to the right chest.

27 A male patient has sustained gunshot wounds to the neck and abdomen. He is unresponsive and has gurgling respirations. Your immediate action would be to: Select one: a. immobilize the spine. b. obtain vital signs. c. insert a nasal airway. d. suction the airway.

suction the airway.

28 You are assessing a male patient who was stabbed three times in the chest and abdomen. As you begin your primary assessment, you note him to have a decreased level of consciousness and gurgling respirations. Your next action would be to: Select one: a. check his pulse. b. apply a cervical collar. c. suction the airway. d. obtain a SpO2 reading.

suction the airway.

27 Assessment of a patient involved in a motor vehicle accident reveals him to have crepitus to the left humerus, instability to the left lateral chest wall and flank, and pain on palpation to left hip region. He also complains of pain to the right side of the neck. Based on this injury pattern, the EMT would recognize the patient was: Select one: a. an unrestrained occupant in a car struck from the side. b. the driver of a car hit on the driver's side. c. the passenger in a car hit from behind. d. an unrestrained driver involved in a head-on collision.

the driver of a car hit on the driver's side.

28 A patient has suffered a small but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT: Select one: a. carefully remove any embedded particles from within the laceration. b. apply an antibiotic ointment prior to cleaning the injury. c. use sterile gauze and wipe away from the site of injury. d. pack the laceration with sterile gauze soaked in saline water.

use sterile gauze and wipe away from the site of injury.

29 You have been called for an intoxicated patient who sustained a full thickness burn to his leg when he passed out against a kerosene heater. After ensuring that the patient's airway, breathing, and circulation are intact, you should cool the burn with water and then: Select one: a. wrap the burn with a dry sterile dressing. b. apply ice packs and secure in place with a sterile dressing. c. cover the burn with a burn sheet soaked in warm sterile water. d. carefully remove smoldering fabric that is adhered to the skin.

wrap the burn with a dry sterile dressing.