EXAM 13 REVIEW OF CHAPTERS 27,28,29,30 & 31

Femoral shaft fractures can result in up to _____ mL of internal blood loss

1,000

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

14

The mastoid process is located approximately: A. 1″ posterior to the external opening of the ear. B. ½″ anterior to the external opening of the ear. C. 1″ inferior to the external opening of the ear. D. 1″ posterior to the angle of the mandible.

1″ posterior to the external opening of the ear

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

3

The cervical spine is composed of _____ vertebrae.

7

Which of the following statements regarding cervical collars is correct? A. Once a cervical collar is applied, you can cease manual head stabilization. B. A cervical collar is used in addition to, not instead of, manual immobilization. C. Cervical collars are contraindicated in patients with numbness to the extremities. D. The patient's head should be forced into a neutral position to apply a cervical collar.

A cervical collar is used in addition to, not instead of, manual immobilization.

Which of the following scenarios is an example of a direct injury? A. A passenger fractures her patella after it strikes the dashboard. B. A skier dislocates his knee after a twisting injury to the ankle. C. A person lands on his or her feet and fractures the lumbar spine. D. A child dislocates his elbow after falling on his outstretched arm.

A passenger fractures her patella after it strikes the dashboard

Bone marrow produces:

BLOOD CELLS

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. A. brain stem B. cerebellum C. spinal cord D. cerebral cortex

BRAIN STEM

The phrenic nerves control the diaphragm and exit the spinal cord at:

C3, C4, and C5

Coordination of balance and body movement is controlled by the: A. medulla. B. cerebrum. C. cerebellum. D. brain stem.

CEREBELLUM

The _________ contain(s) about 75% of the brain's total volume. A. cerebrum B. cerebellum C. brain stem D. meninges

CEREBRUM

The MOST commonly fractured bone(s) in the body is the:

CLAVICLE

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another? A. somatic B. connecting C. peripheral D. autonomic

CONNECTING

Which of the following statements regarding compartment syndrome is correct? A. Compartment syndrome typically develops within 6 to 12 hours after an injury. B. Compartment syndrome occurs because of increased pressure within the bone cavity. C. In most cases, compartment syndrome develops within a few minutes after an injury. D. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

Compartment syndrome typically develops within 6 to 12 hours after an injury.

The tough, fibrous outer meningeal layer is called the: A. pia mater. B. arachnoid. C. gray mater. D. dura mater.

DURA MATER

Which of the following statements regarding the cranium is correct? A. The skull is a subdivision of the cranium. B. Thirty percent of the cranium is occupied by blood. C. The cranium protects the structures of the face. D. Eighty percent of the cranium is occupied by brain tissue

Eighty percent of the cranium is occupied by brain tissue

Traction splints are used primarily to immobilize and secure fractures of the

FEMUR

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.

HEAD

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Which of the following statements regarding secondary brain injury is correct? A. It results from direct brain trauma following an impact to the head. B. Because cerebral edema develops quickly, it is considered to be a primary brain injury. C. Hypoxia and hypotension are the two most common causes of secondary brain injury. D. Signs are often present immediately after an impact to the head

Hypoxia and hypotension are the two most common causes of secondary brain injury.

Which of the following statements regarding striated muscle is correct? A. Striated muscle is involuntary because you have no conscious control over it. B. Most of the body's striated muscle is found within the walls of the blood vessels. C. Striated muscle tissue is attached directly to the bones by tough bands of cartilage. D. It forms the major muscle mass of the body and usually crosses at least one joint.

It forms the major muscle mass of the body and usually crosses at least one joint.

Which of the following statements regarding the vitreous humor is correct? A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost. D. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost

It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:

Kehr sign.

24. Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? A. linear B. basilar C. open D. compressed

LINEAR

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:

LIVER

Which of the following organs would MOST likely bleed profusely when injured? A. bladder B. liver C. stomach D. intestine

LIVER

Which of the following organs or structures does NOT reside within the mediastinum? A. lungs B. trachea C. vena cavae D. esophagus

LUNGS

Which of the following statements regarding shoulder dislocations is MOST correct?

Most shoulder dislocations occur anteriorly

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.

PATHOLOGIC

Which of the following fractures has the greatest potential for internal blood loss and shock?

PELVIS

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. A. central B. somatic C. autonomic D. peripheral

PERIPHERAL

Which of the following nerves carry information from the body to the brain via the spinal cord? A. motor B. central C. somatic D. sensory

SENSORY

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:

SLOW

What part of the nervous system controls the body's voluntary activities? A. central B. sensory C. somatic D. autonomic

SOMATIC

The spinal cord is encased in and protected by the

SPINAL CANAL

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments.

SPRAIN

Which of the following statements regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. They are typically the result of local, low-energy trauma to the head

The absence of raccoon eyes or Battle's sign does not rule it out.

Which of the following statements regarding abdominal eviscerations is correct? A. Most eviscerations occur to the left upper quadrant. B. The protruding organs should be kept warm and moist. C. The organs should be replaced carefully to avoid heat loss. D. Adherent material is preferred when covering an evisceration

The protruding organs should be kept warm and moist

Which of the following statements regarding motor nerves is correct? A. They carry information from the CNS to the muscles. B. They perform special functions such as sight, smell, and hearing. C. They transmit information from the body to the brain via the spinal cord. D. They are part of the CNS and control reflexes

They carry information from the CNS to the muscles

Which of the following statements regarding anterior nosebleeds is correct? A. They cause blood to drain into the posterior pharynx. B. They are usually severe and require aggressive treatment to control. C. They are usually caused by a fracture of the basilar skull. D. They usually originate from the septum area and bleed slowly

They usually originate from the septum area and bleed slowly

The MOST reliable sign of a head injury is:

a decreased level of consciousness

A subluxation occurs when:

a joint is incompletely dislocated

The mesentery is:

a membranous fold that attaches the intestines to the walls of the body

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

A flail chest occurs when

a segment of the chest wall is detached from the thoracic cage

A reflex arc occurs when: A. the motor nerves function automatically without receiving a message from the CNS. B. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body. C. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: A. they must make arrangements for an ICU bed. B. a specialist may need to be called. C. it saves time on repeat assessments at the hospital. D. most patients with facial trauma will need surgery

a specialist may need to be called.

Pneumothorax is defined as

accumulation of air in the pleural space

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: A. regenerating brain cells after they have been damaged. B. acting as a shock absorber for the brain and spinal cord. C. delivering oxygen directly to the CNS. D. producing leukocytes that protect the brain from infection.

acting as a shock absorber for the brain and spinal cord.

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:

administer oxygen and transport to the hospital

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar:

after assessing distal neurovascular functions

A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:

aggressively manage his airway

An open pneumothorax occurs when

air enters the pleural space from outside the body

Subcutaneous emphysema is an indication that

air is escaping into the chest wall from a damaged lung

The MOST significant complication associated with facial injuries is: A. damage to the eyes. B. airway compromise. C. cervical spine injury. D. mandibular immobility.

airway compromise

What is the function of the sternocleidomastoid muscle? A. allows flexion of the neck B. provides respiration C. connects the scapulae together D. allows movement of the head

allows movement of the head

Any unresponsive trauma patient should be assumed to have:

an accompanying spinal injury

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: A. apply direct pressure below the lacerated vessel. B. circumferentially wrap a dressing around his neck. C. apply pressure to the closest arterial pressure point. D. apply direct pressure above and below the wound.

apply direct pressure above and below the wound

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: A. stabilize the impaled glass in her eye. B. administer 100% supplemental oxygen. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye.

apply direct pressure to her arm wound

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:

apply gentle manual traction in line with the limb and reassess for a pulse

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:

apply high-flow oxygen, consider spinal precautions, and transport without delay.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. D. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport

apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

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

applying direct pressure with a dry, sterile dressing

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. The MOST appropriate method of splinting this injury involves

applying padded board splints to both sides of the leg

A short backboard or vest-style immobilization device is indicated for patients who:

are in a sitting position and are clinically stable

With regard to musculoskeletal injuries, the zone of injury is defined as the:

area of soft-tissue damage surrounding the injury

In moving joints, the ends of the bones are covered with:

articular cartilage

After your partner assumes manual in-line stabilization of the patient's head, you should:

assess distal neurovascular status in the extremities

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should:

assess distal pulse, motor, and sensory functions.

You have applied a zippered air splint to a patient's left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to:

assess the amount of air in the splint and let air out as necessary

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes:

assisting ventilations at an age-appropriate rate.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ

The body's functions that occur without conscious effort are regulated by the _________ nervous system. A. sensory B. somatic C. autonomic D. voluntary

autonomic

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: A. carefully examine her eye and remove any foreign objects if needed. B. avoid applying pressure to the globe when you are covering the eye. C. ask her to move the injured eye to assess the integrity of the optic nerve. D. apply firm direct pressure to the injured eye and cover the opposite eye.

avoid applying pressure to the globe when you are covering the eye

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should:

avoid excessive pressure when applying the bandage

When documenting a call involving a female patient who was sexually assaulted, the EMT should

avoid speculation and document only factual data

When worn properly, a seatbelt should lie:

below the anterior superior iliac spines of the pelvis and against the hip joints

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should

bind his legs together on the backboard, keep him warm, and transport without delay

An epidural hematoma is MOST accurately defined as:

bleeding between the skull and dura mater.

The term "hyphema" is defined as: A. blood in the anterior chamber of the eye. B. an acute rupture of the globe of the eye. C. inflammation of the iris, cornea, and lens. D. compression of one or both optic nerves

blood in the anterior chamber of the eye

Which of the following sets of vital signs depicts Cushing's triad?

blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

Which of the following structures is regulated by smooth muscle? A. heart B. skeleton C. blood vessels D. diaphragm

blood vessels

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: A. a lacerated globe. B. a blowout fracture. C. a ruptured eyeball. D. optic vessel compression

blowout fracture

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:

blunt injury to the kidney.

The musculoskeletal system refers to the

bones and voluntary muscles of the body

The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. brain and spinal cord. C. cerebrum and meninges. D. meninges and spinal cord.

brain and spinal cord

Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with: A. retinitis. B. contact lenses. C. conjunctivitis. D. a brain injury.

brain injury

A fracture is MOST accurately defined as A

break in the continuity of the bone

Patients with rib fractures will commonly

breathe rapidly and shallowly

Which of the following findings would be LEAST suggestive of a head injury? A. one pupil larger in size than the other pupil B. failure of the eyes to move in the same direction C. briskly constricting pupils when exposed to light D. failure of the eyes to follow movement of an object

briskly constricting pupils when exposed to light

When caring for a patient with a possible fracture of the scapula, the EMT should

carefully assess the patient for breathing problems.

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: A. leave the contact lenses in place and flush his eyes with sterile water. B. remove the contact lenses and cover his eyes with a dry, sterile dressing. C. leave the contact lenses in place and cover both eyes with a dry dressing. D. carefully remove the contact lenses and then irrigate his eyes with saline

carefully remove the contact lenses and then irrigate his eyes with saline

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):

cerebral concussion.

The MOST common and serious complication of a significant head injury is:

cerebral edema

The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, thoracic, lumbar, sacral, and coccygeal. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, coccygeal, thoracic, sacral, and lumbar

cervical, thoracic, lumbar, sacral, and coccygeal

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A. close her eyes and cover them with a moist dressing. B. secure her eyes open so you can reassess her pupils. C. inspect her eyes and gently remove impaled objects. D. irrigate her eyes with water to prevent mucosal drying

close her eyes and cover them with a moist dressing

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

closely monitor him and reassess him frequently

Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT: A. profound cyanosis. B. collapsed jugular veins. C. bulging intercostal muscles. D. unilaterally absent breath sounds.

collapsed jugular veins

When assessing a patient with a possible fracture of the leg, the EMT should

compare it to the uninjured leg

The frontal and parietal bones of the skull are especially susceptible to:

compressed skull fractures

Rapid deceleration of the head, such as when it impacts the windshield, causes

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain

You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration?

compression of the aorta and vena cava

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. sclera. B. cornea. C. retina. D. conjunctiva.

conjunctiva

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: A. acute retinitis. B. conjunctivitis. C. a detached retina. D. a corneal abrasion

conjunctivitis

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function

constricted pupils

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

control any external bleeding, administer oxygen, and transport at once

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

control the bleeding and cover the wound with a sterile dressing

Hemoptysis is defined as:

coughing up blood

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: A. scrape the splinter away with moist, sterile gauze. B. cover his right eye and flush the left eye with saline. C. cover both of his eyes and transport to the hospital. D. remove the object with a cotton-tipped applicator.

cover both of his eyes and transport to the hospital

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. swelling. B. deformity. C. ecchymosis. D. point tenderness.

deformity.

The MOST significant hazard associated with splinting is

delaying transport of a critically injured patient.

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced: A. conjunctivitis. B. acute hyphema. C. a blowout fracture. D. a detached retina

detached retina

When assessing a conscious patient with an MOI that suggests spinal injury, you should:

determine if the strength in all extremities is equal

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

diaphragm.

The thoracic cavity is separated from the abdominal cavity by the:

diaphragm.

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: A. pressure dressings and chemical ice packs. B. digital pressure to an adjacent pulse point. C. direct pressure using dry, sterile dressings. D. ice packs and elevation of the patient's head.

direct pressure using dry, sterile dressings

The disruption of a joint in which the bone ends are no longer in contact is called a:

dislocation

Which of the following musculoskeletal injuries would MOST likely result in deformity?

displaced fracture

A supracondylar or intercondylar fracture is also known as a fracture of the

distal humerus

A Colles fracture involves a fracture of the

distal radius

Accumulation of blood in the abdominal cavity will MOST likely cause:

distention.

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

engorged jugular veins

When immobilizing a patient on a long backboard, you should

ensure that you secure the torso before securing the head

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?

epidural hematoma

The hormone responsible for the actions of the sympathetic nervous system is: A. insulin. B. thyroxine. C. epinephrine. D. aldosterone.

epinephrine

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.

epiphyseal

The MOST important treatment for patients with a head injury, regardless of severity, is to:

establish an adequate airway

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: A. assessing motor function. B. assessing sensory function. C. evaluating proximal pulses. D. determining capillary refill.

evaluating proximal pulses

A spontaneous pneumothorax would MOST likely occur as the result of:

exertion of a person with a congenital lung defect

The Glasgow Coma Scale (GCS) is used to assess:

eye opening, verbal response, and motor response

It would be MOST appropriate to perform a focused secondary assessment on a patient who:

fainted and fell to the ground from a standing position

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: A. covering him with a warm blanket. B. giving him small sips of plain water. C. promptly transporting to the hospital. D. administering supplemental oxygen

giving him small sips of plain water

The eyeball itself is referred to as the: A. orbit. B. globe. C. sclera. D. cornea.

globe

Contraction or tensing of the abdominal muscles in an effort to ease pain is called:

guarding.

Distraction injuries of the spine are MOST commonly the result of:

hangings.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: A. is allergic to any medications. B. has a history of eye surgeries. C. regularly sees a family physician. D. noticed the change during a meal.

has a history of eye surgeries

The skin and underlying tissues of the face: A. have a rich blood supply and bleed profusely. B. swell minimally when exposed to blunt trauma. C. are well protected by the maxillae and mandible. D. contain a relatively small number of nerve fibers

have a rich blood supply and bleed profusely

Which of the following statements regarding abdominal trauma is correct? A. Most of the vital abdominal organs lie within the retroperitoneal space. B. The absence of abdominal pain does not rule out intra-abdominal bleeding. C. The liver is well protected and is rarely injured during a traumatic event. D. Hollow abdominal organs are vascular and bleed profusely when injured

he absence of abdominal pain does not rule out intra-abdominal bleeding.

When the parasympathetic nervous system is activated: A. blood is shunted away from the digestive organs. B. the heart rate decreases and the blood vessels dilate. C. hormones are released that prepare the body for stress. D. heart rate and blood pressure increase

he heart rate decreases and the blood vessels dilate

Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a

head-on crash.

Common signs and symptoms of a chest injury include all of the following, EXCEPT: A. tachypnea. B. hematemesis. C. localized pain. D. chest wall ecchymosis.

hematemesis.

A sign of kidney damage following blunt trauma is:

hematuria

Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when:

hollow abdominal organs are damaged and spill their contents

In which of the following situations should the EMT splint an injured limb in the position of deformity?

if resistance is encountered or the patient experiences severe pain

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

immediate reassessment following the intervention.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should

immediately request ALS support

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:

immobilize the injury with a sling and swathe

During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes:

immobilizing her to a backboard and rapidly transporting

When splinting an injury of the wrist, the hand should be placed

in a functional position

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

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

The MOST critical treatment for a tension pneumothorax involves:

inserting a needle through the rib cage into the pleural space

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:

instruct him to assist her ventilations while you perform a rapid assessment

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of

intra-abdominal bleeding

Bleeding within the brain tissue itself is called a(n):

intracerebral hematoma

In contrast to a cerebral concussion, a cerebral contusion:

involves physical injury to the brain tissue

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: A. flush both eyes with an alcohol-based solution and transport. B. irrigate both eyes continuously for 20 minutes with plain water. C. neutralize the acid chemical in his eye with an alkaline chemical. D. mix baking soda with water and irrigate his eyes with the solution

irrigate both eyes continuously for 20 minutes with plain water

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: A. irrigating his right eye laterally. B. flushing his eye starting laterally. C. irrigating both eyes simultaneously. D. covering both eyes and transporting

irrigating his right eye laterally

The cricoid cartilage: A. lies superior to the thyroid cartilage in the neck. B. is the only complete circular cartilage of the trachea. C. is easier to see and palpate than the thyroid cartilage. D. lies superior to the cricothyroid membrane in the neck

is the only complete circular cartilage of the trachea

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

it causes a problem managing the ABCs

A tight-fitting motorcycle helmet should be left in place unless:

it interferes with your assessment of the airway.

When a light is shone into the pupil: A. the opposite pupil should dilate. B. it should become smaller in size. C. it should become larger in size. D. both pupils should dilate together.

it should become smaller in size

When opening the airway of a patient with a suspected spinal injury, you should use the:

jaw-thrust maneuver

The superficial temporal artery can be palpated: A. slightly above the ear. B. at the angle of the jaw. C. over the mastoid process. D. just anterior to the tragus.

just anterior to the tragus

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unconscious, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced

laceration of the aorta

The conjunctiva are kept moist by fluid produced by the: A. corneal duct. B. posterior orbit. C. optic chiasma. D. lacrimal gland.

lacrimal gland

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. esophageal tear. B. crushed cricoid. C. collapsed trachea. D. laryngeal fracture.

laryngeal fracture

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:

law enforcement is at the scene

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: A. leaning him forward and pinching his nostrils together. B. packing the nasopharynx with moist, sterile dressings. C. applying a gauze pad in between his lower lip and gum. D. placing him supine and pinching his nostrils together

leaning him forward and pinching his nostrils together

When splinting a possible fracture of the foot, it is MOST important for the EMT to

leave the toes exposed

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's:

level of consciousness.

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

lift the air bag and look for deformity to the steering wheel

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

ligaments.

All of the following are hollow abdominal organs, EXCEPT for the: A. liver. B. bladder. C. ureters. D. stomach.

liver

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the:

lumbar spine

The lower jawbone is called the: A. zygoma. B. maxillae. C. mandible. D. mastoid.

mandible

The upper jawbones are called the: A. mandible. B. mastoid. C. zygoma. D. maxillae.

maxillae

Lacerations to the scalp:

may be an indicator of deeper, more serious injuries

Placing a pregnant patient in a supine position during the third trimester of pregnancy

may decrease the amount of blood that returns to the heart

When a patient experiences a severe spinal injury, he or she

may lose sensation below the level of the injury.

When a person is lying supine at the end of exhalation, the diaphragm:

may rise as high as the nipple line.

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:

minute volume will decrease

Atrophy is a condition that occurs when

muscle decreases in size and function because of disease or trauma

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:

must increase his or her respiratory rate to maintain adequate minute volume.

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a

myocardial contusion

The MOST common and significant complication associated with fractures or dislocations of the knee is

neurovascular compromise

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A. nondisplaced pelvic fracture B. open fractures of a long bone C. an amputation of an extremity D. multiple closed long bone fractures

nondisplaced pelvic fracture

Facial injuries should be identified and treated as soon as possible because: A. of the risk for airway problems. B. bleeding must be controlled early. C. the spine may be injured as well. D. swelling may mask hidden injuries.

of the risk for airway problems

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: A. applying a tight pressure dressing. B. padding between the ear and the scalp. C. packing the ear with sterile gauze pads. D. covering the wound with a moist dressing

padding between the ear and the scalp

A spinal cord injury at the level of C7 would MOST likely result in:

paralysis of the intercostal muscles

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

partially remove the dressing

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. an amputated extremity B. bilateral femur fractures C. nondisplaced long bone fractures D. pelvic fracture with hypotension

pelvic fracture with hypotension

When a hollow organ is punctured during a penetrating injury to the abdomen

peritonitis may not develop for several hours

The ________ nerves control the diaphragm

phrenic

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:

place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps

When immobilizing a child on a long backboard, you should

place padding under the child's shoulders as needed.

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:

pleurisy.

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a

pneumothorax

The MOST reliable indicator of an underlying fracture is

point tenderness.

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

poorly placed lap belt

Crepitus and false motion are

positive indicators of a fracture

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

posterior hip dislocation

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to applying 100% oxygen, you should:

prepare for immediate transport

The primary purpose for splinting a musculoskeletal injury is to:

prevent further injury.

Because the depth of an open abdominal wound is often difficult to determine

prompt transport to the hospital is essential

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:

provide some form of positive-pressure ventilation

A "hip" fracture is actually a fracture of the

proximal femur

The PASG is absolutely contraindicated in patients who have

pulmonary edema

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: A. pupil. B. sclera. C. cornea. D. conjunctiva.

pupil

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: A. pupillary constriction. B. increase in heart rate. C. shunting of blood to vital organs. D. dilation of the bronchiole smooth muscle

pupillary constriction

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. quickly immobilizing her spinal column.

rapidly transporting her to the hospital

Early bruising following abdominal trauma often manifests as

red areas of skin

Applying ice to and elevating an injured extremity are performed in order to:

reduce pain and swelling

A patient who presents with profound cyanosis following a chest injury

requires prompt ventilation and oxygenation

The optic nerve endings are located within the: A. retina. B. sclera. C. pupil. D. cornea.

retina

A patient who cannot remember the events that preceded his or her head injury is experiencing:

retrograde amnesia

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:

rupture of the tympanic membrane following diffuse impact to the head

The pectoral girdle consists of the:

scapulae and clavicles.

The white portion of the eye is called the: A. iris. B. retina. C. sclera. D. cornea.

sclera

The presence of tachycardia following a significant abdominal injury:

should be assumed to be a sign of shock

When assessing a patient with a hemothorax, you will MOST likely find

signs and symptoms of shock

Which of the following types of muscle is under direct voluntary control of the brain? A. cardiac B. skeletal C. smooth D. autonomic

skeletal

Which of the following joints allows no motion?

skull sutures

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by:

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing

What type of muscle contracts and relaxes to control the movement of the contents within its structures?

smooth

Significant trauma to the face should increase the EMT's index of suspicion for a(n): A. airway obstruction. B. displaced mandible. C. basilar skull fracture. D. spinal cord injury.

spinal cord injury

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should

splint the elbow in the position found and transport

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

stabilize her head and perform a primary assessment

During your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:

stabilize the chest wall with a bulky dressing

During your rapid secondary assessment of a 30-year-old male who fell 25′, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:

stabilize the pelvis with a pelvic binder and protect the spine

Skeletal muscle is also referred to as __________ muscle

striated MUSCLE

Frequent reassessments of the patient with face or neck injuries are MOST important because: A. they lend credibility to your documentation. B. such injuries can affect the respiratory system. C. hospital staff require frequent patient updates. D. rapid facial swelling may mask hidden injuries.

such injuries can affect the respiratory system

A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A. begin immediate ventilatory assistance. B. visualize her mouth for obvious wounds. C. apply oxygen via a nonrebreathing mask. D. suction her oropharynx for 15 seconds.

suction her oropharynx for 15 seconds

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

suction his oropharynx for up to 15 seconds

Common signs of a skull fracture include all of the following, EXCEPT: A. mastoid process bruising. B. ecchymosis around the eyes. C. noted deformity to the skull. D. superficial scalp lacerations.

superficial scalp lacerations

Deformity caused by a fracture would MOST likely be masked by

swelling.

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called:

tendons.

The ideal procedure for moving an injured patient from the ground to a backboard is:

the four-person log roll.

Elevation of the rib cage during inhalation occurs when:

the intercostal muscles contract

An open fracture is MOST accurately defined as a fracture in which

the overlying skin is no longer intact.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:

the patient has been completely secured to the backboard

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:

the patient history

In general, musculoskeletal injuries should be splinted before moving the patient unless

the patient is clinically unstable.

The Adam's apple is: A. the upper part of the larynx that is formed by the thyroid cartilage. B. the lower part of the larynx that is formed by the cricoid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. below the thyroid cartilage and forms the upper part of the trachea.

the upper part of the larynx that is formed by the thyroid cartilage.

Very young children tend to breathe predominantly with their diaphragm because:

their intercostal muscles are not fully developed

The act of pulling on a body structure in the direction of its normal alignment is called:

traction

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: A. incus. B. pinna. C. tragus. D. stapes.

tragus

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: A. use tweezers to try to remove the object. B. remove the peanut with a cotton-tipped swab. C. transport her to the emergency department. D. thoroughly flush her ear with sterile saline

transport her to the emergency department

A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should

transport him in the position in which you found him

Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of:

traumatic aortic rupture

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. quickly suction his oropharynx. B. turn the backboard onto its side. C. reassess his breathing adequacy. D. alert the hospital of the situation

turn the backboard onto its side

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? A. pancreas B. fallopian tubes C. urinary bladder D. liver or spleen

urinary bladder

If you do not have the appropriate size cervical collar, you should:

use rolled towels to immobilize the patient's head

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?

ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

Pleural fluid is contained between the

visceral and parietal pleurae

When caring for a patient with an open facial injury, the EMT must: A. closely assess the patient's airway. B. consider the mechanism of injury. C. wear gloves and facial protection. D. manually stabilize the patient's head.

wear gloves and facial protection