Exam 3

For which of the following patients should the EMT carefully continue to monitor the patient's ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure? 17-year-old male with a blistering sunburn on his face. 28-year-old male who spilled a strong industrial acid on his legs. 34-year-old male who opened the radiator of his car and had hot fluid spray on his chest, resulting in redness and pain in an area about the size of the patient's hand. 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest

16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest

Hyperventilation of a patient with a severe brain injury due to an impaled object means that bag-valve-mask ventilations are provided at a rate of ________ per minute. 24 30 34 20

20

For which of the following patients would the use of a short spine immobilization device be appropriate? 52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain 77-year-old female who fell down a flight of stairs and is in an awkward position lying on her side on the landing 15-year-old male who struck a curb with his motorized scooter and flipped over the handlebars Unresponsive driver who was found in the driver's seat of a pickup truck that crashed into a tree

52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain

How many cervical vertebrae are there? 5 12 7 4

7

According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a patient should be transported to a trauma center. 100 80 90 110

90

Which of the following is of concern with a puncture wound? Hidden internal bleeding with minimal external bleeding An object that remains impaled in the body Strong possibility of contamination All of the above

All of the above

Which of the following is true concerning lacerations? They may indicate deeper underlying tissue damage. They may be caused by blunt trauma. They may be caused by penetrating trauma. All of the above

All of the above

You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and that he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient? Tell the patient that his condition is superficial and allow him to return to the game. Place the patient inside the ambulance and begin active rewarming measures. Allow the patient to warm up inside the ambulance by passive rewarming measures. Warm the affected areas with gentle rubbing.

Allow the patient to warm up inside the ambulance by passive rewarming measures.

Which of the following choices is NOT a justifiable reason for delaying transport of a critical trauma patient? Ventilating a patient in respiratory distress Awaiting arrival of the patient's parents on-scene Suctioning the airway Immobilizing the patient to a long spine board

Awaiting arrival of the patient's parents on-scene

Which of the following is part of the body's compensatory response to blood loss? Blood vessels constrict and the heart rate increases. Blood vessels dilate and the heart rate decreases. Blood vessels dilate and the heart rate increases. Blood vessels constrict and the heart rate decreases.

Blood vessels constrict and the heart rate increases.

You assess a 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the burn, you notice a white powder on the burn. What should be your next step? Brush off the powder, bandage the arm, and transport the patient to the closest trauma center. Transport the patient immediately to the closest burn center. Brush the powder off the patient's arm and hand, and then flush with copious amounts of water. Flush the arm and hand with copious amounts of water.

Brush the powder off the patient's arm and hand, and then flush with copious amounts of water.

Your patient is an 11-year-old male who has a swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the immobilization of his injured extremity? Check pulse, movement, and sensation distal to the injury before and after splinting. Use an upper extremity traction splint. Do not attempt to realign the extremity before splinting. Immobilize from the shoulder to the wrist.

Check pulse, movement, and sensation distal to the injury before and after splinting.

Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the BEST sequence of steps in the management of this patient? Direct pressure, high-concentration oxygen, and splinting the leg Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression High-concentration oxygen, tourniquet, PASG, and elevation of the extremity High-concentration oxygen, elevation of the extremity, and application of ice

Direct pressure, high-concentration oxygen, and splinting the leg

Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now? Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent. Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.

Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.

Heat stroke is caused by which of the following mechanisms? Heat-induced swelling of brain tissue Blockage of blood flow to the brain Extreme dilation of all the blood vessels Failure of temperature regulation mechanisms

Failure of temperature regulation mechanisms

Which of the following BEST describes an avulsion? Epidermis that is scraped away by a rough surface An abrasion is an injury where the epidermis is scraped away by a rough surface. Accumulation of blood beneath the skin, resulting in swelling An injury caused by a sharp, pointed object Flap of skin that is partially or completely torn away from the underlying tissue

Flap of skin that is partially or completely torn away from the underlying tissue

Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of action? Explain to the patient that, because you cannot detect circulation in his foot, his leg will most likely have to be amputated above the site of the injury. Gently attempt to straighten the leg to regain a pulse before splinting. Transport rapidly to the nearest trauma center. Splint the leg in the position in which it was found and transport without delay.

Gently attempt to straighten the leg to regain a pulse before splinting.

Which of the following is NOT a principle of splinting that must be considered by the EMT? Splint an isolated extremity injury before moving the patient to the stretcher. Check the distal neurovascular function before and after splinting. Gently replace protruding bone ends back beneath the skin to prevent further contamination. Immobilize the site of an extremity injury from the joint above it to the joint below it.

Gently replace protruding bone ends back beneath the skin to prevent further contamination.

Which of the following is NOT recommended when controlling epistaxis? Keeping the patient calm and quiet Pinching the nostrils together Having the patient tilt the head backward to elevate the nose Placing the unconscious patient in the recovery position

Having the patient tilt the head backward to elevate the nose

Which of the following is a characteristic of venous bleeding? It commonly requires the use of pressure point compression. It can be profuse, but is generally easily controlled. It often requires the use of a tourniquet. It cannot lead to life-threatening amounts of blood loss.

It can be profuse, but is generally easily controlled.

The technique for central rewarming requires the application of heat to which of the following areas of the patient's body?

Lateral chest, neck, armpits, and groin

Which of the following structures connect bone ends, making joints more stable? Cartilage Ligaments Periosteum Tendons

Ligaments

Which of the following BEST describes an evisceration? Flap of skin that is partially or completely torn away from the underlying tissue Accumulation of blood beneath the skin, resulting in swelling Open wound of the abdomen from which organs protrude Epidermis that is scraped away by a rough surface

Open wound of the abdomen from which organs protrude

Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level?

Perfusion

Which of the following is NOT a contraindication for the use of a traction splint? Injury to the lower third of the leg that would interfere with the ankle hitch Severe swelling and redness at a midshaft femur Avulsion or partial amputation where traction could separate the extremity Pelvis, hip, or knee injury

Severe swelling and redness at a midshaft femur

The bony bumps you feel along the center of a person's back are known as which of the following? Vertebrae Foramen magnum Transverse processes Spinous process

Spinous process

You are dispatched to the local high school for a "person struck with a baseball." You arrive on the scene and find a 16-year-old male sitting on the bench. Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next step? Have the patient walk to the ambulance and take him to the ED. No other care needs to be provided, as there is really no significant sign of any injury. Tell the coach the patient is okay and he can go back into the ball game. Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport. Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes.

Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport.

Which of the following describes the proper application of an occlusive dressing for an open chest wound? Trim the dressing so that it is the exact size of the wound. Tape the occlusive dressing on two sides only to create dual flaps for relief pressure build-up. Use a porous material such as a 4" by 4" gauze pad. Tape the dressing securely on three sides.

Tape the dressing securely on three sides.

Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical wire? The burning will continue for hours, perhaps days. The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity. Toxic gases were inhaled. The extent of tissue damage may be much greater than it appears on the surface.

The extent of tissue damage may be much greater than it appears on the surface.

Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being "hit in the face and kicked and punched in his ribs and stomach." Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient? Getting a description of the assailants The presence of any defensive wounds the patient may have sustained The possibility of a pneumothorax Reducing the swelling around his eyes by applying a cold pack

The possibility of a pneumothorax

Which of the following is the most important reason for controlling external bleeding? To prevent hypoperfusion To prevent the patient from becoming upset at the sight of blood To make clean-up of the ambulance and your equipment easier after the call To prevent the spread of infectious diseases

To prevent hypoperfusion

Which of the following is recommended in situations in which a tourniquet must be used? Apply the tourniquet over the elbow or knee. Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb. Apply a bulky dressing and bandage over the tourniquet. Use a material that is wide and thick.

Use a material that is wide and thick.

Rough handling of a patient with severe hypothermia may result in which of the following? Seizures Rewarming shock Ventricular fibrillation Heart attack

Ventricular fibrillation

Which of the following is a complication of bone fractures? Nerve damage Hemorrhage swelling all of the above

all of the above

Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you anticipate? Damage to internal organs Shock Damage to the nerves of the lower extremities All of the above

all of the above

You are treating a patient with paradoxical motion on the left side of the chest. He is breathing shallow at a rate of 4 breaths per minute. You should: roll the patient onto his left side. apply a bulky dressing to the chest. begin positive pressure ventilation. administer 15 lpm oxygen via mask.

begin positive pressure ventilation.

Which of the following describes an open extremity injury? A gunshot wound has penetrated the skin and then fractured the bone. Bone ends have lacerated the soft tissues and skin from the inside. The joint capsule has been torn open during a dislocation. both A and B

both A and B

Which of the following is NOT part of the circulatory system? Heart Blood vessels Brain Blood

brain

The sound or feeling of the ends of broken bones rubbing together is called:

crepitus

To rescue someone who has fallen through the ice, which of the following is the safest device to use?

flat-bottomed aluminum boat

where could you find the phalange bones?

hands and feet

Most radiant heat is lost through which part of the body? hands and feet buttocks head torso

head

When using a short spine immobilization device, which part of the body is secured last?

head

You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry, but his shirt is wet with visible salt rings. You suspect: hypernatremia. heat cramps. myocardial infarction. heat exhaustion.

heat exhaustion.

Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma? Pancreas Kidneys Liver intestines

liver

A 36-year-old male was accidentally shot with a nail gun into the chest. You see the nail, which protrudes about 2 to 3 centimeters from the thorax, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site? The patient develops a tension pneumothorax. The patient begins to complain of shortness of breath. Bleeding from the patient's wound is minimal. none of the above.

none of the above

Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following? natural warming active rewarming core rewarming passive rewarming

passive rewarming

Your patient was ejected from his motorcycle when he struck a deer late at night on a deserted highway. He is drowsy and unable to communicate clearly. As you immobilize him on the long spine board, you find that you are unable to obtain neutral alignment of his spine due to the large helmet he has on. You should: remove the helmet to better manage proper alignment. tip his head back to gain neutral alignment. place towels on either side of the helmet to stabilize it. pad under his shoulders to straighten his neck.

remove the helmet to better manage proper alignment.

What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax with each breath?

sucking chest wound

A 17-year-old girl was injured when her car was struck from behind while she was stopped at a red light. She is complaining of a headache with neck and back pain. You suspect she has sustained a(n): extension injury whiplash injury compression fracture distraction injury

whiplash