Module 5

A "whiplash" type neck injury is most often observed with what type of collision? Answers: A. Ejection B. Rollover C. Rear-end impact D. Frontal impacts

C. Rear-end impact

heat cramps

the body loses salts from sweating, bringing on painful muscle cramps

What are examples of minor burns

-Full thickness burns<2% of surface (excluding face, -hands, feet, genitalia, respiratory trackt partial thickness bursn <15% -superficial burns of 50%

conduction

-Transfer of heat from one material to another through direct contact -Heat will flow from a warmer material to a cooler one

heat stroke

-When the skin is hot - When the pt stops sweating, there is no loss of heat through evaporation

Ataxic respirations

-abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea. -Pattern characterized with progressive damage to the brainstem

What are critical burnss?

-burns complicated by injuries of respiratory track, soft tissue injurie, and injuries to bones - partial thickness or full thickness of face, hands, feet, genitalia, or respiratory tract -full thickness >10% -partial thickness >30% burns complicated by MSK injuries circumferential burns

What are moderate burns?

-full thickness burns of 2-10% (excluding face, hands feet genitalia, or respiratory track - partial thickness bursn of 15-30% - superficial burns of >50%

Which one of the following statements shows that the EMT understands the application of a tourniquet? Answer: A. "A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely stopped." 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. "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." D. "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."

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

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. Answers: A. 1 L B. 2 L C. 250 mL D. 500 mL

A. 1 L

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? Answers: A. 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest B. 17-year-old male with a blistering sunburn on his face C. 28-year-old male who spilled a strong industrial acid on his legs D. 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

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

Which one of the following patients has an isolated head injury that should be considered the most serious? Answers: A. 21-year-old male wearing a deformed motorcycle helmet who does not respond to verbal or painful stimuli B. 53-year-old female who fell and has a large laceration that is bleeding heavily to the back of her head C. 31-year-old male who is nonverbal and extends his arms and legs when you pinch the muscles on his shoulder D. 62-year-old female who fell and hit her head and is becoming very confused and combative

A. 21-year-old male wearing a deformed motorcycle helmet who does not respond to verbal or painful stimuli

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: Answers: A. 7. B. 8. C. 10. D. 9

A. 7.

A respiratory rate of less than ________ and greater than ________ in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines. Answers: A. 8; 32 B. 5; 45 D. 12; 20 D. 10; 29

A. 8; 32

Two cars have collided head on. One car was traveling 55 mph and the other 35 mph. The total speed of impact would be: Answers: A. 90 mph B. 20 mph C. 55 mph D. 35 mph.

A. 90 mph

Which of the following BEST describes the compartment syndrome? Answers: A. A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure B. A non-life-threatening condition caused by orthopedic injuries in which blood flow is stopped when the bone ends compress the blood vessels C. A serious condition caused by the amount of equipment that must be carried in the ambulance compartments D. A life-threatening condition caused by trapping the blood flow by a fracture when the bone ends cut the blood vessels

A. A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure

When assessing a patient who sustained blunt trauma to the chest, which one of the following assessment findings is most indicative of an injury to the lung? Answers: A. Ability to speak a few words and then gasp B. Respiratory rate of 20 breaths per minute C. Ecchymotic area to the anterior chest D. Elevated heart rate and blood pressure

A. Ability to speak a few words and then gasp

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? Answer: A. Apply oxygen at 15 liters per minute via nonrebreather face mask. B. Insert an oral airway and start positive pressure ventilation with oxygen. C. Check the blood pressure and assess for injuries causing blood loss. D. Immobilize the patient with a cervical collar and long back board.

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

Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques? Answers: A. Applying direct pressure to the wound B. Applying an ice pack or chemical cold pack C. Packing the wound with rolled gauze D. Applying an occlusive dressing

A. Applying direct pressure to the wound

Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream? Answers: A. Arterial gas embolism B. Arterial blood gases C. Arterial thrombosis D. Hyperbaric arterial injury

A. Arterial gas embolism

Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization? Answers: A. Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport. B. Use your fingers to pick embedded debris from the wound, bandage with moist saline dressings in place, and transport. C. Do not attempt to remove any debris, apply pressure dressings over the embedded material if necessary, apply high-concentration oxygen, and transport. D. Use a tongue depressor to scrape large pieces of debris out of the wounds, place the patient on high-concentration oxygen, and transport.

A. Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.

While on standby at a semi-professional baseball game, you are summoned onto the field for a player complaining of severe leg pain after colliding with the catcher of the opposing team. The primary assessment shows no threats to the airway, breathing, or circulation. The secondary assessment reveals a severely deformed knee that is swollen and ecchymotic. The leg is pale and cool, and the patient cannot move his leg when asked to do so. In addition, you cannot palpate a pedal pulse. Which one of the following is your priority at this time? Answers: A. Attempt to straighten the leg until a pulse returns. B. Apply cold packs to the knee and transport immediately. C. Check the patient's radial or carotid pulse. D. Apply a traction splint and enough traction until a pulse returns.

A. Attempt to straighten the leg until a pulse returns.

Why is it important to remove constricting items such as rings before thawing a frozen extremity? Answers: A. Because thawed areas often swell B. Because thawing leaves clots behind in the veins C. To prevent damage to the property such as rings and watches D. All of the above

A. Because thawed areas often swell

Your patient has attempted suicide by slitting his wrists. You notice that he has run the knife across his wrist, perpendicular to the arm, and that the wound is rather deep. Which of the following statements is true regarding the likelihood for serious blood loss? Answers: A. Blood loss is probably not life-threatening. B. You should expect severe blood loss. C. There is most likely tremendous internal blood loss. D. A tourniquet will probably be necessary.

A. Blood loss is probably not life-threatening.

Which of the following blood vessels CANNOT stop bleeding by constricting? Answers: A. Capillaries B. Arterioles C. Arteries D. Venules

A. Capillaries

A patient involved in an altercation has been struck at the side of the head with a baseball bat, in addition to suffering several blows to the arms and legs. When assessing this patient, which one of the following signs and symptoms best indicates the patient has suffered a brain injury? Answers: A. Confusion and combativeness B. Ecchymosis to the side of the face C. Complaint of a headache D. Weakness to both arms

A. Confusion and combativeness

Assessment of an 88-year-old female who fell reveals bruising to her right buttock. The skin is intact and the patient complains of tenderness to the area when you palpate. As a knowledgeable EMT, you should recognize what type of injury? Answers: A. Contusion B. Open injury C. Avulsion D. Abrasion

A. Contusion

Which of the following is the process in which heat is lost from the body as wind passes over it? Answers: A. Convection B. Hydrodynamic cooling C. Exposure D. Condensation

A. Convection

You are on the scene of a shooting. Your assessment reveals a 23-year-old male who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is actively bleeding. The second wound is to the left lateral chest and makes a sucking sound every time the patient takes a breath. The initial action of the EMT should be which one of the following? Answers: A. Cover the chest wound with a gloved hand. B. Obtain a sterile dressing and cover the chest wound. C. Place direct pressure over the abdominal gunshot wound. D. Place the patient on high-flow oxygen with a nonrebreather fire mask.

A. Cover the chest wound with a gloved hand.

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? Answers: A. Death of the car's driver B. No airbags in the car C. History of heart problems D. Complaint of head and neck pain

A. Death of the car's driver

The EMT's 32-year-old patient was in a motor-vehicle collision. Which assessment finding should the EMT recognize as potentially life threatening? Answers: A. Deformity of the left femur B. Open fracture to the right forearm C. Crepitus palpated to the right humerus D. Dislocation of two fingers on the left hand

A. Deformity of the left femur

Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve? Answers: A. Dermatome B. Spinous process C. Transverse process D. Malar

A. Dermatome

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? Answers: A. Down and under B. Lateral impact C. Up and over D. High velocity

A. Down and under

Which one of the following assessment findings would best indicate that a patient has suffered a full thickness burn to his leg? Answers: A. Dry skin with little pain B. Red skin that is painful C. Charred skin with intense pain D. Moist skin with blisters

A. Dry skin with little pain

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? Answers: A. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent. B. Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage. C. Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm. D. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.

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

Which of the following is the outermost layer of the skin? Answers: A. Epidermis B. Dermis C. Adipose tissue D. Fascia

A. Epidermis

Which of the following is NOT a mechanism of musculoskeletal injury? Answers: A. Extensive force B. Direct force C. Twisting or rotational forces D. Indirect force

A. Extensive force

Your patient is a 30-year-old construction worker who fell from scaffolding and has been impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the BEST course of action? Answers: A. Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short. B. Test the reinforcement bar for stability and remove it only if it is loose enough to be easily pulled from the wound. C. Transport with the reinforcement bar in place to prevent delay at the scene. D. Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the scene time under 10 minutes.

A. Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

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

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

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

A. Having the patient tilt the head backward to elevate the nose

A patient suffering blunt trauma to the abdomen has a lacerated liver. Which one of the following represents the most immediate threat to life? Answers: A. Hemorrhage B. Pain C. Infection D. Peritonitis

A. Hemorrhage

Which one of the following is incorrect in the application of a tourniquet? Answers: A. If possible, the tourniquet should be placed on a joint. B. A blood pressure cuff can be used as a tourniquet. C. The tourniquet should be 2 to 4 inches wide. D. The tourniquet should be placed approximately 2 inches above the bleeding.

A. If possible, the tourniquet should be placed on a joint.

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? Answers: A. Left hip B. Left ankle C. Left fingers D. Left toes

A. Left hip

You respond to a 22-year-old male patient who fell while exiting the local bar. Bystanders state he drank at least 10 beers and could not keep his balance. Physical exam reveals that the patient is alert to verbal stimuli only. He has a Glasgow Coma Scale of 3, 4, 6; slurred speech; and an obvious scalp laceration to the back of his head. He is refusing treatment and transport and wants his friends to drive him home. The nearest hospital is 5 minutes away, a Level II Trauma Center is 10 minutes away, and a Level I Full Service Trauma Center is 30 minutes away. Which of these is the most appropriate facility for the patient? Answers: A. Level II Trauma Center B. The nearest community facility C. Level I Trauma Center D. Nowhere, since the patient is an adult and refusing; as such, you cannot take him

A. Level II Trauma Center

A patient has been shot in the chest with a rifle. Your assessment reveals a decreasing level of consciousness and inadequate breathing. Positive pressure ventilation is being administered, and you have covered the entrance wound located midclavicular at the second intercostal space on the left side of the chest. Which one of the following should you do next? Answers: A. Look for an exit wound. B. Place a cervical collar. C. Obtain a blood pressure. D. Get a full set of vital signs.

A. Look for an exit wound.

Prior to your arrival on the scene of a motorcycle crash, an Emergency Medical Responder contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable EMT, you should anticipate which one of the following? Answers: A. Loose flap of skin torn on her left arm B. Bruised skin with a portion of bone protruding C. Long and deep laceration with moderate bleeding D. Torn skin with an underlying fracture

A. Loose flap of skin torn on her left arm

Which of the following signs is LEAST likely to indicate a traumatic brain injury? Answers: A. Low blood pressure B. Irregular breathing pattern C. Irrational behavior D. Vomiting

A. Low blood pressure

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? Answers: A. Manually stabilize the lower right leg. B. Ready the traction splint for application. C. Align the leg in a neutral position. D. Check the right foot for pulses and motor ability.

A. Manually stabilize the lower right leg.

What is a primary problem when treating musculoskeletal injuries? Answers: A. Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb. B. Most musculoskeletal injuries are simply splinted and not a life threat to the patient. C. Splints do not adequately fit the patient's extremities and must be modified with padding to ensure immobilization. D. All musculoskeletal injuries are life threatening due to the bone bleeding, leading to hypoperfusion.

A. Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb

An industrial worker has sustained a laceration to his abdomen. On closer inspection, you note what appear to be fat tissue and a portion of intestine protruding through the wound. Which one of the following is most appropriate for treating this injury? Answers: A. Occlusive dressing applied over saline soaked gauze B. Direct pressure using gloved palms to the injury C. Dry sterile dressing applied over the wound D. One attempt at replacement using sterile gloves

A. Occlusive dressing applied over saline soaked gauze

Burns pose a greater risk to infants and children for which of the following reasons? Answers: A. Pediatric patients have a greater risk of shock from the burn. B. Infants and children have a greater risk of infection from the burn. C. Pediatric patients have a greater risk of heart problems associated with the burn. D. None of the above

A. Pediatric patients have a greater risk of shock from the burn.

What trauma triage guidelines did the Centers for Disease Control and Prevention (CDC) release in order to guide the most injured patients into trauma centers? Answers: A. Physiological determinants, anatomic criteria, and mechanism of injury B. Lights, sirens, and diesel C. Determining patient priority, amount of time on-scene, and hospital transport decision D. Teamwork, timing, and transport

A. Physiological determinants, anatomic criteria, and mechanism of injury

Your patient is a 28-year-old male who cut his thigh with a chain saw. It appears that he has lost about 600 cc of blood. Which of the following is NOT part of the proper management of this patient? Answers: A. Replacement of fluid level by giving the patient adequate amounts of water B. Use of a tourniquet C. Administering oxygen D. Using direct pressure to control the bleeding

A. Replacement of fluid level by giving the patient adequate amounts of water

In which of the following ways does the body produce heat in response to being cold? Answers: A. Shivering B. Burning fewer calories C. Excreting more urine D. Increasing the respiratory rate

A. Shivering

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? Answers: A. Splint the knee in the position found prior to providing transport to the hospital. 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. Realign and straighten the injured knee and then immobilize it by binding it to the other leg.

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

Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds? Answers: A. Sterile B. Nonabsorbent C. Occlusive D. Adherent

A. Sterile

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

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

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

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

A new EMT who is treating a suspected femur injury asks his partner, "How much traction should I pull?" The partner's BEST reply is which of the following? Answers: A. The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds. B. No traction splint applied in the field pulls true traction; they must pull 20 pounds of countertraction. C. Pull enough traction to give the patient some relief from the pain. D. The amount of traction applied should be 15 pounds.

A. The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds.

Why are infants and young children more prone to hypothermia than adults? Answers: A. They have less fat than adults. B. They shiver more than adults. C. They are unable to recognize how cold they are. D. Their immune system is not fully developed.

A. They have less fat than adults.

You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step? Answers: A. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound. B. You need to expose the wound completely because you need to clear away any embedded particles and debris from the wound. C. You need to make sure the wound is very clean before trying to control bleeding by exposing the wound completely and cleaning it with alcohol. D. You can treat the wound without total exposure as exposing a wound in that area of the body could be embarrassing.

A. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: Answers: A. a rapid deterioration of neurologic signs. B. acute unilateral paralysis following the injury. C. an acute increase in the patient's pulse rate. D. a progressively lowering blood pressure.

A. a rapid deterioration of neurologic signs.

Pneumothorax is defined as: Answers: A. accumulation of air in the pleural space. B. accumulation of air between the lungs. C. blood collection within the lung tissue. D. blood collection within the pleural space.

A. accumulation of air in the pleural space.

Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming. Answers: A. active B. central C. peripheral D. endogenous

A. active

An Emergency Medical Responder asks you to explain a pneumothorax. Your response should be that it occurs when: Answers: A. air accumulates around the lung, causing a portion of it to collapse. B. air enters the lung and alveoli from a traumatic opening in the chest wall. C. the lung becomes over-inflated with air and collapses. D. the trachea becomes obstructed, causing the lungs to collapse.

A. air accumulates around the lung, causing a portion of it to collapse.

Subcutaneous emphysema is an indication that: Answers: A. air is escaping into the chest wall from a damaged lung. B. blood is slowly accumulating within the tissue of the lung. C. your patient is experiencing a pericardial tamponade. D. at least half of one lung has completely collapsed.

A. air is escaping into the chest wall from a damaged lung.

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: Answers: A. assess distal circulation and readjust the bandage as needed. B. carefully manipulate her arm until the symptoms subside. C. remove the gauze bandage and replace it with an elastic one. D. remove the bandage and dressing and apply another one.

A. assess distal circulation and readjust the bandage as needed.

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Answers: A. assist the patient's ventilations. B. apply a nonrebreathing mask. C. perform a secondary assessment. D. obtain baseline vital signs.

A. assist the patient's ventilations.

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: Answers: A. assume that the arrow injured an internal organ. B. carefully probe the wound to determine its depth. C. transport only if signs of shock begin to develop. D. clean the wound and apply a dry, sterile dressing.

A. assume that the arrow injured an internal organ.

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: Answers: A. begin positive pressure ventilation. B. administer 15 lpm oxygen via mask. C. apply a bulky dressing to the chest. D. roll the patient onto his left side.

A. begin positive pressure ventilation.

Bone marrow produces: Answers: A. blood cells. B. platelets. C. lymphocytes. D. electrolytes.

A. blood cells.

Patients with rib fractures will commonly: Answers: A. breathe rapidly and shallowly. B. prefer to lie in a supine position. C. take a series of deep breaths. D. develop a sucking chest wound.

A. breathe rapidly and shallowly.

You have been called to the local community hospital for a 48-year-old male involved in a motor-vehicle collision one hour ago. He has been diagnosed with a cerebral contusion and must be transported to a trauma center for specialty care. As a knowledgeable EMT, you recognize that a cerebral contusion is: Answers: A. bruising and swelling of the brain tissue. B. an open skull fracture with increased pressure in the skull. C. active bleeding between the brain and the skull. D. the formation of a pocket of blood within the brain tissue.

A. bruising and swelling of the brain tissue.

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

A. collapsed jugular veins.

Your patient has an open abdominal wound with intestines protruding. You should: Answers: A. cover the organs with moist sterile dressings. B. leave them alone and transport rapidly. C. attempt to place the organs back into the abdomen. D. cover the entire abdomen with a blanket.

A. cover the organs with moist sterile dressings.

A 20-year-old waitress spilled hot coffee and burned her right forearm. When assessing the burn, you note a full-thickness burn surrounded by partial-thickness burns. In addition, she complains of pain in the surrounding partial-thickness burn, but not in the center where the full-thickness burn is located. As an EMT, you recognize that the patient is not localizing pain to the center of the burn because of: Answers: A. damage to pain receptors in the dermis. B. destruction of pain receptors in the epidermal layer. C. injury to pain receptors in the subcutaneous layer. D. damage to epidermal nerve endings.

A. damage to pain receptors in the dermis.

The MOST significant hazard associated with splinting is: Answers: A. delaying transport of a critically injured patient. B. aggravation of the injury or worsened pain. C. compression of nerves, tissues, and vasculature. D. reduction in circulation distal to the injury site.

A. delaying transport of a critically injured patient.

A partial-thickness burn involves the outer layer of skin and a portion of the: Answers: A. dermal layer. B. epidermis. C. fatty layer. D. muscle fascia.

A. dermal layer.

The thoracic cavity is separated from the abdominal cavity by the: Answers: A. diaphragm. B. costovertebral angle. C. anterior rib cage. D. intercostal margin.

A. diaphragm.

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

A. dura mater.

During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: Answers: A. during the tertiary phase. B. during the primary phase. C. as a direct result of the pressure wave. D. during the secondary phase.

A. during the tertiary phase.

A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? Answers: A. energy transmission to the spine B. secondary fall after the initial impact C. direct trauma to the spinal column D. lateral impact to the spine

A. energy transmission to the spine

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

A. epinephrine.

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

A. have a rich blood supply and bleed profusely.

When splinting an injury of the wrist, the hand should be placed: Answers: A. in a functional position. B. in an extended position. C. in a straight position. D. into a fist.

A. in a functional position.

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: Answers: A. instruct him to assist her ventilations while you perform a rapid assessment. B. perform a focused secondary assessment of the patient's head and neck. C. immediately place her on a long backboard and prepare for rapid transport. D. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs.

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

The energy of a moving object is called: Answers: A. kinetic energy. B. potential energy. C. converted energy. D. latent energy.

A. kinetic energy.

Which of the following is of LEAST importance when initially assessing the severity of a burn? Answers: A. known drug allergies B. area(s) burned C. past medical history D. age of the patient

A. known drug allergies

When splinting a possible fracture of the foot, it is MOST important for the EMT to: Answers: A. leave the toes exposed. B. observe for tissue swelling. C. apply a pneumatic splint. D. use a pillow as a splint.

A. leave the toes exposed.

All of the following body structures are lined with mucous membranes, EXCEPT for the: Answers: A. lips. B. anus. C. mouth. D. nose.

A. lips.

A 57-year-old male patient has fallen 20 feet while setting up holiday lights on his roof. He impacted the ground feet first and has suffered open fractures to both tibias, with both bones protruding through the skin. Your assessment reveals him to be responsive to painful stimuli. His airway is open, his breathing is rapid, and his radial pulse is weak. The skin is cool and diaphoretic. Vital signs are: pulse 132, respirations 24, and BP 106/90 mmHg. According to family, he has no medical history. Your partner is providing positive pressure ventilation. At this point in the patient's care, it is a priority for you to: Answers: A. look for other injuries. B. cover the patient with a blanket. C. obtain a history. D. immobilize the fractures.

A. look for other injuries.

If a person's tidal volume decreases, but his or her respiratory rate remains unchanged: Answers: A. minute volume will decrease. B. minute volume will remain unchanged. C. excess carbon dioxide will be eliminated. D. minute volume will increase.

A. minute volume will decrease.

Your patient has a suspected cervical spine injury from falling from a rope swing. His vital signs are pulse 62, respirations 20, and blood pressure 90/56. He has no feeling below his mid-chest area but is able to breathe on his own. You should suspect: Answers: A. neurogenic shock. B. psychogenic shock. C. cardiogenic shock. D. hypovolemic shock.

A. neurogenic shock.

Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of blood and you are considering how you will control the bleeding. Your primary treatment should be to place a(n): Answers: A. occlusive dressing. B. dry, sterile dressing. C. bulky dressing. D. pressure dressing.

A. occlusive dressing.

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

A. peripheral

The MOST reliable indicator of an underlying fracture is: Answers: A. point tenderness. B. severe swelling. C. guarding. D. obvious bruising.

A. point tenderness.

Crepitus and false motion are: Answers: A. positive indicators of a fracture. B. indicators of a severe sprain. C. most common with dislocations. D. only seen with open fractures.

A. positive indicators of a fracture.

When assessing a patient who experienced a blast injury, it is important to remember that: Answers: A. primary blast injuries are the most easily overlooked. B. primary blast injuries are typically the most obvious. C. solid organs usually rupture from the pressure wave. D. secondary blast injuries are usually the least obvious.

A. primary blast injuries are the most easily overlooked.

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: Answers: A. remains in motion until acted upon by an external force. B. will most likely be thrown over the steering column. C. will decelerate at the same rate as the motor vehicle. D. is thrust under the steering column onto the floorboard.

A. remains in motion until acted upon by an external force.

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: Answers: A. remove the helmet to better manage proper alignment. B. pad under his shoulders to straighten his neck. C. tip his head back to gain neutral alignment. D. place towels on either side of the helmet to stabilize it.

A. remove the helmet to better manage proper alignment.

An unrestrained 32-year-old female motorist hit a utility pole head on at 35 mph. The car sustained extensive damage. She exhibits labored respirations and is responsive to painful stimuli with an open airway. She is breathing shallowly at 32 breaths per minute. The radial pulse is rapid and weak, and her skin is cool and cyanotic. Breath sounds are decreased on the right side. Emergency Medical Responders are maintaining manual in-line stabilization. Your next action should be to: Answers: A. start positive pressure ventilation. B. palpate the chest wall for instability. C. perform secondary assessment. D. place a cervical collar and immobilize her.

A. start positive pressure ventilation.

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called: Answers: A. tendons. B. fascia. C. cartilage. D. ligaments.

A. tendons.

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with: Answers: A. the fact that her clinical signs could indicate that she is bleeding internally. B. obtaining a complete set of vital signs to rule out the possibility of shock. C. assessing the bruises that overlie major organs in the chest and abdomen. D. performing a detailed secondary assessment to locate all of her injuries.

A. the fact that her clinical signs could indicate that she is bleeding internally.

Elevation of the rib cage during inhalation occurs when: Answers: A. the intercostal muscles contract. B. the diaphragm descends. C. abdominal contents descend. D. intrathoracic pressure decreases.

A. the intercostal muscles contract.

Functions of the skin include all of the following, EXCEPT: Answers: A. the production of key antibodies. B. maintenance of water balance. C. regulation of body temperature. D. sending information to the brain.

A. the production of key antibodies.

Pleural fluid is contained between the: Answers: A. visceral and parietal pleurae. B. parietal pleura and the chest wall. C. parietal pleura and the heart. D. visceral pleura and the lung.

A. visceral and parietal pleurae

A 51-year-old female patient tripped in the kitchen and fell against a deep fryer, splashing hot oil onto her right arm. Assessment reveals partial and deep thickness burns to her arm. It is estimated that the burn covers two percent of her body. Which one of the following statements, made by the patient, reveals the most important information in determining the overall severity of the burn? Answers: A. "The doctor said that I scar very easily." B. "I have been a diabetic for several years." C. "I think that I lost control of my bladder." D. "I had a burn like this several years ago."

B. "I have been a diabetic for several years."

Which one of the following statements about traction splints is true? Answers: 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 mechanical traction is equal to the manual traction and the patient experiences a reduction in pain." C. "Mechanical traction should be applied until the affected leg is approximately one to two inches longer than the unaffected leg." D. "Once the traction splint has been positioned under the leg, and the ankle hitch is applied, manual traction can be released."

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

Your patient has an injury to the elbow and forearm. While you are conducting the reassessment, which one of the following statements made by the patient should concern you most? Answers: A. "My arm seems to be bruising more." B. "My hand feels like it is going to sleep." C. "I am still having a hard time moving my arm." D. "It hurts when I move my fingers."

B. "My hand feels like it is going to sleep."

Which one of the following statements shows an understanding of shock caused by internal bleeding? Answer: A. "If a patient is bleeding internally, the signs of shock-such as a rapid heart rate and pale, cool, and clammy skin-are not as obvious." B. "You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding." C. "The EMT can control internal bleeding by applying direct pressure to the skin, over top of the area of suspected internal bleeding." D. "Internal bleeding is not as much of a life threat as external bleeding since the blood remains in the body."

B. "You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding."

According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA. Answers: A. 4% B. 1% C. 6% D. 2%

B. 1%

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. Answers: A. 36% B. 18% C. 45% D. 27%

B. 18%

Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned? Answers: A. 36% B. 18% C. 9% D. 4.5%

B. 18%

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? Answers: A. 2 B. 3 C. 4 D. 5

B. 3

Which of the following statements is NOT true? Answers: A. A greenstick break is an incomplete break in a bone. B. A comminuted break is when a bone is broken in only one place. C. A fracture is any break in a bone. D. An angulated break is when the broken bone is bent at an angle.

B. A comminuted break is when a bone is broken in only one place.

A male patient who works in a steel fabricating plant has suffered a flash burn to his right arm and hand. Which one of the following assessment findings would assist the EMT in deciding the burn is superficial and not partial thickness? Answers: A. Poor capillary refill B. Absence of blisters C. Strong radial pulse D. Presence of pain

B. Absence of blisters

The strong white fibrous material called the periosteum: Answers: A. protects the perineum. B. covers the bones. C. surrounds the heart. D. surrounds the abdominal cavity.

B. covers the bones.

Which of the following terms describes the temperature of the surrounding air? Answers: A. Shell temperature B. Ambient temperature C. Core temperature D. Wind chill index

B. Ambient temperature

Which of the following traumatic chest injuries may result in massive, often fatal internal hemorrhage? Answers: A. Hemopneumothorax B. Aortic dissection C. Cardiac tamponade D. Hemothorax

B. Aortic dissection

A 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you do? Answers: A. Because of the seriousness of the injury, wait for ALS before providing any care.Immediately apply a tourniquet to control bleeding. B. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient. C. Complete the amputation. D. It will make the injury much easier to handle.

B. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.

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? Answer: A. Apply 15 lpm of oxygen via nonrebreather face mask. B. Apply direct pressure to the laceration. C. Obtain a blood pressure. D. Assess and manage the airway.

B. Apply direct pressure to the laceration.

In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients? Answers: A. Contact medical control for input into the best treatment for this patient. B. Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED. C. Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death. D. Check distal CSM, apply warming packs to the extremities, and transport the patient.

B. Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

You are treating an unresponsive homeless patient found in an alley. During your assessment you notice bruising behind both ears, which is known as which of the following? Answers: A. Warrior's signs B. Battle's signs C. Soldier's signs D. Fatigue signs

B. Battle's signs

In which of the following vessels does the vital exchange take place and also has the thinnest walls through which oxygen, nutrients, and wastes can pass? Answers: A. Microvenules B. Capillaries C. Arterioles D. Veins

B. Capillaries

An unrestrained female driver hit a utility pole at a moderate rate of speed and struck the steering wheel with her chest. Her airway is open, and she states that it is painful to breathe. Her pulse is moderate in strength and irregular. Breath sounds are equal bilaterally, and there is no jugular venous distention noted. Assessment of her chest reveals bruising and instability to the sternum. When asked, she denies any past medical history. Based on this mechanism and assessment findings, the EMT should be suspicious for what condition? Answers: A. Pneumothorax B. Cardiac contusion C. Traumatic asphyxia D. Tension pneumothorax

B. Cardiac contusion

One of the more serious conditions that EMTs are confronted with would occur as follows:A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved.What is this condition called? Answers: A. Perfusing syndrome B. Compartment syndrome C. Fracture syndrome D. Crushing syndrome

B. Compartment syndrome

Which of the following is NOT an open tissue injury? Answers: A. Evisceration B. Contusion C. Abrasion D. Avulsion

B. Contusion

A patient was building a bomb in his garage when it accidentally detonated. Assessment findings from the rapid secondary assessment reveal intestine and a portion of the liver protruding from the right side of the abdomen. Proper care of this injury should include which one of the following? Answers: A. Application of a dry sterile dressing covered with an occlusive dressing taped on three sides B. Covering the exposed organs with a large sterile dressing soaked with sterile water C. Careful replacement of the organs back into the abdominal cavity D. Direct but gentle pressure applied to the exposed organs to hold them in place

B. Covering the exposed organs with a large sterile dressing soaked with sterile water

A patient was struck in the right upper arm with a baseball bat. Which one of the following signs or symptoms indicates the highest probability that the humerus has been fractured? Answers: A. Pain to the right upper arm B. Crepitus felt on palpation C. Deformity to the upper arm D. Decreased sensation in the right hand

B. Crepitus felt on palpation

Which one of following assessment findings would contraindicate the use of the traction splint? Answers: A. Numbness to the foot B. Deformity to the hip C. Open fracture D. Decreased pedal pulses

B. Deformity to the hip

Which of the following is the LEAST effective method of controlling bleeding? Answers: A. Hemostatic agent B. Elevation C. Tourniquet D. Direct pressure

B. Elevation

You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and a high-category trauma; however, due to the mechanism of injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient? Answers: A. Searching for presence of diaphoresis, tachycardia, and hypotension B. Examining the patient for entrance and exit wounds C. Verifying trauma center ER bed availability D. Performing a distal neurological assessment

B. Examining the patient for entrance and exit wounds

A patient exhibits swelling and deformity to the wrist. After splinting, which one of the following positions of the hand is most appropriate? Answers: A. Hand in a fist with thumb inside fist B. Fingers curled inward C. Wrist flexed with fingers extended D. Fingers extended and spread

B. Fingers curled inward

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

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

Which of the following is the opening at the base of the skull? Answers: A. Spinous process B. Foramen magnum C. Orbits D. Temporomandibular joint

B. Foramen magnum

The sound or feeling of the ends of broken bones rubbing together is called: Answers: A. breakilation. B. crepitus. C. crapilation. D. krepitus.

B. crepitus.

You are dispatched to a multiple vehicle collision on a busy interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient's body? Answers: A. Torso, pelvis, and lower extremities B. Head, chest, and torso C. Head, posterior torso, and lower extremities D. Head, chest, and upper extremities

B. Head, chest, and torso

What is the underlying cause of bluish or reddish facial discoloration following a traumatic asphyxiation? Answers: A. The patient has become hypoxic due to a chest injury and the finding suggests central cyanosis. B. High pressure on the chest leads to blood being forced from the right atrium into the face and neck. C. Bluish or reddish facial discoloration is not associated with traumatic asphyxiation; a pale discoloration is usually present. D. The physiological strain of the body results in a flushed appearance and increased risk of a hypertensive event.

B. High pressure on the chest leads to blood being forced from the right atrium into the face and neck.

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? Answers: A. Increased redness and edema to area surrounding stab wound B. Increase in heart rate and restlessness C. Statement that the pain at the injury is increasing D. Observation that blood is beginning to ooze from the injury

B. Increase in heart rate and restlessness

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? Answers: A. Leathery skin that remains hot to the touch B. Intense pain and blister formation C. Reddened skin with decreased pain sensation D. Decreased pain but significant edema

B. Intense pain and blister formation

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? Answers: A. Risk for infection B. Internal blood loss C. Severe pain D. Swelling in the pelvic cavity

B. Internal blood loss

Which of the following would you expect to see in a patient with severe hypothermia? Answers: A. Rapid respirations B. Irrational behavior C. Loss of muscle tone D. Tachycardia

B. Irrational behavior

Which of the following is classified as an open head injury? Answers: A. Contusion without a skull fracture B. Laceration with a skull fracture C. Laceration without a skull fracture D. Both A and B

B. Laceration with a skull fracture

You are transporting a 19-year-old male who was shot in the chest. On scene you covered the wound with an appropriate dressing. Now, as you conduct your reassessment, you note that the patient is tachypneic and complaining of difficulty breathing. Breath sounds on the side of the injury are also diminished. Which one of the following should you do immediately? Answers: A. Tape the dressing on the fourth side. B. Lift the dressing from the wound for several seconds. C. Cover the wound with another dressing. D. Provide positive pressure ventilation with high-flow oxygen.

B. Lift the dressing from the wound for several seconds.

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? Answers: A. Vehicle collision B. Organ collision C. Body collision D. Physiologic collision

B. Organ collision

Which of the following fractures has the greatest potential for internal blood loss and shock? Answers: A. femur B. pelvis C. humerus D. hip

B. pelvis

You believe that a patient who has been shot in the lower abdomen is bleeding internally and is in an early stage of shock. Which one of the following shows appropriate prehospital care of this patient? Answer: A. Semi-Fowler's position and direct pressure over the injury site B. Oxygen therapy and rapid transport to the hospital C. Oxygen therapy and cold packs to the abdomen D. Supine position and administration of water by mouth

B. Oxygen therapy and rapid transport to the hospital

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? Answers: A. Pain is described as "the worst I have ever felt." B. Partial thickness burn completely encircles the knee. C. Blisters on the lower leg have broken and are leaking fluid. D. Skin on the posterior lower leg is sloughing off

B. Partial thickness burn completely encircles the knee.

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? Answer: A. Transfer to the ambulance, perform the primary assessment, provide oxygen therapy, and provide rapid transport. B. Perform the primary assessment, administer high-flow oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport. C. Perform a primary and rapid secondary assessment, move to the stretcher for immediate transport, and start positive pressure ventilation en route to the hospital. D. Transfer to the ambulance, provide rapid transport, perform primary and secondary assessments, and administer oxygen therapy en route to the hospital.

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

Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae? Answers: A. Autonomic nervous system B. Peripheral nervous system C. Central nervous system D. All of the above

B. Peripheral nervous system

For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups? Answers: A. Inadequate salt intake B. Poor ability to regulate body temperature C. Faster metabolism D. Increased body mass

B. Poor ability to regulate body temperature

Severe external bleeding should be controlled during what phase of the patient assessment? Answer: A. Reassessment B. Primary assessment C. Rapid secondary assessment D. Scene size-up

B. Primary assessment

Assessment findings of a patient ejected from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and a SpO 2 at 94%. Breath sounds are clear and equal bilaterally. You are prepared to start positive pressure ventilation. Given these assessment findings, what type of injury underlying the flail segment is your primary concern? Answers: A. Hemothorax B. Pulmonary contusion C. Pneumothorax D. Rib fractures

B. Pulmonary contusion

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? Answers: A. Weight of the vehicle B. Speed of the vehicle at impact C. Deployment of airbags D. Nighttime conditions

B. Speed of the vehicle at impact

As 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? Answers: A. Frontal-type collision B. Starring of a windshield C. Airbag deployment D. Blood on a patient's clothing

B. Starring of a windshield

A 42-year-old male was involved in a fight and was stabbed in the right lateral chest. The knife is still impaled, and he is complaining of shortness of breath. When he speaks he gurgles and blood drains from his mouth. His respirations are labored and his radial pulse is weak. Which one of the following should you do first? Answers: A. Provide positive pressure ventilation. B. Suction the blood from the airway. C. Stabilize the knife with bulky dressings. D. Remove the knife and seal the injury with a dressing.

B. Suction the blood from the airway.

Which one of the following statements is NOT true? Answers: A. Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for articulation. B. Tendons are bands of connective tissue that bind the ligaments to muscles. C. Ligaments are connective tissues that connect bone to bone. D. Muscles are the tissues or fibers that cause movement of body parts or organs.

B. Tendons are bands of connective tissue that bind the ligaments to muscles.

Which of the following statements regarding the dermis is correct? Answers: A. The cells of the dermis are worn away and are constantly replaced. B. The dermis contains hair follicles, sweat glands, and nerve endings. C. The dermis lies above the germinal layer and provides protection. D. The dermis produces a substance that provides color to the skin.

B. The dermis contains hair follicles, sweat glands, and nerve endings.

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

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

Another crew has called for your assistance in extricating an obese male with a nosebleed from a third-floor bedroom. As you enter the room, which one of the following shows proper management of the patient's condition? Answer: A. The patient is supine, head turned to the side, blood draining from the nose and mouth, cold pack to bridge of the nose. B. The patient is sitting upright, leaning forward, with nostrils pinched shut. C. The patient is sitting upright, head tilted back, sterile gauze packed in each nostril. D. The patient is lying on his side, a loose dressing has been applied below his nose, and a cold pack is on the bridge of his nose.

B. The patient is sitting upright, leaning forward, with nostrils pinched shut.

You're an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated county road. It appears the patient was unrestrained, or not wearing a seat belt, and struck the steering wheel with his chest. On assessment, you notice a paradoxical motion to the patient's chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include? Answers: A. The patient is showing signs of abdominal bleeding. B. The patient may have a flail chest. C. The patient may have an abdominal evisceration. D. The patient is showing signs of an open chest injury.

B. The patient may have a flail chest.

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

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

To which of the following sections of the spine are the ribs attached? Answers: A. Sacral B. Thoracic C. Lumbar D. Cervical

B. Thoracic

The ________ nerves control the diaphragm. Answers: A. vagus B. phrenic C. intercostal D. costal

B. phrenic

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

B. To prevent hypoperfusion

Your patient is a 16-year-old male who ran his truck off of the road and into a ditch. He was driving just fast enough to cause the air bag to deploy when he hit the ditch. He is complaining of some neck and shoulder pain. His vital signs are respirations 20, pulse 110, blood pressure 116/80, and pupils equal and reactive. How should you manage this patient? Answers: A. Place him on oxygen, and then slowly move him to the stretcher. B. Use a short spine board or vest device, then transfer him to a long spine board. C. Apply a cervical collar, and then rotate him to a long spine board. D. Perform a rapid extrication and spinal immobilize him on a long spine board.

B. Use a short spine board or vest device, then transfer him to a long spine board.

Which of the following is NOT used to calculate a patient's GCS? Answers: A. Motor response B. Work of breathing C. Verbal response D. Eye movement

B. Work of breathing

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? Answers: A. incision B. abrasion C. avulsion D. laceration

B. abrasion

A wound in which the epidermis is scraped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called a(n): Answers: A. avulsion. B. abrasion. C. evisceration. D. contusion.

B. abrasion.

When worn properly, a seatbelt should lie: Answers: A. above the anterior posterior iliac spines of the pelvis and below the hip joints. B. across the abdominal wall at the level of the umbilicus and against the hip joints. C. below the anterior superior iliac spines of the pelvis and against the hip joints. D. across the abdominal wall at the level of the diaphragm and below the hip joints.

B. across the abdominal wall at the level of the umbilicus and against the hip joints.

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should: Answers: A. place him in a sitting position and give him oxygen. B. administer oxygen and prepare for rapid transport. C. perform a focused physical exam of his abdomen. D. conclude that he is experiencing intracranial bleeding.

B. administer oxygen and prepare for rapid transport.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: Answers: A. a spinal fracture. B. an air embolism. C. an ischemic stroke. D. nerve fiber damage.

B. an air embolism.

A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should: Answers: A. control the bleeding from the wound and prepare to transport at once. B. apply an occlusive dressing to the wound and continue your assessment. C. place a sterile dressing over the wound and apply direct pressure. D. direct your partner to assist the patient's ventilations with a bag-mask device.

B. apply an occlusive dressing to the wound and continue your assessment.

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: Answers: A. administering 100% oxygen via a nonrebreathing mask. B. applying direct pressure with a dry, sterile dressing. C. requesting a paramedic to administer pain medication. D. covering the avulsion with moist, sterile dressings.

B. applying direct pressure with a dry, sterile dressing.

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: Answers: A. auscultate bowel sounds. B. assess for an exit wound. C. apply a cervical collar. D. obtain baseline vital signs.

B. assess for an exit wound.

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: Answers: A. ask her to move the injured eye to assess the integrity of the optic nerve. B. avoid applying pressure to the globe when you are covering the eye. C. carefully examine her eye and remove any foreign objects if needed. D. apply firm direct pressure to the injured eye and cover the opposite eye.

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

You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search and rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is to: Answers: A. actively rewarm the digits. B. bandage the digits. C. keep the digits frozen on ice until they can be properly rewarmed at the hospital. D. gently warm the digits by slowly massaging them.

B. bandage the digits.

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

B. blood in the anterior chamber of the eye.

Which of the following sets of vital signs depicts Cushing's triad? Answers: A. blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min B. blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min C. blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min D. blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min

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

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: Answers: A. capitation. B. cavitation. C. congruent. D. conversion.

B. cavitation.

The MOST common and serious complication of a significant head injury is: Answers: A. acute hypotension. B. cerebral edema. C. a hypoxic seizure. D. a skull fracture.

B. cerebral edema.

The MOST commonly fractured bone(s) in the body is the: Answers: A. radius and ulna. B. clavicle. C. scapula. D. midshaft femur.

B. clavicle.

You have been called for a male worker complaining of arm pain. On scene the 31-year-old patient states that his arm was crushed between two heavy boxes. There was minimal pain at that time, but now his right forearm is swollen and painful, especially with movement. He also states that the arm and fingers feel like they are "asleep." You note decreased strength to the arm and a radial pulse that is weak when compared to the left. There is no deformity to the arm and the skin is intact, although hard on palpation. Vital assigns are pulse 88, respiration 18, and blood pressure 134/76 mmHg. Given these assessment findings, the EMT should be suspicious of: Answers: A. hemorrhagic shock. B. compartment syndrome. C. stroke. D. fracture.

B. compartment syndrome

The mechanism of injury in which a patient's chest has struck an immovable object, such as a steering wheel, may most accurately be described as a(n): Answers: A. open trauma injury. B. compression injury. C. coup contrecoup injury. D. penetrating injury.

B. compression injury.

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

B. conjunctiva.

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: Answers: A. cover his right eye and flush the left eye with saline. B. cover both of his eyes and transport to the hospital. C. remove the object with a cotton-tipped applicator. D. scrape the splinter away with moist, sterile gauze.

B. cover both of his eyes and transport to the hospital.

An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a fallen tree, that results in damage to muscle cells and the accumulation of waste products in the tissue is called a(n): Answers: A. contusion. B. crush injury. C. evisceration. D. abrasion.

B. crush injury.

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? Answers: A. intrusion into the vehicle B. deployment of the air bag C. dismounted seats D. steering wheel deformity

B. deployment of the air bag

A fair-skinned patient was exposed to the sun and has a painful superficial thickness burn to her upper back. As a knowledgeable EMT, you would recognize that the ________ layer(s) of the skin has been affected. Answers: A. dermal B. epidermal C. subcutaneous D. epidermal and dermal

B. epidermal

A patient has suffered an open crush injury to his elbow. As you approach, you note the patient sitting upright holding a towel to his elbow. Although the towel is soaked with blood, the elbow does not appear to be actively bleeding. Your first action in caring for this patient should be to: Answers: A. place a sterile dressing over the injury. B. evaluate the patient's airway. C. apply oxygen through a nonrebreather mask. D. examine the patient's elbow.

B. evaluate the patient's airway.

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

B. evaluating proximal pulses.

Two of the MOST common mechanisms of injury for blunt trauma are: Answers: A. motor vehicle collisions and stabbings. B. falls and motor vehicle collisions. C. gunshot wounds and vehicle ejections. D. low-caliber gunshot wounds and falls.

B. falls and motor vehicle collisions.

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

B. globe.

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. Answers: A. lower extremities B. head C. chest D. waist

B. head

The cervical spine is MOST protected from whiplash-type injuries when the: Answers: A. air bag correctly deploys upon impact. B. headrest is appropriately positioned. C. patient tenses up at the time of impact. D. rear end of the vehicle is initially struck.

B. headrest is appropriately positioned.

Localized cold injury occurs due to vasoconstriction and: Answers: A. chemical imbalance in the tissues. B. ice crystal formation in the tissues. C. blood clots. D. loss of calcium.

B. ice crystal formation in the tissues

In which of the following situations should the EMT splint an injured limb in the position of deformity? Answers: A. if transport time to the hospital is greater than 20 to 30 minutes B. if resistance is encountered or the patient experiences severe pain C. if a traction splint will be used to immobilize the injured extremity D. when distal circulation and neurological functions are absent

B. if resistance is encountered or the patient experiences severe pain

The MOST critical treatment for a tension pneumothorax involves: Answers: A. surgically removing the portion of the lung that is damaged. B. inserting a needle through the rib cage into the pleural space. C. assisting the patient's breathing with increased tidal volume. D. placing a bulky dressing over the affected side of the chest.

B. inserting a needle through the rib cage into the pleural space.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: Answers: A. rupture of a hollow organ. B. intra-abdominal bleeding. C. a severe liver laceration. D. a ruptured spleen.

B. intra-abdominal bleeding.

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

B. it should become smaller in size.

A hematoma develops when: Answers: A. small amounts of blood leak into the epidermis. B. large blood vessels beneath the skin are damaged. C. cells and small vessels in the dermis are damaged. D. severe swelling compromises arterial circulation.

B. large blood vessels beneath the skin are damaged.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: Answers: A. perform an immediate head-to-toe assessment. B. open his airway and assess his breathing status. C. apply high-flow oxygen and assess his injuries. D. assess his pulse for rate, regularity, and quality.

B. open his airway and assess his breathing status.

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: Answers: 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

B. padding between the ear and the scalp.

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

B. pupil.

When the speed of a motor vehicle doubles, the amount of kinetic energy: Answers: A. doubles. B. quadruples. C. is not affected. D. triples.

B. quadruples.

Applying ice to and elevating an injured extremity are performed in order to: Answers: A. prevent further injury. B. reduce pain and swelling. C. enhance tissue circulation. D. maintain extremity perfusion.

B. reduce pain and swelling.

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

B. sclera.

Which of the following organs can tolerate inadequate perfusion for up to 2 hours? Answers: A. kidneys B. skeletal muscle C. brain D. heart

B. skeletal muscle

Some drawbacks to using sterile aluminum foil as an occlusive dressing include: Answers: A. a flutter valve is difficult to create. B. skin lacerations may occur from the sharp edges. C. foil cannot create an airtight seal. D. sterility cannot be ensured unless the materials were autoclaved.

B. skin lacerations may occur from the sharp edges.

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: Answers: A. apply a heat pack to the elbow to reduce swelling. B. splint the elbow in the position found and transport. C. gently straighten the elbow and apply an air splint. D. gently manipulate the elbow to improve circulation.

B. splint the elbow in the position found and transport.

The severity of bleeding should be based on all of the following findings, EXCEPT: Answers: A. clinical signs and symptoms. B. systolic blood pressure. C. poor general appearance. D. the mechanism of injury.

B. systolic blood pressure.

Internal injuries caused by gunshot wounds are difficult to predict because: Answers: A. exit wounds caused by the bullet are usually small. B. the bullet may tumble or ricochet within the body. C. the area of damage is usually smaller than the bullet. D. the caliber of the bullet is frequently unknown.

B. the bullet may tumble or ricochet within the body.

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

B. the heart rate decreases and the blood vessels dilate.

Patients with full-thickness (third-degree) burns generally do not complain of pain because: Answers: A. subcutaneous vessels are usually clotted. B. the nerve endings have been destroyed. C. blister formation protects the burn. D. he or she is generally not conscious.

B. the nerve endings have been destroyed.

An open fracture is MOST accurately defined as a fracture in which: Answers: A. a large laceration overlies the fracture. B. the overlying skin is no longer intact. C. a bullet shatters the underlying bone. D. bone ends protrude through the skin.

B. the overlying skin is no longer intact.

You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with: Answers: A. preventing the risk of infection. B. the potential for airway swelling. C. treating him for hypothermia. D. estimating the extent of his burns.

B. the potential for airway swelling.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: Answers: A. the primary impact point. B. the speed of the fall. C. the height of the fall. D. the surface struck.

B. the speed of the fall.

A patient has a history of tendonitis of the right elbow. Based on this, the EMT should understand that the: Answers: A. bones making up the elbow joint are infected. B. tissue connecting the muscle to the bones of the elbow is inflamed. C. patient suffered a previous fracture to the right elbow. D. muscles surrounding the elbow are inflamed.

B. tissue connecting the muscle to the bones of the elbow is inflamed.

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she was first cut, blood spurted from the wound, and then within a second or two, it subsided to a mere trickle. She asks why this would happen. Which one of the following is the correct response? Answer: A. "Red blood cells will quickly repair the injury to the blood vessel." B. "Blood has the ability to clot within a second or two of injury." C. "Blood vessels will constrict quickly once they are injured." D. "The skin around the injured blood vessels quickly swells and stops bleeding."

C. "Blood vessels will constrict quickly once they are injured."

Which one of the following statements made by an EMT shows an understanding of chest trauma? Answers: A. "Open chest injuries are more serious than closed chest injuries, because air and bacteria can enter the chest through the open wound." B. "In general, an open chest injury caused by blunt trauma is more life-threatening than a closed one due increased blood loss." C. "Closed chest injuries are caused by blunt trauma, and can be just as serious as open chest injuries." D. "Closed chest injuries are caused by penetrating trauma and cause more life-threatening injuries than do open chest injuries."

C. "Closed chest injuries are caused by blunt trauma, and can be just as serious as open chest injuries."

An adult female is found unresponsive after being shot in the chest. Which one of the following EMT statements about this patient is of most concern? Answers: A. "Her SpO2 has gone from 90% to 93%." B. "She does not have any jugular venous distention." C. "She is getting more difficult to ventilate." D. "I see an entry wound but no exit wound anywhere."

C. "She is getting more difficult to ventilate."

What is the Glasgow Coma Score (GCS) measurement of altered mental status, which according to CDC guidelines necessitates transport to a trauma center? Answers: A. 14 B. 12 C. 13 D. 8

C. 13

According to the rule of nines for infants and young children, the patient's head and neck account for what percentage of the total body surface area? Answers: A. 9% B. 13.5% C. 18% D. 14%

C. 18%

Which one of the following patients should the EMT recognize as suffering the most critical burn? Answers: A. 58-year-old with a scald burn to the anterior chest B. 41-year-old with a partial-thickness burn to the upper left arm C. 22-year-old with a partial-thickness burn to the right hand D. 12-year-old with a superficial thickness burn to the neck and chest

C. 22-year-old with a partial-thickness burn to the right hand

Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations? Answers: A. An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS response B. An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of pelvic pain C. A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC D. An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt

C. A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC

Which one of the following statements about different musculoskeletal injuries is true? Answers: A. Strains are injuries that occur to ligaments and the joints to which they are attached. B. A dislocation occurs when the bone within a joint is broken. C. A sprain is an injury to a joint with possible damage to or tearing of ligaments. D. A fracture occurs when a tendon connecting muscle to a bone is overstretched and injured.

C. A sprain is an injury to a joint with possible damage to or tearing of ligaments.

Your patient is a 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and painful, but without blisters. When caring for this injury in the prehospital setting, which of the following is appropriate? Answers: A. Apply a plastic bag full of ice to the skin. B. Apply an antibiotic ointment. C. Apply a dry sterile dressing. D. Apply a lotion containing a topical anesthetic and aloe vera.

C. Apply a dry sterile dressing.

Direct pressure has failed to control an arterial bleed on a patient's leg. Which one of the following should the EMT do next? Answer: A. Immediate transport. B. Splint the extremity. C. Apply a tourniquet. D. Provide oxygen.

C. Apply a tourniquet.

In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next? Answers: A. Apply an ice pack over the original dressing. B. Remove the saturated dressings and apply a large trauma dressing. C. Apply additional dressing material over the top of the original dressing and bandage it in place. D. Apply a tourniquet.

C. Apply additional dressing material over the top of the original dressing and bandage it in place.

A nine-year-old boy has fallen from a swing. Assessment findings reveal no threats to the airway, breathing, or circulation, but do indicate deformity, pain, and swelling to his right wrist. The right radial pulse is strong and is accompanied by skin that is pink and warm to the touch. Which one of the following actions indicates that the EMT is properly caring for this patient? Answers: A. Straightening the wrist to promote blood flow to the hand B. Massaging the wrist gently to decrease the pain C. Applying cold packs to the wrist to reduce swelling D. Maintaining the wrist below the level of the heart to decrease swelling

C. Applying cold packs to the wrist to reduce swelling

Which of the following vessels has the thickest muscular walls that allow constriction and dilation? Answers: A. Capillaries B. Veins C. Arteries D. Lymphatic vessels

C. Arteries

While responding to a domestic emergency with possible injuries, the dispatcher informs you that the police on scene report a male patient knife cut and arterial bleeding. Given this information, which one of the following do you expect? Answer: A. Dark red blood flowing from the injury that is difficult to control B. Bright red blood oozing from the injury site that is easy to control C. Bright red blood that is spurting with each beat of the heart D. Spurting blood that is darker red in color and difficult to control

C. Bright red blood that is spurting with each beat of the heart

A 68-year-old female patient is complaining of a headache and generalized weakness. Her husband informs you that she was with a friend yesterday and was involved in a motor-vehicle collision. She did strike her face on the dashboard, but refused treatment on scene. Her past medical history includes a stroke with right arm weakness and high blood pressure for which she takes medications. When assessing this patient, which one of the following findings should concern the EMT most? Answers: A. Complaint of pain when she moves her jaw B. Contusion to her left cheek area C. Bruising behind her left ear D. Weakness to the right-hand grip

C. Bruising behind her left ear

An alert and oriented 22-year-old male has fallen off a tractor and is complaining of pain to his right leg. As you quickly scan the patient, you note obvious deformity to the tibia-fibula region of the lower extremity. After conducting the primary assessment and manually stabilizing the leg, which one of the following should the EMT do? Answers: A. Apply the traction splint. B. Splint the leg in the position found. C. Check for a pedal pulse. D. Transfer the patient to the stretcher.

C. Check for a pedal pulse.

Which of the following statements regarding crush syndrome is correct? Answers: A. Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely because toxins are quickly eliminated from the body. B. Provided that a patient with a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal. C. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. D. With crush syndrome, massive blood vessel damage occurs following severe soft-tissue injuries, such as amputation of an extremity.

C. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

A patient who is lying on cold ground is losing the most amount of heat by what mechanism? Answers: A. Radiation B. Convection C. Conduction D. Shivering

C. Conduction

Which of the following is a function of the autonomic nervous system? Answers: A. Speaking B. Solving complex math problems C. Constriction of blood vessels D. Running or walking

C. Constriction of blood vessels

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? Answers: A. Carefully replace the exposed bowel into the abdomen and transport. B. Cover the exposed bowel and keep his legs in a straight position. C. Cover it with moist, sterile gauze and secure with an occlusive dressing. D. Irrigate it with sterile water and cover it with a dry dressing.

C. Cover it with moist, sterile gauze and secure with an occlusive dressing.

You are called for a young man who was diving head first off a dock into a lake. Bystanders say he struck his head on the bottom because the water was too shallow. They said he was not breathing when they pulled him from the water and they have been performing rescue breathing for him. He is awake, but he is unable to breathe on his own. What type of damage or injury does this indicate? Answers: A. Closed head injury B. Damage to his thoracic spine C. Damage to C-3, C-4, or C5 D. Open head injury

C. Damage to C-3, C-4, or C5

You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect? Answers: A. Near drowning B. Myocardial infarction C. Decompression sickness D. Air embolism

C. Decompression sickness

When assessing a patient, which one of the following signs or symptoms is most indicative of the patient suffering from a pneumothorax? Answers: A. Severe pain with each inspiration B. SpO2 of 90% on high-flow oxygen C. Decreased breath sounds to the right lung D. Crepitus to the chest wall

C. Decreased breath sounds to the right lung

Which of the following is NOT a common field finding in spinal injuries? Answers: A. Impaired breathing B. Pain C. Deformity D. Tenderness

C. Deformity

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? Answers: A. Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression B. High-concentration oxygen, tourniquet, PASG, and elevation of the extremity C. Direct pressure, high-concentration oxygen, and splinting the leg D. High-concentration oxygen, elevation of the extremity, and application of ice

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

When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building? Answers: A. Before departing from the scene B. As he approaches the patient C. En route to the hospital D. At the hospital before writing the care report

C. En route to the hospital

Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do? Answers: A. Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a pillow and a cold pack applied to the injury. B. Transport the patient immediately to a trauma center, applying high-concentration oxygen en route. C. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle. D. Explain to the patient that her ankle is fractured and you must splint her ankle to prevent further injury and reduce pain.

C. Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.

Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the following? Answers: A. Motor response, arm movement, and speech B. Grip strength, verbal response, and eye opening C. Eye opening, verbal response, and motor response D. Verbal response, motor response, and AVPU

C. Eye opening, verbal response, and motor response

In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury? Answers: A. Gently apply pressure to the top of the patient's head. B. Maintain the patient's head and neck in the position they are found. C. Hold the patient's head still in a neutral, "eyes forward" position. D. Provide approximately 15 pounds of upward cervical traction.

C. Hold the patient's head still in a neutral, "eyes forward" position.

Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues. Which of the answers is NOT a major type of shock? Answers: A. Cardiogenic B. Hypovolemic C. Hypervolemic D. Hemorrhagic

C. Hypervolemic

Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the BEST way to immobilize this patient's extremities prior to transport? Answers: A. Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize the fractures. B. Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard. C. Immobilize the patient to a long backboard without splinting the extremities individually. D. Use padded board splints for the upper extremities and PASG for the lower extremities.

C. Immobilize the patient to a long backboard without splinting the extremities individually.

Which of the following causes worsening of the damage in a brain injury? Answers: A. Failure to keep the patient awake and talking B. Administration of 100% oxygen C. Improper management of airway and ventilation D. Allowing seepage of cerebrospinal fluid (CSF) from the ears or nose

C. Improper management of airway and ventilation

A 65-year-old man was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury? Answers: A. Increased pulse rate B. Glasgow Coma Scale (GCS) of 15 C. Increased blood pressure D. Constricted pupils

C. Increased blood pressure

You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a pulse of 60 beats per minute, and slightly irregular breathing. The patient's presentation is most likely caused by which of the following? Answers: A. Increased arterial pressure B. Coup-contrecoup injury C. Increased intracranial pressure D. Closed head injury

C. Increased intracranial pressure

Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms? Answers: A. Twisting motion B. Direct force C. Indirect force D. Sudden acceleration

C. Indirect force

Which of the following BEST describes the benefit of a three-sided occlusive dressing over a four-sided occlusive dressing for an open chest wound? Answers: A. It prevents the development of a hemothorax by allowing blood to escape. B. It eliminates the need to continue monitoring the patient's respiratory status. C. It reduces the chances of developing a tension pneumothorax. D. It allows easy access for re-examination of the wound en route to the hospital.

C. It reduces the chances of developing a tension pneumothorax.

Which of the following statements is NOT true concerning the proper transport of an avulsed ear? Answers: A. It should be labeled with the patient's name, as well as the date and time it was bagged. B. It should be kept as cool as possible. C. It should be in a dry sterile dressing. D. It should not be immersed in cooled water or saline.

C. It should be in a dry sterile dressing.

Which of the following structures connect bone ends, making joints more stable? Answers: A. Periosteum B. Cartilage C. Ligaments D. Tendons

C. Ligaments

You are treating a 35-year-old male patient that has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient's presentation is most likely caused by which of the following? Answers: A. Septic shock B. Increased intracranial pressure C. Neurogenic shock D. Cardiogenic shock

C. Neurogenic shock

You have arrived on the scene for a patient assaulted with a baseball bat. As you approach, which one of the following positions seems to indicate that he was struck and suffered injury to the abdomen? Answers: A. Standing with restless movement and pacing B. Supine with legs extended and toes pointed C. On his side with knees drawn to the chest D. Prone with hands on the back

C. On his side with knees drawn to the chest

Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following? Answers: A. Core rewarming B. Active rewarming C. Passive rewarming D. Natural rewarming

C. Passive rewarming

A 52-year-old male is unresponsive and has bruises and lacerations to the head, chest, and abdomen. Bystanders state that the patient was intoxicated and got into a fight with several patrons of a bar. They state that he was beaten with their fists, and not other objects or weapons. The patient has snoring respirations, shallow breathing, and a strong radial pulse. His skin is warm and dry. After taking manual in-line spinal stabilization, which one of the following should be your next action? Answers: A. Insert a nasal or oral airway. B. Start positive pressure ventilation. C. Perform the jaw-thrust maneuver. D. Apply a cervical collar.

C. Perform the jaw-thrust maneuver.

A traction splint may be used on which of the following musculoskeletal injuries? Answers: A. Suspected multiple fractures of the femur, tibia, and fibula B. Possible fracture of the humerus C. Possible fracture of the femur D. Possible fracture of the cervical spine

C. Possible fracture of the femur

Heat cramps occur due to loss of which of the following substances? Answers: A. Magnesium B. Water C. Salt D. Water and potassium

C. Salt

In which of the following situations would a person lose heat by conduction? Answers: A. Breathing B. Going outside without a coat during a cold but calm day C. Sitting on cold metal bleachers at a football game D. Wearing wet clothing in windy weather

C. Sitting on cold metal bleachers at a football game

When performing the primary assessment, which one of the following signs or symptoms best shows that the patient is in shock? Answer: A. Radial pulse of 72 beats per minute B. Crackles heard in both lungs C. Skin that is cool and diaphoretic D. Vomitus in the airway

C. Skin that is cool and diaphoretic

The bony bumps you feel along the center of a person's back are known as which of the following? Answers: A. Vertebrae B. Transverse processes C. Spinous process D. Foramen magnum

C. Spinous process

Which one of the following emergency care measures for a patient with a possible bone fracture can be an effective means to reduce pain? Answers: A. Administering oxygen therapy B. Applying warm packs to the fracture site C. Splinting the fracture D. Massaging the injury site

C. Splinting the fracture

Which of the following is a characteristic of arterial bleeding? Answers: A. Steady flow B. Dark red color C. Spurting under pressure D. Both B and C

C. Spurting under pressure

Which of the following layers of the skin is the MOST important in insulating the body against heat loss? Answers: A. Subdural layer B. Epidermis C. Subcutaneous layer D. Parietal layer

C. Subcutaneous layer

Which one of the following definitions is NOT true? Answers: A. A sprain is the stretching and tearing of ligaments. B. Another name for manual traction is tension. C. Tendons connect muscles to ligaments. D. Joints are places where bones articulate.

C. Tendons connect muscles to ligaments.

Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and transport? Answers: A. Hemopneumothorax B. Flail chest C. Tension pneumothorax D. Abdominal evisceration

C. Tension pneumothorax

Which one of the following is occurring in the body when a person is in shock? Answer: A. The blood has an adequate amount of oxygen, but not enough nutrients for cell survival. B. The cells are getting glucose and other nutrients, but not oxygen. C. The cells are not getting enough oxygen and waste products are accumulating. D. The amount of oxygen to the cells is adequate, but CO2 is not being eliminated.

C. The cells are not getting enough oxygen and waste products are accumulating.

Which of the following is a description of the rule of nines for an adult? Answers: A. The rule of nines assigns 9% to the head and neck, as well as each upper extremity; 10% to the chest, the abdomen, and the upper back; 8% to the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region. B. The rule of nines assigns 9% to the head and neck; 6% to each upper extremity; 12% to the chest and abdomen; 9% to the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region. C. The rule of nines assigns 9% to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region. D. The rule of nines assigns 9% to the head and neck, each upper extremity, the chest, the abdomen, the upper back, and the lower back and buttocks; 8% to the front of each lower extremity; and 10% for the back of each lower extremity, then 1% to the genital region.

C. The rule of nines assigns 9% to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region.

Which of the following BEST describes a partial thickness burn? Answers: A. The skin is white and dry with no sensation of pain. B. The skin is charred or blackened and lacks sensation. C. The skin is red and moist with blister formation. D. The skin is red, but dry and painful.

C. The skin is red and moist with blister formation.

Which of the following statements regarding gunshot wounds is correct? Answers: A. Low-velocity bullets will cause the greatest amount of trauma. B. The size of a bullet has the greatest impact on producing injury. C. The speed of a bullet has the greatest impact on producing injury. D. High-velocity bullets will cause less severe internal injuries.

C. The speed of a bullet has the greatest impact on producing injury.

Which one of the following statements about voluntary muscles is true? Answers: A. They have the ability to cause movement by extending. B. They comprise less mass in the body than involuntary muscles. C. They generally connect to the skeletal system. D. They are mostly located on the torso of the body.

C. They generally connect to the skeletal system.

Which of the following is the correct sequence for securing the straps on a long spine board? Answers: A. Head, legs, torso B. Head, torso, legs C. Torso, legs, head D. Legs, torso, head

C. Torso, legs, head

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

C. Use a material that is wide and thick.

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? Answer: A. Lymphatic B. Capillary C. Venous D. Arterial

C. Venous

Rough handling of a patient with severe hypothermia may result in which of the following? Answers: A. Heart attack B. Seizures C. Ventricular fibrillation D. Rewarming shock

C. Ventricular fibrillation

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: Answers: A. suspect a severe hemopneumothorax. B. perform a secondary assessment. C. aggressively manage his airway. D. request a paramedic ambulance.

C. aggressively manage his airway.

An epidural hematoma is MOST accurately defined as: Answers: A. bleeding between the dura mater and brain. B. an injury caused by a damaged cerebral artery. C. bleeding between the skull and dura mater. D. venous lacerations that occur within the brain.

C. bleeding between the skull and dura mater.

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

C. cervical, thoracic, lumbar, sacral, and coccygeal.

Perfusion is MOST accurately defined as the: Answers: A. effective transfer of oxygen from the venules across the systemic capillary membrane walls. B. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs. D. effective removal of carbon dioxide and other metabolic waste products from the body's cells.

C. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

When assessing a patient with a possible fracture of the leg, the EMT should: Answers: A. carefully move it to elicit crepitus. B. ask the patient to move the injured leg. C. compare it to the uninjured leg. D. assess proximal circulation.

C. compare it to the uninjured leg.

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has: Answers: A. internal hemorrhage. B. a severe closed fracture. C. compartment syndrome. D. damage to the radial nerve.

C. compartment syndrome.

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? Answers: A. blood accumulation in the pleural space B. hidden bleeding in the thoracic cavity C. compression of the aorta and vena cava D. a total collapse of the affected lung

C. compression of the aorta and vena cava

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

C. direct pressure using dry, sterile dressings.

An 18-year-old male patient was struck in the head by a palette of concrete blocks being moved by a crane at a construction site. He has a large laceration to the left side of his head and noted instability to the skull beneath the wound, with moderate bleeding occurring. His airway is open, his breathing is adequate, and his pulse is strong and regular. Proper care for this patient should include: Answers: A. rapid transport in an upright position. B. insertion of a nasal airway. C. dressing over top of the laceration. D. positive pressure ventilation.

C. dressing over top of the laceration.

The most common form of a hemostatic agent is hemostatic: Answers: A. powders. B. tourniquet. C. dressings. D. granules.

C. dressings.

When assessing a patient, you note a bruise to his chest. On the prehospital care report, this injury is properly documented as: Answers: A. hematoma. B. erythematic. C. ecchymosis. D. cyanosis.

C. ecchymosis.

Traction splints are used primarily to immobilize and secure fractures of the: Answers: A. humerus. B. pelvis. C. femur. D. hip.

C. femur.

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: Answers: A. hypernatremia. B. heat cramps. C. heat exhaustion. D. myocardial infarction.

C. heat exhaustion

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: Answers: A. perform a rapid secondary assessment. B. straighten his arm and apply a board splint. C. immobilize the injury with a sling and swathe. D. place a pillow under his arm and apply a sling.

C. immobilize the injury with a sling and swathe.

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

C. liver

An unresponsive patient has been ejected from a car as it rolled at a high rate of speed. The primary assessment is complete and you are providing positive pressure ventilation with high-flow oxygen. The patient has a significant deformity to the right side of his head, and both pupils are equal but slow to react to light. He also has deformity to the forearms. Vital signs are: pulse 144, respirations 24 and inadequate, and blood pressure 90/50 mmHg. Based on this presentation, the EMT should: Answers: A. apply the automated external defibrillator and prepare for possible seizure activity. B. reassess the pupils and treat the patient for a severe head injury. C. look for evidence of bleeding in an area of the body other than the brain. D. splint both arms and reassess the vital signs prior to departing the scene.

C. look for evidence of bleeding in an area of the body other than the brain.

A teenage male has fallen onto a railing while skateboarding. He complains of right-sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. You should: Answers: A. cover the wound with an occlusive dressing. B. apply a bulky dressing over the section. C. monitor the patient for adequate ventilation. D. begin positive pressure ventilation.

C. monitor the patient for adequate ventilation.

A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a: Answers: A. ruptured aorta. B. tension pneumothorax. C. myocardial contusion. D. pericardial tamponade.

C. myocardial contusion.

The MOST common and significant complication associated with fractures or dislocations of the knee is: Answers: A. ligament and cartilage damage. B. total depletion of synovial fluid. C. neurovascular compromise. D. internal bleeding and shock.

C. neurovascular compromise.

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. Answers: A. transverse B. comminuted C. pathologic D. greenstick

C. pathologic

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: Answers: A. anterior hip dislocation. B. a thoracic spine fracture. C. posterior hip dislocation. D. fracture of the tibia or fibula.

C. posterior hip dislocation.

A "hip" fracture is actually a fracture of the: Answers: A. pubic symphysis. B. femoral shaft. C. proximal femur. D. pelvic girdle.

C. proximal femur.

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

C. 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: Answers: A. quickly immobilizing her spinal column. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. requesting a paramedic ambulance.

C. rapidly transporting her to the hospital.

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should: Answers: A. perform a secondary assessment. B. assess the quality of her pulse. C. repeat the primary assessment. D. begin assisting her ventilations.

C. repeat the primary assessment.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: Answers: A. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing. B. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. C. replace the avulsed flap to its original position and cover it with a sterile dressing. D. carefully probe the wound to determine if the bleeding is venous or arterial.

C. replace the avulsed flap to its original position and cover it with a sterile dressing.

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

C. retina.

The pectoral girdle consists of the: Answers: A. clavicles and rib cage. B. sternum and scapulae. C. scapulae and clavicles. D. acromion and clavicles.

C. scapulae and clavicles.

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. Answers: A. strain B. dislocation C. sprain D. fracture

C. sprain

Skeletal muscle is also referred to as __________ muscle. Answers: A. connective B. smooth C. striated D. involuntary

C. striated

Deformity caused by a fracture would MOST likely be masked by: Answers: A. crepitus. B. ecchymosis. C. swelling. D. guarding.

C. swelling.

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? Answers: A. asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta B. fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia C. ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle D. collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest

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

When assessing an elderly patient who fell, it is important to remember that: Answers: A. bilateral hip fractures usually occur when an elderly person falls. B. any fall in the elderly is considered to be high-energy trauma. C.osteoporosis can cause a fracture that may have resulted in the fall. D. elderly patients who fall usually have a secondary head injury.

C.osteoporosis can cause a fracture that may have resulted in the fall.

The EMT showed that he understands the difference between a pneumothorax and a tension pneumothorax when he made which one of the following statements? Answers: A. "A tension pneumothorax causes blood to accumulate around the lung; a pneumothorax involves the accumulation of air only around the lung." B. "A pneumothorax is caused by a closed chest injury; a tension pneumothorax is caused by an open chest injury." C. "A pneumothorax describes a collapsed lung; a tension pneumothorax involves both a collapsed lung and blood loss." D. "A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output."

D. "A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output."

Your patient is a young female, who was thrown from a horse and is now confused. Assessment findings include an open airway, adequate breathing, and a strong radial pulse. Her vital signs are normal. Which one of the following questions would be the most important to ask her mother, who was riding with her? Answers: A. "Is she allergic to anything?" B. "Are all of her immunizations up to date?" C. "Has she ever needed to be hospitalized for injuries before?" D. "Did she lose consciousness?"

D. "Did she lose consciousness?"

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? Answer: A. "My blood pressure sometimes runs a little high." B. "I drank a lot of alcohol last night." C. "I take steroids for my lung disease." D. "I take Coumadin for my irregular heartbeat."

D. "I take Coumadin for my irregular heartbeat."

A 28-year-old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual in-line stabilization. Based on these assessment findings, which one of the following instructions should you provide to the EMRs? Answer: A. "Let's go ahead and move him to the stretcher for immediate transport to the hospital." B. "Do not cover him with a blanket since that will cause his blood vessels to dilate and drop his BP." C. "Since he is unresponsive, let's go ahead and open the airway with the head tilt-chin lift." D. "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

D. "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

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? Answers: A. "Take some sterile gauze and carefully place it inside the open wound to prevent potential bleeding." B. "Do not worry about covering the wound, just place a cervical collar on him and carefully transfer him to the long board." C. "Apply a sterile dressing over the wound and hold it in place by wrapping roller gauze around his neck." D. "Place an occlusive dressing over the wound and tape on all four sides."

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

In the average adult, the sudden loss of ________ cc of blood is considered serious. Answers: A. 750 B. 150 C. 500 D. 1,000

D. 1,000

What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts? Answers: A. 12 B. 15 C. 13 D. 14

D. 14

Of the following patients, which injury is the highest priority to receive bag-valve-mask ventilations? Answers: A. 70-year-old male who struck his head when he fell in the parking lot, has a large laceration on his forehead, and is disoriented B. 25-year-old male who regained consciousness one or two minutes after being struck on the head by a baseball bat and is now asking repetitive questions C. 25-year-old female victim of battery who is awake but complains of a headache and has bloody fluid draining from her nose and left ear D. 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli

D. 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli

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

D. 1″ posterior to the external opening of the ear.

Who is the most susceptible to hypothermia? Answers: A. 55-year-old male patient who sprained his knee snow skiing B. 76-year-old male patient involved in a vehicle accident on icy roads C. 80-year-old male patient on the ground who slipped and has a hip fracture D. 21-year-old near-drowning patient on a warm spring day

D. 21-year-old near-drowning patient on a warm spring da

The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss. Answers: A. 0.5 B. 1 C. 5 D. 3

D. 3

Which of the following is NOT a type of avulsion? Answers: A. The skin is stripped off the hand, like removing a glove. B. An ear is partially torn away from the head. C. The skin is partially torn away from the foot. D. A finger is cut off with a butcher's saw.

D. A finger is cut off with a butcher's saw.

You have been dispatched for a patient whose arm was caught in a grinding machine. Assessment reveals a deformed arm covered with a bloody towel. The patient is alert and anxious, and he has a patent airway. His breathing is adequate. Radial pulse is fast but strong. Which one of the following should you do next? Answer: A. Insert an oropharyngeal airway and administer oxygen. B. Start positive pressure ventilation. C. Perform a secondary assessment focusing on his arm. D. Administer oxygen through a nonrebreather mask.

D. Administer oxygen through a nonrebreather mask.

While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop? Answers: A. Deep vein embolus B. Air thrombosis C. Deep vein thrombosis D. Air embolus

D. Air embolus

A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat? Answers: A. Airway obstruction B. Cervical spine trauma C. Brain injury D. All of the above

D. All of the above

Which of the following injuries requires the use of an occlusive dressing? Answers: A. Open wound to the neck B. Open wound to the chest C. Open wound to the abdomen from which a loop of intestine is protruding D. All of the above

D. All of the above

Which of the following is a consideration in determining a burn's severity? Answers: A. Body surface area (BSA) involved in the burn B. The type of agent that caused the burn C. Other illnesses or injuries the patient may have D. All of the above

D. All of the above

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

D. All of the above

Which of the following may be a hazard of an improperly fitting cervical collar? Answers: A. Allows flexion of the neck B. Allows hyperextension of the neck C. Prevents the patient from opening his mouth D. All of the above

D. 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? Answers: A. Damage to internal organs B. Shock C. Damage to the nerves of the lower extremities D. All of the above

D. All of the above

Although it can be difficult to definitively determine hip dislocation in the field, certain signs and symptoms are usually there. Which of the following statements is false? Answers: A. Often there is lack of sensation in the limb. B. The posterior hip dislocation is the most common. C. A posterior hip dislocation presents with a bent knee and the foot may hang loose. D. An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed.

D. An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed.

Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following? Answers: A. Practice outside the scope of practice in order to provide the greatest good. B. Respond above and beyond the call of duty. C. Provide the best quality care possible, including definitive care on-scene. D. Anticipate and treat problems with a greater level of complexity than usual

D. Anticipate and treat problems with a greater level of complexity than usual

Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound? Answers: A. Elevation of the wound above the level of the heart B. Application of a dry, sterile dressing C. Keeping the site clean D. Application of antibiotic ointment

D. Application of antibiotic ointment

You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-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. Which is the best treatment for the patient? Answers: A. Have the patient sip water slowly to replace what he has lost. B. Have the patient drink at least 1 liter of water to replace what he has lost. C. Cool the patient with tepid water. D. Apply high-concentration oxygen and rapidly transport to the nearest medical facility.

D. Apply high-concentration oxygen and rapidly transport to the nearest medical facility.

You are on the scene of a 50-year-old male who lacerated his arm on a sheet of plate glass. He is pale, diaphoretic, and mumbling incoherently. You have controlled an arterial bleed with direct pressure. His blood pressure is 70/40, pulse 120, and respiratory rate of 28. Which of the following signs is the most concerning? Answers: A. Tachycardia B. Respiratory rate C. Altered mental status D. Blood pressure

D. Blood pressure

If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute? Answers: A. Use a rope tie-down to make a tourniquet B. Air or vacuum splint C. Ice packs tied in place with triangle bandage D. Blood pressure cuff

D. Blood pressure cuff

Your patient is a 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the BEST way to manage this situation? Answers: A. Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands. B. Brush away the powder and bandage the hands in a position of function. C. Have the fire department connect to a hydrant and spray down the patient from head to toe. D. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.

D. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.

The phrenic nerves control the diaphragm and exit the spinal cord at: Answers: A. C1, C2, and C3. B. C1 and C2. C. C3 and C4. D. C3, C4, and C5.

D. C3, C4, and C5.

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

D. linear

Which of the following allows for smooth movement of bone surfaces against one another at joints? Answers: A. Smooth muscle B. Ligaments C. Peritoneum D. Cartilage

D. Cartilage

Which of the following is NOT considered soft tissue? Answers: A. The skin B. Muscles C. Membranes D. Cartilage

D. Cartilage

A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder, it "pops back into place." What should your next step be? Answers: A. Contact medical control for input into the best treatment for this patient. B. Check distal CSM, apply a traction splint, and transport the patient. C. Continue splinting and report the popping sound to the triage nurse when you arrive at the hospital. D. Check distal CSM, apply a sling and swathe, and transport the patient.

D. Check distal CSM, apply a sling and swathe, and transport the patient.

You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions? Answers: A. Cardiac tamponade B. Aortic dissection C. Tension pneumothorax D. Commotio cordis

D. Commotio cordis

In addition to lacerations, blunt trauma resulting in a closed chest injury creates the potential for which of the following internal injuries? Answers: A. Abrasion B. Evisceration C. Avulsion D. Contusion

D. Contusion

You suspect that a patient involved in a motor-vehicle collision is in shock. As a knowledgeable EMT, you know that which one of the following signs and symptoms of shock will be observed last? Answer: A. Pale and diaphoretic skin B. Tachycardia C. Increased respirations D. Decreased blood pressure

D. Decreased blood pressure

When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move? Answers: A. EMT at the heaviest portion of the patient B. EMT with the most seniority C. EMT with the highest level of training D. EMT at the head of the patient

D. EMT at the head of the patient

Which of the following BEST describes a localized cold injury with a clear line of demarcation of its limits? Answers: A. Late frostbite B. Immersion foot C. Deep frostnip D. Early frostnip

D. Early frostnip

Based on the following presentations of patient injuries, which one would be considered MOST severe, justifying immediate transportation to a trauma center? Answers: A. Closed head injury B. Open (compound) midshaft femur fracture c. Midline cervical spine pain D. Flail chest

D. Flail chest

Which one of the following statements is NOT true concerning a knee injury? Answers: A. Fractures can occur to the patella. B. Fractures can occur to the proximal tibia and fibula. C. There could be pain and tenderness. D. Fractures can occur to the proximal femur.

D. Fractures can occur to the proximal femur.

You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center. However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform next? Answers: A. Begin providing CPR to the patient. B. Call dispatch for an ALS intercept en route to the hospital. C. Begin providing BVM-assisted ventilations to the patient. D. Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. And re-seal the wound

D. Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. And re-seal the wound

A burn extending into the subcutaneous fat would be classified as which type of burn? Answers: A. Superficial B. Superficial partial thickness C. Deep partial thickness D. Full thickness

D. Full thickness

You are called for an 8-year-old boy who has fallen. On scene the boy's mother states that he was running while flying a kite and tripped, striking his face on a rock. Assessment reveals a large reddish-blue lump with intact skin under his left eye. When alerting the hospital emergency department of your arrival, you should inform them that the patient has what type of injury? Answers: A. Evisceration B. Ecchymosis C. Contusion D. Hematoma

D. Hematoma

A 45-year-old female was at a family reunion and fell off a trampoline. She impacted a picnic table with the left side of her lower rib cage and is very anxious and confused. Her airway is open, and her breathing is adequate. Her radial pulse is rapid and weak and her skin is cool and diaphoretic. Vital signs are: pulse 132, respirations 20, blood pressure 102/78 mmHg, and SpO 2 at 97%. She has ecchymosis to the left lower rib area as well as tenderness and instability. She also has a superficial abrasion to her forehead. Given these findings, you should suspect and treat her for what condition? Answers: A. Hypoxia B. Closed head injury C. Spinal shock D. Hypovolemic shock

D. Hypovolemic shock

Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is NOT true? Answers: A. You should always check for a distal pulse. B. The lack of a distal pulse could be a signal of a real emergency. C. In a knee dislocation, the tibia is forced anteriorly or posteriorly in relation to the distal femur. D. In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced.

D. In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced.

Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be MOST appropriate? Answers: A. Insert an oropharyngeal airway and give oxygen by nonrebreather mask at 10 lpm. B. Insert a nasopharyngeal airway and give oxygen by nonrebreather mask (NRB) at 15 lpm. C. Insert an oropharyngeal airway (OPA) and ventilate via bag-valve mask (BVM) at 30 breaths per minute. D. Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.

D. Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.

You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find the 16-year-old patient unresponsive with agonal respirations and a weak carotid pulse. What is your first action? Answers: A. Insert a Combitube. B. Apply high-concentration oxygen by nonrebreather mask. C. Apply high-concentration oxygen by bag-valve mask. D. Insert an oropharyngeal airway.

D. Insert an oropharyngeal airway.

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

D. It can be profuse, but is generally easily controlled.

Which of the following BEST describes the function of blood? Answers: A. It clots, flows, transports, protects, and excretes on a daily basis. B. It flows from the heart with the vital gases and nutrients to maintain lack of perfusion. C. It is a life-giving liquid that supports all the body's functions to maintain hypoperfusion. D. It transports gases along with nutrients, aids in excretion, and provides protection and regulation.

D. It transports gases along with nutrients, aids in excretion, and provides protection and regulation.

A 49-year-old male was climbing on a truck at a construction site when he fell backward to the ground. He presents with a two-inch linear wound to the top of his head. Bleeding has been controlled and the skull can be seen through the wound. How should you document this injury on the prehospital care report? Answers: A. Crush B. Avulsion C. Contusion D. Laceration

D. Laceration

The technique for central rewarming requires the application of heat to which of the following areas of the patient's body? Answers: A. Head, neck, chest, and back B. Chest, back, neck, and armpits C. Head, neck, chest, and groin D. Lateral chest, neck, armpits, and groin

D. Lateral chest, neck, armpits, and groin

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? Answers: A. Pancreas B. Intestines C. Kidneys D. Liver

D. Liver

A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site? Answers: A. The nail is less than 2 inches in length. B. Bleeding from the wound is minimal. C. The patient's distal pulse, motor function, and sensation are intact. D. None of the above

D. None of the above

You have been called by family members for their mother who is "not acting right." On scene the family informs you that they are concerned because their 68-year-old mother has been complaining of a headache and today is very confused. Assessment reveals a bruise to the right side of the head that family states occurred one week ago when she fell in church. Since all other aspects of the assessment are normal, you suspect a head injury. Which condition would make the most sense given these findings and history? Answers: A. Cerebral contusion B. Concussion C. Scalp laceration D. Occult subdural hematoma

D. Occult subdural hematoma

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? Answers: A. Partial fracture B. Closed fracture C. Laceration D. Open fracture

D. Open fracture

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

D. Open wound of the abdomen from which organs protrude

When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what "six Ps"? Answers: A. Pain, pallor, paresthesia, pulses, placement, and pressure B. Pain, pallor, position, pulses, placement, and pressure C. Pain, pallor, position, pulses, placement, and pad D. Pain, pallor, paresthesia, pulses, paralysis, and pressure

D. Pain, pallor, paresthesia, pulses, paralysis, and pressure

Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following BEST describes his level of consciousness? Answers: A. Verbal B. Unresponsive C. Alert D. Painful

D. Painful

You have just arrived on the scene of a very serious motor-vehicle collision. Emergency Medical Responders (EMRs) have rapidly extricated an unresponsive female from the driver's seat. The EMRs report that she was unrestrained and struck the steering wheel with her chest and abdomen. As you start the primary assessment, you note that she has snoring respirations and is breathing shallowly at a rate of 24 breaths per minute. Which one of the following should you do next? Answers: A. Obtain her vital signs. B. Start positive pressure ventilation. C. Immobilize her to the backboard. D. Perform a jaw-thrust maneuver.

D. Perform a jaw-thrust maneuver.

Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level? Answers: A. Osmosis B. Circulation C. Hydrostatic pressure D. Perfusion

D. Perfusion

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? Answer: A. Careful place a nasopharyngeal airway. B. Gently place rolled sterile gauze into the nostrils. C. Lightly pinch the patient's nostrils shut. D. Place a loose dressing under the nose.

D. Place a loose dressing under the nose.

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? Answers: A. Getting a description of the assailants B. The swelling around his eyes, which may be reduced by applying a cold pack C. The presence of any defensive wounds the patient may have sustained D. Potential internal injuries

D. Potential internal injuries

What is the most important intervention an EMT can perform for an unstable multisystem trauma patient? Answers: A. Oxygen B. Cervical spine precautions C. Airway management D. Rapid transport

D. Rapid transport

You suspect a trauma patient to be suffering from a hemothorax to the left lung. Which one of the following assessment findings should reinforce your suspicion? Answers: A. Neck vein distention and absent breath sounds to the right lung B. Bradycardia and hypertension C. Cyanosis and a blood pressure of 210/100 mmHg D. Respiratory distress and the signs and symptoms of shock

D. Respiratory distress and the signs and symptoms of shock

Which of the following is recommended when caring for an amputated part? Answers: A. Always transport the amputated part with the patient. B. Wrap the part in aluminum foil to preserve body temperature. C. Rinse away debris with saline solution and place the part in a container of ice. D. Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.

D. Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.

Which of the following is an accurate definition of a flail chest? Answers: A. Lung that has been punctured by a fractured rib, resulting in a buildup of air B. Fracture of at least four ribs in two or more places C. Fracture of one rib in two or more consecutive places D. Section of the chest wall that is unstable, leading to breathing problems

D. Section of the chest wall that is unstable, leading to breathing problems

A woman has fallen from a second-story window onto the concrete sidewalk below. She is unresponsive and has deformity noted to the back and top of her skull. Additional assessment findings include abdominal bruising and an angulated left ankle. Your partner reports that the patient's vital signs are: pulse 68, respirations 14 and irregular, blood pressure 198/110 mmHg, and SpO 2 at 91%. Based on these assessment findings, which one of the following should the EMT recognize? Answers: A. Shock caused by bleeding occurring within the skull B. History of high blood pressure for which prescribed medications have not been taken C. Shock caused by bleeding in an area of the body other than the head D. Severe head injury with increasing pressure within the skull

D. Severe head injury with increasing pressure within the skull

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

D. Severe swelling and redness at a midshaft femur

Which one of the following is NOT a key decision for the EMT when faced with a multisystem or multiple trauma patient? Answers: A. Do I need to minimize on-scene time? B. Should I transport to a trauma center? C. Is the patient seriously injured? D. Should I allow police to interview the patient on-scene?

D. Should I allow police to interview the patient on-scene?

You have arrived on the scene of an assault involving a knife. Assessment of the unresponsive 21-year-old male reveals him to have sustained multiple lacerations to the arms and abdomen, with a section of his intestine protruding through a large laceration to the area around the umbilicus. He has lost a significant amount of blood. His airway is open and he is breathing shallowly at a rate of 28. His radial pulse is weak, and his skin is cool and pale. Which one of the following should the EMT do first? Answers: A. Cover the intestine with saline soaked gauze. B. Check the blood pressure. C. Immobilize to a long board. D. Start positive pressure ventilation.

D. Start positive pressure ventilation.

Which of the following is an injury to the musculature of an extremity? Answers: A. Luxation B. Sprain C. Fracture D. Strain

D. Strain

A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also observe bruising to the chest and abdomen. Which one of the following should you do immediately? Answer: A. Administer high-concentration oxygen. B. Determine the blood pressure. C. Evaluate for shock. D. Suction the airway.

D. Suction the airway.

You respond to a professional volleyball tournament for a potential heatstroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping? Answers: A. Cooling off too quickly B. Heat exhaustion C. Drinking too many sports drinks D. Sweating too much

D. Sweating too much

You are examining a 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this mean? Answers: A. You can only use the rule of palm for children, so you would use the rule of nines instead. B. The palm of the patient's hand equals 9% of the body's surface area. C. The palm of your hand represents 1% of the body's surface area. D. The palm of the patient's hand equals about 1% of the body's surface area.

D. The palm of the patient's hand equals about 1% of the body's surface area.

You are getting ready to transport an unresponsive 25-year-old female patient. She was hit by a vehicle while crossing the street. She is 26 weeks pregnant. You are 10 minutes away from the nearest facility, 15 minutes away from a Level I Trauma Center, and 15 minutes away from a hospital that specializes in high-risk obstetrics. You should transport the patient to which hospital? Answers: A. The high-risk obstetric hospital: the fetus will need specialized neonatology surgeons B. The trauma center: the fetus will need specialized neonatology surgeons C. The nearest facility: she is unresponsive and unstable D. The trauma center: the patient will need specialized trauma surgeons

D. The trauma center: the patient will need specialized trauma surgeons

The maxillae form which of the following structures? Answers: A. Cheek bones B. Forehead C. Lower jaw D. Upper jaw

D. Upper jaw

A trauma surgeon informs you that the patient you transported to the emergency department earlier was diagnosed with an epidural hematoma. The patient was taken into surgery and the hematoma was removed. Right now the patient is in guarded condition. Based on this information, the EMT should recognize that an epidural hematoma is: Answers: A. cerebral spinal fluid accumulated in a pocket on top of the brain tissue. B. blood from a ruptured vein collected between the dura mater and brain tissue. C. blood from a ruptured artery forming a hematoma within a section of brain tissue. D. a pocket of arterial blood collected between the skull and dura mater.

D. a pocket of arterial blood collected between the skull and dura mater.

If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply: Answers: A. a splint and elevate the extremity. B. additional sterile dressings. C. digital pressure to a proximal artery. D. a tourniquet proximal to the injury.

D. a tourniquet proximal to the injury.

An open pneumothorax occurs when: Answers: A. extreme pleural pressure causes the lung to rupture. B. a fractured rib perforates the tissue of the lung. C. air enters the pleural space from a perforated lung. D. air enters the pleural space from outside the body.

D. air enters the pleural space from outside the body.

When treating a partial-thickness burn, you should: Answers: A. immerse the affected part in warm water. B. rupture any blisters to prevent an infection. C. cover the burn with a moist, sterile dressing. D. avoid the use of creams, lotions, or antiseptics.

D. avoid the use of creams, lotions, or antiseptics.

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: Answers: A. a lacerated liver or spleen. B. a ruptured urinary bladder. C. external genitalia injury. D. blunt injury to the kidney.

D. blunt injury to the kidney.

A fracture is MOST accurately defined as a(n): Answers: A. disruption in the midshaft of a bone. B. total loss of function in a bone. C. abnormality in the structure of a bone. D. break in the continuity of the bone

D. break in the continuity of the bone

When caring for a patient whose arm is covered with a dry chemical, you should: Answers: A. deactivate the chemical with a 5% vinegar solution. B. use forceful streams of water to remove the chemical. C. quickly irrigate the arm with large amounts of water. D. brush away the chemical before flushing with water.

D. brush away the chemical before flushing with water.

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): Answers: A. intracerebral hematoma. B. intracranial hemorrhage. C. cerebral contusion. D. cerebral concussion.

D. cerebral concussion.

Which of the following is a severe burn in a 35-year-old patient? Answers: A. superficial burn covering 50% of the BSA B. full-thickness burn to 5% of the body surface area (BSA) C. partial-thickness burn to 20% of the BSA D. circumferential partial-thickness burn to the chest

D. circumferential partial-thickness burn to the chest

The frontal and parietal bones of the skull are especially susceptible to: Answers: A. nondisplaced skull fractures. B. linear skull fractures. C. basilar skull fractures. D. compressed skull fractures.

D. compressed skull fractures.

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

D. constricted pupils.

An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n): Answers: A. avulsion. B. abrasion. C. concussion. D. contusion.

D. contusion.

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

D. deformity.

Burns are classified according to: Answers: A. location and pain. B. degree and location. C. extent and location. D. depth and extent.

D. depth and extent.

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. Answers: A. greenstick B. metaphyseal C. diaphyseal D. epiphyseal

D. epiphyseal

A patient rescued from an apartment fire has sustained partial- and full-thickness burns from his chest down to his feet. The EMT should recognize that this patient is prone to develop: Answers: A. hyperthermia. B. hypoglycemia. C. hypertension. D. hypothermia.

D. hypothermia.

Functions of dressings and bandages include all of the following, EXCEPT: Answers: A. prevention of contamination. B. protection from further injury. C. control of external hemorrhage. D. immobilization of the injury.

D. immobilization of the injury.

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: Answers: A. applying a traction splint to immobilize her femur. B. carefully splinting each of her deformed extremities. C. applying and inflating the pneumatic antishock garment (PASG) and transporting. D. immobilizing her to a backboard and rapidly transporting.

D. immobilizing her to a backboard and rapidly transporting.

A patient sustained a crush injury after being struck with a baseball bat in the left upper quadrant of the abdomen. Assessment shows bruising to that area with instability noted to the rib cage. The EMT's highest concern regarding this injury should be: Answers: A. abdominal evisceration. B. fractured ribs. C. abdominal contusion. D. injury to the spleen.

D. injury to the spleen.

In contrast to a cerebral concussion, a cerebral contusion: Answers: A. does not cause pressure within the skull. B. results from a laceration to the brain tissue. C. usually does not cause a loss of consciousness. D. involves physical injury to the brain tissue.

D. involves physical injury to the brain tissue.

Bones are connected to other bones by bands of tough fibrous tissues called: Answers: A. tendons. B. cartilage. C. bursa. D. ligaments.

D. ligaments.

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: Answers: A. coccygeal spine. B. symphysis pubis. C. thoracic spine. D. lumbar spine.

D. lumbar spine.

Placing a pregnant patient in a supine position during the third trimester of pregnancy: Answers: A. often causes hypotension secondary to cardiac compression. B. results in spontaneous urinary incontinence if the bladder is full. C. is recommended if the patient has severe abdominal discomfort. D. may decrease the amount of blood that returns to the heart.

D. may decrease the amount of blood that returns to the heart.

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: Answers: A. call for a paramedic ambulance. B. begin rapid transport at once. C. begin ventilatory assistance. D. partially remove the dressing.

D. partially remove the dressing.

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: Answers: A. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. B. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. C. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg. D. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

D. 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: Answers: A. defer cervical collar placement to avoid discomfort. B. place the child's head in a slightly extended position. C. secure the head prior to securing the torso and legs. D. place padding under the child's shoulders as needed.

D. place padding under the child's shoulders as needed.

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: Answers: A. apply bulky dressings to the sternum. B. determine if he has cardiac problems. C. apply an automated external defibrillator (AED) and take his blood pressure. D. prepare for immediate transport.

D. prepare for immediate transport.

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: Answers: A. a detailed assessment of his abdomen. B. applying oxygen via nasal cannula. C. performing a focused physical exam. D. preparing for immediate transport.

D. preparing for immediate transport.

Hypoperfusion is another name for: Answers: A. cellular death. B. cyanosis. C. hypoxemia. D. shock.

D. shock.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: Answers: A. weak. B. irregular. C. rapid. D. slow.

D. slow.

Assessment findings on a 33-year-old female who has been shot in the right side of the chest indicate that she is suffering from a pneumothorax. During your reassessment, your primary concern is monitoring the injury for: Answers: A. arterial bleeding. B. sucking sound at the wound site. C. infection at the wound site. D. tension pneumothorax.

D. tension pneumothorax.

External bleeding from a vein is relatively easy to control because: Answers: A. veins carry deoxygenated blood. B. blood typically oozes from a vein. C. veins hold smaller blood volume. D. veins are under a lower pressure.

D. veins are under a lower pressure.

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): Answers: A. compression fracture. B. distraction injury. C. extension injury. D. whiplash injury.

D. whiplash injury.

GCS scoring rubric

Eyes: 4- opens spontaneous 3- opens to voice 2- opens to pian 1- none Verbal: 5-oriented 4-confused 3-inappropriate words 2-inappropriate sounds 1-none Motor: 6-obeys commands 5- localizes pain 4- withdraws from pain 3- flexion-decorticate posturing 2-extension-decerebrate posturing 1-none

how does evaporation cause heat loss

Occurs when the body perspires or gets wet

heath exhaustion

Prolonged exposure to excessive heat can create an emergency in which the patient presents with moist, pale skin that may feel normal or cool to the touch

radiation

The body's atoms and molecules send out rays of heat as they move and change.

convection

When currents of air or water pass over the body, carrying away heat,

how does respiration cause heat loss

causes loss of body heat as a result of exhaled warm air

Decerebrate posture

extendign hte arms with shoulders rotated inward, wrists flexed, and legs extended

Decorticate posturing

flexng hte arms and wrists and extending legs and feet

% burn for infant

head and neck: 18% chest and abd: 18% back: 18% RUE: 9% LUE: 9% RLE: 14% LLE: 14% genital: 1%

% burn for adult

head and neck: 9% chest:9% abd: 9% upper back: 9% lower back and butt: 9% LUE: 9% RUE: 9% front LLE: 9: front RLE: 9% back LLE: 9% back RLE: 9% gentals: 1%

Cheyne-Stokes breathing

tachypnea or quickening and deepening breathing pattern followed by apnea