Trauma Systems, Blunt and Penetrating

At what depth do most divers experience nitrogen narcosis? a. 70 to 100 feet b. 60 to 70 feet c. 200 to 250 feet d. 300 to 350 feet

a. 70 to 100 feet

Which of the following is TRUE of shotgun ammunition? a. A shotgun may either fire one slug or use ammunition with multiple pellets. b. The shot is dispersed from the cartridge with high velocity. c. The closer the shooter is to the victim, the larger the area of visible damage. d. "Double ought" or #00 shot contains a large number of relatively small pellets.

a. A shotgun may either fire one slug or use ammunition with multiple pellets.

Which of the following patients is NOT a candidate for air medical transport? a. Combative trauma patient b. Seriously injured patient with cardiac tamponade c. Patient with prolonged extrication time d. Burn patient with over 50 percent second-degree burns

a. Combative trauma patient

Which of the following is NOT true of trauma triage criteria? a. For patients who meet trauma triage criteria, the appropriate facility is the largest trauma center in your region. b. Assessment of vital signs/level of consciousness, anatomy of injury, mechanism of injury, and age of the patient are key elements of trauma triage criteria. c. Trauma triage criteria are geared to help you formulate an index of suspicion when making decisions about your trauma patient. d. Trauma triage criteria are guidelines to help you determine whether your patient needs transport to a trauma center.

a. For patients who meet trauma triage criteria, the appropriate facility is the largest trauma center in your region.

Which type of motor vehicle collision is most common in rural areas? a. Frontal b. Lateral c. Rollover d. Rear-end

a. Frontal

Which level of trauma facility has minimal surgical support but can stabilize before transferring to a higher-level trauma facility? a. III b. II c. IV d. I

a. III

The passage through tissue of a high-energy bullet creates a temporary cavity and a permanent cavity. Which of the following statements is TRUE of the permanent cavity created by penetrating trauma? a. It is filled with disrupted tissues, some air, fluid, and debris. b. It is the damage done when the projectile fragments penetrate. c. It is a space created by a projectile as tissue moves rapidly away in its path. d. It is a potential space, not an actual space.

a. It is filled with disrupted tissues, some air, fluid, and debris.

Your patient is a 30-year-old female with a stab wound to the neck. She is sitting up and appears very anxious and short of breath. There is minimal external bleeding noted, but there is bubbling from the wound. Which of the following should you suspect, based on the mechanism of injury and assessment findings? a. Laceration of the trachea b. An injury to the spinal cord at the level of the stab wound c. Laceration of the ipsilateral carotid artery d. All of the above

a. Laceration of the trachea

Which of the following accounts for the highest number of trauma deaths in the United States of America? a. Motor vehicle crashes b. Falls c. Assaults d. Firearms injuries

a. Motor vehicle crashes

You are dispatched to a building collapse with an entrapped patient who will require a lengthy extrication. Which of the following medications should you consider for this patient while awaiting extrication? a. Sodium bicarbonate b. Diazepam c. Furosemide d. Calcium channel blockers

a. Sodium bicarbonate

Your patient is a 60-year-old male with a gunshot wound in the second intercostal space anteriorly on the left. You note that he has frothy blood coming from his mouth. For which of the following must you have the highest index of suspicion? a. Tension pneumothorax b. A history of congestive heart failure c. Pericardial tamponade d. Traumatic asphyxia

a. Tension pneumothorax

Which of the following injuries is NOT associated with the use of vehicle restraint systems? a. Traumatic brain injury b. Abrasions and contusions to the clavicle and chest area c. Lumbar spine trauma d. Abdominal injury

a. Traumatic brain injury

Which of the following physical findings indicates the need for immediate transport? a. Vital signs: systolic blood pressure 80, respiratory rate 8 b. Glasgow Coma Scale Score of 15 c. Second-degree burns involving 9 percent of total body surface area in an adult patient d. Fractured right femur

a. Vital signs: systolic blood pressure 80, respiratory rate 8

You have responded to a soccer field on which two 13-year-olds have collided during a game. Which of the following findings in either patient requires ambulance transport for further evaluation in the emergency department? a. Weakness in the upper extremities b. Complaint of "getting the wind knocked out of me" c. Contusion to the thigh d. Minor epistaxis

a. Weakness in the upper extremities

To gain an appreciation for the potential for trauma from high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to ________ times. a. 25 b. 100 c. 50 d. 80

b. 100

Which of the following statements about stab wounds is TRUE? a. The presence of defense wounds decreases the likelihood of trauma to the neck, thorax, and abdomen. b. Damage is usually limited to physical injury caused by direct contact between the blade and the victim's tissue. c. The size and shape of the weapon allow precise prediction of the injury. d. Stab wounds by female attackers are seldom lethal.

b. Damage is usually limited to physical injury caused by direct contact between the blade and the victim's tissue.

Modern medicine treats trauma as a ________. a. Crisis b. Disease c. Life threat d. Medical problem

b. Disease

People in which of the following age groups are prone to significant trauma due to falls? a. College-aged adults b. Geriatric population c. Pediatric population d. Teenagers

b. Geriatric population

Which of the following injuries is most likely in a rear-end collision? a. Thoracic and abdominal injuries b. Head and neck injuries c. Pelvic fractures d. Lumbar spine injuries

b. Head and neck injuries

Which of the following acts resulted in the development of modern EMS systems? a. Ryan White Act b. Highway Safety Act of 1966 c. Good Samaritan Act d. The Trauma Care Systems Planning and Development Act of 1990

b. Highway Safety Act of 1966

Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns? a. Traumatic brain injury b. Hip and femur fractures c. Rupture of the diaphragm d. Rupture of hollow organs

b. Hip and femur fractures

Upon arriving on a scene where the mechanism of injury indicates a potentially life-threatening injury, you should employ which of the following interventions to BEST help deliver the care that is needed? a. Reevaluate the scene size-up. b. Initiate transport immediately, delaying more extensive care until you are en route. c. Ask a surgeon to respond to the scene. d. Call immediately for air medical transport to reduce the "Golden Period."

b. Initiate transport immediately, delaying more extensive care until you are en route.

Which of the following is most likely to occur when military ammunition is used? a. It will "mushroom" or flatten. b. It will remain intact. c. It will fragment. d. It will explode.

b. It will remain intact.

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision? a. Increased gravitational forces due to multiple changes in direction and velocity b. Lack of a crumple zone c. Taking the up-and-over pathway d. The force of side-impact air bag deployment

b. Lack of a crumple zone

Which of the following best differentiates medical and trauma patient assessment? a. There is no concept for "medical load and go" patients. b. Palpation is frequently not as crucial when assessing the medical patient. c. Scene safety is not an issue with the medical patient. d. Assessing breath sounds is not crucial to trauma assessment.

b. Palpation is frequently not as crucial when assessing the medical patient.

The initial assessment of a patient with a gunshot wound to the chest should focus on detecting which of the following? a. Pancreatitis b. Tension pneumothorax c. Cardiac contusion d. Peritonitis

b. Tension pneumothorax

As the mass of an object increases, which of the following occurs? a. The amount of energy decreases. b. The amount of energy increases. c. The maximum speed it can attain increases. d. The maximum speed it can attain decreases.

b. The amount of energy increases.

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier wall? a. The energy dissipates as sound waves. b. The body of the vehicle and its occupants absorb the energy. c. The wall's foundation absorbs the energy. d. The energy converts to heat through friction.

b. The body of the vehicle and its occupants absorb the energy.

Which of the following statements about lateral impact collisions is TRUE? a. Damage to the vehicle is a reliable indication of the seriousness of injuries. b. The degree of injury may be greater than the damage alone would indicate. c. Fatalities are rare because the upper extremities absorb the energy. d. The substantial lateral crumple zone prevents most injuries.

b. The degree of injury may be greater than the damage alone would indicate.

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a stop? a. Braking allows the kinetic energy to be absorbed evenly into the frame of the vehicle, rather than concentrating it at the point of impact. b. The energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants. c. The inertia of the tree increases the kinetic energy transmitted to the occupants by a factor of 10. d. None of the above describes why.

b. The energy gradually dissipates as heat due to the friction of braking, rather than transferring to the vehicle and its occupants

A vehicle is struck in its right front as it passes through an intersection, resulting in an oblique impact. Which of the passengers is subjected to the greatest acceleration forces? a. The right-rear passenger b. The left-rear passenger c. The front-seat passenger d. The driver

b. The left-rear passenger

Which of the following is typical of the trajectory of a knife when a female assailant stabs someone? a. The trajectory is lateral: right-to-left if she is right-handed and left-to-right if she is left-handed. b. The movement is downward as the assailant raises the knife and swings downward. c. The movement is upward as the assailant drives upward with the knife. d. The trajectory tends to be in a horizontal plane at the level of the assailant's shoulder.

b. The movement is downward as the assailant raises the knife and swings downward.

Which of the following is generally considered to be important in the assessment of both medical and trauma patients (the others being generally reserved for a trauma patient)? a. The detailed exam b. The reassessment c. The identification of mechanism of injury d. The rapid trauma assessment

b. The reassessment

The leading cause of death in people under age 44 is: a. Heart attack. b. Trauma. c. Cancer. d. Cardiovascular disease.

b. Trauma.

Which two factors related to kinetic energy proportionately affect the damage a projectile will do? a. Velocity and yaw b. Velocity and mass c. Mass and fragmentation d. Fragmentation and velocity

b. Velocity and mass

Which two of the following factors proportionately affect the kinetic energy of a bullet fired from a gun? a. Friction and distance b. Velocity and mass c. Friction and velocity d. Mass and friction

b. Velocity and mass

Which of the following factors is NOT a consideration in the severity of injury related to falls? a. Landing surface b. Wind resistance c. The initial point of impact d. Distance of the fall

b. Wind resistance

Which of the following is best described as "the area of contused tissue resulting from penetrating trauma that may be slow to heal due to disrupted blood flow and tissue damage"? a. Temporary cavity b. Zone of injury c. Zone of coagulation d. Permanent cavity

b. Zone of injury

You are called to the scene of a vehicle crash in which a car was rear-ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated index of suspicion for injuries? a. The amount of energy transmitted to an object is inversely proportional to its rate of deceleration. b. Energy can neither be created nor destroyed. c. A body at rest will remain at rest unless acted on by an outside force. d. A body in motion will remain in motion unless acted on by an outside force.

c. A body at rest will remain at rest unless acted on by an outside force.

Which of the following statements about bullets is TRUE? a. A high-velocity bullet is three times less likely to do major harm. b. The larger the bullet the smaller its energy. c. A small, light bullet does the most harm. d. The hunting rifle's bullet is usually a lighter bullet, but it travels faster.

c. A small, light bullet does the most harm.

Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The air bag deployed. Considering the likelihood of organ collision, for which of the following injuries should you maintain a high index of suspicion? a. Cardiac contusion b. Anterior flail segment c. Abruptio placentae d. Fractured sternum

c. Abruptio placentae

The two factors that refer to the rate of change of speed are: a. Deceleration and velocity b. Mass and weight c. Acceleration and deceleration d. Acceleration and inertia

c. Acceleration and deceleration

Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient? a. Shrubbery b. A body of water c. Bridge abutment d. Signpost

c. Bridge abutment

When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation? a. Hot, red skin b. Increased urine output c. Cardiac arrhythmia d. Central hyperventilation syndrome

c. Cardiac arrhythmia

Which of the following is most likely to be fractured from a fall onto outstretched hands? a. Carpals b. Metacarpals c. Clavicle d. Ulna

c. Clavicle

Which of the following injuries is NOT commonly related to snowmobiling? a. Ejections b. Crush injuries c. Drowning d. Glancing blows against obstructions in the snow

c. Drowning

Which of the following mechanisms would yield the greatest index of suspicion for serious injury? a. Helmeted bicyclist losing control and falling off his bike onto a gravel surface at 15 miles per hour b. Adult falling 12 feet from a ladder landing in the mud c. Fifty-mile-per-hour motor vehicle crash with partial ejection d. Roll-over motor vehicle collision with a restrained driver

c. Fifty-mile-per-hour motor vehicle crash with partial ejection

In addition to handling all types of specialty trauma, which level of trauma center provides continuing medical and public education programs? a. IV b. III c. I d. II

c. I

Which level of trauma facility stabilizes and prepares to transport trauma patients to a higher-level facility but does NOT necessarily have surgical capabilities? a. I b. II c. IV d. III

c. IV

Which of the following is TRUE of the temporary cavity formed by penetrating trauma? a. It heals more slowly than the permanent cavity because of the nature of the tissue damage. b. It fills with disrupted tissues, some air, fluid, and debris. c. It is a space indirectly created by a projectile as tissue moves rapidly away from its path. d. It is the damage that occurs when the projectile fragments.

c. It is a space indirectly created by a projectile as tissue moves rapidly away from its path.

In which of the following types of impact should you have a higher index of suspicion because the degree of injury may be greater than the damage alone indicates? a. Rear-end b. Oblique c. Lateral d. Frontal

c. Lateral

Which of the following organs would be most likely to be injured by a stab wound to the sixth intercostal space in the midaxillary line on the right side? a. Liver, bladder, kidney, small intestine b. Stomach, pancreas, lung c. Liver, diaphragm, lung, kidney d. Spleen, diaphragm, lung, kidney

c. Liver, diaphragm, lung, kidney

Which of the following best defines the term energy? a. The ability to deform solid objects b. The rate of motion related to time c. The capacity to do work d. The amount of heat generated through friction

c. The capacity to do work

When you are assessing someone with a gunshot wound from a rifle, which of the following is important to remember? a. The cavitation is limited to the direct path of the bullet. b. The muzzle velocity is less than that of a handgun. c. The zone of injury is larger than that expected with other types of weapons. d. The trajectory is longer, allowing more energy to be dissipated by drag before it strikes the victim.

c. The zone of injury is larger than that expected with other types of weapons.

Which of the following is TRUE of defense wounds in the victim of a knife attack? a. They usually occur to the shoulder as the victim attempts to turn away from the attack. b. They often occur to the neck and head as the victim doubles over into a protective posture. c. They usually occur to the hands and arms as the victim raises them to ward off the attacker. d. They rarely occur because the victim is usually taken by surprise.

c. They usually occur to the hands and arms as the victim raises them to ward off the attacker.

According to the Haddon Matrix, which of the following would be a pre-event host factor impacting the risk for injury in a vehicle collision? a. Level of EMS providers responding b. The type of vehicle c. Using a cellular phone while driving d. Road design

c. Using a cellular phone while driving

Which of the following patients does NOT require specialty-center capabilities beyond that offered by a trauma center? a. A 67-year-old with second- and third-degree burns over 50 percent of the body b. A 25-year-old with amputation of three fingers c. A 4-year-old with a closed-head injury d. A 22-year-old with bilateral open femur fractures

d. A 22-year-old with bilateral open femur fractures

Which of the following requires immediate transport to a trauma center? a. A 40-year-old who fell 12 feet from a garage roof with a radius fracture b. A 36-year-old female in a motor vehicle crash who has a blood pressure of 100/60 c. A 22-year-old motorcyclist with a tibia fracture d. A 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

d. A 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

Vehicle supplemental restraint systems (air bags) are meant to: a. Prevent unrestrained occupants from taking the down-and-under pathway in frontal impacts b. Protect infants and children who ride in the front seat of the vehicle c. Prevent injury from secondary impacts d. Absorb the energy exchange of rapid deceleration

d. Absorb the energy exchange of rapid deceleration

When inspecting the interior of a vehicle involved in a frontal collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries might this indicate? a. Fracture of the acetabulum b. Femur fracture c. Knee injury d. All of the above

d. All of the above

Which of the following is TRUE about determining the pathway of the bullet when assessing a patient with a gunshot wound? a. You should try to determine the bullet's pathway. b. The purpose of determining the bullet's pathway is to anticipate which organs may have been affected, which will help to guide your priorities for on-scene care or rapid transport. c. It is difficult to determine the pathway of a bullet because it may not travel in a straight line, possibly being deflected by structures in its path or being shifted by natural movements of the diaphragm and other organs and structures of the body. d. All of the above

d. All of the above

Which of the following statements about trauma is TRUE? a. Life-threatening injuries may exist with little external evidence. b. Dramatic-appearing extremity injuries may draw the paramedic's focus from life-threatening injuries. c. Life-threatening injury occurs in less than 10 percent of trauma patients. d. All of the above are true.

d. All of the above are true.

The purpose of determining the mechanism of injury and the index of suspicion for the trauma patient at the same time is to allow you to: a. Decide whether to transport the patient b. Identify comorbid factors c. Document a complete scene size-up d. Anticipate your patient's injuries

d. Anticipate your patient's injuries

You have arrived on the scene of a 17-year-old male with a gunshot wound to the thigh. Police are on the scene. There is significant ongoing hemorrhage from the wound. The patient is screaming for someone to help him. Which of the following should you do first? a. Control hemorrhage with direct pressure. b. Begin high-concentration oxygen administration. c. Perform a rapid trauma assessment. d. Ask the police if they have searched the patient for weapons yet.

d. Ask the police if they have searched the patient for weapons yet.

Penetrating trauma to the face can complicate airway management by which of the following mechanisms? a. Laryngotracheal edema b. Airway obstruction c. Destruction of anatomical landmarks d. B and C

d. B and C

Your patient is a 50-year-old male with a gunshot wound to the right anterior chest. He is unresponsive. Which of the following should you do first? a. Check for a carotid pulse. b. Seal the chest wound. c. Auscultate breath sounds. d. Check for breathing.

d. Check for breathing.

If you were to design a bullet to have the highest energy exchange, what would you do? a. Decrease the drag b. Increase the caliber c. Decrease the bullet's trajectory d. Design the bullet to become more unstable

d. Design the bullet to become more unstable

Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory. a. Wavier, straighter b. Flatter, wavier c. More rounded, curved d. Flatter, straighter

d. Flatter, straighter

Which of the following is NOT one of the major types of recreational vehicles involved in crashes? a. Snowmobiles b. Jet Skis c. All-terrain vehicles d. Go-carts

d. Go-carts

Which type of firearm usually limits trauma to direct injury? a. Hunting rifle b. Military rifle c. Automatic weapon d. Handgun

d. Handgun

Which of the following statements about the impact of motorcycle helmet usage is TRUE? a. Helmet use moderately increases the incidence of cervical spine injury. b. Helmet use moderately decreases the incidence of cervical spine injury. c. Helmet use substantially decreases the incidence of cervical spine injury. d. Helmet use neither increases nor decreases the incidence of cervical spine injury.

d. Helmet use neither increases nor decreases the incidence of cervical spine injury.

A trauma center that has surgical care capability available at all times and can handle all but the most seriously injured specialty and multisystem trauma patients is a Level ________ trauma center. a. III b. I c. IV d. II

d. II

Which of the following statements about low-velocity penetrating trauma is TRUE? a. Shorter knives and ice picks may be removed if they are left in the wound. b. There is no pressure shock wave with a knife wound as there is with an arrow wound. c. More injuries are sustained from arrows than from knives. d. Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.

d. Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.

Which of the following mechanisms is most consistent with fractured vertebrae from a rapid lateral twisting motion? a. Direct trauma, such as from a blow to the head b. Low-velocity penetrating trauma from an ice pick c. High-velocity penetrating trauma from a gunshot wound d. Lateral-impact motor vehicle collision

d. Lateral-impact motor vehicle collision

Which of the following is TRUE of the injuries sustained by the elderly due to falls? a. The elderly sustain injuries similar to other age groups in comparable falls. b. The injuries sustained by the elderly are less likely to result in hospitalization. c. Only more significant falls cause fractures. d. Less significant falls may cause fractures.

d. Less significant falls may cause fractures.

In falls, which section of the spinal column is the MOST prone to compression injury? a. Sacral b. Cervical c. Thoracic d. Lumbar

d. Lumbar

Which of the following is NOT a consideration when assessing a trauma patient? a. SAMPLE history b. MedicAlert bracelets c. Underlying medical conditions d. Medical insurance coverage

d. Medical insurance coverage

Which of the following statements about entrance and exit wounds is TRUE? a. Exit wounds are usually the size of the bullet's profile. b. Entrance wounds most often appear as stellate. c. Cavitational wave energy is greatest at a bullet's point of entrance. d. Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.

d. Only a thorough forensic examination by a qualified expert can determine with certainty whether a given wound is an entrance wound or an exit wound.

As a paramedic your role in trauma care consists of all of the following EXCEPT: a. Providing rapid transport to appropriate facilities b. Promoting injury prevention c. Providing care to seriously injured trauma patients d. Providing surgical interventions to stop hemorrhage

d. Providing surgical interventions to stop hemorrhage

Which of the following is considered a high-velocity weapon? a. Shotgun b. Arrow c. Handgun d. Rifle

d. Rifle

In a motor vehicle collision, when the driver's chest strikes the steering wheel, what produces injury next? a. The air bag deploys a second time. b. The steering column shears off, causing penetrating trauma. c. Unsecured objects in the vehicle become projectiles. d. The heart continues its forward motion until it strikes the chest wall.

d. The heart continues its forward motion until it strikes the chest wall.

Which of the following is TRUE of the pressure wave that accompanies high-velocity penetrating trauma? a. Hollow organs are less tolerant of the stress than solid organs are. b. Pressure waves cause no injury to surrounding tissues; they only momentarily disrupt function. c. Elastic tissues are less tolerant of the stress than nonelastic tissues. d. The pressure wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

d. The pressure wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

A penetrating injury to which of the following organs is LEAST likely to result in severe hemorrhage? a. Liver b. Kidney c. Spleen d. Ureter

d. Ureter

Which statement about ballistics is TRUE? a. Damage is less when the bullet does not exit the body. b. When a bullet tumbles, it decreases the damage. c. In penetrating trauma, the mass of a projectile is more significant than its velocity when determining kinetic energy. d. When a bullet yaws, it increases the damage.

d. When a bullet yaws, it increases the damage.

As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs? a. Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound. b. There is no vacuum created when there is both an entrance and an exit wound. c. Negative pressure is generated inside the cavity, drawing debris into the wound. d. There is negative pressure at the entrance wound and positive pressure at the exit wound.

c. Negative pressure is generated inside the cavity, drawing debris into the wound.

Which of the following is more relevant to the assessment and history of the medical patient than to the trauma patient? a. AVPU b. SAMPLE c. OPQRST d. DCAP-BTLS

c. OPQRST

Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen? a. Pneumothorax and myocardial contusion b. Cardiac tamponade and aortic dissection c. Pneumothorax and diaphragmatic rupture d. Pulmonary and myocardial contusions

c. Pneumothorax and diaphragmatic rupture

Your patient is an eight-year-old male with a pencil impaled 2 centimeters inferior to the xiphoid process. You note that the pencil is pulsating. Which of the following is the best action? a. Start an IV and request orders for analgesia and sedation. b. Remove the pencil and apply direct pressure to the wound; transport to a trauma center if the bleeding does not stop with direct pressure. c. Stabilize the pencil in place and transport to a trauma center. d. Stabilize the pencil and transport to the nearest medical facility.

c. Stabilize the pencil in place and transport to a trauma center.

Which of the following is most important when assessing the damage done by a gunshot? a. The type of gun used b. The size of the bullet c. The distance from the shooter d. Whether there was an upward or a downward trajectory when the bullet was fired

c. The distance from the shooter

The path a projectile follows during a flight is called its: a. Cavity b. Ballistics c. Trajectory d. Drag

c. Trajectory

Which of the following bullet characteristics would create the most damage? a. Lack of tumble b. A small profile c. A full metal jacket d. "Mushrooming" or flattening on impact

d. "Mushrooming" or flattening on impact

Which of the following increases a bullet's profile? a. Tumbling 180 degrees on impact b. "Mushrooming" on impact c. The use of rifling in the barrel of the firearm d. A and C

d. A and C

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle collision? a. The vehicle strikes an object b. The occupants' organs strike the interior of the body cavity c. The body of the occupant strikes the interior of the vehicle d. A hubcap flies off and strikes a tree

d. A hubcap flies off and strikes a tree

Which of the following mechanisms may result in a conventional explosion? a. Fumes b. Dust c. Aerosol propellants d. All of the above

d. All of the above

Which level of trauma facility can provide neurosurgery, microsurgery, and care for multisystem trauma? a. III b. I c. II d. IV

b. I

Which of the following means "the anticipation of injury to a body region or organ"? a. Index of injury b. Index of suspicion c. Newton's First Law of Motion d. Mechanism of injury

b. Index of suspicion

Which of the following is most susceptible to damage from the pressure wave when a bullet enters it? a. Femoral artery b. Liver c. Intestines d. Lungs

b. Liver

Which of the following is the most important priority when caring for a patient with a shallow-water diving injury? a. Assessing the cervical spine for deformity b. Maintaining cervical spine stabilization while opening the airway c. Removing the patient from the water as soon as possible d. Initiating rescue breathing once out of the water

b. Maintaining cervical spine stabilization while opening the airway

Which of the following is associated with assault rifle wounds but not hunting rifle wounds? a. Permanent cavitation b. Multiple wounds c. Smaller exit wounds d. Larger exit wounds

b. Multiple wounds

Which of the following is an acceptable way of reducing prehospital time to maximize the use of the "Golden Period" for trauma patients? a. Load the patients and begin transport before doing a primary assessment b. Skip spinal immobilization in the blunt trauma patient c. Call for air medical transport, if indicated d. Start all IVs on the scene to allow for more rapid transport

c. Call for air medical transport, if indicated

The study of the characteristics of projectiles in motion and their effects on the objects they impact is called: a. Trajectory b. Cavitation c. Ballistics d. Forensics

c. Ballistics

Which of the following is NOT an example of trauma? a. An abrasion to the knee b. Chest pain c. Cerebral contusion d. A stab wound to the abdomen

b. Chest pain

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "spidered," or "starred," and that the driver was not restrained. Which of the following injuries is most likely? a. Whiplash injury of the neck muscles b. Compression injury of the cervical spine c. Distraction injury of the cervical spine d. Ligamentous neck injury due to rotation beyond the range of motion

b. Compression injury of the cervical spine

You are the first arriving unit for injured persons due to a propane tank explosion. The first patient you notice is a young adult male who appears to be seriously injured. Which of the following should you do first? a. Request an arson investigator to come to the scene. b. Do a scene size-up and establish incident command. c. Locate all patients. d. Begin resuscitation of any patients who are apneic and/or pulseless.

b. Do a scene size-up and establish incident command.

Which of the following is NOT considered a significant mechanism of injury in pediatric patients? a. Vehicle collision with intrusion into compartment where child is a passenger b. Fall of 5 feet c. Bicycle-vehicle collision at 30 mph d. Any collision in which a child is ejected from the vehicle

b. Fall of 5 feet

Which of the following injuries is associated with the tertiary phase of a blast? a. Crush injuries b. Barotrauma c. Burns d. Projectile injuries

a. Crush injuries

Which of the following is NOT considered penetrating trauma? a. A laceration on the forehead as a result of being struck with a metal pipe b. Receiving a wood splinter in the foot while walking on an unfinished deck c. A laceration from a kitchen knife d. A superficial wound resulting from a pellet from a pellet gun being lodged under the skin

a. A laceration on the forehead as a result of being struck with a metal pipe

Which of the following statements about rifles is TRUE? a. Assault rifles generally increase the number of wounds the victim sustains. b. Hunting rifles have larger magazines and operate semiautomatically. c. Assault rifles do not accept domestic hunting ammunition and thus create a projectile profile that is smaller and causes less damage. d. Assault rifles have greater velocity than hunting rifles and only operate automatically.

a. Assault rifles generally increase the number of wounds the victim sustains.

Which of the following statements is NOT true of occupant ejection in motor vehicle collisions? a. Ejection has not been reported with lateral-impact collisions. b. The number of occupant impacts increases with ejection. c. Ejection is most often associated with frontal-impact collisions. d. Ejection accounts for 27 percent of motor vehicle fatalities.

a. Ejection has not been reported with lateral-impact collisions

Which of the following may result from aggressive ventilation of the blast patient? a. Emboli b. Pericardial tamponade c. Hemorrhage d. Acidosis

a. Emboli

Which of the following is TRUE of motorcycle collisions? a. Frontal impact can result in intraabdominal, pelvic, and femur injuries. b. A rider who "lays down the bike" will generally receive more severe injuries than a rider who stays with the bike. c. The structural steel of the vehicle absorbs most of the kinetic energy in a motorcycle collision. d. The use of helmets has drastically reduced the incidence of cervical spine injuries.

a. Frontal impact can result in intraabdominal, pelvic, and femur injuries.

Axial loading is most likely to occur in which type of impact? a. Frontal with an up-and-over pathway b. Frontal with a down-and-under pathway c. Rear with the headrest too low d. Lateral on the side of the vehicle opposite the occupant Feedback

a. Frontal with an up-and-over pathway

Which of the following traumas contributes most significantly to motor vehicle collision mortality? a. Head b. Cervical spine c. Chest d. Abdominal

a. Head

Your patient is a construction worker who fell 15 feet and has a 3-foot metal concrete reinforcement bar (rebar) impaled in his right thigh. Which of the following is the best action? a. If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length. b. If you can see both ends of the rebar, gently remove it and irrigate the wound with sterile saline. c. Administer sodium bicarbonate to combat acidosis resulting from the destruction of muscle tissue. d. Transport the patient without attempting to shorten or remove the rebar.

a. If the proper tools and personnel are present, have rescuers cut the rebar to a manageable length.

As a bullet tumbles, its potential to inflict damage: a. Increases b. Remains the same c. Is determined by the trajectory d. Decreases

a. Increases

During the scene size-up on a call for a patient with penetrating trauma due to a stab wound, which of the following should you do? a. Collect anything that could be used as evidence. b. Check for weapons on or near the patient. c. Try to find out in which direction the assailant fled. d. Assume that the patient has no weapons if law enforcement is on the scene.

b. Check for weapons on or near the patient.

Which of the following mechanisms of injury does NOT call for immediate transport to a trauma center? a. Motor vehicle crash with a 20-mile-per-hour impact b. Thirty-foot fall from a tree c. Motor vehicle crash requiring 1 hour for patient extrication d. Pedestrian struck by a vehicle at 25 miles per hour

a. Motor vehicle crash with a 20-mile-per-hour impact

Which of the following is the best, most cost-effective way for EMS personnel to help reduce trauma-related morbidity and mortality? a. Participate in injury-prevention programs b. Keep up-to-date on trauma management knowledge and skills c. Transport all trauma patients to a trauma center d. Provide complete patient care reports so that accurate data can be entered into the trauma registry

a. Participate in injury-prevention programs

Which of the following injuries is associated with the pressure wave produced by a blast? a. Pneumothorax b. Lacerated liver c. Fractures d. Ruptured spleen

a. Pneumothorax

Which of the following is TRUE of body armor use? a. There are no reported cases of penetrating trauma among victims who were shot while wearing body armor. b. Blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn. c. Blunt trauma only occurs if ceramic inserts are placed in the vest. d. Ceramic inserts are dangerous and should not be used, because they generally fragment and create secondary projectiles when they are struck by a bullet.

b. Blunt trauma may be significant, but the potential for life-threatening injury is less than if armor had not been worn

Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum teres? a. Sudden deceleration b. Sudden acceleration c. Gradual acceleration d. Gradual deceleration

a. Sudden deceleration

Which of the following is NOT a complication of crush syndrome? a. Systemic alkalosis b. Cardiac arrhythmias c. Renal failure d. Difficult-to-control hemorrhage

a. Systemic alkalosis

Which of the following is TRUE of supplemental restraint systems? a. They may deploy during rescue operations, injuring the patient and/or EMS personnel. b. When worn incorrectly, they may cause spinal injury or decapitation. c. They guard against thoracic impact with the steering wheel. d. They are primarily useful in preventing injury to infants and children riding in the front seat.

a. They may deploy during rescue operations, injuring the patient and/or EMS personnel.

Your patient has a gunshot wound to the left posterior thorax. Which of the following is NOT appropriate in initial assessment? a. Beginning bag-valve-mask ventilation b. Auscultating breath sounds bilaterally in six places, anteriorly and posteriorly c. Stabilizing a flail segment, should one be noted d. Placing a gloved hand over a sucking chest wound

b. Auscultating breath sounds bilaterally in six places, anteriorly and posteriorly

Which of the following abdominal organs is the least affected by the pressure wave associated with penetrating trauma? a. Spleen b. Bowel c. Kidneys d. Liver

b. Bowel

The pathway of injury left in the wake of a penetrating mechanism of injury is called: a. Cone of injury b. Cavitation c. Profile d. Trajectory

b. Cavitation