Chapter 32 EMS Systems - Exam

After direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: Select one: A. apply high-flow oxygen, consider spinal precautions, and transport without delay. B. hyperventilate him with a bag valve mask and monitor his oxygen saturation. C. apply high-flow oxygen, perform a detailed secondary assessment, and transport. D. focus your assessment on his scapulae and clavicles and apply high-flow oxygen.

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

A 17-year-old football player collided with another player and has pain to his left clavicle. 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: Select one: A. immobilize the injury with a sling and swathe. B. place a pillow under his arm and apply a sling. C. perform a rapid secondary assessment. D. straighten his arm and apply a board splint.

A. immobilize the injury with a sling and swathe.

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed, and she complains of severe pain. You should: Select one: A. keep her knee flexed and secure it with padded board splints. B. gently straighten her knee and apply a padded board splint. C. flex her knee slightly more and assess for distal circulation. D. make one attempt to return the patella to its normal position..

A. keep her knee flexed and secure it with padded board splints.

A 30-year-old man complains of severe pain to his right tibia after an injury that occurred the day before. The patient's leg is pale, and he is unable to move his foot. The EMT should suspect that: Select one: A. pressure in the fascial compartment is elevated. B. a severe infection has developed in the muscle. C. the nerves supplying the foot have been severed. D. the nerves behind the knee are compromised.

A. pressure in the fascial compartment is elevated.

A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment reveals that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect: Select one: A. separation of the acromioclavicular joint. B. posterior dislocation of the shoulder. C. multiple fractures of the proximal humerus. D. dislocation of the glenohumeral joint.

A. separation of the acromioclavicular joint.

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 is barely palpable. His vital signs are stable, and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should: Select one: A. splint the elbow in the position found and transport. B. apply a heat pack to the elbow to reduce swelling. C. gently manipulate the elbow to improve circulation. D. gently straighten the elbow and apply an air splint.

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

Deformity caused by a fracture would most likely be masked by: Select one: A. swelling. B. crepitus. C. guarding. D. ecchymosis.

A. swelling.

An open fracture is most accurately defined as a fracture in which: Select one: A. the bone is broken but does not penetrate the skin. B. an external wound is present over the fracture site. C. a bullet or other projectile shatters the underlying bone. D. fractured bone ends protrude through the skin.

B. an external wound is present over the fracture site.

A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should: Select one: A. administer high-flow oxygen to the patient. B. apply a tourniquet just below the shoulder. C. wrap the severed arm in a sterile dressing. D. remove the towel and inspect the wound.

B. apply a tourniquet just below the shoulder.

A Colles fracture involves a fracture of the: Select one: A. radius and ulna. B. distal radius. C. distal ulna. D. proximal radius.

B. distal radius.

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

B. posterior hip dislocation.

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

B. reduce pain and swelling.

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should: Select one: A. apply manual stabilization to both of her femurs. B. stabilize her head and perform a primary assessment. C. administer oxygen and perform a rapid assessment. D. assess for a carotid pulse and assist her ventilations.

B. stabilize her head and perform a primary assessment.

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: Select one: A. splint the elbow in the position of deformity and transport immediately. B. carefully straighten the injured arm and secure it with padded board splints. C. apply gentle manual traction in line with the limb and reassess for a pulse. D. make two or three attempts to restore distal circulation by manipulating the elbow.

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

Care for a patient with a fractured tibia and suspected compartment syndrome includes: Select one: A. immobilizing the leg with an air splint. B. applying traction to maintain distal pulses. C. keeping the leg at the level of the heart. D. applying chemical hot packs to the leg.

C. keeping the leg at the level of the heart.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should: Select one: A. flex the knee slightly and apply a formable splint. B. bind the legs together and elevate them six feet to eight feet. C. apply a traction splint to realign the deformity. D. apply padded board splints to both sides of the leg.

D. apply padded board splints to both sides of the leg.

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious but restless and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. You should: Select one: A. apply traction splints to both of his legs, keep him warm, and transport without delay. B. splint each of his deformed femurs with air splints, elevate his lower extremities, and transport. C. splint each of his deformed femurs with long board splints and transport without delay. D. bind his legs together on the backboard, keep him warm, and transport without delay.

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

During your secondary assessment of a 19-year-old female with multiple traumas, 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: Select one: A. splinting her femur fracture with padded board splints. B. carefully splinting each of her deformed extremities. C. applying a traction splint to immobilize her femur. D. immobilizing her to a backboard and rapidly transporting.

D. immobilizing her to a backboard and rapidly transporting.

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

D. ligaments.

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 ledg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: Select one: A. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. B. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. 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.