EMS 201 Chapter 25-41
Difficulty breathing and a sunken appearance of the anterior abdominal wall is most indicative of a ruptured: a. diaphragm. b. stomach. c. spleen. d. Aorta.
a. diaphragm.
Early signs and symptoms of intra-abdominal bleeding include: a. pain and distention. b. significant hypotension. c. widespread ecchymosis. d. bruising only.
a. pain and distention.
General techniques for communicating with hearing-impaired patients include: a. positioning yourself approximately 18″ directly in front of the patient. b. exaggerating your lip movements to ensure the patient understands. c. speaking directly into the patient's ear with an increased voice pitch. d. removing any hearing aids and using pen and paper to ask questions.
a. positioning yourself approximately 18″ directly in front of the patient.
Light sensitive area at back of the globe where images are projected; has numerous nerve endings that respond to light by transmitting nerve impulses through optic nerve: a. retina b. sclera c. iris d. cornea
a. retina
Your primary concern when arriving at the scene of a motor vehicle crash is: a. surveying the area for hazards. b. requesting additional resources. c. immediately beginning triage. d. gaining access to the patient(s).
a. surveying the area for hazards.
An air embolism associated with diving occurs when: a. the diver holds his or her breath during a rapid ascent. b. the diver hyperventilates prior to entering the water. c. high water pressure forces air into the mediastinum. d. the alveoli completely collapse due to high pressure.
a. the diver holds his or her breath during a rapid ascent.
An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: a. trauma to the pelvis. b. blunt abdominal trauma. c. a severe closed head injury. d. penetrating thoracic trauma.
a. trauma to the pelvis.
Bruising to the right upper quadrant of the abdomen after blunt trauma is most suggestive of injury to the: a. liver. b. spleen. c. stomach. d. kidney
a. liver.
Findings during the social assessment of an older patient include all of the following, except: a. outdated medications. b. delays in obtaining meals. c. daily activity assistance. d. interaction with others.
a. outdated medications.
Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. These are signs of a/an: A: flail chest. B: isolated rib fracture. C: pneumothorax. D: pulmonary contusion.
A: flail chest.
An unrestrained driver was crushed in between the steering wheel and his seat when his truck collided with a tree. Assessment reveals cyanosis to his neck and face, jugular venous distention, and bleeding into the sclera of his eyes. The EMT should suspect: A) aortic dissection. B) traumatic asphyxia. C) massive hemothorax. D) pericardial tamponade.
B) traumatic asphyxia.
You are assessing a young male who was stabbed in the right lower chest. He is semiconscious and has labored breathing, collapsed jugular veins, and absent breath sounds on the right side of his chest. This patient MOST likely has a: A:liver laceration. B:hemothorax. C:pneumothorax. D:ruptured spleen.
B: hemothorax.
The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min, a pink body but blue hands and feet, and rapid respirations. The baby cries when the soles of its feet are flicked and resists attempts to straighten its legs. You should assign an Apgar score of: A. 4. B. 6. C. 8. D. 9.
C. 8.
Pinpoint pupils, bradycardia, and excessive salivation are signs of exposure to: a. Lewsite b. Soman c. Cyanide d. Phospgene
b. Soman
Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. You should manage this situation initially by A. clamping and cutting the umbilical cord B. gently pulling on the cord to facilitate removal C. trying to remove the cord from around the neck. D. keeping the cord moist and providing rapid transport
C. trying to remove the cord from around the neck.
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: A. liver. B. pancreas. C. gallbladder. D. spleen.
D. spleen.
Which of the following sets of vital signs is MOST suggestive of increased intracranial pressure in a patient who has experienced a traumatic brain injury? A:BP, 92/60 mm Hg; pulse, 120 beats/min; respirations, 24 breaths/min B:BP, 160/72 mm Hg; pulse, 100 beats/min; respirations, 12 breaths/min C:BP, 84/42 mm Hg; pulse, 60 beats/min; respirations, 32 breaths/min D:BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min
D:BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min
Three ambulances respond to golf course where six golfers were struck by lightening. Two of the golders are conscious and alert with superficial burns (group 1). The next two golfers have minor fractures and appear confused. (group 2) and the last two golfers are in cardiac arrest(group 3). According to reverse triage with lightening strikes who should be treated first?
Group 3
An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. a. 100 mL b. 200 mL c. 150 mL d. 50 mL
a. 100 mL
Bleeding within the brain tissue itself is called a(n): a. intracerebral hematoma. b. epidural hematoma. c. subdural hematoma. d. subarachnoid hemorrhage.
a. intracerebral hematoma.
Burns associated with lightning strikes are typically: a. superficial. b. full-thickness. c. third-degree. d. Partial-thickness.
a. superficial.
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 body surface area. a. 45% b. 18% c. 27% d. 36%
b. 18%
A 5 year old boy was burned when he pulled a BBQ grill over on himself. He has partial- and full-thickness burns to his anterior chest and circumferentially on both arms. What percentage of his TBSA has been burned? a. 18% b. 27% c. 36% d. 45%
b. 27%
A 44 year old man was struck in the back of the head and was reportedly unconscious for approximately 30 seconds. He complains of a severe headache and "seeing stars," and states that he regained his memory shortly before your arrival. His presentation is MOST consistent with a(n): a. Contusion b. Concussion c. Subdural hematoma d. Intracerebral hemorrhage
b. Concussion
Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? a. Steering wheel collapse b. Deployment of the airbag c. Intrusion into the vehicle d. Dismounted seats
b. Deployment of the airbag
A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries is the LEAST likely? a. Pulmonary contusion b. Head injury c. Multiple rib fractures d. Cardiac contusion
b. Head injury
The most reliable sign of a head injury is: a. a pulse that is rapid and thready. b. a decreased level of consciousness. c. decreased sensation in the extremities. d. an abnormally low blood pressure.
b. a decreased level of consciousness.
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should: a. place her supine and elevate her lower extremities. b. provide ventilation assistance with a bag valve mask. c. perform a rapid head-to-toe physical assessment. d. apply 100% oxygen via a nonrebreathing mask.
b. provide ventilation assistance with a bag valve mask.
After recognizing that an incident involves a hazardous material, you should contact the hazardous materials team and then a. not allow anyone within 25′ to 50′ of the incident scene. b. take measures to ensure the safety of yourself and others. c. don standard equipment before gaining access to any patients. d. identify the chemical using the Emergency Response Guidebook
b. take measures to ensure the safety of yourself and others.
Elevation of the rib cage during inhalation occurs when: a. intrathoracic pressure decreases. b. the intercostal muscles contract. c. abdominal contents descend. d. the diaphragm descends.
b. the intercostal muscles contract.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash. a. lumbar and sacral b. thoracic and lumbar c. thoracic and sacral d. lumbar and coccygeal
b. thoracic and lumbar
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 body surface area. a. 2% b. 4% c. 1% d. 6%
c. 1%
Femoral shaft fractures can result in up to _____ mL of internal blood loss. a. 4,000 b. 2,000 c. 1,000 d. 1,500
c. 1,000
A portable oxygen cylinder should have a minimum capacity of ____ of oxygen a. 750 L b. 250 L c. 500 L d. 1,000 L
c. 500 L
Shivering in the presence of hypothermia that the a. Musculoskelatal system is damaged b. Nerve endings are damaged causing loss of muscle control c. Body is trying to generate more heat through muscular activity d. Thermoregulatory system has failed and body temperature is falling
c. Body is trying to generate more heat through muscular activity
In addition to severe bleeding, the most life-threatening complication associated with an open neck injury is: a. nerve fiber damage. b. an ischemic stroke. c. an air embolism. d. a spinal fracture.
c. an air embolism.
The main objective of traffic control at the scene of a motor vehicle crash is to: a. facilitate a route for the media to access the scene. b. prevent curious onlookers from observing the scene. c. warn oncoming traffic and prevent another crash. d. get oncoming traffic past the scene as soon as possible.
c. warn oncoming traffic and prevent another crash.
In older patients, the first indicator of nontraumatic internal bleeding might be: a. a heart rate over 120 beats/min. b. diaphoresis and pale skin. c. weakness or dizziness. d. a low blood pressure.
c. weakness or dizziness.
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. a. 500 mL b. 250 mL c. 2 L d. 1 L
d. 1 L
Phosgene (CG) has an odor that resembles: a. garlic. b. bleach. c. almonds. d. cut grass
d. cut grass
You are transporting a women who is 8 months pregnant. To prevent supine hypotensive syndrome, how should you position this patient? a. on her right side b. supine c. semi-fowler d. on her left side
d. on her left side
The need and extent of newborn resuscitation is based on: a. 1-minute Apgar score b. gestational age of the newborn c. newborn's response to oxygen d. respiratory effort, heart rate, and color
d. respiratory effort, heart rate, and color
Which of the following sets of vital signs depicts Cushing's triad? A.blood pressure, 190/110 mm Hg pulse, 55 beats/min respirations, 30 breaths/min B.blood pressure, 90/50 mm Hg pulse, 120 beats/minrespirations, 10 breaths/min C.blood pressure, 200/100 mm Hg pulse, 140 beats/min pulse, 140 beats/min respirations, 28 breaths/min D.blood pressure, 80/40 mm Hg pulse, pulse 30 beats/min respirations, 32 breaths/min
A. blood pressure 190/110, HR 55, respirations 30 - Cushings triad is widening pulse pressure where systolic increases and diastolic decreases, HR is decreased, and patient has irregular respirations
Which of the following devices is contraindicated in patients with blunt chest trauma? A:Oral airway B:Nasal airway C:Oxygen-powered ventilator D:Bag-mask device
C:Oxygen-powered ventilator
A patient experienced blunt chest trauma and has asymmetrical chest wall movement. This MOST likely indicates: A:accumulation of blood in both of the lungs. B:shallow breathing secondary to severe pain. C:decreased air movement into one lung. D:several ribs broken in numerous places.
C:decreased air movement into one lung.
A common cause of shock in an infant is: a. dehydration from vomiting and diarrhea. b. excessive tachycardia. c. a cardiac dysrhythmia. d. cardiovascular disease.
a. dehydration from vomiting and diarrhea.
The wall that separates the left and right sides of the heart is called the: A: pericardium. B: carina. C: mediastinum. D: septum.
D: septum.
Airbags are designed to: a. decrease the severity of deceleration injuries. b. prevent a second collision inside the car. c. be used with or without a shoulder harness. d. prevent the driver from sustaining head trauma.
a. decrease the severity of deceleration injuries.
A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head, face, and anterior trunk. What percentage of her body surface area has been burned? a. 30% b. 36% c. 18% d. 27%
a. 30%
Shortly after ascending rapidly to the surface of the water while holding his breath, a 29 yr old diver begins coughing up pink frothy sputum and complains of dyspnea and chest pain. You should suspect and treat the patient for a. Air embolism b. A pneumothorax c. Pneumomediastinum d. Decompression sickness
a. Air embolism
A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the most indicative of decompensated shock a. Blood pressure of 70/40 mm Hg b. Pulse rate greater than 120/min c. Capillary refill time of 4 seconds d. Respiratory rate of 30 breaths/min
a. Blood pressure of 70/40 mm Hg
Which of the following is a severe burn in a 35-year-old patient? a. Circumferential partial-thickness burn to the chest b. Superficial burn covering 50% of the body surface area c. Full-thickness burn to 5% of the body surface area d. Partial-thickness burn to 20% of the body surface area
a. Circumferential partial-thickness burn to the chest
A patient who experiences an immediate loss of consciousness followed by a lucid interval has a(n): a. Epidural hematoma b. Subdural hematoma c. Concussion d. Contusion
a. Epidural hematoma
When a patient is exposed to a vesicant agent, you should expect to encounter: a. Skin blistering b. Loss of hearing c. Vomiting blood d. Profound bradycardia
a. Skin blistering
The mesentery is: a. a membranous fold that attaches the intestines to the walls of the body. b. a layer of thick skeletal muscles that protects the abdominal organs. c. a complex network of blood vessels that supply blood to the liver. d. the point of attachment between the small and large intestines.
a. a membranous fold that attaches the intestines to the walls of the body.
Common signs and symptoms of a serious head injury include all of the following, EXCEPT: a. a rapid, thready pulse. b. decerebrate posturing. c. cerebrospinal fluid leakage from the ears. d. widening pulse pressure
a. a rapid, thready pulse.
A normal level of consciousness in an infant or child is characterized by a. age-appropriate behavior, good muscle tone, and good eye contact. b. normal interactiveness, awareness to time, and pink skin color. c. crying or combativeness, good muscle tone, and awareness to time. d. awareness to place, pink and dry skin, and consistent eye contact.
a. age-appropriate behavior, good muscle tone, and good eye contact.
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: a. aggressively manage his airway. b. suspect a severe hemopneumothorax. c. perform a secondary assessment. d. request a paramedic ambulance.
a. aggressively manage his airway.
During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should: a. assist ventilations with a bag valve mask. b. apply high-flow oxygen via nonrebreathing mask. c. make note of it and continue your assessment. d. request a paramedic to decompress the chest.
a. assist ventilations with a bag valve mask.
A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should: a. assess his blood pressure to detect hypotension. b. apply a compression device around his pelvis. c. stabilize his pelvis by placing him onto his side. d. elevate his legs, keep him warm, and transport.
b. apply a compression device around his pelvis.
A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should: 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.
When worn properly, a seat belt should lie: a. across the abdominal wall at the level of the umbilicus and against the hip joints. b. below the anterior superior iliac spines of the pelvis and against the hip joints. c. across the abdominal wall at the level of the diaphragm and below the hip joints. d. above the anterior posterior iliac spines of the pelvis and below the hip joints.
b. below the anterior superior iliac spines of the pelvis and against the hip joints.
Cerebral palsy is a condition that results from damage or injury to the: a. spinal cord. b. brain. c. peripheral nervous system. d. voluntary muscles.
b. brain.
A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures but has had a recent ear infection. You should: a. suspect that the child has meningitis and transport at once. b. cool the child with tepid water and transport to the hospital. c. allow the mother to drive her daughter to the hospital. d. place the child in cold water to attempt to reduce her fever.
b. cool the child with tepid water and transport to the hospital.
Signs and symptoms of preeclampsia include: a. dyspnea and bradycardia. b. headache and edema. c. marked hypoglycemia. d. dysuria and constipation.
b. headache and edema.
A sign of kidney damage after blunt trauma is: a. hematemesis. b. hematuria. c. hemoptysis. d. Hematochezia.
b. hematuria.
Laceration: a. rarely penetrates through the subcutaneous tissue to the muscle. b. is a jagged cut caused by a sharp object or blunt force trauma. c. is a sharp, smooth cut that is made by a surgical scalpel. d. is an injury that separates various layers of soft tissue.
b. is a jagged cut caused by a sharp object or blunt force trauma.
A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing: a. acute appendicitis. b. an aortic aneurysm. c. gastrointestinal bleeding. d. intrathoracic hemorrhaging.
c. gastrointestinal bleeding.
The cervical spine is MOST protected from whiplash-type injuries when the: a. patient tenses up at the time of impact. b. rear end of the vehicle is initially struck. c. headrest is appropriately positioned. d. airbag correctly deploys upon impact.
c. headrest is appropriately positioned.
Circular eye muscle that adjusts size of the opening to regular amount of light that enters; dilates and constricts pupils: a. retina b. sclera c. iris d. cornea
c. iris
General principles for approaching a potential HazMat incident include: a. taking standard precautions before entering any HazMat scene. b. asking for wind direction from dispatch and entering downwind. c. maintaining a safe distance and viewing the scene with binoculars. d. parking the ambulance in a location that is upwind and downhill.
c. maintaining a safe distance and viewing the scene with binoculars.
Signs and symptoms of an air embolism include all of the following, except: a, dizziness. b. dysphasia. c. pale skin. d. joint pain.
c. pale skin.
High air temperature reduces the body's ability to lose heat by: a. convection. b. evaporation. c. radiation. d. Conduction.
c. radiation.
The primary route of exposure of vesicant agents is the: a. respiratory tract. b. nervous system. c. skin. d. vascular system.
c. skin.
The __________ area is where incoming ambulances meet and await further instructions at the scene of a multiple-casualty incident. a. triage b. support c. staging d. transportation
c. staging
The EMT's role at the scene of a search and rescue attempt is to a. direct the search effort from a centralized location. b. accompany search team members and provide care. c. stand by at the command post until the person is located. d. report to a location where the patient will be carried.
c. stand by at the command post until the person is located.
Which of the following is considered a severe burn? a. Any full-thickness burn b. 20% partial-thickness burn c. 10% full-thickness burn with abrasions d. 5% full-thickness burn with a fracture
d. 5% full-thickness burn with a fracture
Which of the following agents blocks the body's ability to use oxygen and possesses an odor similar to almonds? a. Phosgene oxime b. Organophosphates c. Carbon monoxide d. Hydrogen cyanide
d. Hydrogen cyanide
Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is most consistent with: a. a ruptured eyeball. b. a lacerated globe. c. optic vessel compression. d. a blow-out fracture.
d. a blow-out fracture.
The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: a. regenerating brain cells after they have been damaged. b. delivering oxygen directly to the CNS. c. producing leukocytes that protect the brain from infection. d. acting as a shock absorber for the brain and spinal cord.
d. acting as a shock absorber for the brain and spinal cord.
After your partner assumes manual in-line stabilization of the patient's head, you should: a. thoroughly palpate the patient's head for deformities. b. use four people to log roll the patient onto a backboard. c. apply an appropriately sized rigid cervical collar. d. assess distal neurovascular status in the extremities.
d. assess distal neurovascular status in the extremities.
A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured, and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should: a. request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment of the patient. b. decontaminate the patient as they would any other patient and then move him to the area where EMTs are waiting. c. defer the decontamination procedure and bring the patient directly to awaiting EMS personnel for immediate treatment. d. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can.
d. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can.
Death from a rollover motor vehicle crash is MOST often secondary to: a. crushing injuries. b. airbag-related trauma. c. multiple collisions to the interior of the car. d. ejection of the patient from the motor vehicle.
d. ejection of the patient from the motor vehicle.
The purpose of the incident command system (ICS) is to: a. reduce overall mortality and morbidity from large-scale, mass-casualty incidents and to restore key infrastructure. b. quickly and efficiently respond to natural disasters and terrorist incidents, regardless of the complexity of the incident. c. protect the public from the effects of large- and small-scale disasters and to minimize the financial impact from such incidents. d. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.
d. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.
Aggressive ambulance driving might have a negative effect on other motorists because a. they might become enraged and attempt to run you off the road. b. they often freeze when they see the lights in the rearview mirror. c. they move to the right or drive as close to the curb as possible. d. it might not allow for their reaction time to respond to your vehicle.
d. it might not allow for their reaction time to respond to your vehicle.
Signs and symptoms that might be found in a patient who has experienced a concussion include: a. anxiety and restlessness. b. hypotension and nosebleed. c. tachycardia and diaphoresis. d. nausea and ringing in the ears.
d. nausea and ringing in the ears.
