EMT Chapter 22, 23, 33, 34
Which of the following intracranial physiological events is most likely to occur in a patient with traumatic brain injury but not in a patient with nontraumatic brain injury? A. Increased intracranial pressure B. Cerebral contusion C. Cerebral hemorrhage D. Cerebral edema
Cerebral contusion
Which of the following is least necessary for a patient to maintain consciousness? A. Water B. Medication C. Glucose D. Oxygen
Medication
For a patient complaining of dizziness, what would you ask regarding vomiting? A. "Is the vomit black and tarry?" B. "Is there blood or material resembling coffee grounds?" C. "Was the vomiting accompanied by an urge to urinate?" D. "Is the vomit clear or opaque?"
"Is there blood or material resembling coffee grounds?"
If you are computing a Revised Trauma Score and the patient's GCS score is 14 with a respiratory rate of 30/min., a blood pressure of 102 systolic, and a heart rate of 104, what is the patient's total Revised Trauma Score? A. 12 B. 9 C. 10 D. 11
11
The possible numerical range for the Glasgow Coma Scale is: A. 3-15. B. 0-15. C. 3-10. D. 0-10.
3-15
Up to how many points are assigned to each element of the Revised Trauma Score? A. 4 B. 8 C. 15 D. 12
4
Which of the following readings on a glucometer for a symptomatic diabetic person with diaphoresis or mildly altered mental status would be of concern to the EMT? A. 108 mg/dl B. 58 mg/dl C. 118 mg/dl D. 78 mg/dl
58 mg/dl
Your patient responds to painful stimulus with decorticate posturing (arms bent to his chest, fists clenched, and legs straight out), his eyes do not open to pain, and he makes incomprehensible sounds when you pinch him. What score would you give him on the Glasgow Coma Scale? A. 3 B. 4 C. 6 D. 5
6
Which of the following statements is true? A. A complex partial seizure is often preceded by an aura, which might be a rising sensation in the stomach. B. A patient tends to experience an aura during the tonic phase of a convulsive seizure. C. Auras involving bright lights always precede all seizures, whether partial or generalized. D. A patient tends to experience an aura during the clonic phase of a convulsive seizure.
A complex partial seizure is often preceded by an aura, which might be a rising sensation in the stomach.
Your multisystem trauma patient also has a burn injury. Which of the following destinations is recommended? A. A burn center B. A designated trauma center C. An urgent care center D. The closest hospital
A designated trauma center
Which of the following situations would most likely lead to hyperglycemia? A. A patient self-administers too much insulin. B. A patient forgets to self-administer insulin. C. A patient fails to eat adequately after self-administering insulin. D. A patient overexercises after self-administering insulin.
A patient fails to eat adequately after self-administering insulin.
Which patient has least likely suffered a disruption of the reticular activating system? A. An unresponsive patient appears to have overdosed on prescribed painkillers. B. A patient complains of frequent absence seizures. C. A patient complains of acute-onset slurred speech. D. A patient has sustained minor lacerations from falling off a bicycle.
A patient has sustained minor lacerations from falling off a bicycle.
If a standard medically approved occlusive dressing is not available, what material might be effective in treating an open neck wound? A. A water- or saline-soaked 4×4 gauze pad B. Aluminum foil C. Elastic wrap (e.g., an Ace bandage) D. A piece of heavy plastic that is at least 2 inches larger in diameter than the wound site
A piece of heavy plastic that is at least 2 inches larger in diameter than the wound site
Which of the following patients would most likely be triaged to a trauma center? A. A trauma patient with tachycardia and tachypnea with hypertension B. A trauma patient with a long bone fracture C. A patient who was injured in a motorcycle accident D. A pregnant multisystem trauma patient
A pregnant multisystem trauma patient
If a patient had a longstanding vascular malformation in her brain that went unrecognized for years but finally resulted in a burst blood vessel, with what type of stroke will she likely present? A. An ischemic stroke on the opposite side of the brain B. A subarachnoid hemorrhagic stroke C. A transient ischemic attack D. An ischemic stroke with bilateral deficits
A subarachnoid hemorrhagic stroke
An 18-year-old male has been found unconscious. Which of the following findings would indicate that his altered mental status has been caused by hyperglycemia? A. Acetone breath B. Urinary retention C. Cool, moist skin D. Rapid onset of symptoms
Acetone breath
What mechanism is responsible for most strokes? A. Low blood sugar B. Prolonged hypertension C. High blood sugar D. An artery occluded by a clot or embolism
An artery occluded by a clot or embolism
Which case of altered mental status is least likely to be rapidly correctable by treating the underlying cause? A. An infant showing no sign of infection or trauma appears to be convulsing and unresponsive. B. A dehydrated patient is confused. C. A patient suffering an asthma attack is hypoxic and is losing consciousness. D. An overdosing patient is unresponsive.
An infant showing no sign of infection or trauma appears to be convulsing and unresponsive.
A 19-year-old female has lost consciousness while traveling home from a house party. Friends note that she vomited and then she appeared to "pass out" for several minutes. They note this has never happened before. The patient is responsive, has a patent airway, and is breathing adequately. She insists that she did not drink or take any drugs at the party. Which of the following questions would be least appropriate to this situation? A. "Are you afraid of the consequences of admitting substance abuse?" B. "Did you have any warning? If so, what was it like?" C. "Did you hurt yourself?" D. "What position were you in when the episode happened?"
Are you afraid of the consequences of admitting substance abuse?"
Which of the following findings is least likely in a patient with nontraumatic brain injury? A. Slurred speech B. Battle sign C. Unequal pupils D. Altered level of consciousness
Battle sign
Which of the following scenarios is an anatomical criterion for transporting a motor vehicle collision patient to a trauma center? A. Hypotension B. Unresponsiveness C. Bilateral femur fractures D. Death of another occupant
Bilateral femur fractures
Which of the following statements about blood glucose meters is true? A. Blood glucose meters are not commonly used. B. Blood glucose meters are portable and reliable. C. People with diabetes typically use blood glucose meters no more than once a day. D. Blood glucose meters are typically unreliable unless administered by specialized personnel in a hospital setting.
Blood glucose meters are portable and reliable.
A 70-year-old male was sitting comfortably when he suddenly had a brief syncopal episode. His vital signs are P 46, R 20, BP 96/60, indicating a slow heart rate but normal respiration and a blood pressure that is not elevated. Which of the following do you suspect caused the syncopal episode? A. Cardiac dysrhythmia B. DKA C. Hypertension D. Hypovolemia
Cardiac dysrhythmia
Which of the following is a transport decision for a multisystem trauma patient? A. Deciding how long to spend on scene B. Deciding to manage some injuries en route to the hospital C. Deciding what to do when there is disagreement on patient care D. Deciding on a hospital destination
Deciding on a hospital destination
Which of the following is a component of Cushing reflex? A. Decreased intracranial pressure B. Decreased heart rate C. Decreased blood pressure D. Increased cerebral perfusion
Decreased heart rate
Which of the following is likely the most critical associated injury from serious blunt or penetrating trauma to the face? A. Mandibular dislocation B. Dislodged teeth stuck in the airway C. The entrance of blood into the digestive tract D. Distortion of the facial landmarks
Dislodged teeth stuck in the airway
Your patient attempted suicide by hanging. What type of spinal injury is most likely? A. Extension injury B. Compression injury C. Distraction injury D. Flexion injury
Distraction injury
Which of the following is most likely to have associated spinal injury? A. Burn injury B. Abdominal injury C. Facial trauma D. Extremity trauma
Facial trauma
Which of the following is the most common cause of seizures in infants? A. Infection B. Fever C. Head injury D. Epilepsy
Fever
The Revised Trauma Score rates the: A. diastolic blood pressure, systolic blood pressure, and respiratory rate. B. Glasgow Coma Scale, systolic blood pressure, and respiratory rate. C. heart rate, pulse rate, and respiratory rate. D. skin condition, color, and temperature.
Glasgow Coma Scale, systolic blood pressure, and respiratory rate.
What is not a typical sign of stroke? A. Nausea or vomiting B. High blood pressure C. Heightened alertness D. Difficult respiration or snoring
Heightened alertness
You have a patient with an altered mental status that has developed over the past 2-3 days, according to family members. He is wearing a medical alert tag that is inscribed with the letters "DM." What is your initial field impression? A. Hyperglycemic episode B. Hyperosmolar episode C. Hypertension episode D. Hyperinsulin episode
Hyperglycemic episode
A 50-year-old female patient has been found unconscious and unresponsive. She is breathing rapidly and has pale, sweaty skin. Her vital signs are P 130, R 30, BP 140/80. Which of the following conditions would most likely explain these findings? A. Presyncope B. transient ischemic attack C. Stroke D. Hypoglycemia
Hypoglycemia
Diabetic problems are a common cause of altered mental status. Which of the following statements is true of diabetes mellitus? A. All patients with type II diabetes require insulin to maintain an appropriate blood sugar level. B. Type I diabetes is usually acquired in adulthood, and is often controlled by diet and oral medication. C. Insulin is a hormone secreted by the liver that is needed to move glucose from the blood into the cells. D. Hypoglycemia, or low blood sugar, may result from too much insulin, which causes glucose to be used up by the cells too rapidly.
Hypoglycemia, or low blood sugar, may result from too much insulin, which causes glucose to be used up by the cells too rapidly.
A 24-year-old female who has been ill with diarrhea reports increasing dizziness that is made worse by standing up. She has a rapid pulse rate and is diaphoretic. She has no history of diabetes and takes no medications. What is the most likely source of her dizziness? A. Stroke B. Low blood sugar C. Use of recreational drugs D. Hypovolemia
Hypovolemia
You arrive on scene to an assault victim who is grabbing the side of her neck. You notice hemorrhage on the left side of her neck. How should you manage this patient's neck wound once you arrive at her side? A. Apply firm, direct pressure bilaterally to the neck B. Locate an occlusive dressing and place it on the wound in a timely fashion C. Immediately cover the wound with a gloved hand D. Immediately wrap a bandage around the neck
Immediately wrap a bandage around the neck
Which of the following indicates a possible mandible injury? A. Memory loss B. Improperly aligned teeth C. Bruising around the eyes D. Unequal pupils
Improperly aligned teeth
Why does diabetic ketoacidosis cause dehydration? A. The ketoacidosis begins breaking down adipocytes and releasing their water stores into the bloodstream. The kidneys then remove this influx of water from the body via urine. B. The ketones bind with the cells' receptors, preventing water from being absorbed into the cytosol. C. In an attempt to rid the blood of excess sugar, the body will increase urination. D. The high glucose level in the bloodstream causes oversaturation in the brain cells. This leads to a form of euphoric instability marked by the inability to care for oneself.
In an attempt to rid the blood of excess sugar, the body will increase urination.
You witness an adult patient experiencing a seizure in which a progressive twitching of his right arm leads to his entire body's twitching. What can you reasonably say about the seizure's origin? A. The seizure was caused by a stroke on the right side of the brain. B. It was a partial seizure that became generalized to the entire body. C. The beginning of the seizure in the arm has no clinical relevance. D. The seizure focus likely began in the right hemisphere of his brain.
It was a partial seizure that became generalized to the entire body.
Which manual airway maneuver should you always use to open the airway of a patient with a suspected neck injury? A. Cross-fingers technique B. Jaw-thrust maneuver C. Head-tilt, chin-lift maneuver D. Head-tilt, neck-lift maneuver
Jaw-thrust maneuver
What is your first priority for a patient with massive facial trauma? A. Keeping the airway open B. Protecting the patient's privacy C. Preventing permanent scarring D. Bandaging all open injuries
Keeping the airway open
Which of the following conditions is most likely to lead to a stroke? A. Asthma B. Longstanding high blood pressure C. Anemia D. Low blood pressure
Longstanding high blood pressure
For an unconscious stroke patient, you would provide oxygen based on saturation readings and transport the patient as soon as possible. What else should you do? A. Maintain an open airway B. Refrain from aggressive treatment, to avoid overtreatment C. Administer a clot-busting thrombolytic drug D. Administer fluids by mouth in order to keep the patient hydrated
Maintain an open airway
Which of the following structures is the only movable part of the face? A. Zygoma B. Maxilla C. Mandible D. Mastoid
Mandible
What is the underlying pathophysiology of DKA? A. Too much insulin B. Not enough glucagon C. Not enough insulin D. Not enough glycogen
Not enough insulin
Which of the following statements about patients with altered mental status is correct? A. One of the most common causes of altered mental status is hypoxia. B. A patient is considered alert if the patient is at least responsive to a verbal stimulus. C. You may assume that a patient is still responsive even if there is no response to a painful stimulus. D. Hypoperfusion in combination with shock generally does not cause altered mental status.
One of the most common causes of altered mental status is hypoxia.
Under what circumstance can an EMT use a glucometer to determine a patient's blood glucose level? A. If the patient allows it and signs a release first B. Only if no higher level of EMS is available C. Under no circumstance D. Only if allowed by medical direction and local protocols
Only if allowed by medical direction and local protocols
Which of the following statements about altered mental status in pediatric patients is correct? A. Assess mentation in children just as you would for an adult. B. Altered mentation in pediatric patients will be obvious. C. Parents are usually poor historians regarding their children. D. Parents are usually the best judges of their children's mental status.
Parents are usually the best judges of their children's mental status.
Which of the following statements about an epidural hematoma is true? A. The bleeding site is between the brain and the dura mater. B. Patients with epidural hematomas may present similarly to those with subdural hematomas. C. Unlike subdural hematomas, which occur rapidly, epidural hematomas take hours or days to develop. D. Epidural hematomas do not carry the threat to life that subdural hematomas do.
Patients with epidural hematomas may present similarly to those with subdural hematomas.
According to the CDC, which of the following factors should be taken into consideration in triaging a trauma patient? A. Distance from a trauma center B. Availability of an air ambulance C. Physiological criteria D. Patient age
Physiological criteria
In managing an open wound to the neck, what actions can you take while waiting for occlusive dressings to be obtained or opened? A. Apply oxygen via a nonrebreather mask at 15 lpm. B. Apply direct pressure to the open wound with two fingers. C. Place a standard, sterile 4×4 gauze pad over the wound. D. Place your gloved hand over the wound to close it off from air entry.
Place your gloved hand over the wound to close it off from air entry.
Which of the following statements about a seizure that is unusually long in duration is correct? A. Patients with prolonged seizures have a history of epilepsy, and often require no medical care. B. Patients with prolonged seizures should be suspected of being off their antiseizure medication. C. Prolonged seizures can be life-threatening. D. Prolonged seizures mean that the patient has a history of seizures.
Prolonged seizures can be life-threatening.
With a multisystem trauma patient, which of the following should be used to determine when to bypass one hospital for another? A. Provider preference B. Protocols C. Area familiarity D. Making a shift change on time
Protocols
When you are caring for a victim of multisystem trauma, which of the following is LEAST likely to be a part of scene treatment? A. Stopping any serious external hemorrhage B. Securing an advanced airway C. Providing appropriate fluid resuscitation D. Ensuring adequate oxygenation and ventilations
Providing appropriate fluid resuscitation
Which of the following findings are commonly associated with diabetic ketoacidosis (DKA)? A. Overhydration B. Low blood sugar C. Rapid breathing D. Slow breathing
Rapid breathing
During the primary assessment, what is a sign of shock? A. Radial pulses B. Flushed skin C. Perfusion D. Rapid heart rate
Rapid heart rate
Which of the following is the highest priority for your multisystem trauma patient? A. Management of all secondary injuries B. Determining the exact extent of injuries C. Rapid transport D. Thorough documentation
Rapid transport
For a stroke patient, what is the most important treatment priority? A. Keeping the patient calm B. Rapid transport to an appropriate destination C. Administering supplemental oxygen, if necessary D. Monitoring the patient's airway
Rapid transport to an appropriate destination
The family of a 30-year-old male states that the patient recently had a tonic-clonic seizure. The event lasted 5 minutes, and the family notes that the patient has no previous history of seizures. The family also states that the patient has no past medical history of any kind. Until the point he began seizing, he had seemed fine. Which of the following causes most likely explains the previous findings? A. Anxiety B. Recent head trauma C. Hypoxia D. Hypoglycemia
Recent head trauma
You are on scene with a 24-year-old female car crash victim. During your assessment, she tells you that she can't feel all of her teeth. You note swelling to the jaw and misaligned teeth. Your primary concern in treating this patient is which of the following? A. Identifying the type of Le Fort fracture B. Obtaining a baseline set of vital signs C. Trending the patient's vital signs to identify signs of increased intracranial pressure D. Removing debris from the airway
Removing debris from the airway
You respond to the scene of an assault, where you find a 26-year-old male patient with a knife impaled in the left lobe of his skull near the temporal membrane. He is alert but disoriented. How should you manage this patient's injury? A. Perform a secondary assessment prior to stabilizing the knife B. Stabilize the knife with bulky dressings C. Stabilize the knife and carefully cut the handle off to prepare for transport D. Approximate the depth of insertion and carefully remove the knife
Stabilize the knife with bulky dressings
Your patient is a 19-year-old male who was reportedly unconscious for a brief time. You learn that he regained consciousness in about 30 seconds. You find no evidence of drowsiness or neurological deficits. Which of the following is most likely the cause? A. Status epilepticus B. Syncope C. Hyperglycemia D. Stroke
Syncope
You are caring for an adult trauma patient. Which of the following is a definitive sign that your patient is in shock? A. Diastolic BP below 90 mmHg B. Systolic BP below 100 mmHg C. Diastolic BP above 90 mmHg D. Systolic BP below 90 mmHg
Systolic BP below 90 mmHg
You are the second unit on the scene of a multiple-vehicle crash. You and your partner are caring for a middle-aged woman who is sitting in the passenger seat of a vehicle that seems undamaged. You see no signs of injury in this patient. When you ask her about pain, she replies in a foreign language. What should you do? A. Examine the patient more closely, and look for physical signs of pain when you palpate her back. B. The patient's language has no bearing on how you treat here. She does not require immobilization. C. Take full spinal precautions, because you cannot determine the extent of the patient's injuries. D. Although communication is important, given the fact that there are no MOIs and no signs of injury, you can safely choose not to immobilize the patient.
Take full spinal precautions, because you cannot determine the extent of the patient's injuries.
Which of the following will help you and your crew best manage a multisystem trauma patient? A. An incident commander B. Waiting for ALS personnel to arrive C. Teamwork and communication D. Slow, deliberate decision making
Teamwork and communication
Why is it necessary to take the patient to the hospital if the symptoms of a stroke have subsided by the time you arrive on the scene? A. The patient will probably need to be given insulin. B. The patient is likely to start seizing. C. The patient still needs assessment and treatment for stroke. D. The patient will need a period of bed rest.
The patient still needs assessment and treatment for stroke.
Which of the following statements regarding the spinal cord is true? A. The nerves that branch from the spinal cord at the vertebrae alternate from left to right. B. If the spinal cord is severed, the body will experience widespread vasoconstriction. C. The spinal cord lacks the membranes that surround the brain. D. The spinal cord is the central pathway for messages to and from the brain.
The spinal cord is the central pathway for messages to and from the brain.
Over which of the following factors that affect the survivability of a stroke patient does the EMT have the most influence? A. Initiation of an IV by ALS providers B. Reduction of blood pressure C. Intubation of the trachea D. Time to treatment
Time to treatment
What is your overall goal in caring for a multisystem trauma patient? A. To manage all injuries discovered B. To treat immediate threats to life C. To manage the patient until ALS personnel arrive D. To provide definitive care
To treat immediate threats to life
A seizure that affects the entire brain and is characterized by jerking movements of paired muscle groups is often called what type of seizure? A. Postictal B. Tonic-clonic C. Jacksonian D. Petit mal
Tonic-clonic
What type of convulsion usually lasts for only a few minutes, and has three distinct phases? A. Hypoglycemia B. Stroke C. Partial seizure D. Tonic-clonic-seizure
Tonic-clonic-seizure
What is a less immediate benefit of trauma scores that does not involve determining whether a patient should go to a trauma center? A. A trauma score helps evaluate an EMT's standard of care. B. Trauma scores are useful for medical billing and insurance coding. C. Trauma centers may use the scores to compare outcomes of trauma patients with similar injuries. Your answer is correct. D. They provide proof of care in case of malpractice lawsuits.
Trauma centers may use the scores to compare outcomes of trauma patients with similar injuries.
A 12-year-old boy experienced a tonic-clonic seizure after being struck in the head with a baseball. Which of the following would most likely be the cause of the seizure? A. Epilepsy B. Toxins C. Hypoxia D. Traumatic brain injury
Traumatic brain injury
What is the typical mental status of a patient who is actively experiencing a generalized tonic-clonic seizure? A. Awake B. Confused C. Unresponsive D. Cyanotic
Unresponsive
Which of the following would be an appropriate description of the reticular activating system? A. Vegetative and thought center B. React and move center C. Wake and sleep center D. Feed or breed center
Wake and sleep center
Which of the following is the best explanation of how dehydration leads to altered brain function? A. Water is essential to keep the brain fully expanded. B. Water is necessary to remove waste products from the brain. C. Water is necessary to keep brain tissue hydrated. D. Water is necessary for electrical signals to travel throughout the brain.
Water is necessary to keep brain tissue hydrated.
When is administering oral glucose to a hypoglycemic patient the worst thing you could do? A. When the patient can't protect the patient's airway B. When the patient desperately needs sugar C. When the patient has an altered mental status D. When the patient has a history of diabetes
When the patient can't protect the patient's airway
Which of the following is vehicle telemetry LEAST likely to be able to tell you? A. Whether the driver suffered an amputation proximal to the wrist or ankle B. Which part of the vehicle was struck C. Whether the vehicle rolled over D. Vehicle speed at time of crash
Whether the driver suffered an amputation proximal to the wrist or ankle
While assessing a patient using the Cincinnati Prehospital Stroke Scale, you note that the patient has acute-onset facial droop on the left side. This indicates: A. a normal finding for older patients. B. the likelihood that the patient experienced a seizure. C. a likelihood that the patient is experiencing a stroke. D. that the patient had a previous stroke.
a likelihood that the patient is experiencing a stroke.
A 5-year-old male is frequently witnessed simply staring off into space. Several times a day he loses focus, which has been affecting his ability to pay attention to instructions and know what's going on around him. Today his teacher saw him fall off his chair and strike his head on his desk. He now has a bleeding laceration above his right eye. The patient is now awake and crying. His vital signs are P 100, R 24, BP 100/60. His blood glucose level is 80 mg/dl. Given the patient's history, you suspect he has been suffering from: A. tonic-clonic-seizures. B. simple partial seizures. C. absence seizures. D. complex partial seizures.
absence seizures.
Your adult trauma patient has a score of 14 on the Glasgow Coma Scale, a systolic blood pressure of 90 mm Hg, and a respiratory rate of 10. You should: A. package the patient for immediate transport to a trauma center. B. reassess blood pressure and respiratory rate. C. decide whether the mechanism of injury is significant enough to merit transport to a trauma center. D. address whether the patient meets the anatomic criteria for transport to a trauma center.
address whether the patient meets the anatomic criteria for transport to a trauma center
A 73-year-old female complains of a new onset of vertigo, and states that she almost passed out when she tried to stand. She is alert but weak. Her vital signs are P 70, R 20, BP 100/60. Her pulse oximeter reads 95%. The action among the following that it is least necessary to take for this patient is to: A. administer oxygen. B. loosen any tight clothing around the neck. C. lay the patient flat. D. assess the patient's likelihood to remain stable.
administer oxygen.
A 24-year-old male has regained consciousness after a tonic-clonic seizure and is now alert. He is fatigued, and complains of generalized muscle pain. You note that he is slightly cyanotic and breathing rapidly. His vital signs are P 116, R 28, BP 174/88. You should next: A. initiate rapid transport. B. place the patient in the recovery position. C. administer supplemental oxygen. D. administer a tube of oral glucose.
administer supplemental oxygen.
A patient in the postictal state will have: A. violent movements of the body and possible cyanosis of the face and lips. B. altered mental status. C. bradycardia and dry skin. D. rigidity or stiffening of the muscles and loss of bladder control.
altered mental status.
A large puncture wound or laceration to the neck must be immediately sealed with an occlusive dressing to prevent: A. an air embolus. B. cervical spine injury. C. excessive bleeding. D. airway compromise.
an air embolus.
During the primary assessment, one clinical indication that a patient may be experiencing a hypoglycemic emergency is: A. an altered mental status. B. flushed skin. C. shallow breathing. D. a loss of appetite.
an altered mental status.
A sensation experienced by a seizure patient right before the seizure is: A. an aura. B. a vital sign. C. a premonition. D. a symptom.
an aura.
When a clot or embolism occludes an artery, this causes: A. a hemorrhagic stroke. B. receptive aphasia. C. expressive aphasia. D. an ischemic stroke.
an ischemic stroke.
In managing a patient who you have decided has an AVPU of "U," it will be important to: A. administer oxygen by nasal cannula. B. apply a pressure bandage. C. assess the patient's position and place an airway adjunct if necessary. D. use the Cincinnati Prehospital Stroke Scale.
assess the patient's position and place an airway adjunct if necessary.
Emergency medical care of a patient with suspected spinal injury includes: A. using manual cervical spine traction until a cervical collar can be applied. B. opening and maintaining the airway using the head-tilt, chin-lift method if the patient is responsive. C. assessing neurological deficits by testing grip strength. D. using sandbags to immobilize the patient's head on the long backboard.
assessing neurological deficits by testing grip strength.
Another term for a compression injury to the spine is: A. ankylosing spondylitis. B. extension injury. C. axial loading. D. flexion injury.
axial loading
Hyperglycemia is high: A. blood sugar. B. carbon dioxide. C. carbohydrates. D. oxygen.
blood sugar.
A stroke refers to the death or injury of: A. heart muscle. B. a major artery. C. brain tissue. D. a patient.
brain tissue
A patient presenting with dizziness and a rapid heart rate may be experiencing: A. hypovolemia. B. vasovagal syncope. C. cardiac dysrhythmia. D. hypoglycemia.
cardiac dysrhythmia
In assessing a possible stroke patient for arm drift, it is important to have the patient: A. keep one eye open. B. blink rapidly. C. close both eyes. D. keep both eyes open.
close both eyes.
A 52-year-old male complains of not feeling well. Family members state that upon awakening this morning, they noticed that the patient had right-sided facial droop and was slurring his words slightly. The patient states that he is a diabetic, and 5 minutes ago, his blood glucose was 88 mg/dL. After completing the primary assessment, you should next: A. complete a Cincinnati Prehospital stroke assessment. B. administer high-concentration oxygen. C. administer oral glucose. D. recheck the patient's blood glucose.
complete a Cincinnati Prehospital stroke assessment.
A diver struck his head on the bottom of the swimming pool and now complains of neck pain and numbness in his lower extremities. You suspect: A. distraction injury. B. rotational injury. C. crush injury. D. compression injury.
compression injury.
When an individual sustains blunt-force trauma to the head that results in a brief disruption of the neural network without any physical evidence or lasting residual effects, this would be termed a: A. cerebral hematoma. B. brain contusion. C. concussion. D. herniation.
concussion
A 76-year-old male patient has been found with facial droop and paralysis to the left side of his body. His vital signs are P 88, R 20, BP 210/100. His oxygen saturation is 90%. You administer oxygen and initiate transport to the local stroke center. Ten minutes later, you note that he has recovered fully. You should next: A. continue to the stroke center. B. divert to the nearest hospital. C. discontinue the oxygen. D. return the patient to his home.
continue to the stroke center.
In diabetic ketoacidosis, shock is usually caused by: A. vasoconstriction. B. blood loss. C. vasodilation. D. dehydration.
dehydration.
A stroke patient appears to understand you but can't find the correct words to express his condition. The words he uses don't make sense. This is: A. expressive aphasia. B. a partial seizure. C. receptive aphasia. D. a generalized seizure.
expressive aphasia
The hole where the spinal cord exits the cranium is called the: A. vertebral foramen. B. tentorium cerebri. C. foramen magnum. D. brainstem.
foramen magnum.
An idiopathic seizure: A. is caused by hypoglycemia. B. is caused by infection. C. has no known cause. D. is caused by irregularities in the patient's metabolism.
has no known cause.
The process by which the brain is compressed toward and through the foramen magnum is known as: A. cerebral contusion. B. herniation. C. concussion. D. subdural hematoma.
herniation
Hemorrhagic stroke is frequently the result of longstanding: A. high blood pressure. B. chronic obstructive pulmonary disease (COPD). C. high sodium intake. D. blunt-force trauma to the head.
high blood pressure
After properly measuring a patient's blood glucose level, the glucometer reading displays the word "low." This finding indicates: A. hypoxemia. B. hypoglycemia. C. hyperglycemia. D. a normal blood glucose level.
hypoglycemia.
A patient fainted when she tried to stand up, and you discover signs of internal bleeding during your assessment. This patient's syncope was likely from: A. hypovolemia. B. hypoxia. C. absence seizure. D. cardiac dysrhythmia.
hypovolemia
Skull injuries divide into two general categories, which are: A. direct and indirect. B. open and closed. C. subdural and epidural. D. traumatic and nontraumatic.
open and closed.
The police call you for a 50-year-old male patient who has a history of intoxication and belligerence. You find him sitting on the curb with a small abrasion, minimal bleeding to his forehead, and his hands cuffed behind his back. He is exhibiting tremors, and his speech is slurred. He denies any pain, denies any consumption of alcohol, and says that he sustained the abrasion 3 days earlier. You should: A. transport him without spinal precautions. B. explain the risks to the patient and let him choose whether or not to be immobilized. C. ask law enforcement for permission to immobilize the patient. D. immobilize him, because the history seems unreliable.
immobilize him, because the history seems unreliable.
Paralysis of the extremities is probably the most reliable sign of spinal cord injury: A. if accompanied by paresthesia. B. if verbal response is also impaired. C. in patients who are conscious. D. in pediatric patients.
in patients who are conscious
Abnormally high pressure within the skull is known as: A. cerebral hypertension. B. intracranial hemorrhage. C. concussive injury. D. increased intracranial pressure.
increased intracranial pressure.
When treating a patient with damage to the facial bones, you should have a high index of suspicion for: A. cranial cohesion B. thoracic separation. C. injury to the brain. D. aphagia.
injury to the brain
A patient with more than one serious injury: A. has a triage score of 3. B. is a triage patient. C. is a multiple trauma patient. D. is a multisystem trauma patient.
is a multiple trauma patient.
If you describe a patient as presyncope, you mean that the patient: A. is experiencing an absence seizure. B. is about to faint. C. is agitated. D. is hypoglycemic.
is about to faint.
A 16-year-old male athlete suffered a syncopal episode while playing soccer on a hot, humid day. You find him lying supine and complaining of dizziness. He has no apparent injuries. You should: A. ask the patient to stand while you take his pulse and blood pressure. B. apply high-concentration oxygen, and transport in Trendelenburg position. C. initiate high-priority transport to the nearest hospital and intercept with ALS. D. keep the patient supine and allow him to slowly recover. Consider ALS and/or transport.
keep the patient supine and allow him to slowly recover. Consider ALS and/or transport.
Hyperglycemia is usually caused by a decrease in insulin, which: A. causes an excessive amount of water to build up in the tissues of the body. B. leaves sugar in the bloodstream rather than helping it enter the cells. C. signals the liver to release glycogen to raise blood glucose levels. D. engages the fight-or-flight response of the autonomic nervous system.
leaves sugar in the bloodstream rather than helping it enter the cells.
A 17-year-old female has been actively seizing for over 5 minutes. The patient's jaw is clenched, and you note that she is cyanotic around her lips. Her vitals are P 130, R 18, BP 180/92. You should next: A. protect the patient from injury until the convulsions subside. B. begin CPR. C. maintain the airway and administer oxygen as appropriate. D. reassess the patient.
maintain the airway and administer oxygen as appropriate.
Dizziness: A. is simply another term for altered mental status. B. means different things to different people. C. is the sudden sensation of a loss of strength. D. is the rapid onset of extreme vertigo.
means different things to different people.
Your patient was involved in a motor vehicle collision. You have decided to transport him to a trauma center because another occupant in the same vehicle died. Your decision is based on: A. physiological findings. B. pathophysiological findings. C. mechanism of injury. D. anatomical findings.
mechanism of injury.
The three sections of the Glasgow Coma Scale (GCS) include: A. appearance. B. motor response. C. level of consciousness. D. breathing effort.
motor response.
To prevent additional injuries during repeated seizures, you should: A. place the patient on his back. B. move objects away from the patient. C. immediately transport the patient. D. bind the patient's hands and feet.
move objects away from the patient.
Shock, or hypoperfusion, caused by a spinal cord injury is classified as: A. hypovolemic. B. neurogenic. C. cardiogenic. D. idiopathic.
neurogenic.
In neurogenic shock, the pulse rate may be: A. normal. B. lower than the blood pressure. C. undetectable. D. erratic.
normal.
Syncope due to gastrointestinal bleeding is especially common in: A. younger patients. B. older patients. C. diabetic patients. D. otherwise healthy patients.
older patients
In the Cincinnati Prehospital Stroke Scale (CPSS) screening method, arm drift is when: A. one arm drifts compared with the other. B. both arms are held to the patient's sides. C. both arms move equally. D. the palms of both hands face upward.
one arm drifts compared with the other.
A partial seizure affects: A. consciousness. B. one part or one side of the brain. C. the extremities. D. the entire brain.
one part or one side of the brain
You arrive on scene at a motor vehicle crash, where you notice that the patient has severe bleeding from her head with gray matter showing. This type of injury is a(n): A. open skull fracture. B. closed head injury. C. subdural hematoma. D. mortal injury.
open skull fracture.
Hyperglycemia typically develops: A. over the course of an hour or so. B. over days or even weeks. C. in a few seconds. D. in a few minutes.
over days or even weeks
A 62-year-old female was found confused and diaphoretic. Her blood glucose level was assessed to be 35 mg/dl. After administering a tube of oral glucose, you should next: A. make sure the patient can swallow. B. perform a reassessment. C. administer a second tube of oral glucose. D. initiate transport.
perform a reassessment.
If your patient is actively seizing, it may be necessary to: A. insert a tongue depressor. B. place the patient on the floor or ground. C. insert a bite block. D. forcibly restrain the patient.
place the patient on the floor or ground.
If a patient becomes unresponsive during administration of oral glucose, the EMT should: A. insert a tongue depressor. B. reassess the airway and breathing. C. repeat the oral glucose. D. give oxygen via a nonrebreather mask.
reassess the airway and breathing
After administering oral glucose to a patient in a diabetic emergency, you should: A. find out if the patient has a history of diabetes. B. take the patient's vital signs. C. perform a primary assessment. D. reassess the patient.
reassess the patient.
If a patient in a diabetic emergency is not awake enough to swallow, then: A. treat the patient as though the patient has an alert mental status, and let the patient self-administer oral glucose. B. secure the airway, provide ventilations if necessary, and be prepared to perform CPR if necessary. C. position the patient on the patient's back, to prevent choking on or aspiring fluids or vomitus. D. administer oral glucose and then reassess the patient.
secure the airway, provide ventilations if necessary, and be prepared to perform CPR if necessary.
The steps in immobilizing a supine patient to a long backboard include: A. removing the cervical collar once the patient is immobilized on the board. B. securing the patient's torso to the board before securing the head. C. not placing padding on the board, as it might move the spine out of alignment. D. using the logroll and then quickly assessing the anterior body.
securing the patient's torso to the board before securing the head.
Objects that are impaled into the head and interfere with transport should be: A. gently but firmly removed. B. left in place and transported in a flat-bed vehicle. C. stabilized and cut with minimal movement of the object. D. pushed through to the other side for removal.
stabilized and cut with minimal movement of the object.
Diabetes mellitus is also known as: A. stroke. B. sugar diabetes. C. hypoglycemia. D. hyperglycemia.
sugar diabetes
In a patient who sustained massive impact trauma to the face during a motor vehicle crash, the presence of facial fractures and a fractured mandible should lead you to suspect: A. That the patient was unrestrained. B. that the patient is not likely to have a brain injury, because the facial fractures absorbed all of the energy at impact. C. that a compromised airway is not very likely. D. that the energy involved might have caused skull or brain injury.
that the energy involved might have caused skull or brain injury.
An injury to the cranium would directly affect: A. the part of the nervous system that controls involuntary functions. B. the fluid that surrounds the brain and spinal cord. C. the two fused bones forming the upper jaw. D. the bony structure making up the forehead and top, back, and upper sides of the skull.
the bony structure making up the forehead and top, back, and upper sides of the skull.
The term "golden hour" refers to the importance of getting critical trauma patients to surgery within one hour of the time when: A. EMS arrived on scene. B. EMS was activated. C. the injury occurred. D. the patient was transported.
the injury occurred.
The difference between a multisystem trauma patient and a multiple trauma patient is: A. the seriousness of injuries. B. whether the injuries involve blood loss. C. the number of body systems affected. D. whether the injuries involve the cardiovascular system.
the number of body systems affected.
You are taking the history of a 35-year-old male patient who is unresponsive in the postictal phase of a tonic-clonic seizure from the patient's spouse, who informs you that the patient has been taking a prescribed medication for managing generalized seizures for several months. Based on this information, you suspect it is most likely that: A. the patient failed to take his prescribed medication. B. the prescribed medication's dosage was probably insufficient to manage the patient's seizures. C. the prescribed medication is not correct for the patient's type of seizure. D. the prescribed medication has expired without the patient's realizing it.
the patient failed to take his prescribed medication.
A hypoglycemic 15-year-old female has been found unconscious. You should not administer oral glucose, because: A. the patient is not awake enough to swallow. B. the patient's problem is too little insulin. C. the patient is severely hypoglycemic. D. the patient needs to consent to glucose administration.
the patient is not awake enough to swallow
If your patient is wearing a helmet, you should leave it in place if: A. there are no impending airway or breathing problems. B. the helmet is loose enough to allow you to assess the patient's head and neck. C. the helmet has been damaged. D. the helmet is not too snug to remove easily.
there are no impending airway or breathing problems.
Contraindications to the use of oral glucose in a patient with altered mental status and a history of medication-controlled diabetes include: A. the patient's taking insulin today but not eating. B. the patient's being unable to swallow. C. not knowing whether the patient has taken insulin today. D. a history of type II diabetes.
the patient's being unable to swallow.
Your patient has a Revised Trauma Score of 3. This means that: A. the patient has the lowest score possible. B. the patient has the highest score possible. C. the patient's condition is moderate. D. the patient's condition is critical.
the patient's condition is critical.
The 12 vertebrae in the upper back are known as the: A. thoracic spine. B. lumbar spine. C. coccyx. D. sacral spine.
thoracic spine
During your primary assessment, it is important to remember: A. that inadequate breathing may result from spinal cord damage from a thoracic spine injury. B. that the patient's skin may be cool, pale, and moist below the site of spinal cord injury and warm and dry above the site of injury. C. to open the airway of an unresponsive patient using the head-tilt, chin-lift method. D. to initiate immediate manual in-line spinal stabilization according to patient need.
to initiate immediate manual in-line spinal stabilization according to patient need.
The phase of the seizure in which muscles become contracted and tense is called the: A. postictal phase. B. tonic phase. C. preictal phase. D. clonic phase.
tonic phase.
Your patient fell 15 feet from a roof. He has a deformed lower leg and a decreased level of consciousness. You designate the patient as a multisystem trauma patient who should be taken to a nearby trauma center. This is a: A. physical examination. B. secondary assessment. C. transport decision. D. primary assessment.
transport decision.
Calculating the trauma score may help to determine whether a patient should go to a(n): A. trauma center. B. emergency department. C. burn center. D. hospital.
trauma center.
You are caring for an elderly trauma patient. The mechanism of injury is not remarkable, but your instincts tell you that something is wrong. You should: A. delay your transport decision and further evaluate the patient. B. ignore your instincts until you have evidence. C. trust your judgment. D. wait for ALS personnel to arrive.
trust your judgment.
The purpose of spinal motion restriction is to prevent movement of individual: A. tendons. B. joints. C. muscles. D. vertebrae.
vertebrae