EMT Chapters 24, 25, 26, 27, 29, 30, 31, 32

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: (a) perform a head-to-toe assessment while she is in the car. (b) lift the air bag and look for deformity to the steering wheel. (c) carefully assess her upper chest for seatbelt-related injuries. (d) extricate her immediately and transport to a trauma center.

(b) lift the air bag and look for deformity to the steering wheel.

Which of the following statements regarding rebound tenderness is correct? (a) It should be assessed for by vigorously palpating the abdomen. (b) Rebound tenderness is a specific sign found with a spleen injury. (c) It is often discovered when the patient is jarred or moved suddenly. (d) The absence of rebound tenderness rules out intra-abdominal injury

(c) It is often discovered when the patient is jarred or moved suddenly.

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: (a) air bag deployment. (b) failure to wear seatbelts. (c) a poorly placed lap belt. (d) rapid vehicle deceleration.

(c) a poorly placed lap belt.

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? (a) Pancreas (b) Fallopian tubes (c) Urinary bladder (d) Liver or spleen

(c) urinary bladder

Management of evisceration injuries includes _______. (a) keeping the injury cool and dry (b) applying firm, direct pressure (c) closing the injury with duct tape (d) keeping the injury moist and warm

(d) keeping the injury moist and warm

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?

30%

Which of the following scenarios is an example of a direct injury? A) A passenger fractures her patella after it strikes the dashboard. B) A skier dislocates his knee after a twisting injury to the ankle. C) A person lands on his or her feet and fractures the lumbar spine. D) A child dislocates his elbow after falling on his outstretched arm.

A) A passenger fractures her patella after it strikes the dashboard.

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A) Nondisplaced pelvic fracture B) Open fractures of a long bone C) An amputation of an extremity D) Multiple closed long bone fractures

A) Nondisplaced pelvic fracture

In which of the following situations would external bleeding be the MOST difficult to control? A. Femoral artery laceration and a blood pressure of 140/90 mm Hg B.Jugular vein laceration and a systolic blood pressure of 90 mm Hg C. Carotid artery laceration and a systolic blood pressure of 60 mm Hg D. Antecubital vein laceration and a blood pressure of 138/92 mm Hg

A. Femoral artery laceration and a blood pressure of 140/90 mm Hg

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. apply a compression device around his pelvis. B. assess his blood pressure to detect hypotension. C. stabilize his pelvis by placing him onto his side. D. elevate his legs, keep him warm, and transport.

A. apply a compression device around his pelvis.

A 40-year-old man, who was the unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. You should be MOST concerned that he: A.has injured his myocardium. B.has a collapsed lung and severe hypoxia. C.has extensive bleeding into the pericardial sac. D.is at extremely high risk for ventricular fibrillation.

Answer: A Rationale: A myocardial contusion, or bruising of the heart muscle, is usually the result of blunt trauma—specifically to the center of the chest. In some cases, the injury may be so severe that it renders the heart unable to maintain adequate cardiac output; as a result, blood pressure falls. The pulse rate is often irregular; however, lethal cardiac dysrhythmias such as ventricular tachycardia and ventricular fibrillation are uncommon.

5.While inspecting the interior of a wrecked automobile, you should be MOST suspicious that the driver experienced an abdominal injury if you find: A.a deformed steering wheel. B.that the airbags deployed. C.a crushed instrument panel. D.damage to the lower dashboard.

Answer: A Rationale: Airbags save lives when used in conjunction with properly worn seatbelts. Unfortunately, however, not all drivers wear their seatbelts. If unrestrained, the driver's abdomen may strike the steering wheel, resulting in significant trauma. Suspect this if you lift the airbag and note that the lower part of the steering wheel is deformed.

Which of the following mechanisms of injury would MOST likely cause a crushing injury of the larynx and/or trachea? A.Attempted suicide by hanging B.Gunshot wound to the lateral neck C.Car crash involving lateral impact D.Patient whose head hits the windshield

Answer: A Rationale: Any crushing injury of the upper part of the neck is likely to involve the larynx or trachea. Examples include the anterior neck impacting a steering wheel, hanging (distraction) mechanisms, and clothesline injuries.

When caring for a female with trauma to the external genitalia, the EMT should: A.use local pressure to control bleeding. B.carefully pack the vagina to reduce bleeding. C.remove any impaled objects from the vagina. D.cover any open wounds with moist, sterile dressings.

Answer: A Rationale: Bleeding from the external genitalia should be controlled by applying a dry, sterile dressing and local direct pressure. Never pack anything into the vagina to try to control bleeding; this increases the risk of infection, and anything you place into the vagina will only need to be removed at the hospital. Impaled objects in the genitalia should be carefully stabilized in place, not removed.

When caring for a chemical burn to the eye, the EMT should: A.prevent contamination of the opposite eye. B.immediately cover the injured eye with a sterile dressing. C.avoid irrigating the eye, as this may cause further injury. D.irrigate both eyes simultaneously, even if only one eye is injured.

Answer: A Rationale: When irrigating a chemical burn to the eye, it is important to direct the stream away from the uninjured eye. If you do not, you will likely flush the chemical into the unaffected eye. After irrigating the eye for the appropriate amount of time, cover both eyes with a sterile dressing.

The primary reason for applying a sterile dressing to an open injury is to: A.prevent contamination. B.control external bleeding. C.reduce the risk of infection. D.minimize any internal bleeding.

Answer: B Rationale: Although prevention of contamination is an important reason for applying a sterile dressing to an open injury, the primary reason is to control the external bleeding associated with it.

When a person is exposed to cold temperatures and strong winds for an extended period of time, he or she will lose heat mostly by: A.radiation. B.convection. C.conduction. evaporation.

Answer: B Rationale: Convection occurs when heat is transferred to circulating air, as when cool air moves across the body surface. A person wearing lightweight clothing and standing outside in cold, windy weather is losing heat to the environment mostly by convection

Signs and symptoms of a chest injury include all of the following, EXCEPT: A.hemoptysis. B.hematemesis. C.asymmetrical chest movement. D.increased pain with breathing.

Answer: B Rationale: Signs and symptoms of a chest injury include bruising to the chest, chest wall instability, increased pain with breathing, asymmetrical (unequal) chest movement if a pneumothorax is present, and hemoptysis (coughing up blood) if intrapulmonary bleeding is occurring. Hematemesis (vomiting blood) indicates bleeding in the gastrointestinal tract—usually the esophagus or stomach—not the chest cavity.

When a person is looking at an object up close, the pupils should: A.dilate. B.constrict. C.remain the same size. D.dilate, and then constrict.

Answer: B Rationale: The pupils, which allow light to move to the back of the eye, constrict in bright light and dilate in dim light. The pupils should also constrict when looking at an object up close and dilate when looking at an object farther away; this is called pupillary accommodation. These pupillary adjustments occur almost instantaneously.

A patient tripped, fell, and landed on her elbow. She is in severe pain and has obvious deformity to her elbow. You should: A.assess distal pulses. B.manually stabilize her injury. C.assess her elbow for crepitus. apply rigid board splints to her arm.

Answer: B Rationale: When caring for a patient with an orthopaedic injury, you should first manually stabilize the injury site; this will prevent further injury. You should then assess pulse, motor functions, and sensory functions distal to the injury. Splint the injury using the appropriate technique, and then reassess pulse, motor functions, and sensory functions. Do not intentionally assess for crepitus; this is a coincidental finding that you may encounter during your assessment and should not be elicited.

You respond to a soccer game for a 16-year-old male with severe ankle pain. When you deliver him to the hospital, the physician tells you that he suspects a sprain. This means that: A.there is a disruption of the joint and the bone ends are no longer in contact. B.the patient has an incomplete fracture that passes only partway through the bone. C.stretching or tearing of the ligaments with partial or temporary dislocation of the bone ends has occurred. D.the muscles of the ankle have been severely stretched, resulting in displacement of the bones from the joint.

Answer: C Rationale: A sprain is a joint injury in which there is both partial or temporary dislocation of the bone ends and partial stretching or tearing of the supporting ligaments. Sprains are typically marked by swelling, pain, and ecchymosis.

Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? A.Head-on collision B.Angular collision C.Ejection Controlled crash

Answer: C Rationale: During an ejection, the rider will travel at high speed until stopped by a stationary object, another vehicle, or road drag. Severe abrasion injuries (road rash) down to bone can occur with drag.

A motorcyclist crashed his bike and has closed deformities to both of his midshaft femurs. He is conscious, but restless; his skin is cool and clammy; and his radial pulses are rapid and weak. The MOST appropriate splinting technique for this patient involves: A.applying rigid board splints. B.applying two traction splints. C.securing him to a long backboard. immobilizing his femurs with air splints

Answer: C Rationale: In this particular case, it is more practical—and less time-consuming—to secure the patient to a long backboard. He is in shock and requires rapid transport. Taking the time to apply traction splints, air splints, or board splints will only delay transport.

Even when seatbelts are worn properly and the airbags deploy, injury may occur to the: A.chest. B.extremities. C.iliac crests. D.lower ribcage.

Answer: C Rationale: Seatbelts should be positioned over the iliac crests of the pelvis. If they are positioned higher, significant intra-abdominal injury can occur. Even when seatbelts are properly positioned and the airbags deploy, injury to the iliac crests may occur as the locking mechanism of the seatbelt engages during a motor vehicle crash that involves rapid deceleration.

5.When caring for a patient with internal bleeding, the EMT must first: A.ensure a patent airway. B.obtain baseline vital signs. C.control any external bleeding. D. take appropriate standard precautions

Answer: D Rationale: All of the interventions in this question must be performed. However, before providing patient care—whether the patient is bleeding or not—the EMT must first ensure that he or she has taken the appropriate standard precautions.

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.

Answer: D Rationale: Rollover crashes are the most unpredictable with regard to injuries sustained by the patient. An unrestrained passenger may have struck multiple points within the vehicle. However, the most life-threatening event in a rollover is ejection or partial ejection of the patient from the vehicle.

8.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

Answer: D Rationale: Severe burns include the following: full-thickness burns involving the hands, feet, face, airway, or genitalia; full-thickness burns covering more than 10% of the body's total surface area (BSA); partial-thickness burns covering more than 30% of the BSA; burns involving the respiratory tract (eg, smoke inhalation); burns complicated by fractures; and burns on patients younger than 5 years or older than 55 years that would otherwise be classified as "moderate" burns on younger adults.

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

B) leave the toes exposed.

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. A) strain B) sprain C) fracture D) dislocation

B) sprain

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessmentreveals minimal bleeding. Appropriate care for this injury includes: A. applying a tight pressure dressing. B. padding between the ear and the scalp. C. packing the ear with sterile gauze pads. D. covering the wound with a moist dressing.

B. Padding between the ear and the scalp

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. quickly suction his oropharynx. B. turn the backboard onto its side. C. reassess his breathing adequacy. D. alert the hospital of the situation.

B. Turn the backboard onto its side

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

B. collapsed jugular veins

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should: A. Apply ice packs to his axillae B. Move him into the cooled ambulance

B. move him into the cooled ambulance

Signs and symptoms of an air embolism include all of the following, EXCEPT: A. dysphasia. B. pale skin. C. dizziness. D. joint pain.

B. pale skin.

A patient with a core body temperature of 95°F (35°C) will MOST likely experience: A. a slow pulse. B. rapid breathing. C. muscle stiffness. D. loss of consciousness.

B. rapid breathing.

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

B. repeat the primary assessment.

A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A.deployed airbags. B.steering wheel deformity. C.starring of the windshield. D.a crushed instrument panel.

B.steering wheel deformity. Rationale: Blunt chest injuries during a motor vehicle crash typically occur when the chest impacts the steering wheel. Therefore, your inspection of the vehicle's interior will most likely reveal a deformed steering wheel.

Which of the following statements regarding shoulder dislocations is correct? A) Posterior dislocations are most common. B) They are caused by forced arm adduction. C) Most shoulder dislocations occur anteriorly. D) They involve the acromion process and humerus.

C) Most shoulder dislocations occur anteriorly.

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: A) administer high-flow oxygen to the patient. B) remove the towel and inspect the wound. C) apply a tourniquet just below the shoulder. D) wrap the severed arm in a sterile dressing.

C) apply a tourniquet just below the shoulder.

A 30-year-old man complains of severe pain to his right tibia following 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: A) the nerves behind the knee are compromised. B) a severe infection has developed in the muscle. C) pressure in the fascial compartment is elevated. D) the nerves supplying the foot have been severed.

C) pressure in the fascial compartment is elevated.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: A. incus. B. pinna. C. tragus. D. stapes.

C. Tragus

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: A. a swimmer breathes shallowly before entering the water. B. a diver holds his or her breath during a staged ascent. C. a swimmer hyperventilates prior to entering the water. D. a diver holds his or her breath for a long period of time.

C. a swimmer hyperventilates prior to entering the water.

Signs of late heat stroke include: A. hot, moist skin. B. nausea and vomiting. C. a weak, rapid pulse. D. a change in behavior.

C. a weak, rapid pulse.

You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration? A. a total collapse of the affected lung. B. Hidden bleeding in the thoracic cavity C. Compression of the aorta and vena cava D. Blood accumulation in the plural space.

C. compression of the aorta and vena cava

All of the following snakes are pit vipers, EXCEPT for the: A. copperhead. B. rattlesnake. C. coral snake. D. cottonmouth.

C. coral snake.

Common signs and symptoms of a chest injury include all of the following, EXCEPT: A. localized pain B. tachypnea C. hematemesis D. chest wall ecchymosis

C. hematemesis

A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A.Deployed airbag B.Bent steering wheel C.Nonintact windshield D.Crushed instrument panel

C.Nonintact windshield Rationale: The mechanism of injury and condition of the vehicle's interior suggest likely areas of injury. Head and neck injuries are likely to result when the head and face impact the windshield

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

D) point tenderness.

You are dispatched to a convenience store where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: A. apply direct pressure below the lacerated vessel. B. circumferentially wrap a dressing around his neck. C. apply pressure to the closest arterial pressure point. D. apply direct pressure above and below the wound.

D. Apply direct pressure above and below the wound

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. Esophageal tear B. Crushed cricoid C. Collapsed trachea D. Laryngeal fracture

D. Laryngeal fracture

The hallmark sign of compartment syndrome is: A. a lack of pain despite the severity of the injury. B. extreme redness to the injury site. C. a bounding pulse distal to the injury. D. pain out of proportion to the injury.

D. pain out of proportion to the injury.

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip 2 days ago. On the basis of this patient's presentation, you should suspect:

Lyme Disease

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect:

a black widow spider bite.

A patient with a chest injury has a blood pressure of 100/60 mm Hg and a pulse rate of 120 beats/min. Which of the following additional findings should make you suspect a pericardial tamponade? a. the pulse becomes irregular b. Repeat BP of 90/68 mm Hg c. Flattening of the jugular veins d. Unilaterally absent breath sounds

b. Repeat BP of 90/68 mm Hg

What is hyphema?

bleeding into the anterior chamber of the eye

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

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

When assessing a patient with a hemothorax, you will MOST likely find: A. jugular venous engorgement b. ipsilateral tracheal deviation. c. distant or muffled heart tones d. signs or symptoms of shock.

d. signs or symptoms of shock.

The esophagus, trachea, and great vessels reside in the _______.

mediastinum

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

move him as a unit to a supine position.