EMT Exam 4: Ch 29-35

You suspect that your patient has a GI bleed. She presents with​ tachycardia, hypotension, and pale skin. What stage of shock is she most likely​ in?

decompensated shock

The layer of skin that is rich with blood​ vessels, nerves, and specialized structures is​ the:

dermis

In a​ contusion, what remains​ intact?

epidermis

The skin is the largest organ of the body. It is composed of three​ layers, including​ the:

epidermis

Which patient most likely has an abdominal​ injury?

Patient tries to lie still with legs drawn up.

Which of the following statements is​ true?

Pediatric and geriatric patients are especially at risk for hypothermia.

You are assessing a victim of a gunshot wound to the head. Her eyes are​ open, but she does not follow or track any movement. There is no eye​ blink, and her pupils are fixed and dilated. Her motor response score is a​ 1, and her verbal response is a 1 as well. What is her​ eye-opening score?

1

Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso​ (chest and​ abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface​ burned?

22.5%

Which of the following patients is the most​ critical, based on trauma triage​ guidelines?

31-year-old male​ construction-site fall victim who fell approximately two stories and who demonstrates signs and symptoms of shock

You are assessing a patient who is unconscious but who responds to painful stimuli by attempting to push away the painful stimulus​ (for instance, a pinch on the​ leg) with his hand. How would you score his motor response according to the Glasgow Coma​ Scale?

5

How many vertebrae make up the cervical​ spine?

7

During severe external​ bleeding, the brain may suffer a lack of oxygen. Which of the following contributes most to that lack of​ oxygen?

A reduction in the number of red blood cells and blood pressure

In cold​ weather, which of the following persons is most susceptible to a cold​ emergency?

A warmly dressed person lying flat on the cold ground

Which of the following patients at the scene of an accident is most likely developing​ shock?

An elderly female is vomiting on her hands and knees.

The humerus is an example of​ a(n):

Appendicular bone

Which of the following statements is​ true? (arteries)

Arteries carry blood from the heart.

In neurogenic​ shock, what mechanism causes​ hypoperfusion?

Arteries that are under continuous nervous control lose their ability to maintain contraction and dilate​ fully, causing a drop in blood pressure.

You are treating a​ 42-year-old male complaining of chest pain and shortness of breath. You notice that he appears​ pale, cool, and sweaty. What is the most likely reason for these​ findings?

Blood vessels constrict in response to sympathetic​ stimulation, causing a decrease in blood flow to the skin.

Which of the following statements is​ true? (trauma)

Bullet wounds are a type of penetrating​ trauma, and involve both internal and external injuries.

How does the skin provide temperature​ regulation?

By altering the blood flow to the skin and by controlling perspiration

When treating a patient with an open musculoskeletal injury to the​ thigh, how would you best treat the open​ wound?

Cover the open wound with a sterile​ dressing, elevate the​ extremity, and apply a cold pack to the area to help reduce swelling.

Which of the following describes shock following spinal​ injury?

Dilation of the blood​ vessels, resulting in reduction of perfusion to tissues

Which of the following statements about puncture wounds is​ correct?

Even​ insignificant-looking puncture wounds can cause devastating injuries.

In all forms of​ shock, what is the greatest consequence to the​ body?

Inadequate delivery of oxygen to the cells

You are treating a​ 29-year-old motorcycle crash victim who appears​ pale, cool, and diaphoretic. You suspect he sustained a traumatic brain injury based on decreased pupillary response. Based on these findings and the mechanism of​ injury, which of the following is the most appropriate method to manage this​ patient?

Limit​ on-scene time and promptly transport the patient to the hospital.

You are caring for a​ 19-year-old female patient who was involved in a motor vehicle crash. She sustained​ blunt-force trauma to her face with​ contusions, swelling, and minor bleeding throughout her facial region. Which of the following findings most strongly suggests a fractured​ mandible?

Lower teeth that are out of alignment in the front

Which of the following is the best sign of a pelvic​ injury?

Pain in the​ pelvis, significant mechanism of​ injury, obvious deformity

To stabilize a hip​ fracture, how should you bind the legs​ together?

Place a folded blanket between the​ patient's legs and bind the legs together with wide​ straps, Velcro-equipped​ straps, or wide cravats.

You are treating a​ 22-year-old male who was stabbed in the neck during a bar fight. What is an important part of the treatment of this​ injury?

Sealing the wound with an occlusive dressing

Which of the following statements about the​ body's response to heat loss is​ true?

Shivering stops when the patient becomes severely hypothermic.

You arrive on scene to a patient with an arterial bleed from his right lower leg. The patient is​ lethargic, and has many other injuries. What should you do​ first?

Stop the hemorrhage with direct pressure

The region where the jaw articulates with the remainder of the head is termed​ the:

TMJ (temporomandibular joint)

What is the purpose of a​ flutter-valve occlusive​ dressing?

To allow air to escape but not enter

In caring for an open neck​ wound, it is important to avoid compressing both carotid arteries at the same time.​ Why?

To prevent a dangerous reduction of blood flow to the brain

You suspect that your patient has a deep local cold injury. Which of the following signs or symptoms would you​ expect?

White, waxy-appearing skin

If you see angulation when assessing a​ patient, then:

a bone or bones are out of anatomical position.

The first step in the progression of compartment syndrome is​ that:

a fracture or crush injury causes bleeding or swelling in an extremity.

Which of the following statements is true of a compression​ injury?

a mechanism of injury involving a compression injury could be a driver striking his chest on a steering column.

A GCS of 8​ indicates:

a significant likelihood of head injury.

All burns are to be treated as more serious​ if:

accompanied by other injuries or medical problems.

Which of the following may be dangerous if done incorrectly or used when not​ indicated?

active rewarming

Timing in multisystem trauma management​ involves:

an awareness that time on scene must be efficiently managed in order to expedite transport

When caring for the victim of a motor vehicle​ collision, the EMT should suspect critical injuries​ if:

another occupant was killed

Your patient presents with signs and symptoms of shock after a motor vehicle crash. Which of the following would be one such​ sign?

apparent agitation

You have a patient with a long laceration to his thigh after falling through a roof on which he was working. The bleeding is bright red and​ spurting, and the patient is becoming increasingly pale and disoriented. How would you characterize this​ bleeding?

arterial

You suspect that your patient is suffering from severe hypothermia. When checking for a​ pulse, you should check​ for:

at least 60 seconds

When a flap of tissue is traumatically​ removed, this condition is called​ a(n):

avulsion

When​ crushed, the liver and​ spleen:

bleed profusely and cause shock.

Which of the following is a common cause of nontraumatic brain​ injury?

blood clot

What type of injury is likely to produce a flail​ segment?

blunt trauma

In the case of a large​ evisceration, you should place layers​ of:

bulky dressings over a dressing moistened with saline.

You are caring for a victim who was rescued from a burning building by the fire department. The patient is alert and oriented with superficial burns to the​ arms, chest,​ neck, and face. He complains that he cannot breathe well. What is this​ patient's most critical​ injury?

burns to the face

Microscopically small structures in the circulatory system that supply every cell in the body​ are:

capillaries

For a patient at what stage of shock are the efforts of EMTs likely to be most successful and have the greatest impact on a positive​ outcome?

compensated shock

You respond to the scene of a​ 27-year-old female who was working on her car when she​ "snagged her hand on a sharp​ edge." She has napkins around her hand covering the wound. You uncover it and note that the bleeding is slow and dark red in color. Direct pressure easily stops the bleeding. Based on this​ information, what is the source of her​ bleeding?

cephalic vein

An internal injury with no open pathway from the outside is​ called:

closed

A fracture that results in multiple bone pieces at the fracture site is termed​ a:

comminuted fracture

You are dispatched to the local​ park, where a​ 15-year-old male is in sudden cardiac arrest after being struck in the chest by a ball. As you arrive at the​ patient, you should immediately do which of the​ following?

confirm pulseless arrest and begin cpr

For a young child with isolated genital​ injuries, you​ should:

consider the possibility of​ abuse, and treat the child with sensitivity.

You and your partner disagree on the best destination for a trauma patient. In this​ situation, you​ should:

consult your protocols or medical direction

The catcher at a baseball game is struck on the front of his head by a thrown bat. He sustains a cerebral bruise on the front of his brain but also has a contusion on the back of his brain. The bruise on the back of his brain is called​ a(n):

contrecoup injury

when palpating a fracture site on a​ patient's mid-thigh, you notice a grating sensation. This is known​ as:

crepitus

Which of the following statements should you use as a guideline in managing patients with a local cold​ injury?

do not​ re-expose the patient to cold.

Generally, when providing emergency care of open​ wounds, the first thing you would do​ is:

expose the wound

You just arrived at the scene of a motor vehicle crash involving two cars. The passenger of one car is sitting in the front​ seat, unconscious, with her chin to her chest. She is having snoring​ respirations, so you carefully position her head in a neutral position to clear her airway. In doing​ so, you notice that her nose is​ bleeding, there is a reddened area on her forehead at the​ hairline, and the windshield is​ starred, with some hair stuck in the fractured glass. What type of cervical injury should you​ suspect?

extension or flexion injury

Which of the following blood vessels do you believe will cause the most significant hemorrhage if​ injured?

femoral artery

A fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment is called​ a:

flail chest

During transport of a hypothermic patient who is alert and responding​ appropriately, and whom local protocols dictate you may actively​ rewarm, you​ should:

gently apply heat to the​ patient's body.

You are caring for a​ 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be most preferred in managing this​ wound?

gloves and a face shield

Which of the following components is not used during the evaluation of the Revised Trauma​ Score?

heart rate

A swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel is​ a(n):

hematoma

You find out that one of your patients from an earlier car wreck suffered bleeding that caused the blood to collect and pool within the​ patient's skull. Based on this​ information, you know that the patient most likely suffered which type of brain​ injury?

hematoma

Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is​ this?

hematoma

An open wound to the​ chest, if an occlusive dressing is not​ available, should be​ sealed:

immediately with a gloved hand

For a​ high-priority, unstable patient with musculoskeletal​ injuries, you​ should:

immobilize the whole body on a long spine board and​ "load and​ go."

Hypoperfusion​ is:

inadequate blood flow to the tissues.

What is the primary concern about a splint that is applied too​ loosely?

it could allow the bone fragments to​ move, which could cause further damage.

In a​ dislocation, what structures other than the joint capsule are likely to be​ injured?

ligaments

Damage to which of the following organs is least likely in the case of abdominal​ bruising?

lungs

Your patient is unable to move his lower jaw or speak. You should suspect an injury to​ the:

mandible

For an older trauma​ patient, what is LEAST important to determining the​ patient's priority for triage to a higher level of​ care?

medications for chronic conditions

Which of the following is the best indicator of perfusion in the​ adult?

mental state and alertness

In your care of a patient suffering from shock due to a motor vehicle​ crash, which of the following is most​ critical?

minimizing your scene time

Blunt trauma​ is:

more common in rural and suburban areas

A brain injury is classified as nontraumatic if it​ is:

not attributable to an external cause.

A fracture may be classified​ as:

open or closed

A movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is​ called:

paradoxical motion

Which of the following types of patients typically have an ineffective shivering response to​ cold?

pediatric patients

The term used for the delivery of oxygen and nutrients from the blood through the thin capillary walls into the cells and the removal of carbon dioxide and other waste products from the cells​ is:

perfusion

When air is present in the chest​ cavity, the injury is called​ a:

pneumothorax

Which pregnant trauma patient is the highest priority for transport to a trauma​ center?

pregnant for 24 weeks

The skin serves which of the following​ functions?

protection

For a patient with severe​ hypothermia, you:

provide passive rewarming but do not actively rewarm the patient

You are performing a secondary assessment on your​ 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point​ to?

punctured lung

Burns involving the airway often lead​ to:

respiratory compromise

A​ 22-year-old female patient slipped running down​ stairs, and has injured her right tibia and fibula. You have used an air splint to splint the injury. To test the​ splint, you​ can:

see if you can cause a slight dent in the plastic with fingertip pressure.

You have been called to a nursing​ home, where you find an​ 88-year-old female patient who is confused and combative. The staff states that this is not her normal behavior but that she has been bedridden from a previous stroke. They also report that she has had a recent urinary tract infection from an indwelling catheter. You note that her skin is flushed and​ warm, her pulse is​ 108, and her blood pressure is​ 80/44. You should​ suspect:

septic shock

Your patient was just involved in a motor vehicle collision. She is breathing very fast and shallowly. You auscultate her lung sounds and find diminished breath sounds on the right side. You suspect that the patient is most likely suffering​ from:

simple pneumothorax

Injury to which of the following organs would be most likely to cause​ peritonitis?

small intestine

You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which of the following additional injuries should you have a high level of​ suspicion?

spinal injury

While assessing the abdomen of a​ 25-year-old female, you note that she has a large piece of glass sticking out of her right upper quadrant. What should you​ do?

stabilize the glass

Which layer of the skin provides shock absorption and​ insulation?

subcutaneous

If an individual sustains a head​ injury, and blood has accumulated on top of the brain but beneath the​ dura, this type of injury is termed​ a(n):

subdural hematoma

An open chest wound that pulls air into the thoracic cavity is known as what type of​ injury?

sucking

Which of the following is most clearly an example of an open chest​ injury?

sucking chest wound

Knowing what you will do on scene and how that relates to what your partner will do is part​ of:

teamwork

You respond to the scene of a​ 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his​ chest, where you notice a puncture wound. From what is this patient most likely​ suffering?

tension pneumothorax

To see the effect of direct​ force, you would look​ at:

the area of the point of impact.

The first effects of a bone injury are swelling of soft tissue​ and:

the formation of a blood clot in the area of the fracture.

To realign an​ extremity, an EMT grasps the distal extremity while a partner places one hand above and one hand below the injury​ site, and​ then:

the partner supports the site while the first EMT creates gentle manual traction in the direction of the long axis of the extremity.

If your trauma patient had an initial GCS score of 13 and now has a score of​ 10, this implies​ that:

the patient is deteriorating

You respond to the scene of a​ 34-year-old male whose left lower arm is bleeding profusely after an accidental amputation at the wrist while cutting planks with a circular saw. Direct pressure does not stop the​ bleeding, so you decide to place a tourniquet on the​ patient's limb. Which of the following statements is the most​ accurate?

the tourniquet should be applied proximal to the​ wound, but not over a joint.

A​ 14-year-old girl has fallen from her bicycle. She sustained injuries when she landed with her arm extended to catch her fall. According to the principles of indirect mechanisms of​ injury, which of the following bones is least likely to have been injured in this​ fall?

thoracic vertebra

Which of the following would most likely be used to determine whether a patient would be transported to a trauma​ center?

trauma score

You are evaluating a​ 45-year-old male car wreck victim. Your evaluation of this patient is based on specific characteristics that will be assigned a specific score. What is this score known​ as?

trauma score

You are treating a​ 42-year-old male assault victim who presents with​ nausea, vomiting, and sharp abdominal pain. While inspecting his​ abdomen, you note redness to his right upper quadrant. Based on your assessment​ findings, the patient is most likely suffering from which of the​ following?

traumatic hemorrhage of the liver

When you are stabilizing an impaled object in the​ head, always:

use bulky and rigid support

The problem of blood vessels dilating in compensation for trauma is primarily related​ to:

vascular capacity that is too great

Rough handling of a hypothermic patient may lead​ to:

ventricular fibrillation

In caring for an amputated​ part, it is important​ to:

wrap the part in sterile gauze and keep it cool.