EMT Exam Three: Chapters 22-30

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 BSA.

1%

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:

14

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.

20%

The body's functions that occur without conscious effort are regulated by the _________ nervous system.

Autonomic

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should:

Carefully remove the contact lenses and then irrigate his eyes with saline.

The germinal layer of the epidermis contains pigment granules that are responsible for skin:

Color

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another?

Connecting

Your presence is requested by law enforcement toassess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

Control any external bleeding, administer oxygen, and transport at once.

Signs of a pulmonary blast injury include:

Coughing up blood

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured

Diaphragm

Two of the most COMMON MOI for blunt trauma are

Falls and motor vehicle collisons

Contraction or tensing of the abdominal muscles in an effort to ease pain is called

Guarding

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

Have you experienced recent abdominal trauma?

Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a:

Head-on crash

Gastrointestinal bleeding should be suspected if a patient presents with:

Hematemesis.

A sign of kidney damage following blunt trauma is:

Hematuria

Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when:

Hollow abdominal organs are damaged and spill their contents.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:

Infection

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs?

Linear

Which of the following organs would MOST likely bleed profusely when injured?

Liver

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

May decrease the amount of blood that returns to her heart

When a hollow organ is punctured during a penetrating injury to the abdomen:

Peritonitis may not develop for several hours.

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:

Prepare for immediate transport

When assessing a patient who experienced a blast injury, it is important to remember that:

Primary blast injuries are typically the most obvious.

A patient who presents with profound cyanosis following a chest injury:

Requires prompt ventilation and oxygenation.

Which of the following statements regarding severe burns is correct?

Severe burns are typically a combination of all degrees of burn.

The presence of tachycardia following a significant abdominal injury:

Should be assumed to be a sign of shock

Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred 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:

Spleen

Which of the following statements regarding abdominal trauma is correct?

The absence of abdominal pain does not rule out intra-abdominal bleeding.

Elevation of the rib cage during inhalation occurs when:

The intercostal muscles contract.

Which of the following statements regarding abdominal eviscerations is correct?

The protruding organs should be kept warm and moist.

Which of the following statements regarding motor nerves is correct?

They carry information from the CNS to the muscles.

The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:

Transport to a trauma center

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

Urinary Bladder

The sebaceous glands produce sebum, a material that

Waterproofs the skin and keeps it supple.

The mesentery is:

a membranous fold that attaches the intestines to the walls of the body

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

a poorly placed lap belt

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:

a rapid deterioration of neurologic signs.

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should:

apply direct pressure to her arm wound.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

assume that the arrow injured an internal organ.

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should:

avoid applying pressure to the globe when you are covering the eye.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

avoid speculation and document only factual data.

When worn properly, a seatbelt should lie:

below the anterior superior iliac spines of the pelvis and against the hip joints

When caring for a patient whose arm is covered with a dry chemical, you should:

brush away the chemical before flushing with water.

Perfusion is MOST accurately defined as the:

circulation of blood within an organ in adequate amounts to meet the body's metabolic needs. Save

Which of the following is a severe burn in a 35-year-old patient?

circumferential partial-thickness burn to the chest

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

closely monitor him and reassess him frequently

A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?

compression of the head against the roof

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

conjunctivitis.

A 12-year-old male jumped approximately 12' from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?

energy transmission to the spine

In which of the following situations would external bleeding be the MOST difficult to control?

femoral artery laceration and a blood pressure of 140/90 mm Hg

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT:

giving him small sips of plain water.

The cervical spine is MOST protected from whiplash-type injuries when the

headrest is appropriately positioned.

Common signs and symptoms of a chest injury include all of the following, EXCEPT

hematemesis

A 45-year-old male was working on his roof when he fell approximately 12',landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:

immobilize his spine and perform a focused secondary exam

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should:

irrigate both eyes continuously for 20 minutes with plain water.

A laceration

is a jagged cut caused by a sharp object or blunt force trauma.

A tight-fitting motorcycle helmet should be left in place unless:

it interferes with your assessment of the airway.

When a light is shone into the pupil:

it should become smaller in size.

The conjunctiva are kept moist by fluid produced by the:

lacrimal gland.

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:

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

During the normal wound healing process, bleeding may occur from even a minor injury because:

new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.

Facial injuries should be identified and treated as soon as possible because

of the risk for airway problems.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:

open his airway and assess his breathing status.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:

partially remove the dressing.

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:

pinching the patient's nostrils and having him lean forward.

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:

pleurisy.

Because the depth of an open abdominal wound is often difficult to determine:

prompt transport to the hospital is essential

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:

rapidly transporting her to the hospital.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:

replace the avulsed flap to its original position and cover it with a sterile dressing

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:

suction his oropharynx for up to 15 seconds.

The severity of bleeding should be based on all of the following findings, EXCEPT:

systolic blood pressure.

which of the following statements regarding the rule of nines is correc

the anterior trunk of an adult is equal to 18 % of the BSA

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration.

Very young children tend to breathe predominantly with their diaphragm because

their intercostal muscles are not fully developed.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:

transport her to the emergency department.

A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:

transport him in the position in which you found him.

When caring for a patient with an open facial injury, the EMT must:

wear gloves and facial protection.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:

Causes problems with managing ABC's

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:

Cavitation

The _________ contain(s) about 75% of the brain's total volume

Cerebrum

The thoracic cavity is separated from the abdominal cavity by the:

Diaphragm

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:

Direct pressure using dry, sterile dressings

Accumulation of blood in the abdominal cavity will MOST likely cause:

Distention

The MOST important treatment for patients with a head injury, regardless of severity, is to:

Establish an adequate airway

Which of the following statements regarding secondary brain injury is correct?

Hypoxia and hypotension are the two most common causes of secondary brain injury.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to

Identify contact points and predict potential injuries.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:

Intra-abdominal bleeding

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:

Intracranial bleeding

Bleeding from the nose following head trauma:

Is a sign of skull fracture and should not be stopped

Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:

Kehr sign

Which of the following interventions is the MOST critical to the outcome of a patient with multi-system trauma?

Rapid transport to a trauma center

Early bruising following abdominal trauma often manifests as:

Red areas on the skin

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

applying direct pressure with a dry, sterile dressing.

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned?

30%

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct?

39 year old is at high risk of infection

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to:

unbolt the kickstand from the bike frame and stabilize it with bulky dressings.