exam 6 trauma

A construction worker has a metal rod impaled in his right forearm. Assessment of the injury indicates heavy bleeding from around the impaled object. What should you do first? Select one: A. Apply direct pressure around the rod B. Apply pressure on the rod to stabilize it C. Place a tourniquet above the injury site D. Attempt once to remove the metal rod

A. Apply direct pressure around the rod

A 27-year-old male fell down a full flight of stairs while escaping his burning apartment. Which assessment finding in this patient should demand your immediate attention? Select one: A. Burns on the face B. Tenderness to the right upper abdominal quadrant C. Deformity of the left wrist D. Full-thickness burn on the hands

A. Burns on the face

A bullet fired from a gun at close range passes through the patient's liver. However, on autopsy, the coroner discovers that the man's pancreas, stomach, and gallbladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which mechanism is responsible for injuries to these additional organs? Select one: A. Cavitation B. Drag force C. Blunt injury D. Profile impact

A. Cavitation

You are responding to a call for a 4-year-old child hit by a car. When assessing this child, which injury patterns would you recognize as typical based on the child's age and mechanism of injury? Select one: A. Deformed femurs, bruises to the chest and abdomen, and head injury B. Left arm and leg deformities, and head injury C. Bilateral ankle deformity, contusions to the back, and face trauma D. Head injury with deformities to both upper arms and neck trauma

A. Deformed femurs, bruises to the chest and abdomen, and head injury

A young female wears her lap belt too low, over her upper thighs, because the belt is uncomfortable when worn properly. If she is involved in a head-on "up and over" type of collision, to which injury is she most prone, given the position of her lap belt? Select one: A. Dislocated hips B. Internal abdominal injury C. Tibia-fibula fractures D. Bilateral arm fractures

A. Dislocated hips

When assessing a patient, you note a bruise to his chest. On the prehospital care report, this injury is properly documented as: Select one: A. Ecchymosis B. Erythematic C. Hematoma D. Cyanosis

A. Ecchymosis

Which of the statements concerning trauma is most accurate? Select one: A. Multisystem trauma has a higher mortality rate than single-system injuries B. A "spider web" or "star" pattern of cracks on the windshield means the patient impacted the windshield with his head C. The mechanism of injury is the best predictor of patient outcome D. Falls are the leading cause of trauma deaths

A. Multisystem trauma has a higher mortality rate than single-system injuries

A patient, who was constructing a bomb in his basement, has sustained a secondary-phase blast injury. Which presentation would the EMT most likely observe from this blast phase? Select one: A. Screwdriver impaled in the thorax B. Burns to the head, neck, and chest C. Headache and shortness of breath D. Complaint of nausea after inhaling fumes

A. Screwdriver impaled in the thorax

Which statement best characterizes the capabilities of a Level III trauma center? Select one: A. The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and them and still arrange transfer B. The hospital can manage all trauma patients and injuries, 24 hours a day, 7 days a week C. The hospital will provide any emergency surgical services to a trauma patient and then transfer the patient once stable D. The hospital can handle most trauma patients, but will transfer those who require specialty care for specific injuries such as neurologic trauma

A. The hospital has some surgical capabilities to help trauma patients, but will generally stabilize and them and still arrange transfer

Which statement made by the EMT shows an understanding of dressing and bandaging a wound? Select one: A. "If bleeding from a wound cannot be initially stopped with direct pressure, I apply a bandage and dressing so I can take care of other injuries." B. "I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation is possible." C. "I always bandage across the joint above the wound since this helps control bleeding by applying pressure to the proximal blood vessels." D. "When applying a bandage over a dressing, I apply it loosely so as not to interfere with circulation to the extremity."

B. "I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation is possible."

A 28-year-old male was cutting limbs from a tree when he lost his footing and fell 20 feet. He is unresponsive and breathing very poorly, at 28 times per minute. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed the patient on a nonrebreather face mask and are holding manual cervical spine motion restriction. A blanket has also been applied and covers the man. Based on these assessment findings, which instruction would you give to the EMRs? Select one: A. "Let's uncover him since increased temperature will dilate his blood vessels and drop his BP." B. "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing." C. "Since he is unresponsive, let's open the airway with the head-tilt, chin-lift maneuver." D. "Let's move him to the stretcher for immediate transport to the hospital."

B. "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

Which statement indicates an understanding of the EMT's prehospital role in caring for the patient in shock secondary to significant soft tissue trauma? Select one: A. "Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so proper care can be given." B. "Since trauma is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport." C. "The job of the EMT is to assume a trauma patient is in shock and get him or her to the hospital as quickly as possible." D. "If shock is in its early stage, it is not yet life-threatening and the EMT can take more time in assessing and treating the patient."

B. "Since trauma is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."

Two cars have collided head-on. One car was traveling at a speed of 55 mph and the other at 35 mph. The total speed of impact would be: Select one: A. 35 mph B. 90 mph C. 20 mph D. 55 mph

B. 90 mph

Regarding the field triage of injured patients, which of these patients is NOT a member of a special patient population that would necessitate transport to a trauma center? Select one: A. A female patient with a suspected brain injury from a fall who also takes prescribed anticoagulants B. A female patient who is 12 weeks pregnant and who fell on the sidewalk, injuring her hip and wrist C. A male patient with a broken femur and burns to 25 percent of his body after jumping from a second-story window of a house that was on fire D. A 70-year-old male patient with a systolic blood pressure of 104 mmHg after wrecking his car into a tree

B. A female patient who is 12 weeks pregnant and who fell on the sidewalk, injuring her hip and wrist

Which type of injury is most likely to result in capillary bleeding only? Select one: A. Laceration B. Abrasion C. Penetration D. Avulsion

B. Abrasion

You are assessing a patient who was involved in a motorcycle accident. He states that he saw an oncoming car and "laid the bike down" to avoid an outright collision. He was wearing a helmet. Which injury pattern would make sense given the action of the motorcyclist? Select one: A. "Road rash" to the entire body surface B. Burn to the inside of the leg from the motorcycle exhaust pipe C. Angulation to both femurs with protrusion D. Bilateral broken forearms with upper extremity trauma

B. Burn to the inside of the leg from the motorcycle exhaust pipe

Which statement concerning a flash burn is accurate? Select one: A. Turnout gear does not provide adequate protection from a flash burn B. Clothing will typically protect the skin from a flash burn C. A flash burn is caused by UV radiation D. A flash burn is the result of welding without proper protection

B. Clothing will typically protect the skin from a flash burn

You have arrived on the scene of an explosion in a warehouse used to store fertilizers. A paramedic, who has already triaged the nine patients involved, directs you to a young man sitting under a tree. The man states that he is having excruciating ear pain. The initial assessment and rapid trauma assessment reveal no obvious injuries. Given this presentation, the EMT would recognize the injury was likely sustained: Select one: A. From the noise of the explosion B. During the primary blast phase C. As a result of exposure to superheated air D. After the secondary blast phase

B. During the primary blast phase

The best way to detect contact lenses for removal is to: Select one: A. Apply a sterile contact lens detector over the iris B. Shine a penlight into each eye at a slight angle and look for a shadow C. Turn on the overhead lights and look for your reflection over the iris D. Lightly run a gloved finger across the globe of the eye and sweep any lens to the corner

B. Shine a penlight into each eye at a slight angle and look for a shadow

Assessment findings for a driver who was ejected from his vehicle in a rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute with absent alveolar breath sounds. His skin is cool and diaphoretic; the radial pulses are weak. Manual cervical spine motion restriction is being maintained. The EMT's next action would be to: Select one: A. Examine the fracture site more closely B. Start positive pressure ventilation C. Apply an appropriately sized cervical collar D. Obtain a heart rate and blood pressure

B. Start positive pressure ventilation

What is the best description of the "platinum 10 minutes" as it applies to care of the trauma patient? Select one: A. The target maximum time that the multisystem trauma patient should spend in the emergency department before being transferred to surgery B. The target maximum scene time for EMS as it applies to the seriously injured trauma patient C. The time it should take the transporting ambulance to get the trauma patient to the closest medical facility D. The goal for total amount of time from the actual injury to arrival of EMS at the scene

B. The target maximum scene time for EMS as it applies to the seriously injured trauma patient

When triaging multiple burn patients, the EMT would recognize which patient as having the most critical burn? Select one: A. A 41-year-old patient with a partial-thickness burn to the upper left arm B. A 58-year-old patient with a scald burn to the anterior chest C. A 22-year-old patient with a partial-thickness burn to the right hand D. A 12-year-old patient with a superficial burn to the neck and chest

C. A 22-year-old patient with a partial-thickness burn to the right hand

You have been called for an intoxicated male who sustained a full-thickness burn to his leg after passing out against a kerosene heater. After ensuring that his airway, breathing, and circulation are intact, you cool the burn with water and then: Select one: A. Apply ice packs and secure in place with a sterile dressing B. Carefully remove smoldering fabric that is adhered to the skin C. Carefully wrap the burn with a dry sterile dressing D. Cover the burn with a burn sheet soaked in warm sterile water

C. Carefully wrap the burn with a dry sterile dressing

A patient who was involved in a motor vehicle collision is complaining of neck pain. Which piece of information would most contribute to the EMT's high index of suspicion that the patient may have suffered more significant injuries beyond isolated neck pain? Select one: A. Difficulty turning is head to the right B. External damage to the car is significant C. Death of the car's driver D. Lack of air bags in the car

C. Death of the car's driver

A car has been hit head-on by another vehicle at a moderate rate of speed. Seat belts were in place and the air bags deployed. The patient complains of chest pain. Quick observation reveals a bruise to his sternum. The EMT should immediately: Select one: A. Deflate the air bag to get breath sounds B. Suspect an injury related to the air bag C. Lift the air bag and check for steering wheel deformity D. Check the windshield for starring

C. Lift the air bag and check for steering wheel deformity

Which statement is true regarding linear skull fractures? Select one: A. Linear skull fractures are identifiable by a mild depression in the skull B. Linear skull fractures are rare and infrequently encountered C. Linear skull fractures cannot typically be identified with palpation D. Linear skull fractures place the patient at risk for blood loss and hypoperfusion

C. Linear skull fractures cannot typically be identified with palpation

An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion to his heart. The EMT would recognize that this injury occurred during which impact of the collision? Select one: A. Body collision B. Physiological collision C. Organ collision D. Vehicle collision

C. Organ collision

You arrive at the scene where a young male patient fell out of a tree he was climbing. Although he fell from a lower branch, he was still reportedly 10-12 feet in the air when he fell. The patient landed on his side on the ground. Which element of the kinematics of trauma would explain the mechanism of any injuries he may have sustained? Select one: A. Terminal velocity B. Rapid acceleration C. Rapid deceleration D. Terminal mass

C. Rapid deceleration

Which statement made by an EMT shows that he understands the major cause of death in the prehospital setting for a burn patient? Select one: A. "Burn patients most often die before reaching the hospital from the increased body temperature caused by the heat of the burns." B. "The most common cause of death for burn patients in the prehospital setting is infection, which can be minimized by applying a sterile burn sheet." C. "Most patients who die before getting to the hospital die from burn shock, caused by massive fluid loss from the burns." D. "Most burn patients who die before getting to the hospital die of airway or bleeding problems, not the burn itself."

D. "Most burn patients who die before getting to the hospital die of airway or bleeding problems, not the burn itself."

A middle-aged male's arm became caught in a grinding machine, and the arm was eventually extricated from the machine by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Given this information, which care would be provided first for this patient? Select one: A. Insert an oropharyngeal airway and administer oxygen B. Perform a detailed secondary exam focusing on his arm C. Start positive pressure ventilation D. Administer supplemental oxygen

D. Administer supplemental oxygen

A teenage female patient was ejected from a car as it rolled down a hill after she ran off the road. She is responsive, but with signs of early shock and respiratory distress. She has bruising to her anterior abdomen and chest, a laceration to her left temple, and deformity to her left wrist. At which point should the wrist injury be splinted? Select one: A. Just before leaving the scene B. Before transferring the patient to the stretcher C. Prior to full spinal motion restriction precautions being provided D. En route to the hospital

D. En route to the hospital

You are first on the scene of a two-car motor vehicle collision. Two patients are entrapped in one vehicle. In the other vehicle, there is a male driver complaining of chest pain. During this time, your primary concern is: Select one: A. Calling for additional help B. Triaging the patients C. Determining severity of injuries D. Ensuring personal safety

D. Ensuring personal safety

You arrive on the scene of a motorcycle accident and find an unresponsive male patient lying in the middle of the road with blood coming from his ears and nose. He was not wearing a helmet and has snoring respirations. Which sequence of events would be most appropriate in the care of this patient? Select one: A. Primary assessment, spine motion restriction, transfer to the ambulance after 8 minutes of scene time, all other care provided en route B. Full spine motion restriction procedures, transfer to the ambulance, provide all assessment and care en route to the hospital, with total scene time of 7 minutes C. Primary assessment, oxygen administration, transfer to stretcher, transport within 5 minutes of arriving on scene with spine motion restriction precautions done en route D. Primary assessment, airway and ventilatory management, oxygen administration, spine motion restriction precautions, transport within 10 minutes of arriving on scene

D. Primary assessment, airway and ventilatory management, oxygen administration, spine motion restriction precautions, transport within 10 minutes of arriving on scene

When teaching Emergency Medical Responders about air bags, which point would you emphasize? Select one: A. Air bags are effective in decreasing injury in a rollover-type collision B. Air bags prevent broken glass from striking the occupant C. Properly placed air bags eliminate the need for seat belts D. The benefit of air bags is lessened in a multiple-vehicle collision impact

D. The benefit of air bags is lessened in a multiple-vehicle collision impact