NREMT: Trauma

A​ 75-year-old female complains of burning pain in her arms. She was working in her garden and spilled a dry powder on them. After you remove the​ powder, you observe circumferential blistered and mottled skin of both her forearms and hands. What percentage of her Total Body Surface Area should you estimate is​ burned? A. 13.5 B. 9 C. 18 D. 4.5

9

A​ 3-month-old female was cut across her abdomen by a piece of broken glass. You observe bowel contents protruding from the wound. You​ should: A. cleanse the bowel with sterile water and gently replace it. B. cover the wound with a​ moist, sterile dressing. C. cover the wound with a​ dry, sterile dressing. D. wrap the abdomen with an elastic dressing.

cover the wound with a​ moist, sterile dressing.

A​ 51-year-old male has a​ quarter-inch diameter metal bar that is six feet long impaled in his forearm. There is minor bleeding around the bar. He can move his fingers with a slight increase in his pain. You​ should: A. cut the bar while stabilizing it. B. stabilize the bar and transport him. C. remove the bar and pack the wound with hemostatic gauze. D. apply a tourniquet and remove the bar

cut the bar while stabilizing it.

A​ 38-year-old male is found lying on the ground next to an open electrical panel. His coworker tells you she heard him fall and saw him shaking. As you​ approach, he appears confused and is unable to sit up. You do not observe any deformities or injuries other than small areas of black burned skin on the tips of his fingers. You should​ suspect: A. epilepsy. B. hemorrhagic stroke. C. electrical burns. D. hypoglycemia

electrical burns.

An unresponsive​ 35-year-old female was struck in the head with a softball bat. She has a​ four-inch laceration, and you palpate an unstable area of the occipital region. Fifteen minutes after the​ injury, her vital signs are P​ 48, R 16 and​ irregular, BP​ 216/104, and SpO2 is​ 94% on room air. You should suspect​ a: A. closed head injury. B. skull fracture. C. subdural hemorrhage. D. neurogenic shock.

skull fracture.

A​ 77-year-old female complains of pain in her left upper arm. She tells you she tripped on a rug and fell. Her left proximal humerus is​ unstable, she can move her​ fingers, feel your​ touch, and the radial pulse is present. You should apply​ a(n): A. sling and swathe. B. padded board. C. traction splint. D. air splint.

sling and swathe.

A​ 7-year-old female has a pencil impaled in her right cheek. She is upset but follows your instructions. You can visualize that the tip of the pencil is impaled in her palate. You​ should: A. remove the pencil and apply an external dressing. B. stabilize the pencil in place. C. twist the pencil to determine if it is lodged in her palate. D. remove the pencil and apply external and internal dressings

stabilize the pencil in place.

A​ 58-year-old male has a degloving injury to his left hand after it was trapped in a piece of machinery. You observe minor​ bleeding, and his hand is misshapen. You should apply​ a(n): A. splint with his hand in the position of function. B. air splint. C. pressure dressing. D. sterile dressing.

sterile dressing.

A​ 73-year-old female injured her back when she scraped against a sharp piece of metal. She has an irregular cut across her skin that exposes fat and muscle tissue. You should suspect​ a(n): A. avulsion. B. laceration. C. incision. D. abrasion.

laceration.

A​ 68-year-old female was shot in her left chest wall. She is lying on the​ ground, moaning​ 12/minute. You observe a bubbling​ half-inch wound on her left anterior​ chest, third intercostal space on the midclavicular line. You should cover the wound with your gloved hand and​ next: A. apply a hemostatic dressing. B. assist her ventilation. C. look for an exit wound. D. administer oxygen

look for an exit wound.

An unresponsive​ 2-year-old male fell eight feet from a slide at a city park. You observe a hematoma to his occiput. His skin above his axilla is pale and​ diaphoretic, and pink and dry below. His left forearm is obviously fractured. His vital signs are P​ 156, R​ 48, and his capillary refill is less than two seconds. Prior to​ transport, you should administer oxygen​ and: A. perform a detailed assessment. B. splint his arm. C. perform spinal motion restriction. D. wait for his mother to arrive

perform spinal motion restriction.

An​ 11-month-old female was stabbed in the chest with a knife. You open her shirt and observe a​ half-inch laceration to the right side of her chest that is bubbling. You should​ immediately: A. place a vented occlusive dressing over the wound. B. pack the wound with hemostatic gauze. C. place your gloved hand over the wound. D. place an occlusive dressing over the wound.

place your gloved hand over the wound.

A​ 21-year-old female complains of chest pain. She has a gunshot wound to her left chest​ wall, and she has mild dyspnea. Her skin is pink and dry. You should​ first: A. place your gloved hand over the wound. B. assess her vital signs. C. administer oxygen by​ non-rebreather mask. D. assist her ventilation

place your gloved hand over the wound.

A​ 47-year-old female complains of right hip pain. She was the unrestrained driver of a car that crashed into a tree. Her airbag​ deployed, but there is damage to the dash where her right knee struck it. As you move her onto the long​ backboard, you observe that her right leg is rotated​ inward, her hip is​ flexed, and her knee is bent. You should suspect​ a(n): A. midshaft femur fracture. B. posterior hip dislocation.. C. open book pelvic fracture. D. anterior hip dislocation.

posterior hip dislocation.

A​ 7-year-old male was struck in his left chest with a baseball bat. He complains of pain to the​ area, and you observe a large red mark. He has equal chest wall​ expansion, and his neck veins are flat. You auscultate rales on the left side of his chest. You should​ suspect: A. cardiac tamponade. B. congestive heart failure. C. pulmonary contusion. D. tension pneumothorax

pulmonary contusion.

A​ 41-year-old female complains of​ left-sided chest pain. She tells you she was stabbed in her left breast with a knife. She denies difficulty​ breathing, and her lungs are clear to auscultation. You observe slight oozing bleeding from the wound. Her vital signs are P​ 98, R​ 16, BP​ 138/78, and SpO2 is​ 97% on room air. You should suspect​ a: A. cardiac tamponade. B. bronchial transection. C. tension pneumothorax. D. simple pneumothorax.

simple pneumothorax.

An unresponsive​ 51-year-old female was the driver involved in a car crash. There is 20 inches of intrusion to her door. Her pelvis is unstable when palpated. Her vital signs are P​ 108, R​ 18, BP​ 102/78, and SpO2 is​ 92% on room air. Which of the following is the most valuable finding to indicate that she is a high priority​ patient? A. Injuries B. Amount of intrusion C. Vital signs D. Level of consciousness

Level of consciousness

A​ 21-year-old female was stabbed in her right upper abdominal quadrant with a pencil. She complains of pain to the area. Her abdomen is tender to​ palpation, and you observe blood trickling from the wound. Her vital signs are P​ 120, R​ 18, BP​ 108/86, and SpO2 is​ 94% on room air. What organ should you suspect was​ injured? A. Spleen B. Stomach C. Kidney D. Liver

Liver

An​ 85-year-old male complains of severe pain in his right thigh after he was struck above his knee with a metal pole. He complains of weakness in his​ leg, and you observe bruising where he was struck. You do not palpate any instability or deformity. You​ should: A. apply a padded board splint. B. immobilize him to a long backboard. C. apply a traction splint. D. wrap his thigh with an elastic bandage.

apply a padded board splint.

An unresponsive​ 61-year-old female was run over by a train at low speed. Her skin is pale and cool. She has a below the knee amputation of her left leg. You observe minor bleeding from the injury. While stabilizing her​ spine, you​ should: A. assess her vital signs. B. apply a tourniquet three inches above her left knee. C. apply a tourniquet as high as you can on her left leg. D. assess her breathing and circulation.

assess her breathing and circulation.

An unresponsive​ 2-year-old female has burnt skin on her left hand and left knee. Her father tells you he heard a loud noise and found her this way. She has​ irregular, slow, shallow respirations and a rapid carotid pulse. You should​ first: A. assess her vital signs. B. administer oxygen by nasal cannula. C. administer oxygen by​ non-rebreather mask. D. assist her ventilation

assist her ventilation

An unresponsive​ 43-year-old female was struck in the chest with a metal pipe during an assault. You observe a portion of her left chest wall moves outward when she exhales. She is taking​ rapid, shallow breaths. While your partner stabilizes her​ head, you should​ next: A. assist her ventilation with a BVM. B. immobilize her to a long backboard. C. assess her vital signs. D. administer oxygen by​ non-rebreather mask.

assist her ventilation with a BVM.

A​ 57-year-old male was stabbed multiple times in his anterior right chest wall with a screwdriver. He tells you he has pain and difficulty breathing. You should apply occlusive dressings​ and: A. place him in the right lateral recumbent position. B. auscultate his lung sounds. C. assist his ventilation. D. secure him to a long backboard.

auscultate his lung sounds.

A​ 16-year-old female was bitten in the chest by a dog. She has an avulsed flap of tissue three inches wide by five inches long to her right chest wall. You observe bubbling blood when she breathes. You​ should: A. apply an emergency trauma dressing over the wound. B. cover the wound with an occlusive dressing. C. pack the wound with hemostatic gauze. D. place a​ moist, sterile dressing over the wound

cover the wound with an occlusive dressing.

An unresponsive​ 28-year-old male's face appears​ flattened, and you observe clear fluid draining from his nose. He was an unrestrained front seat passenger and struck his face on the dash during a​ high-speed car crash. He is lying supine on your​ stretcher, and you hear gurgling when he breathes. You​ should: A. apply downward pressure on his nose. B. insert a nasopharyngeal airway. C. place him in the​ semi-Fowler's position. D. suction his airway

suction his airway

A​ 68-year-old male complains of pain after he slammed his right second phalange in a door. You observe bleeding and angulation of the distal tip. He has a capillary refill of two seconds. You should apply a sterile dressing​ and: A. realign his finger and tape it to a tongue depressor. B. wrap his fingers and wrist with an elastic dressing. C. tape his second and third phalanges together. D. immobilize his lower arm with padded board splints

tape his second and third phalanges together.

A​ 6-year-old male was thrown 10 feet after he was struck by a car. He complains of neck and back pain. The skin on his​ face, shoulders, and arms is pale and diaphoretic. He has no feeling below his nipple​ line, and his skin is warm and pink. You should suspect an injury to​ his: A. thoracic spine above​ T-5. B. cervical spine above​ C-4. C. cervical spine below​ C-4. D. thoracic spine below​ T-5.

thoracic spine above​ T-5.

A​ 58-year-old female complains of pain after she twisted her ankle while running. Her foot is severely​ angled, and her sock is bloody. When you remove her​ sock, you observe an open wound and bone. The skin of her foot is warm and pink. You​ should: A. apply gentle traction and immobilize her foot in the position of function. B. immobilize her foot in the position found. C. wrap her​ foot, ankle, and lower leg with an elastic dressing. D. apply an air splint.

immobilize her foot in the position found.

A​ 5-year-old female who was only wearing a lap belt when she was involved in a car crash complains of abdominal pain. Her skin is pale and cool. The only injury you observe is a reddened​ three-inch wide mark across her abdomen at the level of her umbilicus. Her vital signs are P​ 130, R​ 34, BP​ 98/80, and SpO2 is unobtainable. Her capillary refill is three seconds. You should administer oxygen​ and: A. transport her in a position of comfort. B. transport her in Trendelenburg position. C. apply a pelvic binder. D. keep her warm

keep her warm

A​ 32-year-old female complains of abdominal pain and left leg pain after she was stabbed in her left lower abdominal quadrant. You do not observe any injuries to her​ legs, but her left leg is cyanotic and cold. Her vital signs are P​ 108, R​ 18, BP​ 98/58, and SpO2 is​ 91% on room air. You should administer oxygen​ and: A. apply a​ moist, sterile dressing. B. keep her warm. C. immobilize her left leg. D. pack the wound with hemostatic gauze

keep her warm.

A​ 95-year-old male complains of right arm pain. He tells you he fell and landed with his arms outstretched. You observe a midshaft deformity to his forearm. You should suspect a fracture of​ his: A. tibia and fibula. B. scapula and clavicle. C. radius and ulna. D. carpal and metacarpal.

radius and ulna.

An unresponsive​ 70-year-old female was the unrestrained driver involved in a front end car crash. She has a hematoma to her​ forehead, she is taking​ rapid, shallow​ respirations, and you observe paradoxical chest wall movement. You should​ first: A. secure a bulky dressing to her chest. B. administer oxygen. C. apply a​ vest-type extrication device. D. rapidly extricate her

rapidly extricate her

An​ 88-year-old male spilled muriatic acid on himself while cleaning metal. He complains of pain to his chest and abdomen. You observe that his clothing is wet where he spilled the acid. You should​ first: A. pour water over him. B. remove his clothing. C. apply baking soda to his clothing. D. place him in your ambulance.

remove his clothing.

An unresponsive​ 20-year-old male was shot in the left upper abdominal quadrant. His skin is pale and diaphoretic. His airway is​ open, and his lungs are clear to auscultation. You palpate a pulsating mass midline between his xiphoid process and umbilicus. You should​ immediately: A. transport him. B. apply a cervical collar and secure him to a long backboard. C. apply a​ dry, sterile dressing. D. assess his vital signs

transport him.

A​ 26-year-old male trapped between a car and wall complains of right hip pain. When he is​ extricated, his pelvis is unstable to​ palpation, and his right foot is turned outward. You​ should: A. apply a traction splint to his right leg. B. use a sheet as a pelvic wrap. C. apply cold packs to his right hip. D. use longboard splints to immobilize his right hip.

use a sheet as a pelvic wrap.

A​ 43-year-old female who stepped into a campfire complains of pain in her lower leg. The skin on her lower leg is reddened and blistered. The skin on her foot has areas of blackened skin and other areas that are​ dry, white, and leathery. She denies pain to this area when you cover it with a dressing. What type of burn should you suspect she has to her​ foot? A. First degree B. Full thickness C. Partial thickness D. Second degree

Full thickness

An unresponsive​ 21-year-old male was shot in the left upper abdominal quadrant. His skin is pale and diaphoretic. You auscultate clear lung​ sounds, and his neck veins are flat. His vital signs are P​ 116, R​ 20, BP​ 100/72, and SpO2 is​ 92% on room air. What type of shock should you​ suspect? A. Hemorrhagic B. Extrinsic Cardiogenic C. Distributive D. Intrinsic Cardiogenic

Hemorrhagic

Why is a​ 7-year-old female more prone to fracture her spleen in a car crash than an​ adult? A. Her abdominal muscles displace it superiorly. B. It is encapsulated in the liver. C. It has not become fully calcified. D. Her ribs do not protect it as well.

Her ribs do not protect it as well.

Why can a fracture to the proximal end of a​ 3-year-old male's humerus be more serious than a fracture in the same location of a​ 33-year-old female if it is not treated​ properly? A. His arm may be less moveable. B. He may have increased hemorrhaging. C. His arm may not grow properly. D. He may have increased soft tissue injuries

His arm may not grow properly.

A​ 60-year-old male was working on an electrical appliance when he shocked himself and became unresponsive. His wife tells you that while he was​ unresponsive, he was shaking all over. His only past medical history is hypertension. You observe full thickness burns to his right hand and both knees. His vital signs are P 82 and​ irregular, R​ 16, BP​ 168/78, and SpO2 is​ 94% on room air. Which of the above findings has the potential to be an immediate life​ threat? A. Irregular pulse B. Hypertension C. Full thickness burns D. Seizure

Irregular pulse

A​ 23-year-old female has a​ five-inch laceration to her left thigh. You were unable to control her​ hemorrhage, so you applied a tourniquet and stopped the bleeding. During​ transport, her vital signs are P​ 104, R​ 18, BP​ 88/62, and SpO2 is​ 97% on oxygen by​ non-rebreather mask at 12​ L/minute. Of the​ following, which will help to improve her outcome the​ most? A. Keeping her warm B. Applying a hemostatic dressing C. Increasing her SpO2 to​ 100% D. Elevating her left leg

Keeping her warm

Penetrating injury to which of the following organs would cause peritonitis the​ quickest? A. Spleen B. Liver C. Stomach D. Large intestine

Stomach

An unresponsive​ 37-year-old female was kicked in the head by a donkey. She has snoring​ respirations, and you observe clear fluid draining from her nose. You should​ suspect: A. fluid in her lower airway. B. fluid in her upper airway. C. a tear duct laceration. D. a skull fracture.

a skull fracture.

2-year-old male has bright red blood in his urine. He complains of left flank tenderness and thirst. His skin is​ pale, cool, and diaphoretic. He tells you that an hour ago he was the restrained driver of a car involved in a crash. He tells you the​ driver's door was pushed in a​ foot, but he refused treatment. You​ should: A. allow him to drink small sips of water. B. administer oxygen and keep him warm. C. apply a cervical collar and immobilize him to a long backboard. D. collect a sample of urine.

administer oxygen and keep him warm.

A​ 63-year-old male has an irregular​ three-inch laceration across his right forearm. He tells you he feels nauseated and​ light-headed. You observe a steady flow of​ dark, red blood. You are unable to stop the flow with direct pressure. You should​ next: A. apply a pressure dressing. B. apply a tourniquet proximal to the injury. C. elevate his arm above his heart. D. apply pressure to his brachial artery.

apply a tourniquet proximal to the injury.

An unresponsive​ 45-year-old female was stabbed in her right chest an inch lateral to her sternum. Her skin is pale and diaphoretic. You observe jugular vein distention and auscultate clear lung sounds bilaterally in all fields. Her vital signs are P 118 and R 18. You​ should: A. place her in the right lateral recumbent position. B. apply a cervical collar. C. assist her ventilation. D. apply an occlusive dressing.

apply an occlusive dressing.

A​ 38-year-old female was struck across her lower abdomen with a baseball bat. Her skin is​ pale, cool, and diaphoretic. She tells you she has bright red bleeding from her vagina. You should apply​ a: A. direct pressure to the source of her bleeding. B. hemostatic dressing to her wound. C. cold pack to her abdomen. D. bulky dressing to her vaginal opening

bulky dressing to her vaginal opening

A​ 21-year-old female tells you she was stabbed by a piece of metal in her abdomen 15 minutes ago. When you examine the​ area, you observe minimal bleeding and pink​ sausage-like tissue protruding from the opening in her left lower abdominal quadrant. You should suspect​ a(n): A. evisceration. B. tumor. C. uterine inversion. D. impaled object

evisceration.

A​ 19-year-old female complains of groin pain. She tells you she lacerated her perineum when she crashed her bicycle. You observe bright red blood running down her leg. You should​ first: A. assess her vital signs. B. pack the wound with hemostatic gauze. C. expose the injury and apply direct pressure. D. apply a bulky dressing

expose the injury and apply direct pressure

An​ 80-year-old female was the restrained driver of a car that was struck directly in the​ driver's side door. There is 10 inches of​ intrusion, and she complains of upper abdominal pain and difficulty breathing. She has equal chest wall​ expansion, and you auscultate diminished breath sounds and bowel sounds in the base of her left lung. You​ should: A. administer oxygen. B. wrap her chest with an elastic bandage. C. apply a bulky dressing to the left side of her chest. D. place her on her left side.

administer oxygen.

A​ 35-year-old female complains of arm pain where she was bitten by a male attacker. You observe teeth​ marks, slight​ bleeding, and bruising to the area. She tells you she​ doesn't want to go to the​ hospital, and she just wants you to look at it. You​ should: A. inform her that if she does not go to the​ hospital, you cannot treat her. B. cleanse the​ wound, apply a​ dressing, and have her sign a refusal form. C. apply a sterile dressing and explain why she should go to the hospital. D. inform her that if she​ doesn't receive​ treatment, she will lose her arm.

apply a sterile dressing and explain why she should go to the hospital.

An​ 81-year-old male complains of abdominal pain and difficulty breathing. He tells you he was stabbed in his abdomen. He has a history of hypertension and high cholesterol. You observe a​ one-inch laceration just below his xiphoid process. You auscultate diminished lung sounds and bowel sounds in the base of his left lung. His vital signs are P​ 76, R​ 20, BP​ 144/88, and SpO2 is​ 93% on room air. You should administer oxygen​ and: A. apply an occlusive dressing. B. place him in the Trendelenburg position. C. place him on his left side. D. apply a​ moist, sterile dressing

apply an occlusive dressing.

A​ 6-year-old male fell off his bicycle and cut his upper arm. His mother is holding a​ blood-soaked towel over the wound. When you examine the​ wound, you see a​ five-inch laceration that is spraying blood. You should​ immediately: A. apply direct pressure. B. apply a tourniquet two inches above the laceration. C. compress his brachial artery. D. elevate his arm above his heart.

apply direct pressure.

A​ 52-year-old female was cutting a branch when she accidentally cut through the power line to her house. She is standing outside and tells you she has severe pain in her right upper arm and cannot feel anything in her right lower arm. You observe full thickness burns to her right hand and elbow. You should​ first: A. immobilize her to a long backboard. B. assess her vital signs. C. assess for a radial pulse in her right wrist. D. immobilize her arm with a sling and swathe.

assess her vital signs.

A​ 23-year-old male complained of chest pain after he was stabbed in the right chest with a knife. You applied an occlusive dressing and continued your treatment. His initial vital signs were P​ 92, R​ 18, BP​ 128/82, and SpO2 was​ 93% on room air. During​ transport, he complains of difficulty​ breathing, and his vital signs are P​ 114, R​ 22, BP​ 104/88, and SpO2 is​ 91% on oxygen 12​ L/minute by​ non-rebreather mask. You​ should: A. place him on his right side. B. burp the occlusive dressing. C. increase the oxygen flow rate. D. assist his ventilation

burp the occlusive dressing.

A​ 60-year-old female was choking on a piece of steak. She became​ unresponsive, and bystanders dislodged it after performing chest compressions for 30 seconds. She now complains of pain in her chest. Her lungs are clear to auscultation. You should​ suspect: A. myocardial infarction. B. Costochondritis. C. cardiac contusion. D. Prinzmetal's angina

cardiac contusion.

An unresponsive​ 51-year-old male was stabbed in the fourth intercostal space of his left chest an inch lateral to his sternum. His skin is​ pale, cool, and diaphoretic. His lungs are clear to​ auscultation, and you observe his neck veins are distended. You should​ suspect: A. tension pneumothorax. B. cardiac tamponade. C. hemothorax. D. hemopneumothorax

cardiac tamponade.

A​ 25-year-old female complains of abdominal pain and vaginal bleeding after she was kicked midline in her lower abdomen by a horse. You should suspect her bleeding is from an injury to​ her: A. cervix. B. colon. C. sacrum. D. bladder.

cervix.

A​ 32-year-old female fell while hiking and she complains of extreme left calf pain. You do not observe any abnormal angulation of her leg. The skin on her left calf is​ pale, swollen, and she tells you she feels a pins and needles sensation. You are unable to palpate a distal pulse. You should​ suspect: A. a severe muscle spasm. B. neurological injury. C. a comminuted fracture. D. compartment syndrome.

compartment syndrome.

A​ 25-year-old male complains of severe leg pain. He tells you he went to the urgent care center yesterday and they applied a temporary cast wrapped with an elastic bandage because he broke his left tibia. He tells you the pain has been getting worse and he feels pins and needles in his leg. You​ should: A. tighten the elastic bandage around the temporary cast. B. apply warm compresses to his left lower leg. C. remove the temporary cast and apply an air splint. D. loosen the elastic bandage around the temporary cast.

loosen the elastic bandage around the temporary cast.

A confused​ 52-year-old female has an​ eight-inch full thickness laceration diagonally across her right thigh. Her skin is pale and​ diaphoretic, and you observe a steady flow of dark red blood oozing from the wound onto the carpeted floor. The carpet under her leg is saturated. You should​ suspect: A. minor bleeding. B. arterial hemorrhage. C. massive hemorrhage. D. capillary bleeding

massive hemorrhage.

A​ 72-year-old female complains of eye pain after she splashed drain cleaner into her eye. You observe that her right eye is​ red, and both eyes are tearing. You should hold her eyelids open and flush her eye from​ the: A. inferior to superior aspect. B. medial to lateral aspect. C. superior to inferior aspect. D. lateral to medial aspect

medial to lateral aspect.

An​ 8-year-old male was stabbed in the chest with a knife. You observe a​ half-inch laceration an inch lateral to the sternum at the third intercostal space. You do not see any active​ bleeding, and his neck veins are distended. His lungs are clear to auscultation. His capillary refill is three​ seconds, and his skin is pale and cool. You should​ suspect: A. obstructive shock. B. hypovolemic shock. C. tension pneumothorax. D. hemothorax

obstructive shock.

A​ 36-year-old female was struck by a car and thrown eight feet. She complains of pain in her left​ hip, and her leg is externally rotated. When you press on her iliac​ crests, she complains of increased​ pain, and you feel instability. You should suspect​ a(n): A. posterior femur dislocation. B. femur fracture. C. pelvic fracture. D. anterior femur dislocation.

pelvic fracture.

An unresponsive​ 11-year-old female jumped from a​ second-story window and landed on an uneven surface. Her skin is​ pale, cool, and you do not observe any bruising. She has a capillary refill of four seconds. Her left leg is shortened. When you compare her​ femurs, they are the same. Her abdomen is soft to​ palpation, and you feel crepitus when you assess her pelvis. You should suspect torn blood vessels in​ her: A. pelvis. B. liver. C. thigh. D. spleen

pelvis.

A​ 79-year-old male lost his balance and​ fell, landing on his back. He complains of pain in his upper​ back, and you palpate a deformity to​ T-6. He has a history of CHF and tells you he needs to sit up so he can breathe. He is on home oxygen by nasal​ cannula, 3​ L/minute. He is not able to feel below his xiphoid process or move his legs. You should apply a cervical collar​ and: A. immobilize him to a long backboard for transport. B. secure him in the​ semi-Fowler's position on the stretcher. C. secure him supine on the stretcher and increase the oxygen flow rate. D. secure him supine on the stretcher and administer oxygen by​ non-rebreather mask

secure him in the​ semi-Fowler's position on the stretcher.

A​ 74-year-old male complains of upper back pain and difficulty breathing after a fall. He has pain and crepitus in the right side of his back below his scapula. He has equal chest wall​ expansion, and his breath sounds are diminished in the affected area. His vital signs are P​ 82, R​ 18, BP​ 142/92, and SpO2 is​ 96% on room air. You should suspect​ a: A. simple pneumothorax. B. cardiac tamponade. C. tension pneumothorax. D. flail segment.

simple pneumothorax.

A​ 50-year-old male was lifting a heavy weight when he felt a tearing sensation in his right bicep. His bicep is tender to​ palpation, but you do not note any instability of his arm. His distal​ motor, circulation, and sensation are intact. You should apply​ a(n): A. elastic compression wrap to his upper arm. B. sling and cold pack. C. padded board splint to his upper arm. D. swathe and hot pack

sling and cold pack.

A​ 51-year-old female complains of chest pain and increasing difficulty breathing. She has a large caliber gunshot wound to her right chest​ wall, fourth intercostal space on the anterior axillary line. You auscultate absent breath sounds on the right side. Her vital signs are P​ 112, R​ 22, BP​ 104/90, and SpO2 is​ 91% on room air. You should​ suspect: A. pneumothorax. B. tension pneumothorax. C. flail chest. D. cardiac tamponade

tension pneumothorax.

An​ 82-year-old female was bitten by a dog. You observe an irregularly shaped flap of skin on her arm. You should suspect​ a(n): A. amputation. B. abrasion. C. avulsion. D. laceration.

avulsion.

Which of the following is a characteristic of pediatric trauma that can mask significant internal injuries after a child is struck by a​ car? A. There may be no obvious evidence of external trauma. B. Their compensatory mechanisms are not as well developed as adults. C. Children normally have bruises in multiple stages of healing. D. Their abdominal organs are better protected by the ribs

There may be no obvious evidence of external trauma.

During compensated hemorrhagic​ shock, why can the skin become pale and​ cool? A. Anaerobic metabolism is reduced in the skin. B. Blood flow is reduced to the skin. C. Cardiac output is reduced. D. Peripheral vascular resistance is reduced.

Blood flow is reduced to the skin.

Which of the following describes how the body responds to increased intracranial​ pressure? A. Pulse rate becomes​ irregular, blood pressure decreases B. Blood pressure​ increases, pulse rate decreases C. Respiratory rate becomes​ irregular, pulse rate increases D. Pulse rate​ increases, respiratory rate decreases

Blood pressure​ increases, pulse rate decreases

Besides bound to​ hemoglobin, how is oxygen transported to the​ cells? A. Bound to leukocytes B. Dissolved in bicarbonate C. Bound to platelets D. Dissolved in plasma

Dissolved in plasma

Why should you irrigate the eye of a patient who was splashed with drain cleaner longer than a patient who was splashed with muriatic​ acid? A. The pH of muriatic acid is similar to the eye and does not cause significant damage. B. Drain cleaner coagulates tissue and can damage more tissue. C. Drain cleaner liquifies tissue and can damage more tissue. D. Muriatic acid is more soluble in water than drain cleaner.

Drain cleaner liquifies tissue and can damage more tissue.

A​ 16-year-old female complains of chest pain. She has a six foot long pole impaled in her fifth intercostal​ space, one inch lateral to the midclavicular line on the right side of her chest. You​ should: A. stabilize the pole and place her on her right side. B. cut the pole flush with her skin and apply an occlusive dressing. C. remove the pole and apply an occlusive dressing. D. cut the pole four inches from her chest and stabilize it

cut the pole four inches from her chest and stabilize it

A​ 17-year-old female has a broken broom handle with a​ one-inch diameter impaled in her​ neck, entering at the sternal​ notch, and exiting below her right ear. She​ states, "I was outside when the handle blown by the tornado hit​ me." You​ should: A. remove it and apply occlusive dressings. B. apply a cervical collar and secure her to a long backboard. C. cut the handle at the surface of her skin and apply a cervical collar. D. stabilize it in the position found

stabilize it in the position found

A​ 73-year-old male has a nail impaled in the palm of his hand near the base of his thumb. He tells you he was using a nail gun and it ricocheted off the wood into his hand. He can move all his digits and does not have any neurological or circulatory deficits. You​ should: A. stabilize the nail with a bulky dressing. B. splint his hand. C. apply a cold pack. D. remove the nail and apply an adhesive dressing.

stabilize the nail with a bulky dressing.

Which of the following patients involved in a car crash has the most severe​ findings? A.A​ 32-year-old female complains of head and chest​ pain, she was ejected from the​ vehicle, her vital signs are P​ 104, R​ 18, and BP​ 116/92 B.A​ 28-year-old male complains of abdominal​ pain, he was the restrained​ driver, his vital signs are P​ 106, R​ 18, and BP​ 88/62 C.A​ 42-year-old female complains of chest​ pain, another passenger in the vehicle​ died, her vital signs are P​ 88, R​ 20, and BP​ 142/90 D.A​ 19-year-old male complains of head​ pain, the vehicle rolled over​ twice, his vital signs are P​ 98, R​ 16, and BP​ 114/72

A​ 28-year-old male complains of abdominal​ pain, he was the restrained​ driver, his vital signs are P​ 106, R​ 18, and BP​ 88/62

Why should you not remove an impaled object from the chest​ wall? A. It may be stabilizing fractured bone ends. B. It may be stopping air from entering the pleural space. C. It may be obstructing the airway. D. It may be occluding​ life-threatening hemorrhage

It may be occluding​ life-threatening hemorrhage

What characteristic must an open wound to the parietal pleura have for it to allow air to be drawn into the pleural space through the chest​ wall? A. It must penetrate the visceral pleural membrane. B. The pressure inside the chest cavity must be higher than outside the pleural space. C. It must be similar in size to the glottic opening. D. The pressure outside the chest wall must be lower than inside the pleural space.

It must be similar in size to the glottic opening.

How does compartment syndrome develop after an injury to the lower​ leg? A. Swelling increases the pressure in muscle tissue which occludes normal blood flow. B. Fractured bone ends occlude normal blood flow into the lower leg. C. Nerve damage from fractured bone ends causes pain and numbness. D. Bleeding creates fluid compartments that occlude blood vessels and nerve pathways.

Swelling increases the pressure in muscle tissue which occludes normal blood flow.

A​ 56-year-old female has a full thickness burn to her left anterior forearm from an industrial alkali. Why does she only have pain in the skin surrounding the​ burn? A. Over-stimulation of the nervous system by the surrounding tissue is blocking nerve impulses from the area of the burn. B. The alkali has an analgesic effect on the transmission of nerve impulses in the area of the burn. C. An alkali burn is a cool burn like frostbite and does not cause pain. D. The nerve cells are destroyed in the area of the burn

The nerve cells are destroyed in the area of the burn

Why should an apparently minor human bite that breaks the skin be evaluated at the​ hospital? A. There is a high risk of underlying tissue damage. B. They take longer to heal than avulsions. C. They take longer to develop underlying contusions. D. There is a high risk of infection

There is a high risk of infection

A​ 22-year-old male complains of difficulty breathing after being struck in the chest with a pipe. He has a​ six-inch bruise over his right axilla. His lung sounds are absent on the right lower chest. His vital signs are P​ 122, R​ 20, BP​ 88/72, and SpO2 is​ 94% on room air. You​ should: A. administer oxygen and keep him warm. B. place him in the Trendelenburg position. C. place him on the injured side. D. fully expose him and immobilize him to a long backboard

administer oxygen and keep him warm.

A​ 27-year-old male complains of pain in his left upper abdominal quadrant and left shoulder. He tells you he was in a bar fight five days ago. You observe yellowing bruises to his​ face, chest, and upper abdomen. His vital signs are P​ 116, R​ 18, BP​ 116/90, and SpO2 is​ 95% on room air. You​ should: A. administer aspirin and have him sip water. B. sling and swath his left arm and apply a cold pack. C. administer oxygen and keep him warm. D. apply a cervical collar and immobilize him to a long backboard.

administer oxygen and keep him warm.

An unresponsive​ 62-year-old male was struck in the head with a falling tree branch. He has a​ five-inch full thickness laceration to his right parietal region. It is​ bleeding, and you observe bone fragments in the wound. When you stimulate​ him, his arms twist outward. His vital signs are P​ 54, R 18 and​ irregular, BP​ 220/106, and SpO2 is​ 96% on room air. You should cover the wound with gauze​ and: A. apply an occlusive dressing. B. administer oxygen. C. apply direct pressure. D. assist his ventilation at a rate of​ 24/minute.

administer oxygen.

An​ 87-year-old male complains of difficulty breathing. He tells you he fell four feet from his porch and struck his chest on a brick wall. You observe a segment of his right chest wall moves inward when he inhales. You auscultate clear lung sounds in all fields. You​ should: A. immobilize him to a long backboard. B. assist his ventilation with a BVM. C. administer oxygen. D. pad the flail segment with a bulky dressing.

administer oxygen.

A​ 4-year-old male complains of difficulty breathing. He tells you he was struck by a car. You observe contusions and abrasions to his chest and abdomen. You auscultate decreased lung sounds and bowel sounds in his left lower chest. His vital signs are P​ 112, R​ 40, BP​ 100/74, and SpO2 is​ 92% on room air. You​ should: A. assist his ventilation. B. transport him on his left side. C. administer oxygen. D. transport him on his right side

administer oxygen.

A​ 58-year-old male complains of midsternal chest pain after a car crash. He tells you that he was​ pain-free before the crash. His skin is pale and diaphoretic. His lungs are clear to​ auscultation, and the pain increases with deep inspiration. His vital signs are P​ 112, R​ 18, BP​ 118/86, and SpO2 is​ 95% on room air. You​ should: A. administer oxygen. B. assess for orthostatic hypotension. C. administer aspirin. D. assist with the administration of his nitroglycerin.

administer oxygen.

A​ 70-year-old female who was the unrestrained driver in a car crash complains of difficulty breathing. She has a history of asthma and a pacemaker implanted. You auscultate diminished lung sounds and bowel sounds in her left base. Her vital signs are P​ 70, R​ 22, BP​ 138/74, and SpO2 is​ 96% on room air. You​ should: A. administer oxygen. B. assist with the administration of her inhaler. C. wrap her chest with an elastic bandage. D. assist her ventilation

administer oxygen.

A​ 9-year-old female was struck by a car while she was riding her bicycle. She complains of pain in her left​ forearm, right​ shoulder, and abdomen. Her skin is pale and cool. Her right shoulder appears uninjured. You observe an angulated injury to her​ forearm, and distal pulses are present. She has an abrasion to her right upper abdominal​ quadrant, and the pain increases with palpation. You should perform spinal motion​ restriction, A. gently realign her left arm into the position of​ function, and apply a splint. B. splint her left​ arm, and apply a sling to her right arm. C. splint her left arm in the position​ found, and apply a cold pack. D. administer​ oxygen, and transport immediately

administer​ oxygen, and transport immediately

A disoriented​ 19-year-old male was struck in the right temple with a golf club. You observe an expanding hematoma to the area and clear fluid draining from his ear. His vital signs are P​ 64, R​ 14, BP​ 192/102, and SpO2 is​ 94% on room air. You​ should: A. apply a cervical collar. B. assist his ventilation at a rate of​ 24/minute. C. apply direct pressure to the hematoma. D. pack his ear with gauze.

apply a cervical collar.

A​ 60-year-old male complains of shoulder pain. He tells you he tripped and grabbed the door frame as he fell backward. He is holding his right arm against his​ chest, and he tells you he is unable to move it. You observe a deformity below his clavicle and above his​ axilla, and he has a good radial pulse. You​ should: A. apply gentle traction and lift his arm. B. rotate his shoulder into the anatomical position. C. secure a padded board splint to his bicep and forearm. D. apply a sling and swathe

apply a sling and swathe

An​ 82-year-old male complains of foot pain after he stepped on a nail. You observe a small puncture wound and a small amount of blood on his sock. You​ should: A. cleanse the wound with a​ 10% bleach solution. B. soak his foot in​ warm, soapy water. C. wrap his foot with an elastic bandage. D. apply a sterile bandage

apply a sterile bandage

A​ 51-year-old male has a​ five-inch partial thickness laceration to his left thigh. You have applied direct pressure and controlled the hemorrhage. His vital signs are P​ 92, R​ 16, BP​ 132/76, and SpO2 is​ 95% on room air. You​ should: A. treat for shock. B. administer oxygen. C. apply a sterile dressing. D. pack the wound with a hemostatic agent

apply a sterile dressing.

A​ 20-year-old male was shot in the neck. You observe​ life-threatening bleeding from the wound. After you apply direct pressure with your gloved​ hand, you​ should: A. pack the wound with a hemostatic dressing. B. apply a circumferential compression dressing. C. apply a cervical collar. D. apply an occlusive dressing.

apply an occlusive dressing.

A​ 92-year-old male tripped and fell onto a ceramic figurine that created a​ two-inch hole in his right upper chest wall. You observe muscle tissue and bone fragments in the wound and hear bubbling sounds when he breathes. You​ should: A. assist his ventilation. B. apply an occlusive dressing. C. suction the wound. D. pack the wound with hemostatic gauze

apply an occlusive dressing.

An unresponsive​ 78-year-old male fell down a flight of stairs. You hear snoring respirations and see uncontrolled bleeding from a laceration on his head. You should​ first: A. apply a cervical collar. B. suction his airway. C. insert an oropharyngeal airway. D. apply direct pressure to the laceration

apply direct pressure to the laceration

A​ 41-year-old female was stabbed in her right thigh with a screwdriver. Her skin is​ warm, dry, and pink. You observe blood oozing from a​ two-centimeter wound and feel an expanding hematoma under her skin. You​ should: A. apply a sterile dressing. B. pack the wound with hemostatic gauze. C. apply direct pressure to the wound. D. apply a tourniquet.

apply direct pressure to the wound.

A​ 43-year-old female tells you that she was sexually assaulted. She complains of pain in her chest and groin from being kicked. You do not see any signs of bleeding through her outer clothing. You should listen to her lung sounds​ and: A. expose her to examine for bleeding. B. ask her if she is bleeding. C. request that a female law enforcement officer examine her for bleeding. D. transport her to the hospital for evaluation

ask her if she is bleeding.

A​ 60-year-old male tells you that he was sexually assaulted by a staff member where he lives. He denies any​ bleeding, and you do not see any blood on his undergarments. He appears frightened and tells you he​ doesn't want to go to the hospital. You​ should: A. ask him if he has a friend who can stay home with him. B. tell him that everything will be fine and transport him. C. encourage him to go to the hospital for evaluation. D. inspect his groin for bleeding

encourage him to go to the hospital for evaluation.

A​ 78-year-old female fell off her bicycle and struck her head. She tells you she does not remember the crash. Bystanders tell you that she was unresponsive before your arrival. While you are assessing​ her, she becomes unresponsive. You should suspect​ a(n): A. vasovagal syncopal episode. B. intracerebral bleed. C. subdural bleed. D. epidural bleed

epidural bleed

A​ 5-year-old male complains of pain in his left hand after he spilled liquid drain cleaner on it. His hand is​ reddened, and you smell a strong chemical odor. You​ should: A. flush his hand with water. B. neutralize the substance with baking soda. C. apply a sterile dressing. D. brush the substance off his hand

flush his hand with water.

An unrestrained​ 48-year-old male who was the front seat passenger in a​ high-speed car crash struck his face on the dash. He has abnormal movement of his maxilla. You should suspect​ a: A. TMJ dislocation. B. Le Fort III injury. C. muscle spasm. D. fracture

fracture

A​ 24-year-old female complains of chest pain and difficulty breathing. She tells you a horse kicked her in the chest. Her skin is pale and diaphoretic. You observe a contusion to the left side of her anterior chest wall. Breath sounds are absent over her left lower lung. Her vital signs are P​ 116, R​ 22, BP​ 92/80, and SpO2 is​ 95% on room air. You should​ suspect: A. flail chest. B. tension pneumothorax. C. hemothorax. D. pneumothorax

hemothorax.

A​ 91-year-old female complains of pain after she twisted her right ankle. You observe edema and ecchymosis over her lateral malleolus. The skin on her foot is​ pink, and she can feel you touch her toes. You​ should: A. move her foot to determine the range of motion of her ankle. B. apply a hot pack to her ankle. C. immobilize her foot and lower leg. D. apply an air splint

immobilize her foot and lower leg.

A​ 71-year-old male has partial thickness flash burns to his face. He tells you he was smoking in the bathroom while on oxygen by nasal cannula when it happened. The hair in his nostrils and eyebrows is singed. While he is speaking to​ you, you notice his voice is becoming more hoarse. He complains that his throat is​ tightening, and he has trouble breathing. You​ should: A. transport immediately. B. administer oxygen by nasal cannula. C. administer oxygen by​ non-rebreather mask. D. assess his vital signs

transport immediately.

A​ 50-year-old female has a​ four-centimeter full thickness laceration to the left side of her neck. You should apply an occlusive dressing to prevent air from entering​ her: A. arterial circulation. B. trachea. C. venous circulation. D. pleural space

venous circulation.

A​ 66-year-old male complains of hand pain. Three of his fingers were caught in an industrial sander and pulled off his hand. Bleeding is minor and controlled with a dressing. His coworkers bring you the fingers. You​ should: A. wrap the fingers in sterile​ gauze, place them in a plastic​ bag, and place the bag on ice. B. brush off any contaminants and place them in a jar of ice water. C. splint the fingers in the position of function and wrap them in sterile gauze. D. wash the fingers in sterile​ water, place them in a plastic​ bag, and place the bag on ice.

wrap the fingers in sterile​ gauze, place them in a plastic​ bag, and place the bag on ice.

An​ 89-year-old male cut his abdomen on a knife while preparing dinner. You observe several loops of bowel protruding from the wound and minimal bleeding. What type of dressing should you apply to his​ wound? A. Dry, sterile B. Self-adhering occlusive C. Moist, sterile D. Hemostatic

​Moist, sterile