Shock maybe

External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg. A. femoral vein, 114/60 B. carotid artery, 100/70 C. brachial artery, 68/46 D. jugular vein, 96/62

B. carotid artery, 100/70

A healthy adult can tolerate blood loss of up to ____ mL over a period of 15 to 20 minutes without any negative effects. A. 500 B. 1,500 C. 750 D. 1,000

A. 500

Which of the following factors would have the MOST negative effect on the body's process of hemostasis? A. Anticoagulant use B. Chronic heroin use C. Bradycardia D. Hyperthermia

A. Anticoagulant use

Which of the following signs would you MOST likely observe in a patient with compensated shock? A. Anxiety or agitation B. Absent peripheral pulses C. Dilation of the pupils D. Response to painful stimuli

A. Anxiety or agitation

Which of the following organs is LEAST susceptible to pressure changes caused by an explosion? A. Liver B. Tympanic membrane C. Lungs D. Gastrointestinal tract

A. Liver

Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A. Mechanism of injury B. Index of suspicion C. Past medical history D. Age of the patient

A. Mechanism of injury

Which of the following is NOT a benefit of a properly worn seat belt? A. Minimal risk of whiplash injuries after a rear-end collision B. Prevention of occupants from violently contacting each other C. Distribution of deceleration energy over a greater surface area D. Prevention of partial or complete ejection from the vehicle

A. Minimal risk of whiplash injuries after a rear-end collision

Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A. Severe burns B. Fractures C. Blunt trauma D. Hemothorax

A. Severe burns

Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body? A. Spleen B. Heart C. Fluid volume D. Vasculature

A. Spleen

Which of the following factors is the LEAST influential in the severity of a stab wound? A. The size of the attacker B. The length of the knife blade C. The angle of penetration D. The anatomic area involved

A. The size of the attacker

Decompensated shock in the adult is characterized by: A. a falling blood pressure. B. bounding radial pulses. C. 15% blood loss or more. D. increased tidal volume.

A. a falling blood pressure.

The MOST common site of deceleration injury in the chest is the: A. aorta. B. esophagus. C. heart. D. vena cava.

A. aorta.

Unlike deceleration injuries, crush and compression injuries occur: A. at the time of impact. B. from penetrating mechanisms. C. after the initial impact. D. before impact occurs.

A. at the time of impact.

A patient with hemorrhagic shock would be expected to have: A. flattened jugular veins. B. warm, flushed skin. C. a widened pulse pressure. D. an increased hematocrit.

A. flattened jugular veins.

Following a rotational impact, the MOST severely injured patients will likely be found at the point of: A. greatest deceleration. B. greatest acceleration. C. least deceleration. D. secondary impact.

A. greatest deceleration

If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: A. has a known bleeding disorder. B. is older than 45 years of age. C. takes any kind of medication. D. is emotionally upset or angry.

A. has a known bleeding disorder.

The peak magnitude of the pressure wave experienced by a person: A. lessens as the person is farther away from the center of the explosion. B. causes secondary and tertiary injuries as a result of the explosion. C. will cause less severe trauma if the person is standing beside a solid object. D. causes more severe trauma if the person is in an open area during the explosion.

A. lessens as the person is farther away from the center of the explosion.

When applying a tourniquet to control major external hemorrhage from an extremity injury, you should: A. maintain direct pressure to the wound until the tourniquet has been fully applied. B. secure the tourniquet in place until the pulses distal to the injury have weakened. C. apply the tourniquet over a joint, as this will further help compress blood vessels. D. apply a pressure dressing over the tourniquet to further help control the bleeding.

A. maintain direct pressure to the wound until the tourniquet has been fully applied.

Afterload is defined as the: A. pressure in the aorta against which the left ventricle must pump. B. amount of blood ejected from the ventricle with each contraction. C. amount of resistance to blood flow offered by the heart valves. D. volume of blood remaining in the ventricles following contraction.

A. pressure in the aorta against which the left ventricle must pump.

Patients with internal hemorrhage will benefit MOST from: A. rapid transport. B. PASG placement. C. IV therapy. D. high-flow oxygen.

A. rapid transport.

Perfusion is defined as: A. the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. B. the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. C. the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation. D. an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg.

A. the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.

The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. A. 150, 40 B. 140, 50 C. 170, 30 D. 160, 30

B. 140, 50

A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation? A. Proximal upper extremity fractures B. Bilateral femur fractures C. Sympathetic nervous system failure D. Closed head injury

B. Bilateral femur fractures

Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock? A. Nasal decongestants B. Calcium channel blockers C. Beta-2 adrenergic agonists D. Tricyclic antidepressants

B. Calcium channel blockers

Which of the following organs or body systems requires a constant blood supply, regardless of external factors? A. Skin B. Kidneys C. Muscles D. Gastrointestinal tract

B. Kidneys

Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A. Hemothorax B. Severe burns C. Blunt trauma D. Fractures

B. Severe burns

Which of the following characteristics of an entry wound indicates that the weapon was fired at close range? A. Severe bleeding from the wound B. Tattoo marks from powder burns C. Indentation of cutaneous tissues D. Abrasions around the wound

B. Tattoo marks from powder burns

When summoning an air transport service to transport a critically injured patient, it is MOST important to: A. predetermine the destination facility. B. activate the service as soon as possible. C. ensure that the fire department is present. D. determine the flight crew's credentials.

B. activate the service as soon as possible.

You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should: A. keep him warm, administer high-flow oxygen, establish one large-bore IV line at the scene, and transport. B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route. C. Keep him warm, assist his ventilations, place a hemostatic agent in the wound, transport, and start a large-bore IV en route. D. administer high-flow oxygen, start two large-bore IV lines at the scene and give a 2- to 3-L fluid bolus, and transport.

B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.

Lap belts that are worn alone and too high by a pregnant woman: A. usually do not injure the fetus because the uterus is a highly muscular organ. B. allow enough forward flexion and subsequent compression to rupture the uterus. C. will provide equal distribution of forces and prevent forward flexion of the mother. D. will provide adequate protection for the uterus if the air bag properly deploys.

B. allow enough forward flexion and subsequent compression to rupture the uterus.

The primary determinants of the extent of trauma a patient sustains are the: A. physical size of the patient and the part of the body that sustains direct impact from an object. B. amount of energy in the object and the mechanism by which the object is delivered to the body. C. type of object that strikes a patient and the part of the body that sustains the most impact. D. size of the object that strikes the body and any secondary injuries that occur if the patient falls. Incorrect

B. amount of energy in the object and the mechanism by which the object is delivered to the body.

A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A. hypotension and tachycardia. B. bradycardia and hypotension. C. hypertension and bradycardia. D. syncope and hypertension.

B. bradycardia and hypotension.

After a motorcyclist is ejected from his or her motorcycle, secondary collisions: A. typically cause bilateral fractures of the femurs and tibias. B. cause an unpredictable combination of blunt injuries. C. result in less severe injuries if the rider is wearing leather. D. most commonly involve a stationary object.

B. cause an unpredictable combination of blunt injuries.

The third phase of a motor vehicle accident involves: A. impact by another vehicle. B. deceleration of internal organs. C. injuries caused by flying debris. D. crush injuries to the body.

B. deceleration of internal organs.

Most external hemorrhage can be controlled with a combination of: A. pressure dressings and ice. B. direct pressure and pressure dressings. C. pressure point control and elevation. D. elevation and immobilization.

B. direct pressure and pressure dressings.

The law of conservation of energy states that: A. a body at rest will remain at rest unless acted upon by an outside force. B. energy can be neither created nor destroyed; it can only change form. C. the force that an object can exert is the product of its mass multiplied by its acceleration. D. kinetic energy can be converted only to thermal or chemical energy.

B. energy can be neither created nor destroyed; it can only change form.

Agents such as Celox, HemCon, and QuikClot are used to: A. replace lost blood. B. promote hemostasis. C. repair damaged vessels. D. raise blood pressure.

B. promote hemostasis.

When a patient takes the "up and over" pathway during a head-on collision: A. secondary injuries as the patient is ejected are often less severe than the primary injuries. B. the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx. C. injuries to the parietal aspect of the skull are common as the head strikes the side window. D. the head takes a higher trajectory, striking the windshield and causing stretching injuries to the neck.

B. the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.

Compared to stab wounds to the posterior part of the body, stab wounds to the anterior part of the body are generally: A. multiple. B. upward. C. downward. D. single.

B. upward.

A trauma patient with suspected internal hemorrhage and inadequate breathing requires: A. oxygen via nonrebreathing mask and transport. B. ventilation assistance and rapid transport. C. intubation that is facilitated by medications. D. on-scene IV therapy and rapid fluid boluses.

B. ventilation assistance and rapid transport.

Confusion, a sustained heart rate greater than 120 beats/min, and a respiratory rate of 32 breaths/min are MOST consistent with class ___ hemorrhage? A. II B. IV C. III D. I

C. III

Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock? A. Nasal decongestants B. Beta-2 adrenergic agonists C. Calcium channel blockers D. Tricyclic antidepressants

C. Calcium channel blockers

Which of the following two factors DIRECTLY affect cardiac output? A. Preload and afterload B. Blood pressure and pulse rate C. Stroke volume and pulse rate D. Vessel size and stroke volume

C. Stroke volume and pulse rate

Which of the following general statements regarding gunshot wounds is correct? A. Wounds to lower extremities that are not associated with a fracture or neurovascular compromise are always explored surgically. B. Injuries from a shotgun blast are most devastating when the distance between the gun and the target is less than 100 yards. C. The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes. D. Tissue of high elasticity, such as muscle, is less able to tolerate temporary cavitation than tissue of low elasticity, such as the liver.

C. The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes.

What is "warm ischemic time"? A. The preservation of ischemic organs and tissues when the patient's body temperature is reduced by 1°F per hour B. The period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs C. The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature D. The preservation of ischemic organs and tissues when the patient's body temperature is increased to at least 101°F

C. The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature

According to the Waddell triad, the second impact from a motor vehicle occurs when the: A. child is run over by the car as he or she is propelled to the ground. B. car's bumper strikes the pelvis and femurs instead of the knees. C. chest and abdomen strike the grille or low on the hood of the car. D. head strikes the ground, resulting in skull and facial fractures.

C. chest and abdomen strike the grille or low on the hood of the car.

If you discover minor external bleeding during your primary assessment of a patient, you should: A. establish a large-bore IV line immediately. B. stop your assessment and take the patient's blood pressure. C. make note of it and continue your assessment. D. stop your assessment and control the bleeding.

C. make note of it and continue your assessment.

During a lateral impact collision: A. properly worn seat belts protect the passenger from pelvic trauma at the time of impact. B. the patient's head moves away from the object causing the impact, resulting in stretching injuries. C. trauma to the upper extremities depends on the spatial orientation of the arms upon impact. D. the far-side occupant, even if properly restrained, experiences double the amount of force as the driver.

C. trauma to the upper extremities depends on the spatial orientation of the arms upon impact.

All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT: A. dizziness. B. syncope. C. vomiting. D. weakness.

C. vomiting.

A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation? A. Sympathetic nervous system failure B. Proximal upper extremity fractures C. Closed head injury D. Bilateral femur fractures

D. Bilateral femur fractures

Which of the following organs can sustain the longest period of inadequate perfusion? A. Spinal cord B. Skeletal muscle C. Kidneys D. Gastrointestinal tract

D. Gastrointestinal tract

Which of the following organs or body systems requires a constant blood supply, regardless of external factors? A. Gastrointestinal tract B. Muscles C. Skin D. Kidneys

D. Kidneys

Unlike adults, children who are struck by a motor vehicle are MORE likely to: A. experience injuries to the lower extremities from the initial impact. B. be propelled onto the hood of the vehicle during the second impact. C. turn away from the oncoming vehicle, resulting in posterior trauma. D. be run over by the vehicle as they are propelled to the ground.

D. be run over by the vehicle as they are propelled to the ground.

A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A. syncope and hypertension. B. hypotension and tachycardia. C. hypertension and bradycardia. D. bradycardia and hypotension.

D. bradycardia and hypotension.

When a person falls from a significant height and lands on his or her feet, axial loading results in: A. crushing injuries to the heels and hip dislocations. B. disc injuries to the lower cervical and upper thoracic spine. C. shearing injuries to the liver, spleen, and aorta. D. compression or burst fractures to the lumbar spine.

D. compression or burst fractures to the lumbar spine.

If a person survives the initial trauma from a shotgun wound at close range: A. he or she typically dies within 24 hours secondary to liver or renal failure. B. it is likely that only soft tissue was injured and major organs were spared. C. nervous system damage is likely due to the internal dispersal of the pellets. D. contaminants that were driven into the wound can cause a severe infection.

D. contaminants that were driven into the wound can cause a severe infection.

Sudden deceleration of a motor vehicle that is traveling at 60 mph: Choose one answer. A. initially causes whiplash injuries to the patient's neck. B. causes the driver's body to stop moving at the same time. C. typically generates forces of up to 10 to 20 g. D. dissipates tremendous forces and causes major injuries.

D. dissipates tremendous forces and causes major injuries.

The shock wave velocity from an explosion is slower and its duration is longer if a person is: A. standing beside a solid object. B. standing behind a solid object. C. closer to the explosion. D. farther from the explosion.

D. farther from the explosion

Compared to a handgun, a rifle: A. is less accurate. B. has less powerful ammunition. C. fires a single projectile. D. fires at a higher velocity.

D. fires at a higher velocity.

Venous bleeding: A. is generally more difficult to control than arterial bleeding. B. is bright red in color and typically spurts from a wound. C. is dark red in color and usually oozes from the wound. D. is more likely to clot spontaneously than arterial bleeding.

D. is more likely to clot spontaneously than arterial bleeding.

The paramedic's MAIN goal in treating a patient with shock is to: A. maintain body temperature and elevate the patient's legs 6 to 12 inches in order to improve blood flow to the core of the body. B. administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%. C. start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion. D. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.

D. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.