AT BOC Prep Domain III - Immediate and Emergency Care

D: It is normal for health-care providers to experience distress following a catastrophic incident. Group debriefi ng allows the participants to process what happened and helps to expedite recovery

A 15-year-old freshman running back suffered an acute cardiac incident and died despite the care provided by the athletic trainer, coaches, and emergency medical providers. The athletics director requests that the staff members that were involved in the incident participate in a group psychological debriefing. What is the purpose of this activity? A. To protect the school from any liability by having each person write down exactly what happened in his or her own words B. To walk through the incident to identify possible areas of improvement for future emergency situations C. To discuss the stress that the other athletes and students may be experiencing and develop a plan for assisting them D. To alleviate some of the distress the staff may be feeling and help expedite their personal recovery process

B: Bacterial meningitis is a potentially lifethreatening illness that develops quickly and can result in severe consequences, including limb amputation, coma, and death. Patients with symptoms consistent with this condition should be immediately transported to an emergency care facility

A 19-year-old male student athlete presents to your athletic training facility with an increasingly severe headache, cervical rigidity, high fever (103°F), nausea, confusion, and other signs and symptoms consistent with bacterial meningitis. How should you best coordinate care for this patient? A. Make an appointment for him to be seen by a physician later in the day at the school ' s student health services. B. Arrange for him to be immediately transported to an emergency care facility. C. Provide him with over-the-counter medications and recommend he immediately return to his room to get rest so his body can fight the infection. D. Recommend he visit a nearby walk-in urgent care facility as soon as possible, and provide him with the facility ' s address and contact information.

D: If a joint reduces, damage can still occur to distal arteries and veins. Distal swelling may be indicative of poor venous return, and cyanosis and poor capillary refi ll also indicate vascular involvement

A basketball player sustains an anterior shoulder dislocation when he gets undercut and falls to the floor. The joint spontaneously reduces itself when he attempts to get up. The athletic trainer removes the athlete from practice to complete an evaluation. The initial assessment is consistent with an anterior dislocation, and the athlete is provided with ice and a sling. Toward the end of practice, the athlete begins to complain of pain in his hand and fingers. Which of the following additional findings would warrant immediate referral of the athlete for further evaluation? A. Sweating B. Throbbing in the shoulder joint that radiates toward the elbow C. Pain when asked to squeeze the examiner ' s hand D. Bluish tint to nailbeds and swelling of the fingers and hand

A: Keeping the leg elevated and icing will help control swelling of the muscles within the compartment. Paying attention to signs of numbness or tingling and immediate response to those signs can help reduce further damage to other tissues from hypoxia or nerve damage.

A field hockey player sustains a direct blow to her right anterior lower leg from an opponent ' s stick. Following your evaluation, you are concerned that the athlete may develop acute compartment syndrome. What instructions should you give the athlete before allowing her to return to her dorm for the evening? A. Keep her leg elevated, ice the injury as much as possible, and go to the emergency department if she experiences any numbness, tingling, or increased pain overnight. B. Keep the compression wrap on until she returns for reevaluation the next morning, and take ibuprofen as needed for pain. C. Use crutches if walking is painful, soak in a hot bath with Epsom salt, and wear a neoprene compression sleeve while sleeping. D. Use the transcutaneous electrical nerve stimulation (TENS) unit as instructed for pain control, take acetaminophen only as needed for pain, and go to the emergency department if these two modalities do not manage pain. E. Schedule an appointment with the massage therapist, use topical thermal cream to relieve pain and spasm, and call the athletic trainer if she experiences an increase in symptoms.

C: Accepted reduction of a dislocated patella is to apply pressure in a medial direction while having the athlete actively extend the knee. This should reduce the pain and deformity at the patellofemoral joint

A field hockey player sustains a noncontact lateral patellar dislocation during play. What is the accepted method for on-field reduction of this dislocation? A. With the athlete supine, apply gentle pressure to the patella in the medial direction while the athlete actively fl exes the knee. B. With the athlete seated, apply gentle pressure to the patella in an inferior and lateral direction while the athlete actively extends the knee. C. With the athlete seated, apply gentle pressure to the patella in the medial direction while the athlete actively extends the knee. D. With the athlete side-lying, apply gentle pressure to the patella in the medial direction while the athlete actively fl exes the knee to the chest. E. With the athlete seated, apply gentle pressure to the patella in the superior and lateral direction while the athlete actively fl exes the knee.

A: The athletic trainer should suspect sickle cell collapse due to the fact that the athlete collapsed early in the practice and his core temperature is not greatly elevated

A football player conditioning during a summer workout collapses. Which of the following factors suggest the athlete is suffering from an exertional sickling crisis? A. The collapse occurs early in the workout, and the athlete ' s core temperature is not greatly elevated. B. The collapse is associated with visible, rock-hard muscle contractions. C. The athlete ' s rectally assessed core temperature is above 106°F at collapse. D. The collapse is associated with excruciating pain and occurs late in the conditioning session.

A: Having the athlete relax can reduce the chance of further injury. Assuring the athlete that he will receive the best care is important in allowing him to relax as well

A football player incurs an axial load mechanism injury. During your neurological assessment of this athlete, you note bilateral sensation deficits in the lower extremity. The athlete becomes anxious at this time and tells you he cannot feel his legs. What is the most appropriate response to this injured athlete? A. Encourage the athlete to relax and assure him that you are going to get him the best possible care. B. Indicate to the athlete that your findings are consistent with his sensations and tell him he needs to go to the emergency department. C. Encourage the athlete to take deep breaths and to try not to think about the seriousness of this injury. D. Ask the athlete if his parents are in the stands and how they handle bad news. E. Tell the athlete that you have handled other serious neck injuries and that your team physicians are the best in the area, so he will be perfectly fine.

C: The referee is breathing and if the heart is still beating and a pulse may be palpated, it is contraindicated to begin chest compressions. However, due to his collapse, an automated external defi brillator (AED) should be brought to the scene, and emergency medical services (EMS) should be contacted

A male referee running down the sidelines during a punt return suddenly grasps at his chest and collapses. His face becomes ashen, and his breathing is difficult, but he maintains consciousness. Because you are trained in first aid, you suspect a heart attack. What should you do? A. Treat for shock and send someone to get an automated external defibrillator (AED). B. Begin artificial respirations, monitor pulse, and activate emergency medical services (EMS). C. Monitor the patient ' s vital signs, send someone to get an AED, and activate EMS. D. Administer CPR, monitor vital signs, and activate EMS using your cell phone. E. Place the patient in a semireclining position, provide electrolyte fluids along with low-dose aspirin, send someone to get an AED, and activate EMS.

D: In addition to a rapid and strong heartbeat, exertional heatstroke is characterized by an elevated core body temperature of greater than 105°F and central nervous system dysfunction

A normal pulse rate for adults is between 60 and 100 beats/min. Which of the following conditions might be indicated by a pulse that is more rapid than normal but is also strong? A. Diabetic coma B. Shock C. Cerebral vascular incident D. Heatstroke

D: Shock occurs when there is a decreased supply of oxygenated blood to the circulatory system and body tissues. As a result, vital signs indicate stress on the circulatory system

A rugby player sustains a compound fracture of the radius and ulna. While the injury is being splinted, the athlete begins to complain of light-headedness. Assessment of vital signs reveals blood pressure 88/60 mm Hg, pulse 105 beats/min and weak, and respirations 25 and shallow. Based on these findings, what condition do you suspect? A. Compromised limb B. Sepsis C. Panic attack D. Shock

A: Applying an additional layer of gauze on top of saturated gauze allows the clinician to continue applying direct pressure without disrupting the wound

A soccer goalie comes out of the box to retrieve a rebounded shot. The attacking forward seizes the opportunity to shoot and his foot makes direct contact with the goalie ' s face, resulting in profuse bleeding. Management of external bleeding includes the use of direct pressure, elevation, and pressure points. What is the correct procedure to follow if the blood soaks through the dressing being used to apply direct pressure? A. Apply additional gauze atop saturated gauze. B. Remove saturated gauze and replace with new gauze. C. Remove saturated gauze and replace with more absorbent dressing. D. Remove saturated gauze, apply a layer of petroleum jelly, and replace with new gauze. E. Apply a layer of petroleum jelly atop saturated gauze and apply an additional layer of gauze

A: Intrusive luxations require immediate referral for radiographic evaluation to assess the root of the tooth

A soccer player is brought into the athletic training room by his teammates. They report that they were playing pick-up when someone kicked a ball and the athlete did not see the ball coming toward his head. The athlete turned unexpectedly and met the full force of the ball with his head and face. Your evaluation reveals that the athlete ' s bottom three central incisors appear to have been forced down into their sockets. What action should the athletic trainer take to manage this injury? A. The athlete should be immediately transported to a trauma-trained dentist or the emergency department. B. The athlete should be asked to bite on a gauze pad to hold the teeth in place and then referred to the team dentist. C. The athletic trainer should attempt to gently reposition the teeth and then refer to the team dentist. D. The athlete should be allowed to return back to his dorm to rest and then return for reevaluation later in the day as the teeth will more than likely rebound to their original position.

A: An open basket weave allows for accommodation in response to an increase in swelling as well as providing the additional support for the injured structures

A volleyball player sustains an acute eversion ankle sprain. What taping technique should be applied to best control swelling and provide limited support? A. Open basket weave B. Gibney C. Low-dye D. Kinesio taping E. McConnell taping

C: Because the location of the hit in the right fl ank area correlates with the location of the kidneys, the athlete should watch for hematuria, or blood in the urine, to make sure there was no damage to the kidneys

A young club lacrosse player sustains a severe blow to the right fl ank area during a game. He is unable to continue playing, so you conduct an evaluation and treat this athlete. Before releasing this athlete to his parents' care for the evening, what instructions should you provide? A. Instruct the parents to encourage the athlete to drink copious amounts of water and other fluids over the next 8 hours. B. Instruct the parents to wake the athlete every hour during the night and encourage him to urinate as much as possible. C. Instruct the parents to check for hematuria during the athlete ' s next two to three voiding episodes. D. Instruct the parents to check for occult blood in the stool for each bowel movement over the next 3 days. E. Instruct the parents to take the athlete immediately to the emergency department at the nearby hospital.

C: The goal of treatment of a patient with exertional heatstroke (EHS) is to lower core body temperature to 102°F within the fi rst 30 minutes after collapse. Patients with EHS should be cooled before being transported to an emergency care facility

According to research-based recommendations for the appropriate management of exertional heatstroke (EHS), what treatment should be provided to a patient demonstrating signs and symptoms of EHS before transportation to an emergency care facility? A. Oral fluids containing glucose and electrolytes until patient ceases to be thirsty B. Foods such as bananas containing both sugars and necessary vitamins and minerals C. Cold water immersion to cool the patient ' s core body temperature to at least 102°F D. Antipyretic medications such as acetaminophen (Tylenol) to decrease core body temperature

A: The National Association of EMS Physicians states that CPR cessation should occur after 15 minutes of unsuccessful resuscitation and CPR

According to the National Association of EMS Physicians, which of the following is an accepted criterion for cessation of CPR procedures? A. A nonhypothermic athlete is in cardiac arrest for more than 30 minutes. B. An emergency medical technician instructs you to discontinue treatment of the athlete. C. The athlete regains normal breathing pattern. D. Another rescuer arrives on the scene and offers assistance. E. The automated external defi brillator (AED) has provided at least one shock.

A: The primary goal of the athletic trainer is to reduce any unnecessary head movement; however, if the face mask is hindering the control of the airway, the helmet should be removed to establish ventilation. While the helmet is being removed, spinal immobilization must be maintained to reduce the motion at the cervical spine and therefore improve the overall prognosis

According to the National Athletic Trainers' Association (NATA) position statement on management of the cervical spine-injured athlete, which of the following statements is correct regarding face mask removal? A. If the face mask cannot be removed in a reasonable amount of time, the helmet should be removed in the safest manner possible. B. If the face mask cannot be removed in a reasonable amount of time, a pocket mask should be inserted under the face mask while ensuring cervical stabilization. C. If the face mask must be removed, cutting tools are generally faster and produce less head movement than powered (cordless) screwdrivers. D. Once the decision to immobilize and transport has been made, the athletic trainer should allow the paramedics to determine whether the face mask should be removed. E. The face mask should be removed before a primary assessment to ensure the most accurate evaluation of the airway

A: Individuals who may have come in contact or were in close vicinity of an athlete with bacterial meningitis should be treated with prophylactic antibiotics

After returning from a road trip, a member of your swim team is diagnosed with bacterial meningitis. Which of the following is the most appropriate management approach for this condition? A. Individuals who have been in close contact with the sick athlete should be placed on prophylactic antibiotics. B. Individuals who have been in close contact with the sick athlete should be tested for the disease using a nasal swab. C. Everyone in the travel party should be quarantined and monitored for 48 hours to ensure no one else has contracted the disease. D. Everyone in the travel party should be tested for the disease using a lumbar puncture. E. Everyone in the travel party should be encouraged to eat well, get plenty of rest and fluids, and report to the athletic training room immediately if they begin to experience any symptoms.

E: A crown fracture is a fracture to the part of the tooth that is visible and above the gum line. This can leave the dentin and pulp visible. This type of fracture should be referred to a dentist

An athlete has sustained a crown fracture. Referral to which health-care provider is most appropriate for this condition? A. Oral surgeon B. Oral and maxillofacial surgeon C. Endodontist D. Periodontist E. Dentist

A: Educational sessions are not a form of therapy, but they do reduce potential psychological problems by allowing people to process and better understand the consequences of traumatic situations

An athlete on your equestrian team is thrown from a horse and suffers a cervical spine injury that results in paraplegia. Which of the following strategies might best prepare the athlete ' s teammates to interact with their friend moving forward? A. Educational session to discuss the nature of the injury and its associated limitations and answer questions the teammates may have about how to best help their friend B. Critical incident stress debriefing to help the athletes process the injury they saw C. Individual meetings with school counseling center to evaluate how each individual athlete is processing the situation D. Cognitive behavioral therapy to gradually expose the athletes to memories of the tragic event

D: Pain in the right lower quadrant, otherwise known as McBurney ' s point, and these symptoms suggest appendicitis. Referral to the local emergency facility is important because the appendix could rupture

An athlete reports to the athletic training facility complaining of nausea, slight fever, mild diarrhea, and nonspecific discomfort located around the umbilicus and the right lower quadrant. The athlete is able to manage pain only by staying in the fetal position. The pain has been steadily increasing over the past several hours. Which acute condition do you suspect, and how should this best be managed? A. Acute pelvic inflammatory disease; instruct the athlete to call her gynecologist B. Irritable bowel syndrome; schedule the athlete to see the team physician later in the day C. Cholecystitis; schedule an appointment with a gastroenterologist for the athlete D. Appendicitis; the athlete should be transported to the local emergency facility E. Kidney stone; refer the athlete to the local emergency facility

D: One of the key points of the SCAT5 states: "Any athlete with suspected concussion should be removed from play, medically assessed and monitored for deterioration. No athlete diagnosed with concussion should be returned to play on the day of injury."

An athlete sustains a blow to the head in the first few minutes of a contest and is diagnosed with a concussion. According to the Sport Concussion Assessment Tool, 5th edition (SCAT5), what recommendation is made regarding returning this athlete to the contest? A. The athlete can be returned to the contest before half-time if his SCAT5 scores indicate a "normal" rating. B. The athlete can be returned to the contest after halftime if his SCAT5 scores indicate a "normal" rating. C. The athlete can return to the contest immediately, as long as he is not demonstrating any of the SCAT5 "red flags," such as neck pain or tenderness, double vision, severe or increasing headache, and vomiting. D. The athlete should not be returned to participation on that day.

A: A positive halo test is indicative of leaking cerebrospinal fl uid and possible skull fracture. Any athlete that has a positive halo test should be referred immediately for further evaluation.

An athlete sustains a head injury. During the evaluation of the athlete, the halo test is positive. What does this indicate, and what steps should be taken to manage this injury? A. The athlete is leaking cerebrospinal fluid and should be referred immediately for evaluation of possible skull fracture. B. The athlete is bleeding from a skull fracture and should be referred immediately. C. The athlete has an epidural hematoma, and emergency medical services (EMS) should be called for immediate transport. D. The athlete has a concussion and should be monitored and reassessed every 20 minutes. E. The athlete has sustained a nasal fracture that involves the sinuses and should be referred to an ear, nose, and throat specialist.

B: Post-traumatic stress disorder (PTSD) may develop after a person experiences a traumatic event. The disorder is characterized by persistently reliving the experience during the day or in nightmares. Referral for counseling is recommended

An athlete who suffered a career-ending knee dislocation as a result of a collision during a football game is becoming consistently noncompliant with his rehabilitation plan. His roommates, who are also on the team, share that he often wakes up several times a night crying out, sweating, and breathing very quickly. He makes excuses so he does not have to attend team events, and he refuses to go back to the field where the injury occurred. What actions should the athletic trainer take? A. Suspect the athlete is a harm to himself and alert public safety and residence life to begin conducting routine welfare checks B. Suspect the athlete may be experiencing posttraumatic stress disorder (PTSD) and speak to him about going to see the team psychologist C. Suspect the athlete may be having repeated panic attacks and contact his parents to have him taken home for further treatment D. Suspect the athlete may be experiencing adjustment disorder and begin regular cognitive behavioral therapy sessions with the athlete.

D: Hydrocolloid and other occlusive dressings can stay in place for up to 7 days, provided that they are inspected daily for signs of infection or adverse reactions

An athlete with a partial-thickness laceration has been treated with a hydrocolloid occlusive dressing. How often does this dressing need to be changed if there is no sign of infection or adverse reaction present on daily inspection? A. Daily B. Every other day C. Every third day D. Dressing can stay in place for 5 to 7 days

B: Pertinent medical information, such as medical conditions, allergies, and medications, should be included on the emergency action plan (EAP) pocket emergency card

An emergency action plan (EAP) pocket emergency card can assist sports medicine health-care professionals in the event of a medical emergency. In addition to the venue ' s EAP, what information should be printed on a pocket emergency card to aid in the timely referral of a seriously injured or ill athlete? A. Parent or guardian name and contact information for each participating athlete B. Pertinent medical information of each participating athlete C. Class schedule with teacher contact information for each participating athlete D. Medical insurance information for each participating athlete

E: In the event of a posterior-superior tibiofi bular dislocation of the femur, the athletic trainer should assess the circulation and neurological status of the leg, assess the athlete for shock, and activate emergency medical services (EMS).

An offensive lineman sustains a low chop block at the same time he incurs a posteriorly directed blow to his upper body, resulting in a posteriorsuperior tibiofibular dislocation of the femur. What is the most appropriate immediate care for this knee injury? A. Apply a vacuum splint, use a manual conveyance technique to transport the athlete to the sidelines, and perform a complete lower extremity evaluation. B. Apply a padded, long board splint; assess the athlete for shock; and activate emergency medical services (EMS). C. Perform a lower extremity evaluation, use a manual conveyance technique to transport the athlete to the sidelines, and activate EMS. D. Activate EMS, apply a traction splint, and monitor for shock. E. Assess circulation and neurological status of the leg, assess the athlete for shock, and activate EMS.

B: Targeted time from collapse until emergency medical services (EMS) is called and CPR is initiated is 1 minute and time from collapse to administration of the fi rst shock with the automated external defi brillator (AED) is 3 to 5 minutes. Early defi brillation can produce survival rates of up to 75%

As the athletic trainer at a local high school, you recognize the need to provide access to early defibrillation in the event that an athlete suffers a sudden cardiac arrest event. With this in mind, you enlist the help of the athletics director to hold annual training for all members of the coaching staff and administrators to practice implementation of the emergency action plan (EAP). What is the recommended target time from collapse to administration of the first shock? A. 1 minute B. 3 to 5 minutes C. 6 to 10 minutes D. Less than 15 minutes

B: Supraventricular tachycardia is characterized by a pulse rate greater than 150 beats/min.

Assessment of a 45-year-old woman who began experiencing light-headedness during a tennis match reveals a heart rate of 155 beats/min. How would you describe this heart rate to emergency medical services (EMS) personnel when they arrive on the scene? A. The patient is demonstrating normal pulse rate for her age, gender, and activity level. B. The patient is demonstrating supraventricular tachycardia. C. The patient is demonstrating tachycardia but this will likely go down at the next assessment because she just stopped playing. D. The patient is demonstrating bradycardia that is consistent with the stimulant medication she is currently taking.

C: Deep wounds that require sutures or staples to attain tissue approximation should be referred to a physician for treatment. Also, heavily contaminated wounds requiring extensive cleaning, débridement, or possible prophylactic antibiotics should be referred to a physician, as should wounds with tendon or nerve injury

Athletic trainers can treat most acute skin trauma without complication. However, according to the National Athletic Trainers' Association (NATA) position statement on management of acute skin trauma, patients with which of the following skin conditions should be referred to a physician for treatment? A. Wound requiring débridement B. Wound requiring an occlusive dressing C. Wound requiring tissue approximation with sutures or staples D. Wound producing exudate during the healing process

A: A cordless screwdriver has been shown to be the best method of face mask removal, as it has been shown to be faster, to be easier to use, and to create the least amount of motion compared with other removal tools. However, due to potential screw corrosion and rust, relying solely on a screwdriver is risky. Therefore, a combined-tool technique is recommended whereby a cordless screwdriver is the primary removal device, and a proven effective cutting device serves as a backup cutting tool

Based on current research investigating the best method of removing football helmet face masks to access the airway, the combined tool technique has been recommended. What emergency equipment should be accessible for applying this technique? A. Cordless power screwdriver and Trainer ' s Angel B. Trainer ' s Angel and FM Extractor C. Cordless power screwdriver and manual screwdriver D. EMT scissors and FM Extractor

D: When treating a minor, consent by the parent or guardian is necessary; however, in an emergent, life-threatening situation, consent is assumed, and the athletic trainer should perform all necessary lifesaving techniques in order to prevent worsening of the athlete ' s condition or death

During a boys' soccer college recruiting summer tournament a player collapses and is unresponsive. The athlete ' s parent is not in attendance, and no written consent-to-treat form exists. Which of the following statements best reflects the athletic trainer ' s ability to treat this athlete? A. Actual consent can be obtained from the parent via phone before the athletic trainer administers any treatment. B. The coach can act as the parent and provide consent for treatment. C. The athletic trainer can activate emergency medical services (EMS) and communicate findings but may not provide direct treatment to the athlete. D. Consent to treat is implied on the part of the athlete and the parents because this is a potentially life-threatening injury.

C: The neurological, vascular, and circulatory systems must be assessed before and after splinting, and immobilization is performed because these are indicative of the health of the limb; if any parameters are lacking or change after immobilization, emergency relocation and reduction need to be done

During a gymnastics meet, an athlete falls from the balance beam, injuring her right shoulder. Palpation reveals posterior displacement of the head of the humerus. The athlete ' s arm is abducted approximately 45°, and any movement results in severe pain. The decision is made to splint the arm as it was found using pillows and cravats. Which of the following parameters should be assessed before and after the splint is applied? . Blood pressure in the injured arm B. Heart rate, rhythm, and strength C. Distal neurovascular and circulatory functions D. Respiratory rate, rhythm, and depth E. Strength of the forearm muscles

A: When multiple victims are present, surveying the scene provides baseline information on which to base actions. Basic triage priorities include assessing for life-threatening injuries fi rst. The athlete with the lower leg injury is obviously breathing and has a pulse, so a rapid primary assessment of the prone athlete takes priority

During a lacrosse game, two players collide at midfield and fall to the turf. One player is writhing around holding his leg, which appears to be obviously deformed, and the other player is lying prone on the turf and not moving. As the athletic trainer jogs onto the field, what should be his first action? A. Survey the scene and move first to assess the prone athlete while directing a coach to calm down the player with the lower leg injury B. Activate the emergency action plan (EAP) and call emergency medical services (EMS) while jogging toward the prone athlete C. Survey the scene and move quickly to the athlete with the obvious fracture D. Ask a coach to remove all athletes from the field and quickly conduct a primary assessment of the athlete with the lower leg injury followed by a primary assessment of the prone athlete.

A: Dislocations of the ankle have a high risk of developing avascular necrosis. This can be minimized by immediate transport by emergency medical services (EMS), who can maintain immobilization, monitor neurovascular status, and provide faster access to emergency physicians who can reduce the dislocation

During a soccer game an athlete goes down to the turf writhing in pain after a particularly high force tackle. Observation reveals significant deformity of the talocrural joint, effusion, and significant pain. The athletic trainer determines that the athlete needs to be splinted and transported for further evaluation of a possible ankle dislocation. What would be the most appropriate method of transport to the emergency department? A. Activate emergency medical services (EMS) for transport of the athlete by trained emergency medical technicians who can provide more immediate access to early reduction, monitor neurovascular status, and provide medication as needed. B. The athlete can be transported by a coach with the athletic trainer maintaining immobilization and frequently monitoring neurovascular status. C. The athlete can be transported by the team physician who is present at the game in the physician ' s personal vehicle. D. The athlete can be transported by the parents with an athletic training student present to monitor pulse and sensation.

C: This athlete is demonstrating signs and symptoms consistent with mild hypothermia. Even though the temperature is a comfortable 55°F for the spectators, the athletes are subjected to a different type of cold associated with the dampness. This environment predisposes the athlete to hypothermia. To prevent the hypothermia from increasing in severity, the athlete should be relocated to a warm shelter, wet clothing should be removed, and warm blankets and fl uids should be provided to help raise the core body temperature.

During a triathlon, the athletes have completed the swimming leg and are on the cycling segment. The ambient air temperature is 55°F, and the wind is steady at 15 mph. An athlete has difficulty and cannot continue riding. During your evaluation, you notice the athlete is disoriented and lethargic, has garbled speech, and has a core temperature of 95°F. The athlete ' s respirations are shallow, and the heart rate is notably slow. What would be the appropriate initial treatment for this athlete? A. Cover the athlete with cool, damp towels and send for emergency assistance. B. Administer a warm IV saline solution and prepare for immediate transport. C. Move the athlete to a sheltered area, remove wet clothing, wrap the athlete in a warm blanket, and administer warm fluids. D. Position the athlete on a table with feet elevated, cover with a blanket, and monitor for shock. E. Move the athlete to a sheltered area, administer cool fluids, and prepare the athlete for transportation.

C: As the athlete is conscious, alert, and responding to the athletic trainer, the athlete is not suffering from a life-threatening head injury and can be transported by his parents instead of by ambulance

During a youth baseball tournament, you observe a 10-year-old pitcher drop to the mound after sustaining a line drive to the posterior lateral aspect of his head. When you reach the mound, the player is seated, alert, crying, and rubbing his head. The athlete ambulates to the dugout where you conduct an off-field evaluation. You inform the player ' s parents he must be transported to a health-care facility to be evaluated by a physician. What is the most appropriate method of transporting this athlete? A. Call emergency medical services (EMS) and request an ambulance transport the athlete to a health-care facility B. Ask the assistant coach to drive the athlete to the health-care facility. C. Ask the athlete ' s parents to take him to the health-care facility. D. Instruct the athletic training student working with you to take the athlete to the health-care facility.

A: All organized sports organizations should have a system for documenting medical emergencies. Times for key events, such as time of injury and times of various treatments provided, should be documented whenever possible so the event can be evaluated and assessed for possible improvements

During an incident in which the automated external defibrillator (AED) is used, which of the following should be included in the postevent documentation? A. Time of collapse, time AED was used, and time advanced help arrived B. Copy of the patient ' s medical history form C. Log of persons who witnessed the event so that counseling can be provided D. Names and ID numbers of emergency medical services (EMS) personnel who responded to the event

C: The normal vital signs for children are respiration rate of 14 to 26 breaths/min and heart rate of 62 to 130 beats/min. A temperature of 98.6°F is normal.

During assessment of the vital signs of an 8-year-old baseball player, you note the following: respiration rate of 25 breaths/min, pulse of 108 beats/min, temperature of 98°F, and pink skin. What should you conclude? A. The athlete is hyperventilating. B. The athlete is bradycardic. C. The athlete is exhibiting normal vital signs. D. The athlete is hyperventilating and tachycardic. E. The athlete is erythemic and bradycardic.

C: An exertional sickling collapse is a medical emergency. If the patient does not immediately improve after giving supplemental oxygen, the athletic trainer should call 911, attach an automated external defi brillator (AED), and be prepared to give CPR. It is important to get the patient to the hospital as quickly as possible.

During football practice an athlete with known sickle cell trait experiences an exertional sickling collapse. He is responsive and cooperative, and you immediately administer high-fl ow supplemental oxygen and check his vital signs. He does not immediately improve, and he is now demonstrating bradycardia. What treatment should now be provided by the athletic trainer to appropriately manage this patient? A. Cool the athlete using cold water immersion. B. Promote oral ingestion of water and electrolyte solutions to increase blood volume. C. Call 911 and attach an automated external defibrillator (AED) and be ready to start CPR. D. Apply ice to cramping muscles and move the athlete to a cooler climate

D: Hypovolemic shock results from trauma-induced blood loss. With blood loss the body ' s blood pressure drops, and there is not enough blood to properly supply organs with oxygen

During halftime of a football game, you recheck the vital signs of a player who sustained abdominal trauma from a hard tackle midway through the first half. His blood pressure has decreased to 94/54 mm Hg, and his heart rate is 100 beats/ min. You are concerned the abdominal trauma has caused blood loss and the athlete is experiencing shock. When referring this patient, what type of shock should you communicate this athlete is experiencing? A. Neurogenic shock B. Septic shock C. Metabolic shock D. Hypovolemic shock

B: The athlete is exhibiting signs and symptoms consistent with anaphylaxis and requires immediate attention. Before injection and treatment, the athletic trainer must have consulted state practice guidelines to confi rm use of an EpiPen is permitted

During practice, a member of your softball team approaches you complaining of intensely itchy erythematous areas on her body. As you begin to question her about this condition, you note some facial edema and that she is beginning to have difficulty breathing and talking because her tongue is swelling. What is the most appropriate immediate treatment for this athlete ' s condition? A. Apply ice bags over the throat and mouth areas. B. Use an epinephrine autoinjector. C. Give the athlete two doses of an oral antihistamine. D. Use a rapid-acting beta-agonist inhaler. E. Apply topical anesthetic over erythematous areas.

D: After an exposure, the exposed individual is entitled to a confi dential medical evaluation, with documentation of the exposure incident including identifi cation of the involved individual, blood testing, counseling, and treatment of any related illness

During the management of a major bleeding incident, an athletic trainer is exposed to a patient ' s blood and bodily fluids when they splatter onto the athletic trainer ' s face and clothes. In accordance with Occupational Safety and Health Administration (OSHA) guidelines, what must the athletic trainer ' s employer provide as a result of this exposure? A. Prophylactic treatment for the most commonly transmitted bloodborne pathogen-related illnesses B. Blood testing of the athlete with results reported to the athletic trainer C. Monetary compensation for exposure due to a hazardous work environment D. A confidential medical evaluation and counseling as needed

B: When an athletic emergency occurs, documentation of all events, whether done during or after the event, is important for many reasons, such as improving patient care, but the primary reason for documenting all aspects of the event is to protect against or avoid potential litigation.

Each venue-specific emergency action plan (EAP) should state the person responsible for documenting the events of the emergency situation, including all actions taken during patient treatment and transport. What is the primary reason for this level of documentation? A. Quality assurance B. Potential litigation C. Continuity of care D. Personnel redistribution

D: The available emergency equipment should be based on the type of event (i.e., lacrosse game) and possible emergency situations. For example, if a game will take place in a hot and humid environment, heat illness should be anticipated, and equipment such as an ice-water immersion tub and rectal thermometer should be readily available.

Early one Saturday morning you receive a phone call from another certified athletic trainer on your university ' s sports medicine staff asking you to serve as the athletic trainer for the men ' s lacrosse match scheduled for 2 p.m. He tells you he has a family emergency and must immediately leave town. You have no experience providing athletic training services for a men ' s lacrosse match. On what should you base your decision regarding the emergency equipment available on the sidelines during the match? A. Age range of the participants B. Type of protective equipment worn by players C. Presence of a physician on the sidelines D. Anticipated possible emergency scenarios

A: The goal of spinal motion restriction (SMR) is to prevent harm to the spinal cord by maintaining the head and neck in neutral alignment with the long axis of the body so the head and entire spine is treated as one unit and sustains minimal movement during transport and referral

Following an acute, severe spinal cord injury, the most important principle in moving and transporting the patient is spinal motion restriction (SMR) to prevent further harm to the spinal cord. How is SMR achieved during the transport and referral process? A. Maintaining the head and neck in neutral alignment with the long axis of the body B. Maintaining the head and neck in the initial position of injury C. Maintaining the head and neck in 10° to 15° of cervical flexion D. Maintaining the head and neck in 15° to 20° of cervical extension

C: An orthopedist is a physician who specializes in the treatment of injuries to the musculoskeletal system. 2

For the past 4 weeks you have been directing the treatment and rehabilitation program for an athlete with unilateral shoulder impingement syndrome. The athlete is failing to meet treatment and rehabilitation goals and is reporting ongoing symptoms. Referral to which health-care provider is most appropriate for this patient? A. Neurologist B. Internist C. Orthopedist D. Podiatrist E. Psychiatrist

A: Manual conveyance is used when the athlete must be moved a distance greater than he or she could walk easily even if with assistance or if the athlete is having diffi culty following directions from the medical staff

For which of the following injuries would a manual conveyance method for transporting a mildly injured athlete be used? A. An athlete sitting in the middle of the track and exhibiting signs of heat illness B. An athlete kneeling by the sideline with a lateral ankle sprain C. An athlete sitting in front of the goal with a suspected anterior cruciate ligament sprain D. An athlete lying in the middle of the football field with a hip pointer E. An athlete exhibiting signs of an acute asthma attack on the bench during a baseball game

C: Personal protective equipment recommendations are based on risk of exposure to potentially infectious body fl uids and substances

For which of the following procedures is a mask or eye protection required as part of personal protective equipment? A. Controlling minor bleeding B. Starting an IV C. Placing an advanced airway D. Administering an intramuscular injection E. Taking vital signs

B: The pocket mask or barrier device enables the athletic trainer to provide appropriate care for the patient as well as protecting himself or herself while reducing the risk for infection

In 1992, what piece of equipment did the Occupational Safety and Health Administration (OSHA) mandate athletic trainers use while performing CPR? A. Bag-valve mask to provide standard quantity of oxygen delivery B. Barrier device or pocket mask to minimize transmission of bloodborne pathogens C. Gloves to minimize transmission of bloodborne pathogens D. Supplemental oxygen to increase oxygen saturation E. Watch with a second hand to more accurately perform compressions at the recommended rate

B: The location of the emergency care facility with respect to the activity venue is one important consideration when selecting emergency care facilities for referral

One component of an emergency action plan (EAP) is identification of the emergency care facilities to which injured individuals will be transported. In addition to the level of capabilities, what should be considered when selecting an appropriate emergency care referral site? A. Accessibility for patient ' s family members B. Location with respect to the venue C. Accepted medical insurance plans D. Amount of sports medicine education and training of facility personnel

B: Guillain-Barré syndrome is an acute, diffuse demyelinating disorder of the spinal roots and peripheral nerves. Guillain-Barré syndrome manifests with bilateral distal muscle weakness and loss of refl exes and typically initially manifests in the legs

The 20-year-old tennis player you saw 2 weeks ago for a gastrointestinal tract virus reports to your athletic training facility complaining of pain and weakness of both legs and nocturnal muscle cramps. During your examination, you note he does not have a fever, but he is demonstrating slightly diminished reflexes bilaterally. Based on his presentation and your examination findings, you refer him to your university ' s health-care facility to be seen by a physician. When documenting your examination and referral for this athlete, which of the following conditions should you indicate is included in your initial differential diagnosis? A. Viral meningitis B. Guillain-Barré syndrome C. Multiple sclerosis D. Bell ' s palsy

B: Removal of individual equipment in ice hockey and American football may cause a compromise in spinal alignment. Therefore, it is indicated by the National Athletic Trainers' Association (NATA) position statement that the helmet and shoulder pads be removed as an all-or-nothing endeavor. This also allows full exposure of the chest in the event an automated external defi brillator (AED) needs to be applied

The National Athletic Trainers' Association (NATA) position statement on acute management of the cervical spine-injured athlete recommends considering the removal of the helmet and shoulder pads to be an all-or-nothing endeavor for which sport in addition to American football? A. Men ' s lacrosse B. Men ' s ice hockey C. Field hockey D. Women ' s lacrosse E. Australian rules football

A: A scoop stretcher has detachable hinges at each end allowing it to be split completely into two halves. Each half can be placed at the sides of the injured athlete and easily slid under the patient and secured together. The injured athlete is "scooped" into the stretcher so it is not necessary to lift or roll the athlete.

The venue-specific emergency action plan (EAP) for the sports facility where you are providing medical coverage includes using a scoop stretcher for transporting a patient with a potential spine injury. What is the advantage of using a scoop stretcher instead of a spine board? A. Using a scoop stretcher eliminates the need to lift or roll the injured patient. B. Using a scoop stretcher eliminates the need to secure the patient with straps before transport. C. Using a scoop stretcher eliminates the need to maintain manual in-line cervical stabilization. D. Using a scoop stretcher eliminates the need to remove the football helmet and shoulder pads.

C: All athletic personnel and members of the emergency action team should have automated external defi brillators (AEDs) readily available and be trained in their proper use

To comply with American Heart Association guidelines, which state that early defibrillation is considered a critical component of basic life support, what emergency equipment must be on hand for all athletic practices and events? A. Advanced airway aids B. Supplemental oxygen C. Automated external defibrillator (AED) D. Immobilization splints

B: The femoral artery is the primary arterial blood supply for the lower leg

To what pressure point should digital pressure be applied to control bleeding from a wound in the lower leg? A. Brachial B. Femoral C. Subclavian D. Bicipital E. Carotid

E: Lack of blood fl ow to the brain results in unconsciousness in 20 to 30 seconds, permanent brain damage in 4 to 6 minutes, and most likely death in 10 minutes without treatment

Under most circumstances, after how many minutes of oxygen deprivation will brain damage occur in a nonbreathing victim? A. Less than 1 minute B. 1 to 2 minutes C. 2 to 3 minutes D. 3 to 4 minutes E. 4 to 6 minute

D: To reinforce the athlete ' s role in the management of concussions, documentation should include written evidence of each student athlete ' s knowledge of concussion signs and symptoms and responsibility to report a concussion

What administrative action can an athletic trainer take to reinforce the athlete ' s role in reporting concussions? A. Document all communications with academic support services personnel and similar offices regarding student athletes with concussions. B. Use written documentation to regularly communicate the status of student athletes with concussions to the team physician. C. Document each concussion evaluation, treatment, physical activity recommendation, and return-to play decision. D. Document the athlete ' s understanding of concussion signs and symptoms and the athlete ' s responsibility to report a concussion.

A: The primary survey determines the presence of potentially life-threatening situations. Any patient with a life-threatening condition should be rapidly transported to an emergency care facility

What aspect of the examination and treatment of an injured athlete best assists emergency care providers in making emergency transportation decisions? A. Primary survey B. Secondary survey C. First aid provided D. Off-site examination

B: In a noncatastrophic injury, one rescuer provides an extra set of hands to help calm and reassure the athlete, gather supplies as needed, and provide directions to bystanders to coordinate care

What is the benefit of having two rescuers conducting an on-field assessment in a non-head related or non-spine-related injury? A. One can conduct an upper quarter screen, while the other conducts a lower quarter screen. B. One can conduct the assessment, while the other communicates with bystanders and calms the patient. C. One can call the team physician, while the other provides care. D. One can hold the athlete down to keep him from moving, while the other conducts special tests.

D: Irrigate the eye with copious amounts of clear water because the clear water will not react with the chemical, whereas saline or a glucose solution could. The clear water treatment can be administered by the athletic trainer or at a chemical eye wash station

What is the first step that should be taken when providing immediate care for a chemical burn of the eye? A. Irrigate eye with a solution of sodium bicarbonate. B. Clean eye with a sterile cloth. C. Cover eye with a moist sterile cloth. D. Irrigate eye with copious amounts of clear water. E. Irrigate eye with a hypertonic glucose solution.

E: Exertional heatstroke occurs when the body is unable to regulate its own temperature and the core temperature rises to above 104°F. Immediate treatment should be aimed at reducing the core temperature by using a full-body ice immersion technique, such as an ice bath, until the core temperature is below 104°F, and then transport can occur

What is the most appropriate immediate treatment for an athlete with exertional heatstroke? A. Use ice bags and wet towels to cool the athlete, and transport the athlete to a health-care facility. B. Immediately transport the athlete to a health-care facility. C. Move the athlete into an air-conditioned room and provide fluids. D. Provide IV fluids along with oral fluids, and transport the athlete to a health-care facility. E. Use full-body ice immersion to cool the athlete, and transport the athlete to a health-care facility.

C: Cooling fi rst and then transporting an athlete exhibiting signs of exertional heat illness provides the best patient outcomes

What strategy is recommended by the National Federation of State High School Associations Sports Medicine Advisory Committee for management of athletes exhibiting serious signs of exertional heat illness? A. Remove to a cool location and provide oral fluids. B. Contact the student ' s parents for transport to an emergency facility for treatment. C. Provide immediate cooling using cold water immersion or ice bags to the neck, axilla, and groin if a pool is not available. D. Activate emergency action plan (EAP) and wait for trained rescuers to arrive.

C: Cuff should be infl ated to greater than 200 mm Hg and then gradually defl ated at a rate of 2 to 3 mm Hg per second.

When assessing a patient ' s blood pressure, how much should the cuff be inflated? A. The cuff should be inflated 5 to 10 mm Hg above the patient ' s normal systolic measurement. B. The cuff should be inflated to a minimum of 200 mm Hg. C. The cuff should be inflated 15 to 20 mm Hg above the point at which the last Korotkoff sound is heard. D. The cuff should be inflated 15 to 20 mm Hg above the point at which the first Korotkoff sound is heard.

C: Children may have diffi culty using most pain scales because they do not have a frame of reference, but they can relate to happy or sad faces because they associate pain with negative emotions

When assessing pain in a pediatric athlete, which type of pain scale is most effective? A. Numeric pain scale B. Visual analog scale C. Happy face scale D. Animal scale

A: Cheyne-Stokes respirations are associated with signifi cant brain injury

When monitoring an athlete ' s respirations, you note an abnormal breathing pattern characterized by increased rate and depth of respirations followed by a brief period of apnea. What type of injury is associated with this breathing pattern? A. Brain injury B. Heat illness C. Exertional sickling D. Internal bleeding E. Pneumothorax

D: Turbulent blood fl ow or valvular vibration noted during systole and diastole can indicate a heart murmur, so the athlete should be referred for further evaluation

When performing cardiac auscultations, which of the following findings would necessitate referral to a physician for further evaluation? A. During inspiration, the S2 sound is split into two components. B. While taking the carotid pulse during auscultation, you note that the "lubb" sound is synchronous with the carotid pulse. C. When auscultating over the fourth intercostal space along the lower left sternal border, you fail to hear a bruit sound. D. When auscultating over the mitral valve, you note turbulent blood fl ow or valvular vibration during systole and diastole. E. When auscultating over the second right intercostal space at the right sternal border, you note a loud "lubb-dupp" sound.

A: The clinician should avoid applying friction massage to rewarm the tissues. The integrity of the athlete ' s skin is decreased when chilblains occurs; therefore, friction massage on the area affected by chilblains could cause further damage to the skin, such as blistering or open wounds

When treating an athlete with chilblains, which of the following treatments would be contraindicated? A. Applying friction massage to rewarm the tissue B. Removing wet or constrictive clothing C. Washing or drying the area D. Covering the affected area E. Placing a space heater near the patient

C: The tongue and nail beds are the two locations where cyanosis may be visually apparent to the examiner for a patient with a dark complexion. Cyanosis is when the skin color changes to a dark purple or blue tint due to loss of oxygen. The change in skin color may not be apparent in patients of various ethnicities; therefore, it is vital for the athletic trainer to note the other areas susceptible to color change.

Where is cyanosis best observed in a dark-skinned person? A. Eyes B. Lips and abdomen C. Tongue and nailbeds D. Earlobes E. Pupils

E: Placing the tooth in a commercially prepared preservation solution, such as Hank ' s Balanced Salt Solution, allows the tooth to retain its properties to allow for the best healing and prognosis in an environment proven and tested to house avulsed teeth. This kit should be used immediately, and transport to the dentist should occur as soon as possible to improve the implantation prognosis

Which method is recommended to preserve an avulsed tooth that cannot be reimplanted until the athlete can see a dentist? A. Wrap the tooth as is in moist gauze and take the tooth and athlete to the dentist. B. Place the tooth in a 10% hydrogen peroxide solution to preserve it and take the athlete to the dentist within the next 24 hours. C. Scrub the tooth vigorously, then place it in milk, and take the athlete to the dentist within the next 3 days. D. Apply a topical dental anesthetic (such as Orajel) to the tooth and take the tooth and the athlete to the dentist. E. Place the tooth in a commercially prepared preservation solution and take the tooth and the athlete to the dentist.

B: The shock position is defi ned as the athlete lying supine with legs elevated 12 inches off the fl oor. This position is used to deliver more blood to the core and vital organs due to the low blood volume that is present with shock.

Which of the following actions should you take when treating a person who is in shock? A. Administer oral fluids. B. Elevate the legs. C. Elevate the head and trunk. D. Induce vomiting. E. Assist the patient in taking shock medications.

B: Providing a schedule of athletic events alerts the hospital staff of the types of activities happening. If there are a large number of spectators gathering, they can also better prepare to assist as needed

Which of the following administrative actions could improve the response of an emergency facility when an athlete is transported? A. Provide documents regarding appropriate removal of equipment and management of common athletic injuries to the staff at the hospital annually. B. Provide a schedule of all home athletic events to the hospital. C. Provide the hospital with a copy of the emergency action plan (EAP) for each venue. D. Provide the hospital with copies of the athlete emergency information card for all athletes at the beginning of each season.

A: An athlete who presents with breath sounds that are scratching, high-pitched vesicular sounds should be referred to a physician for further evaluation. These breath sounds, also known as wheezing, could be indicative of asthma or airway constriction

Which of the following adventitious breath sounds would require referral to a physician for further evaluation? A. Scratching, high-pitched vesicular sounds B. Coarse, loud bronchial sounds C. Coarse bronchovesicular sounds D. High-pitched, breezy vesicular sounds E. Whistling bronchovesicular sounds

D: OPA size can be estimated by holding the airway against the patient ' s cheek. The airway should fi t within the space between the tip of the ear and the corner of the mouth

Which of the following is the best way to estimate the appropriate size of an oral pharyngeal airway (OPA) before insertion? A. Use large size in men, medium size in women, and small size in adolescents and children B. Estimated frame size correlates with OPA airway size (small, medium, and large) C. Estimated patient height correlates with OPA airway size (small, 60 in. or less; medium, 60 to 72 in.; large, greater than 72 in.) D. Hold OPA against patient ' s cheek

B: An athlete who has suffered a posterior glenohumeral joint dislocation requires medical attention, but the timeline for treatment does not require emergency transport.

Which of the following situations is least likely to require activating the emergency transport system? A. The patient has lost consciousness. B. The patient has suffered a posterior glenohumeral joint dislocation. C. The patient is unresponsive. D. CPR is being performed on the patient. E. Bleeding from an open fracture cannot be controlled.

A: When the athletic trainer is performing rescue breathing, the percentage of oxygen delivered is going to be signifi cantly lower than the oxygen that is administered with supplemental oxygen. The bag valve mask provides more concentrated oxygen than rescue breathing because most of the oxygen is not being used for the rescuer ' s oxygen needs. Supplemental oxygen provides the highest percentage of oxygen, as it is not interrupted

Which of the following statements correctly describes administration of supplemental oxygen? A. Supplemental oxygen provides 90% oxygen, a bag-valve mask provides 21% oxygen, and rescue breathing provides only 16% oxygen. B. An athletic trainer who has completed a CPR class at the professional rescuer level may provide supplemental oxygen to a victim who is having trouble breathing. C. Supplemental oxygen cylinders are easily identified because they are red in color and bear a yellow diamond that clearly states oxygen. D. Supplemental oxygen should be delivered at a rate of 5 to 10 L/min as indicated by a fl ow rate meter. E. An athletic trainer must have a physician ' s prescription on file in all states to administer supplemental oxygen.

A: Due to the location, size, shape, and mobility of the pelvis, it is best immobilized using a spine board

Which of the following types of splints is recommended for immobilization of a suspected pelvis fracture? A. Spine board B. Long leg vacuum splint C. Traction splint D. Long leg air splint with a rigid SAM Splint extension

B: The athlete emergency information card will provide information about pertinent medical conditions, medications, allergies, and insurance information

Which of the following will enhance patient care by improving the transfer of care from the athletic training staff to the emergency medical services (EMS) and hospital personnel? A. Providing EMS with a copy of the emergency action plan (EAP) B. Providing a copy of the athlete emergency information card to EMS personnel for review and transfer to hospital personnel C. Contacting the athlete ' s parent or guardian to meet the ambulance at the hospital D. Providing a copy of the initial evaluation form

A: Accommodation assesses the ability of the pupils to move in conjunction with each other

While conducting a secondary survey, an athletic trainer assesses the pupils of the patient. The patient is asked to follow the examiner ' s finger as it moves in different directions using just his eyes. What should be assessed in this portion of the evaluation? A. Ability of the eyes to accommodate by pupils moving simultaneously and smoothly B. Ability of the pupil to react to the changes in light it is taking in as it moves C. Ability of the pupil to constrict as the finger moves in different directions D. Ability of the pupils to remain an equal size as they move in different directions

C: Submerging a spine board under the athlete while maintaining cervical stabilization results in the least amount of cervical movement while removing the athlete from the pool

While you are covering a swim meet, a swimmer sustains a suspected cervical spine injury. The lifeguard covering the event maintains cervical stabilization and together you determine the athlete needs to be placed on a spine board. How is this best accomplished? A. The athlete is placed in a cervical collar and then moved to the deck to be spine boarded. B. The athlete ' s arms are raised overhead by the ears to provide cervical stabilization and then a rescuer on the deck pulls the athlete onto the deck while a rescuer in the pool guides and lifts the athlete ' s body onto the deck to be spine boarded. C. The lifeguard maintains cervical stabilization while a second rescuer submerges a spine board under the athlete, who is then strapped onto the board and lifted out of the water. D. The lifeguard maintains cervical stabilization while the spine board is floated in the pool. Several bystanders are recruited to lift and slide the athlete onto the board, and then the athlete is strapped onto the board and lifted out of the water.

B: When a bacteria or virus invades the body, chemical substances cause the preoptic area of the anterior hypothalamus (POAH) to "reset" to a higher temperature than normal. Antipyretic medications block this chemical response to prevent the body ' s temperature from increasing

Why are antipyretic medications not indicated for the treatment of athletes with exertional heatstroke? A. Antipyretic medications may promote dehydration by delaying return to normal body temperature in a person with exertional heatstroke. B. Because the increase in body temperature during exercise is not a chemical response, antipyretic medications are ineffective in treating exertional heatstroke C. Antipyretic medications cannot penetrate to the active muscles and so are ineffective in treating exertional heatstroke. D. Because exertional heatstroke affects the preoptic area of the anterior hypothalamus (POAH), antipyretic medications are ineffective in treating exertional heatstroke.

C: Ventricular fibrillation occurs when the ventricle has disorganized electrical activity causing the heart to quiver and not deliver enough oxygen to the body. This cardiac emergency responds well to the shock delivered that calibrates the heart ' s pumping. Cardiac arrest occurs when the heart has a sudden cessation of activity; therefore, administration of a shock by an automated external defi brillator (AED) is indicated

Why are automated external defi brillators (AEDs) effective in preventing sudden death from a cardiac emergency during sports activity? A. Most cardiac emergencies in sports activities involve atrial fibrillation. B. Most cardiac emergencies in sports activities involve cardiac arrest. C. Most cardiac emergencies in sports activities involve ventricular fibrillation and cardiac arrest. D. Most cardiac emergencies in sports activities involve cardiac arrhythmia and congestive heart failure. E. Most cardiac emergencies in sports activities involve valve dysfunction.

A: Short-acting beta-2-agonist inhalers are recommended for treatment of acute asthma attacks

You are assisting in the medical treatment tent at a local youth soccer tournament. This is the first tournament of the spring season. One of the coaches escorts a 10-year-old player to the tent. The athlete appears to be having difficulty catching his breath. You have conducted an initial assessment and determined the athlete is suffering from an asthma attack. While you are consulting with the physician in the medical tent, the athlete ' s mother arrives carrying asthma medications. Which inhaler is the most appropriate for the immediate management of this athlete ' s current symptoms? A. Albuterol (Proventil) B. Fluticasone propionate and salmeterol (Advair) C. Salmeterol (Serevent) D. Fluticasone propionate (Flovent)

D: When speaking to an injured athlete, it is appropriate to get the athlete to relax and to monitor him for signs of shock. The athlete should be informed that the emergency department physicians will assess his injuries and make a clinical diagnosis. Promises regarding injury management and prognosis should be avoided

You are assisting in the transfer into the waiting ambulance of a lacrosse player who has sustained a nonreducible anterior glenohumeral joint dislocation. The athlete is extremely anxious about the injury and worried that he will never play again. What is the most appropriate response to the injured athlete? A. Tell the athlete that you have seen other athletes come back from this injury very quickly. B. Tell the athlete that this injury could be much worse than just a dislocation. C. Tell the athlete his neurovascular status was intact and a simple closed reduction should be easily achieved. D. Encourage the athlete to relax and not to draw any conclusions until the emergency department physicians have completed their evaluation.

B: A gynecologist focuses on female reproductive health, so referring an athlete with a symptomatic ovarian cyst to a gynecologist would be appropriate.

You are concerned that an athlete may have a symptomatic ovarian cyst. Referral to which healthcare provider is most appropriate for this condition? A. Obstetrician B. Gynecologist C. Gastroenterologist D. General surgeon

E: 30:2 is the recommended ratio of compressions to breaths to move oxygenated blood to the brain and other vital organs. Laypersons may elect to provide compression-only CPR

You are performing one-person CPR on an unconscious victim. What is the proper compression to-breath ratio? A. 5:1 B. 5:2 C. 30:1 D. 15:2 E. 30:2

A: The automated external defi brillator (AED) should be applied as soon as it arrives on the scene. Compression should cease as soon as the pads are in place, as motion may interfere with the ability of the device to analyze heart rhythm

You are the athletic trainer assigned to your high school ' s football game. While covering a kickoff return, one of your players attempts to tackle the ball carrier. You see him lower his head, drive the top of his helmet into the ball carrier ' s numbers, and then fall to the ground, where he lies motionless. While you are administering CPR, the automated external defibrillator (AED) arrives at your side. How will you integrate the AED into the emergency care currently being provided? A. Continue CPR until the AED pads are in place and the machine is ready to analyze the athlete ' s heart rhythm. B. Continue CPR until the AED indicates the need for a shock. C. Immediately discontinue CPR, apply the AED pads, and permit the machine to analyze the patient ' s heart rhythm. D. Complete your current five cycles of compressions and breaths, then discontinue CPR and apply the AED pads to the athlete and permit the machine to analyze the patient ' s heart rhythm. E. Complete 30 more chest compressions and administer two more breaths, then discontinue CPR and apply AED pads to the athlete and permit the machine to analyze the athlete ' s heart rhythm.

D: On arrival in the emergency department, patients who are not transported by ambulance are fi rst evaluated by a triage nurse to determine the nature and severity of the injury

You elect to transport a student athlete to the emergency department for evaluation of a closed head injury. Which health professional will the athlete encounter first when you enter the emergency department? A. Physician ' s assistant or nurse practitioner B. Emergency department physician C. Registered trauma nurse D. Triage nurse E. Neurologist

A: Individuals should be placed on their left side because the stomach is on the left and in the case of the aspiration the airway is less likely to become obstructed. The right arm is draped for support so the patient remains in a side-lying position, and the right leg is crossed over the left for comfort

You have been caring for an athlete who is unconscious, but his vital signs are stable, and you do not suspect a cervical spine injury. Before arriving on the scene, emergency medical services (EMS) personnel request that you position the athlete in the recovery position and monitor vital signs. Which of the following best describes this position? A. Side-lying on the left side with the left arm moved aside and the right arm draped across the body as support and the right leg crossed over the left B. Side-lying on the right side with right arm moved aside and the left arm draped across the body as support and the right leg crossed over the left C. Side-lying on the right side with right arm moved aside and the left arm draped across the body as support and the left leg crossed over the right D. Side-lying on the left side with the left arm moved aside and the right arm draped across the body as support and the left leg crossed over the right E. Side-lying on the right side with both arms overhead, next to the ears and the left leg crossed over the right

D: The patient is demonstrating a negative reaction to the fresh cut grass, fertilizer, or other allergens; therefore, the athletic trainer needs to administer a treatment to reduce the infl ammation in the airway and reduce the bronchial spasm that may accompany it. A fast-acting beta-2-agonist is indicated in acute situations.

Your soccer team is practicing on a recently mowed and fertilized field. One of the athletes, who has asthma, begins to wheeze uncontrollably. What is the first action you should take to manage this athlete? A. Send another athlete to get an inhaled corticosteroid from the athlete ' s locker. B. Give the athlete oral fluids and encourage her to relax and slow her breathing. C. Position the athlete in a semirecumbent position to open the airway. D. Send another athlete to get a fast-acting beta-2- agonist inhaler from your kit. E. Have the athlete put her hands over her head and breathe in through her nose and out through her mouth.

B: Following a compound tibiofi bular fracture, the athletic trainer should apply a dressing to minimize the risk of infection, and the leg should be splinted in the position that it was found. Neurovascular status should be continually rechecked to ensure that blood fl ow to the distal leg and foot is not being occluded by the fracture, and an emergency action plan (EAP) should be activated because this injury could be potentially threatening to the athlete ' s overall health if the blood fl ow is being occluded to the lower leg and foot, and there is a large risk of infection if the athlete is in an athletic setting. Additionally, getting the athlete to a local hospital quickly and effi ciently is important

n the last 2 minutes of a soccer game, a forward charging toward the goal collides with the sweeper from the opposing team and sustains a compound midshaft tibiofibular fracture. What is the most appropriate immediate care for this injury? A. Activate emergency medical services (EMS), splint the injury in correct alignment, elevate the distal extremity, and monitor for shock. B. Apply dressing to the wound, splint the injury in the position it was initially found, continually check neurovascular status, and activate EMS. C. Monitor the patient ' s vital signs, activate EMS, and remain with the athlete until assistance arrives. D. Apply dressing to the wound, splint the injury in correct alignment, transport the athlete to the sideline using ambulatory aid techniques, and reassess. E. Apply an antibiotic dressing to the wound, apply a half-ring splint ensuring correct alignment, activate EMS, and monitor for shock.

C: Lower motor neuron lesions are indicated by decreased refl exes, fl accid paralysis, and atrophy that corresponds to a specifi c spinal level. The triceps refl ex corresponds to the C7 level of the upper quarter screen.

A decreased triceps reflex is indicative of a lower motor neuron lesion at which level? A. C5 B. C6 C. C7 D. C8 E. T1

B: An orbital blowout fracture is a medical emergency. Immediate referral is vital to not only save the eye, but also to rule out brain bleeds

A tennis player moves up to the net to volley a hard return but misses and sustains an orbital blowout fracture. How should you best coordinate care for this athlete? A. Ask the assistant coach to transport the athlete to the local emergency facility. B. Activate emergency medical services (EMS) to transport the athlete to the local emergency facility. C. Call a local ophthalmologist and request the next available appointment. D. Transport the athlete to the team physician ' s office for evaluation.

C: Normal respiration rate in adults is 12 to 20 breaths/min, whereas 15 to 30 breaths/min is normal in children. Slow breathing, a rate lower than normal, is termed bradypnea

Following a chest wall contusion, an athlete presents with shallow, slow breathing. Which breathing term should you use when communicating this to the physician? A. Tachypnea B. Dyspnea C. Bradypnea D. Apnea

A: Trauma to the spinal cord above the C4 level has a high probability of death secondary to involvement of the brainstem or the phrenic nerve

Trauma to the spinal cord above which level of the cervical spine has a high probability of death? A. C4 B. C5 C. C6 D. C7

B: If the patient is already supine, lift and slide is the most effective technique. However, if the patient is prone, the log roll technique is recommended

What is the recommended technique for moving a supine athlete with a suspected spinal injury to the spine board for transport off the field? A. Log roll B. Lift and slide C. Manual conveyance D. Scoop extraction

D: Ventricular fi brillation represents electrical chaos and is the rhythm most amenable to treatment.

When assessed by an automated external defibrillator (AED), which of the following is the most commonly occurring initial cardiac rhythm in a patient with sudden cardiac arrest? A. Pulseless electrical activity B. Asystole C. Atrial fibrillation D. Ventricular fibrillation

A: A nondisplaced nasal fracture is not a medical emergency, and treatment of this condition falls within the scope of practice of a primary care sports medicine physician

Which of the following acute conditions would be most appropriately referred to a primary care sports medicine physician for evaluation and treatment? A. Nondisplaced nasal fracture B. Traumatic hyphema C. Avulsed tooth D. Scapholunate dislocation E. Acute appendicitis

B: Rapid hydration is most easily achieved through IV intervention. This is especially important if the athlete is unable to consume oral fl uids

While assisting athletes in the emergency care tent at a local marathon, you observe a physician begin an IV treatment on a recently collapsed runner. Which of the following is most likely the purpose of this treatment? A. To minimize the risk of hyponatremia B. To achieve rapid hydration C. To minimize the risk of exertional sickling D. To decrease core body temperature E. To restore blood glucose levels

D: If an athlete experiencing an anaphylactic reaction does not feel comfortable self-administering an epinephrine injection, you should administer the injection for the athlete. Uncap the autoinjector. Administer the injection fi rmly in the musculature between the hip and knee until a click is heard. Hold in place for 10 seconds and then remove. Emergency medical services (EMS) should also be activated in the event that the injection is ineffective. If needed, a second dose can be administered at an interval of 5 to 15 minutes

A beach volleyball player comes to the sidelines at practice with symptoms of wheezing, difficulty breathing, dizziness, feeling of throat tightening, and extreme anxiety. The athlete tells you that she thinks she was just stung by a bee. You are able to quickly identify a red mark on her lower leg that appears to be a sting. The athlete has an EpiPen in her bag but does not feel comfortable using it. What are your next steps? A. Demonstrate to the athlete how to use the EpiPen and help her self-administer the injection and then monitor vital signs to determine the need for referral. B. Ask a coach to call 911 and monitor the athlete ' s vital signs while you wait for help to arrive. C. Provide a single dose of diphenhydramine (Benadryl) to minimize the reaction, monitor vital signs, and call her parents to ask if she should be transported. D. Administer the epinephrine injection, holding the injector in place for 10 seconds, and stay with the athlete while a coach calls 911

B: The arterial portion of the circulatory system has the role of delivering blood from the heart to the rest of the body; therefore, the pressure and fl ow of the blood are very powerful. Due to the extreme pressure needed for the blood to reach the different muscles and organs throughout the body, the arterial blood will spurt from a wound instead of fl ow consistently

A cross country runner tripped running through a wooded trail and sustained a severe laceration of her lower leg that is bleeding. What is the best way to distinguish arterial from venous bleeding? A. Arterial blood produces a more steady fl ow of blood. B. Arterial blood spurts from the wound. C. Arterial blood produces a fl ow of dark red blood. D. Arterial blood slowly oozes from the tissues. E. Arterial blood clots rapidly.

B: Any athlete demonstrating or expressing signs and symptoms consistent with suicidal ideation should be referred to campus mental health professionals. Walking a student over to the counseling center ensures the student is connected with care

A freshmen women ' s basketball player who is struggling with balancing schoolwork, roommate issues, and the demands of the team arrives at practice in tears. Midway through practice, she walks off the court. When you approach her in the hallway, she is visibly upset and she tells you she just wants to put an end to all the pain and hurting. You are concerned that she may attempt suicide. What is the most appropriate immediate management for this situation? A. Notify your campus security or public safety office and request they transport her to the hospital ' s emergency department for a psychiatric evaluation. B. Comfort the athlete, and then escort her to the campus counseling center. C. Ask the coach to get her involved in practice to get her mind off her worries and make an appointment at the campus counseling center for the next morning. D. Ask the coach to assign a teammate to stay with her at all times until you can arrange an appointment with your team physician the next day.

C: One of the roles within the emergency team is direction of emergency medical services (EMS) to the scene of the emergency. When developing an emergency action plan (EAP), an individual should be designated to be in charge of directing EMS to the site of the emergency, which includes giving directions and unlocking any gates or doors that might be in the way for EMS.

A gymnast dismounting into a pit misses the pit and sustains a severe head injury. The athletic trainer activates the emergency action plan (EAP) and calls emergency medical services (EMS), but the arrival of the ambulance is delayed because the driveway closest to the facility entrance is blocked. Once inside the athletics complex the EMS responders are delayed further due to difficulty finding the gymnastics practice facility. Which component of the EAP was poorly executed? A. Identifying qualified personnel B. Ensuring presence of emergency care equipment C. Assignment of duties and responsibilities D. Activation of EMS

C: Universal precautions should be used any time there is the possibility of exposure to cerebrospinal fl uid, blood, semen, vaginal secretions, synovial fl uid, amniotic fl uid, pleural fl uid, peritoneal fl uid, and pericardial fl uid

A pitcher is struck in the head by a batted ball. Palpation of the injured area reveals what may be a small depressed skull fracture. The athletic trainer elects to perform the halo test to confirm the suspected diagnosis. Why is it important to wear gloves while performing this special test? A. It prevents the introduction of infection into the fracture site. B. It protects the athletic trainer from exposure to bleeding, as a laceration often accompanies an injury of this nature. C. Universal precautions are required, as cerebrospinal fluid may carry bloodborne pathogens. D. Insertion of the gauze into the external auditory canal may introduce bacteria to the ear canal.

A: The best person to meet the emergency medical services (EMS) personnel would be someone who knows the facility well and has keys to any doors or gates that may be locked to facilitate the most effi cient route to the scene.

A spectator collapses during a college basketball game. The emergency action plan (EAP) is activated, and emergency medical services (EMS) is en route. Which staff member would be in the best position to meet and direct EMS personnel to the location of the emergency? A. The facility manager B. The athletics director C. One of the coaches D. An athletic training student

B: When employing the fl at torso technique, the cut shoulder pads are slid laterally without having to elevate the torso.

An emergency action plan (EAP) may include protocols for football helmet and shoulder pad removal. Which shoulder pad removal technique can be used only when the shoulder pads have previously been cut or separated both anteriorly and posteriorly? A. Elevated torso technique B. Flat torso technique C. 8-person lift technique D. 8-person lateral slide technique

A: Emergency action plans (EAPs) must be implemented at the local level but under the guidance and oversight of the national governing body.

According to the Inter-Association Task Force Document on Emergency Health and Safety for youth sports leagues, who is responsible for development, communication, and implementation of emergency action plans (EAPs) in youth sports? A. The local member leader (commissioner, director, or league safety officer) B. The national governing body leadership C. Local emergency medical services (EMS) D. Head coaches of each team

C: Separate emergency action plans (EAPs) should be developed for each sport venue (basketball court, swimming pool, wrestling center, fields, equestrian center, etc.)

According to the National Athletic Trainers' Association (NATA) position statement on acute management of the cervical spine-injured athlete, which of the following dictates the development of separate emergency action plans (EAPs)? A. Injury risk level of sports B. Gender of athlete C. Sport or activity locations D. Sport seasons

B: To ensure proper care, the player should be completely honest about the involved athlete's activities and alcohol use.

After a big win, the members of your soccer team throw a party where alcohol is served. In the early morning hours, a player calls you because he is unable to wake his teammate. You ask the player what the teammate actually did. What is the role of the player in the immediate care of the ill teammate? A. The player should relate information only about the teammate ' s current condition. B. The player should be completely honest about the evening ' s activities. C. The player should avoid providing details without the teammate ' s permission. D. The player should request that the athletic trainer keep all provided information strictly between them. E. The player should convene a team meeting to make sure all players provide the same story.

C: It is important for athletes to wait for the athletic trainer to care for the athlete to avoid making injuries worse and to ensure that the injured athlete gets proper care management

After the running back on your football team completes a first down, you notice that he is still lying face down on the field as the other players return to the huddle. As you watch from the sideline, a teammate jogs over to the down player before you can get to him. What is the most helpful action this teammate could take to assist in the care of this injured athlete? A. Help the player to get up by grabbing his shoulder pads and lifting superiorly so he can get his feet under him. B. Take the player by one shoulder and arm and gently roll him over onto his back to maximize airflow. C. Ask the down player if he is injured and instruct him to lie still until the athletic trainer comes out. D. Tell the player that because he cannot move his legs he is probably paralyzed and should not move until the athletic trainer comes out. E. Tell his teammates in the huddle to stay where they are because the down player is seriously hurt.

B: Because several studies have shown a higher rate of respiratory and infectious complications with methylprednisolone use, patients and their families should be consulted on the risks and benefi ts of this medication in the treatment of an acute spinal cord injury

Although once considered the standard of care, the use of high-dose methylprednisolone for the treatment of acute spinal cord injury is currently controversial. What led to this change? A. Research suggests that patients given methylprednisolone for the treatment of acute spinal cord injury did not demonstrate signifi cantly better functional outcome measures than patients given a placebo medication. B. Several research studies have demonstrated a higher incidence of respiratory and infectious complications with methylprednisolone. C. Recent research has demonstrated support for the use of methylprednisolone only in patients with thoracic spinal cord injury. D. Research suggests that the use of methylprednisolone may lead to dangerous drops in blood pressure

B: Application of the sterile gauze will decrease the risk for infection, whereas the pressure applied to the femoral artery will decrease the bleeding. The femoral artery is the major blood supply for the leg; therefore, its fl ow must be decreased in the case of an open wound to decrease the likelihood of shock

An athlete sustains a compound fracture of the middle third of the right tibia. In an initial attempt to control the bleeding, which of the following techniques would be the most effective and appropriate? A. Elevate the leg above the level of the heart to slow the bleeding. B. Gently apply sterile gauze over the wound and apply digital pressure over the femoral artery. C. Apply sterile gauze and direct pressure over the fracture site. D. Apply a tourniquet just above the knee. E. Gently apply sterile gauze over the wound and apply pressure at the dorsal pedal pressure point.

B: During the CHECK phase, members of the emergency action team should check the scene; check the area around the athlete for information on what may have happened to the athlete; check the injured athlete to see if he or she is conscious or unconscious; check all vital signs; and check for bleeding, fractures, and dislocations

An emergency action plan (EAP) should direct the emergency team to follow a CHECK-CALL-CARE system when responding to an emergency. Which of the following is an action taken during the initial CHECK? A. Check ambulance route to make sure all gates, doors, and other entrances are accessible. B. Check the scene to make sure it is safe for you to aid the athlete. C. Check the athlete ' s medical records, noting preexisting conditions and medication allergies. D. Check stability provided by the immobilization devices you have applied.

A: If an injury occurs, it is important for teammates to leave the athlete in the position he is in and wait for the athletic trainer to assess the injured athlete. Moving an injured athlete, even at his request, may worsen some injuries

As the athletic trainer for a high school football team, you hold a team meeting before the start of each season to discuss emergency management protocols with the players. What is the most important information the athletes should receive? A. If an injury occurs, players should not touch or move the injured athlete until instructed to do so by the athletic trainer. B. If an injury occurs, the players should assist the injured athlete in removing his helmet if the player is unable to remove it himself. C. If an injury occurs, every effort should be made by the teammates to get the injured player to the sideline, where he can be seen by the athletic trainer. D. If an injury occurs, only the team captain should signal the ambulance staff to come onto the field to transport the athlete.

A: It is important for youth athletes with potential life-threatening injuries to be educated on how to self-administer their medications under the direction of their prescribing physician

As trained medical personnel are often not present at youth sporting events, which education is considered to be critical for youth athletes with potentially life-threatening conditions such as asthma or severe allergies? A. Education on self-administration of medications B. Education on past medical history C. Education on current emergency action plan (EAP) D. Education on how to contact emergency personnel

A: A primary survey must be performed to ensure that the athletic trainer will not be injured in the process of trying to administer lifesaving care. This primary survey will help determine the nature of the injury, the course of the decision-making, and the actions that must be taken to provide the best emergency care.

During a thunderstorm, lightning strikes a power pole, resulting in a live power line falling onto an outfield chainlink fence. After the storm passes, the coaches go out to assess the damage. One of the coaches inadvertently touches the fence, receives an electrical shock, and collapses several feet away from the fence. What is the first step you should take to care for the injured coach? A. Perform a primary survey. B. Call the power company to have the electricity shut off. C. Move the coach off the wet grass and onto a dry blanket. D. Activate emergency medical services (EMS), and do not touch the victim to protect yourself. E. Use a wooden bat to see if the coach is still carrying a charge.

A: A cerebrovascular accident (CVA), also known as a stroke, is a lack of oxygen being delivered to the brain typically caused by a blood clot or aneurysm. Symptoms of a stroke include unilateral numbness of the face, arms, or legs; confusion; blurred vision; slurred speech; balance problems; and dizziness. A CVA is a medical emergency, so activation of emergency medical services (EMS) is the correct fi rst thing to do.

Following a yelling and screaming episode, a basketball coach appears confused. He drops the pen from his clipboard, begins to slur his speech, and complains of numbness and weakness on the right side of his face. What condition should be suspected, and how is this condition best treated? A. Cerebrovascular accident; activate emergency medical services (EMS), and encourage the coach to remain calm B. Myocardial infarction; activate EMS, and provide a low-dose aspirin to the coach C. Transient ischemic attack; provide a low-dose aspirin, and instruct him to call his physician D. Supraventricular tachycardia; instruct the coach to lie supine and monitor him for shock E. Deep vein thrombosis; provide a glucose beverage, and reassess vital signs every 10 minutes

A: A pre-event "time out" should be used to have all athlete health-care professionals at an event go over a checklist for that venue ' s emergency action plan (EAP) to make certain they are prepared to handle an emergency

In 2012 the National Athletic Trainers' Association (NATA) released the official statement entitled "Time Outs Before Athletic Events Recommended for Health Care Providers." What is the purpose of the recommended "time out"? A. Ensure all the athletic health-care professionals who comprise the emergency response team go through a pre-athletic event checklist reviewing the venue ' s emergency action plan (EAP). B. Ensure all athletic health-care professionals providing emergency care for a specific sport event have appropriate and current first responder certifications and are willing to provide care in case of an emergency. C. Make certain all emergency equipment and first aid supplies are complete, in excellent working order, and easily accessible to all persons involved in any aspect of athletic healthcare for a specific sporting event. D. Ensure all athletic health-care professionals for a specific sport have reviewed the medical records of all participants, have access to participant emergency contact information (cards), and have adequate knowledge for using any potentially necessary emergency equipment and first aid supplies

B: Any athlete experiencing signs and symptoms consistent with a concussion should be removed from activity and referred to an athletic trainer or physician with experience in concussion management. If a concussion is diagnosed, the athlete should be withheld from all activity for the remainder of the day and then follow the institution ' s concussion protocol

In accordance with the National Collegiate Athletic Association (NCAA) Inter-Association Consensus Statement on management of concussion, what is the standard procedure for management of a student athlete diagnosed with a concussion? A. An athlete should be screened and, if assessments are within 10% of baseline measures, they can return to competition. B. An athlete may not return to the practice or competition and should be withheld from all activity for the remainder of the day. C. An athlete should be removed from activity and referred to a physician for evaluation and management. D. An athlete can return to activity later in the same day if cognition and balance have returned to normal limits and only a headache remains.

B: Cardiac arrest should be assumed until ruled out in a collapsed and unresponsive athlete.

In order to avoid potentially fatal delays in providing CPR, what should be communicated to athlete health-care professionals regarding a collapsed and unresponsive athlete? A. If patient is gasping, even occasionally, a cardiac arrest can be ruled out. B. Every collapsed and unresponsive athlete should be treated as having a cardiac arrest until a noncardiac cause is determined or the athlete becomes responsive. C. Seizure-like activity is rarely associated with cardiac arrest; therefore, the collapsed and unresponsive athlete should be treated as having a neurological condition. D. A rescuer trained in CPR detecting a pulse in a collapsed and unresponsive athlete is a strong indicator the athlete is not experiencing a cardiac arrest.

C: Occupational Safety and Health Administration (OSHA) guidelines for exposure to bloodborne pathogens were developed to protect health-care providers. Health-care workers managing blood or bodily fl uids should make use of the appropriate personal protective equipment, including, but not limited to, disposable latex gloves, nonabsorbent gowns or aprons, masks and shields, and eye protection

In order to comply with the Occupational Safety and Health Administration (OSHA) standards that govern occupational exposure to bloodborne pathogens, what emergency equipment should be included in a venue specific emergency action plan (EAP)? A. Automated external defibrillator (AED) B. Pneumatic splint kit C. Personal protective equipment D. Spine board with padding and straps

A: It is recommended epinephrine be administered when the initial signs and symptoms of anaphylaxis are present, regardless of severity. Fatalities from anaphylaxis usually result from delayed administration of epinephrine

In order to ease respiratory distress and restore cardiac output, what drug does the World Health Organization recommend be available for immediate treatment of acute anaphylaxis? A. Epinephrine B. Albuterol C. Benadryl D. Prednisone

D: When an injury occurs, the most qualifi ed person at the site should assess the condition, provide necessary acute care, and communicate to the other members of the emergency team so that additional care can be provided and the patient can be transported to a health-care facility.

One component of an emergency action plan (EAP) is the formation of an emergency team. There are four basic roles within this emergency team. What is the first and most important role? A. Activating emergency medical services (EMS) and providing information to 911 dispatcher B. Retrieving emergency equipment C. Directing EMS personnel to the scene D. Establishing safety at the scene and providing immediate patient care

C: An indirect fatality is a fatality caused by systemic failure as a result of exertion while participating in football or by a complication that was secondary to a nonfatal injury

The number of recorded direct fatalities resulting from participation in the fundamental skills of football at the high school, collegiate, and professional level have declined dramatically since the late 1970s as a result of major rule changes, helmet standards, better coaching, and improved medical care of athletes. However, indirect fatalities have remained high and have even increased during some decades. Which of the following is the leading cause of football indirect fatalities? A. Asthma B. Internal trauma C. Exertional heatstroke D. Concussion

D: The letter D represents disability or defi brillation if the patient is in cardiac arrest

The components of a primary survey can be designated by the mnemonic ABDCE. Which component of the primary survey includes a brief neurological examination or, in the case of cardiac arrest, application of an automated external defi brillator (AED)? A. A B. B C. C D. D E. E

D: First responders should be trained to provide care designed to support life until emergency medical services (EMS) can arrive and assume care

The emergency action plan (EAP) for a high school identifies head and assistant coaches as targeted first responders to assist the athletic trainer in providing care in an emergency situation. What is the minimum level of training that should be provided to these first responders? A. Handout on the EAP that clearly defines roles and responsibilities B. Basic first aid training C. Advanced life support training D. Certified training in CPR and automated external defibrillator (AED) use

C: Airway management supplies include oropharyngeal and nasopharyngeal airways (various sizes), oropharyngeal airways (various sizes), and suction devices

The emergency medical equipment available on-site should be based on the type of event being covered and the possible emergency scenarios associated with that event. If an emergency scenario requiring advanced airway management is anticipated, what emergency medical equipment needs to be readily available at the event venue? A. Automated external defibrillator (AED) with extra pads B. Pulse oximeter C. Oral pharyngeal airway (OPA) D. EpiPen

C: Once an emergency unit arrives at the injury location, time is required to remove emergency equipment and arrive at the patient ' s side. This time may vary based on venue and should be considered in developing an emergency action plan (EAP).

The length of an emergency medical services (EMS) response time may factor into an emergency action plan (EAP) in regard to necessary emergency equipment and whether on-site ambulance coverage is warranted. When determining an EMS response time, both horizontal and vertical response times should be considered. What is vertical response time? A. The time from when the EMS call goes out until a driven dispatched unit arrives on the scene B. The time from when the EMS call goes out until a medical helicopter arrives on the scene C. The time from when the dispatched unit arrives on the scene until patient treatment begins D. The time from when the dispatched unit arrives on the scene until the patient is completely loaded into the emergency transportation vehicle

C: Athletes with a history of anaphylaxis should be prescribed an epinephrine autoinjector (EpiPen).

To effectively manage athletes with a history of anaphylactic reactions, what medical equipment should health-care professionals stock and be trained to use at the first sign of anaphylaxis? A. Nebulizer B. Supplemental oxygen C. EpiPen D. Metered dose inhaler

B: Hospital medical personnel are rarely trained in equipment removal procedures during their medical training and could benefi t from partnerships and education by the athletic training staff

To improve patient outcomes, an athletic trainer in a rural county may need to educate facility administrators and medical staff at local emergency care facilities in which of the following areas, as the information may not be part of their standard education program? A. Management of heat-related illness B. Proper removal of athletic equipment C. Management of concussion D. Splinting and immobilization techniques

A: Catastrophic injuries cause permanent damage and disruptions in daily life and must be taken very seriously

Which of the following best describes a catastrophic injury or illness? A. A sudden death or injury in which there is life-altering physical and/or mental impairment B. A sudden death or injury that results in paralysis C. An injury that terminates an athlete ' s sports participation D. An injury that results in criminal and/or civil legal actions E. An injury that permanently disables an aspect of the central nervous system

E: Level I trauma centers are the highest level trauma centers and are capable of providing total care for all aspects of injuries

Trauma centers are designated levels by states and municipalities and are verified by the American College of Surgeons (ACS). Additionally, a facility may have different designations for adults and pediatrics. Which trauma center level designation is defined as a "comprehensive regional resource that is a tertiary care facility central to the trauma system" and is the highest level? A. Level V B. Level IV C. Level III D. Level II E. Level I

B: Double gloving may provide extra protection in situations of heavy bleeding or when sharp objects are being used.

What action is recommended to protect a health-care provider against exposure to bloodborne pathogens when there is heavy bleeding present? A. Double hand washing following glove removal B. Double gloving C. Changing gloves when they become saturated D. Using alcohol-based hand sanitizer following glove removal and hand washing

B: A core temperature of 105°F or higher taken rectally is a diagnostic criterion for exertional heatstroke

What emergency medical equipment should be included in an athletic trainer's emergency action plan (EAP) to diagnose an athlete with exertional heatstroke? A. Pen light B. Rectal thermometer C. Reflex hammer D. Urinalysis dipstick

C: Thicker than the arachnoid mater, the pia mater is the innermost of the three layers of the meninges

What highly vascularized, loose connective tissue membrane adheres closely to the surface of the brain? A. Dura mater B. Nuchal ligament C. Pia mater D. Scalp

B: For severe acute asthma attacks, rapid sequential administration of a short-acting beta-2-agonist inhaler three times may be tried, and then referral is indicated. Long-acting beta-2-agonist inhalers, corticosteroids, and leukotrienes are used prophylactically and to control symptoms.

While covering a middle school softball game, one of the players suffers an acute asthma attack. You assist the athlete in using her short-acting beta-2-agonist rescue inhaler. The athlete ' s symptoms do not diminish after a second administration of the medication. What are the recommended next steps? A. Assist the athlete in using her long-acting beta-2- agonist inhaler. B. Provide a third administration of the rescue inhaler and if symptoms do not subside refer promptly to a health-care facility. C. Assist the athlete in using her corticosteroid inhaler. D. Refer the athlete immediately to a health-care facility.

D: Severe hypoglycemia is considered to be a medical emergency. If an athlete is unable to swallow or loses consciousness, oral carbohydrates cannot be provided, and injectable glucagon should be provided if available

A diabetic athlete comes to the sideline during practice complaining of dizziness, fatigue, trembling, heart racing, and headache. The athlete also has a fruity odor on his breath. As the athletic trainer begins the evaluation, the athlete becomes more and more confused. What action should the athletic trainer take? A. Provide an insulin injection and based on the athlete ' s response activate the emergency action plan (EAP). B. Activate the EAP and monitor vital signs until emergency medical services (EMS) personnel arrive. C. Move the athlete to a cool location, monitor core body temperature, and provide oral fluids. D. Activate the EAP, and attempt to provide carbohydrates orally or through glucagon injection if the athlete is unable to swallow

A: Trauma centers are classifi ed from I to V by the scope of services they are able to provide. Level I centers provide the most comprehensive services from initial evaluation through rehabilitation, whereas Level V centers are able to provide initial evaluation and stabilization to prepare for transport to a higher-level center

A football player sustains an acute cervical spine injury during a game. The emergency action plan (EAP) is activated, and the athlete is spine boarded for transport to an emergency medical facility for evaluation and treatment. On arrival the emergency medical services (EMS) provider asks which local hospital you would like to use. Which of the following facilities would provide the medical professionals that are best equipped to manage this injury from evaluation through the treatment and rehabilitation process? A. Level I trauma center B. Level II trauma center C. Level III trauma center D. Level IV trauma center E. Level V trauma center

C: Anytime an overdose is suspected, a poison control center should be contacted, as personnel can provide guidance for immediate care while waiting for emergency medical services (EMS) to arrive.

A member of your field hockey team calls you in a highly emotional state to report that she came back to her residence hall room to find her roommate, who is also her teammate, unconscious on the floor with an empty bottle of pills beside her. Which of the following would be appropriate next steps? A. Tell the athlete to hang up and call 911 and then report back to you on the status after they arrive. B. Tell the athlete that you will call 911 and the athlete should call her teammate ' s parents. C. Tell the athlete to hang up and call 911 and you will contact the poison control center and meet her at her room. D. Tell the athlete to have her resident advisor call 911 and then she should attempt to provide CPR

B: Diabetic coma occurs when a diabetic patient does not properly treat his or her illness through either proper diet or insulin use. Too little insulin results in hyperglycemia and ketoacidosis, which then causes a loss of potassium, sodium, and ketone bodies through excess urination

A middle-aged coach falls unconscious on the sideline. Her skin is cool and dry, and her breathing is labored. Her face is flushed, and there is a sweet odor on her breath. What do you suspect? A. Stroke B. Diabetic coma C. Insulin shock D. Anaphylactic shock

D: Albuterol is an inhaled short-acting beta-agonist that stimulates the beta-adrenergic receptors in the bronchi and bronchioles, resulting in widening of these airways and improved airflow.

A nebulizer, also known as an atomizer, is effective in treating a severe asthma attack because it can deliver a higher medication dose compared with a metered dose inhaler. When treating a serious respiratory rescue situation, what medication is typically administered with a nebulizer? A. Montelukast B. Salmeterol C. Formoterol D. Albuterol

A: The two techniques that are recommended for stabilizing the cervical spine during helmet and shoulder pad removal are the head-squeeze technique and the trap-squeeze method, in which the rescuer grips the patient ' s trapezius muscles bilaterally using the forearms to stabilize the head

A standard procedure for helmet and shoulder pad removal of an athlete with a cervical spine injury can be part of a venue-specific emergency action plan (EAP). Based on current guidelines, there are two recommended techniques for stabilizing the cervical spine. Which of the following is one of those techniques? A. Trap-squeeze method B. Inverted-hands method C. Diagonal-squeeze method D. Chin-forehead method

A: When activating emergency medical services (EMS), a visible emergency action plan (EAP) posted near a landline telephone can assist in providing information regarding the address of the facility, specifi c directions to the facility including street names, and location of entrances

A venue-specifc emergency action plan (EAP) should include information for the following subjects: emergency personnel, emergency communication, emergency equipment, medical emergency transportation, venue directions with map. To aid in providing effective emergency communication, where in the athletic training facility should a copy of the EAP be posted? A. Near the landline telephone B. Near the facility entrance C. Near the treatment tables D. Near the entrance to the storage facility

A: Testicular torsion is when one of the testicles, typically the left, twists and often blocks blood fl ow. Symptoms include scrotal swelling, pain in the testicle and the abdomen, nausea, and a unilateral elevated testicle. Elevating the involved testicle can rule out epididymitis if pain is not relieved. As testicular torsion is a urological emergency, referral should be immediate to prevent total tissue death.

A wrestler is visibly uncomfortable and complains of scrotal swelling, abdominal pain, nausea, and unilateral testicular tenderness. He reports no trauma, tells you he woke up with the symptoms this morning, and says it feels like his left testicle is not in the right place. You ask him to elevate the involved testicle, but no relief is noted. What condition should you suspect, and what is the most appropriate immediate care? A. Testicular torsion; refer immediately to the team physician or emergency department B. Testicular torsion; apply ice and attempt manual reduction after area is numb C. Epididymitis; refer to the team physician for antibiotic prescription D. Epididymitis; apply ice and notify the coach that he will be unable to practice today E. Hydrocele; the athlete should be scheduled to see the team physician later in the day

B: Exercise-associated hyponatremia is defi ned as a serum sodium concentration of less than 135 mmol/L during or within 24 hours of physical activity

An athlete who has just completed running a marathon on a hot and humid late summer day is demonstrating signs and symptoms of exertional hyponatremia. What is the physiological cause of this condition and its associated clinical presentation? A. A decrease in serum or plasma chloride (Cl − ) concentration B. A decrease in serum or plasma sodium (Na + ) concentration C. An increase in serum or plasma potassium (K + ) concentration D. An overall increase in serum or plasma volume

C: Emergency treatment for exertional sickling includes monitoring vital signs, activating the emergency action plan (EAP), providing high-fl ow (15 L/min) oxygen with a nonrebreather mask, cooling as necessary, initiation of IV line if feasible, and monitoring for rhabdomyolysis and cardiac arrhythmias

An athlete with sickle cell trait collapses during a training session and exertional sickling is suspected. In addition to removal from activity, monitoring vital signs, and activating the emergency action plan (EAP), what other therapeutic interventions are indicated for this athlete? A. Urinalysis to assess for possible rhabdomyolysis B. Peak fl ow measurements to assess lung function C. High-fl ow oxygen administration with a nonrebreather mask D. Elevation of the extremities to prevent shock

D: Normal pulse oximeter readings are greater than 95%. Values less than 90% require supplemental oxygen

An athletic trainer is assessing vital signs as part of a primary survey. The athlete's pulse oximetry value is less than 90%. What is the appropriate interpretation and recommended intervention for this patient? A. Value is normal; no intervention is required at this time. B. Value is very high; encourage patient to slow down rate of respiration. C. Value is on the low end of normal; encourage patient to take one or two slow deep breaths to see if value increases. D. Value is low; supplemental oxygen is indicated.

C: The most qualifi ed individual on the scene should direct immediate care of the injured athlete. The physician may direct the athletic trainer to provide care, or the physician and the athletic trainer may share in caring for the athlete

In an on-field emergency situation, which member of the emergency team should direct the immediate care of the injured athlete? A. Athletic trainer B. Athletic training student C. Team physician D. Local emergency medical services (EMS) personnel covering the game

B: The Occupational Safety and Health Administration (OSHA) mandates that bloodborne pathogen training be conducted each year to make sure all providers are using the most current information.

In order to protect health-care professionals providing care in a life-threatening emergency, how often does the Occupational Safety and Health Administration (OSHA) require mandatory training for managing bloodborne pathogens? A. Every 6 months B. Annually C. Every other year D. Every 5 years

C: After the primary survey has ruled out any life threatening conditions or all life-threatening conditions have been managed, the secondary survey may be performed. In this scenario, the secondary survey can be initiated because the patient is stable and not exhibiting life-threatening conditions.

In which of the following situations would it be appropriate for the athletic trainer to progress from the primary survey to the secondary survey when managing a patient with an on-field injury? A. Airway, breathing, and circulation have been established, and the athlete is bleeding profusely from an open leg wound. B. The athlete is conscious, stable, and being treated for shock. C. The athlete is unconscious, supine, and breathing, and vital signs are stable. D. The athlete is conscious with an obvious closed tibia-fibula fracture; is exhibiting nervousness, nausea, and chills; and appears pale.

C: In addition to the information in answer C, the 911 caller should be able to provide the following information: type of emergency situation, type of suspected injury, location of telephone being used, and any limitation in the facility that has to be entered.

What information should an athletic trainer be prepared to communicate to a 911 dispatcher? A. Caller ' s name, title and position, condition of the patient, and medical history of patient B. Location of telephone being used, date of caller ' s most recent CPR training, and type of suspected emergency C. Present condition of the patient, current assistance being given, exact location of emergency, and how to enter facility D. Type of emergency situation, patient's medical history, and name of the person meeting the ambulance E. Current assistance being given to patient, number of persons on scene who are certified in CPR, and location of telephone being used

C: AEMT stands for Advanced Emergency Medical Technician, which is one of the four levels of emergency medical services (EMS) providers. Paramedics provide the most extensive prehospital care of injured persons

What is indicated when a first responder carries an AEMT classification? A. Trained to provide only basic emergency care B. Trained to provide care to patients at scene of accident and transport patients by ambulance to the hospital under medical direction C. Trained to provide care to patients that includes the administration of intravenous fluids, use of manual defibrillators, and application of advanced airway techniques D. Trained to provide the most advanced pre-hospital care by administering drugs orally and intravenously, interpreting electrocardiograms, performing endotracheal intubations, and using monitors and other complex equipment

A: Knowing your site ' s emergency action plan (EAP) is important, and being able to execute it is even more important. Unannounced EAP drills demonstrate your team ' s readiness and knowledge of your site ' s EAP. This can show areas your team needs to review or holes or fl aws in the EAP

What is the advantage of conducting unannounced emergency action plan (EAP) drills? A. They give a good indication how the EAP team will respond during an actual emergency. B. They are required to meet catastrophic insurance coverage requirements. C. They are important to educate all EAP team members on their individual roles and responsibilities. D. They serve as an acceptable defense to avoid potential litigation.

D: Carotid is the next best location to palpate for a heart rate due to the proximity to the heart and associated blood vessels. The athletic trainer must ensure to apply light pressure over this artery because it is responsible for delivering oxygenated blood to the brain, neck, and face

What is the best location to determine the pulse rate of a patient who has a weak radial pulse? A. Dorsal pedal B. Popliteal C. Brachial D. Carotid E. Femoral

C: Standard of care is defi ned as "the manner in which an individual must act based on his or her training and education."

What is the legal basis for institutions needing to have emergency action plans (EAPs) established for athletic venues? A. An EAP protects institutions against legal actions. B. An EAP guarantees injured athletes will have positive outcomes. C. An EAP is an accepted standard of care. D. An EAP prevents first responders from making decisions or taking actions that may result in legal actions.

A: Maintenance of cardiovascular system function is most important because without adequate cardiovascular functioning, the body is not provided with blood and oxygen to function appropriately. Secondarily, the central nervous system, including the brain, is unable to perform

What is the primary goal when providing emergency care? A. Maintain cardiovascular function and, indirectly, central nervous system function. B. Maintain central nervous system function and, indirectly, respiratory system integrity. C. Maintain adequate blood supply and, indirectly, brain function. D. Maintain breathing and, indirectly, central nervous system function. E. Maintain visceral organs and, indirectly, peripheral function

C: Preincident surveys allow local emergency medical services (EMS) to evaluate the emergency action plan (EAP) for accessibility and to identify any problems so they can be addressed ahead of time

What is the purpose of a preincident survey by local emergency medical personnel? A. Identify current levels of satisfaction from local citizens regarding emergency response. B. Identify amount of time it takes to reach individual venues. C. Visit specific venues identified in an emergency action plan (EAP) to identify potential problems or poorly accessible areas. D. Survey local sports medicine personnel to determine role of emergency medical services staff when responding to sports-related emergencies.

B: Detailed documentation in chronological order allows for the management team to be able to critique the emergency action plan (EAP) and edit to avoid any holes or fl aws in the plan. Documentation may also provide necessary information for any potential legal action

What is the purpose of writing a chronology of events following a catastrophic injury? A. It assists the injured party ' s legal team in developing legal action against the medical staff and the institution. B. It allows the management team to critique the process while providing a basis for reviewing the efficacy of the procedures. C. It assists the counseling team by providing a comprehensive background of events from which they can formulate a care plan. D. It aids the administration in making decisions regarding the employment status of involved personnel.

B: Consultation with local emergency medical services (EMS) staff who will be responding when the emergency action plan (EAP) is activated will improve continuity of care

What outside entities should be consulted when an educational institution sets out to develop an effective emergency action plan (EAP)? A. Campus health services staff B. Local emergency medical services (EMS) C. Medical staff from other schools within the conference D. Local police department personnel

E: Unilateral absence of lung sounds during auscultation is indicative of complete obstruction or lung collapse

When auscultating the lungs as part of assessment of a thoracic injury, which of the following sounds would be indicative of a collapsed lung? A. Stridor B. Wheezing C. Rhonchi D. Crackles E. No sounds

D: Level of consciousness is the fi rst step assessed in the primary survey because the main purpose of the primary survey is to assess life-threatening conditions, including level of consciousness, airway, breathing, circulation, severe bleeding, and shock

When completing a primary survey, what is the first component that should be assessed? A. Airway, breathing, and circulation B. Presence of spinal cord involvement C. Patient ' s position and presence of deformities D. Level of consciousness

B: The emergency action plan (EAP) for each venue should include information concerning the following: accessibility to emergency personnel, communication systems, emergency equipment, and emergency vehicle transportation.

When creating your emergency action plan (EAP), what information should be included for each specific venue? A. Emergency vehicle transportation, emergency equipment, location of lightning safe shelters B. Accessibility to emergency personnel, communication systems, emergency equipment C. Name and location of nearest emergency care facility, number of stairs between floors, availability of emergency transportation D. Location of lightning safe shelters, policy for activating emergency transportation, communication systems

B: Emergency personnel should be trained in properly using all emergency medical equipment

When developing a venue-specifi c emergency action plan (EAP), which of the following should be consistent with the type of available emergency equipment? A. Institution ' s medical equipment budget B. Level of training of the emergency care personnel C. Athlete exposure rate and injury rate for sports at venue D. Number of emergency care personnel

C: It is the responsibility of the host athletic trainer to make sure visiting personnel are familiar with key components of the emergency action plan (EAP) so that they can also implement it effectively

When hosting an athletic event, what information should be communicated to the visiting athletic team staff by the host athletic trainer? A. Location of the posted emergency action plan (EAP) B. Copy of department ' s policy and procedure manual C. Available medical personnel, methods of communication, and available equipment D. Transportation policy detailing which types of injuries merit transport

C: When a patient is unable to speak, cough, or breathe, the airway is completely obstructed. This is a medical emergency, and emergency medical services (EMS) should be activated

When managing an athlete with an acute airway obstruction, when should emergency medical services be activated? A. If the athlete complains of throat irritation following dislodgment of the obstruction B. On initiation of CPR C. When the athlete cannot cough, speak, or breathe D. If the athlete cannot be stopped from coughing forcefully and continually

E: Establish and maintain an open airway. This is the fi rst action that the athletic trainer should perform in this instance because oxygen must be delivered to the organs in order for them to thrive and continue functioning. After this action is executed successfully, heart rate and other vital signs should be assessed and maintained, and then head stabilization should be performed

When providing primary emergency care to an unconscious athlete with a suspected cervical spine injury, what is the first action that should be taken? A. Apply a rigid cervical collar to stabilize the spine. B. Place a towel in the posterior curve of the neck to establish normal lordotic curve. C. Treat athlete for shock by elevating the lower extremity. D. Assess heart rate via the carotid pulse. E. Establish and maintain an open airway.

A: Paramedics are trained to provide advanced life support, which includes advanced airways and administration of medications as well as IV administration and other invasive procedures

Which emergency medical services (EMS) provider has training and authority to provide advanced airway support, perform invasive procedures such as IV placement, and administrater medication under the supervision of a physician as part of his or her scope of practice? A. Paramedic B. Emergency medical technician C. Basic life support provider D. Emergency medical responder

D: Written communications with step-by-step instructions will improve understanding and compliance with emergency action plans (EAPs)

Which of the following actions would assist youth sports league coaches and personnel in effectively implementing an emergency action plan (EAP)? A. Policy statement from the national governing board distributed to all team personnel B. Required meeting for all coaches and parents at the beginning of the season to explain safety rules C. Overview of legal cases involving youth sports coaches to motivate compliance D. One-page handout with clearly presented EAP that outlines step-by-step directions for team staff in conjunction with emergency medical services (EMS)

C: An emergency action plan (EAP) should include information on emergency personnel, emergency communication, emergency equipment, roles of first responders, activation of emergency medical services (EMS), venue directions, and sports medicine staff/ administration names and contact information

Which of the following are components of an emergency action plan (EAP)? A. Roles of first responders, venue directions, and emergency contact information for each athlete B. Names and contact information for staff and administration personnel, date of most recent EAP practice session, list of available emergency equipment C. Emergency personnel, modes of communication, and venue directions or site map D. Location of personal protective equipment, roles of first responders, method of activating emergency medical services (EMS).

B: Partial seizures are marked by the patient remaining conscious throughout the seizure event. The symptoms begin with disturbances in motor, sensory, or autonomic functioning, which may be seen or sensed by the patient as involuntary facial or skeletal motion; feelings of tingling or pins and needles; or auditory, visual, olfactory, or gustatory hallucinations. The discriminating factor between simple and complex seizures is the fact that simple seizures do not lead to a loss of consciousness.

Which of the following best characterizes a simple partial epileptic seizure? A. Impairment of consciousness alone or in association with purposeful movements such as automatism B. A brief bout of uncontrolled shaking of the limbs on one side of the body and no loss of consciousness C. A brief bout of uncontrolled shaking of the limbs bilaterally and no loss of consciousness D. A brief bout of uncontrolled shaking of the limbs with a loss of consciousness E. Total body convulsions with a loss of consciousness

A: An emergency action plan (EAP) must be created for each separate location where sports and activities take place. The plan must be comprehensive and include all possible situations

Which of the following descriptions best defines an emergency action plan (EAP)? A. Written document that defines the standard of care required in every conceivable event during an emergency situation B. Step-by-step procedures that are specific to the needs of each institution and athletic facility during an emergency situation C. A statement that will drive the institution ' s functional goals, which in turn formulate all medical operating procedures D. Detailed plan that describes the roles of involved personnel during an emergency situation E. Written, site-specific plan for transporting injured athletes in an emergency situation

E: If a contact lens becomes displaced during sports participation, it will need to be cleaned before being returned to the eye. A mirror is helpful for the athlete to view the eye when replacing the displaced lens. A contact lens case can provide new contacts or serve as a storage case for a displaced lens that cannot be returned to the eye.

Which of the following groups of field kit supplies is most helpful in managing an athlete with a displaced contact lens? A. Penlight, mirror, and sterile gauze pads B. Blue light, fluorescein strips, and eye patch C. Sterile eyewash, tweezers, and cotton-tipped applicators D. Contact lens case, eye patch, and sterile saline solution E. Sterile saline solution, mirror, and contact lens case

B: A bleb is a small air-fi lled sac. When this sac ruptures, the air becomes entrapped in the chest wall between the parietal and visceral pleura causing the lung to collapse. A spontaneous pneumothorax is deemed spontaneous if it occurs without a traumatic blow or injury to the chest or lungs.

Which of the following mechanisms would most likely cause a spontaneous pneumothorax? A. Acute bacterial pneumonia B. Rupture of a bleb C. Costochondral separation D. Posterior displaced sternoclavicular joint separation E. Hyperventilation

A: Automated external defi brillators (AEDs) must be easily accessible in order to provide early defi brillation

Which of the following recommendations is in alignment with the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletes? A. An automated external defi brillator (AED) should be on-site and accessible within 1 to 3 minutes for all organized athletic activities. B. A resting ECG should be obtained for all secondary school athletes to make clearance decisions. C. Sports drinks should be available for all practices in hot environments to reduce the risk of exertional heat illness. D. Athletes with suspected concussion can return to activity the same day if cleared through objective concussion testing and reviewed by the school nurse and/or physician.

C: Hypovolemic shock is caused by trauma that results in blood loss, decreasing the overall blood volume. The body reacts by shunting the blood that is left to the organs to ensure they receive enough oxygen; therefore, the blood pressure declines because of the loss of blood. The skin will lose its color and feel cold and clammy because the blood is not available

Which of the following signs and symptoms best characterize hypovolemic shock? A. Slow, deep breathing; agitation; and cold, pale clammy skin B. Dilated pupils, excessive urine output, and bluish lips and fi ngernails C. Very low blood pressure; rapid, weak pulse; and cold, pale clammy skin D. Profuse sweating; hot, dry skin; and rapid, shallow breathing E. Hyperventilation; lightheadedness; and slow, thready pulse

A: Traction splints are indicated for long-bone fractures, particularly of the lower extremity, such as the femur. The longitudinal pull the splint exerts limits spasm. Use of this type of splint requires special training such as that provided to emergency medical technicians (EMTs).

Which type of splint is indicated for stabilization of long-bone fractures because it limits spasm of surrounding musculature that might negatively impact fracture alignment? A. Traction splint B. Dynamic splint C. Vacuum splint D. Air splint

C: To determine blood pressure, the cuff must be infl ated to 200 mm Hg to occlude the brachial artery blood fl ow. The fi rst sound heard should be the systolic blood pressure and is marked by the fi rst beating sound. Once the beating disappears, this point is marked as the diastolic blood pressure

While assessing an athlete ' s blood pressure, you initially inflate the cuff to 150 mm Hg. When you release the pressure, the first sound you hear is a swooshing sound or soft murmur. What does this sound indicate? A. The cuff was inflated too high initially, and you are hearing the brachial artery blood fl ow occlusion. B. The cuff was inflated to a correct pressure, and you are hearing the first Korotkoff sound, which should be recorded as systolic pressure. C. The cuff was not inflated to a high enough initial pressure, and you are hearing the second Korotkoff sound instead of the first. D. The cuff was inflated to a correct pressure, and you are hearing the fifth Korotkoff sound, which should be recorded as diastolic pressure. E. The cuff was inflated to a correct pressure, and you are hearing the first Korotkoff sound, which should be recorded as diastolic pressure.

C: Even compression-only CPR provided by an untrained bystander may prevent the situation from deteriorating and increase the chance the defi brillation will be effective and preserve heart and brain function until trained rescuers can arrive.

While attending a local theater performance, you observe a man collapse in the aisle of the theater, and bystanders begin compression-only CPR. According to the American Heart Association Guidelines, how would you characterize the response to this emergency situation? A. Bystanders regardless of level of training should provide breaths in addition to compressions in case the cause of arrest is related to asphyxial causes. B. CPR performed in any way is ineffective without use of an automated external defibrillator (AED). C. Untrained bystanders are more likely to perform compression-only CPR and can be more easily guided by dispatchers. In addition, the survival rates between compression-only and conventional CPR are not significantly different. D. Bystanders could provide the most effective assistance by foregoing compressions and instead calling 911 and administering an AED if available.

C: Proper splinting principles indicate that the joint above and below the injured area should be immobilized to prevent displacement at the fracture site

While covering a youth soccer game, you are called to the field to evaluate an athlete who was injured after an opponent completed a slide tackle directly into his lower leg. Your evaluation reveals a possible tibia fracture and you elect to splint the athlete before transport to a local hospital for evaluation. When applying a splint, which area should be stabilized by the splint? A. Ankle and lower leg B. Lower leg and knee C. Ankle, lower leg, and knee D. Entire leg from foot to hip

E: The nerve root most likely associated with this impairment is C7. One of the defi cits that is often associated with impairment of C7 is triceps brachii weakness, which would explain the athlete ' s inability to extend his elbow against resistance

While evaluating a football player for a brachial plexus injury on the sideline, the athletic trainer determines that the athlete is unable to extend his elbow against resistance. A deficit in which nerve root is most associated with this impairment? A. C3 B. C4 C. C5 D. C6 E. C7

D: A lone trained rescuer should immediately activate emergency medical services (EMS), obtain an automated external defi brillator (AED), and then return to provide care. If multiple rescuers are present, care can begin while EMS is activated and the AED is obtained. 1

While leaving the office one evening, you notice the custodian collapse at the end of the hallway. You determine that the custodian is unresponsive. As you are the only person in the building at the time, what action should you take? A. Assess airway, breathing, and circulation and call loudly in the hope that someone will come and help. B. Complete one cycle of CPR, activate emergency medical services (EMS), and then get the automated external defi brillator (AED). C. Activate EMS while starting CPR and then obtain the AED after completing one cycle of CPR. D. Activate EMS, obtain an AED, and return immediately to assist the victim.

D: The most current recommendation for on-fi eld management of a cervical spine injury is to remove protective athletic equipment while maintaining cervical spine immobilization before transport to an emergency facility. Additionally, it is recommended that both the shoulder pads and the helmet, not just one, be removed before transport

While practicing, an ice hockey player collides with a teammate and sustains a potential cervical spine injury. The player is supine on the ice and you are providing cervical spine stabilization when two other athletic trainers arrive to provide assistance. Emergency medical services (EMS) has been contacted and dispatched to your location. Based on recent practice recommendations, you and your colleagues begin the process of removing the player's helmet. To avoid potential compromise of the cervical spine, what other personal protective equipment should be removed from this patient before transporting him to an emergency facility? A. Ice skates B. Jersey C. Elbow pads D. Shoulder pads

B: A rapid form vacuum immobilizer is most useful for injuries that must be splinted in the position in which they are found, such as joint dislocations and angulated fractures

While rebounding a shot, a basketball player lands awkwardly on another player ' s foot before falling to the floor. When the athletic trainer reaches the injured player it is obvious the ankle is deformed with one or more possible fractures. What emergency medical equipment is most appropriate to immobilize this athlete ' s injury? A. SAM Splint B. Rapid form vacuum immobilizer C. Half-ring splint D. Stack splint

B: The AVPU scale states that V (for verbal) signifi es the patient responds to verbal cues but is not oriented to person, time, or place

You are assessing an injured athlete ' s level of consciousness. The athlete responds to your voice but is not fully oriented to person, time, or place. How would this be categorized when employing the AVPU scale? A. A B. V C. P D. U

D: An automated external defi brillator (AED) is an essential piece of basic life support. Evidence shows that early use of an AED increases survival. AEDs analyze heart rhythm and decide whether or not to shock the heart to attempt to correct its rhythm.

You have recently been hired as the first athletic trainer for a brand new high school. Currently the school has no medical emergency equipment. Your athletic director has approved the purchase of only one piece of emergency equipment. Which piece of equipment is the most appropriate purchase? A. Spine board (with straps and padding) B. Rapid form vacuum splints C. Vital signs monitor D. Automated external defibrillator (AED)

A: Requesting the emergency action plan (EAP) before the fi rst practice session allows the athletic trainer time to review the plan and get answers to any questions before the fi rst practice session

Your collegiate lacrosse team is practicing at a nearby school because it has a synthetic turf field. How should you obtain a copy of the emergency action plan (EAP) for the school where you will be practicing? A. You should request the EAP from the school before your first practice session. B. The host school is required by law to provide all facility users a copy of the EAP. C. The coach should request a copy of the EAP from the host school ' s coach. D. As the EAP will be posted at the practice site, you do not need to obtain a copy.