EMT Chapter 28 & 30
A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: A. padding between the ear and the scalp. B. covering the wound with a moist dressing. C. applying a tight pressure dressing. D. packing the ear with sterile gauze pads.
A
A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: Select one: A. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport. C. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport. D. assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport.
A
A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: Select one: A. irrigate both eyes continuously for 20 minutes with plain water. B. flush both eyes with an alcohol-based solution and transport. C. mix baking soda with water and irrigate his eyes with the solution. D. neutralize the acid chemical in his eye with an alkaline chemical.
A
A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: A. avoid applying pressure to the globe when you are covering her eye. B. apply firm direct pressure to the injured eye and cover the opposite eye. C. carefully examine her eye and remove any foreign objects if needed. D. ask her to move the injured eye to assess the integrity of the optic nerve.
A
Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function.
A
Double vision, a marked decrease in vision, or a loss of sensation above the eyebrow, over the cheek, or in the upper lip may be caused by a(n): A. Orbital fracture. B. Temporal bone fracture. C. Cervical spine injury. D. Detached retina.
A
Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: Select one: A. a blowout fracture. B. a lacerated globe. C. optic vessel compression. D. a ruptured eyeball.
A
Frequent reassessments of the patient with face or neck injuries are MOST important because: A. such injuries can affect the respiratory system. B. hospital staff require frequent patient updates. C. rapid facial swelling may mask hidden injuries. D. they lend credibility to your documentation.
A
If you need to remove a foreign particle from the eye, the technique includes: A. Flushing the eye with clean water while holding the eyelids apart. B. Using a small forceps to remove the object. C. Pulling the lower lid up and over the upper lid, allowing the lashes of the upper lid to remove the object. D. Removing a foreign object lodged in the eyeball with a cotton swab.
A
Motion of the mandible occurs at the: A. temporomandibular joint B. mastoid process C. chin D. mandibular ankle
A
The Adam's apple is: A. the upper part of the larynx that is formed by the thyroid cartilage. B. the lower part of the larynx that is formed by the cricoid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. below the thyroid cartilage and forms the upper part of the trachea.
A
The conjunctiva are kept moist by fluid produced by the: A. lacrimal gland. B. optic chiasma. C. posterior orbit. D. corneal duct.
A
The cricoid cartilage: A. is the only complete circular cartilage of the trachea. B. is easier to see and palpate than the thyroid cartilage. C. lies superior to the thyroid cartilage in the neck. D. lies superior to the cricothyroid membrane in the neck.
A
The five vertebrae that form the midback are called the: A. Lumbar spine. B. Coccyx. C. Sacral spine. D. Thoracic spine.
A
The skin and underlying tissues of the face: A. have a rich blood supply and bleed heavily. B. swell minimally when exposed to blunt trauma. C. contain a relatively small number of nerve fibers. D. are well protected by the maxillae and mandible.
A
What is the function of the sternocleidomastoid muscle? A. Allows movement of the head B. Allows flexion of the neck C. Connects the scapulae together D. Facilitates chest movement
A
When a light is shone into the pupil: Select one: A. it should become smaller in size. B. both pupils should dilate together. C. the opposite pupil should dilate. D. it should become larger in size.
A
When caring for a chemical burn to the eye, the EMT should: A. prevent contamination of the opposite eye. B. immediately cover the injured eye with a sterile dressing. C. avoid irrigating the eye, as this may cause further injury. D. irrigate both eyes simultaneously, even if only one eye is injured.
A
Which of the following mechanisms of injury would MOST likely cause a crushing injury of the larynx and/or trachea? A. Attempted suicide by hanging Gunshot B. wound to the lateral neck C. Car crash involving lateral impact D. Patient whose head hits the windshield
A
Which of the following statements is NOT true regarding the treatment of bleeding from a neck injury? A. Apply firm pressure to the carotid artery to reduce the amount of bleeding. B. Apply pressure to the bleeding site using a gloved fingertip C. Apply a sterile occlusive dressing D. Use gauze to secure the dressing in place
A
Which of the following statements regarding anterior nosebleeds is correct? Select one: A. They usually originate from the septum area and bleed slowly. B. They are usually caused by a fracture of the basilar skull. C. They are usually severe and require aggressive treatment to control. D. They cause blood to drain into the posterior pharynx.
A
Which of the following statements regarding the "Adam's apple" is FALSE? A. It is inferior to the cricoid cartilage. B. It is formed by the thyroid cartilage. C. It is the uppermost part of the larynx. D. It is more prominent in men than in women
A
You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. turn the backboard onto its side. B. reassess his breathing adequacy. C. quickly suction his oropharynx. D. alert the hospital of the situation.
A
Which of the following blood vessels can be lacerated by a fractured rib?
Aorta In blunt trauma, a blow to the chest may fracture the ribs, the sternum, or whole areas of the chest wall; bruise the lungs and the heart; and even damage the aorta. Almost one-third of people who are killed immediately in car crashes die as a result of traumatic rupture of the aorta.
A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: A. leave the contact lenses in place and cover both eyes with a dry dressing. B. carefully remove the contact lenses and then irrigate his eyes with saline. C. leave the contact lenses in place and flush his eyes with sterile water. D. remove the contact lenses and cover his eyes with a dry, sterile dressing.
B
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: Select one: A. quickly immobilizing her spinal column. B. rapidly transporting her to the hospital. C. careful monitoring her vital signs. D. requesting a paramedic ambulance.
B
A black eye is frequently an indication of a fractured: A. Temporal bone. B. Maxilla. C. Occipital complex. D. Mandible.
B
A fracture involving the nasal bone and inferior maxilla, which separates the nasal bone and lower maxilla from the facial skull and remainder of the cranial bones describes: A. a Le Fort III fracture. B. a Le Fort II fracture. C. a Le Fort I fracture. D. craniofacial disjunction.
B
Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. esophageal tear B. laryngeal fracture C. collapsed trachea D. crushed cricoid
B
The AEMT should be MOST suspicious of a Le Fort fracture if a patient who experienced massive blunt force trauma to the face presents with: A. misalignment of the teeth. B. mobility of the facial bones. C. numbness of the chin. D. flattening of the cheekbones.
B
The MOST common and serious complication of a significant head injury is: a) a hypoxic seizure. b) cerebral edema. c) a skull fracture. d) acute hypotension.
B
The MOST significant complication associated with facial injuries is: Select one: A. mandibular immobility. B. airway compromise. C. cervical spine injury. D. damage to the eyes.
B
The eyes, face, and neck may be subject to a wide variety of injuries. Which of the following is true regarding these injuries? A. Because of the lack of major blood vessels, injuries to the eyes, face, and neck hemorrhage little. B. Patients with an eye, face, or neck injury may be more emotionally distraught than patients with other types of trauma. C. Because few eye, face, or neck injuries involve physical assault, scene safety is rarely a concern. D. Proper body substance isolation precautions will consist of the use of gloves only for most situations involving eye, face, or neck injuries
B
The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, thoracic, lumbar, sacral, and coccygeal. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, coccygeal, thoracic, sacral, and lumbar.
B
The head is divided into two parts: the cranium and the: A. brain B. face C. skull D. medulla oblongata
B
The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. retina. B. conjunctiva. C. sclera. D. cornea.
B
When a person is looking at an object up close, the pupils should: A. dilate. B. constrict. C. remain the same size. D. dilate, and then constrict.
B
When assessing a patient with a mandibular fracture, you would MOST likely encounter: A. pain directly over the chin. B. misalignment of the teeth. C. impaired ocular movement. D. lateral bulging of the jaw.
B
When caring for a patient with facial trauma, the EMT should be MOST concerned with A. Spinal trauma B. Airway compromise C. Associated eye injuries D. Severe external bleeding
B
When stabilizing a large foreign object in the eye, you should first cover the eye with a moist dressing, then: A. irrigate the eye with saline B. surround the object with a doughnut-shaped collar made from gauze C. apply tape around the object and then secure the tape to the forehead D. place an ice pack over the eye to reduce swelling
B
When treating a patient with damage to the facial bones, you should also have a high index of suspicion for: A. Cranial cohesion. B. Injury to the brain. C. Aphagia. D. Thoracic separation.
B
Which of the following signs is least indicative of a head injury? A. Asymmetrical pupils B. Pupillary constriction to bright light C. Both eyes moving in opposite directions D. Inability to look upward when instructed to
B
Which of the following statements regarding cervical collars is MOST correct? A. The patient's head should be forced into a neutral position to apply a cervical collar. B. A cervical collar is used in addition to, not instead of, manual immobilization. C. Once a cervical collar is applied, you can cease manual head stabilization. D. Cervical collars are contraindicated in patients with numbness to the extremities
B
Which of the following statements regarding the vitreous humor is correct? A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost. D. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost.
B
A 21-year-old male has a large laceration to his neck. When you assess him, you note that bright red blood is spurting from the left side of his neck. You should immediately: A. apply a pressure dressing to his neck. B. sit the patient up to slow the bleeding. C.place your gloved hand over the wound. D. apply 100% oxygen via nonrebreathing mask.
C
A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: A. acute retinitis. B. a detached retina. C. conjunctivitis. D. a corneal abrasion.
C
A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. use tweezers to try to remove the object. B. remove the peanut with a cotton-tipped swab. C. transport her to the emergency department. D. thoroughly flush her ear with sterile saline.
C
A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with heavy bleeding. As your partner manually stabilizes the patient's head, you should: A. administer 100% supplemental oxygen. B. stabilize the impaled glass in her eye. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye.
C
An 82-year-old man experienced a minor facial injury when he tripped and fell. He is conscious and alert and complains of slight pain to his cheekbones. His medical history includes hypertension, blood clots in his legs, hypothyroidism, and type 2 diabetes. During your assessment, it is important to remember that: A. his blood glucose level should be assessed immediately. B. patients with hypothyroidism are especially prone to falls. C. he is at an increased risk for severe posterior epistaxis. D. any patient who falls should have their spine immobilized.
C
Any injury to the _____ should automatically be assumed to have caused spinal injury. A. Head B. Back C. Neck D. Chest
C
Assessment and care guidelines for a patient with an eye injury should include: A. Bandaging only the injured eye, as the patient will be more at ease if able to see what is going on. B. Placing drops in the eye to keep it lubricated. C. Giving the patient nothing by mouth. D. Opening the eye if it is swollen shut to properly examine the globe.
C
During your initial assessment, history, and physical exam of a patient with an eye, face, or neck injury, remember to: A.Open the airway with the head-tilt/chin-lift maneuver and suction the patient's airway as needed. B. Apply high-concentration oxygen at 15 lpm by a nonrebreather mask as soon as severe bleeding is controlled. C. Establish manual in-line stabilization of the head and neck on first contact with the patient. D. Conduct a focused trauma assessment of the injury site if the mechanism of injury is significant.
C
For injuries to the face, emergency care includes all of the following EXCEPT: A. Wrapping an avulsed tooth in a sterile gauze pad soaked in saline. B. Providing oxygen by a nonrebreather mask at 15 lpm. C. Establishing and maintaining the patient's airway by the use of airway adjuncts. D. Establishing and maintaining in-line spinal stabilization.
C
If your patient swallows blood following facial trauma, there is an increased risk of ________. Select one: A. hypotension B. GI trauma C. vomiting D. altered LOC
C
Special considerations you should heed for injuries to the face, mouth, or jaw include: A. Establish manual in-line stabilization of the spine on first contact with the patient and maintain it until a rigid cervical collar is applied. B. Blood loss from facial injuries alone is not enough to cause signs and symptoms of shock. C. The tongue may lose its support structure with a facial injury and may fall back, requiring you to grasp the tongue and pull it forward. D. When the mandible is fractured, it is generally fractured in only one place.
C
The ______ connects the cricoid cartilage and thyroid cartilage. A. larynx B. cricoid membrane C. cricothyroid membrane D. thyroid membrane
C
The cervical spine is composed of _____ vertebrae. A. 5 B. 6 C. 7 D. 8
C
The lower jawbone is called the: A. maxillae. B. zygoma. C. mandible. D. mastoid.
C
The presence of subcutaneous emphysema following trauma to the face and throat is MOST suggestive of: A. esophageal injury. B. cervical spine fracture. C. crushing tracheal injury. D. carotid artery laceration.
C
The purpose of the eustachian tube is to: A.move in response to sound waves. B. transmit impulses from the brain to the ear. C. equalize pressure in the middle ear when external pressure changes. D. house fluid within the inner chamber of the ear and support balance.
C
The superficial temporal artery can be palpated: Select one: A. at the angle of the jaw. B. slightly above the ear. C. just anterior to the tragus. D. over the mastoid process.
C
The upper jawbones are called the: A. mastoid. B. mandible. C. maxillae. D. zygoma.
C
When caring for a patient with an open facial injury, the AEMT must: A. consider the mechanism of injury. B. manually stabilize the patient's head. C. wear gloves and facial protection. D. closely assess the patient's airway.
C
When caring for a patient with an open facial injury, the EMT's immediate priority should be to: Select one: A. manually stabilize the patient's head. B. closely assess the patient's airway. C. wear gloves and facial protection. D. consider the mechanism of injury.
C
When flushing an eye with saline to remove a foreign object, it is important to remember to: A. flush from the outside of the eye in toward the nose B. flush from the top of the eye in toward the nose C. flush from the nose side of the eye toward the outside D. flush only along the bottom of the eye
C
When performing a full body scan, you should assess for ________. Select one: A. AVPU B. OPQRST C. DCAP-BTLS D. SAMPLE
C
When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: Select one: A. it saves time on repeat assessments at the hospital. B. most patients with facial trauma will need surgery. C. they may need to call a specialist to see the patient. D. they must make arrangements for an ICU bed.
C
Which of the following findings is LEAST suggestive of a head injury? A. One pupil larger in size than the other pupil B. Failure of the eyes to move in the same direction C. Briskly constricting pupils when exposed to light D. Failure of the eyes to follow movement of an object
C
Which of the following is NOT a sign of a possible facial fracture? A. Bleeding in the mouth B. Absent or loose teeth C. Bleeding from the forehead D. Loose and/or moveable bone fragments
C
Which of the following is the MOST significant complication associated with facial injuries? A. Cervical spine injury B. External hemorrhage C. Airway compromise D. Damage to the eyes
C
Which of the following statements regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. They are typically the result of local, low-energy trauma to the head.
C
You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: Select one: A. noticed the change during a meal. B. is allergic to any medications. C. has a history of eye surgeries. D. regularly sees a family physician.
C
You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: A. circumferentially wrap a dressing around his neck. B. apply direct pressure below the lacerated vessel. C. apply direct pressure above and below the wound. D. apply pressure to the closest arterial pressure point.
C
You should always use the _______ maneuver to open the airway of a patient with a suspected neck injury. A. Cross-fingers technique B. Head-tilt/chin-lift C. Jaw-thrust D. Head-tilt/neck-lift
C
Your physical exam of a patient with an eye injury should include: A. Using the AVPU mnemonic to assess any pain. B. Applying slight pressure to the globe to check for any leakage of fluid. C. Checking for crepitation in facial injuries. D. Never palpating the eye sockets or bones of the cheek, nose, or jaw, as any increase in pressure may cause additional pain or damage.
C
________ in a patient with a chest injury is a sign that the blood is not being oxygenated sufficiently.
Cyanosis Cyanosis is the classic blue or ashen gray appearance around the lips and fingernails that indicates that blood is not being oxygenated sufficiently.
A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: A. applying a gauze pad in between his lower lip and gum. B. packing the nasopharynx with moist, sterile dressings. C. placing him supine and pinching his nostrils together. D. leaning him forward and pinching his nostrils together.
D
A 30-year-old female was assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A. apply oxygen via a nonrebreathing mask. B. visualize her mouth for obvious wounds. C. begin immediate ventilatory assistance. D. suction her oropharynx for 15 seconds.
D
A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A. secure her eyes open so you can reassess her pupils. B. inspect her eyes and gently remove impaled objects. C. irrigate her eyes with water to prevent mucosal drying. D. close her eyes and cover them with a moist dressing.
D
A 58-year-old woman fell and landed face-first on a concrete sidewalk. She is conscious, but confused. Her skin is pale, cool, and clammy; her radial pulses are weak and rapid; and her blood pressure is 72/54 mm Hg. Further assessment reveals crepitus to her left cheekbone. After administering high-flow oxygen, you should: A. perform a detailed secondary assessment, immobilize her entire spine, and establish IV access. B. place her in a sitting position on the stretcher, insert a saline lock, and reassess her blood pressure. C. apply a cervical collar only, establish two large-bore IV lines, and administer 2 liters of normal saline. D. immobilize her entire spine, establish at least one large-bore IV line, and give a 20-mL/kg crystalloid bolus.
D
Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with: A. conjunctivitis. B. contact lenses. C. retinitis. D. a brain injury.
D
Approximately _____ of the nose is composed of bone. The remainder is composed of cartilage. A. nine tenths B. two thirds C. three quarters D. one third
D
As an EMT, your objective when treating patients with face and neck injuries is to: A. prevent further injury B. manage any acute airway problems C. control bleeding D. all of the above
D
Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: A. digital pressure to an adjacent pulse point. B. ice packs and elevation of the patient's head. C. pressure dressings and chemical ice packs. D. direct pressure using dry, sterile dressings.
D
Clinical findings associated with a laryngeal injury include: A. hematemesis, bulging eyes, and jugular venous distention. B. pallor, a mediastinal shift, and tracheal deviation. C. posterior neck deformity, Battle's sign, and a dry cough. D. hemoptysis, subcutaneous emphysema, and cyanosis.
D
Facial injuries must be identified and treated as soon as possible because: A. bleeding must be controlled early. B. swelling may mask hidden injuries. C. the spine may be injured as well. D. of the risk for airway problems.
D
Impaled objects that penetrate all the way through the cheek need to be removed. Steps for removal include: A. Not placing dressing material inside the mouth, as it may become an airway obstruction. B. Using one large piece of gauze to dress both the inside and outside of the wound, and securing it to the outside of the mouth. C. Pulling or pushing the object out of the cheek in the opposite direction in which it entered. D. Suctioning the mouth and throat frequently throughout transport.
D
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: A. a spinal fracture. B. nerve fiber damage. C. an ischemic stroke. D. an air embolism.
D
Significant trauma to the face should increase the AEMT's index of suspicion for a/an: A. displaced mandible. B. airway obstruction. C. basilar skull fracture. D. spinal cord injury.
D
The body systems represented in the neck include: A. Central nervous B. Musculoskeletal C. Respiratory D. All of the above
D
The globe of the eye is also called the: A.lens. B. orbit. C. retina. D. eyeball.
D
The presence of air in the soft tissues of the neck that produces a crackling sensation is called: A. the "Rice Krispy" effect B. a pnumothorax C. rales D. subcutaneous emphysema
D
The term "hyphema" is defined as: A. an acute rupture of the globe of the eye. B. inflammation of the iris, cornea, and lens. C. compression of one or both optic nerves. D. blood in the anterior chamber of the eye.
D
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: A. an appropriately sized cervical collar has been applied. B. the patient has been secured to the ambulance stretcher. C. the head has been stabilized with lateral immobilization. D. the patient has been completely secured to the backboard.
D
Which of the following is NOT a sign or symptom of a laryngeal injury? A. Hoarseness B. Difficulty breathing C. Subcutaneous emphysema D. Wheezing
D
Which of the following statements regarding scalp lacerations is correct? A. Because the scalp is highly vascular, you should always apply a tight pressure dressing to control bleeding B. Patients who take antihypertensive medications bleed more severely from scalp lacerations C. Although deep scalp lacerations bleed profusely, they are rarely associated with skull fractures D. Blood loss from a scalp laceration may result in hypovolemic shock, especially in children
D
You respond to a 68 year old man who was involved in a motor vehicle collision. He is unresponsive, and as you approach you notice he is not breathing. He was unrestrained and has massive facial injuries. When you check his airway, it is obstructed. Which of the following is NOT likely to cause an upper airway obstruction in a patient with facial trauma? A. Heavy bleeding B. Loosened teeth or dentures C. Soft-tissue swelling D. Inflamed tonsils
D
You respond to a 71 year old woman who is unresponsive. You try to get her to respond but have no success. Her airway is open, and she is breathing at a rate of 14 breaths/min. You know you can check a pulse on either side of the neck. You know that the jugular veins and several nerves run through the neck next to the trachea. What structure are you trying to locate to take a pulse? A. Hypothalamus B. Subclavian arteries C. Cricoid cartilage D. Carotid arteries
D
Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. Which of the following descriptions represents the MOST appropriate way for removing the patient from the vehicle? A. Apply a cervical collar and perform rapid extrication onto a long backboard. B. Have the patient stand up and then do a "standing take-down" onto a long backboard. C. Place the backboard on the stretcher and have the patient stand, turn, and lie down on the backboard while you maintain manual in-line stabilization of the cervical spine. D. Apply a cervical collar and short spine immobilization device before removing to a long backboard.
D
You are assessing a patient who sustained a blunt force chest injury during a motorcycle accident. There are no obvious signs of external bleeding, but the patient is hypovolemic and there are decreased breath sounds on the left side. Which of the following should you suspect?
Hemothorax The MOI and signs point to a hemothorax (bleeding in the pleural space).
When a patient sustains a spinal cord injury above the C3 region, which of the following is likely to happen?
Loss of the ability to breathe due to loss of ability of phrenic nerves to function
What are the two most common injuries caused by penetrating chest trauma?
Open pneumothorax and cardiac tamponade are the two common injuries caused by penetrating chest trauma
Which of the following are you likely to see in flail chest?
Paradoxical motion Paradoxical motion is a sign of flail chest. The detached portion of the chest wall moves opposite of normal: It moves in instead of out during inhalation and out instead of in during exhalation.
You are treating a patient who fell hard on her right side when she fell off a bike. Exposure of the patient's chest reveals a large bruise on the lateral aspect of the right side of the chest. When you palpate the area, the patient yells out in extreme pain and states that she cannot take a deep breath. What condition should you suspect?
Rib Fracture Rib fractures are common in this type of injury. The pain is the result of broken ends of the fracture rubbing against each other with each inspiration and expiration.
What is the best position in which to place a patient when you want to assess for jugular vein distention?
Sitting at a 45-degree angle
A patient is involved in an altercation and was struck in the ribs with a baseball bat. Your assessment reveals intact skin with significant bruising to the right lateral chest. When palpating this area, you note instability and crepitus to the rib cage. The patient is also complaining of difficulty breathing. The EMT would recognize: Select one: a. chest injury caused by blunt trauma. b. pulmonary injury caused by penetrating trauma. c. thoracic injury secondary to penetrating trauma. d. chest wall injury cause by acceleration forces.
a.
A young female wears her lap belt low, over her upper thighs, because the belt is uncomfortable when worn properly. If involved in a head-on "up and over" type collision, to what injury is she most prone, given the position of her lap belt? Select one: a. Dislocated hips b. Internal abdominal injury c. Bilateral arm fractures d. Tibia-fibula fractures
a.
An 8-year-old boy fell forward off of a swing onto outstretched arms. He did not hit his head or lose consciousness and is complaining of left forearm pain. There is deformity to the left wrist, but no other injuries or life threats. His vital signs are pulse 132, respirations 20, blood pressure 108/62, and SpO2 100%. The proper care of this patient would be: Select one: a. splint the forearm and apply a cold pack before transporting non-emergently. b. immediately load and transport, splinting the injury en-route. c. call ALS so that the patient can be given intravenous pain medications before splinting the forearm. d. apply high-flow oxygen, anatomically splint the forearm when the patient is immobilized to a long backboard.
a.
As part of your service to the community, you are certified as a car seat specialist and provide monthly classes on the safe transport of infants and children. Several cars have pulled into your station and asked you to look at their car seats. Which of the following car seat positions would indicate that the parent is safely transporting his or her infant (less than one year old)? Select one: a. Facing backward in the back seat in an upright position b. Facing backward in an upright position in the front seat c. Facing forward in the back seat in a reclined position d. Facing backward in the back seat in a reclined position
a.
Which of the following statements concerning trauma is true? Select one: a. Multi-system trauma has a higher mortality rate than single-system injuries. b. Mechanism of injury is the best predictor of patient outcome. c. A "spider web" or "star" pattern of cracks on the windshield means the patient impacted the windshield with his head. d. Falls are the leading cause of trauma deaths.
a.
A male patient has sustained gunshot wounds to the neck and abdomen. He is unresponsive and has gurgling respirations. Your immediate action would be to: Select one: a. immobilize the spine. b. suction the airway. c. insert a nasal airway. d. obtain vital signs.
b.
During an in-service focusing on care of the trauma patient, the medical director asks if anyone can correctly describe the "platinum 10 minutes." Which of the following indicates the best response? Select one: a. "If the transport to a trauma center is going to exceed 10 minutes, EMS should strongly consider the use of an aeromedical helicopter." b. "EMS should initiate transport of the critically injured trauma patient to the hospital within 10 minutes of arriving on scene." c. "EMS should spend a total of 10 minutes assessing the patient for life-threatening injuries prior to initiating transport to a trauma center." d. "EMS systems should be designed so that it takes an ambulance no longer than 10 minutes to respond to a trauma call."
b.
Emergency Medical Responders have removed an intoxicated and confused patient from a car that struck another car at a high rate of speed. The patient was unrestrained and his car did not have airbags. Assessment reveals deformity bilaterally to the hips and femurs and bruising to the knees. Based on this injury pattern, the EMT would recognize what type of injury mechanism? Select one: a. High velocity b. Down and under c. Up and over d. Lateral impact
b.
You are assessing a male patient who was stabbed three times in the chest and abdomen. As you begin your primary assessment, you note him to have a decreased level of consciousness and gurgling respirations. Your next action would be to: Select one: a. check his pulse. b. suction the airway. c. obtain a SpO2 reading. d. apply a cervical collar.
b.
You are assessing a patient involved in a motorcycle accident. He states that he saw an oncoming car and "laid the bike down" to avoid an outright collision. He was wearing a helmet. Which of the following injuries would make sense given the action of the motorcyclist? Select one: a. Bilateral broken forearms b. Burn to the inside of the leg c. "Road rash" to the entire body d. Angulation to both femurs
b.
You are hosting a discussion on injury prevention when a participant asks you if you believe that helmets for motorcyclists will truly make a difference. You would respond by saying: Select one: a. "Helmets have been shown to prevent motorcycle accidents." b. "Motorcycle helmets decrease the risk of death when involved in a collision." c. "Wearing a helmet decreases the chance of being ejected from a motorcycle." d. "A motorcycle helmet decreases the chance of permanent spinal injury."
b.
A car has been hit head-on by another vehicle at a moderate rate of speed. Seatbelts were in place and the airbags deployed. The patient is complaining of chest pain. Quick observation reveals a bruise to his sternum. The EMT would immediately: Select one: a. deflate the airbag to get breath sounds. b. check the windshield for starring. c. lift the airbag and check the steering wheel. d. suspect an injury related to the airbag.
c.
A teenage female patient has been ejected from a car as it rolled down a hill. She is responsive, but with signs of early shock. She has bruising to her anterior abdomen, a laceration to her left temple, and deformity to he left wrist. At what point should the wrist injury be splinted? Select one: a. Prior to immobilizing the patient b. Just before leaving the scene c. En-route to the hospital d. Before transferring to the stretcher
c.
An unrestrained driver of a car that has struck a tree at 45 mph has suffered a contusion (bruise) to his heart. The EMT would recognize that this injury occurred during which impact of the collision? Select one: a. Vehicle collision b. Physiologic collision c. Organ collision d. Body collision
c.
The EMT understands the importance of evaluating the mechanism of injury when he states: Select one: a. "The mechanism of injury is a useful tool in determining if the patient's outcome will be good or bad." b. "Evaluating the mechanism of injury is important since it determines whether emergency transport to the hospital is needed." c. "The mechanism of injury can be used to guide your assessment and treatment of the patient." d. "The mechanism of injury is useful in determining the exact injuries the patient has sustained."
c.
A bullet fired from a gun at close range passes through the patient's liver. However, on autopsy, the coroner discovers that the man's pancreas, stomach, and gall bladder were also injured, even though not in direct contact with the bullet. As a knowledgeable EMT, you would recognize that which of the following is responsible for injury to these additional organs? Select one: a. Blunt injury b. Profile impact c. Drag force d. Cavitation
d.
As you pull up to a motor vehicle collision, you quickly scan the scene for clues as to the type and severity of injuries. Which of the following scene clues would best indicate that a patient may have a head injury? Select one: a. Frontal-type collision b. Blood on a patient's clothing c. Airbag deployment d. Starring of a windshield
d.
Assessment of a patient involved in a motor vehicle accident reveals him to have crepitus to the left humerus, instability to the left lateral chest wall and flank, and pain on palpation to left hip region. He also complains of pain to the right side of the neck. Based on this injury pattern, the EMT would recognize the patient was: Select one: a. an unrestrained driver involved in a head-on collision. b. the passenger in a car hit from behind. c. an unrestrained occupant in a car struck from the side. d. the driver of a car hit on the driver's side.
d.
What piece of information would you provide to a group of older drivers with musculoskeletal problems to decrease their chance of suffering a "whiplash" type injury? Select one: a. Position the car seats in a full upright position. b. Properly wear seatbelts with a headrest in the down position. c. Consider purchasing a car with side door airbags. d. Ensure that the head rest is properly positioned.
d.
Which of the following is a high-velocity wounds that carries the greatest risk for death when considering the concept of cavitation? Select one: a. Stab wound to the liver b. Shotgun wound to the lung c. Gunshot wound to the stomach d. Gunshot wound to the spleen
d.
In which condition is it recommended you use positive-pressure ventilation?
flail chest
You are assessing a patient and notice he has a collapsed jugular vein. What does this indicate?
hemothorax or shock.
What is ventilation?
the body's ability to move air in and out of the chest and lung tissue.