EMT Chapter 31-32

Femoral shaft fractures can result in up to ______mL of internal blood loss. A. 2,000 B. 4,000 C. 1,500 D. 1,000

1,000

There is often a significant amount of blood loss, as much as 500 to ______ mL, after a fracture of the shaft of the femur. (pg. 1127)

1,000

Most heatstroke cases occur when the temperature is around _____ F and the humidity is 80%.

80 degrees

Hypothermia occurs when the core temperature falls below: A. 88 F (31 C) B. 90 F (32 C) C. 95 F (35 C) D. 98 F (37 C)

95 F (35 C)

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: A. A relatively small surface area. B. A smaller overall muscle mass. C. A smaller amount of body fat. D. A decreased ability to shiver.

A relatively small surface area.

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the: A. Chest B. Neck C. Forehead D. Abdomen

Abdomen

The MOST prominent symptom of decompression sickness is: A. Tightness in the chest. B. Difficulty with vision. C. Abdominal or joint pain. D. Dizziness and nausea.

Abdominal or joint pain.

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: A. Carefully straighten the injured arm and secure it with padded board splints. B. Apply gentle manual traction in line with the limb and reassess for a pulse. C. Splint the elbow in the position of deformity and transport immediately. D. Make two or three attempts to restore distal circulation by manipulating the elbow.

Apply gentle manual traction in line with the limb and reassess for a pulse.

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. Area of obvious deformity over the site of impact. B. Part of the body that sustained secondary injury. C. Area of soft-tissue damage surrounding the injury. D. Exact part of the bone or joint that was disrupted. (pg. 1092)

Area of soft-tissue damage surrounding the injury.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: A. Gently attempt to move his arm toward his body. B. Assess distal pulse, motor, and sensory functions. C. Flex his arm at the elbow and then apply a sling. D. Place a pillow under his arm and apply a swathe.

Assess distal pulse, motor, and sensory functions.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: A. Open his airway and give two rescue breaths. B. Apply chemical heat packs to his groin and axillae. C. Assess for a carotid pulse for up to 60 seconds. D. Apply and AED and asses his cardiac rhythm.

Assess for a carotid pulse for up to 60 seconds

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:

Assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

Blood is shunted away from the extremities to the body's core.

The musculoskeletal system refers to the: A. Nervous system's control over the muscles. B. Bones and voluntary muscle of the body. C. Involuntary muscles of the nervous system. D. Connective tissue that supports the skeleton. (pg. 1087)

Bones and voluntary muscle of the body.

The organs most severely affected by air embolism are the: A. Brain and lungs. B. Brain and heart. C. Brain and spinal cord. D. Heart and lungs.

Brain and spinal cord.

A fracture is MOST accurately defined as a(n): A. Abnormality in the structure of a bone. B. Total loss of function in a bone. C. Disruption in the midshaft of a bone. D. Break in the continuity of the bone. (pg. 1093)

Break in the continuity of the bone.

Which of the following statements regarding compartment syndrome is correct? A. In most cases, compartment syndrome develops within a few minutes after an injury. B. Compartment syndrome typically develops within 6 to 12 hours after injury. C. Compartment syndrome occurs because of increased pressure within the bone cavity. D. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

Compartment syndrome typically develops within 6 to 12 hours after injury.

When a warm hand is immersed in water that is 70 F (21C), heat is transferred from the hand to the water through a process called: A. Convection B. Evaporation C. Radiation D. Conduction

Conduction

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should: A. Gently manipulate the injured leg until the numbness dissipates. B. Control the bleeding and cover the wound with a sterile dressing. C. Assess distal pulses as well as sensory and motor functions. D. Manually stabilize the leg above and below the site of injury. (pg. 1103)

Control the bleeding and cover the wound with a sterile dressing.

Drowning is MOST accurately defined as: A. Water in the lungs following submersion in water. B. Temporary survival after submersion in water. C. Death from suffocation after submersion in water. D. Death beyond 24 hours after submersion in water.

Death from suffocation after submersion in water.

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. Severe strain B. Hairline fracture C. Displaced fracture D. Moderate sprain (pg. 1093)

Displaced fracture

Which of the following medications increases a person's risk of a heat-related emergency? A. Tylenol B. Diuretics C. Motrin D. Aspirin

Diuretics

A(n) ____ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities.

Epiphyseal

High humidity reduces the body's ability to lose heat through: A. Conduction B. Convection C. Evaporation D. Radiation

Evaporation

The body's natural cooling mechanism, in which sweat is converted to a gas, is called: A. Convection B. Radiation C. Evaporation D. Conduction

Evaporation

All of the following terms refer to a body part that is cold but not frozen, EXCEPT: A. Immersion foot B. Trench foot C. Frostbite D. Frostnip

Frostbite

_____________ is the least common but most serious illness caused by heat exposure, occurring when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed.

Heat stroke

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia? A. Head injury B. Severe infection C. Hyperglycemia D. Spinal cord injury

Hyperglycemia

In which of the following situations should the EMT splint an injured limb in the position of deformity? A. If transport time to the hospital is greater than 20 to 30 minutes. B. When distal circulation and neurological functions are absent. C. If a traction splint will be used to immobilize the injured extremity. D. If resistance is encountered or the patient experiences severe pain. (pg. 1105)

If resistance is encountered or the patient experiences severe pain.

Which of the following statements regarding striated muscle is correct? A. It forms the major muscle mass of the body and usually crosses at least one joint. B. Most of the body's striated muscle is found within the walls of the blood vessels. C. Striated muscle is involuntary because you have no conscious control over it. D. Striated muscle tissue is attached directly to the bones by tough bands of cartilage.

It forms the major muscle mass of the body and usually crosses at least one joint.

Which of the following statements regarding the brown recluse spider is NOT true? A. Bites rarely cause systemic signs and symptoms. B. Its venom is not neurotoxic. C. It is larger than the black widow spider. D. It lives mostly in the southern and central parts of the country.

It is larger than the black widow spider.

Which of the following statements about compartment syndrome is NOT true? A. It is characterized by pain that is out of proportion to the injury. B. It most commonly occurs with a fractured femur. C. It occurs 6 to 12 hours after injury. D. It is usually a result of excessive bleeding, a severely crushed extremity, or the rapid return of blood to an ischemic limb. (pg. 1132)

It most commonly occurs with a fractured femur.

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should: A. flex her knee slightly more and assess for distal circulation. B. make one attempt to return the patella to its normal position. C. keep her knee flexed and secure it with padded board splints. D. gently straighten her knee and apply a padded board splint. (pg. 1129)

Keep her knee flexed and secure it with padded board splints.

Care for a patient with a fractured tibia and suspected compartment syndrome includes:

Keeping the leg at the level of the heart.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should: A. administer one tube of oral glucose and reassess his mental status. B. load him into the ambulance and begin rapid cooling interventions. C. place him in a sitting position and have him drink 1L of water. D. perform a head-to-toe assessment and look for signs of trauma.

Load him into the ambulance and begin rapid cooling interventions.

Which of the following is an early sign of pit viper envenomation? A. Signs and symptoms of hypoperfusion B. General weakness and diaphoresis C. Local swelling and ecchymosis D. Syncope and bleeding at distal sites

Local swelling and ecchymosis

Atrophy is a condition that occurs when:

Muscle decreases in size and function.

The venom of a black widow spider is toxic to the: A. Nervous system B. Respiratory system C. Renal system D. Cardiovascular system

Nervous system

Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following, EXCEPT: A. Normal vital signs. B. Dizziness, weakness, or faintness. C. Cold, clammy skin with ashen pallor. D. Normal thirst.

Normal thirst.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. Nondisplaced long bone fractures B. An amputated extremity C. Pelvic fracture with hypotension D. Bilateral femur fractures

Pelvic fracture with hypotension

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: A. Bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher. B. Manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. C. Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. D. Carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg.

Place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

The EMT must assume that any unwitnessed water-related incident is accompanied by: A. alcohol intoxication. B. an air embolism. C. possible spinal injury. D. cold-water immersion.

Possible spinal injury.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:

Posterior hip dislocation

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: A. Administer oxygen via a nonrebreather mask. B. Protect the affected part from further injury. C. Rewarm his foot in 102F to 104F (38.9C to 40C) water. D. Cover his foot with chemical heat compresses.

Protect the affected part from further injury.

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely: A. Secondary to decreased perfusion in the extremities. B. Accurate because he has signs of respiratory failure. C. Accurate because shivering affects hemoglobin binding. D. A direct reflection of his increased respiratory rate.

Secondary to decreased perfusion in the extremities.

Signs and symptoms of severe systemic hypothermia include all of the following, EXCEPT: A. Weak pulse B. Very slow respirations C. Shivering D. Coma

Shivering

Which of the following joints allows no motion? A. Sacroiliac joint B. Skull sutures C. Sternoclavicular joint D. Shoulder joint

Skull sutures

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should: A. Assess for a carotid pulse and assist her ventilations. B. Apply manual stabilization to both of her femurs. C. Stabilize her head and perform a primary assessment. D. Administer oxygen and perform a rapid assessment. (pg. 1099-1100)

Stabilize her head and perform a primary assessment.

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should: A. Log roll the patient onto a long backboard and transport at once. B. Stabilize the pelvis with a pelvic binder and protect the spine. C. Perform a focused physical exam with emphasis not he pelvis. D. Defer spinal immobilization and transport to a trauma center. (pg. 1114-1115)

Stabilize the pelvis with a pelvic binder and protect the spine.

You and your partner are preparing to apply a traction splint to a patient's deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should: A. Stop and splint the leg in the deformed position. B. Assess distal pulses and continue pulling traction. C. Flex the knee and place a pillow under the thigh. D. Gently massage the thigh muscles to relax them.

Stop and splint the leg in the deformed position.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

Suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for pneumothorax, and contact medical control regarding transport to a recompression facility.

Burns associated with lightning strikes are typically: A. Superficial B. Partial-thickness C. Full-thickness D. third-degree

Superficial

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: A. Elevating the lower extremities and giving antivenin. B. Transporting only with close, continuous monitoring. C. Supine positioning, splinting the leg, and transporting. D. Applying ice to the wound and transporting quickly.

Supine positioning, splinting the leg, and transporting

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

Tachycardia

Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called: A. Fascia B. Cartilage C. Ligaments D. Tendons

Tendons

Which of the following MOST accurately describes hyperthermia? A. The body eliminates more heat than it can generate. B. The body is exposed to more heat than it can lose. C. Heat evaporates a significant amount of body water. D. The core body temperature exceeds 99.5F (37C).

The body is exposed to more heat than it can lose.

Heat stroke occurs when: A. the ambient temperature exceeds 90F (32C) and the humidity is high. B. a person's core body temperature rises above 103F (39C). C. the body's heat-eliminating mechanisms are overwhelmed. D. a person becomes dehydrated secondary to excess water loss.

The body's heat-eliminating mechanisms are overwhelmed.

An air embolism associated with diving occurs when:

The diver holds his or her breath during a rapid ascent.

An open fracture is MOST accurately defined as a fracture in which: A. The overlying skin is no longer intact. B. A large laceration overlies the fracture. C. Bone ends protrude through the skin. D. A bullet shatters the underlying bone. (pg. 1093)

The overlying skin is no longer intact.

In general, musculoskeletal injuries should be splinted BEFORE moving the patient unless: A. the patient is in severe pain. B. the patient is clinically unstable. C. deformity and swelling are present. D. transport time is less than 15 minutes.

The patient is clinically unstable.

Most of the serious injuries associated with scuba diving are caused by: A. too rapid of a descent. B. cold water temperature. C. too rapid of an ascent. D. alcohol consumption.

Too rapid of an ascent.

Heat loss from the body through respiration occurs when:

Warm air is exhaled into the atmosphere.

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: A. apply high-flow oxygen, perform a detailed secondary assessment, and transport. B. Focus your assessment on his scapulae and clavicles and apply high-flow oxygen. C. apply high-flow oxygen, consider spinal precautions, and transport without delay. D. hyperventilate him with a BVM and monitor his oxygen saturation.

apply high-flow oxygen, consider spinal precautions, and transport without delay.

In moving joints, the ends of the bones are covered with: A. muscular fascia B. articular cartilage C. synovial tendons D. gliding cartilage

articular cartilage

Bone marrow produces: A. electrolytes B. lymphocytes C. blood cells D. cartilage

blood cells

The bones in the skeleton produce __________ in the bone marrow. (pg. 1091)

blood cells

In contrast to Lyme disease, Rocky Mountain spotted fever: A. presents with flu-like symptoms and a bull's-eye rash. B. can cause paralysis and cardiorespiratory collapse. C. may be confused with rheumatoid arthritis. D. causes painful joint swelling after a few days or weeks.

can cause paralysis and cardiorespiratory collapse.

When caring for a patient with a possible fracture of the scapula, the EMT should: A. assume that minimal force was applied to the back. B. recognize that scapular fractures are life threatening. C. apply rigid board splints across the chest and back. D. carefully assess the patient for breathing problems.

carefully assess the patient for breathing problems.

The ________ is one of the most commonly fractured bones in the body. (pg. 1115)

clavicle

Never assume that a(n) __________ , pulseless patient is dead.

cold

A grating or grinding sensation known as ___________ can be felt, and sometimes even heard, when fractured bone ends rub together. (pg. 1095)

crepitus

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. point tenderness B. ecchymosis C. deformity D. swelling

deformity

The MOST significant hazard associated with splinting is: A. aggravation of the injury or worsened pain. B. delaying transport of a critically injured patient. C. reduction in circulation distal to the injury site. D. compression of nerves, tissues, and vasculature. (pg. 1115)

delaying transport of a critically injured patient.

A supracondylar or intercondylar fracture is also known as a fracture of the: A. proximal radius B. olecranon process C. distal humerus D. radial head (pg. 1118)

distal humerus

A Colles fracture involves a fracture of the: A. distal ulna B. proximal radius C. radius and ulna D. distal radius

distal radius

Signs and symptoms of a dislocated joint include of the following, EXCEPT: A. marked deformity B. tenderness on palpation C. ecchymosis D. locked joint (pg. 1096)

ecchymosis

Traction splints are used primarily to immobilize and secure fractures of the: A. humerus. B. femur. C. pelvis. D. hip.

femur.

Blood in the urine is known as: A. hemotysis B. hemoglobin C. hematocrit D. hematuria (pg. 1125)

hematuria

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A. headache. B. nausea. C. hot, dry skin. D. tachycardia.

hot, dry skin.

When splinting an injury of the wrist, the hand should be placed: A. in an extended position. B. into a fist. C. in a funcional position. D. in a straight position.

in a funcional position.

Improperly applying a splint can cause all of the following, EXCEPT: A. compression of nerves, tissues, and blood vessels. B. aggravation of the distal circulation. C. increase of distal circulation if the splint is too tight. D. delay in transport of a patient with a life-threatening injury. (pg. 1115)

increase of distal circulation if the splint is too tight.

The rate and amount of heat loss by the body can be modified by all of the following, EXCEPT: A. increasing heat production B. wearing insulated clothing C. moving to an area where heat loss is decreased D. increasing fluid intake

increasing fluid intake

In contrast to the brown recluse spider, the black widow spider: A. has a bite that is typically painless until a blister develops. B. is larger and has a red-orange hourglass mark on its abdomen. C. has a bite that usually produces local pain but no systemic signs or symptoms. D. is very small and has a violin-shaped marking on its back.

is larger and has a red-orange hourglass mark on its abdomen.

In order for sweating to be an effective cooling mechanism: A. the relative humidity must be above 90%. B. several layers of clothing must be worn. C. it must be able to evaporate from the body. D. the body must produce at least 1L per hour.

it must be able to evaporate from the body.

Because of local tenderness and swelling, it is easy to confuse a nondisplaced or minimally displaced fracture of the knee with a: A. fracture-dislocation B. ligament injury C. tendon injury D. dislocation (pg. 1128)

ligament injury

The MOST common and significant complication associated with fractures or dislocations of the knee is: A. internal bleeding and shock. B. ligament and cartilage damage. C. total depletion of synovial fluid. D. neuromuscular compromise.

neuromuscular compromise

Crepitus and false motion are: A. positive indicators of a fracture. B. only seen with open fractures. C. most common with dislocations. D. indicators of a severe sprain. (pg. 1095)

positive indicators of a fracture.

A "hip" fracture is actually a fracture of the: A. pubic symphysis B. femoral shaft C. proximal femur D. pelvic girdle (pg. 1126)

proximal femur

In the United States, the most common form of pit viper is the ___________.

rattlesnake

Treatment of drowning or near drowning begins with: A. opening the airway. B. rescue and removal from the water. C. suctioning the lungs to remove the water. D. ventilation with 100% oxygen via bag-mask device.

rescue and removal from the water.

Involuntary muscle is also known as:

smooth muscle.

Skeletal muscle is also known as:

striated muscle.

The two MOST efficient ways for the body to eliminate excess heat are: A. perspiration and tachycardia. B. sweating and vasodilation. C. respiration and bradycardia. D. hyperventilation and tachycardia.

sweating and vasodilation.

Joints are bathed and lubricated by _________ fluid. (pg. 1091)

synovial