EMT chapters 26-30
The mastoid process is located approximately:
1 inch posterior to the external opening of the ear.
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, the patient has burns that cover__________of his BSA.
18%
A patient with a head injury presents with abnormal flexion of his extremities. What numeric value you assign to him for motor response?
3
Which of the following interventions may be used to help reduce intracranial pressure?
30-degree elevation of the head
Common signs and symptoms of a serious head injury include all of the following, EXCEPT:
A rapid, thready pulse
Which of the following open soft-tissue injuries is limited to the superfical layer of the skin and results in the least amount of blood loss?
Abrasion
A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:
Administer high-flow oxygen
When immobilizing a seated patient with a short back board or vest-style immobilization device, you should apply a cervical collar:
After assessing distal neurovuscular functions.
A 37-year-old male was pinned between a flatbed truck and a loading dock on exam, you find bruising on the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:
Aggressively manage his airway
Which of the following is a severe burn in a 2-year-old child?
Any full-thickness burn, regardless of its location on the body.
Which of the following is most likely to cause immediate death?
Aortic rupture
A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should:
Apply an occlusive dressing to the wound and continue your assessment.
A short backboard or a vest-style immobilization device is indicated for patients who:
Are in a sitting position and are clinically stable.
During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should:
Assist ventilations with a bag-valve mask.
A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:
Begin CPR and apply the AED
Which of the following sets of vital signs depicts cushing triad?
Blood pressure, 190/110 mm Hg; Pulse, 55 beats/min; respirations, 30 breaths/min
The central nervous system (CNS) is composed of the:
Brain and spinal cord
The phrenic nerves the diaphragm and exit the spinal cord at:
C3, C4, and C5
The_________contain(s) about 75% of the brain's total volume.
Cerebrum
Which of the following is severe burn in a 35-year-old patient?
Circumferential partial thickness burn to the chest.
A 39-year-old female experienced a severe closed head injury. She is unresponsive 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:
Close her eyes and over them with a moist dressing.
Rapid deceleration to the head, such as when it impacts the windshield, causes:
Compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.
Which of the following statements regarding crush syndrome is correct?
Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.
Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another:
Connecting
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life threatening injures, how you should care fo his wounds?
Cover it with moist, sterile gauze and secure with an occlusive dressing.
When performing a full body scan, you should assess for_____
DCAP-BTLS
The MOST reliable sign of a head injury is:
Decreased level of consciousness
Which of the following areas of the body has the thinnest skin?
Ears
Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?
Engorged jugular veins
Which of the following statements regarding electrical burns is correct?
Entrance wounds are small relative to the amount of internal tissue damage.
Which of the following head injures would cause the patient's condition to deteriorate MOST rapidly?
Epidural hematoma
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:
Fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
In a patient with a head injury, hypertension, bradycardia, and Biot respirations indicate:
Herniation of the brain stem
Which of the following statements regarding secondary brain injury is correct?
Hypoxia and hypotension are the two most common causes of secondary brain injury
You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:
Immediately request ALS support
A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and his stable vital signs. You should:
Immobilize his spine and perform a focused secondary exam.
Compression injury is most likely due to which of the following?
Improperly placed lab belt
Which of the following is true injury to the kidneys?
Injury to the kidneys usually indicates injury to other organs.
Which of the following breathing patterns is MOST indicative of increased intracranial pressure?
Irregular rate, pattern, and volume of breathing with intermittent periods of apnea
Which of the following statements regarding the vitreous humor is correct?
It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.
Which of the following is of LEAST important when initially assessing the severity of a burn?
Known drug allergies
In pediatric patients, the liver and spleen are__________
Larger in proportion to the abdomen
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the:
Liver
Which of the following organs would MOST likely bleed profusely when injured?
Liver
Which of the following organs or structures does NOT reside within the mediastinum?
Lungs
In which of the following situations would the EMT be the LEAST likely to immobilize a patient's spine?
No distracting injuries or evidence of intoxication
When should you visually, inspect the external genitalia on your patient?
Only when there is a complaint of severe pain or other injury.
A spinal cord injury at the level of C7 would MOST likely result in:
Paralysis of the intercostal muscles
Which of the following is a severe burn in a 65-year-old patient?
Partial-thickness burn to 20% of the BSA
You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia and is developing cyanosis. You should:
Partially remove the dressing
Burns to pediatric patients are generally considered more serious than burns to adults because:
Pediatric patients have more surface area relative to total body mass.
A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should:
Prepare for immediate transport
In which of the following patients should you remove an impaled object?
Pulseless and apneic patient with a knife impaled in the back.
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and s lying unresponsive on the ground; the power line is lying across his chest. You should:
Rapidly assess the patient after ensuring that the power line is not live.
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
Rupture of the tympanic membrane following diffuse impact to the head.
Which of the following nerves carry information from the body to the brain via the spinal cord?
Sensory
Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would MOST likely cause an injury to the liver or spleen to be overlooked?
Shoulder fracture
During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct?
The 39-year-old female is at high risk for an infection.
Which of the following statements regarding a basilar skull fracture is correct?
The absence of a raccoon eyes or battle sign does not rule it out.
Which of the following statements regarding the rule of nines is correct?
The anterior trunk of an adult is equal to 18% of the BSA.
Which of the following statements regarding the dermis is correct?
The dermis contains hair follicles, sweat glands, and nerve endings.
Which of the following processes occurs during the inflammation phase of the healing process?
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
Which of the following statements regarding abdominal eviscerations is correct?
The protruding organs should be kept warm and moist.
Which of the following statements regarding motor nerves is correct?
They carry information from the CNS to the muscles.
Which of the following statements regarding nosebleeds is correct?
They usually originate from the septum area and bleed slowly.
A female patient with a suspected head injury has slow, shallow breathing. The MOST appropriate treatment for her includes:
Ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.
The sebaceous glands produce sebum, a material that:
Waterproofs the skin and keeps it supple.
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:
a blowout fracture
A patient who is complaining of seeing flashing lights, specks, or "floater" in his or her filed of vision has MOST likely experienced:
a detached retina
You should suspect a kidney injury anytime the patient presents with _______.
a hematoma in the flank region
The mesentery is:
a membranous fold that attaches the intestines to the walls of the body
An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is:
a rapid deterioration of neurologic signs
A flail chest occurs when:
a segment of the chest wall is detached from the thoracic cage.
A reflex arc occurs when:
a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.
The cerebrospinal fluid (CSF) that circulates in between each meningeal layer:
acts as a shock absorber for the brain and spinal cord.
While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should:
administer oxygen and transport to the hospital
An open pneumothorax occurs when:
air enters the pleural space from outside the body.
The MOST significant complication associated with facial injures is:
airway compromise
In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is:
an air embolism
A 54-year-old male experienced and avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants to remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for his patient includes:
applying direct pressure with a dry, sterile dressing.
Injuries to the external male genitalia___________
are rarely life threatening
You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should:
assess distal circulation and readjust the bandage as needed.
After your partner assumes manual in-line stabilization of the patient's head, you should:
assess distal neuromuscular status in the extremities
A young female experienced a laceration to her left eyeball from lying 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 injure eye you should:
avoid applying pressure to the globe when you are covering the eye.
An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):
avulsion
A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:
axial loading
Your documentation on a sexual assault victim should _______.
be objective and factual
When worn properly, a seatbelt should lie:
below the anterior superior iliac spines of the pelvis and against the hip joints.
An epidural hematoma is MOST accurately defined as:
bleeding between the skull and dura mater.
Closed chest injures are typically caused by_____
blunt trauma
The_______is the best protected part of the CNS and controls the functions of the cardiac and respiratory systems.
brain stem
When caring for a patient whose arm is covered with a dry chemical, you should:
brush away the chemical before flushing with water.
A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n):
cerebral concussion
The MOST common and serious complication of a significant head injury is:
cerebral edema
The five sections of the spinal column, in descending order, are the:
cervical, thoracic, lumbar, sacral, and coccygeal.
You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:
closely monitor him and reassess him frequently
The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the:
conjunctiva
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:
conjunctivitis
Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:
control any external bleeding, administer oxygen, and transport at once.
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
contusion
The frontal and parietal bones of the skull are especially susceptible to:
depressed skull fractures
A partial thickness burn involves the outer layer of skin and a portion of the:
dermal layer.
Difficultly breathing and a sunken appearance of the anterior wall is MOST indicative of a ruptured:
diaphragm
The thoracic cavity is separated from the abdominal cavity by the:
diaphram
Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:
direct pressure using dry, sterile dressings.
Accumulation of blood in the abdominal cavity will MOST likely cause:
distention
The tough, fibrous outer meningeal layer is called the:
dura mater
When immobilizing a patient on a long backboard, you should:
ensure that you secure the torso before securing the head.
What layer of the skin forms a watertight, protective seal for the body?
epidermis
The hormone responsible for the actions of the sympathetic nervous system is:
epinephrine
The Glasgow Coma Scale (GSC) is used to assess:
eye opening, verbal response, and motor response.
It would be MOST appropriate to perform a focused secondary assessment on a patient who:
fainted and fell to the ground from a standing position
The eyeball itself is referred to as the:
globe
Contraction or tensing of the abdominal muscles in an effort to ease pain is called:
guarding
When a patient stiffens the muscles of the abdomen, it is known as _______.
guarding
Hyperextension injuries of the spine are MOST commonly the result of:
hangings
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:
has a history of eye surgeries
Peritonitis usually occurs when:
hollow abdominal organs are damaged and spill their contents into the peritoneal cavity.
The effectiveness of positive pressure ventilations when treating a head injured patient can ONLY be determined by:
immediate reassessment following the intervention.
Abdominal pain, vomiting, and fever are most likely due to_____
infection
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is sign of:
intra abdominal bleeding
Bleeding within the brain tissue itself is called a(n):
intracerebral hematoma
In contrast to a cerebral concussion, a cerebral contusion:
involves physical injury to the brain tissue.
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:
irrigate both eyes continuously for 20 minutes with plain water.
A laceration:
is a jagged cut caused by a sharp object or blunt force trauma.
simple pneumothorax
is commonly caused by blunt chest trauma.
The cricoid cartilage:
is the only complete circular cartilage of the trachea.
Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
it causes a problem managing the airway.
A tight-fitting motorcycle helmet should be left in place unless:
it interferes with your assessment of the airway
When a light is shone into the pupil:
it should become smaller in size.
The superficial temporal artery can be palpated:
just anterior to the tragus.
You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tacky-cardiac, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a:
laceration of the aorta
With regard to the pediatric rule of nines, the:
legs are proportionately smaller than an adult's.
All of the following body structures are lined with mucous membranes, EXCEPT for the:
lips
The lower jawbone is called the:
mandible
The upper jawbones are called the:
maxillae
Placing a pregnant patient in a supine position during the third trimester of pregnancy:
may decrease the amount of blood that returns to the heart
When a person is lying supine at the end of exhalation, the diaphragm:
may rise as high as the nipple line
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she:
must increase his or her respiratory rate to maintain adequate minute volume.
During the normal would-healing process, bleeding may occur from even a minor injury because:
new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.
As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:
open his airway and assess his breathing status.
When a person is exposed to a cold environment:
peripheral vessels constrict and divert blood away from the skin.
When a hollow organ is punctured during a penetrating injury to the abdomen:
peritonitis may not develop several hours
The__________nerves control the diaphram
phrenic
In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:
pneumothorax
Immediately life-threatening chest injuries must be found and managed during the _______.
primary assessment
Because the depth of an open abdominal wound is often difficult to determine:
prompt transport to the hospital is essential.
A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:
pulmonary contusion
When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:
pupillary constriction
A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficultly. 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:
rapidly transporting her to the hospital.
Early bruising following abdominal trauma often manifests as:
red areas of skin
When assessing a patient with a closed soft-tissue injury, it is MOST important to:
remain alert for more severe underlying injuries.
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should:
replace the avulsed flap to its original position and cover it with a sterile dressing.
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
report the incident to the appropriate authorities
A patient who presents with profound cyanosis following a chest injury:
requires prompt ventilation oxygenation
The optic nerve endings are located within the:
retina
The white portion of the eye is called the:
sclera
During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a:
shotgun
The presence of tachycardia following a significant abdominal injury:
should be assumed to be a sign of shock.
You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is:
slow
What part of the nervous system controls the body's voluntary activities?
somatic
The spinal cord is encased in and protected by the:
spinal canal
significant trauma to the face should increase the EMT's index of suspicion for a(n):
spinal column injury
All of the following are hollow abdominal organs, EXCEPT the:
spleen
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
suction his oropharynx for up to 15 seconds.
A burn that is characterized by redness and pain is classified as a:
superficial burn
Patients with chest injuries will often present with _______.
tachypnea
The ideal procedure for moving an injured patient from the ground to a backboard is:
the four-person log roll
When the parasympathetic nervous system is activated:
the heart rate decreases and the blood vessels dilate.
Elevation of the rib cage during inhalation occurs when:
the intercostal muscles contract
Patients with full-thickness (third-degree) burns generally do not complain of pain because:
the nerve endings have been destroyed
When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until:
the patient has been completely secured to the backboard.
The Adam's apple is:
the upper part of the larynx that is formed by the thyroid cartilage.
Children are often "belly breathers" because
their intercostal muscles are not developed
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:
they may need to call a specialist to see the patient.
A 4-year-old female has a peanut lodged in the external lodged in the external auditory canal of her right ear. You should:
transport her to the emergency department.
If you do not have the appropriate size cervical collar, you should:
use rolled towels to immobilize the patient's head.
Pleural fluid is contained between the:
visceral and parietal pleurae.
If your patient swallows blood following facial trauma, there is an increased risk of ________.
vomiting
When caring for a patient with an open facial injury, the EMT's immediate priority should be to:
wear gloves and facial protection
