EXT Exam #9 (ch. 29-32, 40)
Which of the following scenarios is an example of a direct injury? Question 10 options: 1) A passenger fractures her patella after it strikes the dashboard. 2) A skier dislocates his knee after a twisting injury to the ankle. 3) A person lands on his or her feet and fractures the lumbar spine. 4) A child dislocates his elbow after falling on his outstretched arm.
A passenger fractures her patella after it strikes the dashboard.
Patients with rib fractures will commonly: Question 7 options: 1) breathe rapidly and shallowly. 2) take a series of deep breaths. 3) prefer to lie in a supine position. 4) develop a sucking chest wound.
breathe rapidly and shallowly.
Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: Question 2 options: 1) aorta. 2) spleen. 3) stomach. 4) diaphragm.
diaphragm.
The thoracic cavity is separated from the abdominal cavity by the: Question 4 options: 1) diaphragm. 2) anterior rib cage. 3) intercostal margin. 4) costovertebral angle.
diaphragm.
Accumulation of blood in the abdominal cavity will MOST likely cause: Question 7 options: 1) distention. 2) referred pain. 3) diffuse bruising. 4) nausea or vomiting.
distention.
The Centennial Park bombing during the 1996 Summer Olympics is an example of: Question 1 options: 1) domestic terrorism. 2) apocalyptic violence. 3) an ecoterrorist attack. 4) state-sponsored terrorism.
domestic terrorism.
The body's natural cooling mechanism, in which sweat is converted to a gas, is called: Question 2 options: 1) radiation. 2) convection. 3) conduction. 4) evaporation.
evaporation.
Placing a pregnant patient in a supine position during the third trimester of pregnancy: Question 9 options: 1) may decrease the amount of blood that returns to the heart. 2) often causes hypotension secondary to cardiac compression. 3) results in spontaneous urinary incontinence if the bladder is full. 4) is recommended if the patient has severe abdominal discomfort.
may decrease the amount of blood that returns to the heart.
When a person is lying supine at the end of exhalation, the diaphragm: Question 1 options: 1) contracts and flattens inferiorly. 2) may rise as high as the nipple line. 3) is less prone to penetrating trauma. 4) descends below the level of the navel.
may rise as high as the nipple line.
If a person's tidal volume decreases, but his or her respiratory rate remains unchanged: Question 5 options: 1) minute volume will increase. 2) minute volume will decrease. 3) minute volume will remain unchanged. 4) excess carbon dioxide will be eliminated.
minute volume will decrease.
A frostbitten foot can be identified by the presence of: Question 7 options: 1) gross deformity. 2) soft, smooth skin. 3) mottling and blisters. 4) blanching of the skin.
mottling and blisters.
Atrophy is a condition that occurs when: Question 3 options: 1) increased use of skeletal muscle causes an increase in its strength. 2) the tendons that attach muscle to bone become stretched or injured. 3) muscle decreases in size and function because of disease or trauma. 4) carbon dioxide, lactic acid, and other wastes accumulate in the muscle.
muscle decreases in size and function because of disease or trauma.
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she: Question 6 options: 1) often breathes at a slower rate because of lung damage caused by the injury. 2) will eliminate more carbon dioxide than if he or she were breathing deeply. 3) must increase his or her respiratory rate to maintain adequate minute volume. 4) will maintain adequate minute volume if his or her respiratory rate stays the same.
must increase his or her respiratory rate to maintain adequate minute volume.
If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she: Question 8 options: 1) often breathes at a slower rate because of lung damage caused by the injury. 2) will eliminate more carbon dioxide than if he or she were breathing deeply. 3) must increase his or her respiratory rate to maintain adequate minute volume. 4) will maintain adequate minute volume if his or her respiratory rate stays the same.
must increase his or her respiratory rate to maintain adequate minute volume.
A rapid, irregular pulse following blunt trauma to the chest is MOST suggestive of a: Question 5 options: 1) ruptured aorta. 2) myocardial contusion. 3) pericardial tamponade. 4) tension pneumothorax.
myocardial contusion.
Early bruising following abdominal trauma often manifests as: Question 10 options: 1) localized pain. 2) red areas of skin. 3) gross distention. 4) dark purple marks.
red areas of skin.
A persistent or nonvolatile chemical agent can: Question 5 options: 1) evaporate quickly when left on a surface. 2) remain on a surface for more than 24 hours. 3) explode without warning and releases gases. 4) remain in the environment for many weeks.
remain on a surface for more than 24 hours.
A patient who presents with profound cyanosis following a chest injury: Question 5 options: 1) should be placed in Trendelenburg's position. 2) is most likely experiencing severe blood loss. 3) has most likely experienced a ruptured aorta. 4) requires prompt ventilation and oxygenation.
requires prompt ventilation and oxygenation.
The presence of tachycardia following a significant abdominal injury: Question 6 options: 1) is always accompanied by hypotension. 2) indicates a state of decompensated shock. 3) should be assumed to be a sign of shock. 4) is most commonly caused by severe pain.
should be assumed to be a sign of shock.
When assessing a patient with a hemothorax, you will MOST likely find: Question 9 options: 1) jugular venous engorgement. 2) ipsilateral tracheal deviation. 3) distant or muffled heart tones. 4) signs and symptoms of shock.
signs and symptoms of shock.
A 52-year-old male presents with a fever of 102.5°F and a severe headache. As you assess him, you note the presence of multiple blisters on his face and chest, which are all identical in shape and size. This patient's clinical presentation is MOST consistent with: Question 10 options: 1) smallpox. 2) sarin toxicity. 3) yellow fever virus. 4) cutaneous anthrax.
smallpox.
All of the following are hollow abdominal organs, EXCEPT the: Question 6 options: 1) spleen. 2) bladder. 3) ureters. 4) stomach.
spleen.
The phrenic nerves control the diaphragm and exit the spinal cord at: Question 8 options: 1) C1 and C2. 2) C3 and C4. 3) C1, C2, and C3. 4) C3, C4, and C5.
C3, C4, and C5.
You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration? Question 8 options: 1) A total collapse of the affected lung 2) Hidden bleeding in the thoracic cavity 3) Compression of the aorta and vena cava 4) Blood accumulation in the pleural space
Compression of the aorta and vena cava
Which of the following statements regarding abdominal eviscerations is correct? Question 2 options: 1) Most eviscerations occur to the left upper quadrant. 2) The protruding organs should be kept warm and moist. 3) The organs should be replaced carefully to avoid heat loss. 4) Adherent material is preferred when covering an evisceration.
The protruding organs should be kept warm and moist.
Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? Question 3 options: 1) Pancreas 2) Fallopian tubes 3) Urinary bladder 4) Liver or spleen
Urinary bladder
Which of the following statements regarding the persistency and volatility of a chemical agent is correct? Question 6 options: 1) Sarin, a powerful nerve agent, is nonvolatile and can remain on a surface for long periods. 2) Sulfur mustard, a vesicant agent, is generally considered to have a low level of persistence. 3) Lewisite, a vesicant agent, is nonvolatile and evaporates quickly in an optimum temperature. 4) VX, a highly persistent nerve agent, can remain in the environment for weeks to months.
VX, a highly persistent nerve agent, can remain in the environment for weeks to months.
A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred? Question 1 options: 1) Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle 2) Asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta 3) Fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia 4) Collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest
Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: Question 6 options: 1) apply full spinal motion restriction precautions. 2) keep him on his side but gently straighten his legs. 3) place him supine but allow him to keep his knees bent. 4) transport him in the position in which you found him.
transport him in the position in which you found him.
A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: Question 8 options: 1) apply full spinal motion restriction precautions. 2) keep him on his side but gently straighten his legs. 3) place him supine but allow him to keep his knees bent. 4) transport him in the position in which you found him.
transport him in the position in which you found him.
Immediate death from blunt chest trauma following a motor vehicle crash is MOST often the result of: Question 4 options: 1) a tension pneumothorax. 2) traumatic aortic rupture. 3) penetrating lung injuries. 4) a massive cardiac contusion.
traumatic aortic rupture.
The body's natural protective mechanisms against heat loss are: Question 4 options: 1) shivering and vasodilation. 2) vasodilation and respiration. 3) respiration and vasoconstriction. 4) vasoconstriction and shivering.
vasoconstriction and shivering.
Pleural fluid is contained between the: Question 4 options: 1) visceral and parietal pleurae. 2) parietal pleura and the heart. 3) visceral pleura and the lung. 4) parietal pleura and the chest wall.
visceral and parietal pleurae.
The process performed to artificially maximize the target population's exposure to a biologic agent, thereby exposing the greatest number of people and achieving the desired result, is called: Question 2 options: 1) potentiation. 2) alkalization. 3) dissemination. 4) weaponization.
weaponization.
Which of the following structures is regulated by smooth muscle? Question 4 options: 1) Heart 2) Skeleton 3) Blood vessels 4) Diaphragm
Blood vessels
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? Question 5 options: 1) Engorged jugular veins 2) Widening pulse pressure 3) Diminished breath sounds 4) A rapid, irregular pulse
Engorged jugular veins
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him? Question 4 options: 1) What does your blood pressure normally run? 2) Do you take any over-the-counter medications? 3) Has blood soaked through your undergarments? 4) Have you experienced recent abdominal trauma?
Have you experienced recent abdominal trauma?
Which of the following agents blocks the body's ability to use oxygen and possesses an odor similar to almonds? Question 8 options: 1) Hydrogen cyanide 2) Phosgene oxime 3) Organophosphates 4) Carbon monoxide
Hydrogen cyanide
Which of the following statements regarding striated muscle is correct? Question 2 options: 1) Striated muscle is involuntary because you have no conscious control over it. 2) Most of the body's striated muscle is found within the walls of the blood vessels. 3) Striated muscle tissue is attached directly to the bones by tough bands of cartilage. 4) It forms the major muscle mass of the body and usually crosses at least one joint.
It forms the major muscle mass of the body and usually crosses at least one joint.
Which of the following statements regarding rebound tenderness is correct? Question 1 options: 1) It should be assessed for by vigorously palpating the abdomen. 2) Rebound tenderness is a specific sign found with a spleen injury. 3) It is often discovered when the patient is jarred or moved suddenly. 4) The absence of rebound tenderness rules out intra-abdominal injury.
It is often discovered when the patient is jarred or moved suddenly.
Which of the following organs would MOST likely bleed profusely when injured? Question 8 options: 1) Bladder 2) Liver 3) Stomach 4) Intestine
Liver
Which of the following organs or structures does NOT reside within the mediastinum? Question 3 options: 1) Lungs 2) Trachea 3) Vena cavae 4) Esophagus
Lungs
A patient with a chest injury has a blood pressure of 100/60 mm Hg and a pulse rate of 120 beats/min. Which of the following additional findings should make you suspect a pericardial tamponade? Question 7 options: 1) The pulse becomes irregular 2) Repeat BP of 90/68 mm Hg 3) Flattening of the jugular veins 4) Unilaterally absent breath sounds
Repeat BP of 90/68 mm Hg
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? Question 4 options: 1) Femur fracture 2) Pelvic fracture 3) Shoulder fracture 4) Lumbar spine fracture
Shoulder fracture
A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. Question 9 options: 1) Strain 2) Sprain 3) Fracture 4) Dislocation
Sprain
Which of the following statements regarding abdominal trauma is correct? Question 5 options: 1) Most of the vital abdominal organs lie within the retroperitoneal space. 2) The absence of abdominal pain does not rule out intra-abdominal bleeding. 3) The liver is well protected and is rarely injured during a traumatic event. 4) Hollow abdominal organs are vascular and bleed profusely when injured.
The absence of abdominal pain does not rule out intra-abdominal bleeding.
The mesentery is: Question 2 options: 1) the point of attachment between the small and large intestines. 2) a layer of thick skeletal muscles that protects the abdominal organs. 3) a complex network of blood vessels that supply blood to the liver. 4) a membranous fold that attaches the intestines to the walls of the body.
a membranous fold that attaches the intestines to the walls of the body.
Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: Question 3 options: 1) air bag deployment. 2) failure to wear seatbelts. 3) a poorly placed lap belt. 4) rapid vehicle deceleration.
a poorly placed lap belt.
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: Question 5 options: 1) a decreased ability to shiver. 2) a relatively small surface area. 3) a smaller amount of body fat. 4) a smaller overall muscle mass.
a relatively small surface area.
A flail chest occurs when: Question 3 options: 1) a segment of the chest wall is detached from the thoracic cage. 2) more than three ribs are fractured on the same side of the chest. 3) multiple ribs are fractured on both sides of the thoracic cage. 4) a segment of fractured ribs bulges during the inhalation phase.
a segment of the chest wall is detached from the thoracic cage.
Pneumothorax is defined as: Question 2 options: 1) accumulation of air between the lungs. 2) blood collection within the lung tissue. 3) accumulation of air in the pleural space. 4) blood collection within the pleural space.
accumulation of air in the pleural space.
A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should: Question 7 options: 1) aggressively manage his airway. 2) request a paramedic ambulance. 3) perform a secondary assessment. 4) suspect a severe hemopneumothorax.
aggressively manage his airway.
An open pneumothorax occurs when: Question 1 options: 1) a fractured rib perforates the tissue of the lung. 2) air enters the pleural space from outside the body. 3) extreme pleural pressure causes the lung to rupture. 4) air enters the pleural space from a perforated lung.
air enters the pleural space from outside the body.
Subcutaneous emphysema is an indication that: Question 3 options: 1) at least half of one lung has completely collapsed. 2) your patient is experiencing a pericardial tamponade. 3) air is escaping into the chest wall from a damaged lung. 4) blood is slowly accumulating within the tissue of the lung.
air is escaping into the chest wall from a damaged lung.
A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should: Question 8 options: 1) administer high-flow oxygen to the patient. 2) remove the towel and inspect the wound. 3) apply a tourniquet just below the shoulder. 4) wrap the severed arm in a sterile dressing.
apply a tourniquet just below the shoulder.
An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should: Question 8 options: 1) open the patient's airway. 2) apply direct pressure to the wound. 3) apply oxygen via nonrebreathing mask. 4) ventilate the patient with a BVM.
apply direct pressure to the wound.
The skin lesions associated with smallpox: Question 9 options: 1) initially form on the lower trunk. 2) are of different shapes and sizes. 3) develop early during the disease. 4) are identical in their development.
are identical in their development.
A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: Question 9 options: 1) transport only if signs of shock begin to develop. 2) carefully probe the wound to determine its depth. 3) assume that the arrow injured an internal organ. 4) clean the wound and apply a dry, sterile dressing.
assume that the arrow injured an internal organ.
A fracture is MOST accurately defined as a(n): Question 7 options: 1) total loss of function in a bone. 2) break in the continuity of the bone. 3) disruption in the midshaft of a bone. 4) abnormality in the structure of a bone.
break in the continuity of the bone.
Multiple people in a small town began experiencing abdominal cramps, excessive salivation and urination, and muscle twitching shortly after a small crop duster plane made several passes over the community. As you are assessing the patients, you further determine that most of them are bradycardic and have miosis. In addition to high-flow oxygen, the MOST appropriate treatment for these patients includes: Question 7 options: 1) amyl nitrate and naloxone. 2) activated charcoal and glucose. 3) atropine and pralidoxime chloride. 4) epinephrine and hyperbaric oxygen.
atropine and pralidoxime chloride.
When documenting a call involving a female patient who was sexually assaulted, the EMT should: Question 9 options: 1) theorize as to why the sexual assault occurred. 2) include the results of his or her internal vaginal exam. 3) include a description of the suspected perpetrator. 4) avoid speculation and document only factual data.
avoid speculation and document only factual data.
A dysbarism injury refers to the signs and symptoms related to changes in: Question 1 options: 1) rapid ascent. 2) rapid descent. 3) decompression. 4) barometric pressure.
barometric pressure.
When worn properly, a seat belt should lie: Question 4 options: 1) below the anterior superior iliac spines of the pelvis and against the hip joints. 2) across the abdominal wall at the level of the diaphragm and below the hip joints. 3) above the anterior posterior iliac spines of the pelvis and below the hip joints. 4) across the abdominal wall at the level of the umbilicus and against the hip joints.
below the anterior superior iliac spines of the pelvis and against the hip joints.
Bone marrow produces: Question 5 options: 1) platelets. 2) blood cells. 3) lymphocytes. 4) electrolytes.
blood cells.
Patients with generalized hypothermia are at an increased risk of a local cold injury because: Question 6 options: 1) blood is shunted away from the extremities to the body's core. 2) peripheral vasodilation brings warm blood to the skin's surface. 3) the major muscles of the body become rigid during hypothermia. 4) the patient is usually unable to escape the cold ambient temperature.
blood is shunted away from the extremities to the body's core.
A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for: Question 2 options: 1) external genitalia injury. 2) a lacerated liver or spleen. 3) blunt injury to the kidney. 4) a ruptured urinary bladder.
blunt injury to the kidney.
The musculoskeletal system refers to the: Question 1 options: 1) bones and voluntary muscles of the body. 2) nervous system's control over the muscles. 3) connective tissue that supports the skeleton. 4) involuntary muscles of the nervous system.
bones and voluntary muscles of the body.
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: Question 3 options: 1) closely monitor him and reassess him frequently. 2) perform a comprehensive secondary assessment. 3) begin documenting the call on the patient care form. 4) forgo the hospital radio report because of his condition.
closely monitor him and reassess him frequently.
Signs and symptoms of a tension pneumothorax include all of the following, EXCEPT: Question 1 options: 1) profound cyanosis. 2) collapsed jugular veins. 3) altered mental status. 4) unilaterally absent breath sounds.
collapsed jugular veins.
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: Question 4 options: 1) visualize the vaginal area and pack the vagina with sterile dressings. 2) allow her to change her clothes and take a shower before you transport. 3) arrange for a rape crisis center representative to speak with the patient. 4) control any external bleeding, administer oxygen, and transport at once.
control any external bleeding, administer oxygen, and transport at once.
Hemoptysis is defined as: Question 7 options: 1) vomiting blood. 2) coughing up blood. 3) abnormal blood clotting. 4) blood in the pleural space.
coughing up blood.
A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should: Question 6 options: 1) cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage. 2) gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing. 3) cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket. 4) make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.
cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.
Most terrorist attacks are: Question 3 options: 1) covert. 2) impulsive. 3) unplanned. 4) nuclear attacks.
covert.
A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: Question 4 options: 1) covering him with a warm blanket. 2) giving him small sips of plain water. 3) promptly transporting to the hospital. 4) administering supplemental oxygen.
giving him small sips of plain water.
Contraction or tensing of the abdominal muscles in an effort to ease pain is called: Question 3 options: 1) flexing. 2) referring. 3) guarding. 4) withdrawing.
guarding.
A sign of kidney damage following blunt trauma is: Question 10 options: 1) hematuria. 2) hemoptysis. 3) hematemesis. 4) hematochezia.
hematuria.
Peritonitis usually occurs when: Question 2 options: 1) solid abdominal organs bleed secondary to penetrating trauma. 2) the vessels that supply the abdominal organs become inflamed. 3) bacteria or viruses invade the walls of the gastrointestinal tract. 4) hollow abdominal organs are damaged and spill their contents.
hollow abdominal organs are damaged and spill their contents.
Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: Question 10 options: 1) nausea. 2) headache. 3) tachycardia. 4) hot, dry skin.
hot, dry skin.
Shivering is a mechanism in which the body generates heat by: Question 3 options: 1) increasing the metabolic rate. 2) decreasing the use of oxygen. 3) decreasing the metabolic rate. 4) retaining excess carbon dioxide.
increasing the metabolic rate.
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: Question 7 options: 1) perform a comprehensive secondary assessment to determine why his clinical status has changed. 2) insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM. 3) reassess his vital signs and then notify the receiving hospital of the change in his clinical status. 4) suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.
insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
The MOST critical treatment for a tension pneumothorax involves: Question 3 options: 1) placing a bulky dressing over the affected side of the chest. 2) assisting the patient's breathing with increased tidal volume. 3) surgically removing the portion of the lung that is damaged. 4) inserting a needle through the rib cage into the pleural space.
inserting a needle through the rib cage into the pleural space.
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: Question 5 options: 1) a ruptured spleen. 2) a severe liver laceration. 3) intra-abdominal bleeding. 4) rupture of a hollow organ.
intra-abdominal bleeding.
A simple pneumothorax: Question 2 options: 1) is commonly caused by blunt chest trauma. 2) often has a nontraumatic cause. 3) is caused by penetrating chest trauma. 4) heals on its own without any treatment.
is commonly caused by blunt chest trauma.
As you and your partner report for duty, you check your ambulance and begin talking about the possibility of a terrorist attack. The MOST effective and appropriate way to determine the likelihood of this happening is to: Question 4 options: 1) check with local businesses to see if they have received any terrorist threats. 2) ask your immediate supervisor if he or she has been watching the local news. 3) know the current threat level issued by the Department of Homeland Security. 4) ascertain the current situation overseas with regard to the number of casualties.
know the current threat level issued by the Department of Homeland Security.
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, tachycardic, 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: Question 10 options: 1) massive hemothorax. 2) tension pneumothorax. 3) pericardial tamponade. 4) laceration of the aorta.
laceration of the aorta.
You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if: Question 1 options: 1) the patient is conscious. 2) law enforcement is at the scene. 3) there are other patients involved. 4) the severity of the injury is known.
law enforcement is at the scene.
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: Question 5 options: 1) perform a head-to-toe assessment while she is in the car. 2) lift the air bag and look for deformity to the steering wheel. 3) carefully assess her upper chest for seatbelt-related injuries. 4) extricate her immediately and transport to a trauma center.
lift the air bag and look for deformity to the steering wheel.
Bones are connected to other bones by bands of tough fibrous tissues called: Question 6 options: 1) bursa. 2) tendons. 3) cartilage. 4) ligaments.
ligaments.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: Question 1 options: 1) liver. 2) spleen. 3) kidney. 4) stomach.
liver.
Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: Question 1 options: 1) liver. 2) spleen. 3) kidney. 4) stomach.
liver.
A spinal cord injury at the level of C7 would MOST likely result in: Question 2 options: 1) immediate cardiac arrest. 2) paralysis of the diaphragm. 3) paralysis of the intercostal muscles. 4) paralysis of all the respiratory muscles.
paralysis of the intercostal muscles.
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: Question 7 options: 1) begin ventilatory assistance. 2) partially remove the dressing. 3) begin rapid transport at once. 4) call for a paramedic ambulance.
partially remove the dressing.
When a hollow organ is punctured during a penetrating injury to the abdomen: Question 10 options: 1) the abdomen will become instantly distended. 2) peritonitis may not develop for several hours. 3) it will bleed profusely and rapidly cause shock. 4) it commonly protrudes through the injury site.
peritonitis may not develop for several hours.
The ________ nerves control the diaphragm. Question 5 options: 1) vagus 2) costal 3) phrenic 4) intercostal
phrenic
Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called: Question 2 options: 1) pleurisy. 2) dyspnea. 3) pneumonitis. 4) pneumothorax.
pleurisy.
Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called: Question 8 options: 1) pleurisy. 2) dyspnea. 3) pneumonitis. 4) pneumothorax.
pleurisy.
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: Question 10 options: 1) flail chest. 2) pneumothorax. 3) cardiac tamponade. 4) myocardial contusion.
pneumothorax
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: Question 4 options: 1) apply an AED and assess his BP. 2) prepare for immediate transport. 3) determine if he has cardiac problems. 4) apply bulky dressings to the sternum.
prepare for immediate transport.
Because the depth of an open abdominal wound is often difficult to determine: Question 5 options: 1) vital signs should be monitored frequently. 2) prompt transport to the hospital is essential. 3) the EMT must perform a thorough exam. 4) the abdomen must be vigorously palpated.
prompt transport to the hospital is essential.
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: Question 8 options: 1) rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water. 2) administer oxygen via a nonrebreathing mask. 3) cover his foot with chemical heat compresses. 4) protect the affected part from further injury.
protect the affected part from further injury.
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should: Question 9 options: 1) apply 100% oxygen via a nonrebreathing mask. 2) place her supine and elevate her lower extremities. 3) perform a rapid head-to-toe physical assessment. 4) provide ventilation assistance with a BVM.
provide ventilation assistance with a BVM.
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: Question 9 options: 1) traumatic asphyxia. 2) pulmonary contusion. 3) massive hemothorax. 4) tension pneumothorax.
pulmonary contusion.
The two MOST efficient ways for the body to eliminate excess heat are: Question 9 options: 1) respiration and bradycardia. 2) perspiration and tachycardia. 3) sweating and vasodilation. 4) hyperventilation and tachycardia.
sweating and vasodilation.
Common signs and symptoms of a chest injury include all of the following, EXCEPT: Question 6 options: 1) tachypnea. 2) hematemesis. 3) localized pain. 4) chest wall ecchymosis.
tachypnea.
Elevation of the rib cage during inhalation occurs when: Question 4 options: 1) the diaphragm descends. 2) abdominal contents descend. 3) intrathoracic pressure decreases. 4) the intercostal muscles contract.
the intercostal muscles contract.
Very young children tend to breathe predominantly with their diaphragm because: Question 2 options: 1) their chest wall and ribs are very pliable. 2) they require less tidal volume per breath. 3) their intercostal muscles are not fully developed. 4) there is no nerve innervation of the intercostal muscles.
their intercostal muscles are not fully developed.
