Mod.4
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):
laryngeal fracture.
Which of the following types of muscle is under direct voluntary control of the brain?
skeletal
Which of the following organs can tolerate inadequate perfusion for two to three hours?
skeletal muscle
You should be most suspicious that a patient has experienced a significant head injury if his or her pulse is:
slow
Hypothermia occurs when the core body temperature falls below:
95°F (35°C).
Gastrointestinal bleeding should be suspected if a patient presents with:
hematemesis.
Common signs and symptoms of heat exhaustion include all of the following, except:
hot, dry skin
Which of the following is a sign of compartment syndrome?
Pain with minor movement or out of proportion to the visible injury
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 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 findings would be the most significant when assessing a patient with possible internal bleeding?
The patient takes rivaroxaban (Xarelto).
Which of the following organs is at most risk for injury as the result of a pelvic fracture?
Urinary bladder
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.
When caring for a patient whose arm is covered with a dry chemical, you should:
brush away the chemical before flushing with water.
A(n) __________ fracture occurs in the growth section of a child's bone and might lead to bone growth abnormalities.
epiphyseal
High humidity reduces the body's ability to lose heat through:
evaporation
What is the approximate blood volume of an 80-kg adult male?
6.0 L
A person's ability to shiver is lost when his or her body temperature falls below:
90°F (32°C).
Traction splints primarily immobilize and secure fractures of the:
femur
Bone marrow produces:
blood cells
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh.
1 L
The mastoid process is located approximately:
1 inch posterior to the external opening of the ear.
According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total body surface area.
1%
An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost.
100 mL
Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:
14
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, this patient has burns that cover _____ of his body surface area.
18%
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
20%
In which of the following patients should you remove an impaled object?
A pulseless and apneic patient with a knife impaled in the back
Which of the following is a severe burn in a 35-year-old patient?
Circumferential partial-thickness burn to the chest
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 sets of vital signs depicts Cushing triad?
Blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min
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?
Compression of the aorta and vena cava
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 four hours.
Covering a patient's _________ will significantly minimize radiation heat loss.
head
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
Which of the following statements regarding electrical burns is correct?
Entrance wounds are small relative to the amount of internal tissue damage.
When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements.
Head
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?
Repeat BP of 90/68 mm Hg
Which of the following statements regarding the dermis is correct?
The dermis contains hair follicles, sweat glands, and nerve endings.
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?
Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
Abnormal variations in pupil size and reaction would most likely be observed in a patient with:
a brain injury
A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has most likely experienced:
a detached retina.
The mesentery is:
a membranous fold that attaches the intestines to the walls of the body.
Common signs and symptoms of a serious head injury include all of the following, except:
a rapid, thready pulse.
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except:
a relatively small surface area.
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:
a tourniquet proximal to the injury.
Signs of late heatstroke include:
a weak, rapid pulse.
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:
abdomen
Blood stasis, changes in the vessel wall, and certain medications affect the:
ability of the blood to effectively clot.
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:
aggressively manage his airway.
The most significant complication associated with facial injuries is:
airway compromise
An open fracture is most accurately defined as a fracture in which:
an external wound is present over the fracture site.
An open pneumothorax is:
an open chest wound through which air moves during breathing
A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:
apply a compression device around his pelvis.
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.
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:
apply direct pressure above and below the wound.
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 active venous bleeding. As your partner manually stabilizes the patient's head, you should:
apply direct pressure to her arm wound.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first:
apply direct pressure to the wound.
A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:
apply padded board splints to both sides of the leg.
Most cases of external bleeding from an extremity can be controlled by:
applying local direct pressure.
A young male was shot in the abdomen by an unknown type of gun. Law enforcement personnel have ensured that the scene is safe. The patient is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
assist the patient's ventilations.
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:
assume that the arrow injured an internal organ.
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.
You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:
bacterial meningitis.
A dysbarism injury refers to the signs and symptoms related to changes in:
barometric pressure.
When worn properly, a seat belt should lie:
below the anterior superior iliac spines of the pelvis and against the hip joints.
A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious but restless and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. You should:
bind his legs together on the backboard, keep him warm, and transport without delay.
An epidural hematoma is most accurately defined as:
bleeding between the skull and dura mater.
The term "hyphema" is defined as:
blood in the anterior chamber of the eye
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:
blunt injury to the kidney.
The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:
bradycardia and a slowing of the metabolic rate.
The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems.
brain stem
The venom of a brown recluse spider is cytotoxic, meaning that it:
causes severe local tissue damage.
Perfusion is most accurately defined as the:
circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
The most commonly fractured bone(s) in the body is the:
clavicle
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 cover them with a moist dressing.
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.
Signs and symptoms of a tension pneumothorax include all of the following, except:
collapsed jugular veins.
A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be most concerned that this patient has:
compartment syndrome
The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the:
conjunctiva
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 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:
control the bleeding and cover the wound with a sterile dressing.
A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-foot steel rod impaled in his left leg. You should in order of importance:
control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately.
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
contusion.
The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:
convection
Hemoptysis is defined as:
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:
cover the exposed bowel with a moist sterile dressing and then secure it in place with a large occlusive bandage.
Difficulty breathing and a sunken appearance of the anterior abdominal wall is most indicative of a ruptured:
diaphragm
The thoracic cavity is separated from the abdominal cavity by the:
diaphragm
The disruption of a joint in which the bone ends are no longer in contact is called a:
dislocation
A Colles fracture involves a fracture of the:
distal radius
Accumulation of blood in the abdominal cavity will most likely cause:
distension
The tough, fibrous outer meningeal layer is called the:
dura mater
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
exhibit poor thermoregulation.
A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing:
gastrointestinal bleeding.
A 40-year-old male presents with severe abdominal pain after 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:
giving him small sips of plain water.
Contraction or tensing of the abdominal muscles to ease pain is called:
guarding.
The skin and underlying tissues of the face:
have a rich blood supply and bleed profusely.
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 has stable vital signs. You should:
immobilize his spine and perform a focused secondary exam
A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:
immobilize the injury with a sling and swathe.
When splinting an injury of the wrist, the hand should be placed:
in a functional position.
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 bag valve mask.
The most critical treatment for a tension pneumothorax involves:
inserting a needle through the rib cage into the pleural space.
A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include:
irrigating his right eye laterally.
A 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.
Bones are connected to other bones by bands of tough fibrous tissues called:
ligaments
Bruising to the right upper quadrant of the abdomen after blunt trauma is most suggestive of injury to the
liver
Placing a pregnant patient in a supine position during the third trimester of pregnancy:
might decrease the amount of blood that returns to the heart.
If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:
minute volume will decrease.
A frostbitten foot can be identified by the presence of:
mottling and blisters.
Signs and symptoms that might be found in a patient who has experienced a concussion include:
nausea and ringing in the ears.
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:
padding between the ear and the scalp.
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.
A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.
pathologic
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 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:
pinching the patient's nostrils and having him lean forward.
After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:
place additional dressings over the wound.
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:
place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.
Crepitus and false motion are:
positive indicators of a fracture.
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
A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes:
preparing for immediate transport.
A 30-year-old man complains of severe pain to his right tibia after an injury that occurred the day before. The patient's leg is pale, and he is unable to move his foot. The EMT should suspect that:
pressure in the fascial compartment is elevated.
Because the depth of an open abdominal wound is often difficult to determine:
prompt transport to the hospital is essential.
A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.
A "hip" fracture is actually a fracture of the:
proximal femur
High air temperature reduces the body's ability to lose heat by:
radiation.
A patient with a core body temperature of 95°F (35°C) will most likely experience:
rapid breathing
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:
rapidly transporting her to the hospital.
Hypoperfusion is another name for:
shock
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
After blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the:
spleen.
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:
stabilize her head and perform a primary assessment.
A 30-year-old female was robbed and assaulted as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
suction her oropharynx.
Heatstroke occurs when:
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.
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.
You and your partner arrive at the scene of a house fire where firefighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed, and he is coughing up sooty sputum. You should be most concerned with:
the potential for airway swelling.
The small, rounded, fleshy bulge immediately anterior to the ear canal is called the:
tragus
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:
turn the backboard onto its side.
Rough handling of a hypothermic patient with a pulse might cause:
ventricular fibrillation.
In older patients, the first indicator of nontraumatic internal bleeding might be:
weakness or dizziness.
