Paramedic volume 4 chapter 6-11 study, Volume 4, Chapter 11, Volume 4, Chapter 10, Volume 4, Chapter 9, Volume 4, Chapter 8, Volume 4, Chapter 7, Volume 4, Chapter 6

Which rib pairs have no anterior attachment

11th and 12th

How many trauma score points are recorded for a GCS score of 11?

3

What is the highest trauma score value that can be applied by the Glasgow coma scale?

4

Anterior cord syndrome

A flexion-extension injury that results in damage to the vertebral artery through either disruption or compression of edema, leading to subsequent ischemia and infarction.

To receive a revised trauma score of a 4 for respiratory rate the patient must be breathing at:

A minimum of 10 breaths per minute

Hypotension occurs in relation to :

A reduction in blood pressure

Your​ ten-year-old male patient was involved in a bicycle accident that lacerated his right calf and caused significant​ bleeding; he is showing signs of hypovolemia. When providing intravenous fluid replacement to this​ patient, fluid boluses should be administered at the rate​ of: A. 20​ mL/kg delivered a maximum of three times. B. 60​ mL/kg, C. 20​ mL/kg titrated to a systolic BP of 100. D. 20​ mL/kg titrated to a systolic BP of 100 and pulse below 125.

A. 20​ mL/kg delivered a maximum of three times.

How many trauma score points are recorded for a GCS score of​ 11? A. 3 B. 4 C. 2 D. 5

A. 3

As you approach a vehicle involved in a​ single-car accident involving a​ tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinal​ control, you introduce yourself and complete a primary assessment. His airway is open and his breathing seems​ adequate; you check the radial pulse and find a rate of​ 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer​ bleeding, but was responsible for a majority of his overt hemorrhaging. You initiate​ high-flow oxygen via a nonrebreather​ mask, quickly dress the​ scalp, and perform a rather lengthy extrication onto a spine board. After moving him you note that he is no longer speaking to​ you; his radial pulse is now 124 and​ thready, his respiratory rate has dropped to 6 and​ shallow, and his abdomen appears to be slightly distended. What is now the maximum time interval between reassessments of your​ patient? A. 5 minutes B. Whenever you note any change in the​ patient's condition C. When you institute any significant intervention D. 15 minutes

A. 5 minutes

Your​ 12-year-old patient has a significant head injury with a​ rapid, thready​ pulse, slowed capillary​ refill, and a lowered level of consciousness. When providing fluid​ resuscitation, you​ should, in rapid​ succession, administer serial boluses of an isotonic​ solution, titrated to blood​ pressure, to maintain a systolic blood pressure​ of: A. 80 mmHg. B. 75 mmHg. C. 65 mmHg. D. 90 mmHg.

A. 80 mmHg.

What might a victim suffering a concussion and epidural hematoma concurrently present with prior to an increase in intracranial​ pressure? A. A lucid interval B. Decerebrate posturing C. ​Cushing's reflex D. ​Cheyne-Stokes respirations

A. A lucid interval

What is the least protected body​ cavity? A. Abdomen B. Cranium C. Pelvis D. Thoracic

A. Abdomen

Approximately how many motor vehicle deaths can be attributed to thoracic trauma in the United States​ annually? A. About​ 8,000 B. About​ 19, 000 C. About​ 32,000 D. About​ 50,000

A. About​ 8,000

You are caring for a patient who was playing flag football at the park. The patient states that after a particular​ play, he was tackled and felt sharp pain in his left​ ankle, after which he was unable to bear weight on it. What tendon may have been injured in this​ situation? A. Achilles B. Quadriceps C. Lateral malleoli D. Patellar

A. Achilles

What​ high-altitude disease typically presents with​ light-headedness, breathlessness,​ weakness, headache,​ nausea, and​ vomiting? A. Acute mountain sickness B. Dysbaria C. ​High-altitude cerebral edema D. ​High-altitude pulmonary edema

A. Acute mountain sickness

When treating a victim of heat​ cramps, what should your next step be after moving him to a cool or shaded​ environment? A. Administer oral fluids. B. Rapidly cool him with sheets soaked in tepid water. C. Monitor for an arrhythmia. D. Administer​ high-flow oxygen.

A. Administer oral fluids.

When treating the traumatic asphyxia​ patient, what should be​ considered, prior to the release of​ compression, if the entrapment has lasted more than 20​ minutes? A. Administration of 1​ mEq/kg of sodium bicarbonate B. Assistance of ventilations with a BVM C. Initiation of two​ large-bore IVs D. Administration of​ high-flow oxygen

A. Administration of 1​ mEq/kg of sodium bicarbonate

What should be avoided prior to spending time in a cold​ environment? A. Alcohol B. Exercise C. Carbohydrates D. Cold soda

A. Alcohol

How does the progression of signs and symptoms of pediatric head injury differ from an​ adult? A. An infant is more prone to direct injury but has a slower progression of increasing ICP. B. The infant is less prone to direct injury and increasing ICP. C. The infant is less prone to direct injury but more prone to increasing ICP. D. An infant is more prone to direct injury and more rapidly progresses through the stages of increasing ICP.

A. An infant is more prone to direct injury but has a slower progression of increasing ICP.

Which syndrome results from bony fragments or pressure compressing arteries that perfuse the ventral aspect of the spinal​ cord? A. Anterior cord syndrome B. ​Brown-Sequard syndrome C. Spinal perfusion syndrome D. Central cord syndrome

A. Anterior cord syndrome

When the​ brain, floating in cerebrospinal fluid inside the​ cranium, "sloshes" toward the impact and then away from​ it, again impacting the cranial​ interior, what is the second injury​ called? A. Contrecoup injury B. Indirect brain injury C. Ipsilateral brain injury D. Direct brain injury

A. Contrecoup injury

Which​ "CUPS" criteria patient will not receive additional assessment beyond the primary​ assessment? A. Critical B. Stable C. Potentially unstable D. Unstable

A. Critical

Which factor can predispose an individual to​ hypothermia? A. Diabetes B. ​Short-term cold exposure C. Low humidity D. Middle age

A. Diabetes

What is an advantage of air medical​ transport? A. Direct flight at 100-140 MPH B. Lower cost of operation than EMS ground vehicles C. Scene arrival prior to EMS ground vehicles D. The ability to perform landings at the scene in all weather

A. Direct flight at 100-140 MPH

What primary medical benefit results from the use of a hyperbaric chamber for​ dysbarism? A. Elimination of circulating emboli B. Removal of pollutants from a​ diver's air tank C. Administration of​ high-flow oxygen D. Elimination of​ 24-hour wait period for flying

A. Elimination of circulating emboli

Your male patient was attacked by a prostitute he was attempting to have sex with. The assailant managed to cut off a section of the​ man's penis with a knife she had hidden. Upon your​ arrival, the male patient is using direct pressure to stop the​ bleeding, and you see the amputated body part on the floor. The assailant has left the building. What should be the​ paramedic's first assessment​ action? A. Ensure the patient has an open airway and adequate breathing. B. Place the amputated part on ice. C. Instruct the patient to release the direct pressure to see if the bleeding has stopped. D. Initiate an IV and administer a narcotic for pain relief.

A. Ensure the patient has an open airway and adequate breathing.

Shifting of expiratory air from an uninjured side of the thorax to the injured​ side, resulting in reduced tidal​ volume, is a common result of which​ injury? A. Flail chest B. Pneumothorax C. Rib fracture D. Mediastinal shift

A. Flail chest

What condition occurs when three or more adjacent ribs fracture in two or more​ places? A. Flail chest B. Tension pneumothorax C. Pneumothorax D. Compound rib fracture

A. Flail chest

Osteoporosis is a bone disorder that may contribute to the ease with which a bone fractures secondary to trauma in what type of​ patient? A. Geriatric B. Male C. Multisystem trauma D. Pediatric

A. Geriatric

What type of​ fracture, typically seen in pediatric​ bones, results in an incomplete​ break? A. Greenstick fracture B. Hairline C. Comminuted D. ​Salter-Harris type II

A. Greenstick fracture

Hyperthermia is usually caused by which​ mechanism? A. Heat transfer from the external environment B. Excessive heat generation within the body C. Heat transfer through vasodilation D. Use or abuse of some medications

A. Heat transfer from the external environment

You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which additional injury should you have a high level of​ suspicion? A. Hyperflexion of the cervical spine B. Axial stress on the cervical spine C. Hyperextension of the cervical spine D. Distraction of the cervical spine

A. Hyperflexion of the cervical spine

Which anatomical structure is directly responsible for temperature regulation in the human​ body? A. Hypothalamus B. Circulatory system C. Nervous system D. Negative feedback system

A. Hypothalamus

What​ impact, if​ any, does hypothermia have on the utilization of oxygen at the cellular​ level? A. Hypothermia can disrupt cellular oxygen use to decrease metabolism. B. Oxygen fails to circulate in the hypothermic patient. C. Oxygen does not bond to hemoglobin when the patient is hypothermic. D. Hypothermia does not impact cellular oxygen use.

A. Hypothermia can disrupt cellular oxygen use to decrease metabolism.

As you approach a vehicle involved in a​ single-car accident involving a​ tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinal​ control, you introduce and identify​ yourself; he responds without difficulty. Since his airway is open and his breathing seems​ adequate, you check the radial pulse and find a rate of​ 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer​ bleeding, but was responsible for a majority of his overt hemorrhaging. What is your next​ step? A. Initiate​ high-flow oxygen via a nonrebreather mask. B. Establish his level of consciousness. C. Work to control the hemorrhage. D. Place a pulse oximeter.

A. Initiate​ high-flow oxygen via a nonrebreather mask.

What does the term ​"blood-brain ​barrier" refer​ to? A. It refers to CNS capillary walls that are​ thicker, more complete​ than, and not as permeable as those found elsewhere in the body. B. It refers to how the meningeal layers are impermeable to blood. C. It references the connective tissue layer below the meninges. D. It refers to the choroid plexus.

A. It refers to CNS capillary walls that are​ thicker, more complete​ than, and not as permeable as those found elsewhere in the body.

Which abdominal organ is responsible for detoxifying​ blood, producing​ bile, storing​ glycogen, producing proteins utilized in the clotting​ process, and assisting in osmotic fluid​ regulation? A. Liver B. Spleen C. Gall bladder D. Pancreas

A. Liver

What is an unintended consequence of fluid resuscitation in the trauma​ patient? A. Lowering of the core body temperature B. Reduced oxygen delivery at the cellular level C. Crenation of erythrocytes D. Development of pulmonary edema

A. Lowering of the core body temperature

When the​ body's compensatory mechanisms can no longer maintain the core temperature due to heat​ loss, what​ happens? A. Metabolic rate and cardiac output fall. B. Piloerection occurs. C. Muscle tone increases. D. Shivering begins.

A. Metabolic rate and cardiac output fall.

What injury would be classified as a diffuse brain​ injury? A. Mild axonal injury B. Decreased intracranial perfusion C. Diffuse cerebral contusion D. Lucid interval

A. Mild axonal injury

Which statement regarding musculoskeletal injuries is​ true? A. Most patients who suffer multisystem trauma experience significant musculoskeletal injuries. B. Sprains and strains are the least common musculoskeletal injuries paramedics encounter. C. Osteoporosis accounts for only a small number of fractures. D. Orthopedic injuries are rarely encountered by paramedics.

A. Most patients who suffer multisystem trauma experience significant musculoskeletal injuries.

A​ 68-year-old woman lives in an​ upper-floor, urban area apartment without air conditioning. In early​ May, an unseasonable heat wave​ occurs, with a sudden change in temperature into the​ mid-90s with high humidity. On the fourth day of the heat​ wave, the​ woman's neighbor finds her passed out. In your assessment of this​ patient, you find she is responsive only to pain and has​ hot, reddened, dry skin. What steps should your treatment of this patient​ include? A. Move her to a cool​ environment, initiate active rapid​ cooling, give oxygen as​ required, run IV normal saline wide open​ initially, and initiate ECG monitoring. B. Move her to a cool​ environment, initiate active rapid​ cooling, and run IV normal saline wide open. C. Move her to a cool​ environment, initiate active rapid​ cooling, run IV normal saline wide​ open, and initiate ECG monitoring. D. Initiate active rapid​ cooling, run IV normal saline wide open​ initially, and transport.

A. Move her to a cool​ environment, initiate active rapid​ cooling, give oxygen as​ required, run IV normal saline wide open​ initially, and initiate ECG monitoring.

What are the discrete tissues and muscles of the body that are controlled by specific spinal nerve​ roots? A. Myotomes B. Dendrites C. Dermatomes D. Areas of innervation

A. Myotomes

Which population is at a higher risk of​ pelvic, rib, and extremity fractures due to​ trauma? A. Obese adults B. ​Middle-aged men C. Female teenagers D. Infants

A. Obese adults

What is​ "pins-and-needles" sensation​ called? A. Paresthesia B. Anesthesia C. Paralysis D. Paresis

A. Paresthesia

You are dispatched to the scene of a shooting. While en​ route, dispatch directs you to a secure staging​ area, set up by law​ enforcement, half of a block from the incident. On​ arrival, you see two officers dragging another officer between them to your unit. You exit the unit and quickly pull the cot out of the​ back, and the officers place the victim sitting up. They quickly explain that he was securing the perimeter when he was shot in the left shoulder by an unknown assailant. Your patient appears alert and well oriented and is complaining of severe left shoulder pain. You note a bullet hole in the front of his body​ armor, high on the left side. You cut off his vest and as you remove​ it, a bullet drops out of the vest onto the​ cot, and you also see an exit wound at the inferior edge of the left scapula with little blood exiting. You apply an occlusive dressing and lay the victim back on the cot. You then notice an entrance wound at the second intercostal​ space, also hemorrhaging​ slightly, and place an occlusive dressing there also. Your patient still appears well oriented but is very anxious and excited about what has happened. You quickly auscultate the lungs and find breath sounds equal and clear on both sides with a rate of 34. Your​ victim's pulse is 120 and easily palpable in his left radial​ artery, and the pulse ox reads 100 percent. While there appears to be no change in the injury site or​ respirations, he is now complaining of numbness and tingling in his fingers and toes. You opt to take his blood pressure and find it to be​ 138/76. As you continue your exam and​ care, how would you mentally note the​ patient's complaint of numbness and​ tingling? A. Patient complains of numbness and tingling in the fingers and toes B. Anesthesia at site of injury and sensation in the fingers and toes C. General anesthesia and sensation in the fingers and toes D. Patient complains of numbness at site of injury and tingling in extremities

A. Patient complains of numbness and tingling in the fingers and toes

What is the optimal way of dealing with musculoskeletal​ injuries? A. Prevention B. Immobilization and pain management C. Splinting D. Rest

A. Prevention

You are dispatched to the local feed mill for a​ 54-year-old man who was crushed when his wife inadvertently pinned him between the​ semi-trailer she was backing up and the loading dock. When you arrive you are directed to the loading area where the man is lying on the ground behind an idling semi. Dock workers tell you that his right side was​ pinned, and they lowered him to the ground after directing his wife to pull forward. As you approach you request that the semi be shut​ down, and you radio dispatch for an additional unit to assist you with the patient and his overwhelmingly​ panic-stricken wife. The man is unconscious and the right side of his tee shirt is soaked with blood. He has​ shallow, labored respirations and gurgling. He is​ ashen, with cool and clammy skin and a trickle of blood flowing from his mouth. What is your first concern with this​ patient? A. Protect the airway. B. Control the hemorrhage. C. Administer​ high-flow oxygen. D. Immobilize the fractures.

A. Protect the airway.

What type of barotrauma is most likely to occur if a diver fails to breathe during​ ascent? A. Pulmonary overpressure injury B. Pneumomediastinum C. Pneumothorax D. Arterial gas embolism

A. Pulmonary overpressure injury

After your​ assessment, you believe that your patient has chemical peritonitis. Which finding would contribute to this field​ impression? A. Rapid onset of pain and associated tenderness at the injury location B. Diffuse pain to either of the flank regions of the posterior abdominal wall C. Absence of involuntary guarding in the presence of a known penetration injury D. Gradual onset of pain with heightened sensitivity when you palpate the abdomen

A. Rapid onset of pain and associated tenderness at the injury location

What contributes significantly to hypothermia in the trauma​ patient? A. Rerouting of available blood to critical organs as the blood volume diminishes B. The​ body's lowering of core temperature to slow metabolism for​ self-preservation C. The decrease in cellular metabolism resulting from decreasing pH D. The decrease of heat from cellular metabolism carried on by erythrocytes due to hemorrhage

A. Rerouting of available blood to critical organs as the blood volume diminishes

Pelvic fractures can be​ life-threatening injuries due to what​ mechanism? A. Significant blood loss B. Rupture of the urinary bladder with resultant chemical inflammation C. Spinal cord damage to motor nerve roots D. Loss of function to lower extremities

A. Significant blood loss

When treating the victim of multisystem​ trauma, what should be addressed after gaining control of the airway and​ ventilation? A. Significant hemorrhage B. Severe fractures C. IV fluid therapy D. Rapid transport to a trauma center

A. Significant hemorrhage

Internal intercostal​ muscles, along with the diaphragm and what other​ muscle(s), are the major muscles of​ inhalation? A. Sternocleidomastoids B. Latissimus dorsi C. Obliques D. Trapezius

A. Sternocleidomastoids

What is temporary hypotension caused by the weight of the gravid​ uterus, which occurs in the third trimester of​ pregnancy? A. Supine hypotensive syndrome B. Positional hypotension C. Predelivery hypotension D. Abruptio placentae

A. Supine hypotensive syndrome

You are caring for a pregnant female veterinarian who was kicked in the stomach by a horse she was caring for. The patient is in her final trimester. She presents with marginally normal vital​ signs, anxiety, and mild dyspnea. Given her present medical​ condition, what should the paramedic assume regarding fetal​ circulation? A. The fetus is likely being deprived of blood flow. B. Fetal circulation will not be harmed secondary to this type of mechanism unless the​ mother's blood pressure drops below 60 mmHg. C. Fetal blood flow is enhanced because this is a normal feedback mechanism with trauma in pregnancy. D. Fetal blood flow is normal because the​ mother's BP is still normal.

A. The fetus is likely being deprived of blood flow.

For an isolated​ mid-shaft femur​ fracture, when should you stop the application of​ traction? A. The limb is immobilized and patient discomfort ceases. B. The patient reports increasing pain. C. The​ patient's muscle spasms have increased in strength. D. The limb is extended at half its initial length.

A. The limb is immobilized and patient discomfort

What is the most direct result of alveolar shunting caused by atelectasis in the drowning​ victim? A. The return of deoxygenated blood to the bloodstream B. The loss of surfactant C. Laryngospasm D. Leakage of plasma protein into the alveoli

A. The return of deoxygenated blood to the bloodstream

Which statement concerning contact sports is most​ accurate? A. They remain a significant cause of injury. B. Improved conditioning has been the most effective way of reducing injury. C. Improved equipment design has virtually eliminated injury. D. Most sports no longer allow contact.

A. They remain a significant cause of injury.

Your​ patient, the​ 52-year-old driver of a vehicle that struck a​ tree, is complaining of chest pain and severe difficulty breathing. As you​ approach, you notice that he is​ cyanotic, has​ hemoptysis, and is visibly panicked. During your primary​ assessment, you note that his respirations are 22 and​ shallow, his radial pulse is​ 128, and his SpO2 is 83 percent. He has pervasive subcutaneous emphysema. You immediately start him on​ high-flow oxygen via a nonrebreather mask. His lung sounds are equal but diminished bilaterally. What initial field diagnosis will you base your treatment plan​ on? A. Tracheobronchial disruption B. Hemothorax C. Pericardial tamponade D. Tension pneumothorax

A. Tracheobronchial disruption

Which type of pelvic fracture does not involve the pelvic ring and includes avulsion fractures and those of the​ pubis, sacrum,​ coccyx, ischium, or iliac​ wing? A. Type I B. Type III C. Type II D. Type IV

A. Type I

Which patient would receive a GCS score of 3 for verbal​ response? A. Uses inappropriate words​ (irritable) B. Confused C. Incomprehensible words D. Oriented

A. Uses inappropriate words​ (irritable)

What is commotio​ cordis? A. Ventricular fibrillation induced by a direct chest blow from blunt trauma B. A breakdown of muscle fibers and release of degraded muscle fiber contents into circulation C. Ventricular fibrillation in the presence of heat exhaustion D. Shifting of expiratory air from an uninjured side of the thorax to the injured​ side, resulting in reduced tidal volume

A. Ventricular fibrillation induced by a direct chest blow from blunt trauma

What has contributed heavily to an increase in thoracic trauma in urban​ areas? A. Violent crime B. Increased tunnel projects C. Skyscraper construction D. Automobile accidents

A. Violent crime

Which activity is an example of the EMS system taking an active role in public accident​ prevention? A. Voluntary home inspection B. Assisting in DUI checkpoints C. Defensive driving for medical personnel D. Enforcing workplace safety standards

A. Voluntary home inspection

You are caring for a patient who fell down some steps while leaving church on Sunday morning. Assessment reveals an open fracture to the right tibia with minor bleeding that is easily controlled. The patient has no other injuries from the fall and is presenting as stable. Care for the injured limb would begin​ with: A. aligning the limb. B. assessing​ circulation, sensation, and motor function. C. immobilizing the limb with gentle traction. D. immobilizing the limb with board splints.

A. aligning the limb.

Joints that allow some very limited movement​ are: A. amphiarthroses. B. metaphyses. C. synarthroses. D. sesamoids.

A. amphiarthroses.

The aorta is fixed at three positions within the​ thorax: the​ annulus, where it leaves the​ heart; at the ligamentum arteriosum near the bifurcation of the pulmonary​ artery; and at​ the: A. aortic hiatus. B. diaphragmatic outlet. C. inferior passage. D. umbilical ligament.

A. aortic hiatus.

The bones of the upper and lower​ extremities, including the shoulder girdles and​ pelvis, make up​ the: A. appendicular skeleton. B. locomotive skeleton. C. articulating skeleton. D. cartilaginous skeleton.

A. appendicular skeleton.

The maintenance of a continuum of patient care is reliant​ upon: A. appropriate interactions between EMS system members. B. the paramedic controlling all aspects of the​ scene, including extrication. C. consultation of the ED physician upon arrival at the scene. D. being adequately trained for all the types of rescue you may encounter.

A. appropriate interactions between EMS system members.

A patient history is​ gathered: A. at the conclusion of a rapid or focused trauma assessment. B. following a focused trauma assessment only. C. during scene​ size-up. D. during reassessment.

A. at the conclusion of a rapid or focused trauma assessment.

The portion of the skull that protects the brain is called​ the: A. cranium. B. aponeurotica. C. foramen magnum. D. fused boney plates.

A. cranium.

Complete the rapid or focused trauma assessment​ by: A. determining the​ patient's Glasgow Coma Scale score. B. completing a detailed physical examination of the patient. C. collecting a baseline set of vital signs. D. making a preliminary transport decision.

A. determining the​ patient's Glasgow Coma Scale score.

It is incumbent on all members of the prehospital care portion of the EMS system​ to: A. ensure that our patients receive the best care and chance for survival. B. leave transport decisions to medical direction. C. eliminate any procedure if doing so will shorten scene times. D. provide a minimum of prehospital care to promote rapid transport.

A. ensure that our patients receive the best care and chance for survival.

An athlete who twisted his leg completing a long jump now displays signs of potentially severe​ muscle, tendon, and ligament soft tissue injury to his left thigh. The patient complains of significant pain at the knee and​ hip, and there is inflammation and swelling at these joints. You suspect at least a Grade II sprain of the knee and the hip. The​ athlete's coach is advising him to walk it​ off, which your patient seems to be trying to convince himself is the right thing to do. He seems to be about to get up to comply with what his coach wants. You should​ first: A. ensure the patient places no additional stress on the injured leg. B. monitor distal neurovascular function. C. apply local cooling to suppress edema and pain. D. immobilize the adjacent joints.

A. ensure the patient places no additional stress on the injured leg.

Completing the rapid trauma assessment for a patient with a musculoskeletal injury does not​ involve: A. evaluating the​ patient's mental status and ABCs. B. obtaining a Glasgow Coma Scale value. C. obtaining a baseline set of vital signs. D. gathering a patient history.

A. evaluating the​ patient's mental status and ABCs.

The increased intracranial pressure associated with HACE is attributable​ to: A. increased fluid in the brain from being at a high altitude that one is not acclimated for. B. swelling of brain gray matter from increased air pressure. C. ​high-altitude changes causing an increase in cardiac​ output, which raises hydrostatic pressure and causes edema. D. blood migrating across the blooddashbrain barrier.

A. increased fluid in the brain from being at a high altitude that one is not acclimated for.

Musculoskeletal injuries do not include injuries to​ the: A. internal organs. B. muscles. C. bones. D. cartilage.

A. internal organs.

An injury to the lower chest that lacerates the diaphragm is unlikely to also injure​ the: A. kidneys. B. gallbladder. C. stomach. D. spleen.

A. kidneys.

Your patient has a nontraumatic fracture of the left wrist. To splint this​ fracture, you​ first: A. place a roll of bandaging in the​ patient's hand to maintain position of function. B. secure the extremity to a padded board. C. assess sensation in the​ patient's wrist. D. inflate the air splint.

A. place a roll of bandaging in the​ patient's hand to maintain position of function.

A significant reduction in mortality rate associated with trauma can be realized by instituting a comprehensive program​ addressing: A. prevention. B. continuing care provider education. C. documentation. D. run reviews.

A. prevention.

Patients presenting with isolated musculoskeletal injuries and who are stable should​ be: A. provided a focused trauma assessment. B. provided a rapid trauma assessment. C. transported to a Level I trauma center. D. immobilized with air splints as opposed to board splints.

A. provided a focused trauma assessment.

You are examining a patient who was involved in a motor vehicle collision and has been extracted from the vehicle and immobilized. In palpating the first quadrant of the​ patient's abdomen, you notice a pain response as you release the pressure of your hand. This​ is: A. rebound tenderness. B. an indication of breathing difficulty. C. an indication of hemorrhage. D. guarding.

A. rebound tenderness.

In​ trauma, the incidence of musculoskeletal injury is second only to that​ of: A. soft tissue injuries. B. chest trauma. C. burns. D. abdominal trauma

A. soft tissue injuries.

Expert information regarding diving emergencies can be provided​ by: A. the Divers Alert Network. B. Medical Command. C. the diver. D. the ED.

A. the Divers Alert Network.

What are triaxial​ joints? A. ​Ball-and-socket joints that permit full motion in a cone of about 180 degrees and allow a limb to rotate B. Joints of the thumbs C. Ellipsoidal joints D. Gliding joints that provide movement in two directions

A. ​Ball-and-socket joints that permit full motion in a cone of about 180 degrees and allow a limb to rotate

Ascending from a dive too rapidly can create gas bubbles in the blood and​ tissues; these gas bubbles can then grow in size as the pressure is​ reduced, in accordance​ with: A. ​Boyle's law. B. ​Dalton's law. C. the gas ascent law. D. ​Henry's law.

A. ​Boyle's law.

What law accounts for the fact that at different depths below sea​ level, the pressure of air will​ change? A. ​Dalton's B. ​Henry's C. ​Boyle's D. Gravity

A. ​Dalton's

What findings would merit the highest priority for transport when assessing a patient with a potential​ heat-related emergency? A. ​Hot, dry skin and altered mental status B. Cool skin and nausea C. ​Warm, moist skin and muscle cramps D. Profuse perspiration and flushed skin

A. ​Hot, dry skin and altered mental status

What is the least protected body cavity

Abdomen

Abdominal pain with external vaginal hemorrhage in the in the near term trauma victim is primarily indicative of:

Abruptio placentae

What is the temperature at which all molecular motion has stopped?

Absolute zero

What has been the greatest source of advancement in treatment of thoracic trauma

Advances in treatment made during military conflicts

Bones of the upper and lower extremities including the shoulder giridles and pelvis make up the

Appendicular skeleton

Osteoporotic fractures :

Are much more common in women than men.

You are treating the victim of an automobile accident who is presenting with no open​ wounds, but a slightly distended abdomen. He was initially alert and well​ oriented, had a pulse of​ 100; respirations of 22 and a blood pressure of​ 88/70. During reassessment you note that he is still alert and well oriented but his vital signs are now a pulse of​ 110; respirations of 30 and a blood pressure of​ 84/70. What would the change in his Revised Trauma Score​ be? A. 10 B. -1 C. ​+1 D. no change

B. -1

Which rib​ pair(s) have no anterior​ attachment? A. 9th and 10th ribs B. 11th and 12th ribs C. 10th and11thrib D. 1st and 2nd ribs

B. 11th and 12th ribs

What is the highest trauma score value that can be applied by the Glasgow Coma​ Scale? A. 3 B. 4 C. 2 D. 5

B. 4

At what age does the body begin to lose its ability to maintain bone​ structure? A. 65 B. 40 C. ​18-20 D. 50

B. 40

The mortality rate for​ cold-related disorders significantly increases for victims with a core body temperature​ below: A. 80 degrees. B. 86 degrees. C. 89 degrees. D. 82 degrees.

B. 86 degrees.

Prolonged crush injuries can result in​ rhabdomyolysis; what is this​ process? A. Systemic shifting of circulation to an acidotic environment B. A breakdown of muscle fibers and release of degraded muscle fiber contents into circulation C. The release of byproducts of anaerobic metabolism D. Increased respiration in response to metabolic acidosis

B. A breakdown of muscle fibers and release of degraded muscle fiber contents into circulation

What accurately reflects the pathophysiology of anterior cord​ syndrome? A. Caused by a penetrating injury that hemitransects the​ cord; damage to one side results in sensory and motor loss to the ipsilateral side of the body B. A flexiondashextension injury that results in damage to the vertebral artery through either disruption or compression by​ edema, leading to subsequent ischemia and infarction C. A temporary insult to the spinal cord affecting the body below the level of​ injury; the affected area becomes flaccid and without​ feeling, and the patient is unable to move the extremities or other musculature D. Results from hyperextension of the cervical spine resulting in motor weakness of the upper extremities

B. A flexiondashextension injury that results in damage to the vertebral artery through either disruption or compression by​ edema, leading to subsequent ischemia and infarction

Which finding is most critical to the paramedic regarding a genital injury to a female from​ assault? A. Preserving physical evidence B. A foreign object inserted into the vaginal canal C. Determining where the assailant is D. Psychological trauma

B. A foreign object inserted into the vaginal canal

Which patient is most likely to sustain a pathological​ fracture? A. A teenager with​ Osgood-Schlatter disease B. A geriatric patient receiving radiation therapy for cancer C. A pediatric patient with a history of​ Salter-Harris fractures D. An adult patient taking calcium supplements

B. A geriatric patient receiving radiation therapy for cancer

What is the term for placental detachment from the uterine wall that can occur from blunt abdominal trauma in the pregnant​ female? A. Guarding B. Abruptio placentae C. Erector spinae D. Supine hypotensive syndrome

B. Abruptio placentae

You are dispatched to the scene of a winter drowning in which a​ 10-year-old male patient was found by his parents floating in a hole in the ice on their farm pond. On​ arrival, you find the victim pulseless and apneic with CPR being performed by neighbors. You continue​ CPR, maintain the airway by​ intubation, administer 100 percent​ oxygen, and attach an ECG​ monitor, which shows ventricular fibrillation. What should your next action should​ be? A. Continue CPR and rapidly rewarm the patient to a core temperature of 86 degrees with application of external heat sources. B. Administer defibrillation. C. Continue​ CPR, remove wet​ clothing, and cover to conserve body heat. D. Continue CPR and initiate an IV of D5W TKO.

B. Administer defibrillation.

You suspect increased intracranial pressure in a patient with penetrating chest trauma. Which of the following is appropriate​ treatment? A. Withhold fluid resuscitation measures unless the systolic blood pressure rises. B. Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg. C. Administer fluid resuscitation to maintain a systolic blood pressure of 80 mmHg. D. Withhold fluid resuscitation measures until the systolic blood pressure falls to 75 mmHg.

B. Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg.

You are dispatched to the scene of an automobile accident along with two other units. As you approach the​ scene, you see a compact car under the trailer of a​ semi-truck that turned in front of the car. The fire department has secured the area and is opening the​ driver's door of the car with jaws as you pull up. After the door is​ opened, you find a male​ victim, in the​ driver's seat, lying over the center console. You hear gurgling respirations that sound shallow at a rate of​ 20, and he is apparently​ unresponsive, but you are unable to see his head from the​ driver's door. You are successful at ascertaining a pedal pulse with a rate of 70 and strong. A rescue worker informs you that they are unable to access the passenger side until the trailer is lifted​ off, as the wheels are in the way. As you are unable to take control of the cervical spine or administer any other type of​ care, you slide the victim​ out, feet​ first, supine along his long axis onto a long spine board and move him to the stretcher. You first inspect his​ head, noticing that there are no landmarks inferior to the supraorbital margin. His respirations are now​ shallow, at a rate of​ 10; he has a radial pulse of 60 and​ bounding; and the pulse ox is 93 percent. As you begin clearing blood and flesh from the​ oropharynx, your partner tells you that he sees no other significant injuries. From the facial injury and others​ signs, what will your initial care center​ on? A. Hemorrhage control B. Airway maintenance C. Fracture immobilization D. Increasing ICP

B. Airway maintenance

What medication would be least appropriate for premedicating a patient with an anterior ankle dislocation prior to attempting relocation to reduce the​ joint? A. Fentanyl B. Asprin C. Diazepam D. Morphine

B. Asprin

You are dispatched to the city pool for a shallow water diving accident. On arrival you are directed poolside at the shallow end where you find an unconscious male​ teenager, approximately 16 years​ old, who has been removed from the water by the lifeguard. The top of his head has been​ bandaged, and he is currently unresponsive. While your partner takes over manual​ traction, the lifeguard tells you that he saw him dive in head first and float to the surface. He rotated him onto his back in the water and slid him out onto the concrete axially with the assistance of another lifeguard. The teenager is​ flushed, has a palpable radial pulse of​ 58, and displays diaphragmatic respirations with a rate of 10. His lungs are clear. Which choice would be included in your next​ step? A. Place a cervical collar. B. Assist respirations with a BVM and supplemental oxygen. C. Check the laceration for hemorrhage control. D. Establish a set of baseline vitals.

B. Assist respirations with a BVM and supplemental oxygen.

What is the white matter of the spinal cord composed​ of? A. Dendrites B. Axons C. Nerve roots D. Neural cell bodies

B. Axons

What type of blunt thoracic trauma results from a chemical reaction that creates a pressure​ wave? A. ​Paper-bag injury B. Blast injury C. Deceleration injury D. Impact injury

B. Blast injury

Which definition most accurately depicts the pathophysiology of a cerebral​ contusion? A. Blunt trauma to local brain tissue causing hemorrhage within the​ meninges, specifically beneath the dura mater and within the subarachnoid space B. Blunt trauma to local brain tissue that produces capillary bleeding into the​ brain's substance C. Blunt trauma to local brain tissue causing hemorrhage and decreased intracranial perfusion D. Significant mechanical disruption of many axons in both cerebral hemispheres with extension into the brainstem

B. Blunt trauma to local brain tissue that produces capillary bleeding into the​ brain's substance

Damage to what hollow organ can result in hemorrhage and content spillage into the​ retroperitoneal, peritoneal, or pelvic​ spaces? A. Pancreas B. Colon C. Spleen D. Kidneys

B. Colon

You have a patient with a closed fracture of the femur. During​ assessment, you note that the area is very distended with taught skin circumferentially in the area of the injury. The patient states that he has no feeling distal to the injury​ site, and the distal pulse is absent. In addition to the fractured​ femur, what other type of condition may​ exist? A. Fascia hypertonicity B. Compartment syndrome C. Interstitial hypertension D. Neural delamination

B. Compartment syndrome

What form of​ cold-related disorder exhibits signs and symptoms of hypothermia with a normal core​ temperature? A. Moderate hypothermia B. Compensated hypothermia C. Convection heat loss D. Mild hypothermia

B. Compensated hypothermia

When faced with a decrease in the core​ temperature, what mechanism does the body use in response to​ this? A. Basal metabolic rate B. Countercurrent heat exchange C. Vasodilation to carry excess heat toward the skin D. Sweating

B. Countercurrent heat exchange

Which statement is accurate regarding the rapid administration of crystalloid solutions in the trauma​ patient? A. Fluid administration should be discontinued in patients displaying symptoms of increasing ICP​ (Cushing's triad). B. Crystalloid solutions should be warmed as close to body temperature as possible prior to administration. C. Administration of crystalloid solutions should be titrated to a systolic BP of 100. D. Fluid administration should be discontinued in the face of narrowing pulse pressure.

B. Crystalloid solutions should be warmed as close to body temperature as possible prior to administration.

You are dispatched to the scene of a shooting. While en​ route, dispatch directs you to a secure staging​ area, set up by law​ enforcement, half of a block from the incident. On arrival you see two officers dragging another officer between them to your unit. You exit the unit and quickly pull the cot out of the​ back, and the officers place the victim sitting up. They quickly explain that he was securing the perimeter when he was shot in the left shoulder by an unknown assailant. Your patient appears alert and well oriented and is complaining of severe left shoulder pain. You note a bullet hole in the front of his body​ armor, high on the left side. You cut off his​ vest, and as you remove​ it, a bullet drops out of the vest onto the​ cot, and you also see an exit wound at the inferior edge of the left scapula with little blood exiting. You apply an occlusive dressing and lay the victim back on the cot. You then notice an entrance wound at the second intercostal​ space, also hemorrhaging​ slightly, just lateral of the midclavicular line. As you continue to assess and care for this​ patient, what would be a sign of​ shock? A. Strong tachycardia B. Decreased level of consciousness or orientation C. A dull sound on percussing the chest D. An absent radial pulse

B. Decreased level of consciousness or orientation

What is a sign of deterioration during​ reassessment? A. Increasing level of consciousness B. Decreasing pulse strength C. Decreasing capillary refill time D. Increasing respiratory volume

B. Decreasing pulse strength

What is the nonprofit diver consultation service sponsored by Duke University Medical​ Center? A. Diver Flight B. Divers Alert Network C. Hyperbaric Air Medical Transport D. Hyperbaric Location Service

B. Divers Alert Network

During which phase of the trauma assessment format should you form your general​ impression? A. From dispatch information B. During all the phases leading up to and including patient contact C. During the primary assessment D. During scene​ size-up

B. During all the phases leading up to and including patient contact

What has had a major effect on reducing mortality and morbidity from head​ injuries? A. Dietary and nutritional programs B. Educational programs promoting safe practices C. Gun registration programs D. Exercise and health promotion programs

B. Educational programs promoting safe practices

Bile performs what​ function? A. Regulates blood glucose levels B. Emulsifies fats C. Activates the immune system D. Regulates osmosis

B. Emulsifies fats

What should be performed in anticipation of freeing a patient who has been trapped for 40 minutes and is suffering from traumatic​ asphyxia? He is already receiving​ high-flow oxygen and respiratory assistance with a BVM. A. Establish a​ large-bore IV and prepare the PASG for application. B. Establish two​ large-bore IVs, consider 1​ mEq/kg of sodium​ bicarbonate, and prepare for immediate expedited transport. C. Establish two​ large-bore IVs, consider 1​ mg/kg of sodium​ bicarbonate, and prepare for immediate expedited transport. D. Establish a​ large-bore IV and prepare spinal immobilization equipment and splinting materials.

B. Establish two​ large-bore IVs, consider 1​ mEq/kg of sodium​ bicarbonate, and prepare for immediate expedited transport.

You are dispatched to an unknown medical emergency near the city park. You arrive to find police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the​ manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped​ forward, unconscious. You also hear sonorous respirations and see a visible open femur fracture that is freely​ hemorrhaging, and blood dripping from her face or head. What is your first​ concern? A. Repositioning her airway B. Establishing the safety of her location so you can initiate care C. Controlling the bleeding D. Administering​ high-flow oxygen

B. Establishing the safety of her location so you can initiate care

Your patient has sustained a deep laceration to the anterior abdominal wall secondary to an industrial accident. When you remove his clothing during your​ assessment, you note that portions of the bowel are now protruding through the abdominal wall. What type of injury is this known​ as? A. Ectopia cordis B. Evisceration C. Abdominodesiccation D. Abdominal effusion

B. Evisceration

Which structure fixes the heart in the mediastinum and prevents kinking of the great​ vessels? A. Serous pericardium B. Fibrous pericardium C. Visceral pleura D. Parietal pleura

B. Fibrous pericardium

Which accessory organ receives bile and stores it until it is needed during digestion of fatty​ food? A. Stomach B. Gallbladder C. Spleen D. Small intestine

B. Gallbladder

Which disorder results from loss of the​ body's hypothalamic temperature regulation​ system? A. Heat exhaustion B. Heatstroke C. Profound hypothermia D. Pyrexia

B. Heatstroke

In patients with rib​ fractures, what benefit does​ grunting, or partial expiration against a closed​ glottis, provide? A. Helps​ "splint" the rib in place B. Helps limit atelectasis C. Provides no benefit D. Clears mucus from the upper airway

B. Helps limit atelectasis

What intervention should be provided for a suspected rupture of a tendon attached near the knee so as to limit the amount of damage to the​ tendon? A. Ice pack or cold pack B. Immobilization C. ​Low-flow oxygen D. Pain medications

B. Immobilization

Which statement is true regarding intracranial hemorrhage in an​ adult? A. Intracranial hemorrhage does not expose brain tissue to contact with blood because of the blooddashbrain barrier. B. Intracranial hemorrhage does not contribute significantly to hypovolemia. C. Intracranial hemorrhage decreases intracranial pressure in an adult. D. Intracranial hemorrhage does not irritate brain tissue it may contact.

B. Intracranial hemorrhage does not contribute significantly to hypovolemia.

A victim of penetrating trauma to the neck can also become the victim of an air embolism due to which​ mechanism? A. Laceration of the carotid artery B. Laceration of the internal jugular vein C. Perforation of the trachea D. Laceration of the external jugular vein

B. Laceration of the internal jugular vein

What population is most at risk for head or spinal column​ injury? A. Males aged 45dash55 B. Males aged 15dash24 C. Females aged 20dash30 D. Males aged 25dash35

B. Males aged 15dash24

Developing workplace safety standards is the responsibility​ of: A. OSHA B. NIOSH C. CDC D. NTSB

B. NIOSH

Enforcement of the workplace safety standards put forth by NIOSH is the responsibility​ of: A. NTSB B. OSHA C. NIOSH D. CDC

B. OSHA

What bone cells dissolve bone structures when they are not carrying pressures of articulation and​ support? A. Haversian canals B. Osteoclasts C. Perforating canals D. Osteoblasts

B. Osteoclasts

For a Caucasian​ patient, how would you classify a very light pink or white appearance to the​ skin? A. Cyanotic B. Pale C. Ashen D. Normal

B. Pale

What patient demographic is most likely to suffer a greenstick​ fracture? A. Geriatric B. Pediatric C. Male D. Female

B. Pediatric

What accurately reflects the pathophysiology of ​Brown-Séquard ​syndrome? A. Hyperextension of the cervical​ spine, resulting in motor weakness of the upper extremities B. Penetrating injury that hemitransects the​ cord, resulting in sensory and motor loss to the ipsilateral side of the body C. A flexiondashextension injury that results in damage to the vertebral​ artery, with damage to the cord from vascular disruption and subsequent ischemia and infarction D. Compression of nerve roots at the lower end of the spinal​ cord, interrupting sensation and motor control

B. Penetrating injury that hemitransects the​ cord, resulting in sensory and motor loss to the ipsilateral side of the body

You are dispatched to the scene of a​ shooting; while en​ route, dispatch directs you to a secure staging​ area, set up by law​ enforcement, half of a block from the incident. On​ arrival, you see two officers dragging another officer between them to your unit. You exit the unit and quickly pull the cot out of the​ back, and the officers place the victim sitting up. They quickly explain that he was securing the perimeter when he was shot in the left shoulder by an unknown assailant. Your patient appears alert and well oriented and is complaining of severe left shoulder pain. You note a bullet hole in the front of his body​ armor, high on the left side. You cut off his​ vest, and as you remove​ it, a bullet drops out of the vest onto the​ cot, and you also see an exit wound at the inferior edge of the left scapula. What does your next action​ include? A. Securing the round for the officers B. Placement of an occlusive dressing on the exit wound C. Inspecting the posterior wound D. Administering​ high-flow oxygen

B. Placement of an occlusive dressing on the exit wound

You are dispatched to the scene of a residential fall. On your arrival you find that your​ patient, a​ 46-year-old male, has fallen approximately 30 feet from a lift basket where he was removing limbs from a tree. According to witnesses your patient landed on his​ side, on the chainsaw he was operating. Your partner immediately takes control of the​ c-spine. Your rapid trauma assessment reveals a​ conscious, well-oriented patient with a palpable radial pulse of​ 128, lying supine next to the saw. He is visibly short of breath and winces as he inhales. As you remove his shirt you observe an area of paradoxical movement near the right​ mid-axillary line appearing to involve ribs 4 through 8. The pulse oximeter indicates​ 90%. You start your patient on​ high-flow oxygen and auscultate his lung​ fields, noting that his breath sounds are equal bilaterally. You splint his flail section with a bulky dressing and get a blood pressure of​ 92/72, and his SpO2 reading is now​ 96%. He tells you that he is having less trouble breathing. What would your next consideration​ include? A. Initiate IV and administer normal saline​ bolus; supplement respiration with​ BVM; provide spinal​ immobilization; transport. B. Provide rapid spinal immobilization and rapid​ transport; place​ IV; provide further respiratory​ support, if/when​ required, en route. C. Supplement respiration with​ BVM; provide spinal​ immobilization; transport. D. Initiate IV and consider further respiratory​ support; provide spinal immobilization.

B. Provide rapid spinal immobilization and rapid​ transport; place​ IV; provide further respiratory​ support, if/when​ required, en route.

What is the elevation of the body temperature above the normal temperature for that​ person, usually because of​ pathogens? A. Heat stroke B. Pyrexia C. Heat exhaustion D. Pyrogenic

B. Pyrexia

What is the typical cause of dysbarism when​ diving? A. Holding your breath B. Rapid ascent C. Uncontrolled descent D. Excessive CO2 in the tank mix

B. Rapid ascent

Questioning a patient about respirophasic​ pain, or pain with breathing​ effort, would happen during what part of​ assessment? A. Scene​ size-up B. Rapid trauma assessment C. Primary assessment D. Reassessment

B. Rapid trauma assessment

The pathophysiology of​ high-altitude illness revolves around which​ condition(s)? A. Acclimatization B. Reduced air pressure and oxygen availability C. Diet and rest D. Exertion

B. Reduced air pressure and oxygen availability

Which item is considered to be a key element of the information shared between health care providers on the​ PCR? A. Patient next of kin B. Results of assessment C. Others administering care D. Time of dispatch

B. Results of assessment

A child fell backward off a trampoline​ yesterday, striking her head. She now has a severe headache and dizziness. In addition to cervical spine injuries that may be​ present, what other​ finding(s) may indicate a skull​ fracture? A. Respiratory rate​ > 24/min B. Retroauricular ecchymosis C. Sonorous breathing D. Brisk pupillary response

B. Retroauricular ecchymosis

What is the first opportunity to begin the assessment​ process? A. Scene​ size-up B. Review of dispatch information C. Interviewing bystanders D. Approaching the patient

B. Review of dispatch information

You are caring for a patient with a closed fracture of the left femur after falling out of the bed of a moving pickup. If this is the only isolated​ injury, which immobilization device cannot be​ used? A. Reel Splint B. SAM splint C. Hare splint D. Sager traction splint

B. SAM splint

What has contributed to the increase in thoracic trauma in urban​ areas? A. Easy access to​ "Saturday night​ specials" B. Semiautomatic hand guns C. A lack of prehospital care in urban areas D. A reduction in paramedic skills

B. Semiautomatic hand guns

In an injury to the abdominal​ wall, visible ecchymosis and swelling typically takes how long to​ develop? A. Several moments B. Several hours C. Several days D. Several minutes

B. Several hours

Which term is defined as a significant mechanical disruption of axons in both cerebral hemispheres with extension into the​ brainstem? A. A focal axonal injury B. Severe diffuse axonal injury C. Subdural hematoma D. Axonal concussion

B. Severe diffuse axonal injury

Which form of thoracic trauma provides the highest risk of aortic​ dissection? A. Severe whiplash from forward momentum B. Severe lateral blunt force trauma C. Severe blunt force trauma to the back D. Severe blunt force trauma to the sternum

B. Severe lateral blunt force trauma

What is the fibrous connective tissue sheet directly beneath the skin and covering the most superior surface of the​ head? A. Sphenoid membrane B. The galea aponeurotica C. Dorsum sellae D. Sella turcica

B. The galea aponeurotica

What is not a reason that the​ atlas/axis joint is the site of the majority of fatal spine​ injuries? A. The atlas and axis are more easily crushed due to axial loading. B. The spinal cord roots exit the spinal column at this point. C. The atlas and axis are exceptionally delicate. D. The atlas and axis are exceptionally mobile and susceptible to fracture or dislocation.

B. The spinal cord roots exit the spinal column at this point.

How does the pathophysiology differ between salt water and freshwater​ drowning? A. Metabolic acidosis is significantly greater in saltwater. B. There are no pathophysiological differences between saltwater and freshwater drowning. C. Hemodilution is greater with freshwater. D. Electrolyte shifts are present with saltwater.

B. There are no pathophysiological differences between saltwater and freshwater drowning.

How many compartments is the abdominal cavity divided​ into? A. Four B. Three C. Two D. One

B. Three

How many layers of connective tissue are there between the cranium and the​ brain? A. Four B. Three C. Two D. None

B. Three

Decorticate posturing as a response to painful stimuli is indicative​ of: A. Medulla disruption. B. Upper brainstem disruption. C. Hypothalamus involvement. D. Depression of the reticular activating system.

B. Upper brainstem disruption.

Which environmental factor would predispose a person to heat or cold​ disorders? A. Acclimatization B. Wind C. Health D. Age

B. Wind

Where is fat stored in a​ bone? A. The periosteum B. Yellow bone marrow C. Cartilage D. Red bone marrow

B. Yellow bone marrow

Lower salt concentrations in perspiration and increased fluid reserves are benefits​ of: A. homeostasis. B. acclimatization. C. exposure. D. exercise.

B. acclimatization.

​High-energy penetrating wounds create a wound track much larger than the projectile size due to a phenomenon known​ as: A. compression. B. cavitation. C. deceleration. D. crepitus.

B. cavitation.

During scene​ size-up for a patient with an apparent gunshot wound to the​ chest, after responding law enforcement has ensured the scene is safe for you to​ enter, you​ should: A. attach the ECG electrodes and monitor for arrhythmias. B. determine the probable projectile pathway. C. palpate the thorax carefully looking for signs of injury. D. observe the general color of the patient.

B. determine the probable projectile pathway.

Decreasing​ P, QRS, and T amplitude with every other cardiac cycle seen in the​ 12-lead ECG of a person with a significant MOI for chest trauma and resulting pericardial tamponade may​ be: A. multifocal atrial dysrhythmia. B. electrical alternans. C. ​second-degree heart block. D. ​beta-adrenergic overstimulation.

B. electrical alternans.

When providing emergency care to the pregnant​ victim, you should place special emphasis​ on: A. the size of the uterus. B. ensuring an adequate​ airway, ventilation, and circulation. C. the prenatal history. D. the secondary exam.

B. ensuring an adequate​ airway, ventilation, and circulation.

You are managing a patient with an anterior knee dislocation with neurovascular compromise following a bicycle wreck. You should​ first: A. grasp the calf muscle just above the ankle. B. have another care provider immobilize the femur firmly in position. C. pull the limb toward alignment with the femur. D. apply firm and progressive traction along the axis of the tibia.

B. have another care provider immobilize the femur firmly in position.

The process of maintaining constant suitable conditions within the body is​ called: A. adjustment. B. homeostasis. C. accommodation. D. adaptation.

B. homeostasis.

When a​ person's core body temperature drops below​ 95°F, they are considered to​ be: A. hyperthermic. B. hypothermic. C. hypothalamic. D. thermically hypogenic.

B. hypothermic.

Operation of a helicopter at the scene of an​ emergency: A. always benefits the care of the patient. B. increases the overall risk to rescue personnel. C. decreases the overall risk to rescue personnel. D. increases the overall availability of helicopters for other emergencies.

B. increases the overall risk to rescue personnel.

Bulging fontanelles in the infant patient who has suffered a traumatic event may be indicative​ of: A. cranial deformation. B. increasing intracranial pressure. C. volume displacement syndrome. D. Down syndrome.

B. increasing intracranial pressure.

Once bubbles of nitrogen have formed in various​ tissues: A. they dissolve into the bloodstream. B. it is difficult for the body to remove them. C. they are quickly eliminated with normal respiration. D. they are metabolized along with oxygen.

B. it is difficult for the body to remove them.

A fracture that runs across the bone at an angle is​ a(n): A. comminuted fracture. B. oblique fracture. C. fatigue fracture. D. transverse fracture.

B. oblique fracture.

You have responded to the scene of a​ middle-aged female who was struck in the abdomen by a bat during a domestic dispute. After being signaled to approach the​ scene, you perform your initial assessment and begin your secondary​ assessment; while assessing the abdomen you​ should: A. check all quadrants except the injured quadrant for rebound tenderness. B. palpate a quadrant at a​ time, saving the injured quadrant for last. C. palpate the injured quadrant first. D. check the injured quadrant for rebound tenderness.

B. palpate a quadrant at a​ time, saving the injured quadrant for last.

You are caring for a male patient who was involved in an industrial fall in which he landed in a straddle position on a steel beam. The patient has severe​ pain, disfigurement, and swelling to the genitalia. Patient care should include all of the following​ except: A. psychological reassurance. B. position of comfort for transport. C. stabilizing any avulsed tissue. D. applying ice packs to control the swelling.

B. position of comfort for transport.

Dressing​ appropriately, eating at regular​ intervals, and getting plenty of rest are all preventative measures​ for: A. improving overall health. B. preventing​ cold-related injury. C. assisting recovery from hypothermia. D. preventing overexertion.

B. preventing​ cold-related injury.

The pancreas is responsible​ for: A. detoxification of blood. B. production of glucagon and insulin. C. storage of bile. D. production of bile.

B. production of glucagon and insulin.

One example of the use of public education to reduce morbidity and mortality related to abdominal trauma​ is: A. the use of tourniquets. B. proper use of seat belts. C. training paramedics in accurate determination of the amount of blood loss into the abdominal cavity. D. actively recruiting abdominal surgeons.

B. proper use of seat belts.

Musculoskeletal injuries to the upper​ extremities: A. more often constitute threats to life and limb than lower extremity injuries. B. rarely threaten life to the same degree that lower extremity injuries often do. C. are generally associated with a greater magnitude of force than lower extremity injuries. D. typically involve greater secondary blood loss than lower extremity injuries.

B. rarely threaten life to the same degree that lower extremity injuries often do.

Assessment of a trauma victim whenever you note a change in condition or you perform a significant intervention is​ called: A. focused trauma assessment. B. reassessment. C. CUPS assessment. D. secondary assessment.

B. reassessment.

Sources of musculoskeletal injuries do not​ include: A. acts of violence. B. smoking. C. falls. D. sports.

B. smoking.

EMS systems can actively participate in trauma prevention by following the example​ of: A. hospitals. B. the fire service. C. the military. D. law enforcement.

B. the fire service.

When performing CPR on the​ near-term pregnant​ victim, it is important to remember​ that: A. additional respirations should be performed. B. the heart is further superior and to the lateral left. C. the compression depth should be shallower. D. the compression rate should be increased.

B. the heart is further superior and to the lateral left.

The three methods the body utilizes to create heat are all types​ of: A. insulation. B. thermogenesis. C. conservation. D. volatile reactions.

B. thermogenesis.

You are treating a​ late-term, pregnant trauma victim who requires spinal immobilization. When​ transporting, the backboard should​ be: A. placed flat on the stretcher. B. tilted 15 degrees. C. turned on its right side. D. ​avoided; use a cervical board instead.

B. tilted 15 degrees.

During controlled​ ascent, with decreasing​ pressure, dissolved gases come out of the blood and tissues​ slowly, escaping gradually through​ respiration, according​ to: A. the law of inertia. B. ​Boyle's law. C. ​Dalton's law. D. ​Henry's law.

B. ​Boyle's law.

Major diving emergencies while at the bottom of the dive often involve nitrogen​ narcosis, a state of​ stupor, commonly called​ "raptures of the​ deep." This is due to the effect of nitrogen on cerebral function. What gas law explains the occurrence of nitrogen​ narcosis? A. ​Dalton's law B. ​Henry's law C. Ideal gas law D. ​Boyle's law

B. ​Henry's law

The initial symptoms of what​ high-altitude illness include dry​ cough, mild shortness of breath on​ exertion, and slight crackles in the​ lungs? A. ​High-altitude cerebral edema B. ​High-altitude pulmonary edema C. Acute mountain sickness D. Dysbaria

B. ​High-altitude pulmonary edema

A​ 34-year-old male patient received a​ small-caliber gunshot wound to the right anterior chest at the third intercostal on the midclavicular line. He is conscious and well oriented and complaining of pain at the wound site and difficulty breathing. His respirations are 22 and seem​ shallow, his radial pulse is​ 110, and his SpO2 is 92. He has reduced breath sounds on his right​ side, but percussion of the chest seems equal on both sides. What would your initial treatment​ include? A. Application of a sterile occlusive dressing and monitored vitals B. ​High-flow oxygen and application of a​ one-way valve dressing C. ​High-flow oxygen and assisted ventilation D. Application of a sterile occlusive dressing and rapid transport

B. ​High-flow oxygen and application of a​ one-way valve dressing

Which of the following is not an effect produced by pericardial​ tamponade? A. Distended jugular veins B. ​Strong, bounding pulse C. Diminished pulse strength D. Decreased pulse pressure

B. ​Strong, bounding pulse

What are triaxial joints?

Ball and socket joints that permit full motion in cone of about 180 degrees and allow a limb to rotate

What is the definition of hematochezia

Blood in stool

During controlled ascent, with decreasing pressure, dissolved gases come out of the blood and tissues slowly escaping gradually through respiration, according to:

Boyle's law

What is not a common sign or symptom of blunt cardiac trauma?

Bradycardia

You are caring for a patient with penetrating abdominal trauma secondary to an industrial explosion. The patient has an altered mental status and is found to be​ hypotensive, tachycardic, and tachypneic. During your fluid​ administration, what minimum systolic blood pressure do you wish to​ maintain? A. 70 mmHg B. 60 mmHg C. 80 mmHg D. 90 mmHg

C. 80 mmHg

What is the preferred technique to secure a fractured​ humerus? A. An unpadded rigid splint B. An air splint C. A sling and swathe D. A vacuum splint

C. A sling and swathe

You are assessing a patient with blunt abdominal trauma. You note that the abdomen is slightly​ distended, rigid to the​ touch, with an ecchymotic area surrounding the umbilicus. What does this finding​ imply? A. Penetrating trauma somewhere in the flank area B. Evisceration through laceration of the abdominal wall C. An abdominal injury that is likely several hours old D. Very recently sustained blunt abdominal trauma

C. An abdominal injury that is likely several hours old

What is the purpose of a focused trauma​ assessment? A. Evaluation of traumatic injury in the face of​ near-term pregnancy B. Establishment of a CUPS rating C. Assessment of a specific isolated injury D. Location of serious traumatic injuries

C. Assessment of a specific isolated injury

What is the effect of even a small amount of water entering the lungs during a​ drowning? A. Mammalian diving reflex B. Hypocarbia C. Atelectasis D. Laryngospasm

C. Atelectasis

Which individual would you most likely assess and treat for​ heatstroke? A. A​ 50-year-old woman out walking her dog on an evening with a temperature of 75 degrees and 16 percent humidity B. A​ 30-year-old man playing tennis in an​ air-conditioned indoor court C. A​ high-school football player in the first few days of practice with temperatures in the 90s and high humidity D. A​ 68-year-old man who lives in a small house without air conditioning with a summer temperature between 80 and 85 degrees Fahrenheit

C. A​ high-school football player in the first few days of practice with temperatures in the 90s and high humidity

Your squad is dispatched to a local department store for a fall. When you arrive you are met by a panicked store manager and led to one of the aisles where a construction worker in his​ mid-20s has fallen approximately 20 feet through the roof and is lying on the floor after landing on a set of shelves. As you approach you note that the worker is unconscious and breathing at a rate of​ 10/min. He has a pulse rate of 72 and thready. You immediately start him on​ high-flow oxygen via a nonrebreather mask and perform a rapid trauma​ assessment, which reveals that he has no response to​ pain, apparent abdominal​ distention, open bilateral tibia and fibula​ fractures, and a closed femur fracture on his left side. His blood pressure is​ 80/68. What care should be performed prior to​ transport? A. Rapid sequence intubation B. Full physical exam C. Bleeding control and full immobilization on a long spine board D. Initiation oftwo​ large-bore IVs of a crystalloid solution

C. Bleeding control and full immobilization on a long spine board

What is not a type of soft​ splint? A. Pillow splint B. Air splint C. Cardboard splint D. Pelvic sling

C. Cardboard splint

Your EMS system permits care providers to treat patients with minor injuries and then release them to see their personal physician. After treating a patient for heat​ cramps, she seems to have recovered and she reports that the slight dizziness that she had been experiencing is gone. You determine that you can release this patient according to your​ system's local protocols. What do you need to​ do? A. Contact medical direction. B. Reassess the​ patient's vital signs one last time. C. Carefully explain to this patient what heat emergency signs to watch out for and ensure she understands. D. Have the patient sign a refusal of care form.

C. Carefully explain to this patient what heat emergency signs to watch out for and ensure she understands.

Which condition results from hyperextension of the cervical​ spine, such as may occur from a forward fall and facial​ impact? A. Anterior cord syndrome B. Cauda equina syndrome C. Central cord syndrome D. ​Brown-Sequard syndrome

C. Central cord syndrome

What type of bone injury is said to occur when the bone itself becomes​ fractured, but there is no penetration of sharp bone ends through the overlying​ skin? A. Spiral fracture B. Greenstick fracture C. Closed fracture D. Open fracture

C. Closed fracture

Your patient has an abdominal wound that resulted in an evisceration of bowel. How should this be​ managed? A. Cover the exposed bowel with an occlusive dressing. B. Gently tuck the bowel back into the abdominal cavity without rinsing it with saline. C. Cover the exposed bowel with a​ saline-soaked trauma pad. D. Wash off the bowel with saline and tuck it gently back into the abdominal cavity.

C. Cover the exposed bowel with a​ saline-soaked trauma pad.

During primary​ assessment, which of the following signs indicates​ hypoxia? A. Distended jugular veins B. Dyspnea C. Cyanosis D. Limited chest movement

C. Cyanosis

What does not result in thermolysis of​ body-generated heat? A. Radiation B. Respiration C. Digestion D. Evaporation

C. Digestion

What type of orthopedic injury may have occurred when a joint is injured in such a way that it becomes fixed in an abnormal​ position, is resistive to​ motion, is extremely​ painful, and will likely have noticeable​ deformity? A. Impacted fracture B. Transverse fracture C. Dislocation D. Comminuted injury

C. Dislocation

You are planning to assist your neighbor with installing a roof on his house on a sunny summer day. The weather is supposed to be hot with a high of 88 degrees and humidity of 85 percent. What measure will help you avoid a​ heat-related injury? A. Attempt to finish work for the day prior to​ mid-afternoon. B. Take frequent breaks. C. Drink fluids. D. Acclimatize slowly.

C. Drink fluids.

Which demographic of trauma victim appears to benefit least from air medical​ services? A. Young adults B. Infants C. Elderly D. Adolescents

C. Elderly

How do superficial scalp wounds provide a risk of infection that can involve the​ brain? A. The confluence of sinuses drains into the lymphatic system. B. Dural sinuses drain into frontal sinuses. C. Emissary veins from the dural sinuses drain into superficial venous circulation. D. Arteries supplying the meninges also supply the scalp.

C. Emissary veins from the dural sinuses drain into superficial venous circulation

You are working as a paramedic diver assisting a search and rescue team in locating a private aircraft that crash landed and rapidly sank in a local lake. You are searching in approximately 80 feet of water when you notice that your dive partner is beginning to act​ erratically, rapidly changing direction and swimming down into the bottom and stirring up silt. You suspect your partner is suffering from nitrogen narcosis. What should you​ do? A. Encourage your partner to rapidly ascend to the water surface and then check for and treat pneumothorax. B. Encourage your partner to rapidly ascend to the​ surface, administer​ high-flow oxygen, expedite​ transport, initiate an IV en​ route, and administer naloxone for nitrogen narcosis. C. Encourage your partner to ascend to the​ surface, assuring that he stages his ascent. D. Return to the surface to declare a diver​ emergency, and then descend back to your partner and pull him to the surface.

C. Encourage your partner to ascend to the​ surface, assuring that he stages his ascent.

You are treating a patient who received a knife wound to the left anterior chest. You have initiated​ high-flow oxygen and a​ large-bore IV. His vital signs are pulse​ 90, respirations​ 14, and blood pressure​ 110/74, and his lungs are clear bilaterally. After moving him to your​ stretcher, you notice that he is developing jugular vein distention that diminishes upon​ exhalation; a check of his radial pulse reveals that it has risen to​ 126, and you are barely able to detect it. His lungs are still clear​ bilaterally, but his heart sounds distant. What is your transport plan for this​ patient? A. ​Smooth, easy transport to the nearest trauma center B. Expedited transport to the nearest trauma center C. Expedited transport to the nearest ED D. ​Smooth, easy transport to the nearest ED

C. Expedited transport to the nearest ED

What is responsible for the low survival rate for victims of commotio​ cordis? A. Systemic electrolyte imbalance B. The low percentage of trained people at sporting events C. Failure to initially recognize the condition D. Resistant​ V-tach

C. Failure to initially recognize the condition

Which condition is a primary predisposing factor for environmental​ injuries? A. Balanced diet B. Stress C. Fatigue D. Exertion

C. Fatigue

Which type of head injury carries a 75 percent or higher mortality rate and is second in lethality after head injuries from auto​ crashes? A. Contrecoup injuries B. Whiplash C. Gunshot wounds D. Deceleration injuries

C. Gunshot wounds

What are the tubes of a bone through which blood vessels travel​ called? A. Arterioles B. Osteoclasts C. Haversian canals D. Osteocytes

C. Haversian canals

The use of which adjunct has reduced the occurrence of head injury in​ sports? A. CT scans for concussions B. Injured roster time for concussions C. Helmets D. Seat belts

C. Helmets

What effect does hypothyroidism have on​ cold-related disorders? A. Hypothyroidism chronically reduces the​ body's release of catecholamines that maintain metabolic activity and heat production. B. Hypothyroidism prevents glycogen storage in the liver. C. Hypothyroidism depresses the​ body's heat-producing mechanisms. D. Hypothyroidism reduces the​ body's thermal mass.

C. Hypothyroidism depresses the​ body's heat-producing mechanisms.

What term refers to a reduced volume in the cardiovascular​ system, caused by hemorrhage or by an excess of fluid loss against inadequate fluid​ intake, or by losses into third​ spaces? A. Hypotension B. Hypoperfusion C. Hypovolemia D. Dehydration

C. Hypovolemia

Which cause of abdominal trauma is on the​ rise? A. Auto accidents due to higher highway speed limits B. Auto accidents due to a decline in the use of seat belts C. Increasing violence in society D. Injury resulting from poor employer safety policies

C. Increasing violence in society

What would blunt trauma to the neck that damages the cartilaginous rings of the trachea​ and/or the vocal cords not​ cause? A. Soft tissue swelling B. Epiglottitis C. Injury to the​ T-12/L-1 transition point D. Collapse of the airway on inspiration

C. Injury to the​ T-12/L-1 transition point

During a fight with a​ knife-wielding assailant, your teenage patient was stabbed in the lower left abdominal​ quadrant, at roughly the 5​ o'clock position. Bleeding is​ minimal, and the patient is conscious and in extreme pain. Given this​ injury, what structure is most likely injured from the​ stabbing? A. Small bowel B. Gallbladder C. Large bowel D. Inferior vena cava

C. Large bowel

In a drowning​ incident, how much water typically enters the​ lungs? A. About 300 mL B. The lungs fill C. Less than 30 mL D. None

C. Less than 30 mL

In which stage of hypothermia is the ability to shiver usually​ lost? A. Compensated hypothermia B. Severe hypothermia C. Moderate hypothermia D. Mild hypothermia

C. Moderate hypothermia

What type of bone injury carries with it the greatest likelihood of a secondary​ infection? A. Compartment syndrome B. Hairline collagen fracture C. Open fracture D. Paresthesia

C. Open fracture

What accelerated degenerative bone disease results from​ demineralization? A. Osteopenia B. Pathological fractures C. Osteoporosis D. Cramping

C. Osteoporosis

Which unique finding may be noted in compartment syndrome as a result of compression damage to the nerves and vascular supply in the femoral​ region? A. Presence of a distal pulse B. ​Hyper-reactivity of the reflexes on the injured limb C. Paresthesia between the medial toes D. No pain with passive extension of the extremity

C. Paresthesia between the medial toes

What should be done with the information you receive from emergency medical responders and EMTs about the​ patient's condition and the care he received after you finish formulating a patient management​ plan? A. Avoid receiving the information until after you have formed your own management plan. B. Verify the information. C. Pass the information along to the ED. D. List it in the ​"Prior Care" section of the PCR.

C. Pass the information along to the ED.

What type of injury is most likely to result in frank​ hematuria? A. Mesenteric injury B. Thoracic injury C. Pelvic fracture D. Femur fracture

C. Pelvic fracture

What type of trauma is most likely to cause vascular injuries to the​ abdomen? A. Deceleration B. Compression C. Penetrating D. Shear

C. Penetrating

Open chest wall injuries are almost entirely the result of what​ mechanism? A. Firearms B. Blunt trauma C. Penetrating trauma D. ​Low-velocity wounds

C. Penetrating trauma

Which meningeal layer is closest to the​ brain? A. Cerebro mater B. Dura mater C. Pia mater D. Arachnoid membrane

C. Pia mater

What is the best method by which to reduce the morbidity and mortality associated with abdominal​ trauma? A. Improved diagnostic imaging B. Mobile surgical intervention units C. Prevention D. Improved passive restraint systems on automobiles

C. Prevention

You are dispatched for a fall at the local mall. When you arrive you are led by security to a location on the sidewalk where a​ 43-year-old male patient is lying on his back. He is alert and oriented and tells you that he was running to cross in front of a car when he tripped on the​ curb, striking his head on the sidewalk. He then rolled onto his back and can no longer move his​ hands, legs, or​ trunk, although he can still move his arms. You suspect a low cervical or high thoracic spinal injury. At what point in the assessment would you apply spinal stabilization to this​ patient? A. Scene​ size-up B. Rapid trauma assessment C. Primary assessment D. Secondary assessment

C. Primary assessment

What contribution have EMS systems made to the reduction in morbidity and mortality associated with abdominal​ injuries? A. Definitive prehospital treatment of abdominal hemorrhage B. Placement of surgeons in the prehospital system of rural areas C. Reduced​ injury-to-surgery times D. Reduced​ "go/no go" standards for air medical transport

C. Reduced​ injury-to-surgery times

What is the result of an injury that disrupts the bellows effect of the thoracic​ cavity? A. Hyperventilation syndrome B. Great vessel damage C. Respiratory insufficiency D. Pericardial tamponade

C. Respiratory insufficiency

What is the characteristic sign of a basilar skull fracture involving the auditory​ canal? A. Le Fort criteria B. Bilateral periorbital ecchymosis C. Retroauricular ecchymosis D. Epistaxis

C. Retroauricular ecchymosis

In addition to the traditional management of a patient with spinal injury and abdominal trauma who is immobilized on a​ backboard, what intervention should be provided for the​ 8-months-pregnant female with abdominal​ trauma? A. Initiate a​ large-bore IV and keep the systolic pressure at greater than 100 mm Hg. B. Place the pregnant female in a​ semi-supine position to alleviate pressure of the uterus on the vena cava. C. Rotate the board 15 degrees to the left. D. Use​ low-flow oxygen only to avoid fetal hyperoxia.

C. Rotate the board 15 degrees to the left.

Which part of the inner ear is responsible for​ equilibrium? A. Cochlea B. Ganglia C. Semicircular canals D. Vestibule

C. Semicircular canals

What bodily activity that results from hypothermia robs the trauma victim of much needed metabolic​ resources? A. Fight or flight B. Body splinting C. Shivering D. Peripheral vascular dilation

C. Shivering

When palpating a​ patient, what does a​ "Rice Krispies" feel to the skin​ signify? A. Rebound tenderness B. Flaccidity C. Subcutaneous emphysema D. Muscle spasm

C. Subcutaneous emphysema

You are dispatched to an unknown medical emergency near the city park. You arrive to find the fire department and police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the​ manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped​ forward, unconscious. You also note sonorous respirations and see a visible open femur fracture that is freely hemorrhaging and blood dripping from her face or head. The fire department has determined that the atmosphere in the manhole is​ safe, and you enter the space. Your partner repositions the airway while initiating manual spinal alignment. The sonorous respirations​ cease, but you note that she has audible gurgling and an apparent maxillary​ fracture; she is bleeding heavily from the mouth and nose. Which choice would be your next​ step? A. Suction as required and place on​ high-flow oxygen via nonrebreather mask. B. Place on​ high-flow oxygen and control the bleeding at the femur. C. Suction as​ required, place a mechanical​ airway, and assist ventilations as needed. D. Place her in a slatted stretcher and extricate her from the manhole.

C. Suction as​ required, place a mechanical​ airway, and assist ventilations as needed.

Which of the statements regarding the Glasgow Coma Scale is​ accurate? A. The GCS is a precise indicator of airway compromise. B. The GCS can be administered uniformly across all ages. C. The GCS is not a​ "perfect" means to accurately represent a​ patient's level of consciousness. D. The GCS should be repeated every 15 minutes for traumatized victims.

C. The GCS is not a​ "perfect" means to accurately represent a​ patient's level of consciousness.

What is the general term for the loss of heat from warmer substances to cooler​ substances, regardless of the mechanism of heat​ loss? A. Transfer B. Chilling C. Thermolysis D. Radiation

C. Thermolysis

Which statement is most accurate when considering spinal precautions as part of your primary​ assessment? A. No patients are excluded from spinal precautions. B. When in​ doubt, err on the side on forgoing spinal precautions in favor of more rapid transport. C. They should be immediately employed when an MOI or patient condition warrants it and discontinued if the patient is completely cleared. D. Spinal precautions are generally not employed for elderly or pediatric patients.

C. They should be immediately employed when an MOI or patient condition warrants it and discontinued if the patient is completely cleared.

You are called to the scene of a shooting. After being directed to approach the scene by law​ enforcement, you are escorted to a​ 42-year-old male patient complaining of a single gunshot wound to the anterior right upper quadrant of the abdomen without an exit wound. What information would initially assist you in determining the associated internal​ injuries? A. The brand of the firearm B. The build of the victim C. The​ height, distance,​ direction, and angle of the firearm when the shooting occurred D. The size of the assailant

C. The​ height, distance,​ direction, and angle of the firearm when the shooting occurred

In comparison with the adult​ patient, what type of fracture would the pediatric patient be more prone​ to? A. Pathologic B. Comminuted C. Torus D. Febrile

C. Torus

You are dispatched to a residence for a​ 32-year-old female complaining of a severe headache and blurry vision in her left eye. When you question​ her, she tells you that the headache began the previous day and got worse as the day went​ on, forcing her to leave work early. When she awoke this​ morning, she noticed the dizziness and vision change in her eye and decided not to drive herself to the doctor. As you perform your​ exam, you notice that she winces when you touch the left parietal area of her head. When​ asked, she remembers that she was struck on the left side of the head by an object she believed was thrown by a lawn mower she walked past three days prior as she was walking the dog. She stated that the object​ didn't hurt very much so she​ didn't stop and subsequently forgot about it. You decide to expedite transport for this patient. Which mode of transport is​ best? A. Transport via air medical service B. Transport at high speed using lights and sirens sparingly C. Transport at reduced speed using lights and sirens sparingly D. Transport at high speed with red lights and sirens used throughout

C. Transport at reduced speed using lights and sirens sparingly

Continued advances in what area can do the most to improve prevention of musculoskeletal​ injury? A. Protective gear for sports B. Workplace safety enforcement C. Vehicle and highway design D. Home safety

C. Vehicle and highway design

To receive a Revised Trauma Score of 4 for respiratory rate the patient must be breathing​ at: A. greater than 29 breaths per minute. B. a maximum of 10 breaths per minute. C. a minimum of 10 breaths per minute. D. 6 to 9 breaths per minute.

C. a minimum of 10 breaths per minute.

Hypotension occurs in relation​ to: A. a decrease in blood volume. B. an increase in blood pressure. C. a reduction in blood pressure. D. an increase in blood volume.

C. a reduction in blood pressure.

Osteoporotic​ fractures: A. are more common in pediatric patients. B. are more common among patients who are athletes. C. are much more common in women than men. D. are uncommon in the United States.

C. are much more common in women than men.

You are treating a novice diver who is the victim of a​ pneumothorax, which resulted from him holding his breath during ascent from a​ 20-foot-deep dive and causing pulmonary overpressure. You have successfully treated the pneumothorax but have a concern because the same type of barotrauma can also additionally result​ in: A. ruptured eardrum. B. nitrogen narcosis. C. arterial gas embolism. D. decompression sickness.

C. arterial gas embolism.

The patient with an aortic dissection may complain of severe tearing pain that radiates to​ the: A. neck. B. head. C. back. D. extremities.

C. back.

The exchange of information between patient care providers​ should: A. include anecdotal information. B. not contain patient information ascertained prior to your arrival. C. be​ rapid, thorough, and accurate. D. be publicly available.

C. be​ rapid, thorough, and accurate.

Mortality resulting from a hemothorax is primarily attributable​ to: A. hypoxemia. B. other associated injuries. C. blood loss. D. tension hemothorax.

C. blood loss.

The portion of the membranous lining that covers the outside of the heart is​ the: A. lateral cardiohylum. B. pericardium. C. epicardium. D. endocardium.

C. epicardium.

Myocardial aneurysm or rupture occurs almost exclusively​ in: A. penetrating trauma. B. blunt cardiac injury. C. extreme blunt thoracic trauma. D. blunt force from CPR.

C. extreme blunt thoracic trauma.

The basic goal of splinting is​ to: A. eliminate pain from injury. B. have the patient test a range of motion for the proximal joint. C. help reduce or eliminate movement of an injured extremity. D. strengthen the injured joint.

C. help reduce or eliminate movement of an injured extremity.

When identifying a​ patient's level of​ consciousness, you should at a​ minimum: A. assign the patient a Glasgow Coma Scale​ (GCS) score. B. establish his degree of orientation. C. identify the​ patient's level of consciousness using the AVPU mnemonic. D. determine whether the patient is conscious or unconscious.

C. identify the​ patient's level of consciousness using the AVPU mnemonic.

Morbidity and mortality for various abdominal injuries has been on the decline due​ to: A. a reduction in occurrences of penetrating trauma. B. development of prehospital definitive care techniques. C. improved surgical and critical care techniques. D. a reduction in the rush to surgical intervention.

C. improved surgical and critical care techniques.

Most motor vehicle accident deaths that are attributable to thoracic trauma result​ from: A. flail chest. B. tension pneumothorax. C. injury to the heart and great vessels. D. airway obstruction.

C. injury to the heart and great vessels.

The risk of becoming a victim to a​ heat-related disorder can be most practically reduced​ by: A. taking salt tablets. B. reducing the outdoor humidity level. C. maintaining an adequate fluid intake. D. avoiding exposure to hot environments.

C. maintaining an adequate fluid intake.

Members of the emergency medical system can most effectively impact morbidity and mortality of trauma victims​ by: A. updating standing orders. B. reducing scene times. C. participating actively in prevention. D. practicing skills.

C. participating actively in prevention.

To secure the hand in the position of function when splinting a forearm​ fracture: A. use a sling and swathe. B. splint the hand along with the forearm. C. place a large dressing material wad in the palm. D. wrap the hand tightly in bandages.

C. place a large dressing material wad in the palm.

It is a​ clear, warm August afternoon when your squad is dispatched to a construction site for a​ 22-year-old male complaining of numbness and​ tingling, muscle​ cramps, and headache after operating a jackhammer all morning. Upon arrival you verify that the site is secure and then are led to the shady side of a concrete block wall where your victim is sitting on the ground with his head in his hands. As you approach and introduce​ yourself, your patient anxiously tells you that he feels like​ he's going to pass out. He is diaphoretic and very warm with a thready pulse of 98 and a respiratory rate of 16 and​ shallow, with a pulse ox of 99 percent on ambient air. He tells you he has no medical history or allergies. As you assist your patient to a supine​ position, you ask your partner​ to: A. radio medical direction. B. prepare​ high-flow oxygen. C. prepare an IV of normal saline. D. get a glass of cold water.

C. prepare an IV of normal saline.

The ability of the paramedic to trend improvement or deterioration in a​ patient's condition is most reliant​ upon: A. patient history. B. ​follow-up findings in the ED. C. reassessment. D. increasing anxiety.

C. reassessment.

A large region of cortical disruption may cause confusion and affect the​ patient's mental​ status, such as the patient forgetting the circumstances leading up​ (before) the incident​ itself, which is​ called: A. anterograde amnesia. B. event amnesia. C. retrograde amnesia. D. retroauricular ecchymosis.

C. retrograde amnesia.

During the rapid trauma assessment for a patient with an extremity fracture or muscular​ injury, you should assess the distal​ pulses, capillary​ refill, temperature, muscle​ tone, and, if the patient is​ conscious: A. blood loss. B. oxygen saturation. C. sensation and motor function. D. blood pressure.

C. sensation and motor function.

Storing salts needed for metabolism is primarily the job of​ the: A. liver. B. muscles. C. skeleton. D. kidneys.

C. skeleton.

You are treating a female patient who was attacked and robbed. The patient presents with labored breathing due to a knife that has been impaled into the upper left abdominal quadrant. Treatment of this injury should​ include: A. removing the knife and placing an occlusive dressing. B. bandaging the protruding portion tight against the abdomen. C. stabilizing the knife in place. D. cutting the protruding part of the knife.

C. stabilizing the knife in place.

Submersion of the face in cold water can​ trigger: A. laryngospasm. B. hypoxia. C. the mammalian reflex. D. aspiration.

C. the mammalian reflex.

Entanglement in kelp fields causing fatigue or​ drowning, diving into cold water causing​ blackouts, and injury from boats in the area are types of injury associated​ with: A. the bottom. B. ascent. C. the surface. D. descent.

C. the surface.

The great​ vessels, trachea, and​ esophagus, as well as the vagus and phrenic​ nerves, enter the mediastinum through​ the: A. thyroid opening. B. esophageal passage. C. thoracic inlet. D. mediastinum.

C. thoracic inlet.

What results from penetrating injury that affects one side of the​ cord? A. Cauda equina syndrome B. Anterior cord syndrome C. ​Brown-Sequard syndrome D. Central cord syndrome

C. ​Brown-Sequard syndrome

You are dispatched to the scene of an automobile accident along with two other units. As you approach the​ scene, you see a compact car under the trailer of a​ semi-truck that turned in front of the car. The fire department has secured the area and is opening the​ driver's door of the car with jaws as you pull up. After the door is​ opened, you find a male victim in the​ driver's seat, lying over the center console. You hear gurgling respirations that sound shallow at a rate of​ 20, and he is apparently​ unresponsive, but you are unable to see his head from the​ driver's door. You are successful at ascertaining a pedal pulse with a rate of 70 and strong. A rescue worker informs you that they are unable to access the passenger side until the trailer is lifted​ off, as the wheels are in the way. With the provided​ information, prioritize your initial concerns in terms of injury. A. Airway​ compromise, hemorrhage,​ extrication, severe head injury B. Severe head​ injury, respiratory​ distress, extrication C. ​Extrication, airway​ compromise, severe head​ injury, cervical​ spine, hemorrhage, hypothermia D. Severe head​ injury, cervical spine​ injury, respiratory​ distress, extrication

C. ​Extrication, airway​ compromise, severe head​ injury, cervical​ spine, hemorrhage, hypothermia

Which illness is caused by an increase in pulmonary pressure and hypertension precipitated by changes in blood flow that occur at high​ altitudes? A. Acute mountain sickness B. ​High-altitude cerebral edema C. ​High-altitude pulmonary edema D. Dysbarism

C. ​High-altitude pulmonary edema

Which illness is caused by an increase in pulmonary pressure and hypertension precipitated by changes in blood flow that occur at high​ altitudes? A. ​High-altitude cerebral edema B. Dysbarism C. ​High-altitude pulmonary edema D. Acute mountain sickness

C. ​High-altitude pulmonary edema

Which femur fracture is most likely to be immobilized with a traction​ splint? A. Proximal femur fracture B. ​Mid-shaft femur fracture with associated hip injury C. ​Mid-shaft femur fracture D. ​Mid-shaft femur fracture with concurrent pelvic injury.

C. ​Mid-shaft femur fracture

A conscious patient with a severe open fracture in the right thigh and other less severe but still significant musculoskeletal injuries in the lower right leg and foot asks you anxiously if she will be able to walk again. What is your best​ response? A. Tell the patient you are not allowed to make a prognosis and continue care. B. Smile and​ say, "You'll be​ fine," while continuing care. C. ​Say, "We'll do everything we can to provide you with necessary​ care," while continuing care. D. Ignore the patient while concentrating on continuing care.

C. ​Say, "We'll do everything we can to provide you with necessary​ care," while continuing care.

Trauma-related hypothermia occurs in relation to​ the: A. external temperature. B. lack of external heat sources. C. ​fight-or-flight response. D. wind chill.

C. ​fight-or-flight response.

A dislocation at the sternoclavicular joint should be immobilized with​ a: A. traction splint. B. rigid splint. C. ​figure-eight dressing. D. sling and swath.

C. ​figure-eight dressing.

Retroauricular ecchymosis

Characteristic sign of a basilar skull fracture involving the auditory canal

Which population is at highest risk for high -altitude pulmonary edema?

Children

What type of bone injury is said to occur when the bone itself becomes fractured, but there is no penetration of sharp bone end through overlying skin?

Closed fracture

Central cord syndrome

Condition results from hyperextension of cervical spine, such as may occur from a forward fall and facial impact

In what form of heat loss does the body lose heat to cooler air currents that pass by the body?

Convection

What percentage of victims that suffer an impact to the head require​ hospitalization? A. 35 percent B. 20 percent C. 50 percent D. 10 percent

D. 10 percent

You are treating the victim of an automobile accident who is presenting with no open​ wounds, but a slightly distended abdomen. He is alert and well​ oriented, has a pulse of​ 100, respirations of​ 22, and a blood pressure of​ 88/70. What would his Revised Trauma Score​ be? A. 12 B. 8 C. 16 D. 11

D. 11

You find significant hypoglycemia is an unresponsive patient with a head injury. You​ administer: A. 125 mg of glucose and 600 mg of thiamine. B. 50 mg of glucose and 75 mg of thiamine. C. 100 mg of glucose and 500 mg of thiamine. D. 25 mg of glucose and 100 mg of thiamine.

D. 25 mg of glucose and 100 mg of thiamine.

What percentage of motor vehicle deaths are due to thoracic​ trauma? A. 35 percent B. 52 percent C. 10 percent D. 25 percent

D. 25 percent

What is the most common outcome of blunt head​ trauma? A. A focal injury B. A cerebrovascular accident C. Impeded intracranial perfusion D. A diffuse injury

D. A diffuse injury

To correct the hypoxia of a drowning​ patient, what is the first​ step? A. Examine the patient for airway​ patency, breathing, and pulse. B. Position the patient on a flat surface parallel to the water. C. Manage the airway using proper suctioning and airway adjuncts. D. A trained rescue swimmer removes the patient from the water.

D. A trained rescue swimmer removes the patient from the water.

What is the temperature at which all molecular motion has​ stopped? A. Fahrenheit zero B. ​-250 degrees C C. Entropic zero D. Absolute zero

D. Absolute zero

What task does a hyperbaric chamber​ perform? A. Return of the diver to his previous dive depth in a bell chamber B. Increase of atmospheric air pressure C. Replacement of a​ diver's air tanks D. Administration of oxygen at greater than air pressure

D. Administration of oxygen at greater than air pressure

What has been the greatest source of advancement in treatment of thoracic​ trauma? A. Improved patient care quality assurance B. Shorter response times C. Delivery of definitive care by paramedics D. Advances in treatment made during military conflicts

D. Advances in treatment made during military conflicts

Which drug does not interfere with proper​ heat-generating mechanisms? A. Alcohol B. Antihistamines C. NSAIDs D. Antibiotics

D. Antibiotics

When clearing the cervical​ spine, what would a distracting injury​ include? A. Any injury that appears​ significant, even if pain is not an issue B. Any injury that would distract the paramedic from clearing the cervical spine C. Injury to other​ patients, which would distract the paramedic from clearing the cervical spine D. Any injury that produces clinically apparent pain that might distract the patient from the pain of a spine injury

D. Any injury that produces clinically apparent pain that might distract the patient from the pain of a spine injury

You are treating the victim of an auto accident who struck the steering wheel when the air bag failed to deploy. You notice severe bruising of the anterior chest but​ don't detect any rib fractures or displacement. When you arrived the patient was conscious and well oriented with respirations of 22 and a palpable radial pulse of 96. His SpO2 is​ 95; you immediately apply​ high-flow oxygen. After extrication and​ immobilization, you notice that the​ patient's breathing is more shallow but his rate remains about the same. His radial pulse is​ 114, his blood pressure is​ 96/70, and his SpO2 has dropped to 92 percent. In addition he appears to be developing some abdominal distention and is beginning to complain of dyspnea. You auscultate his lungs and find that they are diminished to absent in the lower lobes. What would your next actions​ include? A. Initiate two​ large-bore IVs and administer a 500 cc bolus of normal​ saline; expedite transport. B. Assist ventilation and apply the​ PASG; expedite transport. C. Perform rapid sequence intubation and transport. D. Assist ventilation with a BVM at the​ patient's current​ rate, initiate two​ large-bore IVs​ TKO, and expedite transport.

D. Assist ventilation with a BVM at the​ patient's current​ rate, initiate two​ large-bore IVs​ TKO, and expedite transport.

You are dispatched to the scene of a shallow water diving accident. While en​ route, what would you consider to be the most likely result of this method of​ injury? A. Excessive rotation of the cervical spine B. Hyperextension of the cervical spine C. Hyperflexion of the cervical spine D. Axial loading of the cervical spine

D. Axial loading of the cervical spine

What is the definition of​ hematochezia? A. Vomiting blood B. Blood in the urine C. Blood in the abdominal cavity that irritates the peritoneum D. Blood in the stool

D. Blood in the stool

What is not a common sign or symptom of blunt cardiac​ injury? A. Bruising of the chest wall B. Blunt injury to the chest C. Severe nagging pain D. Bradycardia

D. Bradycardia

How does a hyperbaric chamber treat​ dysbarism? A. By rationing oxygen administration B. By increasing the ambient air pressure above the maximum ocean depth C. By testing the pressurized air in the​ diver's tank D. By redissolving nitrogen bubbles that have formed in the blood

D. By redissolving nitrogen bubbles that have formed in the blood

What results from compression of the nerve roots at the lower end of the spinal​ cord? A. Central cord syndrome B. ​Brown-Sequard syndrome C. Anterior cord syndrome D. Cauda equina syndrome

D. Cauda equina syndrome

What patient demographic has an elevated predisposition to developing heat​ disorders? A. ​Middle-aged adults B. Acclimatized adults C. Young adults D. Children

D. Children

Which population is at the highest risk for​ high-altitude pulmonary​ edema? A. Elderly B. ​Middle-aged women C. ​Middle-aged men D. Children

D. Children

In what form of heat loss does the body lose heat to cooler air currents that pass by the​ body? A. Radiation B. Evaporation C. Conduction D. Convection

D. Convection

Which assessment type is most rarely used in the prehospital​ setting? A. Rapid trauma assessment B. Primary assessment C. Focused trauma assessment D. Detailed physical exam

D. Detailed physical exam

You are called to the scene of an automobile accident in which the driver was wearing his shoulder belt improperly and struck his face on the steering wheel. As you approach the​ vehicle, you see the door has been opened and the driver is​ unconscious, with his head still against the wheel and blood flowing freely from his nose and mouth. His respirations are 18 and shallow and his pulse is 102 radially. To extricate this​ patient, how should you​ proceed? A. Keep the spine in a​ neutral, in-line position while permitting maximum flexion and extension. B. Pull the patient from the vehicle in one swift movement without stabilization. C. Stabilize the​ patient's spine,​ elbows, and ribcage with the​ patient's nose,​ navel, and heels kept in line. D. Ensure that any providers assisting you are coordinated and understand what movement is to take place.

D. Ensure that any providers assisting you are coordinated and understand what movement is to take place.

You have a patient who was trapped beneath a truck along the freeway when he was trying to repair the brakes. By the time you​ arrive, the local fire department has already extricated the patient from underneath the​ truck, and he is currently immobilized. They advise you that the patient has a crushed​ pelvis, an open fracture to the left​ femur, a distended​ abdomen, and vomitus in the airway. The patient suddenly became unresponsive when the weight of the truck was lifted from him. What should be your first priority of​ management? A. Position the patient for comfort. B. Initiate an IV for fluid resuscitation. C. Immobilize the fractured femur. D. Establish an open airway.

D. Establish an open airway.

Which injury would you be likely to encounter while treating the driver of a motor vehicle that has been struck from​ behind? A. Hyperflexion of the cervical vertebrae B. Rotational subluxation C. Lateral compression fracture of a vertebra D. Fracture of the posterior vertebral elements

D. Fracture of the posterior vertebral elements

Which precaution can maximize the ability of​ heat-generating mechanisms to replenish energy supplies when in cold​ environments? A. Dress lightly. B. Perform physical labor to promote perspiring. C. Eat less than usual. D. Get plenty of rest.

D. Get plenty of rest.

What trauma injury is the most frequent cause of​ death? A. Injury to the lungs B. Severed spinal cord C. Abdominal hemorrhage D. Head injury

D. Head injury

Which heat disorder is generally characterized by a body temperature of at least 105degrees​F, central nervous system​ disturbances, and usually the cessation of​ sweating? A. Hyperthermia B. Heat cramps C. Heat exhaustion D. Heatstroke

D. Heatstroke

What​ condition, resulting from the presence of air and blood in the thoracic pleural​ space, is typically seen with penetrating chest​ trauma? A. Pneumothorax B. Tension pneumothorax C. Compound hemothorax D. Hemopneumothorax

D. Hemopneumothorax

Which term describes low or inadequate distribution of blood to body organs and tissues caused by​ cardiac, vascular,​ neurogenic, or volume​ problems? A. Hypotension B. Hypovolemia C. Hemorrhage D. Hypoperfusion

D. Hypoperfusion

Which term refers to the distribution of blood to the​ body's organs and​ tissues? A. Hypertension B. Hypovolemia C. Hypotension D. Hypoperfusion

D. Hypoperfusion

What term refers to a drop in blood pressure caused by a reduction in blood pressure caused by​ cardiac, vascular,​ neurogenic, or volume problems to a level that is lower than normal for the​ patient? A. Dehydration B. Hypovolemia C. Hypoperfusion D. Hypotension

D. Hypotension

A​ 78-year-old woman fell in her kitchen and broke her hip. She was unable to call for help and lay on the tile floor for 28 hours before being found. She is confused and has cool skin. You notice that she is dressed in a light nightgown and that the thermostat is set on 68 degrees F. What environmental disorder may be complicating this​ patient's condition? A. Conduction B. Decompensation C. Thermoregulation disorder D. Hypothermia

D. Hypothermia

What effect does hypothermia have on blood​ clotting? A. Hypothermia reduces the​ erythrocytes' ability to flow through​ capillaries, resulting in DIC. B. Hypothermia increases the viscosity of​ blood, thereby shortening clotting time. C. Hypothermia increases the effectiveness of enzymes that participate in the clotting cascade. D. Hypothermia stimulates the release of a​ heparin-like anticoagulant.

D. Hypothermia stimulates the release of a​ heparin-like anticoagulant.

What do the signs and symptoms of​ Cushing's triad​ include? A. Decreasing systolic blood​ pressure, decreasing heart​ rate, and agonal respirations B. ​Confusion, amnesia, and nausea C. Increasing diastolic blood pressure and pulse with a decreased level of consciousness D. Increasing systolic blood​ pressure, slowing​ pulse, and irregular respirations

D. Increasing systolic blood​ pressure, slowing​ pulse, and irregular respirations

You are dispatched to an industrial accident for a​ 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On​ arrival, you find the patient in the company​ first-aid station supine on a​ cot, secured to a scoop​ stretcher, cervical collar in​ place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse​ 70, BP​ 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he has a bounding pulse of about 60 and is now only purposefully responsive to pain. What would your initial treatment and transport decisions​ include? A. Auscultate the patient. B. Palpate the patient. C. Inspect the patient. D. Initiate rapid transport to a trauma center.

D. Initiate rapid transport to a trauma center.

Which statement is true regarding pediatric head​ trauma? A. Head trauma in the pediatric patient has the same pathophysiologic process as for an adult. B. The​ adult's skull distorts more easily with trauma and transmits injury forces more directly to the central nervous tissues. C. Adults display signs and symptoms of ICP more slowly than younger pediatric patients. D. Intracranial hemorrhage in the pediatric patient can contribute significantly to hypovolemia.

D. Intracranial hemorrhage in the pediatric patient can contribute significantly to hypovolemia.

What causes the tissue edema resulting from an intracerebral​ hemorrhage? A. Pressure of hemorrhaging blood B. Osmotic plasma pressure C. Encapsulation of the damaged area by the body D. Irritation of nervous tissue

D. Irritation of nervous tissue

What organ is responsible for regulatory control over the osmotic balance of the body by retaining or releasing water or sodium and other body​ salts? A. Spleen B. Bladder C. Pancreas D. Kidneys

D. Kidneys

What is an appropriate reason to utilize air medical resources at the scene of an​ emergency? A. The number of access ramps on a freeway is limited. B. Heavy snow is limiting the use of ground services. C. Adequate utilization is required to financially support the service. D. Local EMS resources are exceeded.

D. Local EMS resources are exceeded.

What is the​ body's physiologic reaction called should the face suddenly be submerged into cold​ water? A. Mild hypothermia B. Reflex hypothermia C. Submersion reflex D. Mammalian diving reflex

D. Mammalian diving reflex

What two government agencies have done much to help in prevention of musculoskeletal​ injury? A. National Transportation Safety Board and the Occupational Safety and Health Administration B. Occupational Safety and Health Administration and Centers for Disease Control C. National Transportation Safety Board and National Institute of Occupational Safety and Health D. National Institute of Occupational Safety and Health and Occupational Safety and Health Administration

D. National Institute of Occupational Safety and Health and Occupational Safety and Health Administration

Growth plate fractures are most damaging to what type of​ patient? A. Geriatric males B. Adult C. Postmenopausal females D. Pediatric

D. Pediatric

You are treating a patient who received a knife wound to the left anterior chest. You have initiated​ high-flow oxygen and a​ large-bore IV. His vital signs are pulse​ 90, respirations​ 14, and blood pressure​ 110/74, and his lungs are clear bilaterally. After moving him to your stretcher you notice that he is developing jugular vein distention that diminishes upon​ exhalation; a check of his radial pulse reveals that it has risen to​ 126, and you are barely able to detect it. His lungs are still clear​ bilaterally, but his heart sounds distant. Which field diagnosis will you base your treatment plan​ on? A. Tension pneumothorax B. Laceration of the vena cava C. Laceration of the aortic artery D. Pericardial tamponade

D. Pericardial tamponade

What term refers to irritation of the anterior abdominal​ cavity? A. Mesentery B. Guarding C. Rebound tendersness D. Peritonitis

D. Peritonitis

What is the​ visible, cartilaginous, outer portion of the ear​ termed? A. Lobe B. Adit C. Semicircular canals D. Pinna

D. Pinna

You suspect the driver of a car in a motor vehicle collision​ (MVC) with airbag​ deployment, despite having no complaint of​ injury, might still have sustained a spinal injury based on the​ high-force mechanism of injury. At which point in the assessment would you develop this​ suspicion? A. Rapid trauma assessment B. Primary assessment C. Secondary assessment D. Scene​ size-up

D. Scene​ size-up

Which of the following is a type of pulmonary​ injury? A. Rib fractures B. Sternal fractures C. Flail chest D. Simple pneumothorax

D. Simple pneumothorax

What are the two main subsystems of the musculoskeletal​ system? A. Locomotion and protection B. Smooth and striated C. Long and irregular D. Skeleton and muscles

D. Skeleton and muscles

A. Descending aorta B. Gravid uterus C. Urinary bladder D. Spleen

D. Spleen

What is bleeding called that occurs within the​ meninges, specifically beneath the dura mater and within the subarachnoid​ space? A. Epidural bleed B. Cerebral contusion C. Contrecoup injury D. Subdural hematoma

D. Subdural hematoma

Which thoracic injury may result in crimping of the vena​ cava? A. Open pneumothorax B. Blunt trauma C. Simple pneumothorax D. Tension pneumothorax

D. Tension pneumothorax

Why is the basilar skull commonly the site of fractures due to​ trauma? A. The area is commonly fractured as a result of axial loading. B. The cranial bones are thinnest at this point. C. The area is commonly the site of impact with blunt force instruments​ (clubs, bats,​ etc.). D. The area is permeated with openings.

D. The area is permeated with openings.

You are dispatched to an industrial accident for a​ 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On​ arrival, you find the patient in the company​ first-aid station supine on a cot with a scoop stretcher and cervical collar in​ place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse​ 70, BP​ 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he is now only purposefully responsive to pain. When examining this​ patient's head, other than noting obvious signs of​ trauma, to where should you direct special​ attention? A. The underside of the jawline B. Behind the ears C. The back of the head D. The eyes

D. The eyes

During the full body physical exam of a patient in a motor vehicle collision​ (MVC), you notice a transverse line across the​ patient's body at the level of a suspected spinal cord injury beneath which the skin is flush and warm and above which the skin is cool and clammy. What is the reason for​ this? A. Peripheral vasodilation above the level of injury B. Adequate compensation for shock C. Peripheral vascular constriction below the level of injury D. The loss of nervous control below the level of injury

D. The loss of nervous control below the level of injury

What structure helps to support the digestive​ tract? A. The iliocoly B. The umbilical ligament C. The peritoneum D. The mesentery

D. The mesentery

In blunt​ trauma, how does injury of the abdominal wall muscles compare to the injury transmitted to the organs within the​ abdomen? A. Organ damage and muscle damage both result from the same force and so would be similar. B. The muscular lining would be injured​ worse, but it takes longer to become apparent. C. The muscular lining of the abdomen absorbs the​ trauma, resulting in less injury to the internal organs. D. The muscular lining of the abdomen is more resistant to injury than many of the internal​ organs, so most of the injury would be transmitted to the organs within the abdomen.

D. The muscular lining of the abdomen is more resistant to injury than many of the internal​ organs, so most of the injury would be transmitted to the organs within the abdomen.

Why is accurate assessment of the geriatric trauma victim especially essential to proper​ treatment? A. The victim may try to mislead the paramedic. B. The victim may exaggerate to receive attention. C. Caregivers typically provide a bad history. D. The problem may be masked or confused by signs and symptoms of preexisting disease.

D. The problem may be masked or confused by signs and symptoms of preexisting disease.

What is the​ lung's sole fixation point in the thoracic​ cage? A. The xiphisternal joint B. The ligamentum arteriosum C. The pleural lining D. The pulmonary hilum

D. The pulmonary hilum

Which patient would be the best candidate for the administration of​ mannitol? A. The severe head injury patient exhibiting signs of herniation and diminished kidney function B. The severe head injury patient exhibiting signs of significant hypoglycemia C. The severe head injury patient exhibiting signs of herniation with a systolic BP over 80 D. The severe head injury patient exhibiting signs of herniation with a systolic BP over 90

D. The severe head injury patient exhibiting signs of herniation with a systolic BP over 90

What is likely the most critical associated injury of serious blunt or penetrating trauma to the​ face? A. Distortion of the facial landmarks B. The entrance of blood into the digestive tract C. Mandibular dislocation D. The threat to airway patency

D. The threat to airway patency

You are evaluating a​ 32-year-old female in her third trimester after being called to her residence for a fall. During your​ exam, she tells you she is having​ contractions, which you are unable to feel by palpation. The abdomen also feels​ "soft." What has likely​ occurred? A. Abruptio placentae B. Placenta previa C. Amniotic sac rupture D. Uterine rupture

D. Uterine rupture

What is the primary underlying pathophysiology behind deaths associated with traumatic​ asphyxia? A. Hypotension B. Relative hypovolemia C. Hyperoxygenation D. Vascular compression

D. Vascular compression

As a general​ rule, when would air medical transport benefit a trauma​ victim? A. In highly congested urban areas B. When the victim is below the age of 55 C. When the weather is clear D. When ground transport time will exceed 45 minutes

D. When ground transport time will exceed 45 minutes

When should any significant findings of the rapid or focused trauma assessment be​ rechecked? A. Every 15 minutes on the unstable trauma patient B. Every 5 minutes on the stable trauma patient C. When performing vital signs D. Whenever you note any change in the​ patient's condition

D. Whenever you note any change in the​ patient's condition

Any victim of musculoskeletal trauma with a significant MOI or signs and symptoms that suggest a more serious injury pattern may exist should be provided​ with: A. a focused trauma assessment. B. a detailed physical exam. C. reassessment prior to transport. D. a rapid trauma assessment.

D. a rapid trauma assessment.

When you suspect a patient has a serious traumatic injury to the body and are inclined to transport him quickly to the trauma​ center, you should​ perform: A. a secondary assessment. B. a reassessment. C. a focused trauma assessment. D. a rapid trauma assessment.

D. a rapid trauma assessment.

Abdominal pain with external vaginal hemorrhage in the​ near-term trauma victim is primarily indicative​ of: A. fetal trauma. B. uterine rupture. C. rupture of the amniotic sac. D. abruptio placentae.

D. abruptio placentae.

Rigid splints are not constructed​ from: A. metal. B. plastic. C. wood. D. an airtight fabric bag.

D. an airtight fabric bag.

When an injury occurs directly at the point of impact as the brain moves toward and collides with the interior of the​ skull, this is called​ a(n): A. subdural hematoma. B. contrecoup injury. C. epidural hematoma. D. coup injury.

D. coup injury.

Two specific injury mechanisms can cause energy transfer to the pulmonary tissue and result in pulmonary​ contusions, of which the more common​ is: A. puncture of the chest wall. B. the pressure wave from a​ high-velocity bullet. C. the pressure wave from an explosion. D. deceleration.

D. deceleration.

Failure of the bone to support weight can be the result​ of: A. calcification. B. diaphysis. C. synarthroses. D. devascularization.

D. devascularization.

Wounds like those caused by​ arrows, knives, and other relatively​ slow-moving objects primarily cause injury​ by: A. temporary cavitation. B. limited cavitation. C. laceration. D. direct contact.

D. direct contact.

It is a​ hot, sunny summer day with an outdoor temperature in the 90s. You and your partner are dispatched to a residence for a female in her 40s. Her husband told the dispatcher that he came home from work to find her in bed. She moves when he arouses her but acts drugged. On your arrival you verify the safety of the scene and are led by the frantic husband into the house toward a bedroom. As you move through the house you note that the temperature indoors is probably in the​ 60s; the husband tells you that since his wife started her new hypothyroid medication she is always hot and turns down the thermostat when he leaves in the morning. His wife is lying on the​ bed, on top of the​ bedspread, wrapped in a towel with her hair still wet from an apparent shower. As you approach the bed you call her name and she mouths a few unintelligible syllables without opening her eyes. You move to check her pulse and note that she is pale and her skin feels cold and firm. She has a radial pulse of 58 and a respiratory rate of 8. You are unable to obtain a blood​ pressure, and her pupils are dilated. You ask her husband if she has any medical​ history, and he tells you that she is only being treated for the hypothyroidism. You place the patient on​ high-flow oxygen and an ECG​ monitor, where you note that she has atrial fibrillation and J waves. Knowing you are only 10 minutes from the​ hospital, your preliminary treatment plan will​ include: A. drying and covering with​ blankets, elevating the​ legs, testing blood glucose​ level, initiating an​ IV, applying heat guns and​ lights, and providing rapid transport. B. applying​ high-flow oxygen, applying​ warm-water immersion, elevating the​ legs, testing blood glucose​ level, and providing rapid transport. C. covering with​ blankets, elevating the​ legs, checking for medication​ bottles, expediting​ transport, and initiating IV en route. D. drying and covering with​ blankets, applying oxygen as​ needed, elevating the ambulance interior​ temperature, assessing glucose​ level, providing rapid but gentle​ transport, and initiating an IV.

D. drying and covering with​ blankets, applying oxygen as​ needed, elevating the ambulance interior​ temperature, assessing glucose​ level, providing rapid but gentle​ transport, and initiating an IV.

According to current research regarding prehospital trauma​ care, patient deaths could be reduced​ by: A. replacing ambulances with helicopters. B. Transporting patients without performing prehospital care. C. forgoing spinal immobilization for earlier transport. D. identifying and eliminating prehospital skills that do not improve patient outcomes or that increase morbidity and mortality.

D. identifying and eliminating prehospital skills that do not improve patient outcomes or that increase morbidity and mortality.

You determine that your elderly patient likely has an anterior dislocation of the hip with reduced circulation in the affected foot. Your treatment should​ include: A. sedating the patient and make one attempt to reduce the dislocation. B. making one attempt to reduce the dislocation. C. applying a traction splint and transport. D. immobilizing in the position found and consider rapid transport.

D. immobilizing in the position found and consider rapid transport.

The central space within the thoracic cavity that houses the heart is​ the: A. thoracic inlet. B. interpulmonary space. C. xyphoid space. D. mediastinum.

D. mediastinum.

Any abdominal​ jarring, as occurs with percussion or when you quickly release the pressure of deep​ palpation, can cause a twinge of pain​ called: A. abdominal flexion. B. reflex pain. C. guarding. D. rebound tenderness.

D. rebound tenderness.

A patient who was lost walking in the woods in January presents with a​ 95°F core​ temperature, elevated blood pressure and​ respirations, fatigue, and intense shivering. The legs of her jeans are wet from the​ snow, and her​ boots, which​ aren't adequate for​ hiking, also appear to be soaked through. Your treatment for this patient should​ include: A. removing the patient to a warm​ environment, removing all of her​ clothing, placing the patient in a supine​ position, assessing mental​ status, and applying passive rewarming with blankets. B. removing the patient to a warm​ environment, removing the wet​ clothing, placing the patient in a supine​ position, assessing mental​ status, and applying active rewarming with heat packs applied directly to the skin. C. removing the patient to a warm​ environment, removing the wet​ clothing, placing the patient in a left lateral recumbent​ position, assessing mental​ status, and applying passive rewarming with blankets. D. removing the patient to a warm​ environment, removing the wet​ clothing, placing the patient in a supine​ position, assessing mental​ status, and applying passive rewarming with blankets.

D. removing the patient to a warm​ environment, removing the wet​ clothing, placing the patient in a supine​ position, assessing mental​ status, and applying passive rewarming with blankets.

In accordance with​ Henry's law, as a diver descends deeper into the​ water: A. significantly more oxygen is dissolved in the blood. B. the volume of oxygen will significantly reduce. C. the volume of nitrogen will significantly reduce. D. significantly more nitrogen is dissolved in the blood.

D. significantly more nitrogen is dissolved in the blood.

An injury that occurs when muscle fibers are overstretched by forces that exceed the​ fiber's strength is called​ a: A. fracture. B. sprain. C. dislocation. D. strain.

D. strain.

Protocols and procedures for the use of air medical support are determined​ by: A. the senior paramedic. B. the ED. C. the fire chief. D. the EMS system.

D. the EMS system.

Fluid overload in the geriatric patient is a risk of treating shock​ because: A. their spleen is likely removed. B. they have reduced interstitial flexibility. C. their kidneys store additional fluids. D. their system cannot accommodate large fluctuations in fluid reserves.

D. their system cannot accommodate large fluctuations in fluid reserves

In the​ body, perspiration and vasodilation are both mechanisms​ of: A. thermogenesis. B. conduction. C. blood pressure control. D. thermolysis.

D. thermolysis.

Comparison of results from each reassessment to baseline findings and those from previous reassessments can identify any deterioration or improvement in the​ patient's condition; this is​ called: A. mapping. B. deterioration. C. reassessment. D. trending.

D. trending.

Initial information you receive from emergency medical responders and EMTs about the​ patient's condition and the care he received should​ be: A. omitted from your PCR. B. reviewed only after implementing your management plan. C. passed along to the ED without review. D. used in developing your initial patient impression and then formulating a patient management plan.

D. used in developing your initial patient impression and then formulating a patient management plan.

While monitoring the victim of a brain injury during the secondary​ assessment, you should be especially watchful​ for: A. narrowing pulse pressure. B. a rising GCS. C. tachycardia. D. ​Cushing's triad.

D. ​Cushing's triad.

Which illness in its early stages is easily reversible with descent and administration of​ oxygen? A. Cerebral overpressure edema B. Acute mountain sickness C. ​High-altitude pulmonary edema D. ​High-altitude cerebral edema

D. ​High-altitude cerebral edema

What treatment should be performed in the prehospital setting for divers who display signs of​ dysbarism, prior to placement in a hyperbaric​ chamber? A. Oxygen rationing B. Administration of NitroBindSuperscript ® C. Placement of warm packs on affected joints D. ​High-flow oxygen therapy

D. ​High-flow oxygen therapy

At a​ minimum, what information regarding your patient should be passed on to subsequent patient care​ providers? A. Your level of certification B. HIPAA compliance information C. Patient personal and insurance information D. ​MOI, assessment​ results, and interventions

D. ​MOI, assessment​ results, and interventions

Your​ high-altitude HEMS team is dispatched to the​ 14,000-foot level of the West Buttress route of Mount McKinley for a climber who fell unconscious could not be awakened. As your team proceeds to the​ location, you consider that the likely cause​ is: A. early​ high-altitude pulmonary edema​ (HAPE). B. nitrogen narcosis. C. acute mountain sickness​ (AMS). D. ​high-altitude cerebral edema​ (HACE).

D. ​high-altitude cerebral edema​ (HACE).

Ascending from a dive too rapidly can create gas bubbles in the blood and tissues;these gas bubbles can then grow in size as the pressure is reduced, in accordance with:

Dalton's law

What does not result in thermolysis of body generated heat?

Digestion

Myotomes

Discrete tissues and muscles of the body that are controlled by specific spinal nerve roots

What has had a major effect on reducing mortality and morbidity from head injuries?

Education programs promoting safe practices

Bike performs what function?

Emulsifies fats

Myocardial aneurysm or rupture occurs almost exclusively in...

Extreme blunt thoracic trauma

Which conduction is a primary predisposing factor for environmental injuries?

Fatigue

Which accessory organ receives bile and stored it until it is needed during digestion of fatty food?

Gallbladder

Hyperthermia is usually caused by which mechanism?

Heat transfer from external environment

Which disorder results from loss of the body's hypothalamic temperature regulation system?

Heatstroke

Which heat disorder is generally characterized by a body temperature of at least 105, central nervous system disturbances,and usually the cessation of sweating?

Heatstroke

The initial symptoms of high-altitude illness include dry cough,mild SOB on exertion, light crackles in lungs?

High-Altitude pulmonary edema

Which illness in its early stages is easily reversible with descent and administration of oxygen

High-altitude cerebral edema

The process of maintaining constant suitable conditions within the body is called

Homeostasis

What findings would merit the highest priority for transport when assessing a patient with a potential heat- related emergency?

Hot, dry skin and AMS

Which term describes low or inadequate distribution of blood to body organs and tissues caused by cardiac, vascular, neurogenic, or volume problems?

Hypoperfusion

Which anatomical structure is directly responsible for temperature regulation in the human body?

Hypothalamus

What effect does hypothyroidism have on cold-related disorders?

Hypothyroidism depresses the body's heat producing mechanisms.

Morbidity and mortality for various abdominal injuries has been on decline due to :

Improved surgical and critical care techniques

Sternocleidomastoid

Internal intercostal muscles, along with diaphragm and what other muscles are the major muscles of inhalation

Musculoskeletal injuries do not include

Internal organs

An injury to the lower chest that lacerated the diaphragm is unlikely to also injure the:

Kidneys

Which organ is responsible for regulatory control over the osmotic balance of the body by retaining or releasing water or sodium and other body salts?

Kidneys

In a drowning incident, how much water typically enters the lungs

Less than 30 ml

At a minimum, what information regarding your patient should be passed on to subsequent patient care providers?

MOI, assessment results, and interventions

The risk of becoming a victim to a heat related disorder can be most practically reduced by:

Maintaining an adequate fluid intake.

What is the body's physiological reaction called should the face suddenly be submerged into cold water?

Mammalian diving reflex

When the body's compensatory mechanisms can no longer maintain the core temperature due to heat loss, what happens?

Metabolic rate and cardiac output fall

In which stage of hypothermia is the ability to shiver usually lost?

Moderate hypothermia

Developing workplace safety standards is the responsibility of

NIOSH

Which population is at a higher risk of pelvic rib and extremity due to trauma?

Obese patients

What bone cells dissolve bone structures when they are not carrying pressures of articulation and support?

Osteoclasts

What is the pins and needles sensation called:

Paresthesia

Growth plate fractures are most damaging to what type of patient?

Pediatric

What type of injury is most likely to result in flank hematuria?

Pelvic fracture

Brown-sequard syndrome

Penetrating injury that hemitransects the cord, resulting in sensory and motor loss to the ipsilateral side of body

What term refers to irritation of the anterior abdominal cavity

Peritonitis

What is the best method by which to reduce the morbidity and mortality associated with abdominal trauma?

Prevention

Musculoskeletal injuries to the upper extremities

Rarely threaten life

Any abdominal jarring, as occurs with percussion or when you quickly release the pressure of deep palpating, can cause a twinge of pain called:

Rebound tenderness

Blood-brain barrier

Refers to the CNS capillary walls that are thicker, more complete than, and not as permeable as those found elsewhere in the body.

A child fell backward off a trampoline yesterday, striking her head. She now has a severe headache and dizziness. In addition to cervical spine injuries that may be present, what other findings may indicate a skull fracture?

Retroauricular ecchymosis

What is the first opportunity to begin the assessment process?

Review of dispatch information

What has contributed to the increase in thoracic trauma in urban areas?

Semiautomatic hand guns

Which form of thoracic trauma provides the highest risk of aortic dissection

Severe lateral blunt force trauma

Axial loading accident

Shallow water diving

In accordance with Henry's law, as a diver descends deeper into the water:

Significantly more nitrogen is dissolved in the blood

What are the two main subsystems of the musculoskeletal system?

Skeleton and muscles

Storing salts needed for metabolism is primarily the job of the :

Skeleton.

What is the preferred techniques secure s fractured humerus ?

Sling and swath

Which solid organ is relatively well protected by the lower ribs, back and flank muscles, spinal column?

Spleen

An injury that occurs when muscle fibers are overstretches by forces that exceed the fibers strength is called:

Strain

Expert information regarding diving emergencies can be provided by

The Divers Alert Network

What structure helps support the digestive tract?

The mesentery

Epicardium

The portion of the membranous lining that covers the outside of the heart

Cranium

The portion of the skull that protects the brain

The three methods the body utilizes to create heat are all types of :

Thermogenesis

What is the general term for the loss of heat from warmer substances,regardless of the mechanism of heat loss?

Thermolysis

SAM splint

Thin sheet of pliable aluminum covered with padding

The great vessels, trachea, and esophagus, as well as the vagus and phrenic nerves , enter the mediastinum through the :

Thoracic inlet

How many compartments is the abdominal cavity decided into?

Three

How many layer of connective tissue are there between the cranium and the brain

Three

In comparison with the adult patients, what type of fracture would the pediatric patient be more prone too?

Torus

Continued advances in what area can do the most to improve prevention of musculoskeletal injury ?

Vehicle and highway designs

Pinna

Visible, cartilaginous, outer portion of the ear

Subdural hematoma

What is the bleeding called that occurs within the meninges, specifically beneath the dura mater and within the subarachnoid space?

Which environmental factor would predispose a person to heat or cold disorders?

Wind

What task does a hyperbaric chamber perform?

administration of oxygen at greater than air pressure

atelectasis

collapsed lung: effect of small amount of water entering the lungs during a downing

compartment syndrome

injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast

Where is fat stored in the bone?

yellow bone marrow