EMT Chpt 24

which of the following injuries would most likely occur as a direct result of the third collision in a motor vehicle crash?
a. aortic rupture
b. flail chest
c. extremity fractures
d. forehead lacerations

a.

a young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. as your partner is assessing/managing his airway, you should control the obvious bleeding and then:
a. assess for an exit wound
b. apply a cervical collar
c. obtain baseline vital signs
d. auscultate bowel sounds

a.

in contrast to a level 3 trauma center, a level 1 trauma center must:
a. be involved in trauma prevention progs
b. have general surgeons that are in house 24/day
c. have access to an emerg. physician within 30 min
d. be able to stabilize pts before transferring to higher level facility

b

2 of the most common mechanisms of injury for blunt trauma are:
a. gunshot wounds, vehicle ejections
b. falls, motor vehicle collisions
c. low caliber gunshot wounds, falls
d. motor vehicle collisions, stabbings

b

with regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct?
a. it provides the least amt of info about the mechanism of injury
b. it occurs when the unrestrained occupant collides with the interior of the vehicle
c. it has a direct affect on patient care bc of the obvious vehicle damage
d. it’s the most dramatic part of the collision, may make extrication difficult

d

the driver of a sports utility vehicle lost control and struck a pole head-on. the driver was killed instantly. the passenger is conscious and alert and has several small abrasions, lacerations to her left forearm. treatment for the passenger should include:
a. secondary assessment at the scene
b. a focused exam of her forearm
c. transport to a trauma center
d. transport to a local community hospital

c

force acting over a distance defines the concept of:
a. potential energy
b. latent energy
c. work
d. kinetic energy

c.

approx. 25% of severe injuries to the aorta occur during
a. rear end collisions
b. lateral collisions
c. frontal collisions
d. rollover collisions

b.

which of the following interventions is the most critical to the outcome of a pt. with multsystem trauma?
a. elevation of lower extremities
b. rapid transport to a trauma center
c. early admin. of oxygen
d. IV fluid admin.

b

when eval. the mechanism of injury of a car vs. pedestrian collision, you should first:
a. approx. speed of vehicle that struck the pedestrian
b. eval. the vehicle that struck the pt. for structural damage
c. determine if pt. was propelled away from vehicle
d. determine if pt. was struck and pulled under the vehicle

a.

cervical spine is most protected from whiplash type injuries when the:
a. airbag correctly deploys upon impact
b. pt. tenses up a the time of impact
c. rear end of the vehicle is intially struck
d. headrest is appropriately positioned.

d.

when caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is most important to:
a. realize that the a.b. malfunctioned at the time of impact
b. suspect that the pt. may have experienced serious injuries
c. recognize that the force of impact was most likely not severe
d. remember that it could still deploy and seriously injure you

d.

when the speed of a motor vehicle doubles, the amt. of kinetic energy:
a. quadruples
b. doubles
c. is not affected
d. triples

a. quadruples

when assessing a pt. who experienced a blast injury, it’s important to remember that:
a. solid organs usually rupture from the pressure wave
b. primary blast injuries are the most easily overlooked
c. secondary blast injuries " "
d. primary blast injuries are typically the most obvious

b.

your pt. has a GCS score of 13, a sys. BP of 80 mmHg, and a resp rate of 8 breaths/min, his revised trauma score (RTS) is:
a. 10
b. 11
c. 9
d. 8

c.

when treating a pt. who experienced a pulmonary blast injury, you should:
a. use a demand valve to ventilate the pt.
b. suspect an accompanying cardiac tamponade
c. admin. lg. amts. of IV fluid
d. avoid giving oxygen under pos. pressure

d.

a 30 year old male sustained a stab wound to the neck when he was attacked outside a nightclub. during your assessment you should be most alert for:
a. damage to internal structures
b. injury to the cervical spine
c. potential airway compromise
d. alterations in his mental status

c.

accdg. to the amer. college of surgeons, an adult trauma pt. meets level 1 criteria if he/she:
a. has a gcs score of less than or equal to 8
b. was involved in an mvc in which another pt in the same vehicle was killed
c. has a bleeding disorder
d. has a systolic bp of less than 110 mmhg or hr greater than 110 beats/min

a.

which of the following statements regrading low energy penetrating injuries is correct?
a. it is usually easy to differentiate between an entrance and an exit wound
b. exit wounds are typically easy to locate with low energy penetrating injuries
c. internal injuries caused by low velocity bullets are usually easy to predict.
d. the area of injury is usually close to the path the object took through the body.

d.

air bags are designed to:
a. prevent 2nd collision insie the car
b. prevent driver from sustaining head trauma
c. be used with/without a shoulder harness
d. decrease the severity of deceleration injuries

d.

if a person is standing near a building when it explodes which of the following inj. would he/she most likely experience as a result of the pressure wave?
a. severe burns
b. impaled objects
c. fractured bones
d. stomach rupture

d.

by what mech. is a person injured when he/she falls from a significant height?
a. kinetic energy converted to poten. energy; poten. energy is then converted into work of bring body to a stop
b. as person falls, amt of kinetic energy is converted to work, work then converted to kinetic energy upon impact
c. potential energy is created as the person is falling
d. potential energy is converted to kinetic energy; the kinetic energy is then converted to the work of bringing the body to a stop

d.

a driver involved in a rollover MVC will most likely experience serious injuries/death if he/she:
a. remains within vehicle
b. is ejected/partially ejected
c. experiences multiple impact
d. is only wearing a lapbelt

b.

what types of mvc’s present the greatest potential for multiple impacts?
a. frontal, rotational
b. lateral, rollover
c. rear end, rotational
d. rotational, rollover

d.

accdg to aams, you should consider air medical transport of a trauma pt. if
a. ground transport will take your amb. out of service etc etc
b. the patient requires als and stabilization and the nearest als ground amb is more than 5-10 mins away
c. traffic conditions hamper the ability to get the pt…..
d. he/she was involved in a mvc in which another occupant in the same vehicle was killed, even if your patient’s injuries are minor

c.

when a driver is in a car equipped with an airbag, but isn’t wearing a belt, he will most likely strike the ____ when the air bag deploys upon impact

door

internal injuries caused by gunshot wounds are difficult to predict because:
a. caliber of bullet is unknown
b. exit wounds caused are usually small
c. area of damage is smaller than bullet
d. bullet may tumble/ricochet within the body

d.

index of suspicion is most accurately defined as:
a. the way in which traumatic injuries occur
b. predictable pattern that leads to serious injuries
c. the detection of less obvious life threatening injuries
d. your concern for potentially serious underlying inj.

d.

which of the following would most likely occur as a direct result of th 2nd collision in an mvc?
a. intrathoracic hemorrhage
b. deformed steering wheel
c. caved in passenger door
d. collapsed dashboard

b.

which of the following statements regarding gunshot wounds is right?
a. speed has the greatest impact
b. low vel. bullets cause greatest amt. of trauma
c. size has greatest impact
d. high vel. bullets will cause less severe internal injuries

a.

energy of moving object is called

kinetic energy

if 1 or more occupants in same vehicle are killed in a crash the emt should:

suspect that all living occupants experienced the same serious trauma

which of the following pts has experienced the most signficant fall at 13′?
a. 5’0
b. 5’9
c. 4’8
d. 4’6

d.

when a mv strikes a tree at 40mph the unrestrained occupant
a. remains in motion until acted upon by external force
b. most likely thrown
c. decelerate at same rate as the vehicle
d. is thrust under steering column onto the floorboard

a.

during your assessment of a pt. who experienced a blast injury, you note that he has a depressed area to the front of his skull. this injury most likely occurred:
a. as a direct result of the pressure wave
b. during the tertiary phase
c. during the secondary phase
d. during the primary phase

b.

during your assessment of pt. with a head inj. you note that he opens his eyes when you pinch his trapez. muscle, is mumbling and has his arms curled towards his chest. his gcs is:
a. 8
b. 9
c. 10
d. 7

d.

factors that should be considered when assessing a pt. who has falled include all of the following except:
a. speed of the fall
b. surface struck
c. height of fall
d. primary impact point.

a.

signs of pulm. blast injury include:
a. multiple rib fractures
b. coughing up blood
c. vomiting blood
d. irregular pulse

b.

phenomenon of pressure waves emanating from the bullet, causing damage remote from its path is called:
a. cavitation
b. congruent
c. capitation
d. conversion

a.

when assessing the interior of a crashed motor vehicle for damage, you are gathering information for the:
a. index of suspicion
b. kinetic energy
c. poten. energy
d. mech. of injury

d.

when assessing an elderly pt. who fell, its important to remember that
a. any fall in the elderly is considered high energy trauma
b. elderly pts who fall usually have secondary head inj.
c. bilateral hip fractures usualy occur when an elderly person falls.
d. osteoporosis can cause a fracture that may have resulted in the fall.

d.

eval. of the interior of a crashed MV during extric. will allow the emt to:
a. determine speed at time of impact
b. recog. if driver hit brakes before impact.
c. identify contact pts and predict poten. injuries
d. assess severity of 3rd collision

c.

small compact car: what injury mech is most likely responsible?

compression of head against roof.

passengers who are seated in the rear and are only wearing lap belts have higher incidence of injuries to the

thoracic and lumbar spine.

which of the following findings would be least suggestive of the presence of high energy trauma?
a. dismounted seats
b. intrusion into the vehicle
c. deployment of the airbag
d. steering wheel deployment

c.

a 40 year old unrestrained female impacted the wheel of her vehicle with her chest when she hit a tree. she is conscious, alert, but experiencing chest pain and shortness of breath. which of the following injuries did this pt. likely not experience?
a. rib fractures
b. pulmonary contusion
c. head injury
d. cardiac contusion

c.

while assessing a young male who was struck in the chest with a steel pipe, you notice that his pulse is irregular. you should be MOST suspicious for:
a. traumatic rupture of the aorta
b. lacerated coronary artery
c. underlying cardiac disease
d. bruising of the heart mucle

d.

which of the following splinting devices would be most appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
a. vacuum splint
b. sling and swathe
c. cardboard splint
d. air splint

d. air splint

in which of the following situations would ext. bleeding be most difficult to control?
a. jugular vein laceration, syst. BP of 90 mmHg
b. femoral artery laceration
c. carotid artery laceration
d. antecubital vein laceration

b.

in nontrauma pts, an early indicator of internal bleeding is:

dizziness upon standing

hypovolemic shock occurs when:
a. pt’s syst. bp is < 100 mm Hg
b. at least 10% of the pt’s blood volume is lost
c. the body can’t compensate for rapid blood loss
d. clotting ability of the blood is enhanced

c.

severity of the bleeding should be based on all of the following findings except:
a. poor general appeance
b. clinical signs/symptoms
c. mech. of injury
d. systolic blood pressure

d.

systemic veins function by:
a. returning oxygen-rich blood black to the left atrium.
b. delivering deoxygenated blood to the capillaries.
c. delivering oxygen poor blood back to the capillaries
d. returning deoxygenated blood back to the heart

d.

organ or tissue may be better able to resist damage from hypoperfusion if the:
a. body’s demand for ox. is markedly increased
b. systolic arterial bp is at least 60 mm Hg
c. body’s temp is considerably less than 98.6
d. hr is maintained at more than 100 b/min

c.

22 yr old male kicked in abdomen during attack by a gang

prepare for immediate transport

hypoperfusion is another name for

shock

most cases of ext. bleeding from extremity can be controlled by

applying local direct pressure

when using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the emt should:
a. stop twisting the stick when the bleeding stops
b. remove tourniquet if the bleeding has stopped
c. cover the tourniquet w/ a sterile dressing
d. twist stick until radial pulse disappears

a.

signfic. vital sign changes will occur if the typical adult acutely loses more than ___ of his or her own total blood volume
a. 20%
b. 10%
c. 5%
d. 15%

a.

an inf. with a total blood volume of 800 ml would start showing signs of shock when as little as ___ of blood is lost
a. 100 ml
b. 200 ml
c. 150 ml
d. 50 ml

a.

external bleeding from a vein is relatively easy to control because
a. veins hold smaller blood volume
b. veins are under a lower pressure
c. blood typically oozes from a vein
d. veins carry deoxygenated blood

b.

39 year old male sustained large laceration to his leg during accident with chainsaw and experiencing signs and symptoms of shock. you should:

follow appropriate standard precautions

what is the approximate blood volume of a 75 kg adult?

5.25 L

gastrointestinal bleeding should be suspected if a pt. presents with

hematemesis

following blunt trauma to the abdomen, a 21 year old female complains of left upper quadrant abdominal pain with referred pain the left shoulder. your assessment reveals that her abdomen is distended and tender to palpation. on the basis of these findings, you should be most suspicious of injury to the:
a. pancreas
b. gallbladder
c. liver
d. spleen

d.

if direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply:
a. additional dressings
b. tourniquet proximal to the inj.
c. digital pressure to a prox. artery
d. a splint & elevate the extrem.

b.

which of the following statements regarding the clotting of blood is correct?
a. venous & capillary blood typically does not clot spontaneously
b. bleeding begins to clot when the end of a damaged vess. dilates
c. a person taking aspirin will experience slower blood clotting
d. direct contact with the env’t prevents blood from clotting.

c.

male accidentally cut his wrist while sharpening his knife. he’s conscious/alert with adequate breathing but is bleeding significantly from the wound. you should:

control the bleeding with direct pressure

in older patients the first indicator of nontraumatic internal bleeding may be:

weakness or dizziness

the ability of a person’s cardiovascular system to compensate for blood loss is most related to:

how rapidly he/she bleeds

a young male was shot in the abdomen by a gun. he is semiconscious, has shallow breathing and is bleeding externally from the wound. as you control the external bleeding your partner should:
a. apply nonrebreathing mask
b. perform secondary assessment
c. obtain baseline vitals
d. assist pt’s ventilations

d.

blood stasis, changes in the vessel wall, and certain medications affect the:

ability of the blood to effectively clot.

which of the following statements regarding hemophilia is right?
a. pts with hemophilia may bleed spontaneously.
b. hemophiliacs take aspirin to enhance blood clotting
c. approx 25% of the pop has hemophilia
d. hemophilia is defined as total lack of platelets

a.

43 year old man has severe nosebleed. his bp is 190/110 mmhg and his hr is 90 bpm and pounding. treatment includes:
a. having pt pinch is nostrils and lie supine
c. pinching the pt’s nostrils and leaning forward
c. packing both nostrils with gauze pads
d. placing a rolled 4×4 dressing between lower lip and gum

c.

fracture femur can result in the loss of ___ of more blood into the soft tissues of the thigh.

1 liter

67 yr old male has weakness, dizziness, melena that began approx 2 hours ago. he denies hx of trauma. his bp is 90/50 mmhg and his pulse is 120 bpm/thready. you should be most suspicious that this pt is experiencing:
a. aortic aneurysm
b. gastrointestinal bleeding
c. acute appendcitis
d. intrathoracic hemorrhaging

b.

as red blood cells begin to clump together ro form a clot _____ reinforces the clumped red blood cells.

fibrinogen

early signs/symptoms of intra-abdominal bleeding include:
a. pain/distension
b. significant hypotension
c. bruising only
d. widespread ecchymosis

a.

whether you are using a commericial device or a stick and a triangular bandage as a tourniquet, it’s important to remember that:

the tourniquet should ONLY be removed at the hospital b/c bleeding may return if the tourniquet’s released

which organ can tolerate inadequate perfusion for up to 2 hours?

the skeletal muscle

bleeding from the nose following head trauma:

is a sign of skull fracture and should not be stopped.

after applying a pressure dressing to a laceration on a pt’s arm, yo notice that blood is slowly beginning to saturate it. you should:
a. place additional dressings
b. splint the arm
c. replace dressing with another
d. apply tourniquet prox. to wound

a.

you arrive at home of a 50 yr old woman with severe epistaxis. after treating her it is most important to recall that
a. pt at risk for vomiting and aspiration
b. detailed exam needed to determine cause
c. many medications interfere with blood clotting
d. pt may be significantly hypertensive

a.

smaller vessels that carry blood away from heart and connect arteries to capillaries are:

arterioles

which of the following body systems/components is the least critical for supplying/maintaining adequate blood flow to the body?
a. effectively pumping heart
b. intact system of blood vessels
c. adequate blood in the vasculature
d. filtering of blood cells in the spleen

d.

during transport of a 40 yr old female with acute abdom. pain, you note that she has stopped talking to you and has become extremely diaphoretic. you should:
a. begin assisting ventilations
b. perform secondary assessment
c. repeat primary assessment
d. assess quality of her pulse.

c.