Chapter 27 Chapter test EMT

You are treating a patient with paradoxical motion on the left side of the chest. He is breathing shallow at a rate of 4 breaths per minute. You​ should:
begin positive pressure ventilation.
Which of the following is an unreliable sign for determining the presence of a tension​ pneumothorax?
Trachea that shifts to the side opposite the injury
​You’re an​ off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated county road. It appears the patient was​ unrestrained, or not wearing a seat​ belt, and struck the steering wheel with his chest. On​ assessment, you notice a paradoxical motion to the​ patient’s chest on inspiration and expiration. When you radio for dispatch of an​ ambulance, which of the following pieces of information would you be sure to​ include?
The patient may have a flail chest.
Your patient is a​ 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You​ should:
begin chest compressions.
Which of the following injuries requires the use of an occlusive​ dressing?
All of the above
Which of the following is of concern with a puncture​ wound?
All of the above
Which of the following is a true statement regarding the​ skin’s status in the case of a closed chest​ injury?
The skin is not penetrated.
You are on an EMS standby for a boxing tournament. During one of the​ matches, one of the female boxers delivers a forcible uppercut to the chest of her​ opponent, who falls to the ground. The match is declared over on the basis of a TKO.​ However, the opponent fails to arise following a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic​ conditions?
Commotio cordis
For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline and then cover it with an occlusive​ dressing?
Gunshot wound​ (GSW) to the abdomen from which a loop of intestine is protruding
While palpating the radial pulses of a patient who was involved in a motor vehicle​ crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated​ with:
aortic dissection.
Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and​ transport?
Tension pneumothorax
You are caring for a​ 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his​ ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center.​ However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform​ next?
Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. And​ re-seal the wound.
Bleeding from open abdominal injuries should initially be controlled with which one of the following​ techniques?
Applying direct pressure to the wound
Which of the following is true concerning​ lacerations?
All of the above
Which of the following types of bandages should NOT be used by the EMT providing wound​ care?
Tourniquet
You are dispatched to a​ 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and a​ high-category trauma;​ however, due to the mechanism of​ injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the​ patient?
Examining the patient for entrance and exit wounds
Blunt trauma resulting in a closed chest injury creates the potential for which of the following internal​ injuries?
Contusion
What is the correct terminology for a wound in which a vacuum has been created within the​ chest, drawing air into the thorax with each​ breath?
Sucking chest wound
The mechanism of injury in which a​ patient’s chest has struck an immovable​ object, such as a steering​ wheel, may most accurately be described as​ a(n):
compression injury.
Some drawbacks to using sterile aluminum foil as an occlusive dressing​ include:
skin lacerations may occur from the sharp edges.
Your patient is a​ 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being​ “hit in the face and kicked and punched in his ribs and​ stomach.” Your examination reveals contusions and swelling around both​ eyes, bleeding from the​ nose, a laceration of his upper​ lip, and multiple contusions of the​ chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this​ patient?
The possibility of a pneumothorax
Which of the following is a strategy to maintain an occlusive dressing to bloody or diaphoretic​ skin?
Manually maintain pressure.
Which of the following traumatic chest injuries may result in​ massive, often fatal internal​ hemorrhage?
Aortic dissection
Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in​ life-threatening hemorrhage following high mechanism of injury blunt​ trauma?
Liver
You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsing mass. You​ should:
defer further abdominal palpation.
Which of the following is NOT appropriate in caring for a patient with closed​ soft-tissue injuries and a significant mechanism of​ injury?
Bandage and splint all injuries prior to transport.
The chest cavity can hold up to​ ________ liter(s) of blood in an​ adult, leading to the possibility of massive internal hemorrhage without any external blood loss.
3
Which of the following is required in the management of all open​ soft-tissue injuries?
The use of Standard Precautions by the EMT
Which of the following BEST describes an​ evisceration?
Open wound of the abdomen from which organs protrude
A​ 36-year-old male was accidentally shot with a nail gun into the chest. You see the​ nail, which protrudes about 2 to 3 centimeters from the​ thorax, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury​ site?
None of the above
On assessment of the midsection of a​ 32-year-old male who was struck by a​ car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a​ clean-cut laceration and the bleeding is controlled. Which of the following is the BEST approach toward managing the exposed​ intestines?
Moisten a sterile dressing with saline solution and cover the abdominal contents.
Your patient is a​ 21-year-old male who has a gunshot wound to the chest. Which of the following is the highest priority in managing this​ patient?
Placing an occlusive dressing over the wound
Which of the following is a desirable characteristic of dressings used in the prehospital management of most open​ wounds?
Sterile
You have covered an open chest wound with your gloved hand and the​ patient’s breathing has improved. In order to free your hand to provide further​ care, you​ should:
cover the wound with an occlusive dressing.
Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely​ suffered?
Traumatic asphyxia
A teenage male has fallen onto a railing while skateboarding. He complains of​ right-sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. You​ should:
apply a bulky dressing over the section.
Which of the following injuries may produce distended neck veins​ (JVD)?
All of the above
Your patient has an open abdominal wound with intestines protruding. You​ should:
cover the organs with moist sterile dressings.
A patient with jugular vein distention​ (JVD) is most likely suffering from which of the following​ injuries?
A patient with jugular vein distention​ (JVD) is most likely suffering from which of the following​ injuries?
Which of the following describes the proper application of an occlusive dressing for an open chest​ wound?
Tape the dressing securely on three sides.
Which of the following BEST describes the benefit of a​ three-sided occlusive dressing over a​ four-sided occlusive dressing for an open chest​ wound?
It reduces the chances of developing a tension pneumothorax.
Which of the following is an accurate definition of a flail​ chest?
Section of the chest wall that is​ unstable, leading to breathing problems
You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental​ oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time​ you’re making the decision to transport. Which of the following BEST encapsulates the correct strategy for​ transport?
Transport the patient emergently because of the high index of suspicion for a serious injury.
You find a​ middle-aged male is sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should​ IMMEDIATELY:
place your gloved hand over the wound.
What is the underlying cause of bluish or reddish facial discoloration following a traumatic​ asphyxiation?
High pressure on the chest leads to blood being forced from the right atrium into the face and neck.
Which of the following is NOT an open tissue​ injury?
Contusion
Common signs and symptoms following an injury to a hollow abdominal organ​ include:
irritation and peritonitis.
The pathophysiology of​ ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fill​ adequately, usually secondary to trauma.
cardiac tamponade