MOD6 – Chapter 27 – 39

Which of the following vessels has the thickest muscular walls that allow constriction and dilation?
Answer

Arteries
Capillaries
Veins
Lymphatic vessels

Arteries
In which of the following vessels does the vital exchange take place and also has the thinnest walls through which oxygen, nutrients, and wastes can pass?
Answer

Capillaries
Microvenules
Arterioles
Veins

Capillaries
Which of the following types of vessels have valves to maintain one-way blood flow?
Answer

Arteries
Capillaries
Veins
Arterioles

Veins
Which of the following vessels contain blood under the highest amount of pressure?
Answer

Veins
Arteries
Venules
Capillaries

Arteries
Which of the following BEST describes the function of blood?
Answer

It is a life-giving liquid that supports all the body’s functions to maintain hypoperfusion.
It clots, flows, transports, protects, and excretes to fight disease and life.
It transports gases along with nutrients, aids in excretion, and provides protection and regulation.
It flows from the heart with the vital gases and nutrients to maintain lack of perfusion.

It transports gases along with nutrients, aids in excretion, and provides protection and regulation.
Which of the following BEST describes the delivery of oxygen and nutrients at the body’s cellular level?
Answer

Hydrostatic pressure
Perfusion
Osmosis
Circulation

Perfusion
Which of the following is another way of describing the condition of shock?
Answer

Internal bleeding
Hypotension
Hypoperfusion
Hemorrhage
.

Hypoperfusion
Which of the following is the major cause of shock that the EMT will encounter?
Answer

Vomiting
High blood pressure
Hemorrhage
Excessive sweating

Hemorrhage
Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels?
Answer

Veins
Arteries
Lymphatic vessels
Capillaries

Capillaries
Which of the following is a characteristic of arterial bleeding?
Answer

Steady flow
Dark red color
Spurting under pressure
Both B and C

Spurting under pressure
In the average adult, the sudden loss of ___________ cc of blood is considered serious.
Answer

150
500
1,000
750

1,000
Which of the following is a characteristic of venous bleeding?
Answer

It commonly requires the use of pressure point compression.
It can be profuse, but is generally easily controlled.
It cannot lead to life-threatening amounts of blood loss.
It often requires the use of a tourniquet.

It can be profuse, but is generally easily controlled.
Which of the following may occur when there is bleeding from a large vein?
Answer

Transmission of bloodborne illnesses
Air embolism
Hypoperfusion
All of the above

All of the above
Which of the following must be kept in mind when considering the severity of external bleeding?
Answer

Signs of shock do not appear until a large amount of blood has been lost.
The amount of blood loss is easily estimated by the amount of blood visible on the ground.
A younger person can tolerate more blood loss than an older one.
All of the above

Signs of shock do not appear until a large amount of blood has been lost.
Which of the following is the most important reason for controlling external bleeding?
Answer

To prevent hypoperfusion
To prevent the spread of infectious diseases
To make clean up of the ambulance and your equipment easier after the call
To prevent the patient from becoming upset at the sight of blood

To prevent hypoperfusion
Which of the following is the most effective way of controlling external bleeding?
Answer

Running cold water over the wound
Using direct pressure with a dressing
Elevating the affected part
Using an ice pack

Using direct pressure with a dressing
Your patient is a 28-year-old male who cut his thigh with a chain saw. It appears that he has lost about 600 cc of blood. Which of the following is NOT part of the proper management of this patient?
Answer

Use of a tourniquet
Replacement of fluid level by giving the patient adequate amounts of water
Using direct pressure to control the bleeding
Administering oxygen

Replacement of fluid level by giving the patient adequate amounts of water
Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now?
Answer

Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.
Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.
Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.

Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute?
Answer

Air or vacuum splint
Blood pressure cuff
Ice packs tied in place with triangle bandage
Use a rope tie-down to make a tourniquet

Blood pressure cuff
The most common form of a hemostatic agent is:
Answer

hemostatic granular.
hemostatic dressings.
hemostatic tourniquet.
hemostatic powder.

hemostatic dressings.
In which of the following instances would PASG be an appropriate choice to control bleeding?
Answer

Multiple lacerations to the lower extremities
A knife impaled in the abdomen
A laceration of the large veins of the neck
A gunshot wound to the chest

Multiple lacerations to the lower extremities
Which of the following is recommended in situations in which a tourniquet must be used?
Answer

Apply a bulky dressing and bandage over the tourniquet.
Apply the tourniquet over the elbow or knee.
Use a material that is wide and thick.
Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb.

Use a material that is wide and thick.
Which of the following is NOT recommended when controlling epistaxis?
Answer

Pinching the nostrils together
Keeping the patient calm and quiet
Having the patient tilt the head backward to elevate the nose
Placing the unconscious patient in the recovery position

Having the patient tilt the head backward to elevate the nose
Which of the following is responsible for most of the signs and symptoms of early shock?
Answer External bleeding
Internal bleeding
Dilation of the peripheral blood vessels
The body’s attempts at compensation for blood loss
The body’s attempts at compensation for blood loss
Your patient is a 19-year-old motorcyclist who has crashed into a parked car and was ejected from his motorcycle. He was wearing a helmet; he is awake, shivering, and anxious. The patient is pale, with slight cyanosis of his lips, a slightly increased respiratory rate, and a rapid, thready radial pulse. Bystanders state that there was no loss of consciousness. The patient has abrasions to his hands and face, and blood is saturating the thigh area of both legs of his jeans. A rapid trauma assessment reveals that the patient has swelling and deformity of both thighs. Which of the following is NOT appropriate in the on-scene management of this patient?
Answer

The use of a long backboard
The use of traction splinting for the lower extremity injuries
The use of PASG
The use of high-concentration oxygen by nonrebreather mask

The use of traction splinting for the lower extremity injuries
When deciding where to transport a patient who is in hypovolemic shock or who has the potential for developing hypovolemic shock, which of the following is the most important service to be provided by the receiving hospital?
Answer

Critical-care nursing
Immediate surgical capabilities
Availability of a chaplain
Rehabilitation services

Immediate surgical capabilities
Which of the following circumstances may result in hypoperfusion?
Answer

There is external bleeding.
Blood vessels are dilated.
The heart is damaged.
All of the above

All of the above
Which of the following is a consequence of hypoperfusion?
Answer

Cellular waste products are not removed.
Cells are not supplied with nutrients.
Cells are not supplied with oxygen.
All of the above

All of the above
Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the BEST sequence of steps in the management of this patient?
Answer

High-concentration oxygen, elevation of the extremity, and application of ice
Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
High-concentration oxygen, tourniquet, PASG, and elevation of the extremity
Direct pressure, high-concentration oxygen, and splinting the leg

Direct pressure, high-concentration oxygen, and splinting the leg
Which of the following is part of the body’s compensatory response to blood loss?
Answer

Blood vessels constrict and the heart rate increases.
Blood vessels dilate and the heart rate increases.
Blood vessels dilate and the heart rate decreases.
Blood vessels constrict and the heart rate decreases.

Blood vessels constrict and the heart rate increases.
Which of the following signifies a failure in the patient’s compensatory response to blood loss?
Answer

Hypotension
Tachycardia
Tachypnea
Pale, cool skin

Hypotension
Which of the following is the most sensitive indicator of hypoperfusion?
Answer

Delayed capillary refill
Dilation of the pupils
Increased heart rate
Altered mental status

Altered mental status
Which of the following distinguishes irreversible shock from other stages of shock?
Answer

Cell damage and death in the vital organs
Altered mental status
Delayed capillary refill time
Low blood pressure

Cell damage and death in the vital organs
Which of the following is NOT indicated in the management of a patient in shock?
Answer

Minimizing on-scene time
Delaying a detailed exam until en route to the hospital
High-speed ambulance transportation
On-scene spinal precautions, if indicated

High-speed ambulance transportation
For which of the following shock patients would the use of PASG be contraindicated?
Answer

A 50-year-old man whose pelvis has been crushed by a forklift
A 7-year-old male with massive soft-tissue loss of the left thigh from a shark bite
A 70-year-old female who is vomiting blood and has crackles in her lungs
A 23-year-old pregnant woman with obvious fractures of both femurs

A 70-year-old female who is vomiting blood and has crackles in her lungs
The use of PASG is NOT advised for which of the following injuries?
Answer

External bleeding of the lower extremities
Pelvic fracture
Gunshot wound to the chest
Internal bleeding to the lower extremities

Gunshot wound to the chest
Which of the following is the purpose of making airway management the highest priority of patient care when managing the patient in shock?
Answer

It allows for oxygenation of the lungs.
It allows for improved elimination of carbon dioxide.
It minimizes the chances of aspiration of blood or vomit.
All of the above

All of the above
Which of the following should increase the EMT’s suspicion of internal bleeding?
Answer

Penetrating trauma to the chest or abdomen
High-speed motor vehicle collision
Fall from a height two or more times the patient’s height
All of the above

All of the above
Which of the following BEST explains the reason for minimizing scene-time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?
Answer

There is nothing the EMT can do for a patient in shock.
It gives the EMT less opportunity to make mistakes in the patient’s care.
Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.
All of the above

Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.
Which of the following will worsen the condition of the patient in shock?
Answer

Applying high-concentration oxygen when it is not needed
Elevating the patient’s legs 8 to 10 inches
Conducting oneself in a manner that increases the patient’s fear and anxiety
Transporting without first splinting all extremity fractures

Conducting oneself in a manner that increases the patient’s fear and anxiety
Which of the following is a major function of the skin?
Answer

Excretion of wastes
Protection from the environment
Temperature regulation
All of the above

All of the above
Which of the following is the outermost layer of the skin?
Answer

Dermis
Epidermis
Adipose tissue
Fascia

Epidermis
Which of the following layers of the skin is the most important in insulating the body against heat loss?
Answer

Parietal layer
Subcutaneous layer
Epidermis
Subdural layer

Subcutaneous layer
Which of the following is required in the management of all open soft-tissue injuries?
Answer

Provision of high-concentration oxygen
Use of Standard Precautions by the EMT
Cervical spine precautions
Application of a disinfectant solution

Use of Standard Precautions by the EMT
An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n):
Answer

contusion.
abrasion.
concussion.
avulsion.

contusion
Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils?
Answer

Avulsion
Laceration
Puncture
Incision

Puncture
A wound in which the epidermis is scraped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called a(n):
Answer

abrasion.
contusion.
avulsion.
evisceration.

abrasion.
An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a fallen tree, that results in damage to muscle cells and the accumulation of waste products in the tissue is called a(n):
Answer

crush injury.
evisceration.
contusion.
abrasion.

crush injury.
Which of the following BEST describes an avulsion?
Answer

An injury caused by a sharp, pointed object
A flap of skin that is partially or completely torn away from the underlying tissue
The epidermis that is scraped away by a rough surface
An accumulation of blood beneath the skin, resulting in swelling

A flap of skin that is partially or completely torn away from the underlying tissue
Bleeding from soft-tissue injuries should initially be controlled with which one of the following techniques?
Answer

Application of an ice pack or chemical cold pack
Direct pressure
Elevation of the injured part
Running cold water over the wound

Direct pressure
Which of the following is NOT an open tissue injury?
Answer

Abrasion
Contusion
Avulsion
Evisceration

Contusion
A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site?
Answer

The nail is less than 2 inches in length.
The patient’s distal pulse, motor function, and sensation are intact.
Bleeding from the wound is minimal.
None of the above

None of the above
Which of the following injuries requires the use of an occlusive dressing?
Answer

An open wound to the neck
An open wound to the abdomen from which a loop of intestine is protruding
An open wound to the chest
All of the above

All of the above
Which of the following is recommended when caring for an amputated part?
Answer

Rinse away debris with saline solution and place the part in a container of ice.
Wrap the part in aluminum foil to preserve body temperature.
Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.
Always transport the amputated part with the patient.

Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack.
A burn extending into the subcutaneous fat would be classified as which type of burn?
Answer

Deep partial thickness
Full thickness
Superficial partial thickness
Superficial

Full thickness
Which of the following BEST describes a partial thickness burn?
Answer

The skin is red, but dry and painful.
The skin is charred or blackened and lacks sensation.
The skin is white and dry with no sensation of pain.
The skin is red and moist with blister formation.

The skin is red and moist with blister formation.
Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound?
Answer

Application of a dry, sterile dressing
Application of antibiotic ointment
Elevation of the wound above the level of the heart
Keeping the site clean

Application of antibiotic ointment
Your patient is a 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and painful, but without blisters. When caring for this injury in the prehospital setting, which of the following is appropriate?
Answer

Apply an antibiotic ointment.
Apply a lotion containing a topical anesthetic and aloe vera.
Apply a plastic bag full of ice to the skin.
Apply a dry sterile dressing.

Apply a dry sterile dressing.
Which of the following patients has the greatest likelihood of being cared for in a burn center?
Answer

A 45-year-old man who has a full thickness burn about 3 inches long by 1/2 inch wide on his posterior arm from backing into a barbecue grill
A 30-year-old woman who has deep partial thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
A 12-year-old male with a superficial partial thickness burn involving his forearm as a result of making a torch by lighting aerosol from a can of hairspray
A 16-year-old female who came into contact with a motorcycle exhaust pipe and has a full thickness burn on her leg about 2 inches in diameter

A 30-year-old woman who has deep partial thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
For which of the following patients should the EMT carefully continue to monitor the patient’s ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure?
Answer

A 17-year-old male with a blistering sunburn on his face
A 34-year-old male who opened the radiator of his car and had hot fluid spray on his chest, resulting in redness and pain in an area about the size of the patient’s hand
A 28-year-old male who spilled a strong industrial acid on his legs
A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest

A 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest
Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds?
Answer

Absorbent
Occlusive
Adherent
Sterile

Sterile
In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next?
Answer

Remove the saturated dressings and apply a large trauma dressing.
Apply an ice pack over the original dressing.
Apply a tourniquet.
Apply additional dressing material over the top of the original dressing and bandage it in place.

Apply additional dressing material over the top of the original dressing and bandage it in place.
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?
Answer

The presence of any defensive wounds the patient may have sustained
The swelling around his eyes, which may be reduced by applying a cold pack
Potential internal injuries
Getting a description of the assailants

Potential internal injuries
Which of the following is NOT appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury?
Answer

Treat for shock if you think there are internal injuries even if the patient’s vital signs are normal.
Anticipate vomiting.
Splint any swollen, deformed extremities.
All of the above are appropriate.

All of the above are appropriate.
Which of the following is true concerning lacerations?
Answer

They may indicate deeper underlying tissue damage.
They may be caused by penetrating trauma.
They may be caused by blunt trauma.
All of the above

All of the above
Which of the following is of concern with a puncture wound?
Answer

An object that remains impaled in the body
Hidden internal bleeding with minimal external bleeding
A strong possibility of contamination
All of the above

All of the above
Which of the following is NOT a type of avulsion?
Answer

The skin is partially torn away from the foot.
A finger is cut off with a butcher’s saw.
An ear is partially torn away from the head.
The skin is stripped off the hand, like removing a glove.

A finger is cut off with a butcher’s saw.
Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization?
Answer

Use your fingers to pick embedded debris from the wound, bandage with moist saline dressings in place, and transport.
Do not attempt to remove any debris, apply pressure dressings over the embedded material if necessary, apply high-concentration oxygen, and transport.
Use a tongue depressor to scrape large pieces of debris out of the wounds, place the patient on high-concentration oxygen, and transport.
Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.

Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.
Your patient is a 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital setting?
Answer

Push the hook through the wound to avoid further damage from the barbed end.
Leave the hook in place and try not to disturb it.
Apply a pressure dressing over the hook.
Pull the hook out from the same direction in which it entered the hand.

Leave the hook in place and try not to disturb it.
Which of the following is a consideration in determining a burn’s severity?
Answer

Other illnesses or injuries the patient may have
Body surface area involved in the burn
The type of agent that caused the burn
All of the above

All of the above
Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned?
Answer

18 percent
9 percent
36 percent
4.5 percent

18 percent
Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical wire?
Answer

The extent of tissue damage may be much greater than it appears on the surface.
The burning will continue for hours, perhaps days.
The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity.
Toxic gases were inhaled.

The extent of tissue damage may be much greater than it appears on the surface.
Your patient is a 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the BEST way to manage this situation?
Answer

Have the fire department connect to a hydrant and spray down the patient from head to toe.
Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands.
Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
Brush away the powder and bandage the hands in a position of function.

Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms, the EMT must be aware of which of the following?
Answer

Being involved in a crime makes the patient part of the chain of evidence, requiring a police officer to ride with you to the hospital.
The burn is the most serious injury to the patient.
Medical conditions may be aggravated by the burn.
The patient may need to be questioned by police and fire officials about the cause of the fire.

Medical conditions may be aggravated by the burn.
Burns pose a greater risk to infants and children for which of the following reasons?
Answer

Pediatric patients have a greater risk of heart problems associated with the burn.
Pediatric patients have a greater risk of shock from the burn.
Infants and children have a greater risk of infection from the burn.
None of the above

Pediatric patients have a greater risk of shock from the burn.
You are assessing a 30-year-old male patient that had his arm caught in a piece of machinery. By the time you arrive he has been freed. The patient tells you that he does not understand why you were called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspension of which of the following injuries?
Answer

Puncture
Crush injury
Chemical burn
High-pressure injection

High-pressure injection
While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)?
Answer

None of the choices
Airway
Hypothermia
Bleeding

Airway
You assess a 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the burn, you notice a white powder on the burn. What should be your next step?
Answer

Transport the patient immediately to the closest burn center.
Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
Flush the arm and hand with copious amounts of water.
Brush off the powder, bandage the arm, and transport the patient to the closest trauma center.

Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
When using the rule of palm to estimate the approximate body surface area burned, the patient’s palm equals about what percentage of the body’s surface area?
Answer

1 percent
2 percent
5 percent
3 percent

1 percent
According to the Rule of Nines for infants and young children, the patient’s head and neck account for what percentage of the total body surface area?
Answer

13.5 percent
14 percent
9 percent
18 percent

18 percent
Which of the following is a true statement regarding the skin’s status in the case of a closed chest injury?

Internal contusions and lacerations cannot occur.
The skin may be penetrated and occluded.
The skin is penetrated.
The skin is not penetrated.

The skin is not penetrated.
Which of the following is a strategy to maintain an occlusive dressing to bloody or diaphoretic skin?

Do not use occlusive dressings in this case.
Manually maintain pressure.
Do not use adhesive tape.
Wrap the dressing circumferentially with gauze.

Manually maintain pressure.
Some drawbacks to using sterile aluminum foil as an occlusive dressing include:

sterility cannot be ensured unless the materials were autoclaved.
a flutter valve is difficult to create.
foil cannot create an airtight seal.
skin lacerations may occur from the sharp edges.

skin lacerations may occur from the sharp edges.
Which of the following is required in the management of all open soft-tissue injuries?

Provision of high-concentration oxygen to the patient
The use of Standard Precautions by the EMT
Cervical spine precautions
Application of a disinfectant solution during clean-up

The use of Standard Precautions by the EMT
In addition to lacerations, blunt trauma resulting in a closed chest injury creates the potential for which of the following internal injuries?

Abrasion
Contusion
Evisceration
Avulsion

Contusion
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 illness, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient?

Verifying trauma center ER bed availability
Examining the patient for entrance and exit wounds
Searching for presence of diaphoresis, tachycardia, and hypotension
Performing a distal neurological assessment

Examining the patient for entrance and exit wounds
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?

Intestines
Liver
Pancreas
Kidneys

Liver
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 an abdominal evisceration.
The patient is showing signs of abdominal bleeding.
The patient is showing signs of an open chest injury.
The patient may have a flail chest.

The patient may have a flail chest.
Which of the following BEST describes an evisceration?

An open wound of the abdomen from which organs protrude
A flap of skin that is partially or completely torn away from the underlying tissue
An accumulation of blood beneath the skin, resulting in swelling
The epidermis that is scraped away by a rough surface

An open wound of the abdomen from which organs protrude
Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques?

Packing the wound with rolled gauze
Applying an occlusive dressing
Applying direct pressure to the wound
Applying an ice pack or chemical cold pack

Applying direct pressure to the wound
Which of the following is NOT an open tissue injury?

Contusion
Evisceration
Avulsion
Abrasion

Contusion
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?
Answer Bleeding from the patient’s wound is minimal.
The patient develops a tension pneumothorax.
The patient begins to complain of shortness of breath.
None of the above
None of the above
Which of the following injuries does NOT produce distended neck veins?

Traumatic asphyxia
Tension pneumothorax
Cardiac tamponade
All of the answer choices may cause distended neck veins.

All of the answer choices may cause distended neck veins.
Which of the following injuries requires the use of an occlusive dressing?

An open wound to the chest
An open wound to the neck
An open wound to the abdomen from which a loop of intestine is protruding
All of the above

All of the above
Which of the following is an unreliable sign for determining the presence of a tension pneumothorax?
Answer Distended neck veins
Signs and symptoms of shock
Shortness of breath
Trachea that shifts to the side opposite the injury
Trachea that shifts to the side opposite the injury
Which of the following describes the proper application of an occlusive dressing for an open chest wound?

Trim the dressing so that it is the exact size of the wound.
Use a porous material such as a 4″ by 4″ gauze pad.
Tape the dressing securely on three sides.
None of the above

Tape the dressing securely on three sides.
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?

A gunshot wound to the abdomen from which a loop of intestine is protruding
A stab wound to the chest
A laceration to the neck
The stump of an amputated extremity

A gunshot wound to the abdomen from which a loop of intestine is protruding
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.

pericardial effusion
hemopneumothorax
cardiac tamponade
commotio cordis

cardiac tamponade
Which of the following traumatic chest injuries may result in massive, often fatal internal hemorrhage?

Hemopneumothorax
Hemothorax
Aortic dissection
Cardiac tamponade

Aortic dissection
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 1-2 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?

Cardiac tamponade
Aortic dissection
Tension pneumothorax
Commotio cordis

Commotio cordis
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.
tension pneumothorax.
commotio cordis.
flail chest.

aortic dissection.
Common signs and symptoms following an injury to a hollow abdominal organ include:

increasing intrathoracic pressures.
irritation and peritonitis.
massive hemorrhage.
absence of unilateral pulses.

irritation and peritonitis.
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
Flail chest
Abdominal evisceration
Hemopneumothorax

Tension pneumothorax
Which of the following types of bandages should NOT be used by the EMT providing wound care?

Self-adherent roller gauze
Tourniquet
A triangular bandage
Adhesive tape

Tourniquet
Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds?

Nonabsorbent
Sterile
Occlusive
Adherent

Sterile
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 to release pressure buildup.
Begin providing BVM-assisted ventilations to the patient.
Call dispatch for an ALS intercept en route to the hospital.
Begin providing CPR to the patient.

Free a corner or edge of the dressing to release pressure buildup.
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 presence of any defensive wounds the patient may have sustained
Getting a description of the assailants
The possibility of a pneumothorax
Reducing the swelling around his eyes by applying a cold pack

The possibility of a pneumothorax
Which of the following is NOT appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury?

Treat for shock if you think there are internal injuries even if the patient’s vital signs are normal.
Anticipate vomiting.
Splint any swollen, deformed extremities.
All of the answer choices are appropriate.

All of the answer choices are appropriate.
Which of the following is true concerning lacerations?

They may be caused by blunt trauma.
They may be caused by penetrating trauma.
They may indicate deeper underlying tissue damage.
All of the above

All of the above
Which of the following is of concern with a puncture wound?

The object that remains impaled in the body
The strong possibility of contamination
Hidden internal bleeding with minimal external bleeding
All of the above

All of the above
Which of the following is an accurate definition of a flail chest?

A lung that has been punctured by a fractured rib, resulting in a buildup of air
A section of the chest wall that is unstable, leading to breathing problems
The fracture of one rib in two or more consecutive places
The fracture of at least four ribs in two or more places

A section of the chest wall that is unstable, leading to breathing problems
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.
The patient has become hypoxic due to a chest injury and the finding suggests central cyanosis.
The physiological strain of the body results in a flushed appearance and increased risk of a hypertensive event.
Bluish or reddish facial discoloration is not associated with traumatic asphyxiation; a pale discoloration is usually present

High pressure on the chest leads to blood being forced from the right atrium into the face and neck.
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.
Gently replace the intestines after moistening with sterile saline solution.
Leave the abdominal contents in the place in which they were found and transport immediately.
Cover the abdomen with an occlusive dressing of aluminum foil.

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 the patient in the shock position
Performing a rapid trauma assessment
Placing a pressure dressing over the wound to control bleeding
Placing an occlusive dressing over the wound

Placing an occlusive dressing over the wound
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 eliminates the need to continue monitoring the patient’s respiratory status.
It prevents the development of a hemothorax by allowing blood to escape.
It allows easy access for re-examination of the wound en route to the hospital.
It reduces the chances of developing a tension pneumothorax.

It reduces the chances of developing a tension pneumothorax.
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:

blunt trauma injury.
compression injury.
penetrating injury.
coup contrecoup injury.

compression injury.
The chest cavity can hold up to ________ liter(s) in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss.

3
5
0.5
1

3
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?

The patient does not necessarily need transport, so allow him to refuse if he wants.
Transport the patient emergently because of the high index of suspicion for a serious injury.
Begin transport non-emergently and upgrade if the patient’s condition deteriorates.
Transport the patient non-emergently because he’s complaint free.

Transport the patient emergently because of the high index of suspicion for a serious injury.
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?

A sucking chest wound
A closed tension pneumothorax
An open chest wound
A gurgling chest wound

A sucking chest wound
A patient with jugular vein distention is most likely suffering from which of the following injuries?

Pneumothorax
Hemothorax
Hemopneumothorax
Tension pneumothorax

Tension pneumothorax
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?

Hemothorax
Traumatic asphyxia
Pneumothorax
Flail chest

Traumatic asphyxia
What is a primary problem when treating musculoskeletal injuries?

Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb.
All musculoskeletal injuries are life threatening due to the bone bleeding, leading to hypoperfusion.
Splints do not adequately fit the patient’s extremities and must be modified with padding to ensure immobilization.
Most musculoskeletal injuries are simply splinted and not a life threat to the patient.

Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb.
The part of the skeleton that is made up from the skull and spinal column is called the:

appendicular skeleton.
boney skeleton.
axial skeleton.
torso.

axial skeleton.
Which of the following structures connect bone ends, making joints more stable?

Ligaments
Cartilage
Tendons
Periosteum

Ligaments
Which of the following allows for smooth movement of bone surfaces against one another at joints?

Smooth muscle
Ligaments
Peritoneum
Cartilage

Cartilage
Where could you find the phalange bones?

Upper extremities
Lower extremities
Skull and neck
Hands and feet

Hands and feet
Which of the following is a complication of bone fractures?

Nerve damage
Swelling
Hemorrhage
All of the above

All of the above
Which of the following bones is found in the chest?
Answer Tarsals
Ilium
Sternum
Metacarpals
Sternum
Your patient is a 60-year-old woman who stepped off a curb and injured her ankle. Your exam shows that her left ankle is swollen and painful. Which of the following should you do?

Explain to the patient that her ankle is fractured and you must splint her ankle to prevent further injury and reduce pain.
Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.
Transport the patient immediately to a trauma center, applying high-concentration oxygen en route.
Explain to the patient that her ankle is sprained and transport her with her ankle elevated on a pillow and a cold pack applied to the injury.

Explain to the patient that you cannot tell if her ankle is sprained or fractured until she is X-rayed at the emergency department, then splint the ankle.
Which of the following BEST describes the compartment syndrome?

A serious condition caused by the amount of equipment that must be carried in the ambulance compartments.
A life-threatening condition caused by trapping the blood flow by a fracture when the bone ends cut the blood vessels.
A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure.
A non life-threatening condition caused by orthopedic injuries in which blood flow is stopped when the bone ends compress the blood vessels.

A serious condition caused by the bleeding and swelling from a fracture or crush injury that becomes so strong that the body can no longer perfuse the tissues against that pressure.
Your patient is a 12-year-old female who fell onto her outstretched hands while rollerblading. She has a deformity of her forearm, about 2 inches proximal to her wrist. This injury is a result of which of the following mechanisms?

Direct force
Indirect force
Sudden acceleration
Twisting motion

Indirect force
Which of the following is an injury to the musculature of an extremity?

Luxation
Strain
Fracture
Sprain

Strain
Which of the following describes an open extremity injury?

A gunshot wound has penetrated the skin and then fractured the bone.
Bone ends have lacerated the soft tissues and skin from the inside.
The joint capsule has been torn open during a dislocation.
Both A and B

Both A and B
A traction splint may be used on which of the following musculoskeletal injuries?

A possible fracture of the cervical spine
A possible fracture of the femur
Suspected multiple fractures of the femur, tibia, and fibula
A possible fracture of the humerus

A possible fracture of the femur
Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient?

Gently attempting to flex the mid-portion of the bone to check for angulation
Asking the patient to see if he can bear weight on the extremity
Comparing the injured side to the uninjured side
Seeing if you can elicit crepitus on palpation

Comparing the injured side to the uninjured side
Which of the following is NOT a benefit of splinting an injury to bones and connective tissues?

It prevents neurological damage due to movement of bone ends or fragments.
It may prevent a closed injury from becoming an open injury.
It restricts blood flow to the site of the injury to prevent swelling.
It reduces pain.

It restricts blood flow to the site of the injury to prevent swelling.
Your patient is a 20-year-old college student who has fallen from a third-level balcony onto a wooden deck below. The patient responds to verbal stimuli, is pale in color with moist skin, and has a very obvious deformity with protruding bone ends of his right forearm. Which of the following is the BEST sequence of intervention for this patient?

Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow.
Open the airway; assess breathing; check the carotid pulse; splint the forearm injury; immobilize the patient to a long backboard; apply high-concentration oxygen; and transport.
Provide immediate manual in-line stabilization of the cervical spine; apply high-concentration oxygen by nonrebreather mask; perform a focused history and assessment; apply the cervical collar; apply a padded board splint, sling, and swathe to the forearm injury; and transport.
Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; and check with medical control about the need to splint the forearm injury prior to transport.

Provide manual in-line stabilization of the cervical spine along with assessment of breathing, pulse, and the presence of significant hemorrhage; apply high-concentration oxygen; perform a rapid trauma exam; immobilize to a long backboard; transport; and splint the extremity en route if time and resources allow.
When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what “Six Ps”?

Pain, pallor, position, pulses, placement, and pressure
Pain, pallor, paresthesia, pulses, placement, and pressure
Pain, pallor, position, pulses, placement, and pad
Pain, pallor, paresthesia, pulses, paralysis, and pressure

Pain, pallor, paresthesia, pulses, paralysis, and pressure
Your patient is an 11-year-old male who has a swollen, painful, and angulated right lower arm after falling from his bicycle onto his hands. Which of the following should be considered in the immobilization of his injured extremity?

Check pulse, movement, and sensation distal to the injury before and after splinting.
Immobilize from the shoulder to the wrist.
Use an upper extremity traction splint.
Do not attempt to realign the extremity before splinting.

Check pulse, movement, and sensation distal to the injury before and after splinting.
Which of the following is NOT a principle of splinting that must be considered by the EMT?

Immobilize the site of an extremity injury from the joint above it to the joint below it.
Splint an isolated extremity injury before moving the patient to the stretcher.
Check the distal neurovascular function before and after splinting.
Gently replace protruding bone ends back beneath the skin to prevent further contamination.

Gently replace protruding bone ends back beneath the skin to prevent further contamination.
A new EMT who is treating a suspected femur injury asks his partner, “How much traction should I pull?” The partner’s BEST reply is which of the following?

No traction splint applied in the field pulls true traction; they must pull 20 pounds of countertraction.
Pull enough traction to give the patient some relief from the pain.
The amount of traction applied should be roughly 10 percent of the patient’s body weight and not exceed 15 pounds.
The amount of traction applied should be 15 pounds.

The amount of traction applied should be roughly 10 percent of the patient’s body weight and not exceed 15 pounds.
Which of the following complications may arise from properly splinting an injured extremity?

Converting a closed fracture to an open one
Compromising circulation to the extremity
Ignoring life-threatening problems while focusing on an extremity injury
All of the above

Ignoring life-threatening problems while focusing on an extremity injury
Your patient is a 3-year-old girl who is unable to move her elbow after her mother picked her up by the forearm. Proper splinting of this injury would be to immobilize from the ________ to the ________.

wrist; elbow
wrist; shoulder
forearm; humerus
fingertips; shoulder

forearm; humerus
You are treating a 16-year-old skateboarder who has fallen at the skate park. She has an angulated left forearm that she has in a guarded position. When do you splint this injury?

En route to the hospital
Immediately
During the primary exam
During the secondary exam

During the secondary exam
Your patient is a 28-year-old male who was ejected from his motorcycle after striking a parked vehicle. He has multiple deformities to his upper and lower extremities on both sides. Which of the following would be the BEST way to immobilize this patient’s extremities prior to transport?

Use traction splints for the lower extremities and allow the upper extremities to be immobilized by the long backboard.
Use padded board splints for the upper extremities and PASG for the lower extremities.
Use moldable splints for the upper and lower extremities, padding any voids to fully stabilize the fractures.
Immobilize the patient to a long backboard without splinting the extremities individually.

Immobilize the patient to a long backboard without splinting the extremities individually.
Your patient is a 37-year-old man who tripped while walking down a hill and now has a painful, deformed right leg. Your assessment reveals that the foot is cold and mottled in appearance. You cannot detect a pulse in the foot or ankle. Which of the following is the BEST course of action?

Explain to the patient that, because you cannot detect circulation in his foot, his leg will most likely have to be amputated above the site of the injury.
Gently attempt to straighten the leg to regain a pulse before splinting.
Splint the leg in the position in which it was found and transport without delay.
Transport rapidly to the nearest trauma center.

Gently attempt to straighten the leg to regain a pulse before splinting.
A suspected musculoskeletal injury of the shoulder is BEST managed by which of the following techniques?

Placing the arm in a sling and using a triangular bandage to secure it to the body
Using an upper extremity traction splint
Placing two long padded board splints on either side of the extremity, extending from the shoulder to the wrist
Using a long-arm air splint

Placing the arm in a sling and using a triangular bandage to secure it to the body
The PASG may be used as a splinting device for patients with which of the following suspected injuries?

Hip dislocation
Compression fracture of the lumbar or sacral spine
Fractured pelvis
None of the above

Fractured pelvis
Blood at the meatus of the penis (opening of the urethra) is a sign of:

spinal fracture or injury.
pelvic trauma/fracture.
pelvic dislocation syndrome.
priapism.

pelvic trauma/fracture.
Your patient is a 70-year-old male whose tractor rolled over onto him. Your assessment makes you suspicious that the patient has a fractured pelvis. Which of the following complications should you anticipate?

Shock
Damage to internal organs
Damage to the nerves of the lower extremities
All of the above

All of the above
A painter falls from his ladder and tells you he has dislocated his shoulder again. When you attempt to splint the shoulder it “pops back into place.” What should your next step be?

Contact medical control for input into the best treatment for this patient.
Check distal CSM, apply a sling and swathe, and transport the patient.
Check distal CSM, apply a traction splint, and transport the patient.
Continue splinting and report the popping sound to the triage nurse when you arrive at the hospital.
.

Check distal CSM, apply a sling and swathe, and transport the patient.
Messages from the body to the brain are carried by which of the following types of nerves?

Sensory
Skeletal
Motor
Cranial

Sensory
Which of the following is a function of the autonomic nervous system?

Speaking
Running or walking
Constriction of blood vessels
Solving complex math problems

Constriction of blood vessels
Which of the following is controlled by the left side of the brain?

Sensation in the left arm
Sensation of the right leg
Movement of both lower extremities
Movement of the left arm

Sensation of the right leg
The maxillae form which of the following structures?

Lower jaw
Upper jaw
Cheek bones
Forehead

Upper jaw
To which of the following sections of the spine are the ribs attached?

Thoracic
Sacral
Cervical
Lumbar

Thoracic
How many cervical vertebrae are there?

7
12
5
4

7
A fracture of which of the following bones would be considered a skull fracture?

Temporal bone
Nasal bones
Maxilla
Any of the above

Any of the above
Which of the following is classified as an open head injury?

Contusion without a skull fracture
Laceration with a skull fracture
Laceration without a skull fracture
Both A and B

Laceration with a skull fracture
Which of the following is a sign of possible brain injury?

A deep laceration of the scalp
Projectile vomiting
Irregular breathing pattern
All of the above

All of the above
Your patient has been involved in a motor vehicle collision. He has a contusion on his forehead, is confused, and is bleeding from his nose. His heart rate is 90 beats per minute, blood pressure is 80/58 mmHg, respirations are 20 breaths per minute, and his skin is cool and clammy. Which of the following sets of injuries should you suspect?

Head injury, spine injury, and internal bleeding
Head injury
Head injury and spine injury
Head injury and internal bleeding

Head injury, spine injury, and internal bleeding
Hyperventilation of a patient with a severe brain injury means that bag-valve-mask ventilations are provided at a rate of ________ per minute.

20
24
30
34

20
Which of the following is a potential complication of hyperventilating a patient with a brain injury?

Increasing the amount of carbon dioxide in the blood
Increasing blood flow to the brain
Decreasing blood flow to the brain
Decreasing the patient’s blood pressure

Decreasing blood flow to the brain
Your patient is a 30-year-old female involved in a motorcycle crash. She was not wearing a helmet and struck her head on the pavement. She is unresponsive and has a blood pressure of 152/110 mmHg. Her pulse is 60 beats per minute and respirations are 8 breaths per minute and shallow. Which of the following is an appropriate intervention?

Elevate the legs.
Provide cervical spine immobilization.
Hyperventilate at a rate of 24 breaths per minute using supplemental oxygen.
Apply a pressure dressing to her scalp lacerations.

Provide cervical spine immobilization.
A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle with his face. Which of the following injuries should you prepare to treat?

Cervical spine trauma
Brain injury
Airway obstruction
All of the above

All of the above
Which of the following statements concerning a concussion is true?

It is a bruising of the brain tissue.
The patient may not have any symptoms of the injury.
It is accompanied by recurrent episodes of unconsciousness.
All of the above

The patient may not have any symptoms of the injury.
Which of the following causes worsening of the damage in a brain injury?

Allowing seepage of cerebrospinal fluid from the ears or nose
Administration of 100 percent oxygen
Failure to keep the patient awake and talking
Improper management of airway and ventilation

Improper management of airway and ventilation
Which portions of the spine are the most vulnerable to injury?

Thoracic and lumbar
Cervical and lumbar
Cervical and sacra
Thoracic and sacra

Cervical and lumbar
In most cases, which of the following is the correct way to provide initial management of a suspected cervical spine injury?

Hold the patient’s head still in a neutral, “eyes forward” position.
Gently apply pressure to the top of the patient’s head.
Maintain the patient’s head and neck in the position they are found.
Provide approximately 15 pounds of upward cervical traction.

Hold the patient’s head still in a neutral, “eyes forward” position.
Which of the following is NOT a common field finding in spinal injuries?

Deformity
Impaired breathing
Tenderness
Pain

Deformity
Which of the following observations may the EMT use to rule out a spinal injury in a trauma patient?

Patient is able to walk at the scene.
There is a lack of mechanism of injury.
There is a lack of numbness and paralysis of the extremities.
Patient denies pain in his spine.

There is a lack of mechanism of injury.
Which of the following is the underlying cause of neurogenic shock?

Blood loss from damaged spinal blood vessels
Failure of the heart to adequately pump blood
Extreme emotional response to paralysis
Dilation of blood vessels

Dilation of blood vessels
Which of the following may result from the application of a cervical collar that is too large for the patient?

Rotation of the head and neck
Hyperflexion of the neck
Hyperextension of the neck
Excessive lateral movement of the mandible

Hyperextension of the neck
Your patient is pregnant at 20 weeks’ gestation and has been thrown from a horse. She is complaining of back pain. Which of the following is the correct procedure for immobilizing her spine?

Use a short immobilization device and transport the patient in a sitting position.
Place the patient supine on the backboard.
Place the patient on her left side on the backboard.
Place the patient supine on the backboard, then put a pillow under the right side of the backboard.

Place the patient supine on the backboard, then put a pillow under the right side of the backboard.
Which of the following signs is LEAST likely to indicate a traumatic brain injury?

Low blood pressure
Irregular breathing pattern
Vomiting
Irrational behavior

Low blood pressure
Your patient is a 10-year-old male whose jacket hood caught on a branch as he jumped out of a tree. He was momentarily suspended about 12 inches off the ground but was immediately lowered to the ground by his brothers. Which of the following injuries should you suspect?

Cervical spine injury
Lumbar spine injury
Soft-tissue injury of the neck only
Thoracic spine injury

Cervical spine injury
Which of the following injuries is considered an indirect brain injury?

Cerebral laceration
Depressed skull fracture with cerebral penetration by bone fragments
Gunshot wound to the head
Concussion

Concussion
Your patient is a 27-year-old male who has been involved in a motorcycle collision in which he was not wearing a helmet. He does not respond when you speak to him, but he makes incomprehensible sounds when you press your knuckles on his sternum. Which of the following BEST describes his level of consciousness?

Alert
Verbal
Painful
Unresponsive

Painful
Your patient is a 35-year-old woman who was driving a minivan that was struck in the driver’s side door by another vehicle. You notice that when you apply pressure to her sternum with your knuckles she extends her legs and flexes her arms and wrists. When giving your radio report, which of the following terms should you use to describe this?

Tonic-clonic activity
Posturing
Cushing’s reflex
Battle’s sign

Posturing
Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which of the following interventions would be MOST appropriate?

Insert an oropharyngeal airway and ventilate via bag-valve mask at 30 breaths per minute.
Insert a nasopharyngeal airway and give oxygen by nonrebreather mask at 15 lpm.
Insert an oropharyngeal airway and give oxygen by nonrebreather mask at 15 lpm.
Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.

Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.
Which of the following measures is NOT appropriate for a patient with a significant isolated head injury?

Treat for shock by elevating the foot of the backboard.
Keep the patient from becoming overheated.
Try to keep the patient from being agitated.
Control bleeding from head wounds.

Treat for shock by elevating the foot of the backboard.
Of the following patients, which injury is the highest priority to receive controlled hyperventilation?

A 25-year-old female victim of battery who is awake but complains of a headache and has bloody fluid draining from her nose and left ear
A 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli
A 25-year-old male who regained consciousness one or two minutes after being struck on the head by a baseball bat and is now asking repetitive questions
A 70-year-old male who struck his head when he fell in the parking lot, has a large laceration on his forehead, and is disoriented

A 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays decerebrate movements in response to painful stimuli
What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a horse, has his eyes open, can follow your commands to squeeze his hands, but is confused about what happened and his whereabouts?

12
14
15
13

14
Your patient is a 30-year-old construction worker who fell from a scaffolding and has been impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient responds to verbal stimuli and appears to have multiple other injuries. Which of the following is the BEST course of action?

Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the scene time under 10 minutes.
Transport with the reinforcement bar in place to prevent delay at the scene.
Test the reinforcement bar for stability and remove it only if it is loose enough to be easily pulled from the wound.
Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.
When blood accumulates between the brain and the dura mater, what is the result?

Epidural contusion
Subdural contusion
Epidural hematoma
Subdural hematoma

Subdural hematoma
As pressure within the cranium increases, which of the following is the result?

Decreased blood pressure, decreased pulse
Increased blood pressure, decreased pulse
Decreased blood pressure, increased pulse
Increased blood pressure, increased pulse

Increased blood pressure, decreased pulse
Your patient is a 21-year-old male who slid head-first down a water slide at his fraternity house and impacted the bales of straw that his fraternity brothers had erected as a barrier to keep participants from sliding onto the adjacent highway. The patient is conscious and complaining of neck pain. Which of the following should be included in your assessment?

If the patient has no numbness or tingling, ask him to stand and try to walk.
Apply painful stimuli to his extremities, starting distally and moving closer and closer to the body.
Ask the patient to cautiously touch his chin to his chest to check for range of motion.
Ask the patient to grasp and squeeze your hands.

Ask the patient to grasp and squeeze your hands.
The proper procedure for opening the airway of an unresponsive trauma patient is:

head-tilt without chin-lift.
jaw-thrust maneuver.
Sellick’s maneuver.
head-tilt, chin-lift maneuver.

jaw-thrust maneuver.
Which of the following pieces of equipment is acceptable for use in the prehospital stabilization of suspected cervical spine injuries?

Soft cervical collars
Five-pound sand bags
Rigid cervical collars
All of the above

Rigid cervical collars
At which point may manual stabilization of the cervical spine be terminated?

Only when directed to do so by medical control
When the patient is secured to a long backboard
After a short immobilization device has been applied
After a cervical collar has been applied

When the patient is secured to a long backboard
Which of the following describes the proper position of the patient’s head for spinal immobilization?

Chin tilted upward for airway maintenance
Neutral, in-line “eyes forward” position
Stabilized in position found
The “sniffing” position

Neutral, in-line “eyes forward” position
Which of the following may be a hazard of an improperly fitting cervical collar?

Allows hyperextension of the neck
Prevents the patient from opening his mouth
Allows flexion of the neck
All of the above

All of the above
When log-rolling a patient with a suspected spinal injury, which of the following EMTs directs the move?

The EMT at the head of the patient
The EMT with the highest level of training
The EMT with the most seniority
The EMT at the heaviest portion of the patient

The EMT at the head of the patient
Which of the following is the correct sequence for securing the straps on a long spine board?

Legs, torso, head
Head, torso, legs
Torso, legs, head
Head, legs, torso

Torso, legs, head
Your patient is a 38-year-old male driver of a vehicle that left the roadway and struck a bus stop shelter and a tree. He is conscious and alert, he has some abrasions on his forehead, his skin is warm and dry, and he has a strong radial pulse and no difficulty breathing. Which of the following descriptions represents the MOST appropriate way for removing the patient from the vehicle?

Apply a cervical collar and perform rapid extrication onto a long backboard.
Have the patient stand up and then do a “standing take-down” onto a long backboard.
Place the backboard on the stretcher and have the patient stand, turn, and lie down on the backboard while you maintain manual in-line stabilization of the cervical spine.
Apply a cervical collar and short spine immobilization device before removing to a long backboard.

Apply a cervical collar and short spine immobilization device before removing to a long backboard.
For which of the following patients would the use of a short spine immobilization device be appropriate?

A 52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain
An unresponsive driver who was found in the driver’s seat of a pickup truck that crashed into a tree
A 15-year-old male who struck a curb with his motorized scooter and flipped over the handlebars
A 77-year-old female who fell down a flight of stairs and is in an awkward position lying on her side on the landing

A 52-year-old female who crashed her vehicle into the front of a convenience store and who is awake, oriented, and complaining of neck pain
When using a short spine immobilization device, which part of the body is secured last?

Arms
Torso
Head
Legs

Head
In which of the following circumstances should a helmet be removed?

If you suspect a skull fracture and need to palpate the head
If you want to place a nasal cannula on the patient but cannot because his ears are covered by the helmet
If the helmet interferes with airway management
If the helmet fits so snugly that you cannot inspect the ears for the presence of blood or fluid

If the helmet interferes with airway management
When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his apartment building?

At the hospital before writing the care report
En route to the hospital
As he approaches the patient
Before departing from the scene

En route to the hospital
Which of the following is NOT used to calculate a patient’s GCS?

Eye movement
Verbal response
Work of breathing
Motor response

Work of breathing
Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae?

Peripheral nervous system
Central nervous system
Autonomic nervous system
All of the above

Peripheral nervous system
What is another name for the zygomatic bone?

Malar
Maxillae
Temporal
Mandible

Malar
The bony bumps you feel along the center of a person’s back are known as which of the following?

Vertebrae
Foramen magnum
Spinous process
None of the above

Spinous process
Which of the following is the opening at the base of the skull?

Foramen magnum
Orbits
Spinous process
Temporomandibular joint

Foramen magnum
You are treating a 54-year-old female patient who was involved in a domestic dispute; you notice an abrasion to the side of her head. The patient is unresponsive with a blood pressure of 200/110, a pulse of 60 beats per minute, and slightly irregular breathing. The patient’s presentation is most likely caused by which of the following?

Increased intracranial pressure
Coup-contrecoup injury
Closed head injury
Increased arterial pressure

Increased intracranial pressure
You are treating an unresponsive homeless patient found in an alley. During your assessment you notice bruising behind both ears. This is known as what?

Fatigue signs
Warrior’s signs
Soldier’s signs
Battle’s signs

Battle’s signs
You respond to a patient who was hit in the face with a chair. Upon arrival, you notice a patient leaning in the corner and bleeding profusely from the mouth and nose. Your first action should be which of the following?

Assure scene safety.
Suction the airway and have the patient lean back.
Take c-spine precautions.
Place the patient on a nonrebreather mask at 15 lpm.

Assure scene safety.
Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the following?

Eye opening, verbal response, and motor response
Grip strength, verbal response, and eye opening
Verbal response, motor response, and AVPU
Motor response, arm movement, and speech

Eye opening, verbal response, and motor response
While assessing a patient with a laceration to the neck, the EMT must be aware that which of the following conditions may develop?

Deep vein thrombosis
Air embolus
Air thrombosis
Deep vein embolus

Air embolus
Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve?

Spinous process
None of the above
Malar
Dermatome

Dermatome
You are treating a 35-year-old male patient that has been involved in a motorcycle incident. The patient is unresponsive with a blood pressure of 60/40, a pulse of 66 beats per minute, and respirations of 18 breaths per minute. The patient’s presentation is most likely caused by which of the following?

Cardiogenic shock
Septic shock
Increased intracranial pressure
Neurogenic shock

Neurogenic shock
What is the definition of multiple trauma?

A trauma in which the patient has more than one serious injury.
A trauma in which there are multiple casualties.
A trauma that requires the response of multiple agencies.
Multiple injuries that affect more than one body system.

A trauma in which the patient has more than one serious injury.
What is the definition of multisystem trauma?

Multiple injuries that affect more than one body system.
Trauma in which the patient has more than one serious injury.
A trauma in which there are multiple casualties.
A trauma that requires the response of multiple agencies

Multiple injuries that affect more than one body system.
Multiple trauma and multisystem trauma patients are situations in which the EMT is expected to perform which of the following?

Anticipate and treat problems with a greater level of complexity than usual.
Provide the best quality care possible, including definitive care on-scene.
Respond above and beyond the call of duty.
Practice outside the scope of practice in order to provide the greatest good.

Anticipate and treat problems with a greater level of complexity than usual.
What are three elements of successful trauma care that field practitioners can use which will ultimately translate into greater rates of survival?

Teamwork, timing, and transport
Ground ambulances, air helicopters, and trauma centers
Lights, sirens, and diesel
Physiological determinants, anatomic criteria, and mechanism of injury

Teamwork, timing, and transport
What are some of the most important critical decisions an EMT can make on the scene of a serious trauma?

Determining patient priority, amount of time on-scene, and hospital transport decision
Whether to await ALS care on-scene or begin BLS transport
Load and go versus stay and play
Physiological determinants, anatomic criteria, and mechanism of injury

Determining patient priority, amount of time on-scene, and hospital transport decision
You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is considered the BEST approach regarding transport of this patient?

Dispatch and await the medical helicopter, which is 20 minutes away.
Transport to a local community hospital approximately 15 minutes away via ground.
Begin transport to the trauma center on the ground, which is 1.5 hours’ driving time.
Dispatch the medical helicopter to meet your unit at the community hospital.

Dispatch and await the medical helicopter, which is 20 minutes away.
What trauma triage guidelines did the Centers for Disease Control and Prevention release in order to guide the most injured patients into trauma centers?

Teamwork, timing, and transport
Physiological determinants, anatomic criteria, and mechanism of injury
Determining patient priority, amount of time on-scene, and hospital transport decision
Lights, sirens, and diesel

Physiological determinants, anatomic criteria, and mechanism of injury
What is the Glasgow Coma Score (GCS) measurement of altered mental status, which according to CDC guidelines necessitates transport to a trauma center?

12
13
8
14

13
According to CDC guidelines, a systolic blood pressure of less than _______ indicates a patient should be transported to a trauma center.

90
100
110
80

90
A respiratory rate of less than _______ in infants is a significant finding and indicates a critical patient, who should be immediately transported to a trauma center if secondary to trauma.

20
25
18
30

20
A respiratory rate of less than _______ and greater than _______ in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines.

8; 32
10; 29
12; 20
5; 45

10; 29
What criteria based on the CDC guidelines allows a discretionary approach to trauma triage? For example, a patient not meeting ordinary trauma triage criteria may be transported to a trauma center based on what consideration?

Review of morbidity and mortality
The CDC “No-protocol Protocol”
“Golden Hour” criteria
EMS provider judgment

EMS provider judgment
Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone?

Vehicle rollover
Vehicle crash-generated telemetry data
Intrusion into the occupant area greater than 8 inches
Auto versus pedestrian

Auto versus pedestrian
Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations?

An end-stage renal disease patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt
An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS response
A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC
An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of pelvic pain

A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC
Based on the following presentations of patient injuries, which one would be considered MOST severe, justifying immediate transportation to a trauma center?

Midline cervical spine pain
An open (compound) midshaft femur fracture
Closed head injury
Flail chest

Flail chest
You are dispatched to a motorcycle crash with one patient involved. What is the most important intervention to perform first?

Begin chest compressions
Manually stabilize the cervical spine
Suction the vomit and secretions from the airway
Stabilize the pelvis to a long spine board

Manually stabilize the cervical spine
Which of the following choices is NOT a justifiable reason for delaying transport of a critical trauma patient?

Suctioning the airway
Awaiting arrival of the patient’s parents on-scene
Ventilating a patient in respiratory distress
Immobilizing the patient to a long spine board

Awaiting arrival of the patient’s parents on-scene
What is the BEST option an EMT has when encountering poor BVM compliance when attempting to ventilate a patient?

Begin chest compressions.
Place the patient on supplemental oxygen.
Address ventilation en route to the hospital or ALS intercept.
Involve two people in the procedure.

Involve two people in the procedure.
You are dispatched to a multiple vehicle collision on a busy Interstate highway. Your crew identifies a critical patient entrapped in a small sedan with significant intrusion into the occupant area on the front and left side. One of your crew members, dressed in fully protective gear, volunteers to enter the vehicle to begin assessment and treatment. Given that access to the patient is limited, you tell him to concentrate on assessing which of the following parts of the patient’s body?

Head, posterior torso, and lower extremities
Head, chest, and upper extremities
Torso, pelvis, and lower extremities
Head, chest, and torso

Head, chest, and torso
What are the three elements of the Revised Trauma Score?

GCS, pulse rate, and respiratory rate
GCS, systolic blood pressure, and pulse rate
GCS, systolic blood pressure, and respiratory rate
Level of consciousness, systolic blood pressure, and pulse rate

GCS, systolic blood pressure, and respiratory rate
You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make note that the occupants of both vehicles are outside, and request additional units to proceed non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During secondary assessment of past medical history, you make note of several important details: The patient is on high blood pressure medications, and has had a heart attack in the past. He is complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may have been from the seat belt, but is refusing care and transport. The patient did not lose consciousness. Based on this information, which transport decision would be most appropriate for this patient?

Take the patient to a trauma center.
Allow the patient to sign a refusal.
Call for ALS intercept.
Take the patient to a local community hospital.

Take the patient to a local community hospital.
Which one of the following is NOT a key decision for the EMT when faced with a multisystem or multiple trauma patient?

Should I transport to a trauma center?
Do I need to minimize on-scene time?
Should I allow police to interview the patient on-scene?
Is the patient seriously injured?

Should I allow police to interview the patient on-scene?
What is the height from which an adult fall would meet trauma triage criteria set forth by the CDC?

10 feet
25 feet
20 feet
15 feet

20 feet
You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the BEST transport decision?

Call medical control for advice from the trauma center.
Divert to the trauma center because the patient is becoming symptomatic.
Continue transporting to the local hospital because you’ve already given report and they accepted the patient.
Continue transporting to the local hospital since it’s the closest facility.

Divert to the trauma center because the patient is becoming symptomatic.
What type of trauma triage criteria regarding transport would a finger amputation receive?

Any hospital, as long as on-line medical direction approves the facility’s capabilities
Any hospital with surgical facilities
Trauma center
The patient’s choice of destination

Any hospital with surgical facilities
In which of the following ways does the body produce heat in response to being cold?

Excreting more urine
Burning fewer calories
Shivering
Increasing the respiratory rate

Shivering
In which of the following situations would a person lose heat by conduction?

Sitting on cold metal bleachers at a football game
Wearing wet clothing in windy weather
Breathing
Going outside without a coat during a cold but calm day

Sitting on cold metal bleachers at a football game
When the body is in water, how many times faster does it lose heat than when it is in still air?

2
100
10
25

25
A patient who is lying on cold ground is losing the most amount of heat by what mechanism?

Radiation
Convection
Conduction
Shivering

Conduction
Which of the following is the process in which heat is lost from the body as wind passes over it?

Convection
Hydrodynamic cooling
Exposure
Condensation

Convection
Which of the following is the most significant way in which the body cools itself?

Respiration
Perspiration
Radiation
Vasoconstriction

Perspiration
Why is it important to keep patients at rest when they are hypothermic?

Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature.
Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure.
Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.
None of the above

Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature.
Which of the following does NOT make infants and children more prone to hypothermia?

Inefficient metabolism
Large body surface area
Small muscle mass
Little body fat

Inefficient metabolism
Which of the following terms describes the temperature of the surrounding air?

Wind chill index
Shell temperature
Core temperature
Ambient temperature

Ambient temperature
In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?

Contact medical control for input into the best treatment for this patient.
Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death.
Check distal CSM, apply warming packs to the extremities, and transport the patient.
Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.
To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient’s body?

Forehead
Cheek
Abdomen
Inner wrist

Abdomen
Allowing a patient’s body temperature to increase by preventing further heat loss is referred to as which of the following?

Core rewarming
Passive rewarming
Active rewarming
Natural rewarming

Passive rewarming
Applying an external source of heat to the patient’s body to rewarm him is called ________ rewarming.

central
active
endogenous
peripheral

active
The technique for central rewarming requires the application of heat to which of the following areas of the patient’s body?

Chest, back, neck, and armpits
Lateral chest, neck, armpits, and groin
Head, neck, chest, and back
Head, neck, chest, and groin

Lateral chest, neck, armpits, and groin
Which of the following is acceptable when actively rewarming a hypothermic patient?

Encouraging the patient to exercise
Giving coffee or brandy to drink
Warming the patient as quickly as possible
Applying humidified oxygen

Applying humidified oxygen
In a hypothermic patient the coldest blood is found in what part of the patient’s body?

Intestines
Heart and lungs
Head
Extremities

Extremities
You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt, but does not have pants on. His skin feels cold to the touch. The week’s temperatures have not been above 50°F. Which of the following should you do immediately after ensuring the patient has an adequate airway?

Apply the AED.
Provide manual stabilization of the cervical spine.
Begin passive rewarming.
Check the pulse.

Check the pulse.
Rough handling of a patient with severe hypothermia may result in which of the following?

Ventricular fibrillation
Seizures
Heart attack
Rewarming shock

Ventricular fibrillation
When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has:

been ventilated for at least 30 minutes with an oropharyngeal airway in place.
developed rigor mortis.
been defibrillated a total of nine times.
been rewarmed.

been rewarmed.
Which of the following is NOT a classification of localized cold injury?

Hypothermia
Frostbite
Frostnip
All of the above are localized cold injuries.

Hypothermia
The term gangrene means tissue:

damage.
discoloration.
infection.
death.

death
Localized cold injury occurs due to vasoconstriction and:

chemical imbalance in the tissues.
blood clots.
ice crystal formation in the tissues.
loss of calcium.

ice crystal formation in the tissues.
Which of the following BEST describes a localized cold injury with a clear line of demarcation of its limits?

Early frostnip
Late frostbite
Immersion foot
Deep frostnip

Early frostnip
The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors?

White or lighter
Blue or purple
Red
Black

White or lighter
Which of the following should the EMT do during the treatment of localized cold injury?

Encourage the patient to use the affected part.
Rub the affected area with snow.
Massage the affected area.
Gradually warm the affected area.

Gradually warm the affected area.
When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ °F.

115-120
100-105
85-95
80-90

100-105
Which of the following describes the condition of having an abnormally high body temperature?

Hyperthermia
Septic shock
Hyperdynamic state
Heat shock

Hyperthermia
For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups?

Faster metabolism
Increased body mass
Inadequate salt intake
Poor ability to regulate body temperature

Poor ability to regulate body temperature
Heat cramps occur due to loss of which of the following substances?

Water
Salt
Magnesium
Water and potassium

Salt
Heat stroke is caused by which of the following mechanisms?

Blockage of blood flow to the brain
Extreme dilation of all the blood vessels
Failure of temperature regulation mechanisms
Heat-induced swelling of brain tissue

Failure of temperature regulation mechanisms
When submerged in water, biological death may be delayed if the water temperature is below ________ °F.

70
98.6
50
32

70
Regarding drowning in adults, which of the following statements is true?

Colder water improves survival chances in saltwater drowning but not in freshwater drowning.
Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.
The colder the water, the better the chances of survival in either saltwater or freshwater drowning.
The warmer the water, the better the chances of survival in saltwater drowning.

The colder the water, the better the chances of survival in either saltwater or freshwater drowning.
Which of the following spiders can cause a characteristic wound with a bite that is often painless?

Brown recluse spider
Sheet web spider
Argiope spider
Black widow spider

Brown recluse spider
Where should a constricting band be placed to reduce lymphatic flow after a venomous snake bite?

Two inches above the bite
Two inches below the bite
Two inches above and two inches below the bite
None of the above; constricting bands should not be used.

Two inches above and two inches below the bite
The purpose of a constricting band after a venomous snake bite is to impede the flow of which of the following?

Lymph
Arterial blood
Venom
Both A and C

Lymph
Of the following venomous snakes, which one usually has the highest incidence of a “dry bite”?

Coral snake
Water moccasin
Mississauga rattlesnake
Copperhead

Coral snake
Which of the following could worsen the effects of a snake bite?

Application of ice
Cutting and suctioning out the venom
Constricting bands above and below the bite
All of the above

Application of ice
Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following?

Sterile saline solution
Gasoline or kerosene
Cold water
Vinegar

Vinegar
Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream?

Arterial thrombosis
Arterial blood gases
Hyperbaric arterial injury
Arterial gas embolism

Arterial gas embolism
Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive?

“Squeeze” injuries of the ear and sinuses
Pulmonary embolism
Decompression sickness
Nitrogen narcosis

Decompression sickness
Which of the following increases a scuba diver’s risk of decompression sickness?

Taking cold or sinus medications before a dive
Flying within several hours after a dive
Diving on a full stomach
Breathing 100 percent oxygen before a dive

Flying within several hours after a dive
You arrive on the scene to find a scuba diver on board a boat slumped over in the captain’s chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?

Decompression sickness
The bends
Air embolism
Caisson’s disease

Air embolism
Which of the following types of snake is NOT a pit viper?

Water moccasin
Rattlesnake
Coral snake
Copperhead

Coral snake
You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do NOT know how to swim or consider yourself a poor swimmer, which of the following should you do first?

Row the boat out to the swimmer.
Use the buoy to float out to the swimmer.
Find someone who can swim to try to swim out and save the swimmer.
Call for help and try to throw the buoy to the swimmer.

Call for help and try to throw the buoy to the swimmer.
To rescue someone who has fallen through the ice, which of the following is the safest device to use?

A jet-ski
A flat-bottomed aluminum boat
A ladder
A ring buoy

A flat-bottomed aluminum boat
Most radiant heat is lost through which part of the body?

The hands and feet
The head
The buttocks
The torso

The head
Which of the following signs would you NOT expect to see in a patient suffering from severe hypothermia?

Numbness
Shivering
Drowsiness
Skin cool to touch

Shivering
Why is it important to remove constricting items such as rings before thawing a frozen extremity?

Because thawed areas often swell
To prevent damage to the property such as rings and watches
Because thawing leaves clots behind in the veins
All of the above

Because thawed areas often swell
Which of the following would you expect to see in a patient with severe hypothermia?

Irrational behavior
Loss of muscle tone
Rapid respirations
Tachycardia

Irrational behavior
In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long?

30 to 45 seconds
20 to 30 seconds
5 to 10 seconds
15 to 20 seconds

30 to 45 seconds
Your patient is a 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this patient?

Break blisters before wrapping both feet in sterile dressings.
Have the patient sit with his feet lower than the rest of his body.
Gradually rewarm both feet.
Massage the feet briskly.

Gradually rewarm both feet.
Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?

Have the patient drink an electrolyte solution or sports drink and apply cold packs to her neck, armpits, and groin.
Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask.
Give oxygen by nonrebreather mask, have the patient sip a sports drink or electrolyte solution, remove heavy clothing, and place cold packs on her neck, armpits, and groin.
Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.
Which of the following is often associated with water-related emergencies?

Hypothermia
Cardiac arrest
Alcohol use
All of the above

All of the above
Which of the following is acceptable in the management of a patient stung by a honey bee?

Soak the affected area in warm water.
Pull the stinger out using tweezers.
Remove jewelry from any affected limbs.
Elevate the affected site above the level of the heart to reduce swelling.

Remove jewelry from any affected limbs.
Which of the following agencies have developed regulations for dealing with hazardous materials emergencies?

OSHA and EPA
DOT and FCC
NAEMT and NHTSA
NHTSA and NRC

OSHA and EPA
To respond to a hazardous materials incident, the EMT should be trained at which of the four levels?

Operations
Specialist
Technician
Awareness

Awareness
In which of the following settings should the EMT be alert to the possibility of hazardous materials emergencies?

Manufacturing industries
Farm service agencies
Shipping ports
All of the above

All of the above
You are called to a garden center where four shoppers have collapsed after a section of shelving fell and dumped hazardous products on the floor. When you arrive on the scene, you should:

think hazmat, secure the scene by limiting access, isolate the possible contaminated from the noncontaminated, and request hazmat response.
think hazmat, dress in a Tyvek suit, secure the scene by limiting access, isolate the possible contaminated from the noncontaminated, and request hazmat response.
secure the scene quickly, triage each patient, and move to fresh air.
think hazmat, dress in a Tyvek suit, access the scene to identify the spilled product, secure the MSDS sheets, and remove victims to fresh air.

think hazmat, secure the scene by limiting access, isolate the possible contaminated from the noncontaminated, and request hazmat response.
Which of the following are desirable characteristics of the “safe or cold zone” in a hazardous materials incident?

Upwind, uphill from the spill
Upwind, on the same level as the spill
Downwind, uphill from the spill
Downwind, downhill from the spill

Upwind, on the same level as the spill
Which of the following is NOT the role of the first arriving EMT at the scene of a possible hazardous materials emergency?

Requesting special resources to respond
Recognizing a hazardous materials emergency
Establishing a safe zone
Rescuing any victims still in the area of the spill

Rescuing any victims still in the area of the spill
In which of the following zones is the EMT expected to be staged at the scene of a hazardous materials incident?

Warm zone
Hot zone
Cold zone
Ground zero

Cold zone
Which of the following should be considered during the scene size-up of a hazardous materials emergency?

Potential for spread of the substance
The properties and potential dangers of the substance
Identification of the substance
All of the above

All of the above
Which of the following is NOT an acceptable way of attempting to identify a hazardous material?

Checking the material safety data sheet
Collecting a sample of the material for laboratory analysis
Asking the driver of the tractor-trailer truck involved in the incident
Using binoculars to obtain information from the placard on a container

Collecting a sample of the material for laboratory analysis
Which of the following is a resource for specific actions to be taken by personnel dealing with a hazardous materials incident?

Medical protocols
Emergency response guidebook
Medical dictionary
Food and Drug Administration toll-free hotline

Emergency response guidebook
When seeking expert advice on how to proceed at a hazardous materials incident, which of the following information is important to provide?

The amount of the substance involved
Your level of EMS certification
Your background in chemistry
Both A and B

The amount of the substance involved
Which of the following is NOT a responsibility of an EMT at the scene of a hazardous materials emergency?

Rehabilitating the hazmat team
Decontaminating injured victims
Treating injured patients
Staying in the cold zone

Decontaminating injured victims
Which of the following is NOT a desirable characteristic of the rehabilitation sector of a hazardous materials incident?

It is large enough to accommodate multiple rescue crews.
It allows for rapid re-entry to the emergency operation.
It is protected from weather elements.
It is located in the warm zone.

It is located in the warm zone.
Which of the following is a function of the rehabilitation sector in a hazardous materials incident?

Providing for hydration of rescue crews
Taking baseline vital signs before rescuers enter the operations area
Performing medical assessment of rescue crews
All of the above

All of the above
Which of the following actions may need to be taken by the EMT when treating and transporting a patient who was exposed to, and contaminated by, a hazardous material?

Wearing heavy cloth gloves
Disposing of patient care equipment such as blood-pressure cuffs and backboards
Wearing a gown, mask, and goggles to prevent secondary contamination
Placing towels on the floor of the ambulance to soak up contaminated runoff water

Disposing of patient care equipment such as blood-pressure cuffs and backboards
Which of the following personal protective items must be used by EMS personnel caring for patients in a hazardous materials emergency?

Structural firefighting gear
HEPA mask
Chemical permeable gloves
Tyvek or other chemical impermeable coveralls

Tyvek or other chemical impermeable coveralls
Which of the following is NOT a mechanism of decontamination from hazardous materials?

Disinfecting
Disposing
Deodorizing
Emulsifying

Deodorizing
When grossly decontaminating a patient who is not wearing personal protective equipment in a hazardous materials incident, which of the following techniques should be used?

Taking a low-pressure decontamination shower
Scrubbing with a long-handled brush
Sponging with a dilute solution of water and white vinegar
Using a high pressure water jet system

Taking a low-pressure decontamination shower
Which of the following is the most common type of multiple-casualty incident that EMS providers will respond to?

Outbreaks of influenza
Motor vehicle collisions
Structure fires
Hazardous materials incidents

Motor vehicle collisions
You are on the scene of a church bus roll-over collision. There are 30 passengers involved. As triage officer, which one of the following patients should you assign the highest priority?

A 30-year-old man with multiple lower extremity fractures who is awake, has a strong radial pulse, and is complaining of severe pain
A 35-year-old pregnant woman with a cut on her head, neck pain, and numbness and tingling in her arms
A 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side
An unresponsive 9-year-old male with an open skull fracture who is in cardiac arrest

A 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side
Which of the following is a feature of a good disaster plan?

It is specific to the geographical location.
It has been practiced in mock disasters.
It is based on the availability of resources in a particular area.
All of the above

All of the above
You are on the scene of a riot following a decision in a controversial court case. A large group of people have set fire to vehicles, broken windows, and assaulted people in the area. Which of the following would be the BEST method of incident command?

Singular command by EMS
Singular command by fire service
Unified command
Singular command by law enforcement

Unified command
Which of the following is a principle of effective incident command?

Command is most effective when one person is responsible for not more than six other people.
The command location must not be revealed to anyone on the scene.
Police, fire, and EMS must establish separate command locations.
None of the above

Command is most effective when one person is responsible for not more than six other people.
You are an EMT on the scene of a mass-casualty incident in which there are 50 patients from a bus roll-over. Incident command has been established and EMS, law enforcement, and rescue sectors are established. You have just discovered that one of the bus passengers was carrying a suspicious package that is now leaking a white powdery substance. Which of the following entities should you contact about this?

Incident commander
EMS sector officer
Rescue sector officer
Dispatch

EMS sector officer
When responding to a multiple-casualty incident, staging refers to which of the following?

Setting up a triage center from the back of your ambulance
Staying on station until called upon to receive a patient
Keeping a log of all patients transported
Waiting in a designated location until called upon by the designated sector officer

Waiting in a designated location until called upon by the designated sector officer
You are on the scene of a mass-casualty incident in which the grandstand at a race track has collapsed. As the triage officer, you have encountered a 14-year-old male whose leg has been amputated above the knee. He is responsive to verbal stimuli, and he has an open airway, shallow rapid breathing, and a weak, rapid carotid pulse. This patient would be classified as a Priority ________ for treatment and transport.

2
3
1
4

1
You are beginning triage at the scene of a mass-casualty incident in which a commuter train has derailed. Which of the following should you do first?

Do a quick pulse check on all patients at the scene.
Identify all Priority 1 patients.
Announce that everyone who can get up and walk needs to go to the parking lot of a nearby building.
Check the airway status of all patients who do not appear to be moving.
.

Announce that everyone who can get up and walk needs to go to the parking lot of a nearby building.
_______________ is the response agency, established in Washington, DC, as a service of the Chemical Manufacturers Association, that can provide either you or your dispatcher with information about the hazardous material and contact the shipper to provide you with information about the material.

OSHA
CHEMTREC
HAZMART
EPA

CHEMTREC
You are just leaving the scene of a multiple-casualty incident with two Priority 1 patients. Which of the following is appropriate regarding communication?

Allow the transportation sector officer to notify the receiving facility.
Notify the receiving facility by radio of the nature of the patients’ injuries.
Notify the receiving hospital by cellular phone of the nature of the patients’ injuries.
Have dispatch relay your patient reports to the receiving facility.

Allow the transportation sector officer to notify the receiving facility.
The senior EMT on the first ambulance that arrived on a scene with multiple patients should assume which of the following roles until relieved by a senior official?

Transport sector supervisor
Commander of the entire incident
Triage sector supervisor
Commander of the medical aspect of the scene

Commander of the medical aspect of the scene
Where is the decon corridor located where patients, personnel, and equipment are decontaminated?

Hot zone
Cold zone
Warm zone
Cool zone

Warm zone
Name the process that removes the biological (etiological) contamination hazards as it destroys microorganisms and their toxins.

Dilution
Emulsification
Disinfection
Absorption

Disinfection
What constitutes a multiple-casualty incident (MCI)?

An event that unfolds over a long period of time and requires federal, state, and local response
An incident with 3 to 15 patients that the service handles without calling for additional resources
An event that places a great demand on EMS equipment and personnel resources
Any event that requires additional ambulances to adequately transport the patients from the scene

An event that places a great demand on EMS equipment and personnel resources
Disaster plans are a predefined set of instructions that should be written to address the events that are conceivable for a particular location and which other three parts?

Written, multijurisdictional, and rehearsed
Well publicized, multijurisdictional, and rehearsed
Well publicized, realistic, and rehearsed
Written, realistic, and rehearsed

Well publicized, realistic, and rehearsed
ICS systems recognize that the manageable span of control is:

6 people.
12 people.
18 people.
24 people.

6 people.
When several agencies work independently but cooperatively, rather than one agency exercising control over the others, this is called:

unified command.
single incident command.
ICS.
NIMS.

unified command.
EMS operations generally include the Mobile command center and what other six areas?

Extrication, Operations, Logistics, Triage, Finance, and Transportation
Extrication, Staging, Logistics, Triage, Operations, and Transportation
Extrication, Staging, Triage, Treatment, Transportation, and Rehabilitation
Extrication, Staging, Triage, Air operations, Transportation, and Rehabilitation

Extrication, Staging, Triage, Treatment, Transportation, and Rehabilitation
Simple Triage and Rapid Treatment (START) is a system that relies on some simple commands and what three physiologic parameters?

Respiration, pain, and mental status
Circulation, sensory, and motor status
Respiration, sensory, and motor status
Respiration, pulse, and mental status

Respiration, pulse, and mental status
With START triage, when you arrive on the scene you ask all the patients who can walk to move to one area. These patients are categorized as:

yellow tagged.
Priority 3 walking wounded.
red tagged.
Priority 4 walking wounded.

Priority 3 walking wounded.
You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you have 5 patients. Your closest unit is 30 minutes away. Please triage this patient based on this scenario:
Patient #1 is a 16-year-old female with the following vital signs: respirations 28, pulse 132, and altered mental status with cool clammy skin.

Priority 3, green tag
Priority 4, black tag
Priority 1, red tag
Priority 2, yellow tag

Priority 1, red tag
You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Please triage this patient based on this scenario:
Patient #2 is an 8-year-old male with the following vital signs: respirations 10, pulse 102, and alert mental status with warm dry skin.

Priority 1, red tag
Priority 3, green tag
Priority 2, yellow tag
Priority 4, black tag

Priority 3, green tag
You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Please triage this patient based on this scenario:
Patient #3 is a 38-year-old female with the following vital signs: respirations 0, pulse 0, and nonresponsive.

Priority 4, black tag
Priority 1, red tag
Priority 2, yellow tag
Priority 3, green tag

Priority 4, black tag
You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Please triage this patient based on this scenario.
Patient #4 is a 13-year-old female with the following vital signs: respirations 8, pulse 124, and nonresponsive with blood from the ears and nose.

Priority 3, green tag
Priority 4, black tag
Priority 1, red tag
Priority 2, yellow tag

Priority 1, red tag
You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Please triage this patient based on this scenario:
Patient #5 is a 17-year-old male with the following vital signs: respirations 18, pulse 104, alert, crying, and wanting his mother; he is ambulatory.

Priority 2, yellow tag
Priority 3, green tag
Priority 1, red tag
Priority 4, black tag

Priority 3, green tag
Who is the person that is in charge of tracking the patient’s final destination?

Treatment officer
Staging officer
Transportation officer
Incident commander

Transportation officer
Good Luck on your test!!
HM3 Yulo ( [email protected])
Good Luck on your test!!
HM3 Yulo ( [email protected])