EMT Trauma Practice Test 2

Question 1

En route to the hospital, you intubate the patient. During your assessment of tube placement, you hear wheezing in the upper lung fields. What is most likely causing this wheezing?

Accepted Answer

Inhalation injury to the lower airway

Answer

Wheezing is a high-pitched whistling sound, typically heard on exhalation, caused by narrowing or obstruction of the lower airways (bronchioles). In a patient who has been intubated after a traumatic event, new-onset wheezing in the upper lung fields suggests an issue within the smaller, lower airways, such as bronchospasm or edema resulting from an inhalation injury (e.g., smoke, chemicals).

Question 2

Following the immobilization of an extremity fracture to the lower right arm, the paramedic should perform what step last?

Accepted Answer

Assessing presence of distal motor, sensory, and perfusion.

Answer

After immobilizing any extremity fracture, it is crucial to reassess the neurovascular status distal to the injury as the final step. This involves checking for motor function, sensation, and perfusion (pulses, capillary refill, skin color/temperature) to ensure the splint is not too tight and is not compromising circulation or nerve function. This assessment must be performed both before and after splinting to identify any changes and confirm proper application.

Question 3

Please answer the following question.  You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. What condition do you think is most likely present with this patient?

Accepted Answer

Pericardial tamponade

Answer

The patient's presentation of a gunshot wound to the back, confusion, pale/diaphoretic skin, cyanosis, hypotension, tachycardia, and critically, jugular vein distention (JVD) with clear and equal breath sounds, strongly indicates pericardial tamponade. JVD with hypotension and muffled heart sounds (though not explicitly stated, clear lungs rule out tension pneumothorax) in a trauma patient is a classic presentation of this life-threatening condition, where blood compresses the heart.

Question 4

Please answer the following question. You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. Which of the following treatment regimens would be the most appropriate for this patient?

Accepted Answer

High flow oxygen, spinal precautions, occlusive dressing over entrance wound, rapid transport.

Answer

For a patient with suspected pericardial tamponade from a gunshot wound, immediate priorities include providing high-flow oxygen to support oxygenation and initiating spinal precautions due to the mechanism of injury. An occlusive dressing should be applied to the entrance wound to prevent air from entering the chest cavity if it's a penetrating chest injury. Rapid transport to a trauma center is critical for definitive surgical intervention, as pericardial tamponade is a life-threatening condition.

Question 5

Please answer the following question.  You are treating a 12-year-old male patient who was hit in the nose with a baseball. His nose is deviated to the left with moderate epistaxis. He is complaining of severe pain to his nose. He is alert and oriented with no loss of consciousness. Which of the following treatment sequences would best manage this patient?

Accepted Answer

Have patient lie supine while holding pressure to nares.

Answer

While leaning forward and pinching the nostrils is the standard initial treatment for epistaxis, in a trauma patient with a suspected nasal fracture and severe pain, having the patient lie supine might be considered for overall patient stability. This position can facilitate a more thorough assessment for other head/neck injuries and manage potential syncope from pain or blood loss, even if it's not the ideal position solely for nosebleed control.

NREMT Practice Test

NREMT Practice Test

EMT Trauma Practice Test 2