EMT/NREMT Practice Test (Trauma)

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You arrive at a patient who has fallen off a ladder. Which of the following information is NOT important to the patient's care?

Correct! Wrong!

The height of the ladder is unimportant in your assessment as the patient may not have been at the top of the ladder when he fell.

You've arrived at the scene of an MVA, where three patients have minor visible injuries. Two of them are refusing treatment, while the third is complaining neck and back pain. What should you do next?

Correct! Wrong!

All patient refusals must be an informed refusal and in writing. If you treat all three patients even though they refused you are guilty of battery.

Your patient is a 17-year-old guy who was discovered face down in a pool. He's being held face up on the water's surface currently. He is breathing and has a pulse, but he is unconscious. What is the most effective treatment for this patient?

Correct! Wrong!

Because you do not know what caused the patient to became unconscious, spinal precautions need to be taken.

When there is penetrating trauma, the projectile contacts the tissues and forms a permanent cavity. What causes a temporary cavity to form?

Correct! Wrong!

When a projectile is traveling through space it is giving off energy as it pushes away the air molecules. When it impacts with human tissue, kinetic energy is transferred from the projectile to the tissue. When this projectile is a high velocity missile, the tissue which absorbs this energy transfer is often damaged but not disrupted enough to be permanently damaged.

_______________ is the term that describes how a patient gets injured.

Correct! Wrong!

The mechanism of injury transfers energy to the patient, causing a pattern of injury which is predictable. The way a patient is injured is referred to as the Mechanism of injury. For example, a frontal impact auto accident is considered a mechanism of injury. This allows the clinician to predict the type of injuries the patient may have and predict their response to treatment. Injury pattern can be predicted by looking at the mechanism of injury.

What is your first order of business when you arrive at a trauma scene?

Correct! Wrong!

Scene safety must be the first order of business upon approaching the scene. If you are injured then you cannot help those you were called to help. In addition, you will now compound the incident since you are now a victim. Body substance isolation is important after you arrive at the scene and approach the patient (s). Once you find the patient, then Airway/C-spine control are the next steps.

This is known as the large collection of blood under the skin.

Correct! Wrong!

A hematoma is a large collection of blood, caused by larger blood vessels being damaged. A hematoma often is located between layers of tissues. A contusion is generally a smaller collection of blood within tissue such as the dermis. A bruise is a generic term which is often used interchangeably between a contusion and a larger hematoma.

The bleeding must be stopped in every traumatic incident where tissue damage has caused bleeding. What are the best ways to stop bleeding?

Correct! Wrong!

Direct pressure stops 90% of all bleeding and should be done first. If direct pressure does not work in the first minute or two, then digital pressure should be applied next. Next steps include elevation and finally a tourniquet for uncontrolled or excessive bleeding. Pressure dressings should only be used once bleeding has stopped.

Your 16-year-old trauma patient appears to have a femur fracture in the mid-shaft. There is a laceration directly over the suspected fracture, which you observe. The bleeding is under control. What kind of fracture could this be?

Correct! Wrong!

Any time there is open skin over a fracture it is considered an open fracture. A greenstick is generally found in children whose bones have not fully ossified. Comminuted is a fracture resulting from extreme forces causing many smaller fractures at the site of the fracture.

You intubate the patient on the way to the hospital. You hear wheezing in the upper lung areas during your assessment of tube placement. What's the most likely cause of wheezing?

Correct! Wrong!

An inhalation injury inferior to the glottis can result in wheezing and bronchospasm. An inhalation injury superior to the glottis can cause a hoarse voice and stridor. Inhalation of the byproducts of combustion can cause wheezing but this would still be classified as an inhalation injury to the lower airway.

What step should the paramedic do after immobilizing an extremity fracture in the lower right arm?

Correct! Wrong!

The last part of immobilizing the arm fracture (or any suspected fracture for that matter), is the assessment of distal motor, sensory, and perfusion status. This is done to assure there was no additional trauma from the immobilization process, and to assure the splint was not put on incorrectly (for example an air splint inflated too high). If there is a loss in the motor, sensory, perfusion findings following immobilization, the paramedic should immediately reassess the splinting process and correct any errors

You're working on a 24-year-old woman who has a gunshot wound on the right side of her back. There are no visible exit wounds. She is awake, but she is confused. Her skin is pale and diaphoretic, and her oral mucosa has cyanosis. Breathing sounds are clear and balanced on both sides. There is jugular vein distention. The blood pressure is 90/78 mmHg, the heart rate is 124 beats per minute, and the respiratory rate is labored at 28 beats per minute. The cardiac monitor shows sinus tachycardia. Which condition do you think this patient is most likely suffering from?

Correct! Wrong!

Pericardial tamponade causes decreased cardiac output as seen by pale skin and hypotension. In addition, jugular vein distention may be seen along with a narrowed pulse pressure. Other signs and symptoms include tachycardia, respiratory difficulties, and cyanosis of the face, neck, and arms. With tension pneumothorax or a significant hemothorax, decreased or absent breath sounds will be present.

You're working on a 24-year-old woman who has a gunshot wound on the right side of her back. There are no visible exit wounds. She is awake, but she is confused. Her skin is pale and diaphoretic, and her oral mucosa has cyanosis. Breathing sounds are clear and balanced on both sides. There is jugular vein distention. The blood pressure is 90/78 mmHg, the heart rate is 124 beats per minute, and the respiratory rate is labored at 28 beats per minute. The cardiac monitor shows sinus tachycardia. Which of the following treatment regimens is best for this patient?

Correct! Wrong!

Treatment of a gunshot wound to the thorax would include taking necessary spinal precautions. The open wound should be covered with an occlusive dressing. The respiratory distress should be treated with high flow oxygen with consideration of positive pressure ventilation and possible intubation. In addition, an IV should be started for a fluid route if hypotension worsens. Rapid transport is indicated for pericardiocentesis and possible surgery.

Which of the following patients should be triaged to a non-trauma facility?

Correct! Wrong!

Of the 4 choices, the patient with a laceration on her thigh has an isolated injury and can be effectively managed by a non-trauma center. The other 3 patients require a more thorough assessment and therefore should be evaluated at a trauma center.

You were dispatched to the home of a 37-year-old man who had lacerated his leg while working with a chainsaw in the backyard. The patient's wife, who is a nurse, applied pressure to the wound and had the patient in a Trendelenburg position prior to your arrival. Your examination of the patient reveals that he is responsive to painful stimuli, has a weak carotid pulse, and his blood pressure is undetermined. The patient on the ground is surrounded by a large amount of blood. The wound was arterial, according to the wife, and the accident happened about 10 to 15 minutes ago. What are your treatment priorities for this patient, in addition to oxygen therapy?

Correct! Wrong!

Direct pressure and fluids are this patient's best chance for survival and prevention of decompensated shock. ALS should be activated to administer fluids as soon as possible.

Which of the following is the most common and noticeable finding in a crush injury?

Correct! Wrong!

Pain is generally the most obvious sign of a crush injury and tends to present earliest out of all of the other associated signs and symptoms.

You were dispatched to assist a 43-year-old man who was involved in a fight. The patient was allegedly beaten with a baseball bat in the face and head. The patient is unable to communicate. The patient's face is unstable from the orbits to the mandible, according to an evaluation. How would you definitively handle this patient's airway based on this information?

Correct! Wrong!

This patient has an unstable face and an unstable airway. Ultimately, this patient needs to have his airway protected as quickly as possible with an endotracheal tube. With facial instability, it is imperative that an adjunct be placed to ensure that the airway is not occluded by the pressure on the jaw created with the application of the Bag-Valve-Mask.

Which of the following should you do if you have an open fracture?

Correct! Wrong!

When bone is exposed, care must be taken to prevent further injury and infection. A good rule of thumb for the use of moist, sterile dressings is as follows: If the protruding part is normally on the inside of the body, cover it with a moist sterile dressing. Do not attempt to reinsert or reduce the exposed bone back into the body.

Which of the following is the most common spinal injury caused by improper lifting techniques?

Correct! Wrong!

The most common spinal injury is injury to the cervical spine. Improper lifting techniques, however, often result in lumbar injuries. Common lumbar injures are bulging and/or compressed vertebra. You must remember to lift with your legs and knees and not your back.

Your patient has Epistaxis. What should you do?

Correct! Wrong!

Epistaxis is a nosebleed. Having them tilt their head back could cause them to aspirate blood, become sick or vomit.

What are the symptoms and indicators of shock?

Correct! Wrong!

Early signs of shock are increased heart rate and respirations. The patient may also have pale, cool and clammy skin and show signs of hypoxia. Later stages of shock will include a drop in blood pressure.

Your patient is a 22-year-old man who has an object impaled on his right side of his chest, just below the shoulder. What is the best course of action for this patient after determining that the object isn't blocking his airway?

Correct! Wrong!

The only time you want to remove an impaling object is when it is obstructing the airway, as doing so may cause uncontrolled bleeding and even death. Cutting the object will cause the object to move and could result in further injury.

Your patient has ligaments that have been overstretched and torn. What kind of injury has this patient sustained?

Correct! Wrong!

In a pre-hospital setting, you would treat all of the above injuries the same, but this particular injury is a sprain. Sprains occur to the ligaments; dislocations are in the joint; fractures are bone related, and strains are muscle injuries.

What is the best way to treat a suspected talus bone fracture?

Correct! Wrong!

The Talus bone is located at the top of the foot and rests between the tibia, fibula, calcaneus, and navicular. In this instance, you want to splint the ankle in order to immobilize it, ice it to reduce swelling, and elevate.

Which portion of the brain do you think will be damaged if a patient has a back of the head injury?

Correct! Wrong!

The Occipital region of the brain is located in the posterior (rear) area of the brain and is the most likely to be injured by trauma to the back of the head.

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