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Your EMS unit arrives at the scene of a reported altercation. Your patient is lying in a pool of blood in obvious respiratory distress. Your first concern should be with which of the following choices?
Assuring that the scene is safe
Which of the following choices is the best indicator of adequate breathing?
Which of the following vital signs best suggests compensated shock (Class II)
Pulse-112; Skin-pale, cool, & moist; B/P-normal; LOC-unaltered
Your patient is the unrestrained driver of a SUV involved in a head-on collision found still sitting upright in the driver’s seat. Assessment reveals the patient to be conscious but confused. The airway is patent with rapid, shallow ventilations and equal bilateral breath sounds. There are no palpable radial pulses but weak, rapid carotid pulses and the skin is pale, cool, and diaphoretic to your touch. There is significant bruising to the mid-chest and upper abdominal area. These assessment findings would best indicate which of the following conditions?
Which of the following trauma situations is the most common mechanism for spinal injuries in children?
Falls from heights
Which of the following choices is the most reliable assessment method of neurological function for a patient suspected of having a traumatic brain injury (TBI)
D. Glasgow Coma Scale (GCS) score
Your patient is a 44-year-old male who has sustained burns to the front of his right leg, his entire left leg and his anterior abdomen. What is the estimated percent of body surface area involved?
Which of the following injury patterns occur most often to patients involved in a lateral impact motor vehicle crash?
Mid-shaft clavicle and rib fractures
Your patient is a 25 year old male who has fallen from the roof of a one-story home. The patient is conscious, moaning and complaining of pain in his leg. He has an obviously deformed left lower leg. While you are assessing his airway, you should simultaneously do which of the following?
Manually stabilize his head and neck
Which of the following is the primary benefit of supplemental oxygen administration to the trauma patient?
Increased concentration of oxygen at the alveolar level
Which of the following patients exhibits signs and symptoms of irriversible shock (Class IV)?
D. 37-year-old gunshot wound patient, very slow ventilatory rate, markedly
increased heart rate, and an absent radial pulse
Your patient is a 7-year-old female who was injured jumping out of a swing. She has an obviously deformed right forearm. Her vital signs are ventilations 20/min, pulse 88/min and regular, B/P 108/66. Which of the following statements is TRUE concerning her vital signs?
Within normal limits for her age group
When assessing a patient with a suspected traumatic brain injury (TBI), which of the following vital sign presentations suggests increased intracranial pressure (ICP)?
Pulse 50, B/P 188/104
Your patient is a 52-year-old male who was involved in a rollover MVC. Assessment reveals GSC – 3, ventilations 18 & regular, radial pulse 54 & regular, B/P 80/52, skin is pink in color, dry and warm to the touch, and capillary refilling time of less than 2 seconds. Based on your assessment findings, which of the follow types of shock do you suspect?
Which of the following injuries is commonly associated with shearing forces?
When caring for a critically injured trauma patient, supplemental oxygen should be delivered in sufficient quantities to maintain a minimum pulse oximetry (SpO2) reading of at least what percent?
Which of the following statements regarding edema (increased interstitial fluid) is TRUE?
C. Edema decreases the diffusion (transfer) of oxygen and carbon dioxide at the
Which of the following mechanisms of injury most commonly causes blunt cardiac injury?
In trauma involving the spine, which part of the spine is most commonly injured?
A patient with a suspected traumatic brain injury (TBI) has the following vital signs: ventilations 22/min, pulse 124 and regular, B/P 80/56, skin pale, cool, and diaphoretic. Which of the following choices do the patient’s vital signs most likely represent?
Hypovolemic shock from associated injures
Your patient is a young male who was involved in a motorcycle crash. His airway is patent, ventilations 26/min & regular; no palpable radial pulses; weak, rapid carotid pulse at 128/min, and B/P 78/60. The abdomen is rigid with an unstable pelvis. Of the following choices, which is the most appropriate management for this patient?
Apply PASG and inflate all sections prior to transfer of the patient.
A “bull’s-eye fracture” (starring) of the windshield in a motor vehicle crash (MVC) is most commonly associated with which of the following choices?
You are dispatched to a local hunting club where a 54-year-old male has been shot. Your initial assessment shows the patient is bleeding from a neck wound; there is blood in his airway; his radial pulse is weak and rapid. Which of the following choices would be your first priority?
Suction the airway
Which of the following is NOT a goal for the prehospital management of the patient in decompensated shock?
Identifying and treating all injuries
Your patient is a 26-year-old male stabbed in the right side of his posterior neck and right flank during an altercation. Assessment reveals B/P 84/40, pulse 128 & regular, ventilations 24/min and shallow, skin pale in color, cool and moist to the touch, GCS
15, moving all extremities well, and mild hemorrhage from both stab wounds. Of the following choices which would be your next step?
B. Secure the patient on the cot without spinal immobilization and rapid transport
to the nearest trauma center
Your patient is a 19-year-old female who struck a tree while snow skiing. She is conscious and looking about and has an obvious abrasion of her forehead. She looks at you when you ask questions but does not know where she is or what happened. She repetitively asks you what happened. She is able to move all her extremities in response to your commands. You calculate her Glasgow Coma scale to be which of the following?
Your patient is a 76-year-old female who was the unrestrained driver in a 45 mph(70 kmh) MVC. Vitals are; GCS – 15, ventilatory rate 18 & regular, pulse 86 & irregular, B/P 112/88. She is complaining of mild anterior chest pain. Which of the following statements is FALSE?
D. A list of her medications she is currently taking is not relevant to your
You are dispatched to the scene of a single vehicle MVC. Bystanders state the car crashed into a retaining wall at about 40 mph (67 kmh). You note a bulls eye starring of the windshield, major damage to the front-end of the vehicle, and one patient sitting inside the vehicle. Your assessment reveals a 44-year-old male, conscious but
anxious with labored ventilations; weak, rapid radial pulse and skin that is pale in color, cool and moist to touch. Based on your assessment, which of the following choices would be the correct treatment?
Rapid extrication, immobilization to a long backboard, rapid transport
Which of the following choices is considered to be a primary blast injury?
Which of the following statements regarding elderly trauma patients is TRUE?
C. Heart rate may be a poor indicator of shock due to the medications elderly
Your patient is a 19-year-old female obviously pregnant, lying on her back on the pavement of a parking lot. The patient is conscious and alert. She states that she was walking to her car when she twisted her left ankle then fell onto her left knee and then onto her side. Bystanders who saw her fall insisted that she lie down until the ambulance arrived. The patient states she is in her third trimester (34th week) of this pregnancy and denies any difficulties associated with the pregnancy. Assessment findings are B/P 80/54, pulse 124 & regular, ventilations 20/min & regular, patient complains of pain in her left ankle and being lightheaded while lying down. Which of the following would be the correct treatment for her?
Place her on her left side and continue your assessment
Your patient is a 16-year-old female who collided violently with two other soccer players. Your primary survey reveals the following; patent airway, ventilatory rate of 30/min & shallow, radial pulse strong and slow, patient moans and withdraws to a painful stimulus (GCS – 8). Based on your assessment you would suspect which of the following as her primary traumatic injury?
Traumatic brain injury
Which of the following patients is exhibiting signs of adequate ventilations?
C. 76-year-old male with symmetrical chest movement, no accessory muscle use,
ventilatory rate of 18/min & re
Your patient is a 28-year-old male involved in a shooting incident. He has a GSW to the left posterior chest area. After your initial assessment you treat the patient with high concentration of oxygen via a non-rebreather mask, occlusive dressing to the GSW, and a large bore IV. Follow-up vital signs are: B/P 92/74, pulse 128 & regular, ventilations of 28/min & regular, distended neck veins and his radial pulses fade away each time he takes a breath. Which of the following do you suspect is causing the patient to lose his radial pulses with each breath?
Which of the following statements regarding spinal immobilization is FALSE?
Ensure that the cervical collar is tight enough to prevent the jaw from moving
Your patient is a 34-year-old male with a history of missing a step and falling down one flight of stairs this morning. He struck his head and was briefly “knocked out”. After “coming to”, the patient’s wife states that her husband complained of having a headache and then laid down for a brief nap. After 1 hour she attempted to wake him without success. Based on the presenting history, which of the following traumatic brain injury (TBI) would you suspect?
Your patient is a 28-year-old male who was the driver of an all terrain vehicle that flipped over. The patient is conscious and alert complaining loudly about the pain in his right ankle. Assessment reveals the following; ventilatory rate 24/min & shallow and a weak, rapid radial pulse at 124/min. The skin is pale in color, cool and diaphoretic to the touch. His abdomen is distended and tender to the touch and there is an open fracture/dislocation to his right ankle with minimal bleeding. In addition to spinal immobilization and supplemental oxygen, which of the following would be the appropriate field management for this patient?
Rapid transportation to the closest trauma center
At 2:30 p.m. on a hot, humid summer afternoon you are dispatched to a residential area for an “ill” man. Your patient is a construction worker in his mid-twenties who is sitting under a tree. He states that he has been installing shingles on a two-story house for about 6 hours and is now very dizzy and light-headed when he tries to stand up. Assessment reveals ventilations of 20/min & regular, B/P 104/76, pulse 120/min & regular, skin is extremely diaphoretic and cool to the touch. Which of the following heat related conditions do you suspect this patient to have?
D. Heat exhaustion
Mechanisms of injury that produce shearing forces are commonly associated with injuries to which of the following organs?
Liver & kidneys
Your patient is a 42-year-old male involved in a frontal impact MVC. He is non- responsive with a GCS score of 5T (E 2, V T, M 3). He is orally intubated (ET tube at 21 cm at the teeth) and being ventilated with a bag-valve system and high flow oxygen. While “bagging” the patient you notice that it is getting increasing difficult to ventilate him. Re-assessment reveals good breath sounds on the right side, significantly decreased breath sounds on the left side, absent radial pulses bilaterally, and a rapid, weak carotid pulse. Which of the following choices would be the most appropriate treatment?
Perform a needle chest decompression on the left side
Regarding fluid resuscitation in children, which of the following statements is FALSE?
Intraosseous lines are the preferred vascular access technique
Your patient is a young male who was involved in a bicycle crash. His right forearm is deformed with absent distal pulses. Which of the following choices is the most appropriate step at this time?
Reposition and reevaluate for return of pulses
Your patient is a 24-year-old female who was thrown from a horse. Assessment reveals a deteriorating mental status (GCS 7), ventilations of 22/min and noisy (snoring), and a strong radial pulse of 80/min & regular. Which of the following treatments is the most appropriate intervention at this time?
Pre-oxygenation and endotracheal intubation
Which of the following statements concerning thermal injuries (burns) is FALSE?
Dry lime and soda ash should be briefly rinsed prior to transport
Your patient is a 26-year-old male who suffered a shotgun wound to the neck and face. Your assessment reveals obstruction of the upper airway due to extensive soft-tissue damage and fractures of the mandible, maxilla, and hard palate. The patient has a bubbling open wound to anterior neck about 1 cm inferior to the cricoid cartilage, opening the trachea to the environment. Which of the following describes the best way to manage this patient's airway after controlling bleeding to the neck?
D) Introduce an endotracheal tube into the trachea through the wound.
You arrive on the scene of a two-car, head-on, motor vehicle collision in which your patient was the unrestrained passenger. The patient complains of numbness and tingling of both upper extremities. She presents with epistaxis, a 2 cm laceration on her cheek, and poor gross motor strength bilaterally. She states she has a history of spinal cord stenosis, insulin dependent diabetes, and hypertension. Based on the findings, which of the following might you suspect?
anterior cord syndrome
Your patient is a 7-year-old male with a fracture of the proximal tibia. Which of the following is the most likely and serious complication of this injury?
A) Disruption of bone growth
You are on the scene of a shooting. The scene is safe. The patient has a gunshot wound (GSW) to the head. She is cyanotic with gurgling ventilations of 5/min, and does not respond to your voice. Which of the following choices is the most appropriate for this patient?
Perform a trauma jaw-thrust maneuver, suction the airway, and assist
ventilations with a bag-valve-mask and high-concentration supplemental
The kinematics involved with shallow water diving trauma usually results in which of the following injuries?
Compression of the cervical vertebrae
Drinking alcohol with a fatty meal. Know about it.
Like the liver, the spleen is a solid organ in the peritoneum. Both lie in upper quadrants and are often protected by the lower ribcage.
Statement about crush injury that is correct.
Diabetic patients would most likely present with atypical signs and symptoms of what?
Elderly patients and those with diabetes present atypically with (Acute Myocardial Infarction) AMI.
Which of the following is an example of endocrine regulation via a negative feedback mechanism?
The neural regulating mechanism decreases its signals to the adrenal medulla, decreasing epinephrine release.