Q&A Hero

Q: Which of the following is of concern with a puncture wound? A) An object that remains impaled in the body B) Hidden internal bleeding with minimal external bleeding C) Strong possibility of contamination D) All of the above

Q: Which of the following is NOT true concerning lacerations? A) They may indicate deeper underlying tissue damage. B) They may be caused by penetrating trauma. C) They may be caused by blunt trauma. D) They may be degloving injuries to the skin or tissue.

Q: Which of the following is NOT appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury? A) Treat for shock if you think there are internal injuries even if the patient's vital signs are normal. B) Anticipate vomiting. C) Splint any swollen, deformed extremities. D) Allow the patient to have small sips of water.

Q: 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? A) The presence of any defensive wounds the patient may have sustained B) The swelling around his eyes, which may be reduced by applying a cold pack C) Potential internal injuries D) Getting a description of the assailants

Q: You are dispatched to the local high school for a "person struck with a baseball." You arrive on the scene and find a 16-year-old male sitting on the bench. Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next step? A) Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes. B) Have the patient walk to the ambulance and take him to the ED. No other care needs to be provided, as there is really no significant sign of any injury. C) Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport. D) Tell the coach the patient is okay and he can go back into the ball game.

Q: 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): A) crush injury. B) evisceration. C) contusion. D) abrasion.

Q: An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n): A) contusion. B) abrasion. C) concussion. D) avulsion.

Q: The meatus is: A) an orifice of the urethra. B) in a male, the area between the scrotum and the anus. C) the tube that carries urine from the kidney to the bladder. D) the canal through which urine is discharged from the bladder to the exterior of the body.

Q: Which of the following is NOT considered soft tissue? A) The skin B) Muscles C) Membranes D) Cartilage

Q: Which of the following layers of the skin is the MOST important in insulating the body against heat loss? A) Parietal layer B) Subcutaneous layer C) Epidermis D) Subdural layer

Q: Which of the following is NOT a major function of the skin? A) Excretion of wastes B) Protection from the environment C) Temperature regulation D) Regulates the pH balance of the body

Q: Which of the following is a description of the rule of nines for an adult? A) The rule of nines assigns 9% to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region. B) The rule of nines assigns 9% to the head and neck, as well as each upper extremity; 10% to the chest, the abdomen, and the upper back; 8% to the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region. C) The rule of nines assigns 9% to the head and neck, each upper extremity, the chest, the abdomen, the upper back, and the lower back and buttocks; 8% to the front of each lower extremity; and 10% for the back of each lower extremity, then 1% to the genital region. D) The rule of nines assigns 9% to the head and neck; 6% to each upper extremity; 12% to the chest and abdomen; 9% to the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1% to the genital region.

Q: You are examining a 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this mean? A) The palm of your hand represents 1% of the body's surface area. B) The palm of the patient's hand equals about 1% of the body's surface area. C) The palm of the patient's hand equals 9% of the body's surface area. D) You can only use the rule of palm for children, so you would use the rule of nines instead.

Q: Which of the following is the outermost layer of the skin? A) Dermis B) Epidermis C) Adipose tissue D) Fascia

Q: You are dispatched to the local elementary school for an injured student. Upon arrival you find that two 7-year-olds got into a fight and one of them jabbed a pencil in the other's cheek. The pencil is still sticking out of the child's cheek. When you examine the patient, you cannot see the end of the pencil that went through the cheek, as it appears to be stuck in the palate. There is not significant bleeding, and the child is not having any difficulty breathing. The child is very upset and wants you to pull the pencil out. What should you do? A) Stabilize the object, but do not try to remove it. B) Remove the object and put a bandage on the outside of the cheek. C) Call the parents and see what they want you to do. D) Let the child carefully pull the object out.

Q: Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds? A) Absorbent B) Occlusive C) Adherent D) Sterile

Q: Which of the following injuries requires the use of an occlusive dressing? A) Open wound to the neck B) Open wound to the abdomen from which a loop of intestine is protruding C) Open wound to the chest D) All of the above

Q: Which of the following statements is incorrect regarding an electrical injury? A) Patients with electrical burns may be treated with the automated external defibrillator (AED) and CPR. B) Treatment of a source burn is the same as for other thermal burns. C) Injury is usually limited to the area around the source and ground burns. D) Patients with burns that appear insignificant are treated as having critical injuries.

Q: When managing an electrical burn, the EMT should: A) always attempt to remove the patient from the electrical source. B) check for a source and ground burn injury. C) never attempt CPR unless it is within 4 minutes of contact. D) quickly check the pulse, even if the patient is still in contact with the electrical source.

Q: You are dispatched to a local industrial plant for an "electrical injury." You arrive on-scene and find a 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next step? A) Load and goconduct any other care in the ambulance en route due to the potential seriousness of the burns. B) Put the patient on oxygen and help him into your ambulance. C) Stay with the patient awhile, and if he does not appear to be in distress, encourage him to refuse care. D) While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.

Q: Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical wire? A) The extent of tissue damage may be much greater than it appears on the surface. B) The burning will continue for hours, perhaps days. C) The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity. D) Toxic gases were inhaled.

Q: You are dispatched to an industrial plant for a burn. You arrive and find a 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you do? A) Because of his age, immediately put him in your ambulance and transport him to a burn center. B) Call for air transport and continue to pour water on the burns until transport arrives. C) Care for the burn and do a complete patient assessment, including cervical spine precautions. D) Before doing treatment, call the local burn center for instruction.

Q: 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? A) Transport the patient immediately to the closest burn center. B) Brush the powder off the patient's arm and hand, and then flush with copious amounts of water. C) Flush the arm and hand with copious amounts of water. D) Brush off the powder, bandage the arm, and transport the patient to the closest trauma center.

Q: 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? A) Have the fire department connect to a hydrant and spray down the patient from head to toe. B) Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands. C) 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. D) Brush away the powder and bandage the hands in a position of function.

Q: 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? A) Apply an antibiotic ointment. B) Apply a lotion containing a topical anesthetic and aloe vera. C) Apply a plastic bag full of ice to the skin. D) Apply a dry sterile dressing.

Q: 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? A) Application of a dry, sterile dressing B) Application of antibiotic ointment C) Elevation of the wound above the level of the heart D) Keeping the site clean

Q: Which of the following patients has the greatest likelihood of being cared for in a burn center? 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 B) 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 C) 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 D) 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

Q: Which of the following statements is NOT true when you are on-scene and treating a patient that appears to be in shock? A) It is important to spend on-scene time to be sure you have corrected and dealt with any of the causes of the shock so that it does not get worse. This is more important than rapid transport. B) The patient should be promptly put on high-concentration oxygen. C) Airway management is of top priority. D) Prompt transportation is a very high priority.

Q: Limiting time spent at a scene can be especially important if the mechanism of injury suggests that the patient could go into shock. In order to keep the time at the scene to a minimum, which of the following assessments or treatments should NOT be performed on the scene? A) ABCs with spinal precautions B) Immobilization C) Rapid trauma exam D) Splinting swollen extremities

Q: Which of the following will worsen the condition of the patient in shock? A) Applying high-concentration oxygen when it is not needed B) Elevating the patient's legs 8 to 10 inches C) Conducting oneself in a manner that increases the patient's fear and anxiety D) Transporting without first splinting all extremity fractures

Q: 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? A) There is nothing the EMT can do for a patient in shock. B) It gives the EMT less opportunity to make mistakes in the patient's care. C) Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival. D) The clock for the "golden hour" of trauma begins at the time of your arrival.

Q: Which of the following is NOT indicated in the management of a patient in shock? A) Minimizing on-scene time B) Delaying a detailed exam until en route to the hospital C) High-speed ambulance transportation D) On-scene spinal precautions, if indicated

Q: 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? A) Critical-care nursing B) Immediate surgical capabilities C) Availability of a chaplain D) Rehabilitation services

Q: Which of the following is NOT the purpose of making airway management the highest priority of patient care when managing the patient in shock? A) It allows for oxygenation of the lungs. B) It allows for improved elimination of carbon dioxide. C) It minimizes the chances of aspiration of blood or vomit. D) It allows the bronchoconstriction of the smaller airways to be reversed.

Q: Which of the following distinguishes decompensated shock from compensated stage of shock? A) Cell damage and death in the vital organs B) Altered mental status C) Delayed capillary refill time D) Low blood pressure

Q: Which of the following is a classification of the severity of shock? A) Consumption B) Compensated C) Uncompensated D) Non-compensated

Q: Which of the following statements is true when talking about neurogenic shock? A) Neurogenic shock is sometimes caused by spinal injuries. B) Neurogenic shock is the result of the blood vessels decreasing in size. C) Neurogenic shock is caused by the blood vessels overfilling with blood, causing leaking into the nerves. D) Neurogenic shock is very common in the field.

Q: Which of the following circumstances may result in hypoperfusion? A) There is external bleeding. B) Blood vessels are dilated. C) The heart is damaged. D) All of the above

Q: Which of the following is the major cause of shock that the EMT will encounter? A) Vomiting B) High blood pressure C) Hemorrhage D) Excessive sweating

Q: Although many of the signs and symptoms of shock are the same no matter what the cause, the symptoms follow a logical progression as shock develops and worsens. Arrange the following signs and symptoms in the likely order that they will appear. 1. Altered mental status 2. Dropping blood pressure 3. Nausea and vomiting 4. Pale, cool, and clammy skin 5. Increased pulse 6. Increased respirations A) 1, 4, 3, 6, 5, 2 B) 2, 5, 6, 3, 4, 1 C) 1, 3, 4, 5, 6, 2 D) 5, 3, 4, 2, 6, 1

Q: Which of the following signifies a failure in the patient's compensatory response to blood loss? A) Hypotension B) Tachycardia C) Tachypnea D) Pale, cool skin

Q: Which of the following is part of the body's compensatory response to blood loss? A) Blood vessels constrict and the heart rate increases. B) Blood vessels dilate and the heart rate increases. C) Blood vessels dilate and the heart rate decreases. D) Blood vessels constrict and the heart rate decreases.

Q: Which of the following is NOT a consequence of hypoperfusion? A) Cellular waste products are not removed. B) Cells are not supplied with nutrients. C) Cells are not supplied with oxygen. D) Aerobic metabolism will continue in the cell.

Q: Which of the following is responsible for most of the signs and symptoms of early shock? A) Increased respirations of the patient B) Constriction of the peripheral blood vessels C) Dilation of the peripheral blood vessels D) The body's attempts at compensation for blood loss

Q: Which of the following is the MOST sensitive indicator of hypoperfusion? A) Delayed capillary refill B) Dilation of the pupils C) Increased heart rate D) Altered mental status

Q: Which of the following is another name for describing the condition of shock? A) Internal bleeding B) Hypotension C) Hypoperfusion D) Hemorrhage

Q: You will frequently be called upon to deal with internal bleeding. Blunt trauma is the leading cause of internal injuries and bleeding. Which of the following are mechanisms of blunt trauma that may cause internal bleeding? 1. Falls 2. Motor vehicle or motorcycle crashes 3. Auto-pedestrian collisions 4. Blast injuries A) 1, 2, 3 B) 2, 3 C) 1, 2, 3, 4 D) 1, 4

Q: As an EMT, your BEST clue indicating the possibility of internal bleeding may be the presence of: A) a tender, rigid, or distended abdomen. B) painful, swollen, or deformed extremities. C) mechanism of injury. D) bruising, swelling, or pain over vital organs.

Q: Which of the following should increase the EMT's suspicion of internal bleeding? A) Penetrating trauma to the chest or abdomen B) High-speed motor vehicle collision C) Fall from a height three or more times the patient's height D) All of the above

Q: The most common form of a hemostatic agent is hemostatic: A) granules. B) dressings. C) tourniquet. D) powders.

Q: If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute? A) Air or vacuum splint B) Blood pressure cuff C) Ice packs tied in place with triangle bandage D) Use a rope tie-down to make a tourniquet

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

Q: 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? A) Use of a tourniquet B) Replacement of fluid level by giving the patient adequate amounts of water C) Using direct pressure to control the bleeding D) Administering oxygen

Q: Which of the following is the MOST effective way of controlling external bleeding? A) Running cold water over the wound B) Using direct pressure with a dressing C) Elevating the affected part D) Using an ice pack

Q: Which one of the following is incorrect in the application of a tourniquet? A) The tourniquet should be placed approximately 2 inches above the bleeding. B) The tourniquet should be 2 to 4 inches wide. C) A blood pressure cuff can be used as a tourniquet. D) If possible, the tourniquet should be placed on a joint.

Q: Which of the following is recommended in situations in which a tourniquet must be used? A) Apply a bulky dressing and bandage over the tourniquet. B) Apply the tourniquet over the elbow or knee. C) Use a material that is wide and thick. D) Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb.

Q: Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except: A) it should not be used alone but rather in conjunction with other manual techniques. B) it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound. C) it should not be left in place for more than 20 minutes. D) it will reduce pain.

Q: Which of the following is the LEAST effective method of controlling bleeding? A) Direct pressure B) Elevation C) Tourniquet D) Hemostatic agent

Q: Which of the following may occur when there is bleeding from a large vein? A) Transmission of bloodborne illnesses B) Air embolism C) Hypoperfusion D) All of the above

Q: Your patient has attempted suicide by slitting his wrists. You notice that he has run the knife across his wrist, perpendicular to the arm, and that the wound is rather deep. Which of the following statements is true regarding the likelihood for serious blood loss? A) You should expect severe blood loss. B) There is most likely tremendous internal blood loss. C) Blood loss is probably not life-threatening. D) A tourniquet will probably be necessary.

Q: Which of the following is NOT recommended when controlling epistaxis? A) Pinching the nostrils together B) Keeping the patient calm and quiet C) Having the patient tilt the head backward to elevate the nose D) Placing the unconscious patient in the recovery position

Q: 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? A) High-concentration oxygen, elevation of the extremity, and application of ice B) Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression C) High-concentration oxygen, tourniquet, PASG, and elevation of the extremity D) Direct pressure, high-concentration oxygen, and splinting the leg

Q: Which of the following is the most important reason for controlling external bleeding? A) To prevent hypoperfusion B) To prevent the spread of infectious diseases C) To make clean-up of the ambulance and your equipment easier after the call D) To prevent the patient from becoming upset at the sight of blood

Q: Which of the following must be kept in mind when considering the severity of external bleeding? A) Signs of shock do not appear until a large amount of blood has been lost. B) The amount of blood loss is easily estimated by the amount of blood visible on the ground. C) A younger person can tolerate more blood loss than an adult. D) All of the above

Q: In the average adult, the sudden loss of ________ cc of blood is considered serious. A) 150 B) 500 C) 1,000 D) 750

Q: External bleeding may be classified according to types. Which one of the following is one of those types? A) Cardiac bleeding B) Brain bleeding C) Capillary bleeding D) Liver bleeding

Q: Which of the following is a characteristic of venous bleeding? A) It commonly requires the use of pressure point compression. B) It can be profuse, but is generally easily controlled. C) It cannot lead to life-threatening amounts of blood loss. D) It often requires the use of a tourniquet.

Q: Which of the following is a characteristic of arterial bleeding? A) Steady flow B) Dark red color C) Spurting under pressure D) Both B and C

Q: 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? A) Veins B) Arteries C) Lymphatic vessels D) Capillaries

Q: Which of the following vessels contain blood under the highest amount of pressure? A) Veins B) Arteries C) Venules D) Capillaries

Q: Which of the following blood vessels CANNOT stop bleeding by constricting? A) Arteries B) Capillaries C) Venules D) Arterioles

Q: Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level? A) Hydrostatic pressure B) Perfusion C) Osmosis D) Circulation

Q: 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? A) Capillaries B) Microvenules C) Arterioles D) Veins

Q: Which of the following is NOT part of the circulatory system? A) Heart B) Brain C) Blood vessels D) Blood

Q: Which of the following BEST describes the function of blood? A) It is a life-giving liquid that supports all the body's functions to maintain hypoperfusion. B) It clots, flows, transports, protects, and excretes on a daily basis. C) It transports gases along with nutrients, aids in excretion, and provides protection and regulation. D) It flows from the heart with the vital gases and nutrients to maintain lack of perfusion.

Q: Which of the following types of vessels have valves to maintain one-way blood flow? A) Arteries B) Capillaries C) Veins D) Arterioles

Q: Which of the following vessels has the thickest muscular walls that allow constriction and dilation? A) Arteries B) Capillaries C) Veins D) Lymphatic vessels

Q: Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues. Which of the answers is NOT a major type of shock? A) Hypovolemic B) Hemorrhagic C) Hypervolemic D) Cardiogenic

Q: Prehospital management of all the urinary system problems of the kidney transplant patient by the EMT can be characterized by: A) very invasive techniques. B) varied pharmacological interventions. C) supportive care. D) intensive lab testing.

Q: The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility of: A) infection. B) renal failure. C) ulcers. D) congestive heart failure.