Q&A Hero

Q: You are called for a man who is not acting right. His wife says he was outside working in the garden but didn't come in for lunch when he was called. She went to check on him and found him sitting next to a stump, confused. You assessment shows a pulse rate of 58, blood pressure of 186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of trauma and you don't see any obvious indication that he has fallen. You should suspect a(n): A) closed head injury. B) open head injury. C) insecticide poisoning. D) nontraumatic brain injury.

Q: A young female was injured in an automobile wreck, striking her head on the windshield. She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your assessment shows that her cranium is intact. Her vital signs are pulse 68, blood pressure 148/90, and her pupils are unequal. You should suspect a(n): A) concussion. B) closed head injury. C) contusion. D) open head injury.

Q: Your patient is a 16-year-old centerfielder on his high school baseball team. He was injured when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to tell you what happened. His vital signs are pulse 88, blood pressure 132/86, respiratory rate 16, and pupils equal. As you assess his head, you do not see any cuts or bleeding, but you feel a spongy, depressed area over his left ear. You should suspect a(n): A) closed head injury. B) skull injury. C) open head injury. D) direct injury.

Q: 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? A) Assure scene safety. B) Suction the airway and have the patient lean back. C) Take cervical spine precautions. D) Place the patient on a nonrebreather mask (NRB) at 15 lpm.

Q: 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? A) Insert an oropharyngeal airway (OPA) and ventilate via bag-valve mask (BVM) at 30 breaths per minute. B) Insert a nasopharyngeal airway and give oxygen by nonrebreather mask (NRB) at 15 lpm. C) Insert an oropharyngeal airway and give oxygen by nonrebreather mask at 10 lpm. D) Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.

Q: 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? A) Cervical spine trauma B) Brain injury C) Airway obstruction D) All of the above

Q: Your patient is a 30-year-old construction worker who fell from 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? A) Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the scene time under 10 minutes. B) Transport with the reinforcement bar in place to prevent delay at the scene. C) Test the reinforcement bar for stability and remove it only if it is loose enough to be easily pulled from the wound. D) Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.

Q: A 36-year-old male was accidentally shot with a nail gun into the head. You see the nail, which protrudes about 2 to 3 centimeters from the skull, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site? A) Bleeding from the patient's wound is minimal. B) The patient develops excessive intracranial pressure (ICP). C) The patient begins to complain of shortness of breath. D) None of the above

Q: Hyperventilation of a patient with a severe brain injury due to an impaled object means that bag-valve-mask ventilations are provided at a rate of ________ per minute. A) 20 B) 24 C) 30 D) 34

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

Q: You are treating an unresponsive homeless patient found in an alley. During your assessment you notice bruising behind both ears, which is known as which of the following? A) Fatigue signs B) Warrior's signs C) Soldier's signs D) Battle's signs

Q: Of the following patients, which injury is the highest priority to receive bag-valve-mask ventilations? 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 B) 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 C) 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 D) 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

Q: Which of the following signs is LEAST likely to indicate a traumatic brain injury? A) Low blood pressure B) Irregular breathing pattern C) Vomiting D) Irrational behavior

Q: Which of the following causes worsening of the damage in a brain injury? A) Allowing seepage of cerebrospinal fluid (CSF) from the ears or nose B) Administration of 100% oxygen C) Failure to keep the patient awake and talking D) Improper management of airway and ventilation

Q: Which of the following is a potential complication of hyperventilating a patient with a brain injury? A) Increasing the amount of carbon dioxide in the blood B) Increasing blood flow to the brain C) Decreasing blood flow to the brain D) Decreasing the patient's blood pressure

Q: 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? A) Head injury, spine injury, and internal bleeding B) Head injury C) Head injury and spine injury D) Head injury and internal bleeding

Q: Which of the following is a sign of possible brain injury? A) Deep laceration of the scalp B) Projectile vomiting C) Irregular breathing pattern D) All of the above

Q: 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? A) Increased intracranial pressure B) Coup-contrecoup injury C) Closed head injury D) Increased arterial pressure

Q: 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? A) Tonic-clonic activity B) Posturing C) Cushing's reflex D) Battle's sign

Q: When blood accumulates between the brain and the dura mater, what is the result? A) Epidural contusion B) Subdural contusion C) Epidural hematoma D) Subdural hematoma

Q: Which of the following statements concerning a concussion is true? A) It is a bruising of the brain tissue. B) The patient may not have any symptoms of the injury. C) It is accompanied by recurrent episodes of unconsciousness. D) All of the above

Q: Which of the following is classified as an open head injury? A) Contusion without a skull fracture B) Laceration with a skull fracture C) Laceration without a skull fracture D) Both A and B

Q: Which of the following injuries is considered an indirect brain injury? A) Cerebral laceration B) Depressed skull fracture with cerebral penetration by bone fragments C) Gunshot wound to the head D) Concussion

Q: A fracture of which of the following bones would be considered a skull fracture? A) Temporal bone B) Nasal bones C) Maxilla D) Any of the above

Q: As pressure within the cranium increases, which of the following is the result? A) Decreased blood pressure, decreased pulse B) Increased blood pressure, decreased pulse C) Decreased blood pressure, increased pulse D) Increased blood pressure, increased pulse

Q: A 65-year-old man was doing some work on his roof when he lost his footing and fell to the ground, approximately 15 feet. He is unconscious but his respirations are normal. You note an obviously angulated left leg. You are more concerned about a possible head injury. Which of the following would indicate a possible head injury? A) Increased blood pressure B) Glasgow Coma Scale (GCS) of 15 C) Constricted pupils D) Increased pulse rate

Q: How many cervical vertebrae are there? A) 7 B) 12 C) 5 D) 4

Q: Which of the following is the opening at the base of the skull? A) Foramen magnum B) Orbits C) Spinous process D) Temporomandibular joint

Q: Which portions of the spine are the most vulnerable to injury? A) Thoracic and lumbar B) Cervical and lumbar C) Cervical and sacra D) Thoracic and sacra

Q: To which of the following sections of the spine are the ribs attached? A) Thoracic B) Sacral C) Cervical D) Lumbar

Q: Which of the following is controlled by the left side of the brain? A) Sensation in the left arm B) Sensation of the right leg C) Movement of both lower extremities D) Movement of the left arm

Q: Which of the following is a function of the autonomic nervous system? A) Speaking B) Running or walking C) Constriction of blood vessels D) Solving complex math problems

Q: Which of the following systems includes the pairs of nerves that enter and exit the spinal cord between each pair of vertebrae? A) Peripheral nervous system B) Central nervous system C) Autonomic nervous system D) All of the above

Q: Messages from the body to the brain are carried by which of the following types of nerves? A) Sensory B) Skeletal C) Motor D) Cranial

Q: Which of the following is defined as an area of the body surface that is innervated by a single spinal nerve? A) Spinous process B) Transverse process C) Malar D) Dermatome

Q: The bony bumps you feel along the center of a person's back are known as which of the following? A) Vertebrae B) Foramen magnum C) Spinous process D) Transverse processes

Q: What is another name for the zygomatic bone? A) Malar B) Maxillae C) Temporal D) Mandible

Q: The maxillae form which of the following structures? A) Lower jaw B) Upper jaw C) Cheek bones D) Forehead

Q: A pillow is frequently used to splint an ankle or foot injury. It is effective, rapid, and can be used for most patients. Its main weakness is: A) it requires three people to apply. B) you might not have a pillow on your ambulance. C) you are not immobilizing the knee and the joint adjacent to the ankle. D) it is hard to access distal pulses after application.

Q: 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? A) 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. B) Gently attempt to straighten the leg to regain a pulse before splinting. C) Splint the leg in the position in which it was found and transport without delay. D) Transport rapidly to the nearest trauma center.

Q: Which of the following statements is NOT true concerning a pelvic wrap? A) It can be used if the pelvis shows deformity. B) It can be used if the pelvis shows instability. C) It should not be used unless the patient shows signs of shock. D) You can consider its use based on mechanism of injury (MOI).

Q: Blood at the meatus of the penis (opening of the urethra) is a sign of: A) spinal fracture or injury. B) pelvic trauma/fracture. C) pelvic dislocation syndrome. D) priapism.

Q: The PASG may be used as a splinting device for patients with which of the following suspected injuries? A) Hip dislocation B) Compression fracture of the lumbar or sacral spine C) Fractured pelvis D) None of the above

Q: A suspected musculoskeletal injury of the shoulder is BEST managed by which of the following techniques? A) Placing the arm in a sling and using a triangular bandage to secure it to the body B) Using an upper extremity traction splint C) Placing two long padded board splints on either side of the extremity, extending from the shoulder to the wrist D) Using a long-arm air splint

Q: 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 ________. A) wrist; elbow B) wrist; shoulder C) forearm; humerus D) fingertips; shoulder

Q: Which of the following complications may arise from properly splinting an injured extremity? A) Converting a closed fracture to an open one B) Compromising circulation to the extremity C) Ignoring life-threatening problems while focusing on an extremity injury D) All of the above

Q: 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? A) En route to the hospital B) Immediately C) During the primary exam D) During the secondary exam

Q: 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? A) No traction splint applied in the field pulls true traction; they must pull 20 pounds of countertraction. B) Pull enough traction to give the patient some relief from the pain. C) The amount of traction applied should be roughly 10% of the patient's body weight and not exceed 15 pounds. D) The amount of traction applied should be 15 pounds.

Q: 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? A) Check pulse, movement, and sensation distal to the injury before and after splinting. B) Immobilize from the shoulder to the wrist. C) Use an upper extremity traction splint. D) Do not attempt to realign the extremity before splinting.

Q: 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? A) 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. B) 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. C) 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. D) 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.

Q: Which of the following is NOT a benefit of splinting an injury to bones and connective tissues? A) It prevents neurological damage due to movement of bone ends or fragments. B) It may prevent a closed injury from becoming an open injury. C) It restricts blood flow to the site of the injury to prevent swelling. D) It reduces pain.

Q: There are general rules that apply to all types of splinting. Which of the following is NOT a general rule of splinting? A) In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable. B) Expose the injury. C) Assess distal CSM. D) Align long-bone injuries to anatomical position.

Q: Which of the following is NOT a principle of splinting that must be considered by the EMT? A) Immobilize the site of an extremity injury from the joint above it to the joint below it. B) Splint an isolated extremity injury before moving the patient to the stretcher. C) Check the distal neurovascular function before and after splinting. D) Gently replace protruding bone ends back beneath the skin to prevent further contamination.

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

Q: Which of the following is NOT a contraindication for the use of a traction splint? A) Pelvis, hip, or knee injury B) Avulsion or partial amputation where traction could separate the extremity C) Injury to the lower third of the leg that would interfere with the ankle hitch D) Severe swelling and redness at a midshaft femur

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

Q: 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? A) Explain to the patient that her ankle is fractured and you must splint her ankle to prevent further injury and reduce pain. B) 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. C) Transport the patient immediately to a trauma center, applying high-concentration oxygen en route. D) 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.

Q: What is a primary problem when treating musculoskeletal injuries? A) Many musculoskeletal injuries have a grotesque appearance, and the EMT cannot be distracted from life-threatening conditions by a deformed limb. B) All musculoskeletal injuries are life threatening due to the bone bleeding, leading to hypoperfusion. C) Splints do not adequately fit the patient's extremities and must be modified with padding to ensure immobilization. D) Most musculoskeletal injuries are simply splinted and not a life threat to the patient.

Q: A method of assessing compromise to an extremity when a musculoskeletal injury is suspected is to learn and follow the six Ps. Which of the items below is NOT one of the six Ps? A) Pain B) Pallor C) Paresthesia D) Parenthesis

Q: One of the more serious conditions that EMTs are confronted with would occur as follows: A fracture or crush injury causes bleeding and swelling within the extremity. Pressure and swelling caused by the bleeding within the muscle compartment become so great that the body can no longer perfuse the tissues against the pressure. Cellular damage occurs and causes additional swelling. Blood flow to the area is lost. The limb itself may be lost if the pressure is not relieved. What is this condition called? A) Compartment syndrome B) Crushing syndrome C) Perfusing syndrome D) Fracture syndrome

Q: When the EMT is assessing compromise to an extremity, perhaps due to an orthopedic injury, the EMT should initially check what "six Ps"? A) Pain, pallor, position, pulses, placement, and pressure B) Pain, pallor, paresthesia, pulses, placement, and pressure C) Pain, pallor, position, pulses, placement, and pad D) Pain, pallor, paresthesia, pulses, paralysis, and pressure

Q: Which of the following is appropriate in the examination of a painful, swollen extremity of a conscious patient? A) Gently attempting to flex the mid-portion of the bone to check for angulation B) Asking the patient to see if he can bear weight on the extremity C) Comparing the injured side to the uninjured side D) Seeing if you can elicit crepitus on palpation

Q: Which of the following BEST describes the compartment syndrome? A) A serious condition caused by the amount of equipment that must be carried in the ambulance compartments B) A life-threatening condition caused by trapping the blood flow by a fracture when the bone ends cut the blood vessels C) 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 D) A non-life-threatening condition caused by orthopedic injuries in which blood flow is stopped when the bone ends compress the blood vessels

Q: A traction splint may be used on which of the following musculoskeletal injuries? A) Possible fracture of the cervical spine B) Possible fracture of the femur C) Suspected multiple fractures of the femur, tibia, and fibula D) Possible fracture of the humerus

Q: Which of the following is a complication of bone fractures? A) Nerve damage B) Swelling C) Hemorrhage D) All of the above

Q: Distinguishing between a knee dislocation and a patella dislocation can sometimes be difficult. Which of the following statements is NOT true? A) In a patellar dislocation, the knee will be stuck in flexion but the knee cap will not be displaced. B) In a knee dislocation, the tibia is forced anteriorly or posteriorly in relation to the distal femur. C) You should always check for a distal pulse. D) The lack of a distal pulse could be a signal of a real emergency.

Q: Although it can be difficult to definitively determine hip dislocation in the field, certain signs and symptoms are usually there. Which of the following statements is false? A) An anterior hip dislocation would probably present with the entire lower limb rotated inward and the hip would usually be flexed. B) A posterior hip dislocation presents with a bent knee and the foot may hang loose. C) The posterior hip dislocation is the most common. D) Often there is lack of sensation in the limb.

Q: Which of the following describes an open extremity injury? A) A gunshot wound has penetrated the skin and then fractured the bone. B) Bone ends have lacerated the soft tissues and skin from the inside. C) The joint capsule has been torn open during a dislocation. D) Both A and B

Q: Which of the following is an injury to the musculature of an extremity? A) Luxation B) Strain C) Fracture D) Sprain

Q: Which one of the following statements is NOT true concerning a knee injury? A) Fractures can occur to the proximal femur. B) Fractures can occur to the proximal tibia and fibula. C) Fractures can occur to the patella. D) There could be pain and tenderness.

Q: Which of the following statements is NOT true? A) A fracture is any break in a bone. B) A comminuted break is when a bone is broken in only one place. C) A greenstick break is an incomplete break in a bone. D) An angulated break is when the broken bone is bent at an angle.

Q: Which of the following is NOT a mechanism of musculoskeletal injury? A) Direct force B) Indirect force C) Twisting or rotational forces D) Extensive force

Q: 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? A) Shock B) Damage to internal organs C) Damage to the nerves of the lower extremities D) All of the above

Q: 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? A) Direct force B) Indirect force C) Sudden acceleration D) Twisting motion

Q: Which one of the following statements is NOT true? A) Cartilage is connective tissue that covers the outside of the bone end and acts as a surface for articulation. B) Tendons are bands of connective tissue that bind the ligaments to muscles. C) Ligaments are connective tissues that connect bone to bone. D) Muscles are the tissues or fibers that cause movement of body parts or organs.

Q: The strong white fibrous material called the periosteum: A) covers the bones. B) protects the perineum. C) surrounds the heart. D) surrounds the abdominal cavity.

Q: Which of the following bones is found in the chest? A) Tarsals B) Ilium C) Sternum D) Metacarpals

Q: Where could you find the phalange bones? A) Upper extremities B) Lower extremities C) Skull and neck D) Hands and feet

Q: The part of the skeleton that is made up from the skull and spinal column is called the: A) appendicular skeleton. B) boney skeleton. C) axial skeleton. D) torso.

Q: Which one of the following definitions is NOT true? A) A sprain is the stretching and tearing of ligaments. B) Tendons connect muscles to ligaments. C) Another name for manual traction is tension. D) Joints are places where bones articulate.