Q&A Hero

Q: The sound or feeling of the ends of broken bones rubbing together is called: A) crepitus. B) krepitus. C) crapilation. D) breakilation.

Q: Which of the following allows for smooth movement of bone surfaces against one another at joints? A) Smooth muscle B) Ligaments C) Peritoneum D) Cartilage

Q: Which of the following structures connect bone ends, making joints more stable? A) Ligaments B) Cartilage C) Tendons D) Periosteum

Q: Your patient is a 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. You should: A) elevate the patient's legs. B) attach the AED and analyze. C) begin chest compressions. D) place him on a backboard.

Q: A teenage male has fallen onto a railing while skateboarding. He complains of right-sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. You should: A) roll the patient over onto his right side. B) begin positive pressure ventilation. C) cover the wound with an occlusive dressing. D) apply a bulky dressing over the section.

Q: You are treating a patient with paradoxical motion on the left side of the chest. He is breathing shallow at a rate of 4 breaths per minute. You should: A) begin positive pressure ventilation. B) apply a bulky dressing to the chest. C) administer 15 lpm oxygen via mask. D) roll the patient onto his left side.

Q: Your patient is a 21-year-old male who has a gunshot wound to the chest. Which of the following is the highest priority in managing this patient? A) Placing the patient in the shock position B) Performing a rapid trauma assessment C) Placing a pressure dressing over the wound to control bleeding D) Placing an occlusive dressing over the wound

Q: On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration and the bleeding is controlled. Which of the following is the BEST approach toward managing the exposed intestines? A) Moisten a sterile dressing with saline solution and cover the abdominal contents. B) Gently replace the intestines after moistening with sterile saline solution. C) Leave the abdominal contents in the place in which they were found and transport immediately. D) Cover the abdomen with an occlusive dressing of aluminum foil.

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) All of the above

Q: Which of the following types of bandages should NOT be used by the EMT providing wound care? A) Self-adherent roller gauze B) Tourniquet C) Triangular bandage D) Adhesive tape

Q: For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline and then cover it with an occlusive dressing? A) Gunshot wound (GSW) to the abdomen from which a loop of intestine is protruding B) Stab wound to the chest C) Laceration to the neck D) The stump of an amputated extremity

Q: A 36-year-old male was accidentally shot with a nail gun into the chest. You see the nail, which protrudes about 2 to 3 centimeters from the thorax, 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 a tension pneumothorax. C) The patient begins to complain of shortness of breath. D) None of the above

Q: Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques? A) Packing the wound with rolled gauze B) Applying an occlusive dressing C) Applying direct pressure to the wound D) Applying an ice pack or chemical cold pack

Q: You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and a high-category trauma; however, due to the mechanism of injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient? A) Verifying trauma center ER bed availability B) Examining the patient for entrance and exit wounds C) Searching for presence of diaphoresis, tachycardia, and hypotension D) Performing a distal neurological assessment

Q: Which of the following is required in the management of all open soft-tissue injuries? A) Provision of high-concentration oxygen to the patient B) The use of Standard Precautions by the EMT C) Cervical spine precautions D) Application of a disinfectant solution during clean-up

Q: Which of the following is a strategy to maintain an occlusive dressing to bloody or diaphoretic skin? A) Do not use occlusive dressings in this case. B) Manually maintain pressure. C) Do not use adhesive tape. D) Wrap the dressing circumferentially with gauze.

Q: Your patient has an open abdominal wound with intestines protruding. You should: A) leave them alone and transport rapidly. B) attempt to place the organs back into the abdomen. C) cover the entire abdomen with a blanket. D) cover the organs with moist sterile dressings.

Q: You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsing mass. You should: A) defer further abdominal palpation. B) ask your partner to verify your findings. C) bind the abdomen with an elastic bandage. D) apply cold packs to the abdomen.

Q: Common signs and symptoms following an injury to a hollow abdominal organ include: A) increasing intrathoracic pressures. B) irritation and peritonitis. C) massive hemorrhage. D) absence of unilateral pulses.

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

Q: Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma? A) Intestines B) Liver C) Pancreas D) Kidneys

Q: You have covered an open chest wound with your gloved hand and the patient's breathing has improved. In order to free your hand to provide further care, you should: A) cover the wound with a sterile dressing. B) cover the wound with an occlusive dressing. C) apply a bulky dressing over the wound. D) remove your hand to see if the wound has closed.

Q: You find a middle-aged male is sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You should: A) place the patient on high-concentration oxygen. B) cover the wound with an occlusive dressing. C) place a trauma dressing over the wound. D) place your gloved hand over the wound.

Q: Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likely suffered? A) Hemothorax B) Traumatic asphyxia C) Pneumothorax D) Flail chest

Q: You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you're making the decision to transport. Which of the following BEST encapsulates the correct strategy for transport? A) The patient does not necessarily need transport, so allow him to refuse if he wants. B) Transport the patient emergently because of the high index of suspicion for a serious injury. C) Begin transport non-emergently and upgrade if the patient's condition deteriorates. D) Transport the patient non-emergently because he's complaint free.

Q: Which of the following BEST describes the benefit of a three-sided occlusive dressing over a four-sided occlusive dressing for an open chest wound? A) It eliminates the need to continue monitoring the patient's respiratory status. B) It prevents the development of a hemothorax by allowing blood to escape. C) It allows easy access for re-examination of the wound en route to the hospital. D) It reduces the chances of developing a tension pneumothorax.

Q: What is the underlying cause of bluish or reddish facial discoloration following a traumatic asphyxiation? A) High pressure on the chest leads to blood being forced from the right atrium into the face and neck. B) The patient has become hypoxic due to a chest injury and the finding suggests central cyanosis. C) The physiological strain of the body results in a flushed appearance and increased risk of a hypertensive event. D) Bluish or reddish facial discoloration is not associated with traumatic asphyxiation; a pale discoloration is usually present.

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) Getting a description of the assailants C) The possibility of a pneumothorax D) Reducing the swelling around his eyes by applying a cold pack

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

Q: While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated with: A) aortic dissection. B) tension pneumothorax. C) commotio cordis. D) flail chest.

Q: You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. However, the opponent fails to arise following a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumatic conditions? A) Cardiac tamponade B) Aortic dissection C) Tension pneumothorax D) Commotio cordis

Q: Which of the following traumatic chest injuries may result in massive, often fatal internal hemorrhage? A) Hemopneumothorax B) Hemothorax C) Aortic dissection D) Cardiac tamponade

Q: The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fill adequately, usually secondary to trauma. A) pericardial effusion B) hemopneumothorax C) cardiac tamponade D) commotio cordis

Q: Which of the following describes the proper application of an occlusive dressing for an open chest wound? A) Trim the dressing so that it is the exact size of the wound. B) Use a porous material such as a 4" by 4" gauze pad. C) Tape the dressing securely on three sides. D) Tape the occlusive dressing on two sides only to create dual flaps for relief pressure build-up.

Q: Which of the following is an unreliable sign for determining the presence of a tension pneumothorax? A) Distended neck veins B) Signs and symptoms of shock C) Shortness of breath D) Trachea that shifts to the side opposite the injury

Q: Which of the following injuries may produce distended neck veins (JVD)? A) Traumatic asphyxia B) Tension pneumothorax C) Cardiac tamponade D) All of the above

Q: You're an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated county road. It appears the patient was unrestrained, or not wearing a seat belt, and struck the steering wheel with his chest. On assessment, you notice a paradoxical motion to the patient's chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include? A) The patient may have an abdominal evisceration. B) The patient is showing signs of abdominal bleeding. C) The patient is showing signs of an open chest injury. D) The patient may have a flail chest.

Q: Some drawbacks to using sterile aluminum foil as an occlusive dressing include: A) sterility cannot be ensured unless the materials were autoclaved. B) a flutter valve is difficult to create. C) foil cannot create an airtight seal. D) skin lacerations may occur from the sharp edges.

Q: Which of the following is a true statement regarding the skin's status in the case of a closed chest injury? A) Internal contusions and lacerations cannot occur. B) The skin may be penetrated and occluded. C) The skin is penetrated. D) The skin is not penetrated.

Q: The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without any external blood loss. A) 3 B) 5 C) 0.5 D) 1

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

Q: Which of the following is true concerning lacerations? A) They may be caused by blunt trauma. B) They may be caused by penetrating trauma. C) They may indicate deeper underlying tissue damage. D) All of the above

Q: A patient with jugular vein distention (JVD) is most likely suffering from which of the following injuries? A) Pneumothorax B) Hemothorax C) Hemopneumothorax D) Tension pneumothorax

Q: What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax with each breath? A) Sucking chest wound B) Closed tension pneumothorax C) Open chest wound D) Gurgling chest wound

Q: Which of the following is an accurate definition of a flail chest? A) Lung that has been punctured by a fractured rib, resulting in a buildup of air B) Section of the chest wall that is unstable, leading to breathing problems C) Fracture of one rib in two or more consecutive places D) Fracture of at least four ribs in two or more places

Q: You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center. However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to perform next? A) Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. And re-seal the wound B) Begin providing BVM-assisted ventilations to the patient. C) Call dispatch for an ALS intercept en route to the hospital. D) Begin providing CPR to the patient.

Q: The mechanism of injury in which a patient's chest has struck an immovable object, such as a steering wheel, may most accurately be described as a(n): A) open trauma injury. B) compression injury. C) penetrating injury. D) coup contrecoup injury.

Q: Which of the following is NOT an open tissue injury? A) Contusion B) Evisceration C) Avulsion D) Abrasion

Q: In addition to lacerations, blunt trauma resulting in a closed chest injury creates the potential for which of the following internal injuries? A) Abrasion B) Contusion C) Evisceration D) Avulsion

Q: Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment and transport? A) Tension pneumothorax B) Flail chest C) Abdominal evisceration D) Hemopneumothorax

Q: Which of the following BEST describes an evisceration? A) Open wound of the abdomen from which organs protrude B) Flap of skin that is partially or completely torn away from the underlying tissue C) Accumulation of blood beneath the skin, resulting in swelling D) Epidermis that is scraped away by a rough surface

Q: While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)? A) Blood pressure B) Airway C) Hypothermia D) Bleeding

Q: According to the rule of nines for infants and young children, the patient's head and neck account for what percentage of the total body surface area? A) 13.5% B) 14% C) 9% D) 18%

Q: When using the rule of palm to estimate the approximate body surface area burned, the patient's palm equals about what percentage of the body's surface area (BSA)? A) 1% B) 2% C) 5% D) 3%

Q: Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned? A) 18% B) 9% C) 36% D) 4.5%

Q: Which of the following is a consideration in determining a burn's severity? A) Other illnesses or injuries the patient may have B) Body surface area (BSA) involved in the burn C) The type of agent that caused the burn D) All of the above

Q: A burn extending into the subcutaneous fat would be classified as which type of burn? A) Deep partial thickness B) Full thickness C) Superficial partial thickness D) Superficial

Q: Which of the following BEST describes a partial thickness burn? A) The skin is red, but dry and painful. B) The skin is charred or blackened and lacks sensation. C) The skin is white and dry with no sensation of pain. D) The skin is red and moist with blister formation.

Q: You are treating a 5-year-old for extensive burns. You know that burns pose a greater risk to infants and children. The reason for this is: A) the parents' interference with your assessment and treatment can delay your response. B) the child will likely be upset and crying and therefore hard to evaluate. C) child abuse is usually the reason for the burns. D) their body surface area is greater in relation to their total body size.

Q: Burns pose a greater risk to infants and children for which of the following reasons? A) Pediatric patients have a greater risk of heart problems associated with the burn. B) Pediatric patients have a greater risk of shock from the burn. C) Infants and children have a greater risk of infection from the burn. D) None of the above

Q: While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms, the EMT must be aware of which of the following? A) Being involved in a crime makes the patient part of the chain of evidence, requiring a police officer to ride with you to the hospital. B) The burn is the most serious injury to the patient. C) Medical conditions may be aggravated by the burn. D) The patient may need to be questioned by police and fire officials about the cause of the fire.

Q: For which of the following patients should the EMT carefully continue to monitor the patient's ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure? A) 17-year-old male with a blistering sunburn on his face B) 34-year-old male who opened the radiator of his car and had hot fluid spray on his chest, resulting in redness and pain in an area about the size of the patient's hand C) 28-year-old male who spilled a strong industrial acid on his legs D) 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest

Q: Which of the following is recommended when caring for an amputated part? A) Rinse away debris with saline solution and place the part in a container of ice. B) Wrap the part in aluminum foil to preserve body temperature. C) Seal the part in a plastic bag and place it in a pan of water cooled by an ice pack. D) Always transport the amputated part with the patient.

Q: You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers? A) Fingers cannot be reattached so you can discard them in red bag trash. B) Because it is cold out, you merely need to wrap them in a 5 9 dressing and give them to the staff at the ED. C) Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool. D) Place the fingers directly on ice or use cold packs, as they must be kept very cold.

Q: A 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you do? A) Immediately apply a tourniquet to control bleeding. B) Complete the amputation. It will make the injury much easier to handle. C) Because of the seriousness of the injury, wait for ALS before providing any care. D) Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.

Q: You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step? A) You can treat the wound without total exposure as exposing a wound in that area of the body could be embarrassing. B) You need to expose the wound completely because you need to clear away any embedded particles and debris from the wound. C) You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound. D) You need to make sure the wound is very clean before trying to control bleeding by exposing the wound completely and cleaning it with alcohol.

Q: Your patient is a 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital setting? A) Push the hook through the wound to avoid further damage from the barbed end. B) Leave the hook in place and try not to disturb it. C) Apply a pressure dressing over the hook. D) Pull the hook out from the same direction in which it entered the hand.

Q: In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next? A) Remove the saturated dressings and apply a large trauma dressing. B) Apply an ice pack over the original dressing. C) Apply a tourniquet. D) Apply additional dressing material over the top of the original dressing and bandage it in place.

Q: A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site? A) The nail is less than 2 inches in length. B) The patient's distal pulse, motor function, and sensation are intact. C) Bleeding from the wound is minimal. D) None of the above

Q: Which of the following statements is NOT true concerning the proper transport of an avulsed ear? A) It should be labeled with the patient's name, as well as the date and time it was bagged. B) It should be kept as cool as possible. C) It should not be immersed in cooled water or saline. D) It should be in a dry sterile dressing.

Q: You are dispatched to an auto repair shop for an "accident." You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you do? A) The patient is correct. This type of wound will heal on its own and he can go back to work. B) Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority. C) Continue to apply cold, elevate and splint the limb, and transport the patient high priority. D) Tell the patient that if it does not get better within the next few days he should consult his own doctor.

Q: Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization? A) Use your fingers to pick embedded debris from the wound, bandage with moist saline dressings in place, and transport. B) Do not attempt to remove any debris, apply pressure dressings over the embedded material if necessary, apply high-concentration oxygen, and transport. C) Use a tongue depressor to scrape large pieces of debris out of the wounds, place the patient on high-concentration oxygen, and transport. D) Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.

Q: You are assessing a 30-year-old male patient that had his arm caught in a piece of machinery. By the time you arrive he has been freed. The patient tells you that he does not understand why you were called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspicion of which of the following injuries? A) Puncture B) Crush injury C) Chemical burn D) High-pressure injection

Q: Which of the following is NOT a type of avulsion? A) The skin is partially torn away from the foot. B) A finger is cut off with a butcher's saw. C) An ear is partially torn away from the head. D) The skin is stripped off the hand, like removing a glove.

Q: Which of the following BEST describes an avulsion? A) An injury caused by a sharp, pointed object B) Flap of skin that is partially or completely torn away from the underlying tissue C) Epidermis that is scraped away by a rough surface D) Accumulation of blood beneath the skin, resulting in swelling

Q: Which of the following is required in the management of all open soft-tissue injuries? A) Provision of high-concentration oxygen B) Use of Standard Precautions by the EMT C) Cervical spine precautions D) Application of a disinfectant solution

Q: Bleeding from soft-tissue injuries should initially be controlled with which one of the following techniques? A) Application of an ice pack or chemical cold pack B) Direct pressure C) Elevation of the injured part D) Running cold water over the wound

Q: A wound in which the epidermis is scraped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called a(n): A) abrasion. B) contusion. C) avulsion. D) evisceration.

Q: Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils? A) Avulsion B) Laceration C) Puncture D) Incision

Q: Which of the following is NOT an open tissue injury? A) Abrasion B) Contusion C) Avulsion D) Evisceration