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West Coast EMT Block Exam #4 Questions and Answers
A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? Select one: A. Lateral impact to the spine B. Secondary fall after the initial impact C. Direct trauma to the spinal column D. Energy transmission to the spine ✔Ans✔ D. Energy transmission to the spine A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: Select one: A. leave her bicycle helmet on. B. obtain baseline vital signs. C. stabilize her entire spine. D. inspect the helmet for cracks. ✔Ans✔ C. stabilize her entire spine. A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: Select one: A. auscultate bowel sounds. B. assess for an exit wound. C. apply a cervical collar. D. obtain baseline vital signs. ✔Ans✔ B. assess for an exit wound.
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According to the American College of Surgeons Committee on Trauma (ACS-COT), an adult trauma patient should be transported to the highest level of trauma center if he or she: Select one: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. B. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma. ✔Ans✔ D. has a GCS score of less than or equal to 13 with a mechanism attributed to trauma. According to the Association of Air Medical Services, you should consider air medical transport of a trauma patient if: Select one: A. the patient requires advanced life support care and stabilization, and the nearest ALS- ground ambulance is more than 5 to 10 minutes away. B. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. C. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. D. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor. ✔Ans✔ B. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. Approximately 25% of severe injuries to the aorta occur during: Select one: A. frontal collisions. B. rollover collisions.
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A. solid organs usually rupture from the pressure wave. B. secondary blast injuries are usually the least obvious. C. primary blast injuries are the most easily overlooked. D. primary blast injuries are typically the most obvious. ✔Ans✔ C. primary blast injuries are the most easily overlooked. When assessing an elderly patient who fell, it is important to remember that: Select one: A. any fall in the elderly is considered to be high-energy trauma. B. osteoporosis can cause a fracture as a result of a fall from a standing position. C. bilateral hip fractures usually occur when an elderly person falls. D. elderly patients who fall usually have a secondary head injury. ✔Ans✔ B. osteoporosis can cause a fracture as a result of a fall from a standing position. When the speed of a motor vehicle doubles, the amount of kinetic energy: Select one: A. quadruples. B. is not affected. C. triples. D. doubles. ✔Ans✔ A. quadruples. Which of the following destinations is most appropriate for a 41-year-old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal? Select one: A. A Level I or Level II trauma center B. Only a Level I trauma center C. A Level IV or Level III trauma center
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D. Any designated trauma center is acceptable. ✔Ans✔ A. A Level I or Level II trauma center Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? Select one: A. Intrusion into the vehicle B. Dismounted seats C. Steering wheel deformity D. Deployment of the air bag ✔Ans✔ D. Deployment of the air bag Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? Select one: A. Flail chest B. Forehead lacerations C. Aortic rupture D. Extremity fractures ✔Ans✔ C. Aortic rupture Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? Select one: A. Intravenous fluid administration B. Early administration of oxygen C. Rapid transport to a trauma center D. Elevation of the lower extremities ✔Ans✔ C. Rapid transport to a trauma center Which of the following statements regarding gunshot wounds is correct? Select one: A. The size of a bullet has the greatest impact on the injury produced. B. High-velocity bullets will cause less severe internal injuries.
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A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. packing both nostrils with gauze pads until the bleeding stops. B. placing a rolled 4² × 4² dressing between his lower lip and gum. C. pinching the patient's nostrils and having him lean forward. D. having the patient pinch his own nostrils and then lie supine. ✔Ans✔ C. pinching the patient's nostrils and having him lean forward. A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one: A. an aortic aneurysm. B. acute appendicitis. C. gastrointestinal bleeding. D. intrathoracic hemorrhaging. ✔Ans✔ C. gastrointestinal bleeding. A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. perform a secondary assessment. B. apply a nonrebreathing mask. C. obtain baseline vital signs. D. assist the patient's ventilations. ✔Ans✔ D. assist the patient's ventilations. Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______.
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Select one: A. perfusion B. hypoperfusion C. coagulation D. hemorrhage ✔Ans✔ A. perfusion Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. spleen. B. gallbladder. C. pancreas. D. liver. ✔Ans✔ A. spleen. Hypovolemic shock occurs when: Select one: A. the patient's systolic blood pressure is less than 100 mm Hg. B. the clotting ability of the blood is enhanced. C. the body cannot compensate for rapid blood loss. D. at least 10% of the patient's blood volume is lost. ✔Ans✔ C. the body cannot compensate for rapid blood loss. If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound
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A. 10%
B. 5%
C. 20%
D. 15% ✔Ans✔ C. 20% The severity of bleeding should be based on all of the following findings, EXCEPT: Select one: A. systolic blood pressure. B. poor general appearance. C. the mechanism of injury. D. clinical signs and symptoms. ✔Ans✔ A. systolic blood pressure. What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct. ✔Ans✔ D. All of these answers are correct. Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. B. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. C. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.
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D. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. ✔Ans✔ D. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Select one: A. The patient takes rivaroxaban (Xeralto). B. The patient has a history of hypertension. C. The patient has not eaten in 24 hours. D. The patient had a stroke 5 years prior. ✔Ans✔ A. The patient takes rivaroxaban (Xeralto). Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Air splint B. Cardboard splint C. Vacuum splint D. Sling and swathe ✔Ans✔ A. Air splint Which of the following statements regarding hemophilia is correct? Select one: A. Hemophilia is defined as a total lack of platelets. B. Hemophiliacs take aspirin to enhance blood clotting. C. Approximately 25% of the population has hemophilia. D. Patients with hemophilia may bleed spontaneously. ✔Ans✔ D. Patients with hemophilia may bleed spontaneously.
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C. 18%
D. 36% ✔Ans✔ C. 18% A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? Select one: A. Irrigate it with sterile water and cover it with a dry dressing. B. Carefully replace the exposed bowel into the abdomen and transport. C. Cover the exposed bowel and keep his legs in a straight position. D. Cover it with moist, sterile gauze and secure with an occlusive dressing. ✔Ans✔ D. Cover it with moist, sterile gauze and secure with an occlusive dressing. A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: Select one: A. palpate his radial pulses. B. administer high-flow oxygen. C. apply ice to the hematoma. D. perform a neurologic exam. ✔Ans✔ B. administer high-flow oxygen. A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: Select one: A. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing. B. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. C. replace the avulsed flap to its original position and cover it with a sterile dressing.
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D. carefully probe the wound to determine if the bleeding is venous or arterial. ✔Ans✔ C. replace the avulsed flap to its original position and cover it with a sterile dressing. A burn that is characterized by redness and pain is classified as a: Select one: A. second-degree burn. B. partial-thickness burn. C. full-thickness burn. D. superficial burn. ✔Ans✔ D. superficial burn. A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): Select one: A. contusion. B. crush injury. C. abrasion. D. hematoma. ✔Ans✔ A. contusion. An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: Select one: A. ask the child's father to try to locate the dog. B. advise the child that he will need rabies shots. C. report the incident to the appropriate authorities. D. administer oxygen via a nonrebreathing mask. ✔Ans✔ C. report the incident to the appropriate authorities
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In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: Select one: A. an air embolism. B. a spinal fracture. C. an ischemic stroke. D. nerve fiber damage. ✔Ans✔ A. an air embolism. In which of the following patients should you remove an impaled object? Select one: A. An apneic patient with a shard of glass impaled in the abdomen B. A conscious and alert patient with a fishhook impaled in the eye C. A pulseless and apneic patient with a knife impaled in the back D. A semiconscious patient with an ice pick impaled in the chest ✔Ans✔ C. A pulseless and apneic patient with a knife impaled in the back The sebaceous glands produce sebum, a material that: Select one: A. pulls the hair erect when you are cold. B. facilitates shedding of the epidermis. C. discharges sweat onto the skin's surface. D. waterproofs the skin and keeps it supple. ✔Ans✔ D. waterproofs the skin and keeps it supple. When caring for a patient whose arm is covered with a dry chemical, you should: Select one: A. quickly irrigate the arm with large amounts of water. B. brush away the chemical before flushing with water.
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C. use forceful streams of water to remove the chemical. D. deactivate the chemical with a 5% vinegar solution. ✔Ans✔ B. brush away the chemical before flushing with water. Which of the following areas of the body has the thinnest skin? Select one: A. Ears B. Scalp C. Back D. Soles of the feet ✔Ans✔ A. Ears Which of the following is a severe burn in a 65-year-old patient? Select one: A. Superficial burn to 30% of the BSA B. Full-thickness burn to 1% of the BSA C. Second-degree burn covering 10% of the BSA D. Partial-thickness burn to 20% of the BSA ✔Ans✔ D. Partial-thickness burn to 20% of the BSA Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? Select one: A. Incision B. Abrasion C. Laceration D. Avulsion ✔Ans✔ B. Abrasion Which of the following processes occurs during the inflammation phase of the healing process?
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D. assess distal circulation and readjust the bandage as needed. ✔Ans✔ D. assess distal circulation and readjust the bandage as needed. A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: Select one: A. acute retinitis. B. a detached retina. C. conjunctivitis. D. a corneal abrasion. ✔Ans✔ C. conjunctivitis. A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. thoroughly flush her ear with sterile saline. B. use tweezers to try to remove the object. C. remove the peanut with a cotton-tipped swab. D. transport her to the emergency department. ✔Ans✔ D. transport her to the emergency department. A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: Select one: A. assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. B. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the
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dislodged teeth, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. D. fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport. ✔Ans✔ C. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: Select one: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. quickly immobilizing her spinal column. ✔Ans✔ C. rapidly transporting her to the hospital. A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: Select one: A. neutralize the acid chemical in his eye with an alkaline chemical. B. mix baking soda with water and irrigate his eyes with the solution. C. irrigate both eyes continuously for 20 minutes with plain water. D. flush both eyes with an alcohol-based solution and transport. ✔Ans✔ C. irrigate both eyes continuously for 20 minutes with plain water. Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: Select one:
