1.
The skin and underlying tissues of the face:
A.
have a rich blood supply and bleed profusely.
B.
swell minimally when exposed to blunt trauma.
C.
are well protected by the maxillae and mandible.
D.
contain a relatively small number of nerve fibers.


2.
The MOST significant complication associated with facial injuries is:
A.
damage to the eyes.
B.
airway compromise.
C.
cervical spine injury.
D.
mandibular immobility.


3.
A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include:
A.
irrigating his right eye laterally.
B.
flushing his eye starting laterally.
C.
irrigating both eyes simultaneously.
D.
covering both eyes and transporting.


4.
You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:
A.
is allergic to any medications.
B.
has a history of eye surgeries.
C.
regularly sees a family physician.
D.
noticed the change during a meal.


5.
The superficial temporal artery can be palpated:
A.
slightly above the ear.
B.
at the angle of the jaw.
C.
over the mastoid process.
D.
just anterior to the tragus.


6.
A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes:
A.
applying a tight pressure dressing.
B.
padding between the ear and the scalp.
C.
packing the ear with sterile gauze pads.
D.
covering the wound with a moist dressing.


7.
Facial injuries should be identified and treated as soon as possible because:
A.
of the risk for airway problems.
B.
bleeding must be controlled early.
C.
the spine may be injured as well.
D.
swelling may mask hidden injuries.


8.
Frequent reassessments of the patient with face or neck injuries are MOST important because:
A.
they lend credibility to your documentation.
B.
such injuries can affect the respiratory system.
C.
hospital staff require frequent patient updates.
D.
rapid facial swelling may mask hidden injuries.


9.
The opening in the center of the iris, which allows light to move to the back of the eye, is called the:
A.
pupil.
B.
sclera.
C.
cornea.
D.
conjunctiva.


10.
The optic nerve endings are located within the:
A.
retina.
B.
sclera.
C.
pupil.
D.
cornea.


11.
Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
A.
the speed of the fall.
B.
the surface struck.
C.
the height of the fall.
D.
the primary impact point.


12.
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
A.
capitation.
B.
cavitation.
C.
congruent.
D.
conversion.


13.
Internal injuries caused by gunshot wounds are difficult to predict because:
A.
the caliber of the bullet is frequently unknown.
B.
the area of damage is usually smaller than the bullet.
C.
the bullet may tumble or ricochet within the body.
D.
exit wounds caused by the bullet are usually small.


14.
Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?
A.
collapsed dashboard
B.
deformed steering wheel
C.
caved-in passenger door
D.
intrathoracic hemorrhage


15.
When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact.
A.
door
B.
dashboard
C.
windshield
D.
steering wheel


16.
Which of the following statements regarding low-energy penetrating injuries is correct?
A.
Internal injuries caused by low-velocity bullets are usually easy to predict.
B.
Exit wounds are typically easy to locate with low-energy penetrating injuries.
C.
It is usually easy to differentiate between an entrance wound and an exit wound.
D.
The area of injury is usually close to the path the object took through the body.


17.
When evaluating the mechanism of injury of a car versus pedestrian collision, you should first:
A.
determine if the patient was propelled away from the vehicle.
B.
approximate the speed of the vehicle that struck the pedestrian.
C.
evaluate the vehicle that struck the patient for structural damage.
D.
determine if the patient was struck and pulled under the vehicle.


18.
Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is:
A.
8.
B.
9.
C.
10.
D.
11.


19.
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:
A.
determine the vehicle's speed at the time of impact.
B.
assess the severity of the third collision of the crash.
C.
recognize if the driver hit the brakes before impact.
D.
identify contact points and predict potential injuries.


20.
While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for:
A.
underlying cardiac disease.
B.
a lacerated coronary artery.
C.
bruising of the heart muscle.
D.
traumatic rupture of the aorta.


21.
Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly?
A.
cerebral contusion
B.
subdural hematoma
C.
cerebral concussion
D.
epidural hematoma


22.
A tight-fitting motorcycle helmet should be left in place unless:
A.
it interferes with your assessment of the airway.
B.
the patient must be placed onto a long backboard.
C.
the patient complains of severe neck or back pain.
D.
the helmet is equipped with a full face shield or visor.


23.
The central nervous system (CNS) is composed of the:
A.
cerebellum and brain.
B.
brain and spinal cord.
C.
cerebrum and meninges.
D.
meninges and spinal cord.


24.
Common signs of a skull fracture include all of the following, EXCEPT:
A.
mastoid process bruising.
B.
ecchymosis around the eyes.
C.
noted deformity to the skull.
D.
superficial scalp lacerations.


25.
Which of the following statements regarding the cranium is correct?
A.
The skull is a subdivision of the cranium.
B.
Thirty percent of the cranium is occupied by blood.
C.
The cranium protects the structures of the face.
D.
Eighty percent of the cranium is occupied by brain tissue.


26.
Distraction injuries of the spine are MOST commonly the result of:
A.
falls.
B.
diving.
C.
hangings.
D.
compression.


27.
Which of the following statements regarding a basilar skull fracture is correct?
A.
Bloody CSF commonly leaks from the nose.
B.
In most cases, mastoid bruising occurs.
C.
The absence of raccoon eyes or Battle's sign does not rule it out.
D.
They are typically the result of local, low-energy trauma to the head.


28.
When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates:
A.
fractures to the internal structures of the ear following direct trauma.
B.
a linear skull fracture and a significant increase in intracranial pressure.
C.
significant pressure and bleeding in between the skull and dura mater.
D.
rupture of the tympanic membrane following diffuse impact to the head.


29.
The five sections of the spinal column, in descending order, are the:
A.
thoracic, cervical, lumbar, coccygeal, and sacral.
B.
cervical, thoracic, lumbar, sacral, and coccygeal.
C.
coccygeal, sacral, lumbar, thoracic, and cervical.
D.
cervical, coccygeal, thoracic, sacral, and lumbar.


30.
Coordination of balance and body movement is controlled by the:
A.
medulla.
B.
cerebrum.
C.
cerebellum.
D.
brain stem.


31.
A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?
A.
ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
B.
asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta
C.
fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia
D.
collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest


32.
Pneumothorax is defined as:
A.
accumulation of air between the lungs.
B.
blood collection within the lung tissue.
C.
accumulation of air in the pleural space.
D.
blood collection within the pleural space.


33.
If a person's tidal volume decreases, but his or her respiratory rate remains unchanged:
A.
minute volume will increase.
B.
minute volume will decrease.
C.
minute volume will remain unchanged.
D.
excess carbon dioxide will be eliminated.


34.
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:
A.
apply 100% oxygen and immediately transport.
B.
place her supine and elevate her lower extremities.
C.
perform a rapid head-to-toe physical assessment.
D.
provide some form of positive-pressure ventilation.


35.
A flail chest occurs when:
A.
a segment of the chest wall is detached from the thoracic cage.
B.
more than three ribs are fractured on the same side of the chest.
C.
multiple ribs are fractured on both sides of the thoracic cage.
D.
a segment of fractured ribs bulges during the inhalation phase.


36.
The thoracic cavity is separated from the abdominal cavity by the:
A.
diaphragm.
B.
anterior rib cage.
C.
intercostal margin.
D.
costovertebral angle.


37.
Hemoptysis is defined as:
A.
vomiting blood.
B.
coughing up blood.
C.
abnormal blood clotting.
D.
blood in the pleural space.


38.
A spontaneous pneumothorax would MOST likely occur as the result of:
A.
exertion of a person with a congenital lung defect.
B.
excessive coughing in a patient with pneumonitis.
C.
abnormally slow breathing in a patient with pleurisy.
D.
blunt or penetrating trauma to the anterior chest wall.


39.
During your assessment of a patient with blunt chest trauma, you note paradoxical movement of the left chest wall. As your partner is administering oxygen to the patient, you should:
A.
request a paramedic to decompress the chest.
B.
make note of it and continue your assessment.
C.
stabilize the chest wall with a bulky dressing.
D.
reassess the adequacy of the patient's breathing.


40.
A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:
A.
aggressively manage his airway.
B.
request a paramedic ambulance.
C.
perform a secondary assessment.
D.
suspect a severe hemopneumothorax.


41.
Because the depth of an open abdominal wound is often difficult to determine:
A.
vital signs should be monitored frequently.
B.
prompt transport to the hospital is essential.
C.
the EMT must perform a thorough exam.
D.
the abdomen must be vigorously palpated.


42.
Which of the following statements regarding abdominal eviscerations is correct?
A.
Most eviscerations occur to the left upper quadrant.
B.
The protruding organs should be kept warm and moist.
C.
The organs should be replaced carefully to avoid heat loss.
D.
Adherent material is preferred when covering an evisceration.


43.
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
A.
perform a comprehensive secondary assessment to determine why his clinical status has changed.
B.
insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.
C.
reassess his vital signs and then notify the receiving hospital of the change in his clinical status.
D.
suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.


44.
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?
A.
What does your blood pressure normally run?
B.
Do you take any over-the-counter medications?
C.
Has blood soaked through your undergarments?
D.
Have you experienced recent abdominal trauma?


45.
The mesentery is:
A.
the point of attachment between the small and large intestines.
B.
a layer of thick skeletal muscles that protects the abdominal organs.
C.
a complex network of blood vessels that supply blood to the liver.
D.
a membranous fold that attaches the intestines to the walls of the body.


46.
Accumulation of blood in the abdominal cavity will MOST likely cause:
A.
distention.
B.
referred pain.
C.
diffuse bruising.
D.
nausea or vomiting.


47.
Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a:
A.
rollover crash.
B.
lateral collision.
C.
head-on crash.
D.
rear-end collision.


48.
Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when:
A.
solid abdominal organs bleed secondary to penetrating trauma.
B.
the vessels that supply the abdominal organs become inflamed.
C.
bacteria or viruses invade the walls of the gastrointestinal tract.
D.
hollow abdominal organs are damaged and spill their contents.


49.
Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the:
A.
Kehr sign.
B.
Cullen sign.
C.
Grey Turner sign.
D.
Brudzinski sign.


50.
A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:
A.
apply full spinal motion restriction precautions.
B.
keep him on his side but gently straighten his legs.
C.
place him supine but allow him to keep his knees bent.
D.
transport him in the position in which you found him.


51.
When splinting an injury of the wrist, the hand should be placed:
A.
into a fist.
B.
in a straight position.
C.
in an extended position.
D.
in a functional position.


52.
Of the following musculoskeletal injuries, which is considered to be the LEAST severe?
A.
nondisplaced pelvic fracture
B.
open fractures of a long bone
C.
an amputation of an extremity
D.
multiple closed long bone fractures


53.
Which of the following scenarios is an example of a direct injury?
A.
A passenger fractures her patella after it strikes the dashboard.
B.
A skier dislocates his knee after a twisting injury to the ankle.
C.
A person lands on his or her feet and fractures the lumbar spine.
D.
A child dislocates his elbow after falling on his outstretched arm.


54.
The MOST reliable indicator of an underlying fracture is:
A.
guarding.
B.
severe swelling.
C.
obvious bruising.
D.
point tenderness.


55.
In moving joints, the ends of the bones are covered with:
A.
articular cartilage.
B.
synovial tendons.
C.
muscular fascia.
D.
gliding cartilage.


56.
When caring for a patient with a possible fracture of the scapula, the EMT should:
A.
carefully assess the patient for breathing problems.
B.
apply rigid board splints across the chest and back.
C.
assume that minimal force was applied to the back.
D.
recognize that scapular fractures are life threatening.


57.
Which of the following structures is regulated by smooth muscle?
A.
heart
B.
skeleton
C.
blood vessels
D.
diaphragm


58.
Which of the following statements regarding striated muscle is correct?
A.
Striated muscle is involuntary because you have no conscious control over it.
B.
Most of the body's striated muscle is found within the walls of the blood vessels.
C.
Striated muscle tissue is attached directly to the bones by tough bands of cartilage.
D.
It forms the major muscle mass of the body and usually crosses at least one joint.


59.
During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:
A.
splint the elbow in the position of deformity and transport immediately.
B.
apply gentle manual traction in line with the limb and reassess for a pulse.
C.
carefully straighten the injured arm and secure it with padded board splints.
D.
make two or three attempts to restore distal circulation by manipulating the elbow.


60.
With regard to musculoskeletal injuries, the zone of injury is defined as the:
A.
area of obvious deformity over the site of impact.
B.
exact part of the bone or joint that was disrupted.
C.
area of soft-tissue damage surrounding the injury.
D.
part of the body that sustained secondary injury.



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