1.
When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
A.
tachypnea.
B.
tachycardia.
C.
vasodilation.
D.
restlessness.


2.
Shock is the result of:
A.
hypoperfusion to the cells of the body.
B.
the body's maintenance of homeostasis.
C.
temporary dysfunction of a major organ.
D.
widespread constriction of the blood vessels.


3.
Clinical signs of compensated shock include all of the following, EXCEPT:
A.
cool and clammy skin.
B.
absent peripheral pulses.
C.
restlessness or anxiety.
D.
rapid, shallow breathing.


4.
All of the following conditions would make you suspect shock, EXCEPT:
A.
anaphylaxis.
B.
heart attack.
C.
severe infection.
D.
tachycardia.


5.
One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:
A.
lactic acid.
B.
carbon dioxide.
C.
pyruvic acid.
D.
carbon monoxide.


6.
You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:
A.
take his vital signs in 15 minutes.
B.
arrange for an ALS rendezvous.
C.
reassess his condition in 5 minutes.
D.
repeat your secondary assessment.


7.
Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:
A.
vasovagal shock.
B.
neurogenic shock.
C.
psychogenic shock.
D.
neurologic shock.


8.
A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying 100% supplemental oxygen, you should:
A.
perform a head-to-toe exam.
B.
allow him to drink plain water.
C.
obtain a repeat blood pressure in 5 minutes.
D.
prepare for immediate transport.


9.
A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:
A.
form a general impression.
B.
call for an ALS ambulance.
C.
follow standard precautions.
D.
ask bystanders what happened.


10.
Which of the following would MOST likely result in hemorrhagic shock?
A.
severe vomiting
B.
liver laceration
C.
excessive sweating
D.
repeated diarrhea


11.
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:
A.
venules.
B.
arterioles.
C.
vena cavae.
D.
capillary arteries.


12.
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?
A.
an effectively pumping heart
B.
an intact system of blood vessels
C.
adequate blood in the vasculature
D.
the filtering of blood cells in the spleen


13.
External bleeding from a vein is relatively easy to control because:
A.
veins carry deoxygenated blood.
B.
veins hold smaller blood volume.
C.
veins are under a lower pressure.
D.
blood typically oozes from a vein.


14.
During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:
A.
assess the quality of her pulse.
B.
repeat the primary assessment.
C.
begin assisting her ventilations.
D.
perform a secondary assessment.


15.
Most cases of external bleeding from an extremity can be controlled by:
A.
elevating the injured extremity.
B.
packing the wound with gauze.
C.
compressing a pressure point.
D.
applying local direct pressure.


16.
Perfusion is MOST accurately defined as the:
A.
effective transfer of oxygen from the venules across the systemic capillary membrane walls.
B.
ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure.
C.
effective removal of carbon dioxide and other metabolic waste products from the body's cells.
D.
circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.


17.
Gastrointestinal bleeding should be suspected if a patient presents with:
A.
dyspnea.
B.
hematuria.
C.
hemoptysis.
D.
hematemesis.


18.
Hypoperfusion is another name for:
A.
shock.
B.
cyanosis.
C.
hypoxemia.
D.
cellular death.


19.
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply:
A.
additional sterile dressings.
B.
a splint and elevate the extremity.
C.
a tourniquet proximal to the injury.
D.
digital pressure to a proximal artery.


20.
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:
A.
obtain baseline vital signs.
B.
apply a nonrebreathing mask.
C.
perform a secondary assessment.
D.
assist the patient's ventilations.


21.
In which of the following patients should you remove an impaled object?
A.
a semiconscious patient with an ice pick impaled in the chest
B.
an apneic patient with a shard of glass impaled in the abdomen
C.
a pulseless and apneic patient with a knife impaled in the back
D.
a conscious and alert patient with a fishhook impaled in the eye


22.
A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should:
A.
control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.
B.
remove the steel rod, control the bleeding, apply an automated external defibrillator (AED), begin CPR, and transport to a trauma center.
C.
stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center.
D.
control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.


23.
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.
A.
18%
B.
27%
C.
36%
D.
45%


24.
A laceration:
A.
is an injury that separates various layers of soft tissue.
B.
is a sharp, smooth cut that is made by a surgical scalpel.
C.
is a jagged cut caused by a sharp object or blunt force trauma.
D.
rarely penetrates through the subcutaneous tissue to the muscle.


25.
Patients with full-thickness (third-degree) burns generally do not complain of pain because:
A.
blister formation protects the burn.
B.
he or she is generally not conscious.
C.
the nerve endings have been destroyed.
D.
subcutaneous vessels are usually clotted.


26.
Which of the following is a severe burn in a 2-year-old child?
A.
superficial burn that covers 25% of the BSA
B.
any full-thickness burn, regardless of its location on the body
C.
partial-thickness burn that covers 10% of the BSA
D.
any burn that involves the arms, legs, or posterior part of the body


27.
When a person is exposed to a cold environment:
A.
sweat is produced and is warmed when the vessels constrict.
B.
blood vessels dilate and divert blood to the core of the body.
C.
the skin becomes flushed secondary to peripheral vasodilation.
D.
peripheral vessels constrict and divert blood away from the skin.


28.
Burns to pediatric patients are generally considered more serious than burns to adults because:
A.
pediatric patients are more prone to hyperthermia.
B.
most burns in children are the result of child abuse.
C.
pediatric patients have a proportionately larger volume of blood.
D.
pediatric patients have more surface area relative to total body mass.


29.
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?
A.
Irrigate it with sterile water and cover it with a dry dressing.
B.
Cover the exposed bowel and keep his legs in a straight position.
C.
Carefully replace the exposed bowel into the abdomen and transport.
D.
Cover it with moist, sterile gauze and secure with an occlusive dressing.


30.
When assessing a patient with a closed soft-tissue injury, it is MOST important to:
A.
manipulate the injury site for signs of a fracture.
B.
assess circulation distal to the site of the injury.
C.
remain alert for more severe underlying injuries.
D.
recognize that the integrity of the skin is broken.



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