Trimester 2 MidTerm - Trauma

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Trimester 2 MidTerm - Trauma
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2013-06-20 17:59:55
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Paramedic Trimester Midterm Exam Study Trauma
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Midterm Trimester 2
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  1. The purpose of determining the mechanism of injury and the index of suspicion for the trauma Pt at the same time is to allow you to:

    A. Decide whether to transport the patient
    B. Document a complete scene size-up
    C. Anticipate your patient's injuries
    D. Identify comorbid factors
    C. Anticipate your patient's injuries
    (this multiple choice question has been scrambled)
  2. Which of the following accounts for the highest number of trauma deaths in the US?

    A. Motor vehicle crashes
    B. Falls
    C. Assaults
    D. Firearms injuries
    A. Motor vehicle crashes
    (this multiple choice question has been scrambled)
  3. Which of the following acts resulted in the development of modern EMS systems?

    A. The Trauma Care Systems Planning and Development Act of 1990
    B. Good Samaritan Act
    C. Ryan White Act
    D. Highway Safety Act of 1966
    D. Highway Safety Act of 1966
    (this multiple choice question has been scrambled)
  4. Which of the following physical findings indicates the need for immediate transport?

    A. Vital signs: systeolic BP 80, respiratory rate 8
    B. GCS score of 15
    C. Second-degree burns involving 9% of BSA in an adult
    D. Fractured right femur
    A. Vital signs: systeolic BP 80, respiratory rate 8
    (this multiple choice question has been scrambled)
  5. As a paramedic your role in trauma care consists of all of the following EXCEPT:

    A. Providing care to seriously injured trauma patients
    B. Providing rapid transport to appropriate facilities
    C. Promoting injury prevention
    D. Providing surgical interventions to stop hemorrhage
    D. Providing surgical interventions to stop hemorrhage
    (this multiple choice question has been scrambled)
  6. Which of the following is NOT considered a significant MOI in pediatric patients?

    A. Fall of 5 feet
    B. Any collision in which a child is ejected from the vehicle
    C. Vehichle collision with intrusion into compartment where child is a passenger
    D. Bicycle-Vehicle collision at 30 mph
    A. Fall of 5 feet
    (this multiple choice question has been scrambled)
  7. Which of the following is NOT an example of trauma?

    A. Cerebral contusion
    B. An abrasion to the knee
    C. Chest pain
    D. A stab wound to the abdomen
    C. Chest pain
    (this multiple choice question has been scrambled)
  8. Which of the following is NOT a consideration when assessing a trauma patient?

    A. Medical insurance coverage
    B. Underlying medical conditions
    C. SAMPLE history
    D. MedicAlert bracelts
    A. Medical insurance coverage
    (this multiple choice question has been scrambled)
  9. Which of the following patients is NOT a candidate for air medical transport?

    A. Seriously injured patient with cardiac tamponade
    B. Combative trauma patient
    C. Burn patient with over 50% second-degree burns
    D. Patient with prolonged extrication time
    B. Combative trauma patient
    (this multiple choice question has been scrambled)
  10. Whic of the following is more relevant to the assessment and history of the medical patient than to the trauma patient?

    A. AVPU
    B. OPQRST
    C. SAMPLE
    D. DCAP-BTLS
    B. OPQRST
    (this multiple choice question has been scrambled)
  11. Vehicle supplemental restraint systems (air bags)are meant to:

    A. Absorb the energy exchange of rapid deceleration
    B. Protect infants and children who ride in the front seat of the vehicle
    C. Prevent unrestrained occupants from taking the down-and-under pathway in frontal impacts
    D. Prevent injury from secondary impacts
    A. Absorb the energy exchange of rapid deceleration
    (this multiple choice question has been scrambled)
  12. When assessing a patient with a crush injury, which of the following findings would indicate that toxins have entered the central circulation?

    A. Increased urine output
    B. Hot, red skin
    C. Cardiac arrhythmia
    D. Central hyperventilation syndrome
    C. Cardiac arrhythmia
    (this multiple choice question has been scrambled)
  13. Which of the following is NOT a complication of crush syndrome?

    A. Renal failure
    B. Cardiac arrhythmias
    C. Difficult-to-control hemorrhage
    D. Systemic alkalosis
    D. Systemic alkalosis
    (this multiple choice question has been scrambled)
  14. Which of the following injuries is most likely in a rear-end collision?

    A. Lumbar spine injuries
    B. Pelvic fractures
    C. Thoracic and abdominal injuries
    D. Head and neck injuries
    D. Head and neck injuries
    (this multiple choice question has been scrambled)
  15. In falls, which section of the spinal column is the MOST prone to compression injury?

    A. Lumbar
    B. Cervical
    C. Thoracic
    D. Sacral
    A. Lumbar
    (this multiple choice question has been scrambled)
  16. Applying Newton's second law of motion to a vehicle traveling 70 mph, crashing into which of the following would transfer the most force to the patient?

    A. Signpost
    B. Shrubbery
    C. A body of water
    D. Bridge abutment
    D. Bridge abutment
    (this multiple choice question has been scrambled)
  17. Your patient is an eight-year-old male with a pencil impaled 2 centimeters inferior to the xiphoid process.  You note that the pencil is pulsating.  Which of the following is the best action?

    A. Stabilize the pencil in place and transport to a trauma center
    B. Stabilize the pencil and transport to the nearest medical facility
    C. Start an IV and request orders for analgesia and sedation
    D. Remove the pencil and apply direct pressure to the wound; transport to a trauma center if the bleeding does not stop with direct pressure
    A. Stabilize the pencil in place and transport to a trauma center
    (this multiple choice question has been scrambled)
  18. The pathway of injury left in the wake of a penetrating MOI is called:

    A. Profile
    B. Trajectory
    C. Cavitation
    D. Cone of Injury
    C. Cavitation
    (this multiple choice question has been scrambled)
  19. Your patient is a 50 yo male with a GSW to the right anterior chest.  He is unresponsive.  Which fo the following should you do first?

    A. Seal the chest wound
    B. Check for breathing
    C. Check for a carotid pulse
    D. Auscultate breath sounds
    B. Check for breathing
    (this multiple choice question has been scrambled)
  20. A penetrating injury to which of the following ogans is LEAST likely to result in severe hemorrhage?

    A. Spleen
    B. Liver
    C. Ureter
    D. Kidney
    C. Ureter
    (this multiple choice question has been scrambled)
  21. Which of the following is TRUE of shotgun ammunition?

    A. The closer the shooter is to the victim, the larger the area of visible damage
    B. The shot is dispersed from the cartridge with high velocity
    C. "Double ought" or #00 shot contains a large number of relatively small pellets
    D. A shotgun may either fire one slug or use ammuntion with multiple pellets
    D. A shotgun may either fire one slug or use ammuntion with multiple pellets
    (this multiple choice question has been scrambled)
  22. Which of the following abdominal organs is the least affected by the pressure wave associated with penetrating trauma?

    A. Spleen
    B. Liver
    C. Kidneys
    D. Bowel
    D. Bowel
    (this multiple choice question has been scrambled)
  23. he study of the characteristics of projectiles in motion and their efects on the objects they impact is called:

    A. Forensics
    B. Ballistics
    C. Trajectory
    D. Cavitation
    B. Ballistics
    (this multiple choice question has been scrambled)
  24. In a previously healthy individual, which of the following types of shock may NOT result in the typical signs of cool, pale, moist skin; tachycardia; and narrowed pulse pressure?

    A. Hypovolemic
    B. Cardiogenic
    C. Neurogenic
    D. Hemorrhagic
    C. Neurogenic
    (this multiple choice question has been scrambled)
  25. Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorhagic shock?

    A. Administer synthetic oxygen-carrying fluids as necessary to increase the level of consciousness
    B. Administer isotonic crytalloid fluids only as necessary to maintain perfusion
    C. Administer hpertonic saline solution or colloids at a keep-open rate
    D. Begin with a 2,000 mL bolus of isotonic crystalloid solution infused under pressure
    B. Administer isotonic crytalloid fluids only as necessary to maintain perfusion
    (this multiple choice question has been scrambled)
  26. Your patient is a 23 yo male with GSW to the abdomen and an exit wound in the right flank.  He responds to verabal stimuli; has pale, cool, diaphoretic skin; and has a HR of 128, respirations at 24, and a BP o 82/60.  These findings indicate which of the following kind of shock?

    A. Neurogenic
    B. Ireversible
    C. Decompensated
    D. Compensated
    C. Decompensated
    (this multiple choice question has been scrambled)
  27. Which of the following, located in the aortic arch, monitor BP and send feedback o the medulla oblongata to maintain homeostasis?

    A. Volume receptors
    B. Proprioceptors
    C. Baroreceptors
    D. Chemoreceptors
    C. Baroreceptors
    (this multiple choice question has been scrambled)
  28. Which of the following is deined as the colume of blood ejected from the heart with each beat?

    A. Ventricular capacitance
    B. Afterload
    C. Stroke volume
    D. Cardiac output
    C. Stroke volume
    (this multiple choice question has been scrambled)
  29. The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the _____ phase.

    A. Hemostatic
    B. Vascular
    C. Hemolytic
    D. Ischemic
    B. Vascular
    (this multiple choice question has been scrambled)
  30. Which of the following is NOT a benefit of PASG?

    A. An autotransfusion of up to 2,000 mL of blood from the lower extremities
    B. Minimizing movement of the pelvis and lower extremities
    C. Increasing peripheral vascular resistance
    D. Decreasing the size of the vascular container
    A. An autotransfusion of up to 2,000 mL of blood from the lower extremities
    (this multiple choice question has been scrambled)
  31. The blood flowing to the heart best describes:

    A. Afterload
    B. Preload
    C. Vascular phase
    D. Contractility
    B. Preload
    (this multiple choice question has been scrambled)
  32. You are called to a commerical creamery where an employee go his arm trapped in he ice cream-mixing machinery.  You note that the skin has been pulled of his hand and arm from the midfoream down.  The patient's muscles, tendons, and bones are exposed.  This type of injury is a(n):

    A. Degloving injury
    B. Crush injury
    C. Skinning injury
    D. Amputation
    A. Degloving injury
    (this multiple choice question has been scrambled)
  33. You are assessing an assault victim and note a contusion over he abdomen.  Which of the following should you remember while caring for this patient?

    A. A contusion to the abdomen should always increase your index of suspicion for underlying injury
    B. The significance of th trauma is related to the amount of pain the patient experiences on palpation
    C. Unless the contusion is over a critical area, such as the spleen or liver, the likelihood of serious injury is minimal
    D. If there is no rigidity or disension of the abdomen, serious injury is unlikely
    A. A contusion to the abdomen should always increase your index of suspicion for underlying injury
    (this multiple choice question has been scrambled)
  34. You have responded for an injured person at an address you know to be a motorcycle clubhouse.  Your patient was attacked b another party iwth a broken beer bottle.  Your patient has a large laceration on her neck with moderate bleeding.  Which property of your dressing material is most important in caring for this patient?

    A. Adherent
    B. Sterile
    C. Occlusive
    D. Absorbant
    C. Occlusive
    (this multiple choice question has been scrambled)
  35. The tough, fibrous sheaths that bundle skeletal muscle are called:

    A. Sarcolemma
    B. Tendons
    C. Fibers
    D. Fascia
    D. Fascia
    (this multiple choice question has been scrambled)
  36. Which of the following is best described as the accumulation of a pocket of blood in the tissues?

    A. Hematoma
    B. Abrasion
    C. Contusion
    D. Compartment syndrome
    A. Hematoma
    (this multiple choice question has been scrambled)
  37. The acute breakdown of muscle fibers in crushing injury is called:

    A. Rouleaux formation
    B. Sarcoidosis
    C. Rhabdomyolysis
    D. Myoglobinemia
    C. Rhabdomyolysis
    (this multiple choice question has been scrambled)
  38. You arrive on the scene of a patient with severe blunt trauma to the face.  You hear gurgling as you approach the patient.  After opening the airway with a manual maneuver, what should your next action be?

    A. Control the source of hemorrhage
    B. Suction
    C. Apply a cervical collar
    D. Ventilate
    B. Suction
    (this multiple choice question has been scrambled)
  39. Your Pt is an 18 yo male who stepped on a nail in the barnyard.  The nail penetrated his tennis shoe and punctured his foot.  On your arrival, the Pt has removed the nail and the shoe.  The wound is about 2mm in diameter with minor bleeding that has been controlled.  The skin around the wound is red.  The Pt does not want to be transported but asks if you can give him "some ointment and a Band-Aid."  You should explain to the Pt that this type of injury is associated with an increased risk of:

    A. Scarring
    B. Infection
    C. Nerve damage
    D. Delayed bleeding
    B. Infection
    (this multiple choice question has been scrambled)
  40. In which type of soft-tissue injury is the skin cut or torn, leaving a flap of skin attached?

    A. Avulsion
    B. Amputation
    C. Laceration
    D. Abrasion
    A. Avulsion
    (this multiple choice question has been scrambled)
  41. The layer of skin that contains adipose tissue is the _____ layer.

    A. Connective
    B. Epidermal
    C. Dermal
    D. Subcutaneous
    D. Subcutaneous
    (this multiple choice question has been scrambled)
  42. Which of the following is a principle that should be used when considering application of a tourniquet to control bleeding?

    A. A narrow, nonelastic material is best for generating the pressure needed to stop bleeding
    B. Every 15 minutes the tourniquet will need to be removed for 5 minutes, then reapplied
    C. A tourniquest should be used for severe bleeding that cannot be controlled by any other means
    D. A blood pressure cuff used as a tourniquet will maintain its pressure if it has been properly applied
    C. A tourniquest should be used for severe bleeding that cannot be controlled by any other means
    (this multiple choice question has been scrambled)
  43. Your Pt is a 45 yo type II diabetic who has a nonhealing wound on his right foot.  You note that the right leg is discolored and edematous follow and has subcutaneous emphysema and a foul odor.  Which of the following should you suspect?

    A. MRSA
    B. Compartment syndrome
    C. Tetanus
    D. Gangrene
    D. Gangrene
    (this multiple choice question has been scrambled)
  44. The three primary factors that determine the severity of radiation are:

    A. Duration, distance, and shielding
    B. Duration, shielding, and dose
    C. Dose, symptoms, and shielding
    D. Distance, shielding, and symptoms
    A. Duration, distance, and shielding
    (this multiple choice question has been scrambled)
  45. Which of the following has contributed most significantly to the decline in US burn mortality?

    A. Improved building codes and construction and sprinkler and smoke detector use
    B. Paramedic involvement in publid education
    C. Public service announcements on radio, television, and billboards
    D. Visits to elementary schools by firefighters
    A. Improved building codes and construction and sprinkler and smoke detector use
    (this multiple choice question has been scrambled)
  46. Which classification of burn is characterized mainly by blisters?

    A. Full-thickness
    B. Partial-thickness
    C. Superficial
    D. Minor
    B. Partial-thickness
    (this multiple choice question has been scrambled)
  47. An area of burned tissue that is not painful is most likely a _____ burn injury.

    A. Partial-thickness
    B. Full-thickness
    C. Superficial
    D. Second-degree
    B. Full-thickness
    (this multiple choice question has been scrambled)
  48. Which tissue layer(s) is (are) affected by partial thickness burns?

    1-Epidermis
    2-Dermis
    3-Subcutaneous
    4-Muscle

    A. 1, 2, 3, & 4
    B. 1
    C. 1, 2, & 3
    D. 1 & 2
    D. 1 & 2
    (this multiple choice question has been scrambled)
  49. Contact with strong alkalis results in burns involving _____ necrosis of the tissue.

    A. Coagulation
    B. Liquefacation
    C. Ischemis
    D. Thermal
    B. Liquefacation
    (this multiple choice question has been scrambled)
  50. Your Pt has circumferential full-thickness burns of the thorax.  He is intubated, and you have noticed an increase in resistance as you bag him.  His skin is very tight and inflexible as you try to ventilate.  Which of the following is required to improve this Pt's ventilatory status?

    A. Escharotomy
    B. IV sedation
    C. Needle thoracostomy
    D. Fasciotomy
    A. Escharotomy
    (this multiple choice question has been scrambled)
  51. Which of the following patient factors increases the criticality of the patient's burn injuries?

    A. Male gender
    B. Prior history of burns
    C. Being in the geriatric age group
    D. Taking antidepressants
    C. Being in the geriatric age group
    (this multiple choice question has been scrambled)
  52. You are dispatched to a structure fire at which there is a report of a burned person.  Your patient is a 32 yo male with blisters on his anterior chest and circumferential superficial burns to both lower extremities.  Using the "Rule of Nines", what percentage of burn does this patient have?

    A. 54
    B. 45
    C. 36
    D. 27
    B. 45
    (this multiple choice question has been scrambled)
  53. Which of the following afents is the best choice for analgesia in a patient with 9 percent partial-thickness burns involving the right lower exremity?

    A. Fentanyl
    B. Acetaminophen
    C. Naproxen Sodium
    D. Ketorolac
    A. Fentanyl
    (this multiple choice question has been scrambled)
  54. According the Jackson's Theory of Thermal Wounds, which of the following zones has suffered the greatest damage?

    A. Disintegration
    B. Hyperemia
    C. Stasis
    D. Coagulation
    D. Coagulation
    (this multiple choice question has been scrambled)
  55. Which type of radiation particle can travel through 6 to 10 feet of air, penetrate a few layers of clothing, and cause external and internal injuries?

    A. Beta
    B. Gamma
    C. Neutron
    D. Alpha
    A. Beta
    (this multiple choice question has been scrambled)
  56. Which of the following accounts for the most severe thermal burns of the airway?

    A. Inhalation of superheated steam
    B. Inhalation of superheated air
    C. Inhalation of radioactive particles in smoke
    D. Inhalation of toxic fases
    A. Inhalation of superheated steam
    (this multiple choice question has been scrambled)
  57. The first step for treating a patient who has been contaminated with dry lime is to:

    A. Flush the skin with large amounts of isopropyl alcohol
    B. Flush with copious amounts of tepid water
    C. Brush away as much of the powder as possible
    D. Neutralize the lime with a mild acidic solution, such as vinegar and water
    C. Brush away as much of the powder as possible
    (this multiple choice question has been scrambled)
  58. During which phase of a burn injury does extravasation of proteins, water, and electrolytes occur, resulting in edema and potential hypovolemia?

    A. Hyperemia
    B. Fluid shift
    C. Hypermetabolic
    D. Emergent
    B. Fluid shift
    (this multiple choice question has been scrambled)
  59. Patients who survive the first several days of a moderate to critical burn are most likely to die from which of the following complications?

    A. Infection
    B. Organ failure
    C. Hypovolemia
    D. Hypothermia
    A. Infection
    (this multiple choice question has been scrambled)
  60. You are assessing a 17 yo male patient with a burn on the lateral aspect of his thigh.  Which of the following guidelines is most helpful when estimating the percentage of total body surface area involved?

    A. The Rule of Palms
    B. The Parkland formula
    C. The modified pediatric Rule of Nines
    D. The Rule of Nines
    A. The Rule of Palms
    (this multiple choice question has been scrambled)
  61. Which of the following body structures is the best electricity conductor?

    A. Skin
    B. Bones
    C. Muscle
    D. Nerves
    D. Nerves
    (this multiple choice question has been scrambled)
  62. Your Pt is a football player who had his right foot planted and was tackled from the left rear, causing his body to rotate around the axis of his right lower extremity.  This MOI is most consistent with which of the following types of fractures?

    A. Spiral
    B. Oblique
    C. Impacted
    D. Comminuted
    A. Spiral
    (this multiple choice question has been scrambled)
  63. you Pt is a 20 yof complaining of ankle pain after stepping off a curb.  She states that she is concerned  because she had a grade III sprain a year and a half ao that required extensive treatment & rehabilitation.  Which of the following most accurately describes the patient's previous injury?

    A. The ankle ligaments were completely torn
    B. The ankle ligaments were stretched but not torn
    C. The ankle ligaments had a minor tear
    D. The ankle ligaments were torn but not all the way
    A. The ankle ligaments were completely torn
    (this multiple choice question has been scrambled)
  64. Tendons connect _____ to _____.

    A. Muscles, bones
    B. Muscles, fascia
    C. Cartilage, bones
    D. Bones, bones
    A. Muscles, bones
    (this multiple choice question has been scrambled)
  65. The use of PASG is indicated in the treatment of which of the following musculoskeletal injuries?

    A. Bilateral tibia/fibula fractures
    B. Pelvic fracture
    C. Knee dislocation
    D. Lumbar vertebral compression fracture
    B. Pelvic fracture
    (this multiple choice question has been scrambled)
  66. A partial displacement of a bone end fom its position in the joint is called a:

    A. Dislocation
    B. Subluxation
    C. Sprain
    D. Contracture
    B. Subluxation
    (this multiple choice question has been scrambled)
  67. A fracture in which significant energy exchange shatters or splinters bone, creating  many fragments, is called a(n) _____ fracture.

    A. Comminuted
    B. Oblique
    C. Spiral
    D. Impacted
    A. Comminuted
    (this multiple choice question has been scrambled)
  68. The morbidity associated with simple pneumothorax is primarily due to which of the following?

    A. Loss of chest wall integrity
    B. Occlusion of pulmonary circulation
    C. Increased intrathoracic pressure
    D. Ventilation/perfusion mismatch
    D. Ventilation/perfusion mismatch
    (this multiple choice question has been scrambled)
  69. The trachea divides into the right and left mainstem bronchi at the:

    A. Carina
    B. Hilum
    C. Thoracic inlet
    D. Lingual
    A. Carina
    (this multiple choice question has been scrambled)
  70. You Pt is a 38 yo male who was pinned beneath the frame of a vehicle when it slipped off the makeshift jacks he was using to elevate it.  The Pt's brother thinks he may have been trapped for up to 20 minutes.  The rescue unit is preparing to use airbags to lift the vehicle off the patient.  Which of the following medications could you consider  giving this patient?

    A. Potassium chloride
    B. Magnesium sulfate
    C. Calcium chloride
    D. Sodium bicarbonate
    D. Sodium bicarbonate
    (this multiple choice question has been scrambled)
  71. An individual is struck in the left ventricle with a high-velocity projectile.  As compare to low-velocity penetrating trauma, you should have a higher index of suspicion for:

    A. Blunt cardiac injury
    B. Simple pneumothorax
    C. Ventricular rupture
    D. Pericardial tamponade
    D. Pericardial tamponade
    (this multiple choice question has been scrambled)
  72. Your Pt is an 80 yo male who was the unrestrained driver of a vhicle without airbas that was involved in a frontal collision with a parked car.  Your assessment reveals that he is hydpneic, tachypneic, and tachycardic.  He is awake but unable to respond to questions.  There are no obvious signs of injury to the head or neck.  The Pt has paradoxiacal movement of the sternum with breathing, along with crepitus and subcutaneous air noted on palpation.  Chest excursion is limited, and the patient has cyanosis of his lips, ears, and nail beds.  Which of the following is MOST needed in this patient?

    A. Intubation and positive-pressure ventilation
    B. Application of bulky dressings over the site of paradoxical motion
    C. Being placed in a prone position to stabilize the chest wall
    D. Infusion of isotonic crystalloid solution using a large-bore IV
    A. Intubation and positive-pressure ventilation
    (this multiple choice question has been scrambled)
  73. Traumatic asphyxia is a(n) _____ type of injury.

    A. Deceleration
    B. Acceleration
    C. Compression
    D. Decompression
    C. Compression
    (this multiple choice question has been scrambled)
  74. Which of the following are the two most important prehospital considerations for head injury patients?

    A. Cervical spine immobilization and ventilation
    B. ICP monitoring and administering coricosteroids
    C. Ventilation and administering corticosteroids
    D. Ventilation and maintaining adequate blood pressure
    D. Ventilation and maintaining adequate blood pressure
    (this multiple choice question has been scrambled)
  75. The cerebral perfusion pressure is represented by which of the following equations?

    A. CPP = CVP - ICP
    B. CPP = ICP - MAP
    C. CPP = MAP - ICP
    D. CPP = MAP - CVP
    C. CPP = MAP - ICP
    (this multiple choice question has been scrambled)

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