Question: When caring for a trauma patient, a principle is what is necessary for patient improvement or survival. A preference is how the principle is achieved and depends upon four factors. Thefactors used to establish the preference in treating the patient include all except:a) Condition of the patientb) Equipment availablec) Situation that existsd) Research information

Answer: Research information

Question: Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age?a) 10 to 12 years of ageb) 5 to 6 years of agec) 1 to 2 years of aged) Less than 1 year of age

Answer: 1 to 2 years of age

Question: In addition to glucose, what is required to maintain the metabolic processes of life and energy production?a) Carbon monoxideb) Krebs cellsc) Lymphocytesd) Oxygen

Answer: Oxygen

Question: You respond to a patient who has sustained a stab wound to the left upper thorax. She is barely responsive, pale and diaphoretic. Which of the following is the most appropriate for transport?a) Stair chairb) Long board with spinal motion restrictionc) Scoop stretcherd) Short immobilization device

Answer: Scoop stretcher

Question: Units responding to a motor vehicle accident on the highway should consider which of the following as part of their pre-arrival assessment?a) Calling for more units to respondb) Weather conditionsc) The need for immediate transportd) Post-exposure prophylaxis

Answer: Weather conditions

Question: The most appropriate airway maneuver in the initial management of a trauma patient is which of the following?a) Head tilt, chin liftb) Supraglottic airwayc) Trauma jaw thrustd) Oropharyngeal airway

Answer: Trauma jaw thrust

Question: When verifying ET tube placement on a perfusing patient, the "gold standard" of monitoring is considered to be?a) Colorimetric carbon dioxide detectorb) Pulse oximetryc) Listening to lung soundsd) Waveform capnography

Answer: Waveform capnography

Question: A patient presents with a blunt trauma injury to the chest. On exam, he has absent breath sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumothorax?a) Distended neck veinsb) Inspiratory wheezingc) narrowed pulse pressured) Tracheal deviation towards the side of injury

Answer: Distended neck veins

Question: Hemostatic agents should be used for excessive bleeding when direct pressure alone does not work. The proper way to use most hemostatic agents is which of the following?a) Placing the agent around the edges of the woundb) Placing the agent properly into the wound and holding direct pressurec) Only using it after a tourniquet has been applied for 10 minutesd) Hemostatic agents should never be used unless you have a fall in blood pressure

Answer: Placing the agent properly into the wound and holding direct pressure

Question: Of the following, which is a preventable cause of secondary brain injury addressable during the transport phase?a) Intraparenchymal hemorrhageb) Systemic hypoxiac) Intracranial hematomasd) Herniation syndromes

Answer: Systemic hypoxia

Question: You are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does notrecall the incident, and is vomiting with a headache. Which of the following injuries is most likely?a) Brain herniationb) Intraabdominal hemorrhagec) Diffuse axonal injuryd) Concussion

Answer: Concussion

Question: When using a selective spinal immobilization protocol, which of the following findings indicate the need for immobilization?a) Past history of spinal injuryb) Being an unrestrained passenger in a motor vehicle crashc) Being ambulatory at the scened) An associated femoral shaft fracture with severe pain

Answer: An associated femoral shaft fracture with severe pain

Question: In a blast-related multiple patient situation, which of the following patients should be treated first?a) A 33-year-old female with altered level of consciousness and decreased capillary refillb) A 28-year-old male with an arm amputation who has bleeding controlled with a tourniquetc) A 14-year-old pulseless female with grey matter visible from a head woundd) a 78-year-old male awake and unable to hear

Answer: A 33-year-old female with altered level of consciousness and decreased capillary refill

Question: Excessive fluid resuscitation of the trauma patient can result in which of the following?a) Worsening coagulopathyb) Decreased mortalityc) Earlier discharge from the hospitald) A higher incidence of sepsis in the ICU

Answer: Worsening coagulopathy

Question: The secondary survey should be accomplished:a) Never on a critical patientb) Before transportc) When time and situation allowd) Before moving the patient

Answer: When time and situation allow

Question: When approaching a trauma patient, what is the first assessment that must be made?a) Exsanguinating hemorrhageb) Scene safetyc) Airwayd) Breathing

Answer: Scene safety

Question: The most common type of shock resulting from trauma is?a) Neurogenicb) Septicc) Spinald) Hemorrhagic

Answer: Hemorrhagic

Question: Which of the following best guides the decision to provide spinal immobilization?a) History and complaintb) Obvious signs of associated injuryc) Patient's age and presence of pressure soresd) Mechanism alone

Answer: History and complaint

Question: A 38-year-old male sustains a large wound to his right thigh while at work. Which of the following actions is the most important initial step?a) Obtain IV access and infuse crystalloidb) Administer supplemental oxygenc) Hemorrhage controld) Rapid transport

Answer: Hemorrhage control

Question: You respond to a local bar for an unconscious person. On arrival, you are met by a police officer who reports that one of their "regular alcoholics" was found in the alley behind the bar.On exam, you note the smell of an alcoholic beverage as well as the following: Patient flexes his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12breaths per minute and a BP of 210/100. What condition do you suspect?a) Subarachnoid hemorrhageb) Alcohol poisoningc) Ruptured abdominal aortic aneurysmd) Subdural hematoma

Answer: Subdural hematoma

Question: The pre-hospital assessment of the trauma patient begins with which of the following?a) Assessment of scene safety and situationb) Information provided by the dispatcherc) The initial assessmentd) The primary survey

Answer: Information provided by the dispatcher

Question: EMS responds for a patient involved in a motorcycle vs. motor vehicle collision. The patient is poorly responsive with no movement of lower extremities and loss of temperature sensation (hot vs cold) below the T10. Which of the following types of shock is the patient most likely experiencing?a) Cardiogenicb) Hypovolemicc) Neurogenicd) Obstructive

Answer: Neurogenic

Question: Which of the following is the best indicator of shock in a trauma patient?a) Depressed level of cognitionb) Heart rate of 80c) Respirations of 18d) GCS of 15

Answer: Depressed level of cognition

Question: Which best describes the goal of airway management in a trauma patient?a) Perform complex airway maneuversb) Perform a surgical cricothyrotomyc) Provide for adequate exchange of oxygen and CO2d) Perform RSI

Answer: Provide for adequate exchange of oxygen and CO2

Question: What is the most common cause of airway obstruction in the unresponsive trauma patient?a) Bloodb) Teethc) Tongued) Vomitus

Answer: Tongue

Question: While caring for a patient who was involved in an altercation, the patient vomits, causing his airway to become totally obstructed with vomitus and blood. What is the most important action?a) Performing an RSIb) Performing a head-tilt chin liftc) Intubatingd) Suctioning the airway

Answer: Suctioning the airway

Question: When energy produced by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions?a) Aerobic metabolismb) Anaerobic metabolismc) Lactic acidosisd) Ketosis

Answer: Aerobic metabolism

Question: Which of the following information is assessed during the secondary survey?a) Skin temperatureb) Hemorrhagec) Breathingd) Vital signs

Answer: Vital signs

Question: Hyperventilation of a patient with suspected traumatic brain injury should occur when?a) At time of injuryb) When signs of impending brain herniation are presentc) During a concussiond) Whenever the patient complains of headache

Answer: When signs of impending brain herniation are present

Question: Patients with suspected traumatic brain injuries (TBI) are susceptible to secondary injuries which are typically preventable. In addition to hypoxia and hypotension which of the following can also decrease cerebral perfusion?a) Hypothermiab) Cerebral vasodilationc) Increased cardiac outputd) Inadvertent or excess hyperventilation

Answer: Inadvertent or excess hyperventilation

Question: Hypotension due to a spinal cord injury is a result of what physiological mechanism?a) Loss of sympathetic tone causing vasodilationb) Increased capillary permeabilityc) Increased sympathetic tone causing vasoconstrictiond) Increased intrathoracic pressure

Answer: Loss of sympathetic tone causing vasodilation

Question: Which of the following patients will compensate for blood loss the longest?a) 24-year-old maleb) 82-year-old femalec) 45-year-old femaled) 6-year-old male

Answer: 6-year-old male

Question: You respond to a reported assault at a local bar. On arrival, you find a 46-year-old male in the bathroom floor with snoring respirations at 4 times per minute and obvious facial injuries. Pupils reveal the R pupil is 4mm and the L pupil is 7mm and non-reactive. What is the most appropriate first step?a) Jaw thrust maneuverb) Pharmacologically assisted intubationc) Perform nasotracheal intubationd) Perform a surgical cricothyrotomy

Answer: Jaw thrust maneuver

Question: In a multi-system trauma patient what is considered the best method for confirming proper placement of an endotracheal tube?a) Auscultation of the left upper abdominal quadrantb) Waveform capnographyc) Presence of bilateral breath soundsd) Pulse oximetry

Answer: Waveform capnography

Question: What is the most likely source of bleeding in a patient with signs of shock and no obvious injury?a) Femur fractureb) Intra-abdominal injuryc) Severe traumatic brain injuryd) Pelvic fracture

Answer: Intra-abdominal injury

Question: Hypoperfusion will affect which of the following organs first?a) Kidneyb) GI tractc) Braind) Liver

Answer: Brain

Question: A 23-year-old male construction worker fell approximately 30 feet from a roof. The patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his L pupil is 3mm. He hasirregular respirations at 8 breaths per min. You do not have waveform capnography, so what is the most appropriate rate of ventilations?a) 30 BPMb) 25 BPMc) 20 BPMd) 12 BPM

Answer: 20 BPM

Question: A 30-year-old male is thrown from his horse, landing on the top rail of a pipe fence and now has a loss of sensation from the nipples down. What level of the spine do you suspect he injured?a) C3b) T4c) T10d) T12

Answer: T4

Question: In a patient with a suspected traumatic brain injury, what is the most concerning physical finding?a) BP 140/90b) Heart rate of 58c) Respiratory rate of 30d) Altered level of consciousness

Answer: Altered level of consciousness

Question: You have a patient who is 35 weeks pregnant who was assaulted by her boyfriend. Patient is having severe abdominal pain described as "tearing" and on exam you note her abdomen isasymmetrical and believe you can feel the fetus through the abdominal wall. What condition do you suspect?a) Placenta previab) Abruptio placentac) Ruptured uterusd) Abdominal aortic aneurysm

Answer: Ruptured uterus

Question: EMS responds to an adult barista with partial-thickness burns to the abdomen and right leg, sustained from a cooking accident. Initial treatment of this injury would include:a) Apply antibiotic ointmentb) Run copious amounts of room temperature water over the burnc) Cover burned area with dry sterile dressingsd) Cover burned area with moist sterile dressings

Answer: Cover burned area with dry sterile dressings

Question: Prehospital providers have treated a sucking chest wound with an occlusive dressing. During transport to the hospital, the patient develops increasing respiratory distress with increasedrespirations and absent lung sounds are noted on repeat auscultation. What is the most appropriate next intervention?a) Release and reapply the occlusive dressingb) Perform needle decompressionc) Provide positive-pressure ventilationd) Perform endotracheal intubation

Answer: Release and reapply the occlusive dressing

Question: EMS arrives on a scene and finds that emergency medical responders have attempted to immobilize a pediatric patient onto a long backboard. They note that the patient's head is in aflexed position. Which of the following actions is the most appropriate?a) Adjust the cervical collarb) Logroll patient into a left lateral recumbent positionc) Place padding under the patient's head and neckd) Place padding under the patient's torso

Answer: Place padding under the patient's torso

Question: Falls are the most common cause of death in trauma patients over _____ years of agea) 65b) 75c) 55d) 69

Answer: 75

Question: __________ is the earliest sign of deterioration in a patient with a flail chest.a) Respiratory rate increaseb) Oxygen saturation decreasec) Pulse rate increased) Blood pressure decrease

Answer: Respiratory rate increase

Question: EMS is treating a 24-year-old soccer player who was kicked in the chest. Prehospital providers note paradoxical movement of a portion of the patient's chest wall. The patient's respiratory rateis 16 and oxygen saturation is 94%. What is the most appropriate action?a) Endotracheal intubationb) Provide supplemental oxygen and transport to a trauma centerc) Place bulky dressing over the wound and tightly wrap the chestd) Stabilize the segment with sandbags on the chest

Answer: Provide supplemental oxygen and transport to a trauma center

Question: Prehospital providers respond to a 17-year-old male who fell through a sliding glass door and sustained a large laceration to his arm that is bleeding heavily. He is restless and diaphoretic,with a weak, thready pulse. What is the most appropriate first action?a) Apply a tourniquetb) Pack the wound with a hemostatic dressingc) Initiate intravenous accessd) Apply direct pressure

Answer: Apply direct pressure

Question: When managing a pediatric patient, pre-hospital providers should do all of the following EXCEPT:a) Use appropriately sized equipmentb) Frequently reassess the patientc) Preserve body heatd) Use half the adult dose or medication administration

Answer: Use half the adult dose or medication administration

Question: Which of the following is a Golden Principle of trauma care?a) Ensure adequate airway and ventilationb) Complete a thorough head-to-toe survey before initiating treatmentc) Rescuer safety is secondary to caring for the patientd) Use chilled intravenous fluids to promote hypothermia

Answer: Ensure adequate airway and ventilation

Question: A 30-year-old male is injured in a terror bombing. He experiences traumatic amputation of his left leg at knee level. An improvised tourniquet was put in place by bystanders. The victim is conscious and in severe pain. Your first action should be to do which of the following?a) Provide IV analgesiab) Put on pressure dressingc) Confirm the tourniquet was properly appliedd) Check the airway

Answer: Confirm the tourniquet was properly applied