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. If a person survives the initial trauma from a shotgun wound at close range:
A) nervous system damage is likely due to the internal dispersal of the pellets.
B) contaminants that were driven into the wound can cause a severe infection.
C) he or she typically dies within 24 hours secondary to liver or renal failure.
D) it is likely that only soft tissue was injured and major organs were spared.
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Terms in this set (250)
. If a person survives the initial trauma from a shotgun wound at close range:
A) nervous system damage is likely due to the internal dispersal of the pellets.
B) contaminants that were driven into the wound can cause a severe infection.
C) he or she typically dies within 24 hours secondary to liver or renal failure.
D) it is likely that only soft tissue was injured and major organs were spared.
B) contaminants that were driven into the wound can cause a severe infection.
. Compared to a handgun, a rifle:
A) is less accurate.
B) fires a single projectile.
C) fires at a higher velocity.
D) has less powerful ammunition.
C) fires at a higher velocity.
Which of the following general statements regarding gunshot wounds is correct?
A) The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes.
B) Injuries from a shotgun blast are most devastating when the distance between the gun and the target is less than 100 yards.
C) Wounds to lower extremities that are not associated with a fracture or neurovascular compromise are always explored surgically.
D) Tissue of high elasticity, such as muscle, is less able to tolerate temporary cavitation than tissue of low elasticity, such as the liver.
A) The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes.
Which of the following characteristics of an entry wound indicates that the weapon was fired at close range?
A) Abrasions around the wound
B) Indentation of cutaneous tissues
C) Severe bleeding from the wound
D) Tattoo marks from powder burns
D) Tattoo marks from powder burns
Which of the following statements regarding exit wounds is correct?
A) Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.
B) Compared to entrance wounds, exit wounds are generally much smaller and typically have regular edges.
C) Despite fragmentation of the projectile, there is usually only one exit wound for each round that is fired.
D) With low-velocity gunshot wounds, the exit wound is always a mirror image of the entrance wound.
A) Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.
. A robbery suspect was shot once in the left anterior chest by law enforcement personnel when he pulled a gun on them. The patient is exhibiting obvious signs of shock, is in significant respiratory distress, and is coughing up blood. Further assessment reveals collapsed jugular veins and absent breath sounds over the left hemithorax. After covering the gunshot wound with the appropriate dressing, you should:
A) perform a needle thoracentesis to the left side of the chest, initiate rapid transport, and administer 20-mL/kg fluid boluses en route.
B) administer 100% oxygen, administer 1 to 2 L of normal saline, and transport to a trauma center for an emergency pericardiocentesis.
C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.
D) ventilate the patient with a demand valve, transport to a trauma center, and run two large-bore IV lines wide open while en route to the hospital.
C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.
C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.
You arrive at the scene of a shooting. The patient, a 19-year-old man, has a gunshot wound to the side of his head with a large amount of exposed brain matter. Further assessment reveals that the patient is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should:
A) begin resuscitative measures at once and contact the patient's family to determine if he is an organ donor.
B) begin CPR immediately, cover the wound with a bulky dressing, and prepare to transport the patient.
C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.
D) place plastic bags over the patient's hands, apply a cardiac monitor to confirm asystole, and notify the coroner's office.
C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.
. Afterload is defined as the:
A) volume of blood returned to the left and right atrium.
B) amount of blood pumped from the heart per contraction.
C) degree of pressure against which the left ventricle pumps.
D) volume of blood pumped ejected from the heart per minute.
C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.
Afterload is defined as the:
A) volume of blood returned to the left and right atrium.
B) amount of blood pumped from the heart per contraction.
C) degree of pressure against which the left ventricle pumps.
D) volume of blood pumped ejected from the heart per minute.
C) degree of pressure against which the left ventricle pumps.
What physiologic response occurs when a person loses blood?
A) Vessels constrict and myocardial contractility increases.
B) The heart rate increases and cardiac afterload decreases.
C) The sympathetic nervous system decreases SA node discharge.
D) Blood vessels dilate in order to increase arterial blood pressure.
A) Vessels constrict and myocardial contractility increases.
What happens when systemic vasoconstriction occurs? A) Preload decreases. B) Afterload increases. C) Afterload and preload increase. D)Afterload and preload decrease.B) Afterload increases.Atrial kick is defined as: A) the blood that flows passively into the ventricles. B) pressure on the AV valves during ventricular contraction. C) an attempt of the atria to contract against closed valves. D) increased preload pressure as a result of atrial contraction.D) increased preload pressure as a result of atrial contraction.An increase in peripheral vascular resistance causes: A) an increase in afterload. B) a decrease in blood pressure. C) an increase in cardiac output. D) a decrease in cardiac workload.A) an increase in afterload.. Jugular venous distention in a patient sitting at a 45ยฐ angle: A) is not clinically significant. B) is a sign of reduced preload. C) suggests left-sided heart failure. D) indicates right-sided heart compromise.D) indicates right-sided heart compromise.. What is the mechanism of action of nitroglycerin? A) Vascular constriction; increased preload; decreased afterload B) Smooth muscle relaxation; decreased preload and afterload C) Vascular dilation; increased preload and afterload D) Smooth muscle relaxation; decreased preload; increased afterloadD) Smooth muscle relaxation; decreased preload; increased afterloadHypotension may occur following initiation of a dobutamine infusion because it: A) is a direct vasodilator. B) blocks alpha-1 receptors. C) reduces cardiac afterload. D) has negative inotropic effects.C) reduces cardiac afterload.. The physiologic effects of nitroglycerin when given to patients with cardiac-related chest pain include: A) increased myocardial oxygen consumption. B) decreased preload and coronary vasodilation. C) coronary vasoconstriction and increased preload. D) increased afterload and peripheral vasodilation.B) decreased preload and coronary vasodilation.Which of the following mechanisms causes hypertension? A) Arteriosclerosis results in increased elasticity of the arteries, causing vasodilation and increased arteriolar capacity. B) Atherosclerotic plaque narrows one or more of the coronary arteries, resulting in increased cardiac perfusion. C) Increased afterload stimulates the Frank-Starling reflex, which raises the pressure behind the blood leaving the heart. D) Heart rate that is persistently above 80 beats/min causes an increase in cardiac output and a resultant increase in blood pressure.C) Increased afterload stimulates the Frank-Starling reflex, which raises the pressure behind the blood leaving the heart.A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by: A) myocardial stretching due to increased preload. B) decreases in stroke volume and ventricular filling. C) increased automaticity of the cardiac pacemaker. D) ectopic pacemaker sites in the atria or ventricles.B) decreases in stroke volume and ventricular filling.You are assessing the 12-lead tracing of a 40-year-old man with chest pain and note ST-segment elevation in leads II, III, and aVF. Lead V4R shows 2-mm ST-segment elevation. The patient's blood pressure is 88/58, and his heart rate is 72 beats/min and regular. He denies any significant past medical history but is allergic to salicylates. After placing the patient on oxygen and starting an IV line of normal saline, you should: A) administer up to 325 mg of baby aspirin. B) give 2-mg increments of morphine sulfate. C) start a dopamine infusion at 2 ยตg/kg/min. D) give crystalloid boluses to increase preload.D) give crystalloid boluses to increase preload.Afterload is defined as the: A) pressure in the aorta against which the left ventricle must pump. B) amount of resistance to blood flow offered by the heart valves. C) amount of blood ejected from the ventricle with each contraction. D) volume of blood remaining in the ventricles following contraction.A) pressure in the aorta against which the left ventricle must pump.Which of the following two factors DIRECTLY affect cardiac output? A) Preload and afterload B) Vessel size and stroke volume C) Stroke volume and pulse rate D) Blood pressure and pulse rateC) Stroke volume and pulse rateThe heart hypertrophies with age, MOST likely in response to: A) a progressive increase in preload and chronic myocardial stretching. B) left-sided heart failure that results in chronic pulmonary hypertension. C) a chronically increased afterload caused by arteriosclerotic blood vessels. D) a significant decline in cardiac output due to a reduction in stroke volume.C) a chronically increased afterload caused by arteriosclerotic blood vessels.The amount of blood returned to the heart is called: A) preload. B) cardiac output. C) afterload. D) stroke volume.A) preload.The force or resistance against which the heart pumps is called: A) preload. B) blood pressure. C) afterload. D) systemic vascular resistance.C) afterload.Systemic effects of epinephrine include: A) bronchoconstriction. B) decreased preload. C) increased afterload. D) diffuse vasodilation.C) increased afterload.Afterload is increased following alpha-1 stimulation because of: A) decreased preload. B) arteriolar constriction. C) increased contractility. D) widespread vasodilation.B) arteriolar constriction.According to the Frank-Starling mechanism: A) systemic venous pooling of blood results in a decrease in preload. B) an increase in systolic blood pressure causes a reflex bradycardia. C) coronary artery perfusion is directly proportional to cardiac output. D) the length of myocardial fibers determines force of cardiac contraction.D) the length of myocardial fibers determines force of cardiac contraction.If a woman who is 35 weeks pregnant is placed in a supine position: A) a paradoxical bradycardia will occur. B) atrial preload may be reduced markedly. C) aortic compression will cause hypotension. D) uterine circulation will increase exponentially.B) atrial preload may be reduced markedly.The body's ability to spontaneously cease bleeding is called: A) fibrinolysis. B) hemostasis. C) homeostasis. D) thrombolysis.B) hemostasis.. What occurs during the initial phase of hemostasis? A) Thrombin converts fibrinogen to fibrin. B) Fibrin binds to a platelet plug and forms a clot. C) Thromboplastin activates clotting proteins. D) Local vasoconstriction and platelet activation occur.D) Local vasoconstriction and platelet activation occur.Administering large amounts of an isotonic crystalloid solution to a patient with internal bleeding would MOST likely: A) expand the vascular space and improve systemic perfusion. B) cause acute hypotension as fluid is drawn from the vascular space. C) change the ratio of hemoglobin and red blood cells. D) increase the severity of internal bleeding by interfering with hemostasis.D) increase the severity of internal bleeding by interfering with hemostasis.A patient with thrombocytopenia: A) is severely anemic. B) has blood that clots rapidly. C) has a decreased platelet count. D) is at high risk for a pulmonary embolism.C) has a decreased platelet count.Production of clotting factors is a function of the: A) kidney. B) liver. C) spleen. D) bone marrow.B) liver.During the second stage of disseminated intravascular coagulopathy: A) decreased clotting factors cause uncontrolled hemorrhage. B) free thrombin and fibrin deposits increase in the bloodstream. C) the coagulation and fibrinolytic systems become overwhelmed. D) large quantities of platelets aggregate and cause the blood to clot.A) decreased clotting factors cause uncontrolled hemorrhage.Which of the following factors would have the MOST negative effect on the body's process of hemostasis? A) Bradycardia B) Hyperthermia C) Chronic heroin use D) Anticoagulant useD) Anticoagulant useAgents such as Celox, HemCon, and QuikClot are used to: A) repair damaged vessels. B) replace lost blood. C) raise blood pressure. D) promote hemostasis.D) promote hemostasis.The physiologic process of hemostasis is achieved through: A) an increased production of red blood cells. B) the destruction of fibrin and platelets. C) the use of anticoagulants such as Coumadin. D) vasoconstriction and platelet aggregation.D) vasoconstriction and platelet aggregation.What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation? A) Fibrin B) Calcium C) Plasmin D) PlateletsD) PlateletsVenous bleeding: A) is dark red in color and usually oozes from the wound. B) is bright red in color and typically spurts from a wound. C) is more likely to clot spontaneously than arterial bleeding. D) is generally more difficult to control than arterial bleeding.C) is more likely to clot spontaneously than arterial bleeding.. Much of the bleeding associated with unsplinted fractures continues because: A) most fractures are unstable and usually lacerate major blood vessels. B) swelling associated with such fractures prevents platelet aggregation. C) bone ends will continue to move and destroy partially formed clots. D) patient anxiety increases the blood pressure, which exacerbates bleeding.C) bone ends will continue to move and destroy partially formed clots.During the process of wound healing, hemostasis: A) permanently stops the wound from bleeding and facilitates healing. B) is a physiologic process in which the body's platelets are destroyed. C) occurs when the bone marrow transiently produces more red blood cells. D) temporarily stops bleeding via vasoconstriction and platelet aggregation.D) temporarily stops bleeding via vasoconstriction and platelet aggregation.Which of the following medications would MOST likely interfere with hemostasis? A) Paxil B) Procrit C) Plavix D) TylenolC) PlavixWhat is the mechanism of action of anticoagulant medications? A) They dissolve existing clots, thereby restoring distal blood flow. B) They prevent new clot formation and the growth of existing clots. C) They inhibit platelet aggregation during acute coronary syndrome. D) They promote hemostasis in patients with pulmonary emboli.B) They prevent new clot formation and the growth of existing clots.After controlling the bleeding from a grossly contaminated open wound to the leg, you should next: A) irrigate with sterile water and apply a sterile dressing. B) apply a pressure bandage and elevate the extremity. C) elevate the extremity and administer 100% oxygen. D) gently pick out any foreign bodies with hemostats.A) irrigate with sterile water and apply a sterile dressing.Applying direct pressure to a bleeding wound stops the flow of blood because: A) pressure stimulates the release of fibrin. B) direct pressure facilitates vasoconstriction. C) it allows platelets to seal the vascular walls. D) pressure shunts blood away from the injury.C) it allows platelets to seal the vascular walls.You should splint an open soft-tissue injury to an extremity because: A) most patients do not keep the extremity still when asked to do so. B) most open soft-tissue injuries are associated with a fracture. C) splinting is an excellent means of providing relief from pain. D) motion of the extremity may disrupt the blood-clotting process.D) motion of the extremity may disrupt the blood-clotting process.What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation? A) Fibrin B) Calcium C) Plasmin D) PlateletsD) PlateletsWhich of the following substances or elements reinforces red blood cells, creating the final step in the formation of a blood clot? A) Fibrin B) Plasminogen C) Fibrinogen D) PlateletsC) Fibrinogen. Disseminated intravascular coagulation is defined as a(n): A) decrease in white blood cell count, which results in decreased resistance to infection. B) pathophysiologic reaction that occurs when cellular ischemia leads to anaerobic metabolism. C) abnormal process in which disease or injury causes hemostasis due to platelet aggregation. D) pathological condition in which the proteins that normally control blood clotting become active.D) pathological condition in which the proteins that normally control blood clotting become active.What effect would the restoration of normotension have on a patient with internal bleeding and a blood pressure of 70/54 mm Hg? A) Increased hemostasis and improved cerebral perfusion B) Acute pulmonary edema secondary to volume overload C) Facilitation of the clotting mechanisms that stop bleeding D) Formed clot dislodgement and worsened internal bleedingD) Formed clot dislodgement and worsened internal bleedingIn trauma patients with shock, hypothermia: A) decreases internal hemorrhage. B) enhances the shivering response. C) facilitates the process of hemostasis. D) interferes with the coagulation of blood.D) interferes with the coagulation of blood.When activated, fibrinogen is converted to: A) fibrin. B) plasmin. C) thrombin. D) thromboplastin.A) fibrin.81. Which of the following volume expanders has been shown to interfere with platelet function and cause clotting problems? A) Dextran B) Hespan C) Plasmanate D) Lactated Ringer'sA) DextranWhich of the following substances or elements reinforces red blood cells, creating the final step in the formation of a blood clot? A) Fibrin B) Plasminogen C) Fibrinogen D) PlateletsC) Fibrinogen. __________ is the protein that bonds to form the fibrous component of a blood clot. A) Kinin B) Plasmin C) Fibrin D) CollagenC) FibrinThe destruction of a blood clot is called: A) adhesion. B) fibrinolysis. C) chemotaxis. D) agglutination.B) fibrinolysis.Wounds that heal by primary intention: A) do not utilize fibrin or fibronectin. B) heal without the formation of a scab. C) are generally clean wounds with opposed margins. D) have a more pronounced and prolonged inflammatory phase.C) are generally clean wounds with opposed margins.With regard to the heart, ejection fraction is defined as the: A) volume of blood that enters the lungs. B) volume of blood ejected from both atria. C) percentage of blood ejected from the heart. D) percentage of blood returned to the heart.C) percentage of blood ejected from the heart.Which of the following statements regarding blood flow is correct? A) Ejection fraction is the percentage of blood that the heart pumps per contraction. B) If more blood returns to the heart, stroke volume decreases and cardiac output falls. C) As more blood is pumped with each contraction, the ejection fraction increases. D) The amount of blood that returns to the atrium remains fixed from minute to minute.A) Ejection fraction is the percentage of blood that the heart pumps per contraction.If the left ventricle contains 80 mL of blood before a contraction and ejects 60 mL during the contraction, the ejection fraction is: A) 60%. B) 65%. C) 70%. D) 75%.D) 75%.. If the left ventricle fills with 85 mL of blood and ejects 60 mL during a contraction, the ejection fraction is approximately ___%. A) 55 B) 60 C) 65 D) 70D) 70The LEAST significant complication associated with damage to the skin following a burn injury is: A) decreased melanin granules. B) disturbances in fluid balance. C) difficulty with thermoregulation. D) susceptibility to bacterial invasion.A) decreased melanin granules.The severity of a thermal burn correlates directly with: A) the body's ability to effectively dissipate significant heat energy and the patient's general state of health. B) the presence of any underlying medical problems, the duration of exposure, and the temperature of the heat source. C) the duration of exposure, the physical size of the patient, and the presence of concomitant traumatic injuries. D) the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure.D) the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure.Thermal burns are MOST commonly caused by exposure to: A) hot liquids. B) hot solid objects. C) an open flame. D) superheated steam.C) an open flame.Which of the following statements regarding scald burns is correct? A) Once hot liquids come in contact with clothing, heat is rapidly dissipated. B) Scald burns often cover large surface areas because liquids spread quickly. C) Scald burns caused by grease or oil are typically limited to the epidermis. D) Scald burns are less commonly seen in pediatric patients than adult patients.B) Scald burns often cover large surface areas because liquids spread quickly.What type of thermal burn is MOST commonly associated with inhalation injury? A) Steam burns B) Flame burns C) Scald burns D) Arc burnsA) Steam burnsFlash burns: A) are usually relatively minor compared with the potential for trauma from whatever caused the flash. B) are caused by prolonged exposure to intense heat, usually resulting in burns that extend deep into the dermis. C) are a common source of burn injury and are most often the result of hot liquids, such as radiator fluid. D) are generally confined to a very small area of the body, but cause extensive damage to the dermis.A) are usually relatively minor compared with the potential for trauma from whatever caused the flash.. The subcutaneous tissue is: A) the layer of tissue above the dermis that mainly produces sweat. B) a thin layer of tissue from which blood vessels exclusively originate. C) also called the superficial fascia and consists mainly of adipose tissue. D) the deep fascial layer that ensheathes muscle and other internal structures.C) also called the superficial fascia and consists mainly of adipose tissue.The progression of a chemical burn is MOSTLY dependent on: A) the length of time the corrosive chemical remains on the skin. B) the surface area of the body exposed to a corrosive chemical. C) whether the corrosive substance is a strong acid or alkali. D) the patient's general health and the thickness of his or her skin.A) the length of time the corrosive chemical remains on the skin.Chemicals such as Lewisite and phosgene oxime: A) are strong alkalis that cause liquefaction necrosis. B) damage the body by extracting water from the tissues. C) are most commonly found in drain and oven cleaners. D) are vesicant agents that produce cutaneous blisters rapidly.D) are vesicant agents that produce cutaneous blisters rapidly.. Which of the following chemicals causes a painless burn and can result in significant damage before it is identified? A) Phenol B) Sulfur mustard C) Sulfuric acid D) Potassium hydroxideA) PhenolThe appropriate treatment for MOST chemical burns is: A) application of a dry, sterile dressing. B) flushing with copious amounts of water. C) neutralization with an alkaline substance. D) application of a moist, sterile dressing.B) flushing with copious amounts of water.A burn caused by a sodium metal should be treated by: A) administering calcium chloride. B) covering the burn wound with oil. C) applying a moist, sterile dressing. D) irrigating the wound with water.B) covering the burn wound with oil.The outer zone of an entrance or exit wound caused by a contact electrical burn is: A) the red zone of coagulation necrosis. B) simply caused by local inflammation. C) a charred area of full-thickness burn. D) characterized by cold, gray, dry tissue.A) the red zone of coagulation necrosis.. Relative to the entrance wound caused by an electrical burn, the exit wound: A) is a predictor of internal injury. B) heals without surgical intervention. C) is often much smaller in diameter. D) can be quite extensive and deep.D) can be quite extensive and deep.Victims standing near an object that is struck by lightning: A) most commonly experience blast-type injuries. B) often have burns characterized by a feathering pattern. C) typically experience intractable ventricular fibrillation. D) experience full-thickness burns that require debridement.B) often have burns characterized by a feathering pattern.Which of the following statements regarding frostbite is correct? A) Frostbite is an ischemic injury that is classified as superficial or deep. B) Frostbite most commonly affects the trunk and lower extremities. C) Frostbite can only occur if the ambient temperature is below 40ยฐF. D) Increased blood flow to an extremity exacerbates deep frostbite.A) Frostbite is an ischemic injury that is classified as superficial or deep.The MOST common symptom of superficial frostbite is: A) localized edema. B) white, waxy skin. C) an altered sensation. D) cyanosis of the skin.C) an altered sensation.Treatment for a superficial frostbite injury includes: A) rewarming with radiant heat. B) elevating the frostbitten part. C) rewarming the area with hot water. D) gently rubbing the frostbitten area.B) elevating the frostbitten part.. Unlike chemical burns, radiation burns: A) generally extend into the dermal layer. B) may appear hours or days after exposure. C) are typically confined to the epidermis. D) are immediately apparent after exposure.B) may appear hours or days after exposure.When assessing a burn patient, it is MOST important to: A) accurately calculate the extent of body surface area burned. B) be alert for occult trauma that could affect patient outcome. C) apprise medical control of the situation as soon as possible. D) rapidly determine if the patient will require an escharotomy.B) be alert for occult trauma that could affect patient outcome.Upon initial contact with a severely burned patient, you must: A) assess airway and breathing adequacy. B) cover the patient to prevent hypothermia. C) ensure that the patient is not still burning. D) quickly establish the extent of the burns.C) ensure that the patient is not still burning.According to the rule of nines, an adult man with partial- and full-thickness burns to his head, face, and anterior chest has burns to ____% of his total body surface area. A) 18 B) 27 C) 36 D) 45A) 18Full-thickness circumferential burns to the chest: A) require the paramedic to incise the burn to decompress it. B) may cause significant restriction of respiratory excursion. C) are generally not significant unless the skin is unyielding. D) necessitate immediate intubation and ventilatory support.B) may cause significant restriction of respiratory excursion.. Immediate care for a burn patient involves: A) applying sterile burn sheets. B) establishing a patent airway. C) stopping the burning process. D) maintaining body temperature.C) stopping the burning process.The application of ice to partial-thickness burns: A) often negates the need to administer a narcotic. B) is not necessary because such burns are painless. C) offers excellent pain relief and minimizes swelling. D) can exacerbate tissue injury and should be avoided.D) can exacerbate tissue injury and should be avoided.. A patient with full-thickness burns surrounded by areas of superficial and partial-thickness burns should be treated with all of the following, EXCEPT: A) analgesia. B) high-flow oxygen. C) moist dressings. D) sterile burn pads.C) moist dressings.Which of the following burn injuries would MOST likely require transport to a burn specialty center? A) Superficial burns to more than 40% of the body B) Burns that involve the hands, feet, or genitalia C) Partial-thickness burns to more than 5% of the body D) Any burn that occurs in a child under 5 years of ageB) Burns that involve the hands, feet, or genitaliaA partial-thickness burn is considered to be critical if it: A) occurs in any patient over the age of 45 years. B) is located to the proximal aspect of an extremity. C) is rated as at least a 5 on a pain scale of 0 to 10. D) involves more than 30% of the body surface area.D) involves more than 30% of the body surface area.A full-thickness burn is considered to be critical if it: A) is located on any part of the thorax or abdomen. B) covers more than 5% of the total body surface area. C) was irrigated with water prior to the arrival of EMS. D) occurs in a patient with a significant medical illness.D) occurs in a patient with a significant medical illness.You are caring for a 41-year-old man who was trapped in his burning house before being rescued by fire fighters. He has full-thickness burns to his head and anterior trunk, and mixed partial- and full-thickness burns to both anterior upper extremities. What percentage of his total body surface area has been burned? A) 18% B) 27% C) 36% D) 45%C) 36%. You and your partner are transferring a severely burned patient from a community hospital to a burn specialty center. The patient, a 110-pound woman, has partial- and full-thickness burns that cover approximately 55% of her body. She has two large-bore IV lines in place, is intubated, and is on a cardiac monitor. According to the Parkland formula, how much normal saline should she receive in 30 minutes? A) 340 mL B) 355 mL C) 370 mL D) 395 mLA) 340 mLA 52-year-old man sustained superficial and partial-thickness burns to his left arm approximately 15 minutes ago when he opened the radiator cap on his car. He is conscious, alert, and in severe pain. His BP is 138/76 mm Hg, pulse is 110 beats/min and strong, respirations are 22 breaths/min and regular, and oxygen saturation is 99% on room air. He denies any other injuries. Initial management for this patient involves: A) applying ice to the burn to provide immediate pain relief. B) applying cool, wet dressings to the burn and elevating his arm. C) starting an IV of normal saline and administering 2 mg of morphine. D) administering oxygen and applying an anesthetic cream to the burn.B) applying cool, wet dressings to the burn and elevating his arm.A 33-year-old man was burned when the hot water heater he was working on exploded. The patient has superficial and partial-thickness burns to his face, neck, and arms. Your primary assessment reveals that he is restless and tachypneic. His BP is 80/54 mm Hg and his heart rate is 120 beats/min and weak. You should: A) conclude that he is experiencing burn shock, start two large-bore IV lines of normal saline, and administer fluids based on the Parkland formula. B) assist his ventilations with a bag-mask device, cover him with a blanket, and start a large-bore IV of normal saline set at a keep vein open rate. C) apply oxygen via nonrebreathing mask, cover his burns with cold moist dressings, start an IV with normal saline, and give up to 4 mg of morphine for pain. D) administer high-flow oxygen, keep him warm, start at least one large-bore IV of normal saline, and administer fluid boluses to maintain adequate perfusion.D) administer high-flow oxygen, keep him warm, start at least one large-bore IV of normal saline, and administer fluid boluses to maintain adequate perfusion.. A 74-year-old man experienced partial- and full-thickness burns to his arms and chest resulting from a fire that started after he fell asleep while smoking his cigar. The patient's son, who arrived at the scene shortly after you, states that his father has congestive heart failure, rheumatoid arthritis, and atrial fibrillation. In addition to administering supplemental oxygen, it is MOST important for you to: A) avoid narcotic analgesics because of his medical history. B) auscultate his breath sounds before administering IV fluids. C) obtain a 12-lead ECG to assess for signs of cardiac ischemia. D) apply cold, moist dressings to his burns to provide pain relief.B) auscultate his breath sounds before administering IV fluids.Burn shock is caused by: A) a massive infection that occurs when microorganisms breach burned skin. B) renal failure secondary to excess myoglobin production from burned muscle. C) fluid loss across damaged skin and volume shifts within the rest of the body. D) acute dehydration, and it commonly manifests within 30 minutes after the burn.. If an acutely burned patient is in shock in the prehospital setting: A) it is likely that he or she is experiencing burn shock. B) you should look for another injury as the source of shock. C) administer a 250-mL bolus of normal saline and reassess. D) avoid IV fluids unless the systolic BP is below 80 mm Hg.B) you should look for another injury as the source of shock.The MOST acute complication associated with large body surface area burns is: A) infection. B) hypovolemia. C) hypothermia. D) myoglobinemia.C) hypothermia.. Supraglottic damage following a burn is MOST often caused by: A) the inhalation of superheated gases. B) exposure to carbon monoxide or cyanide. C) the inhalation of hot particulate steam. D) direct flame exposure to the oropharynx.A) the inhalation of superheated gases.Damage to the kidneys following an electrical injury: A) is caused by excess serum potassium levels. B) occurs when damaged muscle produces myoglobin. C) can be prevented with boluses of lactated Ringer's. D) is the result of electricity passing through the kidneys.B) occurs when damaged muscle produces myoglobin.After an adult victim is struck by lightning and experiences cardiac arrest: A) 5 minutes of CPR generally restores a pulse. B) perform a compression to ventilation ratio of 15:2. C) his or her heart may resume beating spontaneously. D) the ECG usually shows an organized cardiac rhythm.C) his or her heart may resume beating spontaneously.. Many of the physiologic changes caused by acute radiation syndrome: A) can be reversed if chemotherapy is administered within 24 hours. B) occur over time and will not be apparent in the prehospital setting. C) are a direct result of beta particles and are usually life threatening. D) manifest with lethal cardiac dysrhythmias and sudden cardiac arrest.B) occur over time and will not be apparent in the prehospital setting.. If a burn patient presents with a hoarse voice and states, "I'm cold," your MOST immediate concern should be: A) hypothermia. B) burn shock. C) inhalation injury. D) cyanide toxicity.C) inhalation injury.Patients suspected of having burns to the upper airway will benefit MOST from: A) unhumidified oxygen. B) cool, humidified oxygen. C) an inhaled beta-2 agonist. D) anticholinergic bronchodilators.B) cool, humidified oxygen.If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because: A) doing so increases the risk of intubating the right mainstem bronchus. B) facial edema may cause tube dislodgement 2 to 3 days after the burn. C) drugs given via the ET tube will not adequately disperse in the lungs. D) it may result in excessive volumes of air being delivered to the patient.B) facial edema may cause tube dislodgement 2 to 3 days after the burn.. During your primary assessment of a 21-year-old man with a suspected inhalation injury, you note that he is combative and his respirations are profoundly labored and stridorous. The closest appropriate medical facility is approximately 25 miles by ground, and the local air transport service is unavailable. You should: A) provide supplemental oxygen via nonrebreathing mask, insert an intraosseous catheter, and administer a sedative medication. B) assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea. C) administer humidified oxygen, start at least one large-bore IV, and visualize his upper airway to assess the severity of soft-tissue swelling. D) insert an oropharyngeal airway, ventilate him with a bag-mask device at 20 breaths/min, and prepare to nasotracheally intubate him.B) assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea.Which of the following conditions would MOST likely cause laryngeal spasm and edema? A) Croup B) Inhalation injury C) Viral pharyngitis D) Mild asthma attackB) Inhalation injuryWhich of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burnsD) Severe burnsWhich of the following statements regarding burns in the pediatric patient is correct? A) A child's larger skin surface-to-body mass ratio increases his or her susceptibility to heat and fluid loss. B) A burn that is characterized by clear demarcation lines is generally suggestive of an unintentional burn. C) Unlike adults, the rule of palm is an inaccurate tool to determine the extent of burns in pediatric patients. D) A child with burns to both lower extremities has burns to approximately 36% of his or her body surface area.A) A child's larger skin surface-to-body mass ratio increases his or her susceptibility to heat and fluid loss.What portion of the eye may become icteric in patients with hepatitis? A) Iris B) Sclera C) Cornea D) ConjunctivaB) ScleraThe anterior chamber is the portion of the globe between the _____ and the _____, and is filled with _____ humor. A) iris, lens, vitreous B) cornea, iris, aqueous C) lens, iris, vitreous D) lens, cornea, aqueousD) lens, cornea, aqueousA patient with a loss of peripheral vision MOST likely has damage to the: A) retina. B) pupil. C) cornea. D) lens.A) retina.. Cardiac monitoring is recommended when caring for a patient with an eye-related emergency because: A) eye drops or medication can cause a marked elevation in the heart rate. B) ocular pressure can stimulate the vagus nerve and cause bradycardia. C) vitreous humor loss can result in a variety of ventricular dysrhythmias. D) AV heart blocks commonly occur when vitreous humor is lost.B) ocular pressure can stimulate the vagus nerve and cause bradycardia.Hyphema is defined as: A) severe ecchymosis to the orbital region. B) blood in the anterior chamber of the eye. C) marked swelling of the globe of the eye. D) double vision following blunt eye trauma.B) blood in the anterior chamber of the eye.Signs and symptoms of retinal detachment include: A) flashing lights, specks, or floaters in the field of vision. B) double vision and partial or complete loss of peripheral vision. C) immediate pain and total loss of vision following blunt eye trauma. D) paralysis of upward gaze and greater than 50% loss of central vision.A) flashing lights, specks, or floaters in the field of vision.. If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be MOST suspicious for a(n): A) Le Fort II fracture. B) nasal bone fracture. C) orbital skull fracture. D) basilar skull fracture.C) orbital skull fracture.What part of the eye is MOST commonly injured following a thermal burn? A) Globe B) Retina C) Cornea D) EyelidsD) EyelidsA flattened appearance to the face and loss of sensation over the cheek following blunt facial trauma is MOST indicative of a(n): A) zygomatic fracture. B) orbital skull fracture. C) Le Fort I fracture. D) temporomandibular joint dislocation.A) zygomatic fracture.General care for an eye injury involves: A) applying direct pressure to the globe. B) irrigating the eye with sterile saline solution. C) covering both eyes to minimize further injury. D) applying a cold compress to the eyeball.C) covering both eyes to minimize further injury.Hyphema is defined as: A) severe ecchymosis to the orbital region. B) blood in the anterior chamber of the eye. C) marked swelling of the globe of the eye. D) double vision following blunt eye trauma.B) blood in the anterior chamber of the eye.Alkali or strong acid burns to the eye should be irrigated for at least ____ minutes. A) 10 B) 15 C) 20 D) 30C) 20Signs and symptoms of retinal detachment include: A) flashing lights, specks, or floaters in the field of vision. B) double vision and partial or complete loss of peripheral vision. C) immediate pain and total loss of vision following blunt eye trauma. D) paralysis of upward gaze and greater than 50% loss of central vision.A) flashing lights, specks, or floaters in the field of vision.The ONLY indication for removing contact lenses in the prehospital setting is: A) chemical eye burns. B) acute conjunctivitis. C) cardiopulmonary arrest. D) a foreign body in the eye.A) chemical eye burns.What part of the eye is MOST commonly injured following a thermal burn? A) Globe B) Retina C) Cornea D) EyelidD) EyelidWhich of the following statements regarding anisocoria is correct? A) Anisocoria is a condition in which the pupils are unequal. B) Anisocoria is a normal finding in the majority of the population C) Physiologic anisocoria indicates significant intracranial pressure. D) Anisocoria is a condition characterized by bilateral pupillary dilation.A) Anisocoria is a condition in which the pupils are unequal.Retinal injuries that are caused by exposure to extremely bright light: A) are generally not painful but may result in permanent damage. B) cause immediate intense pain and result in permanent blindness. C) are painless and almost always heal without permanent damage. D) cause severe pain but heal quickly and without permanent damage.A) are generally not painful but may result in permanent damage.. In which of the following situations is the Morgan lens NOT appropriate to use? A) Eye burn from a strong alkali B) An object impaled in the eye C) Eye burn from a strong acid D) Any foreign body in the eyeB) An object impaled in the eye. A patient with a dysconjugate gaze following an ocular injury: A) most likely has a concomitant basilar skull fracture. B) should have ice applied to the eyes to prevent blindness. C) has discoordination between the movements of both eyes. D) should be treated by irrigating both eyes for 20 minutes.C) has discoordination between the movements of both eyes.. When treating a patient with an ocular injury, what should you do to avoid an increase in intraocular pressure? A) Apply light pressure to both eyes. B) Discourage the patient from coughing. C) Administer prophylactic atropine sulfate. D) Ensure that the patient remains supine.B) Discourage the patient from coughing.. Movement of both of the eyes in unison is called: A) dysconjugate gaze. B) sympathetic eye movement. C) extraocular movement. D) physiologic anisocoria.B) sympathetic eye movement.Alkali or strong acid burns to the eye should be irrigated continuously for at least ___ minutes. A) 10 B) 15 C) 20 D) 30C) 20The ONLY indication for removing contact lenses in the prehospital setting is: A) chemical eye burns. B) acute conjunctivitis. C) cardiopulmonary arrest. D) a foreign body in the eye.A) chemical eye burns.. Following blunt trauma to the face, a 30-year-old man presents with epistaxis, double vision, and an inability to look upward. You should be MOST suspicious of: A) traumatic conjunctivitis. B) an orbital blowout fracture. C) traumatic retinal detachment. D) fracture of the cribriform plate.B) an orbital blowout fracture.You are dispatched to a high school where a 16-year-old male was stabbed in the eye with a pencil. The patient is conscious and in severe pain. A classmate removed the pencil prior to your arrival. The MOST appropriate care for this patient's injury includes: A) irrigating the injured eye with sterile saline, covering both eyes with a protective eye shield, and transporting immediately. B) applying an icepack to the affected eye, administering 1 ยตg/kg of fentanyl IM, elevating the patient's legs, and transporting. C) covering the affected eye with a sterile dressing and protective eye shield, covering the unaffected eye, and transporting promptly. D) covering the affected eye with a moist, sterile dressing, applying gently pressure to reduce intraocular pressure, and transporting at once.C) covering the affected eye with a sterile dressing and protective eye shield, covering the unaffected eye, and transporting promptly.You are caring for a man with a chemical burn to both eyes. The patient, who has contact lenses in place, is in severe pain and tells you that he can't see. Proper care for this patient includes: A) carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation. B) leaving his contact lenses in place to avoid further injury and transporting at once with irrigation of both eyes performed en route. C) removing his contact lenses, covering both eyes with moist, sterile dressings, administering a narcotic analgesic, and transporting. D) asking the patient to remove his contact lenses, irrigating both eyes for no more than 10 minutes, covering both eyes with sterile dressings, and transporting.A) carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation.. A construction worker was hammering when he experienced a sudden severe pain to his right eye. Assessment of his eye reveals that it is irritated and you can see a small sliver of metal imbedded in the globe. He is also wearing contact lenses. You should: A) remove his contact lenses and irrigate his eye with copious amounts of water. B) leave his contact lenses in place and cover both eyes with a sterile dressing. C) attempt to remove the foreign object only if he has any visual disturbances. D) remove his contact lenses and administer a narcotic analgesic for pain.B) leave his contact lenses in place and cover both eyes with a sterile dressing.A man who was using an arc welder without eye protection presents with bilateral eye pain and diminished vision. He is conscious and alert, has a patent airway, and has stable vital signs. Treatment should include: A) covering his eyes with sterile, moist dressings; applying cool compresses lightly over his eyes; and placing him in a supine position. B) immediately irrigating his eyes with sterile saline or water; covering both eyes with dry, sterile dressings; and allowing him to sit up. C) placing him in a lateral recumbent position, keeping his eyelids closed with tape, and applying chemical warm compresses to his eyes. D) mixing baking powder with sterile water or saline and irrigating his eyes to prevent further damage caused by the ultraviolet light.A) covering his eyes with sterile, moist dressings; applying cool compresses lightly over his eyes; and placing him in a supine position.. A 34-year-old female states that she feels like she has a grain of sand in her eye. Assessment reveals that her eye and the surrounding area are red. Treatment for her should include: A) carefully assessing her eye for an object imbedded in the globe and removing it if one is present. B) instructing her to continue rapid eye blinking and administering analgesia as indicated. C) gently rubbing the surface of the eye with a cotton-tipped applicator to remove the foreign body. D) gently irrigating her eye and taping the affected eye closed to prevent it from drying out.D) gently irrigating her eye and taping the affected eye closed to prevent it from drying out.. Cerebrospinal fluid drainage from the ears is MOST indicative of: A) a nasal fracture. B) intracerebral bleeding. C) an epidural hematoma. D) a skull fracture.D) a skull fracture.. Death following a head injury is MOST often the result of: A) an epidural hematoma. B) trauma to the brain. C) airway compromise. D) spinal cord transection.B) trauma to the brain.. An epidural hematoma typically causes rapid deterioration in the head-injured patient's condition because: A) numerous axons are severely damaged. B) the meningeal veins are often disrupted. C) it is associated with brisk arterial bleeding. D) concomitant spinal cord injury is often present.C) it is associated with brisk arterial bleeding.Common clinical findings associated with a subdural hematoma include all of the following, EXCEPT: A) rapidly increasing intracranial pressure. B) an underlying skull fracture. C) a fluctuating level of consciousness. D) unilateral hemiparesis or slurred speech.A) rapidly increasing intracranial pressure.A subdural hematoma is classified as acute if clinical signs and symptoms develop: A) immediately following the injury. B) within 24 hours following the injury. C) within 36 hours following the injury. D) within 48 hours following the injury.B) within 24 hours following the injury.Chronic subdural hematomas are MOST commonly seen in patients who: A) are less than 2 years of age. B) have alcoholism. C) are prone to hypoglycemia. D) have high cholesterol.B) have alcoholism.What type of intracranial hemorrhage would MOST likely be caused by a penetrating head injury? A) Subdural hematoma B) Intracerebral hematoma C) Epidural hematoma D) Subarachnoid hemorrhageB) Intracerebral hematomaSigns of meningeal irritation, such as nuchal rigidity, are MOST commonly seen in patients with a(n): A) subdural hematoma. B) epidural hematoma. C) intracerebral hematoma. D) subarachnoid hemorrhage.D) subarachnoid hemorrhage.. Common signs and symptoms of meningitis include: A) irritability, back pain, headache, and hypertension. B) slow-onset fever, tinnitus, and an occipital headache. C) mental status changes, fever, stiff neck, and headache. D) a dark red rash, combativeness, and a low-grade fever.C) mental status changes, fever, stiff neck, and headache.A 30-year-old man presents with jaw and neck stiffness and fever. During your assessment, he tells you that he cut his hand on a piece of metal about a week ago. You should be MOST suspicious that this patient has: A) tetanus. B) meningitis. C) a viral infection. D) a staph infection.A) tetanus.Common signs and symptoms of meningitis in young children include all of the following, EXCEPT: A) poor feeding. B) nuchal rigidity. C) bulging fontanelle. D) irritability and fever.B) nuchal rigidity.Following a traumatic brain injury, initial swelling of the brain occurs due to: A) severe ischemia. B) acute hypertension. C) cerebral vasodilation. D) an increase in cerebral water.C) cerebral vasodilation.Hyperventilating a patient who has increased intracranial pressure (ICP) will: A) dilate the cerebral vasculature and cause further increases in ICP. B) constrict the cerebral vasculature and decrease cerebral perfusion. C) increase the carbon dioxide levels in the brain through vasodilation. D) decrease ICP and maintain adequate cerebral perfusion.B) constrict the cerebral vasculature and decrease cerebral perfusion.The MOST disastrous consequence of a severe traumatic brain injury is: A) an increase in intracranial pressure. B) an increase in mean arterial pressure. C) severe hypertension and bradycardia. D) a decrease in cerebral perfusion pressure.D) a decrease in cerebral perfusion pressure.Prehospital treatment of the patient with a traumatic brain injury must focus primarily on: A) maintaining cerebral perfusion pressure. B) hyperventilating the patient at 20 breaths/min. C) maintaining a systolic blood pressure of at least 120 mm Hg. D) taking measures to decrease intracranial pressure.A) maintaining cerebral perfusion pressure.Hyperventilation of the brain-injured patient: A) shunts oxygen away from the brain and may result in decreased cerebral perfusion pressure. B) has clearly demonstrated decreased mortality and morbidity in patients with a severe head injury. C) causes cerebral vasodilation with increased intracranial pressure and should be avoided. D) is only appropriate if the patient is unresponsive and has bilaterally dilated and sluggishly reactive pupils.. When assessing the severity of a traumatic brain injury, the MOST important assessment parameter is the patient's: A) initial Glasgow Coma Scale score. B) blood pressure. C) level of consciousness. D) response to verbal stimuli.C) level of consciousness.Following a traumatic injury, a 19-year-old woman presents with confusion, tachycardia, and significant hypotension. Her skin is cool, clammy, and pale. Further assessment reveals abdominal rigidity and deformity with severe pain over her thoracic vertebrae. In addition to administering high-flow oxygen and immobilizing her spine, you should: A) start at least one large-bore IV line and give crystalloid boluses as needed to maintain adequate perfusion. B) conclude that she is in neurogenic shock, start an IV line of normal saline, and initiate a dopamine infusion. C) start at least one large-bore IV of normal saline and administer a narcotic analgesic to treat her severe pain. D) perform a focused history and physical exam, start an IV of normal saline, and administer a corticosteroid.A) start at least one large-bore IV line and give crystalloid boluses as needed to maintain adequate perfusion.An infant or small child who falls from a significant height would MOST likely experience: A) lumbar spine fractures. B) lateral thoracic trauma. C) a traumatic brain injury. D) bilateral femur fractures.C) a traumatic brain injury.. If the pleural space becomes filled with air or blood: A) increased surface tension ruptures the lung. B) surface tension forces the pleurae together. C) the lung expands and fills the thoracic space. D) surface tension is lost and the lung collapses.D) surface tension is lost and the lung collapses.Pneumothorax is MOST accurately defined as: A) air or gas within the pleural cavity. B) perforation of a lung by a broken rib. C) injury to the visceral or parietal pleura. D) partial or complete collapse of a lung.A) air or gas within the pleural cavity.. An open pneumothorax causes ventilatory inadequacy when: A) positive pressure created by expiration forces air into the pleural space. B) the heart stops perfusing the lung on the side of the open chest injury. C) negative pressure created by inspiration draws air into the pleural space. D) the glottic opening is much larger than the open wound on the chest wall.C) negative pressure created by inspiration draws air into the pleural space.. Pneumothoraces create a ventilation-perfusion mismatch when: A) concomitant myocardial injury prevents adequate pulmonary perfusion and the lung collapses. B) perfusion of the involved lung continues while the pneumothorax prevents adequate ventilation. C) the vasculature of the affected lung is not intact and intrapulmonary gas exchange is impaired. D) the affected lung continues to expand adequately despite a decrease in pulmonary perfusion.B) perfusion of the involved lung continues while the pneumothorax prevents adequate ventilation.. What type of chest injury is characterized by air accumulation in the pleural space when a perforation in the lung parenchyma acts as a one-way valve? A) Tension pneumothorax B) Simple pneumothorax C) Massive hemothorax D) Spontaneous pneumothoraxA) Tension pneumothoraxAs air accumulates in the pleural space, the FIRST thing to occur is: A) decreased pulmonary function. B) contralateral tracheal deviation. C) compression of the great vessels. D) marked decrease in venous return.A) decreased pulmonary function.Most hemothoraces occur when: A) the intercostal arteries are lacerated. B) a penetrating injury perforates the lung. C) severe barotrauma ruptures one of the lungs. D) a fractured rib injures the lung parenchyma.D) a fractured rib injures the lung parenchyma.By definition, a massive hemothorax is characterized by: A) pulmonary injury with secondary myocardial injury. B) 10% of circulating blood volume within the pleural space. C) cardiac arrest secondary to severe intrapleural bleeding. D) more than 1,500 mL of blood within the pleural space.D) more than 1,500 mL of blood within the pleural space.During a frontal collision, MOST pneumothoraces occur when: A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact. B) the diaphragm rapidly ascends into the chest cavity during impact, causing an increase in intrathoracic pressure. C) the chest strikes the steering wheel, which fractures one or more ribs and causes a perforation injury to one of the lungs. D) the patient is ejected through the windshield, and his or her chest collides with a secondary object outside the vehicle.A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact.Increased intravenous pressure commonly manifests as: A) jugular venous distention. B) a widened pulse pressure. C) bounding peripheral pulses. D) a pulsating abdominal mass.A) jugular venous distention.. A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is indicative of: A) a pneumothorax. B) a diaphragmatic hernia. C) Pierre Robin sequence. D) a pericardial tamponade.A) a pneumothorax.. Any patient with a presumptive diagnosis of a pneumothorax should: A) receive a prophylactic needle thoracentesis. B) be intubated and ventilated at a rate of 15 breaths/min. C) be considered unstable and reassessed every 5 minutes. D) be transported to a trauma center via air medical transport.C) be considered unstable and reassessed every 5 minutes.. Which of the following thoracic injuries would you LEAST likely discover in the primary assessment? A) Flail chest B) Myocardial contusion C) Bronchial disruption D) Open pneumothoraxB) Myocardial contusionA patient with a small simple pneumothorax would MOST likely present with diminished breath sounds: A) in the apices of the affected lung if he or she is sitting upright. B) after more than 50% of the affected lung has been collapsed. C) in the posterior bases of the affected lung if he or she is sitting. D) on the contralateral side as the mediastinum begins to shift.A) in the apices of the affected lung if he or she is sitting upright.Immediate treatment for an open pneumothorax involves: A) assisting ventilations with a bag-mask device. B) covering the open wound with a porous dressing. C) converting the pneumothorax to a closed injury. D) administering oxygen via nonrebreathing mask.C) converting the pneumothorax to a closed injury.. Jugular venous distention during a tension pneumothorax: A) indicates a significant increase in atrial preload. B) is caused by blood accumulation in the vena cava. C) occurs before a unilateral absence of breath sounds. D) manifests early as air accumulates in the pleural space.B) is caused by blood accumulation in the vena cava.A blood pressure of 100/70 mm Hg in the presence of clinical signs of a tension pneumothorax: A) should be treated with crystalloid fluid boluses to prevent hypotension. B) indicates that prehospital needle decompression likely will not be required. C) is likely the result of systemic vasodilation in an attempt to reduce preload. D) suggests adequate cardiac compensation for the diminished venous return.D) suggests adequate cardiac compensation for the diminished venous return.Which of the following clinical signs may not be present in a patient with a tension pneumothorax and associated internal bleeding? A) Tachycardia B) Jugular vein distention C) Mediastinal shift D) Contralateral tracheal deviationB) Jugular vein distentionThe preferred site for performing a needle thoracentesis is: A) superior to the third rib into the intercostal space at the midclavicular line. B) just below the second rib into the intercostal space at the midaxillary line. C) just above to the fifth rib into the intercostal space at the midaxillary line. D) inferior to the third rib into the intercostal space at the midclavicular line.A) superior to the third rib into the intercostal space at the midclavicular line.Unlike a tension pneumothorax, a massive hemothorax would MOST likely present with: A) signs of shock. B) tracheal deviation. C) collapsed jugular veins. D) severe respiratory distress.C) collapsed jugular veins.When caring for a patient with an open chest wound, you should: A) routinely transport the patient in a left lateral recumbent position. B) place a porous dressing over the wound and secure it on three sides. C) secure a dressing in place by circumferentially wrapping the chest. D) frequently assess breath sounds for indications of a pneumothorax.D) frequently assess breath sounds for indications of a pneumothorax.. A 50-year-old man was working on his car when the jacks collapsed and the car landed on his chest. Your assessment reveals profound cyanosis and swelling to his chest and face, agonal respirations, and a weak carotid pulse. This patient will benefit MOST from: A) bilateral needle thoracenteses and 100% oxygen. B) rapid IV fluid boluses en route to a trauma center. C) aggressive airway management and rapid transport. D) prompt endotracheal intubation and hyperventilation.C) aggressive airway management and rapid transport.You are transporting a conscious and alert man who experienced an isolated blunt injury to the right anterolateral chest. His vital signs are stable, but he is dyspneic and his breath sounds are diminished over the apex of his right lung. In addition to administering high-flow oxygen, the MOST critical intervention for this patient involves: A) frequently reassessing him for signs of clinical deterioration. B) performing a needle thoracentesis to release intrapleural tension. C) positioning him on his right side to facilitate effective breathing. D) administering a 500-mL normal saline bolus to maintain perfusion.A) frequently reassessing him for signs of clinical deterioration.. A convenience store clerk was stabbed during a robbery attempt. He is semiconscious with shallow breathing and weak radial pulses. During the rapid assessment, you find a single stab wound to his left anterior chest. His jugular veins are distended and his breath sounds are bilaterally diminished but equal. The MOST appropriate treatment for this patient involves: A) performing bilateral needle thoracenteses, intubating the patient and ventilating at 10 to 12 breaths/min, and transporting him to a trauma center. B) administering oxygen via nonrebreathing mask, transporting at once, and placing an occlusive dressing over the stab wound if his oxygen saturation is low. C) assisting his ventilations, initiating transport, starting a large-bore IV line en route, and administering fluids to maintain a systolic blood pressure of 100 mm Hg. D) covering the stab wound with an occlusive dressing, assisting ventilations, transporting at once, and establishing large-bore IV lines en route.D) covering the stab wound with an occlusive dressing, assisting ventilations, transporting at once, and establishing large-bore IV lines en route.. The MOST immediate treatment for the patient with a tension pneumothorax is to: A) establish a large-bore IV line. B) ventilate with a bag-mask device. C) evacuate air from the pleural space. D) apply high-flow supplemental oxygen.C) evacuate air from the pleural space.A robbery suspect was shot once in the left anterior chest by law enforcement personnel when he pulled a gun on them. The patient is exhibiting obvious signs of shock, is in significant respiratory distress, and is coughing up blood. Further assessment reveals collapsed jugular veins and absent breath sounds over the left hemithorax. After covering the gunshot wound with the appropriate dressing, you should: A) perform a needle thoracentesis to the left side of the chest, initiate rapid transport, and administer 20-mL/kg fluid boluses en route. B) administer 100% oxygen, administer 1 to 2 L of normal saline, and transport to a trauma center for an emergency pericardiocentesis. C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center. D) ventilate the patient with a demand valve, transport to a trauma center, and run two large-bore IV lines wide open while en route to the hospital.C) provide oxygenation and ventilation support, transport at once, and maintain adequate perfusion with IV fluids while en route to a trauma center.. Following blunt trauma to the anterior chest, a 44-year-old man presents with restlessness, respiratory distress, perioral cyanosis, and tachycardia. Further assessment reveals a midline trachea, engorged jugular veins, and absent breath sounds on the right side of his chest. You should: A) ventilate the patient with a bag-mask device and transport immediately. B) perform an immediate needle thoracentesis to the right side of the chest. C) give 100% oxygen and start a large-bore IV line en route to the hospital. D) transport at once and decompress the chest if tracheal deviation is observed.B) perform an immediate needle thoracentesis to the right side of the chest.Patients with decompensated asthma or COPD who require positive-pressure ventilation: A) should be ventilated routinely at a rate that is slightly faster than the rate for a patient without an underlying pulmonary disease. B) may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly. C) should be intubated promptly and ventilated at a rate of 20 to 24 breaths/min to eliminate excess carbon dioxide. D) should be given forceful positive-pressure breaths because their primary problem is difficulty with inhalation.B) may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.You and your team are treating an unresponsive trauma patient. Which of the following questions would be the MOST relevant to ask your team when evaluating for the presence of a tension pneumothorax? A) What is the patient's systolic blood pressure? B) Are the patient's heart tones becoming muffled? C) Is the patient becoming difficult to ventilate? D) Does the patient's pulse weaken during inhalation?C) Is the patient becoming difficult to ventilate?. A person who experiences sharp chest pain followed by increasing dyspnea after he or she coughs MOST likely has: A) pleurisy. B) a pleural effusion. C) a pneumothorax. D) acute pneumonia.C) a pneumothorax.. Intubation of a patient with severe asthma: A) is clearly indicated if the patient's condition does not resolve following field corticosteroid therapy. B) is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces. C) should only be performed after hyperventilating the patient with a bag-mask device for 2 to 3 minutes. D) is generally contraindicated because weaning the patient off of a ventilator can take several days.B) is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces.Pericardial tamponade can be differentiated from a tension pneumothorax by the presence of: A) jugular venous distention. B) a narrowing pulse pressure. C) clear and equal breath sounds. D) alterations in the QRS amplitude.C) clear and equal breath sounds.. Which of the following clinical findings is LEAST suggestive of a pneumothorax in an intubated child? A) Decreased ventilation compliance B) Stronger breath sounds on the right side C) Persistent cyanosis despite ventilations D) Stronger breath sounds on the left sideB) Stronger breath sounds on the right side. In which of the following situations would you likely NOT be able to palpate a pulse despite effective chest compressions? A) Profound hypoxia B) Severe acidosis C) Hyperkalemia D) Tension pneumothoraxD) Tension pneumothoraxAfter you have intubated an apneic patient with chest trauma, your partner is auscultating breath sounds and tells you that breath sounds are faint on the right side of the chest. You should: A) slightly withdraw the tube as your partner auscultates breath sounds. B) suspect that the patient has a pneumothorax on the right side of the chest. C) immediately remove the ET tube and oxygenate the patient for 30 seconds. D) increase the force of your ventilations as your partner reauscultates the lungs.B) suspect that the patient has a pneumothorax on the right side of the chest.A flail chest is characterized by: A) a free-floating segment of fractured ribs. B) bulging of fractured ribs during inspiration. C) excessive negative intrathoracic pressure. D) drawing in of fractured ribs during expiration.A) a free-floating segment of fractured ribs.You would NOT expect a patient with a flail chest to present with: A) cyanosis. B) hyperpnea. C) shallow breathing. D) decreased breath sounds.B) hyperpnea.. A 26-year-old unrestrained woman struck her chest on the steering wheel when her car collided with another vehicle. After performing your primary assessment and administering high-flow oxygen, you assess her chest and note a segment of obviously fractured ribs that bulges outward during exhalation. You should: A) increase intrathoracic pressure with a demand valve. B) apply a bulky dressing to the segment of fractured ribs. C) position her on her injured side and monitor her breathing. D) apply pressure to the segment of ribs as the patient inhales.B) apply a bulky dressing to the segment of fractured ribs.A 30-year-old man felt a snap in his chest when he abruptly twisted his torso. He is conscious and alert, and complains of severe pain during inhalation. Your assessment reveals palpable tenderness over the fifth and sixth ribs on the left side. His vital signs are stable and he denies other injuries. In addition to administering supplemental oxygen, the MOST appropriate treatment for this patient involves: A) instructing the patient to hold a pillow against his chest, considering IV analgesics, and transporting to the hospital. B) stabilizing the injured area by circumferentially wrapping the chest with 3-inch tape and transporting him to a local hospital. C) encouraging the patient to take deeper breaths to maintain adequate minute volume and transporting him to the hospital. D) sedating the patient with midazolam or diazepam, assisting ventilations with a bag-mask device, and transporting at once.A) instructing the patient to hold a pillow against his chest, considering IV analgesics, and transporting to the hospital.Which of the following statements regarding Grey Turner sign is correct? A) Grey Turner sign is characterized by bruising around the umbilicus. B) The presence of Grey Turner sign should make you suspicious for hepatitis. C) Grey Turner sign is the cessation of inspiration during abdominal palpation. D) Grey Turner sign is characterized by flank bruising and indicates retroperitoneal hemorrhage.D) Grey Turner sign is characterized by flank bruising and indicates retroperitoneal hemorrhage.Grey Turner sign is defined as ecchymosis to the _________ and is indicative of _________. A) umbilicus, peritoneal bleeding B) epigastrium, stomach rupture C) flank, retroperitoneal bleeding D) back, traumatic aortic dissectionC) flank, retroperitoneal bleeding. Periumbilical ecchymosis is: A) commonly observed in the prehospital setting following blunt force trauma to the abdomen. B) referred to as Cullen sign and may take hours or days to develop following abdominal trauma. C) usually seen in conjunction with flank bruising and is highly suggestive of injury to the liver or spleen. D) also called Grey Turner sign and manifests almost immediately following blunt abdominal trauma.B) referred to as Cullen sign and may take hours or days to develop following abdominal trauma.The most important nerve of the cervical plexus, which innervates the diaphragm, is the: A) vagus nerve. B) trochlear nerve. C) abducens nerve. D) phrenic nerve.D) phrenic nerve.. Signs of a diaphragmatic hernia include all of the following, EXCEPT: A) a scaphoid or concave abdomen. B) bilaterally absent breath sounds. C) noted increased work of breathing. D) audible bowel sounds in the chest.B) bilaterally absent breath sounds.. Normal inhalation is the result of: A) diaphragmatic relaxation. B) air passively entering the lungs. C) negative pressure in the thoracic cavity. D) positive pressure in the thoracic cavity.C) negative pressure in the thoracic cavity.. Which of the following statements regarding the thorax is correct? A) The thoracic cavity extends to the ninth or tenth rib posteriorly. B) The diaphragm inserts into the anterior thoracic cage below the fifth rib. C) The dimensions of the thorax are defined inferiorly by the thoracic inlet. D) The dimensions of the thorax are defined anteriorly by the thoracic vertebrae.B) The diaphragm inserts into the anterior thoracic cage below the fifth rib.Anatomically, the abdominal cavity extends from the: A) fifth rib to the pelvis. B) umbilicus to the pelvis. C) diaphragm to the pelvis. D) nipple line to the diaphragm.C) diaphragm to the pelvis.Which of the following statements regarding a child's chest wall is correct? A) Lung sounds are difficult to hear because of the thick intercostal muscles. B) Children are belly breathers because they rely heavily on their diaphragms. C) A child's chest wall has proportionately more subcutaneous fat on the chest. D) Retractions are less obvious in children owing to their noncompliant rib cages.B) Children are belly breathers because they rely heavily on their diaphragms.. Infants are referred to as belly breathers because: A) their rib cages are more rigid than an adult's. B) their intercostal muscles are not innervated. C) they rely mostly on their diaphragm to breathe. D) their ribs are not fully attached to the sternum.C) they rely mostly on their diaphragm to breathe.. The diaphragm curves from its point of attachment at the _______ rib and peaks in the center at the _______ intercostal space. A) ninth, third B) tenth, seventh C) twelfth, fourth D) eighth, seventhC) twelfth, fourthThe diaphragm: A) is an accessory muscle used during respiratory distress. B) works in conjunction with the sternum during inspiration. C) forms a barrier between the thoracic and abdominal cavities. D) creates positive intrathoracic pressure when it increases in size.C) forms a barrier between the thoracic and abdominal cavities.Which of the following statements regarding diaphragmatic injury is correct? A) During the latent phase of a diaphragmatic injury, abdominal contents herniate through the defect, cutting off their blood supply. B) The spleen provides significant protection to the diaphragm on the left side, resulting in a higher incidence of right-sided diaphragmatic injuries. C) Because the diaphragm is protected by the liver on the right side, most diaphragmatic injuries caused by blunt force trauma occur on the left side. D) Once the diaphragm has been injured, the healing process is facilitated by the natural pressure differences between the abdominal and thoracic cavities.C) Because the diaphragm is protected by the liver on the right side, most diaphragmatic injuries caused by blunt force trauma occur on the left side.At term, displacement of the diaphragm by the uterus causes a(n): A) decrease in expiratory reserve volume. B) increase in functional reserve capacity. C) decrease in inspiratory reserve volume. D) marked increase in residual volume.A) decrease in expiratory reserve volume.. Management of a diaphragmatic injury focuses on: A) maintaining adequate oxygenation and ventilation, and rapid transport. B) inserting a nasogastric tube to decompress the gastrointestinal organs. C) applying the pneumatic antishock garment to stabilize the diaphragm. D) intubation and hyperventilation with 100% supplemental oxygen.A) maintaining adequate oxygenation and ventilation, and rapid transport.There is a higher incidence of abdominal injuries in association with chest trauma in pregnant women because: A) seat belts are usually not worn. B) the peritoneum is maximally stretched. C) the diaphragm is elevated nearly 2 inches. D) the abdomen is large and protuberant.C) the diaphragm is elevated nearly 2 inches.A patient with diaphragmatic breathing without intercostal muscle use has MOST likely experienced a spinal injury above the level of: A) C2. B) C5. C) C7. D) T2.D) T2.. A gastric tube is MOST useful for: A) performing prehospital gastric lavage in patients with a toxic ingestion. B) blocking off the esophagus so that an ET tube can be placed. C) decompressing the stomach and decreasing pressure on the diaphragm. D) removing blood from the esophagus in patients with esophageal varices.C) decompressing the stomach and decreasing pressure on the diaphragm.The appendicular skeleton is composed of the: A) bones of the spinal column, scapulae, and clavicles. B) bones of the upper extremities and the structures of the torso. C) pectoral girdle, pelvic girdle, and bones of the extremities. D) thoracic ribs, cervical vertebrae, and bones of the cranium.C) pectoral girdle, pelvic girdle, and bones of the extremities.The risk of a pulmonary embolism following musculoskeletal trauma is HIGHEST in patients with: A) upper extremity fractures that result in lengthy hospital admissions. B) pelvic and lower extremity injuries that lead to prolonged immobilization. C) numerous rib fractures who are taking anticoagulant medications. D) any proximal long bone fracture that occurred greater than 72 hours prior to medical intervention.B) pelvic and lower extremity injuries that lead to prolonged immobilization.A 40-year-old woman has an unstable pelvis following a motor vehicle crash. She is conscious but confused. Her blood pressure is 80/50 mm Hg, pulse is 120 beats/min and weak at the radial arteries, and respirations are 24 breaths/min and shallow. After starting at least one large-bore IV line, you should: A) run it wide open until her systolic blood pressure is greater than 100 mm Hg. B) administer a 250-mL normal saline bolus and then reassess her blood pressure. C) set the IV flow rate to keep the vein open unless her systolic blood pressure falls below 70 mm Hg. D) give enough isotonic crystalloid fluids to improve her mental status and radial pulse quality.D) give enough isotonic crystalloid fluids to improve her mental status and radial pulse quality.. Correctly splinting an injured extremity: A) typically provides complete pain relief without the need to administer narcotic analgesia. B) effectively reduces swelling and inflammation by shunting blood away from the injured area. C) eliminates the need to elevate the extremity because immobilization causes blood stasis. D) helps to control internal bleeding by allowing clots to form where vessels are damaged.D) helps to control internal bleeding by allowing clots to form where vessels are damaged.Beta blockers should be used with extreme caution in patients with reactive airway because: A) beta-1 receptor antagonism will result in profound bronchoconstriction. B) beta-2 receptors can potentially be antagonized, resulting in bronchospasm. C) there are no beta-blockers that selectively target beta-1 receptors only. D) they inhibit catecholamine release, potentially causing bronchoconstriction.B) beta-2 receptors can potentially be antagonized, resulting in bronchospasm.Toxic effects from beta blockers include all of the following, EXCEPT: A) hypotension. B) bradycardia. C) conduction delays. D) tachycardia.D) tachycardia.Beta receptor stimulation results in all of the following effects, EXCEPT: A) positive cardiac inotropy. B) positive cardiac chronotropy. C) vascular smooth muscle contraction. D) relaxation of bronchiole smooth muscle.C) vascular smooth muscle contraction.Common causes of bradycardia include: A) exercise. B) hyperthermia. C) amphetamines. D) beta blocker use.D) beta blocker use.Metoprolol has the brand name _____________, which may be a subtle reference to lowering the blood pressure.B) Lopressor. Atenolol is indicated for all of the following conditions, EXCEPT: A) hypertension. B) paroxysmal SVT. C) atrial flutter. D) AV heart block.D) AV heart block.Pharmacologic management for a black widow spider bite may include: A) atropine. B) diazepam. C) diltiazem. D) etomidate.B) diazepam.Which of the following statements regarding freshwater and saltwater drownings is correct? A) Freshwater drowning has a much higher mortality rate. B) Patients with freshwater drowning often require diuresis. C) Both freshwater and saltwater can lead to pulmonary injuries. D) Normal saline should be avoided in saltwater drowning victims.A) Freshwater drowning has a much higher mortality rate.Pulmonary overpressurization syndrome occurs when a diver: A) holds his or her breath during ascent. B) exhales constantly as he or she ascends. C) panics and hyperventilates during descent. D) experiences a pneumothorax under water.A) holds his or her breath during ascent.. An estimate of the pressure to which a diver is exposed is based on the: A) diver's heart rate. B) depth of the dive. C) water temperature. D) length of time under water.B) depth of the dive.Gas-filled organs are affected by the pressure changes experienced during descent and ascent through water because they: A) expand rapidly. B) contain oxygen. C) are compressible. D) do not compress.C) are compressible.Nitrogen causes decompression sickness: A) on descent because of the bubbles that form on reduction of pressure. B) on ascent because of the bubbles that form on reduction of pressure. C) on descent because of a progressive increase in atmospheric absolute. D) on ascent because of a progressive increase in atmospheric absolute.B) on ascent because of the bubbles that form on reduction of pressure.Following return of spontaneous circulation, a patient remains comatose. Which of the following interventions would MOST likely be performed? A) Dextrose infusion B) Field extubation C) Epinephrine bolus D) Induced hypothermiaD) Induced hypothermia. Which of the following interventions is emphasized the MOST in the 2010 guidelines for emergency cardiac care? A) Defibrillation B) Chest compressions C) Artificial ventilation D) Tracheal intubationB) Chest compressionsIf a cardiac arrest patient's airway is maintained with an oral airway and ventilation with a bag-mask device is producing adequate chest rise, then: A) a King LT or Combitube is preferred over tracheal intubation. B) the paramedic should deliver one breath every 5 to 6 seconds. C) insertion of an advanced airway device is not a high priority. D) there should be no pause in chest compressions to deliver a breath.C) insertion of an advanced airway device is not a high priority.Hyperventilation of a patient who is in cardiac arrest: A) increases preload and enhances cardiac output. B) causes a marked decrease in intrathoracic pressure. C) is indicated if the arrest interval exceeds 10 minutes. D) has been shown to reduce coronary artery perfusion.D) has been shown to reduce coronary artery perfusion.. In which of the following situations would endotracheal intubation MOST likely be indicated? A) The patient has an end-tidal CO2 reading of 36 mm Hg with a King LT airway in place. B) The patient is experiencing a ventricular fibrillation that is refractory to defibrillation and epinephrine. C) Following return of spontaneous circulation, the patient remains comatose. D) Bag-mask ventilation is adequate, but the patient has undergone more than 2 minutes of cardiac arrest.C) Following return of spontaneous circulation, the patient remains comatose.The chance for return of spontaneous circulation is BEST when: A) a vasopressor is administered every 3 to 5 minutes during CPR. B) an advanced airway device is inserted during a resuscitation attempt. C) an antidysrhythmic drug is used if ventricular fibrillation is present. D) timely chest compressions are performed with little or no interruption.D) timely chest compressions are performed with little or no interruption.. Full recoil of the chest in between compressions enhances blood return to the heart by which of the following mechanisms? A) Increased residual lung volume B) Negative intrathoracic pressure C) Decreased myocardial preload D) Coronary artery vasoconstrictionB) Negative intrathoracic pressureEpinephrine is primarily administered during cardiac arrest because its ________effects cause ________. A) vasoconstrictive, enhanced coronary blood flow B) antidysrhythmic, decreased cardiac irritability C) beta-2 agonistic, dilation of the bronchioles D) vasodilatory, a reduction in cardiac afterloadA) vasoconstrictive, enhanced coronary blood flowIn addition to high-quality CPR, which of the following interventions has clearly made a positive and measurable difference in survival from sudden cardiac arrest? A) Defibrillation B) IV fluid boluses C) Epinephrine therapy D) Tracheal intubationA) Defibrillation. You and your partner arrive at the scene of an unresponsive middle-aged man. Your primary assessment reveals that he is apneic and pulseless. Which of the following interventions will provide the BEST chance of survival for this patient? A) Five minutes of CPR prior to analyzing his cardiac rhythm B) CPR at the appropriate rate and with minimal interruptions C) Prompt insertion of an advanced airway to prevent aspiration D) Immediate defibrillation for presumed ventricular fibrillationB) CPR at the appropriate rate and with minimal interruptions. While en route to the scene of a patient in cardiac arrest, the emergency medical dispatcher advises you that she has the caller on the phone, but the caller refuses to do CPR on the patient. With an estimated time of arrival at the scene of 5 minutes, you should: A) ask the dispatcher to inform the man to do chest compressions only. B) recall that the caller has a legal and moral duty to act in this situation. C) have the dispatcher reassure the caller that he will not contract a disease. D) advise the dispatcher to tell the caller that the patient will die without CPR.A) ask the dispatcher to inform the man to do chest compressions only.You and your partner are off duty and are playing golf. Suddenly, you see an elderly man grab his chest and collapse to the ground. You should: A) tell your partner to call 9-1-1 as you proceed to assess the man. B) both proceed to the man and begin two-rescuer CPR if needed. C) perform 2 minutes of CPR if needed and then call an ambulance. D) tell the man's golf buddy to perform a precordial thump at once.A) tell your partner to call 9-1-1 as you proceed to assess the man.You are performing one-rescuer CPR on a 50-year-old woman in cardiac arrest. A bystander returns with an AED. You ask the bystander to attach the pads to the patient's chest as you continue CPR. After rhythm analysis, the AED states, "Shock advised." You should: A) confirm the absence of a pulse and deliver the shock. B) perform CPR for 2 more minutes and then defibrillate. C) defibrillate the patient and reassess for a carotid pulse. D) deliver a single shock and immediately resume CPR.D) deliver a single shock and immediately resume CPR.Defibrillation of a patient who is in asystole is detrimental to the patient because it: A) makes ruling out underlying causes impossible. B) stops the cardiac cells from spontaneously depolarizing. C) causes an unnecessary interruption in chest compressions. D) has been shown to render epinephrine ineffective.C) causes an unnecessary interruption in chest compressions.Your team is attempting resuscitation of a man in cardiac arrest. One of the team members intubates the patient and confirms proper placement of the endotracheal tube. Your MOST appropriate next action should be to: A) presume that the patient is in severe metabolic acidosis and hyperventilate him for at least 2 to 3 minutes. B) instruct the person ventilating to provide one breath every 6 to 8 seconds while chest compressions are continuous. C) administer 2.5 mg of epinephrine 1:10,000 via the endotracheal tube without interrupting chest compressions. D) defibrillate the patient with the maximum energy setting, reassess for a pulse, and continue CPR if he remains pulseless.B) instruct the person ventilating to provide one breath every 6 to 8 seconds while chest compressions are continuous.. After determining that an unresponsive adult patient is not breathing, you should: A) give two rescue breaths that make the chest visibly rise. B) assess for a carotid pulse for no longer than 10 seconds. C) reposition the patient's airway and reassess for breathing. D) perform a finger sweep of the patient's mouth to remove any debris.B) assess for a carotid pulse for no longer than 10 seconds.. How does CPR change after an advanced airway device is inserted? A) One breath should be delivered every 10 to 12 seconds. B) Ventilations should be faster after the device is inserted. C) Ventilations should be asynchronous with chest compressions. D) Cycles of 30 compressions and 2 breaths should be delivered.C) Ventilations should be asynchronous with chest compressions.Your partner returns with the AED as you are performing CPR on a 5-year-old child. As he opens the AED, he tells you that there are no pediatric pads, only adult pads. You should: A) instruct him to apply the adult pads as you continue one-rescuer CPR. B) tell him to resume one-rescuer CPR as you try to locate pediatric pads. C) use the adult AED pads, but only provide a total of two defibrillations. D) continue two-rescuer CPR until a manual defibrillator is available.A) instruct him to apply the adult pads as you continue one-rescuer CPR.Anterior-posterior placement of the defibrillation pads should be used if the patient is younger than ___ year(s) of age or less than ___ kg. A) 1, 10 B) 3, 15 C) 4, 20 D) 5, 30