Study Guide 4

A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?
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A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes:
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:pinching the patient's nostrils and having him lean forward.A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:apply a compression device around his pelvis.A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing:gastrointestinal bleedingAfter applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:place additional dressings over the wound.All of the following should be addressed during the primary assessment except:capillary bleedingWhich of the following findings would be the most significant when assessing a patient with possible internal bleeding?The patient takes rivaroxaban (Xeralto).A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.18%A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be most concerned that this patient has:compartment syndromeA 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how should you care for his wound?Cover it with moist, sterile gauze and secure with an occlusive dressing.A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:begin CPR and apply the AED.A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:administer high-flow oxygen.A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-foot steel rod impaled in his left leg. You should:control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately.A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should:rapidly assess the patient after ensuring that the power line is not live.According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA.1%Burns are classified according to:depth and extentCommon signs and symptoms of an airway burn include all of the following, exceptchest pressurePatients with full-thickness (third-degree) burns generally do not complain of pain because:the nerve endings have been destroyed.Which of the following statements regarding crush syndrome is correct?Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.Which of the following statements regarding penetrating injuries is correct?External bleeding may be minimal but internal injuries can be extensive.You and your partner arrive at the scene of a house fire where firefighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed, and he is coughing up sooty sputum You should be most concerned with:the potential for airway swelling.You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be most concerned with:the fact that her clinical signs could indicate that she is bleeding internally.A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The most appropriate care for this patient includes:leaning him forward and pinching his nostrils together.A 30-year-old female was robbed and assaulted as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:Suction her oropharynx.A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:cover both of his eyes and transport to the hospital.Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with:blow-out fractureFollowing direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n):laryngeal fractureSignificant trauma to the face should increase the EMT's index of suspicion for a(n):spinal column injury.You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:has a history of eye surgeries.You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:apply direct pressure above and below the wound.You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should:turn the backboard onto its side.A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:axial loadingA patient who cannot remember the events that preceded his or her head injury is experiencing:retrograde amnesiaA tight-fitting motorcycle helmet should be left in place unless:it interferes with your assessment of the airway.After your partner assumes manual in-line stabilization of the patient's head, you should:assess distal neurovascular status in the extremities.During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:suction his oropharynx for up to 15 seconds.In the setting of a head injury, hypertension, bradycardia, and Biot respirations indicate:herniation of the brain stem.When activated, the sympathetic nervous system produces all of the following effects, EXCEPT:pupillary constrictionWhich of the following statements regarding a basilar skull fracture is correct?The absence of raccoon eyes or Battle's sign does not rule it out.Which of the following statements regarding secondary brain injury is correct?Hypoxia and hypotension are the two most common causes of secondary brain injury.You are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. You should recognize that this patient is at risk for:bacterial meningitisA 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycleA 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:aggressively manage his airway.During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should:assist ventilations with a bag-valve mask.Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?Engorged jugular veinsYou are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is most likely causing this patient's deterioration?Compression of the aorta and vena cavaYou have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:partially remove the dressing.A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:transport him in the position in which you found him.A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except:giving him small sips of plain water.A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes:applying direct pressure with a dry, sterile dressing.A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious ous and alert and there is minimal bleeding from the wound. You should:cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:control any external bleeding, administer oxygen, and transport at once.A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should:splint the elbow in the position found and transport.A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be most suspicious for:posterior hip dislocation.A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:apply padded board splints to both sides of the leg.A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should:apply a tourniquet just below the shoulder.During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:apply gentle manual traction in line with the limb and reassess for a pulse.During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:stabilize the pelvis with a pelvic binder and protect the spine.You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should:assess distal pulse, motor, and sensory functions.Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?Muscle activity increasesYou and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:move him as a unit to a supine position.You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:move him into the cooled ambulance.You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and pink froth coming from his nose and mouth. You should:suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.