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The LEAST significant complication associated with damage to the skin following a burn injury is:
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Terms in this set (251)
The LEAST significant complication associated with damage to the skin following a burn injury is:
decreased melanin granules.
The skin sheds excess heat from the body through:
the evaporation of sweat
The severity of a thermal burn correlates directly with:
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:
an open flame.
Which of the following statements regarding scald burns is correct?
Scald burns often cover large surface areas because liquids spread quickly.
Which of the following burn injuries or patterns should make you the MOST suspicious for abuse?
Burns with formed shapes
What type of thermal burn is MOST commonly associated with inhalation injury?
Steam burns
Flash burns:
are usually relatively minor compared with the potential for trauma from whatever caused the flash.
Burn shock is caused by:
fluid loss across damaged skin and volume shifts within the rest of the body.
If an acutely burned patient is in shock in the prehospital setting:
you should look for another injury as the source of shock.
Supraglottic damage following a burn is MOST often caused by:the inhalation of superheated gases.Which of the following is the LEAST common cause of death from fires?Integument burnsWhich of the following statements regarding carbon monoxide (CO) poisoning is correct?Never rule out CO poisoning because of the absence of cherry red skin.The progression of a chemical burn is MOSTLY dependent on:the length of time the corrosive chemical remains on the skin.The degree of absorption of a corrosive chemical determines:whether toxicity is local or systemicDry powder chemicals:should be brushed off the skin before irrigation with water.Phosphorus is found in _____________ and burns when exposed to _____________.fireworks, airChemicals such as Lewisite and phosgene oxime: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?PhenolThe appropriate treatment for MOST chemical burns is:flushing with copious amounts of water.A person who is exposed to cement:may not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat.A burn caused by a sodium metal should be treated by:covering the burn wound with oil.The outer zone of an entrance or exit wound caused by a contact electrical burn is:the red zone of coagulation necrosis.Relative to the entrance wound caused by an electrical burn, the exit wound:can be quite extensive and deep.Victims standing near an object that is struck by lightning:often have burns characterized by a feathering pattern.Cardiac arrest following an electrical shock:may occur secondarily from hypoxia or as a direct result of the shock.Damage to the kidneys following an electrical injury:occurs when damaged muscle produces myoglobin.The two MOST common causes of death from an electrical injury are:asphyxia and cardiopulmonary arrest.Most lightning-related injuries occur when the victim:receives a "splash" effect after lightning strikes a nearby object.Which of the following locations would provide the BEST protection from a lightning strike?A car with the windows rolled upAfter an adult victim is struck by lightning and experiences cardiac arrest:his or her heart may resume beating spontaneously.The majority of victims struck by lightning:experience confusion and some degree of amnesia.Compared to beta radiation particles, alpha radiation particles:have minimal penetrating energy.________ radiation is very penetrating and easily passes through the body and solid materials.GammaMany of the physiologic changes caused by acute radiation syndrome:occur over time and will not be apparent in the prehospital setting.The onset of ___________ soon after exposure to radiation is a predictor of poor outcomes.vomitingUnlike chemical burns, radiation burns:may appear hours or days after exposure.When assessing a burn patient, it is MOST important to:be alert for occult trauma that could affect patient outcome.While standing by at the scene of a structural fire, it is MOST important to remember that:toxic gases are often present, even after the fire is out.Upon initial contact with a severely burned patient, you must:ensure that the patient is not still burning.If a burn patient presents with a hoarse voice and states, "I'm cold," your MOST immediate concern should be:inhalation injury.Patients suspected of having burns to the upper airway will benefit MOST from:cool, humidified oxygen.With regard to a thermal burn injury, the zone of coagulation:is the central part of the burn and suffers the most damage.A superficial burn is:characterized by reddened skin with varying degrees of pain.Which of the following statements regarding partial-thickness burns is correct?Partial-thickness burns are usually extremely painful for the patient.Unlike partial-thickness burns, full-thickness burns:destroy the base membrane of the dermis that produces new skin cells.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 area18Which of the following statements regarding the rule of palms is correct?The patient's palm, excluding the fingers, represents 1% of his or her total body surface areaThe purpose of estimating a patient's total body surface area burns in the prehospital setting is to:help the paramedic determine the most appropriate destination hospital.The secondary assessment of a severely burned patient is intended to:identify other injuries that may have a higher priority for treatment.Full-thickness circumferential burns to the chest:may cause significant restriction of respiratory excursion.A burn patient with a history of chronic obstructive pulmonary disease:may be triaged as a critically burned patient, even if the burn injury is small.Assessment of a patient who may have been exposed to radiation begins by:determining if the scene is safe to enter.Immediate care for a burn patient involves:stopping the burning process.The MOST acute complication associated with large body surface area burns is:hypothermia.Nasotracheal intubation of a patient with upper airway burns:is a complicated procedure and should be avoided.If intubation of a burn patient becomes necessary, you should avoid cutting the ET tube down to make it shorter because:facial edema may cause tube dislodgement 2 to 3 days after the burnWhich of the following statements regarding prehospital vascular access and fluid therapy in the severely burned patient is correct?At least one large-bore IV should be started while en route to the hospital.When considering analgesia for a burn patient who is in severe pain, you must remember that:burns increase the metabolic rate, which may necessitate higher than normal doses of analgesics.The application of ice to partial-thickness burns: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 moist dressings.Which of the following statements regarding sodium metal chemical burns is correct?Do not flush with water as doing so may produce heat and cause an explosion.Specific treatment for a hydrofluoric acid burn is:calcium chloride.Which of the following burn injuries would MOST likely require transport to a burn specialty center?Burns that involve the hands, feet, or genitaliaA partial-thickness burn is considered to be critical if it:involves more than 30% of the body surface area.A full-thickness burn is considered to be critical if it:occurs in a patient with a significant medical illnessYou 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?36%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:assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea.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?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: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:administer high-flow oxygen, keep him warm, start at least one large-bore IV of normal saline, and administer fluid boluses to maintain adequate perfusionA 4-year-old boy pulled a pot of boiling water off of the stove and experienced partial-thickness splash burns to his neck, anterior trunk, and both anterior arms. During your assessment, you note that the child is conscious but is not crying. He is tachypneic and tachycardic, and his skin is cool and moist. Other than the burns, there are no other gross injuries. Which of the following statements regarding this scenario is correct?The child may be hypoglycemic and requires assessment of his blood glucose level.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:auscultate his breath sounds before administering IV fluids.You respond to an industrial plant for a 42-year-old man with a chemical burn. Upon arrival at the scene, you find the patient to be ambulatory. He tells you that he was moving some bags of dry lime when one of the bags broke and spilled lime all over him. After donning the appropriate personal protective equipment, you should:remove his clothing, brush as much of the lime off of him as possible, and flush the affected areas with copious amounts of water.A 24-year-old woman was struck by lightning. Bystanders moved the patient to an area of safety but did not provide any other care before your arrival. Your primary assessment reveals that the patient is pulseless and apneic. You begin CPR and apply the cardiac monitor, which reveals asystole. After requesting a backup paramedic unit, the MOST appropriate treatment for this patient involves:continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary.You are transporting a conscious but confused 29-year-old man after he was electrocuted. The patient is on high-flow oxygen, has an IV line of normal saline in place, is on a cardiac monitor, and has his spine fully immobilized. During transport, it is especially important for you to:remain alert for lethal cardiac dysrhythmias and be prepared to defibrillate.D) hemorrhage1. The MOST significant immediate threat to a patient with a soft-tissue injury is: A) nerve damage. B) infection. C) disfigurement. D) hemorrhage.B) integument.2. The skin is also referred to as the: A) melanin. B) integument. C) epithelium. D) collagen.A) providing the immune response for the body3. All of the following are functions of the skin, EXCEPT: A) providing the immune response for the body. B) protecting the underlying tissue from injury. C) sensing changes in the external environment. D) assisting in the regulation of body temperature.A) consists of nonliving cells that are continuously being shed.4. The outermost layer of the epidermis: A) consists of nonliving cells that are continuously being shed. B) is a tough, highly elastic layer than contains melanin granules. C) contains numerous fibroblasts that secrete collagen and elastin. D) is comprised of living cells that give rise to the stratum corneum.C) Collagen5. _________ is a fibrous protein that gives the skin high resistance to breakage under mechanical stress. A) Fibrin B) Elastin C) Collagen D) MelaninB) blood vessels in the dermis dilate, which increases blood flow to the skin and allows heat to dissipate.6. When the ambient temperature is high: A) the dermis produces less collagen, which temporarily decreases the skin's ability to retain warmth. B) blood vessels in the dermis dilate, which increases blood flow to the skin and allows heat to dissipate. C) sweat glands in the epidermis produce sweat, which is evaporated from the skin surface by the air. D) constriction of the vessels in the dermis brings warm blood to the surface of the skin, where it is eliminated.D) triggers mast cells to degranulate and synthesize special chemical mediators, which causes the injured area to become warm and red.7. Physical injury to the skin: A) causes a decrease in the production of macrophages and lymphocytes, thus increasing the risk of infection. B) commonly destroys the stratum corneum, the deep dermal layer of the skin, and causes nerve damage. C) promotes cutaneous vasoconstriction, which shunts blood away from the injury and manifests as pallor around the injury site. D) triggers mast cells to degranulate and synthesize special chemical mediators, which causes the injured area to become warm and red.B) the production of sweat, which is evaporated from the surface of the skin.8. The skin helps regulate body temperature through: A) peripheral vasodilation, which shunts cool blood to the core of the body. B) the production of sweat, which is evaporated from the surface of the skin. C) increased elastin production, which provides insulation to the epidermis. D) cutaneous vasoconstriction, which brings warm blood to the skin's surface.A) Sebum9. Which of the following substances is produced in the dermis and keeps the skin supple so that it doesn't crack? A) Sebum B) Elastin C) Collagen D) Ground substanceC) also called the superficial fascia and consists mainly of adipose tissue.10. 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) often remains open, heals more slowly, and is more likely to result in abnormal scar formation.11. A laceration that lies perpendicular to the skin's tension lines: A) results in minimal external bleeding and typically heals spontaneously within 2 to 3 hours. B) generally remains closed and does not require suturing or other methods of wound closure. C) often remains open, heals more slowly, and is more likely to result in abnormal scar formation. D) does not disrupt the body's blood-clotting process and tends to heal without the formation of a scar.B) They are often the most obvious, but are seldom the most life threatening.12. Which of the following statements regarding soft-tissue injuries is correct? A) Most soft-tissue injuries require immediate care to prevent blood loss. B) They are often the most obvious, but are seldom the most life threatening. C) Soft-tissue injuries should be covered immediately upon patient contact. D) Most soft-tissue injuries are hidden and require a systematic assessment.D) temporarily stops bleeding via vasoconstriction and platelet aggregation.13. 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.B) histamine causes vasodilation and increased blood flow to the injury.14. During the inflammation phase of the healing process: A) white blood cells are forced away from the injury by vasoconstriction. B) histamine causes vasodilation and increased blood flow to the injury. C) damaged cell parts and microorganisms invade and infect the wound. D) the processes of epithelialization and collagen synthesis are impaired.A) new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue.15. During the neovascularization phase of the wound healing process: A) new blood vessels form as the body attempts to bring oxygen and nutrients to the injured tissue. B) histamine makes the capillaries more permeable, resulting in swelling in and around the injury site. C) collagen provides stability to the damaged tissue and joins wound borders, thereby closing the open tissue. D) microscopic vasculature damaged by the injury is digested by macrophages through a process called phagocytosis.A) Diabetes16. Which of the following conditions or factors would MOST likely delay or impair healing of a wound? A) Diabetes B) Obesity C) Alcohol use D) HypertensionD) corticosteroids17. A patient taking _______________ would MOST likely experience a delay in the healing of a wound. A) antidepressants B) acetaminophen C) antihypertensives D) corticosteroidsC) it is caused by a human or animal bite.18. A wound is at HIGHEST risk for infection if: A) the patient uses an antibacterial spray. B) it occurs to any part of the facial area. C) it is caused by a human or animal bite. D) the patient has poor peripheral circulation.B) A bedridden patient19. Which of the following patients is at HIGHEST risk for a pressure injury? A) An obese patient B) A bedridden patient C) A hypertensive patient D) A patient with diabetesA) Degloving injuries20. Which of the following wounds usually requires substantial irrigation and debridement prior to closure? A) Degloving injuries B) Jagged lacerations C) Any wound to the face D) Wounds over tension linesC) Hemolytic streptococci21. Which of the following is the MOST common cause of necrotizing fasciitis? A) A fungal infection B) Clostridium tetani C) Hemolytic streptococci D) Clostridium perfringensC) fever and chills.22. Systemic signs of infection secondary to a soft-tissue injury include: A) erythema. B) pus drainage. C) fever and chills. D) lymphangitis.B) gangrene.23. Necrosis of tissue caused by an anaerobic, toxin-producing bacterium is called: A) tetanus. B) gangrene. C) fasciitis. D) lymphedema.D) tetanus.24. An infection characterized by painful muscle contractions is called: A) pertussis. B) polio. C) rabies. D) tetanus.D) leakage of fluid into spaces between the cells.25. The swelling that occurs in conjunction with a contusion is caused by: A) inflammation of the injured blood vessels. B) rupture of large blood vessels in the dermis. C) aggregation of platelets to the injured site. D) leakage of fluid into spaces between the cells.B) caused by large vessel damage.26. In contrast to a contusion, a hematoma is: A) accompanied by ecchymosis. B) caused by large vessel damage. C) rarely accompanied by a bruise. D) a less significant closed injury.A) how the wound is managed.27. Whether the contamination from an open wound produces infection depends MOSTLY on: A) how the wound is managed. B) the location of the wound. C) the patient's medical history. D) how large the open wound is.C) requires prompt transport to the hospital.28. A patient with nerve compromise following an open injury to the hand: A) should be given analgesia for the pain. B) will likely lose all neurologic function. C) requires prompt transport to the hospital. D) will not be able to move his or her hand.A) is limited because the skin is unbroken.29. Compared to the bleeding from an open wound, bleeding from a closed wound: A) is limited because the skin is unbroken. B) generally requires surgical intervention. C) is not significant enough to produce shock. D) can usually be controlled with direct pressure.C) covering it lightly with a sterile dressing.30. Primary treatment in the prehospital setting for an abrasion involves: A) administering a narcotic analgesic. B) applying an antibiotic ointment or cream. C) covering it lightly with a sterile dressing. D) thoroughly cleaning it to prevent infection.B) The seriousness of a laceration depends on its depth and the structures that have been damaged.31. Which of the following statements regarding lacerations is correct? A) Lacerations are linear cuts that tend to heal well due to their relatively even wound margins. B) The seriousness of a laceration depends on its depth and the structures that have been damaged. C) The first priority in treating a laceration is to cover it with a sterile dressing to prevent infection. D) A laceration must be sutured or otherwise closed within 8 to 10 hours following the injury.D) a loss of blood supply to the avulsed flap.32. In addition to bleeding and contamination, the principal danger associated with an avulsion is: A) undetectable internal damage. B) disfigurement due to severe scarring. C) invasion of the wound with Clostridium tetani. D) a loss of blood supply to the avulsed flap.D) can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly.33. A crushing or tearing amputation: A) is initially treated by applying a proximal tourniquet and retrieving any detached body parts. B) causes less blood loss than expected because the blood vessels retain their ability to constrict. C) cannot be surgically reattached due to the severe vascular and soft-tissue damage that accompanies it. D) can result in excessive blood loss due to hemorrhage if the paramedic does not intervene rapidly.C) Crush syndrome can occur if the body part is entrapped for more than 4 hours.34. Which of the following statements regarding crush injury is correct? A) A crush injury can occur if the PASG is left in place for greater than 1 hour. B) Gangrene often sets in if a body part is entrapped for longer than 30 minutes. C) Crush syndrome can occur if the body part is entrapped for more than 4 hours. D) In a crush injury, the external appearance is a good predictor of internal damage.A) rhabdomyolysis.35. When muscles are crushed beyond repair, tissue necrosis develops and causes the release of harmful products. This process is called: A) rhabdomyolysis. B) myoglobinuria. C) hyperphosphatemia. D) necrotizing fasciitis.B) after the patient's leg is freed from entrapment.36. When a patient's leg is entrapped under a crushing object for a prolonged period of time, toxic metabolic waste products are released into the systemic circulation: A) and result in low serum potassium levels. B) after the patient's leg is freed from entrapment. C) after the leg has been entrapped for 2 hours. D) only if the renal system is functioning properly.A) Compartment syndrome is more likely to occur with closed injuries.37. Which of the following statements regarding compartment syndrome is correct? A) Compartment syndrome is more likely to occur with closed injuries. B) Compartment syndrome is caused by increased pressure within the bone. C) Definitive treatment almost always includes amputation of the affected limb. D) Local tissue death occurs after 2 hours of persistent compartment syndrome.B) erythema.38. Signs and symptoms of compartment syndrome include all of the following, EXCEPT: A) pressure. B) erythema. C) parasthesia. D) passive stretch pain.D) human39. The bite from a ________ poses the greatest risk for serious infection. A) cat B) dog C) raccoon D) humanB) your safety.40. The FIRST aspect to address in any patient with a soft-tissue injury is: A) bleeding. B) your safety. C) airway patency. D) decontamination.C) Plavix41. Which of the following medications would MOST likely interfere with hemostasis? A) Paxil B) Procrit C) Plavix D) TylenolA) Elevation42. Which of the following interventions encourages drainage from the site of a closed wound and reduces swelling? A) Elevation B) Splinting C) Firm compression D) Application of iceA) irrigate with sterile water and apply a sterile dressing.43. 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) cover the wound with an occlusive dressing.44. If your patient has an open wound in which there is a risk of air being drawn into the vasculature, you should: A) cover the wound with an occlusive dressing. B) cover the wound with a hemostatic agent. C) apply direct pressure with moist dressings. D) transport quickly to a hyperbaric chamber.D) they provide a medium for pathogens to grow.45. The use of wet dressings in the field is limited because: A) their use may result in severe hypothermia. B) they are of no value in providing pain relief. C) their sterility cannot be maintained in the field. D) they provide a medium for pathogens to grow.B) Elastic bandages46. Which of the following bandages is associated with the HIGHEST risk of blood flow compromise? A) Roller bandages B) Elastic bandages C) Triangular bandages D) Nonabsorbent bandagesC) it allows platelets to seal the vascular walls.47. 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.B) helps control the bleeding when used in conjunction with direct pressure.48. Elevation of an extremity that has a venous laceration to it: A) is often the only intervention needed to control the bleeding effectively. B) helps control the bleeding when used in conjunction with direct pressure. C) should only be performed if pressure point control has proven ineffective. D) is of minimal to no benefit if the patient is bradycardic and hypotensive.D) motion of the extremity may disrupt the blood-clotting process.49. 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.A) early notification of the hospital is important50. When caring for an amputated body part: A) early notification of the hospital is important. B) the body part should be kept at room temperature. C) the part should be tightly wrapped in a dry dressing. D) applying ice to the body part will keep the cells viable.C) Cardiac arrest patient with an ice pick impaled in the center of the back51. In which of the following patients should the impaled object be removed? A) Apneic patient with a shard of glass impaled in the center of the chest B) Pulseless and apneic patient with a knife impaled in the lower abdomen C) Cardiac arrest patient with an ice pick impaled in the center of the back D) Semiconscious patient with a screwdriver impaled in the side of the headA) carefully assess the skull for an underlying fracture.52. When applying a dressing and bandage to a scalp wound, you should: A) carefully assess the skull for an underlying fracture. B) remove any foreign particles from the wound first. C) always use a loose dressing to soak up the blood. D) apply a cervical collar in case the c-spine is injured.A) airway compromise.53. Your MAIN concern when caring for a patient with a soft-tissue injury to the face should be: A) airway compromise. B) hypovolemic shock. C) injuries to the eyes. D) preventing contamination.D) frequently assess breath sounds for indications of a pneumothorax.54. 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 pneumothoraxB) make every effort to treat the patient before removing the crushing object.55. When managing a patient who is entrapped by a crushing object, it is MOST important to: A) assess perfusion and sensory and motor functions every 5 minutes. B) make every effort to treat the patient before removing the crushing object. C) infuse 2 L of lactated Ringer's solution to combat hyperkalemia. D) give sodium bicarbonate immediately after removing the crushing object.D) aggressively infusing normal saline.56. Renal failure, a key complication of crush syndrome, can be prevented by: A) administering calcium chloride. B) giving 40 mL/kg of lactated Ringer's. C) giving the patient 25 g of glucose. D) aggressively infusing normal saline.C) apply a dry, sterile dressing and transport her to the hospital.57. A 63-year-old diabetic woman presents with an open wound to her forearm that she experienced when she fell a week ago. She tells you that the wound has been draining purulent fluid, but has not been bleeding. The wound itself is red, inflamed, and warm to the touch. You should: A) carefully irrigate the wound with sterile water for 5 minutes. B) apply a moist, sterile dressing and transport to the hospital. C) apply a dry, sterile dressing and transport her to the hospital. D) apply a light coat of antibiotic ointment and cover the wound.A) tetanus58. 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) start two large-bore IV lines of normal saline, apply a cardiac monitor, and contact medical control before removing the rock from her legs.59. While hiking, a 24-year-old woman was pinned from the waist down under a rock that collapsed on her. Upon your arrival, the patient is conscious and alert, and states that she can't feel her legs. She further tells you that she thinks she has been pinned for about 5 hours. She is breathing adequately and has stable vital signs. In addition to administering supplemental oxygen, you should: A) start two large-bore IV lines of normal saline, apply a cardiac monitor, and contact medical control before removing the rock from her legs. B) quickly remove the rock from her legs to restore distal neurovascular function, and administer a 20-mL/kg bolus of lactated Ringer's solution. C) administer 2 mEq/kg of sodium bicarbonate followed by 25 g of 50% dextrose as you slowly and carefully remove the rock from her legs. D) start at least one large-bore IV line and administer 2 to 4 L of normal saline before attempting to remove the rock from her legs.D) carefully assess the scene for safety hazards.60. You are dispatched to a residence for a man who cut his hand with a chainsaw. Upon arriving at the scene, your FIRST action should be to: A) immediately gain access to the patient. B) apply gloves, a gown, and facial protection. C) determine if air medical transport is available. D) carefully assess the scene for safety hazards.B) suction the blood from his mouth and assist ventilations with a bag-mask device.61. A 41-year-old man was assaulted during a robbery attempt. Your primary assessment reveals that the patient is semiconscious. He has massive soft-tissue trauma to the face, inadequate breathing, and oropharyngeal bleeding. You should: A) apply direct pressure to his facial wounds and promptly intubate him. B) suction the blood from his mouth and assist ventilations with a bag-mask device. C) insert a nasal airway, apply oxygen via nonrebreathing mask, and transport. D) suction his oropharynx for 30 seconds and then perform endotracheal intubation.C) apply an icepack to the hematoma and monitor his level of consciousness.62. A 22-year-old man was struck in the forehead by a softball. He is conscious and alert, but complains of a severe headache. Your assessment reveals a large hematoma to his forehead. His vital signs are stable and his breathing is adequate. You should: A) apply firm manual pressure to the hematoma to reduce internal bleeding. B) place him in a sitting position and apply a chemical heat pack to his head. C) apply an icepack to the hematoma and monitor his level of consciousness. D) start an IV of normal saline and administer 2 mg of morphine for the pain.A) readjust the bandage if needed and reassess distal neurovascular function.63. You have dressed and bandaged a laceration to the arm of a 16-year-old woman and are transporting her to the hospital. En route, the patient complains that her fingers are tingling. You touch her hand and note that it is cool. You should: A) readjust the bandage if needed and reassess distal neurovascular function. B) conclude that the laceration has probably severed a major nerve in her arm. C) elevate her arm, apply an icepack over the bandage, and reassess her hand. D) contact the receiving facility and have them place a neurosurgeon on standby.C) apply a tourniquet between her elbow and wrist.64. A young woman attempted to commit suicide by cutting her wrist. Bright red blood is spurting from the injury site. Despite direct pressure and a pressure dressing, the wound continues to bleed heavily. You should: A) apply supplemental oxygen and keep her warm. B) elevate the extremity above the level of her heart. C) apply a tourniquet between her elbow and wrist. D) locate and apply digital pressure to the brachial artery.D) immediately request a special rescue team.65. You are the first unit to arrive at the scene of a small building collapse. As you exit the ambulance, you can see a man pinned under a large metal beam. You should: A) free the patient first and then assess him. B) carefully access the patient and assess him. C) contact medical control for further guidance. D) immediately request a special rescue team.B) Spleen1. Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body? A) Heart B) Spleen C) Vasculature D) Fluid volumeD) with the beginning of the next contraction2. The cardiac cycle begins with the onset of myocardial contraction and ends: A) as blood returns to the right atrium. B) as both ventricles are filling with blood. C) when the ventricles are emptied of blood. D) with the beginning of the next contraction.A) pressure in the aorta against which the left ventricle must pump.3. 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.C) Stroke volume and pulse rate4. 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 rateA) Ejection fraction is the percentage of blood that the heart pumps per contraction.5. 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.B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues.6. Hemoglobin functions by: A) dissolving in blood plasma to create the partial pressure of carbon dioxide. B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues. C) absorbing hydrogen ions in the blood in order to maintain acid-base balance. D) transporting red blood cells throughout the body to ensure adequate oxygenation.D) Platelets7. 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) PlateletsB) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.8. Perfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.C) Kidneys9. Which of the following organs or body systems requires a constant blood supply, regardless of external factors? A) Skin B) Muscles C) Kidneys D) Gastrointestinal tractA) Gastrointestinal tract10. Which of the following organs can sustain the longest period of inadequate perfusion? A) Gastrointestinal tract B) Kidneys C) Spinal cord D) Skeletal muscleA) the body's metabolic rate is slower11. An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because: A) the body's metabolic rate is slower. B) cells shrink as body temperature falls. C) hypothermia promotes oxygen metabolism. D) hypothermia protects hemoglobin molecules.A) preload12. The amount of blood returned to the heart is called: A) preload. B) cardiac output. C) afterload. D) stroke volume.D) carotid artery, 100/7013. External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg. A) jugular vein, 96/62 B) brachial artery, 68/46 C) femoral vein, 114/60 D) carotid artery, 100/70C) rapid transport14. Patients with internal hemorrhage will benefit MOST from: A) IV therapy. B) high-flow oxygen. C) rapid transport. D) PASG placement.A) 4.8 L15. What is the approximate total blood volume of a 150-pound male? A) 4.8 L B) 5.1 L C) 6.2 L D) 6.5 LB) the period of time over which the blood is lost.16. The MOST significant factor that determines how well the body compensates for blood loss is: A) the patient's pulse rate at the time of the injury. B) the period of time over which the blood is lost. C) whether the bleeding is internal or external. D) whether the bleeding is venous or arterial.C) is more likely to clot spontaneously than arterial bleeding.17. Venous 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.D) Anticoagulant use18. 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) keep the patient warm and administer oxygen.19. If you suspect internal bleeding during the primary assessment, you should: A) stop the assessment and transport at once. B) start two large-bore IV lines of normal saline. C) determine the source of the internal bleeding. D) keep the patient warm and administer oxygen.B) is the passage of stools that contain bright red blood.20. Hematochezia: A) indicates digested blood from the upper gastrointestinal tract. B) is the passage of stools that contain bright red blood. C) suggests kidney injury and is characterized by bloody urine. D) is the passage of dark stools and indicates lower gastrointestinal bleeding.A) vomiting.21. All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT: A) vomiting. B) syncope. C) weakness. D) dizziness.C) direct pressure and pressure dressings.22. Most external hemorrhage can be controlled with a combination of: A) pressure dressings and ice. B) elevation and immobilization. C) direct pressure and pressure dressings. D) pressure point control and elevation.A) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature23. What is "warm ischemic time"? A) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature B) The preservation of ischemic organs and tissues when the patient's body temperature is reduced by 1°F per hour C) The period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs D) The preservation of ischemic organs and tissues when the patient's body temperature is increased to at least 101°FC) bone ends will continue to move and destroy partially formed clots.24. 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.B) maintain direct pressure to the wound until the tourniquet has been fully applied.25. When applying a tourniquet to control major external hemorrhage from an extremity injury, you should: A) apply the tourniquet over a joint, as this will further help compress blood vessels. B) maintain direct pressure to the wound until the tourniquet has been fully applied. C) secure the tourniquet in place until the pulses distal to the injury have weakened. D) apply a pressure dressing over the tourniquet to further help control the bleeding.D) promote hemostasis.26. Agents such as Celox, HemCon, and QuikClot are used to: A) repair damaged vessels. B) replace lost blood. C) raise blood pressure. D) promote hemostasis.B) flattened jugular veins27. A patient with hemorrhagic shock would be expected to have: A) warm, flushed skin. B) flattened jugular veins. C) a widened pulse pressure. D) an increased hematocrit.D) Severe burns28. Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burnsA) ventilation assistance and rapid transport.29. A trauma patient with suspected internal hemorrhage and inadequate breathing requires: A) ventilation assistance and rapid transport. B) intubation that is facilitated by medications. C) on-scene IV therapy and rapid fluid boluses. D) oxygen via nonrebreathing mask and transport.D) maintain the systolic blood pressure in a low normal range.30. A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to: A) increase the systolic blood pressure to at least 110 mm Hg. B) restore the patient's blood pressure to its pretrauma reading. C) increase the pulse rate by no more than 10 beats/min. D) maintain the systolic blood pressure in a low normal range.B) Calcium channel blockers31. Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock? A) Tricyclic antidepressants B) Calcium channel blockers C) Nasal decongestants D) Beta-2 adrenergic agonistsC) III32. Confusion, a sustained heart rate greater than 120 beats/min, and a respiratory rate of 32 breaths/min are MOST consistent with class ___ hemorrhage? A) I B) II C) III D) IVA) 50033. A healthy adult can tolerate blood loss of up to ____ mL over a period of 15 to 20 minutes without any negative effects. A) 500 B) 750 C) 1,000 D) 1,500D) vasoconstriction and platelet aggregation.34. 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.C) mottled skin and dilated pupils.35. In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with: A) polyuria and weak pulses. B) bounding radial pulses. C) mottled skin and dilated pupils. D) restlessness and pale cool skin.C) aldosterone and antidiuretic hormone.36. A fall in blood pressure and the resultant changes in plasma osmolality cause the release of: A) glycogen and luteinizing hormone. B) T3 and T4 from the thyroid gland. C) aldosterone and antidiuretic hormone. D) acetylcholine and angiotensin I.A) perfusion.37. Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called: A) perfusion. B) respiration. C) oxygenation. D) metabolism.A) Septic38. Which of the following types of shock is caused by poor blood vessel function? A) Septic B) Cardiogenic C) Hypovolemic D) HemorrhagicD) make note of it and continue your assessment.39. If you discover minor external bleeding during your primary assessment of a patient, you should: A) stop your assessment and take the patient's blood pressure. B) establish a large-bore IV line immediately. C) stop your assessment and control the bleeding. D) make note of it and continue your assessment.C) recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.40. The paramedic's MAIN goal in treating a patient with shock is to: A) administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%. B) start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion. C) recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs. D) maintain body temperature and elevate the patient's legs 6 to 12 inches in order to improve blood flow to the core of the body.D) a falling blood pressure41. Decompensated shock in the adult is characterized by: A) increased tidal volume. B) bounding radial pulses. C) 15% blood loss or more. D) a falling blood pressure.A) Anxiety or agitation42. Which of the following signs would you MOST likely observe in a patient with compensated shock? A) Anxiety or agitation B) Dilation of the pupils C) Absent peripheral pulses D) Response to painful stimuliC) apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.43. You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should: A) administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route. B) administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route. C) apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route. D) control the bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport.B) Bilateral femur fractures44. A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation? A) Closed head injury B) Bilateral femur fractures C) Proximal upper extremity fractures D) Sympathetic nervous system failureB) administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.45. You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should: A) keep him warm, administer high-flow oxygen, establish one large-bore IV line at the scene, and transport. B) administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route. C) administer high-flow oxygen, start two large-bore IV lines at the scene and give a 2- to 3-L fluid bolus, and transport. D) Keep him warm, assist his ventilations, place a hemostatic agent in the wound, transport, and start a large-bore IV en route.B) trauma.1. The acute physiologic and structural change that occurs in a patient's body when an external source of energy dissipates faster than the body's ability to sustain and dissipate it is called: A) injury. B) trauma. C) deceleration. D) kinematics.C) potential, kinetic2. The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy. A) kinetic, potential B) barometric, kinetic C) potential, kinetic D) chemical, potentialA) predict injury patterns found in a patient3. Knowledge of kinetics can help the paramedic: A) predict injury patterns found in a patient. B) determine which organs have been injured. C) quantify how much blood a patient has lost.B) amount of energy in the object and the mechanism by which the object is delivered to the body.4. The primary determinants of the extent of trauma a patient sustains are the: A) type of object that strikes a patient and the part of the body that sustains the most impact. B) amount of energy in the object and the mechanism by which the object is delivered to the body. C) size of the object that strikes the body and any secondary injuries that occur if the patient falls. D) physical size of the patient and the part of the body that sustains direct impact from an object.C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma.5. Which of the following general statements regarding trauma is correct? A) Bullet impact is less if the energy in the bullet is applied to a small area. B) The position of the patient at the time of the event is considered to be an internal factor. C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. D) Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period.D) Mechanism of injury6. Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A) Index of suspicion B) Past medical history C) Age of the patient D) Mechanism of injuryB) systolic blood pressure is less than 90 mm Hg7. According to the American College of Surgeons, an injured patient should be transported to a Level I trauma center if his or her: A) heart rate is greater than 100 beats/min. B) systolic blood pressure is less than 90 mm Hg. C) respiratory rate is less than 14 breaths/min. D) Glasgow Coma Scale score is less than 15.A) Rear-end collision with restrained driver8. Which of the following mechanisms of injury poses the LEAST threat for significant injury? A) Rear-end collision with restrained driver B) Death of an occupant in the same vehicle C) Motorcycle crash at greater than 20 mph D) Vehicular intrusion of greater than 12 inchesA) Two or more proximal long bone fractures B9. Which of the following injuries would MOST likely require transport to a Level I trauma center? A) Two or more proximal long bone fractures B) Superficial burns to an entire lower extremity C) Lateral neck pain following a motor vehicle crash D) Penetrating injury that is distal to the elbow or kneeD) has a known bleeding disorder10. If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: A) is older than 45 years of age. B) takes any kind of medication. C) is emotionally upset or angry. D) has a known bleeding disorder.C) has 24-hour in-house coverage by general surgeons.11. A specific attribute of a Level I trauma center is that it: A) is involved in an injury prevention program. B) can initiate definitive care for all injured patients. C) has 24-hour in-house coverage by general surgeons. D) has rapid access to an off-site anesthesiologist.B) be able to initiate definitive care for all injured patients.12. At a minimum, a Level II trauma center should: A) have an in-house neurosurgeon 24 hours a day. B) be able to initiate definitive care for all injured patients. C) have access to an emergency physician within 20 minutes. D) provide total care for every aspect of a patient's injuries.C) via air transport to the Level I trauma center.13. If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury: A) by ground to the Level I trauma center. B) to the closest hospital for stabilization. C) via air transport to the Level I trauma center. D) by ground to the Level II trauma center.A) The need for definitive airway management14. Which of the following is NOT a factor when considering transport of a trauma patient via helicopter? A) The need for definitive airway management B) Distance from the scene to the landing zone C) Time it will take the aircraft to reach the scene D) Type of terrain on which the helicopter will landD) activate the service as soon as possible.15. When summoning an air transport service to transport a critically injured patient, it is MOST important to: A) determine the flight crew's credentials. B) ensure that the fire department is present. C) predetermine the destination facility. D) activate the service as soon as possibleB) maximum time spent at a scene for a trauma patient16. The "platinum 10 minutes" refers to the: A) maximum amount of time to extricate a patient. B) maximum time spent at a scene for a trauma patient. C) amount of time before decompensated shock occurs. D) amount of time taken to perform a rapid assessment.B) increasing its velocity than by increasing its mass17. An object increases its kinetic energy more by: A) decreasing its speed than by increasing its mass. B) increasing its velocity than by increasing its mass. C) decreasing its velocity than by decreasing its mass. D) increasing its mass than by increasing its velocity.A) 140, 5018. The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. A) 140, 50 B) 160, 30 C) 150, 40 D) 170, 30C) energy can be neither created nor destroyed; it can only change form.19. The law of conservation of energy states that: A) kinetic energy can be converted only to thermal or chemical energy. B) the force that an object can exert is the product of its mass multiplied by its acceleration. C) energy can be neither created nor destroyed; it can only change form. D) a body at rest will remain at rest unless acted upon by an outside force.C) dissipates tremendous forces and causes major injuries20. Sudden deceleration of a motor vehicle that is traveling at 60 mph: A) typically generates forces of up to 10 to 20 g. B) initially causes whiplash injuries to the patient's neck. C) dissipates tremendous forces and causes major injuries. D) causes the driver's body to stop moving at the same time.D) The pressure wave caused by a blast21. Which of the following injury mechanisms would MOST likely result in blunt trauma? A) Small-caliber gunshot wound B) Explosion involving shards of glass C) Falling from a tree onto a fence D) The pressure wave caused by a blastB) tissues are penetrated by single or multiple objects22. Penetrating trauma occurs when: A) internal organs are lacerated and bleed profusely. B) tissues are penetrated by single or multiple objects. C) blunt force trauma causes explosive open injuries. D) a fractured rib perforates the parenchyma of a lung.A) shearing or rupturing of internal organs can occur.23. During abrupt deceleration: A) shearing or rupturing of internal organs can occur. B) the neck commonly sustains hyperextension injuries. C) the skull provides excellent protection for the brain. D) supporting structures of the aorta keep it attached.A) at the time of impact.24. Unlike deceleration injuries, crush and compression injuries occur: A) at the time of impact. B) before impact occurs. C) after the initial impact. D) from penetrating mechanisms.C) aorta.25. The MOST common site of deceleration injury in the chest is the: A) heart. B) esophagus. C) aorta. D) vena cava.C) deceleration of internal organs.26. The third phase of a motor vehicle accident involves: A) crush injuries to the body. B) impact by another vehicle. C) deceleration of internal organs. D) injuries caused by flying debris.B) the front seat occupant has a cervical spine injury until proven otherwise.27. If the windshield of a wrecked vehicle is cracked or broken: A) you should assume that the driver has a severe intracerebral hemorrhage. B) the front seat occupant has a cervical spine injury until proven otherwise. C) the rear seat passenger was likely thrust from the seat into the windshield. D) it is likely that the vehicle was traveling at least 55 mph at the time of impact.D) the presence of tire skid marks at the scene.28. The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is: A) deformity to the driver's brake pedal. B) severe damage to the front rims of the tires. C) a trail of debris leading to the site of impact. D) the presence of tire skid marks at the scene.B) the physical size of the patient29. The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT: A) objects inside the vehicle. B) the physical size of the patient. C) the design of the motor vehicle. D) safety features of the motor vehicleA) knees.30. The initial point of bodily impact when an unrestrained passenger takes the "down and under" pathway during a frontal collision is the: A) knees. B) pelvis. C) femurs. D) abdomen.C) the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.31. When a patient takes the "up and over" pathway during a head-on collision: A) the head takes a higher trajectory, striking the windshield and causing stretching injuries to the neck. B) secondary injuries as the patient is ejected are often less severe than the primary injuries. C) the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx. D) injuries to the parietal aspect of the skull are common as the head strikes the side window.A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact.32. 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.D) trauma to the upper extremities depends on the spatial orientation of the arms upon impact.33. During a lateral impact collision: A) the far-side occupant, even if properly restrained, experiences double the amount of force as the driver. B) the patient's head moves away from the object causing the impact, resulting in stretching injuries. C) properly worn seat belts protect the passenger from pelvic trauma at the time of impact. D) trauma to the upper extremities depends on the spatial orientation of the arms upon impact.B) the position of the headrest.34. The severity of hyperextension injuries to the neck following a rear-end collision depends MOSTLY on: A) the proper use of seat belts. B) the position of the headrest. C) proper deployment of the air bags. D) whether the driver tenses up.B) greatest deceleration35. Following a rotational impact, the MOST severely injured patient(s. will likely be found at the point of: A) least deceleration. B) greatest deceleration. C) secondary impact. D) greatest acceleration.C) Unrestrained passengers are struck with each change in direction the car makes.36. Which of the following statements regarding rollover motor vehicle crashes is correct? A) Injuries to the passengers are usually not serious if seat belts are worn properly. B) Ejection of the patient from the vehicle increases the chance of death by 5 times. C) Unrestrained passengers are struck with each change in direction the car makes. D) The restrained occupant's head and neck usually remain stationary during a rollover.A) Minimal risk of whiplash injuries after a rear-end collision37. Which of the following is NOT a benefit of a properly worn seat belt? A) Minimal risk of whiplash injuries after a rear-end collision B) Prevention of partial or complete ejection from the vehicle C) Prevention of occupants from violently contacting each other D) Distribution of deceleration energy over a greater surface areaD) Abdominal and lumbar spine38. What type of injuries will MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact? A) Pelvic and lumbar spine B) Femur and thoracic spine C) Kidney and thoracic spine D) Abdominal and lumbar spineB) Air bags will provide protection from both initial and secondary impacts39. All of the following statements regarding front air bags are correct, EXCEPT: A) Small children riding in the front seat can be killed when the air bag deploys. B) Air bags will provide protection from both initial and secondary impacts. C) Without the use of a seat belt, front air bags are insufficient in preventing ejection. D) Front air bags will not activate in side impacts or impacts to the front quarter panel.B) minor skin burns40. Common air bag-related injuries include: A) spinal fractures. B) minor skin burns. C) hyperflexion injuries. D) abdominal abrasions.C) allow enough forward flexion and subsequent compression to rupture the uterus.41. Lap belts that are worn alone and too high by a pregnant woman: A) usually do not injure the fetus because the uterus is a highly muscular organ. B) will provide adequate protection for the uterus if the air bag properly deploys. C) allow enough forward flexion and subsequent compression to rupture the uterus. D) will provide equal distribution of forces and prevent forward flexion of the mother.A) protective gear worn by the rider.42. Structural protection afforded to a motorcycle rider during a crash comes from: A) protective gear worn by the rider. B) the main frame of the motorcycle. C) side foot pedals and the handlebars. D) the handlebars and large engine block.A) not protect the cervical spine43. A properly worn motorcycle helmet will: A) not protect the cervical spine. B) eliminate the risk of head trauma. C) decrease the risk of a spinal injury. D) minimize the trauma caused by secondary impacts.D) femurs and tibias44. Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the: A) cervical spine. B) chest and abdomen. C) wrists and forearms. D) femurs and tibias.B) cause an unpredictable combination of blunt injuries45. After a motorcyclist is ejected from his or her motorcycle, secondary collisions: A) most commonly involve a stationary object. B) cause an unpredictable combination of blunt injuries. C) typically cause bilateral fractures of the femurs and tibias. D) result in less severe injuries if the rider is wearing leather.B) adults tend to turn to the side or away from the impact.46. When an adult pedestrian is struck by a motor vehicle, lateral and posterior injuries are most common because: A) the patient is thrust onto the hood of the vehicle. B) adults tend to turn to the side or away from the impact. C) the patient is thrown and lands on his or her side or back. D) the initial impact by the bumper spins the patient to the side.C) pelvis and chest47. The second impact that occurs when an adult pedestrian is struck by a motor vehicle would MOST likely result in injuries to the: A) head and neck. B) hips and knees. C) pelvis and chest. D) lower extremities.A) be run over by the vehicle as they are propelled to the ground.48. Unlike adults, children who are struck by a motor vehicle are MORE likely to: A) be run over by the vehicle as they are propelled to the ground. B) experience injuries to the lower extremities from the initial impact. C) be propelled onto the hood of the vehicle during the second impact. D) turn away from the oncoming vehicle, resulting in posterior trauma.D) chest and abdomen strike the grille or low on the hood of the car.49. According to the Waddell triad, the second impact from a motor vehicle occurs when the: A) head strikes the ground, resulting in skull and facial fractures. B) car's bumper strikes the pelvis and femurs instead of the knees. C) child is run over by the car as he or she is propelled to the ground. D) chest and abdomen strike the grille or low on the hood of the car.A) compression or burst fractures to the lumbar spine.50. When a person falls from a significant height and lands on his or her feet, axial loading results in: A) compression or burst fractures to the lumbar spine. B) shearing injuries to the liver, spleen, and aorta. C) crushing injuries to the heels and hip dislocations. D) disc injuries to the lower cervical and upper thoracic spine.B) 15 feet51. The MOST significant fall occurs from a height greater than: A) 10 feet. B) 15 feet. C) 1.5 times the patient's height. D) 2 times the patient's height.C) involves a disruption of the skin and underlying tissues in a small, focused area.52. Unlike blunt trauma, penetrating trauma: A) is especially common during the primary blast injury following an explosion. B) often causes damage to a large body surface area, even from a single projectile. C) involves a disruption of the skin and underlying tissues in a small, focused area. D) is usually more fatal because of the severe external bleeding that accompanies it.A) The size of the attacker53. Which of the following factors is the LEAST influential in the severity of a stab wound? A) The size of the attacker B) The anatomic area involved C) The length of the knife blade D) The angle of penetrationD) upward54. Compared to stab wounds to the posterior part of the body, stab wounds to the anterior part of the body are generally: A) downward. B) single. C) multiple. D) upward.B) contaminants that were driven into the wound can cause a severe infection.55. 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.C) fires at a higher velocity.56. 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.A) The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes57. 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.D) Tattoo marks from powder burns58. 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 burnsA) Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.59. 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.D) the patient is struck by flying debris, such as shrapnel.60. During an explosion, secondary blast injuries occur when: A) hollow organs rupture due to the pressure wave. B) the patient is thrown against a stationary object. C) the patient sustains severe burns from the intense heat. D) the patient is struck by flying debris, such as shrapnel.B) Primary blast injuries are the most easily overlooked.61. Which of the following statements regarding primary blast injuries is correct? A) Primary blast injuries are typically the most obvious injuries. B) Primary blast injuries are the most easily overlooked. C) Primary blast injuries are the result of flying glass or shrapnel. D) Primary blast injuries are due entirely to intense heat.C) lessens as the person is farther away from the center of the explosion.62. The peak magnitude of the pressure wave experienced by a person: A) causes secondary and tertiary injuries as a result of the explosion. B) will cause less severe trauma if the person is standing beside a solid object. C) lessens as the person is farther away from the center of the explosion. D) causes more severe trauma if the person is in an open area during the explosion.C) farther from the explosion.63. The shock wave velocity from an explosion is slower and its duration is longer if a person is: A) closer to the explosion. B) standing behind a solid object. C) farther from the explosion. D) standing beside a solid object.A) Liver64. Which of the following organs is LEAST susceptible to pressure changes caused by an explosion? A) Liver B) Lungs C) Tympanic membrane D) Gastrointestinal tractD) bradycardia and hypotension65. A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A) syncope and hypertension. B) hypertension and bradycardia. C) hypotension and tachycardia. D) bradycardia and hypotension.