NREMT Trauma Exam Questions and Answers (2023 / 2024) (Verified Answers)
Damaged small blood vessels beneath the skin following blunt trauma causes:
A:mottling.
B:ecchymosis.
C:hematoma.
D:cyanosis.
B;
Reason:
When small blood vessels beneath the skin are damaged, blood seeps into...
When small blood vessels beneath the skin are damaged, blood seeps into the soft
tissues. This manifests as a bruise, also referred to as ecchymosis. A hematoma
develops when larger blood vessels are ruptured and the internal bleeding forms a
"lump." Cyanosis is a blue or purple discoloration of the skin and signifies a low content
of oxygen in the blood. Mottling occurs when the skin takes on a blotched, purple
appearance and is a sign of shock (hypoperfusion).
During transport of a patient with a head injury, which of the following will
provide you with the MOST information regarding the patient's condition?
A:Heart rate
B:Mental status
C:Pupil size
D:Blood pressure
B;
Reason:
The patient's mental status provides you with the most information regarding overall
perfusion status, especially when monitoring a patient with a head injury. Frequent
neurologic assessments, which includes assessing the patient's pupils, are critical in
determining if the patient's condition is improving or deteriorating. Vital signs should be
monitored according to the patient's condition, at least every 5 minutes if he or she is
unstable and at least every 15 minutes if he or she is stable.
You are called to a local nightclub for an injured patient. Law enforcement
personnel have secured the scene. Upon arrival, you see a young man who is
lying on the ground screaming in pain; bright red blood is spurting from an
apparent stab wound to his groin area. You should:
A:control the bleeding.
B:prevent hypothermia.
,C:ensure an open airway.
D:apply 100% oxygen.
A; This is correct!
Reason:
This patient's airway is obviously patent; he is screaming in pain. Blood spurting from
the groin area indicates arterial bleeding from the femoral artery. If this bleeding is not
controlled immediately, the patient will die. Oxygen and other shock treatment (ie,
keeping him warm) should be initiated after this life-threatening bleeding is controlled. If
you take the time to set up and administer oxygen prior to managing the bleeding, the
patient will die. Base your treatment priorities on what will kill the patient first.
When assessing and treating a patient with a gunshot wound, you should
routinely:
A:evaluate the pulses proximal to the wound.
B:apply ice directly to the wound.
C:determine why the patient was shot.
D:look for the presence of an exit wound.
D;
Reason:
When assessing a patient who sustained a gunshot wound, you should routinely look
for an exit wound, which may be difficult to find. Exit wounds can be a source of
continued bleeding, both externally and internally. They may or may not follow the same
path as the entrance wound. This is why it is important to conduct a thorough
examination of the patient. Ice can be applied to the wound, but only after the wound
has been covered by a sterile dressing. Determining why the patient was shot is the
responsibility of law enforcement, not the EMT. If the wound is close to an extremity,
pulse, motor, and sensory function should be assessed distal to the wound.
Following blunt trauma to the chest, a 33-year-old male has shallow, painful
breathing. On assessment, you note that an area to the left side of his chest
collapses during inhalation and bulges during exhalation. These are signs of
a/an:
,If two or more ribs are fractured in two or more places or if the sternum is fractured
along with several ribs, a segment of chest wall may be detached from the rest of the
thoracic cage. This injury is called a flail chest. In a flail chest, the detached portion of
the chest wall moves opposite of normal. It moves in during inhalation and out during
exhalation (paradoxical motion). Isolated (single) rib fractures are not associated with
paradoxical motion because they are usually only fractured in one place. In a
pneumothorax, the patient's respirations are often labored; in severe cases, an entire
side of the chest may not move at all (asymmetrical chest movement). A pulmonary
contusion (bruising of the lung tissue) does not cause paradoxical chest motion unless
associated with a flail chest.
Following a head injury, a young female is semiconscious and is bleeding from
the nose and left ear. You should:
A:control the bleeding from her nose by pinching her nostrils closed.
B:place a pressure dressing over her ear to prevent blood loss.
C:cover her ear and nose with a loose gauze pad to collect the blood.
D:insert a nasal airway to keep her tongue from blocking the airway.
C;
Reason:
Blood draining from the ears or nose following a head injury may contain cerebrospinal
fluid (CSF) and indicates a skull fracture. In these cases, do NOT attempt to stop the
flow of blood. Applying excessive pressure may force the blood leaking from the ears or
nose to collect within the cranium, which could increase the pressure on the brain and
cause permanent damage. Loosely cover the ears or nose with a sterile gauze pad to
collect the blood and help keep contaminants out (patients with a skull fracture and CSF
leakage are at risk for meningitis). The nasopharyngeal (nasal) airway is contraindicated
in patients with a possible skull fracture, especially if blood is draining from the nose.
The airway adjunct may inadvertently enter the cranial vault through the fracture.
A 23-year-old male was struck across the face with a baseball bat. His eyes are
swollen shut, he has massive facial bruising and deformities, and has blood in
his mouth. Your MOST immediate concern should be:
Few things will kill a patient quicker than a compromised (nonpatent) airway. Blood in a
, patient's mouth must be removed immediately. It may be aspirated into the lungs or, if
clotted, obstruct the airway. Spinal trauma, intracranial bleeding, and vision loss are all
possible in a patient with blunt trauma to the face; however, airway compromise is the
most immediate life threat. Remember, treat what will kill your patient first.
A young male has an open abdominal wound through which a small loop of
bowel is protruding. There is minimal bleeding. The BEST way to treat his injury
is to:
A:apply dry sterile gauze pads to the wound and then keep them continuously
moist by pouring sterile saline or water on them throughout transport.
B:apply a sterile trauma dressing moistened with sterile saline directly to the
wound and secure the moist dressing in place with a dry sterile dressing.
C:cover the wound with a dry sterile trauma dressing and tightly secure it in place
by circumferentially wrapping roller gauze around the abdomen.
D:gently clean the exposed loop of bowel with warm sterile saline, carefully
replace it back into the wound, and cover it with a dry sterile dressing.
B;
Reason:
An abdominal evisceration occurs when a loop of bowel, an organ, or fat protrudes
through an open abdominal injury. Never try to replace an organ that is protruding from
an open abdominal wound, whether it is a small fold of peritoneum or nearly all of the
intestines; this significantly increases the risk of infection. Instead, cover it with sterile
gauze pads or a sterile trauma dressing moistened with sterile saline and secure the
moist dressing in place with a dry sterile dressing. Some EMS protocols call for an
occlusive dressing over the organs, secured by trauma dressings. Do not apply
excessive pressure when dressing and bandaging the wound; this may force the
protruding organ or loop of bowel back into the abdominal cavity.
Displaced fractures of the proximal femur are characterized by:
A:a flexed hip joint and inward thigh rotation.
B:hip joint extension and external leg rotation.
C:lengthening and internal rotation of the leg.
D:shortening and external rotation of the leg.
D;
Reason:
Fractures of the proximal (upper) part of the femur are especially common in older
people, particularly those with osteoporosis, but may also occur as a result of high-
energy trauma in younger patients. Although they are usually called hip fractures, they
rarely involve the hip joint. Instead, the break goes through the neck of the femur, the
middle region, or across the proximal shaft. Patients with displaced fractures of the
proximal femur display a very characteristic deformity. They lie with the leg externally
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