JBL Trauma ; Questions and Answers (A+)
EMTs are assessing a man who was injured while trying to rescue a pet from his
burning house. Which of the following assessment findings should be the MOST
immediately concerning?
A) Severe blisters to both hands
B) Closed deformity of the wrist
C) Dry cough and a hoarse voice
D) Clothes adhered to burned skin Correct Answer-C
(Any condition or injury that involves airway, breathing, or circulation warrants
the EMT's most immediate attention. A dry cough and hoarse voice are signs of
inhalation injury and airway swelling. Carefully monitor the pt and be prepared
to ventilate him if his breathing becomes inadequate. Transport without delay; a
paramedic intercept should be requested. If the pt's airway completely closes,
more invasive airway management will be needed [cricothyrotomy]. Tend to the
other injuries listed during transport)
Factors that affect a person's ability to compensate for internal or external blood
loss include all of the following, EXCEPT:
A) advanced age.
B) the rate of blood loss.
C) high cholesterol in the blood.
D) blood-thinning medications. Correct Answer-C
(The compensatory responses of tachycardia and peripheral vasoconstriction
decrease as a person ages; thus, older pts are not able to compensate as
effectively as younger pts. Older pts commonly take medications to treat high
BP, such as beta blockers; these drugs may blunt the body's release of the
catecholamines necessary to increase the heart rate. The ability to compensate
for blood loss is also related to how rapidly blood loss occurs. Pts who take
blood-thinning medications [warfarin {Coumadin}] bleed longer than those not
, JBL Trauma ; Questions and Answers (A+)
taking such medications. There is no known correlation between high
cholesterol and a person's ability to compensate for blood loss)
A 44-year-old male experienced burns to his anterior trunk and both arms. He is
conscious and alert, but is in extreme pain. Assessment of the burns reveals
reddening and blisters. This patient has ________________ burns that cover
_____ of his total body surface area.
A) first-degree, 27%
B) partial-thickness, 36%
C) second-degree, 45%
D) full-thickness, 18% Correct Answer-B
(Partial-thickness [second degree] burns damage the epidermis and part of the
dermis, and are characterized by blistering and severe pain. Areas of superficial
[1st degree] burns, which cause reddening of the skin, commonly surround
partial-thickness burns. The anterior trunk [chest and abdomen] accounts for
18% of the total body surface area [TBSA] and each entire arm accounts for 9%.
Full thickness burns [3rd degree] are characterized by charred or white, leathery
skin. Because the entire dermis, including the nerves, are destroyed, pts do not
feel pain)
Prior to your arrival at the scene, a young female was removed from a body of
water after being submerged for an unknown period of time. You should
manage her airway appropriately while considering the possibility of:
A) spinal injury.
B) hyperthermia.
C) internal bleeding.
D) airway obstruction. Correct Answer-A
, JBL Trauma ; Questions and Answers (A+)
(When caring for a pt with a submersion injury [near drowning], you should
consider the possibility of a spinal injury. Many water-related incidents occur
when a pt dives into shallow water and strikes their head. Water can be
aspirated into the lungs, but will not cause an obstruction of the upper airway.
Another common finding in pts with a submersion injury is hypothermia.
Although it is possible for the pt to have internal bleeding at the same time,
especially if they experienced a traumatic injury before the submersion, spinal
injuries are more common)
Which of the following clinical findings is consistent with decompensated shock?
A) Diaphoresis and pallor
B) Falling blood pressure
C) Restlessness and anxiety
D) Tachycardia and tachypnea Correct Answer-B
(During shock, the compensatory mechanisms of the body attempt to maintain
the BP. This is accomplished by increasing the heart rate, shunting blood from
the skin to more vital organs, and increasing the respiratory rate to increase the
O2 content of the blood. Once these compensatory mechanisms fail, the BP will
fall [hypotension]. Restlessness, anxiety, tachycardia, tachypnea, and cool,
clammy skin [diaphoresis] are earlier signs of shock)
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:
A) flail chest.
B) pneumothorax.
C) isolated rib fracture.
, JBL Trauma ; Questions and Answers (A+)
D) pulmonary contusion. Correct Answer-A
(Flail chest: 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 the chest wall may be
detached from the rest of the thoracic cage; the detached portion of the chest
wall moves opposite of normal. It moves in during inhalation and out during
exhalation [paradoxical motion]. Isolated rib fractures are not associated with
paradoxical motion because they are usually fractured in only now place.
Pneumothorax: the pt's respirations are often labored; in severe cases, an entire
side of the chest may not move at all. Pulmonary contusion: [bruising of there
lung tissue] does not cause paradoxical chest motion unless associated with a
flail chest)
A 33-year-old factory worker was crushed between two pieces of machinery.
You find him lying supine on the ground complaining of severe pain to his pelvis.
He is restless, diaphoretic, and tachycardic. What should you do?
A) Prepare for immediate transport
B) Perform a detailed secondary exam
C) Carefully log roll him to check his back
D) Palpate his pelvis to assess for crepitus Correct Answer-A
(Based on the MOI and the presence of signs of shock [restlessness, tachycardia,
diaphoresis], you should suspect that the pt has a fractured pelvis and is
bleeding internally. Therefore, after completing your primary assessment and
initiating shock treatment, you should perform a rapid H>T assessment to assess
for other injuries and then prepare for transport. You should also avoid
palpating his pelvis; this will only cause further pain and may cause additional
injury. Palpation of the pelvis is performed to assess stability, not to elicit
crepitus. Consider applying a pelvic binder device or tying a sheet around his
hips in order to reduce the space within the pelvis; doing so may help slow
internal bleeding. A detached secondary exam of a critically injured pt at the
