Question 1

Your patient is a 38-year-old man who was pinned beneath the frame of a vehicle when it slipped off the makeshift jacks he was using to elevate it. The patient's brother thinks he may have been trapped for up to 20 minutes. The rescue unit is preparing to use airbags to lift the vehicle off the patient. Which of the following medications could you consider giving this patient?

Accepted Answer

A)  Magnesium sulfate 
B)  Calcium chloride 
C)  Sodium bicarbonate 
D)  Potassium chloride

Question 2

The uncritical use of which of the following when caring for the trauma patient has been questioned by research?

Accepted Answer

A)  PASG 
B)  Rapid isotonic fluid infusion 
C)  Capillary refill as an indicator of tissue perfusion 
D)  All of the above

Question 3

The suspicion of blunt abdominal trauma should be based primarily on:

Accepted Answer

A)  the mechanism of injury. 
B)  distension of the abdomen on palpation. 
C)  the patient's complaint of abdominal pain. 
D)  the presence of contusions.

Question 4

Which of the following best explains the importance of determining the trauma patient's level of consciousness and orientation in the primary assessment?

Accepted Answer

A)  It determines whether the patient requires further assessment. 
B)  It provides immediate information about the severity of the patient's injury. 
C)  It immediately rules in or out the need for spinal immobilization. 
D)  It serves as a baseline for determining improvement or deterioration in the patient's condition.

Question 5

Your patient is a 15-year-old male who was struck in the chest with a baseball. He is unresponsive, pulseless, and apneic. The monitor shows ventricular fibrillation. This condition is most accurately described as:

Accepted Answer

A)  pericardial tamponade. 
B)  blunt cardiac injury. 
C)  commotio cordis. 
D)  traumatic asphyxia.

Question 6

The phrenic nerve consists of peripheral nerve roots ________ through ________.

Accepted Answer

A)  C-1; C-3 
B)  C-5; C-8 
C)  C-3; C-5 
D)  C-1; C-8

Question 7

When administering fluid to a multisystem trauma patient with no signs of head injury but with signs of hypoperfusion, the paramedic should administer fluid only to maintain a systolic blood pressure equal to ________ mmHg.

Accepted Answer

A)  70 
B)  80 
C)  60 
D)  100

Question 8

Which of the following does NOT indicate compensated shock?

Accepted Answer

A)  Anxiety 
B)  Altered mental status 
C)  Weakness 
D)  Thirst

Question 9

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "starred," and that the driver is not restrained. Which of the following injuries is MOST likely?

Accepted Answer

A)  Whiplash injury of the neck muscles 
B)  Compression injury of the cervical spine 
C)  Distraction injury of the cervical spine 
D)  Ligamentous neck injury due to rotation beyond the range of motion

Question 10

Your patient is a 12-year-old boy who was struck in the right temporal area of the head with a baseball. He had a brief loss of consciousness and is alert on your arrival. You note that he is becoming drowsy and has a strong radial pulse of 60, a blood pressure of 140/70, and a respiratory rate of 12. Which of the following best describes this patient's condition?

Accepted Answer

A)  He is stable, and he most likely has a subarachnoid hemorrhage with no increase in intracranial pressure. 
B)  He is critical, and he most likely has an epidural hematoma with rapidly increasing intracranial pressure. 
C)  He is stable, and he most likely has a mild diffuse axonal injury with no increase in intracranial pressure. 
D)  He is serious, and he most likely has a subdural hematoma with an increase in intracranial pressure.

Question 11

Decompression sickness commonly occurs in divers who are diving below what level?

Accepted Answer

A)  44 feet 
B)  33 feet 
C)  22 feet 
D)  11 feet

Question 12

Which of the following best describes the finding of tracheal shift in the trauma patient?

Accepted Answer

A)  Its absence rules out tension pneumothorax. 
B)  It is the earliest sign of tension pneumothorax. 
C)  It is a rare finding in patients with tension pneumothorax. 
D)  It is a contraindication to needle thoracostomy in tension pneumothorax.

Question 13

Your patient is an 18-year-old man who stepped on a nail in the barnyard. The nail penetrated his tennis shoe and punctured his foot. On your arrival, the patient has removed the nail and the shoe. The wound is about 2 mm in diameter with minor bleeding that has been controlled. The skin around the wound is red. The patient does not want to be transported but asks if you can give him "some ointment and a Band-Aid." You should explain to the patient that this type of injury is associated with an increased risk of:

Accepted Answer

A)  infection. 
B)  delayed bleeding. 
C)  scarring. 
D)  nerve damage.

Question 14

Which of the following parameters should be used to guide the oxygenation and ventilation of the patient with a traumatic brain injury?

Accepted Answer

A)  Maintain an oxygen saturation level of at least 96 percent and a capnography reading between 35 and 40 mmHg. 
B)  Maintain an oxygen saturation level of at least 90 percent and a capnography level  45 mmHg. 
D)  Maintain an oxygen saturation level of at least 90 percent and a capnography reading < 35 mmHg.

Question 15

The substance within the body that is responsible for preventing atelectasis is:

Accepted Answer

A)  alveolar fluid. 
B)  surfactant. 
C)  pleural fluid. 
D)  atelectasis fluid.

Question 16

When a patient falls, which section of the spinal column is the most prone to compression injury?

Accepted Answer

A)  Sacral 
B)  Cervical 
C)  Thoracic 
D)  Lumbar

Question 17

The angle of Louis serves as a landmark for performing needle thoracostomy at which of the following locations?

Accepted Answer

A)  Second intercostal space anteriorly 
B)  Second intercostal space laterally 
C)  Fourth intercostal space anteriorly 
D)  Fourth intercostal space laterally

Question 18

The portion of skin affected by superficial frostbite is the ________ layer.

Accepted Answer

A)  epidermal 
B)  subdural 
C)  intradural 
D)  subcutaneous

Question 19

Which type of radiation particle can travel through 6 to 10 feet of air, penetrate a few layers of clothing, and cause external and internal injuries?

Accepted Answer

A)  Gamma 
B)  Alpha 
C)  Neutron 
D)  Beta

Question 20

Your patient is an 18-year-old man who was slashed across the abdomen with a machete. He has a mass of omentum and small bowel protruding from the wound. Which of the following is your primary concern with this patient?

Accepted Answer

A)  Immediately covering the wound with an occlusive dressing, using your gloved hand if nothing else is available 
B)  Irrigating the exposed organs with sterile saline to remove debris and gently tucking them back into the opening to keep them warm and moist and to prevent further contamination 
C)  Covering the wound with a sterile, saline-moistened dressing covered by an occlusive dressing 
D)  Having the patient hold the omentum and placing him on the stretcher in a position of comfort to transport rapidly

Exam 4: Trauma and Trauma Systems