Question 1

The blood pressure of the pregnant woman falls by 5 to 15 mmHg during which trimester?

Accepted Answer

A)   First
B)   Second
C)   Third
D)   Fourth B

Question 2

Which of the following best describes the appropriate timing of the rapid trauma assessment?

Accepted Answer

A)   After the focused history and assessment of the stable trauma patient
B)   After establishing airway, ventilation, and hemorrhage control in a critical trauma patient
C)   Upon making initial contact with the unresponsive trauma patient
D)   When considering accepting a refusal of treatment and transport from a stable trauma patient B

Question 3

Which of the following guidelines applies to prehospital fluid resuscitation of hypotensive patients with intraabdominal hemorrhage?

Accepted Answer

A)   In most cases, fluid administration should be limited to 3 liters.
B)   IV access should be obtained using a saline lock, but fluid resuscitation is contraindicated in the prehospital setting.
C)   Fluid administration rate should be titrated to maintain a systolic blood pressure of 60 mmHg.
D)   IV access is necessary only if the use of PASG fails to improve the patient's clinical condition. A

Question 4

The first stage of wound healing is:

Accepted Answer

A)   hemostasis.
B)   neovascularization.
C)   inflammation.
D)   epithelialization.

Question 5

As the energy from a medium- or high-velocity projectile pushes tissue from its path, which of the following occurs?

Accepted Answer

A)   Damage depends on the net difference between pressure at the entrance wound and pressure at the exit wound.
B)   No vacuum is created when there are both an entrance and an exit wound.
C)   Negative pressure is generated inside the cavity, drawing debris into the wound.
D)   There is negative pressure at the entrance wound and positive pressure at the exit wound.

Question 6

Which of the following is TRUE of defense wounds in the victim of a knife attack?

Accepted Answer

A)   They usually occur to the shoulder as the victim attempts to turn away from the attack.
B)   They often occur to the neck and head as the victim doubles over into a protective posture.
C)   They usually occur to the hands and arms as the victim raises them to ward off the attacker.
D)   They rarely occur because the victim is usually taken by surprise.

Question 7

Which type of firearm usually limits trauma to direct injury?

Accepted Answer

A)   Hunting rifle
B)   Military rifle
C)   Automatic weapon
D)   Handgun

Question 8

Which of the following is associated with assault rifle wounds but not hunting rifle wounds?

Accepted Answer

A)   Permanent cavitation
B)   Multiple wounds
C)   Smaller exit wounds
D)   Larger exit wounds

Question 9

Which diagnostic test is important for the paramedic to include in the assessment of patients with a heat- or cold-related emergency?

Accepted Answer

A)   Blood glucose level
B)   Arterial blood gases
C)   Electrocardiogram
D)   Urine protein level

Question 10

Which of the following agents is the best choice for analgesia in a patient with 9 percent partial thickness burns involving the right lower extremity?

Accepted Answer

A)   Naproxen sodium
B)   Ketorolac
C)   Acetaminophen
D)   Fentanyl

Question 11

Which of the following mechanisms would yield the greatest index of suspicion for serious injury?

Accepted Answer

A)   Helmeted bicyclist losing control and falling off his bike onto a grassy surface at 15 miles per hour
B)   Adult falling 5 feet from a ladder and landing in the mud
C)   Seventy-mile-per-hour motor vehicle crash with partial ejection
D)   Pedestrian struck by a car travelling 5 miles/hour

Question 12

Traumatic asphyxia is a(n) ________ type of injury.

Accepted Answer

A)   compression
B)   deceleration
C)   decompression
D)   acceleration

Question 13

Your patient is a 19-year-old man who was thrown from a horse while riding in a rodeo. After throwing the patient off, the horse stepped on the patient's abdomen. When you reach the patient, you note that his face, neck, and shoulders are pale, cool, and diaphoretic but that the patient's skin is otherwise warm and dry. The patient has some movement and sensation in his forearms and hands but otherwise no movement or sensation below the shoulders. He is anxious and has a respiratory rate of 24, a heart rate of 68, and a blood pressure of 106/66. Which of the following should be the primary concern when determining this patient's transport priority?

Accepted Answer

A)   The potential for neurologic shock, requiring immediate surgery
B)   The potential for intraabdominal hemorrhage that may be masked by loss of nervous function
C)   The potential for traumatic brain injury
D)   The potential for respiratory failure secondary to paralysis of the diaphragm

Question 14

Which of the following represents the modified body surface area percentages in the "rule of nines" for pediatric patients?

Accepted Answer

A)   Posterior chest is 7 percent.
B)   Upper extremities are 13.5 percent each.
C)   External genitalia is 1 percent.
D)   Lower extremities are 13.5 percent each.

Question 15

For the head injury patient without signs of herniation, adjust ventilation rates to maintain a capnography reading of between:

Accepted Answer

A)   15 and 20 mmHg.
B)   25 and 30 mmHg.
C)   45 and 50 mmHg.
D)   35 and 40 mmHg.

Question 16

Which of the following is a complication of positive-pressure ventilation in the patient with significant chest trauma?

Accepted Answer

A)   Pulmonary contusion
B)   Atelectasis
C)   Exacerbation of flail chest
D)   Impaired venous return to the heart

Question 17

Regarding the primary assessment of the patient with suspected traumatic brain injury, which of the following describes the best approach to assessing the patient's neurological functioning?

Accepted Answer

A)   The use of AVPU
B)   Assessing the patient for level of consciousness and orientation to person, place, and time
C)   Assessing a revised trauma score
D)   Assessing a Champion trauma scale score

Question 18

Your patient is the 23-year-old female victim of an attempted abduction at knifepoint. The assailant was interrupted and drew his knife across the victim's throat as he fled the scene. A first responder on the scene immediately applied direct pressure to the neck wound. Your assessment reveals a very agitated young woman with ongoing blood loss despite direct pressure to the wound. There appears to be both bright-red bleeding and slower but steady dark-red bleeding. It appears that the trachea has not been penetrated but that there is a hematoma around the laceration. Which of the following is the most appropriate sequence of intervention for this patient?

Accepted Answer

A)   Apply a pressure dressing to the wound, accompanied by pressure-point compression.
B)   Use rapid sequence intubation of the patient to protect the trachea from the expanding hematoma while maintaining direct pressure on the wound.
C)   Apply an occlusive dressing to the wound, and continue direct pressure.
D)   Apply direct pressure, and request an order from medical control to decompress the hematoma.

Question 19

Which of the following best describes the pathophysiology of most burns to the human body?

Accepted Answer

A)   Heat causes evaporation of water and denatures protein.
B)   Radiation, including solar radiation and radiant heat, alters cell structures.
C)   Chemicals cause an endothermic reaction that destroys tissue.
D)   The skin, and sometimes deeper tissues, are destroyed through combustion.

Question 20

You have responded for an injured person at an address you know to be a motorcycle clubhouse. Your patient was attacked by another party with a broken beer bottle. Your patient has a large laceration on her neck with moderate bleeding. Which property of your dressing material is most important in caring for this patient?

Accepted Answer

A)   Occlusive
B)   Sterile
C)   Absorbent
D)   Adherent

Exam 4: Trauma and Trauma Systems