Deck 28: Bleeding and Soft Tissue Trauma

Question 1

Severe external bleeding should be controlled during what phase of the patient assessment?

A) Primary assessment
B) Scene size-up
C) Secondary assessment
D) Reassessment

Answer 1

A

Question 2

A young male was riding a motorcycle when he lost control and was ejected. The patient is unresponsive and receiving positive pressure ventilation. The secondary assessment reveals bright blood flowing from both nostrils. Management of this bleeding would include:

A) inserting sterile gauze into the nose.
B) placing a loose dressing under the nose.
C) placing in an upright and forward position
D) lightly pinching both nostrils closed.

Answer 2

B

Question 3

Your patient is confused and anxious after falling 20 feet from a ladder onto the grass below. What sign is most suggestive of shock?

A) Heart rate of 112
B) Deformity to the left arm
C) Large hematoma to the head
D) Constricted pupils

Answer 3

A

Question 4

The EMT is by the side of a young female who was cut while washing dishes. She has a jagged laceration to her left forearm that is bleeding steadily and heavily. When attempting to control the bleeding, the EMT would first:

A) tightly wrap roller gauze around a large sterile dressing placed over the top of the injury.
B) apply direct pressure to the elbow to slow the flow of blood into the distal arm.
C) place a large sterile dressing over the site with hand pressure applied over the top of the dressing.
D) wrap the injury site tightly with roller gauze and apply a tourniquet above the laceration.

Question 5

A middle-aged male's arm became caught in a grinding machine, and then immediately removed by coworkers. As you approach the patient, you note him to be holding a bloody towel over a severely deformed right arm. The patient is alert and anxious, and he has a patent airway. His breathing is adequate and his left radial pulse is fast and strong. You note his skin to be cool and diaphoretic. Of the following, which would be done first for this patient?

A) Start positive pressure ventilation.
B) Perform a secondary assessment focusing on his arm.
C) Insert an oropharyngeal airway and administer oxygen.
D) Administer oxygen through a nonrebreather mask.

Question 6

Which statement demonstrates an understanding of shock caused by internal bleeding?

A) "Internal bleeding is not as much of a life threat as external bleeding since the blood remains in the body."
B) "The EMT can control internal bleeding by applying direct pressure to the skin, over the top of the area of suspected internal bleeding."
C) "If a patient is bleeding internally, the signs of shock-such as a rapid heart rate and pale, cool, and clammy skin-are not as obvious."
D) "You should always suspect internal bleeding in a patient with the signs and symptoms of shock but no external bleeding."

Question 7

While en route to a domestic with possible injuries, the police contact you and report a male patient with arterial bleeding from a stab wound to the arm. Given this information, which of the following do you expect?

A) Dark red blood flowing from the injury that is difficult to control
B) Bright red blood oozing from the injury site that is easy to control
C) Spurting blood that is dark red in color and difficult to control
D) Bright red blood that is spurting with each beat of the heart

Question 8

Direct pressure has failed to control an arterial bleed on a patient's leg. The EMT's next action would be:

A) provide oxygen.
B) apply a tourniquet.
C) immediate transport.
D) splint the extremity.

Question 9

You have arrived on a scene where a young girl has pushed her arms through a plate glass window. She is responsive to painful stimuli and has blood spurting from a large laceration on her right upper arm. Your paramedic partner yells for you to immediately apply direct pressure to the laceration to prevent further blood loss, while he works to control the airway. You have yet to apply latex gloves, but are wearing goggles and a gown. What would you do next?

A) Place a tourniquet above the laceration, careful not to get blood on your hands.
B) Apply gloves prior to applying direct pressure over the injury site.
C) Control bleeding by pushing the skin of the laceration together until you can apply gloves.
D) Apply direct pressure to the site with your hands until someone with gloves can take over.

Question 10

Which statement shows that the EMT understands the use of a tourniquet in controlling bleeding?

A) "A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely stopped."
B) "If the tourniquet appears to have stopped the bleeding, the EMT should loosen it slightly to allow a small amount of blood to perfuse the tissues."
C) "If a blood pressure cuff is used as a tourniquet, the EMT should inflate it approximately 50 mmHg above the patient's systolic blood pressure."
D) "Since arteries run close to the body's surface in a joint, the best place to apply a tourniquet is over the joint just above the site of hemorrhage."

Question 11

You arrive at a meat packing plant to find a 30-year-old male cut in the wrist with a sharp knife. The patient appears pale and blood is spurting from the laceration. Your immediate action would be to:

A) assess and manage the airway.
B) apply direct pressure to the laceration.
C) provide supplemental oxygen.
D) check the pulse and blood pressure.

Question 12

You believe that a patient who has been shot in the lower abdomen is bleeding internally and is in an early stage of shock. Which one of the following shows appropriate prehospital care of this patient?

A) Semi-Fowler's position and direct pressure over the injury site
B) Supine position and administration of water by mouth
C) Oxygen therapy and rapid transport to the hospital
D) Oxygen therapy and cold packs to the abdomen

Question 13

In the human body, what occurs when a person is in shock?

A) The cells are getting glucose and other nutrients, but not oxygen.
B) The amount of oxygen to the cells is adequate, but CO₂ is not being eliminated.
C) The blood has an adequate amount of oxygen, but not enough nutrients for cell survival.
D) The cells are not getting enough oxygen and waste products are accumulating.

Question 14

Of the statements that follow, which one describes the best way to determine the severity of a patient's blood loss?

A) "I estimate the blood loss based on the fact that one cup of blood is about 250 mL."
B) "If the pulse rate is over 100 beats per minute, the patient has lost at least 200 mL of blood."
C) "I use the patient's signs and symptoms to judge the severity of the blood loss."
D) "I look at the blood pressure, and if it is less than 100 systolic, the patient has lost 500 mL of blood."

Question 15

A 24-year-old male has cut his arm with a table saw. Assessment reveals dark red blood flowing steadily from the laceration. As an EMT, you would identify this bleeding as:

A) arterial.
B) capillary.
C) venous.
D) lymphatic.

Question 16

As you approach a young male lying on the sidewalk, you observe an area of dark blood on his pants. He appears lethargic, pale, and diaphoretic. Your first action in caring for this patient would be to:

A) apply oxygen.
B) cut the pants.
C) assess the airway.
D) elevate the leg.

Question 17

When performing the primary assessment, which of the following signs or symptoms best suggests that the patient is in shock?

A) Skin that is cool and diaphoretic
B) Radial pulse of 72 beats per minute
C) Bloody shirt from external bleeding
D) Pain at the site of injury

Question 18

You are having a difficult time controlling bleeding from a small skin avulsion on a patient's ankle. Which one of the following statements made by the patient best explains why control has been difficult to achieve?

A) "I take Coumadin for my irregular heartbeat."
B) "My blood pressure sometimes runs a little high."
C) "I take steroids for my lung disease."
D) "I drank a lot of alcohol last night."

Question 19

Another crew has called for your assistance in extricating an obese male with a nosebleed from a third-floor bedroom. As you enter the room, which observation indicates proper management of the patient's condition?

A) The patient is supine, head turned to the side, blood draining from the nose and mouth, cold pack to bridge of the nose.
B) The patient is sitting upright, head tilted back, sterile gauze packed in each nostril.
C) The patient is lying on his side, a loose dressing has been applied below his nose, and a cold pack is on the bridge of his nose.
D) The patient is sitting upright, leaning forward, with nostrils pinched shut.

Question 20

You have been dispatched to a residence where a woman lacerated her arm after falling while holding a drinking glass. She informs you that when she was first cut, blood spurted from the wound, and then within a second or two, it subsided to a mere trickle. She asks why this would happen. Which one of the following is the correct response?

A) "Blood has the ability to clot within a second or two of injury."
B) "Blood vessels tend to constrict quickly once they are injured."
C) "Red blood cells will quickly repair the injury to the blood vessel."
D) "The skin around the injured blood vessels quickly swells and stops bleeding."

Question 21

Which statement indicates an understanding of the EMT's prehospital role in caring for the patient in shock?

A) "The job of the EMT is to assume a trauma patient is in shock and get him or her to the hospital as quickly as possible."
B) "Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so proper care can be given."
C) "If shock is in its early stage, it is not yet life-threatening and the EMT can take more time in assessing and treating the patient."
D) "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport."

Question 22

When providing prehospital care to a patient with a soft-tissue injury, which of the following is true?

A) Gloves are needed only if she has an open soft-tissue injury.
B) Hands must be washed even if gloves were worn during care.
C) Sterile gloves are essential to prevent infection to the patient.
D) Double gloving is necessary to protect from bloodborne diseases.

Question 23

Assessment of an 88-year-old female who fell reveals bruising to her right buttock. The skin is intact and the patient complains of tenderness to the area when you palpate. As a knowledgeable EMT, you would recognize what type of injury?

A) Avulsion
B) Abrasion
C) Open injury
D) Contusion

Question 24

The EMT knows that a function of the skin is to:

A) regulate temperature.
B) prevent blood loss.
C) eliminate wastes like CO₂.
D) permit movement of the body.

Question 25

When assessing a patient, you note a bruise to his chest. On the prehospital care report, this injury is properly documented as:

A) ecchymosis.
B) cyanosis.
C) erythematic.
D) hematoma.

Question 26

While cleaning a gun, a 44-year-old man accidentally shot himself in the abdomen. On arrival the patient is responsive to painful stimuli and lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which of the following shows the correct sequence of events when caring for this patient?

A) Perform a primary and rapid secondary assessment, move to the stretcher for immediate transport, and start positive pressure ventilation en route to the hospital.
B) Perform the primary assessment, administer supplemental oxygen, perform the secondary assessment, transfer to the stretcher, and provide rapid transport.
C) Transfer to the ambulance, provide rapid transport, perform primary and secondary assessments, and administer oxygen therapy en route to the hospital.
D) Transfer to the ambulance, perform the primary assessment, provide oxygen therapy, and provide rapid transport.

Question 27

A 24-year-old female was an unrestrained driver of a car that struck a guardrail, causing her to sustain blunt trauma to the chest and abdomen. Vitals obtained by Emergency Medical Responders (EMRs) are pulse 120, respirations 22, blood pressure 100/58 mmHg, and SpO₂ 96%. As you transport her to the hospital, what finding indicates that the patient is deteriorating?

A) Heart rate 124 beats per minute
B) Blood pressure 86/50 mmHg
C) Blood coming from an abdominal laceration
D) Restless and confused mental status

Question 28

Which of the following signs and symptoms of shock will be observed last?

A) Tachycardia
B) Increased respirations
C) Decreased blood pressure
D) Pale and diaphoretic skin

Question 29

A patient sustained a crush injury after being struck with a baseball bat in the left upper quadrant of the abdomen. Assessment shows bruising to that area with instability noted to the rib cage. The EMT's highest concern regarding this injury should be:

A) fractured ribs.
B) abdominal contusion.
C) injury to the spleen.
D) abdominal evisceration.

Question 30

When managing a patient with a soft-tissue injury, it is essential that the EMT perform which of the following?

A) Thoroughly disinfect dirty lacerations.
B) Control bleeding using sterile dressings only.
C) Use the appropriate personal protective equipment.
D) Cover hematomas with occlusive dressings.

Question 31

A 28-year-old male was cutting limbs from a tree when he lost his footing and fell 20 feet. He is unresponsive and breathing poorly at 28 times per minute. His radial pulse is weak and thready and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual in-line stabilization. A blanket has also been applied and covers the man. Based on these assessment findings, what instruction would you give to the EMRs?

A) "Since he is unresponsive, let's go ahead and open the airway with the head-tilt, chin-lift."
B) "Let's uncover him since increased temperature will dilate his blood vessels and drop his BP."
C) "Let's go ahead and move him to the stretcher for immediate transport to the hospital."
D) "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing."

Question 32

Which of the following describes the layers of the skin?

A) Dermis, muscle, epidermis
B) Epidermis, subcutaneous, muscle
C) Dermis, subcutaneous, muscle
D) Subcutaneous, epidermis, dermis

Question 33

What statement regarding contusions is true?

A) The epidermis is open and actively bleeding.
B) Blood vessels in the subcutaneous layer have been broken.
C) Blood vessels in the dermal layer have ruptured.
D) Blood vessels in the epidermis have broken but the skin is intact.

Question 34

Your patient is a young man who fell down a flight of stairs and is now restless and confused. His airway is open, and he is breathing adequately at 18 times per minute. He has a radial pulse of 92 beats per minute and his skin is cool and diaphoretic. Your next action would be to:

A) check the blood pressure and assess for injuries causing blood loss.
B) administer supplemental oxygen.
C) insert a nasal airway and start positive pressure ventilation with oxygen.
D) immobilize the patient with a cervical collar and long back board.

Question 35

A patient has suffered abrasions to the legs after falling on a moving treadmill. In relation to the function of the skin, the EMT should be most concerned about:

A) loss of body heat.
B) risk for infection.
C) formation of scar tissue.
D) swelling and bruising.

Question 36

Assessment findings of a driver who was ejected from his vehicle in a rollover-type collision include unresponsiveness and bruising to the abdominal and pelvic areas, along with an open femur fracture. The patient has an open airway and is breathing at 32 times per minute. His skin is cool and diaphoretic and the radial pulses are weak. Manual in-line spinal stabilization is being maintained. The EMT's next action would be to:

A) obtain a heart rate and blood pressure.
B) start positive pressure ventilation.
C) examine the fracture site closer.
D) apply an appropriately sized cervical collar.

Question 37

You are called for an 8-year-old boy who has fallen. On scene the boy's mother states that he was running while flying a kite and tripped, striking his face on a rock. Assessment reveals a large reddish-blue lump with intact skin under his left eye. When alerting the hospital emergency department of your arrival, you should inform them that the patient has what type of injury?

A) Ecchymosis
B) Hematoma
C) Evisceration
D) Contusion

Question 38

A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also observe bruising to the chest and abdomen. Which one of the following should you do immediately?

A) Determine the blood pressure.
B) Administer high-concentration oxygen.
C) Evaluate for signs of shock.
D) Suction the airway.

Question 39

You are called for a 2-year-old boy who fell and cut his arm. While en route to the call, the dispatcher informs you that the patient has hemophilia (clotting disorder). As an EMT, you should recognize that:

A) the patient requires oxygen.
B) the patient's blood is infectious.
C) the bleeding may be significant.
D) a mask will need to be worn.

Question 40

A male patient has been shot in the chest with a small-caliber gun. What presentation indicates that he is in an early stage of shock?

A) Alert and anxious, pulse 96, BP 134/88 mmHg, pale and cool skin
B) Slightly confused, pulse 116, BP 112/90 mmHg, warm skin that is flushed
C) Confused and anxious, pulse 144, BP 82/palpation, cool skin that is mottled
D) Confused, pulse 44, BP 110/68 mmHg, cool and cyanotic skin

Question 41

A 62-year-old male was the restrained driver of a car that was hit on the driver's side. Emergency Medical Responders have extricated and fully immobilized him with a cervical collar and long board. When asked, he complains of dizziness as well as leg and arm pain. Assessment reveals multiple contusions and deformity to his left forearm and a laceration with minor bleeding to the left side of his face. His airway is open and his breathing is labored. A rapid radial pulse is felt. Skin is cool and dry. What assessment finding would the EMT address first?

A) Bleeding from facial laceration
B) Rapid pulse
C) Complaint of dizziness
D) Labored breathing

Question 42

An alert and oriented patient has had a portion of his hand amputated by a table saw. Assessment reveals the patient to be in great pain with a moderate amount of dark red blood still coming from the injury site. His airway is open and his breathing is fast, but adequate. The radial pulse is rapid and strong, and his skin is warm and dry. The patient's hand has been placed in a bag of ice by coworkers. Which one of the following should the EMT do immediately?

A) Insert a nasopharyngeal airway.
B) Remove the amputated part from the ice.
C) Control the bleeding with direct pressure.
D) Obtain a full set of vital signs.

Question 43

A 40-year-old homeless male is found lying in the street. On physical examination, you notice that the patient has a stab wound to the mid-chest. He is unresponsive and his skin is cool to the touch. His respirations are snoring at 40 per minute and his pulse is 120. Which of the following would the EMT perform first?

A) Apply a sterile dressing to the wound.
B) Start positive pressure ventilations.
C) Perform a jaw-thrust maneuver.
D) Listen to breath sounds.

Question 44

While riding a bike, a young boy fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out and ran home, where his mother called 911. Assessment reveals a gaping wound to the right neck. All hemorrhage has clotted off and manual in-line spinal stabilization is being maintained. Which one of the following instructions should you provide to the other EMTs on scene?

A) "Take some sterile gauze and carefully place it inside the open wound to prevent additional bleeding."
B) "Place an occlusive dressing over the wound and tape it on all four sides."
C) "Apply a sterile dressing over the wound and hold it in place by wrapping roller gauze around his neck."
D) "Do not worry about covering the wound, just place a cervical collar on him and carefully transfer him to the long board."

Question 45

Which one of the following patients would the EMT recognize as suffering from an evisceration injury?

A) Female with a large flap of skin that has been torn loose from her scalp
B) Male patient with a knife impaled in this right upper abdomen
C) Male patient with a loop of intestine protruding from an open surgical wound
D) Female shot in the chest with "bubbling" coming from the wound as the patient breathes

Question 46

A patient presents with an arrow impaled in the right lower quadrant of his abdomen. He is in excruciating pain and states that he was accidentally shot by a friend while hunting. While there is no external bleeding coming from the injury, the surrounding skin is ecchymotic. Other assessment findings indicate early shock. Which action should the EMT perform first?

A) Carefully remove the arrow.
B) Administer supplemental oxygen.
C) Stabilize the arrow with bulky dressings.
D) Establish manual in-line spinal stabilization.

Question 47

A young female was involved in an altercation and stabbed in the abdomen with an ice pick. After being stabbed, she quickly removed the ice pick. She states that there was not much bleeding but does say it "stings" quite a bit. Assessment reveals a small puncture wound to the right upper quadrant with some dried blood around the site. Which of the following best describes the primary focus of the EMT in caring for this patient?

A) Keeping the entry site clean and free of infection
B) Assessing for internal blood loss or shock
C) Assessing for underlying injury to the spleen
D) Preventing air from entering the abdominal cavity

Question 48

A patient was assaulted and sustained various and multiple injuries. Which injury does the EMT recognize as presenting the greatest risk for infection?

A) Contusion to the chin
B) Closed crush injury to the knee
C) Abrasion to the right side of the face
D) Hematoma to the left foot

Question 49

A patient was building a bomb in his garage when it accidentally detonated. Assessment findings from the rapid secondary assessment reveal intestine and a portion of the liver protruding from the right side of the abdomen. Proper care of this injury would include which of the following?

A) Careful replacement of the organs back into the abdominal cavity
B) Direct but gentle pressure applied to the exposed organs to hold them in place
C) Application of a dry sterile dressing covered with an occlusive dressing taped on three sides
D) Covering the exposed organs with a large sterile dressing soaked with sterile water

Question 50

Which observations direct the EMT to classify a patient's soft tissue injury as an abrasion?

A) Intact skin with ecchymosis noted; patient states minor pain
B) Irregular break in the skin; bleeding moderate but controllable
C) Intact skin with large accumulation of dark blood underneath
D) The skin is scraped and red; blood oozing from the injury site

Question 51

A patient has suffered a small but jagged laceration to her left hand. When cleaning the wound, it is important that the EMT:

A) use sterile gauze and wipe away from the site of injury.
B) apply an antibiotic ointment prior to cleaning the injury.
C) carefully remove any embedded particles from within the laceration.
D) place saline-soaked gauze in the laceration.

Question 52

Prior to your arrival on the scene of a motorcycle crash, an Emergency Medical Responder contacts you via radio and reports that there is one patient who has an avulsion to her left arm. As a knowledgeable EMT, you should anticipate which one of the following?

A) Loose flap of skin torn on her left arm
B) Torn skin with an underlying fracture
C) Bruised skin with a portion of bone protruding
D) Long and deep laceration with moderate bleeding

Question 53

A small metal rod was shot from a metal lathe and is impaled in a man's inner thigh. Assessment indicates that there is no active bleeding from the site, but the surrounding tissues are ecchymotic. The paramedic asks you to stabilize the rod with bulky dressings. You recognize this action as important because it will:

A) prevent motion of the rod and further internal injury.
B) control any internal hemorrhage that may be occurring.
C) prevent bacteria from entering into the body.
D) apply pressure to the broken blood vessels in the skin.

Question 54

You are transporting a male patient who was stabbed in the left upper quadrant of the abdomen. On scene the patient was alert and oriented with a patent airway and adequate respirations. There was minimal hemorrhage from the stab wound, which was covered with a sterile dressing. Oxygen was applied and transport was initiated. During the reassessment, which one of the following assessment findings should the EMT consider of most concern?

A) Statement that the pain at the injury is increasing
B) Observation that blood is beginning to ooze from the injury
C) Increased redness and edema to area surrounding stab wound
D) Increase in heart rate and unexplained restlessness

Question 55

The EMT's initial concern when treating a patient with a gunshot wound to the chest is:

A) evaluating for shock.
B) ensuring an open airway.
C) applying sterile bandages.
D) looking for an exit wound.

Question 56

You are called for a 78-year-old female who fell earlier in the day. As you enter her kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be blood on her pants. She is on oxygen and is breathing in a moderately labored manner. She states that she fell a few hours ago and now the pain and swelling in her arm are unbearable. Which one of the following would you do first?

A) Take manual in-line spinal stabilization.
B) Place a cold pack to her cheek.
C) Check her SpO₂ level.
D) Examine her arm for deformity.

Question 57

A patient has suffered an open crush injury to his elbow. As you approach, you note the patient sitting upright holding a towel to his elbow. Although the towel is soaked with blood, the elbow does not appear to be actively bleeding. Your first action in caring for this patient should be to:

A) apply supplemental oxygen.
B) evaluate the patient's airway.
C) place a sterile dressing over the injury.
D) examine the patient's elbow.

Question 58

A 49-year-old male was climbing on a truck at a construction site when he fell backward to the ground. He presents with a 2-inch linear wound to the top of his head. Bleeding has been controlled and the skull can be seen through the wound. How should you document this injury on the prehospital care report?

A) Avulsion
B) Contusion
C) Crush
D) Laceration

Question 59

Which one of the following patients requires the EMT to remove an impaled object in the field?

A) Young female with a broken pencil through her cheek and into the oropharynx; blood from the injury is flowing into her throat
B) Male patient with a six-inch knife to his left upper quadrant; there is active bleeding around the injury site
C) Female with a knife to the right side of her chest; she is short of breath and coughing up blood
D) Male patient who fell on a screwdriver, which is impaled through his hand; the patient is in pain and requesting that you remove the screwdriver

Question 60

Which instruction is appropriate when helping a new EMT care for a male patient with a laceration to his left arm?

A) "When you are done cleaning the laceration, apply some sterile gauze soaked in sterile saline."
B) "It is best to let the wound bleed some. This is the body's natural way of cleaning the wound."
C) "Don't worry about removing embedded dirt from the wound, just the dirt around the laceration."
D) "Do not cut away his sleeve over the top of the laceration as it will help control the bleeding."

Question 61

You are called for an alert and oriented female who had a cesarean section several days ago. Today she bent over and tore the surgical incision open. There is a moderate amount of bleeding coming from the site. What should the EMT do to control the bleeding?

A) Place a saline-soaked bandage over the top of the incision.
B) Administer supplemental oxygen.
C) Apply a large dressing over the incision.
D) Pack sterile gauze dressings into the incision.

Question 62

You have just applied a pressure dressing to the leg of a woman who suffered a deep laceration to her calf from a piece of broken glass. Which one of the following should you do next?

A) Determine if the bleeding has stopped.
B) Obtain a follow-up blood pressure.
C) Apply a tourniquet above the laceration.
D) Assess for a pedal pulse.

Question 63

Which one of the following statements made by the EMT shows an understanding of dressing and bandaging a wound?

A) "When applying a bandage over a dressing, I apply it loosely so as not to interfere with circulation to the extremity."
B) "If bleeding from a wound cannot be initially stopped with direct pressure, I apply a bandage and dressing so I can take care of other injuries."
C) "I always leave the tips of the fingers or toes exposed when bandaging the arm or leg so future assessment of circulation can be made."
D) "I always bandage across the joint above the wound since this helps control bleeding by applying pressure to the proximal blood vessels."

Question 64

Which of the following statements about dressings and bandages is true?

A) Dressings must be airtight to prevent contamination.
B) Bandages should not be applied until bleeding is controlled.
C) Dressings are placed over bandages.
D) Dressings should be placed into open wounds.

Question 65

A patient has had part of his right thumb amputated in an industrial accident. Coworkers have retrieved the thumb and wrapped it in a towel. The EMT demonstrates appropriate handling of the amputated part when he:

A) places the thumb in ice water.
B) keeps the thumb warm during transport.
C) places the thumb in sterile saline.
D) wraps it in a dry sterile dressing.

Question 66

A female patient has been involved in a motorcycle crash. Your scene size-up reveals her to be unresponsive and lying in the roadway. It also appears that her left leg has been amputated at the knee. Which one of the following should you do immediately?

A) Assess the leg for bleeding.
B) Perform the jaw-thrust maneuver.
C) Cover the knee with a sterile dressing.
D) Locate the amputated leg.

Question 67

A pregnant 31-year-old has been shot in the neck. Currently, she is responsive to verbal stimuli, with an open airway and rapid, but adequate respirations. Her radial pulse is weak and fast. Vital signs are as follows: pulse 152, respirations 22, blood pressure 92/76, and SpO₂ at 100% on high-concentration oxygen. When caring for this patient, what other intervention will most benefit this patient?

A) Application of the pneumatic anti-shock garment (PASG)
B) Wait on scene for an ALS paramedic with an ETA of 10 minutes
C) Immobilization and immediate transport
D) Cover with a blanket and transport in a semi-Fowler's position

Question 68

Your patient is a 48-year-old male who is in shock from injuries sustained in a motor vehicle collision. Which one of the following assessment findings is an indication for the use of the pneumatic anti-shock garment (PASG)?

A) Heart rate of 148 beats per minute
B) Patient response to painful stimuli with a moan
C) Evisceration of abdominal contents
D) Pelvic instability with a BP of 78/48 mmHg

Question 69

Which one of the following types of injuries is most likely to result in capillary bleeding only?

A) Avulsion
B) Abrasion
C) Laceration
D) Penetration

Question 70

Which one of the following best describes a topical hemostatic agent?

A) Rapid acting pill that promotes clotting in the body
B) Topical medication that reduces chances of infection
C) Dressing specially designed to stop bleeding
D) Liquid that stops bleeding by "gluing" the edges of a laceration together

Question 71

A construction worker has a metal rod impaled in his right forearm. Assessment of the injury indicates heavy bleeding from around the impaled object. Which one of the following should you do first?

A) Apply direct pressure around the rod.
B) Place a tourniquet above the injury site.
C) Attempt once to remove the metal rod.
D) Apply pressure on the rod to stabilize it.

Question 72

Which statement made by the EMT shows an understanding of bandaging an open wound?

A) "Bandages are sterile gauze pads used to stop bleeding."
B) "I use bandaging material to secure a dressing in place."
C) "You must always make sure that the bandage is sterile."
D) "After you apply a bandage, a dressing should be placed over it."

Question 73

A 54-year-old male patient has been involved in a car crash. Window glass has caused an open wound to his upper neck. Which one of the following dressings is best for this injury?

A) Sterile gauze
B) Self-adhering roller gauze
C) Moist sterile gauze
D) Occlusive dressing

Question 74

A man has been bitten in his arm by his dog. He states that the bite occurred several hours earlier when he accidentally stepped on the dog's paw. When asked, he tells you that the dog is up-to-date on all of her shots, including the rabies vaccine. Assessment reveals two small puncture wounds to the hand with some bruising in the surrounding tissue. The patient wants to refuse treatment and transport. Given these assessment findings, which one of the following indicates the primary reason the patient should be seen in the emergency department?

A) Risk for infection
B) Possible shock from blood loss
C) Need to complete a police report
D) Prevent formation of a contusion