Emergency Medical Care: Shock and Trauma Management, Exams of Nursing

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EMT Section 3 Exam Questions And Answers With Complete Solutions A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: Correct Answer apply a tourniquet proximal to the wrist A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. Correct Answer 18% A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? Correct Answer rapid transport to a trauma center A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: Correct Answer assess for a carotid pulse for up to 60 seconds. A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture

marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: Correct Answer supine positioning, splinting the leg, and transporting. A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? Correct Answer cover it with moist, sterile gauze and secure with an occlusive dressing. A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: Correct Answer administer high-flow oxygen. A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Correct Answer pinching the patient's nostrils and having him lean forward. A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: Correct Answer replace the avulsed flap to its original position and cover it with a sterile dressing.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Correct Answer gastrointestinal bleeding. A burn that is characterized by redness and pain is classified as a: Correct Answer superficial burn. A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): Correct Answer contusion A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Correct Answer assist the patient's ventilations. All of the following terms refer to a body part that is cold but not frozen, EXCEPT: Correct Answer frostbite An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: Correct Answer report the incident to the appropriate authorities. As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be? Correct Answer control the bleeding

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: Correct Answer open his airway and assess his breathing status. Burns associated with lightning strikes are typically: Correct Answer superficial Burns to pediatric patients are generally considered more serious than burns to adults because: Correct Answer pediatric patients have more surface area relative to total body mass. Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste- removal needs is termed _______. Correct Answer perfusion Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: Correct Answer hot, dry skin Distributive shock occurs when: Correct Answer widespread dilation of the blood vessels causes blood to pool in the vascular beds Drowning is MOST accurately defined as: Correct Answer death from suffocation after submersion in water. During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small

puncture wounds surrounding it. This wound pattern is MOST consistent with a: Correct Answer shotgun Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Correct Answer spleen. Foods, medications, and insects are common causes of ________. Correct Answer anaphylactic shock Hypothermia occurs when the core body temperature falls below: Correct Answer 95°F (35°C). Hypovolemic shock caused by severe burns is the result of a loss of: Correct Answer plasma Hypovolemic shock occurs when: Correct Answer the body cannot compensate for rapid blood loss. If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Correct Answer all of these answers are correct. If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Correct Answer a tourniquet proximal to the injury.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: Correct Answer an air embolism. In an acute injury setting, neurogenic shock is commonly accompanied by: Correct Answer hypothermia In contrast to Lyme disease, Rocky Mountain spotted fever: Correct Answer can cause paralysis and cardiorespiratory collapse. In older patients, the first indicator of nontraumatic internal bleeding may be: Correct Answer weakness or dizziness. In which of the following patients should you remove an impaled object? Correct Answer a pulseless and apneic patient with a knife impaled in the back Inadequate circulation of blood throughout the body is called ________. Correct Answer shock Internal bleeding into a fractured extremity is MOST often controlled by: Correct Answer splinting the extremity. Most of the serious injuries associated with scuba diving are caused by: Correct Answer too rapid of an ascent Pulmonary edema and impaired ventilation occur during: Correct Answer cardiogenic shock

Shock due to severe infection is called ________. Correct Answer septic shock Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. Correct Answer 20% The body's natural cooling mechanism, in which sweat is converted to a gas, is called: Correct Answer evaporation The EMT must assume that any unwitnessed water-related incident is accompanied by: Correct Answer possible spinal injury The MOST prominent symptom of decompression sickness is: Correct Answer abdominal or joint pain The sebaceous glands produce sebum, a material that: Correct Answer waterproofs the skin and keeps it supple. The severity of bleeding should be based on all of the following findings, EXCEPT: Correct Answer systolic blood pressure. The venom of a black widow spider is toxic to the: Correct Answer nervous system To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: Correct Answer the skin

What are the three components of the "perfusion triangle"? Correct Answer Heart, blood vessels, blood What mechanism(s) does the body use to control bleeding? Correct Answer all of these answers are correct. When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called: Correct Answer conduction When assessing a patient with signs and symptoms of shock, it is important to remember that: Correct Answer blood pressure may be the last measurable factor to change in shock When caring for a patient whose arm is covered with a dry chemical, you should: Correct Answer brush away the chemical before flushing with water. When should nonlifesaving interventions be performed for your multisystem trauma patient? Correct Answer en route to the hospital When treating an 80-year-old patient who is in shock, it is important to remember that: Correct Answer changes in gastric motility may delay gastric emptying, which increases the risk for vomiting Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Correct Answer the tourniquet should only be removed at

the hospital because bleeding may return if the tourniquet is released. Which of the following areas of the body has the thinnest skin? Correct Answer ears Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Correct Answer the patient takes rivaroxaban (Xeralto). Which of the following injuries would MOST likely cause obstructive shock? Correct Answer cardiac tamponade Which of the following is a severe burn in a 65-year-old patient? Correct Answer partial-thickness burn to 20% of the BSA Which of the following is an early sign of pit viper envenomation? Correct Answer local swelling and ecchymosis Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax? Correct Answer decompression of the injured side of the chest Which of the following MOST accurately describes hyperthermia? Correct Answer the body is exposed to more heat than it can lose. Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? Correct Answer abrasion

Which of the following processes occurs during the inflammation phase of the healing process? Correct Answer the immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Correct Answer air splint Which of the following statements regarding crush syndrome is correct? Correct Answer compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. Which of the following statements regarding hemophilia is correct? Correct Answer patients with hemophilia may bleed spontaneously. Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Correct Answer gastrointestinal system Which portion of the blood carries oxygen to and wastes away from body tissues? Correct Answer red blood cells Which section of the heart receives deoxygenated blood? Correct Answer right You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he

is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should: Correct Answer assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible. You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: Correct Answer protect the affected part from further injury. You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: Correct Answer assess distal circulation and readjust the bandage as needed. You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should: Correct Answer load him into the ambulance and begin rapid cooling interventions.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: Correct Answer suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility. You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________. Correct Answer peripheral vasoconstriction Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________. Correct Answer cardiogenic shock Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________. Correct Answer compensated shock