Q: For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline and then cover it with an occlusiveâ dressing?

Gunshot woundâ (GSW) to the abdomen from which a loop of intestine is protruding

Question 1

You are treating a patient with paradoxical motion on the left side of the chest. He is breathing shallow at a rate of 4 breaths per minute. Youâ should:

Accepted Answer

begin positive pressure ventilation.

Question 2

Which of the following is an unreliable sign for determining the presence of a tensionâ pneumothorax?

Accepted Answer

Trachea that shifts to the side opposite the injury

Question 3

âYou\'re anâ off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off the road along an isolated county road. It appears the patient wasâ unrestrained, or not wearing a seatâ belt, and struck the steering wheel with his chest. Onâ assessment, you notice a paradoxical motion to theâ patient\'s chest on inspiration and expiration. When you radio for dispatch of anâ ambulance, which of the following pieces of information would you be sure toâ include?

Accepted Answer

The patient may have a flail chest.

Question 4

Your patient is aâ 17-year-old male baseball player found pulseless and apneic after being struck in the chest by a baseball 6 minutes ago. He is surrounded by other players and staff but no one is providing care. Youâ should:

Accepted Answer

begin chest compressions.

Question 5

Which of the following injuries requires the use of an occlusiveâ dressing?

Accepted Answer

All of the above

Question 6

Which of the following is of concern with a punctureâ wound?

Accepted Answer

All of the above

Question 7

Which of the following is a true statement regarding theâ skin\'s status in the case of a closed chestâ injury?

Accepted Answer

The skin is not penetrated.

Question 8

You are on an EMS standby for a boxing tournament. During one of theâ matches, one of the female boxers delivers a forcible uppercut to the chest of herâ opponent, who falls to the ground. The match is declared over on the basis of a TKO.â However, the opponent fails to arise following a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and breathing agonal gasps. You suspect which of the following traumaticâ conditions?

Accepted Answer

Commotio cordis

Question 9

For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline and then cover it with an occlusiveâ dressing?

Accepted Answer

Gunshot woundâ (GSW) to the abdomen from which a loop of intestine is protruding

Question 10

While palpating the radial pulses of a patient who was involved in a motor vehicleâ crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associatedâ with:

Accepted Answer

aortic dissection.

Question 11

Which of the following patients is at greatest risk of respiratory failure and should be carefully monitored for ventilatory status throughout treatment andâ transport?

Accepted Answer

Tension pneumothorax

Question 12

You are caring for aâ 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by hisâ ex-girlfriend. You have placed an occlusive dressing to the site and began emergent transport to the closest trauma center.â However, while en route the patient begins to complain of increasing shortness of breath. You notice a decrease in ventilatory volume and an increase in thoracic diameter. Which of the following options would be the best step to performâ next?

Accepted Answer

Free a corner or edge of the dressing and have the patient exhale to release pressure buildup. Andâ re-seal the wound.

Question 13

Bleeding from open abdominal injuries should initially be controlled with which one of the followingâ techniques?

Accepted Answer

Applying direct pressure to the wound

Question 14

Which of the following is true concerningâ lacerations?

Accepted Answer

All of the above

Question 15

Which of the following types of bandages should NOT be used by the EMT providing woundâ care?

Accepted Answer

Tourniquet

Question 16

You are dispatched to aâ 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and aâ high-category trauma;â however, due to the mechanism ofâ injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing theâ patient?

Accepted Answer

Examining the patient for entrance and exit wounds

Question 17

Blunt trauma resulting in a closed chest injury creates the potential for which of the following internalâ injuries?

Accepted Answer

Contusion

Question 18

What is the correct terminology for a wound in which a vacuum has been created within theâ chest, drawing air into the thorax with eachâ breath?

Accepted Answer

Sucking chest wound

Question 19

The mechanism of injury in which aâ patient\'s chest has struck an immovableâ object, such as a steeringâ wheel, may most accurately be described asâ a(n):

Accepted Answer

compression injury.

Question 20

Some drawbacks to using sterile aluminum foil as an occlusive dressingâ include:

Accepted Answer

skin lacerations may occur from the sharp edges.

Question 21

Your patient is aâ 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of beingâ \"hit in the face and kicked and punched in his ribs andâ stomach.\" Your examination reveals contusions and swelling around bothâ eyes, bleeding from theâ nose, a laceration of his upperâ lip, and multiple contusions of theâ chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of thisâ patient?

Accepted Answer

The possibility of a pneumothorax

Question 22

Which of the following is a strategy to maintain an occlusive dressing to bloody or diaphoreticâ skin?

Accepted Answer

Manually maintain pressure.

Question 23

Which of the following traumatic chest injuries may result inâ massive, often fatal internalâ hemorrhage?

Accepted Answer

Aortic dissection

Question 24

Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result inâ life-threatening hemorrhage following high mechanism of injury bluntâ trauma?

Accepted Answer

Liver

Question 25

You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsing mass. Youâ should:

Accepted Answer

defer further abdominal palpation.

Question 26

Which of the following is NOT appropriate in caring for a patient with closedâ soft-tissue injuries and a significant mechanism ofâ injury?

Accepted Answer

Bandage and splint all injuries prior to transport.

Question 27

The chest cavity can hold up toâ ________ liter(s) of blood in anâ adult, leading to the possibility of massive internal hemorrhage without any external blood loss.

Accepted Answer

3

Question 28

Which of the following is required in the management of all openâ soft-tissue injuries?

Accepted Answer

The use of Standard Precautions by the EMT

Question 29

Which of the following BEST describes anâ evisceration?

Accepted Answer

Open wound of the abdomen from which organs protrude

Question 30

Aâ 36-year-old male was accidentally shot with a nail gun into the chest. You see theâ nail, which protrudes about 2 to 3 centimeters from theâ thorax, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injuryâ site?

Accepted Answer

None of the above

Question 31

On assessment of the midsection of aâ 32-year-old male who was struck by aâ car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have aâ clean-cut laceration and the bleeding is controlled. Which of the following is the BEST approach toward managing the exposedâ intestines?

Accepted Answer

Moisten a sterile dressing with saline solution and cover the abdominal contents.

Question 32

Your patient is aâ 21-year-old male who has a gunshot wound to the chest. Which of the following is the highest priority in managing thisâ patient?

Accepted Answer

Placing an occlusive dressing over the wound

Question 33

Which of the following is a desirable characteristic of dressings used in the prehospital management of most openâ wounds?

Accepted Answer

Sterile

Question 34

You have covered an open chest wound with your gloved hand and theâ patient\'s breathing has improved. In order to free your hand to provide furtherâ care, youâ should:

Accepted Answer

cover the wound with an occlusive dressing.

Question 35

Your patient was working on a car when it fell off the jack and trapped him between the tire and ground. His face is very blue and his eyes are bloodshot. Which of the following has the patient most likelyâ suffered?

Accepted Answer

Traumatic asphyxia

Question 36

A teenage male has fallen onto a railing while skateboarding. He complains ofâ right-sided chest pain and moderate dyspnea. Exposure of the chest reveals a section of his ribs that is moving opposite of the rest of the ribs. Youâ should:

Accepted Answer

apply a bulky dressing over the section.

Question 37

Which of the following injuries may produce distended neck veinsâ (JVD)?

Accepted Answer

All of the above

Question 38

Your patient has an open abdominal wound with intestines protruding. Youâ should:

Accepted Answer

cover the organs with moist sterile dressings.

Question 39

A patient with jugular vein distentionâ (JVD) is most likely suffering from which of the followingâ injuries?

Accepted Answer

A patient with jugular vein distentionâ (JVD) is most likely suffering from which of the followingâ injuries?

Question 40

Which of the following describes the proper application of an occlusive dressing for an open chestâ wound?

Accepted Answer

Tape the dressing securely on three sides.

Question 41

Which of the following BEST describes the benefit of aâ three-sided occlusive dressing over aâ four-sided occlusive dressing for an open chestâ wound?

Accepted Answer

It reduces the chances of developing a tension pneumothorax.

Question 42

Which of the following is an accurate definition of a flailâ chest?

Accepted Answer

Section of the chest wall that isâ unstable, leading to breathing problems

Question 43

You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplementalâ oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the timeâ you\'re making the decision to transport. Which of the following BEST encapsulates the correct strategy forâ transport?

Accepted Answer

Transport the patient emergently because of the high index of suspicion for a serious injury.

Question 44

You find aâ middle-aged male is sitting against a wall in obvious distress. The patient appears to be extremely short of breath and has an open wound to his chest that is making a sucking sound. You shouldâ IMMEDIATELY:

Accepted Answer

place your gloved hand over the wound.

Question 45

What is the underlying cause of bluish or reddish facial discoloration following a traumaticâ asphyxiation?

Accepted Answer

High pressure on the chest leads to blood being forced from the right atrium into the face and neck.

Question 46

Which of the following is NOT an open tissueâ injury?

Accepted Answer

Contusion

Question 47

Common signs and symptoms following an injury to a hollow abdominal organâ include:

Accepted Answer

irritation and peritonitis.

Question 48

The pathophysiology ofâ ________ is one in which the pericardial sac fills with blood to the point where the chambers of the heart no longer fillâ adequately, usually secondary to trauma.

Accepted Answer

cardiac tamponade

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