H-1) An open abdominal wound with protruding organs is called: A. an evisceration. An evisceration is an
intestine or other internal organ protruding through a wound in the abdomen. H-2) When a patient who has a flail segment exhales, the segment of the ribs will push outward while the rest of the chest cavity pulls inward. This is referred to as: B. paradoxical motion. The movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is called paradoxical motion. H-3) A pneumothorax may occur when: D. air leaks into the chest cavity from a damaged lung with no opening through the outer chest. Pneumothorax occurs when air accumulates in the potential space in the area where the lung tissue adheres to the chest wall. When air accumulates in this space, it pushes lung tissue away from the chest wall, causing collapse of the lung. Air can enter this space through an external wound or through escape from a punctured lung. Occasionally both events may occur. H-4) Which of the following best describes
an open chest wall injury? D. Knife wound to the left anterior chest A knife wound is a type of mechanism that can cause an open chest wall
injury. The other options are more likely to cause a closed chest injury. H-5) A 34-year-old female patient received a small-caliber gunshot wound to the right anterior chest. She is complaining of dyspnea. Her respirations are 22 and shallow. This patient is presenting with: C. an open pneumothorax. The location and type of trauma and the reduced breath sounds indicate an open pneumothorax, and the lack of hyperresonance does not exclude pneumothorax. H-6) Your patient has received a blunt trauma injury to the chest from being hit with a baseball bat. You notice a flail
segment, lung sounds are diminished, and the patient is having difficulty breathing. You note that the patient's trachea is deviating toward the uninjured side. You suspect: D. a tension pneumothorax. A tension pneumothorax occurs when air accumulates in the
pleural cavity until the lung collapses, and the pressure buildup will eventually start to shift the intrathoracic contents toward the contralateral side of the injury. This injury can happen with either blunt or penetrating trauma. H-7) Paradoxical motion is caused by: B. a flail segment moving in the direction opposite to the movement of the uninjured side of the rib cage. During inhalation and exhalation, the flail segment displays
paradoxical motion; that is, the flail segment moves in a direction opposite to the movement of the rest of the chest wall. H-8) You are treating a patient who was diagnosed with multiple rib fractures following a motor vehicle collision. You note equal chest rise and fall. He appears short of breath as well as pale, cool, and diaphoretic. Given the patient's presentation as well as his acute medical
history, what condition is he most likely to suffer? B. Hemothorax Hemothorax can be caused when lacerations within the chest cavity are produced by penetrating objects or fractured ribs. Blood will flow into the space around the lung, the lung may collapse, and the patient will experience a
loss of blood, leading to shock. H-9) Emergency care of a patient with an open chest wound should include: A. applying an occlusive dressing taped on three sides to any open chest wound. Apply an occlusive dressing to seal the wound (not a regular porous dressing, which would allow air to enter easily). The occlusive dressing should be a few inches wider than the wound. Place it over the entire wound, and tape it on three sides. H-10) Which of the following signs and symptoms would lead you to believe that your patient had a tension pneumothorax? B. Severely decreased or absent breath
sounds on the injured side Severely decreased or absent breath sounds on the injured side are the most serious of the signs and symptoms listed that would indicate development of a tension pneumothorax H-11) A tension pneumothorax differs from a simple pneumothorax in that: B. a tension pneumothorax puts pressure on the heart, the great vessels, and the unaffected lung. If there is no opening to the outside chest, air that leaks from the lung has no avenue of
escape. Pressure builds up in the chest cavity, compressing the heart, the great vessels, and the unaffected lung. H-12) Blunt abdominal trauma that causes the perforation of a vascular structure in the abdomen may cause: C. significant blood loss. An injury to a vascular structure such as the liver or spleen typically involves a serious and often life-threatening hemorrhage. There is often heavy blood loss into the abdominal compartment that may go unrecognized for a period of time. H-13) Why
should the EMT complete a full assessment on a patient with a bullet wound to the abdomen? D. To determine the probable extent of injuries Penetrating abdominal
wounds can be associated with wounds in adjacent areas of the body. For example, a bullet can enter the chest cavity, pierce the diaphragm, and cause widespread damage in the abdomen. A complete patient assessment is essential in determining the probable extent of injuries. Always assess for an exit wound. Bullet trajectories are rarely straight, and internal damage cannot be easily assessed, so determining the straightness of the bullet's trajectory and definitively identifying all
injured organs is likely impossible in a prehospital setting. Transport is mandatory. H-14) An object that is impaled in the abdomen should be: A. stabilized in place. Like any
impaled object in the trunk of the body, the item should be stabilized in place and not removed by the EMT. The amount of damage that could be caused by pulling it out is unknown, and may be fatal. H-15) You arrive on scene to an alert 27-year-old male patient with an obvious abdominal evisceration. He is restless, pale, cool, and diaphoretic. After administering high-concentration oxygen, you should
immediately: A. cover the wound with a dressing moistened with saline. Do not touch or try to replace any eviscerated, or exposed, organs. Apply a sterile dressing moistened with sterile saline over
the wound site. Some EMS systems may recommend that you apply an occlusive dressing as well. It may be necessary to remoisten the dressings with additional saline to ensure that the eviscerated organ or organs do not dry out. In cases of large eviscerations, maintain warmth by placing layers of bulky dressing over the moistened dressing. PT-1) You are treating a 42-year-old male assault victim who presents
with nausea, vomiting, and sharp abdominal pain. While inspecting his abdomen, you note redness to his right upper quadrant. Based on your assessment findings, the patient is most likely suffering from which of the following? A.
Traumatic hemorrhage of the liver PT-2) What is the purpose of a flutter-valve occlusive dressing? A. To allow
air to escape but not enter PT-3) Which of the following is most clearly an example of an open chest injury? PT-4) Which patient most likely has an abdominal injury? C. Patient tries to lie still with legs drawn up. PT-5) An open wound to the chest, if an occlusive dressing is not available, should be sealed: A. immediately with a gloved hand. PT-6) Injury to which of the following organs would be most likely to cause peritonitis? PT-7) What type of injury is likely to produce a flail segment? PT-9) You respond to the scene of a 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side
of his chest, where you notice a puncture wound. From what is this patient most likely suffering? PT-9) You respond to the scene of a 24-year-old gunshot victim and find your patient to have a decreased mental status as well as hypotension. You note absent breath sounds on the left side of his chest, where you notice a puncture
wound. From what is this patient most likely suffering? PT-10) When air is present in the chest cavity, the injury is called a: PT-11) In the case of a large
evisceration, you should place layers of: A. bulky dressings over a dressing moistened with saline. PT-12) Your patient was just involved in a motor vehicle collision. She is breathing very fast and shallowly. You auscultate her lung sounds and find diminished breath sounds on the right side. You suspect that the patient is most likely suffering from: PT-13) While assessing the
abdomen of a 25-year-old female, you note that she has a large piece of glass sticking out of her right upper quadrant. What should you do? PT-14) An open chest wound that pulls air into the thoracic cavity is known as what type of injury? CT-1) You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsating mass. You should: B. defer further abdominal palpation. CT-2) Which of the following best describes an evisceration? B. Open wound of the abdomen from which organs protrude CT-3) Your patient is a 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. You should: C. begin chest compressions. CT-4) Your patient is a 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 being "hit in the face and kicked and punched in his ribs and stomach." Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient? C. The potential for serious internal damage CT-5) The chest cavity can hold up to ________ liter(s) of blood in an adult, leading to the possibility of massive internal hemorrhage without
any external blood loss. CT-6) What is the underlying cause of bluish or reddish facial discoloration following traumatic asphyxia? B. High pressure on the chest leads to blood being forced from the right atrium into the face and neck. CT-7) For which of the following wounds should the EMT apply an absorbent dressing moistened with sterile saline? C. Gunshot wound to the abdomen from which a loop of intestine is protruding CT-8) Common signs and symptoms following an injury to a hollow abdominal organ include: B. irritation and peritonitis. CT-9) You are on an EMS standby for a boxing tournament. During one of the matches, one of the female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground. The match is declared over on the basis of a TKO. 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 traumatic conditions? CT-10) You find a middle-aged male 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 should: D. place your gloved hand over the wound. CT-11) Which of the following injuries may produce distended neck veins? CT-12) You are stabilizing a patient who has just been stabbed in the chest to the right of the mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves. You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time you're making the decision to transport. Which of the following best
encapsulates the correct strategy for transport? B. Transport the patient emergently because of the high index of suspicion for a serious injury. CT-13) Which of the following best describes the potential benefit of a three-sided occlusive dressing over a four-sided occlusive dressing for an open chest wound? A. It may reduce the chances of developing a tension pneumothorax. CT-14) A 36-year-old male
was accidentally shot with a nail gun into the chest. You see the nail, which protrudes about 2 to 3 centimeters from the thorax, when you visualize the injury site. Under which of the following circumstances should you remove the nail from the injury site? CT-15) Which of the following is a vascular organ in the abdomen that can produce blood loss quickly enough to result in life-threatening hemorrhage following high mechanism of injury blunt trauma? CT-16) You are treating a patient with paradoxical motion on the left side of the chest. He is breathing is
shallow at a rate of 4 breaths per minute. You should: A. begin positive pressure ventilation. CT-17) Your patient is a
21-year-old male who has a sucking gunshot wound to the chest. Which of the following is the highest priority in managing this patient? D. Placing an occlusive dressing over the wound CT-18) Your patient has an open abdominal wound with intestines protruding. You should: C. cover the organs with moist sterile dressings. CT-19) Bleeding from open abdominal injuries should initially be controlled with which one of the following techniques? D. Applying direct pressure to the wound CT-20) You are caring for a 27-year-old male who has a puncture wound to the right upper chest. The patient was stabbed with a serrated steak knife by his ex-girlfriend. You have placed an occlusive dressing on the site and begun emergent transport to the closest
trauma center. 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 perform next? D. Free a corner or edge of the dressing to release pressure buildup. CT-21) A patient with jugular vein distention is most likely suffering from which of the following injuries? CT-22) The pathophysiology of ________ is one in which the pericardial sac fills with blood to the point that the chambers of the heart no longer fill adequately, usually secondary to trauma. CT-23) While palpating the radial pulses of a patient who was involved in a motor vehicle
crash, you notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may be associated with: CT-24) What is the correct terminology for a wound in which a vacuum has been created within the chest, drawing air into the thorax through a penetration of the chest wall with each breath? CT-25) Which of the following is an unreliable sign for determining the presence of a tension pneumothorax? C. Trachea that shifts to the side opposite the injury CT-26) 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 likely suffered? CT-27) You have covered an open chest wound with your gloved hand, and the patient's breathing has improved. In order to free your hand to provide further care, you should: A. cover the wound with an occlusive dressing. CT-28) On assessment of the midsection of a 32-year-old male who was struck by a car, you find an abdominal evisceration with several loops of his large intestine exposed. The abdomen appears to have a clean-cut laceration, and the bleeding is controlled. Which of the following is the
best approach toward managing the exposed intestines? A. Moisten a sterile dressing with saline solution and cover the abdominal contents. CT-29) What is a drawback to using sterile aluminum foil as an occlusive dressing? B. The foil may lacerate eviscerated organs. CT-30) The mechanism of injury in which a patient's chest has struck an immovable object, such as a steering wheel, may most accurately be described as a(n): CT-31) Which of the following is an accurate definition of a flail chest? D. Section of the chest wall that is unstable, leading to breathing problems CT-32) You're an off-duty EMT who encounters a patient sitting behind the wheel of a vehicle that ran off an isolated county road. It appears the patient was not wearing a seat belt and struck the steering wheel with his chest. On assessment, you notice a
paradoxical motion to the patient's chest on inspiration and expiration. When you radio for dispatch of an ambulance, which of the following pieces of information would you be sure to include? D. The patient may have a flail chest. CT-33) Which of the following is a strategy to maintain adherence of an occlusive dressing to bloody or diaphoretic skin? D. Manually maintain pressure. CT-34) Which of the following describes the proper application of an occlusive dressing for an open chest wound? C. Apply an occlusive dressing to each penetrating wound. CT-35) You are dispatched to a 42-year-old male who was shot in the abdomen and thrown from a vehicle. The patient is critical and high-category trauma;
however, due to the mechanism of injury, it is necessary to backboard the patient prior to transport. What is an important assessment before securing the patient? A. Examining the patient for entrance and exit wounds Which of the following is the best way to care for a person with an abdominal injury where their organs are exposed?Carefully position the person on his or her back with the knees bent, if that position does not cause pain. Do not apply direct pressure. Do not push any protruding organs back into the open wound. Remove clothing from around the wound.
Which of the following is a proper dressing for an abdominal evisceration?applying an occlusive dressing, secured by trauma dressings. Rationale: Although the preferred management for an abdominal evisceration includes the application of a moist, sterile dressing covered by a dry dressing, protocols in some EMS systems call for an occlusive dressing, secured by trauma dressings.
Which of the following is recommended when caring for an amputated part?Do not scrub. Wrap the amputated part in a dry, sterile gauze or clean cloth. Put the wrapped part in a plastic bag or waterproof container. Place the plastic bag or waterproof container on ice.
Which of the following is appropriate in caring for a patient with closed soft tissue injuries and a significant?12) Which of the following is appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury? ) Treat for shock if you think there are internal injuries even if the patient's vital signs are normal.
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Your patient has an open abdominal wound with intestines protruding. you should:
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