H-1) Lacerations are cuts that are: A. penetrating or perforating. B. a tearing away or off. C. smooth or jagged. D. crushing or fracturing.
C. smooth or jagged
H-2) A puncture wound that is shallow or deep is a: A. fracturing puncture wound. B. penetrating puncture wound. C. crushing puncture wound. D. perforating puncture wound.
B. penetrating puncture wound
A penetrating puncture wound is an open wound that tears through the skin and destroys underlying tissues. A penetrating puncture wound can be shallow or deep. A perforating puncture wound has both an entrance and an exit wound
H-3) Which of the following is a function of the skin? A. Digestion B. Circulation C. Sensation D. Respiration
C. Sensation
It is important to remember that the skin plays a fundamental role in our interactions each day. Nerve endings provide us with sensory input in the form of tactile (touch) stimulation. We sense temperature and pleasurable and painful stimuli.
H-4) The structures within the dermis include: A. muscle cells. B. sweat glands. C. periosteum. D. adipose tissue.
B. sweat glands
H-5) A wound under the skin that involves the collection of blood from injury to a large blood vessel is called a: A. contusion. B. crush injury. C. hematoma. D. concussion.
C. hematoma
A hematoma is similar to a contusion except that hematomas involve a larger amount of tissue damage, including damage to larger blood vessels with greater internal blood loss. Whereas a contusion may cause some minor injury to small blood vessels, a hematoma is characterized by much more severe internal bleeding and the collection of a larger volume of blood beneath the skin.
H-6) Crush injuries often can be identified by what?
A. Finding of bleeding from the nose or ears
B. Swelling or deformity
C. Mechanism of injury
D. Palpation of the wound
B. Swelling or deformity
Crush injuries may be difficult or impossible to identify during assessment, so you must rely on the MOI. Patients with a significant MOI should be considered to have internal bleeding and shock until they are ruled out in the emergency department.
H-7) Possible injury to the cervical spine or brain could be indicated by a(n): A. contusion to the trunk. B. avulsion of an extremity. C. penetration of the sternum. D. bruise on the head or neck.
D. bruise on the head or neck
H-8) Abdominal bruising should be considered a sign of possible: A. internal organ damage. B. pneumothorax. C. pelvic fracture. D. head injury.
A. internal organ damage
H-9) A simple scratch or scrape of the outer layer of the skin is called a(n): A. contusion. B. abrasion. C. laceration. D. avulsion.
B. abrasion
The classification of abrasion includes simple scrapes and scratches in which the outer layer of the skin is damaged but not all the layers are penetrated. Even though an abrasion is considered a superficial injury, it often is extremely painful because of the presence of exposed nerve endings. In most cases, blood will ooze from the wound (capillary bleeding), which can be controlled easily with direct pressure.
H-10) A degloving injury is an example of a(n): A. amputation. B. avulsion. C. bite. D. hand fracture.
B. avulsion
A special type of avulsion is the degloving injury. In this wound, the mechanism of injury tears the skin off the underlying muscle, connective tissue, blood vessels, and bone.
H-11) Your 24-year-old patient was riding an ATV through the woods and impaled herself on a dead tree branch. The one-inch diameter branch went in through her mouth and out her right cheek before breaking from the tree. You can see both ends of the penetrating branch. On your arrival, the patient is bleeding heavily into her mouth and is struggling to breathe unless she is leaning forward. To gain control of the patient’s bleeding and thereby her airway, you should:
A. sacrifice spinal immobilization and transport the patient in a sitting position, leaning forward.
B. insert a nasopharyngeal airway.
C. pack the patient’s mouth full of gauze and tell her to breathe through her nose.
D. attempt to remove the object.
D. attempt to remove the object
You may remove an object that is impaled in the cheek if you find perforation and you can see both ends of the object. Pull it out in the direction it entered the cheek. If this cannot be easily done, leave the object in place
H-12) To stabilize an object impaled in an eye, you should:
A. place a roll of 3-inch gauze bandage or folded 4x4s on either side of the object, along the vertical axis of the head, in a manner that will stabilize the object.
B. place a paper cup over the impaled object and secure in place with a self-adherent roller bandage.
C. snap off as much of the object as you can and then seal the eye with an occlusive dressing before bandaging it with a self-adherent roller bandage.
D. wrap a roll of 3-inch gauze bandage around the entirety of the patient’s head along the horizontal axis, covering the eyes.
A. place a roll of 3-inch gauze bandage or folded 4x4s on either side of the object, along the vertical axis of the head, in a manner that will stabilize the object
H-13) The emotional and psychological damage from burn injuries:
A. usually occurs only with the most severe injuries.
B. begins at the emergency scene.
C. typically is not long-lasting.
D. is not a concern for EMTs.
B. begins at the emergency scene.
In addition to the physical damage caused by burns, patients often suffer emotional and psychological problems that begin at the emergency scene and may last a lifetime.
H-14) Singed nasal hairs in a burned patient are an ominous sign because:
A. the smell can be overpowering.
B. they are very painful.
C. they could indicate airway damage.
D. they make it difficult to administer oxygen.
C. they could indicate airway damage.
H-15) A way of identifying the seriousness of a burn is by its degree. Which of the following statements is true?
A. A first-degree burn is the most serious and the deepest.
B. A second-degree burn is characterized by red, dry, smooth skin.
C. A superficial burn is also called a second-degree burn.
D. A full-thickness burn is also known as a third-degree burn
D. A full-thickness burn is also known as a third-degree burn
The older description of burns was by degrees. In that classification system, a third-degree burn has the same characteristics as a full-thickness burn, as both represent injuries that involve all three layers of the skin.
H-16) Which of the following statements about a partial-thickness burn is true?
A. The formation of blisters is common.
B. Partial-thickness burns are not very painful, because of the nerve ending damage.
C. A partial-thickness burn involves only the epidermis.
D. The damaged skin of a partial-thickness burn is called eschar.
A. The formation of blisters is common.
A partial-thickness burn involves not only the epidermis but also portions of the dermis. Blisters are an indication of a partial-thickness burn.
H-17) If a child pulled a pot of boiling water off the stove and was burned by it, this burn would be: A. an electrical burn. B. a delayed burn. C. a thermal burn. D. a flash burn.
C. a thermal burn.
H-18) What is the first step in removing dry chemicals from the body? A. Brush off the excess material. B. Vacuum off excess material. C. Pour water on the body. D. Neutralize the chemical with vinegar.
A. Brush off the excess material.
The first step with dry chemicals on the body is to brush off any excess chemical first, then flush with copious amounts of water.
H-19) Chemical burns to the eyes should be: A. bandaged shut. B. left alone. C. flushed with water. D. rinsed with a neutralizing solution.
C. flushed with water.
Flush the eyes with water, being careful not to flush the chemical into the other eye.
H-20) A patient with an electrical injury is least likely to present with which of the following signs and symptoms? A. Hypotension B. Muscle tenderness C. Visual difficulties D. Restlessness or irritability
A. Hypotension
Hypotension is not a common sign of an electrical injury, but visual difficulties, restlessness or irritability, and muscle tenderness are common signs and symptoms.
H-21) Your patient was involved in a serious industrial accident, and sustained critical electrical burns to both his hands when he accidentally grabbed a live wire. Despite the severity of his burns, the patient says he doesn’t feel that bad. This patient will need to:
A. have his wounds flushed with hot, sterilized water immediately.
B. be administered bag-valve-mask ventilations.
C. be transported as soon as possible.
D. have his wounds wrapped loosely in sterile bandages with no dressings.
C. be transported as soon as possible.
This patient should be transported as soon as possible. Some problems with electrical injuries have a slow onset. If there are burns, there also may be more serious hidden problems. In any case of electrical shock, heart problems may develop. The other treatments are inappropriate, and this patient should be administered high-concentration oxygen but should not be administered bag-valve-mask ventilations, because there are no signs of inadequate breathing.
H-22) After treating an actively bleeding head laceration with a sterile dressing and bandage, you notice that the dressing has become blood-soaked and that blood is seeping through the bandage. You should:
A. remove the blood-soaked dressing and replace it with new, sterile dressing.
B. reapply pressure and place additional sterile dressings over the blood-soaked dressing.
C. apply direct pressure to the patient’s neck with both hands.
D. remove the bandage and reposition the dressing, being sure to rewrap it tightly.
B. reapply pressure and place additional sterile dressings over the blood-soaked dressing.
Do not remove dressings. Once a dressing has been applied to a wound, it must remain in place. Bleeding may restart and tissues at the wound site may be injured if the dressing is removed. If the bleeding continues, reapply pressure, apply additional hemostatic agent, and put new dressings over the blood-soaked one.
H-23) It is characteristic of hemostatic dressings to: A. form an airtight seal. B. stop or slow bleeding. C. be bulky. D. control bleeding through pressure.
B. stop or slow bleeding.
Many EMS systems now carry hemostatic dressings used to stop bleeding. Hemostatic dressings facilitate clotting through a chemical process.
PT-1) When a flap of tissue is traumatically removed, this condition is called a(n): A. puncture. B. avulsion. C. incision. D. laceration.
B. avulsion.
PT-2) The layer of skin that is rich with blood vessels, nerves, and specialized structures is the: A. subcutaneous. B. fascia. C. dermis. D. epidermis.
C. dermis.
PT-3) A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can talk, and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the highest priority in this patient’s assessment and treatment?
A. Care for spine injuries, head injuries, and severe fractures.
B. Transport as soon as possible.
C. Evaluate the electrical burns.
D. Apply sterile dressings to the burn sites.
A. Care for spine injuries, head injuries, and severe fractures.
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PT-4) What is the resulting injury called when the burn penetrates all the way to the bottom layer of skin? A. Superficial partial-thickness B. Partial-thickness C. Full-thickness D. Superficial
C. Full-thickness
PT-5) You are called to the scene of a patient who was burned by an electrical shock while installing a washing machine. On your arrival, the patient is lying beside the washing machine on which he was working. What is your first consideration for this patient?
A. Place an AED on the patient.
B. Assume the source of electricity is still active.
C. Establish baseline vital signs on the patient.
D. Establish an airway, because he may have suffered burns to the mouth.
B. Assume the source of electricity is still active.
PT-6) You are caring for a 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be most preferred in managing this wound? A. Gloves and a gown B. Gloves and a face shield C. Gown and mask D. Gloves only
B. Gloves and a face shield
PT-7) Which layer of the skin provides shock absorption and insulation? A. Epidermis B. Adipose C. Subcutaneous D. Dermis
C. Subcutaneous
PT-8) For a young child with isolated genital injuries, you should:
A. consider the possibility of abuse, and treat the child with sensitivity.
B. withhold care until law enforcement arrives.
C. avoid questioning the child about the cause of the injuries, so as not to embarrass the child.
D. challenge the parents directly about the possibility of child abuse.
A. consider the possibility of abuse, and treat the child with sensitivity.
PT-9) When crushed, the liver and spleen:
A. cause muscle, nerve, and tissue damage.
B. cause contusions on the surface of the skin.
C. cause severe inflammation and sepsis.
D. bleed profusely and cause shock.
D. bleed profusely and cause shock.
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PT-10) You are called to the scene of a metal fabrication plant, where you are presented with a 30-year-old male patient complaining of bilateral severe eye pain. Upon examination, you notice both eyes are red and irritated. Patient states that one of the dyes he was working with splashed into his eyes. How would you manage this patient’s injury?
A. Cover both eyes with a moist, sterile dressing.
B. Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.
C. Cover both eyes with dry, sterile dressing and transport immediately to the nearest appropriate facility.
D. Neutralize the acid immediately with vinegar or baking soda.
B. Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.
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PT-11) Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso (chest and abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface burned? A. 18% B. 22.5% C. 27% D. 13.5%
B. 22.5%
PT-12) Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is this? A. Stellate B. Crush injury C. Contusion D. Hematoma
D. Hematoma
PT-13) You are performing a secondary assessment on your 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point to? A. Injury to abdominal organs B. A punctured lung C. Damage to the cervical spine D. Damage to the brain
B. A punctured lung
PT-14) How does the skin provide temperature regulation?
A. By increasing or decreasing the metabolism within the skin structures
B. By altering the blood flow to the skin and by controlling perspiration
C. By opening temperature pores in the skin
D. By thickening or thinning the layers of the skin
B. By altering the blood flow to the skin and by controlling perspiration
PT-15) Generally, when providing emergency care of open wounds, the first thing you would do is: A. clean the wound surface. B. bandage a dressing in place. C. control the bleeding. D. expose the wound.
D. expose the wound.
PT-16) Burns involving the airway often lead to: A. bradycardia. B. respiratory compromise. C. hypoglycemia. D. hypertensive crisis.
B. respiratory compromise.
PT-17) In caring for an amputated part, it is important to:
A. place the part in ice water.
B. wrap the part in sterile gauze and pack it in ice.
C. wrap the part in sterile gauze and keep it cool.
D. place the part in milk.
C. wrap the part in sterile gauze and keep it cool.
PT-18) Damage to which of the following organs is least likely in the case of abdominal bruising? A. Spleen B. Kidneys C. Lungs D. Liver
C. Lungs
PT-19) All burns are to be treated as more serious if:
A. accompanied by other injuries or medical problems.
B. they are from a thermal source.
C. they involve the epidermis.
D. they are accompanied by reddening of the skin.
A. accompanied by other injuries or medical problems.
PT-20) Your patient suffered a severe electrical burn injury. In your emergency care, you should always:
A. assess for an entrance and an exit wound.
B. hose the patient down, to stop the burning reaction.
C. pull the patient off the electrical source as soon as possible.
D. treat the patient in the same area where the burn injury occurred.
A. assess for an entrance and an exit wound.
PT-21) You are caring for a victim who was rescued from a burning building by the fire department. The patient is alert and oriented with superficial burns to the arms, chest, neck, and face. He complains that he cannot breathe well. What is this patient's most critical injury? A. Burns to the face B. Burns to the neck C. Burns to the arms D. Burns to the chest
A. Burns to the face
PT-22) You are caring for a 46-year-old female who accidentally sustained burns to her left hand up to the wrist from boiling water. You arrive moments after the incident. Of the following, which should you do first?
A. Check the patient’s pulse and blood pressure in the affected extremity.
B. Remove any rings or other jewelry from the patient’s hand and wrist.
C. Cool the burned area to stop the burning process.
D. Apply a topical analgesic ointment to the burn area to reduce the pain.
C. Cool the burned area to stop the burning process.
PT-23) Which of the following statements about puncture wounds is correct?
A. Puncture wounds carry a much lower risk of infection than do other open wounds.
B. If there is little external evidence of bleeding, internal bleeding is unlikely.
C. Even insignificant-looking puncture wounds can cause devastating injuries.
D. A puncture wound is not serious unless it is deep.
C. Even insignificant-looking puncture wounds can cause devastating injuries.
PT-24) In bandaging a hand wound, what important consideration is necessary?
A. Bandage the lower arm, wrist, and hand, including the fingertips.
B. Bandage the hand in the position of function.
C. The dressing does not need to be sterile, because the hand is typically not clean.
D. The arm should be wrapped with elastic gauze from the elbow toward the fingertips
B. Bandage the hand in the position of function.
CT-1) You are dispatched to an industrial plant for a burn. You arrive and find a 60-year-old male who came in contact with a broken steam line and appears to have partial thickness burns on both hands and arms. He is lying on the ground and coworkers are gently spraying him with water from a nearby hose. What should you do?
A. Care for the burn and do a complete patient assessment, including cervical spine precautions.
B. Before doing treatment, call the local burn center for instruction.
C. Call for air transport and continue to pour water on the burns until transport arrives.
D. Because of his age, immediately put him in your ambulance and transport him to a burn center.
A. Care for the burn and do a complete patient assessment, including cervical spine precautions.
CT-2) Which of the following is a description of the rule of nines for an adult?
A. The rule of nines assigns 9 percent to the head and neck, each upper extremity, the chest, the abdomen, the upper back, and the lower back and buttocks; 8 percent to the front of each lower extremity; and 10 percent for the back of each lower extremity, then 1 percent to the genital region.
B. The rule of nines assigns 9 percent to the head and neck, as well as each upper extremity; 10 percent to the chest, the abdomen, and the upper back; 8 percent to the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1 percent to the genital region.
C. The rule of nines assigns 9 percent to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1 percent to the genital region.
D. The rule of nines assigns 9 percent to the head and neck; 6 percent to each upper extremity; 12 percent to the chest and abdomen; 9 percent to the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1 percent to the genital region.
C. The rule of nines assigns 9 percent to the head and neck, each upper extremity, the chest, the abdomen, the upper back, the lower back and buttocks, the front of each lower extremity, and the back of each lower extremity, then 1 percent to the genital region.
CT-3) Which of the following is a desirable characteristic of dressings used in the prehospital management of most open wounds? A. Occlusive B. Absorbent C. Adherent D. Sterile
D. Sterile
CT-4) Which of the following is required in the management of all open soft-tissue injuries?
A. Use of Standard Precautions by the EMT
B. Provision of high-concentration oxygen
C. Application of a disinfectant solution
D. Cervical spine precautions
A. Use of Standard Precautions by the EMT
CT-5) You are dispatched to the local elementary school for an injured student. Upon arrival, you find that two 7-year-olds got into a fight and one of them jabbed a pencil in the other’s cheek. The pencil is still sticking out of the child’s cheek. When you examine the patient, you cannot see the end of the pencil that went through the cheek, as it appears to be stuck in the palate. There is not significant bleeding, and the child is not having any difficulty breathing. The child is very upset and wants you to pull the pencil out. What should you do?
A. Call the parents and see what they want you to do.
B. Remove the object and put a bandage on the outside of the cheek.
C. Let the child carefully pull the object out.
D. Stabilize the object, but do not try to remove it.
D. Stabilize the object, but do not try to remove it.
CT-6) You are examining a 48-year-old patient who has been burned. You decide to use the rule of palm to measure the extent of the burn. What does this mean?
A. The palm of the patient’s hand equals 9% of the body’s surface area.
B. The palm of your hand represents 1% of the body’s surface area.
C. The palm of the patient’s hand equals about 1% of the body’s surface area.
D. You can only use the rule of palm for children, so you would use the rule of nines instead.
C. The palm of the patient’s hand equals about 1% of the body’s surface area.
CT-7) Which of the following is not an open tissue injury? A. Laceration B. Abrasion C. Contusion D. Avulsion
C. Contusion
CT-8) Which of the following statements is not true concerning the proper transport of an avulsed ear?
A. It should not be immersed in cooled water or saline.
B. It should be labeled with the patient’s name, as well as the date and time it was bagged.
C. It should be in a dry sterile dressing.
D. It should be kept as cool as possible.
C. It should be in a dry sterile dressing.
CT-9) Which of the following is not an open tissue injury? A. Contusion B. Amputation C. Abrasion D. Avulsion
A. Contusion
CT-10) Your patient is a 35-year-old female who spilled a cup of hot coffee on herself. She has an area about twice the size of the palm of her hand on her right thigh that is red and painful, but without blisters. When caring for this injury in the prehospital setting, which of the following is appropriate?
A. Apply a lotion containing a topical anesthetic and aloe vera.
B. Apply a plastic bag full of ice to the skin.
C. Apply an antibiotic ointment.
D. Apply a dry sterile dressing.
D. Apply a dry sterile dressing.
CT-11) Which of the following is not true concerning lacerations?
A. They may involve degloving injuries to the skin or tissue.
B. They may indicate deeper underlying tissue damage.
C. They may be caused by penetrating trauma.
D. They may be caused by blunt trauma.
A. They may involve degloving injuries to the skin or tissue.
CT-12) Your patient is a 14-year-old male who crashed his bicycle, landing prone and sliding along a gravel trail. He has deep abrasions to his hands, arms, chest, and knees. The patient has small pieces of gravel, twigs, and dirt embedded in the abrasions. Which of the following is the best way to manage this situation after taking cervical spine immobilization?
A. Use your fingers to pick embedded debris from the wound, bandage with moist saline dressings in place, and transport.
B. Do not attempt to remove any debris, apply pressure dressings over the embedded material if necessary, apply high-concentration oxygen, and transport.
C. Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.
D. Use a tongue depressor to scrape large pieces of debris out of the wounds, place the patient on high-concentration oxygen, and transport.
C. Assess for additional injuries, flush away large pieces of debris with a sterile dressing, place dressings on the abrasions, bandage them in place, and transport.
CT-13) Which of the following layers of the skin is the most important in insulating the body against heat loss? A. Parietal layer B. Epidermis C. Subdural layer D. Subcutaneous layer
D. Subcutaneous layer
CT-14) A wound in which the epidermis is scraped away with minimal bleeding, such as commonly occurs when a child falls on his knees on a sidewalk, is called a(n): A. avulsion. B. abrasion. C. contusion. D. laceration.
B. abrasion.
CT-15) Your patient is a 32-year-old man with a fish hook that has perforated his hand between the thumb and index finger. Which of the following is the best way to manage the situation in the prehospital setting?
A. Push the hook through the wound to avoid further damage from the barbed end.
B. Pull the hook out from the same direction in which it entered the hand.
C. Apply a pressure dressing over the hook.
D. Leave the hook in place and try not to disturb it.
D. Leave the hook in place and try not to disturb it.
CT-16) While assessing a patient with partial thickness burns to his chest and neck, what should be your highest priority (even if there are no symptoms presently)? A. Airway B. Bleeding C. Blood pressure D. Hypothermia
A. Airway
CT-17) You are dispatched to the local high school for a “person struck with a baseball.” You arrive on the scene and find a 16-year-old male sitting on the bench. Apparently he was the pitcher and was struck in the abdominal area by a line drive ball that was hit very hard. He states that nothing is hurting except he has some mild pain in the area where he was struck. He is upset that the ambulance was called and wants to go back into the game and continue pitching. Your exam reveals nothing remarkable except mild pain when you palpate the injured area. Vital signs are normal. What is the next step?
A. Tell the coach the patient is okay and he can go back into the ball game.
B. Have the coach apply cold to the area and let the pitcher back in the game if he does not get worse in the next 15 minutes.
C. Have the patient walk to the ambulance and take him to the ED. No other care needs to be provided, as there is really no significant sign of any injury.
D. Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport.
D. Take appropriate Standard Precautions, apply high-concentration oxygen by nonrebreather mask, and transport the patient ASAP, carefully monitoring the patient during transport.
CT-18) Which of the following injuries requires the use of an occlusive dressing?
A. Open wound to the abdomen from which a loop of intestine is protruding
B. Open wound to the chest
C. Open wound to the neck
D. All of the above
D. All of the above
CT-19) Which of the following best describes a partial thickness burn?
A. The skin is white and dry with no sensation of pain.
B. The skin is charred or blackened and lacks sensation.
C. The skin is red and moist with blister formation.
D. The skin is red, but dry and painful.
C. The skin is red and moist with blister formation.
CT-20) Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants as he was standing near the pilot light of his hot water heater. He has partial thickness burns from his feet to just above his knees, and circumferentially around both legs. Using the rule of nines, which of the following most accurately represents the extent of body surface area burned? A. 36 percent B. 4.5 percent C. 18 percent D. 9 percent
C. 18 percent
CT-21) The meatus is:
A. the external opening of the urethra.
B. the tube that carries urine from the kidney to the bladder.
C. the canal through which urine is discharged from the bladder to the exterior of the body.
D. in a male, the area between the scrotum and the anus.
A. the external opening of the urethra
CT-22) Which type of wound has a small opening into the skin, but may be quite deep, and is often caused by instruments such as nails, ice picks, or pencils? A. Incision B. Puncture C. Laceration D. Avulsion
B. Puncture
CT-23) In caring for a 27-year-old male who has a large laceration on his anterior forearm, you have noticed that your pressure dressing has become saturated with blood. Which of the following should you do next?
A. Apply a tourniquet.
B. Apply additional dressing material over the top of the original dressing and bandage it in place.
C. Apply an ice pack over the original dressing.
D. Remove the saturated dressings and apply a large trauma dressing.
B. Apply additional dressing material over the top of the original dressing and bandage it in place.
CT-24) You are dispatched to a local industrial plant for an “electrical injury.” You arrive on-scene and find a 46-year-old male lying supine in front of an electrical panel. You are told he was attempting to make a repair and somehow received an electrical shock and was thrown to the ground. The scene is safe and the electricity is off. Your initial exam reveals a conscious person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. Coworkers state that he was unconscious until your arrival. What is the next step?
A. While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.
B. Load and go conduct any other care in the ambulance en route due to the potential seriousness of the burns.
C. Stay with the patient awhile, and if he does not appear to be in distress, encourage him to refuse care.
D. Put the patient on oxygen and help him into your ambulance.
A. While on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries, and transport as soon as possible after the exam.
CT-25) When managing an electrical burn, the EMT should:
A. always attempt to remove the patient from the electrical source.
B. never attempt CPR unless it is within 4 minutes of contact.
C. check for a source and ground burn injury.
D. quickly check the pulse, even if the patient is still in contact with the electrical source.
C. check for a source and ground burn injury.`
CT-26) Your patient is a 40-year-old male who has been exposed to a dry chemical powder and is complaining of severe pain on both of his hands, the site of the contact. He is working in an illegal chemical manufacturing plant and there is no decontamination shower on site. Which of the following would be the best way to manage this situation?
A. Brush away as much powder as possible and then pour a bottle of sterile saline solution over his hands.
B. Brush away the powder and bandage the hands in a position of function.
C. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
D. Have the fire department connect to a hydrant and spray down the patient from head to toe.
C. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or regular garden hose.
CT-27) You are treating the amputation of three fingers on a 40-year-old male. The fingers were torn off while he was cleaning his snow blower. You have stopped the bleeding. What should you do with the amputated fingers?
A. Place the fingers directly on ice or use cold packs, as they must be kept very cold.
B. Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.
C. Fingers cannot be reattached so you can discard them in a biohazard bag.
D. Because it is cold out, you merely need to wrap them in a 5 x 9 dressing and give them to the staff at the ED.
B. Wrap them in a sterile dressing, put them in a plastic bag, and keep them cool.
CT-28) You are treating a 5-year-old for extensive burns. You know that burns pose a greater risk to infants and children. The reason for this is:
A. their body surface area is greater in relation to their total body size.
B. the parents’ interference with your assessment and treatment can delay your response.
C. the child will likely be upset and crying and therefore hard to evaluate.
D. child abuse is usually the reason for the burns.
A. their body surface area is greater in relation to their total body size.
CT-29) Which of the following is the outermost layer of the skin? A. Fascia B. Epidermis C. Adipose tissue D. Dermis
B. Epidermis
Layers = Epidermis
Dermis
Subcutaneous
CT-30) You assess a 35-year-old female patient with a chemical burn to her right forearm and hand. As you assess the burn, you notice a white powder on the burn. What should be your next step?
A. Brush off the powder, bandage the arm, and transport the patient to the closest trauma center.
B. Flush the arm and hand with copious amounts of water.
C. Transport the patient immediately to the closest burn center.
D. Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
D. Brush the powder off the patient’s arm and hand, and then flush with copious amounts of water.
CT-31) A 36-year-old man has accidentally shot a nail into his thigh while using a nail gun. Under which of the following circumstances should the EMT remove the nail from the injury site?
A. Bleeding from the wound is minimal.
B. The patient’s distal pulse, motor function, and sensation are intact.
C. The nail is less than 2 inches in length.
D. None of the above
D. None of the above
CT-32) Which of the following is recommended when caring for an amputated part?
A. Rinse away debris with saline solution and place the part in a container of ice.
B. Wrap the part in aluminum foil to preserve body temperature.
C. Care for the amputated part before worrying about the patient bleeding.
D. Seal the part in a plastic bag and keep it cool.
D. Seal the part in a plastic bag and keep it cool.
CT-33) Which of the following is appropriate in caring for a patient with closed soft-tissue injuries and a significant mechanism of injury (MOI)?
A. Treat for shock if you think there are internal injuries even if the patient’s vital signs are normal.
B. Anticipate vomiting.
C. Splint any swollen, deformed extremities.
D. All of the above
D. All of the above
CT-34) You are dispatched to an auto repair shop for an “accident.” You arrive and are told by the owner that one of the workers apparently got his hand in the way while using a high-pressure grease gun and injected the grease into his hand. You find the patient seated in a chair with a coworker applying ice to the injured hand. Your examination reveals a minor round laceration in the hand. The patient is complaining of pain in the area but wants to let the wound take care of itself and go back to work. What should you do?
A. Tell the patient that if it does not get better within the next few days he should consult his own doctor.
B. Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.
C. The patient is correct. This type of wound will heal on its own and he can go back to work.
D. Continue to apply cold, elevate and splint the limb, and transport the patient high priority.
B. Remove the ice from the wound, then elevate and splint the limb. Transport the patient high priority.
CT-35) Which of the following is true concerning lacerations?
A. They may be caused by blunt trauma.
B. They may be caused by penetrating trauma.
C. They may indicate deeper underlying tissue damage.
D. All of the above
D. All of the above
CT-36) Your patient is a 25-year-old man who picked up an iron skillet with a very hot handle. He has a reddened area with blisters across the palm of his hand. Which of the following must be avoided in the prehospital management of this wound? A. Application of antibiotic ointment B. Removing rings C. Application of a dry sterile dressing D. Keeping the site clean
A. Application of antibiotic ointment
CT-37) Which of the following patients has the greatest likelihood of being cared for in a burn center?
A. 30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
B. 45-year-old man who has a partial thickness burn about 3 inches long by 1/2 inch wide on his posterior arm from backing into a barbecue grill
C. 16-year-old female who came into contact with a motorcycle exhaust pipe and has a superficial burn on her leg about 2 inches in diameter
D. 12-year-old male with a partial thickness burn involving his forearm as a result of making a torch by lighting aerosol from a can of hairspray
A. 30-year-old woman who has full thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
CT-38) Burns pose a greater risk to infants and children for which of the following reasons?
A. Infants and children have a greater risk of infection from the burn.
B. Pediatric patients have a greater risk of shock from the burn.
C. Pediatric patients have a greater risk of heart problems associated with the burn.
D. None of the above
B. Pediatric patients have a greater risk of shock from the burn.
CT-39) You are caring for a 23-year-old female who fell off of a bicycle and sustained a severe laceration on the inside of her upper thigh. Her slacks are torn, and you can see most of the wound. What is the next step?
A. You need to make sure the wound is very clean before trying to control bleeding by exposing the wound completely and cleaning it with alcohol.
B. You need to expose the wound completely because you need to clear away any embedded particles and debris from the wound.
C. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.
D. You can treat the wound without total exposure as exposing a wound in that area of the body could be embarrassing.
C. You need to expose the wound completely, control bleeding, clean the surface by simply removing large pieces of foreign matter if any, and dress and bandage the wound.
CT-40) Which of the following is not considered soft tissue? A. The skin B. Cartilage C. Membranes D. Muscles
B. Cartilage
CT-41) An injury in which the epidermis remains intact, but blood vessels and cells in the dermis are injured, is called a(n): A. avulsion. B. hematoma. C. contusion. D. abrasion.
C. contusion.
CT-42) For which of the following patients should the EMT carefully continue to monitor the patient’s ventilatory status throughout treatment and transport due to the greatest risk of respiratory failure?
A. 34-year-old male who opened the radiator of his car and had hot fluid spray on his chest, resulting in redness and pain in an area about the size of the patient’s hand
B. 28-year-old male who spilled a strong industrial acid on his legs
C. 17-year-old male with a blistering sunburn on his face
D. 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest
D. 16-year-old male whose shirt caught on fire, resulting in circumferential burns of his chest
CT-43) Which of the following is of concern in a patient who received burns to his hand when he grabbed a live electrical wire?
A. The patient remains an electrocution hazard to rescuers for several minutes after being removed from the source of electricity.
B. Toxic gases were inhaled.
C. The burning will continue for hours, perhaps days.
D. The extent of tissue damage may be much greater than it appears on the surface.
D. The extent of tissue damage may be much greater than it appears on the surface.
CT-44) Which of the following is of concern with a puncture wound?
A. An object that remains impaled in the body
B. Hidden internal bleeding with minimal external bleeding
C. Strong possibility of contamination
D. All of the above
D. All of the above
CT-45) A burn extending into the subcutaneous fat would be classified as which type of burn? A. Superficial partial thickness B. Superficial C. Full thickness D. Deep partial thickness
C. Full thickness
CT-46) You are assessing a 30-year-old male patient that had his arm caught in a piece of machinery. By the time you arrive, he has been freed. The patient tells you that he does not understand why you were called, but as you inspect the injured limb you notice a small puncture wound. You should have a high index of suspicion of which of the following injuries? A. High-pressure injection B. Crush injury C. Chemical burn D. Puncture
A. High-pressure injection
CT-47) Which of the following best describes an avulsion?
A. Accumulation of blood beneath the skin, resulting in swelling
B. Flap of skin that is partially or completely torn away from the underlying tissue
C. Epidermis that is scraped away by a rough surface
D. An injury caused by a sharp, pointed object
B. Flap of skin that is partially or completely torn away from the underlying tissue
CT-48) While assessing a 78-year-old male patient who escaped an apartment fire with partial thickness burns to both arms, the EMT must be aware of which of the following?
A. Being involved in a crime makes the patient part of the chain of evidence, requiring a police officer to ride with you to the hospital.
B. Medical conditions may be aggravated by the burn.
C. The patient may need to be questioned by police and fire officials about the cause of the fire.
D. The burn is the most serious injury to the patient.
B. Medical conditions may be aggravated by the burn.
CT-49) When using the rule of palm to estimate the approximate body surface area burned, the patient's palm equals about what percentage of the body's surface area (BSA)? A. 3 percent B. 5 percent C. 1 percent D. 2 percent
C. 1 percent
CT-50) An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a fallen tree, that results in damage to underlying structures, bleeding, and inflammation is called a(n): A. contusion. B. abrasion. C. crush injury. D. avulsion.
C. crush injury
CT-51) Bleeding from soft-tissue injuries should initially be controlled with which one of the following techniques?
A. Application of an ice pack or chemical cold pack
B. Direct pressure
C. Running cold water over the wound
D. Elevation of the injured part
B. Direct pressure
CT-52) Which of the following is not a type of avulsion?
A. The skin is stripped off the hand, like removing a glove.
B. An ear is partially torn away from the head.
C. The skin is partially torn away from the foot.
D. A finger is cut off with a butcher’s saw.
D. A finger is cut off with a butcher’s saw
CT-53) Which of the following is a consideration in determining a burn’s severity?
A. Body surface area (BSA) involved in the burn
B. The type of agent that caused the burn
C. Other illnesses or injuries the patient may have
D. All of the above
D. All of the above
CT-54) A 37-year-old male was hit by a trolley and his foot was almost severed. It is only connected by some skin and crushed bone. What should you do?
A. Immediately apply a tourniquet to control bleeding.
B. Because of the seriousness of the injury, wait for ALS before providing any care.
C. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.
D. Complete the amputation. It will make the injury much easier to handle.
C. Apply a pressure dressing to control bleeding, stabilize the foot by splinting, apply oxygen, and transport as a priority patient.
CT-55) 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 my 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?
A. The presence of any defensive wounds the patient may have sustained
B. Getting a description of the assailants
C. Potential internal injuries
D. The swelling around his eyes, which may be reduced by applying a cold pack
C. Potential internal injuries
CT-56) According to the rule of nines for infants and young children, the patient's head and neck account for what percentage of the total body surface area? A. 14 percent B. 1 percent C. 18 percent D. 9 percent
C. 18 percent
CT-57) Which of the following is not a major function of the skin? A. Temperature regulation B. Regulates the pH balance of the body C. Excretion of wastes D. Protection from the environment
B. Regulates the pH balance of the body
CT-58) Which of the following statements is false regarding an electrical injury?
A. Injury is usually limited to the area around the source and ground burns.
B. Patients with electrical burns may be treated with the automated external defibrillator (AED) and CPR.
C. Patients with burns that appear insignificant are treated as having critical injuries.
D. Treatment of a source burn is the same as for other thermal burns.
A. Injury is usually limited to the area around the source and ground burns.