Chapter 32 - Orthopedic Injuries Flashcards

1
Q

A “hip” fracture is actually a fracture of the:

Select one:

A. pelvic girdle.

B. femoral shaft.

C. proximal femur.

D. pubic symphysis.

A

C. proximal femur.

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2
Q

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain.

You should:

A. make one attempt to return the patella to its normal position.

B. gently straighten her knee and apply a padded board splint.

C. keep her knee flexed and secure it with padded board splints.

D. flex her knee slightly more and assess for distal circulation.

A

C. keep her knee flexed and secure it with padded board splints.

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3
Q

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious.

You should:

A. stabilize her head and perform a primary assessment.

B. assess for a carotid pulse and assist her ventilations.

C. apply manual stabilization to both of her femurs.

D. administer oxygen and perform a rapid assessment.

A

A. stabilize her head and perform a primary assessment.

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4
Q

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot.

You should:

A. gently manipulate the injured leg until the numbness dissipates.

B. control the bleeding and cover the wound with a sterile dressing.

C. assess distal pulses as well as sensory and motor functions.

D. manually stabilize the leg above and below the site of injury.

A

B. control the bleeding and cover the wound with a sterile dressing.

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5
Q

A fracture is MOST accurately defined as a(n):

Select one:

A. break in the continuity of the bone.

B. total loss of function in a bone.

C. abnormality in the structure of a bone.

D. disruption in the midshaft of a bone.

A

A. break in the continuity of the bone.

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6
Q

A supracondylar or intercondylar fracture is also known as a fracture of the:

Select one:

A. proximal radius.

B. distal humerus.

C. olecranon process.

D. radial head.

A

B. distal humerus.

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7
Q

An open fracture is MOST accurately defined as a fracture in which:

Select one:

A. a bullet shatters the underlying bone.

B. bone ends protrude through the skin.

C. a large laceration overlies the fracture.

D. the overlying skin is no longer intact.

A

D. the overlying skin is no longer intact.

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8
Q

Crepitus and false motion are:

Select one:

A. most common with dislocations.

B. positive indicators of a fracture.

C. indicators of a severe sprain.

D. only seen with open fractures.

A

B. positive indicators of a fracture.

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9
Q

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes.

You should:

A. apply gentle manual traction in line with the limb and reassess for a pulse.

B. make two or three attempts to restore distal circulation by manipulating the elbow.

C. splint the elbow in the position of deformity and transport immediately.

D. carefully straighten the injured arm and secure it with padded board splints.

A

A. apply gentle manual traction in line with the limb and reassess for a pulse.

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10
Q

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient’s blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:

Select one:

A. stabilize the pelvis with a pelvic binder and protect the spine.

B. perform a focused physical exam with emphasis on the pelvis.

C. log roll the patient onto a long backboard and transport at once.

D. defer spinal immobilization and transport to a trauma center.

A

A. stabilize the pelvis with a pelvic binder and protect the spine.

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11
Q

In general, musculoskeletal injuries should be splinted before moving the patient unless:

Select one:

A. transport time is less than 15 minutes.

B. the patient is clinically unstable.

C. deformity and swelling are present.

D. the patient is in severe pain.

A

B. the patient is clinically unstable.

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12
Q

In which of the following situations should the EMT splint an injured limb in the position of deformity?

Select one:

A. When distal circulation and neurological functions are absent

B. If resistance is encountered or the patient experiences severe pain

C. If transport time to the hospital is greater than 20 to 30 minutes

D. If a traction splint will be used to immobilize the injured extremity

A

B. If resistance is encountered or the patient experiences severe pain

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13
Q

Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:

Select one:

A. fascia.

B. tendons.

C. ligaments.

D. cartilage.

A

B. tendons.

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14
Q

The MOST significant hazard associated with splinting is:

Select one:

A. compression of nerves, tissues, and vasculature.

B. reduction in circulation distal to the injury site.

C. aggravation of the injury or worsened pain.

D. delaying transport of a critically injured patient.

A

D. delaying transport of a critically injured patient.

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15
Q

The musculoskeletal system refers to the:

Select one:

A. involuntary muscles of the nervous system.

B. nervous system’s control over the muscles.

C. bones and voluntary muscles of the body.

D. connective tissue that supports the skeleton.

A

C. bones and voluntary muscles of the body.

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16
Q

When caring for a patient with a possible fracture of the scapula, the EMT should:

Select one:

A. apply rigid board splints across the chest and back.

B. assume that minimal force was applied to the back.

C. recognize that scapular fractures are life threatening.

D. carefully assess the patient for breathing problems.

A

D. carefully assess the patient for breathing problems.

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17
Q

Which of the following musculoskeletal injuries would MOST likely result in deformity?

Select one:

A. Severe strain

B. Moderate sprain

C. Displaced fracture

D. Hairline fracture

A

C. Displaced fracture

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18
Q

Which of the following musculoskeletal injuries would pose the greatest threat to a patient’s life?

Select one:

A. Pelvic fracture with hypotension

B. Bilateral femur fractures

C. An amputated extremity

D. Nondisplaced long bone fractures

A

A. Pelvic fracture with hypotension

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19
Q

Which of the following statements regarding compartment syndrome is correct?

Select one:

A. Compartment syndrome occurs because of increased pressure within the bone cavity.

B. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

C. In most cases, compartment syndrome develops within a few minutes after an injury.

D. Compartment syndrome typically develops within 6 to 12 hours after an injury.

A

D. Compartment syndrome typically develops within 6 to 12 hours after an injury.

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20
Q

With regard to musculoskeletal injuries, the zone of injury is defined as the:

Select one:

A. part of the body that sustained secondary injury.

B. area of obvious deformity over the site of impact.

C. area of soft-tissue damage surrounding the injury.

D. exact part of the bone or joint that was disrupted.

A

C. area of soft-tissue damage surrounding the injury.

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21
Q

Which of the following fractures has the greatest potential for internal blood loss and shock?

A.hip

B.femur

C.pelvis

D.humerus

A

C.pelvis

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22
Q

A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:

perform a rapid secondary assessment.

straighten his arm and apply a board splint.

immobilize the injury with a sling and swathe.

place a pillow under his arm and apply a sling.

A

immobilize the injury with a sling and swathe.

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23
Q

A construction worker’s arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient’s skin is cool, clammy, and pale. The EMT should:

administer high-flow oxygen to the patient.

remove the towel and inspect the wound.

apply a tourniquet just below the shoulder.

wrap the severed arm in a sterile dressing.

A

apply a tourniquet just below the shoulder.

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24
Q

The primary purpose for splinting a musculoskeletal injury is to:

prevent further injury.

maximize distal circulation.

make the patient comfortable.

facilitate ambulance transport.

A

prevent further injury.

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25
Q

Of the following musculoskeletal injuries, which is considered to be the LEAST severe?

Nondisplaced pelvic fracture

Open fractures of a long bone

An amputation of an extremity

Multiple closed long bone fractures

A

Nondisplaced pelvic fracture

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26
Q

You have applied a zippered air splint to a patient’s left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to:

elevate the injured arm and reassess distal sensory function.

inflate the splint with more air until the patient is comfortable.

assess the amount of air in the splint and let air out as necessary.

remove the air splint and reimmobilize with padded board splints.

A

assess the amount of air in the splint and let air out as necessary.

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27
Q

The pectoral girdle consists of the:

scapulae and clavicles.

clavicles and rib cage.

sternum and scapulae.

acromion and clavicles.

A

scapulae and clavicles.

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28
Q

The MOST reliable indicator of an underlying fracture is:

guarding.

severe swelling.

obvious bruising.

point tenderness.

A

point tenderness.

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29
Q

Which of the following structures is regulated by smooth muscle?

Heart

Skeleton

Blood vessels

Diaphragm

A

Blood vessels

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30
Q

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:

apply a traction splint to realign the deformity.

flex the knee slightly and apply a formable splint.

apply padded board splints to both sides of the leg.

bind the legs together and elevate them 6 to 8 inches.

A

apply padded board splints to both sides of the leg.

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31
Q

Applying ice to and elevating an injured extremity are performed in order to:

prevent further injury.

reduce pain and swelling.

enhance tissue circulation.

maintain extremity perfusion.

A

reduce pain and swelling

32
Q

When assessing a patient with a possible fracture of the leg, the EMT should:

assess proximal circulation.

compare it to the uninjured leg.

carefully move it to elicit crepitus.

ask the patient to move the injured leg.

A

compare it to the uninjured leg.

33
Q

When splinting a possible fracture of the foot, it is MOST important for the EMT to:

use a pillow as a splint.

leave the toes exposed.

apply a pneumatic splint.

observe for tissue swelling.

A

leave the toes exposed.

34
Q

Skeletal muscle is also referred to as __________ muscle.

smooth

striated

connective

involuntary

A

striated

35
Q

A 30-year-old man complains of severe pain to his right tibia following an injury that occurred the day before. The patient’s leg is pale and he is unable to move his foot. The EMT should suspect that:

the nerves behind the knee are compromised.

a severe infection has developed in the muscle.

pressure in the fascial compartment is elevated.

the nerves supplying the foot have been severed.

A

pressure in the fascial compartment is elevated

36
Q

During your secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes:

splinting her femur fracture with padded board splints.

immobilizing her to a backboard and rapidly transporting.

applying a traction splint to immobilize her femur.

carefully splinting each of her deformed extremities.

A

immobilizing her to a backboard and rapidly transporting

37
Q

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments.

strain

sprain

fracture

dislocation

A

sprain

38
Q

Which of the following statements regarding shoulder dislocations is correct?

Posterior dislocations are most common.

They are caused by forced arm adduction.

Most shoulder dislocations occur anteriorly.

They involve the acromion process and humerus.

A

Most shoulder dislocations occur anteriorly

39
Q

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should:

splint the elbow in the position found and transport.

gently manipulate the elbow to improve circulation.

gently straighten the elbow and apply an air splint.

apply a heat pack to the elbow to reduce swelling.

A

splint the elbow in the position found and transport.

40
Q

Which of the following scenarios is an example of a direct injury?

A passenger fractures her patella after it strikes the dashboard.

A skier dislocates his knee after a twisting injury to the ankle.

A person lands on his or her feet and fractures the lumbar spine.

A child dislocates his elbow after falling on his outstretched arm.

A

A passenger fractures her patella after it strikes the dashboard.

41
Q

Deformity caused by a fracture would MOST likely be masked by:

A. crepitus.
B. guarding.
C. swelling.
D. ecchymosis.

A

C. swelling.

42
Q

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture.

A. greenstick

B. transverse

C. commuted

D. pathologic

A

D. pathologic

43
Q

What type of muscle contracts and relaxes to control the movement of the contents within its structures?

A. Skeletal

B. Striated

C. Cardiac

D. Smooth

A

D. Smooth

44
Q

Which of the following types of muscle is under direct voluntary control of the brain?

skeletal:

A. Autonomic

B. Smooth

C. Cardiac

D. Skeletal

A

D. Skeletal

45
Q

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:

A. focus your assessment on his scapulae and clavicles and apply high-flow oxygen

B. apply high-flow oxygen, perform a secondary assessment, and transport

C. hyperventilate him with a BVM and monitor his oxygen saturation

D. apply high-flow oxygen, consider spinal precautions, and transport without delay

A

D. apply high-flow oxygen, consider spinal precautions, and transport without delay

46
Q

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the:

A. Coccygeal spin

B. Symphysis Pubis

C. Lumbar Spine

D. Thoracic Spine

A

C. Lumbar Spine

47
Q

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should:

A. place a pillow under his arm and apply a swathe,

B. gently attempt to his arm toward his body.

C. assess distal pulse, motor, and sensory functions.

D. flex his arm at the elbow and then apply the sling.

A

C. assess distal pulse, motor, and sensory functions.

48
Q

A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment reveals that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect:

A. Separation of the acromioclavicular joint.

B. multiple fractures of the proximal humerus.

C. Posterior dislocation of the shoulder.

D. Dislocation of the glenohumeral joint.

A

A. Separation of the acromioclavicular joint.

49
Q

In moving joints, the ends of the bones are covered with:

A. Gliding cartilage.

B. Articular cartilage.

C. Synovial tendons

D. Muscular fascia.

A

B. Articular cartilage.

50
Q

Which of the following statements regarding striated muscle is correct?

A. It forms the major muscle mass of the body and usually crosses at least one joint.

B. Striated muscle tissue is attached directly to the bones by tough bands of cartilage.

C. Most of the body’s striated muscles are found within the walls of the blood vessels.

D. Started muscle is involuntary because you have no conscious control over it.

A

A. It forms the major muscle mass of the body and usually crosses at least one joint.

51
Q

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient’s blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:

A. stabilize the pelvis with the pelvic binder and protect the spine

B. perform a focused physical exam with emphasis on the pelvis.

C. defer spinal mobilization and transport to a trauma center

D. logo the patient onto a long backboard and transport it once

A

A. stabilize the pelvis with the pelvic binder and protect the spine

52
Q

A supracondylar or intercondylar fracture is also known as a fracture of the:

A. distal humerus

B. olecranon process

C. radial head

D. proximal radius

A

A. distal humerus

53
Q

The most significant hazard associated with splinting is:

A. aggravation of the wound or worsened pain.

B. delaying transport of a critically injured patient

C. reduction in the circulation distal to the injury site

D. compression of nerves, tissues, and vasculature

A

B. delaying transport of a critically injured patient

54
Q

Which of the following musculoskeletal injuries would MOST likely result in deformity?

A. displaced fracture

B. moderate spring

C. hairline fracture

D. severe strain

A

A. displaced fracture

55
Q

With regard to musculoskeletal injuries, the zone of injury is defined as the:

A. area of obvious deformity over the site of impact.
B. exact part of the bone or joint that was disrupted.
C. area of soft-tissue damage surrounding the injury.
D. part of the body that sustained secondary injury.

A

C. area of soft-tissue damage surrounding the injury.

56
Q

Which of the following statements regarding compartment syndrome is correct?

A. Most cases of compartment syndrome occur following a severe fracture of the pelvis

B. Compartment syndrome occurs because of increased pressure within the bone cavity.

C. Compartment syndrome typically develops within 6 to 12 hours after the injury.

D. In most cases, compartment syndrome develops within a few minutes after the injury.

A

C. Compartment syndrome typically develops within 6 to 12 hours after the injury.

57
Q

Crepitus and false motion are:

Select one:

A. Indicators of a severe sprain.

B. Most common with dislocations.

C. Positive indicators of a fracture.

D. Only seen with open fractures.

A

C. Positive indicators of a fracture.

58
Q

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

A. administer oxygen and perform a rapid assessment.
B. stabilize her head and perform a primary assessment.
C. assess for a carotid pulse and assist her ventilations.
D. apply manual stabilization to both of her femurs.

A

B. stabilize her head and perform a primary assessment.

59
Q

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

A. control the bleeding and cover the wound with a sterile dressing

B. gently manipulate the injured leg until the numbness dissipates

C. manually stabilize the leg above and below the injury

D. assess distal pulses as well as sensory and motor functions

A

A. control the bleeding and cover the wound with a sterile dressing

60
Q

A Colles fracture involves a fracture of the:

A. distal radius

B. proximal radius

C. radius and ulna

D. distal ulna

A

A. distal radius

61
Q

You and your partner are preparing to apply a traction splint to a patient’s deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should:

A. stop and splint the leg in the deformed position

B. Assess distal pulses and continue pulling traction

C. flex the knee and place a pillow under the thigh

D. gently massage the thigh muscles to relax them

A

A. stop and splint the leg in the deformed position

62
Q

Bone marrow produces:

A. lymphocytes

B. electrolytes

C. cartilage

D. blood cells

A

D. blood cells

63
Q

Atrophy is a condition that occurs when:

A. increased use of skeletal muscle causes an increase in its strength.
B. the tendons that attach muscle to bone become stretched or injured.
C. muscle decreases in size and function
D. carbon dioxide, lactic acid, and other wastes accumulate in the muscle.

A

C. muscle decreases in size and function

64
Q

When splinting an injury of the wrist, the hand should be placed:

A. into a fist.
B. in a straight position.
C. in an extended position.
D. in a functional position.

A

D. in a functional position.

65
Q

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:

A. distal circulation.
B. the patient history.
C. bruising to the shoulder.
D. the presence of deformity.

A

B. the patient history.

66
Q

Common signs and symptoms of a sprain include all of the following, EXCEPT:

A. swelling.
B. deformity.
C. ecchymosis.
D. point tenderness.

A

B. deformity.

67
Q

Care for a patient with a fractured tibia and suspected compartment syndrome includes:

A. keeping the leg at the level of the heart

B. applying traction to maintain distal pulses

C. immobilizing the leg with an air splint

D. applying chemical hot packs to the leg

A

A. keeping the leg at the level of the heart

68
Q

The act of pulling on a body structure in the direction of its normal alignment is called:

A

Traction

69
Q

The MOST common and significant complication associated with fractures or dislocations of the knee is:

A. internal bleeding and shock

B. ligament cartilage damage

C. neurovascular compromise

D. total depletion of synovial fluid

A

C. neurovascular compromise

70
Q

The musculoskeletal system refers to the:

Select one:

A. Bones involuntary muscles of the body

B. Involuntary muscles of the nervous system.

C. Connective tissue that supports a skeleton.

D. Nervous systems control over the muscles.

A

A. Bones involuntary muscles of the body

71
Q

In which of the following situations should the EMT splint an injured limb in the position of deformity?

A. If resistance is encountered or the patient experiences severe pain.

B. A transport town to the hospital greater than 20 to 30 minutes.

C. When distal circulation and neurologic functions are absent.

D. If a traction splint will be used to immobilize the injured extremity

A

A. If resistance is encountered or the patient experiences severe pain.

72
Q

A “hip” fracture is actually a fracture of the:

Select one:

A. Femoral shaft.

B. Proximal femur.

C. Pelvic girdle.

D. Pubic synthesis.

A

B. Proximal femur.

73
Q

An open fracture is most accurately defined as a fracture in which:

Select one:

A. A bullet shatters the underlying bone.

B. The overlying skin is no longer intact.

C. Bone ends protruding through the skin.

D. A large laceration overlies the fracture

A

B. The overlying skin is no longer intact.

74
Q

Which of the following musculoskeletal injuries would pose the greatest threat to a patient’s life?

Select one:

A. Bilateral femur fractures

B. Nondisplaced long bone fractures

C. An amputated extremity.

D. Pelvic fracture with hypotension

A

D. Pelvic fracture with hypotension

75
Q

When caring for a patient with a possible fracture of the scapula, the EMT should:

Select one:

A. Carefully assess the patient for breathing problems.

B. Recognize that scapular fractures are life threatening.

C. Apply rigid board splints across the back and chest.

D. Assume that minimal force is applied to the back.

A

A. Carefully assess the patient for breathing problems.

76
Q

In general, musculoskeletal injuries should be splinted before moving the patient unless:

Select one:

A. Deformity and swelling are present.

B. Transport time is less than 15 minutes.

C. The patient is in severe pain.

D. Patient is clinically unstable.

A

D. Patient is clinically unstable.

77
Q

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:

Select one:

A. Apply gentle manual traction in line with the limb for a pulse.

B. Make two or three attempts to restore distal circulation by manipulating the elbow

C. Carefully straighten the injured arm and secure it with padded board splints

D. Splint the elbow in the position of the deformity and transport immediately

A

A. Apply gentle manual traction in line with the limb for a pulse.