Test Bank Ch 16-23 Flashcards
(340 cards)
1
Q
A patient complains of severe and sharp pain in the right lower abdominal quadrant. Based on the location, what organ or structure is most likely involved?
A
d. The appendix
2
Q
Because the spleen is a solid organ, the primary threat to life when it is ruptured is:
A
a. blood loss.
3
Q
The pancreas is best described as a(n):
A
c. solid organ.
4
Q
Which of the following statements is most likely to be said by a patient with parietal pain?
A
c. “It hurts right here.”
5
Q
A middle aged female patient informs you that she has a bad gallbladder and that it has been increasingly bothering her. Your assessment reveals tenderness and mild discomfort in the right upper quadrant of her abdomen. She also states that her right shoulder is aching. Given her history and complaint, you would recognize her shoulder pain as:
A
a. referred pain.
6
Q
- Which of the following statements indicates that an OEC Technician understands the goal of assessing a patient with abdominal pain?
A
c. “It is more important to recognize a possible abdominal emergency than to determine its exact cause.”
7
Q
- You are called to aid a patient complaining of abdominal pain. When you arrive, you find him lying supine complaining of pain in his lower abdomen. He is pale and has a look of distress on his face. Which of the following actions should you take first?
A
c. Assess his ABCDs.
8
Q
A 43-year-old woman who is crying states that she has sharp abdominal pain that is localized to her right lower quadrant. When assessing her abdomen, you would:
A
a. start by palpating the left upper quadrant.
9
Q
While providing an in-service on abdominal pain, your medical director states that there are several different categories of pain and asks if anyone can identify and describe visceral pain. Which of the following responses is correct?
A
d. “A patient with visceral pain typically describes the pain as ‘aching’ and has a difficult time identifying its exact location.”
10
Q
Which of the following assessment findings would increase your suspicion of gastrointestinal bleeding?
A
c. Tarry, black stool
11
Q
Assessment of a 21-year-old woman reveals that she has severe abdominal pain localized to her right upper quadrant. She is alert and oriented and has stable vital signs. After placing her supine on a stretcher, she quickly assumes a lateral recumbent position with her knees drawn up to her chest. Which of the following responses from you would be appropriate?
A
d. “Are you more comfortable in that position? If you are, then you should stay on your side.”
12
Q
You are called to assist a woman complaining of abdominal pain. Assessment reveals her to be nauseated and to have pain that is localized to the right lower quadrant of her abdomen. She states that she was not able to take her blood pressure medication this morning, and that she wants to take it now with a small glass of juice. Until she receives a further medical evaluation, you would encourage her to:
A
c. not take her medication or drink juice.
13
Q
You suspect that a man experiencing right lower quadrant pain has appendicitis. He states that he has no health insurance and wants to refuse care. He asks you what can happen if he has appendicitis but does not go to the hospital. Which of the following statements would you make in reply?
A
a. “Your appendix could rupture, causing a major infection, shock, and possible death.”
14
Q
Which of the following statements regarding abdominal pain would lead you to suspect appendicitis?
A
c. “The pain started around my belly button and slowly spread down to the right side of my belly.”
15
Q
When you are obtaining information for a medical history, which of the following items would be significant for a patient with suspected cholecystitis?
A
d. The patient ate fried chicken and potato salad for dinner.
16
Q
14-year-old girl sitting in the lodge is complaining of severe abdominal and flank pain. She tells you that her symptoms started a couple of days ago but have worsened over the last few hours. She has chills and thinks she might have a fever. Based on her complaints, you are concerned that she may have:
A
b. pyelonephritis.
17
Q
Which of the following statements is false?
A
c. Assessment of abdominal complaints is straightforward because the organs are specifically located and easily palpated.
18
Q
Colic is best described as:
A
a. intermittent severe abdominal pain caused by the obstruction and distension of a hollow organ.
19
Q
Which of the following statements regarding acute abdomen is false?
A
a. OEC Technicians need to be able to pinpoint the source of an acute abdomen.
20
Q
Rebound tenderness is best described as:
A
b. severe pain that occurs after the sudden release of abdominal palpation pressure during an examination of the abdomen.
21
Q
A conscious patient with a GI/GU complaint is most often comfortable in:
A
a. a supine position with the knees slightly flexed.
22
Q
An infection involving one or both kidneys and ureters is called:
A
c. pyelonephritis.
23
Q
Abdominal aortic aneurysm (AAA) is a true emergency because it can lead to:
A
a. sudden death.
24
Q
The most common GI problem that OEC Technicians encounter is:
A
d. gastroenteritis.
25
A 49-year-old man has been stabbed in the lower right chest. After assessing him, you suspect that the knife punctured the lung and is causing internal bleeding. In this situation, the mechanism of injury would be:
a. a penetrating injury.
26
A patient involved in an altercation was struck in the ribs with a baseball bat. Your assessment reveals intact skin with significant bruising to the right lateral chest. When palpating this area you note instability and crepitus to the rib cage. An OEC Technician would recognize a:
b. chest injury caused by blunt trauma.
27
A heavy-set snowboarder was critically injured when he crashed into a tree on a Friday night. It was reported that he was clearly out of control while traveling at a high rate of speed down the expert trail. Which of the following factors had the greatest impact on the extent of his injuries?
d. The speed the skier was going
28
A 23-year-old skier falls about 20 feet from the chairlift. Aside from his complaints of soreness, you don’t see any obvious injuries. The skier states that as long as his legs aren’t broken, he’s going to continue skiing. Which of the following statements would be your best response to him?
b. “From a fall of that height you may have hurt some internal organs. You really should be examined.”
29
Your friends are discussing a hunting accident they heard about on the news. A hunter was shot with a high-powered rifle, and the report indicated that he had damage to several internal organs. From your knowledge of mechanisms of injury, you can tell your friends that this type of injury is called a:
b. high-velocity penetrating injury.
30
You are called to the vehicle maintenance department on the mountain, where a fairly large explosion has occurred. The first injured person you talk to tells you that he is having excruciating ear pain. You recognize that his ear pain may be caused by:
b. a primary blast injury to the inner ear.
31
The term golden hour refers to the:
The time after injury in which timely interventions are critical to survival.
32
Which of the following statements indicates that an OEC Technician understands the importance of evaluating the mechanism of injury?
d. “The mechanism of injury can give valuable clues about the source of injury and how seriously a patient is injured.”
33
Which of the following statements best describes the capabilities of a Level III trauma center?
d. The hospital has some surgical capabilities to help trauma patients but does not have every subspecialist available.
34
Which of the following characteristics is not one of the five levels upon which trauma center designations are based?
c. Age of the patient
35
Trauma centers are specifically designed to:
b. manage patients with multi-system trauma.
36
Which of the following descriptions describes a patient suffering from multi-system trauma?
b. A 67-year-old male who fell down a flight of stairs, has an open fracture of the left lower leg, and is complaining of severe abdominal pain
37
You arrive alone at a scene at which a 16-year-old skier has collided with a tree. He is unresponsive and has blood flowing from his ears and nose. He was not wearing a helmet. Which of the following lists reflects the most appropriate care of this patient?
a. Primary assessment, airway management, immobilization, transport as soon as possible
38
Which of the following factors does not directly relate to the severity of bodily injury?
c. The size of the injured person
39
Kinetic energy is absorbed based on the density of the structure/organ involved. Which of the following lists places the organs in the order of their “threshold for injury”?
c. Kidneys, lungs, femur
40
Which of the following terms is not a “mechanism of injury”?
c. Stabbing injury
41
Dislocating a shoulder after catching a ski pole on a tree branch is an example of an injury caused by which MOI?
a. Rotational injury
42
Which of the following injuries is an example of a tertiary blast injury?
a. A fracture caused by the body being thrown to the ground
43
The group of signs and symptoms that are often seen during the initial stages of patient blast management, which is known as the “blast pattern triad,” includes:
c. apnea, hypotension, and bradycardia.
44
A trauma assessment should be completed within 1–2 minutes and includes all of the following tasks except:
d. performing a detailed physical exam.
45
High-velocity injuries and low-velocity injuries are two types of which mechanism of injury?
b. Penetrating injury
46
High-velocity injuries are usually the result of:
b. the impact of a bullet from a high-powered rifle.
47
Tissue damage caused by low-velocity injuries is usually:
c. limited to the path of the object.
48
A patient has a laceration on his arm from a table saw. Assessment reveals dark red blood flowing steadily from the wound. You would recognize this type of bleeding as:
c. venous bleeding.
49
You are responding to a call to aid a patient who has cut himself with a knife. Reportedly arterial bleeding is involved. Given this information, which of the following findings do you expect?
d. Bright-red blood that is spurting with each beat of the heart
50
You arrive at a scene at which a 16-year-old girl has cut her wrist with a knife. She appears to be pale, and blood is spurting from the cut. Which of the following actions should you take first?
b. Apply direct pressure to the cut.
51
Severe external bleeding should be controlled during what phase of a patient assessment?
a. The primary assessment
52
You are treating a patient who has cut herself while working in the lodge kitchen. She has a jagged laceration on her left forearm that is bleeding steadily and heavily. While attempting to control the bleeding, you should first:
c. place a sterile dressing over the site and hold steady pressure on the dressing with your hand.
53
Which of the following actions should you take next when direct pressure, elevation, and femoral artery pressure have failed to control arterial bleeding on a patient’s leg?
b. Apply a tourniquet proximal to the injury.
54
Which of the following statements indicates that the speaker understands the application of a tourniquet?
a. “A tourniquet should be applied tightly enough so that arterial blood flow distal to the tourniquet is completely stopped.”
55
You have just arrived on scene, where a young girl has pushed her arm through a plate glass window. She is responsive and has a patent airway. Bright red blood is spurting from a large laceration on her right upper arm. When your partner tells you to apply direct pressure to the laceration to prevent the further blood loss, you would:
b. put gloves on before applying direct pressure over the injury site.
56
You are having a difficult time controlling bleeding from a small skin avulsion on a patient’s ankle. Which of the following statements made by the patient best explains why the bleeding has been so difficult to control?
a. “I take Coumadin for my irregular heartbeat.”
57
The skin performs which of the following functions?
a. Regulation of temperature
58
A patient has suffered abrasions to the legs after falling on a moving treadmill. In treating this injury you would be most concerned about:
b. the risk of infection.
59
Which of the following lists correctly names the layers of the skin?
d. Subcutaneous, epidermis, dermis
60
When managing a patient with soft-tissue injuries, it is essential that you:
c. use the appropriate personal protective equipment.
61
Assessment of a patient who fell reveals bruising to her right buttock. Her skin is intact and she complains of tenderness in the area when you palpate it. You would recognize which of the following types of injury?
d. A contusion
62
When assessing a patient you note a bruise on the chest. Another word for documenting a bruise is:
a. ecchymosis.
63
Which of the following assessment findings best indicates that a patient’s injury should be classified as an abrasion?
d. Red scrapes involving the outermost layer of skin only
64
You respond to a patient who has an avulsion on the left arm. When you assess this patient, you would expect to find:
a. a loose flap of torn skin on the left arm.
65
A 49-year-old man was climbing on rocks when he fell backward to the ground. He presents with a two-inch linear wound on the top of his head. Bleeding has been controlled. You would document this type of injury as a(n):
d. laceration.
66
You are assessing a patient who received multiple injuries in a fight. Which of the following injuries would present the greatest danger for infection?
c. An abrasion on the right side of the face
67
Which of the following instructions is appropriate for helping a new patroller care for a patient with a large abrasion on his arm?
c. “Don’t worry about cleaning the wound. The patient is going to the hospital, which is only 30 minutes away.”
68
A young boy was out riding his bike in the neighborhood when he fell onto a stick protruding from the ground. The stick impaled him in the neck. The boy immediately pulled the stick out. Assessment reveals a gaping wound to the boy’s right neck. Which of the following types of dressing would you use on this injury?
b. An occlusive dressing that is taped on all sides
69
A patient has had part of his right thumb amputated in an accident. Friends have retrieved the thumb and wrapped it in a towel. When you arrive, you would demonstrate appropriate handling of the amputated part by:
d. wrapping the thumb in a moist sterile dressing and keeping it cool.
70
Which of the following statements indicates that the speaker understands bandaging?
b. “Bandaging material is used to secure a dressing in place.”
71
You have applied a pressure dressing to the calf of a woman who suffered a deep laceration from a piece of broken glass. Which of the following actions should you take next?
d. Check CMS in the patient’s foot.
72
Which of the following statements indicates that the speaker understands dressing and bandaging a wound?
c. “Leave the tips of the fingers or toes exposed when bandaging an arm or a leg so you can continue to assess CMS.”
73
Which of the following statements about pressure dressings and bandages is true?
b. Bandages should be applied in a distal-to-proximal manner.
74
Which of the following injuries is most likely to result in capillary bleeding only?
b. An abrasion
75
What is the function of subcutaneous fat?
d. It insulates the body and stores energy.
76
Which of the following phrases best describes a closed-tissue injury?
d. A wound in which underlying tissues are damaged but the overlying skin remains intact
77
Which of the following statements about impaled objects is true?
b. The impaled object should be left in place during transport.
78
Which of the following statements about a high-pressure injection injury is false?
a. The presenting wound is typically large.
79
Mechanical tattooing is defined as:
c. the introduction of foreign debris such as dirt, gunpowder, or small rocks into the skin
80
A patient has been stabbed in the chest with a 6-inch-long ice pick. When you assess the wound you find it to be very small and insignificant in appearance, with minimal bleeding. Which of the following assumptions can you correctly make about this injury?
b. Damage to the underlying structures is likely.
81
For which of the following injuries may elevation be used to control bleeding?
b. For no injuries; elevation is no longer used to control bleeding.
82
Which of the following statements about the use of a tourniquet is true?
a. It should be placed as distal as possible but at least several inches proximal to the wound.
83
Using a very narrow material such as wire or rope for a tourniquet can cause:
a. serious tissue damage.
84
The most effective method for treating a contusion is to apply a(n):
d. ice pack.
85
Which of the following statements about amputations is true?
d. All amputated body parts should be preserved and sent to the hospital with the patient.
86
Which of the following statements about an impaled object is true?
a. The primary treatment goal in the field is to stabilize the object in the position found.
87
During your secondary assessment, a patient with a stab wound to the abdomen tells you that he is taking Coumadin, a blood thinner. Which of the following implications would taking this medication have for this patient?
c. The medication could cause the patient to bleed more profusely.
88
Which of the following statements concerning a patient who received electrical burns to his hand after grabbing a live wire is true?
c. The extent of tissue damage may be much greater than it appears on the surface.
89
Your patient is a 35-year-old woman who spilled a cup of hot coffee on herself two hours ago. An area on her right thigh that is about twice the size of the palm of her hand is red and painful but has no blisters. Which of the following actions would be appropriate for an OEC Technician to take?
b. Apply a sterile dressing.
90
Your patient is a 40-year-old man who was burned when he spilled gasoline on his pants while 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, circumferentially around both legs. According to the Rules of Nines, the man burned ____ of his body surface.
d. 18 percent
91
Which of the following patients should be cared for in a burn center?
b. A 30-year-old woman who has deep partial-thickness burns on her hand and arm as a result of spilling hot cooking oil on herself
92
Which of the following sentences best describes a partial-thickness burn?
a. The skin is red and moist, and blisters have formed.
93
Your patient is a 10-year-old boy who was exposed to a dry chemical powder and is complaining of severe pain at the site of contact on both of his hands. There is no decontamination shower on site. Which of the following actions would be the best way to manage this situation?
a. Brush away as much of the powder as possible and then have the patient hold his hands under running water from a faucet or garden hose.
94
Your patient is a 25-year-old man who has a reddened area with blisters across the palm of his hand after grabbing the handle of a very hot iron skillet. Which of the following actions must be avoided in the prehospital management of this wound?
c. Applying an antibiotic ointment
95
A burn extending into the subcutaneous layer would be classified as a:
d. full-thickness burn.
96
The largest organ of the human body is the:
d. skin.
97
The top two layers of the skin are the:
a. epidermis and the dermis.
98
Thermal burns:
b. are the most common type of burns.
99
Chemical burns result from exposure to:
d. caustic substances.
100
The most serious chemical burns could result from exposure to a solution with a pH of:
d. 13.
101
Electrical injuries produce severe external and internal injuries because:
a. the skin is a poor conductor with a high resistance, and blood vessels are good conductors with low resistance.
102
Thermal burns result from:
b. direct contact between a heat source and the skin.
103
Which of the following substances cause the most serious chemical burns?
a. An acid with a pH of 1
104
When treating electrical burns, OEC Technicians should always:
c. look for internal injuries.
105
Three types of natural radiation are:
a. alpha, beta, and gamma.
106
Hoarseness or voice changes in a burn patient should alert an OEC Technician that the:
b. heat source may have extended internally into the airway.
107
Alternating current—current that pulses 60 times per second—is more dangerous than direct current because the pulses:
d. can cause the victim to remain in physical contact with the source of the current for a longer time.
108
According to the Rule of Nines, the percentages of total body surface area that are taken up by the heads (front and back) of adults and children are:
a. 9 percent and 18 percent, respectively.
109
Another simple method for estimating the total percentage of area burned is the ______ approach.
c. palm
110
When treating a patient exposed to strong acids or bases, which of the following devices offers the least protection to an OEC Technician?
d. Exam gloves
111
In treating a burn patient, you should cool and irrigate the burned tissue with:
a. room-temperature tap water for 15 minutes.
112
When treating a patient burned by a dry chemical, it is important to brush away any dry residue before flushing with water because:
b. some dry chemicals are activated by water.
113
The type of muscle found in the forearm is:
a. voluntary muscle.
114
The closed fracture of which of the following bone(s) has the greatest potential for internal blood loss?
d. The pelvis
115
Which of the following statements about voluntary muscles is true?
d. They generally connect to the skeletal system.
116
During your SAMPLE inquiry, a patient reports that he had surgery to repair a torn ligament. Based on your training, you know that a ligament is:
b. a tissue that stabilizes two contiguous bone ends.
117
Which of the following statements about musculoskeletal injuries is true?
a. A sprain is an injury to a joint that involves the stretching or tearing of ligaments.
118
The _____________ can be injured when a hip is dislocated, resulting in numbness or paralysis of a lower extremity.
b. sciatic nerve
119
You are assessing a 47-year-old woman who fell about 20 feet from a chair lift. When you palpate her pelvis you note instability, and she complains of pain. Which of the following is your primary concern for a patient who has a potential pelvic fracture?
b. Internal blood loss
120
Which of the following signs has the potential for the most immediate life-threatening consequences?
a. Deformity of the femur
121
You are treating a patient who is complaining of moderate pain in the right knee. The knee is swollen, ecchymotic, and flexed about 45 degrees. CMS is intact. How would you treat this patient?
c. Splint the knee in the position found before moving the patient.
122
Your patient was struck in the right upper arm with a baseball bat. Which of the following signs or symptoms indicates the highest probability that the humerus has been fractured?
a. Crepitus felt on palpation
123
Your secondary assessment of a patient who is complaining of pain in his right leg reveals an opening in the skin where the fractured tibia broke through the skin and retreated back into the leg. You would recognize this injury as a(n):
a. open fracture.
124
You respond to a 9-year-old boy who was injured in the terrain park. He is complaining of pain in his right wrist. Upon examination you note deformity and swelling of the right wrist, pinkness of the right hand, and a strong radial pulse. Which of the following actions would be part of the proper care for this boy?
c. Apply a cold pack to the wrist to reduce swelling.
125
A 42-year-old man has fallen 25 feet while rock climbing. He hit the ground feet first and suffered open fractures to both tibias, which are protruding through the skin. When you arrive, he is responding to painful stimuli. His airway is open, his breathing is adequate, and his radial pulse is strong and rapid. At this point in his care, it is a priority for you to:
b. look for other injuries.
126
When placing a person in anatomic position using the principles of Pretzels and Jams, are the head, shoulders, and buttocks put into a straight line?
a. Yes
127
A patient fell and sustained an open fracture of the left humerus. Assessment reveals that the bone has pulled back into the arm. Bleeding from the site is controlled. For which of the following reasons would splinting the left arm benefit this patient?
a. A splint decreases the likelihood of further injury to nerves and blood vessels.
128
Which of the following emergency care measures for a patient with a possible bone fracture can be an effective way of reducing pain?
c. Splinting the fracture
129
A patient has suffered an injury to his right leg, and deformity of the tibia-fibula region is obvious. After conducting a primary assessment and manually stabilizing the leg, which of the following actions should you take next?
c. Check for a pedal pulse.
130
A patient with a closed fracture to the mid-forearm has been properly splinted when which of the following structures have been immobilized?
b. The wrist, forearm, and elbow
131
You are called to treat a 27-year-old man who fell while snowboarding and struck his leg against a tree. The primary assessment shows no threats to his airway, breathing, or circulation. A secondary assessment reveals a severely deformed knee that is swollen and ecchymotic. The leg is pale and cool, and the patient cannot move the leg when asked to do so. In addition, you cannot palpate a pedal pulse. Which of the following actions should you take at this time?
d. Attempt to straighten the leg once to see if a pulse returns.
132
A 60-year-old woman suffered an open tibial fracture when she stepped sideways on her foot while jogging. Which of the following interventions constitutes appropriate care for this injury?
d. Apply a sterile dressing to the bone end and to the soft-tissue wound.
133
The benefit of applying a traction splint to a deformed femur fracture is that it:
b. decreases pain.
134
You are watching an OEC candidate apply a splint to an injured patient. You note that the splint appears to be loose, and you assist the candidate in properly applying it. After you have delivered your patient to the aid room, you explain to the candidate that a splint applied too loosely could result in:
a. damage to muscles, nerves, and blood vessels.
135
You and a fellow patroller respond to a snowboard injury in a 12-year-old boy who fell on his outstretched arm. His left wrist is swollen and ecchymotic. A radial pulse is readily palpated, and the skin on the hand is warm to the touch. Which of the following instructions to your partner indicates that you have a proper understanding of the care for this patient’s arm?
a. “After we splint his wrist, we will need to apply a sling and swathe to prevent further movement.”
136
You are working in the first-aid room when a patient arrives with an open injury of the left lower leg. Which of the following observations would indicate that the extremity was improperly splinted?
c. The patient is able to flex her left ankle when directed to do so.
137
A patient exhibits swelling and deformity to the wrist. Which of the following positions for the hand is most appropriate when splinting this injury?
a. Fingers curled slightly down around a roller bandage
138
Which of the following statements indicates that an OEC Technician has a good understanding of the proper care of a possible joint dislocation?
b. “The care for a patient with a joint injury is similar to that for a fracture.”
139
Which of the following assessment findings contraindicates the use of a traction splint to treat a femur injury?
a. A gross deformity of the hip that indicates dislocation
140
Which of the following statements about traction splints is correct?
c. Manual traction should be applied until the mechanical traction is at least equal to the manual traction.
141
Which of the following functions is not one of the several functions of bones?
c. Responding to sensory nerve stimulation to protect skin and other tissues
142
Displacement of the bones of a joint is known as:
a. a dislocation.
143
You are discussing a sling and swathe while teaching an OEC class about splints. Which of the following statements regarding a sling and swathe is correct?
b. It provides a stable platform for the arm and can be used to immobilize either the arm alone or the arm with a separate splint in place.
144
A patient for whom you recently provided care stops by to thank you. He reports that he was diagnosed with a strain to his lower right leg. Which of the following structures is the primary structure affected in that injury?
c. A muscle
145
A fracture that has three or more fragments is called a(n):
b. comminuted fracture.
146
The National Ski Patrol’s current recommendation regarding ski boot removal when applying a traction splint is:
d. to leave the boot on if the patient is to be placed in a traction splint in the outdoor environment, unless the local medical director approves doing otherwise.
147
The inside layer of a joint capsule where cells make a viscous fluid for lubricating the joint is the:
a. synovium.
148
Joints provide different degrees of movement. There are five different types of joints. An example of a “pivot” joints is the:
a. radio-ulnar joint of the elbow.
149
You respond to an accident and find a young man lying prone but in a neutral, anatomic position, except that his head is turned to the side. Using the principles of Jams and Pretzels, you would say that this patient is in position:
c. 3.
150
The most frequent injury in skiing is a:
b. knee sprain.
151
The most commonly broken bone in the body is:
b. the clavicle.
152
Your friend tells you that he wants to try snowboarding. He is concerned about his safety and asks you which type of fracture is most common in snowboarders. You learned in your OEC training that this injury involves the:
d. radius.
153
Which of the following statements would you make to the parent of a 10-year-old snowboarder who took a hard fall and complains of some discomfort in a wrist that is slightly swollen but has no deformity?
b. “It could be a nondisplaced fracture.”
154
A fracture of a bone will cause bleeding, and a hematoma forms around the fracture site. Over the next several weeks, this hematoma organizes into a substance called:
a. a callus.
155
Which of the following musculoskeletal tissues does not heal?
d. A cartilage
156
An airplane splint is useful for immobilizing certain types of musculoskeletal injuries. Which of the following statements concerning an airplane splint is not correct?
c. It is used only for injuries that must be maintained at a 90-degree angle.
157
In order to make a SAM splint™ a “rigid” splint, you need to:
b. make a “T” shape lengthwise in its middle.
158
You are demonstrating boot removal to a class of OEC candidates. While explaining Rescuer #1’s role, you indicate that his first task is to:
c. stabilize the patient’s leg and ankle.
159
The structure responsible for transmitting the force of a contracting skeletal muscle to a bone is a:
a. tendon.
160
While you are putting wood into your wood stove, your hand comes in contact with the hot surface. Your body responds by pulling your hand away from the heat. How is this action accomplished?
a. One or more skeletal muscles receive a signal from the brain to contract.
161
The ideal position for patients before you transfer them to a long spine board for immobilization is:
d. supine, in a neutral anatomic position, with the back straight, the eyes facing forward, and the extremities straight with the palms against the thighs.
162
You are working with a candidate OEC Technician who is practicing the application of splints. When checking the sling and swathe that the candidate applied to an upper extremity, you note that it is not applied correctly. You point this out to the candidate and tell him that the purpose of a sling and swathe is to:
b. prevent further movement of an injured extremity.
163
An air splint is a dual-walled, tube-shaped device used to temporarily immobilize a long bone. Which of the following statements about air splints is false?
d. They are made of a tough fibrous material that is difficult to puncture.
164
You are caring for a patient who has an angulated lower leg fracture. To splint this injury you should:
a. use gentle longitudinal tension to align the fracture.
165
You are caring for a 26-year-old woman with a probable wrist fracture. Before applying a splint you ask her to remove her large engagement ring. She hesitates and asks why she should do this. Which of the following responses would be an OEC Technician’s best response?
c. “You should remove the ring now because your fingers may become very swollen.”
166
One method for immobilizing a clavicle fracture is a figure eight splint. Which of the following statements about a figure eight splint is false?
d. This splint is useful for acromioclavicular (A/C) injuries.
167
To properly apply a figure eight splint, an OEC Technician should:
a. tighten the cravats so that the position of the shoulders is the same as if the patient were sitting normally.
168
You and a fellow patroller are applying a blanket roll to a 48-year-old patient with an anteriorly dislocated shoulder. While your partner holds the blanket roll in position under the affected shoulder, which of the following actions should you not take in securing the roll?
b. Tie one of the cravats over the affected shoulder.
169
You are evaluating a new OEC instructor who is teaching a class on displaced humerus fractures. Which of the following statements by the instructor would require your correction?
c. “The fracture should be reduced to achieve better pain control and packaging.”
170
When it becomes apparent that the arm distal to an elbow injury has a CMS deficit, OEC Technicians should:
d. make one attempt to realign and restore CMS before splinting.
171
Which of the following splints should not be used to treat proximal forearm fractures?
d. A splint that does not immobilize the elbow
172
Which of the following statements about the axial skeleton is true?
c. It has 80 bones consisting of the skull, vertebrae, and thoracic cage.
173
61. Which of the following statements about the appendicular skeleton is true?
d. It has 126 bones consisting of the shoulder, arm, pelvis, and legs.
174
Which of the following terms does not describe a type of bone?
b. Short
175
Which of the following splints should not be used for a wrist fracture?
a. A Thomas Splint
176
The outermost part of a bone is a tough lining known as:
d. the periosteum.
177
Which of the following terms does not describe a type of joint?
d. Post
178
Which of the following pairs of proteins causes muscle tissue to shorten or contract?
b. Actin and myosin
179
A sling and swathe can be used for a:
c. humerus fracture if combined with a separate splint.
180
A vacuum splint works because:
a. the splint becomes rigid when air is sucked out of it.
181
An airplane splint works well because:
d. it is a rigid, fixed stabilizing unit.
182
Treatment of an anterior S/C dislocation is best managed using a:
d. sling and swathe.
183
Should a fractured humerus be splinted using a soft splint and a sling and swathe?
b. No
184
Because of the abundant blood vessels and nerves in the elbow, an injury to a child’s elbow should be splinted in:
a. the position found.
185
The finding that upon muscle contraction the active motion of a joint is reduced or completely lost suggests:
d. a ruptured tendon.
186
An injured forearm should be cradled in a sling:
b. with its weight evenly distributed.
187
Care of an anterior dislocated shoulder:
c. requires patience and sometimes creativity.
188
Can a Colles’ fracture or “silver fork” wrist fracture result from falling on a clenched fist?
b. No
189
A common injury among snowboarders who fall forward on an outstretched hand is a fractured:
a. scaphoid.
190
A snowboarder’s fall over the toe side of the board onto an outstretched hand is known as the
d. “mousetrap.”
191
You are dispatched to aid a snowboarder who has sustained a shoulder injury. The injured man is sitting on the side of the trail and reports that because of past dislocations of the shoulder he has a subluxation, and that the shoulder is okay. Which of the following statements best describes his condition?
d. The shoulder joint partially dislocates and then returns to a normal anatomic position.
192
A former patient returns to the Ski Patrol treatment room to thank you for the treatment he received. He informs you that he has a popiteal fossa injury. With your OEC knowledge, you realize that his injury is related to which of the following structures?
b. The back of the knee
193
For a person to make a fist, which of the following must occur?
a. The central nervous system must send a message through the spinal cord and then through the peripheral nerves.
194
Based on the structure of the nervous system, which of the following statements is true?
c. A deep laceration to an arm can sever peripheral nerves.
195
Which of the following signs or symptoms might be evident for an injury to the autonomic nervous system?
b. Elevated heart rate
196
You are notified that a patient is coming to the first-aid room with bruising to the lumbar area of the back. Based on this statement, you would expect to find bruising in which area?
c. The lower back
197
You respond to an accident at which a male patient is complaining of severe back pain. He informs you that his back pain is coming from a recent fracture of his coccyx. Based on this information, what area of the back would the pain be emanating from?
c. The tailbone
198
A patient involved in a motor-vehicle collision has suffered the separation of a rib from a spinal vertebra. Based on the anatomy of the spine, where has this injury occurred?
d. The thoracic spine
199
Based on the anatomy of the spine, which one of the following injuries is possible?
c. A disk injury between thoracic vertebrae 11 and 12
200
A young intoxicated male patient cannot move his lower extremities after diving into the shallow end of a pool and hitting the bottom with his head. Which of the following mechanisms is most likely to be responsible for this injury?
a. Compression
201
A young female was involved in a motor-vehicle collision in which her car struck the rear end of another vehicle. As a result of the impact, her neck muscles were overstretched and torn. She is complaining of neck pain. Based on this mechanism, the most likely type of injury she has is:
b. whiplash.
202
While performing a primary assessment on a patient who has an isolated spinal cord injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect that the spinal cord injury has occurred?
b. The cervical spine
203
Which of the following signs or symptoms best indicates that a patient has suffered an injury to the thoracic spine?
c. Tingling in the legs
204
An elderly patient has fallen down a flight of stairs and is complaining of neck and back pain and weakness to both legs. Your primary assessment reveals no life threats to the airway, breathing, or circulation. Manual in-line spinal stabilization is being maintained. Which of the following actions should you take next?
b. complete a secondary assessment looking for injuries.
205
Which of the following questions or statements indicates that an OEC Technician is correctly assessing motor function in the arms of a patient with potential spine injuries?
b. “Can you hold up two fingers on each hand?"
206
Which of the following statements about the care and treatment of a patient with a spinal injury in a prehospital setting is true?
a. Prehospital care for a patient with a spinal injury involves correcting life-threatening injuries and limiting secondary injury.
207
Which of the following signs is a characteristic sign that may be seen during a secondary assessment of patients with spinal cord injury?
b. Flushed skin color below the level of the injury and impairment or absence of sensation and movement
208
A patient involved in an accident has his head positioned so that his left cheek is touching his left shoulder. He states that he has severe pain in his neck and he cannot move his head. He also states he has no feeling in his arms or legs. You have no equipment. Which of the following is the best course of action?
b. Stabilize and maintain the head in the position in which the patient is holding it.
209
A patient is complaining of back pain and numbness in both legs after being thrown from a bicycle. When should you check the motor function, sensory function, and pulses in this patient?
c. During the primary assessment
210
Assessment of the cervical spine of a patient complaining of lower back pain after falling 20 feet reveals no displacement, tenderness, or instability. Accordingly, you should:
b. apply a properly sized cervical collar.
211
A patient with head, neck, and back pain has just been fully immobilized to a long backboard. Which of the following instructions should you provide to your team next?
c. “Check for CMS before we move him to the stretcher.”
212
Which of the following instructions from one OEC Technician to another describes the appropriate application of a cervical spine immobilization collar?
c. “Keep his head in neutral position while I apply a cervical collar.”
213
For which of the following patients involved in a motor vehicle collision is the use of a vest-type short immobilization device indicated?
d. A 33-year-old female in the backseat who complains of neck pain and a headache
214
A patient with a head and neck injury was sitting found leaning against a tree. You have placed a vest type short immobilization device on the patient. To transport the patient you would:
b. immobilize the patient with the vest-type short immobilization device to a long backboard.
215
You are securing a patient to a long backboard. Which of the following lists indicates the appropriate order for securing the straps?
a. Torso, pelvis, legs, head
216
A patient has just been log rolled and positioned onto the long backboard. Which of the following actions should be performed next?
c. Secure the patient’s chest with straps.
217
You are maintaining manual in-line stabilization of the cervical spine for a patient being log rolled, transferred, and secured to a long backboard. At what point should you release the manual in-line stabilization?
d. After the patient’s head has been secured with a head immobilization device
218
You have been called to aid a 32-year-old male patient who fell down a flight of stairs. The patient is walking toward you and states that he would like to be looked at because his shoulder and lower back hurt. You immediately apply in-line manual cervical stabilization and your partner examines his back, which reveals no sign of injury. How should you immobilize this patient?
a. Place a long board behind the patient and immobilize him in a standing position.
219
Which of the following statements indicates that OEC Technicians are correctly using a vest type short spine immobilization device?
d. The head is secured to the device after the chest has been secured.
220
You and your partner are preparing to backboard a patient using a vest type short spine immobilization device. After ensuring that inline manual spinal stabilization is being maintained, your next instruction should be:
c. “Let’s check motor, sensory, and pulses in the arms and legs.”
221
Which of the following statements about removing a helmet in a prehospital setting is correct?
b. It is acceptable to leave a helmet on a patient if the patient has no airway or breathing problems.
222
A 2-year-old boy fell down a flight of stairs. Which of the following instructions would you provide to other patrollers who are immobilizing the patient?
c. “Let’s place a folded towel under his shoulders to help maintain his head alignment.”
223
You are assessing 30-year-old man who has fallen about 20 feet. He is alert and oriented but states that he cannot move or feel his legs. Additionally, because his blood pressure is 82/48 mmHg, you suspect spinal shock. Which of the following additional assessment findings reinforces your suspicion of spinal shock?
d. Heart rate of 44
224
A 22-year-old female rock climber has fallen 25 feet to the trail below. The primary assessment shows her to be confused and to have an open airway and shallow breathing. Her pulse is 72 beats per minute, and her blood pressure is 78/50 mmHg. She has no motor ability or sensation in her legs. Which of the following conditions is the most likely cause of this patient’s presentation?
b. Spinal cord injury
225
You should recognize a possible spinal column injury with no spinal cord involvement when you discover which of the following assessment findings?
a. Tenderness to the thoracic spine with intact motor and sensory function in each extremity
226
A mechanical injury to the brain that results in a short-term and/or a long-term neurologic deficit is:
d. a traumatic brain injury.
227
A primary injury to the central nervous system would be caused by:
d. a laceration of the spinal cord.
228
You suspect that an unhelmeted climber who struck his head during a fall may have a basilar skull fracture. As you conduct your assessment, which of the following findings reinforces this suspicion?
c. Clear fluid coming from the right ear and left nostril
229
A patient was killed immediately following a self-inflicted gunshot wound to the head. Which portion of the central nervous system was most likely damaged in order to cause the rapid death of the patient?
b. The brain stem
230
You are assessing a patient who tells you she had a previous head injury in which a portion of the cerebellum was destroyed. Which of the following signs and symptoms would you expect to find in relation to this injury?
b. Poor coordination when walking
231
A patient involved in a motor vehicle collision has a deformity to the left side of the head. The skin overlying the deformity is still intact. Based on these assessment findings, which of the following conditions would be your greatest concern?
a. A possible brain injury
232
A 41-year-old male snowboarder struck his head on a metal rail. As you approach him, you note that he appears confused and has blood on the left side of his face and head, and on his shirt. His breathing appears to be labored. Which of the following actions should you perform immediately?
c. Apply manual in-line spinal immobilization.
233
You are called to aid a 61-year-old man who has fallen off a second-floor lodge patio. He is unresponsive and has slow, shallow breathing. When you arrive, a fellow patroller has already opened the airway and has stabilized the head. Which of the following actions should you take immediately?
c. Assist ventilation with a BVM.
234
A 68-year-old female patient is complaining of a headache and generalized weakness. Her husband informs you that she was with a friend yesterday and struck her face on the dashboard during a motor vehicle collision. Her past medical history includes a stroke that caused right arm weakness and high blood pressure. When assessing this patient, which of the following findings should concern you the most?
c. Bruising behind her left ear
235
Which of the following assessment findings is most indicative of increasing pressure within the skull from a closed head injury?
a. Blood pressure of 192/106 mmHg
236
Your patient is a young female who was thrown from her mountain bike and is now confused. Assessment findings include an open airway, adequate breathing, and a strong radial pulse. Which of the following questions would be the most important to ask her friends who were with her?
d. “Did she lose consciousness?”
237
A male soccer player was struck in the head with a soccer ball. Players state that he was dazed for several seconds following the impact and then asked the same questions over and over. He is currently conscious and oriented to person but is confused as to place and time. He also has a reddened area on the side of his head and face. As you proceed with your assessment, his memory continues to improve. Based on these findings, you would suspect which of the following injuries?
a. A concussion/TBI
238
You are participating in training OEC candidates and are asked about cerebral contusions. You would explain to the class that a cerebral contusion is:
c. bruising and swelling of the brain tissue.
239
You are called to the lodge by a family who is concerned that their mother is not acting right. The family tells you that they are concerned because their mother has been complaining of a headache and is very confused today. Assessment reveals a bruise on the right side of the head that the family states she got about a week ago when she fell. Which of the following conditions would you be concerned about based on the history and assessment findings?
a. A subdural hematoma
240
Which of the following findings is most consistent with a skull fracture?
a. Bruising behind the ear that develops several hours after the injury
241
Which of the following findings indicates that a patient who received a blow to the head is suffering from something other than a concussion/TBI?
d. His pupils are noticeably unequal.
242
When explaining the priorities of helmet removal to a candidate patroller, you would stress:
b. sliding the fingers under the occiput so that the head doesn’t drop backward.
243
Which of the following structures works like a camera shutter to adjust the amount of light entering the eye?
b. The iris
244
The part of the eye that focuses light on the retina is called the:
b. sclera.
245
light stimulates nerve endings in which of the following structures to send signals to the brain via the optic nerves?
a. Retina
246
The largest bone of the face, which forms the upper jaw, the hard palate, the floor of the nose, and the lower portion of each eye socket, is the:
d. maxilla.
247
The lower jaw, the only “movable” bone of the face, is hinged on both sides of the skull by the:
b. temporomandibular joints.
248
The three bones that convert sound waves into signals that are then carried to the brain are known as the:
c. auditory ossicles.
249
Which of the following statements concerning the eye socket or orbit is false?
a. It does not take much force to injure the orbital bones.
250
The sternocleidomastoid muscle is responsible for:
d. side-to-side movements of the head.
251
You are assessing a patient who was punched in the eye. You note blood in the white part of his eye. This area of the eye is known as the:
a. sclera.
252
Your friend tells you that she was diagnosed with a corneal abrasion a day ago. She is concerned because she still has some discomfort in the eye. Based on your training, you know that:
d. ongoing pain is not uncommon.
253
A patient who was hit in the face with a cloud of dust while working in an industrial setting is complaining of pain and discomfort to his left eye. While performing your assessment on the eye, you note some redness of the globe but do not see any obvious foreign object. The most appropriate care you can provide to this patient would be to:
a. cover both eyes with a bandage.
254
A young girl is complaining of eye pain after having bleach thrown in her face. When assessing her eyes, you note redness and significant tearing in the right eye. You would treat this girl by:
c. flushing the eye with sterile water.
255
During an altercation, your patient was cut with a sharp knife. Your assessment reveals a laceration across the right eyelid down to the right cheek that is oozing dark red blood. It also appears that the patient’s eye was cut with the knife. You would:
d. cover both eyes with a sterile dressing.
256
What instructions would you give to an OEC candidate who asks how to treat a patient who has visible blood in the anterior chamber of the eye?
d. “Put a shield over the eye and cover both eyes before immediately transporting this patient.”
257
You have responded to a scene at which a young man tells you he splashed a chemical into his eye. He is complaining of burning and pain in his right eye. After performing a primary assessment and finding no life-threatening conditions, you would:
c. hold the patient’s injured eye open and flush it with large amounts of sterile water from the nose to the outer edge of the eye.
258
You respond to the vehicle maintenance department, where a middle-aged man is flushing his eyes with tap water. He tells you that acid splashed in his eyes and that they are burning. Which of the following questions is the most important one to ask right away?
b. “Are you wearing contact lenses?”
259
A young boy was running through the lodge with a pencil and tripped. The pencil impaled the boy’s left eye and remains lodged in place. Appropriate care for the eye would include:
a. stabilizing the impaled object and providing immediate transport.
260
While running outside the lodge, a teenage girl tripped and fell. She hit her face and mouth, knocking one of her top front teeth from its socket. Although she is upset, you have assessed no threats to life, and the bleeding has been controlled. Your partner finds the tooth and asks you what to do with it. Which of the following responses would be best?
b. “Avoid touching the root of the tooth. We will gently irrigate it and place it back in its socket.”
261
You respond to an accident in which a young male has sideswiped a tree on an expert trail. He has an abrasion on the left side of his face and neck and is spitting blood. He also lost several teeth, two of which he is holding. He has an airway and is breathing adequately. Your initial action when caring for the patient would be to:
b. establish manual in-line spinal stabilization.
262
A 15-year-old girl struck in the mouth with a baseball bat has lost her front teeth and is splitting a significant amount of blood. Your primary concern in treating this patient is:
d. observing her for possible airway compromise.
263
A 10-year-old boy arrives in the aid room bleeding from his nose. He states that he did not injure himself and just started bleeding while he was skiing, and that he can’t get it to stop. Based on your OEC training, which of the following statements about treating epistaxis is false?
c. Your initial treatment is to pack the nose with tightly rolled gauze and then apply direct pressure to the nose.
264
You are assisting another OEC Technician to treat a young male with a deep laceration on his neck. Your partner appears to have controlled the bleeding. He asks you to apply a pressure dressing. In addition to helping to control the bleeding, you recognize that another important benefit to this type of dressing on a neck wound is:
c. preventing the entry of air into the circulatory system.
265
When treating a deep laceration to the neck, bandaging should be applied over the pressure dressing by:
a. wrapping roller gauze loosely around the neck and then firmly through the opposite axilla.
266
You are on a snowmobiling trip with friends when you see members of the lead group hollering and waving their hands up ahead. When you get to the scene you note that the lead rider apparently did not see a chain across the road, and he struck the chain with his neck so forcefully that he was thrown backward off his machine. Someone in the group is maintaining manual in-line stabilization. When you assess the injured person, which of the following signs would indicate the injury that must be addressed and managed first?
a. Difficulty speaking
267
You are caring for a 15-year-old male with a laceration of the left ear. Which of the following actions would you not take in dressing this injury?
d. Wrapping gauze loosely around the head and under the opposite axilla
268
A mother brings her 7-year-old child to the aid room and tells you that fluid is draining from the child’s right ear. She tells you that the child has had a fever since this morning and was complaining of right ear pain. Based on your OEC training, you would:
c. have the boy lie on his right side to allow the fluid to drain.
269
The condition characterized by pupils of unequal size is:
a. anisocoria.
270
You and your partner are caring for a patient who tells you that she wears contact lenses. Your partner wants to remove the lenses. You remind him that the removal of contact lenses is indicated in all of the following situations except:
b. any facial trauma.
271
A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which of the following structures may have been injured?
b. The esophagus
272
Which of the following statements indicates that the speaker understands chest trauma?
c. “Internal chest injuries are more difficult to assess and manage than are the more obvious external chest injuries.”
273
A 39-year-old man has been stabbed once in the anterior chest. When notifying the patrol aid room by radio, you inform them that the patient has suffered what possible type of injury?
d. An open chest injury
274
An OEC candidate asks you to explain a pneumothorax. Your response should be that it occurs when:
b. air accumulates between the inner chest wall and the outside of the lung, causing the lung to collapse.
275
When assessing a patient, which of the following signs or symptoms is most indicative that the patient is suffering from a pneumothorax?
c. Decreased breath sounds in the right lung
276
You are at the scene of a shooting. Your assessment reveals a 23-year-old man who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is bleeding. The second wound is to the left lateral chest and makes a sucking sound every time the patient takes a breath. The initial action of an OEC Technician should be which of the following actions?
b. Cover the chest wound with a gloved hand.
277
Which of the following phrases best describes a flail segment?
d. Two or more adjacent ribs that have been broken in two or more places.
278
Your patient was involved in a serious motor vehicle collision. Which of the following assessment findings best helps to determine that the patient has a flail segment?
a. Paradoxical chest wall movement
279
You are managing a patient with a large flail segment in the right lateral chest. The immediate threat to this patient’s life is:
b. hypoxia.
280
When assessing a patient who sustained blunt trauma to the chest, which of the following assessment findings is most indicative of a serious injury to the lung?
a. Hypoxia
281
A patient with blunt chest trauma has paradoxical chest movement. She is conscious and confused and is breathing rapidly and shallowly. After manually stabilizing the flail section of the chest wall, you should:
b. administer oxygen through a nonrebreather facemask.
282
You are assisting at an accident scene and are asked to apply a dressing over a sucking chest wound on the patient’s left anterior chest wall. Which of the following items would you use?
d. Vaseline gauze
283
You have applied a nonporous dressing to a puncture wound on a patient’s chest. An OEC candidate asks you why the dressing was taped only on three sides. Your best response is that taping the dressing on three sides:
b. allows trapped air to escape upon exhalation.
284
You treated a 19 year old with a puncture wound to the chest by covering the wound with an impermeable dressing. Now, as you perform your ongoing assessment, you note that the patient is tachypneic and is complaining of difficulty breathing. Breath sounds on the side of the injury are also diminished. Which of the following actions should you take immediately?
b. Lift a corner of the dressing from the wound for a few seconds; then reapply and check his breath sounds.
285
You have placed an occlusive dressing on a puncture wound on the right side of the chest of a 33-year-old woman. During your ongoing assessment your primary concern is monitoring the injury for:
c. tension pneumothorax.
286
An OEC candidate indicates that she understands the difference between a pneumothorax and a tension pneumothorax when she makes which of the following statements?
b. “A tension pneumothorax can cause cardiac output to decrease; a pneumothorax does not.”
287
You suspect that a trauma patient is suffering from a hemothorax to the left lung. Which of the following assessment findings would reinforce your suspicion?
d. Respiratory distress and the signs and symptoms of shock
288
You are listening to two patrollers discuss the accident to which they just responded. Which of the following injuries would lead you to believe that one of the patients had suffered from traumatic asphyxia?
c. Bluish discoloration of the neck and face
289
Which of the following actions occurs when the diaphragm and the intercostal muscles relax?
d. Exhalation
290
The thorax is enclosed by the:
a. ribs, sternum, thoracic spine, and diaphragm.
291
The heart and lungs are located in the:
a. thoracic cavity.
292
The diaphragm separates the:
c. thoracic cavity from the abdominal cavity.
293
The diaphragm plays a major role in respiration. During inhalation, the diaphragm:
b. contracts and creates a negative pressure in the thorax, which draws air into the lungs.
294
Injuries at which level of the spinal cord can affect the phrenic nerves and therefore respiration?
d. C3–C5
295
Your 35-year-old patient has received major chest trauma. He complains of shortness of breath and pain. Your assessment reveals distended neck veins and pulsus paradoxus. Based on these signs and symptoms, you believe the patient to be suffering from:
b. pericardial tamponade.
296
he most serious chest injury resulting from rapid deceleration is
a. aortic rupture.
297
Commotio cordis is sudden cardiac death resulting from
b. blunt trauma, usually in children younger than 16 years old.
298
You are instructing a class in Outdoor Emergency Care when a student asks you to explain the L.A.P. method of examining the thorax. Your best reply to this question would be which of the following statements?
d. “The L.A.P. method directs you to look, auscultate, and palpate the chest.”
299
You are following the L.A.P. method to examine the chest of a 38-year-old trauma patient. To assess for thoracic cage instability, you would apply moderate downward pressure on the sternum while asking the patient to take a deep breath, and then you would:
c. apply moderate inward pressure on the lateral walls of the rib cage and ask the patient to take a deep breath.
300
You are treating a 26-year-old man with a pneumothorax. The patient’s breathing has been inadequate, and you have been assisting his ventilations with a bag valve mask. The patient’s condition seems to be worsening. Because you understand the physiology involved in a pneumothorax, you are most concerned that:
b. the pressure from the BVM is causing more air to enter the pleural space and is causing a tension pneumothorax.
301
You are treating a 26-year-old man who fell about 20 feet while rock climbing. He is complaining of right sided chest discomfort and dyspnea. You note that his respiratory rate is 28 and shallow. Based on this assessment, the best emergency care would be:
b. performing a rapid body survey and assisting ventilations with BVM and high-flow oxygen.
302
You are treating a 16-year-old male who was skiing out of control and ran off the trail and into the woods. When you arrive, he is alert and complaining of pain in his right lower chest. Upon examination you note that he has impaled himself with a tree branch. He tells you he will feel better if you just remove the branch. Based on your training as an OEC technician, you would respond by making which of the following statements?
c. “We need to leave the branch in place until we get you to a hospital.”
303
What is typically the most comfortable position for a responsive patient who is suffering from abdominal pain?
Supine with knees slightly flexed
304
A 28 year old healthy male presents with recent signs and symptoms of nausea and vomiting but very little abdominal pain. Which one of the following is your best course of action?
The patient has indigestion; suggest that he follow up with his physician if the symptoms continue
305
Which of the following statements regarding assessment of the abdomen is false?
Assessment of the abdominal organs is straightforward because the abdominal organs are specifically located and easily palpated
306
When assessing a patient with a potential acute abdomen, the OECT should do all of the following EXCEPT:
Offer the patient small sips of water to determine whether or not doing so decreases pain or nausea.
307
Which statement about acute abdomen is NOT true?
It is defined as slowly developing, initially minor pain that becomes worse over several hours or days.
308
A middle-aged male presents with severe abdominal pain; nausea; vomiting; cool, moist skin; and uneven femoral pulses. This patient is most likely suffering from what potentially life-threatening condition?
An aortic aneurysm.
309
Which of the following are solid organs?
Liver, pancreas, spleen, and ovaries
310
In which position should most patients complaining of GI/GU pain be transported?
On their back with their knees flexed
311
Which one of the following organs is not located in the abdomen?
Kidney
312
The major considerations in the initial management of a trauma patient include:
The major considerations in the initial management of a trauma patient include:
313
The combination of which two factors has the most impact when considering the potential for injury severity?
Stopping distance and speed
314
The trauma assessment primary survey includes:
Scene size-up, assessment of ABCs, and performance of life-saving interventions as needed.
315
While attempting to place a deformed limb back into the anatomic position, the patient screams and begs you to stop because of the pain. Your best response is to:
Stop and splint the limb in the current position.
316
Which of the following injuries is generally the most serious?
A dislocated knee
317
A patient has suffered an obvious femur fracture at the proximal end of the femur, near the femoral head. The proper splint for this type of injury would be a:
Long spine board.
318
Which of the following most dramatically slows the healing time of bone?
Smoking
319
A patient has suffered a femur fracture. The greatest danger with this injury is:
Severe blood loss.
320
The most important component of field management for musculoskeletal injuries is:
Personal safety.
321
You are caring for a patient with an open humeral fracture. Extrication to definitive medical care will take at least 12-14 hours. The proper method of care for this injury includes:
Wash the fracture site, apply tension until the bone end has slipped back into the body, and then bandage and splint as appropriate.
322
The purpose of field splinting an MS injury includes all but which of the following?
Allowing the bone ends to knit back together
323
One of the most common assessment mistakes is to:
Focus on the less-serious "obvious" injury and miss a potential life threat.
324
Skeletal and smooth refer to what?
Muscles
325
A patient exhibits the following sings and symptoms: respiratory difficulty, difficulty swallowing, upper extremity and facial vein engorgement, red face, and shock. What injury is most likely causing these signs and symptoms?
A posterior sternoclavicular dislocation
326
A patient with a dislocated elbow has no CMS in his hand. One attempt at realignment fails to regain circulation. Your next best course of action would be to:
Secure the arm as best as you can with a rigid splint, sling and swathe as appropriate, administer oxygen, and transport rapidly.
327
A patient has stretched and torn the medial malleolar ligament. This means the patient has:
Sprained her ankle.
328
You notice crepitus when attempting to move a patient's injured wrist back into an anatomically correct position. This is indicative of what type of injury?
A fracture
329
The axial skeleton is responsible for ________________, while the appendicular skeleton provides __________________________.
The upright position of the body, the manipulation of objects or locomotion
330
Hinge, gliding, pivot, and suture refer to what?
Types of joints
331
The MOST important step in applying any splint is to:
Check distal CMS before and after splinting.
332
A patient tells you she felt a "pop" behind her right ankle but there is little or no pain, and she cannot move or walk on the foot. This is most likely indicative of what type of injury?
A ruptured tendon
333
During inhalation, the diaphragm:
Contracts and descends into the abdomen.
334
When assessing a patient, which of the following signs or symptoms is most indicative that the patient is suffering from a tension pneumothorax?
Decreased breath sounds in the right lung
335
Beck's triad consists of which three significant clinical findings?
Distended neck veins, muffled heart sounds, and pulsus paradox
336
All of the following are true about the anatomy and physiology of the chest EXCEPT:
The thorax includes the area from the mandible to the costal margin.
337
A skier collides chest first with a tree at a high rate of speed. Based on this mechanism of injury alone, the OECT should be suspicious of all of the following injuries EXCEPT:
A triple A. (Abdominal Aortic Aneurism)
338
All of the following statements about thoracic trauma are true EXCEPT:
Skiers outnumber snowboarders almost 2:1 for incidences of traumatic chest injuries.
339
Which of the following statements indicates that the speaker understands chest trauma?
"Internal chest injuries are more difficult to assess and manage than are the more obvious external chest injuries."
340
Your patient was involved in a serious motor vehicle collision. Which of the following assessment findings best helps to determine that the patient has a flail chest segment?
Paradoxical chest wall movement
