Trauma (Paramedic) Study Center > Diagnostic Tests > Paramedic Diagnostic Tests > Trauma (Paramedic) Step 1 of 50 2% A 29 year old male has been stabbed in the chest. He complains of pain and difficulty breathing. On examination, you note absent lung sounds on the right and observe JVD. The patient’s vital signs are P 120, R 36, BP 80/60. You should next* apply high concentration oxygen. administer a bolus of normal saline. apply an occlusive dressing over the wound. perform needle decompression of the chest. A 51 year old male has amputated his hand while working with some farm machinery. His lower arm has been crushed and is severely bleeding. First responders stated that they are having trouble controlling the bleeding with direct pressure. You should next* apply a tourniquet. attempt to keep the patient warm. find and care for the missing hand. splint the lower arm. A 31 year old male has been struck in the head during a fight. He complains of head pain and diplopia. Given these findings, you should suspect* an orbit fracture. subconjunctival hemorrhage. a retinal detachment. a zygomatic fracture. A 16 year old male has injured his shoulder after being hit playing football. You find the patient cradling his right arm and complaining of severe pain in his right shoulder. You note obvious deformity of the joint. You should* straighten the right arm to apply a long arm board splint. apply a sling and swathe to the right arm. extend the arm to reduce the deformity. apply a short board to the right humerus. A 25 year old male has been shot in the back just lateral to the spinal column. He complains of pain centered at the level of T-4 halfway between the spine and the mid scapula line. He is neurologically intact but notes slight difficulty breathing. You should first* immobilize this patient to a backboard. lay the patient flat on the stretcher. cover the wound with an occlusive dressing. apply a cervical collar only. A 32 year old male has been stabbed in the chest. He has a small puncture wound at the 4th intercostal space just lateral to the sternum. Over the last five minutes, the patient has become confused, pale and developed dyspnea. You note that his blood pressure has dropped and he has developed JVD. He has clear and equal lung sounds bilaterally. You should suspect* perforated diaphragm. pericardial tamponade. simple pneumothorax. tension pneumothorax. A 16 year old female has sustained a partial thickness burn on her right forearm after falling onto a propane grill roughly one hour ago. She complains of severe pain and called EMS after she “couldn’t take the pain anymore.” She has no other injuries and her vital signs are P 100, R 28, BP 120/80. You should first* administer analgesia. immerse the burned extremity in room temperature water for 20 minutes. conduct a thorough secondary assessment to ensure no further injury. initiate rapid transport. A 79 year old woman has fallen in her driveway. She complains of right-sided chest pain and is tender upon palpation. You believe you feel crepitus while palpating her ribs. You should* use tape to stabilize the chest wall. lay the patient on the injured side to self-splint the injury. administer analgesia immediately. splint the chest wall with bulky dressings and roller gauze. A 29 year old female has had a penetrating injury to her left eye. You have bandaged both eyes with a bulky dressing and are preparing for transport. You should next* administer a topical analgesic to the affected eye. assign a provider to stay closely by the patient and answer her questions. allow the patient to sit quietly alone. allow the patient to adjust the bandages of the eyes to ensure they are comfortable. A 22 year old male has been shot in the back just below C-7. He is conscious and he notes that although he is able to move and feel his right side, he has lost sensation and motor function on the right. You should suspect* a stroke. Brown-Sequard syndrome. central cord syndrome. anterior cord syndrome. The hypotension seen in a tension pneumothorax is most likely caused by* blood loss into the chest cavity. pressure build up within the pericardial sac. compression of the large thoracic vessels. a clot obstructing blood flow to the pulmonary vasculature. A 45 year old male complains of chest pain after a fall from an 18-foot height. Upon examining his chest, you identify that a small section is moving paradoxically to the remainder of the chest wall during ventilation. You should suspect* a flail chest. an open chest injury. a pulmonary contusion. a sucking chest wound. A 56 year old male has been pinned beneath a fallen tree for three hours. Upon removal of the tree, the patient loses consciousness and you note a wide complex tachycardia on the monitor. Your partner states that the patient does not have a pulse and begins CPR. You should next* defibrillate at 200 J. administer sodium bicarbonate. administer 1 L of normal saline. administer calcium chloride. A 49 year old male was injured by an explosion and is bleeding severely from his axilla. You have attempted to place a tourniquet, but the wound is high enough on the arm that you cannot obtain an optimal placement. You should next* apply a pressure bandage. use pressure points. cover the wound with a bulky dressing. apply a hemostatic agent. A 45 year old male has been involved in a rollover motor vehicle crash. You note severe deformity to the vehicle and a “starred” windshield. You find the patient has self-extricated and is ambulatory, but complains of neck pain. You should first* not immobilize this patient. apply a C-collar and ask the patient to lay down on the stretcher. utilize a standing take down to move the patient to the stretcher. immobilize this patient to a long spine board. A 22 year old male has a circumferential partial thickness burn on his left leg and a circumferential superficial burn on his lower left arm. According to the rule of nines, this patient’s total surface area burned would be* 36%. 4.5%. 18%. 9%. A 35 year old female has avulsed a large portion of the muscle on her upper arm after a motorcycle crash. The bleeding has been controlled but a large flap of muscle is displaced. There is also dirt covering the entire wound. You should first* flush the wound with normal saline. replace the avulsed muscle back into the wound. apply a pressure bandage over the wound. splint the arm. Which of the following would best describe the proper process for inserting a chest decompression needle?* Center of the intercostal space Beneath the lower border of the rib Along the long axis of the rib Over the top of the rib Which of the following chemicals causes liquefaction necrosis?* A strong base A strong ammonia A heavy metal solution A strong acid A 29 year old male was sprayed with capsicum (pepper) spray in his eyes after an altercation with law enforcement. He complains of severe burning in his eyes and notes vision loss. You should first* apply bulky dressings to both eyes. flush his eyes with copious amounts of D5W. administer two drops of tetracaine. flush his eyes with copious amounts of lactated Ringer’s. You have applied a tourniquet to the thigh of a 22 year old male with severe arterial bleeding. Despite proper placement and tightening, the bleeding has not stopped. You should next* remove the tourniquet. place a second tourniquet. apply a large bulky dressing over the tourniquet. apply cold packs to the wound. A 40 year old male was bitten on the ankle by a rattlesnake. He is alert and complains of pain in his leg. His vital signs are P 100, R 24, BP 180/92. After completing the primary assessment you should next* immobilize the leg. apply a cold pack to the wound. apply suction to the wound. apply an arterial tourniquet above the wound. A 22 year old male has been shot in the groin. You find him alert, complaining of pain. He has blood spurting from his wound. You should first apply* high concentration oxygen. direct pressure. a tourniquet. a pressure bandage. An 88 year old female has a severe nosebleed and called EMS after 40 minutes of failed attempts to stop it. The patient denies trauma and notes that it “just came on.” On arrival, her nose is bleeding. You should first* apply a cold pack directly to the face and nose. recline the patient into a semi-Fowler’s position. apply external direct pressure to both sides of the nose. pack the nose with gauze. Which of the following types of burns would involve only the epidermis?* Full thickness Partial thickness 4th degree Superficial A 25 year old male complains of paraplegia following a high-speed motor vehicle crash. You note he has flushed skin and a very low blood pressure. You should first* administer a bolus of normal saline. initiate a norepinephrine infusion. administer intramuscular epinephrine. limit fluid administration to prevent volume overload. A 35 year old female has crashed her vehicle at a moderate speed. The car has sustained moderate damage to the front end. The patient states that her ankle feels broken but notes no further injury. Your spinal assessment is negative. Which of the following would be the best way for the patient to exit the vehicle?* Scoop stretcher Self-extrication with a collar A vest type extrication device Self-extrication without a collar A 35 year old male has been shot in the thigh and lost a great deal of blood before your arrival. A tourniquet has been placed and bleeding controlled, however, the patient remains severely hypotensive. You should next* place the patient in the Trendelenburg position. initiate a norepinephrine infusion. administer normal saline to restore a normal blood pressure. administer normal saline to restore systolic blood pressure to 80-90 mmHg. A 30 year old male crashed while riding his bicycle. He has an obviously dislocated patella and complains of severe pain with any movement or palpation of the joint. He has no further injuries. The patient is alert and his vital signs are P 110, R 24, BP 128/70. You should first* administer pain medication. apply a cold pack. reduce the dislocation of the patella. straighten the leg to apply a splint. A 66 year old female was involved in a high-speed motor vehicle crash. Upon extrication, you note she has an obviously fractured right femur and pain around her right pelvis and groin. She is alert and her vital signs are P 120, R 24, BP 90/60. You should first* initiate transport. apply a traction splint. administer 100 micrograms of fentanyl. administer a 500 mL fluid bolus. A 220 pound male has sustained partial and full thickness burns to his anterior chest and abdomen. Given this injury, which of the following would be the most appropriate fluid bolus to administer to him in the next 24 hours?* 10 L 7.2 L 15 L 1.8 L A 35 year old female has been shot in the chest. She has clear lung sounds bilaterally, but she presents with JVD and hypotension. You suspect pericardial tamponade. Which of the following findings would help you confirm this diagnosis?* Widening pulse pressures Diminishing lung sounds on one side Differing blood pressures on either side of the body Muffled heart sounds A 55 year old male patient has crashed his snowmobile. He notes the crash drove the handlebars of the machine into his abdomen. He complains of pain in the lower right quadrant. On exam, you note that a small loop of intestine is protruding from a small wound. You should* push the intestine back into the abdominal cavity. cover the intestine with dry sterile gauze. apply direct pressure to the abdominal wound. cover the intestine with moistened sterile gauze. Which of the following would be the most likely area for a contusion to occur in brain tissue? The occipital lobe The temporal lobe The zygomatic lobe The parietal lobe While on an interfacility transport, a 40 year old male trauma patient has developed paralysis and loss of sensation in a splinted fracture of his right lower leg. You assess the injury and note diminished distal pulses and delayed capillary refill time. After assuring that the splint is not too tight, you should next* move the foot to reestablish blood flow. elevate the extremity. apply a heat pack to the injury site. remove the splint. A 37 year old male was involved in a high-speed motor vehicle crash 1 week ago. He notes the seatbelt “really hurt his belly” but he signed off without transport. Since the crash, the patient has developed increasing diffuse abdominal pain, fever, and vomiting. You note rebound tenderness on your exam. You should suspect an injury to the* intestines. kidney. liver. spleen. A 19 year old hiker is being litter-carried out of the woods after fracturing his lower leg in a fall. The extrication will take a total of three hours. About halfway out, the patient notes that he has had an increase in the pain in his leg and that he can no longer feel his toes. He also notes a “pins and needles” sensation. You should suspect* the normal evolution of fracture-related pain. a deep vein thrombosis in the affected leg. crush syndrome. compartment syndrome. A 71 year old female was bitten by her cat. She notes her family called EMS and that she does not really need care; however, she will follow your instructions. You assess two small puncture wounds on her right hand, but no further injury. You should* ask the patient to wash the affected hand. allow the patient to refuse. cover the wound with an occlusive dressing. apply a venous constricting band around her wrist. A 77 year old female has fallen down a set of stairs. She notes that as she landed, her neck was forced to extend violently. On examination, you find that the patient has isolated weakness in her upper extremities and normal function in the lower extremities. You should suspect* complete transection of the spinal cord. central cord syndrome. anterior cord syndrome. Brown-Sequard syndrome. A 29 year old male is agitated and aggressive after being struck in the head with a baseball bat. He is refusing transport and physically pushes medical providers away from him. His words are confused and his gait is unsteady. You should* immediately administer ketamine as a chemical sedative. suggest law enforcement transport the patient to the hospital. have law enforcement handcuff the patient behind his back. use a four-point soft restraint approach to initiate care. A 59 year old male has been pinned beneath a tractor in a farming accident. The large tractor wheel has pinned the patient’s lower right leg and rescuers are working to free him. Your physical examination finds a large pool of blood beneath the wheel, but you are unable to visualize a specific source of the hemorrhage. The patient is anxious, diaphoretic and his vital signs are P 120, R 30, BP 100/78. You should next* attach a cardiac monitor. administer mannitol. apply a tourniquet to the affected leg. administer a normal saline fluid bolus. A 25 year old male complains of chest pain after striking his chest on a steering wheel during an unbelted motor vehicle crash. He also notes slight difficulty breathing. Your assessment finds tenderness in his left chest and diminished lung sounds on that side. The patient’s vital signs are P 100, R 22, BP 124/82. His pulse oximetry is 91%. You should* apply tape to splint the left chest. administer high concentration oxygen. perform a needle decompression. initiate positive pressure ventilation. A 56 year old electrician has been found unconscious while working on the wiring of a large printing machine. You find him prone with his arm extended into the machine. You observe and smell significant burns to his left hand as it touches the wiring panel. You should first* cool the burns on his left hand. pull the patient away from the wiring panel. wrap his hand in sterile dressings. ensure power has been shut off to the machine. A local SCUBA diver was forced to rapidly surface from a significant depth due to a regulator related emergency. He now complains of pain in his back, knees, and arms. He is alert and denies shortness of breath. His vital signs are P 110, R 24, BP 160/89. His oxygen saturation is 95%. You should first* place the patient in the left lateral recumbent position. administer high concentration oxygen. apply CPAP. administer analgesia. A 16 year old male capsized his canoe and was immersed in cold lake water for roughly five minutes. You find the patient on the shore, cold, shivering and pale. The patient is alert and his vital signs are P 100, R 20, BP 110/80. You should first* administer warmed, high concentration oxygen. place hot packs in the patient’s axilla. ask the patient to walk to the ambulance. administer heated intravenous fluid. A 7 year old female was stung on the leg by a large jellyfish. She was pulled from the water by her parents and now is in severe pain. You note a wide sting mark across her leg. You should first* rinse the wound with fresh, cold water. rinse the wound with vinegar or alcohol. elevate the affected leg. apply a cold pack over the sting. A 29 year old male was stabbed in the left upper quadrant of the abdomen. You note that the wound was bleeding but is now controlled. The patient is agitated and reports dyspnea. You assess JVD and note absent lung sounds on the left side. His vital signs are P 136, R 36, BP 76/58. You should first* apply a pressure dressing to the wound. administer 250 mL of normal saline. lay the patient flat. needle decompress his chest. A vertebra has been fractured and the spinal cord has been impinged. Which of the following sections of the vertebra must have been damaged in order for the impingement to occur?* The transverse process The pedicle The spinous process The broad ligament A 46 year old male was pinned between a forklift and a heavy storage box. You find the patient unconscious, with gasping respirations and with a rapid heart rate. Your exam reveals JVD, multiple rib fractures and no audible lung sounds on either side. His vital signs are P 134, R 38, BP 64/P. You should first* apply a cardiac monitor. initiate positive pressure ventilation. perform bilateral needle decompressions. begin chest compressions. An 80 year old female has had a syncopal episode. You find her unconscious and observe vomit in her airway and minor bleeding from a laceration on her shoulder. You should next* suction the airway. insert a supraglottic airway. apply direct pressure to the shoulder wound. check for a pulse.