21) You are on an EMS standby for a boxing tournament. During one of the matches, one of the
female boxers delivers a forcible uppercut to the chest of her opponent, who falls to the ground.
The match is declared over on the basis of a TKO. However, the opponent fails to arise following
a 1 to 2 minute interval. EMS is summoned to the ring. You find the patient pulseless and
breathing agonal gasps. You suspect which of the following traumatic conditions?
A) Cardiac tamponade
B) Aortic dissection
C) Tension pneumothorax
D) Commotio cordis
Objective: 27.3
22) While palpating the radial pulses of a patient who was involved in a motor vehicle crash, you
notice a difference in the strength of the pulses bilaterally. This is a finding that you suspect may
be associated with:
A) aortic dissection.
B) tension pneumothorax.
C) commotio cordis.
D) flail chest.
Objective: 27.3
11
23) Which of the following is a desirable characteristic of dressings used in the prehospital
management of most open wounds?
A) Nonabsorbent
B) Sterile
C) Occlusive
D) Adherent
Objective: 27.3
24) Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He
states that he was assaulted and robbed by three individuals. He is complaining of being “hit in
the face and kicked and punched in his ribs and stomach.” Your examination reveals contusions
and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple
contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest
concern regarding the prehospital care of this patient?
A) The presence of any defensive wounds the patient may have sustained
B) Getting a description of the assailants
C) The possibility of a pneumothorax
D) Reducing the swelling around his eyes by applying a cold pack
Objective: 27.3
12
25) What is the underlying cause of bluish or reddish facial discoloration following a traumatic
asphyxiation?
A) High pressure on the chest leads to blood being forced from the right atrium into the face and
neck.
B) The patient has become hypoxic due to a chest injury and the finding suggests central
cyanosis.
C) The physiological strain of the body results in a flushed appearance and increased risk of a
hypertensive event.
D) Bluish or reddish facial discoloration is not associated with traumatic asphyxiation; a pale
discoloration is usually present.
Objective: 27.3
26) Which of the following BEST describes the benefit of a three-sided occlusive dressing over a
four-sided occlusive dressing for an open chest wound?
A) It eliminates the need to continue monitoring the patient’s respiratory status.
B) It prevents the development of a hemothorax by allowing blood to escape.
C) It allows easy access for re-examination of the wound en route to the hospital.
D) It reduces the chances of developing a tension pneumothorax.
Objective: 27.3
13
27) You are stabilizing a patient who has just been stabbed in the chest to the right of the
mediastinum. After placing the patient on supplemental oxygen, his shortness of breath resolves.
You also cover the wound with an occlusive dressing. The patient is asymptomatic at the time
you’re making the decision to transport. Which of the following BEST encapsulates the correct
strategy for transport?
A) The patient does not necessarily need transport, so allow him to refuse if he wants.
B) Transport the patient emergently because of the high index of suspicion for a serious injury.
C) Begin transport non-emergently and upgrade if the patient’s condition deteriorates.
D) Transport the patient non-emergently because he’s complaint free.
Objective: 27.3
28) Your patient was working on a car when it fell off the jack and trapped him between the tire
and ground. His face is very blue and his eyes are bloodshot. Which of the following has the
patient most likely suffered?
A) Hemothorax
B) Traumatic asphyxia
C) Pneumothorax
D) Flail chest
Objective: 27.3
14
29) You find a middle-aged male is sitting against a wall in obvious distress. The patient appears
to be extremely short of breath and has an open wound to his chest that is making a sucking
sound. You should:
A) place the patient on high-concentration oxygen.
B) cover the wound with an occlusive dressing.
C) place a trauma dressing over the wound.
D) place your gloved hand over the wound.
Objective: 27.3
30) You have covered an open chest wound with your gloved hand and the patient’s breathing has
improved. In order to free your hand to provide further care, you should:
A) cover the wound with a sterile dressing.
B) cover the wound with an occlusive dressing.
C) apply a bulky dressing over the wound.
D) remove your hand to see if the wound has closed.
Objective: 27.3
15
31) Which of the following is a vascular organ in the abdomen that can produce blood loss
quickly enough to result in life-threatening hemorrhage following high mechanism of injury
blunt trauma?
A) Intestines
B) Liver
C) Pancreas
D) Kidneys
Objective: 27.4
32) Which of the following injuries requires the use of an occlusive dressing?
A) Open wound to the chest
B) Open wound to the neck
C) Open wound to the abdomen from which a loop of intestine is protruding
D) All of the above
Objective: 27.4
16
33) Common signs and symptoms following an injury to a hollow abdominal organ include:
A) increasing intrathoracic pressures.
B) irritation and peritonitis.
C) massive hemorrhage.
D) absence of unilateral pulses.
Objective: 27.4
34) You are palpating the abdomen of a motor vehicle collision patient when you feel a pulsing
mass. You should:
A) defer further abdominal palpation.
B) ask your partner to verify your findings.
C) bind the abdomen with an elastic bandage.
D) apply cold packs to the abdomen.
Objective: 27.4
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