24) Which of the following is a potential complication of hyperventilating a patient with a brain
injury?
A) Increasing the amount of carbon dioxide in the blood
B) Increasing blood flow to the brain
C) Decreasing blood flow to the brain
D) Decreasing the patient’s blood pressure
Objective: 29.4
25) Which of the following causes worsening of the damage in a brain injury?
A) Allowing seepage of cerebrospinal fluid (CSF) from the ears or nose
B) Administration of 100% oxygen
C) Failure to keep the patient awake and talking
D) Improper management of airway and ventilation
Objective: 29.4
26) Which of the following signs is LEAST likely to indicate a traumatic brain injury?
A) Low blood pressure
B) Irregular breathing pattern
C) Vomiting
D) Irrational behavior
Objective: 29.4
11
27) Of the following patients, which injury is the highest priority to receive bag-valve-mask
ventilations?
A) 25-year-old female victim of battery who is awake but complains of a headache and has
bloody fluid draining from her nose and left ear
B) 15-year-old female who was ejected from a vehicle, struck her head on a tree, and displays
decerebrate movements in response to painful stimuli
C) 25-year-old male who regained consciousness one or two minutes after being struck on the
head by a baseball bat and is now asking repetitive questions
D) 70-year-old male who struck his head when he fell in the parking lot, has a large laceration on
his forehead, and is disoriented
Objective: 29.4
28) You are treating an unresponsive homeless patient found in an alley. During your assessment
you notice bruising behind both ears, which is known as which of the following?
A) Fatigue signs
B) Warrior’s signs
C) Soldier’s signs
D) Battle’s signs
Objective: 29.4
12
29) Your patient is a 21-year-old male who slid head-first down a water slide at his fraternity
house and impacted the bales of straw that his fraternity brothers had erected as a barrier to keep
participants from sliding onto the adjacent highway. The patient is conscious and complaining of
neck pain. Which of the following should be included in your assessment?
A) If the patient has no numbness or tingling, ask him to stand and try to walk.
B) Apply painful stimuli to his extremities, starting distally and moving closer and closer to the
body.
C) Ask the patient to cautiously touch his chin to his chest to check for range of motion.
D) Ask the patient to grasp and squeeze your hands.
Objective: 29.4
30) Hyperventilation of a patient with a severe brain injury due to an impaled object means that
bag-valve-mask ventilations are provided at a rate of ________ per minute.
A) 20
B) 24
C) 30
D) 34
Objective: 29.5
13
31) A 36-year-old male was accidentally shot with a nail gun into the head. You see the nail,
which protrudes about 2 to 3 centimeters from the skull, when you visualize the injury site.
Under which of the following circumstances should you remove the nail from the injury site?
A) Bleeding from the patient’s wound is minimal.
B) The patient develops excessive intracranial pressure (ICP).
C) The patient begins to complain of shortness of breath.
D) None of the above
Objective: 29.5
32) Your patient is a 30-year-old construction worker who fell from scaffolding and has been
impaled through the right orbit by a 36-inch piece of concrete reinforcement bar. The patient
responds to verbal stimuli and appears to have multiple other injuries. Which of the following is
the BEST course of action?
A) Remove the reinforcement bar and pack the orbit with sterile moist dressings to keep the
scene time under 10 minutes.
B) Transport with the reinforcement bar in place to prevent delay at the scene.
C) Test the reinforcement bar for stability and remove it only if it is loose enough to be easily
pulled from the wound.
D) Firmly stabilize the reinforcement bar in place so that the rescue crew can cut it short.
Objective: 29.5
14
33) A 44-year-old male involved in a collision at 50 mph struck the windshield of his vehicle
with his face. Which of the following injuries should you prepare to treat?
A) Cervical spine trauma
B) Brain injury
C) Airway obstruction
D) All of the above
Objective: 29.6
34) Your patient is a 16-year-old male who was ejected from an all-terrain vehicle and struck his
head on a large rock. He was not wearing a helmet. He is unresponsive with shallow, irregular
respirations; a blood pressure of 170/110 mmHg; and a heart rate of 50 beats per minute. Which
of the following interventions would be MOST appropriate?
A) Insert an oropharyngeal airway (OPA) and ventilate via bag-valve mask (BVM) at 30 breaths
per minute.
B) Insert a nasopharyngeal airway and give oxygen by nonrebreather mask (NRB) at 15 lpm.
C) Insert an oropharyngeal airway and give oxygen by nonrebreather mask at 10 lpm.
D) Insert an oropharyngeal airway and ventilate via bag-valve mask at 20 breaths per minute.
Objective: 29.6
15
35) You respond to a patient who was hit in the face with a chair. Upon arrival, you notice a
patient leaning in the corner and bleeding profusely from the mouth and nose. Your first action
should be which of the following?
A) Assure scene safety.
B) Suction the airway and have the patient lean back.
C) Take cervical spine precautions.
D) Place the patient on a nonrebreather mask (NRB) at 15 lpm.
Objective: 29.6
36) Your patient is a 16-year-old centerfielder on his high school baseball team. He was injured
when he and the left fielder collided trying to catch a fly ball. He is disoriented and is unable to
tell you what happened. His vital signs are pulse 88, blood pressure 132/86, respiratory rate 16,
and pupils equal. As you assess his head, you do not see any cuts or bleeding, but you feel a
spongy, depressed area over his left ear. You should suspect a(n):
A) closed head injury.
B) skull injury.
C) open head injury.
D) direct injury.
Objective: 29.6
16
37) A young female was injured in an automobile wreck, striking her head on the windshield.
She is unconscious and her breathing is irregular. She is bleeding from a scalp wound, but your
assessment shows that her cranium is intact. Her vital signs are pulse 68, blood pressure 148/90,
and her pupils are unequal. You should suspect a(n):
A) concussion.
B) closed head injury.
C) contusion.
D) open head injury.
Objective: 29.6
38) You are called for a man who is not acting right. His wife says he was outside working in the
garden but didn’t come in for lunch when he was called. She went to check on him and found
him sitting next to a stump, confused. You assessment shows a pulse rate of 58, blood pressure of
186/82, respirations of 16, and one of his pupils is dilated. You are unable to detect any signs of
trauma and you don’t see any obvious indication that he has fallen. You should suspect a(n):
A) closed head injury.
B) open head injury.
C) insecticide poisoning.
D) nontraumatic brain injury.
Objective: 29.7
17
39) Your patient is a 27-year-old male who has been involved in a motorcycle collision in which
he was not wearing a helmet. He does not respond when you speak to him, but he makes
incomprehensible sounds when you press your knuckles on his sternum. Which of the following
BEST describes his level of consciousness?
A) Alert
B) Verbal
C) Painful
D) Unresponsive
Objective: 29.8
40) What is the Glasgow Coma Scale (GCS) of your adult male patient who has fallen off a
horse, has his eyes open, can follow your commands to squeeze his hands, but is confused about
what happened and his whereabouts?
A) 12
B) 14
C) 15
D) 13
Objective: 29.8
41) When should the EMT calculate a GCS with a patient who suffered a fall of 20 feet from his
apartment building?
A) At the hospital before writing the care report
B) En route to the hospital
C) As he approaches the patient
D) Before departing from the scene
Objective: 29.8
18
42) Which of the following is NOT used to calculate a patient’s GCS?
A) Eye movement
B) Verbal response
C) Work of breathing
D) Motor response
Objective: 29.8
43) Glasgow Coma Scale (GCS) is a neurological assessment that looks at which of the
following?
A) Eye opening, verbal response, and motor response
B) Grip strength, verbal response, and eye opening
C) Verbal response, motor response, and AVPU
D) Motor response, arm movement, and speech
Objective: 29.8
44) You are en route to the trauma center with a patient who was injured when he was thrown
from a horse. You suspect multiple trauma injuries including a closed head injury. You will
monitor his mental status using the Glasgow Coma Scale (GCS) per your protocols. Which of the
following will you check?
A) Eye-opening, motor response, and verbal response
B) Motor response, verbal response, and attentiveness
C) Speech patterns, motor patterns, and mental status
D) Verbal responses, motor skills, and mental status
Objective: 29.8
19
45) While assessing a patient with a laceration to the neck, the EMT must be aware that which of
the following conditions may develop?
A) Deep vein thrombosis
B) Air embolus
C) Air thrombosis
D) Deep vein embolus
Objective: 29.9
46) Your patient has sustained a serious laceration to his neck. He appears to have lost a lot of
blood and you are considering how you will control the bleeding. Your primary treatment should
be to place a(n):
A) pressure dressing.
B) occlusive dressing.
C) dry, sterile dressing.
D) bulky dressing.
Objective: 29.9
20