Medical Tests Medical Tests Certifications NREMT Questions & Answers

• Question 111:

  Which of the following is an early, and the most prominent, finding in a crush injury?

  A. Pain

  B. Pulselessness

  C. Paresthesia

  D. Paralysis

  Correct Answer: A

  Pain is generally the most obvious sign of a crush injury and tends to present earliest out of all of the other associated signs and symptoms.

• Question 112:

  You have responded to a local residence of a 37-year-old male who had lacerated his leg while using a chainsaw in the back of his house. Prior to your arrival, the patient's wife, who is a nurse, applied pressure to the wound and has the patient in Trendelenburg position. Your assessment of the patient reveals him to be responsive to painful stimuli with a weak carotid pulse and the blood pressure unobtainable. There is a massive amount of blood surrounding the patient on the ground. The wife tells you that the wound is arterial and the injury occurred about 10 to 15 minutes ago. In addition to oxygen therapy, what are your treatment priorities for this patient?

  A. Continue applying direct pressure to the wound and call for ALS support.

  B. Apply an arterial tourniquet and call for ALS support.

  C. Apply an arterial tourniquet and call for ALS support.

  D. Continue applying direct pressure to the wound and traansport.

  Correct Answer: A

  Direct pressure and fluids are this patient's best chance for survival and prevention of decompensated shock. ALS should be activated to administer fluids as soon as possible

• Question 113:

  Which of the following patients would be most appropriate for triage to a non-trauma center?

  A. 67-year-old female who was electrocuted by a 220 volt electrical outlet

  B. 19-year-old male involved in a single car MVC at a rate of 25 miles per hour

  C. 25-year-old female with a 1-inch laceration on her thigh

  D. 14-year-old male who fell 11 feet out of a tree, landing on his back

  Correct Answer: C

  Of the 4 choices, the patient with a laceration on her thigh has an isolated injury and can be effectively managed by a non-trauma center. The other 3 patients require a more thorough assessment and therefore should be evaluated at a trauma center.

• Question 114:

  You are called for an elderly female that fell down and hurt her knee. When you find the patient, she tells you she tripped and fell, and landed on her left knee. She denies any loss of consciousness or trauma to her head. The patient is only complaining of pain to the distal portion of her femur. During your assessment, you notice deformity and swelling to the femur, proximal to the knee. The patient has good distal pulses, motor function, and sensation. What would be the most appropriate treatment for this patient?

  A. Secure to a backboard and pad appropriately

  B. Application of padded board splints

  C. Traction splinting

  D. Inflation of the PASG on both legs

  Correct Answer: A

  The patient with a femur fracture should be secured to a backboard and padded appropriately. Inflating both leg sections of the PASG is not indicated for this patient. e femur while helping to tamponade any blood loss. Traction splinting is only appropriate if the femur fracture is mid shaft. Padded board splints will not provide sufficient stabilization.

• Question 115:

  You are treating a 12-year-old male patient who was hit in the nose with a baseball. His nose is deviated to

  the left with moderate epistaxis. He is complaining of severe pain to his nose. He is alert and oriented with

  no loss of consciousness.

  Which of the following treatment sequence would best manage this patient?

  A. Pack nares with gauze to control bleeding.

  B. Have patient lie supine while holding pressure to nares.

  C. Align nose in the neutral position while holding pressure to nares.

  D. Have patient sit upright and lean forward while holding pressure to nares.

  Correct Answer: D

  Holding pressure on the nares is the proper technique to control epistaxis while leaning the patient forward to prevent blood from draining down the throat. Leaning the patient forward should not be performed if spinal precautions are necessary.

• Question 116:

  You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. Which of the following treatment regimens would be the most appropriate for this patient?

  A. High flow oxygen, spinal precautions, occlusive dressing over entrance wound, rapid transport.

  B. High flow oxygen by nonrebreather, spinal precautions, allow patient to remain in a position of comfort.

  C. High flow oxygen by nonrebreather, cover entrance wound with an occlusive dressing.

  D. High flow oxygen, pleural decompression to right side of chest, rapid transport.

  Correct Answer: A

  Treatment of a gunshot wound to the thorax would include taking necessary spinal precautions. The open wound should be covered with an occlusive dressing. The respiratory distress should be treated with high flow oxygen with consideration of positive pressure ventilation and possible intubation. In addition, an IV should be started for a fluid route if hypotension worsens. Rapid transport is indicated for pericardiocentesis and possible surgery.

• Question 117:

  Please answer the following question. You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. What condition do you think is most likely present with this patient?

  A. Hemothorax

  B. Tension pneumothorax

  C. Pericardial tamponade

  D. Lacerated aorta

  Correct Answer: C

  Pericardial tamponade causes decreased cardiac output as seen by pale skin and hypotension. In addition, jugular vein distention may seen along with a narrowed pulse pressure. Other signs and symptoms include tachycardia, respiratory difficulties, and cyanosis of the face, neck, and arms. With tension pneumothorax or a significant hemothorax, decreased or absent breath sounds will be present.

• Question 118:

  Following the immobilization of an extremity fracture to the lower right arm, the paramedic should perform what step last?

  A. Ensuring the splint is applied tightly.

  B. Placing the hand in the position of function.

  C. Assessing presence of distal motor, sensory, and perfusion.

  D. Placing the immobilized extremity below the level of the heart

  Correct Answer: C

  The last part of immobilizing the arm fracture (or any suspected fracture for that matter), is the assessment of distal motor, sensory, and perfusion status. This is done to assure there was no additional trauma from the immobilization process, and to assure the splint was not put on incorrectly (for example an air splint inflated too high). If there is a loss in the motor, sensory, perfusion findings following immobilization, the paramedic should immediately reassess the splinting process and correct any errors.

• Question 119:

  En route to the hospital, you intubate the patient. During your assessment of tube placement, you hear wheezing in the upper lung fields. What is most likely causing this wheezing?

  A. Inhalation injury to the upper airway

  B. Inhalation induced cardiac wheezing

  C. Inhalation induced asthma attack

  D. Inhalation injury to the lower airway

  Correct Answer: A

  An inhalation injury inferior to the glottis can result in wheezing and bronchospasm. An inhalation injury superior to the glottis can cause a hoarse voice and stridor. Inhalation of the byproducts of combustion can cause wheezing but this would still be classified as an inhalation injury to the lower airway.

• Question 120:

  Your 16 year trauma patient has what appears to be a mid-shaft femur fracture, you notice that there is a laceration directly over the suspected fracture. Bleeding is controlled, what type of fracture would this be?

  A. Greenstick

  B. Comminuted

  C. Closed

  D. Open

  Correct Answer: D

  Any time there is open skin over a fracture is considered an open fracture. A greenstick is generally found in children whose bones have not fully ossified. Comminuted is a fracture resulting from extreme forces causing many smaller fractures at the site of the fracture.