©THEBRIGHT EXAM STUDY SOLUTIONS 8/27/2024 12:01 PM
JBL Trauma Exam Questions With Correct
Answers
EMTs are assessing a man who was injured while trying to rescue a pet from his burning house.
Which of the following assessment findings should be the MOST immediately concerning?
A) Severe blisters to both hands
B) Closed deformity of the wrist
C) Dry cough and a hoarse voice
D) Clothes adhered to burned skin - answer✔✔C
(Any condition or injury that involves airway, breathing, or circulation warrants the EMT's most
immediate attention. A dry cough and hoarse voice are signs of inhalation injury and airway
swelling. Carefully monitor the pt and be prepared to ventilate him if his breathing becomes
inadequate. Transport without delay; a paramedic intercept should be requested. If the pt's airway
completely closes, more invasive airway management will be needed [cricothyrotomy]. Tend to
the other injuries listed during transport)
Factors that affect a person's ability to compensate for internal or external blood loss include all
of the following, EXCEPT:
A) advanced age.
B) the rate of blood loss.
C) high cholesterol in the blood.
D) blood-thinning medications. - answer✔✔C
(The compensatory responses of tachycardia and peripheral vasoconstriction decrease as a
person ages; thus, older pts are not able to compensate as effectively as younger pts. Older pts
commonly take medications to treat high BP, such as beta blockers; these drugs may blunt the
body's release of the catecholamines necessary to increase the heart rate. The ability to
compensate for blood loss is also related to how rapidly blood loss occurs. Pts who take blood-
thinning medications [warfarin {Coumadin}] bleed longer than those not taking such
medications. There is no known correlation between high cholesterol and a person's ability to
compensate for blood loss)
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A 44-year-old male experienced burns to his anterior trunk and both arms. He is conscious and
alert, but is in extreme pain. Assessment of the burns reveals reddening and blisters. This patient
has ________________ burns that cover _____ of his total body surface area.
A) first-degree, 27%
B) partial-thickness, 36%
C) second-degree, 45%
D) full-thickness, 18% - answer✔✔B
(Partial-thickness [second degree] burns damage the epidermis and part of the dermis, and are
characterized by blistering and severe pain. Areas of superficial [1st degree] burns, which cause
reddening of the skin, commonly surround partial-thickness burns. The anterior trunk [chest and
abdomen] accounts for 18% of the total body surface area [TBSA] and each entire arm accounts
for 9%. Full thickness burns [3rd degree] are characterized by charred or white, leathery skin.
Because the entire dermis, including the nerves, are destroyed, pts do not feel pain)
Prior to your arrival at the scene, a young female was removed from a body of water after being
submerged for an unknown period of time. You should manage her airway appropriately while
considering the possibility of:
A) spinal injury.
B) hyperthermia.
C) internal bleeding.
D) airway obstruction. - answer✔✔A
(When caring for a pt with a submersion injury [near drowning], you should consider the
possibility of a spinal injury. Many water-related incidents occur when a pt dives into shallow
water and strikes their head. Water can be aspirated into the lungs, but will not cause an
obstruction of the upper airway. Another common finding in pts with a submersion injury is
hypothermia. Although it is possible for the pt to have internal bleeding at the same time,
especially if they experienced a traumatic injury before the submersion, spinal injuries are more
common)
Which of the following clinical findings is consistent with decompensated shock?
A) Diaphoresis and pallor
B) Falling blood pressure
C) Restlessness and anxiety
D) Tachycardia and tachypnea - answer✔✔B
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(During shock, the compensatory mechanisms of the body attempt to maintain the BP. This is
accomplished by increasing the heart rate, shunting blood from the skin to more vital organs, and
increasing the respiratory rate to increase the O2 content of the blood. Once these compensatory
mechanisms fail, the BP will fall [hypotension]. Restlessness, anxiety, tachycardia, tachypnea,
and cool, clammy skin [diaphoresis] are earlier signs of shock)
Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On
assessment, you note that an area to the left side of his chest collapses during inhalation and
bulges during exhalation. These are signs of a/an:
A) flail chest.
B) pneumothorax.
C) isolated rib fracture.
D) pulmonary contusion. - answer✔✔A
(Flail chest: if two or more ribs are fractured in two or more places or if the sternum is fractured
along with several ribs, a segment of the chest wall may be detached from the rest of the thoracic
cage; the detached portion of the chest wall moves opposite of normal. It moves in during
inhalation and out during exhalation [paradoxical motion]. Isolated rib fractures are not
associated with paradoxical motion because they are usually fractured in only now place.
Pneumothorax: the pt's respirations are often labored; in severe cases, an entire side of the chest
may not move at all. Pulmonary contusion: [bruising of there lung tissue] does not cause
paradoxical chest motion unless associated with a flail chest)
A 33-year-old factory worker was crushed between two pieces of machinery. You find him lying
supine on the ground complaining of severe pain to his pelvis. He is restless, diaphoretic, and
tachycardic. What should you do?
A) Prepare for immediate transport
B) Perform a detailed secondary exam
C) Carefully log roll him to check his back
D) Palpate his pelvis to assess for crepitus - answer✔✔A
(Based on the MOI and the presence of signs of shock [restlessness, tachycardia, diaphoresis],
you should suspect that the pt has a fractured pelvis and is bleeding internally. Therefore, after
completing your primary assessment and initiating shock treatment, you should perform a rapid
H>T assessment to assess for other injuries and then prepare for transport. You should also avoid
palpating his pelvis; this will only cause further pain and may cause additional injury. Palpation
of the pelvis is performed to assess stability, not to elicit crepitus. Consider applying a pelvic
binder device or tying a sheet around his hips in order to reduce the space within the pelvis;
doing so may help slow internal bleeding. A detached secondary exam of a critically injured pt at
, ©THEBRIGHT EXAM STUDY SOLUTIONS 8/27/2024 12:01 PM
the scene is not appropriate; it takes too long to perform and should be done en route to the
hospital if time permits)
Damaged small blood vessels beneath the skin following blunt trauma cause:
A) mottling.
B) cyanosis.
C) hematoma.
D) ecchymosis. - answer✔✔D
When small blood vessels beneath the skin are damaged, blood seeps into the soft tissues. This
manifests as a bruise, also referred to as ecchymosis. A hematoma develops when larger blood
vessels are ruptured and the internal bleeding forms a noticeable lump. Cyanosis is a blue or
purple discoloration of the skin and signifies a low content of oxygen in the blood. Mottling
occurs when the skin takes on a blotched, purple appearance and is a sign of shock
(hypoperfusion).
While assessing a patient who was ejected from his truck, the EMT notices that his chest
collapses and his abdomen rises during inhalation. What should the EMT suspect?
A) Spinal cord injury
B) Fractured sternum
C) Ruptured diaphragm
D) Intra-abdominal bleeding - answer✔✔A
(Diaphragmatic breathing: this explains why his abdomen moves but his chest does not. This
indicates a spinal cord injury below C5 level. The phrenic nerves which innervate the diaphragm
arise from C3-C5. The intercostal nerves, which arise from below C5 level, have been
interrupted; this would explain the absence of chest wall movement. Fractured sternum:
depending on the severity of the fracture, would be expected to cause the chest to collapse during
inhalation and bulge during exhalation, similar to flail chest. Ruptured diaphragm: expected to
present with a scaphoid [concave] abdomen and decreased abdominal movement; in some cases
of diaphragmatic rupture, bowel sounds may be auscultated over the lung fields [usually left
side]. Intra-abdominal bleeding would present with a rigid, distended abdomen)
A young male has a large laceration to his lateral neck, directly over his jugular vein. His airway
is patent and his breathing is adequate. Your MOST immediate priority should be to:
A) apply high-flow oxygen via a nonrebreathing mask.
B) perform a rapid assessment to detect other injuries.
