1. Which of the following statements about unintentional injuries in the United States is true?

a. The economic effect of unintentional injuries is about $1 million per year
b. About 5% of all hospital ED visits are related to unintentional injuries
c. Unintentional injuries result in more potential life lost than any other cause
d. Unintentional injuries rarely result in death

2. Primary injury data include:

a. The mechanism of injury
b. On-scene education provided
c. Patients' vital signs
d. On-scene time

3. The period after a patient has been injured during which he or she is particularly recepti ve to injuryprevention tips is called the:

a. Teachable moment
b. Receptive opportunity
c. Opportunity for prevention
d. Responsi ve moment

4. The phase of trauma care in which the paramedic delivers direct patient care is known as:

a. Preincident
b. Incident
c. Postincident
d. Preplanning

5. The "golden hour" describes the:

a. Amount of time a serious trauma patient can usually tolerate surgery
b. First hour after severe injury
c. Time spent preparing for an emergency response
d. Transport time for the average trauma patient

6. A hospital that offers a burn center would be classified as a:

a. Level 1
b. Level 2
c. Level 3
d. Specialized care facility

7. A car strikes a tree at 50 miles per hour. Newton's first law of motion states that the:

a. Body inside will travel at 50 miles an hour until acted on by an outside force
b. Energy of the body inside the vehicle cannot be destroyed, but the fonn can be changed
c. Force on the body equals the mass times acceleration
d. Kinetic energy of the body will be determined primarily by the velocity

8. An improperly worn lap belt can cause injury to what area of the spine during frontal impact?

a. C2-C5
b. T2-T5
c. Tl2-L2
d. L3-L4

9. Laying a motorcycle down typically results in:

a. More severe injuries than if the rider had stayed with the bike
b. Major head trauma
c. Less severe injuries than those incurred by other types of impacts
d. Paper-bag injuries

Auto-Pedestrian Scenario
You respond to a call for a 9-year-old child involved in a car-pedestrian collision. Bystanders report that the patient was crossing the street, saw the oncoming vehicle, and just "froze." There is significant damage to the front bumper of the vehicle. You anive to find the child lying supine behind the car.

10. The fact that the child is found lying behind the vehicle leads you to suspect that the child:

a. Was thrown up and over the vehicle
b. Was pulled under the vehicle
c. Is not seriously injured
d. Was moved by bystanders

11. You are called to the scene for a 2-year-old male who has fallen approximately 3 feet onto a concrete
surface. On your arrival, the child is breathing but unconscious. Because of the mechanism of injury,
you suspect trauma to which area of the body?

a. The feet
b. The upper extremities
c. The buttocks
d. The head

12. A bullet's "yaw" describes its:

a. Ability to break into pieces
b. Cavitation potential
c. Tumble
d. Range

13 . Paramedic documentation of entrance and exit wounds resulting from gunshot trauma should include:

a. The location of the entrance wound
b. The location of the exit wound
c. The suspected path of the projectile
d. A description ofthe wounds

14. Shock might best be defined as:

a. Inadequate tissue perfusion
b. Low blood pressure
c. Hypoxemia
d. Internal or external blood loss

15. In relation to cardiovascular physiology, heart rate multiplied by stroke volume equals:

a. Systolic afterload
b. Cardiac output
c. Pulse volume
d. Pulmonic vascular volume

16. The tone of the arterial system is best reflected by the:

a. Pulse pressure
b. Vascular resistance
c. Mean arterial pressure
d. Hemostasis

17. The abnormal narrowing of an artery is called:

a. Emboli
b. Adhesions
c. Angina
d. Stenosis

18. Stage 2 shock occurs with a 15% to 20% decrease in intravascular blood volume, leading to:

a. Normal capillary refill time, normal respiratory rate, increased pulse rate, decreased blood pressure
b. Increased capillary refill time, increased respiratory rate, decreased blood pressure, normal pulse rate
c. Normal capillary refill time, hypotension, tachycardia, tachypnea
d. Increased capillary refill time, normal blood pressure, tachypnea, tachycardia

Shock Scenario
You are treating a 42-year-old woman who was the unrestrained driver of a car that crashed head-on into a tree at approximately 45 miles per hour. Both femurs are obviously fractured and she has an
unstable pelvis. She is unresponsive, tachycardic, tachypneic, and hypotensive.

19. Based on her vital signs, you suspect the woman in the Shock Scenario to be in what stage of shock?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4

20. Patients in the stage of shock presented in the Shock Scenario typically require which of the following treatments to reverse their shock states?

a. Hemorrhage control is usually sufficient
b. Fluid replacement with normal saline
c. Blood replacement
d. This stage of shock is irreversible

21 . Which of the following is a likely cellular response to the stage of shock presented in the Shock Scenario?

a. Disseminated intravascular coagulation
b. Cellular homeostasis
c. Impem1eable pulmonary capillaries
d. Cell death due to sodium and potassium leaking into cells

22. Water and sodium leaking into cells, potassium leaking out of cells, and cellular swelling typically
occur in which phase of shock?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4

23. Your patient has been hypotensive for 3 hours. Following transport to a trauma center, adequate
blood flow and blood pressure are restored. Cells affected by the hypotension are likely to:

a. Die due to inadequate capillary perfusion
b. Resume normal aerobic metabolism
c. Continue to function with anaerobic metabolism
d. Take up to 3 days to resume normal function

24. Which of the following causes obstructive shock?

a. Stenosis
b. Peripheral vascular constriction
c. Tension pneumothorax
d. Deep vein thrombosis

25. Neurogenic shock due to head injury creates:

a. Peripheral vascular dilation
b. Peripheral vascular constriction
c. Decreased cardiac output
d. Hyperventilation syndrome

26. A severe allergic reaction due to histamine release from exposure to an antigen is called:

a. Psychogenic shock
b. Antihistamine shock
c. Septic shock
d. Anaphylactic shock

27. Peritonitis and endocrine disorders might produce what type of shock?

a. Hemorrhagic shock
b. Cardiogenic shock
c. Hypovolemic shock
d. Psychogenic shock

28. A serious systemic bacterial infection most commonly causes what type of shock?

a. Anaphylactic shock
b. Septic shock
c. Hypovolemic shock
d. Psychogenic shock

29. The circulatory status assessment should begin with:

a. A radial pulse check
b. Obtaining a blood pressure
c. The control of arterial bleeding
d. The notation of skin temperature

30. A patient with noted hypotension, bradycardia, and jugular venous distention would lead you to suspect what type of shock?

a. Neurogenic shock
b. Cardiogenic shock
c. Septic shock
d. Hypovolemic shock

Differential Shock Assessment
You are treating a patient who presents with signs of shock. No trauma is noted, and the only pertinent history is a leg fracture 6 weeks earlier.

3 1 . What type of shock do you suspect?

a. Neurogenic shock
b. Obstructive shock
c. Septic shock
d. Hypovolemic shock

Differential Shock Assessment
You are treating a patient who presents with signs of shock. No trauma is noted, and the only pertinent history is a leg fracture 6 weeks earlier.

32. Treatment for this patient includes:

a. Subcutaneous epinephrine
b. Vasopressors
c. Antibiotics
d. Normal saline

33. A patient com plains of a " racing heart" when she stands up. You note that her heart rate increases from 90 to 104 after standing up, leading you to suspect:

a. Cardiac rhythm abnormalities
b. Volume depletion of at least 10%
c. Anaphylaxis
d. Neurogenic shock

34. Hypovolemic shock due to any cause is treated primarily with:

a. Crystalloid fluid volume replacement
b. Vasopressor agents to aid in peripheral vascular resistance
c. Colloid plasma expander agents
d. Vasodilatory agents to aid preload

35. An increase in ambient temperature will cause the pressure in the PASG to:

a. Decrease the pressure on the patient
b. Not significantly change the applied pressure
c. Increase the applied pressure
d. Overheat the patient

36. If aggressive fluid resuscitation is indicated, you should use:

a. A long catheter
b. Long tubing
c. Cold fluids
d. A pressurized IV system

37. The role of thrombin in clot formation is to:

a. Activate the platelets, causing them to adhere to one another
b. Stimulate the release of prothrombin activators
c. Cause the conversion of platelets to prothrombin
d. Convert fibrogen into fibrin threads to help form a blood clot

38. During the healing process of an open wound, what structures prepare the wound for healing by clearing foreign bodies and dead tissues?

a. Platelets
b. Erythrocytes
c. Macrophages
d. Epithelial cells

39. One difference between a hematoma and a contusion is that a hematoma:

a. Results in bruising but contusions do not
b. Is an open injury; a contusion is a closed injury
c. Is a more severe injury and may result in greater blood loss than a contusion
d. Occurs when organs are damaged; a contusion occurs when muscle tissue is damaged

40 . Which of the following is a typical finding in a patient with compartment syndrome?

a. Pain seemingly out of proportion to the injury
b. Spasticity ofthe involved muscle groups
c. No pain associated with passive stretching
d. Lack of tenderness to palpation

Avulsion Scenario
You are dispatched to a local automotive repair shop for a 43-year-old male who injured his forearm while removing a tire. The patient is conscious and alert and tells you that he cut his left forearm with a pry bar. On inspection, you obser e a 2-inch-long, partial-thickness avulsion. Bleeding is moderate with approximately 20 mL of blood loss.

41. Should it become necessary to augment bleeding control by using a blood pressure cuff as a tourniquet, inflation of the cuff should:

a. Never exceed a pressure greater than 50 mm Hg
b. Achieve a pressure slightly greater than arterial pressure
c. Achieve a pressure equal to one-half of the mean arterial pressure
d. Achieve a pressure equal to or slightly less than the diastolic blood pressure

42. Which of the following is true of chemical burns?

a. Thermal heat is not generated during contact
b. The chemical changes in the skin produce more damage than the heat
c. Chemical burns usually occur instantaneously on contact
d. Chemical burns cause less morbidity than thermal bums

Bum Scenario
You are dispatched to the scene of an apartment fire. Your patient is a 27-year-old female who has sustained thermal burns to her left arm, left anterior thorax, head, and neck. She is conscious, alert, and in severe pain when you arrive.

43. The burn area confined to the patient's left anterior torso is red and wet. It is painful and has intact sensation. Blisters are beginning to form. These findings are consistent with which burn classification?

a. First-degree bum
b. Second-degree, superficial partial-thickness burn
c. Second-degree, deep full-thickness burn
d. Third-degree burn

44. The burn area confined to the patient's left forearm is white and leathery in appearance. There is no painful sensation from this area; however, the area that surrounds it is very painful. These findings are consistent with which burn classification?

a. First-degree bum
b. Second-degree, superficial partial-thickness burn
c. Second-degree, deep partial-thickness burn
d. Third-degree burn

45. To most accurately calculate the total body surface area (TBSA) burned, you would use:

a. The Jackson formula
b. The Parkland formula
c. The Modified Brooke formula
d. The Lund and Browder chart

46. The Lund and Browder chart is recommended for measuring burn injuries when:

a. Burns are in·egularly shaped
b. The patient is an infant
c. The patient is at least 12 years of age
d. The patient has first-degree burns

47. Which of the following accurately describes the Consensus Formula for fluid resuscitation following
burns?

a. 1 mL/ kg of fluid multiplied by TBSA burned is administered
b. 50% of the calculated amount is infused in the first 8 hours
c. The consensus formula defines the amount of fluids to be administered for the first 3 days
d. The amount of fluid is calculated on the basis of all types of first-. second-, and third-degree burns

Gas Burns Scenario
You are called to a local industrial center for a 23-year-old male with facial burns. The foreperson informs you that the patient was working on a gas-powered generator when the equipment flashed. On your arrival, the fire is out and the patient is in the restroom washing his face.

48. Your partner has calculated the total body surface area burned to be 20%. This patient weighs 220
pounds. Which of the following fluid boluses would be most appropriate for this patient in the first 24 hours?

a. 4 liters
b. 8 liters
c. 800 mL
d. 400 mL

49. When determining the total body surface area burned to determine fluid resuscitation, your partner should have calculated:

a. Only third-degree burns
b. Only second- and third-degree burns
c. All classifications of burns: first-, second-, and third-degree
d. Only the burns that affect critical areas such as the hands, face, feet, and perineum

50. On assessment you note that this patient has sustained serious inhalation burns of the upper airway.
Which would be the most appropriate type of oxygen delivery?

a. A low concentration of humidified oxygen
b. A high concentration of humidified oxygen
c. A low concentration of nonhumidified oxygen
d. A high concentration of nonhumidified oxygen

Industrial Fire Scenario
You are called to the scene of an industrial fire. Your patient, a 31-year-old male, has been burned over 80% of his body. All intravenous access sites are covered with either blisters or char. The patient is lethargic and moaning.

51. How would you manage fluid resuscitation for this patient?

a. Intravenous fluid resuscitation is contraindicated for this patient
b. Due to increased susceptibility to infection, oral hydration is the only option
c. Intravenous access may be attempted using a large-bore catheter through burned tissue
d. Intravenous access may be attempted using a butterfly-type small catheter through burned tissue

52. What medication may be helpful when treating a patient with carbon monoxide poisoning?

a. Sodium bicarbonate
b. Calcium chloride
c. Sodium thiosulfate
d. Potassium chloride

53. Which of the following is correct treatment for chemical bums?

a. Irrigate the patient before removing his or her clothes or shoes
b. Transport takes precedence over irrigation
c. Irrigate with copious amounts of water before transport
d. Irrigate dry chemicals on the skin - do not brush them off

54. When treating patients with chemical bums, the American Burn Association recommends that:

a. Water be used for treating most chemical burns
b. Stopping the burning process is not a prehospital concern because it involves complex chemical calculations
c. A mild solution of bicarbonate of soda be used to treat most chemical bums
d. Most chemical bums be treated with the neutralizing agent listed on the Materials Safety Data Sheet (MSDS)

Electrical Injury
Your crew is called to the home of a 19-year-old female who was shocked while using an electric hedge trimmer that was plugged into a household outlet that was not properly grounded. On arrival, you find this patient to be in cardiopulmonary arrest.

55. How should you address management of this patient's airway?

a. Intubate the patient at once, using cervical spine precautions
b. Do not intubate because postelectrical injury laryngospasm may be triggered by the insertion of the laryngoscope blade
c. Intubate the patient and extend her head and neck to reduce the possibility of subsequent glottic edema
d. Intubation is not necessary because these patients normally respond immediately to mouth-to-mouth ventilations

Electrical Injury
Your crew is called to the home of a 19-year-old female who was shocked while using an electric hedge trimmer that was plugged into a household outlet that was not properly grounded. On arrival, you find this patient to be in cardiopulmonary arrest.

56. After quite some time and effort, your crew is able to restore this patient's pulse; however, her respiratory status is still tentative. In conferring with medical direction, you anticipate an order to:

a. Provide fluid resuscitation in an effort to ward off subsequent renal failure
b. Withhold all unnecessary fluids to prevent increased intracranial pressure
c. Administer a diuretic (such as Lasix) to decrease third-spacing of fluids and subsequent edema
d. Provide fluid resuscitation if the electrical charge was alternating current (AC) and withhold fluid resuscitation if the electrical charge was direct current (DC)

Lightning Injury
Your crew is called to the scene of an electrocution by lightning strike. Your patient, a 57-year-old male, was struck by lightning while putting his boat into the water at a local lake.

57. The best place to provide treatment for this patient is:

a. In the boat away from shore
b. In the water next to the boat
c. On the lake's beach, staying close to the ground
d. Under a large tree that provides adequate protection from the rain

58. The most dangerous form of penetrating radiation is:

a. Alpha rays
b. Beta rays
c. Delta rays
d. Gamma rays

59. The major cause of maxillofacial injury is:

a. Motor vehicle crashes
b. Intentional violence
c. Athletic injuries
d. Industrial injuries

Fight Scenario
You are called to the scene of a fight at a local park. Your patient, a 45-year-old male, was struck in the face with a baseball bat. On arrival, he is on his feet and holding a towel over his lower face.

60. This patient's nose is bleeding. You have taken full spinal precautions and placed the patient on a long backboard. To control the loss of blood and promote coagulation:

a. Elevate the foot of the backboard
b. Place external pressure on the anterior nares
c. Pack the nostrils with sterile gauze
d. Have the patient sit up, lean forward, and pinch the bridge of his nose

61. You are called to the home of a 15-year-old male who fell off of his bike approximately 10 minutes earlier. He is complaining of left clavicle pain. On inspection, you find bruising behind his left ear at the mastoid process. The patient attributes this to being hit by a softball 1 week ago. What conclusion should you draw?

a. The bruising is attributed to a basilar skull fracture incuned in the bike accident
b. The bruising must be from the softball because Battle's sign takes some time to appear
c. The bruising, known as raccoons' eyes, may be attributed to a basilar skull fracture
d. The bruising must be caused by dependent blood leakage associated with a fractured clavicle

62. Soft tissue injuries to the scalp:

a. Bleed minimally and rarely require treatment
b. Can be managed with direct pressure and pressure dressings
c. Commonly produce stellate wounds
d. Do not bleed enough to cause hypotension

Head Trauma
You are dispatched to a local sports arena for a 14-year-old female who fell from a 7-foot bleacher stand and hit her head. On arrival, the patient is conscious but confused. She has a large hematoma on the back of her head (occipital region).

63. Long-term treatment for this patient should include:

a. Keeping her awake for 24 hours
b. The administration of anticonvulsant medication
c. In-hospital or in-home observation for 24 to 48 hours
d. Surgical evacuation of extravascular pockets of blood

64. Which of the following is the most severe form of brain injury?

a. Concussion
b. Contusion
c. Diffuse axonal injury
d. Hematoma

65. Intubation is recommended for patients with a Glasgow Coma Scale grade of:

a. 8 or less
b. 9 or 10
c. 11 or 12
d. 13 to 15

Grocery Worker Scenario
You are called to a grocery store for a worker who was injured when a case of beer fell on his head from approximately 1 0 feet above ground level. The blow knocked him to his knees, at which point his abdomen struck a plastic crate. He is complaining of severe head and stomach pain. He is somewhat dizzy and states that he has a history of hypoglycemia.

66. A drug that may be administered to decrease cerebral edema is:

a. Nitroglycerin
b. Glucose
c. Diazepam
d. Mannitol

67. Thirty minutes into the transport, the patient loses consciousness. He responds to no verbal or painful stimulation, has no movement, and doesn't open his eyes. His Glasgow Coma Score is:

a. 0
b. 3
c. 6
d. 9

68. Axial loading fractures most commonly occur at:

a. Cl and C2
b. T1 to T6
c. Tl2 to L2
d. L1 to L5

69. Injury mechanisms such as hangings typically cause a ______ type spinal cord injury.

a. Subluxation
b. Distraction
c. Axialloading
d. Hemiation

70. In the adult, the spinal cord terminates in the area of:

a. T12
b. L2
c. S1
d. Coccyx

71. Injuries to the spinal cord that result from swelling and ischemia are called:

a. Impact injuries
b. Reversible injuries
c. Pem1anent injuries
d. Secondary injuries

Car Crash
You arrive at the scene of a two-vehicle collision. Your patient, the unrestrained driver of a vehicle sustaining significant lateral impact, is complaining of back pain and numbness and tingling to the lower body and legs, primarily below the umbilicus. As you continue to treat this patient he becomes progressively worse and now has no feeling below the nipple line.

72. Considering the patient's chief complaint and the dermatome involved in the initial presentation, you
suspect that the initial injury is in the area of:

a. C2 to C4
b. T4
c. T10
d. S1

73 . Central cord syndrome is characterized by:

a. Decreased touch and pressure sensation
b. Paralysis ofthe arms
c. Weakness of the extremities on one side
d. Paralysis of the legs

74. Brown-Sequard syndrome is characterized by:

a. Decreased touch and pressure sensation
b. Paralysis of the arms
c. Weakness of the upper and lower extremities on one side
d. Paralysis ofthe legs

75 . When applying a rigid cervical collar, you will know it is properly positioned if:

a. The head is slightly extended
b. The head is slightly flexed
c. The patient's nose points 5 to 10 degrees past neutral
d. The patient can comfortably open his or her mouth

Lower Back Pain
You are called to the home of a 48-year-old male who is complaining of chronic lower back pain in the lumbar region. The pain has become more intense over the past 24 hours and has begun to radiate down the right thigh. The patient denies trauma and states that the pain is from an old "lifting" injury.

76. Pain radiating from the lumbar nerve root to the thigh is known as:

a. Kerr's sign
b. Babinski pain
c. Sciatica
d. Neural dysfunction

Sports Injury
You are treating a 10-year-old girl who fell on her outstretched hand playing soccer. She complains of pain and tenderness in her right chest and arm.

77. A rare complication associated with this type of injury includes injury to the:

a. Subclavian vein
b. Intercostal artery
c. Aorta
d. Vena cava

78. Rib fractures occur most commonly in:

a. Young children
b. Patients with more resilient cartilage
c. Ribs that are least protected by musculature
d. Sporting activities that include twisting

79. Fractures to the first and second ribs:

a. Occur commonly and have few complications
b. Imply great force was exerted to cause the injury
c. Are commonly complicated by spleen or liver injuries
d. Most commonly occur in children

80. Which of the following signs or symptoms would be associated with a closed (simple) pneumothorax?

a. Diminished breath sounds on the affected side
b. Diminished breath sounds on the opposite side
c. Hypotension
d. Tracheal deviation

81 . Treatment of an open pneumothorax includes:

a. An occlusive dressing that is taped on three sides
b. A sterile gauze that allows for measured air exchange
c. Withholding fluids if the patient also presents with shock
d. A large, bulky dressing that is taped in place

82. Air trapped in the pleural space under pressure is known as:

a. Simple pneumothorax
b. Complete pneumothorax
c. Tension pneumothorax
d. Open pneumothorax

83. Signs or symptoms commonly associated with hemothorax include:

a. Hyperresonance
b. Bradycardia
c. Tracheal deviation to the affected side
d. Shock

84. Which of the following statements is correct regarding pulmonary contusion?

a. Pulmonary contusions most commonly result from penetrating trauma
b. Signs and symptoms of pulmonary contusion develop rapidly and are easy to recognize after the initial injury
c. Large fluid boluses should be considered if pulmonary contusion is suspected
d. Most pulmonary contusions generally heal spontaneously over several weeks

85. Alveolar and lung capillary damage resulting in interstitial and intraalveolar bleeding and swelling
most accurately describe:

a. Pneumothorax
b. Pulmonary contusion
c. Flail chest
d. Paper-bag effect

86. Muffled heart sounds, JVD, and narrowing pulse pressures describe the clinical findings that make
up:

a. Cushing's triad
b. Wemicke-Korsakoff syndrome
c. Beck's triad
d. Einthoven's triangle

87. Cardiac tamponade is:

a. An accumulation of blood in the sac surrounding the heart
b. Commonly caused by blunt trauma
c. Associated with increased pulse pressure
d. Bleeding between the layers of the aorta

88. Definitive treatment of cardiac tamponade includes:

a. Fluid bolus
b. Pericardiocentesis
c. Needle thoracostomy
d. Angioplasty

89. The aorta, pulmonary arteries, and pulmonary veins are known as the:

a. Mediastinum
b. Pericardia! space
c. Great vessels
d. Vena cavae

90. Cardiac output in a patient with pericardia! tamponade can be greatly improved with in-hospital
pericardiocentesis that removes as little as:

a. 5 mL of blood
b. 10 mL of blood
c. 20 mL of blood
d. 30 mL of blood

Neck Trauma
You are treating a patient involved in an MV A who is complaining of neck pain and difficulty breathing. You notice a large hematoma rapidly developing just to the right of the trachea.

91. You realize that the injury could be:

a. Self-limiting and that it rarely presents a problem
b. Compromising the integrity of the trachea
c. Putting pressure on the spinal cord, possibly leading to paralysis
d. Easily treated by the application of a cervical collar

Unrestrained Driver
You are dispatched to a motor verucle collision for a 24-year-old female who is complaining of "stomach pains." She was the driver of a vehicle that hit a power pole at approximately 25 miles per hour, and she was not wearing a seatbelt. She informs you that she hit her stomach and lower chest on the steering wheel at impact. She is nauseous and pale. She is not pregnant.

92. Which ofthe following organs is least likely to suffer injury as a result of this impact?

a. Liver
b. Lungs
c. Spleen
d. Stomach

93. When assessing musculoskeletal injuries, paramedics should:

a. Make every attempt to diagnose the injury correctly
b. Not be concerned with differentiating among sprains, strains, and fractures
c. Manage patients as though they have a sprain
d. Manage patients as though they have a strain

94. A break that occurs at an angle across a bone is called a(n):

a. Open fracture
b. Comminuted fracture
c. Greenstick fracture
d. Oblique fracture

Constntction Scenario
Your crew is called to a construction site where a 2000-pound piece of structural steel was dropped on the pelvis of a 23-year-old male. By the time you arrive, the steel girder has been removed by a crane, and the patient is lying on the ground in obvious distress.

95 . When assessing his pelvis, visual inspection:

a. Does not require exposing the patient because most injuries will be obvious
b. Should not be performed so as to protect the patient's modesty
c. Should be examined with the patient standing so that anatomical differences can be appreciated
d. May not help to identify injuries because of the amount of muscle and other tissues in this region

96. To reduce pain and swelling in the first 24 hours after a sprain, apply:

a. Ice
b. Warm soaks
c. Heat first, then ice, once the muscles are warmed
d. Heat and ice, alternating every 3 to 4 hours

97. You are treating a patient who tells you she has a history of rheumatoid arthritis. This means her
arthritis developed due to:

a. Wear and tear on the joints
b. An autoimmune disorder
c. Uric acid accumulation
d. A previous fracture

98. "Buddy splinting" refers to a technique in which a broken:

a. Arm is secured to a rigid splint
b. Arm is secured to a long backboard
c. Finger or toe is taped to an adjacent but uninjured finger or toe
d. Leg is secured by holding the injury in place against a long backboard

99. A fracture or dislocation should be realigned when:

a. The patient reports extreme pain
b. Circulation is impaired
c. The site is bleeding
d. The lower leg is involved

100. Before manipulating any injured extremity, you must:

a. Position the patient on a long backboard
b. Place the patient on high-flow oxygen
c. Assess distal pulses, sensation, and motor function
d. Administer intravenous analgesic per medical direction