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CIEMT Quiz #5 – Bleeding & Burns Study
Guide
Comprehensive EMT Emergency Care Exam
Prep
EXAM COVERAGE SUMMARY
This comprehensive examination covers all essential concepts from the CIEMT Bleeding &
Burns Study Guide, organized into a randomized 250-question format. The exam addresses
critical topics including:
Hemorrhage Control & Shock Management: Blood loss tolerance, types of bleeding (arterial,
venous, capillary), internal bleeding signs and symptoms, bleeding control techniques (direct
pressure, elevation, tourniquets), and blood clotting medications (Aspirin, Heparin, TPA).
Trauma Assessment & Patient Care: Compartment syndrome, RICES protocol, wound
classification (abrasions, avulsions, lacerations, amputations), impaled object management,
abdominal evisceration, and sucking chest wounds.
Burn Classification & Management: Burn degree identification (superficial, partial thickness,
full thickness), Rules of Nines for adults and pediatrics, Rule of Palm, critical burn criteria, burn
severity categorization (critical, moderate, minor), and emergency burn care protocols.
Specialized Burn Injuries: Chemical burns (liquid and dry), electrical burns, thermal eye burns,
and appropriate dressing applications (DOT vs. LA County protocols).
Head, Eye, Ear, and Dental Injuries: Epistaxis management, skull fractures with CSF leakage,
ocular trauma (hyphema, retinal detachment, blowout fractures), contact lens management, ear
injuries, and dental avulsion protocols.
Chest & Abdominal Trauma: Hemothorax, pneumothorax, spontaneous pneumothorax,
traumatic asphyxia, commotio cordis, blunt myocardial injury, hollow and solid organ injuries,
Kehr's sign, and diaphragm injuries.
Neurological & Spinal Considerations: Ischemia tolerance times, spinal injury implications
below C5, minute ventilation, and anisocoria assessment.
Special Populations & Scenarios: Pediatric considerations, geriatric considerations, and
unique anatomical differences affecting injury patterns and treatment protocols.
Question 1
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A 24-year-old male involved in a motorcycle crash has a penetrating chest wound with bubbling
blood. After applying an occlusive dressing taped on three sides, you note diminished breath
sounds and increasing respiratory distress. What is your immediate action?
A) Remove the dressing to allow air to escape freely
B) Apply a second occlusive dressing over the first
C) Lift one edge of the dressing to release trapped air
D) Initiate positive pressure ventilation with a bag-valve mask
Lift one edge of the dressing to release trapped air
The absent lung sounds with an occlusive dressing indicate tension pneumothorax development;
"burping" the dressing releases trapped air and relieves pressure. Removing the dressing entirely
would convert it back to an open pneumothorax, while additional dressings would worsen the
pressure build-up.
Question 2
A construction worker falls from scaffolding and sustains blunt trauma to his left upper quadrant.
He complains of referred pain to his left shoulder. Which organ is most likely injured?
A) Liver
B) Kidney
C) Stomach
D) Spleen
Spleen
Kehr's sign, characterized by referred pain to the left shoulder, is classic for splenic injury due to
diaphragmatic irritation from blood. The spleen is highly vascular and prone to significant
hemorrhage following blunt trauma, making it a critical organ to assess in left upper quadrant
injuries.
Question 3
Your patient has a deep laceration on the forearm with bright red blood spurting rhythmically
from the wound. What type of bleeding is this?
A) Venous
B) Capillary
C) Arterial
D) Lymphatic
Arterial
Arterial bleeding is characterized by bright red blood that spurts in time with cardiac
contractions, making it the most difficult to control. Venous bleeding is darker and flows steadily
without spurting, while capillary bleeding oozes and is typically controlled more easily.
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Question 4
A 45-year-old female with a history of dialysis presents with a bleeding wound that will not clot.
Which medication is most likely contributing to this bleeding diathesis?
A) Aspirin
B) TPA
C) Heparin
D) Warfarin
Heparin
Heparin is a blood thinner commonly used in dialysis patients to prevent clotting in the dialysis
circuit, causing systemic anticoagulation. Aspirin inhibits platelets, TPA breaks down existing
clots, and while warfarin also affects coagulation, heparin is specifically associated with dialysis
patients.
Question 5
An infant burned with hot water has an estimated 22% TBSA partial thickness burns. How
should this burn severity be classified?
A) Minor burn
B) Moderate burn
C) Critical burn
D) Superficial burn
Critical burn
Partial thickness burns covering more than 30% of TBSA in adults are critical, but in children
under 5 years, the threshold is lower. This infant's 22% partial thickness burn would be
considered critical due to age, as pediatric patients have less physiological reserve and higher
fluid requirements relative to their size.
Question 6
A 62-year-old male has a full thickness burn involving 8% of his TBSA on his right hand. How
should this burn be classified?
A) Minor burn
B) Moderate burn
C) Critical burn
D) Superficial burn
Critical burn
Full thickness burns involving the hands are automatically classified as critical burns regardless
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of the percentage of TBSA involved. The hand is a critical area due to its functional importance,
potential for contracture deformities, and difficulty with rehabilitation if not treated at a
specialized burn center.
Question 7
A patient presents with black, tarry stools after complaining of abdominal pain. What is the
correct medical term for this finding?
A) Hematemesis
B) Hemoptysis
C) Melena
D) Hematochezia
Melena
Melena specifically refers to black, tarry stools resulting from upper gastrointestinal bleeding
where blood has been digested by intestinal enzymes and bacteria. Hematemesis is vomiting
blood, hemoptysis is coughing up blood, and hematochezia is bright red blood in stool from
lower GI bleeding.
Question 8
During an MVA, a patient experiences sudden chest compression from the steering wheel. He
presents with a purple discoloration of his head, neck, and upper chest. What condition should
you suspect?
A) Commotio cordis
B) Traumatic asphyxia
C) Hemothorax
D) Spontaneous pneumothorax
Traumatic asphyxia
Traumatic asphyxia occurs from sudden severe chest compression forcing blood from the heart
backward into the head and neck veins, causing characteristic petechiae and purple
discoloration above the compression site. This condition is commonly seen in MVAs and crush
injuries, resulting from the sudden increase in intrathoracic pressure.
Question 9
A 16-year-old baseball player is struck in the chest by a pitch and immediately collapses. What
cardiac rhythm is most likely causing this sudden collapse?
A) Bradycardia
B) Ventricular fibrillation
CIEMT Quiz #5 – Bleeding & Burns Study
Guide
Comprehensive EMT Emergency Care Exam
Prep
EXAM COVERAGE SUMMARY
This comprehensive examination covers all essential concepts from the CIEMT Bleeding &
Burns Study Guide, organized into a randomized 250-question format. The exam addresses
critical topics including:
Hemorrhage Control & Shock Management: Blood loss tolerance, types of bleeding (arterial,
venous, capillary), internal bleeding signs and symptoms, bleeding control techniques (direct
pressure, elevation, tourniquets), and blood clotting medications (Aspirin, Heparin, TPA).
Trauma Assessment & Patient Care: Compartment syndrome, RICES protocol, wound
classification (abrasions, avulsions, lacerations, amputations), impaled object management,
abdominal evisceration, and sucking chest wounds.
Burn Classification & Management: Burn degree identification (superficial, partial thickness,
full thickness), Rules of Nines for adults and pediatrics, Rule of Palm, critical burn criteria, burn
severity categorization (critical, moderate, minor), and emergency burn care protocols.
Specialized Burn Injuries: Chemical burns (liquid and dry), electrical burns, thermal eye burns,
and appropriate dressing applications (DOT vs. LA County protocols).
Head, Eye, Ear, and Dental Injuries: Epistaxis management, skull fractures with CSF leakage,
ocular trauma (hyphema, retinal detachment, blowout fractures), contact lens management, ear
injuries, and dental avulsion protocols.
Chest & Abdominal Trauma: Hemothorax, pneumothorax, spontaneous pneumothorax,
traumatic asphyxia, commotio cordis, blunt myocardial injury, hollow and solid organ injuries,
Kehr's sign, and diaphragm injuries.
Neurological & Spinal Considerations: Ischemia tolerance times, spinal injury implications
below C5, minute ventilation, and anisocoria assessment.
Special Populations & Scenarios: Pediatric considerations, geriatric considerations, and
unique anatomical differences affecting injury patterns and treatment protocols.
Question 1
,2|Page
A 24-year-old male involved in a motorcycle crash has a penetrating chest wound with bubbling
blood. After applying an occlusive dressing taped on three sides, you note diminished breath
sounds and increasing respiratory distress. What is your immediate action?
A) Remove the dressing to allow air to escape freely
B) Apply a second occlusive dressing over the first
C) Lift one edge of the dressing to release trapped air
D) Initiate positive pressure ventilation with a bag-valve mask
Lift one edge of the dressing to release trapped air
The absent lung sounds with an occlusive dressing indicate tension pneumothorax development;
"burping" the dressing releases trapped air and relieves pressure. Removing the dressing entirely
would convert it back to an open pneumothorax, while additional dressings would worsen the
pressure build-up.
Question 2
A construction worker falls from scaffolding and sustains blunt trauma to his left upper quadrant.
He complains of referred pain to his left shoulder. Which organ is most likely injured?
A) Liver
B) Kidney
C) Stomach
D) Spleen
Spleen
Kehr's sign, characterized by referred pain to the left shoulder, is classic for splenic injury due to
diaphragmatic irritation from blood. The spleen is highly vascular and prone to significant
hemorrhage following blunt trauma, making it a critical organ to assess in left upper quadrant
injuries.
Question 3
Your patient has a deep laceration on the forearm with bright red blood spurting rhythmically
from the wound. What type of bleeding is this?
A) Venous
B) Capillary
C) Arterial
D) Lymphatic
Arterial
Arterial bleeding is characterized by bright red blood that spurts in time with cardiac
contractions, making it the most difficult to control. Venous bleeding is darker and flows steadily
without spurting, while capillary bleeding oozes and is typically controlled more easily.
,3|Page
Question 4
A 45-year-old female with a history of dialysis presents with a bleeding wound that will not clot.
Which medication is most likely contributing to this bleeding diathesis?
A) Aspirin
B) TPA
C) Heparin
D) Warfarin
Heparin
Heparin is a blood thinner commonly used in dialysis patients to prevent clotting in the dialysis
circuit, causing systemic anticoagulation. Aspirin inhibits platelets, TPA breaks down existing
clots, and while warfarin also affects coagulation, heparin is specifically associated with dialysis
patients.
Question 5
An infant burned with hot water has an estimated 22% TBSA partial thickness burns. How
should this burn severity be classified?
A) Minor burn
B) Moderate burn
C) Critical burn
D) Superficial burn
Critical burn
Partial thickness burns covering more than 30% of TBSA in adults are critical, but in children
under 5 years, the threshold is lower. This infant's 22% partial thickness burn would be
considered critical due to age, as pediatric patients have less physiological reserve and higher
fluid requirements relative to their size.
Question 6
A 62-year-old male has a full thickness burn involving 8% of his TBSA on his right hand. How
should this burn be classified?
A) Minor burn
B) Moderate burn
C) Critical burn
D) Superficial burn
Critical burn
Full thickness burns involving the hands are automatically classified as critical burns regardless
, 4|Page
of the percentage of TBSA involved. The hand is a critical area due to its functional importance,
potential for contracture deformities, and difficulty with rehabilitation if not treated at a
specialized burn center.
Question 7
A patient presents with black, tarry stools after complaining of abdominal pain. What is the
correct medical term for this finding?
A) Hematemesis
B) Hemoptysis
C) Melena
D) Hematochezia
Melena
Melena specifically refers to black, tarry stools resulting from upper gastrointestinal bleeding
where blood has been digested by intestinal enzymes and bacteria. Hematemesis is vomiting
blood, hemoptysis is coughing up blood, and hematochezia is bright red blood in stool from
lower GI bleeding.
Question 8
During an MVA, a patient experiences sudden chest compression from the steering wheel. He
presents with a purple discoloration of his head, neck, and upper chest. What condition should
you suspect?
A) Commotio cordis
B) Traumatic asphyxia
C) Hemothorax
D) Spontaneous pneumothorax
Traumatic asphyxia
Traumatic asphyxia occurs from sudden severe chest compression forcing blood from the heart
backward into the head and neck veins, causing characteristic petechiae and purple
discoloration above the compression site. This condition is commonly seen in MVAs and crush
injuries, resulting from the sudden increase in intrathoracic pressure.
Question 9
A 16-year-old baseball player is struck in the chest by a pitch and immediately collapses. What
cardiac rhythm is most likely causing this sudden collapse?
A) Bradycardia
B) Ventricular fibrillation
