1. A 45-year-old male fell down the stairs and is unresponsive and apneic. When you ventilate
him, you notice his neck is swelling and he has minimal chest rise. What should you suspect?
A) Tension pneumothorax
B) Tracheal disruption
C) Cardiac tamponade
D) Flail chest
Subcutaneous emphysema plus poor chest rise with ventilation suggests tracheal or bronchial
injury.
2. What is Beck's triad?
A) Hypotension, tachycardia, and tachypnea
B) Hypotension, JVD, and muffled heart sounds
C) Fever, hypotension, and altered mental status
D) Bradycardia, hypertension, and irregular breathing
Beck’s triad is classic for cardiac tamponade, often from penetrating or blunt chest trauma.
3. What is the most appropriate treatment for a sucking chest wound?
A) Apply direct pressure with a gloved hand
B) Apply an occlusive dressing
C) Insert a chest tube
D) Pack the wound with gauze
An occlusive dressing prevents air from entering the pleural space during inspiration.
4. A 25-year-old male is an unrestrained driver in a car crash. He denies loss of consciousness.
Initial vitals: BP 100/60, P 120, R 18, lungs clear. He suddenly feels dizzy. Repeat vitals: BP
80/40, P 131, R 20. What should you suspect?
A) Simple pneumothorax
B) Delayed hemorrhagic shock from occult injury
C) Cardiogenic shock
,D) Neurogenic shock
Falling BP with rising HR after blunt trauma indicates bleeding, often from spleen or liver.
5. A 46-year-old female was pepper sprayed in the face. What should you do?
A) Administer albuterol nebulizer
B) Irrigate eyes with saline or water and move to fresh air
C) Apply a non-rebreather mask
D) Administer diphenhydramine IM
Pepper spray is an irritant; decontamination and removal from source are priority.
6. A 21-year-old male tripped and fell into a small camp fire. He has partial thickness burns to
his hands, anterior forearms, and upper chest. What percentage of his body has been burned?
A) 9%
B) 15%
C) 18%
D) 27%
*Rule of nines: each hand 1% (front and back combined = 1% per hand? Actually per hand 1%
anterior? Standard: anterior arm 4.5% total for each arm – simplified: hands 1% each, anterior
forearms 2% each, anterior chest 9% = 15%.*
7. A 23-year-old male fell from the top story of a two-story building breaking his femur. There is
bright red blood spurting from the wound. What should you do?
A) Apply direct pressure
B) Apply a tourniquet above the wound
C) Apply a pressure dressing
D) Elevate the leg
Spurting bright red blood indicates arterial hemorrhage; tourniquet is life-saving.
8. A 62-year-old male has a mid-shaft femur deformity with swelling after an MVA. He has no
other injuries, and his vital signs are stable. What should you do?
A) Apply a pelvic binder
B) Apply a traction splint to his leg
C) Transport without splinting
,D) Apply a long spine board only
Isolated stable femur fracture with no pelvic or spine injury may benefit from traction splint.
9. A 35-year-old patient is unresponsive after a motor vehicle collision. You observe paradoxical
movement during respiration. Vital signs: BP 104/72, P 120, R 32 shallow, SpO2 89%. What
should you do?
A) Apply a non-rebreather mask
B) Assist the patient’s ventilations
C) Needle decompress the chest
D) Apply CPAP
Paradoxical movement suggests flail chest; shallow tachypnea and hypoxia require BVM
support.
10. What is the common cause of pulmonary contusions?
A) Penetrating trauma
B) Deceleration trauma
C) Blast overpressure
D) Inhalation injury
Deceleration causes the lung to strike the chest wall, leading to bruising without external injury.
11. An alert 22-year-old male fell 15 feet while skateboarding down a flight of stairs. He cannot
move or feel anything from his shoulders down and you notice inadequate chest rise. Where
should you suspect a fracture?
A) C1
B) C3
C) C5
D) T1
Quadriplegia with diaphragmatic breathing (C3–C5 phrenic nerve) but poor intercostal function
suggests lesion at C3.
12. What is a pathognomonic sign of neurogenic shock?
A) Bradycardia
B) Vasodilation
C) Hypothermia
, D) Diaphoresis
Neurogenic shock causes loss of sympathetic tone → vasodilation and warm, dry skin.
13. A 72-year-old is lying in bed and complains of severe pain in her thigh after falling the day
before. You observe bruising and swelling. The extremity is firm, pale, and cool distal to the
injury. What is the most probable cause?
A) Deep vein thrombosis
B) Compartment syndrome
C) Arterial occlusion
D) Rhabdomyolysis
Pain out of proportion, pallor, coolness, and firmness after injury suggest compartment
syndrome.
14. Which of the following is required when splinting a long bone?
A) Cover all wounds first
B) Immobilize the joints above and below
C) Apply traction before splinting
D) Check pulses after only
Proper splinting requires stabilizing the bone by immobilizing adjacent joints.
15. You are ventilating a 23-year-old female. You notice JVD and decreased lung sounds on the
left. What should you suspect?
A) Massive hemothorax
B) Tension pneumothorax
C) Pericardial tamponade
D) Simple pneumothorax
JVD + absent breath sounds + positive pressure ventilation = tension pneumothorax until
proven.
16. A 44-year-old female is unresponsive after being trapped under heavy debris. Upon removal,
her eyes are bloodshot, and vital signs are P 38, R 8 and shallow, and inaudible BP. What should
you do?
A) Start CPR immediately
B) Ventilate with high-flow oxygen and prepare for transport
him, you notice his neck is swelling and he has minimal chest rise. What should you suspect?
A) Tension pneumothorax
B) Tracheal disruption
C) Cardiac tamponade
D) Flail chest
Subcutaneous emphysema plus poor chest rise with ventilation suggests tracheal or bronchial
injury.
2. What is Beck's triad?
A) Hypotension, tachycardia, and tachypnea
B) Hypotension, JVD, and muffled heart sounds
C) Fever, hypotension, and altered mental status
D) Bradycardia, hypertension, and irregular breathing
Beck’s triad is classic for cardiac tamponade, often from penetrating or blunt chest trauma.
3. What is the most appropriate treatment for a sucking chest wound?
A) Apply direct pressure with a gloved hand
B) Apply an occlusive dressing
C) Insert a chest tube
D) Pack the wound with gauze
An occlusive dressing prevents air from entering the pleural space during inspiration.
4. A 25-year-old male is an unrestrained driver in a car crash. He denies loss of consciousness.
Initial vitals: BP 100/60, P 120, R 18, lungs clear. He suddenly feels dizzy. Repeat vitals: BP
80/40, P 131, R 20. What should you suspect?
A) Simple pneumothorax
B) Delayed hemorrhagic shock from occult injury
C) Cardiogenic shock
,D) Neurogenic shock
Falling BP with rising HR after blunt trauma indicates bleeding, often from spleen or liver.
5. A 46-year-old female was pepper sprayed in the face. What should you do?
A) Administer albuterol nebulizer
B) Irrigate eyes with saline or water and move to fresh air
C) Apply a non-rebreather mask
D) Administer diphenhydramine IM
Pepper spray is an irritant; decontamination and removal from source are priority.
6. A 21-year-old male tripped and fell into a small camp fire. He has partial thickness burns to
his hands, anterior forearms, and upper chest. What percentage of his body has been burned?
A) 9%
B) 15%
C) 18%
D) 27%
*Rule of nines: each hand 1% (front and back combined = 1% per hand? Actually per hand 1%
anterior? Standard: anterior arm 4.5% total for each arm – simplified: hands 1% each, anterior
forearms 2% each, anterior chest 9% = 15%.*
7. A 23-year-old male fell from the top story of a two-story building breaking his femur. There is
bright red blood spurting from the wound. What should you do?
A) Apply direct pressure
B) Apply a tourniquet above the wound
C) Apply a pressure dressing
D) Elevate the leg
Spurting bright red blood indicates arterial hemorrhage; tourniquet is life-saving.
8. A 62-year-old male has a mid-shaft femur deformity with swelling after an MVA. He has no
other injuries, and his vital signs are stable. What should you do?
A) Apply a pelvic binder
B) Apply a traction splint to his leg
C) Transport without splinting
,D) Apply a long spine board only
Isolated stable femur fracture with no pelvic or spine injury may benefit from traction splint.
9. A 35-year-old patient is unresponsive after a motor vehicle collision. You observe paradoxical
movement during respiration. Vital signs: BP 104/72, P 120, R 32 shallow, SpO2 89%. What
should you do?
A) Apply a non-rebreather mask
B) Assist the patient’s ventilations
C) Needle decompress the chest
D) Apply CPAP
Paradoxical movement suggests flail chest; shallow tachypnea and hypoxia require BVM
support.
10. What is the common cause of pulmonary contusions?
A) Penetrating trauma
B) Deceleration trauma
C) Blast overpressure
D) Inhalation injury
Deceleration causes the lung to strike the chest wall, leading to bruising without external injury.
11. An alert 22-year-old male fell 15 feet while skateboarding down a flight of stairs. He cannot
move or feel anything from his shoulders down and you notice inadequate chest rise. Where
should you suspect a fracture?
A) C1
B) C3
C) C5
D) T1
Quadriplegia with diaphragmatic breathing (C3–C5 phrenic nerve) but poor intercostal function
suggests lesion at C3.
12. What is a pathognomonic sign of neurogenic shock?
A) Bradycardia
B) Vasodilation
C) Hypothermia
, D) Diaphoresis
Neurogenic shock causes loss of sympathetic tone → vasodilation and warm, dry skin.
13. A 72-year-old is lying in bed and complains of severe pain in her thigh after falling the day
before. You observe bruising and swelling. The extremity is firm, pale, and cool distal to the
injury. What is the most probable cause?
A) Deep vein thrombosis
B) Compartment syndrome
C) Arterial occlusion
D) Rhabdomyolysis
Pain out of proportion, pallor, coolness, and firmness after injury suggest compartment
syndrome.
14. Which of the following is required when splinting a long bone?
A) Cover all wounds first
B) Immobilize the joints above and below
C) Apply traction before splinting
D) Check pulses after only
Proper splinting requires stabilizing the bone by immobilizing adjacent joints.
15. You are ventilating a 23-year-old female. You notice JVD and decreased lung sounds on the
left. What should you suspect?
A) Massive hemothorax
B) Tension pneumothorax
C) Pericardial tamponade
D) Simple pneumothorax
JVD + absent breath sounds + positive pressure ventilation = tension pneumothorax until
proven.
16. A 44-year-old female is unresponsive after being trapped under heavy debris. Upon removal,
her eyes are bloodshot, and vital signs are P 38, R 8 and shallow, and inaudible BP. What should
you do?
A) Start CPR immediately
B) Ventilate with high-flow oxygen and prepare for transport
