EMT FISDAP TRAUMA EXAM PREDICTIVE | 200
QUESTIONS WITH CORRECT ANSWERS AND RATIONALES
| VERIFIED CONTENT
Question 1
A 22-year-old male was involved in a high-speed motor vehicle collision.
He is complaining of severe diffuse abdominal pain. His blood pressure
is 88/62 mmHg, heart rate is 122 bpm, and respirations are 24 per
minute. His abdomen is distended and tender to palpation in all four
quadrants. Which of the following is the most likely underlying cause of
his presentation?
A) Ruptured aortic aneurysm
B) Isolated liver laceration
C) Significant intra-abdominal hemorrhage
D) Tension pneumothorax
Correct Answer: C) Significant intra-abdominal hemorrhage
Rationale: Blunt abdominal trauma can cause solid organ injury leading
to significant blood loss. The presentation of hypotension, tachycardia,
and a distended, tender abdomen points toward intra-abdominal
hemorrhage. The abdomen can hide a large volume of blood.
Question 2
A patient has sustained a deep laceration to the anterior neck, just
lateral to the trachea. Bubbling is noted from the wound when the
patient breathes. What is the most immediate life-threatening
complication you should anticipate?
,A) Air embolism
B) Hemorrhagic shock
C) Airway obstruction from edema
D) Tension pneumothorax
Correct Answer: A) Air embolism
Rationale: A laceration to the neck that involves the jugular vein can
draw air into the venous system during inspiration due to negative
intrathoracic pressure. An air embolism can travel to the heart or lungs,
causing a fatal obstruction of blood flow.
Question 3
A construction worker fell 20 feet from scaffolding. He is responsive to
pain only and has a large contusion on the right side of his chest. His
trachea is deviated to the left, and breath sounds are absent on the
right. Jugular veins are distended. What is the priority intervention for
this patient?
A) Apply a non-rebreather mask at 15 LPM
B) Perform a needle thoracentesis on the right side
C) Perform a needle thoracentesis on the left side
D) Initiate positive pressure ventilation
Correct Answer: B) Perform a needle thoracentesis on the right side
Rationale: The patient is exhibiting classic signs of a tension
pneumothorax: tracheal deviation away from the affected side, absent
breath sounds, and JVD. The immediate treatment is needle
decompression on the affected side (right), typically at the second
intercostal space, midclavicular line.
Question 4
Which of the following findings is the most indicative of a basilar skull
fracture?
,A) Periorbital ecchymosis
B) Clear fluid draining from the ear
C) A depressed skull fracture visible on palpation
D) Unequal pupil size
Correct Answer: B) Clear fluid draining from the ear
Rationale: Clear fluid from the ear (otorrhea) or nose (rhinorrhea) that
tests positive for glucose is cerebrospinal fluid (CSF) and is a hallmark
sign of a basilar skull fracture. Raccoon eyes and Battle's sign are also
indicative but are not considered as immediate a confirmation of a CSF
leak as the presence of clear fluid.
Question 5
An 18-year-old male was stabbed in the right anterior chest. He is in
severe respiratory distress with absent breath sounds on the right. His
neck veins are flat, and his skin is pale and diaphoretic. Which injury
should you suspect?
A) Tension pneumothorax
B) Pericardial tamponade
C) Simple pneumothorax with significant external blood loss
D) Massive hemothorax
Correct Answer: D) Massive hemothorax
Rationale: A hemothorax is blood in the pleural space. A massive
hemothorax (over 1500 mL of blood) can cause respiratory distress and
signs of hypovolemic shock (pale, diaphoretic skin). JVD is often absent
in hemothorax because the patient is hypovolemic, unlike in tension
pneumothorax where the JVD is present due to impaired venous return.
Question 6
A patient has a gunshot wound to the left thigh. There is a large,
actively bleeding wound. After applying direct pressure and a pressure
, dressing, the wound continues to bleed heavily. Which of the following
is the most appropriate next step?
A) Apply a tourniquet as high as possible on the limb
B) Elevate the leg
C) Apply a second pressure dressing directly on top of the first
D) Pack the wound with hemostatic gauze and apply more pressure
Correct Answer: A) Apply a tourniquet as high as possible on the limb
Rationale: In cases of life-threatening extremity hemorrhage that is not
controlled by direct pressure, a tourniquet is indicated. The tourniquet
should be placed 2-3 inches above the wound, but never over a joint. If
a single tourniquet fails to stop the bleeding, a second should be
applied.
Question 7
A 45-year-old male is trapped in a vehicle after a head-on collision. He is
complaining of severe pain in both of his legs, which are crushed against
the dashboard. What is the primary complication you must monitor for
in this patient?
A) Internal bleeding in the abdomen
B) Compartment syndrome
C) Pelvic fracture
D) Crush syndrome
Correct Answer: D) Crush syndrome
Rationale: Crush syndrome occurs when a large muscle mass is
compressed, leading to rhabdomyolysis. When the crushing force is
released, damaged muscle cells release myoglobin, potassium, and
phosphorus into the bloodstream, which can lead to acute renal failure
and cardiac dysrhythmias.
QUESTIONS WITH CORRECT ANSWERS AND RATIONALES
| VERIFIED CONTENT
Question 1
A 22-year-old male was involved in a high-speed motor vehicle collision.
He is complaining of severe diffuse abdominal pain. His blood pressure
is 88/62 mmHg, heart rate is 122 bpm, and respirations are 24 per
minute. His abdomen is distended and tender to palpation in all four
quadrants. Which of the following is the most likely underlying cause of
his presentation?
A) Ruptured aortic aneurysm
B) Isolated liver laceration
C) Significant intra-abdominal hemorrhage
D) Tension pneumothorax
Correct Answer: C) Significant intra-abdominal hemorrhage
Rationale: Blunt abdominal trauma can cause solid organ injury leading
to significant blood loss. The presentation of hypotension, tachycardia,
and a distended, tender abdomen points toward intra-abdominal
hemorrhage. The abdomen can hide a large volume of blood.
Question 2
A patient has sustained a deep laceration to the anterior neck, just
lateral to the trachea. Bubbling is noted from the wound when the
patient breathes. What is the most immediate life-threatening
complication you should anticipate?
,A) Air embolism
B) Hemorrhagic shock
C) Airway obstruction from edema
D) Tension pneumothorax
Correct Answer: A) Air embolism
Rationale: A laceration to the neck that involves the jugular vein can
draw air into the venous system during inspiration due to negative
intrathoracic pressure. An air embolism can travel to the heart or lungs,
causing a fatal obstruction of blood flow.
Question 3
A construction worker fell 20 feet from scaffolding. He is responsive to
pain only and has a large contusion on the right side of his chest. His
trachea is deviated to the left, and breath sounds are absent on the
right. Jugular veins are distended. What is the priority intervention for
this patient?
A) Apply a non-rebreather mask at 15 LPM
B) Perform a needle thoracentesis on the right side
C) Perform a needle thoracentesis on the left side
D) Initiate positive pressure ventilation
Correct Answer: B) Perform a needle thoracentesis on the right side
Rationale: The patient is exhibiting classic signs of a tension
pneumothorax: tracheal deviation away from the affected side, absent
breath sounds, and JVD. The immediate treatment is needle
decompression on the affected side (right), typically at the second
intercostal space, midclavicular line.
Question 4
Which of the following findings is the most indicative of a basilar skull
fracture?
,A) Periorbital ecchymosis
B) Clear fluid draining from the ear
C) A depressed skull fracture visible on palpation
D) Unequal pupil size
Correct Answer: B) Clear fluid draining from the ear
Rationale: Clear fluid from the ear (otorrhea) or nose (rhinorrhea) that
tests positive for glucose is cerebrospinal fluid (CSF) and is a hallmark
sign of a basilar skull fracture. Raccoon eyes and Battle's sign are also
indicative but are not considered as immediate a confirmation of a CSF
leak as the presence of clear fluid.
Question 5
An 18-year-old male was stabbed in the right anterior chest. He is in
severe respiratory distress with absent breath sounds on the right. His
neck veins are flat, and his skin is pale and diaphoretic. Which injury
should you suspect?
A) Tension pneumothorax
B) Pericardial tamponade
C) Simple pneumothorax with significant external blood loss
D) Massive hemothorax
Correct Answer: D) Massive hemothorax
Rationale: A hemothorax is blood in the pleural space. A massive
hemothorax (over 1500 mL of blood) can cause respiratory distress and
signs of hypovolemic shock (pale, diaphoretic skin). JVD is often absent
in hemothorax because the patient is hypovolemic, unlike in tension
pneumothorax where the JVD is present due to impaired venous return.
Question 6
A patient has a gunshot wound to the left thigh. There is a large,
actively bleeding wound. After applying direct pressure and a pressure
, dressing, the wound continues to bleed heavily. Which of the following
is the most appropriate next step?
A) Apply a tourniquet as high as possible on the limb
B) Elevate the leg
C) Apply a second pressure dressing directly on top of the first
D) Pack the wound with hemostatic gauze and apply more pressure
Correct Answer: A) Apply a tourniquet as high as possible on the limb
Rationale: In cases of life-threatening extremity hemorrhage that is not
controlled by direct pressure, a tourniquet is indicated. The tourniquet
should be placed 2-3 inches above the wound, but never over a joint. If
a single tourniquet fails to stop the bleeding, a second should be
applied.
Question 7
A 45-year-old male is trapped in a vehicle after a head-on collision. He is
complaining of severe pain in both of his legs, which are crushed against
the dashboard. What is the primary complication you must monitor for
in this patient?
A) Internal bleeding in the abdomen
B) Compartment syndrome
C) Pelvic fracture
D) Crush syndrome
Correct Answer: D) Crush syndrome
Rationale: Crush syndrome occurs when a large muscle mass is
compressed, leading to rhabdomyolysis. When the crushing force is
released, damaged muscle cells release myoglobin, potassium, and
phosphorus into the bloodstream, which can lead to acute renal failure
and cardiac dysrhythmias.
