Prehospital Emergency Care Chapter #31
1) A patient who was involved in an altercation was struck on the side
of the head with a baseball bat, in addition to suffering several blows to
the arms and legs. When assessing this patient, which sign or symptom
best indicates the patient has suffered a brain injury?
A) Confusion and combativeness
B) Complaint of a headache
C) Ecchymosis to the side of the face
D) Weakness to both arms - ANSWERSA) Confusion and combativeness
2) A 21-year-old male has a gunshot wound to the head. As you assess
him, which finding would you recognize as a nonpurposeful response to
pain?
A) Garbled and incomprehensible speech when you call his name
B) Flexing his arms across his chest when you pinch his shoulder
C) Attempting to move his hand away from you as you pinch it
D) Exhibiting no response to any stimuli - ANSWERSB) Flexing his arms
across his chest when you pinch his shoulder
3) Which patient has an isolated brain injury that should be considered
the most serious?
A) A 31-year-old male who fell from a roof and who is now nonverbal
and extends his arms and legs when you pinch the muscles on his
shoulder
pg. 1
,B) A 62-year-old female who fell and hit her head and who is becoming
more confused and combative
C) A 53-year-old female who crashed her bicycle and who has a large
laceration that is bleeding heavily on the back of her head
D) A 21-year-old male wearing a deformed motorcycle helmet who
does not respond to verbal or painful stimuli after crashing -
ANSWERSD) A 21-year-old male wearing a deformed motorcycle
helmet who does not respond to verbal or painful stimuli after crashing
4) You are assessing the pupils of a patient who hit his head after falling
from the top of a tractor trailer. Which pupillary finding suggests a
closed head injury?
A) The right pupil constricts when light is shined into the left pupil
B) Both pupils dilate when light is shielded from the eyes
C) Both the left and right pupils constrict vigorously in response to light
D) The left pupil constricts to light but the right pupil does not -
ANSWERSD) The left pupil constricts to light but the right pupil does not
5) A 68-year-old female patient complains of a headache and
generalized weakness. Her husband informs you that she was with a
friend yesterday and was involved in a motor vehicle collision. She did
strike her face on the dashboard, but refused treatment on scene. Her
past medical history includes a stroke with right arm weakness and high
blood pressure, for which she takes medications. When assessing this
patient, which finding should concern the EMT most?
A) Contusion to her left cheek area
pg. 2
, B) Weakness to the right-hand grip
C) Bruising behind her left ear
D) Complaint of pain when she moves her jaw - ANSWERSC) Bruising
behind her left ear
6) The EMT is properly assessing for sensory function in the hands when
he tells or asks the patient:
A) "Squeeze my fingers with both hands."
B) "Can you tell me which finger I am touching?"
C) "Do you feel me touching your right hand?"
D) "Can you wiggle your fingers?" - ANSWERSB) "Can you tell me which
finger I am touching?"
7) A patient was ejected from a car when it overturned at a high rate of
speed. The patient is unresponsive. The primary assessment is
complete and you are providing positive pressure ventilation with
supplemental oxygen. The patient has a significant deformity to the
right side of his head, and both pupils are equal but slow to react to
light. The patient also has deformity to the forearms. Vital signs are
pulse, 144 beats/min; respirations, 24 breaths/min and inadequate;
blood pressure, 90/50 mmHg; and SpO2, 97%. Based on this
presentation, the EMT should:
A) Look for evidence of bleeding in an area of the body other than the
brain
B) Reassess the pupils and treat the patient for a severe head injury
pg. 3
1) A patient who was involved in an altercation was struck on the side
of the head with a baseball bat, in addition to suffering several blows to
the arms and legs. When assessing this patient, which sign or symptom
best indicates the patient has suffered a brain injury?
A) Confusion and combativeness
B) Complaint of a headache
C) Ecchymosis to the side of the face
D) Weakness to both arms - ANSWERSA) Confusion and combativeness
2) A 21-year-old male has a gunshot wound to the head. As you assess
him, which finding would you recognize as a nonpurposeful response to
pain?
A) Garbled and incomprehensible speech when you call his name
B) Flexing his arms across his chest when you pinch his shoulder
C) Attempting to move his hand away from you as you pinch it
D) Exhibiting no response to any stimuli - ANSWERSB) Flexing his arms
across his chest when you pinch his shoulder
3) Which patient has an isolated brain injury that should be considered
the most serious?
A) A 31-year-old male who fell from a roof and who is now nonverbal
and extends his arms and legs when you pinch the muscles on his
shoulder
pg. 1
,B) A 62-year-old female who fell and hit her head and who is becoming
more confused and combative
C) A 53-year-old female who crashed her bicycle and who has a large
laceration that is bleeding heavily on the back of her head
D) A 21-year-old male wearing a deformed motorcycle helmet who
does not respond to verbal or painful stimuli after crashing -
ANSWERSD) A 21-year-old male wearing a deformed motorcycle
helmet who does not respond to verbal or painful stimuli after crashing
4) You are assessing the pupils of a patient who hit his head after falling
from the top of a tractor trailer. Which pupillary finding suggests a
closed head injury?
A) The right pupil constricts when light is shined into the left pupil
B) Both pupils dilate when light is shielded from the eyes
C) Both the left and right pupils constrict vigorously in response to light
D) The left pupil constricts to light but the right pupil does not -
ANSWERSD) The left pupil constricts to light but the right pupil does not
5) A 68-year-old female patient complains of a headache and
generalized weakness. Her husband informs you that she was with a
friend yesterday and was involved in a motor vehicle collision. She did
strike her face on the dashboard, but refused treatment on scene. Her
past medical history includes a stroke with right arm weakness and high
blood pressure, for which she takes medications. When assessing this
patient, which finding should concern the EMT most?
A) Contusion to her left cheek area
pg. 2
, B) Weakness to the right-hand grip
C) Bruising behind her left ear
D) Complaint of pain when she moves her jaw - ANSWERSC) Bruising
behind her left ear
6) The EMT is properly assessing for sensory function in the hands when
he tells or asks the patient:
A) "Squeeze my fingers with both hands."
B) "Can you tell me which finger I am touching?"
C) "Do you feel me touching your right hand?"
D) "Can you wiggle your fingers?" - ANSWERSB) "Can you tell me which
finger I am touching?"
7) A patient was ejected from a car when it overturned at a high rate of
speed. The patient is unresponsive. The primary assessment is
complete and you are providing positive pressure ventilation with
supplemental oxygen. The patient has a significant deformity to the
right side of his head, and both pupils are equal but slow to react to
light. The patient also has deformity to the forearms. Vital signs are
pulse, 144 beats/min; respirations, 24 breaths/min and inadequate;
blood pressure, 90/50 mmHg; and SpO2, 97%. Based on this
presentation, the EMT should:
A) Look for evidence of bleeding in an area of the body other than the
brain
B) Reassess the pupils and treat the patient for a severe head injury
pg. 3
