CFRN ACE GENERAL MEDICINE QUESTIONS &
ANSWERS
Which of the following patients has the highest degree of shock?
30 year old male. Found unresponsive behind gas station with signs of head trauma
and a deformed right arm. GCS 3. HR 110. BP 98/62.
86 year old female after fall down concrete steps. GCS 11. HR 110, BP
212/106.
54 year old female. Lateral impact MVA. Wishes to refuse transport to the hospital. GCS
15. HR 100. BP 106/54.
24 year old male. GSW to femur. GCS 15. HR 140, BP 82/40. - Answer -24 year old
male. Elevated HR low BP
A baby was rescued from a house fire. His entire torso (front and back) has full-
thickness burns.
He has partial burns to the entire left arm and entire left leg. How much fluid should the
baby receive in the first 8 hours post burn if he is 3 kg? - Answer -357 mL
Which of the following patients who were in a structure fire should be intubated without
delay? - Answer -Patient presenting with carbonaceous sputum
Indicates impending swelling and closing of the airway.
A patient with altered mental status has been pulled from a car that was found on fire in
an alleyway. There is no obvious signs that the car was involved in a collision. The
patient has extensive second and third degree burns over most of his body. Vital signs
are P166, R34, BP 64/26, Sp02 100%. This patient almost certainly has - Answer -A
traumatic injury that is not immediately apparent.
Which of the following injuries would you NOT usually predict in the 8 year old who was
struck by a moving vehicle? - Answer -Contusions on the front of the head
Contrecoup injury
Liver laceration
Femur fracture
The pediatric burn patient should be fluid resuscitated to a goal of - Answer -Urine
output of 1 mL/kg/hr
, You are transporting a 56 year old female who was found unresponsive at the bottom of
her basement steps from a freestanding ED to a level 1 trauma center for a
neurosurgical evaluation.
She is intubated and is mechanically ventilated. CT of her head shows a large bright
white starfish pattern on her CT. Vital signs are P 48, R14, BP 200/110, SpO2 98%,
ETCO2 36 mmHg. During transport you decide to treat her blood pressure with
nicardipine. What is the most appropriate systolic blood pressure target for this patient?
- Answer -160 mmHg
Which of the following is considered to be the fluid of choice for burn resuscitation? -
Answer -Lactated Ringers
You are preparing to perform a rapid sequence intubation on a combative patient with a
GCS of 7 who was extricated from a vehicle after a high-mechanism MVA. Vital signs P
156, RR 38, BP 104/52, Sp02 98%. Lung sounds are equal bilaterally. Blood glucose is
78 mg/dL. Infared temperature is
100.4 F. POCUS shows blood in morrison's pouch and kerley B lines in lung fields.
There is lung slide present. The patient is noted to be wearing a medical alert bracelet
that he has a history of an Arnold-Chieri Malformation. What should you HIGHLY
consider when administering RSI drugs to this patient? - Answer -Administering a
reduced dose of an induction agent
The patient is a 24 year old male who crashed a sedan into a tree at high speed. He is
entrapped in the vehicle and is complaining of severe abdominal pain. There is no
evidence of head trauma.
When the car is cut away from the patient is appears that he took the "down and under"
pathway in his accident. In addition to abdominal trauma you would expect to find -
Answer -Femur fractures
Which of the following traumatic events is most likely to cause a liver laceration?
Fall from >20 feet
GSW to pelvis
Frontal impact MVA
Rear-end MVA - Answer -GSW to Pelvis
21 year old female was shot two times in the torso. She is delivered to a community
hospital and you are called to transport her to a Level 1 trauma center. The sending
provider advises you that the patient was intubated successfully and is currently being
well-sedated with Propofol and fentanyl. She has bilateral chest tubes with water seals.
She is currently receiving her fifth unit of whole blood. Vent settings are volume assist
control, Vt 380, f 20, FiO2 0.7, PEEP 6. Vital signs P 104, BP 108/76m, R 20, SpO2
96%. During the transport you review the patient's hospital paperwork and review her
ANSWERS
Which of the following patients has the highest degree of shock?
30 year old male. Found unresponsive behind gas station with signs of head trauma
and a deformed right arm. GCS 3. HR 110. BP 98/62.
86 year old female after fall down concrete steps. GCS 11. HR 110, BP
212/106.
54 year old female. Lateral impact MVA. Wishes to refuse transport to the hospital. GCS
15. HR 100. BP 106/54.
24 year old male. GSW to femur. GCS 15. HR 140, BP 82/40. - Answer -24 year old
male. Elevated HR low BP
A baby was rescued from a house fire. His entire torso (front and back) has full-
thickness burns.
He has partial burns to the entire left arm and entire left leg. How much fluid should the
baby receive in the first 8 hours post burn if he is 3 kg? - Answer -357 mL
Which of the following patients who were in a structure fire should be intubated without
delay? - Answer -Patient presenting with carbonaceous sputum
Indicates impending swelling and closing of the airway.
A patient with altered mental status has been pulled from a car that was found on fire in
an alleyway. There is no obvious signs that the car was involved in a collision. The
patient has extensive second and third degree burns over most of his body. Vital signs
are P166, R34, BP 64/26, Sp02 100%. This patient almost certainly has - Answer -A
traumatic injury that is not immediately apparent.
Which of the following injuries would you NOT usually predict in the 8 year old who was
struck by a moving vehicle? - Answer -Contusions on the front of the head
Contrecoup injury
Liver laceration
Femur fracture
The pediatric burn patient should be fluid resuscitated to a goal of - Answer -Urine
output of 1 mL/kg/hr
, You are transporting a 56 year old female who was found unresponsive at the bottom of
her basement steps from a freestanding ED to a level 1 trauma center for a
neurosurgical evaluation.
She is intubated and is mechanically ventilated. CT of her head shows a large bright
white starfish pattern on her CT. Vital signs are P 48, R14, BP 200/110, SpO2 98%,
ETCO2 36 mmHg. During transport you decide to treat her blood pressure with
nicardipine. What is the most appropriate systolic blood pressure target for this patient?
- Answer -160 mmHg
Which of the following is considered to be the fluid of choice for burn resuscitation? -
Answer -Lactated Ringers
You are preparing to perform a rapid sequence intubation on a combative patient with a
GCS of 7 who was extricated from a vehicle after a high-mechanism MVA. Vital signs P
156, RR 38, BP 104/52, Sp02 98%. Lung sounds are equal bilaterally. Blood glucose is
78 mg/dL. Infared temperature is
100.4 F. POCUS shows blood in morrison's pouch and kerley B lines in lung fields.
There is lung slide present. The patient is noted to be wearing a medical alert bracelet
that he has a history of an Arnold-Chieri Malformation. What should you HIGHLY
consider when administering RSI drugs to this patient? - Answer -Administering a
reduced dose of an induction agent
The patient is a 24 year old male who crashed a sedan into a tree at high speed. He is
entrapped in the vehicle and is complaining of severe abdominal pain. There is no
evidence of head trauma.
When the car is cut away from the patient is appears that he took the "down and under"
pathway in his accident. In addition to abdominal trauma you would expect to find -
Answer -Femur fractures
Which of the following traumatic events is most likely to cause a liver laceration?
Fall from >20 feet
GSW to pelvis
Frontal impact MVA
Rear-end MVA - Answer -GSW to Pelvis
21 year old female was shot two times in the torso. She is delivered to a community
hospital and you are called to transport her to a Level 1 trauma center. The sending
provider advises you that the patient was intubated successfully and is currently being
well-sedated with Propofol and fentanyl. She has bilateral chest tubes with water seals.
She is currently receiving her fifth unit of whole blood. Vent settings are volume assist
control, Vt 380, f 20, FiO2 0.7, PEEP 6. Vital signs P 104, BP 108/76m, R 20, SpO2
96%. During the transport you review the patient's hospital paperwork and review her
