11) The elderly patient in shock may be less likely to exhibit which of the following expected manifestations of shock? A) Cardiac arrhythmias B) Hypothermia C) Altered mental status D) Tachycardia 12) Which of the following statements about the pediatric pedestrian who is struck by a vehicle is NOT true? A) A child commonly turns toward the oncoming vehicle at the moment of impact. B) Smaller children are likely to suffer fractures of the tibia and fibula as a result of impact with the vehicle’s bumper. C) A smaller child is more likely to be thrown to the ground following initial impact, versus being thrown onto the hood. D) Anatomically, the injuries caused by the initial impact of the vehicle will be higher on the body than in an adult. 13) Which of the following best describes the significance of finding an abrasion during the prehospital assessment of the trauma patient? A) Abrasions are superficial wounds and not of particular concern in the prehospital setting. B) There is a risk of infection. C) It increases the risk of hemorrhagic shock. D) It is a possible indication of more significant trauma beneath the abrasion. 14) A thorough inspection of the trauma patient can be best performed if which of the following guidelines is used? A) Assess for tenderness, the ability to move, and distal sensation and circulation. B) Assess for abnormalities in skin color, deformity of any part of the body, and any disruption of the skin. C) Assess for deformity, swelling, and angulation of any part of the body. D) Assess for pulse, paresthesia, pallor, and pain. 15) Your patient is a 24-year-old female driver of a vehicle in a motor vehicle collision. She rear-ended a vehicle stopped at a traffic light at about 25 miles per hour. She was restrained, and the front airbags deployed. She is 32 weeks pregnant. She is anxious because she has not felt the baby move since the impact, and she is complaining of constant pain on the left side of her abdomen. Palpation of the abdomen reveals unusual firmness over the left side of the abdomen. The patient has a pulse of 116, a blood pressure of 92/60, and respirations of 28. Her skin is cool but dry, and she has no other complaints. For which of the following should you have the highest index of suspicion? A) Placenta previa B) Placenta accreta C) Abruptio placentae D) Stress-induced onset of labor 16) Which of the following has the greatest potential for reducing injury-related morbidity and mortality? A) Injury-prevention activities B) Increased funding for rural EMS system development C) Increasing the scope of practice of paramedics to include such lifesaving procedures as pericardiocentesis and trephination of the skull to reduce intracranial pressure D) Using physicians and physician’s assistants as prehospital care providers 17) Which of the following is the most likely indicator of intraabdominal hemorrhage in the prehospital setting? A) Distension and/or rigidity of the abdomen on palpation B) Rebound tenderness of the abdomen on palpation C) Ecchymosis of the abdomen or flanks D) Signs and symptoms of hypovolemia unexplained by other injuries 18) Your patient is a 23-year-old female victim of an attempted abduction at knifepoint. The assailant was interrupted and drew his knife across the victim’s throat as he fled the scene. A first responder on the scene immediately applied direct pressure to the neck wound. Your assessment reveals a very agitated young woman with ongoing blood loss despite direct pressure to the wound. There appears to be both bright-red bleeding and slower but steady dark-red bleeding. It appears that the trachea has not been penetrated but that there is a hematoma around the laceration. Which of the following is the most appropriate sequence of intervention for this patient? A) Apply a pressure dressing to the wound, accompanied by pressure-point compression. B) Use rapid sequence intubation of the patient to protect the trachea from the expanding hematoma while maintaining direct pressure on the wound. C) Apply an occlusive dressing to the wound, and continue direct pressure. D) Apply direct pressure, and request an order from medical control to decompress the hematoma. 19) A critical trauma patient should be reassessed every ________ minute(s) en route to the trauma center. A) 5 B) 10 C) 15 D) 1 20) Assuming none of the following patients has any neurological deficits, which patient requires cervical spinal immobilization? A) A 19-year-old male who has a gunshot wound to the right thigh B) A three-year-old female who fell on the sidewalk while running and who has a bite injury to her tongue C) A ten-year-old male skateboarder who fell while skating down a hill and received abrasions to his hands, elbows, chest, and knees D) A 70-year-old female involved in a moderate-speed, lateral-impact motor vehicle collision who is complaining of left arm pain