1. For a person to make a fist, which of the following must occur? a.

The central nervous system must send a message through the spinal cord and then through the peripheral nerves. b. The central nervous system must send a message through the spinal cord and then through the autonomic nervous system. c. The peripheral nervous system must send a message to the brain and then back through the peripheral nervous system. d. The muscles must signal the brain to send a message through the autonomic nervous system. Answer: a b!ective: "1#1 $eference: %&& ". 'ased on the structure of the nervous system, which of the following statements is true? a. b. c. d. A stroke represents an in!ury to the peripheral nervous system. A gunshot wound to the spinal cord will directly damage the peripheral nerves. A deep laceration to an arm can sever peripheral nerves. (umbness of a leg secondary to a fracture is caused by a central nervous system in!ury.

Answer: c b!ective: "1#1 $eference: %&& ). *hich of the following signs or symptoms might be evident for an in!ury to the autonomic nervous system? a. b. c. d. +omiting ,levated heart rate -nability to move facial muscles Trouble remembering one.s own name

Answer: b b!ective: "1#/ $eference: %&& 0. 1ou are notified that a patient is coming to the first#aid room with bruising to the lumbar area of the back. 'ased on this statement, you would e2pect to find bruising in which area? a. b. c. d. The upper back The neck The lower back The buttocks

Answer: c b!ective: "1#) $eference: %11 /. 1ou respond to an accident at which a male patient is complaining of severe back pain. 3e informs you that his back pain is coming from a recent fracture of his coccy2. 'ased on this information, what area of the back would the pain be emanating from?

a. b. c. d.

The neck The upper back The tailbone The lower back

Answer: c b!ective: "1#) $eference: %11 4. A patient involved in a motor#vehicle collision has suffered the separation of a rib from a spinal vertebra. 'ased on the anatomy of the spine, where has this in!ury occurred? a. b. c. d. The lumbar spine The cervical spine The middle spine The thoracic spine

Answer: d b!ective: "1#) $eference: %1" %. 'ased on the anatomy of the spine, which one of the following in!uries is possible? a. b. c. d. A fracture of the ninth cervical vertebra A dislocation of lumbar vertebra % A disk in!ury between thoracic vertebrae 11 and 1" A compression fracture of lumbar vertebra 1"

Answer: c b!ective: "1#/ $eference: 455 6. A young into2icated male patient cannot move his lower e2tremities after diving into the shallow end of a pool and hitting the bottom with his head. *hich of the following mechanisms is most likely to be responsible for this in!ury? a. b. c. d. 7ompression $otation 8istraction 9enetration

Answer: a b!ective: "1#0 $eference: %&" 5. A young female was involved in a motor#vehicle collision in which her car struck the rear end of another vehicle. As a result of the impact, her neck muscles were overstretched and torn. :he is complaining of neck pain. 'ased on this mechanism, the most likely type of in!ury she has is: a. neural ischemia. b. whiplash.

c. translational strain. d. a ;efferson fracture. Answer: b b!ective: "1#4 $eference: %11 1&. *hile performing a primary assessment on a patient who has an isolated spinal cord in!ury, you note that he is in severe respiratory distress and struggling to breathe. *here should you suspect that the spinal cord in!ury has occurred? a. b. c. d. The diaphragm The cervical spine The thoracic spine The lumbar spine

Answer: b b!ective: "1#/ $eference: %1" 11. *hich of the following signs or symptoms best indicates that a patient has suffered an in!ury to the thoracic spine? a. b. c. d. Altered mental status 9aralysis of the arms Tingling in the legs 7ool and diaphoretic skin

Answer: c b!ective: "1#/ $eference: %16 1". An elderly patient has fallen down a flight of stairs and is complaining of neck and back pain and weakness to both legs. 1our primary assessment reveals no life threats to the airway, breathing, or circulation. <anual in#line spinal stabili=ation is being maintained. *hich of the following actions should you take ne2t? a. b. c. d. apply high#flow o2ygen and move the patient to a stretcher for transport. complete a secondary assessment looking for in!uries. place an oral airway and begin assisting ventilation. place a cervical collar on the patient and immobili=e him to a long spine board.

Answer: b b!ective: "1#6 $eference: %1/ 1). *hich of the following >uestions or statements indicates that an ,7 Technician is correctly assessing motor function in the arms of a patient with potential spine in!uries? a. ?7an you tell me what finger - am touching?@ b. ?7an you hold up two fingers on each hand?A c. ?- am going to move your armB tell me if it hurts.@

d. ?- am going to feel for a pulse in your wrist.@ Answer: b b!ective: "1#6 $eference: %14 10. *hich of the following statements about the care and treatment of a patient with a spinal in!ury in a prehospital setting is true? a. 9rehospital care for a patient with a spinal in!ury involves correcting life#threatening in!uries and limiting secondary in!ury. b. -t is important to identify the site of spinal in!ury so that proper prehospital care can be rendered. c. 'efore transporting a critically in!ured patient with a spinal in!ury, ,7 Technicians must perform a detailed head#to#toe neurological assessment. d. -f a patient with a possible spinal in!ury is in shock, it is permissible to forego immobili=ation because uses up time during the golden hour. Answer: a b!ective: "1#6 $eference: %15 1/. *hich of the following signs is a characteristic sign that may be seen during a secondary assessment of patients with spinal cord in!ury? a. (ormal skin color and complaint of headache and nausea b. Flushed skin color below the level of the in!ury and impairment or absence of sensation and movement c. 'ruising on the back and on the abdomen at the level of the in!ury, with normal or impaired sensation d. Flushed skin color at the level of pinpoint back pain Answer: b b!ective: "1#4 $eference: %16 14. A patient involved in an accident has his head positioned so that his left cheek is touching his left shoulder. 3e states that he has severe pain in his neck and he cannot move his head. 3e also states he has no feeling in his arms or legs. 1ou have no e>uipment. *hich of the following is the best course of action? a. b. c. d. 7arefully straighten the head and neck so that a cervical collar can be placed. :tabili=e and maintain the head in the position in which the patient is holding it. Avoid using a cervical collar or backboard and transport the patient in his current position. Avoid palpation of the cervical spine and apply a vest#type spinal immobili=ation device.

Answer: b b!ective: "1#6 $eference: %1/

1%. A patient is complaining of back pain and numbness in both legs after being thrown from a bicycle. *hen should you check the motor function, sensory function, and pulses in this patient? a. b. c. d. -mmediately after achieving manual in#line spinal immobili=ation -mmediately after applying a cervical collar 8uring the primary assessment 8uring the secondary assessment

Answer: c b!ective: "1#6 $eference: %10 16. Assessment of the cervical spine of a patient complaining of lower back pain after falling "& feet reveals no displacement, tenderness, or instability. Accordingly, you should: a. b. c. d. release manual in#line spinal stabili=ation. apply a properly si=ed cervical collar. immobili=e the patient to a backboard without a cervical collar. inform the team that immobili=ation is not needed.

Answer: b b!ective: "1#6 $eference: %10C%1/ 15. A patient with head, neck, and back pain has !ust been fully immobili=ed to a long backboard. *hich of the following instructions should you provide to your team ne2t? a. b. c. d. ?Doosen the collar so you can palpate the back of the neck.@ ?<aintain manual in#line spinal stabili=ation until he is on the stretcher.@ ?7heck for 7<: before we move him to the stretcher.@ ?$emove the chest straps so he can breathe more easily now that his head and legs are secured.@

Answer: c b!ective: "1#5 $eference: %"" "&. *hich of the following instructions from one ,7 Technician to another describes the appropriate application of a cervical spine immobili=ation collar? a. b. c. d. ?7arefully fle2 his head forward a little so - can pass the collar underneath his neck.@ ?Det.s log roll the patient to one side so - can apply a cervical collar.@ ?Eeep his head in neutral position while - apply a cervical collar.@ ?- need you to e2tend the patient.s chin backward a little so - can fit the collar under his chin.@

Answer: c b!ective: "1#6 $eference: %1/ "1. For which of the following patients involved in a motor vehicle collision is the use of a vest#type short immobili=ation device indicated?

a. A 0"#year#old male who was e!ected from the vehicle and is lying supine in the roadway complaining of back pain b. A "/#year#old restrained driver who is responsive and has a history of diabetes c. A 1/#year#old female complaining of neck and back pain who got out of the car and is standing ne2t to it d. A ))#year#old female in the backseat who complains of neck pain and a headache Answer: d b!ective: "1#4 $eference: %") "". A patient with a head and neck in!ury was sitting found leaning against a tree. 1ou have placed a vest type short immobili=ation device on the patient. To transport the patient you would: a. b. c. d. remove the vest#type short immobili=ation device and secure the patient to a long backboard. immobili=e the patient with the vest#type short immobili=ation device to a long backboard. place the patient in a :emi#Fowler.s position on the stretcher for transport to the hospital. secure the patient with the vest#type short immobili=ation device on a stretcher in a supine position with the feet elevated.

Answer: b b!ective: "1#5 $eference: %") "). 1ou are securing a patient to a long backboard. *hich of the following lists indicates the appropriate order for securing the straps? a. b. c. d. Torso, pelvis, legs, head 3ead, torso, pelvis, legs 3ead, legs, torso, pelvis Degs, head, torso, pelvis

Answer: a b!ective: "1#5 $eference: %"" "0. A patient has !ust been log rolled and positioned onto the long backboard. *hich of the following actions should be performed ne2t? a. b. c. d. Apply a properly si=ed cervical collar. :ecure the patient.s head. :ecure the patient.s chest with straps. $elease manual in#line stabili=ation.

Answer: c b!ective: "1#5 $eference: %"" "/. 1ou are maintaining manual in#line stabili=ation of the cervical spine for a patient being log rolled, transferred, and secured to a long backboard. At what point should you release the manual in#line stabili=ation?

a. nce the patient has been log rolled onto the long backboard b. After the patient.s head, chest, and knees have been secured with straps c. After the patient has been secured to the backboard and transferred to the stretcher d. After the patient.s head has been secured with a head immobili=ation device Answer: d b!ective: "1#5 $eference: %1/ "4. 1ou have been called to aid a )"#year#old male patient who fell down a flight of stairs. The patient is walking toward you and states that he would like to be looked at because his shoulder and lower back hurt. 1ou immediately apply in#line manual cervical stabili=ation and your partner e2amines his back, which reveals no sign of in!ury. 3ow should you immobili=e this patient? a. 9lace a cervical collar on the patient, place a long spine board behind him, and then lower him to the ground. b. 3ave the patient lie down on the ground and immobili=e him in the usual fashion. c. 9lace a long board on a stretcher and carefully assist the patient onto the long board. d. 9lace a cervical collar on the patient and then transfer him to a stretcher. Answer: a b!ective: "1#5 $eference: %") "%. *hich of the following statements indicates that ,7 Technicians are correctly using a vest type short spine immobili=ation device? a. The cervical collar is applied after the chest has been secured to the device. b. The head is secured first, followed by the torso and legs. c. The head is secured to the device immediately after the cervical collar is applied. d. The head is secured to the device after the chest has been secured. Answer: d b!ective: "1#6 $eference: %") "6. 1ou and your partner are preparing to backboard a patient using a vest type short spine immobili=ation device. After ensuring that inline manual spinal stabili=ation is being maintained, your ne2t instruction should be: a. b. c. d. ?Det.s get the cervical collar applied before we place the vest.@ ?Det.s turn the patient away from the tree before applying the vest.@ ?Det.s check motor, sensory, and pulses in the arms and legs.@ ?Det.s place the vest on the backboard and carefully move him onto it.@

Answer: c b!ective: "1#6 $eference: %") "5. *hich of the following statements about removing a helmet in a prehospital setting is correct? a. 3elmets should be removed only if they are too tight or if spinal immobili=ation is re>uired.

b. -t is acceptable to leave a helmet on a patient if the patient has no airway or breathing problems. c. Any patient wearing a helmet should have it removed so that the airway and breathing can be properly assessed. d. 3elmets should never be removed, so ,7 Technicians must be creative in working around the obstacle of a helmet while providing care. Answer: b b!ective: "1#1& $eference: %"0 )&. A "#year#old boy fell down a flight of stairs. *hich of the following instructions would you provide to other patrollers who are immobili=ing the patient? a. b. c. d. ?After he is on the board, place a towel behind his head to keep his airway open.@ ?-t is better if the collar is a little too big because it will be more comfortable for him.@ ?Det.s place a folded towel under his shoulders to help maintain his head alignment.@ ?;ust apply a cervical collar and then place him directly on the stretcher.@

Answer: c b!ective: "1#6 $eference: %"0 )1. 1ou are assessing )&#year#old man who has fallen about "& feet. 3e is alert and oriented but states that he cannot move or feel his legs. Additionally, because his blood pressure is 6"F06 mm3g, you suspect neurogenic shock. *hich of the following additional assessment findings reinforces your suspicion of neurogenic shock? a. b. c. d. *arm and dry skin 3eart rate of 100 :hallow rapid respirations 3eart rate of 00

Answer: d b!ective: "1#4 $eference: %1" )". A ""#year#old female rock climber has fallen "/ feet to the trail below. The primary assessment shows her to be confused and to have an open airway and shallow breathing. 3er pulse is %" beats per minute, and her blood pressure is %6F/& mm3g. :he has no motor ability or sensation in her legs. *hich of the following conditions is the most likely cause of this patient.s presentation? a. b. c. d. -nternal bleeding :pinal cord in!ury 3emorrhagic shock 3ypoglycemia

Answer: b b!ective: "1#/ $eference: %&"

)). 1ou should recogni=e a possible spinal column in!ury with no spinal cord involvement when you discover which of the following assessment findings? a. b. c. d. Tenderness to the thoracic spine with intact motor and sensory function in each e2tremity -ntact motor ability to all four e2tremities with the loss of sensation to the legs 9ain in the cervical spine with the loss of sensation to the right arm and leg -ntact sensation to all four e2tremities with the loss of motor ability in the arms

Answer: a b!ective: "1#/ $eference: %&" )0. A mechanical in!ury to the brain that results in a short#term andFor a long#term neurologic deficit is: a. b. c. d. a repetitive head in!ury. a subdural hematoma. neural ischemia. a traumatic brain in!ury.

Answer: d b!ective: "1#0 $eference: %&/ )/. A primary in!ury to the central nervous system would be caused by: a. b. c. d. drowning. a hematoma. a brachial ple2us in!ury. a laceration of the spinal cord.

Answer: d b!ective: "1#) $eference: %1" )4. 1ou suspect that an unhelmeted climber who struck his head during a fall may have a basilar skull fracture. As you conduct your assessment, which of the following findings reinforces this suspicion? a. b. c. d. 'lood coming from both ears 8ilation and sluggish response to light of the right pupil 7lear fluid coming from the right ear and left nostril 9aralysis of the left arm and left leg

Answer: c b!ective: "1#0 $eference: %&/ )%. A patient was killed immediately following a self#inflicted gunshot wound to the head. *hich portion of the central nervous system was most likely damaged in order to cause the rapid death of the patient? a. The cerebrum

b. The brain stem c. The cerebellum d. The meninges Answer: b b!ective: "1#1 $eference: %&& )6. 1ou are assessing a patient who tells you she had a previous head in!ury in which a portion of the cerebellum was destroyed. *hich of the following signs and symptoms would you e2pect to find in relation to this in!ury? a. b. c. d. -nability to remember information such as a past medical history 9oor coordination when walking 9roblems with the regulation of heart rate and blood pressure -nability to move or feel sensations in one side of the body

Answer: b b!ective: "1#1 $eference: %&& )5. A patient involved in a motor vehicle collision has a deformity to the left side of the head. The skin overlying the deformity is still intact. 'ased on these assessment findings, which of the following conditions would be your greatest concern? a. b. c. d. A possible brain in!ury A fracture of the skull The potential for infection of the brain :oft tissue trauma to the scalp

Answer: a b!ective: "1#0 $eference: %&/, %&4 0&. A 01#year#old male snowboarder struck his head on a metal rail. As you approach him, you note that he appears confused and has blood on the left side of his face and head, and on his shirt. 3is breathing appears to be labored. *hich of the following actions should you perform immediately? a. b. c. d. 7heck his pupils for e>uality and reactivity. Apply o2ygen at 1/ D9< via nonrebreather mask. Apply manual in#line spinal immobili=ation. ,2pose the chest to look for possible bleeding.

Answer: c b!ective: "1#6 $eference: %10 01. 1ou are called to aid a 41#year#old man who has fallen off a second#floor lodge patio. 3e is unresponsive and has slow, shallow breathing. *hen you arrive, a fellow patroller has already opened the airway and has stabili=ed the head. *hich of the following actions should you take immediately? a. Apply a cervical collar.

b. 9lace the patient in the shock position. c. Assist ventilation with a '+<. d. Transfer the patient to a stretcher for emergency transport. Answer: c b!ective: "1#6 $eference: %1/ 0". A 46#year#old female patient is complaining of a headache and generali=ed weakness. 3er husband informs you that she was with a friend yesterday and struck her face on the dashboard during a motor vehicle collision. 3er past medical history includes a stroke that caused right arm weakness and high blood pressure. *hen assessing this patient, which of the following findings should concern you the most? a. b. c. d. A contusion to her left cheek *eakness in the grip of the right hand 'ruising behind her left ear A complaint of pain when she moves her !aw

Answer: c b!ective: "1#0 $eference: %&/ 0). *hich of the following assessment findings is most indicative of increasing pressure within the skull from a closed head in!ury? a. b. c. d. 'lood pressure of 15"F1&4 mm3g 3eart rate of 1)" beats per minute 'lood pressure of 11&F/& 9upils e>ual and reactive

Answer: a b!ective: "1#% $eference: %16 00. 1our patient is a young female who was thrown from her mountain bike and is now confused. Assessment findings include an open airway, ade>uate breathing, and a strong radial pulse. *hich of the following >uestions would be the most important to ask her friends who were with her? a. b. c. d. ?3as she ever needed to be hospitali=ed before?@ ?Are all of her immuni=ations up to date?@ ?-s she allergic to anything?@ ?8id she lose consciousness?@

Answer: d b!ective: "1#4 $eference: %&/ 0/. A male soccer player was struck in the head with a soccer ball. 9layers state that he was da=ed for several seconds following the impact and then asked the same >uestions over and over. 3e is currently conscious and oriented to person but is confused as to place and time. 3e also has a reddened area on

the side of his head and face. As you proceed with your assessment, his memory continues to improve. 'ased on these findings, you would suspect which of the following in!uries? a. b. c. d. A concussionFT'An open head in!ury An epidural hematoma A cerebral contusion

Answer: a b!ective: "1#0 $eference: %&/ 04. 1ou are participating in training ,7 candidates and are asked about cerebral contusions. 1ou would e2plain to the class that a cerebral contusion is: a. b. c. d. an open skull fracture with increased pressure within the skull. the formation of a pocket of blood within the brain tissue. bruising and swelling of the brain tissue. active bleeding between the brain and the skull.

Answer: c b!ective: "1#0 $eference: %&6 0%. 1ou are called to the lodge by a family who is concerned that their mother is not acting right. The family tells you that they are concerned because their mother has been complaining of a headache and is very confused today. Assessment reveals a bruise on the right side of the head that the family states she got about a week ago when she fell. *hich of the following conditions would you be concerned about based on the history and assessment findings? a. b. c. d. A subdural hematoma A scalp laceration A concussion A cerebral contusion

Answer: a b!ective: "1#0 $eference: %&5 06. *hich of the following findings is most consistent with a skull fracture? a. b. c. d. 'ruising behind the ear that develops several hours after the in!ury 'ilateral dilated pupils that do not respond to light A hematoma in the occipital area of the head Altered mental status

Answer: a b!ective: "1#0 $eference: %&/ 05. *hich of the following findings indicates that a patient who received a blow to the head is suffering from something other than a concussionFT'-?

a. b. c. d.

3e cannot remember what happened. 3e asks the same >uestions over and over. 3is heart rate is 5" and his blood pressure is 100F64. 3is pupils are noticeably une>ual.

Answer: d b!ective: "1#% $eference: %16 /&. *hen e2plaining the priorities of helmet removal to a candidate patroller, you would stress: a. b. c. d. sliding the helmet rearward off the head so that you don.t hit the patient.s nose. sliding the fingers under the occiput so that the head doesn.t drop backward. applying a cervical collar before removing the helmet to help stabili=e the head. removing the helmet to ensure the patient.s proper alignment on a backboard.

Answer: b b!ective: "1#1& $eference: %"/