Paramedic Trauma practice questions

Correct answer: B. about 11.5 liters, with half given in the first 8 hours from the time of the burn

Four milliliters per kilogram per percent burned gives roughly 11.5 liters here. Half goes in during the first eight hours, counted from when the burn happened, not from when you arrived. That timing detail is what crews most often get wrong.

• A. You need both weight and burn size. Either one alone is meaningless.
• B. Four milliliters per kilogram per percent gives this volume, front-loaded from the time of injury.
• C. Even distribution under-resuscitates during the period of greatest capillary leak.
• D. That figure has no basis in the formula.

Correct answer: D. the child's height placing the bumper at the level of the legs and the hood at the torso

A vehicle hits a child at different body levels than an adult, and that produces a recognizable triad. Knowing it, you go looking for chest and abdominal injury in a child whose leg injury is the obvious one.

• A. Throw distance depends on speed. It doesn't explain this triad.
• B. Orientation to the vehicle varies, and it doesn't define the pattern.
• C. Muscle mass affects severity, not where the injuries are.
• D. The child's height places vehicle structures at leg, torso and head level in sequence.

Correct answer: A. 27%

In the adult rule of nines, the front of the torso is 18% and a whole arm is 9%, so you're at 27%. That number drives fluid resuscitation and whether this patient goes to a burn center.

• A. Front of the torso at 18% plus one whole arm at 9% gets you to 27%.
• B. Eighteen percent counts the front of the torso and leaves out the arm.
• C. Thirty-six percent would take the whole torso, front and back, plus more.
• D. Forty-five percent badly overestimates what's described.

Correct answer: A. the chest wall is thinner, so the catheter reaches the pleura

A catheter that doesn't reach the pleural space decompresses nothing. At the second interspace, chest wall thickness defeats a standard catheter in a substantial share of adults. The lateral site is thinner in most people.

• A. The chest wall is thinner out laterally, so the catheter is more likely to reach the pleural space.
• B. Distance from the heart isn't the reason for the preference.
• C. Either site is generally easier to reach with the patient supine.
• D. Bleeding risk isn't what drives the choice.

Correct answer: C. injuries are missed when they are hidden beneath clothing

If you don't look, you won't find it, and clothing is best at hiding injuries on the back and in the armpits. Deal with heat loss by exposing, examining and covering again, not by skipping the look.

• A. Clothing has little effect on monitoring accuracy.
• B. Analgesia doesn't depend on exposure.
• C. Hidden injuries get missed unless you expose and examine.
• D. You don't need to expose someone to estimate their weight.

Correct answer: C. fat embolism syndrome

After a long bone fracture, marrow fat can get into the circulation. Typically one to three days later you get the triad: hypoxia, neurological change and a petechial rash. The rash is what separates it from a thrombotic embolism, which otherwise looks a lot like it.

• A. An allergic reaction gives you urticaria, not petechiae.
• B. Sepsis this early from a closed fracture is unlikely, and it doesn't explain the rash.
• C. Hypoxia, confusion and petechiae one to three days after a long bone fracture is the fat embolism triad.
• D. A thrombotic embolism gives you hypoxia, but not the petechial rash.

Correct answer: B. the height of the fall as a mechanism criterion

Mechanism is in the trauma center criteria because a patient can look fine early and still have injuries that need a surgical team. A fall from this height meets the criterion, whatever your first set of numbers says. Good vitals don't downgrade a 25-foot fall.

• A. Normal early vitals are what you'd expect in a compensating trauma patient.
• B. Mechanism is a trauma criterion because early findings can look normal.
• C. The visible injury is the least of what this mechanism can do.
• D. Journey time doesn't override a trauma center criterion that has been met.

Correct answer: D. manual stabilization then a fitted collar

Midline neck pain after a mechanism like this means you can't clear the spine on scene. Manual stabilization, then a properly fitted collar, limits movement without the pressure injuries and breathing restriction that long board time causes.

• A. Long board time causes pressure injury and restricts breathing.
• B. Midline pain after this mechanism is exactly what precautions are for.
• C. Moving all four limbs doesn't rule out an unstable injury that hasn't displaced yet.
• D. Manual stabilization and a fitted collar limit movement without the harms of a board.