Page 1 of 236
NREMT TRAUMA EXAM QUESTIONS AND CORRECT
ANSWERS/ NREMT P-MEDIC: TRAUMA WITH
RATIONALES/ NREMT TRAUMA QUESTIONS AND
100% CORRECT ANSWERS GRADED A (NEWEST!
A 45-year-old male was stabbed in the left anterior chest. He is
conscious, but restless. His skin is cool and clammy, his blood
pressure is 90/60 mm Hg, his respirations are rapid and
shallow, and his heart rate is 120 beats/min and weak. Further
assessment reveals that his breath sounds are clear and equal
bilaterally and his jugular veins are distended. In addition to
giving him high-flow oxygen, you should:
A) control the bleeding from the stab wound with a sterile
porous dressing and reassess his vital signs.
B) perform a detailed physical exam at the scene to ensure that
you locate and treat less obvious injuries.
,Page 2 of 236
C) cover the stab wound with an occlusive dressing, support
ventilation as needed, and transport rapidly.
D) suspect that the patient has a tension pneumothorax and
notify the trauma center as soon as possible. ......ANSWER........C)
cover the stab wound with an occlusive dressing, support
ventilation as needed, and transport rapidly.
Your patient has signs of pericardial tamponade, a condition
usually caused by penetrating chest trauma. In pericardial
tamponade, blood collects in the pericardial sac; this prevents
the heart from filling during the diastolic phase, causing a
decrease in cardiac output and blood pressure. Signs of
pericardial tamponade include muffled or distant heart tones
(difficult to assess in the field); a rapid, weak pulse;
hypotension; jugular venous distention; and a narrowing pulse
pressure (difference between the systolic and diastolic blood
pressures). A tension pneumothorax is unlikely in this patient; his
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breath sounds are clear and equal bilaterally. Treatment for
pericardial tamponade includes ensuring adequate oxygenation
and ventilation, covering the chest wound with an occlusive
dressing (cover all open chest wounds with an occlusive dressing),
controlling any external bleeding, and transporting rapidly.
Pericardial tamponade is a life-threatening condition that
requires definitive treatment at the hospital.
Assessment of a patient with multisystem trauma reveals
decerebrate posturing, rapid irregular breathing, and
bradycardia. These clinical signs indicate injury to the:
A) brainstem.
B) myocardium.
C) temporal lobe.
D) thoracic spine. ......ANSWER........A) brainstem.
, Page 4 of 236
Posturing, either decorticate (flexor) or decerebrate (extensor),
is an ominous sign in a patient with a head injury because it
indicates significant intracranial pressure. Posturing in conjunction
with an abnormal breathing pattern (ie, central neurogenic
hyperventilation, Cheyne-Stokes breathing, ataxic breathing)
indicates injury to the brainstem. Cushing's triad (hypertension,
bradycardia, abnormal breathing) is also representative of
significant intracranial pressure. Temporal lobe injuries often
manifest with loss of fine motor control. In order to posture, the
spinal cord must be able to receive signals from the brain;
therefore, a thoracic spine injury is unlikely. Myocardial injury
would be more likely to present with signs of shock and possibly
cardiac dysrhythmias.
You are assessing a young male who was stabbed in the right
lower chest. He is tachypneic, tachycardic, and diaphoretic. His
NREMT TRAUMA EXAM QUESTIONS AND CORRECT
ANSWERS/ NREMT P-MEDIC: TRAUMA WITH
RATIONALES/ NREMT TRAUMA QUESTIONS AND
100% CORRECT ANSWERS GRADED A (NEWEST!
A 45-year-old male was stabbed in the left anterior chest. He is
conscious, but restless. His skin is cool and clammy, his blood
pressure is 90/60 mm Hg, his respirations are rapid and
shallow, and his heart rate is 120 beats/min and weak. Further
assessment reveals that his breath sounds are clear and equal
bilaterally and his jugular veins are distended. In addition to
giving him high-flow oxygen, you should:
A) control the bleeding from the stab wound with a sterile
porous dressing and reassess his vital signs.
B) perform a detailed physical exam at the scene to ensure that
you locate and treat less obvious injuries.
,Page 2 of 236
C) cover the stab wound with an occlusive dressing, support
ventilation as needed, and transport rapidly.
D) suspect that the patient has a tension pneumothorax and
notify the trauma center as soon as possible. ......ANSWER........C)
cover the stab wound with an occlusive dressing, support
ventilation as needed, and transport rapidly.
Your patient has signs of pericardial tamponade, a condition
usually caused by penetrating chest trauma. In pericardial
tamponade, blood collects in the pericardial sac; this prevents
the heart from filling during the diastolic phase, causing a
decrease in cardiac output and blood pressure. Signs of
pericardial tamponade include muffled or distant heart tones
(difficult to assess in the field); a rapid, weak pulse;
hypotension; jugular venous distention; and a narrowing pulse
pressure (difference between the systolic and diastolic blood
pressures). A tension pneumothorax is unlikely in this patient; his
,Page 3 of 236
breath sounds are clear and equal bilaterally. Treatment for
pericardial tamponade includes ensuring adequate oxygenation
and ventilation, covering the chest wound with an occlusive
dressing (cover all open chest wounds with an occlusive dressing),
controlling any external bleeding, and transporting rapidly.
Pericardial tamponade is a life-threatening condition that
requires definitive treatment at the hospital.
Assessment of a patient with multisystem trauma reveals
decerebrate posturing, rapid irregular breathing, and
bradycardia. These clinical signs indicate injury to the:
A) brainstem.
B) myocardium.
C) temporal lobe.
D) thoracic spine. ......ANSWER........A) brainstem.
, Page 4 of 236
Posturing, either decorticate (flexor) or decerebrate (extensor),
is an ominous sign in a patient with a head injury because it
indicates significant intracranial pressure. Posturing in conjunction
with an abnormal breathing pattern (ie, central neurogenic
hyperventilation, Cheyne-Stokes breathing, ataxic breathing)
indicates injury to the brainstem. Cushing's triad (hypertension,
bradycardia, abnormal breathing) is also representative of
significant intracranial pressure. Temporal lobe injuries often
manifest with loss of fine motor control. In order to posture, the
spinal cord must be able to receive signals from the brain;
therefore, a thoracic spine injury is unlikely. Myocardial injury
would be more likely to present with signs of shock and possibly
cardiac dysrhythmias.
You are assessing a young male who was stabbed in the right
lower chest. He is tachypneic, tachycardic, and diaphoretic. His
