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Prehospital Emergency Care Practice Test: Handing Musculoskeletal Trauma and Nontraumatic Fractures
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Here are some guidelines for handling musculoskeletal trauma and nontraumatic fractures: Splinting: Use ample padding when splinting possible fractures, dislocations, sprains, and strains. Splint limbs in the position of function or normal anatomic alignment. If circulation or neurological functions are compromised, gently reposition the limb. This may require administration of pain medications prior to any movement. Immobilization: To perform a reduction of a fracture, EMS providers start by checking for distal circulation, sensation, and motor function. Next, stabilize above and below the... Show more
Prehospital Emergency Care Practice Test: Handing Musculoskeletal Trauma and Nontraumatic Fractures
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25 Questions

1. Firefighters are extricating the driver of a small car that was struck broadside by a delivery truck at a moderate rate of speed. The patient was unrestrained, and the car sustained severe damage to the driver's side. As the male patient is pulled from the car, you note severe deformity to his left thigh area where an open femur fracture has been bleeding severely. Your primary assessment shows the patient to be responsive to painful stimuli, with an open airway and adequate breathing at 20 breaths per minute. His radial pulse is present but rapid at a rate of 124. After applying oxygen and stopping the leg bleed with direct pressure, the EMT should immediately:
2. A patient with diagnosed osteoporosis is more likely to sustain which type of bone injury?
3. You are caring for a male patient who was ejected from the passenger side of a vehicle that was traveling at a high rate of speed when it left the roadway and overturned several times. During your primary assessment, you note the patient to have blood in the airway, rapid and shallow breathing, an absent radial pulse, and a weak and rapid carotid pulse. You also visualize that his left leg is severely injured, with gross visible angulations from suspected multiple fractures. Your partner is triaging the other occupants of the vehicle and you can hear the wail of the arriving fire department vehicles. Given this situation, what should you do first?
4. Which statement about compartment syndrome is true?
5. A young female patient was walking on a 7-foot-high retaining wall when she lost her balance, stumbled, and fell from the wall. She impacted a concrete sidewalk surface with her left foot and left hand. Your assessment reveals ecchymosis, deformity, and edema to both the left foot and the left hand. Based on the concept of injury caused by indirect force, where else should the EMT look for injury?
6. You have been called for a male worker complaining of arm pain. At the scene, the 31-year- old patient states that his arm was crushed between two heavy boxes that shifted while being stacked by a forklift. He had minimal pain at that time, but now his right forearm is swollen and painful, especially with movement. The patient also states that the arm and fingers feel as if they are 'asleep.' You note decreased strength to the arm and a radial pulse that is weak when compared to the left arm. There is no deformity to the arm and the skin is intact, although hard on palpation. Vital signs are pulse 88 beats/min, respiration 18 breaths/min, and blood pressure 134/76 mmHg. Given these assessment findings, the EMT should be suspicious of:
7. Which bone injury would be said to occur in the appendicular skeletal system?
8. A patient fell and sustained an open fracture to the left humerus. However, assessment reveals the bone to have pulled back into the arm. Bleeding from the site is controlled. How will splinting the left arm benefit this patient?
9. Which statement about traction splints is true?
10. A patient has an injury to the elbow and forearm. While you are conducting the reassessment, which statement made by the patient should concern you most?
11. A vacuum splint has just been applied to the injured arm of a patient who fell backward from a chair while hanging drapes. Which statement or question should the EMT make or ask next after placing the splint?
12. A 9-year-old boy has fallen from a swing. Assessment findings reveal no threats to the airway, breathing, or circulation, but do indicate deformity, pain, and swelling to his right wrist. The right radial pulse is strong and is accompanied by skin that is pink and warm to the touch. Which action indicates that the EMT is properly caring for this patient?
13. While on standby at a semi-professional baseball game, you are summoned onto the field at home plate for a player who complains of severe leg pain after colliding with the catcher of the opposing team. The primary assessment shows no threats to the airway, breathing, or circulation. The secondary assessment reveals a severely deformed knee that is swollen and ecchymotic. The leg is pale and cool, and the patient cannot move his leg when asked to do so. In addition, you cannot palpate a pedal pulse. What should the EMT's priority action be at this time?
14. Your partner is off from work for an extended period because he is having surgery for a torn ligament. Which structure is in need of that surgery?
15. An elderly female patient fell and now complains of right hip and right knee pain. When assessing her, which finding would you find most concerning?
16. Which question is best asked when attempting to determine the degree of sensation in the hand of a patient who has an elbow injury?
17. The greatest benefit of applying a traction splint in the field to a deformed femur and thigh is that it can:
18. Which statement about different musculoskeletal injuries is true?
19. Which assessment finding would contraindicate the use of the traction splint?
20. A 13-year-old boy flipped his bicycle and landed on outstretched arms, which caused a fracture to his collar bone. This is an example of:
21. A female patient with osteoporosis stepped sideways on her foot and has suffered an open tibial fracture to the distal portion of her right leg. Which intervention indicates that appropriate care is being given for this injury?
22. A 57-year-old male fell 20 feet while setting up holiday lights on his roof. He impacted the ground feet first and has suffered open fractures to both tibias, with both bones protruding through the skin. Your assessment reveals him to be responsive to painful stimuli. His airway is open, his breathing is rapid, and his radial pulse is weak. The skin is cool and diaphoretic. Vital signs are pulse 132 beats/min, respirations 24 breaths/min, and blood pressure 106/90 mmHg. According to family, the patient has no pertinent medical history. Your partner is providing positive pressure ventilation. At this point in the patient's care, it is a priority for you to:
23. When using an air splint, the EMT must remember that air splints:
24. A female lifeguard fell 10 feet from her chair and now has deformity, swelling, and ecchymosis to her right lower leg. The leg also is rotated medially. Another lifeguard has taken and is maintaining manual cervical spine motion restriction. As your partner conducts the primary assessment and finds no life threats or disturbances in her mental status, you should perform which action first?
25. Which statement shows that an EMT understands field care of a patient with a possible joint dislocation?

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