COPR COPR - Canadian Organization of Paramedic Regulators Examination Trauma Assessment and Management Questions and Answers 2 — Questions and Answers
Question 1: Which assessment finding most strongly indicates cardiac tamponade in a trauma patient?
- Unequal breath sounds
- Beck's Triad: hypotension, muffled heart sounds, JVD (Correct answer)
- Tracheal deviation toward the affected side
- Crepitus along the rib cage
Correct answer: Beck's Triad: hypotension, muffled heart sounds, JVD
Beck's Triad (hypotension, muffled heart sounds, jugular venous distension) is the classic presentation of cardiac tamponade caused by pericardial blood accumulation.
Question 2: When applying a tourniquet for extremity hemorrhage, where should it be positioned?
- Directly over the wound
- As close to the wound as possible distally
- 2–3 inches proximal to the wound (Correct answer)
- At the mid-shaft of the limb regardless of wound location
Correct answer: 2–3 inches proximal to the wound
A tourniquet should be placed 2–3 inches proximal to the wound to effectively occlude arterial flow without being positioned over a joint.
Question 3: What is the significance of a 'seat belt sign' (bruising across the abdomen) in trauma assessment?
- It indicates only superficial abrasion
- It suggests possible intra-abdominal injury requiring surgical evaluation (Correct answer)
- It rules out spinal injury
- It is clinically insignificant in alert patients
Correct answer: It suggests possible intra-abdominal injury requiring surgical evaluation
A seat belt sign raises strong suspicion for hollow organ injury or mesenteric tears, which may not produce immediate symptoms but require urgent evaluation.
Question 4: In trauma triage using START (Simple Triage and Rapid Treatment), a patient with a respiratory rate of 8/min would be categorized as:
- Green (Minor)
- Yellow (Delayed)
- Red (Immediate) (Correct answer)
- Black (Expectant/Deceased)
Correct answer: Red (Immediate)
In START triage, a respiratory rate less than 10/min is classified as Red (Immediate) because it indicates inadequate ventilation requiring immediate intervention.
Question 5: What is the recommended approach to spinal motion restriction in a responsive trauma patient with no distracting injuries who denies neck pain?
- Always apply a cervical collar and long backboard regardless
- Apply selective spinal precautions based on clinical criteria (Correct answer)
- No spinal precautions are ever required in responsive patients
- Spinal immobilization is mandatory for all MVC patients
Correct answer: Apply selective spinal precautions based on clinical criteria
Evidence-based guidelines support selective spinal motion restriction using validated clinical criteria (e.g., NEXUS or Canadian C-Spine Rule) rather than universal immobilization.
Question 6: A burn patient has circumferential burns to one entire leg. Using the Rule of Nines, what percentage of TBSA is involved?
- 9%
- 13.5%
- 18% (Correct answer)
- 27%
Correct answer: 18%
Each entire lower extremity represents 18% of total body surface area (TBSA) according to the Rule of Nines in adult burn assessment.
COPR COPR - Canadian Organization of Paramedic Regulators Examination Trauma Assessment and Management Questions and Answers 2
Which assessment finding most strongly indicates cardiac tamponade in a trauma patient?