Download 2024/2025 WMA WFR RECERT PRACTICE EXAM (ACTUAL QUESTIONS AND ANSWERS) and more Exams Nursing in PDF only on Docsity!
As you approach the scene of a climbing accident, you observe an injured climber hanging just above the ground. The belay rope disappears over the top of the cliff 20 meters (65 feet) above. Your first acDon should be to: Survey the scene for dangers, numbers of paDents and available resources. The technical team has relieved the belayer and lowered an injured climber to the ground. Your primary assessment reveals a rapid pulse and easy but rapid breathing. Possible causes include: Acute stress reacDon volume shock The injured climber is a on avpu with normal mental status and is able to describe the accident in detail. For field purposes, this finding confirms that there is no: TraumaDc brain injury Your secondary assessment on a climber injured by a 10 meter (32 foot) fall reveals a deformed, tender, and very swollen leM thigh. In addiDon to fracture, this finding also suggests a mechanism for:
2024/2025 WMA WFR RECERT
PRACTICE EXAM (ACTUAL
QUESTIONS AND ANSWERS)
Volume shock significant blood loss a criDcal body system injury Vital signs on a climber with a fractured pelvis from a fall measure as follows: first set of vitals: p: 128, r: 20, bp: 110/72, skin: pale, c: awake with normal metal status. Second set of vitals: p: 136, r: 24, bp: 110/72, skin: cool and pale, c: awake with normal mental status. This paTern fits the assessment of: Compensated volume shock What acDons would be appropriate in the treatment of a climber with a fractured femur following a 10 meter (32 foot) fall? Spine protecDon unless the spine can be cleared request a paramedic for iv fluids and pain control packaging to prevent hypothermia It is best to avoid: High risk evacuaDons for low risk problems. Persistent ischemia is a high-risk problem because it will ulDmately result in: InfarcDon (Dssue death) Why might blunt injury to the chest and abdomen be a mechanism for volume shock? Solid organs like the spleen and liver can rupture and bleed profusely One of your crew members lacerates her shin on a sail track on an offshore passage. The wound exposes bone and muscle, and is about 5 cm (2 inches)
Package the paDent in a hypothermia wrap, provide ppv, and evacuate gently but urgently to medical care. One of your rescue team members dislocates his thumb when it becomes caught in a belay device. His symptoms include an elevated pulse, elevated respiratory rate and mental status changes. This is most likely due to: Acute stress reacDon. Which cause of upper airway obstrucDon would be most difficult to manage without medicaDon and advanced techniques? Swelling from anaphylaxis. The assessment traumaDc brain injury (tbi) carries the anDcipated problem of: Increased intracranial pressure As a ski patroller, you are called to evaluate a young man behaving abnormally. He is carrying a snowboard and wandering around the base area. He seems confused and is unable to tell you what he is doing or how he came to be there. The problem could be: Drug use (intoxicaDon.) Low blood sugar. TraumaDc brain injury. On a camping trip, you are called to evaluate a 10 year old girl who has just been stung by hornets. Exam reveals an awake but very upset paDent with 3 obvious sDngs on her leM leg. She is known to have an allergy to bee sDngs. Vital signs are: p: 120, r: 24 and easy, without wheezing or stridor. Skin: warm and pink with slight swelling and redness at three sites on the leM leg. No hives or facial swelling. The paDent is awake and anxious. This is most likely: SympatheDc acute stress reacDon.
You are treaDng a paDent following a mountain bike accident. What finding leads you to include traumaDc brain injury on your problem list? The paDent cannot remember the accident. Lightning strikes a ridge line near you injuring a hiker. You arrive on scene two minutes later to find several people standing back and afraid to approach the vicDm. You should: Extricate the paDent to a safe locaDon and perform a primary assessment. You arrive on scene 30 minutes aMer a dirt bike accident to find the injured person up and walking around. You can safely conclude that: The paDent can walk. One of your backcountry skiing clients is having difficulty keeping up with the rest of the group. When quesDoned, he describes a fall earlier in the day where he felt a pop and brief pain, aMer which his leM knee 'gave out' on him several Dmes. He reports no numbness or Dngling or other symptoms. He is able to ski only by bearing most of his weight on his right leg. Which statement is true about this case? This is an unstable injury that should be splinted and referred to medical care on a non-emergent basis. One of your crew members on an offshore boat delivery stuck a fish hook through his hand. He comes to you two days later complaining of swelling and pain. You see a scabbed over puncture wound through the web space of the thumb and index finger. The area is swollen, red, and warm to the touch. Which signs would indicate that the infecDon is becoming systemic? Fever and swollen lymph nodes in the armpit. The hasty team has just located the subject of a 36-hour search in wet and cold condiDons. You are called to the scene to perform a medical evaluaDon. Your paDent is curled up under a spruce tree and is awake but mumbling and
Shivering, cold, awake, altered mental status. What symptoms would indicate the development of increased intracranial pressure in an awake paDent with a traumaDc brain injury? Worsening headache and the onset of vomiDng. The wind suddenly shiMs and your hot-shot crew is forced to run from a rapidly advancing wildland fire. One of your crew members tumbles over a 3 meter ( foot) high ledge. He is able to walk but complains of neck pain. An appropriate plan includes: Assist the crew member in running from the fire and evaluate the spine when a safe zone is reached. You are treaDng a paDent following a slip and fall. What finding leads you to include traumaDc brain injury on your problem list? The paDent cannot remember the accident You have administered epinephrine to a paDent experiencing a severe asthma aTack. She is improving. You will be caring for her for at least the next 24 hours. Which would be the most appropriate course of therapy? Give prednisone 60 mg and resume prn use of the albuterol inhaler. What findings support the assessment 'stable injury'? (choose 2) The paDent was able to walk on the ankle for several miles aMer the injury. Swelling developed slowly over 12 hours. Which signs and symptoms would indicate that an ankle injury is definitely unstable? (choose 2) Obvious deformity. The joint "gives out" when the paDent tries to walk.
With which musculoskeletal problems would you also anDcipate criDcal system problems? (choose 2) Unstable pelvis injury. Skull fracture. The purpose of tracDon into posiDon to realign a deformed fracture of the lower leg is: (choose 2) To preserve perfusion to the distal extremity. To prevent injury to adjacent nerves and other soM Dssue. Which mechanisms for shoulder dislocaDon are examples of indirect force? (choose 2) Barn-door swing on one arm while climbing high bracing with a kayak paddle Your paDent with a deformed fracture of the wrist has an elevated pulse and respiratory rate, pale skin, and mildly altered mental status. The cause of these vital signs could be: (choose 2) Volume shock from another injury that you missed on your exam. Acute stress reacDon. An angulated forearm fracture should be restored to normal anatomic posiDon before splinDng unless: (choose 2) The paDent refuses to allow the procedure. Significant pain or resistance develops.
A female crew member complains of a urinary tract infecDon. What symptoms would lead you to believe that it is more serious than a simple uD? (choose 2) Persistent fever. Back pain. Which statements are true about a dislocated shoulder? (choose 2) It should be reduced as soon as possible. The primary concern is ischemia to infarcDon. Immediately following a jellyfish sDng, your mate begins to develop hives, itching, respiratory distress and facial swelling. This is most likely: (choose 2) An anaphylacDc reacDon. A condiDon requiring emergency treatment. Which history and exam findings would prompt you to include traumaDc brain injury (tbi) on the problem list for a paDent that was involved in a lightning strike? (choose 2) The paDent was unconscious for 90 seconds following the strike, but has normal mental status now. The paDent cannot remember the event. A client complains of a sore throat for the past few days. What symptoms might indicate an impending emergency? (choose 2) He is refusing to eat or drink anything. He has a persistent fever of 41°c (105°f) and altered mental status.
A crew member on your yacht delivery has been complaining of chest pain for the past hour. What elements of history would make you more likely to insist on an emergency evacuaDon? (choose 2) He is a 2 pack per day smoker for the past 25 years. He has a history of hypertension and high blood cholesterol. A helicopter evacuaDon at sea or in a mountainous terrain is a high-risk operaDon. Which situaDons might jusDfy it? (choose 2) A traumaDc brain injury with persistent vomiDng. Volume shock from internal bleeding. Which two of the following techniques are the most effecDve in controlling severe bleeding from an extremity? (choose 2) Tourniquet. Direct pressure. Which type of respiratory system problem typically produces wheezing? (choose 2) Asthma lower airway constricDon. You are evaluaDng a student in your wilderness trip leader training program who has been complaining of persistent abdominal pain for the past 16 hours. Which of these presentaDons would moDvate you to perform an urgent evacuaDon? (choose 2) The pain is most severe in the right lower quadrant of the abdomen and is exacerbated by palpaDon and movement.
A spreading infecDon. An emergency. You arrive on scene at a mountain bike accident five kilometers from the trail head. The injured rider is standing up examining his broken helmet. You can safely conclude that There is a mechanism for spine injury Assuming that the scene is stable, the most appropriate plan for the mountain bike rider in the previous (moi for spine) includes: A spine assessment exam to determine if spine stabilizaDon is necessary Which test is not part of the spine assessment criteria used in the wma spine Grip strength Which paDent would definitely be unreliable for spine assessment? Smells of alcohol and admits to drinking You are unable to clear your paDent's spine due to neck pain and tenderness. When is this a high-risk problem? When you find motor weakness and sensory deficit What is the appropriate the appropriate dose of injectable epinephrine in the emergency treatment of anaphylaxis? 0.3 mg On a camping trip you are called to evaluate a 10 year old girl who has just been stung by hornets. How might you be able to disDnguish between acute stress reacDon (asr) and anaphylaxis? Asr does not cause hives and facial swelling Immediately following a jellyfish sDng, your mate begins to develop hives, itching, respiratory distress and facial swelling. This is most likely: Anaphylaxis
You are anchored in a remote bay without immediate access to medical care. Your plan for the paDent (anaphylaxis) in the previous quesDon includes: 0.3 mg of epinephrine, 25 mg of diphenhydramine, and 40mg of prednisone Stopeats Sugar, temperature, oxygen, pressure, electricity, alDtude, toxins, salts You have just administered an injecDon of epinephrine to a 30 year olf man who was having a severe asthma aTack. He is improving. Evac will take at least a day. Your plan should now include: Giving prednisone at 40 - 60 mg po and 6 puffs of his albuterol inhaler. What would moDvate an emergency evac for the asthma paDent? He requires a second ephinephrine injecDon and conDnues to have respiratory distress. Why is it important to reduce a shoulder dislocaDon in the field when access to definiDve care is delayed? The deformity results in ischemia that will result in Dssue death if prolonged. To adjacent structures that can become worse with Dme. You have tried several Dmes to reduce a dislocated shoulder but have not been successful due to pain and resistance. What is the most appropriate plan now? Treat as an unstable injury and plan an urgent evacuaDon. A patella dislocaDon from indirect force will result in displacement of the patella to the Lateral aspect of the knee (il, dm) Under what circumstance would you apply tracDon into posiDon for a dislocated elbow? The forearm is ischemic and you are more than two hours from a hospital In a wilderness situaDon, on which cardiac arrest paDent should you start cpr? An apparent heart aTack paDent who has been pulseless for 45 minutes
