BOC Review

Scenarios 1 (100-200) & 2 (300-500)

100

You are covering a high school field hockey game when one of your players gets hit hard in the mouth with a stick. She comes running off the field with her hand covering her mouth. There is a copious amount of blood on her face and hands. What steps would you take during the initial evaluation? 1. Rinse the athlete's mouth out with water. 2. Clean the athlete's mouth out with a paper towel. 3. Put on gloves. 4. Ask the athlete why she is crying. 5. Ask the athlete if she was wearing a mouthguard. 6. Review the school's liability insurance policy. 7. Observe the mouth, lips, and surrounding structures for lacerations or abrasions. 8. Palpate the mouth and surrounding structures for deformity. 9. Ask an athletic training student to get a cervical collar. 10. Have the athlete open and close her mouth.

1. Rinse the athlete's mouth out with water. 3. Put on gloves. 5. Ask the athlete if she was wearing a mouthguard. 7. Observe the mouth, lips, and surrounding structures for lacerations or abrasions. 8. Palpate the mouth and surrounding structures for deformity. 10. Have the athlete open and close her mouth.

200

You are covering a high school field hockey game when one of your players gets hit hard in the mouth with a stick. She comes running off the field with her hand covering her mouth. There is a copious amount of blood on her face and hands. During your initial evaluation, you observe the athlete is missing a front tooth. One of the patient’s teammates comes to the sidelines with the tooth in her hand. What do you do next? 1. Ask the officials to stop the game. 2. Have an athletic training student take the patient to the school nurse. 3. Discuss your findings with the patient's parents. 4. Call your team physician for guidance. 5. Apply an ice pack to the mouth area. 6. Apply a cotton plug between the lip and injured gum. 7. Place the tooth in a container of sterile saline solution. 8. Rinse the tooth off with water. 9. Send the athlete with the tooth to a dentist in less than 30 minutes. 10.Discard the tooth. 11. Place the athlete in a side-lying position.

3. Discuss your findings with the patient's parents. 5. Apply an ice pack to the mouth area. 6. Apply a cotton plug between the lip and injured gum. 7. Place the tooth in a container of sterile saline solution. 8. Rinse the tooth off with water. 9. Send the athlete with the tooth to a dentist in less than 30 minutes.

300

A soccer player jumps up to head a ball. While he is in the air, he is kicked in the abdominal area by an opponent. He curls up in pain on the ground. What would you do during the initial evaluation? 1. Perform a primary survey. 2. Give the athlete oxygen. 3. Auscultate the athlete's heart. 4. Palpate the abdominal area. 5. Ask the athlete where the pain is located. 6. Have the athlete stand and jog a little. 7. Have the athlete count backward from 100. 8. Have an athletic training student bring out a stretcher. 9. Put on a glove before touching the athlete. 10. Observe the abdominal area for edema or ecchymosis. 11. Ask if the pain radiates anywhere.

1. Perform a primary survey. 4. Palpate the abdominal area. 5. Ask the athlete where the pain is located. 10. Observe the abdominal area for edema or ecchymosis. 11. Ask if the pain radiates anywhere.

400

A soccer player jumps up to head a ball. While he is in the air, he is kicked in the abdominal area by an opponent. He curls up in pain on the ground. Following your initial evaluation, you have determined this patient has sustained a contusion to the lower right quadrant. What actions do you now take? 1. Apply an ice pack to the injured area. 2. Apply a compression wrap to the injured area. 3. Massage the athlete's lumbar area. 4. Massage the athlete's abdominal area. 5. Assist the athlete to walk off the field if he is able to do so. 6. Apply a neoprene rib belt. 7. Position the athlete supine with his knees bent. 8. Monitor the athlete for any changes in pain intensity. 9. Take the athlete's pulse and blood pressure.

1. Apply an ice pack to the injured area. 2. Apply a compression wrap to the injured area. 5. Assist the athlete to walk off the field if he is able to do so. 7. Position the athlete supine with his knees bent. 8. Monitor the athlete for any changes in pain intensity. 9. Take the athlete's pulse and blood pressure.

500

A soccer player jumps up to head a ball. While he is in the air, he is kicked in the abdominal area by an opponent. He curls up in pain on the ground. You follow up with the patient the next day in the athletic training facility. He states he is sore but has less pain today. How would you treat this patient at this time? 1. Continue to apply ice to the injured area. 2. Begin to apply moist heat packs. 3. Manually muscle test the abdominal muscles. 4. Re-evaluate the injury. 5. Have the athlete drink a glass of Gatorade. 6. Pad the area for activity. 7. Have the athlete begin exercises on an upper body ergometer.

1. Continue to apply ice to the injured area. 4. Re-evaluate the injury. 6. Pad the area for activity. 7. Have the athlete begin exercises on an upper body ergometer.

Scenarios 3 (100-200) & 4 (300-500)

100

You are covering a collegiate women’s lacrosse game when you observe 2 players collide as they try to catch a ball in the air. One of the players is struck by her opponent’s stick in the side of the chest. She falls to the ground and is in obvious pain. She is clutching her right side. How will you begin to evaluate the severity of the injury? 1. Observe the athlete for cyanosis. 2. Immediately move the patient off the field. 3. Ask the athlete to move her fingers and toes. 4. Ask the athlete to cough a couple of times to check respiratory competency. 5. Perform a primary survey. 6. Perform and Adson's maneuver. 7. Perform an upper quarter screen. 8. Look for coughing up of blood. 9. Palpate the thorax for point tenderness and crepitus.

1. Observe the athlete for cyanosis. 5. Perform a primary survey. 8. Look for coughing up of blood. 9. Palpate the thorax for point tenderness and crepitus.

200

You are covering a collegiate women’s lacrosse game when you observe 2 players collide as they try to catch a ball in the air. One of the players is struck by her opponent’s stick in the side of the chest. She falls to the ground and is in obvious pain. She is clutching her right side. You are able to assist the patient to the sidelines. She complains of significant pain during inspiration and continues to try to splint her chest with her arms. After a few minutes, you notice her lips look cyanotic. What steps would you take at this time to treat this athlete? 1. Record the rate and depth of respirations. 2. Monitor vital signs. 3. Tightly and continuously wrap the chest with an elastic bandage. 4. Use a vapocoolant spray such as fluromethane to reduce spasm. 5. Apply a sling and swathe, using the athlete's arm as a splint and support with the forearm supported across the chest. 6. Observe the rib cage for any areas of deformity. 7. Check the athlete's shoulder for AROM to make sure there is no injury to the scapula. 8. Perform an Allen's test. 9. Perform a Phalen's test. 10. Activate EMS. 11. Apply a pad over the suspected fracture site. 12. Refer the athlete to a physician as soon as possible.

1. Record the rate and depth of respirations. 2. Monitor vital signs. 5. Apply a sling and swathe, using the athlete's arm as a splint and support with the forearm supported across the chest. 6. Observe the rib cage for any areas of deformity. 10. Activate EMS. 11. Apply a pad over the suspected fracture site. 12. Refer the athlete to a physician as soon as possible.

300

While covering a state track meet, you observe a high jumper land incorrectly on the crash mat. When you get to the high jump pit, you see him lying on his right side and he is not moving. Given the above information, what would your initial steps be in evaluating the condition of this athlete? 1. Call for an ambulance. 2. Ask the athlete where he has pain. 3. Do a primary survey. 4. Make a mental note as to how the athlete is positioned. 5. With assistance from an athletic training student, turn the athlete onto his back. 6. Ask the athlete to wiggle his fingers and toes. 7. Ask the athlete what occurred. 8. Place and ice pack on the athlete's neck. 9. Palpate the athlete's knee for deformity. 10. Check on the athlete for any areas of bleeding on his face. 11. Send for the athlete's parents. 12. Check the athlete's level of consciousness.

2. Ask the athlete where he has pain. 3. Do a primary survey. 4. Make a mental note as to how the athlete is positioned. 6. Ask the athlete to wiggle his fingers and toes. 7. Ask the athlete what occurred. 10. Check on the athlete for any areas of bleeding on his face. 12. Check the athlete's level of consciousness.

400

While covering a state track meet, you observe a high jumper land incorrectly on the crash mat. When you get to the high jump pit, you see him lying on his right side and he is not moving. After speaking to the patient and completing your initial evaluation, you suspect a potentially serious neck injury. What would your next steps be in caring for this athlete? 1. With assistance, carry the athlete to the sidelines. 2. To determine the severity of the injury, see if the athlete can rotate his head. 3. Ask the athlete if he has any numbness or tingling down either upper extremity. 4. Tell the athlete to not move his head. 5. Check the athlete's pupillary response with a penlight. 6. Do a check of cranial nerves IV through XIII. 7. With the assistance of at least 2-4 other people and while maintaining the head in neutral, log-roll the athlete in to a supine position. 8. Ask the officials to stop the meet. 9. Secure the athlete on a spine board. 10. Ask someone to call an ambulance. 11. Place the athlete in a cervical collar. 12. Monitor the athlete's vital signs.

3. Ask the athlete if he has any numbness or tingling down either upper extremity. 4. Tell the athlete to not move his head. 7. With the assistance of at least 2-4 other people and while maintaining the head in neutral, log-roll the athlete in to a supine position. 9. Secure the athlete on a spine board. 10. Ask someone to call an ambulance. 11. Place the athlete in a cervical collar. 12. Monitor the athlete's vital signs.

500

While covering a state track meet, you observe a high jumper land incorrectly on the crash mat. When you get to the high jump pit, you see him lying on his right side and he is not moving. The patient is brought by ambulance to the hospital. What would be your next actions? 1. Contact your team physician. 2. Fill out an accident report form. 3. Return to the meet and follow up with athlete at a later time. 4. Check your records to see if the athlete is allergic to any medications. 5. Check with the coach to see if the athlete is on a scholarship. 6. Contact the athlete's parents to inform them of the accident. 7. Follow the ambulance to the hospital and leave your senior athletic training student to cover the meet. 8. Suggest to the athletic director that the school should eliminate the high jump even next time because it is too dangerous.

1. Contact your team physician. 2. Fill out an accident report form. 6. Contact the athlete's parents to inform them of the accident.

Scenario 5 (100-400)

100

An ice hockey player slams head first into the boards during practice. He is lying face down on the ice and is not moving. You have witnessed this event and no other players are involved. How will you begin the initial evaluation? 1. Perform a secondary survey of the athlete's entire body. 2. With assistance, roll the athlete onto his back while maintaining the head and neck in neutral. 3. Remove the athlete's helmet. 4. Perform a primary survey. 5. Establish the level of consciousness. 6. Begin chest compressions. 7. Have the coach get a vacuum splint. 8. Ask the other players what happened during the last play. 9. Sit the athlete up so he can breathe.

2. With assistance, roll the athlete onto his back while maintaining the head and neck in neutral. 4. Perform a primary survey. 5. Establish the level of consciousness.

200

An ice hockey player slams head first into the boards during practice. He is lying face down on the ice and is not moving. You have witnessed this event and no other players are involved. You have determined the patient is unconscious and is not breathing, but he has a pulse. What are your next steps in treating this athlete? 1. Perform a secondary survey. 2. Have the coach call for an ambulance. 3. Vigorously shake the athlete to try and get a response. 4. Take the athlete's blood pressure. 5. Cut off the face mask. 6. Log-roll the athlete onto his side. 7. Check the athlete for a positive Romberg's sign. 8. Perform abdominal thrusts to clear the airway. 9. Begin artificial respiration. 10. Establish if the athlete is in cardiac arrest. 11. Remove the athlete's mouthguard. 12. Use a jaw-thrust to open the athlete's airway.

2. Have the coach call for an ambulance. 5. Cut off the face mask. 9. Begin artificial respiration. 11. Remove the athlete's mouthguard. 12. Use a jaw-thrust to open the athlete's airway.

300

An ice hockey player slams head first into the boards during practice. He is lying face down on the ice and is not moving. You have witnessed this event and no other players are involved. The EMS team has arrived. The patient begins breathing again and becomes responsive. He states he cannot feel anything. With this information, what will be your next actions? 1. Perform a secondary survey. 2. Continue to monitor breathing, pulse, and blood pressure. 3. Tell the athlete not to worry, that he should feel something soon, and it is a temporary problem. 4. With assistance, secure the athlete to a spine board while maintaining the head and neck in neutral. 5. Call your team doctor. 6. Check pupillary response with a penlight. 7. Argue with the EMS team about whether or not the patient's helmet should be removed. 8. Tell the coach you will be at the emergency room and you will be in touch with him later. 9. Fill out an incident report to document what happened.

1. Perform a secondary survey. 2. Continue to monitor breathing, pulse, and blood pressure. 4. With assistance, secure the athlete to a spine board while maintaining the head and neck in neutral. 6. Check pupillary response with a penlight. 9. Fill out an incident report to document what happened.

400

An ice hockey player slams head first into the boards during practice. He is lying face down on the ice and is not moving. You have witnessed this event and no other players are involved. After practice, you go to the hospital to check on the patient’s condition. The emergency room physician informs you the patient will probably be a C5,6 quadriplegic. With this information available, what would you do next? 1. Check on the athlete to see how he is doing. 2. Call the team physician to inform him what has happened. 3. Contact the athlete's parents. 4. Tell the athlete sometimes doctors make mistakes not to give up hope. 5. Check your liability insurance. 6. Call the local newspaper to give them the story. 7. Return to school and inform the coach. 8. With the coaching staff, inform the team what has happened. 9. Have the emergency room physician contact your athletic director.

1. Check on the athlete to see how he is doing. 2. Call the team physician to inform him what has happened. 3. Contact the athlete's parents. 7. Return to school and inform the coach. 8. With the coaching staff, inform the team what has happened.

500

FINAL JEOPARDY!!!! A wide receiver gets a hard hit from the front while catching the football and lands hard on his right leg. He is lying on is back and is in sever pain. You immediately observe that his injured lower extremeity is in a flexed, adducted, and internally rotated position. You have ruled out a knee injury and suspect that the patient has sustained a traumatic right hip dislocation. With this information, how would you proceed? 1. Call the patient's parents 2. Check the patient for symptoms of shock 3. Get the patient up on crutches 4. Put an ice pack on the right thigh and groin 5. Keep the area clear of players 6. Palpate the popliteal and dorsalis pedis pulses 7. Check the hip for crepitus 8. Apply a vacuum splint to the entire lower extremity

2. Check the patient for symptoms of shock 4. Put an ice pack on the right thigh and groin 5. Keep the area clear of players 6. Palpate the popliteal and doralis pedis pulses

Scenario 6 (100-200) & 7, 8, 9 (300-500)

100

You are traveling with your school’s men’s basketball team when one of your patients comes to you complaining he has been having abdominal cramping and intermittent diarrhea for the past 2 days. Based on the preceding information, how would you proceed with your initial assessment of this athlete? 1. Ask the athlete what his diet has consisted of (food & drink) during the past 2-3 days. 2. Ask the athlete if he is nervous about playing. 3. Ask the athlete if he has had this problem before. 4. Check the athlete's blood pressure. 5. Take the athlete's oral temperature. 6. Check the athlete's body fat levels. 7. Palpate the athlete's abdomen. 8. Have the athlete run on a treadmill for 20 minutes.

1. Ask the athlete what his diet has consisted of (food & drink) during the past 2-3 days. 2. Ask the athlete if he is nervous about playing. 3. Ask the athlete if he has had this problem before. 5. Take the athlete's oral temperature.

200

You are traveling with your school’s men’s basketball team when one of your patients comes to you complaining he has been having abdominal cramping and intermittent diarrhea for the past 2 days. Assuming from your evaluation that this athlete has a gastrointestinal upset because of precompetition anxiety, what might your next steps be in assisting in this athlete’s recovery? 1. Speak with the coach and have the athlete refrain from practice until the symptoms disappear. 2. Weigh the patient before and after practices and games. 3. Give the athlete antimotility drugs, such as Imodium. 4. Make sure the athlete eats a lot of green vegetables, like broccoli and cabbage. 5. Give the athlete milk, soda, or tea to rehydrate. 6. Buy a water-testing kit and evaluate the hotel's drinking water. 7. Have the athlete drink only bottled water.

1. Speak with the coach and have the athlete refrain from practice until the symptoms disappear. 2. Weigh the patient before and after practices and games. 3. Give the athlete antimotility drugs, such as Imodium.

300

A 64 year old male has a gradual onset of bradykinesia, intentional tremors, dysphagia, and gait disturbances. Select the 2 most likely diagnoses from the set below: 1. Multiple Sclerosis 2. Huntington's Chorea 3. Myasthenia gravis 4. Cerebral Palsy 5. Parkinson's Disease

1. Multiple Sclerosis 5. Parkinson's Disease-most likely

400

A 45 year old male experiences "glove and stocking" paresthesias with bilateral upper and lower extremity progressive weakness that takes a rapid course to respiratory distress. Select the 3 most likely diagnoses from the set below: 1. Multiple Sclerosis 2. Duchenne's muscular dystrophy 3. Guillain-Barre Syndrome 4. Brain tumor 5. Parkinson's Disease 6. Amyotrophic lateral sclerosis (Lou Gehrig's Disease)

1. Multiple Sclerosis 3. Guillain-Barre Syndrome 6. Amyotrophic lateral sclerosis (Lou Gehrig's Disease)

500

A 5 year old male presents with an acute onset of anterior groin, thigh, and knee pain. He has difficulty ambulating. A limp is noted with limited hip abduction and stiffness when moving into internal rotation. There is also a flexion contracture of the hip. Select the 2 most likely diagnoses from the set below: 1. Piriformis Syndrome 2. Legg-Calve-Perthes Disease 3. Sacroiliac Rotation 4. Slipped capital femoral epiphysis 5. Femoral nerve entrapment

2. Legg-Calve-Perthes Disease 4. Slipped capital femoral epiphysis

Miscellaneous

100

How is Hepatitis C transmitted, and how long is the incubation period?

What is Blood borne; sexual contact. 15-150 days

200

an athlete comes to the athletic training room complaining of persistent night sweats and has a fever. they also have unexplained weight loss and loss of appetite. White spots or unusual blemishes in the mouth. and a persistent cough unrelated to smoking. What disease do you suspect this athlete has?

What is HIV human immunodeficiency virus?

300

what is a noncardiac cause of sudden death

What is commotio cordis, exercise induced anaphylaxis, sickle cell anemia, exertional rhabdomyolysis substance abuse head injuries heat illness exertional hyperthermia

400

An athletic trainer suspected or should have suspected a neck injury and failed to use a rigid back board to stabilize the individual. what type of negligence is this?

What is nonfeasance?

500

what type of pain is distal to the actual area of the pain that is being generated?

What is referred pain?