TEST BANK for Emergency Care 13E by Daniel Limmer, Michael O'Keefe & Edward Dickinson

TEST BANK

TEST BANK

Chapter 1. Introduction to Emergency Medical Care Limmer: Emergency Care 13th Edition

1) Which of the following refers to a program or process for evaluating and improving the effectiveness of an EMS system?

A) Quality improvement

B) System effectiveness management C) Process Improvement Plan (PIP) D) Total quality system - A) CORRECT. Quality improvement (QI) consists of continuous self-review with the purpose of identifying aspects of the EMS system that require improvement, with subsequent action plans to make subsequent changes.

B) INCORRECT. System effectiveness management does not refer to a program of evaluating and improving an EMS system.

C) INCORRECT. A program or process for evaluating and improving the effectiveness of an EMS system is not referred to as a Process Improvement Program.

D) INCORRECT. The term "total quality system" does not refer to a program for improving the effectiveness of EMS systems.

2) Which of the following groups is credited with developing the earliest documented emergency medical service?

A) The Spanish B) The Egyptians C) The Mayans

D) The French - Explanation: A) INCORRECT. The Spanish did not develop the first documented emergency medical service; the French did in the 1700s.

B) INCORRECT. Although known for progress in technical areas, the Egyptians were not responsible for the first documented emergency medical service. In 1790, the French first began transporting wounded soldiers away from battlefields and to waiting medical care.

C) INCORRECT. The earliest documented emergency medical service was in France in 1790, nearly a thousand years after the Mayan civilization disappeared.

D) CORRECT. The earliest documented emergency medical service was in 1790 when the French began transporting wounded soldiers from the scenes of battle to waiting physicians.

3) In 1966 the National Highway Safety Act charged which of the following agencies with the development of emergency medical service standards?

A) U.S. Department of Transportation B) U.S. Department of the Interior C) U.S. Department of Health Services

D) U.S. Department of Homeland Security - Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with developing EMS standards and assisting the states to upgrade the quality of their prehospital emergency care.

B) INCORRECT. The U.S. Department of the Interior is charged with the management and conservation of federal land and the country's natural resources. The Department of Transportation was charged with developing EMS standards.

C) INCORRECT. Although the U.S. Department of Health and Human Services is charged with protecting the health of all Americans, the United States Department of Transportation was assigned the task of developing emergency medical service standards.

D) INCORRECT. Although the U.S. Department of Homeland Security is tasked with protecting the nation from threats, it was established in 2002 and did not exist in 1966. It was the U.S. Department of Transportation that was charged with developing EMS standards.

4) Centralized coordination of emergency medical access, transportation, and care most refers to which of the following?

A) Emergency preparedness plan B) Trauma system

C) Resource management D) Central deployment - Explanation: A) INCORRECT. Emergency preparedness plans are usually developed to guide the actions of a specific group of people at the outset of an emergency, with the goal of protecting people and/or property. They generally will not address the specifics of medical care or transport.

B) INCORRECT. A trauma system is an organized, coordinated effort between facilities and responders within a defined geographic area to deliver a full range of care to injured patients. It does not address the coordination of basic (non-trauma) emergency care or transportation.

C) CORRECT. Resource management refers to the centralized coordination of an emergency response so that all victims have equal access to basic emergency care and are transported by certified personnel, in a licensed and equipped ambulance, to an appropriate facility.

D) INCORRECT. The centralized coordination of emergency medical access, transportation, and care within an EMS system is not referred to as central deployment.

5) Which of the following agencies is responsible for establishing EMS system assessment programs?

A) Department of Health and Human Services (HHS)

B) National Transportation Safety Board (NTSB) C) National Highway Traffic Safety Administration (NHTSA) D) United States Health Services Agency (HSA) - Explanation: A) INCORRECT. The Department of Health and Human Services (HHS) is not responsible for EMS system assessment programs.

B) INCORRECT. The National Transportation Safety Board (NTSB) does not establish EMS system assessment programs.

C) CORRECT. The National Highway Traffic Safety Administration (NHTSA) Technical Assistance Program has established assessment programs with set standards for EMS systems.

D) INCORRECT. The United States Department of Health and Human Services has no oversight of EMS systems.

6) Which of the following BEST describes the purpose of the modern emergency medical services (EMS) system?

A) To have trained personnel respond quickly and provide emergency care on the scene, during transport, and at the hospital B) To have trained personnel capable of assessing and caring for injured and ill patients on the scene

C) To have trained personnel understand the limitations of their training and "do no harm," while providing prompt transport to the hospital D) To have trained personnel knowledgeable in all aspects of prehospital care - Explanation: A) CORRECT. The modern Emergency Medical Services (EMS) system has been developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff.

B) INCORRECT. In addition to having trained personnel able to help patients on scene, the modern Emergency Medical Services (EMS) system also aims to provide that same assistance while en route to the hospital and at the hospital until hospital staff can take over care.

C) INCORRECT. Although understanding limitations and doing "no harm" are important aspects of an emergency care provider's job, the modern Emergency Medical Services (EMS)

system was developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff.

D) INCORRECT. Although knowledge is an important aspect of an emergency care provider's job, the modern Emergency Medical Services (EMS) system was specifically developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff.

7) What has the modern emergency medical services (EMS) system been developed to provide?

A) Prehospital care B) Prompt emergency response C) Safe emergency transportation

D) Trained medical personnel - Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with assisting the states in upgrading the quality of their prehospital emergency care.

B) INCORRECT. Prompt responses are an important part of any EMS system, but not what they were specifically developed to provide.

C) INCORRECT. Safe emergency transportation is only part of what modern EMS systems were developed for.

D) INCORRECT. Modern EMS systems were designed to provide more than just trained medical personnel.

8) Which of the following is the most common gateway for hospital services for patients who need emergency medical assistance?

A) Emergency department

B) Emergency medical services system C) Surgical services department D) Emergency medical dispatch center - Explanation: A) CORRECT. The emergency department serves as the gateway for the rest of the services offered by a hospital.

B) INCORRECT. The EMS system is not generally involved with hospital services other than the emergency department.

C) INCORRECT. Although an important component of a hospital's services, not all emergency medical patients will require surgery.

D) INCORRECT. An emergency medical dispatch center coordinates transports to the hospitals, but is not involved in determining or promoting specific hospital services.

9) Which of the following BEST describes a communication system capable of identifying the number and location of the phone from which a caller is calling?

A) Data display 911

B) Priority dispatch 911 C) Enhanced 911 D) Advanced 911 - Explanation: A) INCORRECT. Data display 911 does not refer to a system capable of identifying a caller's location.

B) INCORRECT. Priority dispatch 911 would refer more to an internal communication center protocol than a system for displaying locations and phone numbers.

C) CORRECT. An enhanced 911 system has the capability of automatically identifying the caller's phone number and location.

D) INCORRECT. Advanced 911 is an emergency texting system rather than a system for locating callers.

10) What is the minimum level of certification required of ambulance personnel responsible for direct patient care?

A) Emergency Medical Technician B) Emergency Medical Responder

C) Advanced EMT D) Emergency Ambulance Driver - Explanation: A) CORRECT. In most areas, the Emergency Medical Technician (EMT) is considered the minimum level of certification for ambulance personnel.

B) INCORRECT. An Emergency Medical Responder (EMR) is below the EMT certification level, and below the minimum usually expected for ambulance personnel.

C) INCORRECT. Advanced EMTs have a higher level of certification than what is commonly required as the minimum for ambulance personnel.

D) INCORRECT. Most ambulance personnel are expected to be at the EMT level or higher.

11) What BEST describes the level of EMS training that emphasizes activation of the EMS system and provides immediate care for life-threatening problems?

A) Emergency Medical Dispatcher

B) Cardiac care responder C) EMT D) Emergency Medical Responder - Explanation: A) INCORRECT. The Emergency Medical Dispatcher is responsible for coordinating the appropriate EMS response and potentially providing important instructions to the person calling for assistance.

B) INCORRECT. A cardiac care responder is not a recognized level of EMS training.

C) INCORRECT. EMTs provide basic-level medical and trauma care and transportation to a medical facility.

D) CORRECT. The emphasis of an Emergency Medical Responder is on activating the EMS system and providing immediate care for life-threatening injuries, controlling the scene, and preparing for the arrival of the ambulance.

12) What BEST describes the level of EMS training that emphasizes use of advanced airway devices and some prehospital medication administration?

A) Advanced EMT B) Paramedic C) Emergency Medical Responder D) EMT - Explanation: A) CORRECT. The Advanced EMT (AEMT) provides basic-level care and transportation as well as some advanced-level care, such as use of advanced airway devices, monitoring of blood glucose levels, and administration of some medications, which may include intravenous and intraosseous administration.

B) INCORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care.

C) INCORRECT. The first level of EMS training (Emergency Medical Responder) is primarily focused on activating the EMS system and immediate care for life- threatening injuries.

D) INCORRECT. EMTs provide basic-level medical and trauma care but cannot manage advanced airways or administer medications.

13) What level of emergency medical training provides the most advanced pre- hospital care?

A) Advanced EMT

B) Emergency Medical Responder C) Emergency Medical Technician D) Paramedic - Explanation: A) INCORRECT. The AEMT provides basic-level care and transportation as well as some advanced-level care in the pre-hospital setting.

B) INCORRECT. Emergency Medical Responders are trained to activate the EMS system, provide immediate care for life-threatening injuries, control the scene, and prepare for the arrival of the ambulance.

C) INCORRECT. EMTs provide basic-level medical and trauma care and transportation to a medical facility.

D) CORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care.

14) Which of the following is the primary responsibility of the EMT?

A) Protect and stabilize the patient B) Communicate with other responders on the scene C) Maintain personal health and safety D) Provide emergency care - Explanation: A) INCORRECT. Although protecting and stabilizing the patient is an important aspect of the EMT's job, maintaining personal health and safety first is the priority.

B) INCORRECT. Communicating with other emergency responders is necessary for effective scene safety and coordination, but the first priority for any EMT is to ensure their own health and safety.

C) CORRECT. It is not possible to help a patient if you are not physically capable or are injured while performing your job, so your first responsibility is to keep yourself healthy and safe.

D) INCORRECT. Providing emergency care is the EMT's purpose, but maintaining her own personal health and safety is the EMT's primary responsibility.

15) What BEST defines the evaluation of the patient's condition in order to provide emergency care?

A) Patient access

B) Patient assessment C) Medical intervention D) Patient advocacy - Explanation: A) INCORRECT. Patient access means getting to the patient's location.

B) CORRECT. Patient assessment is used to find out enough about what is wrong with your patient to be able to provide the appropriate emergency care.

C) INCORRECT. A medical intervention is the care provided once what is wrong with the patient has been determined.

D) INCORRECT. Patient advocacy is speaking up for the patient.

16) Upon arrival at the hospital, the EMT advises hospital personnel of the patient's condition, observations from the scene, treatment rendered, and other pertinent data to assure continuity of care. This process is known as which of the following?

A) Transfer of care

B) Breach of duty

C) Definitive care D) End of tour - Explanation: A) CORRECT. Providing the receiving hospital staff with information on the patient's condition, observations of the scene, and other pertinent data so that there will be continuity of care is part of the transfer of care process.

B) INCORRECT. A breach of duty occurs when an EMT has a responsibility to care for a patient and does not follow through.

C) INCORRECT. Definitive care refers to the type of care ultimately needed by a patient, not to the process of transferring the patient to hospital staff.

D) INCORRECT. The end of tour generally refers to the end of a scheduled EMS shift and is not related to patient care.

17) Which of the following is a component of patient advocacy?

A) Immobilizing the neck of a patient with a possible spinal injury B) Granting patient wishes and not reporting spousal abuse to the authorities C) Building rapport with the patient during transport to the hospital D) Providing oxygen to a patient that is short of breath - Explanation: A) INCORRECT. This is simply an example of patient care. Advocacy is working to understand the patient so that the EMT can speak up for them and promote their needs.

B) INCORRECT. Patient advocacy is not supporting a patient whose wishes will ultimately be harmful or against the law.

C) CORRECT. Building rapport with the patient is a critical component of advocacy.

Without it, the EMT won't be able to know the patient's needs or challenges enough to effectively speak on their behalf.

D) INCORRECT. Advocacy is about truly understanding the patient and speaking up for them to promote the best care possible, not simply providing an intervention.

18) Who is responsible for on-scene safety of EMS providers?

A) Traffic director B) Law enforcement C) All crew members D) Triage officer - Explanation: A) INCORRECT. The on-scene safety of EMS providers is not the responsibility of a traffic director.

B) INCORRECT. Law enforcement personnel can be an important part of scene safety, but they are not necessarily responsible for the safety of EMS crews.

C) CORRECT. It is the responsibility of all EMS crew members to keep themselves, the patient(s), and bystanders safe.

D) INCORRECT. The triage officer is not solely responsible for the on-scene safety of EMS providers.

19) Which of the following BEST describes a person who speaks up on behalf of the patient and supports his cause?

A) Guardian B) Assistant

C) Advocate D) Representative - Explanation: A) INCORRECT. A guardian is generally someone who is legally responsible for a patient, whether or not they support or advocate for them.

B) INCORRECT. A person who assists a patient with tasks may not necessarily speak up for the patient or support them in seeking better care.

C) CORRECT. EMTs should be advocates for their patients, speaking up for them and supporting them in getting appropriate care.

D) INCORRECT. The term "representative" does not indicate the same level of personal involvement in a patient's care and outcome as an "advocate" has. EMTs should always see themselves as advocates for their patients.

20) To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are all examples of which of the personal traits of a quality EMT? A) Able to listen to others

B) Pleasant C) Judgmental but fair D) Emotionally stable - Explanation: A) CORRECT. To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are examples of the ability to listen to others.

B) INCORRECT. Inspiring confidence and helping to calm the sick and injured are examples of being pleasant.

C) INCORRECT. Being nonjudgmental and fair means treating all patients equally regardless of race, religion, or culture.

D) INCORRECT. Emotional stability is the ability to overcome the unpleasant aspects of an emergency so that needed care may be rendered and any uneasy feelings that exist afterward may be resolved.

21) Which of the following is a physical trait necessary for performing the duties of an EMT? A) Nonjudgmental and fair B) Ability to lift and carry 200 pounds C) Ability to speak clearly D) Ability to remain calm in stressful situations - Explanation: A) INCORRECT. Being nonjudgmental and fair are important personal attributes for an EMT to have, but they are not physical traits.

B) INCORRECT. An EMT would not be expected to lift or carry over 125 pounds, so it would not be considered a necessary ability to carry 200 pounds.

C) CORRECT. An important requirement of an EMT is to have the physical ability to give and receive oral and written instructions.

D) INCORRECT. An EMT's ability to remain calm in stressful situations is a critical personal trait.

22) Which of the following is a personality trait required of EMTs? A) Ability to lift and carry 125 pounds B) Awareness of problems with color vision C) Ability to dominate the patient D) Control of personal habits - Explanation: A) INCORRECT. A physical ability is not a personality trait.

B) INCORRECT. Awareness of a physical problem, such as color vision, is not related to the qualities that make up a person's character.

C) INCORRECT. Although the ability to dominate others may be considered a personality trait, it is not one required to be an EMT. D) CORRECT. To reduce the chances of providing improper care or causing patient discomfort, EMTs should be able to control their personal habits appropriately.

23) Which of the following best describes training that supplements the EMT's original training and that is usually taken in regular intervals?

A) Distance education B) EMT training program

C) Recertification D) Continuing education - Explanation: A) INCORRECT. Distance education refers to the way training or courses are delivered, not specifically to the topic.

B) INCORRECT. An EMT training program is the initial certification course, not the supplemental training that follows it.

C) INCORRECT. Recertification refers to the renewal of an EMT certificate, not specifically to regular ongoing training.

D) CORRECT. Ongoing education that supplements an EMT's original training is called Continuing Education (CE).

24) During the new employee orientation, the training officer meets with the new EMTs and explains to them the monthly training schedule and the classes they must attend for EMT recertification. One of the new EMTs asks the training officer why they have to keep taking EMT courses if they already passed the EMT examination. What is the best answer?

A) The state requires the training.

B) EMTs forget everything once they pass the EMT exam.

C) It looks good to a jury should the service be sued.

D) EMS is constantly evolving in response to evidence-based research. Answer Explanation: A) INCORRECT. Although continuing education is mandated by most states, it is not the reason continuing education is performed.

B) INCORRECT. Continuing education does provide EMTs with a good review of rarely used material; however, it is not accurate that EMTs forget everything once they pass the EMT exam.

C) INCORRECT. Although continuing education can demonstrate to a jury that the service is providing adequate training, one of the goals of continuing education is to prevent lawsuits from happening in the first place, rather than to look good once a lawsuit has been filed.

D) CORRECT. Evidence-based scientific research is what drives changes in EMS. New and improved treatment techniques are derived from this research and the EMT needs to keep abreast of these dynamic changes to his profession.

25) Which of the following is a personal trait an EMT should demonstrate?

A) Self-starter B) Strong student C) Strong communication D) Good eyesight - Explanation: A) CORRECT. One of the personal traits of an effective EMT is that of being a self-starter.

B) INCORRECT. Being a strong student is a good quality, but personal traits relate to the behavior and demeanor of the EMT, not her strength in a particular task.

C) INCORRECT. Strong communication is obviously important for an EMT, but it is the result of certain personal traits (respectful, able to listen, controlled in tone, etc.) — not a personal trait itself.

D) INCORRECT. Good eyesight is a critical physical trait for an EMT to have.

26) What is NOT one the common settings that an EMT may work in?

A) Rural/wilderness settings B) Ambulance services C) Hospitals D) Fire departments - Explanation: A) INCORRECT. One common setting that EMTs work in is rural/wilderness settings.

B) INCORRECT. One common setting that EMTs work in is ambulance services.

C) CORRECT. EMTs do not work in a hospital.

D) INCORRECT. One common setting that EMTs work in is fire departments.

27) The National Registry of Emergency Medical Technicians (NREMT) was founded to establish which of the following?

A) An education curriculum for EMT courses

B) Quality oversight of emergency medical services practices C) National standards for emergency medical services personnel D) Quality improvement and quality assurance programs for emergency medical services Explanation: A) INCORRECT. Although EMT course curricula are based on the standards provided by the NREMT, the National Registry was not founded to create them.

B) INCORRECT. The NREMT created the standards used for modern EMS, but the organization does not oversee or determine the quality of provided services.

C) CORRECT. In 1970, the National Registry of Emergency Medical Technicians (NREMT) was founded to establish national standards within the industry.

D) INCORRECT. The NREMT developed the professional standards for emergency care personnel, but is not involved in quality improvement or any assurance of the care provided.

28) You have just come on duty. The EMT on the previous shift complains to you that the QI manager was giving him grief because he did not document three sets of vital signs on the patient record. The EMT is angry and does not understand why documenting three sets of vital signs is so important. What is the best answer you could give him?

A) Vital signs are something you have to fill out because the state requires it.

B) The recording of three sets of vital signs demonstrates that you were trending the patient's condition.

C) It is important you show the QI manager that you are a team player.

D) The report looks better when all the boxes are filled out. Answer - Explanation: A) INCORRECT. The local or state governmental authority may or may not require three sets of vital signs; regardless, this should not be the primary reason to document them.

B) CORRECT. Recording three sets of vital signs demonstrates that the EMT is reassessing the patient at the appropriate periodic intervals, which is important when providing care for a patient.

C) INCORRECT. Teamwork is an important trait in an EMT, but is not the driving factor for recording vital signs.

D) INCORRECT. QI is not concerned with how the report looks, but rather that the information in the report is complete and accurate.

29) Why is it important for EMTs to participate in quality improvement programs?

A) To ensure that individuals making false calls for EMS are prosecuted B) To identify problem employees and create a corrective action plan C) To identify problems and develop a plan to prevent their recurrence D) To ensure adequate personnel are available for emergencies - Explanation: A) INCORRECT. The aim of any EMS quality improvement program is to continually improve the care and operations within the system — not to identify challenges with particular individuals in the community. EMTs play a critical part

in quality improvement by identifying areas in need of improvement, participating in the improvement process and supporting the changes.

B) INCORRECT. EMTs should participate in Quality Improvement (QI) programs to assist in bettering their EMS systems and processes, not to pinpoint and create action plans for specific individuals.

C) CORRECT. EMS quality improvement programs consist of continuous self- review with the purpose of identifying aspects of the system that require improvement. Once a problem is identified, a plan is developed and implemented to prevent further occurrences of the same problem. It is critical that EMTs participate in this process because they usually have the best visibility to challenges within the system and can provide valuable insight into how to improve.

D) INCORRECT. An EMT's participation in an EMS quality improvement program is not necessarily about adequate staffing. It is about the EMT helping to identify and fix any components in the system that cause inefficiencies and challenges to patient care.

30) After delivering a patient to the emergency department, you discuss with hospital staff the details of your care and ask for suggestions to improve your care. This is an example of your role in which of the following?

A) Patient advocacy

B) Transfer of care C) Quality improvement D) Continuing education - Explanation: A) INCORRECT. A patient advocate is the person who speaks up for the patient and pleads her cause.

B) INCORRECT. Transfer of care is the process of turning care of a patient over to those with higher levels of training.

C) CORRECT. Continuous self-review through numerous means with the purpose of identifying aspects of the system that require improvement is known as quality improvement.

D) INCORRECT. Continuing education is ongoing structured training designed to supplement the EMT's original course.

31) The EMT's role in the quality improvement process includes becoming involved in the quality process, keeping carefully written documentation, obtaining

feedback from patients and the hospital staff, continuing your education, and which of the following?

A) Writing protocols and standing orders B) Maintaining your equipment C) Providing quality care

D) Being a member of the QI committee - Explanation: A) INCORRECT. The Medical Director is responsible for writing protocols and standing orders.

B) CORRECT. Maintaining equipment properly is an important role the EMT plays in the quality improvement process.

C) INCORRECT. Providing quality care is an expectation of all EMTs, but it not part of the quality improvement process.

D) INCORRECT. Although it can be beneficial, being a member of the QI committee is not an expected role for an EMT in the quality improvement process.

32) Which of the following is a role of the EMT in the quality improvement process?

A) Taking responsibility for the actions of one's partner B) Writing complete patient care reports C) Critiquing performance of one's partner D) Assuring personal safety - Explanation: A) INCORRECT. The primary roles of an EMT in quality improvement include; preparing carefully written documentation, involvement in the system's quality improvement process, obtaining feedback from patients and hospital staff, maintaining equipment, and continuing education. Taking responsibility for the actions of others is not a part of the quality improvement process.

B) CORRECT. Since much of an EMS system's clinical quality improvement data comes from patient care documentation, ensuring that each report is complete and accurate is a very important part of an EMT's involvement in quality improvement.

C) INCORRECT. Critiquing the performance of other emergency responders is not a primary role for EMTs in the quality improvement process. An EMT can best assist the process by preparing carefully written documentation, being involved in the system's quality improvement process, obtaining feedback from patients and hospital staff, maintaining equipment, and continuing his education.

D) INCORRECT. Although assuring personal safety is a very important responsibility for EMTs, it is not a role in the quality improvement process.

Continuing education, equipment maintenance, gathering feedback from patients and hospital staff, preparing complete and accurate patient documentation, and getting involved in the EMS system's structured quality improvement program are all examples of roles for the EMT in a QI process.

33) Who assumes the ultimate responsibility for patient care rendered by the EMT? A) EMS supervisor B) EMT C) Director of quality assurance D) Medical Director - Explanation: A) INCORRECT. Although an EMS supervisor can be involved, the EMS service's Medical Director assumes ultimate responsibility for the care provided by an EMT. B) INCORRECT. Since every EMT operates under the license of the EMS service's Medical Director it is the Medical Director, not the EMT, who is ultimately responsible for the patient care.

C) INCORRECT. In every EMS service or agency, the Medical Director is ultimately responsible for the patient care provided by the EMTs. D) CORRECT. The Medical Director of an EMS agency or service is ultimately responsible for all patient care because the EMTs work under the Medical Director's license.

34) The application of oxygen for a patient who is short of breath without having to contact the physician in the emergency department is an example of which of the following?

A) On-line medical direction

B) Standards of care C) Standing orders D) Breach of duty - Explanation: A) INCORRECT. On-line medical directions are orders from an on-duty physician given by radio or phone.

B) INCORRECT. Standards of care refer to the expected actions of an EMT as compared to a reasonable person with the same level of training and in the same situation. It is not related to the authorization of specific skills.

C) CORRECT. Standing orders are physician issued policies or protocols that authorize EMTs to perform particular skills in certain situations.

D) INCORRECT. A breach of duty occurs when an EMT has a responsibility to care for a patient and does not follow through.

35) Which of the following BEST describes a list of steps the EMT should perform while assessing and managing emergency medical situations?

A) Standing orders

B) On-line medical direction C) Protocols D) Standard operating procedures - Explanation: A) INCORRECT. Standing orders, also called off-line medical direction, allow EMTs to give certain medications or perform certain procedures without speaking to the Medical Director or another physician.

B) INCORRECT. On-line medical direction consists of orders from the on-duty physician given directly to an EMT in the field by radio or telephone.

C) CORRECT. Protocols, which are developed by an agency's Medical Director, are lists of steps for assessment and interventions to be performed in different situations.

D) INCORRECT. Standard operating procedures are a collection of policies around EMS agency operations and generally do not apply specifically to medical assessment or management.

36) A written authorization for an EMS provider to perform a particular skill in a specific situation is a(n): A) on-line protocol.

B) standard of care.

C) direct medical order.

D) standing order. Answer - Explanation: A) INCORRECT. Any "on-line" direction indicates a verbal order from a physician to an EMT, usually by phone or radio.

B) INCORRECT. Standard of care refers to the expected actions of an EMT as compared to a reasonable person with the same level of training and in the same situation. It is not related to the authorization of specific skills.

C) INCORRECT. A direct medical order would generally come from a physician in a specific situation and is considered "on-line" direction.

D) CORRECT. A standing order is a policy or protocol issued by a Medical Director that authorizes EMTs and others to perform particular skills in certain situations.

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37) You and another new EMT are studying your local protocols. The other EMT notices that you may give oral glucose without utilizing on-line medical control, but you must get an on-line order from a physician before assisting a patient in taking his nitroglycerin for chest pain. The EMT asks you why some drugs require on-line medical control while others do not. What is the best answer to give him?

A) Glucose is only sugar so it cannot hurt the patient.

B) The physician does not trust EMTs.

C) The patient's nitroglycerin might be expired.

D) The physician wants to be sure it is appropriate for the patient. Answer - Explanation: A) INCORRECT. Although glucose is sugar and relatively safe, it can be harmful if given to an unresponsive patient. But ultimately, this answer does not explain why not to give nitroglycerin without a physician's order.

B) INCORRECT. The reason protocols are written is not because physicians do not trust EMTs; they are written because EMTs do not have the advanced training that physicians have.

C) INCORRECT. Although medications may be expired, this does not require contacting medical control to confirm.

D) CORRECT. Nitroglycerin, although indicated for most chest pain patients, is not appropriate for all cardiac patients. The physician, with his advanced training, is better suited to make that determination.

38) You respond to a 35-year-old male patient who fell 50 feet from a bluff. Your authority to provide emergency care is an extension of the Medical Director's license to practice medicine.

You are acting as a(n) of the Medical Director.

A) subordinate

B) employee C) designated agent D) extension - Explanation: A) INCORRECT. Being a subordinate of the Medical Director does not provide any authority to provide emergency care.

B) INCORRECT. An EMS system's Medical Director does not directly employ EMTs, and simply being an employee does not provide the authority to provide care.

C) CORRECT. An EMT at a basic or advanced level is operating as a designated agent of the Medical Director.

D) INCORRECT. An EMT does not provide care as an extension of the Medical Director.

39) A fellow EMT is talking with the Medical Director at a staff meeting. The EMT states that the neighboring ambulance service is carrying special clotting bandages for serious bleeding wounds. The special bandages cost five times as much as the regular bandages, but the EMT claims they work ten times better. The EMT wants the Medical Director to approve the bandages for use in their ambulances. The Medical Director responds to the EMT by saying he will not approve the bandages until he can prove they are worth the additional cost. How can the EMT best prove the worth of the special bandages?

A) Have a member of the other ambulance service call the Medical Director to provide firsthand information on how the special bandages are much better.

B) Call the manufacturer of the special bandage and request literature to give to the Medical Director.

C) Perform a literature search to see what studies have been done on the special bandages and report the findings to the Medical Director.

D) Order a small number of the special bandages and compare them side-by-side to the regular bandages. Answer - Explanation: A) INCORRECT. Firsthand accounts or anecdotal information do not provide any actual scientific proof that the special bandages are superior.

B) INCORRECT. Literature from the manufacturer is designed to sell the bandages and will only present the positives of the bandages without any negative information.

C) CORRECT. Finding objective, unbiased, evidence-based research that validates the claims of the special bandage is the only way to actually prove that the special bandages are superior.

D) INCORRECT. Product testing of the bandages is a good idea to determine how the bandages will work for that particular service, but does not provide proof that they are actually better.

40) You and your EMT partner are assigned to spend a day at the senior center where you are to inspect the rooms and common areas for fall hazards. Your partner is upset that he is not in the ambulance where the "action is." He complains that "looking for loose rugs" is a waste of his time. What would be the best response to his complaints?

A) It is good practice for the next emergency call.

B) It makes the taxpayers happy.

C) Injury prevention in the community is an important component of EMS.

D) It minimizes the number of 911 calls late at night. Answer - Explanation: A) INCORRECT. EMTs should already have competency in blood pressure techniques prior to hosting any screening clinics.

B) INCORRECT. Although community relations are important, it is not the primary reason for checking blood pressures.

C) CORRECT. Illness and injury prevention is an important component of EMS as EMTs are always in the field, and the role of EMS in public health is expected to only increase in the future.

D) INCORRECT. Blood pressure screening clinics do not impact the number of late night 911 calls.

41) You and your new EMT partner arrive first on the scene of a single car rollover on the shoulder of a busy highway. You pull off in a safe location and just as you stop the ambulance, your partner throws the passenger door open, steps out of the truck, and begins jogging through the scattered debris toward the overturned car. You shout for him to stop and he looks back at you, but then continues to the vehicle and begins assessing the driver. Later, as you are restocking in the ambulance bay of the local trauma center your partner tells you that he thinks you acted unprofessionally by shouting at him. What is the best way to respond?

A) Shouting was an attempt to protect the EMT from a potentially unsafe scene.

B) New EMTs should expect partners to yell at them occasionally.

C) The On-Duty Supervisor should be called.

D) An EMT should never hurry to assist a patient. Answer - Explanation: A) CORRECT. Quickly entering a dangerous scene without taking proper precautions will create additional risks.

A professional EMT should always be concerned about the safety

of everyone on scene; not just themselves and the patients, but other responders as well. In this case, shouting at the EMT was an appropriate attempt to prevent him from entering an unsafe situation.

B) INCORRECT. Although sometimes the noise level of a situation requires responders to raise their voices to be heard, expecting to be yelled at simply because one is a new EMT is not professional or correct.

C) INCORRECT. It is important for EMT partners to be able to communicate effectively and professionally when debriefing calls. Generally, a Supervisor should only become involved if the EMTs cannot resolve a conflict themselves or if they need a specific question answered.

D) INCORRECT. Emergency medical care sometimes does require responders to act quickly, but never when it places others on scene in danger.

Page Ref: 8-9

Chapter 2. Well-Being of the EMT Limmer: Emergency Care 13th Edition

1. While transporting a patient to the hospital who has a history of terminal brain cancer, the patient says, "I know I'm going to die, but first I want to see my grandson graduate from high school." What stage of death and dying describes this patient's current condition?

A. Depression B.Anger C.Denial D. Bargaining Answer - D 2. You are on the scene of an "unknown medical" call. The patient is a 26-year-old, 250-pound male patient who suddenly becomes violently angry. Everything you say to the patient only makes him angrier. Offended by your questions, he screams that he is going to "cut your tongue out" and hurries into the kitchen. What should you do?

A.Radio for police and relay to dispatch important scene information until they arrive.

B.Tackle the patient before he can get a kitchen knife to stab you.

C.Leave immediately to a safe area and then call for police assistance.

D.Radio for police and then calmly walk out of the house, being sure to take all of your medical equipment.

Answer - - C 3. When the potential exists for exposure to exhaled air of a person with suspected or confirmed TB, a(n) mask should be worn by the EMT. A. B-50 B.surgical C. N-95 D. Non rebreather Answer - C 4.

What is a simple step EMTs can perform to help prevent the spread of flu in the prehospital environment?

A.Transport all patients with coughs to negative pressure rooms.

B. Notify the CDC and local health department of flu cases.

C.Encourage patients to get their H1N1 antivirals early in the flu season.

D. Place a surgical mask on suspected flu patients.

Answer - D 5. You are first on the scene of a vehicle collision where a vehicle has gone off a bridge

and is partially submerged. You are told that a person is still trapped in the vehicle. Your partner starts to take off his shoes and prepares to go in to save the victim. You stop your partner and tell him it is too dangerous. He tells you he is prepared to die to save a life. What is the best response to him?

A.His family will not receive any benefits if he is not trained in rescue and dies while attempting a rescue.

B.He is not only putting his life at risk, but also placing the lives of the professional rescuers unnecessarily at risk.

C.He will force additional fire units to come to his aid unnecessarily and waste taxpayer money.

D.The patient's family may sue him if he is not successful in rescuing him. Answer - B 6. Which of the following pathogens can live in dried blood for days and should be a major concern for EMS providers even while cleaning contaminated equipment?

A. AIDS B. Hepatitis B C. Tuberculosis D. Hepatitis A Answer - B 7. For the last few days, your regular EMT partner has been having trouble sleeping, has been on edge, and has trouble concentrating on his job during EMS calls. Luckily, your call volume has been low with no serious calls since the infant cardiac arrest you both worked last month. You ask him if anything is bothering him and he states he is fine in every way. He states that he has been going to the bars lately to relax and invites you to come along for some drinks after work.

Choose the best answer for this situation.

A. Your partner is suffering from acute stress reaction and you should recommend to him that he seek professional counseling.

B. Your partner is suffering from a delayed stress reaction and you should recommend that he seek professional counseling.

C. Your partner is suffering from a cumulative stress reaction. This is a natural response and he should be fine in a few days.

D. Your partner is suffering from post-traumatic stress disorder and you should go to the bar with him to provide moral support and talk with him. Answer - B 8. Which of the following pathogens is transmitted through contact with open wounds or sores?

A. Rubella B.Pertussis C.Meningitis D. Staphylococcus Answer -- D

9. The term burnout is also known as a(n) A. delayed B. cumulative C. acute D. post-traumatic - B

stress reaction.

10. An EMT should consider wearing protective eyewear when caring for which of these patients?

A. A trauma patient who is covered in dirt, rocks, and other foreign debris B. A patient with a difficult-to-visualize scalp laceration C. A patient who was sprayed with mace by police during arrest D. A patient who is actively coughing - D 11. During which of these situations would the EMT be least likely to experience a body substance exposure?

A. Childbirth B. Splinting a sprained ankle C. Bandaging a laceration D. Glucometry - B 12. Which of the following behaviors would be considered a common sign of stress rather than an acute psychological problem?

A. Increased speeding and reckless driving B. Irritability with friends, family, coworkers, or patients C. Failure to use PPE appropriately on a regular basis D. Flashbacks, nightmares, and feelings of detachment - B 13. When responding to the scene of a patient who was discovered to be unresponsive, not breathing, and without a pulse, family members state that the patient has been suffering from cancer for several years. One of his sons is cursing at you and your partner, saying that you are not moving fast enough. Which stage of grief is the patient's son experiencing in response to his father's death?

A. Denial

B. Depression C. Anger D. Acceptance - C 14. Which three "Rs" are essential for the EMT to practice when reacting to danger? A. Ricochet, recover, re-entry B. Retreat, radio, reevaluate C. Realize, react, reassess D. Remember, respect, respond - B Healthcare employers are required by law to provide a hepatitis B available to employees free of charge.

A. cure B. immunity C. vaccine D. prophylaxis - C 15. All of the following are ways that an EMT can increase both physical and mental wellbeing, except: A. following a regular walking regimen. B. eating a balanced diet. C. spending more time relaxing with friends and family. D. drinking moderate amounts of caffeine and alcohol. Answer - D 16. According to Dr. Hans Selye, the third stage of the "Stress Triad" is known as the stage.

A. exhaustion B. alarm C. cumulative D. resistance - A 17. Which of the following is an accurate statement regarding tuberculosis (TB)? A. TB is not spread through surface contamination. B. A tuberculin skin test can detect TB exposure. C.

The TB pathogen only affects lung tissue. D. The incubation period of TB is from 1 to 7 days. Answer - B 18. You are called to an assault on a homeless male. Dried blood from the trauma is visible around the patient's mouth and nose. During assessment, you note the patient has a productive cough. The patient says, "Don't worry, I'm not contagious. I've had this cough for a year." Describe the best approach regarding respiratory isolation.

A. Use gloves for PPE, as that's all that's needed. B. Mask yourself and the patient. C. Isolate the patient with a nonrebreather mask. D. Mask yourself only. Answer - B 19. An EMT involved in an especially difficult call, such as one in which a coworker was killed, should be urged to: A. begin a course of psychiatric medications. B. conceal the problem because care may not be covered financially. C. seek help from a trained mental health professional. D. discuss the experience freely with coworkers. Answer - C 20. Since EMS personnel are often exposed to both acute and chronic stressors, management may be helpful to cope with on-the-job experiences. A. stress prevention B. critical incident stress C. crisis intervention D. chronic stress - B 21. What is the name of the federal act that mandates a procedure by which emergency healthcare providers can find out if they have been exposed to potentially lifethreatening diseases while on the job?

A. Occupational Exposure to Bloodborne Pathogens Act B. Ryan White CARE Act C. EMS Personnel Health Protection Act of 1991

D. Communicable Disease Notification Act - B 22. Due to the high risk of an unstable work environment, EMTs responding to a motor vehicle crash may consider using in addition to standard PPE. A. N-95 masks B. face shields C. Level B hazmat suits D. heavy-duty gloves - D 23. Which of the following parts of the nervous system is responsible for the "fight or flight" response experienced in response to a stressor?

A. Central nervous system B. Parasympathetic nervous system C. Peripheral nervous system D. Sympathetic nervous system - D 24. Which of the following is the form of stress that can cause immediate and long- term problems with an EMT's health and well-being?

A. Distress B. Hyperstress C. Megastress D. Eustress - D 25. Which of the following terms is best defined as "a state of physical and/or psychological arousal to a stimulus?"

A. Homeostasis B. Eustress C. Distress D. Stress - D 26. When covering a patient's mouth and nose with a mask of any kind, which of the following is the primary risk?

A. Causing or exasperating respiratory illnesses B. Upsetting the patient because of the social stigma C. Interfering with patient communication D.

Obstructing the ability to visualize and protect the airway - D 27. Post-traumatic stress disorder may be described as a(n): A. delayed stress reaction. B. severe stress reaction. C. cumulative stress reaction. D. acute stress reaction - A 28. Which hormone helps the body control stress, regulate metabolism, and influence an immune response?

A. Immunoglobulin B. Epinephrine C. Cortisol D. Serotonin - C 29. What is a common term used to describe the items needed for Standard Precautions or body substance isolation precautions?

A. Harm-reduction strategy B. Infection-control plan C. Exposure-control plan D. Personal protective equipment - D 30. What would be the primary reason for an EMT to change gloves between contact with different patients?

A. To prevent spreading infection to the next patient B. To minimize the amount of time the EMT's hands are spent in gloves C. To ensure soiled gloves are changed as soon as possible D. To protect the EMT from becoming infected - A 31. Which of the following descriptions BEST defines the term pathogen? A. An organism that causes infection and disease B.

A study of the origins of infection and disease C. An immunity developed after an exposure D. A medication with a harmful effect - A 32. The CDC recommends using an alcohol-based hand sanitizer in all except which of the following situation(s)?

A. The provider's hands come into contact with fecal matter. B. The provider is not vaccinated against hepatitis B. C. The patient has a respiratory illness. D. The patient has a bloodborne communicable disease - A 33. Which of the following terms refers to a positive form of stress that helps people work when under pressure and respond effectively?

A. Eustress B. Prostress C. Unstress D. Distress - A 34. One's "cognitive ability" refers to his or her ability to do which of the following? A. Use fine motor skills B. Adapt to stress C. Think and solve problems

D. Control his or her emotions - C 35. Critical Incident Stress Debriefings (CISDs): A. have been replaced with "defusings." B. must be held from 2 to 4 hours following an incident to be effective. C. are always recommended. D. are now less common than they once were. Answer - D 36. Which one of these groups is at greatest risk of contracting and transmitting tuberculosis?

A. Uranium mine workers B. Current and former smokers C. Healthcare practitioners D. Immunosuppressed patients - C 37. You have just worked a cardiac arrest call on a 48-year-old father of three. Despite your best efforts, the patient died in the emergency department. As you are getting your ambulance in service, the patient's wife rushes out of the emergency department. She finds you and begins screaming at you that her husband's death is your fault. She blames you for not getting on the scene fast enough, taking too long at the house, and not shocking her husband back to life like she has seen on television. What response should you have to her anger?

A. Listen empathetically to all of her complaints and let her know she can contact you for any additional assistance.

B. Correct her misconceptions and remind her that television shows are fiction, so she will not sue you in the future.

C. Recognize that she is in the denial stage of grief and interrupt her hysterical behavior pattern by getting her attention and helping her calm down.

D. Reassure her that you did everything you could and that everything will be okay. Answer - A 38. What is a positive, healthy way to help deal with stress? A. Adding workload to a busy regular schedule B. Caffeine to "get up and go" C. Drinking alcohol to "unwind" D. Regular physical exercise - D 39. Which of the following provides the greatest personal safety for an EMT working at a

motor vehicle collision?

A. Portable radio B. Nonslip footwear C. Flashlight D. Reflective outer clothing - D 40. What are the minimum Standard Precautions an EMT should take when transporting a patient infected with Middle East Respiratory Syndrome (MERS)? A. Gloves and N-95 mask B. Gloves, N-95 mask, goggles, and gown C. Gloves, N-95 mask, and goggles D. Gloves - B

Chapter 3. Lifting and Moving Patients Limmer: Emergency Care 13th Edition

1. Which of the following behaviors would demonstrate that an EMT understands reactions to death and dying?

A. Giving a dying patient hope that a cure can be found before the patient dies B. Being firm with grieving family members and telling them they need to accept what has happened C. Providing spiritual guidance to patients who express anger at God D. Being tolerant of angry reactions by patients and family members Answer - D 2. You observe a coworker telling a terminal cancer patient and her family, "Everything will be okay." Making false reassurances is considered: A. caring and supportive.

B. ambiguous and uncertain.

C. naive and uncompassionate.

D. professional and discreet.

Answer - C

3. A family member who keeps pleading with a deceased loved one to "wake up" is experiencing which reaction to death and dying?

A. Denial B. Anger C. Rejection D. Projection Answer – A: Denial is the first stage of grief according to the Kübler-Ross model. It is a defense mechanism that buffers the immediate shock of the loss. During this stage, individuals may struggle to accept the reality of the loss. This reaction can manifest as disbelief, feeling numb, or expecting the deceased to "wake up" or return. The pleading behavior reflects an inability to accept the death, which is characteristic of denial.

4. What are some signs and symptoms that a coworker may be experiencing delayed stress reaction (PTSD)?

A. Headaches, stomach ailments, and a chronic cough B. Flashbacks, nightmares, and feelings of detachment C. Excessive sleeping, loss of appetite, and distractibility D. Suspicion of friends, family, coworkers, or patients Answer – B Flashbacks: These are vivid memories of the traumatic event that feel as if they are happening in the present. The person may relive the event repeatedly, which can be distressing and disruptive.

Nightmares: Individuals with PTSD often experience frequent, distressing dreams related to the traumatic event, leading to sleep disturbances and anxiety.

Feelings of detachment: A person may feel emotionally numb, disconnected from others, or unable to engage in activities they once enjoyed. This detachment can extend to relationships with friends, family, and coworkers.

These symptoms are hallmark signs of PTSD and indicate that the individual is struggling with unresolved trauma from a past event.

What action does an organ undergo to best describe the term hypertrophy? A. Wasting B. Changing C. Absence D. Enlargement - D You are treating a patient who has a productive cough and who reports weight loss, loss of appetite, weakness, night sweats, and fever. Which of the following diseases is most likely the cause of these signs and symptoms?

A. Pneumonia B. Hepatitis B C.

AIDS

D. Tuberculosis - D Which of the following statements about HIV/AIDS is true? A. The HIV virus lives longer outside the body than hepatitis B. B. HIV positive needlesticks have a 30 percent infection rate. C. Drugs are not available that slow HIV from progressing into AIDS. D. HIV positive needlesticks have less than a 0.05 percent infection rate. Answer - D You respond to a laceration call. When you arrive on-scene, you walk into the house and find a person suffering from a severe wrist laceration from a broken window. Without thinking, you immediately grab the wrist and apply direct pressure to the wound. You then realize that, in your hurry to save a life, you forgot to put on your gloves. You look down to see your hand is covered in blood. When practical, your next action should be A. If your hands had no open wounds, it is not required to report the exposure as there is no risk of infection, and you could get in trouble at work for failure to follow policy.

B. Report the exposure incident because it is the law and you could be fined a large sum of money for failing to report the exposure.

C. Report the exposure. Failure to report the exposure may result in you not receiving financial compensation for a potential line-of-duty injury.

D. Wash your hands and report the exposure. Answer - D You are dispatched to a "man down" with no further information. As your unit arrives on-scene, you see a crowd of bystanders looking at a man lying in an

alleyway. The bystanders begin screaming to you, "Help him, he's been shot! He's bleeding real bad!" What would be the best course of action?

A. Dispatch law enforcement and wait until the scene is secure. B. Move bystanders aside since the patient will die without treatment. C. Tell law enforcement investigators to meet your unit at the ER. D. Load and go, because you're already on-scene. Answer - A You are approaching the scene of a motor vehicle crash. Which of the following would be the first way to safeguard your well-being as an EMT? A. Take personal protective equipment (PPE) precautions. B. Request additional resources. C. Utilize DOT-approved reflective safety clothing. D. Ensure scene safety. Answer - D The tuberculin skin test (TST), formerly known as the purified protein derivative (PPD) test, is used to: A. detect a person's exposure to tuberculosis. B. determine if a person has infected others with TB. C. inoculate healthcare workers against TB infections. D. prevent tuberculosis from spreading following an exposure. Answer - A Which of the following is a physiologic effect of the "Stress Triad" as described by the physician Hans Selye?

A. Hypertrophy of the lymph nodes B. Bleeding gastric ulcers C. Atrophy of the adrenal glands D. Amnesia for stressful events - B Which of the following is true regarding proper hand cleaning? A. If the EMT's hands are visibly dirty, an alcohol-based hand cleaner is not sufficient.

B. Soap and water should be used following any patient contact if the EMT does not wear gloves.

C. Following patient contact, the EMT should soak his hands in warm soapy water for at least 30 seconds and then shake them vigorously.

D. In cases where soap and water and alcohol-based hand cleaners are not immediately available, bleach wipes should be used. Answer - A A(n) is a situation that may lead to an acute stress reaction. A. injury of a coworker B. abuse of alcohol C. routine call D. ongoing night shift - A An EMT is confronted by an armed gunman who is threatening to kill the EMT and his partner.

An elevation in the EMT's heart rate and blood pressure occurs in which stage of the body's response to stress?

A. Response stage B. Exhaustion stage C. Resistance stage D. Alarm reaction stage - D The "Stress Triad," or the body's response to a stressful stimulation, is known as general syndrome.

A. incident B. reaction C. adaptation D. resistance - C

What mode of transmission most accurately describes the route of spreading hepatitis A? A. Fecal-oral B. Bloodborne C. Respiratory droplet D. Unprotected sex - A You are dispatched to the staging area of a terrorist-related chemical exposure. The incident commander asks you to stand by while hazmat personnel bring patients to the cold zone. As an EMT on-board an ambulance, what statement BEST describes your role?

A. Triage patients to be decontaminated. B. Transport decontaminated patients. C. Coordinate hazmat response. D. Transport patients to be decontaminated. Answer - B

You are dispatched to a female with altered mental status. Once inside the home, you find a female who appears to have been beaten unconscious. A man, who smells of alcohol, says that she is his wife and that he does not know what happened: "I just found her this way!" The husband is behaving suspiciously, appears paranoid, and is pacing erratically around the room.

What would be the safest course of action?

A. Leave the house and call for law enforcement. B. Continue to question the man and begin treating the patient. C. Have your partner call for help while you stay with the patient. D. Evacuate the patient and begin treatment. – A During an emergency move, which of the following techniques should be used, whenever possible, to minimize the possibility of further aggravating a possible spinal injury?

A. Roll the patient over.

B. Pull the patient from the feet, not the shoulders. C. Move the patient sideways, alternating between moving the shoulders, then the hips.

D. Move the patient in the direction of the long axis of the body. Answer - D You are moving an elderly patient down the stairs using a stair chair. The patient is alert and very anxious. What should you do prior to moving the patient to prevent her from grabbing the railing and causing you to fall?

A. Explain to the patient what you are doing and advise her to hold her hands together and not let go until you are finished moving her.

B.

Place the patient on oxygen during the move to calm her down. C. Use a strap to safely secure the patient's arms to the chair without causing any loss of circulation to the patient's extremities.

D. Gently tie the patient's hands together until you are downstairs to prevent her from unconsciously grabbing the railing. Answer - A How far apart should your hands be when using a power grip? A. 10 inches B. 6 inches C. 15 inches D. 24 inches - A You have responded to a nursing home and find an elderly patient in his bed in cardiac arrest.

Which type of move would you perform to get the patient to a hard surface so you can perform chest compressions?

A. Clothing drag B. Non-urgent move C. Emergency move D. Rapid move - C You respond to a call at a park where you find a 550-pound patient who has fallen down a slope near a creek. As you and your partner discuss the situation, you decide to call a second unit for lifting assistance. Once the patient is on a stretcher, how would the additional two personnel help in this lift?

A.You place one person on each corner of the stretcher to balance the weight and share in the lifting.

B.You will place two persons at the head of the stretcher, one at the foot, and one to act as a spotter.

C. You will place two persons at the foot, one at the head, and the other to act as a safety anchor with a rope.

D.They would position themselves half way up the slope to take over when you and your partner get fatigued. Answer - A Which of the following patients should not be transported in a stair chair?

A. Patient who is nauseated B. Patient with a suspected spinal injury C. Patient with difficulty breathing D. Patient found lying in bed Answer- B E. Urgent moves are required when: A.Performed for treatment of life threats along with precautions for spinal injuries.

B.An emergency move is not possible. C.

there are no life threats and conditions are stable. D. rapid transport is necessary. Answer - A You are called to the scene of a patient who fell approximately 5 feet off a stepladder to the floor of a third-story attic of a very old building. He is complaining of severe neck and back pain, and he has an obvious fractured ankle.

You cannot get your stretcher past the first-floor stairs and your long spine board is not practical with the winding spiral staircase and the small attic access. What is the best device to safely get the patient out of the attic where he can be properly immobilized? Ch.40 A. Vest-type extrication device B. Flexible stretcher C. Stair chair D. Scoop stretcher - A Ch.40What is the preferred number of rescuers when using a stair chair? A. Only one with the track-like chair B. Three: two lifting and one spotting C. Four: one for each corner of the device D. Two: one in front and one in back - B Ch.40How many pounds are most battery-powered hydraulic systems rated to safely lift? A. 200 B. 500 C. 700 D. 300 - C Ch.40 What type of move should the EMT use to move a patient who is in a car that has started to burn?

A. Non-urgent move B. No attempt to move C. Emergency move D. Urgent move - C Ch.40Which of the following is another name for the squat-lift position? A. Weight-lifter technique B. Power grip C. Direct carry D. Power lift - D Where should you position the weight of the object being lifted? A. As far from the body as possible B. As close to the body as possible C. To one side or the other D. An arm's length away from the body - B Which of the following should you use when you want to move a patient from a wheelchair to a stretcher?

A. Clothing lift B. Extremity lift

C. Ground transfer D. Modified direct lift - B Which of the following best describes body mechanics? A. Proper use of the body to protect patient safety B. Proper use of the body to facilitate lifting and moving objects C. Equipment designed to minimize stress on the user's body D. Both B and C - B You respond to the scene of a two-vehicle T-bone vehicle collision. The driver's side door is smashed shut and will not open. The front passenger door will open. The front passenger is stable and complaining of severe head and neck pain. You suspect that he has a potential spinal injury. The driver is unresponsive, in critical condition, and has gurgling respirations. You should extricate the passenger by which technique?

A. Take extra care to protect the passenger's neck with a KED board or short spine board because of the injury.

B. Carefully move the patient using full c-spine precautions. C. Move the patient out of the car as quickly as possible, in the direction of the long axis of the body.

D. Move the patient as quickly as possible so he can get to a hospital before paralysis sets in.

Answer - C What is the likely impact of power stretchers on EMS? A.

Insurance reimbursement will increase for ambulance services. B. There is no likely impact of power stretchers on EMS. C. There will be an increase in the number of home health transfers. D. There will be a decrease in the number of injuries among EMTs. Answer - D You are treating an unconscious patient who does not have a possibility of spinal injury and who is breathing adequately. Which of the following is the BEST position for transporting the patient?

A. Semi-Fowler position B. Recovery position C. Supine D. Fowler position - B When a stretcher with a patient secured to it is elevated, what occurs? A. The center of gravity is raised and this causes a tip hazard. B. The patient feels more comfortable being at near normal height. C. The stretcher is more stable and easily pushed. D. The EMTs lessen the possibility of injury from being bent over the patient. Answer - A Which of the following is the correct position of an EMT's feet when lifting? A. Two feet apart B. As close together as possible

C. As wide apart as possible D. Shoulder-width apart - D Which of the following devices should be used to carry a patient down the stairs whenever possible?

A. Stair chair B. Basket stretcher C. Wheeled ambulance stretcher D. Scoop stretcher - A The term body mechanics describes the proper use of your body to lift without injury. What are the three considerations to review before any lift?

A. The object, patient injury, and communication B. Equipment, patient injury, and communication C. The object, your limitations, and communication D. Environment, physical limitations, and communication - C Which of the following devices is best suited for maneuvering a patient through a narrow hallway?

A. Flexible stretcher B. Long backboard C. Basket stretcher

D. Wheeled stretcher - A You and your partner arrive on the scene of a 400-pound patient lying in bed. He complains of nausea and vomiting for the past 3 days. When he tries to sit up, he gets very dizzy and has a syncopal episode. Realizing that he cannot assist you in getting on the stretcher, you decide to do which of the following?

A. Use the patient's sheets to slide him over to the stretcher. B. Call for additional manpower to move the patient. C. Use the power lift technique to carefully and safely lift the patient to the stretcher. D. Place the patient on a backboard to provide better gripping points to move the patient. Answer B Stretchers that are designed to carry obese patients weighing up to 800 pounds (or more) are called: A. battery-powered stretchers. B. wheeled stretchers. C. bariatric stretchers. D. hydraulic stretchers. Answer - C What should you NOT do when using a stair chair? A. Lean forward from the hips. B. Keep your back straight. C. Lean forward from the waist.

D. Flex your knees. Answer - C Which of the following is NOT correct when performing a log roll? A. Place both feet flat on the ground. B. Keep your back straight. C. Use your shoulder muscles. D. Lean forward from the hips. Answer - A For a patient without a possibility of spinal injury, which of the following carries should be used to move him from a bed to a stretcher?

A. Direct-ground lift B. Draw-sheet method C. Firefighter's carry D. Extremity lift - B If the weight being pulled is below the level of the EMT's waist, he should be in a(n) position.

A. squatting B. kneeling C. overhead D. feet-together - B

Which of the following factors should be considered before lifting any patient? A. Your physical limitations B. Communications C. The weight of the patient D. All of the above - D When placing all fingers and the palm in contact with the object being lifted, you are using which of the following?

A. Lock grip B. Power grip C. Vise grip D. Power lift - B Ch.40 You respond to a 48-year-old morbidly obese female patient. Her adult daughter called you because she has not gotten up from her oversized recliner chair in over a week. She has tried to help her out of the chair but states that each time her mother screams in agony. The foul odor presence of urine and feces is strong around the patient. Her feet do not touch the ground, and any attempt to lift the patient by her arms or scoot her down to the end of the chair results in severe pain to the patient. You are finding it nearly impossible to get a good grip on the patient.

How will you get her out of the chair?

A. Vest-type extrication device B. Soft stretcher C. Long spine board

D. Lie the chair back and use a scoop stretcher - A When lifting a patient, a basic principle is to: A. lift with your lower back. B. extend your arms to maximize your lift. C. rush your lift to minimize your lift time. D. know your lifting limits. Answer - D Which of the following best describes an urgent move? A. Moving a patient from a car directly to a long spine board B. Pulling a patient by her feet across a parking lot C. Dragging a patient from a burning house using his shirt D. Using a sheet to move a patient from a bed to the stretcher - A Which of the following statements regarding body mechanics is true? A. Position your feet close together. B. Use your legs to lift. C. Use your back to lift. D. Twist your torso while lifting. Answer - B You have responded to a multiple casualty incident involving an overturned bus. Patients have been thrown around the interior of the bus and several are piled on

top of each other. What type of move would you perform to gain access to the most critically injured patients?

A. Emergency move B. Non-urgent move C. Urgent move D. Extremity lift - A What is the contraindication for the use of a scoop or orthopedic stretcher? A. Internal injuries B. Spinal injury C. Hip fracture D. Pelvic injury - B Which of the following is used to immobilize a patient with a suspected spinal injury?

A. Portable stretcher B. Basket stretcher C. Scoop stretcher D. Long backboard - D What is the main benefit of using a stair chair with a track-like system over a traditional stair chair?

A. There is no benefit of a track-like stair chair over a traditional stair chair. B. A stair chair with a track-like system can be manipulated to lift into an ambulance using a hydraulic system.

C. Only one EMT is required to operate a stair chair with a track-like system. D. A stair chair with a track-like system prevents the patient from having to be lifted down stairs.

Answer - D Which of the following should you do when reaching for something? A. Avoid twisting. B. Avoid reaching more than 15 to 20 inches in front of your body. C. Keep your back in a locked-in position. D. All of the above - D Which of the methods listed below is best described as moving a patient from the floor to a stretcher by having two or more rescuers kneel, curl the patient to their chests, stand, and then reverse the process to place the patient on the stretcher?

A.

Power lift B. Direct ground lift C. Direct carry D. Draw-sheet method - B Ch.40 Which urgent move should be performed for a patient seated in a vehicle? A. Rapid immobilization B. Rapid takedown C. Rapid takeout D. Rapid extrication - D Which of the following is another name for an ambulance cot? A. Stair chair B. Wheeled ambulance stretcher C. Scoop stretcher D. Reeve's stretcher – B You have been under a lot of family stress lately, and you have not been sleeping well. When you got to work this morning, you realized that you had forgotten to place your badge on your uniform shirt. You tell your partner that you cannot seem to think clearly. Your partner tells you that he is concerned about your well-being. After hearing this, you know that your duty as an EMT is to: A. inform your partner that your well-being is not his concern. B. tell your partner that you feel better after talking to him and go about your work. C. take off work until you can straighten out your family problem and make sure that you are mentally prepared to work.

D. recognize that talking about your problems at work is unprofessional and distracts your fellow EMTs. Answer - C What is the term for placing a person in fear of bodily harm? A. Libel B. Slander C. Battery D. AssaulT - D Chapter 4. Medical, Legal, and Ethical Issues

Limmer: Emergency Care 13th Edition 1. A 13-year-old patient involved in a collision who appears to be under the influence of drugs refuses care. Regarding the issue of providing care to this patient, you must consider that this patient: A. has legally refused care.

B. should sign a release form.

C. should be reported to the police.

D. can't legally refuse care.

Answer - D 2. Even if the Good Samaritan laws in a particular state cover the actions of EMTs as rescuers, they can still be held liable and are NOT protected by these laws if: A. their actions cause embarrassment for the patient.

B. the patient dies from the injuries.

C. their actions demonstrate gross negligence.

D. their actions demonstrate poor clinical reasoning.

Answer - C 3. You are on the scene of a motor vehicle collision where a patient's car struck a utility pole.

Witnesses reported to you that the patient was unconscious after the impact. However, the patient is now conscious, alert and oriented, and refusing care and transport. You should: A. leave after having the patient sign the refusal form.

B. inform the patient of your concern and try to persuade her to go to the ED and receive treatment.

C. have the law enforcement officer place the patient under arrest, as she is obviously in danger.

D. use informed consent and tell the patient that since she was unconscious, she is not allowed to refuse. Answer - B 4. You are transporting a victim from a motor vehicle collision, and the patient's condition is deteriorating rapidly. From your experience, you do not think this patient will survive transport.

You noticed on the patient's driver's license that the patient is an organ donor. You can help to facilitate the patient's wishes by: A. notifying medical direction of the patient's organ donor status.

B. transporting the patient to facility other than the trauma center to which you are going.

C. withholding CPR until the patient's donor status is confirmed.

D. trying to contact a family member of the patient to discuss the patient's wishes so that you can alert the hospital when you arrive. Answer - A 5. Which of the following would MOST likely be considered evidence at a crime scene?

A. Medical care by an EMT B. Fingerprints C. Patient advocacy

D. Family pictures Answer - B 6. An EMT fails to properly care for a patient despite having a duty to act. The EMT is most likely guilty of: A. Child endangerment.

B. Psychological abuse.

C. Domestic abuse.

D. Negligence.

Answer - D 7. You document on your run sheet that your patient with altered mental status is "just another drunk." This would likely be considered: A. slander.

B. negligen ce.

C. a HIPAA violation. D. libel - D 8. If an EMT were to release information about how intoxicated a patient was onto a social networking site, this could be considered: A. breach of faith. B. slander.

C. libel.

D. battery - C

9. A legal document allowing the health care provider to withhold resuscitation from a chronically or terminally ill patient is known as: A. an advance directive.

B. a health care proxy.

C. a standard of care.

D. a termination of resuscitation.

Answer: A. an advance directive Rationale: An advance directive is a legal document that outlines a patient's wishes regarding medical treatment, including the decision to withhold resuscitation or other life-sustaining measures. This document is created in advance to guide healthcare providers in situations where the patient may no longer be able to communicate their preferences.

10. The actions and care that are legally allowed for the EMT are called the: A. standing orders.

B. Good Samaritan law.

C. scope of practice.

D. standard of care.

Answer: C. scope of practice Rationale: The scope of practice defines the procedures, actions, and processes that are permitted for a licensed individual within a specific profession. For EMTs, it delineates what they are legally authorized to do based on their training, certification, and regulations set by governing bodies.

11. You observe what appears to be elder abuse in a call to a nursing home. You have a clear: A. legal obligation to report the abuse.

B. implied consent to provide care to any patients at the home.

C. moral obligation to report the abuse.

D. release from liability for negligence in your care.

Answer: A. legal obligation to report the abuse Rationale: Healthcare providers, including EMTs, are mandated reporters in many jurisdictions.

This means they have a legal obligation to report any suspected abuse, including elder abuse, to the appropriate authorities to ensure the safety and protection of vulnerable individuals.

12. What is a set of regulations and ethical considerations that define the extent and limits of the EMT's job?

A. Standard of care B. Scope of practice C. Res ipsa loquitur D. Tort Answer: B. scope of practice

Rationale: The scope of practice encompasses the regulations and ethical considerations that outline what EMTs are permitted to do in their professional role. It defines the boundaries within which they must operate to ensure they provide safe and effective care without exceeding their legal authority.

13 . Wheeling a non-emergency patient into the hospital emergency department, placing him in a bed, and leaving without transferring care directly to ED staff constitutes: A. abandonment.

B. acceptable actions if you have an emergency call to respond to.

C. acceptable actions if someone sees you do them.

D. acceptable actions if the ED is very busy.

Answer: A. abandonment Rationale: Abandonment occurs when a healthcare provider terminates the patient-caregiver relationship without ensuring that care is transferred to another qualified provider. Leaving a patient in a hospital bed without properly handing over their care to the ED staff is considered abandonment and can have serious legal and ethical implications.

14. Which of the following would MOST likely be considered evidence at a crime scene?

A. The position in which the patient is found B. The homeowner's pet C. The refrigerator icemaker D. Clean napkins in a drawer - A 15. What may interfere with an EMT's ability to care for a patient at a crime scene?

A. The patient has multiple injuries.

B. The patient is bleeding from a wrist laceration.

C. The police want to interview the patient.

D. The police have secured the scene - C 16. You have not breached a patient's confidentiality if: A. you only share information specific to that patient when medically necessary.

B. you share information specific to that patient with family and friends.

C. you share a funny item from a patient's medical history with a colleague.

D. you talk about that patient's medical issues when off duty only with your spouse Answer - A

17. You have just arrived at the station to start your shift, and you notice that your partner is asleep in a chair. You proceed to check out your ambulance. Your partner comes in drinking a cup of coffee, and you notice that she has a strong alcohol smell on her breath. Your duty as an EMT is to: A. tell dispatch that you will be out of service for maintenance.

B. tell your partner to go get some rest before you get a call.

C. notify dispatch that you are out of service and have your supervisor come to meet you.

D. see whether someone from the night shift can hold over until your partner can sober up Answer - C 18. You and your partner have arrived on the scene of a person injured as a result of a gunshot wound during a burglary. When police later arrive and secure the scene, one of the police tells you to file a complete report describing what you saw when you arrived on scene, as required by law in your area. You should: A. File a report that leaves out any detail you consider confidential for that patient.

B. refuse to file any report, citing patient confidentiality.

C. file the report and leave out no details.

D. file a report in which you explain in detail why you believe a crime was committed Answer - C 19. The care that would be expected to be provided to the same patient under the same circumstances by another EMT who had received the same training is called the: A. scope of practice.

B. duty to act.

C. standard of care.

D. protocol. Answer - C A 42-year-old patient who is mentally competent has refused care but appears to be experiencing respiratory difficulty. He demands you get into your ambulance and go. You should: A. plead with the patient to sign a release form. B. restrain the patient to provide emergency care. C. remain on the scene and try to persuade the patient to consent to care. D. immediately leave the scene. Answer - C

While providing patient care at a secured crime scene, you should: A. use the telephone to call in a report to medical control. B. pick up any evidence that you find and give it directly to a police officer. C. cover the deceased patient with a sheet and move the body to the ambulance. D. not cut through holes in clothing that might have been caused by bullets or stabbing - D If emergency care providers discover that a seriously injured patient is an organ donor, they should: A. ignore a DNR order and perform CPR. B. confirm with the family that this was the patient's decision. C. treat the patient the same as a nondonor. D. treat the patient as having given prior expressed consent for all emergency care - C A patient is injured but refuses to be transported by ambulance. He is competent to make decisions, and you have exhausted all avenues to convince him to be transported, so you have him sign a refusal of treatment form. This form is intended to release you from: A. liability for not providing care. B. the responsibility to stay on the scene. C. properly informing the patient of the consequences of refusing care. D. the need to provide any care for this patient at any time - A

You proceed to treat a patient who has consented to care, but you have NOT explained the risks and benefits of what you are going to do. This is MOST likely a violation of: A. informed consent. B. scope of practice.

C. implied consent. D. in loco parentis - A The Health Insurance Portability and Accountability Act (HIPAA): A. allows you to discuss patient-specific information only with individuals with whom it is medically necessary to do so.

B. requires you to obtain the patient's signature acknowledging receipt of your agency's privacy policy before you perform any patient interventions.

C. allows you to provide specific patient information to the media without additional patient consent.

D. allows you to discuss specific patient information with other personnel at the station. Answer - A Documents signed by a patient that communicate his or her wishes regarding medical care are called: A. automated care orders. B. extended patient directives. C. advance directives. D.

physician orders - C In a kindergarten, the teachers can give consent for EMT care of their students. Which form of consent applies here?

A. In loco parentis B. Expressed consent C. Parental consent D. Informed consent - A Laws that have been developed by states to minimize the risk of individuals being held liable for providing emergency care to victims of illness or injury are called: A. Good Samaritan laws. B. advance directives. C. immunity proclamations. D. protocols - A The concept of res ipsa loquitur would be MOST relevant to a situation involving: A. EMTs providing care to an unconscious patient. B. harm to a patient in the care of EMTs. C. EMTs explaining the consequences of refusing care to a patient. D. EMTs remaining with a patient who had refused care. Answer - B What is an EMT's primary ethical consideration?

A. Making the company bottom line a priority B. Making partner relations a priority C. Making efficiency a priority D. Making patient care and the patient's well-being a priority - D You are on the scene with a patient who is complaining of chest pain, and you have administered medication. Your partner brings in the stretcher, and the patient tells you that she does not want to be transported to the ED. You should: A. contact medical direction for a consult. B. tell the patient that she can refuse transport, but because you gave her a medication, she has to see a doctor within 24 hours.

C. explain to the patient that she cannot refuse because you have already begun treatment.

D. leave after telling the patient that it's not appropriate to abuse the EMS system - A Medical direction needs to be in the loop on this refusal, as you have administered a medication.

Medical direction can assist the EMS crew in convincing the patient that she needs to go to the ED for further care. If the patient still refuses, consulting with medical direction is another layer of protection for the EMS crew.

Which of the following could be a source of information to let the EMT know that a patient is an organ donor?

A. The on-line physician B. The statement of a bystander who is the patient's neighbor C.

A piece of notepaper stating that fact D. The patient's driver's license - D You may find that the patient is an organ donor when told so by a family member, or a patient may carry an organ donor card. The back of the patient's driver's license may also contain an indication that the patient wishes to donate organs upon his or her death.

As you enter a hectic possible crime scene, you find that a coffee table is blocking your access to the patient. Which of the following is the BEST way to manage this situation?

A. Move the table and get on with your work of caring for the patient. B. Use the table as a place to set your equipment as you are working on the patient. C. Move the table as little as possible, wearing gloves; notify police on the scene; and document your actions precisely in your patient care report.

D. Wait until one of the police officers can move the table for you. Answer - C If you must disturb any items at a crime scene to access a patient, move them as little as possible, wear gloves to avoid leaving additional fingerprints, make a note of the original location of the item, and state exactly how you moved the item You explain a risky procedure to a patient. He says, "As long as it's guaranteed to work, you can do it." You should: A. consult medical direction. B. explain that a risky procedure is not guaranteed. C. begin the procedure.

D. decide not to use the procedure - B

Expressed consent must be informed consent. That is, patients must understand the risks associated with the care they will receive. It is not only a legal requirement but also sound emotional care to explain all procedures to the patient. In this case, the patient's response shows a lack of understanding that there is no guarantee with a risky procedure.

Which of the following would MOST likely be considered evidence at a crime scene?

A. Footprints B. A child's toy C. A paper towel roll D. Movies on DVD - A The condition of the scene, information provided by the patient, fingerprints and footprints, and microscopic findings are all considered evidence.

At a crime scene, which of the following is the first priority of the EMT? A. Evidence preservation B. Working with police C. Patient care and transport D. Critiquing the scene - C After the police have ensured scene safety, your first priority is patient care.

Which is concerned generally with what you can do, as opposed to what you should do and how you should do it?

A. Standard of care B.

Scope of practice and standard of care C. D. Quality improvement - C In general, scope of practice refers to what you should be able to do, while standard of care refers to what you should do in a particular situation and how you should do it. Quality improvement is involved with maintaining standards of care EMS is on the scene of the cardiac arrest of a terminally ill cancer patient. The family states that the patient has a valid DNR but they are unable to locate it. The family is upset and adamant that the patient does not want resuscitation. The EMS crew should: A. verify that the family on scene is related to the patient by asking for identification. If a family member is immediate family, that person can make health care decisions for the patient.

B. begin resuscitation and consider establishing on-line medical direction. C. provide the family with a blank DNR and have them fill it out. D. withhold resuscitation. It is clear the patient is terminally ill, and the family is on scene instructing the crew to withhold care. Answer - C Without a valid document, EMS has the moral and legal obligation to begin full resuscitative efforts and follow all protocols for such events You suspect that a pediatric patient is being abused. You decide not to report this to the appropriate authorities because the parent is very upset and remorseful. This is: A. an ethical violation but definitely not a crime. B. a violation of professional ethics and possibly a crime. C. a reasonable judgment call.

D. a violation of policy but not an ethical violation. Answer - C Failure to report suspected abuse is a violation of the EMT code of ethics. In addition, most states have laws mandating that EMS providers report suspected abuse. Failure to do so could be considered a crime. patient on the basis of: A. expressed consent. B. involuntary transportation. C. implied consent. D. informed consent. Answer - C When the patient is not able to make decisions for himself or herself, the EMT can use implied consent, meaning that the EMT operates under the assumption is that if the patient were of sound mind, the patient would request help for the issue.

A patient who called 911 is now refusing transport. You should: A. make sure there is a law enforcement officer to act as a witness on the scene of every patient refusal.

B. make sure that there is an immediate family member on scene who can sign as a witness to the refusal.

C. assess the patient, advise the patient of the risks of refusal, and clearly document everything in the patient care report.

D. direct the patient to contact his or her primary care physician for instructions on whether or not to go to the hospital. Answer - C There is a potential for a lot of liability on the EMT's part when a patient refuses transport. EMTs must make sure to fully explain to the patient the risks of refusal and to clearly document their actions to protect themselves and the rest of the crew.

Which of the following is MOST clearly a HIPAA violation? A. Your agency receives a subpoena authorizing the release of a copy of a patient care report to a plaintiff's attorney.

B. You provide certain health information on the billing copy of the patient care report.

C. You provide a personal injury attorney with a copy of a patient care report. D. You provide a copy of the patient care report to a paramedic who is assuming care of your patient at the scene. Answer - C HIPAA specifies circumstances in which protected health information can be released. This is generally on a "need to know" basis, when the patient consents in writing, or when the provider or organization is compelled by a court to do so.

Providing a patient care report to a personal injury attorney is a breach of confidentiality under HIPAA. The person who is legally designated to make health care decisions for the patient if the patient is unable to do so is called: A. a patient advocate.

B. a health care proxy. C. the attorney of record. D. the executor of the estate. Answer - B Patients may wish to designate a health care proxy who can legally make decisions for them in the event that they are unable to do so themselves When an EMT takes the time to ask permission from a conscious adult to do an assessment and procedures, this is respecting the legal principle of:

A. proximate cause.

B. implied consent. C. in loco parentis. D. expressed consent - D Expressed consent must be obtained from every conscious, mentally competent adult before treatment is started Which of the following would MOST likely be considered evidence at a crime scene?

A. Blood spatter B. Time of day C. Mouthwash D. Mail coupons - A Why does the EMT's scope of practice vary from state to state? A. Company insurance B. Local legislation C. EMT preference D. National standards - B The skills and medical interventions that the EMT may perform are defined by legislation that varies from state to state. Sometimes different regions within the same state may have different rules and guidelines for their EMTs.

Ethical considerations: A. are less important than following regulations. B. relate primarily to making patient care and well-being a priority. C. fall outside scope of practice. D. are the sole consideration of scope of practice. Answer - B Falling within your scope of practice are certain ethical responsibilities. The primary ethical consideration is to make patient care and well-being a priority, even if this requires some personal sacrifice.

Which of the following is likely to be inscribed on a medical identification device worn as a bracelet?

A. Date of birth B. Hospital preference C. Emergency contact D. Allergies - D A medical alert device may be a necklace, bracelet, or card and may indicate any of a number of conditions, including heart conditions, allergies, diabetes, and epilepsy.

You have just returned to the station after completing a call in which you transported an elderly female patient to the hospital for nausea and vomiting. Upon exiting the ambulance, you are approached by an adult male who indicates that the patient you just transported was his mother and he wants to know the details of the run. You should: A.

tell him that you can pass his contact information along to the privacy officer at your department.

B. ask to see his driver's license to verify last names and, if they match, give him the information.

C. allow him to read the patient care report, as that is public information. D. give the patient the information he is requesting, as he is the patient's son - B The EMT has the duty to protect the rights of the patients they transport, which includes protecting their health information. Your agency's privacy officer should be the primary contact here.

You are at the dinner table with your crew and mention to everyone that a coworker on the opposite shift is moving up the administration chain quickly, probably because she's sleeping with the company CEO. This comment could be considered: A. a HIPAA violation. B. slander.

C. res ipsa loquitur.

D. libel. Answer - B In the spoken context, this comment can be described as slander You are on the scene of a cardiac arrest. You have begun resuscitation as family members arrive and present you with a valid DNR order. You should: A. notify the family that once CPR has been initiated, you are required to transport the patient.

B. follow your local protocols and contact medical direction if unsure how to proceed. C.

have your partner contact the communications center to send law enforcement to the scene, as this is now a legal issue and the officer will make the decision.

D. complete two more rounds of CPR and then check for a pulse. If there is no pulse, you should stop resuscitation. Answer - B DNR protocols vary by state. It is essential you know and follow your local protocols. Contact medical direction if you are unsure how to proceed The actions that an EMT is legally allowed to perform while caring for an injured or ill patient are known as: A. the standard of practice. B. the standard of care.

C. medical direction. D. the scope of practice - D The scope of practice is set by the state and outlines what procedures and skills the EMT is allowed to perform.

Quality improvement relates primarily to: A. state-by-state regulations. B. standard of care.

C. scope of practice.

D. the limits of the EMT job - B The process of quality improvement relates to maintaining standards of care.

Good Samaritan laws were enacted to: A. protect individuals who try to help people in emergencies.

B. keep patients from suing ambulance companies for the actions of their employees. C. protect patients from poor health care delivered by health professionals. D. protect EMS services from lawsuits - A Good Samaritan laws are intended to protect individuals who try to help people during an emergency. Every state has its own version of a Good Samaritan law.

Leaving a patient after initiating care and before the patient has been transferred to someone with equal or greater medical training is known as: A. in loco parentis. B. res ipsa loquitur.

C. abandonment. D. negligence. Answer - C Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training is abandonment.

You are transporting a patient from a doctor's office and see that the patient has not been well cared for. On your documentation, you write that the doctor seemed to be "a quack." This comment could be viewed as: A. res ipsa loquitur.

B. proximate causation. C. libelous. D. slanderous - C

A photo of a pair of EMTs on a call shows them laughing and looking casual and relaxed a few feet away from a patient in apparent distress. This would most likely be used to demonstrate: A. res ipsa loquitur.

B. abandonment. C. proximate causation. D. a patient refusal situation - B The term res ipsa loquitur means "the thing speaks for itself," and in this case, knowing nothing but what is shown in the photo, it would appear that the EMTs were neglecting the patient in distress. It isn't clearly a patient refusal situation because there is nothing to indicate that the patient has refused treatment or transport. It's not abandonment because the EMTs have not actually left the patient. It isn't necessarily proximate causation because the patient's distress isn't clearly the result of the EMTs' actions or inaction.

A suicidal 14-year-old who has critically injured herself is trying to get you to withhold care. She is screaming that she wants to die and that you should not touch her or come near her. You should: A. inform medical direction that you will withhold care. B. call her parents. C. wait for the girl to change her mind or lose consciousness. D. provide the care she needs. Answer - D Children and mentally incompetent adults are not legally allowed to provide consent or refuse medical care and transportation. In cases of life-threatening illness or injury when a parent or guardian is not present, care may be given based on implied consent.

You are caring for a patient who was stabbed. During your assessment, you find a small knife impaled in one of the stab wounds. You determine that removing the weapon now would be dangerous for the patient. You should: A. remove the knife and place it in an evidence bag. B. ask the police officer whether it is acceptable for you to leave the knife in place for transport.

C. treat the wound as usual, but notify police that you must transport the weapon with the patient.

D. have a police officer remove the knife before you transport - C Disturb as little as possible at crime scenes, and do not take items or leave behind items that you brought. However, if you must transport a potential piece of evidence, such as clothing on the patient or an impaled object, notify police. You, not law enforcement, are the medical authority on scene. Patient care decisions are your responsibility.

You are at the scene of a patient with obvious signs of traumatic death. You are required by law in your state to report violent deaths. Your duty as an EMT is to notify: A. your EMS chief.

B. medical direction. C. the district attorney's office. D. law enforcement. Answer - D Because this is a potential crime scene, law enforcement must be notified Good Samaritan laws are based on: A. having no formal training.

B. the patient having no serious injuries. C. providing care in good faith. D. being a volunteer EMT. Answer - C Good Samaritan laws provide limited legal protection for individuals who provide care in good faith and to the level of their training.

Midline of the body - imaginary line dividing the body into equal right and left halves

Chapter 4. Medical Terminology Limmer: Emergency Care 13th Edition The abdominal quadrants include all of the following except the: A. right medial.

B. left upper.

C. right upper.

D. left lower. Answer - A. Right medial Which of the following are the abdominal regions created by drawing two imaginary lines intersecting at the naval?

A. Abdominal quadrants B. Abdominal regions C. Abdominal sextants D. Abdominal planes - A. Abdominal quadrants When discussing left and right in terms of anatomical locations, what do they refer to? - Left and right from the patient's perspective The term lateral is best defined as: A.

under the arms.

B. to the back of.

C. toward the middle of. D. to the side. Answer - D. To the side What word would be used to refer to a patient's rapid breathing? A. Dyspnea B. Tachypnea C. Tachycardia D. Dyseffusion - B. Tachypnea What is another term for the front aspect of the body? - Anterior A patient with quadriplegia would have paralysis of how many limbs? - Four What is the primary reason for an emt to use specific and proper medical terminology? - Medical communication needs to be exact and consistent. you and your emt partner are responding to a medical aid call in the rural west county area. The dispatcher advises that the caller is reporting the patient's condition as a word you can't completely hear, and the part you do hear, the end of the word, could either be "plegia" or "algia". What would be the difference between one and the other? - A word ending in "-plegia" would involve paralysis, whereas a word ending in "-algia" would involve pain What is the distinction between anatomy and physiology? - Anatomy is the study of body structures, and physiology is the study of body function

While transporting a patient with a traumatic wound to the back, you call in a report to the receiving hospital over the radio. Due to radio static and background noise in the emergency department, the physician has had to ask you twice to repeat if the would was superior or inferior. Why would this distinction be important? - The location of the wound is important in determining which types of resources to have available when the patient arrives The inside of a person's thigh is also known as its

aspect. Answer -

medial With regard to medical terminology, a prefix is: A. the foundation of a word or term. B. a modifier that indicates if a term is singular or plural. C. the combination of any two or more whole words. D. added to the beginnings of roots or words to modify or qualify their meaning. Answer - D. Added to the beginnings of roots or words to modify or quality their meaning Which of the following best describes the anatomic position? - Standing, facing forward, with arms are the side, palms forward Which of the following describes Fowler's position? - Sitting upright with the legs straight Your partner asks why EMTs should avoid use of medical terminology when communicating with most patients. What should you tell her?

A. You should say that you are an experienced EMT and since she is new, she should just take your advice and apply it.

B. Tell her that the point of communicating with patients and other providers is so there is clear understanding; using medical terms when not necessary can cause confusion.

C. Explain that using large words and medical terms can be seen as being egotistical, which can alienate both patients and other providers.

D. Tell her that the general public isn't smart enough to understand medical terminology and that all communication must be "dumbed down" when talking to patients. Answer - B. Tell her that the point of communicating with patient's and other providers is so there is clear understanding; using medical terms when not necessary can cause confusion.

A postal worker has been attacked by a dog during her mail delivery route. The patient is a 54year-old female with several dog bites on her lower extremities and left arm. The worst of these bites is located on the back of her right leg just above the ankle. How can you explain the location of this injury using anatomical landmarks?

A. The bite is located on the posterior aspect of the calf distal to the knee. B. The bite is located on the anterior aspect of the calf just distal to the knee. C. The bite is located on the anterior aspect of the calf just proximal to the knee. D. The bite is located on the posterior aspect of the calf just proximal to the knee. Answer - A. The bite is located on the posterior aspect of the calf distal to the knee You respond to a large concert venue where a number of spectators are reported to be severely intoxicated. You are directed to an area where several patients appear to be unconscious, lying face down on the ground. The position of these patients is described as: A. supine.

B. anterior.

C. prone.

D. posterior. Answer - C. Prone Which of the following best describes the location of the mid-axillary line? - A line from the center of the armpit, extending vertically down the side of the chest Your 79-year-old female patient appears to show all signs and symptoms of a stroke. Her level of consciousness has rapidly deteriorated, she is now unconscious, and she can no longer control her own airway. While you intervene to manage her airway, the best position in which to keep fluid or vomitus from occluding her airway would be: - recovery position Which regard to anatomical locations, which of the following is not true?

A. The ears are located on the lateral aspect of the head B. The foot is distal to the knee C. The umbilicus is located in the ventral aspect of the body D. The mouth is proximal to the nose - D. The mouth is proximal to the nose To check the distal pulse of a patient with an injury to the forearm, the EMT would check for a pulse in which location? - Wrist The wrist is

to the elbow. Answer - distal

Why should an emt avoid the use of acronyms and abbreviations when communicating? - There is a chance that they can lead to errors in continued care for the patient.

The electrical impulse of the heart normally begins at the: a.) sinoatrial node b.) bundle of his

c.) purkinje fibers d.) atrioventricular node - sinoatrial node Each pelvic bone is formed by the fusion of the: a.) sacrum and ischium

b.) ilium, ischium, pubis c.) pubis and acetabulum d.) ilium, pubis, and sacrum - ilium, ischium, pubis The largest portion of the brain, which is commonly referred to as the ''gray matter,'' is called the: a.) cerebrum b.) cerebellum c.) brain stem

d.) diencephalon - cerebrum The supporting bone of the arm is the: a.) ulna

b.) humerus c.) radius d.) clavicle - humerus The cervical spine is composed of a.) four b.) five

vertebrae.

c.) six d.) seven - seven The brain connects to the spinal cord through a large opening at the base of the skull called the: a.) foramen ovale

b.) vertebral foramen c.) spinous foramen d.) foramen magnum - foramen magnum The axial skeleton is composed of the:

a.) arms, legs, and pelvis b.) lower part of the torso and the legs c.) skull, face, thorax, and vertebral column d.) bones that comprise the pelvic girdle - skull, face, thorax, and vertebral column

Hemoglobin is a molecule that attaches to

and carries oxygen.

a.) monocytes b.) erythrocytes c.) leukocytes d.) thrombocytes - erythrocytes Which organ lies in the lateral and posterior portion of the left upper quadrant (LUQ) of the abdomen? a.) liver b.) stomach

c.) cecum d.) spleen - spleen The most distal four spinal vertebrae, which are fused together, form the: a.) ilium b.) coccyx

c.) sacrum d.) ischium - coccyx Anterior to the knee is a specialized bone called the: a.) tibia b.) patella

c.) femur d.) calcaneus - patella The femoral head forms a ball-and-socket joint with the:

a.) ilium b.) ischium c.) acetabulum d.) femoral condyle - Acetabulum What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? a.) 5,600 mL

b.) 6,000 mL c.) 7,200 mL d.) 8,000 mL - 5,600 mL Which of the following is a function of the upper airway?

a.) relaxes bronchiole smooth muscle b.) exchanges oxygen and carbon dioxide c.) creates sound from vocal cord vibration d.) warms and humidifies inhaled air - warms and humidifies inhaled air The topographic term used to describe the part of the body that is nearer to the feet is: a.) dorsal

b.) inferior c.) internal d.) superior - inferior The left side of the heart receives oxygenated blood from the lungs through the:

a.) pulmonary veins b.) pulmonary arteries c.) inferior venae cavae d.) superior venae cavae - pulmonary veins The diaphragm is a unique muscle because it:

a.) is the exclusive muscle of breathing b.) does not receive impulses from the brain c.) is both a voluntary and involuntary muscle d.) does not have striations like skeletal muscle - is both a voluntary and involuntary muscle The the abdomen. a.) liver

b.) spleen c.) pancreas

fills the entire anteroposterior depth of the right upper quadrant (RUQ) of

d.) stomach - liver An intoxicated 40-year-old male s found lying face down. How would you document his body's position? a.) dorsal

b.) supine c.) prone d.) recumbent - prone Stimulation of the alpha-adrenergic receptors results in: a.) increased heart rate

b.) dilation of the blood vessels c.) increased cardiac contractility d.) constriction of the blood vessels - Constriction of blood vessels The bones of the forearm are called the: a.) radius and ulna

b.) tibia and radius c.) humerus and ulna d.) radius and humerus - radius and ulna What is the function of the fallopian tubes? a.) connect both ovaries together

b.) supply blood to the uterine lining c.) produce progesterone and estrogen d.) transport a mature egg to the uterus - transport a mature egg to the uterus Which of the following anatomic terms is synonymous with the word ''dorsal''? a.) medial

b.) posterior c.) palmar d.) anterior - posterior The

a.) apex

of the heart is the inferior portion of the left ventricles.

b.) base c.) dorsum d.) septum - apex Relative to the kidneys, the liver is:

a.) medial b.) dorsal c.) unilateral d.) posterior – unilateral Age-related changes in the renal system result in: Select one: A. the formation of large amounts of urine secondary to an increase in kidney mass of up to 20%.

B. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed.

C. a significant increase in filtration, which causes the excretion of large amounts of water from the body.

D. dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function. Answer - B. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed.

At what age does separation anxiety typically peak in infants and small children? Select one: A. 10 to 18 months B. 24 to 36 months C. 6 to 8 months D. 18 to 24 months - A. 10 to 18 months In late adults, the amount of air left in the lungs after expiration of the maximum amount of air: Select one: A. decreases, resulting in widespread collapsing of the alveoli and impaired diffusion of gases.

B. remains unchanged because the lungs have become accustomed to years of breathing pollution.

C. decreases, which increases diffusion in the lungs and causes an accumulation of carbon dioxide.

D. increases, which hampers diffusion of gases because of the stagnant air that remains in the alveoli. Answer - D. increases, which hampers diffusion of gases because of the stagnant air that remains in the alveoli.

The anterior fontanelle fuses together between the ages of: Select one: A. 9 and 18 months.

B. 6 and 8 months.

C. 7 and 14 months.

D. 3 and 4 months. Answer - A. 9 and 18 months.

The decline in cardiac function that commonly occurs in late adulthood is MOST often related to: Select one: A. medication use.

B. hypotension.

C. kidney failure.

D. atherosclerosis. Answer - D. atherosclerosis.

Which of the following are noticeable characteristics of a 9-month-old infant? Select one: A. Places objects in the mouth, pulls himself or herself up B. Walks without help, becomes frustrated with restrictions C. Responds to his or her name, crawls around efficiently D. Knows his or her name, can walk without any assistance - A. Places objects in the mouth, pulls himself or herself up A 16-year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should: Select one: A. inquire about the possibility of pregnancy in private, if possible.

B. obtain the majority of your information from one of her parents.

C. recall that patients in this age group prefer not to be treated as adults.

D. avoid asking questions that she will feel uncomfortable answering. Answer - A. inquire about the possibility of pregnancy in private, if possible.

An infant's blood pressure typically increases with age because: Select one: A. the infant's total blood volume decreases with age.

B. his or her normal heart rate usually increases with age.

C. blood pressure directly corresponds to body weight.

D. as the infant gets older, his or her blood vessels dilate. Answer - C. blood pressure directly corresponds to body weight.

The respiratory rate of 30 breaths per minute in an infant is Select one: A. too shallow B. too slow C. normal D. too fast - C. normal

.

The risk of bleeding in the skull, which increases with age, is MOST directly related to: Select one: A. meningeal deterioration.

B. shrinkage of the brain.

C. blood vessel dilation.

D. a decrease in neurons. Answer - B. shrinkage of the brain.

When providing bag-mask ventilations to an infant, what is most important to remember?

A. Blood pressure typically increases with age.

B. An infant's lungs are fragile.

C. An infant grows at a rate of about 30 g per day.

D. An infant has a proportionately larger tongue than an adult. Answer - B. An infant's lungs are fragile.

You see an infant capable of reaching out to people and drooling. She is most likely: A. 2 months of age.

B. 3 months of age.

C. 4 months of age.

D. 5 months of age. Answer - C. 4 months of age.

An infant who is repeatedly rejected experiences what type of attachment?

A. Secure attachment B. Anxious-avoidant attachment C. Trust and mistrust D. Rejection attachment - B. Anxious-avoidant attachment Why do colds develop so easily in toddlers and preschoolers?

A. They experience a loss of passive immunity.

B. They do not have well-developed lung musculature.

C. They are spending a lot of time around playmates and classmates.

D. All of the above - D. All of the above The pulse rate of a toddler is: A. 80 to 140 beats/min B. 90 to 150 beats/min C. 90 to 180 beats/min D. 100 to 160 beats/min - B. 90 to 150 beats/min A school-age child looking for approval from his peers and society is demonstrating what kind of reasoning?

A. Preconventional reasoning B. Conventional reasoning C. Postconventional reasoning D. Trust and mistrust - B. Conventional reasoning Self-concept is: A. our perception of ourselves.

B. how we feel about ourselves.

C. how we fit in with peers.

D. how we react to certain situations. Answer - A. our perception of ourselves.

Why should you be concerned about a 16-year-old patient who seems depressed?

A. She could be exhibiting rebellious behavior.

B. She has just finished her growth spurt and may be disappointed in the results.

C. Adolescents are at a higher risk for suicide.

D. She may be having unprotected sex. Answer - C. Adolescents are at a higher risk for suicide.

Why do finances become an issue during middle adulthood?

A. Middle adults are often supporting both their children and their parents.

B. Middle adults make less money than early adults.

C. Their deteriorating health makes it difficult to get to work.

D. Hearing loss prevents them from working. Answer - A. Middle adults are often supporting both their children and their parents.

Why is breathing more labor intensive for the elderly?

A. The size of the airway increases and the surface area of the alveoli decreases.

B. The natural elasticity of the lungs decreases.

C. The overall strength of the intercostal muscles and the diaphragm decreases.

D. All of the above - D. All of the above A normal systolic blood pressure for a 30-year-old is between: Select one: A. 70 and 140 mm Hg. B. 80 and 120 mm Hg. C. 60 and 120 mm Hg. D. 90 and 140 mm Hg. Answer - D. 90 and 140 mm Hg. Atherosclerosis is defined as .

Select one: A. the buildup of plaque inside blood vessels B. dilation of the arteries

C. constriction of the blood vessels D. the blockage of a coronary artery - D. the blockage of a coronary artery Children of which age group are considered toddlers? Select one: A. 3-6 years B. Over 6 years C. 1-3 years D. 1 month to 1 year - C. 1-3 years In preconventional reasoning, children: Select one:

A. act almost purely to avoid punishment and to get what they want.

B. make decisions based on their conscience.

C. look for approval from their peers and society.

D. blame their actions on what they have observed in older children. Answer - A. act almost purely to avoid punishment and to get what they want.

Older adults frequently .

Select one: A. are able to increase their muscle mass B. take multiple medications C. experience a decrease in body fat as they age D. are unable to overcome medical problems - B. take multiple medications Physical changes that typically occur in early adults include an: Select one: A. increase in height because of spinal disc expansion.

B. increase in fatty tissue, which leads to weight gain.

C. increase in respiratory rate due to increased metabolism.

D. increase in muscle strength and reflexes. Answer - B. increase in fatty tissue, which leads to weight gain.

The areas of the infant's skull that have not yet fused together are called Select one:

.

A. fontanelles B. cranial valleys C. sutures D. ventricles - A. fontanelles The average pulse rate of persons between 19 and 60 years of age is typically: Select one: A. 90 beats/min.

B. 80 beats/min.

C. 70 beats/min.

D. 60 beats/min. Answer - C. 70 beats/min.

The human body should be functioning at its optimal level between the ages of: Select one: A. 25 and 35 years.

B. 21 and 30 years.

C. 19 and 25 years.

D. 18 and 22 years. Answer - C. 19 and 25 years.

What is the normal respiratory rate for an adult? Select one: A. 12-20 breaths/min

B. 15-30 breaths/min C. 40-60 breaths/min D. 25-50 breaths/min - A. 12-20 breaths/min When you are communicating with an older patient, it is important to remember that: Select one:

A. deafness and blindness are a normal part of the process of aging.

B. the majority of older patients experience a loss of low-frequency hearing.

C. most older patients are confused due to a decrease in brain cells.

D. age-related changes diminish the effectiveness of the eyes and ears. Answer - D. agerelated changes diminish the effectiveness of the eyes and ears.

Which of the following describes the Moro reflex? Select one: A. The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled.

B. An infant's heart rate decreases secondary to hypoxia because he or she depends heavily on the heart rate to perfuse the body.

C. When the sole of the foot is stroked with a blunt object, the big toe lifts upward and the other toes fan outward.

D. When something touches a neonate's cheek, he or she instinctively turns his or her head toward the touch. Answer - A. The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled.

Which of the following is a physical change that typically occurs in the adolescent age group?

Select one:

A. Secondary sexual development begins.

B. Muscle and bone growth both decrease.

C. The systolic blood pressure decreases.

D. The normal pulse rate steadily increases. Answer - A. Secondary sexual development begins.

Which of the following is NOT a common factor that would affect a 75-year-old patient's vital signs?

Select one:

A. Medical conditions B. Overall health C. Medications D. Increased weight - D. Increased weight You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that: Select one:

A. an infant's head should be placed in a flexed position to prevent obstruction.

B. small infants are nose breathers and require clear nasal passages at all times.

C. assisted ventilations in infants often need to be forceful to inflate their lungs.

D. the infant's proportionately small tongue often causes an airway obstruction. Answer B. small infants are nose breathers and require clear nasal passages at all times.

Infants are often referred to as "belly breathers" because: A. their rib cage is less rigid and the ribs sit horizontally.

B. an infant's ribs are brittle and are less able to expand.

C. their intercostal muscles are not functional.

D. their diaphragm does not receive impulses from the brain. Answer - A. their rib cage is less rigid and the ribs sit horizontally.

The pulse rate of a child from ages 6 to 12 years is approximately: A. 60 to 100 beats/min.

B. 70 to 120 beats/min.

C. 90 to 140 beats/min.

D. 100 to 150 beats/min. Answer - B. 70 to 120 beats/min.

When assessing an 80-year-old patient in shock, it is important to remember that: A. it is common to see a more significant increase in heart rate than what would be expected in younger adults.

B. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion.

C. the patient's cardiac output is able to increase by nearly 200% in response to the decrease in perfusion.

D. in older adults, it is especially common to observe a significant decrease in heart rate in response to shock. Answer - B. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion.

Which of the following is an anatomic difference between children and adults?

A. The ribcage of an infant is less flexible than an adult's.

B. An infant's tongue is proportionately larger than an adult's.

C. The trachea of an infant is proportionately longer than an adult's.

D. An infant's head accounts for less body weight than an adult's. Answer - B. An infant's tongue is proportionately larger than an adult's Which of the following statements regarding middle adults is correct?

A. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer.

B. Women in the middle adult age group typically experience menopause in their late 50s or early 60s.

C. Significant impairments in hearing and vision begin to occur in persons between the ages of 41 and 44 years.

D. Increased cholesterol levels in the middle adult age group often do not respond to exercise and diet. Answer - A. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer.

Why does the incidence of diabetes mellitus increase with age?

A. decreased food intake, decreased weight gain, and decreased blood sugar levels B. decreased physical activity, increased weight gain, and decreased insulin production C. increased physical activity, increased food intake, and increased insulin production D. decreased physical activity, increased weight gain, and decreased blood sugar levels - B. decreased physical activity, increased weight gain, and decreased insulin production With increasing age, the heart must work harder to move the blood effectively because: A. the blood vessels become stiff.

B. the arteries dilate significantly.

C. diastolic blood pressure decreases.

D. the blood thickens as a person ages. Answer - A. the blood vessels become stiff.

You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she: A. is unable to track your movements with her eyes.

B. responds to her name but is fearful of your presence.

C. will readily allow you to separate her from her mother.

D. has bulging fontanelles secondary to severe dehydration. Answer - B. responds to her name but is fearful of your presence.

You suspect that a 75-year-old man has internal injuries after he fell and struck his ribs and abdomen on the corner of a table. When assessing and treating an injured patient of this age, you must recall that: A. his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output.

B. it is not uncommon to observe heart rates in excess of 150 beats/min in elderly patients with internal injuries.

C. blood pressure is usually adequately maintained because the blood vessels of older people can contract easily.

D. functional blood volume in patients of this age steadily increases due to increased production of red blood cells. Answer - A. his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output.

Kidney function declines by A. 10% B. 50% C. 45% D. 20% - B. 50%

between the ages of 20 and 90 years.

An adolescent is a person between the ages of: A. 6 and 12 years.

B. 3 and 6 years.

C. 12 and 18 years.

D. 10 and 19 years. Answer - C. 12 and 18 years.

Stealing from a parent's wallet and denying it when caught is an example of reasoning.

A. postconventional B. psychosocial C. conventional D. preconventional - D. preconventional One consequence of the loss of neurons among elderly persons is a(n):

A. change in sleep patterns.

B. steady decline in intelligence.

C. inability to reproduce.

D. loss of physical skills - A. change in sleep patterns.

From birth to 1 month old, a person is called a(n): A. infant.

B. toddler.

C. neonate.

D. newborn. Answer - C. neonate.

The maximum life expectancy for humans is estimated to be A. 120 B. 78 C. 67 D. 56 - A. 120

years.

What do middle adults tend to focus their time and energy on?

A. Raising a family B. Excelling in a career C. Achieving life goals D. Creating a self-image - C. Achieving life goals When encountering a patient with depressed fontanelles, you should suspect: A. respiratory distress.

B. dehydration.

C. atherosclerosis.

D. nephrosis. Answer - B. dehydration.

What is 'vital capacity'?

A. The volume of blood moved by each contraction of the heart B. The maximum thickness of the meninges C. The volume of air moved during the deepest points of respiration D. The amount of air left in the lungs following exhalation - C. The volume of air moved during the deepest points of respiration

Clingy behavior and the fear of unfamiliar people or places are normal among 10- to 18-monthold children and are commonly caused by anxiety.

A. bonding B. separation C. avoidant D. mistrust - B. separation Diastolic blood pressure tends to A. decrease B. compensate C. increase D. decompensate - C. increase

with age.

Work, family, and stress best describe the life stage known as: A. middle adulthood.

B. adolescence.

C. late adulthood.

D. early adulthood. Answer - D. early adulthood.

At what age can an infant normally start tracking objects with his or her eyes and recognizing familiar faces?

A. 7 months B. 2 months C. 4 months D. 10 months - B. 2 months You are dispatched to a public park in the middle of a sprawling for an arm injury. You arrive to find a crying 8-year-old boy cradling his swollen deformed left forearm. His friends tell you that he was holding onto the bars of the play structure and that his arm 'snapped' when he jumped into the sand below. You would expect this boy's pulse to be: A. between 60 and 80 beats/min.

B. higher than 150 beats/min.

C. most likely above 90 beats/min.

D. around 70 beats/min - C. most likely above 90 beats/min.

You are dispatched to a public park in the middle of a sprawling for an arm injury. You arrive to find a crying 8-year-old boy cradling his swollen deformed left forearm. His friends tell you that he was holding onto the bars of the play structure and that his arm 'snapped' when he jumped into the sand below. An adult bystander tells you that the boy kept trying to impress his friends with more and more dangerous stunts on the play structure prior to the injury. This is an indication of reasoning.

A. conventional B. preconventional C. unconventional D. postconventional - A. conventional You are dispatched to a public park in the middle of a sprawling for an arm injury. You arrive to find a crying 8-year-old boy cradling his swollen deformed left forearm. His friends tell you that he was holding onto the bars of the play structure and that his arm 'snapped' when he jumped into the sand below. You would expect to find a respiratory rate of between and breaths/min with this patient.

A. 12; 20 B. 15; 20 C. 10; 15 D. 20; 30 - B. 15; 20 Why do middle adults commonly experience financial concerns?

A.. They are typically receiving social security and must budget with a fixed income.

B. Most people in the middle adult age group have chronic illnesses and cannot work.

C. The majority of middle adults still have small children who live at home with them.

D. The are preparing for retirement but must still manage everyday financial demands. Answer D. The are preparing for retirement but must still manage everyday financial demands.

An infant or small child's airway can be occluded if it is overextended or overflexed because: A. he or she has a long neck, which makes the trachea prone to collapse.

B. the tongue is proportionately small and can fall back into the throat.

C. the back of the head is flat, which prevents a neutral position D. the occiput is proportionately large and the trachea is flexible Ch.40 Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should: Select one: A. direct your partner to apply manual in-line support of the patient's head.

B. apply a cervical collar and quickly remove the patient with a clothes drag.

C. apply a vest-style extrication device before attempting to move the patient.

D. slide a long backboard under his buttocks and lay him sideways on the board. Answer A. direct your partner to apply manual in-line support of the patient's head.

To protect a restrained patient and prevent him from using leverage to break free, the EMT should secure .

Select one: A. both arms above the head B. both arms at the patient's sides C. only the patient's torso D. one arm above the head - D. one arm above the head You have been called to the scene of a high-speed motor vehicle collision involving two compact cars. The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. For the passenger in the second vehicle, you may need to perform a(n) on the driver in order to reach the patient.

Select one: A. extremity lift

B. emergency move C. short backboard D. You should do nothing different; treat each patient the same. Answer - B. emergency move When moving a conscious, weak patient down a flight of stairs, you should: Select one: A. secure the patient to a scoop stretcher and carry him or her headfirst down the stairs to the awaiting stretcher.

B. place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair.

C. collapse the undercarriage of the wheeled stretcher and carefully carry the patient down the stairs on the stretcher.

D. assist the patient in walking down the stairs and place him or her on the wheeled stretcher at the bottom of the stairs. Answer - B. place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair.

You should use a rigid , often called a Stokes litter, to carry a patient across uneven terrain from a remote location that is inaccessible by ambulance or other vehicle.

Select one: A. basket stretcher B. scoop stretcher C. molded backboard D. flotation device - A. Basket stretcher Which of the following conditions or situations presents the MOST unique challenge to the EMT when immobilizing an elderly patient on a long backboard? Select one: A. Joint flexibility B. Patient disorientation C. Naturally deformed bones D. Abnormal spinal curvature - D. Abnormal spinal curvature You may injure your back if you lift:

Select one: A. with your back curved.

B. with your back straight, but bent significantly forward at the hips.

C. with the shoulder girdle anterior to the pelvis.

D. All of these answers are correct. Answer - D. All of these answers are correct.

In lifting with the palm down, the weight is supported by the palm.

Select one: A. fingers B. forearm C. lower back D. wrist - A. fingers

rather than the

You are attending to a 26-year-old female who is 34 weeks pregnant with her first child. Your patient has been having lower abdominal pains and cramping for the past two hours. In placing your patient on the stretcher and preparing for transport, you should place her: Select one: A. supine with her legs elevated.

B. in the Fowler position.

C. on her left side.

D. in a position of comfort. Answer - C. on her left side.

When pulling a patient, you should do all of the following, EXCEPT: Select one: A. extend your arms no more than about 15 to 20 inches (38 to 50 cm).

B. reposition your feet so that the force of pull will be balanced equally.

C. when you can pull no farther, lean forward another 15 to 20 inches (38 to 50 cm).

D. pull the patient by slowly flexing your arms. Answer - C. when you can pull no farther, lean forward another 15 to 20 inches(38 to 50 cm).

To facilitate a safe and coordinated move, the team leader should: Select one:

A. be positioned at the feet so the team can hear.

B. use preparatory commands to initiate any moves.

C. speak softly but clearly to avoid startling the patient.

D. never become involved in the move, only direct the move. Answer - B. use preparatory commands to initiate any moves.

As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden, sharp pain in your lower back. You should: Select one: A. reposition your hands and continue to move the patient.

B. stop the move and request additional lifting assistance.

C. guide your partner while moving the chair backwards.

D. stop the move and have the patient walk down the stairs. Answer - B. stop the move and request additional lifting assistance.

You should perform an urgent move in all of the following situations, EXCEPT: Select one: A. if a patient has an altered level of consciousness.

B. if the patient is complaining of neck pain.

C. in extreme weather conditions.

D. if a patient has inadequate ventilation or shock. Answer - B. if the patient is complaining of neck pain.

Which of the following statements regarding patient weight distribution is correct? Select one: A. The majority of a horizontal patient's weight is in the torso.

B. Most of the patient's weight rests on the foot end of the stretcher.

C. A semi-sitting patient's weight is equally distributed on both ends.

D. The EMT at the patient's head will bear the least amount of weight. Answer - A. The majority of a horizontal patient's weight is in the torso.

You are attending to a 34-year-old male patient who requires transport to the hospital for assessment of his chronic back pain. The patient weighs over 750 pounds. Your bariatric stretcher has a wider surface area to allow for: Select one:

A. increased lifting capacity and patient weight load.

B. increased patient comfort and dignity.

C. increased stability and leverage when lifting with more than two providers.

D. better stability when moving the patient on uneven ground. Answer - B. increased patient comfort and dignity.

The is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle.

Select one: A. coccyx B. sacrum C. thorax D. ischium - B. sacrum To minimize the risk of injuring yourself when lifting or moving a patient, you should: Select one: A. flex at the waist instead of the hips.

B. avoid the use of log rolls or body drags.

C. use a direct carry whenever possible.

D. keep the weight as close to your body as possible. Answer - D. keep the weight as close to your body as possible.

It is essential that you disease.

Select one: A. throw out B. decontaminate C. incinerate D. properly store - B. decontaminate

your equipment to prevent the spread of

In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include: Select one: A. a collapsible undercarriage.

B. weight capacity of up to 650 lb.

C. increased stability from a wider wheelbase.

D. two safety rails on both sides of the stretcher. Answer - C. increased stability from a wider wheelbase.

The proper technique for using the power grip is to: Select one: A. lift with your palms up.

B. rotate your palms down.

C. hold the handle with your fingers.

D. position your hands about 6² apart. Answer - A. lift with your palms up.

Which of the following statements regarding an emergency patient move is correct?

Select one: A. The spine must be fully immobilized prior to performing an emergency move.

B. An emergency move is performed before the primary assessment and treatment.

C. The patient is dragged against the body's long axis during an emergency move.

D. It is not possible to perform an emergency move without injuring the patient. Answer B. An emergency move is performed before the primary assessment and treatment.

The MOST serious consequence of a poorly planned or rushed patient move is: Select one: A. unnecessarily wasting time.

B. injury to you or your patient.

C. causing patient anxiety or fear.

D. confusion among team members. Answer - B. injury to you or your patient.

An EMT may injure his or her back, even if it is straight, if the: Select one: A. back is bent forward at the hips.

B. hands are held close to the legs.

C. shoulder is aligned over the pelvis.

D. force is exerted straight down the spine. Answer - A. back is bent forward at the hips.

You are attending to a 22-year-old female patient who has overdosed. The patient is unresponsive in an upstairs bedroom. The most appropriate way to bring the patient downstairs is: Select one: A. secured to a fracture board with the strongest provider at the head end.

B. secured to a fracture board with the strongest provider at the foot end.

C. secured to a stair chair with the strongest provider at the head end.

D. secured to a stair chair with the strongest provider at the foot end. Answer - A. secured to a fracture board with the strongest provider at the head end.

When pulling a patient, you should extend your arms no more than front of your torso.

Select one: A. 5 to 10 inches B. 10 to 15 inches C. 15 to 20 inches D. 20 to 30 inches - C. 15 to 20 inches

in

Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury?

Select one: A. Long backboard B. Scoop stretcher C. Portable stretcher D. Wheeled stretcher - A. Long backboard what is the first concern when entering a scene? - scene safety You respond to a home where a 25-year-old woman is lying in bed. She is semiconscious but opens her eyes when you speak to her, and is lethargic. How do you rate her on the AVPU scale?

- responsive to verbal stimuli Which of the following terms would be used to describe the patients pulse rate of 140 beats/min?

- tachycardia

What is a pertinent negative? - a negative finding that requires no further care or intervention What is the purpose of the primary assessment? - To identify and begin to treat immediate life threats At what point in the patient assessment process do you investigate the chief complaint? - History taking When treating a 6-year-old, you note a brassy crowing sound, especially when she breathes in.

What is this? - stridor In what phase of patient assessment do you determine MOI/NOI? - scene size-up What is the primary purpose of standard precautions? - infection prevention Which of the following devices would you use to measure a patient's ventilation, circulation, and metabolism? - capnography you should suspect that a patient is experiencing respiratory failure if he or she: - has bradycardia and diminished muscle tone the chief complain is most accurately defined as the: - the most serious thing the patient is concerned about What maneuver should be sued to open the airway of an unresponsive patient with suspected trauma - jaw-thrust maneuver reassessment is preformed to determine all the following except: -patients response to your treatment -nature of any newly identified problems -whether or not patient is deteriorating -the reason why patient called EMS - the reason why patient called EMS

Which of the following statements regarding the secondary assessment is correct? - the secondary assessment should focus on a certain area or region of the body as determined by the chief complaint When approaching a 32 year old male who is complaining of traumatic neck pain, you should? ensure that the patient can see you approaching him Treatment and transport priorities at the scene of a mass-causality incident should be determined after: - all the patients have been triaged An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, 3 for verbal response, 4 for motor response. Which is consist with his findings? - opens eyes in response to pain, uses inappropriate words, withdraws from pain Which of the following statements regarding the mechanic of injury (MOI) is correct? - the MOI may allow you to predict the severity of a patient's injuries an elderly patient has fallen and hit her head. Your initial care should focus on: - airway, breathing, and circulation Which of the following conditions would be LEAST likely to cause an altered level of consciousness - acute anxiety A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: - apply direct pressure to the wound In patients with deeply pigmented skin, changes in color may appear only in certain areas such as: - lips or oral muscosa the palatable pulse is treated by: - pressure waves through the arteries caused by cardiac contraction

which of the following actions would NOT be performed during the scene size-up?

- rapidly assessing a patients respiratory status Which of the following scenarios does NOT involve presence of any symptoms? A 61 year old female who is unconscious with facial cyanosis during an EMS call, you should take standard precautions - before exiting the ambulance and before actual patient contact when you shine a light into one pupil, the normal reaction of the pupil should be to: - become smaller You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should: - position yourself in between the patient and the gun and ask your partner to request law enforcement assistance the rapid exam of a patient that occurs following the primary assessment should take no longer than - 60 to 90 the normal respiratory rate for an adult should range from: - 12 to 20 breaths per minute.

The pulse oximeter is an assessment tool used to evaluate the: - effectiveness of oxygenation.

A patient in unstable condition should be reassessed at least every: - 5 minutes Which of the following patients does NOT have signs of an altered mental status? - A patient with an acute allergic reaction and dizziness The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to: - perform a careful and thorough assessment.

For which of the following patients is spinal immobilization clearly indicated? - Man who was struck in the head and is now confused and has a slurred speech While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should: - confirm this information with law enforcement personnel at the scene.

The goal of oxygenation for most patients is an oxygen saturation of: - 94%-99% When evaluating a patient with multiple complaints, the EMT's responsibility is to: - determine which complaint poses the greatest threat to the patient's life.

A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: - determine if the patient has a medical alert bracelet or wallet card.

When is it MOST appropriate to consider requesting additional ambulances at an accident scene?

- when you determine there are multiple patients Which of the following pupillary changes would indicate depressed brain function?

- Both pupils dilate with introduction of a bright light.

In infants and small children, skin color should be assessed on the: - palms and soles.

During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that the infant's: - Peripheral perfusion is decreased Which of the following is an example of a symptom? - headache Which of the following statements regarding the secondary assessment is correct? - You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment

When performing a reassessment of your patient, you should first: - repeat primary assessment You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should: immediately suction her oropharynx. the goal of the primary assessment is to - identify and rapidly treat all life- threatening conditions.

During the primary assessment, circulation is evaluated by assessing - pulse quality, external bleeding and skin condition

1) For life to be maintained, a balance of oxygen and carbon dioxide is needed. The condition when oxygen levels are low is called: A) hypotension.

B) hypercarbia.

C) hyperventilation.

D) hypoxia. Answer - Explanation: A) INCORRECT. The term hypotension refers to low blood pressure; it is not directly related to oxygen levels.

B) INCORRECT. The condition of having higher than normal levels of carbon dioxide in the blood is called hypercarbia.

C) INCORRECT. A breathing rate that is too rapid to maintain proper carbon dioxide levels is called hyperventilation.

D) CORRECT. The brain and body cells need a steady supply of oxygen to accomplish the tasks of everyday living. Low levels of oxygen, or hypoxia, will disrupt normal function.

Page Ref: 219 Objective: 10.1

2) What are the signs of hypoxia?

A) Warm dry skin, with difficulty in breathing, and hypertension B) Commonly seen as blue or gray skin, deterioration of patient's mental status like confusion or restlessness C) Disease process that robs the patient of adequate breathing and perfusion

D) Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is irreversible - Explanation: A) INCORRECT. A patient with hypoxia will not present with warm, dry skin, and hypertension is unrelated.

B) CORRECT. Hypoxia will cause the patient's skin to have an ashen, bluish appearance and patient's mental status will be severely impaired.

C) INCORRECT. Hypoxia is the result of inadequate breathing and perfusion, not the cause of it; also, the term sign means a condition that can be determined by the EMT through visualization or palpation.

D) INCORRECT. Irreversible shock caused by lack of blood is not the definition of hypoxia, nor is it a sign of it.

Page Ref: 219 Objective: 10.1

3) What signs and symptoms would indicate inadequate breathing in a patient?

A) Increased effort to breathe, increased depth of respiration, pink dry skin, normal mental status B) Rapid breathing, pale skin, and a normal mental status C) Decreased depth of respiration, decreased rate of breathing, hot clammy skin, normal mental status D) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status - Explanation: A) INCORRECT. Other than an increased effort to breathe, the other signs and symptoms indicate normal breathing.

B) INCORRECT. A normal mental status is not indicative of inadequate breathing.

C) INCORRECT. Inadequate breathing will not cause hot, clammy skin and a normal mental status.

D) CORRECT. Inadequate breathing can cause a patient to present with an altered mental status, cyanosis, cool, clammy skin, and an increased effort to breathe. Page Ref: 224

Objective: 10.2

4) In assessing a patient's breathing, what is your first question?

A) Is he breathing?

B) Is he alive or dead?

C) Is his breathing adequate or inadequate?

D) Is he big sick or little sick? - Explanation: A) CORRECT. The first thing that an EMT must determine when assessing a patient's breathing is whether or not the patient is breathing.

B) INCORRECT. Determining life status is not the first step in assessing a patient's breathing.

C) INCORRECT. The adequacy of the breathing is not the first thing that an EMT must determine when assessing a patient's breathing.

D) INCORRECT. Although a patient's breathing can provide clues about his overall condition, this is not the first breathing assessment question that an EMT must ask.

Page Ref: 223 Objective: 10.2

5) Why is inhalation described as an active process?

A) It requires the diaphragm to relax and use energy to move, creating a positive pressure.

B) It requires chest muscles to relax and use energy to move, creating a positive pressure.

C) It requires chest muscles to contract and use energy to move, creating a negative pressure.

D) It uses oxygen to assist chest muscles to contract, creating a negative pressure. Answer Explanation: A) INCORRECT. The term active indicates effort or the expense of energy, the diaphragm relaxing does not use energy.

B) INCORRECT. The chest muscles do not relax during inhalation.

C) CORRECT. Inhalation is an active process. The muscles of the chest expand at the same time the diaphragm contracts in a downward motion. These movements increase the size of the chest cavity and create a negative pressure.

D) INCORRECT. The use of oxygen is not directly related to the term active process, and during inhalation the chest muscles do not contract.

Page Ref: 216 Objective: 10.3

6) The process of air moving in and out of the chest is called: A) tidal volume.

B) inhalation.

C) respiration.

D) ventilation - Explanation: A) INCORRECT. The amount of air moved in one in-and-out respiratory cycle is known as the tidal volume.

B) INCORRECT. Inhalation refers just to the process of air moving into the body.

C) INCORRECT. Respiration refers to the exchange of gases between the alveoli and the blood and between the blood and the cells.

D) CORRECT. Air is moved into and out of the chest in a process called ventilation.

Page Ref: 219 Objective: 10.3

7) The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change of what two gases?

A) Low hydrogen and high carbon monoxide B) High carbon monoxide and low oxygen C) High hydrogen and low carbon dioxide

D) High carbon dioxide and low oxygen - Explanation: A) INCORRECT. Chemoreceptors do not measure hydrogen or carbon monoxide.

B) INCORRECT. Carbon monoxide levels do not register on the body's chemoreceptors.

C) INCORRECT. The chemoreceptors in the cardiovascular system do not monitor hydrogen.

D) CORRECT. Special sensors in the cardiovascular system, called chemoreceptors, detect increasing levels of carbon dioxide as well as low levels of oxygen.

Page Ref: 219 Objective: 10.4

8) Which of the following describes why fast respiration may decrease minute volume?

A) The lungs may not have the time to fill and exchange gas.

B) The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement.

C) It is due to the delay in the movement of the intercostal muscles and the pleural space.

D) The rate does not decrease minute volume; it actually increases. Answer - Explanation:

A) CORRECT. Exceptionally fast breathing can decrease the amount of time that the lungs have to refill and negatively impact alveolar function, decreasing both tidal volume and minute volume.

B) INCORRECT. Tracheal turbulence would not cause an increase in friction that could impact air movement.

C) INCORRECT. Rapid breathing would not cause movement delays in the intercostal muscles.

D) INCORRECT. Extremely rapid breathing can reduce minute volume.

Page Ref: 217 Objective: 10.5

9) To calculate the minute volume, you need to multiply what two measurements?

A) Tidal volume and respiratory rate B) Alveolar ventilation and respiratory rate C) Respiratory rate and bronchial dilation D) Tidal volume and dead space air - Explanation: A) CORRECT. The amount of air moved into and out of the lungs per minute is called minute volume. Minute volume is calculated by multiplying the tidal volume and the respiratory rate.

B) INCORRECT. Alveolar ventilation cannot be measured in the prehospital setting; it is not calculated into minute volume.

C) INCORRECT. Bronchial dilation cannot be measured by EMTs and is not used to calculate minute volume.

D) INCORRECT. There is no way to calculate or multiply dead space air when figuring minute volume.

Page Ref: 217 Objective: 10.5

10) Which of the following statements BEST describes the exchange of gas in the alveoli?

A) Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis occurs.

B) Blood moves from the left heart to the lungs, air arrives in the alveoli sacks, and diffusion occurs.

C) Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs.

D) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs. Answer - Explanation: A) INCORRECT. Gas is not exchanged in the alveoli through the process of osmosis.

B) INCORRECT. Blood does not move from the left heart to the lungs; the left heart feeds the body with oxygenated blood.

C) INCORRECT. Blood does not arrive at the lungs via the pulmonary veins, and osmosis is not involved in gas exchange.

D) CORRECT. When air is inhaled, it moves to the lungs where oxygen and carbon dioxide are exchanged between the alveoli and pulmonary capillaries through the process of diffusion.

Page Ref: 217 Objective: 10.5

11) The movement of oxygen and carbon dioxide between the alveoli and circulating blood is called:

A) internal respiration.

B) osmosis.

C) cellular respiration.

D) pulmonary (external) respiration. Answer - Explanation: A) INCORRECT. Internal respiration describes the movement of gases between the blood and the cells of the body.

B) INCORRECT. Osmosis refers to the movement of fluids through cellular membranes, not gases.

C) INCORRECT. When oxygen and carbon dioxide are exchanged between the blood and the cells, it is called cellular respiration.

D) CORRECT. The diffusion of oxygen and carbon dioxide between the alveoli and the blood is called pulmonary respiration.

Page Ref: 217 Objective: 10.6

12) Why does a patient involved in an auto crash who has major internal abdominal bleeding require oxygen to maintain internal respiration?

A) The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that can be transported.

B) A lack of oxygen in the air decreases the oxygen diffused into the bloodstream, which creates an increase of carbon dioxide.

C) The swelling of the abdominal space causes the diaphragm to be restricted, which will reduce the thorax space.

D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.

Answer - Explanation: A) INCORRECT. Bleeding does not cause the red blood cells to lose hemoglobin.

B) INCORRECT. There would not be a lack of oxygen in the air, just a lack of this patient's ability to utilize it effectively.

C) INCORRECT. Although severe abdominal injuries can affect diaphragm function, this patient's bleeding is a larger concern related to internal respiration.

D) CORRECT. As blood volume is lost, the ability of the body to properly manage oxygen and carbon dioxide is reduced; supplemental oxygen will help bolster the oxygen levels in the decreased blood volume.

Page Ref: 219 Objective: 10.6

13) The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is called: A) external respiration.

B) dehydration.

C) internal respiration.

D) oxygenation. Answer - Explanation: A) INCORRECT. External (or pulmonary) respiration refers to the gas exchange that occurs between the alveoli and the blood.

B) INCORRECT. Dehydration refers to inadequate fluid levels within the body; it does not relate directly to cellular gas exchange.

C) CORRECT. Internal respiration occurs between the blood in the capillaries and the cells.

D) INCORRECT. The term oxygenation refers to the movement of oxygen only.

Page Ref: 219 Objective: 10.6

14) What is the relatively rare condition that can cause respiratory depression?

A) Lungs can react unfavorably to oxygen when the concentration is too high for a long period of time and this can depress breathing.

B) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing.

C) High concentration of oxygen can depress breathing when the patient has an allergic reaction from the oxygen.

D) The eyes can develop scar tissue on the retina from a high concentration of oxygen.

Answer - Explanation: A) INCORRECT. Absent certain chronic respiratory diseases, high-concentrations of oxygen will not cause depressed breathing.

B) CORRECT. COPD patients with a hypoxic drive can experience depressed breathing when exposed to high levels of supplemental oxygen over an extended period; it does not generally apply in the prehospital setting.

C) INCORRECT. Human beings do not develop allergies to oxygen.

D) INCORRECT. Regardless of whether excessive oxygen can cause eye problems in certain situations, it would not be related to respiratory depression.

Page Ref: 219, 243 Objective: 10.7

15) A 16-year-old patient presents with labored breathing and increased respiratory rate, increased heart rate, and leaning forward with his hands on his knees. His skin is pink and his accurate pulse oximetry is 96. This patient is suffering from respiratory: A) failure.

B) hypoxia.

C) distress.

D) arrest. Answer - Explanation: A) INCORRECT. Respiratory failure occurs when the patient can no longer compensate for the breathing challenge; pink skin and a pulse oximetry reading of 96 do not indicate failure.

B) INCORRECT. An accurate pulse oximetry of 96 would indicate that this patient is not hypoxic.

C) CORRECT. This patient is still compensating effectively for the respiratory difficulty, but is considered to be in distress.

D) INCORRECT. Respiratory arrest is when breathing stops.

Page Ref: 220 Objective: 10.8

16) When does respiratory distress change to respiratory failure?

A) When the respiratory challenge continues, the systems fail with the demand for oxygen, pupils dilate, and the skin becomes hot and dry.

B) When the respiratory challenge continues, the systems cannot keep up with the demand, and skin color and mental status change.

C) When the patient who is short of breath, with noisy respiration, presents in the tripod position but then suddenly has the condition clear up and return to normal.

D) When the compensatory mechanism is no longer needed and the patient goes into arrest.

Answer - Explanation:

A) INCORRECT. Dilated pupils and hot, dry skin are not signs of respiratory failure.

B) CORRECT. When the patient's body can no longer compensate for the breathing challenge, the struggle to breathe will weaken, mental status will become altered, and skin color will become bluish-gray.

C) INCORRECT. Recovery from respiratory distress is not respiratory failure.

D) INCORRECT. Respiratory arrest directly follows respiratory failure, not distress.

Page Ref: 220 Objective: 10.8

17) Which of the following BEST describes inadequate breathing?

A) The respiratory rate is slower than normal.

B) The minute volume is less than normal.

C) The minute volume is greater than normal.

D) The respiratory rate is faster than normal. Answer - Explanation: A) INCORRECT. A slower than normal respiratory rate can still provide adequate respiration.

B) CORRECT. In order for the minute volume to be decreased, the respiratory rate and tidal volume must both also be decreased, which indicates inadequate breathing.

C) INCORRECT. An increase in tidal volume and respiratory rate does not describe breathing that is inadequate.

D) INCORRECT. A rapid respiratory rate alone does not indicate inadequate breathing.

Page Ref: 216-217 Objective: 10.8

18) You have arrived at the scene of a call for a "man down." As you enter the residence you note that your patient is a male in his mid-60s who is awake but does not seem to acknowledge your presence. He is perspiring profusely, has cyanosis of his ears and lips, and has rapid, shallow respirations. Which of the following should you do first?

A) Check for a radial pulse.

B) Obtain the patient's medical history.

C) Listen to his lung sounds.

D) Assist ventilations with a bag-valve mask and supplemental oxygen. Answer Explanation: A) INCORRECT. The patient clearly has a pulse so checking for one wouldn't be the first thing an EMT should do in this situation.

B) INCORRECT. Taking the time to ask questions about this patient's medical history before doing anything else would not be appropriate.

C) INCORRECT. Listening to this patient's lung sounds should not be the first thing that an arriving EMT does.

D) CORRECT. This patient is in obvious respiratory failure; providing immediate positive pressure ventilations with supplemental oxygen will help.

Page Ref: 221 Objective: 10.9

19) Your patient is a motorcyclist who was ejected after striking a guard rail. The patient is unresponsive to painful stimuli and is breathing shallowly six to eight times per minute.

Which of the following should you do first?

A) Use a bag-valve mask with supplemental oxygen.

B) Perform a rapid trauma assessment.

C) Apply a cervical collar.

D) Apply a nonrebreather mask with an oxygen flow rate of 15 lpm. Answer - Explanation: A) CORRECT. An unresponsive patient who is not breathing adequately requires immediate positive pressure ventilations and supplemental oxygen in addition to immediate manual spinal stabilization.

B) INCORRECT. This patient is in need of life-saving intervention, the rapid trauma assessment can wait.

C) INCORRECT. For a critical patient who is unresponsive and not breathing adequately, it would not be appropriate to apply a cervical collar as the first intervention.

D) INCORRECT. A nonrebreather mask is only indicated for patients who are already breathing adequately.

Page Ref: 221

Objective: 10.10

20) Which of the following patients does NOT require the administration of supplemental oxygen?

A) A 60-year-old woman with a history of chronic obstructive pulmonary disease (COPD) who can speak two or three words at a time without a breath B) A 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy C) A 31-year-old male who is unresponsive due to an overdose of narcotics

D) A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband - Explanation:

A) INCORRECT. This patient is obviously not breathing adequately and would benefit from supplemental oxygen in the prehospital setting.

B) INCORRECT. A drowsy asthmatic with no breath sounds would require supplemental oxygen.

C) INCORRECT. This unresponsive patient who has overdosed on narcotics would definitely benefit from supplemental oxygen.

D) CORRECT. This patient is upset and hyperventilating; the administration of supplemental oxygen would potentially worsen her condition.

Page Ref: 237 Objective: 10.11

21) You are ventilating an adult patient with a bag-valve mask when you notice that his abdomen is getting bigger. You should: A) apply cricoid pressure.

B) decrease the flow of oxygen.

C) apply pressure to the abdomen.

D) suction the airway. Answer - Explanation: A) CORRECT. Positive pressure ventilation may cause air to enter the esophagus, causing gastric distention. Cricoid pressure moves the tracheal opening to a better position for artificial ventilation.

B) INCORRECT. Gastric distention would not be caused or resolved by adjusting the oxygen flow.

C) INCORRECT. Applying pressure to the patient's abdomen is not the proper way to manage gastric distention.

D) INCORRECT. There is no reason to suction this patient's airway unless the gastric distention causes vomiting.

Page Ref: 226 Objective: 10.12

22) What device is used to perform mouth-to-mask ventilation?

A) Pocket face mask B) Bag-valve mask C) Stoma D) Automatic transport ventilator - Explanation: A) CORRECT. A pocket face mask is used to perform mouth-to-mask ventilation.

B) INCORRECT. A bag-valve mask is used during bag-valve mask ventilation, not mouth-tomask ventilation.

C) INCORRECT. A stoma is a surgical opening in the neck through which the patient breathes and is not involved in mouth-to-mask ventilation.

D) INCORRECT. An automatic transport ventilator is used to provide positive pressure ventilations and is not used in mouth-to-mask ventilations.

Page Ref: 228 Objective: 10.13

23) What is NOT one of the basic parts of a bag-valve-mask system?

A) Self-refilling shell B) Non-jam valve C) Be nonrebreathing D) 15/25 respiratory fitting - Explanation: A) INCORRECT. A self-refilling shell is one of the basic parts of a bag-valve- mask system.

B) INCORRECT. A non-jam valve is one of the basic parts of a bag-valve-mask system.

C) INCORRECT. A bag-valve-mask system should be nonrebreathing.

D) CORRECT. A bag-valve-mask system should have a respiratory fitting, but it should be 15/22 and not 15/25.

Page Ref: 230 Objective: 10.13

24) You are aggressively ventilating an adult patient with a bag-valve mask when you notice that his previously strong pulse is getting weaker. You should: A) increase the concentration of oxygen.

B) reduce the concentration of oxygen.

C) reduce the volume of the ventilations.

D) begin chest compressions. Answer - Explanation: A) INCORRECT. The concentration of oxygen would not be causing this result; increasing the oxygen would not resolve the issue.

B) INCORRECT. Reducing the concentration of oxygen but continuing aggressive ventilations would not resolve this patient's issue.

C) CORRECT. Positive pressure ventilation can increase the pressure inside the chest, inhibiting blood return to the heart. You should ventilate just enough to see the chest rise.

D) INCORRECT. Chest compressions are not indicated for a patient with a pulse.

Page Ref: 226 Objective: 10.14

25) You and your EMT partner are preparing to ventilate an elderly non-trauma patient who has a stoma. Your partner performs the head-tilt, chin-lift maneuver and you ask him to return the patient's head to a neutral position. "Why? This is not a pediatric patient!" your partner protests.

What would you say?

A) Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning.

B) It is not necessary to position the airway of a stoma breather when providing ventilations.

C) Stoma breathers should only have their airways positioned after placement of the ventilation device.

D) Using the head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion. Answer - Explanation: A) INCORRECT. Although some elderly patients can have spinal deformities that can make proper airway positioning difficult, that would not be the reason for leaving this patient's head in a neutral position.

B) CORRECT. When providing ventilations to a stoma breather, leave the head and neck in a neutral position, as it is unnecessary to position the airway.

C) INCORRECT. It is never correct to attach ventilation devices prior to proper positioning of the patient's airway.

D) INCORRECT. Mucus plugs should be cleared prior to ventilating stoma breathers, but it is unrelated to airway positioning.

Page Ref: 233 Objective: 10.15

26) A 21-year-old patient presents with labored breathing and audible wheezes, heart rate of 124, respiration 36; he has significantly altered mentation. What is the treatment for this patient?

A) Supplement the breaths with high-concentration oxygen through a nonrebreather mask.

B) Use a pocket mask, which will provide adequate oxygen to improve the patient's condition.

C) Ventilate with a bag-valve mask with high oxygen or FROPVD.

D) Give mouth-to-mouth breathing with a nasal cannula, providing the patient with an increase of oxygen. Answer - Explanation:

A) INCORRECT. A nonrebreather mask should only be used for patients who are breathing adequately on their own; this patient requires assistance to breathe.

B) INCORRECT. A pocket mask would not be the EMT's first choice for this patient; it is only a last option when other treatments are not available or effective.

C) CORRECT. Since this patient is not breathing adequately positive pressure ventilation is indicated; a BVM or FROPVD should be used to force air or oxygen into his lungs.

D) INCORRECT. It would not be appropriate to provide mouth-to-mouth ventilations or use a nasal cannula on this patient.

Page Ref: 221 Objective: 10.16

27) What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket mask?

A) 50%

B) 21% C) 100% D) 16% - Explanation: A) CORRECT. When high-concentration oxygen is attached to the inlet on a pocket mask, it delivers an oxygen concentration of approximately 50%.

B) INCORRECT. When used correctly, a pocket mask with supplemental oxygen will provide much more than 21%.

C) INCORRECT. A pocket mask with high-flow oxygen attached will not provide 100% oxygen to the patient.

D) INCORRECT. A pocket mask without supplemental oxygen will provide about 16% oxygen to the patient.

Page Ref: 228 Objective: 10.16

28) Your patient is a 55-year-old man with a history of chronic bronchitis. You have been called to his home today because of an increase in his level of respiratory distress. The patient is on 2 liters per minute of oxygen by nasal cannula at home. Your assessment reveals difficulty speaking due to shortness of breath, leaning forward to breathe, a productive cough, and a respiratory rate of 32 per minute. Which of the following is true concerning the best course of action for this patient?

A) Because increased blood levels of carbon dioxide are the primary stimulus to breathe, you should encourage the patient to rebreathe his exhaled air from a paper bag.

B) You should increase the patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate decreases, you can assist him with a bag-valve-mask device.

C) You should increase the patient's oxygen flow rate until his respiratory rate decreases and then resume oxygen administration at 2 liters per minute.

D) You should not increase the patient's oxygen flow rate because of his likely dependence on a hypoxic drive to stimulate breathing. Answer - Explanation: A) INCORRECT. This patient is in respiratory distress and requires oxygen, having him breather into a paper bag is not appropriate care.

B) CORRECT. For chronic respiratory patients, as with all patients, make decisions on oxygenation based on patient presented level of distress and pulse oximetry. Do not withhold oxygen from any patient in distress.

C) INCORRECT. An EMT in the prehospital setting should not be attempting to regulate a COPD patient in this manner.

D) INCORRECT. Regardless of the patient's chronic history, all respiratory distress situations in the prehospital setting should be treated with consistent oxygen therapy.

Page Ref: 243 Objective: 10.16

29) Which of the following is the best device to deliver high-concentration oxygen to a breathing patient?

A) Simple face mask B) Nonrebreather mask C) Nasal cannula D) Oropharyngeal airway - Explanation:

A) INCORRECT. A simple face mask is not an oxygen delivery device.

B) CORRECT. The nonrebreather (NRB) mask is the EMT's best way to deliver high concentrations of oxygen to a breathing patient.

C) INCORRECT. High-concentration oxygen cannot be delivered effectively using a nasal cannula.

D) INCORRECT. An oropharyngeal airway does not supply supplemental oxygen.

Page Ref: 247 Objective: 10.16

30) Your patient is a 65-year-old male with a history of COPD. He is sitting up and complaining of a severe shortness of breath. You should: A) suction the airway with a rigid suction catheter.

B) administer 4 lpm of oxygen via nasal cannula.

C) insert a nasal airway and ventilate.

D) apply a nonrebreather mask giving 15 lpm of oxygen - Explanation: A) INCORRECT. There is no reason to suction this patient's airway.

B) INCORRECT. 4 lpm of oxygen via nasal cannula would not be appropriate for this patient.

C) INCORRECT. A nasopharyngeal airway and positive pressure ventilations would not be indicated for this patient's current presentation.

D) CORRECT. COPD patients that are experiencing severe respiratory distress should receive high-concentration oxygen. Never withhold oxygen from a patient in respiratory distress.

Page Ref: 247 Objective: 10.17

31) A nonrebreather mask at 12 to 15 liters per minute will generally provide the patient what percentage of oxygen?

A) 80-100 B) 16-21 C) 24-44

D) 90-100 - Explanation: A) CORRECT. The nonrebreather mask will provide concentrations of oxygen ranging from 80 to 100% at the optimum flow rate of 12 to 15 liters per minute.

B) INCORRECT. Nonrebreather masks provide more than 16-21% of oxygen.

C) INCORRECT. At optimum flow rates, nonrebreather masks will provide more than 24% to 44% of oxygen.

D) INCORRECT. Nonrebreather masks do not provide 90-100% oxygen.

Page Ref: 247 Objective: 10.17

32) You are transporting a 44-year-old female with chest pain and sudden respiratory distress. She is agitated, anxious, and refuses to have a nonrebreather mask applied. Which of the following is the best option?

A) Use a nasal cannula instead.

B) Have her breathe into a paper bag to control her hyperventilation.

C) Do not make further attempts to administer oxygen as it will only agitate the patient further.

D) Consult with medical control about restraining the patient. Answer - Explanation:

A) CORRECT. It is not uncommon for patients in respiratory distress to dislike the thought of a mask being placed over their mouth and nose; if the patient absolutely refuses, some oxygen from a nasal cannula is better than none.

B) INCORRECT. This patient needs oxygen; it would be poor patient care to have her breathe into a paper bag.

C) INCORRECT. A patient with chest pain and in respiratory distress would benefit from supplemental oxygen; the responders should continue trying to administer it.

D) INCORRECT. It would be inappropriate to restrain this patient.

Page Ref: 248 Objective: 10.17

33) Before applying a nonrebreather mask, the EMT should take what action?

A) Insert a properly sized oropharyngeal airway.

B) Connect the mask to a humidified oxygen source and wait for the patient's heart rate to slow.

C) Make sure the oxygen supply has greater than 2,000 psi in the tank.

D) Inflate the reservoir bag and make sure the bag does not deflate during inspiration - Explanation: A) INCORRECT. Nonrebreather masks are for breathing patients with patent airways; if an oropharyngeal airway is indicated then the patient most likely requires positive pressure ventilations.

B) INCORRECT. Waiting for a patient's heart rate to slow is not required before administering oxygen with a nonrebreather mask.

C) INCORRECT. 2,000 psi is essentially a full oxygen tank; as long as it is not below 200 psi the tank can be used.

D) CORRECT. The reservoir bag must be inflated before the nonrebreather mask is placed on the patient's face.

Page Ref: 247 Objective: 10.18

34) Which of these patients would require a tracheostomy mask for supplemental oxygen administration?

A) A patient with a stoma

B) A patient with quadriplegia C) A patient with chronic bronchitis D) A patient with upper airway inflammation - Explanation: A) CORRECT. A tracheostomy mask is designed to be placed over a stoma or tracheostomy tube to provide supplemental oxygen.

B) INCORRECT. Quadriplegia (paralysis of all four limbs) is not necessarily an indicator that a tracheostomy mask will be required.

C) INCORRECT. A tracheostomy mask would not be indicated just because a patient has chronic bronchitis.

D) INCORRECT. A tracheostomy mask would not be used for a patient because of upper airway inflammation.

Page Ref: 249 Objective: 10.18

35) A

is NOT typically used in the prehospital setting for oxygen

administration.

A) nasal cannula

B) partial rebreather mask C) regulator D) tracheostomy mask - Explanation: A) INCORRECT. Nasal cannulas are very common on ambulances and regularly used for oxygen administration.

B) CORRECT. Partial rebreather masks are used for some patients to preserve the carbon dioxide levels in the blood in order to stimulate breathing. These masks are not typically used in EMS but may be occasionally found in the home setting.

C) INCORRECT. All oxygen administration requires a regulator of some type on the cylinder.

D) INCORRECT. Tracheostomy masks are used to provide supplemental oxygen to patients with stomas or tracheostomy tubes; although not as common as other oxygen delivery devices, they are used in EMS. Page Ref: 247 Objective: 10.18

36) Venturi masks are designed to mix oxygen with: A) nitrogen.

B) inhaled air.

C) humidified air.

D) carbon monoxide. Answer - Explanation: A) INCORRECT. Venturi masks are not specifically used to combine nitrogen with oxygen.

B) CORRECT. Most commonly used for COPD patients, Venturi masks deliver specific concentrations of oxygen by mixing oxygen with inhaled air.

C) INCORRECT. Venturi masks are not specifically made to mix oxygen with humidified air.

D) INCORRECT. Carbon monoxide is a potentially poisonous gas and is not related to Venturi mask use.

Page Ref: 249 Objective: 10.18

37) The oxygen flow rate for a nasal cannula should not exceed per minute.

A) 8

B) 4 C) 6 D) 2 - Explanation: A) INCORRECT. 8 liters per minute is too high for a nasal cannula; it would be very uncomfortable for the patient.

B) INCORRECT. Nasal cannulas can be used with a higher liter flow than 4.

liters

C) CORRECT. When a cannula is used, the liters per minute delivered should be no more than 6. At higher flow rates the cannula begins to feel more uncomfortable and dries out the nasal mucous membranes.

D) INCORRECT. Sometimes patients will require more than 2 liters of oxygen with a nasal cannula.

Page Ref: 248 Objective: 10.19

38) Which of the following oxygen cylinders would normally run out after 50 minutes when flowing at 10 liters per minute?

A) M tank

B) D tank C) G tank D) E tank - Explanation: A) INCORRECT. With a capacity of 3,000 liters of oxygen, an M tank would last almost five hours at 10 lpm.

B) INCORRECT. A D cylinder holds approximately 350 liters, which would run out in about 35 minutes.

C) INCORRECT. G tanks are normally part of an on-board oxygen system and hold up to 5,300 liters — or nearly nine hours of oxygen flowing at 10 liters per minute.

D) CORRECT. An E tank holds approximately 625 liters of oxygen; running at 10 lpm, it would last almost an hour.

Page Ref: 238 Objective: 10.19

39) You are attempting to replace the oxygen cylinder in your truck. After removing the regulator from the old cylinder, removing the old cylinder, and placing the new cylinder in the oxygen compartment, you attempt to connect the regulator. The new cylinder has a yellow stripe around it instead of a green one but was stored with the green cylinders. You are unable to get the regulator to seat properly and it will not turn. You should: A) attempt to force the regulator onto the cylinder.

B) remove the cylinder and get a green cylinder.

C) replace the oxygen regulator with a new one.

D) put the old cylinder back on the truck. Answer - Explanation: A) INCORRECT. Never force a regulator onto a cylinder.

B) CORRECT. Medical gas cylinders are designed to be used only with gas- specific regulators. Air cylinders will not work with oxygen regulators.

C) INCORRECT. A yellow-striped cylinder would not be oxygen, so the regulator is not the problem.

D) INCORRECT. A cylinder that does not contain oxygen or that does not work with an oxygen regulator should not be placed onto the ambulance.

Page Ref: 238 Objective: 10.20

40) Which of the following is acceptable for maintaining a seal between an oxygen cylinder and regulator?

A) Pop-off valve

B) Gasket C) Grease plug D) Medical grade adhesive tape - Explanation: A) INCORRECT. A pop-off valve is an emergency pressure release, unrelated to the seal between a cylinder and a regulator.

B) CORRECT. A gasket that is clean and in good condition can prevent dangerous leaks when it is properly seated between the cylinder and the regulator.

C) INCORRECT. Never use grease, oil, or fat-based soaps on oxygen cylinders or their components.

D) INCORRECT. Never use adhesive tape to protect an oxygen tank outlet or to mark or label any oxygen cylinders or oxygen delivery apparatus. The oxygen can react with the adhesive and debris and cause a fire.

Page Ref: 240 Objective: 10.20

41) Of the three types of oxygen flowmeters, which one can only be used upright?

A) Bourdon gauge flowmeter

B) Hudson gauge flowmeter C) Constant flow selector valve D) Pressure-compensated flowmeter - Explanation: A) INCORRECT. A Bourdon gauge flowmeter, the most common type of meter for pressurized canisters, does not need to be kept upright.

B) INCORRECT. There is no requirement that a Hudson regulator must stay in an upright position.

C) INCORRECT. A constant flow selector valve can operate when held at any angle.

D) CORRECT. A pressure-compensated flowmeter is gravity dependent and must be in an upright position to deliver an accurate reading.

Page Ref: 241 Objective: 10.20

42) Which of the following colors identifies an oxygen cylinder?

A) Orange and red B) Black and tan C) Blue and yellow D) Green and white - Explanation: A) INCORRECT. Oxygen cylinders should not be colored orange and red.

B) INCORRECT. Black and tan tanks would most likely not contain oxygen.

C) INCORRECT. Blue and yellow are not the designated colors for oxygen cylinders.

D) CORRECT. The United States Pharmacopoeia has assigned a color code to distinguish compressed gases. Green and white cylinders have been assigned to all grades of oxygen.

Page Ref: 238 Objective: 10.20

43) The safe residual for an oxygen cylinder is A) 200 B) 300 C) 500

psi.

D) 1,000 - Explanation: A) CORRECT. Oxygen cylinders should never be allowed to empty below the safe residual or the tank may be permanently damaged. The safe residual for an oxygen cylinder is when the pressure gauge reads 200 psi or above.

B) INCORRECT. 300 psi is generally higher than required for an oxygen cylinder safe residual.

C) INCORRECT. The safe residual for an oxygen cylinder is lower than 500 psi.

D) INCORRECT. 1,000 psi is far too high for a standard safe residual.

Page Ref: 238 Objective: 10.20

44) Which of the following is necessary to deliver oxygen to patients at a safe pressure?

A) Filter B) Float ball C) Regulator D) Flowmeter - Explanation: A) INCORRECT. Filters do not adjust the pressure being released from oxygen cylinders.

B) INCORRECT. A float ball is used on some oxygen delivery systems as a pressure indicator only; it does not change the pressure.

C) CORRECT. The pressure in an oxygen cylinder is too high to be delivered to a patient so a pressure regulator must be connected to the cylinder to provide a safe working pressure of 30 to 70 psi.

D) INCORRECT. A flowmeter allows control of the oxygen flow rate; it does not control the pressure.

Page Ref: 240 Objective: 10.21

45) Concerning the use of humidified oxygen, which of the following is true?

A) It should only be used when assisting ventilations with a bag-valve-mask device.

B) The water in the reservoir should be treated with chlorine tablets to prevent the growth of bacteria.

C) It is not of great benefit during short transports but can make the patient more comfortable.

D) The water reservoir should be changed on a weekly basis. Answer - Explanation:

A) INCORRECT. Humidified oxygen is generally not indicated for BVM use and definitely shouldn't be restricted to it.

B) INCORRECT. Proper cleaning of the humidifier equipment is the best way to keep it free from bacteria; chlorine tablets should never be used.

C) CORRECT. In most short-term use, the dryness of the oxygen is not a problem; however, for long transports the patient is usually more comfortable when given humidified oxygen.

D) INCORRECT. Although single-patient-use humidifiers are preferred, if reusable equipment is used, the water reservoir should be cleaned and changed before each shift.

Page Ref: 241 Objective: 10.21 Which of the following situations should MOST indicate a hazard to the EMT during scene sizeup?

A. A bystander who is smoking a cigarette at the scene of an assault at a local park. B. A news media helicopter arrives and hovers overhead at the scene of a vehicle collision.

C. A vehicle collision where bystanders are recording video on their phones. D. The sound of a barking and growling dog upon approaching the door to a residence. Answer D. The sound of a barking and growling dog upon approaching the door to a residence.

You and your partner respond to a residence for a fall. You arrive to find a group of approximately 30 adults surrounding a middle-aged man who appears to be unconscious. A police car pulls in behind you. You should: A. have the police officer drag the victim over to the ambulance. B. enter the scene ahead of the police officer to provide care. C. leave the area and stage until the scene is cleared of people. D. wait for the police officer to assess the safety of the scene. Answer - D. wait for the police officer to assess the safety of the scene.

A patient who has sustained a fall is unconscious and lying face upward. He fell at a construction site, and you cannot determine the distance of the fall or how the patient landed on impact with the ground. You should: A. assess the mechanism of injury as a fall flat on the back. B. assess the mechanism of injury as a fall on the head. C. assess the mechanism of injury as a fall squarely on the feet. D. prioritize the patient for rapid packaging and immediate transport. Answer - D. prioritize the patient for rapid packaging and immediate transport.

When considering the potential for injury from a fall, which of the following is LEAST important?

A. Height of the fall B. Type of surface onto which the patient fell C. Patient's weight D.

Whether the patient struck anything with his body on the way down - C. Patient's weight A patient you are treating after a car wreck has been lacerated in multiple places by broken glass and debris. Injuries such as these lacerations are known as which of the following?

A. Cavitating trauma B. Penetrating trauma C. Internal injuries D. Blunt-force trauma - B. Penetrating trauma At the scene of a vehicle collision in which there are no apparent hazards, which of the following guidelines should be followed for establishing a danger zone?

A. The danger zone should be 50 feet in all directions. B. There is no need to establish a danger zone when there are no apparent hazards. C. The danger zone should be 15 feet in all directions. D. The danger zone should be 150 feet in all directions - A. The danger zone should be 50 feet in all directions.

Which of the following is TRUE concerning scene size-up? A. Determining the number of patients is not important on a medical call. B. Information from bystanders is not important on trauma calls. C. Scene size-up does not play a role in determining the nature of the illness.

D. The need for additional resources must be determined on both medical and trauma calls. Answer D. The need for additional resources must be determined on both medical and trauma calls.

You are on the scene of an explosion at a suspected methamphetamine manufacturing operation.

You and your partner are the first to arrive and note two middle-aged men and a woman on the front lawn with burns and cuts on their faces and arms. The fire department and the police are en route. What should indicate potential for violence?

A. The explosion B. The burns and cuts C. The scene being a suspected meth production operation D. The police being en route - C. The scene being a suspected meth production operation At which of the following points should you begin your scene size-up? A. After exiting the ambulance, but before making patient contact B. When you arrive on the scene, but before exiting the ambulance C. When the patient or family member opens the door to the residence D. As you approach the scene in the ambulance - D. As you approach the scene in the ambulance Which of the following is true concerning the potential for violence at the scene of an EMS call?

A.

The chance for violence is very low at emergency scenes. B. An unusual lack of activity at the scene may signal impending violence against the EMT. C. You do not need to worry about violence at an emergency scene once the police have secured it.

D. Signs of impending violence are obvious if you know what to look for. Answer - B. An unusual lack of activity at the scene may signal impending violence against the EMT. You determine that a patient involved in a vehicular collision has sustained only blunt-force trauma. Which of the following BEST describes blunt-force trauma? A. The object penetrates soft tissue, but it cannot penetrate bone. B. A rounded object impacts the body tissues. C. The object is not sharp, but it penetrates the body when enough force is used. D. An object strikes the body, but it does not penetrate the body tissues. Answer - D. An object strikes the body, but it does not penetrate the body tissues.

You have just arrived on the scene of a motor vehicle collision in which a compact car was struck from behind by a delivery truck. The driver of the delivery truck is standing outside his vehicle talking to police when you arrive, but the driver of the car is still seated in the driver's seat. You have noted moderate damage to the rear of the car. For which of the following injuries should you have the highest level of suspicion?

A. Chest injury B. Neck injury C.

Fractures of the lower extremities D. Abdominal injuries - B. Neck injury When determining possible injuries suffered from a gunshot wound, which of the following is true?

A. The EMT must determine the caliber of ammunition involved. B. The EMT must ask the patient or bystanders exactly where the shooter was standing.

C. The EMT must be aware that bullets cause damage in more than one way. D. Bullets pass in a straight line through the body from the point of entry to the exit wound. Answer - C. The EMT must be aware that bullets cause damage in more than one way.

What law of physics explains why a patient's liver can be injured from the impact of his car with a tree?

A. Second law of motion B. Law of inertia C. Law of kinetic energy D. Newton's law of universal gravitation - B. Law of inertia In which of the following situations should the EMT consult the Emergency Response Guidebook?

A. Downed power lines at the scene of a vehicle collision

B. Chlorine gas leak at a public swimming pool C. Patient with a suspected infectious disease D. Domestic disturbance with the potential for violence - B. Chlorine gas leak at a public swimming pool You are on the scene of a tanker truck versus passenger vehicle collision on a rural highway. The vehicles are just beyond a curve in the roadway and there is a distinct odor of diesel fuel. It is dark and there is little traffic. Which of the following should be used to alert oncoming traffic to the situation?

A. Flashing lights on the ambulance B. Yellow crime scene tape C. Flares D. Reflective triangles - D. Reflective triangles

Your patient fell out of a tree while putting the roof on a tree house. A 15-foot ladder is required to enter the tree house and there is enough room for an adult to stand up inside. Your patient should be transported to: A. a trauma center.

B. the closest hospital. C. an urgent care center. D. a neurosurgery center. Answer - A. a trauma center.

As you approach the scene of a motorcycle accident, you see an EMR trying to stop the bleeding on the patient's left arm. You notice that the EMR has blood covering the front of his shirt and running down his arms. Other than simple protocol, what factor MOST indicates the need for Standard Precautions?

A. It is unclear whether the EMR has already taken Standard Precautions. B. The patient is bleeding and the EMR is covered in blood. C. You haven't established a danger zone around the patient. D. The accident involved a motorcycle. Answer - B. The patient is bleeding and the EMR is covered in blood.

As you are assessing a 32-year-old asthmatic woman who has called EMS due to difficulty breathing, her husband enters the home through a back door and shouts, "Get your hands off her!

She doesn't need your help. She needs to be taught a lesson about her smart mouth." Which of the following is the best course of action? A. Let the husband know that his behavior is inappropriate, and if it continues you will call for the police.

B.

Continue assessment and respond that the patient is sick and needs medical attention.

C. Attempt to remove the patient from the home and continue treatment en route to the hospital.

D. Request police backup immediately and consider leaving the scene. Answer - D. Request police backup immediately and consider leaving the scene.

You are responding to the scene of a rollover collision. You should have a keen awareness that there may be injuries based on your scene size-up. This is known as which of the following?

A. Mechanism of injury B. Nature of illness C. Law of inertia D. Index of suspicion - D. Index of suspicion Which of the following will deliver a medium-velocity impact? A. Ice pick B. Bullet from a handgun C. Bullet from an assault rifle D. Butcher knife - B. Bullet from a handgun At what point is the scene size-up complete? A.

When crashed vehicles have been stabilized B. When the number of patients has been determined C. Upon stabilization of the c-spine D. At the end of the call - D. At the end of the call As you arrive at the scene of a house fire, you see a police officer and a distraught man in the yard, both of whom signal for your attention. You should: A. call out to the officer to approach you. B. approach the distraught man. C. size up the scene before acting. D. approach the police officer. Answer C. size up the scene before acting.

You are a block away from arriving on the scene of an emergency. What should be LEAST important to you at this time is: A. a glimpse of smoke that appears to be above the emergency scene. B. a lack of opposing traffic flow. C. the sound of other emergency vehicles approaching the scene. D. the condition of the buildings you pass. Answer - D. the condition of the buildings you pass.

Which of the following situations is LEAST likely to require additional resources at the scene?

A 300-pound woman complaining of back pain

B. A call to a manufacturing plant where a worker has his hand caught in a machine

C. A patient with emphysema who is on oxygen therapy at home D. A call for a sick person at home during which an odor of natural gas is detected Answer - C. A patient with emphysema who is on oxygen therapy at home

Chapter 39. Hazardous Materials, Multiple-Casualty Incidents, and Incident Management Emergency Care, 14e (Limmer/O'Keefe/Dickinson)

1. You respond to the scene of a vehicle collision. You see no smoke or fumes, but you do see what appears to be liquid beneath the vehicles that have collided, which are in the center of the road with skid marks that seem relatively even. What should you MOST suspect as

potential hazards?

A. No apparent hazards B. Downed power lines or damaged utility poles C. Spilled fuel and/or hazardous materials D. Vehicle on fire or hazardous materials threatened by fire Answer: C. Spilled fuel and/or hazardous materials Rationale: The presence of liquid beneath the vehicles suggests the possibility of spilled fuel or other hazardous materials. Even skid marks imply a sudden stop that could have caused a fuel or fluid leak. This scenario requires a high index of suspicion for hazardous materials, given the potential for leaks from vehicle systems (fuel, coolant, oil, etc.) or transported goods.

2. What reference provides important information regarding hazardous materials, emergency care, and procedures in case of accidental fire or release; supplies definitions of placard colors and identification numbers; and should be standard issue on-board all ambulances and rescue units?

A. Accidental Exposure and Contamination Guide B. Emergency Preparedness and Response Plan C. Emergency Response Guidebook D. Safety Data Sheets Answer: C. Emergency Response Guidebook Rationale: The Emergency Response Guidebook (ERG) is a key resource for first responders dealing with hazardous materials incidents. It contains essential information on the identification of hazardous materials, safety measures, emergency procedures, and placard identification, making it indispensable for emergency care and response.

3. What is the EMT's highest priority at the scene of a hazardous materials incident?

A. Identification of hazardous materials B. Patient care C. Personal safety D. Safety of bystanders Answer – C : Answer: C. Personal safety Rationale: In hazardous materials incidents, the EMT's highest priority is personal safety. Ensuring personal safety allows the EMT to remain effective and not become an additional casualty. Once personal safety is assured, the EMT can then focus on assessing and managing other priorities, such as the safety of bystanders and patient care.

4. Which of the following is NOT a consideration that should be used by the EMT in establishing the size of the danger zone?

A. Presence of hazardous materials B. Wind direction C. Amount of equipment needed D. Fire Answer - C. Amount of equipment needed Answer: C. Amount of equipment needed Rationale: The amount of equipment needed is not a factor in determining the size of the danger

zone. The primary considerations are the presence of hazardous materials, wind direction, and the presence of fire, all of which directly affect safety and the potential spread of hazards. The size of the danger zone should be based on these factors to ensure the safety of all personnel and bystanders.

5. An EMT is responding to a call involving a truck that collided with the side of a building. The driver is unconscious. There is some spilled fuel but no fire. By standers are approaching the scene from all directions. The truck is carrying canisters of material the EMT cannot identify, some of which has spilled out. When should the EMT evaluate the need for Standard Precautions?

A. An evaluation should be made throughout the call.

B. No evaluation is ever needed because the precautions are the same for every call.

C. An evaluation should be made once a general impression of the patient has been formed.

D. An evaluation should be made before arrival on-scene.

Answer: A. An evaluation should be made throughout the call.

Rationale: The need for Standard Precautions should be continually evaluated throughout the call. This ongoing assessment ensures that appropriate precautions are taken as new information becomes available and as the situation evolves. Constant vigilance helps protect the EMT and others from potential hazards, particularly in dynamic and potentially hazardous environments.

Your patient, a 29-year-old female, was the front seat passenger in a vehicle that was struck in the passenger's side door by another vehicle that ran a red light.

Which of the following is MOST likely to have occurred? A. The patient impacted the steering wheel with her chest, causing a fracture of the sternum.

B. The patient took the "up and over" pathway, striking her head on the windshield. C. The patient's body was pushed forcefully out from under her head, causing injury to the cervical spine.

D. The patient took the "down and under" pathway, causing trauma to her lower extremities. Answer - C. The patient's body was pushed forcefully out from under her head, causing injury to the cervical spine.

When assessing along the path of the energy, where should the EMT assess for injury first when caring for a patient who had a two-story fall and landed square on his feet?

A. Upper and lower extremities B. Feet, ankles, and legs C.

Head and neck D. Upper and lower back - B. Feet, ankles, and legs You are dispatched to a local bar for the report of an unresponsive female patient found in the bathroom. As you approach the scene, you notice a large crowd outside the front door holding beer bottles. The group has pulled the patient outside. As you approach the scene, people from the group start yelling, "Do something! She's not breathing." What concerns you the most about this scene? A. The possibility that the patient may be intoxicated B. The fact that the patient has been moved from where she was found C. The large crowd that has been drinking and is now yelling at you D. The crowd stating the patient is not breathing - C. The large crowd that has been drinking and is now yelling at you

You and your partner are en route to a motor vehicle crash involving a tanker truck on a rural road.

Dispatch informs you that fluid is leaking from the truck, that there are several bystanders passed out on the ground near the cab of the truck, and that a caller has reported the code that appears on a placard attached to the tanker truck.

You should: A. park about 50 feet from the truck. B. consult the Emergency Response Guidebook. C. park downwind from the tanker truck. D. remove the bystanders from the scene. Answer - B. consult the Emergency Response Guidebook.

An index of suspicion is: A. an awareness that there may be injuries. B. recognition of potential threats based on previous experiences. C. the need to constantly monitor a scene for new dangers. D. reason to believe a crime has been committed. Answer - A. an awareness that there may be injuries.

Answer - A. An evaluation should be made throughout the call.

1) What BEST defines the immediate sense of the patient's degree of distress, formulated from the patient's immediate environment, appearance, and chief complaint?

A) General impression

B) Primary assessment C) Scene size-up D) Secondary assessment - Explanation: A) CORRECT. Forming a general impression helps you to determine how serious the patient's condition is and to set priorities for care and transport. It is based on your immediate assessment of the environment and the patient's chief complaint and appearance.

B) INCORRECT. Formulating an immediate impression of the patient's level of distress is part of the primary assessment, but not what that particular step of the patient care process is called.

C) INCORRECT. The scene size-up refers to assessing the overall scene for hazards and needs, not individual patients.

D) INCORRECT. Determining a patient's initial condition and priority happens before the secondary assessment.

Page Ref: 285 Objective: 12.1

2) Which of the following is NOT part of the general impression?

A) Patient's facial expression B) Patient's age and race C) Position in which the patient is found D) Patient's past medical history - Explanation:

A) INCORRECT. The expression on a patient's face can be very telling when forming a general impression.

B) INCORRECT. The patient's age and race can provide clues to an EMT when forming a general impression.

C) INCORRECT. Patient positioning can provide valuable visual information when forming a general impression of the patient.

D) CORRECT. Although potentially important, the patient's past medical history does not directly relate to the formation of a general impression.

Page Ref: 285; 288-289 Objective: 12.1

3) In EMS, what does mental status refer to?

A) Patient's level of awareness of his surroundings B) Any history of mental illness that the patient may have C) Patient's general level of intelligence D) None of the above - Explanation: A) CORRECT. When determining mental status, an EMT assesses the patient's level of awareness of his surroundings.

B) INCORRECT. The term mental status does not refer to a patient's history of mental illness.

C) INCORRECT. EMS responders do not evaluate the level of intelligence of their patients.

D) INCORRECT. One of the provided answers is correct.

Page Ref: 290 Objective: 12.1

4) In EMS, which of the following BEST describes the term intervention?

A) Determining if there is a problem B) Taking steps to correct a problem C) Creating a permanent record of patient care D) Decreasing the EMT's liability for negligence - Explanation: A) INCORRECT. The processes of determining the presence of a problem is called assessment.

B) CORRECT. An action taken by an EMT to correct or manage a patient's problem is called an intervention.

C) INCORRECT. A permanent record of patient care is called a Patient Care Report (PCR).

D) INCORRECT. The term intervention is unrelated to decreasing a person's liability.

Page Ref: 285 Objective: 12.1

5) Which of the following describes the chief complaint?

A) Reason why the patient summoned EMS B) Events immediately preceding the call for EMS C) Overall impression of the patient's condition D) All of the above - Explanation: A) CORRECT. The chief complaint is the reason EMS was called, usually in the patient's own words, which should be documented in quotes.

B) INCORRECT. The events immediately preceding activation of the EMS system may or may not relate to the chief complaint.

C) INCORRECT. An EMT's impression of the patient is not considered the chief complaint.

D) INCORRECT. Not all of the answers provided are correct.

Page Ref: 289 Objective: 12.1

6) Which of the following represents the correct order of assessment for the EMT during the primary assessment from start to end?

A) General impression, mental status, airway, breathing, circulation, patient priority B) Mental status, general impression, airway, breathing, circulation, patient priority C) Patient priority, general impression, mental status, airway, breathing, circulation

D) None of the above - Explanation:

A) CORRECT. The order of a primary assessment is: form a general impression, determine mental status, assess airway, assess breathing, assess circulation, and determine patient priority for transport.

B) INCORRECT. Determining mental status is not the first step in a primary assessment.

C) INCORRECT. A patient's priority for transport cannot be determined as the first step of the primary assessment.

D) INCORRECT. One of the options provided is correct.

Page Ref: 285 Objective: 12.2

7) Which of the following is completed first during the primary assessment?

A) Determining transport priority B) Assessing mental status C) Opening the airway D) Forming a general impression - Explanation: A) INCORRECT. Determining transport priority is not the first thing that an EMT does during the primary assessment.

B) INCORRECT. Although an important part of the primary assessment, determining the patient's mental status is not the first thing.

C) INCORRECT. Since the primary assessment begins when the patient is first seen, opening the patient's airway would not be the first thing that an EMT does.

D) CORRECT. The first step of the primary assessment is forming a general impression of the patient.

Page Ref: 285 Objective: 12.2

8) Which of the following BEST describes an EMS provider's "sixth sense"?

A) Diagnostic ability B) General impression C) Clinical judgment D) Scene safety - Explanation:

A) INCORRECT. EMS providers do not diagnose patients, so the term diagnostic ability does not apply.

B) INCORRECT. Although an EMT's "sixth sense" can contribute to forming a general impression, the term does not describe the ability.

C) CORRECT. After gaining some practice assessing and managing patients, EMTs may develop a "sixth sense" that clues them in to the severity of a patient's condition. This is part of what is called clinical judgment, or judgment based on experience in observing and treating patients.

D) INCORRECT. Some EMTs are so observant and experienced that they are able to quickly identify even elusive hazards on scene, but the term scene safety does not describe the ability.

Page Ref: 290 Objective: 12.2

9) Which of the following is the purpose of the primary assessment?

A) To detect and treat immediately life-threatening problems B) To find all of the patient's signs and symptoms C) To discover trends of improvement or deterioration in the patient's condition D) To detect dangers to the patient and/or EMS crew - Explanation: A) CORRECT. The primary assessment is a key part of patient care. Not only is it the first time you physically reach your patient, it is the time when you will be called to identify and take immediate action for problems that can kill your patient.

B) INCORRECT. Evaluating for all signs and symptoms is not part of the primary assessment.

C) INCORRECT. Trending the patient's condition occurs as the care cycle continues; it is not part of the primary assessment.

D) INCORRECT. Looking for hazards on scene is part of the scene size-up, not the primary assessment.

Page Ref: 283 Objective: 12.2

10) Which of the following is true concerning the primary assessment?

A) Manual airway maneuvers must be performed on all patients.

B) The EMT should perform a sternal rub on all patients to test for response to painful stimuli.

C) External bleeding will be obvious as you enter the room and initially see the patient.

D) The primary assessment begins by just observing the patient as you enter the room.

Answer - Explanation: A) INCORRECT. Not all patients are going to require airway maneuvers.

B) INCORRECT. Painful stimulus tests should only be used for unresponsive patients who do not respond to talking or shouting.

C) INCORRECT. Depending on the lighting, the patient's clothing, the type of injury and the overall surroundings, external bleeding is not always obvious.

D) CORRECT. The primary assessment begins as soon as the EMT first sees the patient.

Page Ref: 285 Objective: 12.2

11) You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back with no signs of trauma, has vomited, and has slow, wet sounding respirations. Which of the following should you do next?

A) Determine the respiratory rate.

B) Check for carotid and radial pulses.

C) Assist respirations with a bag-valve-mask device.

D) Open the patient's airway using a head-tilt, chin-lift maneuver. Answer - Explanation: A) INCORRECT. Following the ABC or CAB of emergency care, checking this patient's respiratory rate would not be the next step.

B) INCORRECT. Since the patient is breathing, she obviously has circulation; checking for pulses would not be the EMT's first concern.

C) INCORRECT. Although the patient may ultimately require assisted ventilation, other actions would be required first.

D) CORRECT. Since this is a non-trauma patient with slow, wet sounding respirations, opening her airway with the head-tilt, chin lift maneuver would be indicated.

Page Ref: 291 Objective: 12.3

12) Your patient is a middle-aged man who appears to be in distress and is clutching his chest.

These observations lead you to suspect which type of problem?

A) Choking

B) Cardiac C) Anaphylaxis D) Digestive - Explanation: A) INCORRECT. A patient who is choking will normally place his hands to his throat.

B) CORRECT. Levine's sign, or having a hand clenched over the chest, is a sign of cardiac chest pain.

C) INCORRECT. An anaphylactic patient is not generally found clutching his chest.

D) INCORRECT. Digestive problems will usually cause abdominal discomfort. A patient with abdominal discomfort will most likely not clutch his chest.

Page Ref: 289 Objective: 12.4

13) Which of the following techniques is used when formulating the general impression?

A) Detecting odors B) Listening for unusual sounds C) Looking for visual clues D) All of the above - Explanation: A) INCORRECT. Utilizing sense of smell is only one of many ways for the EMT to develop a general impression.

B) INCORRECT. Although unusual sounds in the environment or from the patient can provide clues to his condition, there are numerous other components that make up the general impression.

C) INCORRECT. A good general impression cannot be formed by just visually observing the patient or his environment.

D) CORRECT. Forming a good general impression requires the EMT to use all of her senses.

Page Ref: 288-289 Objective: 12.4

14) You find a middle-aged unresponsive man lying prone on the ground near a ladder. You should: A) move the ladder out of the way.

B) roll him over to a supine position.

C) pick him up with a scoop stretcher.

D) manually immobilize his head. Answer - Explanation: A) INCORRECT. There is no indication that the ladder is posing a hazard; moving it would not be a priority.

B) INCORRECT. If the patient fell from the ladder, simply rolling him over would be inappropriate.

C) INCORRECT. A scoop stretcher would not be indicated in this situation.

D) CORRECT. The patient's presentation suggests that he fell off of the ladder. You should ensure in-line stabilization before rolling him over.

Page Ref: 288 Objective: 12.4

15) Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps.

She is alert and complaining of pain in her right ankle, but she jokes about her "clumsiness."

Which of the following should you do next?

A) Take immediate manual control of the patient's cervical spine.

B) Administer high-concentration oxygen by nonrebreather mask.

C) Determine the presence of a carotid pulse.

D) Ask if the patient has pain anywhere besides her ankle. Answer - Explanation: A) INCORRECT. There is nothing to indicate that this patient has suffered a neck or head injury; cervical spine precautions would not be necessary.

B) INCORRECT. This patient would not benefit from oxygen administration by nonrebreather mask.

C) INCORRECT. A patient who is conscious and joking would definitely have a carotid pulse.

D) CORRECT. Deciding on this patient's priority would require determining if she has other injuries in addition to the ankle.

Page Ref: 296-297 Objective: 12.4

16) Which of the following questions will most likely elicit your patient's chief complaint?

A) What made you call 911 this evening?

B) Do you have any medical problems?

C) How have you been feeling lately?

D) Have you been drinking today? - Explanation: A) CORRECT. A patient's chief complaint is the reason that the EMS system was activated, usually in the patient's own words.

B) INCORRECT. Asking if there any medical problems would be too general a question to determine a chief complaint.

C) INCORRECT. The chief complaint might not be related to how a patient has been feeling lately.

D) INCORRECT. Inquiring about a patient's oral intake would not be beneficial in trying to determine the chief complaint.

Page Ref: 289 Objective: 12.4

17) A patient whose mental status can be described as "verbal" is able to: A) tell you his or her name, his or her location, and what day it is.

B) respond only to a stimulus such as the EMT rubbing his sternum with his knuckles.

C) talk spontaneously and respond to the EMT's questions.

D) respond to speaking or shouting by opening the eyes. Answer - Explanation: A) INCORRECT. The term verbal response does not indicate that a patient is alert and oriented.

B) INCORRECT. Responding only to painful stimuli would not be described as "verbal."

C) INCORRECT. Talking spontaneously and responding to questions is not a requirement to be referred to as responsive to verbal stimuli.

D) CORRECT. A patient who responds to an EMT speaking or shouting by opening his eyes would be classified as verbally responsive.

Page Ref: 290-291 Objective: 12.4

18) Which of the following is NOT true regarding a patient who has a mental status of less than "alert"?

A) His brain may not be getting enough oxygen.

B) He is in a state of rapid eye movement sleep.

C) He may not have adequate blood circulation.

D) He requires high-concentration oxygen. Answer - Explanation: A) INCORRECT. An unconscious or partially conscious patient may be suffering from hypoxia.

B) CORRECT. A patient who is not fully conscious at an emergency scene would generally not be in a state of REM sleep.

C) INCORRECT. Inadequate circulation may cause a patient to have an altered mental status.

D) INCORRECT. A mentally altered patient may benefit from high-flow oxygen.

Page Ref: 290-291 Objective: 12.4

19) The mnemonic AVPU is used to evaluate which of the following?

A) Patient's chief complaint B) Patient's level of responsiveness C) Patient's transport priority D) EMT's general impression of the patient's condition - Explanation: A) INCORRECT. The mnemonic AVPU does not apply to a patient's chief complaint.

B) CORRECT. A patient's level of responsiveness is usually categorized as Alert, Verbal response, Painful response, or Unresponsive.

C) INCORRECT. Transport priority is unrelated to the mnemonic AVPU. D) INCORRECT. AVPU does not refer to the general impression of the patient.

Page Ref: 290-291 Objective: 12.4

20) You are approaching a young adult male lying supine on the ground with his eyes closed.

You should: A) open his airway.

B) ask him if he is okay.

C) expose his chest.

D) feel for a pulse. Answer - Explanation: A) INCORRECT. Assessing or opening this patient's airway is not the first step in the primary assessment process.

B) CORRECT. Asking the patient a question is the first step in assessing his mental status. If he opens his eyes and speaks, you will know that he is alert, most likely has a patent airway, and is breathing adequately.

C) INCORRECT. There is no reason to expose this patient's chest.

D) INCORRECT. Assessing the patient's circulation would not be the first action taken by an EMT performing a primary assessment.

Page Ref: 290 Objective: 12.4

21) Which of the following is NOT performed during the "Airway" phase of the primary assessment?

A) Head-tilt, chin-lift maneuver

B) Obtaining the respiratory rate C) Suctioning D) Insertion of an oropharyngeal airway - Explanation: A) INCORRECT. The head-tilt, chin-lift maneuver is used to open the patient's airway.

B) CORRECT. Determining the breathing rate of a patient occurs during the "Breathing" phase of the primary assessment.

C) INCORRECT. When determined to be necessary during the "Airway" phase of the primary assessment, suctioning should be performed immediately.

D) INCORRECT. Any intervention aimed at opening or maintaining the patient's airway should occur during the "Airway" phase of the primary assessment.

Page Ref: 291 Objective: 12.4

22) Which of the following is NOT assessed during the "Breathing" phase of the primary assessment?

A) Determining the depth of respiration

B) Counting the respiratory rate C) Determining the presence of respirations D) Obtaining a pulse oximetry reading - Explanation: A) INCORRECT. Depth of the patient's breathing should be assessed during the "Breathing" phase of the primary assessment.

B) INCORRECT. Determining a patient's respiratory rate should happen during the "Breathing" phase of the primary assessment.

C) INCORRECT. One of the most important components of the "Breathing" phase of the primary assessment is determining if the patient is actually breathing.

D) CORRECT. A pulse oximetry reading is not a standard component of the primary assessment.

Page Ref: 291-292 Objective: 12.4

23) You enter a room to find a 16-year-old female sitting upright in a chair with her back straight, leaning forward, and her arms supporting her. She is having a hard time talking to you. You should suspect: A) abdominal pain.

B) chest discomfort.

C) allergic reaction.

D) respiratory distress. Answer - Explanation:

A) INCORRECT. This patient's positioning is not indicative of abdominal pain.

B) INCORRECT. There is nothing in the description of this patient that would indicate chest pain.

C) INCORRECT. An allergic reaction would generally not result in a patient presenting in this position.

D) CORRECT. This patient is sitting in the tripod position, the classic sign of respiratory distress.

Page Ref: 289 Objective: 12.4

24) Which of the following presentations would be considered normal during the "Breathing" phase of the primary assessment?

A) Respiratory rate of 6 with shallow depth B) Respiratory rate of 28 with adequate depth C) Respiratory rate of 12 with adequate depth D) Respiratory rate of 16 with altered mental status - Explanation:

A) INCORRECT. A respiratory rate of 6 with shallow respirations would cause concern during the primary assessment.

B) INCORRECT. Although the depth is adequate, the breathing rate would generally be considered too rapid.

C) CORRECT. This respiratory rate and depth quality falls within the normal range.

D) INCORRECT. Even though the rate may be considered normal, the altered mental status would be cause for concern.

Page Ref: 291; 298 Objective: 12.4

25) In the primary assessment, which of the following is NOT an acceptable method of assessing the patient's circulatory status?

A) Assessing the patient's skin color B) Taking a blood pressure reading C) Checking a radial pulse D) Looking for serious bleeding - Explanation:

A) INCORRECT. Looking at the patient's skin condition is an important way to determine circulatory status initially.

B) CORRECT. A patient's blood pressure is not going to be an effective way to determine immediate life threats; it is not assessed during the primary assessment.

C) INCORRECT. A good way to quickly assess a patient's circulatory status is to check the radial pulse.

D) INCORRECT. Looking for serious bleeding is critical when performing a primary assessment; it is related directly to a patient's circulatory status.

Page Ref: 296 Objective: 12.4

26) For which of the following patients would capillary refill be a reliable sign of circulatory status?

A) 24-year-old homeless man who has spent the night outside in the rain

B) 92-year-old man complaining of weakness on his right side C) 50-year-old woman complaining of chest pain D) 3-year-old child with a fever and cough - Explanation: A) INCORRECT. Capillary refill is not usually an affective indicator of circulatory status for an adult patient.

B) INCORRECT. Capillary refill may be used on adults but in some cases may be unreliable. In some adults, especially in the elderly, it is normal for capillary refill to be delayed.

C) INCORRECT. There are other, more reliable indicators of circulation status for this patient; checking capillary refill would not generally be recommended.

D) CORRECT. A specific technique for checking circulatory status in infants and children is capillary refill.

Page Ref: 301 Objective: 12.4

27) During the primary assessment of a responsive adult patient, where should the pulse be checked?

A) At the radial artery

B) At the femoral artery

C) At the brachial artery D) At the carotid artery - Explanation: A) CORRECT. For a responsive adult patient, the radial pulse should be checked during the primary assessment.

B) INCORRECT. There is no reason to palpate the femoral artery of an alert adult patient during the primary assessment.

C) INCORRECT. During the primary assessment of an adult patient, the EMT would not check the brachial pulse.

D) INCORRECT. A carotid pulse will generally only be checked for unresponsive patients.

Page Ref: 296 Objective: 12.4

28) Your patient is a 42-year-old woman who fell two feet from a ladder and is complaining of pain in her ankle. Which of the following are you unable to determine from the information given?

A) Chief complaint

B) Airway status C) General impression D) Transport priority - Explanation: A) INCORRECT. The patient has clearly stated her chief complaint.

B) INCORRECT. The fact that the patient is verbally complaining of ankle pain indicates that she has a patent airway.

C) INCORRECT. A general impression is determined by assessing the patient's environment, chief complaint, and appearance; all three of which would be possible in this situation.

D) CORRECT. Not enough is yet known about this patient's condition to make a transport priority decision.

Page Ref: 296-297 Objective: 12.4

29) Which of the following patients is a high priority for transport?

A) Adult male with dull abdominal pain

B) Adult male with sharp lower back pain C) Adult male with a headache D) Adult male with difficulty breathing - Explanation: A) INCORRECT. A patient presenting with just dull abdominal pain would not generally be considered unstable or a high priority.

B) INCORRECT. Sharp lower back pain with no other signs or symptoms would not indicate a high priority for transport.

C) INCORRECT. If there are no other signs or symptoms present, an adult patient complaining of headache would not be considered high priority for transport.

D) CORRECT. A patient having difficulty breathing would be considered potentially unstable and would be a high priority for transport.

Page Ref: 296-297 Objective: 12.4

30) You are approaching a 16-year-old male with bright red spurting blood coming from his leg.

He is screaming, and he begs you to help him. You should: A) control the bleeding.

B) ask him to calm down.

C) assess his airway.

D) apply oxygen. Answer - Explanation: A) CORRECT. This patient's most immediate threat to life is the bright red spurting blood coming from his leg.

B) INCORRECT. It would not be reasonable to ask this patient to calm down.

C) INCORRECT. This patient has a patent airway or he would not be able to scream and talk.

D) INCORRECT. Administering oxygen would not be the first intervention for this patient.

Page Ref: 284 Objective: 12.5

31) You find a teenage male lying supine in his bedroom. You hear gurgling sounds from the patient's mouth and see vomit with pill fragments on the floor. You should:

A) ventilate with oxygen.

B) suction the airway.

C) identify the pills.

D) perform chest thrusts. Answer - Explanation: A) INCORRECT. Positive pressure ventilation could cause aspiration of the vomit.

B) CORRECT. Suctioning the airway would be your first priority in this patient.

C) INCORRECT. The identity of the pills would not affect the first few minutes of care for this patient.

D) INCORRECT. Chest thrusts would be ineffective due to the patient's partially open airway.

Page Ref: 284 Objective: 12.5

32) Which of the following is the most reliable means of determining whether a patient has any immediately life-threatening conditions?

A) Systematic approach to assessment

B) Obtaining a detailed medical history C) Thorough scene size-up D) Use of intuition - Explanation: A) CORRECT. A systematic approach to finding threats to life is the best way to make sure they are not missed.

B) INCORRECT. Immediate life threats may have nothing to do with a patient's medical history.

C) INCORRECT. The scene size-up will help to determine environmental hazards but will not generally assess an individual patient's life-threatening conditions.

D) INCORRECT. Intuition can be helpful, but it is not the most reliable way to determine immediate threats to a patient's life.

Page Ref: 290 Objective: 12.5

33) Which of the following is a good indication of an occluded airway?

A) The patient is crying loudly.

B) The patient is speaking clearly.

C) The patient is alert.

D) The patient has snoring respirations. Answer - Explanation: A) INCORRECT. A patient with an obstructed airway would not be crying loudly.

B) INCORRECT. Breathing and speaking clearly are indicators that the patient has a patent airway.

C) INCORRECT. A patient with an occluded airway would not appear alert.

D) CORRECT. A patient who is breathing noisily most likely has an occluded or endangered airway.

Page Ref: 291 Objective: 12.5

34) You have arrived on the scene at a high school football field where a 17-year- old male is lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first?

A) Assist ventilations with a bag-valve-mask device and supplemental oxygen.

B) Open the patient's airway using a manual maneuver.

C) Apply high-concentration oxygen by nonrebreather mask.

D) Insert a nasopharyngeal or oropharyngeal airway. Answer - Explanation: A) INCORRECT. Attempting to assist this patient's breathing would not be the first intervention initiated.

B) CORRECT. Ensuring a patent airway is the first step in the primary assessment.

C) INCORRECT. A patient who does not have a patent airway and is not breathing adequately would not benefit from passive oxygen therapy.

D) INCORRECT. Utilizing an airway device should not be the first step with this patient.

Page Ref: 291 Objective: 12.5

35) Your patient is a 33-year-old man who has been ejected from his vehicle during a highspeed collision. During your primary assessment it is discovered that he is not moving, does not appear to have adequate respirations, and has suffered moderate external bleeding. Which of the following should be done first?

A) Control the bleeding with direct pressure.

B) Open the airway.

C) Begin bag-valve-mask ventilations.

D) Check the patient's carotid pulse. Answer - Explanation: A) INCORRECT. Although blood loss is serious and should be addressed, it would not be the first thing done in this situation.

B) CORRECT. Since the patient does not appear to have adequate respiration, ensuring that his airway is patent would be the first priority.

C) INCORRECT. Initiating positive pressure ventilation would not be the first step taken in this situation.

D) INCORRECT. There would be no benefit in checking this patient's carotid pulse initially; the fact that he is breathing — although inadequately — indicates that he would have a pulse.

Page Ref: 291 Objective: 12.5

36) Which of the following indicates a possible circulatory problem?

A) Weak, thready pulse that is normal in rate B) Slow pulse C) Rapid pulse D) All of the above - Explanation: A) INCORRECT. Any time a patient's pulse deviates from normal characteristics it could indicate problems with circulation.

B) INCORRECT. A pulse that is too slow could indicate a circulatory problem, but so can one that is too fast or too weak.

C) INCORRECT. Circulatory problems should be suspected whenever a patient's pulse falls outside of normal characteristics.

D) CORRECT. All of the answers provided indicate the possibility of circulatory issues.

Page Ref: 296 Objective: 12.5

37) Which of the following is the correct manner for checking for responsiveness in an apparently unresponsive infant?

A) Pinching the earlobe B) Rubbing the sternum with your knuckles C) Flicking the soles of the feet D) Shaking the child - Explanation: A) INCORRECT. It is not accepted practice to pinch an infant's earlobe to check responsiveness.

B) INCORRECT. Rubbing an infant's sternum to check for responsiveness is not appropriate.

C) CORRECT. The mental status of unresponsive infants is typically checked by talking to the infant and flicking the soles of the feet.

D) INCORRECT. Infants should never be shaken, regardless of their level of responsiveness.

Page Ref: 301 Objective: 12.6

38) What is a normal capillary refill time in a pediatric patient?

A) 3 seconds B) 1 minute C) 5 seconds D) less than 2 seconds - Explanation: A) INCORRECT. A pediatric patient with a capillary refill time of 3 seconds should be evaluated further for circulatory problems.

B) INCORRECT. Capillary refill time should never take as long as one minute.

C) INCORRECT. A 5-second capillary refill time is not normal for a healthy pediatric patient.

D) CORRECT. For pediatric patients, when the end of the fingernail is gently pressed, it turns white. When the pressure is released, the nail bed should turn pink again very quickly, usually in less than 2 seconds.

Page Ref: 301 Objective: 12.6

39) Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness?

A) Hyperextension of the neck; placing a pillow under the back if necessary B) Placing the head and neck in a neutral position; using a folded towel under the shoulders if necessary C) Flexing the neck to place the chin on the chest; placing a folded towel under the back of the head if necessary D) Using a cervical collar to keep the chin elevated - Explanation:

A) INCORRECT. Due to the flexibility of their underdeveloped tracheas, hyperextending a child's neck can actually occlude the airway.

B) CORRECT. An child has an airway that is different from an adult's, so opening an infant's or child's airway means moving the head to a neutral position, not tilting it back the way an adult's airway is opened.

C) INCORRECT. Flexing any patient's neck, chin to chest, will potentially cause airway problems.

D) INCORRECT. A cervical collar is never indicated for airway purposes.

Page Ref: 301 Objective: 12.6

40) Which of the following differences should be expected when assessing a pediatric patient, as compared to the adult patient?

A) The normal pulse rate is slower.

B) Capillary refill is not as reliable an indicator of circulatory status.

C) The normal respiratory rate is faster.

D) An adult's tongue is proportionally larger than that of a child and should always be considered as a potential airway obstruction. Answer - Explanation: A) INCORRECT. A child's normal pulse rate is not slower than that of an adult.

B) INCORRECT. Capillary refill is actually more reliable in pediatric patients than it is for adult patients.

C) CORRECT. A child's normal respiratory rate is faster than that of an adult.

D) INCORRECT. A child's tongue is actually proportionally larger than that of an adult.

Page Ref: 301 Objective: 12.6

41) During the primary assessment of an unresponsive two-month old infant, which pulse should be palpated?

A) Brachial B) Carotid

C) Umbilical D) Radial - Explanation: A) CORRECT. The brachial pulse should be palpated when assessing the circulation of an unresponsive infant.

B) INCORRECT. An EMT would not check for a carotid pulse on an unresponsive infant.

C) INCORRECT. An umbilical pulse would never be palpated during the primary assessment of an unresponsive infant. Additionally, only newborn infants would even have an umbilical pulse.

D) INCORRECT. When assessing for circulation in an unresponsive infant, the radial pulse would not be palpated.

Page Ref: 303 Objective: 12.6

42) Which of the following findings is generally NOT used to assess an adult's circulation?

A) Patient's skin color, temperature, and condition B) Patient's distal pulse rate C) Evaluation for bleeding D) Patient's capillary refill time - Explanation: A) INCORRECT. An adult's skin color, temperature, and condition are very helpful when determining circulatory status.

B) INCORRECT. A distal pulse rate is directly related to an adult's circulation.

C) INCORRECT. Assessing for bleeding is an appropriate step when evaluating a patient's circulation.

D) CORRECT. Capillary refill time is generally unreliable for a circulatory assessment in adult patients.

Page Ref: 301 Objective: 12.6

43) Your partner is assessing a 55-year-old man who was found sitting on the tailgate of his truck after being involved in a motor vehicle collision. In order to provide for stabilization of the patient's cervical spine, you should: A) lay the patient down in the truck bed.

B) instruct the patient to stand up.

C) stand behind the patient in the truck bed.

D) assist the patient to the stretcher. Answer - Explanation: A) INCORRECT. This patient should not be moved until after his spine is manually stabilized.

B) INCORRECT. A patient with suspected neck or head injuries should not be asked to stand up.

C) CORRECT. During the primary assessment, patients with suspected spinal injuries should be managed as they are found, unless that would be unsafe.

D) INCORRECT. Assisting this patient to a stretcher would not be appropriate if spinal injury is suspected.

Page Ref: 298 Objective: 12.6

44) You are approaching an adult female lying supine on the ground with snoring respirations.

You should: A) open her airway with a jaw-thrust maneuver.

B) insert an oropharyngeal airway.

C) insert a nasopharyngeal airway.

D) ventilate with a bag-valve mask. Answer - Explanation: A) CORRECT. Snoring is typically caused by the tongue relaxing into the back of the mouth.

A jaw-thrust maneuver will move the tongue back to its normal position, allowing for freer movement of air in and out of the airway.

B) INCORRECT. Inserting an OPA would not be the first intervention in this situation.

C) INCORRECT. An NPA would not initially be indicated for this patient.

D) INCORRECT. Positive pressure ventilations would be ineffective if the patient's airway was not open.

Page Ref: 291

Objective: 12.6 A patient has been shot once in the left hand. After performing the primary assessment, the EMT quickly focuses his attention on the left hand and begins a specific assessment of the injury. What type of exam is the EMT performing?

A. Extremity B. Specific C. Rapid D. Focused - D. Focused When you assess the lower back of an elderly patient who fell, he grimaces and tells you that it hurts when you palpate the injury site. You should recognize which one of the following conditions?

A. Tenderness B. Ecchymosis C. Pain D. Crepitus - A. Tenderness Complete spinal immobilization of a high priority trauma patient typically takes place: A. Immediately upon arrival. B. After the rapid trauma assessment. C.

While en route to the hospital. D. Prior to the primary assessment. Answer - After the rapid trauma assessment.

During your primary assessment, you note the patient's skin to be warm, pink, and dry. This should seemingly indicate: A. possible fever.

B. poor oxygenation. C. possible shock. D. normal circulation. Answer - normal circulation.

Which of the following statements made by an EMT shows that he correctly understands pulse oximetry?

A. "The higher the CO level, the more accurate the SpO2 reading will be." B. "SpO2 is a reliable sign of perfusion in adults but not as reliable in infants and children." C. "A high SpO2 reading is normal in victims of CO poisoning." D. "Red, flushed skin always indicates that the SpO2 will be over 96." - "A high SpO2 reading is normal in victims of CO poisoning."

To stabilize the cervical spine of a trauma patient while simultaneously opening the airway, how should you position her head?

A. Tilted slightly back B. Neutral and in-line C.

In the position found D. Tilted slightly forward - Neutral and in-line Which of the following adult patients should the EMT classify as critical solely on the basis of the mechanism of injury?

A. A patient who was in a car crash that resulted in displacement of the bumper 12 inches toward the engine compartment B. A patient who was in an MVC in which the airbags deployed C. A patient who slipped off a ladder and fell 8 feet onto grass D. A patient with a penetrating injury to the head after crashing a motorcycle - A patient with a penetrating injury to the head after crashing a motorcycle Rationale There are multiple mechanisms of injury that can alert the EMT that the patient is likely to be critical. These include any penetration injury to the head, neck, torso, or extremities above the knee. Airbag deployment can occur in a low-speed impact accident, in which case it does not indicate a significant mechanism. Only after an 18-inch displacement of any vehicle panel (or 12inch displacement into the patient compartment) is the mechanism considered significant. An adult fall of over 20 feet is considered critical.

You have just determined that a 92-year-old female is unresponsive. Your next action would be to: A. check for a pulse.

B. determine the past medical history. C. transport immediately. D.

open the airway. Answer - open the airway.

When is the reassessment phase typically performed on the patient? A. Only if the patient is stable B. Following the scene size-up C. Only when the patient's deteriorating clinical status dictates it D. En route to the hospital - En route to the hospital You are transporting a patient who was injured as he was jogging along a road and was struck by a car. The patient has a GCS score of 10 with a respiratory rate of 30/min and a blood pressure of 78 systolic. The heart rate is 124/min. What is the patient's total revised trauma score?

A. 9 B. 10 C. 11 D. 8-9 Any patient with an SpO2 of below 94 percent should be considered: A. hypoxemic B. overoxygenated. C. hypercapnic.

D. cyanotic. Answer - hypoxemic

You have been called to the side of a 37-year-old female whose chief complaint is confusion, anxiety, and chest tightness. Assessment shows her airway to be patent, respirations 46 per minute, heart rate 134, blood pressure 128/54 mmHg, and SpO2 at 93%. In regards to the respiratory rate, you would recognize: A. it is not a concern because the patient is still getting oxygen. B. it will cause damage to the lungs if not corrected. C. it will result in too much air being placed in the lungs. D. it does not allow the lungs enough time to adequately fill. Answer - it does not allow the lungs enough time to adequately fill.

When performing the primary assessment of a 45dash-yeardash-old patient, which one of the following findings should concern the EMT? A. An SpO2 of 93% B. Pink color to the nail beds C. Skin that is warm to the touch D. 1- second capillary refill - An SpO2 of 93% What is the highest numerical value assigned to the best motor response when computing the GCS?

A. 5 points B. 6 points C. 3 points D.

4 points - B. 6 points The EMT would recognize which one of the following patients as breathing at a normal rate?

A. 6-month-old infant breathing 52 times per minute B. 22-year-old female breathing 26 times per minute C. 8-year-old male breathing 26 times per minute D. 44-year-old male breathing 6 times per minute - 8-year-old male breathing 26 times per minute Forming a general impression is essential in the assessment of any patient because it: A. determines the stability or instability of a patient. B. helps to determine the clinical status of a patient. C. reveals the injuries the patient has suffered. D. indicates whether or not a primary assessment is required. Answer - helps to determine the clinical status of a patient.

What can the placement of a pulse oximeter assist you in the determination of? A. Oxygenation B. Adequate air exchange C. Acidosis D.

CO2 level - A. Oxygenation Which of the following is the best indication that your trauma patient is a high transport priority?

A. Significant mechanism of injury. B. Severe pain. C. Unresponsive to pain. D. Tachycardia. Answer - C. Unresponsive to pain.

At what point would the EMT consider the administration of oxygen to a patient with chest pain and tachycardia?

A. If the pulse ox drops more than 2 percent in any 5-minute period B. If the patient stated that the chest pain lasted more than 30 minutes C. Only if the transport time to the hospital is greater than 60 minutes D. If the pulse ox dropped below 94 percent - If the pulse ox dropped below 94 percent At a continuing education seminar being taught by your medical director, he asks the group for one reason why the secondary assessment is beneficial to perform on the trauma patient. Which response is most appropriate?

A. "It is useful in finding additional injuries and guiding additional care." B. "It is an effective means to determine the exact mechanism of injury."

C. "It is the best assessment for detecting problems with the airway, breathing, or circulation."

D. "It is a good tool that allows the EMT to determine if critical interventions like positive pressure ventilation or CPR are needed." - A. "It is useful in finding additional injuries and guiding additional care."

On scene you find a 91-year-old female who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respirations. What instruction should you immediately give your partner?

A. "Get the suction out and clear out her airway." B. "Let's move her to the stretcher and get moving to the hospital." C. "Check her breathing and let me know the rate." D. "Please perform the head-tilt, chin-lift to open the airway." - A. "Get the suction out and clear out her airway."

Forming a general impression of the patient includes which of the following? A. Ascertaining whether law enforcement is needed on scene B. Obtaining the chief complaint C. Determining the need and type of PPE for the call D. Assessing the baseline vital signs - B. Obtaining the chief complaint You are transporting an 18-year-old male who has been injured in a motor-vehicle collision. He has a decreased level of consciousness and has suffered injuries to his

head, chest, and lower right leg. When you are conducting the reassessment of the patient's head and neck, which one of the following is appropriate?

A. Carefully removing the cervical collar to reassess the back of the neck B. Placing a sterile dressing in the right ear, which is oozing blood C. Taking time to carefully re-palpate the face and scalp D. Maintaining an airway with the head-tilt, chin-lift maneuver - C. Taking time to carefully re-palpate the face and scalp You have been dispatched to a residence for an 89-year-old female with a nonspecific complaint. When assessing this patient, which of the following will you do first to develop a better understanding of the emergency?

A. Contact medical direction for advisement. B. Gather a medical history including allergy information. C. Determine if the complaint is medical or trauma related. D. Obtain the patient's vital signs and current medications. Answer - C. Determine if the complaint is medical or trauma related.

Your adult male patient is complaining of not feeling well after working on his car most of the morning. His chest is rising and falling adequately, you hear and feel good air exchange, the respiratory rate is adequate, and no evidence of respiratory distress is present. His vitals are all normal, and he has an SpO2 of 98 percent on room air. He nevertheless feels anxious and does not wish to sit quietly. What would you do next?

A. Repeat his vitals in 5 minutes. B. Change the probe on the oximeter.

C. Place him on high-flow oxygen. D. Listen to the heart with a stethoscope. Answer - C. Place him on high-flow oxygen.

Which of the following should be completed during the secondary assessment of every trauma patient?

A. Determining if the patient is an organ donor B. Applying the AED C. Inserting an OPA or NPA D. Taking vital signs - D. Taking vital signs In which of the following situations would you abandon completing your modified secondary assessment and instead conduct a complete secondary assessment?

A. While en route to the hospital, the patient's heart rate keeps climbing and the blood pressure keeps falling.

B. While on scene, the patient has an RTS of 12, and en route he still has an RTS of 12.

C. While on scene, the patient states that he does not want to go to the hospital. D. While en route to the hospital, you get diverted to freestanding immediate care center. Answer A. While en route to the hospital, the patient's heart rate keeps climbing and the blood pressure keeps falling.

A 65dash-yeardash-old male has been vomiting "coffee ground" emesis for two days. Your assessment indicates that his airway is open, respirations are adequate, and radial pulse is fast and weak. His skin is cool, capillary refill time is 5 seconds, and SpO2 is 96. The EMT should understand that the pulse oximetry reading: A. correctly indicates that no oxygen is required. B. indicates hypoxia.

C. is artificially high. D. is accurate. Answer - C. is artificially high.

When assessing a stable patient with a trauma complaint, which piece of information will be obtained first and will help to guide the type of examination after the primary assessment has been completed?

A. Mechanism of injury B. Chief complaint C. Vital signs D. Level of consciousness - A. Mechanism of injury As you perform the primary assessment on an unresponsive patient, you discover vomitus in her airway. Which of the following should you do next?

A. Start positive pressure ventilation. B. Suction the airway. C. Apply supplemental oxygen.

D. Check the breathing. Answer B. Suction the airway.

While treating a patient who was assaulted by a mob of angry people in a bar, the EMT finds the patient to be confused, tachycardic, with cool skin and a poor capillary refill. Based on this information, how would you categorize this patient? A. Unstable B. Potential high priority C. Potentially unstable D. Stable - A. Unstable You arrive at the scene of a fall, where a 42minus−yearminus−old woman fell backward off a step ladder while cleaning her kitchen windows. She is seated on the floor complaining of pain to her ankle. She tells you, "If I had just gone to work today instead of using vacation time, this would have never happened!" Based on information thus far, which of the following can you conclude?

A. She does not have any other injuries. B. She is alert with an open airway. C. Her pulse rate is within normal limits. D. She does not require rapid transport. Answer B. She is alert with an open airway.

An Emergency Medical Responder informs you that a 59-year-old female is responsive to verbal stimuli. Which one of the following presentations should you expect?

A. She is awake, but having difficulty telling you her name and where she is. B. Her eyes are closed, but she will wiggle her fingers if told. C. She cannot be awakened when her name is called. D. She is able to answer all questions appropriately when asked. Answer - B. Her eyes are closed, but she will wiggle her fingers if told.

A 62-year-old female was struck by a car traveling approximately 45 miles per hour. After being struck, she was thrown 15 feet onto the sidewalk, impacting the pavement with her head and chest. The primary assessment has been completed and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, which of the following should the EMT perform first?

A. Assess the patient from head to toe for additional injuries. B. Inquire from family if the patient has any past medical history. C. Examine the head and chest for other life-threatening injuries. D. Obtain a full set of vital signs including a pulse oximeter reading. Answer - A. Assess the patient from head to toe for additional injuries.

Which of the following statements made by the EMT indicates that he has appropriately initiated the first phase of the patient assessment?

A. "Blood pressure is 124/80 mmHg." B. "The scene appears to be free of hazards." C. "Can you tell me why you called the ambulance?" D.

"I have placed an oral airway in the patient." - B. "The scene appears to be free of hazards."

Your patient appears to be breathing adequately and his color is good, but you are concerned that he may still be slightly hypoxic. You attempted to apply your pulse oximeter. but you are unable to get the probe to light. What should your next move be?

A. Start positive pressure ventilation. B. Contact medical command. C. Notify dispatch to have an ALS unit meet you with their pulse oximeter. D. Administer oxygen. Answer D. Administer oxygen.

What item regarding breathing rates must the EMT remember when assessing the respirations of a pediatric patient?

A. It is typically slower than that of an adult. B. It is not significant in the assessment. C. It is usually faster than that of an adult. D. It is similar to that of an adult. Answer - C. It is usually faster than that of an adult.

Which one of the following assessment findings indicates that the patient has intact motor function in his lower extremities?

A. The skin of his toes is pink and warm. B. He states that he can feel you touching his toe.

C. He can wiggle his toes when instructed. D. He does not complain of pain to his lower extremities. Answer - C. He can wiggle his toes when instructed.

A conscious and alert 44-year-old female complains of chest pain and mild shortness of breath.

She appears to have no difficulty speaking and states that the pain suddenly started about 2 hours ago. There is a history of blood clots in the lungs in her family, and she is scared and would like to be evaluated. Which of the following should you do first?

A. Determine the adequacy of her breathing. B. Perform a secondary assessment. C. Place her on the stretcher for transport. D. Consider administering oxygen. Answer - A. Determine the adequacy of her breathing.

You are performing a secondary assessment and are assessing your patient's chest. Which one of the following findings do you associate most with fracture of the ribs?

A. Decreased breath sounds B. Jugular venous distention C. Ecchymosis to the chest wall D. Paradoxical chest wall motion - D. Paradoxical chest wall motion

The EMT recognizes that for a trauma patient who is alert and oriented, he should obtain the history during what component of patient assessment?

A. Reassessment B. Scene size-up C. Primary assessment D. Secondary assessment - D. Secondary assessment For the patient who is breathing adequately, at what SpO2 level should supplemental oxygen be administered?

A. 94% B. 98% C. 92% D. 96% - C. 92% You are performing a systematic, anatomical secondary assessment on your high priority patient to determine if there are any remaining life threatening conditions. This is known as: A. a focused physical exam. B. a SAMPLE history. C. a primary assessment. D. a rapid secondary assessment. Answer - D.

a rapid secondary assessment.

As you arrive by the side of a 64-year-old unresponsive female, you hear snoring respirations.

Your immediate action would be to: A. determine the chief complaint. B. perform a manual jaw-thrust maneuver. C. suction the mouth and airway. D. administer supplemental oxygen. Answer - B. perform a manual jaw-thrust maneuver.

What is the minimum pulse ox reading the EMT wants to maintain in the patient with spontaneous breathing?

A. 90% B. 94% C. 96% D. 92% - B. 94% If, during the assessment of an unresponsive medical patient, you find that the patient has no pulse, what should you do next?

A. Initiate chest compressions. B. Listen to breath sounds. C. Apply oxygen via NRB. D.

Assess the blood glucose level. Answer - A. Initiate chest compressions.

At a nursing home, you find an elderly patient extremely short of breath. To best determine if the patient is cyanotic, you should: A. look at and feel the skin on the back of the hand. B. inspect the skin on the fingers and nail beds. C. examine the lining of the lips and mouth. D. press and release the skin on the palm. Answer - C. examine the lining of the lips and mouth.

After your secondary assessment of a medical patient who is unresponsive, you determine that the patient has a heart rate of 102/min, respirations of 20/min, a pulse ox reading of 94 percent, and inspiratory crackles. Which of these findings is the most critical finding?

A. Crackles B. Respiratory rate C. Heart rate D. Pulse ox reading - A. Crackles Which one of the following SpO2 readings is considered the upper limit of normal for an adult female?

A. 90% B. 99%

C. 94% D. 96% - B. 99% While forming a general impression on your patient, you identify a life-threatening condition.

You should: A. continue with your assessment. B. document your findings. C. transport immediately. D. immediately treat the condition. Answer - D. immediately treat the condition.

A 69-year-old male called 911 because of the sudden onset of pain and numbness to his left leg.

He states that he has a history of blood clots that form in the leg and the pain feels exactly as it did the last time that this occurred. He denies any trauma to the extremity. You perform the primary assessment and find him to be alert and oriented with no life-threatening conditions to the airway, breathing, or circulation. When performing the secondary assessment on this patient, which one of the following is most appropriate?

A. Rapid head-to-toe exam B. Placement of a nasal airway C. Physical exam of the leg D. Immediate transport - C. Physical exam of the leg

Which of the following findings is consistent with a "stable" patient? A. Fractured humerus B. GCS 15 C. Respiratory rate of 28/min D. Systolic blood pressure of 88 mmHg - B. GCS 15 What would be a critical finding in an unresponsive medical patient that the EMT would likely identify during the rapid secondary assessment?

A. Altered mental status B. Apnea C. Distended abdomen D. Airway occlusion - C. Distended abdomen An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals him to be extremely irritable, crying weakly, and shows he does not want to be touched by the EMT. Which one of the following best describes this infant's mental status?

A. Crying B. Alert C. Verbal D. Lethargic - B.

Alert In the patient who is breathing adequately, oxygen administration is based on: A. the SpO2 B. the age of the patient. C. signs and symptoms of hypoxia. D. the pulse rate. Answer - C. signs and symptoms of hypoxia.

You are instructing an Emergency Medical Responder course. One of the students asks you how the headminus−tilt, chinminus−lift airway maneuver works to open the airway. Your response is: A. "It opens the airway by relaxing and expanding the size of the throat." B. "It opens the airway by lifting the tongue from the back of the throat." C. "It creates an open airway by separating the lips, thus allowing air to enter." D. "It stimulates the patient to begin taking deeper breaths, thus moving air into the lungs." - B. "It opens the airway by lifting the tongue from the back of the throat."

A 36-year-old patient who has overdosed on an unknown drug presents with his eyes closed, even when his name is loudly called. Which one of the following should the EMT do first?

A. Determine what drug was taken. B. Assess for a radial pulse. C.

Check the mental status. D. Check the patient's vital signs. Answer - C. Check the mental status.

If you are computing a Revised Trauma Score and the patient's GCS score is 9 with a respiratory rate of 32/min, a blood pressure of 80 systolic, and a heart rate of 114, what is the patient's total revised trauma score?

A. 9 B. 8 C. 11 D. 10 - A. 9 While performing the secondary assessment on a male patient who was ejected from his motorcycle, he suddenly states that it has become very hard to breathe. You would: A. reconsider the mechanism of injury and look for a chest injury. B. make a mental note and continue with your exam. C. reassess the patient, beginning with the head. D. stop your exam and evaluate the patient's new complaint. Answer - D. stop your exam and evaluate the patient's new complaint.

You arrive on the scene of a motor vehicle collision and are presented with a patient complaining of chest pain after striking his chest on the steering wheel. On scene Emergency Medical Responders (EMRs) are maintaining cervical immobilization manually. He is alert and oriented and has a patent airway. His

respirations are 24 with good chest rise and fall, and his skin is warm and dry. His heart rate is 96 and SpO2 92% on room air. At this time you should: A. start positive pressure ventilation. B. provide supplemental oxygen. C. apply a cervical spine immobilization collar. D. obtain a blood pressure and medical history. Answer - B. provide supplemental oxygen.

Which one of the following patients should receive supplemental oxygen with a nonrebreather mask or nasal cannula?

A. 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute B. 61-year-old male who is unresponsive with a foreign body airway obstruction that cannot be removed with abdominal thrusts C. 39-year-old male with a sprained ankle and breathing 16 times per minute D. 18-year-old who overdosed on a drug and is unresponsive and breathing 6 times a minute - A. 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute You are interviewing a prospective candidate for the position of EMT with your service. During the interview, you ask the applicant to describe the purpose of the primary assessment. Which statement best describes that purpose?

A. "To determine if the patient's vital signs are stable." B. "Identify and treat life-threatening conditions."

C. "Perform an exam focused on the patient's chief complaint." D. "To establish a chief complaint and gather the past medical history." - B. "Identify and treat life-threatening conditions."

If signs of severe hypoxia are present, the patient is breathing adequately, and you do not have a pulse oximeter or an SpO2 reading cannot be obtained, you should: A. place the patient on a nonrebreather mask at 15 lpm. B. reassess your patient for loss of blood. C. administer low concentration oxygen via a cannula. D. contact medical command. Answer - A. place the patient on a nonrebreather mask at 15 lpm.

If the EMT is assessing an unresponsive patient who suffered a massive stroke, in what order or sequence will the secondary assessment be completed?

A. Baseline vitals, history, rapid secondary assessment B. History, rapid secondary assessment, baseline vitals C. Rapid secondary assessment, baseline vitals, history D. Baseline vitals, rapid secondary assessment, history - C. Rapid secondary assessment, baseline vitals, history A 26-year-old male has been ejected from a car after it rolled several times in the median of the interstate. As you perform the primary assessment, you find him prone and unresponsive. Your immediate action is to: A. slide him onto a backboard.

B. log-roll him supine.

C. assess his breathing. D. place an oral airway. Answer - B. log-roll him supine.

While teaching an EMT class at a local EMS program, you are discussing the difference between the secondary assessment of a responsive patient and of an unresponsive patient. A student asks you why the history is obtained first when the patient is responsive. How do you respond?

A. Often, the history provides more information that identifies the underlying problem than the physical exam does.

B. It is done that way because the emergency department physician will ask questions about the history before asking about the physical exam.

C. The history is always taken first in either the responsive or unresponsive patient to keep the assessment format consistent.

D. If the EMT completes the physical exam first, the patient may become angry and not provide important medical information. Answer - A. Often, the history provides more information that identifies the underlying problem than the physical exam does.

You have completed the primary assessment on a patient who was thrown from a motorcycle, impacting his head and back on the nearby sidewalk. After finding no life threats during the primary assessment, what action should you take first when starting a secondary assessment?

A. Ensure that the airway is patent. B. Apply supplemental oxygen.

C. Reevaluate the mechanism of injury. D. Reassess the patient's mental status. Answer C. Reevaluate the mechanism of injury.

The EMT shows she understands the importance and reason for forming a general impression when she states: A. "Forming a general impression allows me to fully assess the emergency situation." B. "Forming a general impression provides me with a rough idea of the patient's overall status."

C. "The general impression permits a rapid diagnosis of the patient's problem." D. "The general impression enables me to rule out any life-threatening conditions." - B. "Forming a general impression provides me with a rough idea of the patient's overall status."

While you are performing the focused physical examination of a patient who had a minor injury from an insignificant mechanism, you find yourself becoming more and more uncertain about whether the patient is more critical than he is presenting currently. What should you do?

A. Obtain the patient's blood glucose level. B. Contact medical control. C. Apply a higher concentration of oxygen. D. Abandon the focused secondary assessment and quickly perform a complete secondary assessment. Answer - D.

Abandon the focused secondary assessment and quickly perform a complete secondary assessment.

A 44-year-old male was cutting limbs from high in a tree when he fell. He is found to be unresponsive with snoring respirations. His breathing is inadequate at a rate of 8 per minute and his carotid pulse is weak and difficult to locate. Following the primary assessment and initial management of life threats, which of the following actions will the EMT complete while performing the secondary assessment?

A. Start positive pressure ventilation with a bag-valve mask. B. Perform a trauma jaw-thrust to open the airway. C. Obtain vital signs and get a past medical history from the family. D. Place an oral airway and cervical collar on the patient. Answer - C. Obtain vital signs and get a past medical history from the family.

Which patient would be classified as unresponsive? A. 70-year-old female who has suffered a stroke B. 52-year-old who cannot answer your questions C. 46-year-old male who does not respond when his fingers are pinched D. 39-year-old female who is confused - C. 46-year-old male who does not respond when his fingers are pinched You have been called for an adult patient who suffered a seizure. He is sitting on the floor, and looks at you as you enter the room. When questioned, he cannot remember the date or where he is. The patient's mental status can best be described as: A. alert but confused.

B. verbally disoriented. C. lethargic and agitated. D. altered. Answer - A. alert but confused.

You have been dispatched to an apartment for an elderly male complaining of shortness of breath. When do you start the process of forming a general impression about this patient?

A. As soon as you obtain his chief complaint B. After completing the primary assessment C. As you and your partner approach him D. Following the completion of vital signs - C. As you and your partner approach him You are by the side of a 64-year-old male patient who collapsed at home. After assessing his level of consciousness, airway, and breathing, you determine that he is unresponsive with an open airway, but not breathing. What instruction should you immediately give your partner?

A. "Let's place an oral airway and start ventilations." B. "Please check his blood pressure and skin temperature." C. "We will need to start cardiopulmonary resuscitation." D. "Go ahead and apply the automated external defibrillator." - A. "Let's place an oral airway and start ventilations."

During the primary assessment, how should you best determine the adequacy of a patient's breathing?

A. Compare the respirations and pulse rate. B. Examine the rise and fall of the chest. C. Calculate the number of breaths per minute. D. Determine the patient's mental status. Answer - B. Examine the rise and fall of the chest.

What is the highest numerical value assigned to verbal response in computing the GCS? A. 4 points B. 3 points C. 6 points D. 5 points - D. 5 points For the patient who is breathing adequately, at what SpO2 level can the EMT elect to administer no oxygen at all?

A. 93% B. Over 100% C. Over 90% D. 96% - D. 96%

When assessing breath sounds during the secondary assessment, the EMT shows he is employing a correct technique when he listens: A. first to the apex and base of the right lung and then to the apex and base of the left lung.

B. over the left and right lateral wall while instructing the patient to breathe shallowly and fast.

C. to the base of the lung by placing the stethoscope at the third intercostal space laterally.

D. at the left second intercostal space followed by the right second intercostal space - D. at the left second intercostal space followed by the right second intercostal space Assessment of a patient's neck reveals that the trachea is deviated to the left. Based on this assessment finding, the EMT should suspect an injury located to the patient's: A. chest.

B. cervical spine.

C. head.

D. abdomen. Answer - A. chest.

A 31-year-old male breathing at a rate of 6 times per minute can best be described as: A. bradypneic.

B.

bradycardic.

C. hyperventilating. D. tachypneic. Answer - A. bradypneic.

Forming a general impression of your patient includes each of the following, EXCEPT: A. estimating the patient's age. B. the patient's sex. C. obtaining a set of vital signs. D. determining trauma or medical. Answer - C. obtaining a set of vital signs.

You are treating a patient with a primary complaint of dizziness and nausea. The patient had an initial pulse ox of 96 percent upon arrival, but now the value is 93 percent. Additionally, the heart rate has increased from 96/min to 104/min, and the respirations are currently 22/min. The blood pressure is unchanged. What intervention should the EMT provide to the patient?

A. Administer low-concentration oxygen. B. Begin rapid transport and ask medical control whether to administer oxygen. C. Administer high-concentration oxygen. D. Summon ALS to initiate an IV and give fluids for dehydration. Answer - A. Administer low-concentration oxygen.

When teaching a group of Emergency Medical Responders (EMRs) about the mechanism of injury, which one of the following points should you stress?

A. The more significant the mechanism of injury, the greater the chance the patient has been injured.

B. The mechanism of injury should not be overly considered since this causes many patients to be over-treated.

C. The mechanism of injury can be used to dictate the order in which the primary assessment is conducted.

D. The mechanism of injury is the sole criteria by which an EMT decides whether or not immediate transport is required. Answer - A. The more significant the mechanism of injury, the greater the chance the patient has been injured.

When assessing the chest of a patient who was shot multiple times, you find a gunshot wound to the third intercostal space on the left lateral chest. Which one of the following should you do immediately?

A. Cover the opening with a gloved hand. B. Check for equality of breath sounds. C. Roll the patient and look for an exit wound. D. Initiate positive pressure ventilation with oxygen. Answer - A. Cover the opening with a gloved hand.

A patient has called 911 for abdominal pain and generalized weakness. On arrival you note that the patient's skin is a yellow-orange color. Which one of the following diseases revealed to you during the history would best correlate to this patient's skin?

A.

Lung cancer B. Stroke C. Diabetes D. Liver disease - D. Liver disease When performing the secondary assessment, the EMT would find which one of the following injuries first?

A. Bruising to the abdomen B. Decreased pulse in the left foot C. Unstable pelvis D. Deformity to the left thigh - A. Bruising to the abdomen A Glasgow Coma Scale (GCS) score of 13 or less indicates: A. a severe alteration in brain function. B. no response to pain. C. limited on-scene time and rapid transport. D. unconsciousness. Answer - C. limited on-scene time and rapid transport.

As you approach a patient who was involved in a motor vehicle crash, you note that he has dark, oozing blood coming from an open fracture to his lower left tibia.

The patient was removed from the car by bystanders and is being held by a family member.

Which of the following should you do immediately?

A. Apply direct pressure to the bleeding. B. Assess and open the airway. C. Take manual in-line spinal stabilization. This is the correct answer.

D. Provide supplemental oxygen. Answer - C. Take manual in-line spinal stabilization.

Orthopnea refers to difficulty breathing: A. while seated upright. B. during exercise.

C. at night. D. while lying down. Answer - D. while lying down.

You are working with a new EMT and while on scene with an unresponsive medical patient, your partner asks you when he should obtain baseline vitals. What would you tell him?

A. Before the rapid secondary assessment B. After the history has been obtained C. After the rapid secondary assessment D. After the pulse ox has been applied - C.

After the rapid secondary assessment The modified secondary assessment of a responsive medical patient begins with: A. assessing the history. B. a physical assessment of the entire body. C. a rapid medical assessment. D. baseline vital signs. Answer A. assessing the history.

To best evaluate the adequacy of breathing in an unresponsive adult, the EMT should: A. look for cyanosis. B. check the pupils. C. observe the chest rise. D. assess the skin color. Answer C. observe the chest rise.

You are by the side of a patient complaining of shortness of breath with a history of heart problems, including congestive heart failure (CHF). When assessing the airway, which one of the following observations best indicates that it is patent?

A. She is sitting in an upright position because she cannot lie flat. B. She can only speak in extremely short sentences. C. She is lethargic and confused to person, place, and time. D.

She easily tells you that she is having chest pain. Answer - D. She easily tells you that she is having chest pain En route to the hospital, you start the reassessment of a 22-year-old trauma patient. You should begin this assessment by: A. rechecking vital signs. B. checking all interventions. C. assessing for additional injuries. D. repeating the primary assessment. Answer - D. repeating the primary assessment.

A 40-year-old male patient has crashed his motorcycle. He complains of pain to his right leg.

When palpating his leg, you are assessing for: A. crepitation. B. sensation.

C. rigidity.

D. bruising. Answer - A. crepitation.

Which one of the following injuries found during the modified physical examination would NOT cause the EMT to shift to performing a head-to-toe physical examination?

A. A patient with shoulder pain after a fall onto an outstretched arm B. A patient with more injuries than she is complaining of or reporting to the EMT C.

A patient with a penetration injury to the upper leg that was previously hidden by clothing D. A patient who screams in pain when the EMT palpates the pelvis and finds crepitus - A. A patient with shoulder pain after a fall onto an outstretched arm Which of the following patients should the EMT identify as having the most adequate breathing?

A. 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall B. 61-year-old confused female breathing at a rate of 8 breaths per minute C. 19-year-old male breathing 16 times per minute with slight wheezing in the lungs D. 67-year-old female breathing 26 times per minute with good chest rise and fall - A. 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall A 43-year-old male has called 911 with the complaint of difficulty breathing. On scene you note he is breathing at a rate of 18 breaths per minute. He also exhibits intercostal retractions and nasal flaring. The EMT should document this patient's breathing as: A. tachypneic.

B. dyspneic.

C. bradypneic.

D. apneic.

Answer - B. dyspneic.

The patient's family states that their 16-year-old daughter has a history of asthma and has been complaining of shortness of breath for the past two days. She has been taking her metered-dose inhaler with some relief, but this morning, they found her lethargic and struggling to breathe.

Your assessment reveals her to be responsive to verbal stimuli with an open airway and shallow respirations of 44 per minute. You hear minimal wheezing to both lungs. Your immediate action in caring for this patient is to: A. start positive pressure ventilation. B. position her on her side. C. insert an oral airway. D. apply a nonrebreather mask. Answer A. start positive pressure ventilation.

You are assessing a 4-year-old patient whose panicked mother states that she cannot wake him.

The child is breathing but his eyes are closed. To best determine the child's mental status, you should first: A. ask the mother how long the child has been asleep. B. determine the child to be unresponsive. C. apply pressure to the child's nail beds. D. say loudly, "Open your eyes!" - D. say loudly, "Open your eyes!"

Which of the following physical findings is least consistent with an injured extremity?

A. Contusions B.

Burns C. Deformities D. Vomiting - D. Vomiting You arrive at the scene of an "unknown emergency" and find an elderly male sitting on a toilet making incomprehensible sounds when you ask him why EMS was called. This means that: A. you will have to speak with the family to get the chief complaint. B. the patient has most likely had a stroke or is hypoglycemic. C. you will not be able to determine a chief complaint. D. your general impression of the patient will most likely be incorrect. Answer - A. you will have to speak with the family to get the chief complaint.

The "S" in SAMPLE stands for: A. Significance B. Severity C. Signs D. Seriousness - C. Signs When you are caring for a patient with either a medical complaint or traumatic injury, you should typically perform the reassessment: A. before the secondary assessment.

B. when a life-threatening condition is found. C. while transporting the patient to the hospital. D. immediately following the primary assessment. Answer - C. while transporting the patient to the hospital.

You are called for a patient with an injury to the foot. When you arrive you find the patient standing on his porch, leaning against the rail, holding his foot in the air by flexing the leg. The patient states he was doing yard work when he dropped a large stepping stone on his foot. There was neither associated fall nor other findings of trauma or disability. During your management of this patient, how will he be immobilized?

A. Immobilize the foot, but not the body. B. Do not immobilize anything. C. Immobilize the entire body. D. Immobilize the foot and the neck. Answer - A. Immobilize the foot, but not the body.

What does the "S" in OPQRST signify? A. Symptoms B. Severity C. Skin D. Signs - B. Severity

You are performing a secondary assessment on the unrestrained adult passenger involved in a motor vehicle collision, in which the car rolled end over end several times at a high rate of speed. The patient is responsive to painful stimuli and in a state of shock. When assessing the head, which one of the following is appropriate?

A. Cleaning a laceration to the scalp B. Checking the pupils with a penlight C. Applying pressure to a depressed area of the skull D. Performing a blind finger sweep to check the airway - B. Checking the pupils with a penlight In assessing the baseline vital signs for an unresponsive patient, what vital signs should be included beyond pulse, BP, and respirations?

A. Pulse oximetry and BGL B. Skin characteristics, pulse oximetry, and pupillary response C. Pulse oximetry, temperature, and BGL D. Temperature and BGL - B. Skin characteristics, pulse oximetry, and pupillary response Which one of the following patients is considered the lowest priority for a rapid secondary exam and immediate transport?

A. 32-year-old woman who is unresponsive B. 72-year-old man complaining of leg pain for a week C. 55-year-old woman with difficulty breathing

D. 7-year-old boy who has had abdominal pain for 2 hours - B. 72-yearold man complaining of leg pain for a week An intoxicated 19-year-old female has fallen through a large plate glass window. As you approach, you note her to be sitting up and holding her hand over a large laceration that is spurting bright red blood. In this situation, you would immediately: A. determine the presence and rate of the carotid pulse. B. apply direct pressure to the laceration. C. assess the airway for patency and breathing for adequacy. D. provide high-concentration oxygen and treat for shock. Answer - B. apply direct pressure to the laceration.

When assessing the breath sounds (during a rapid secondary exam) of a critical trauma patient, it is best to auscultate each lung in at least how many places?

A. 4 B. 6 C. 8 D. 2 - D. 2 When taking blood pressure, the cuff should be inflated to what point? A. Until the gauge reads 200 mmHg B. Until the Velcro starts to crackle

C. Until the patient says it hurts D. 30 mmHg beyond the point where the pulse disappears - D. 30 mmHg beyond the point where the pulse disappears You have a blood pressure monitor and the patient you are treating is in stable condition. The maximum value for the interval at which the monitor should take the patient's blood pressure is:

A. 10 minutes. B. 15 minutes. C. 20 minutes. D. 5 minutes.

Answer - B. 15 minutes.

The term cyanosis is used when the patient's skin color is noted to be which of the following characteristics?

A. Flushed B. Blue-gray C. Yellow D. Very pale - B. Blue-gray You respond to a childcare center for a report of an injured 4-year-old. Her pulse is 130 beats per minute. Which of the following BEST describes this finding?

A. Tachycardic

B. Normal for the child's age C. Bradycardic D. Unable to determine without knowing the family history - A. Tachycardic You are called to a 72-year-old patient with weakness and headache with an initial blood pressure of 140/92. Her repeat blood pressure at 5 minutes is unchanged. Her condition is called: A. hypotension.

B. stroke.

C. prehypertension. D. hypertension - D. hypertension Which of the following is a known cause of inaccurate oxygen saturation readings? A. Jaundiced nail beds B. Fever C. Hypotension D. Carbon monoxide inhalation - D. Carbon monoxide inhalation Upon assessment of your patient, you notice that he has cool, sweaty skin. This finding is best described as which of the following?

A.

A complaint B. A sign C. A diagnosis D. The patient's condition - B. A sign In a conscious adult patient, which of the following pulses should be assessed initially?

A. Carotid B. Pedal C. Radial D. Brachial - C. Radial You have a 38-year-old patient who has fainted. Following your local protocol, you use a light wave device to determine the SpO2. As the EMT, you attach the device on the patient's finger, which gives you a reading of 91. What does that reading indicate?

A. Mild hypoxia B. Severe hypoxia C. Significant hypoxia D. Normal results - A. Mild hypoxia

You are assessing a 55-year-old male complaining of chest pain and have determined that his radial pulse is barely palpable. You also determine that there were 20 pulsations over a span of 30 seconds. Based on this, how would you report this patient's pulse?

A. Pulse 20, weak, and regular B. Pulse 40 and weak C. Pulse 40, weak, and irregular D. Pulse 20 and weak - B. Pulse 40 and weak What is the pressure remaining in the arteries after the pulse wave has passed through?

A. Diastolic blood pressure B. Resting blood pressure C. Systolic blood pressure D. Venous pressure - A. Diastolic blood pressure A blood pressure in an adult patient of 134/84 mmHg would be considered: A. normal.

B. hypotension.

C. hypertension. D. prehypertension. Answer - prehypertension.

Where do baseline vital signs fit into the sequence of patient assessment? A. At secondary assessment B. Ongoing assessment C. At the patient's side D. At primary assessment - A. At secondary assessment What is LEAST likely to give useful information about the condition of an infant or very young child?

A. Unconsciousness B. Respiratory distress C. Blood pressure D. A sick appearance - C. Blood pressure Slight movement of the chest during respiration is usually indicative of which of the following?

A. Labored breathing B. Shallow breathing C. Normal breathing D. Noisy breathing - B. Shallow breathing

To determine blood pressure, the EMT should position the cuff over the upper arm and place the stethoscope over the brachial artery. Next, she should inflate the cuff, then slowly deflate the cuff, listening for clicks or tapping sounds while remembering the number at the first sound.

What is the next step in taking a blood pressure?

A. Continue releasing pressure until the clicks or tapping stop, and record both numbers. These are the blood pressure.

B. Dump all the pressure and record the number as the diastolic pressure. C. Remove the cuff from the patient's arm, place it on the opposite arm, and repeat the process to verify the reading.

D. Re-inflate the cuff on the patient's arm and repeat the process to verify the reading.

- A. Continue releasing pressure until the clicks or tapping stop, and record both numbers. These are the blood pressure.

Breathing sounds that should concern the EMT are: A. snoring, gurgling, wheezing, crowing, and crowning. B. tachycardia, retractions, and diaphragmatic breathing. C. snoring, gurgling, wheezing, and crowing. D. retractions and diaphragmatic breathing. Answer - C. snoring, gurgling, wheezing, and crowing.

What is the normal response of the pupils when exposed to bright light? A. Fluttering B.

Constriction C. Dilation D. No effect - B. Constriction An example of recording a blood pressure reading is: A. "Blood pressure is 100 beats per minute at 5:53 a.m." B. "Blood pressure is spaced regularly at 12:32 a.m." C. "Blood pressure is 140/90 at 1:10 p.m." D. "Blood pressure is 91% at 2:17 p.m." - C. "Blood pressure is 140/90 at 1:10 p.m."

Which of the following is NOT a cause of unequal pupils? A. Stroke B. Artificial eye C. Eye injury D. Fright - D. Fright The increase in the work of breathing is reported as: A. shallow breathing. B. labored breathing. C.

noisy breathing. D. obstructed breathing. Answer B. labored breathing.

If capillary refill is assessed in a child patient, how long should it take the normal pink color to return to the nail bed?

A. 4 seconds or less B. 3 seconds or less C. 2 seconds or less D. 5 seconds or less - C. 2 seconds or less Which of the following is the BEST way to assess a patient's skin temperature? A. Place your cheek against the patient's forehead. B. Place the back of your hand against the patient's abdomen. C. Place the back of your hand against the patient's forehead. D. Place your cheek against the patient's abdomen. Answer - C. Place the back of your hand against the patient's forehead.

You are assessing an 82-year-old female that has been lost in the woods behind her nursing home for several hours on a crisp fall evening. Your pulse oximeter shows her oxygen saturation to be 82% even though she appears to be breathing adequately. In order to ensure an accurate reading you should: A. place the probe on the patient's earlobe. B.

place the probe on the patient's toe. C. reposition the sensor or move to a different finger. D. try a different pulse oximeter. Answer - C. reposition the sensor or move to a different finger.

The device that some EMS services use as a light wave device to measure oxygen saturation (SpO2) is called a(n): A. end tidal CO2 meter.

B. capnography. C. sphygmomanometer.

D. pulse oximeter. Answer - B. capnography.

Your patient is in late stages of liver failure and has requested to be transported to the emergency department. You take your Standard Precautions and move him to your cot, and you notice his skin is warm and dry with a yellow color. Your radio report to the hospital should state your patient is: A. flushed.

B. jaundiced.

C. cyanotic.

D. mottled.

Answer - B. jaundiced.

A reading of 97 percent could be found when taking which of the following vital signs?

A. Blood pressure B. Pulse rate C. Respiratory rate D. Oxygen saturation - D. Oxygen saturation You are called to care for a child who has fallen out of a third-story window. You arrive to find the child in his mother's arms. As you approach, you notice the child's skin is pale with dark spots of cyanosis. You would report this uncommon condition of blotchy skin as: A. flushed.

B. jaundiced.

C. mottling. D. cyanotic. Answer C. mottling.

You are attempting to assess the blood pressure of a 35-year-old male at the scene of a multiple vehicle collision. The scene is very noisy and you are unable to clearly hear the patient's heartbeat. You should: A. try using the patient's other arm. B. have your partner try auscultating the blood pressure. C. use an automatic blood pressure machine. D. obtain the blood pressure by palpation. Answer - D.

obtain the blood pressure by palpation.

Which of the following is the MOST complete list of the standard vital signs that need to be recorded?

A. Pulse; respiration; skin color, temperature, and condition; pupils; blood pressure; and bowel sounds B. Pulse; respiration; skin color, temperature, and condition; pupils; and blood pressure C. Pulse; respiration; skin color and temperature; pupils; and blood pressure D. Pulse; respiration; skin color, temperature, and condition - B. Pulse; respiration; skin color, temperature, and condition; pupils; and blood pressure You are assessing a 48-year-old male who is unconscious. The scene is safe and you hear the patient gurgling. What is your next action?

A. Insert an airway adjunct. B. Suction the airway. C. Apply supplemental oxygen. D. Quickly check the pulse. Answer B. Suction the airway.

The range of normal blood glucose level is from a low of 60 to 80 mg/dL to a high of: A. 110 to 130.

B. 90 to 100.

C. 100 to 120. D. 120 to 140. Answer - D. 120 to 140.

The regular or irregular spacing of breaths is: A. respiratory quality. B. pulse quality.

C. respiratory rhythm. D. the respiratory rate. Answer C. respiratory rhythm.

You respond to a cafeteria to find an unconscious person with gurgling sounds upon exhalation and inhalation. What is the probable cause of the respiratory sounds?

A. Complete airway obstruction B. Tongue blocking the airway C. Cardiac arrest D. Fluids in the airway - D. Fluids in the airway Your patient is warm, dry, pink, and denies shortness of breath. Which of the following should the EMT expect to find when evaluating the patient's oxygen saturation?

A. 91 percent

B. 95 percent C. 98 percent D. 102 percent - C. 98 percent The abbreviation mmHg indicates that the blood pressure is measured by which of the following comparisons?

A. Atmospheric pressure B. Millimeters of water C. Millimeters of mercury D. Minimum heart rate - C. Millimeters of mercury The method of taking blood pressure by using a stethoscope to listen to the characteristic sounds produced is called: A. auscultation. B. pulsation.

C. palpation.

D. articulation. Answer - A. auscultation.

For a set of vital signs to be an important foundation for critical decision making, it is MOST critical for them to be: A.

brief.

B. complete.

C. accurate.

D. detailed.

Answer - C. accurate.

You respond to a 30-month-old patient who has passed out. Is the patient's blood pressure important to your treatment and why?

A. No, blood pressure taken on children younger than age 3 is difficult and has little impact on the patient's field management.

B. Yes, blood pressure can be taken on children because it is the only way we can understand the patient's condition.

C. No, blood pressure taken on children younger than age 3 can cause damage to the tender tissues of the arm that could lead to hypertension in later life.

D. Yes, blood pressure must be taken on everyone because without it we cannot make proper field management decisions to guide the patient's care. Answer - A. No, blood pressure taken on children younger than age 3 is difficult and has little impact on the patient's field management.

You are unable to find a radial pulse on a patient from a motor vehicle crash. You should: A. attempt to find the carotid pulse. B. begin chest compressions. C. apply the pulse oximeter. D.

listen for heart sounds. Answer - A. attempt to find the carotid pulse.

In a blood pressure reading of 120/80, the 120 is measuring what body process? A. Systolic blood pressure, when the left ventricle contracts and the blood is forced into the arteries B. Systolic blood pressure, when the right ventricle contracts and the blood is forced into the veins C. Diastolic blood pressure, when the left ventricle contracts and the blood is forced into the arteries D. Systolic blood pressure, when the left ventricle contracts and the blood is forced into the veins A. Systolic blood pressure, when the left ventricle contracts and the blood is forced into the arteries How often should a patient's vital signs be reassessed during transport to the hospital after he has had his pulse restored with CPR and the use of an AED? A. Every 10 minutes B. Every 5 minutes C. Every 15 minutes D. Every 2 minutes - B. Every 5 minutes A patient being transported by ambulance to the hospital can have his blood pressure measured by which of the following methods?

A. Auscultation, palpation, and pulse oximetry

B. Blood pressure monitor, pulse oximetry, and reactivity C. Blood pressure monitor, palpation, and reactivity. D. Auscultation, blood pressure monitor, and palpation - D. Auscultation, blood pressure monitor, and palpation Which of the following is a normal respiratory rate for an adult at rest? A. 10 breaths per minute B. 26 breaths per minute C. 12 breaths per minute D. 22 breaths per minute - C. 12 breaths per minute When pupils are dilated, they are:

A. elliptical or elongated in shape. B. smaller than normal. C. irregularly shaped. D. larger than normal. Answer D. larger than normal.

When the EMT checks the pupils, he or she is checking for what three things? A. Movement, gaze, and equality B. Color, equality, and reactivity

C. Reactivity, gaze, and equality D. Size, equality, and reactivity - D. Size, equality, and reactivity Your patient has a heart rate of 82, a respiratory rate of 16, and a blood pressure of 120/80 and does not appear to be in any distress. You should repeat vital sign measurements at least every: A. 5 minutes.

B. 20 minutes. C. 10 minutes. D. 15 minutes.

Answer - D. 15 minutes.

You are transporting a patient down a bumpy road. Your patient's blood pressure has just been measured by the monitor to be 190/110. The patient's blood pressure on scene was 130/80. You should: A. re-measure the blood pressure manually. B. have the driver increase truck speed. C. ignore the blood pressure reading. D. apply the automatic cuff to the other arm. Answer A. re-measure the blood pressure manually.

The first set of vital sign measurements obtained are often referred to as which of the following?

A.

Baseline vital signs B. Normal vital signs C. Standard vital signs D. Primary assessment - A. Baseline vital signs Which of the following BEST describes the proper placement of the blood pressure cuff?

A. Midway between the elbow and wrist B. Covering the patient's elbow C. Covering two-thirds of the upper arm D. One inch below the armpit - C. Covering two-thirds of the upper arm You are transporting a patient to the hospital from a motor vehicle crash. Your patient's initial blood pressure was 88/52. You should reassess blood pressure: A. at least every 15 minutes. B. at least every 5 minutes. C. only if the pulse rate changes. D. only if the patient gets worse. Answer B. at least every 5 minutes.

You take the blood pressure of an unconscious patient and get a high diastolic reading that you're not sure is correct. The pulse sounds seemed to disappear, and

you noted the systolic pressure at that time, but then the pulse sounds seemed to reappear. You should: A. immediately retake the patient's blood pressure. B. count the reading as accurate. C. use a pulse oximeter instead. D. wait a minute or two and take the blood pressure again. Answer - D. wait a minute or two and take the blood pressure again.

Recording and documenting your patient's first set of vital signs is very important because, when combined with reassessments, it allows you to do which of the following?

A. Discover trends and changes in the patient's condition. B. Fill in all of the blanks on the patient care report form. C. Compare your patient's condition with other patients' conditions. D. Make an accurate diagnosis of the patient's illness. Answer - A. Discover trends and changes in the patient's condition.

What are the three ways to take blood pressure? A. Sphygmomanometer, blood pressure monitor, and heart monitor B. Palpation, auscultation, and blood pressure monitor C. Auscultation, palpation, and pulse oximeter D. Sphygmomanometer, auscultation, and blood pressure monitor - B. Palpation, auscultation, and blood pressure monitor

When the heart contracts and forces blood into the arteries, the pressure created is known as the: A. pulse quality.

B. central venous pressure. C. systolic blood pressure. D. diastolic blood pressure. Answer C. systolic blood pressure.

40. Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that:

A. you were exposed to another infected person prior to treating the 34-year-old patient.

B. you contracted the disease by casual contact instead of exposure to secretions.

C. you are actively infected with tuberculosis and should be treated immediately.

D. the disease is dormant in your body, but will probably never cause symptoms. Answer A. you were exposed to another infected person prior to treating the 34-year-old patient.

Most patients with an infectious disease will have

A. seizures B. a fever C. abdominal pain

.

D. a low blood glucose level - B. a fever The BEST way to prevent infection from whooping cough is to:

A. ask all patients if they have recently traveled abroad.

B. wear a HEPA mask when treating any respiratory patient.

C. routinely place a surgical mask on all respiratory patients.

D. get vaccinated against diphtheria, tetanus, and pertussis. Answer - D. get vaccinated against diphtheria, tetanus, and pertussis.

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected problem.

A. cardiac B. endocrine C. respiratory D. neurologic - D. neurologic Which of the following is bacterium resistant to most antibiotics and causes skin abscesses?

A. Whooping cough B. MRSA C. H1N1

D. Avian flu - B. MRSA Most treatments provided in the prehospital setting are intended to

.

A. address the patient's symptoms B. reduce the need for transport to the hospital C. confirm the patient's diagnosis D. correct the patient's underlying problem - A. address the patient's symptoms Assessment of the medical patient is usually focused on the

.

A. associated symptoms B. medical history C. field diagnosis D. nature of illness - D. nature of illness Which of the following conditions is NOT categorized as a psychiatric condition?

A. Depression B. Alzheimer disease C. Substance abuse D. Schizophrenia - C. Substance abuse You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the

road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a:

A. medical emergency.

B. trauma emergency.

C. combination of a medical and trauma emergency.

D. combination of a psychiatric and trauma emergency. Answer - C. combination of a medical and trauma emergency.

Which of the following patients is at greatest risk for complications caused by the influenza virus?

A. 68-year-old woman with type 2 diabetes B. 50-year-old woman moderate obesity C. 39-year-old man with mild hypertension D. 12-year-old child with a fractured arm - A. 68-year-old woman with type 2 diabetes When caring for a patient with an altered mental status and signs of circulatory compromise, you should:

A. perform a detailed secondary assessment prior to transporting the patient.

B. limit your time at the scene to 10 minutes or less, if possible.

C. have a paramedic unit respond to the scene if it is less than 15 minutes away.

D. transport immediately and begin all emergency treatment en route to the hospital.

Answer - B. limit your time at the scene to 10 minutes or less, if possible.

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service?

A. 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days' duration

B. 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes away

C. 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs

D. 61-year-old man with signs and symptoms of a stroke and a ground transport time of 50 minutes - D. 61-year-old man with signs and symptoms of a stroke and a ground transport time of 50 minutes Hepatitis B is more virulent than hepatitis C, which means that it:

A. has a greater ability to produce disease.

B. leads to chronic infection after exposure.

C. is a more contagious type of disease.

D. is less resistant to treatment. Answer - A. has a greater ability to produce disease.

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:

A. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible.

B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

C. load him into the ambulance, begin transport, and perform all treatment en route to the hospital.

D. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly.

Answer - B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to:

A. take standard precautions.

B. notify law enforcement.

C. quickly access the patient.

D. contact medical control. Answer - A. take standard precautions.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made:

A. upon completion of a detailed secondary assessment.

B. as soon as the patient voices his or her chief complaint.

C. once the patient's baseline vital signs are known.

D. after the primary assessment has been completed. Answer - D. after the primary assessment has been completed.

When forming your general impression of a patient with a medical complaint, it is important to remember that:

A. most serious medical conditions do not present with obvious symptoms.

B. it is during the general impression that assessment of the ABCs occurs.

C. the majority of medical patients you encounter are also injured.

D. the conditions of many medical patients may not appear serious at first. Answer - D. the conditions of many medical patients may not appear serious at first.

In 2009, the H1N1 virus accounted for over 200,000 deaths worldwide in the form of the swine flu. In 1919, a similar outbreak of the H1N1 occurred in the form of the Spanish flu. Starting in Kansas City, the virus spread rapidly worldwide, claiming up to 50 million lives. These are both examples of:

A. parasitic infection.

B. epidemics.

C. pandemics.

D. uncontrolled outbreaks. Answer - C. pandemics.

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem?

A. Medical history B. Primary assessment C. Index of suspicion

D. Baseline vital signs - A. Medical history An infectious disease is MOST accurately defined as:

A. any disease that enters the body via the bloodstream and renders the immune system nonfunctional.

B. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs.

C. a disease that can be spread from one person or species to another through a number of mechanisms.

D. a medical condition caused by the growth and spread of small, harmful organisms within the body. Answer - D. a medical condition caused by the growth and spread of small, harmful organisms within the body.

You are on the scene of a 16-year-old patient in respiratory distress. The patient has a history of asthma. After placing the patient on oxygen and performing the primary and secondary assessments, you are confident that the patient is indeed having an asthma attack. How can you be sure your field diagnosis is accurate? - D. Think of all possible causes of respiratory distress and rule them in or out as potential diagnoses based on your clinical findings.

Because critical thinking is a process of analyzing a problem in an organized and efficient manner, it is helpful to EMTs because of their: - D. need to work within limited time and resource constraints.

During a rapid trauma assessment, you would check the nose for wounds, tenderness, deformities, and: - B. drainage of blood or clear fluid.

What would you NOT do as part of checking interventions when reassessing the patient? - C.

Reassess and record vital signs.

In gathering the history of an unresponsive medical patient, what is an object designed to give health care professionals information about a patient's medical history that you might look for? D. The patient's medical identification device When a patient describes how he feels, he is telling you which of the following? - C. His symptoms Your patient was struck in the chest with a baseball bat during a bar fight. A crackling or crunching sensation that is felt when air escapes from its normal passageways and is trapped under the skin is called: - D. subcutaneous emphysema.

What is part of the EMS approach to reaching a diagnosis that is NOT a part of the emergency medicine approach? - D. Transport for more extensive assessment and treatment.

Your patient has a decreased level of consciousness. Your last patient experienced a decreasing level of consciousness from respiratory failure, and you immediately assume the same thing must be true here. This is MOST an example of: - C. availability.

Which of the following is one advantage of using heuristics? - D. It speeds up the process of diagnosis.

What physical examination technique primarily involves touching? - C. Palpation A patient with one or more medical diseases or conditions is: - A. a medical patient.

You ask a patient when he last ate or drank. This relates to: - C.

last oral intake.

Expert clinicians may use different approaches of thinking through problems, but which of the following will they have in common? - A. Strong foundation of knowledge What term describes a surgical incision in the neck that is held open by a metal or plastic tube through which a patient can breathe or be placed on a ventilator? - D. Tracheostomy As an antidote to overconfidence, you should: - C. know your limits.

Which of the following techniques of physical examination must an EMT master?

- B. Observation, palpation, and auscultation Immediately following a rapid physical exam on an unresponsive medical patient, which of the following should you do next? - A. Obtain baseline vital signs.

Flexibility involves: - B. a willingness to adapt to the demands of every situation.

You are dispatched for a patient with chest pain. Your patient tells you that she has had shortness of breath and chest pain for about 20 minutes. Which of the following will give you the best information regarding your patient's chest pain symptoms? - D. How would you describe your pain?

When conducting an examination of a patient's gastrointestinal system, what would MOST be a sign of pain in your patient's abdomen? - C. The patient takes a fetal, knees-to-chest position.

Your patient is a 15-year-old female complaining of shortness of breath. Which of the following is NOT appropriate during the focused exam? - D. Checking her pupils for reactivity to light Critical thinking is: - D. organized and analytical.

While an EMT forms a field diagnosis on the scene of an emergency, how do the steps differ from the traditional approach to diagnosis? - D. The EMT must rule in or out the most serious conditions associated with the patient's presentation.

You have responded for a patient with shortness of breath. He reports that his breathing problems began this morning and have gotten worse over the last few hours. You ask if he has taken anything to help his symptoms and he tells you that he has used his inhaler several times in the last hour. The information you have just gathered can be classified as: - A. the history of present illness.

When you begin interviewing your patient, he tells you that he has not felt well for several months, ever since he had his gallbladder removed. He goes on to tell you that he cannot get his wife to schedule a doctor's appointment for him, and when she remembers to call, the office is always closed. Which of the following is the best way to proceed? - D. Ask him why he decided to call 911 today.

You and another EMT are discussing a call he previously ran. The EMT says the patient had classic chest pain symptoms and he treated it as a possible heart attack, but he later found out the patient just had indigestion and was discharged 2 hours later. The EMT is concerned that his patient assessment skills are not as good as they should be and that the ED physician will no longer trust his judgment. How should you respond to his concerns? - A. Tell him that his misdiagnosis is a result of limited information. A key aspect of A.

is noticing changes over time. Answer -

trending vital signs Your patient is an unresponsive 40-year-old woman. Which of the following should you do immediately after you have taken baseline vital signs? - D. Gather the history of the present illness.

What qualifies something as a diagnosis? - C. It describes the patient's condition.

Mrs. Butler is a 66-year-old woman who is complaining of chest pain. Which of the following questions would be best in helping you determine if the pain is radiating? - D. Are you having pain anywhere besides your chest?

Your patient is a 22-year-old college student complaining of abdominal pain. She is alert and oriented, although somewhat uncomfortable. She has vomited on the floor. What should you do? - A. Inspect the vomit.

You have a long transport of a patient who may have sustained a spinal injury. The patient has been stable throughout your transport. During one of your reassessments, your patient tells you that he is losing the feeling in his feet and toes and his fingers are tingling. At this point you should: - C. reassess him every 5 minutes.

You ask a patient complaining about abdominal pain when the pain began. You are asking about: - B. time.

Learning to love ambiguity for an EMT means: - B. knowing that grappling with the unknown is part of the job.

An example of respiratory-specific patient history is: - C. dyspnea on exertion.

You are on the scene in the bad part of town for an unresponsive 18-year-old type 1 diabetic patient. His mother states that he is very noncompliant with his diabetes management and goes unresponsive often due to low blood sugar. After performing the primary assessment, you believe that this is the most likely cause of his unresponsiveness. However, after taking a capillary glucose reading, you are surprised to see that the patient's sugar level is normal. How will you now determine the field impression? - C. Continue patient care by getting a complete SAMPLE history and perform a complete secondary assessment.

After you repeat pertinent parts of the secondary assessment while reassessing the patient, you would: - D. check interventions.

Hypoglycemia with altered mental status is generally treated by EMTs except in patients: - A. unable to control their own airways.

You are called for a patient who was discovered unconscious in his bed this morning. You immediately complete a primary assessment and determine that he is breathing and has a good pulse. What should you do next? - B. Complete a rapid physical exam.

Critical thought involves an EMT: - B. analyzing situations in an organized and efficient manner.

For a trauma patient, you will usually get the most information from: - D. physically examining the patient.

If a patient complains of abdominal pain localized to a specific area of the abdomen, which of the following techniques should be used to assess the abdomen? - B. Palpate the painful area last.

The emergency medicine approach to diagnosis is a process of: - C.

critically narrowing the possibilities.

Why take a differential diagnosis? - A. The differential diagnosis gives you a list of possible diagnoses for a patient's condition.

The problem of overconfidence is that: - A. it can take the place of thought.

To reach a diagnosis in the field, an EMT may: - C. evaluate a patient's vital signs.

Repeating the pertinent parts of the secondary assessment while reassessing the patient primarily means: - A. focusing on questions relatinged to changes in symptoms and repeating the physical exam related to the patient's specific complaint or injuries.

The patient was a driver in a lateral impact motor vehicle collision. During the assessment of his chest, the EMT notes a segment of the chest wall moving in the opposite direction from the rest of the chest. Which of the following BEST describes this finding? - C. Paradoxical motion Your patient is a 45-year-old female who complains of "twisting her ankle" when she slipped on a patch of ice. Which of the following is NOT appropriate? - D. Performing a detailed head-totoe physical exam When conducting an examination of movement of the extremities, a patient being able to wiggle the fingers of one hand but not the other would suggest: - B. spinal injury.

For an EMT, elaborated knowledge means being able to: - B. work back from signs and symptoms to the conditions that cause them.

You are transporting a victim of domestic violence, a 25-year-old female, who was struck on the head several times with a baseball bat. On the scene, she was responsive to verbal stimuli and was bleeding profusely from an open head wound. During transport the patient becomes unresponsive. Which of the following should you do next? - C. Primary assessment In the assessment of a responsive medical patient, which of the following will provide you with the most important information? - C. Patient's medical history What term describes a permanent surgical opening in the neck through which a patient breathes?

- A. Stoma When using the memory aid SAMPLE, which of the following would you do to determine L? C. Ask, "When was the last time you had anything to eat or drink?"

When using the memory aid OPQRST, which of the following questions would help you find out about P? - B. Does anything make the pain better or worse?

You are assessing a 21-year-old female who was assaulted by an unknown person. She is complaining of abdominal pain. As you perform a rapid assessment of her abdomen, you should check for all of the following except: - D. bowel sounds.

While assessing the past medical history of a 68-year-old male patient involved in a fall from a 4-foot stepladder, you use the acronym SAMPLE. What does the A refer to? - D. Allergies

Mr. Green is complaining of severe difficulty breathing after being stung by a bee. His wife states he has had reactions to bee stings before, but not quite this severe. In taking a history of Mr. Green's present illness, you would not ask about: - A. medications.

A trend in a patient's condition shows a: - D. change.

Which of the following methods should be used to have a patient rate the amount of pain he is having? - D. Have the patient rate the pain on a scale of 1 (least) to 10 (worst).

Which of the following is NOT a purpose of a rapid trauma assessment? - B. To focus on a single body system Surveys consistently show that people: - B. think they know more than they actually do.

Compared to the on-scene examination for a more seriously injured patient, the on- scene examination for a responsive patient with a minor physical injury should be: - C. slower and focused.

A symptom's usefulness in assessing a patient relies MOST on: - C. the accuracy and truthfulness of what the patient tells you.

You are called for a 58-year-old male who is concerned that his blood pressure is too high. He tells you that he has had a headache and is feeling a little dizzy. You notice that his skin is flushed and feels warm to the touch. As you finish taking his vital signs, you should: - A. write down the patient's vital signs.

When examining a patient's mouth during a rapid trauma assessment, you would NOT look for: C. distention and crepitation.

You are transporting a 30-year-old male who has been shot in the chest. He is suffering from a sucking chest wound and has a decreased level of consciousness. How often should you perform a reassessment? - D. Every 5 minutes Mr. Hughes is a 49-year-old man complaining of chest pain. To find out about the quality of his chest pain, which of the following questions is most appropriate? - A. Can you describe how the pain in your chest feels?

A red flag: - A. can save time in reaching a diagnosis.

To avoid the problem of representativeness as much as possible, you should: - A. understand that patients might not describe the textbook symptoms for a condition.

You are called for a patient who reports a headache for several days. He tells you that he has started a new blood pressure medication and is finishing an antibiotic for a skin infection.

During your history taking, you should: - A. write down the pertinent facts.

You are performing a rapid trauma assessment on an unconscious trauma patient. Which order of assessment is correct? - D. Head, face, ears, eyes While transporting a patient to the hospital, the EMT repeats his reassessment, including vital signs, every 15 minutes until he arrives at the emergency department. According to this information, which of the following BEST describes your patient's current status? - D. Stable A patient describes the classic symptoms of myocardial infarction but is only in mild respiratory distress. This situation can be summed up by which of the following? - C.

"If it looks like a duck and quacks like a duck, it must be a duck except when it isn't."

During a rapid trauma assessment, when auscultating the chest for breath sounds, you would listen for: - D. presence, absence, and equality.

You are alone in the back of the ambulance, where you are ventilating an apneic patient. Which of the following is the BEST way to manage the reassessment? - A. Continue ventilating the patient during transport and skip the reassessment.

If you see JVD during the physical examination of a patient, that might indicate: - B. heart failure.

You eat a sandwich and it begins raining. You assume eating the sandwich caused the rainfall.

This is an example of: - B. illusory correlation You are transporting a 20-year-old soccer player who injured his ankle during a match. His injury appears to be isolated and he has no significant past medical history. How frequently should you perform a reassessment on this patient? - C. 15 minutes When inspecting the point of contact with an allergen, what is one thing you would you look for?

- A. Swelling Your patient is a 14-year-old male who was run over by a tractor and is now unresponsive.

During the rapid assessment, you should look for clear drainage coming from the patient's , indicating a serious injury. Answer - B. ears You are treating a 57-year-old male for chest pain. You have gathered all pertinent history of present illness, completed two sets of vital signs, talked with medical

direction, and assisted the patient with two doses of his nitroglycerin. Determination of whether or not the nitroglycerin was effective is assessed during the: - B. reassessment.

Comparing and contrasting the features of different conditions helps will help an EMT to: - A. understand what features set these conditions apart from one another.

A patient was stabbed in the abdomen in a dangerous neighborhood. The patient also appears to have bruising on the arms and chest. Illusory correlation in this case would be deciding that: - A. the bruising must have been caused by the stabbing.

When assessing a 14-year-old male patient that has been involved in a bicycle accident, you notice that he has a small amount of blood coming from his left forearm. This observation is known as which of the following? - D. Sign What BEST describes the pace of the EMT approach to diagnosis? - D. Urgent As you arrive at the emergency department with an unresponsive trauma patient, the nurse asks for your trending assessment. Why is this information important to the nurse? - A. She can evaluate whether or not the patient is improving.

Your patient's initial vital signs were a pulse of 120 per minute and weak, a blood pressure of 90/50 mmHg, and a respiratory rate of 24 per minute. Upon reassessment, you note that the patient now has a weak pulse of 100 per minute, a blood pressure of 110/60 mmHg, and a respiratory rate of 20 per minute. Which of the following can you conclude from this information? - A. The patient's condition may be improving.

Your patient is the 18-year-old male driver of a vehicle that struck a tree. He is conscious and complaining of neck pain. You have performed your primary assessment and manually stabilized the patient's head and neck. Which of the following is the next step? - D. Perform a rapid trauma assessment.

To be able to trend a patient's condition, you must: - C. reassess the patient.

What is the first step in the reassessment process? - D. Repeat the primary assessment.

During the musculoskeletal examination of a patient, if you see a deformity, you should: - B. palpate gently.

An EMT's assessment differs from an assessment made in the emergency department in which way? - C. The EMT is working with more limited resources.

Identifying the presence of a red flag enables the EMT to: - A. identify serious conditions the patient may have.

In order for efficient pulmonary gas exchange to occur:

A. There must be low quantities of pulmonary surfactant to allow for full alveolar expansion B. The pulmonary capillaries must be completely constricted and the alveoli must be collapsed C. Oxygen and carbon dioxide must be able to freely diffuse across the alveolar- capillary membrane D. The percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen Oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane

You are assisting an asthma patient with his prescribed meter-dose inhaler. After the patient takes a deep breath and depressed the inhaler, you should:

A. Advise him to exhale forcefully to ensure medication absorption B. Immediately reapply the oxygen mask and reassess his condition C. Allow him to breathe room air and assess his oxygen saturation D. Instruct him to hold his breath for as long as he comfortably can - Instruct him to hold his breath for as long as he comfortably can If carbon dioxide levels drop too low, the person automatically breathes:

A. Normally B. Slower and less deeply C. Fast and shallow D. Rapidly and deeply - Slower and less deeply When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds.

This means that the patient has:

A. Diminished breath sounds B. Abnormal breath sounds C. Normal breath sounds D. An absence of breath sounds - Abnormal breath sounds Crackles (rales) are caused by

.

A. Severe bronchoconstriction B. Air passing through fluid C. Narrowing of the upper airways D. Mucus in the larger airways - Air passing through fluid A pleural effusion is MOST accurately defined as:

A. A unilaterally collapsed lung B. Fluid accumulation outside the lung

C. Diffuse collapsing of the alveoli D. A bacterial infection of the lung tissue - Fluid accumulation outside the lung In what area of the lungs does respiration occur?

A. Alveoli B. Bronchi C. Capillaries D. Trachea - Alveoli "PASTE" is an alternate assessment tool for

.

A. Respiratory patients B. Cardiac patients C. Seizure patients D. Stroke patients - Respiratory patients Which of the following is MOST characteristics of adequate breathing?

A. 30 breaths/min with supraclavicular retractions and clammy skin B. 24 breaths/min with bilaterally equal breath sounds and pink skin C. 22 breaths/min with irregular pattern of breathing and cyanosis D. 20 breaths/min with shallow movement of the chest wall and pallor - 24 breaths/min with bilaterally equal breath sounds and pink skin Asthma produces a characteristic through partially obstructed air passages.

as patients attempt to exhale

A. Rhonchi B. Stridor C. Rattle D. Wheezing - Wheezing Which of the following must be assessed in every respiratory patient?

A. Orthostatic vital sounds B. Distal pulse, motor, sensation C. Blood glucose levels D. Lung sounds - Lung sounds Which of the following is a genetic disorder the predisposed the patient to repeated lung infections?

A. Cystic fibrosis B. Multiple sclerosis C. Celiac sprue D. Severe acute respiratory syndrome - Cystic fibrosis Which of the following conditions would be LEAST likely to results in hypoxia?

A. Severe anxiety B. Narcotic overdose C. Pleural effusion D. Pulmonary edema - Severe anxiety is a sign of hypoxia to the brain.

A. Decreased respiratory rate B. Altered mental status C. Decreased pulse rate D. Delayed capillary refill time - Altered mental status You are attending to a 3-year-old make patient who is presenting with shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days.

They became worried today, as his level of distress has increased dramatically. One assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:

A. Inflammation of the lower respiratory tract and bronchospasm

B. Viral infection of the upper respiratory tract C. Bacterial infection of the epiglottis D. Inflammation of the bronchioles - Viral infection of the upper respiratory tract His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle.

Based on this information, your patient is most likely suffering from:

A. Bronchiolitis B. Epiglottitis C. Croup D. Pertussis - Bronchiolitis While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both her lungs. This finding is MOST consistent with which of the following conditions?

A. Widespread atelectasis B. Early pulmonary edema C. Aspiration pneumonia D. Acute Asthma attack - Aspiration pneumonia Asthma is caused by a response of the:

A. Respiratory system B. Immune system C. Cardiovascular system D. Endocrine system - Immune system A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications.

During your assessment, you hear wheezing over all the lung fields. His blood

pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is:

A. An antihistamine B. A beta-antagonist C. Epinephrine D. Albuterol - Epinephrine If the level of carbon dioxide in the arterial blood rises above normal, the patient breathes:

A. slower and less deeply B. Normally C. Rapidly and deeply D. Fast and shallow - Rapidly and deeply Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

A. Shortness of breath and blood pressure of 76/56 mm Hg B. Difficulty breathing, two-word dyspnea, and tachycardia C. Conscious and alert patient with an oxygen saturation of 85% D. Pulmonary edema, history of hypertension, and anxiety - Shortness of breath and blood pressure of 76/56 mm Hg Always consider breath.

in patients who were eating just before becoming short of

A. Bronchoconstriction B. Anaphylaxis C. Upper airway obstruction D. Lower airway obstruction - Upper airway obstruction Your patient has a chronic respiratory condition. His stimulus to breath is triggered by low oxygen levels in the blood. This is known as the .

A. Alternate drive B. Hypoxic drive C CO2 drive D. COPD drive - Hypoxic drive A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: - assess the adequacy of his respirations A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: - administer oxygen, give her 324 mg of aspirin, and assess her further A dissecting aortic aneurysm occurs when: - the inner layers of the aorta become separated A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: - remove the battery from the monitor and then remove the vest A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? - Acute myocardial infarction A patient with atherosclerotic heart disease experiences chest pain during exertion because: - the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow After the AED has delivered a shock, the EMT should: - immediately resume CPR Angina pectoris occurs when: - myocardial oxygen demand exceeds supply

Deoxygenated blood from the body returns to the: - right atrium Most AEDs are set up to adjust the voltage based on the impedance, which is the: - resistance of the body to the flow of electricity Nitroglycerin is contraindicated in patients: - who have experienced a head injury Prior to attaching the AED to a cardiac arrest patient, the EMT should: - dry the chest if it is wet Risk factors for AMI that cannot be controlled include: - family history Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: - have chronic hypertension The electrical impulse generated by the heart originates in the: - sinoatrial node The EMT should use an AED on a child between 1 month and 8 years of age if: - pediatric pads and an energy-reducing device are available When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed: - on the thighs or ankles Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? - A rapid heart rate Which of the following signs is commonly observed in patients with right-sided heart failure? Dependent edema You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: - begin high-quality CPR and apply the AED as soon as possible After the AED has delivered a shock, the EMT should:

A. assess for a carotid pulse.

B. transport the patient at once.

C. re-analyze the cardiac rhythm.

D. immediately resume CPR. Answer - D. immediately resume CPR. A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: A. administer oxygen, give her 324 mg of aspirin, and assess her further.

B. give her one nitroglycerin and reassess her systolic blood pressure.

C. give her high-flow oxygen, attach the AED, and transport at once.

D. obtain a SAMPLE history and contact medical control for advice. Answer - A. administer oxygen, give her 324 mg of aspirin, and assess her further.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

A. Heart rate less than 60 beats/min B. Generalized weakness C. Syncope or dizziness D. A rapid heart rate - D. A rapid heart rate Prior to attaching the AED to a cardiac arrest patient, the EMT should: A. contact medical control.

B. perform CPR for 30 seconds.

C. dry the chest if it is wet.

D. assess for a pulse for 20 seconds. Answer - C. dry the chest if it is wet.

A dissecting aortic aneurysm occurs when: A. the inner layers of the aorta become separated.

B. a weakened area develops in the aortic wall.

C. all layers of the aorta suddenly contract.

D. the aorta ruptures, resulting in profound bleeding. Answer - A. the inner layers of the aorta become separated.

The electrical impulse generated by the heart originates in the: A. bundle of His. B. sinoatrial node.

C. atrioventricular node.

D. coronary sinus. Answer - B. sinoatrial node.

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced?

A. Obstructive lung disease B. Thoracic aortic aneurysm C. Uncontrolled hypertension D. Acute myocardial infarction - D. Acute myocardial infarction Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Selected Answer: A. have chronic hypertension.

B. are older than 40 years of age.

C. have had a stroke in the past.

D. regularly take illegal drugs. Answer - A. have chronic hypertension.

Angina pectoris occurs when: A. a coronary artery is totally occluded by plaque.

B. one or more coronary arteries suddenly spasm.

C. myocardial oxygen supply exceeds the demand.

D. myocardial oxygen demand exceeds supply. Answer - D. myocardial oxygen demand exceeds supply.

A patient with atherosclerotic heart disease experiences chest pain during exertion because: Selected Answer: A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

B. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.

C. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.

D. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. Answer - A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

Which of the following signs is commonly observed in patients with right-sided heart failure?

A. Flat jugular veins B. Pulmonary edema C. Dependent edema D. Labored breathing - C. Dependent edema Most AEDs are set up to adjust the voltage based on the impedance, which is the: A. direction that the electrical flow takes in the body.

B. distance between the two AED pads on the chest.

C. resistance of the body to the flow of electricity.

D. actual amount of energy that the AED will deliver. Answer - C. resistance of the body to the flow of electricity.

Risk factors for AMI that cannot be controlled include: A. lack of exercise.

B. hyperglycemia.

C. excess stress.

D. family history. Answer - D. family history.

The EMT should use an AED on a child between 1 month and 8 years of age if: A. his or her condition is rapidly progressing to cardiac arrest.

B. special pads are used and the child has profound tachycardia.

C. pediatric pads and an energy-reducing device are available.

D. he or she is not breathing and has a weakly palpable pulse. Answer - C. pediatric pads and an energy-reducing device are available.

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to 324 mg of baby aspirin.

B. administer up to three doses of nitroglycerin.

C. obtain vital signs and a SAMPLE history.

D. assess the adequacy of his respirations. Answer - D. assess the adequacy of his respirations.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Selected Answer: CorrectA. remove the battery from the monitor and then remove the vest. Answers: A. remove the battery from the monitor and then remove the vest.

B. leave the battery attached to the monitor and remove the vest.

C. perform ventilations only and allow the vest device to defibrillate.

D. remove the battery from the monitor and leave the vest in place. Answer - A. remove the battery from the monitor and then remove the vest.

When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed: Selected Answer: A. on the thighs or ankles.

B. on the lower abdomen.

C. anywhere on the arms.

D. on either side of the chest. Answer - A. on the thighs or ankles.

Deoxygenated blood from the body returns to the: A. right atrium.

B. left ventricle.

C. left atrium.

D. right ventricle. Answer - A. right atrium.

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: A. perform two-rescuer CPR for 5 minutes and request ALS backup.

B. immediately apply the AED pads and analyze his cardiac rhythm.

C. have your partner perform CPR while you question the bystanders.

D. begin high-quality CPR and apply the AED as soon as possible. Answer - D. begin highquality CPR and apply the AED as soon as possible.

Nitroglycerin is contraindicated in patients: A. who have taken up to two doses.

B. who have experienced a head injury.

C. with a systolic blood pressure less than 120 mm Hg. D. with a history of an ischemic stroke. Answer - B. who have experienced a head injury.

What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position? a) 6

b) 8 c) 9 d) 10 - 8 Febrile seizures:

a) are usually benign but should be evaluated. b) are also referred to as petit mal seizures. c) occur when a child's fever progressively rises. d) often result in permanent brain damage. Answer - are usually benign but should be evaluated.

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? a) hypovolemia

b) a postictal state c) intracranial bleeding

d) hypoglycemia - hypovolemia A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: a) administer glucose to rule out hypoglycemia.

b) ask his wife when she noticed the symptoms. c) obtain a complete set of baseline vital signs. d) list all of the patient's current medications. Answer - ask his wife when she noticed the symptoms.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: a) determine when he was last seen by his physician.

b) ask her how long the patient has been taking his medication. c) determine if the patient is a known alcohol abuser. d) obtain a description of how the seizure developed. Answer - obtain a description of how the seizure developed.

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth.

You should: a) use a bag-mask device to assist her ventilations. b) insert an oral airway, apply oxygen, and transport.

c) place her on her side and prepare for rapid transport. d) suction her oropharynx and apply 100% oxygen. Answer - suction her oropharynx and apply 100% oxygen.

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: a) brain stem.

b) cerebrum.

c) cerebral cortex. d) cerebellum. Answer - brain stem.

During the primary assessment of a semiconscious 70-year-old female, you should: a) insert a nasopharyngeal airway and assist ventilations.

b) ensure a patent airway and support ventilation as needed. c) ask family members if the patient has a history of stroke. d) immediately determine the patient's blood glucose level. Answer - ensure a patent airway and support ventilation as needed.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure.

She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: a) place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. b) wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. c) maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. d) restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device. Answer - maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

The mental status of a patient who has experienced a typical seizure: a) typically does not improve, even after several minutes. b) is easily differentiated from that of acute hypoglycemia.

c) is likely to improve over a period of 5 to 30 minutes. d) progressively worsens over a period of a few hours. Answer - is likely to improve over a period of 5 to 30 minutes.

When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: a) if the patient has been hospitalized before.

b) if there is a family history of a stroke.

c) when the patient last appeared normal. d) the patient's overall medication compliance. Answer - when the patient last appeared normal.

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? a) speech b) memory c) arm drift

d) facial droop - memory Interruption of cerebral blood flow may result from all of the following, EXCEPT:

a) an embolism. b) an acute arterial rupture. c) a thrombus. d) cerebral vasodilation. Answer - cerebral vasodilation.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: a) has bleeding within the brain.

b) is older than 60 years of age. c) has had a prior heart attack. d) has a GCS score that is less than 8. Answer - has bleeding within the brain.

A patient who is experiencing aphasia is:

a) not able to swallow without choking. b) unable to produce or understand speech. c) usually conscious but has slurred speech. d) experiencing a right hemispheric stroke. Answer - unable to produce or understand speech.

The spinal cord exits the cranium through the: a) foramen lamina. b) vertebral foramen. c) foramen magnum.

d) cauda equina. Answer - foramen magnum.

The left cerebral hemisphere controls: a) breathing and blood pressure. b) the right side of the body.

c) the right side of the face. d) heart rate and pupil reaction. Answer - the right side of the body.

Status epilepticus is characterized by:

a) profound tachycardia and total muscle flaccidity. b) an absence seizure that is not preceded by an aura. c) prolonged seizures without a return of consciousness. d) generalized seizures that last less than 5 minutes. Answer - prolonged seizures without a return of consciousness.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: a) are typically alert and attempt to communicate with health care providers. b) always take oral medications to maintain normal blood glucose levels. c) do not present with slurred speech or weakness to one side of the body.

d) usually have an altered mental status or decreased level of consciousness. Answer usually have an altered mental status or decreased level of consciousness.

A patient with an altered mental status is:

a) not thinking clearly or is incapable of being aroused. b) completely unresponsive to all forms of stimuli. c) typically alert but is confused as to preceding events. d) usually able to be aroused with a painful stimulus. Answer - not thinking clearly or is incapable of being aroused.

The MOST significant risk factor for a hemorrhagic stroke is:

a) severe stress. b) heavy exertion. c) diabetes mellitus. d) hypertension. Answer - hypertension.

An absence seizure is also referred to as a:

a) grand mal seizure. b) petit mal seizure. c) total body seizure. d) generalized motor seizure. Answer - petit mal seizure.

When caring for a patient with documented hypoglycemia, you should be MOST alert for: a) an acute stroke. b) a febrile convulsion.

c) respiratory distress. d) a seizure. Answer - a seizure.

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: a) assess the patient for a facial droop and hemiparesis.

b) perform CPR for 5 minutes before applying the AED. c) obtain a blood glucose sample to rule out hypoglycemia. d) initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible. Answer - initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.

A transient ischemic attack (TIA) occurs when: a) the normal body processes destroy a clot in a cerebral artery.

b) signs and symptoms resolve spontaneously within 48 hours. c) medications are given to dissolve a cerebral blood clot. d) a small cerebral artery ruptures and causes minimal damage. Answer - the normal body processes destroy a clot in a cerebral artery.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? a) hyperventilation and hypersalivation

b) a gradually decreasing level of consciousness

c) confusion and fatigue d) a rapidly improving level of consciousness - confusion and fatigue You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: a) instruct the patient to keep her eyes open and then repeat the arm drift test. b) repeat the arm drift test and ensure that her palms are facing downward. c) defer this part of the test and assess her for facial droop and slurred speech.

d) repeat the arm drift test, but move the patient's arms into position yourself. Answer repeat the arm drift test, but move the patient's arms into position yourself.

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: a) kidneys.

b) liver. c) brain. d) pancreas. Answer - liver.

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include: a) assisting him with his migraine medication and transporting without lights and siren. b) applying warm compresses to the back of his neck and transporting with lights and siren. c) dimming the lights in the back of the ambulance and transporting without lights and siren. d) placing him in a supine position and transporting with lights and siren to a stroke center.

Answer - dimming the lights in the back of the ambulance and transporting without lights and siren.

The three major parts of the brain are the:

a) cerebrum, cerebellum, and brain stem. b) brain stem, midbrain, and spinal cord. c) cerebellum, medulla, and occiput. d) midbrain, cerebellum, and spinal cord. Answer - cerebrum, cerebellum, and brain stem.

When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: a) recumbent position with the paralyzed side up. b) recumbent position with the paralyzed side down.

c) sitting position with the head at a 45° to 90° angle. d) supine position with the legs elevated 6″ to 12″. Answer - recumbent position with the paralyzed side down.

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: a) administer one tube of oral glucose and prepare for immediate transport. b) give her small cups of water to drink and observe for further seizure activity.

c) monitor her airway and breathing status and assess her blood glucose level. d) place her in the recovery position and transport her with lights and siren. Answer monitor her airway and breathing status and assess her blood glucose level.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should: a) apply oxygen via a nonrebreathing mask, place her on her left side, and transport.

b) apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test. c) assist ventilations, perform a rapid exam, and prepare for immediate transport. d) place a bite block in her mouth in case she has a seizure and transport at once. Answer assist ventilations, perform a rapid exam, and prepare for immediate transport Successful treatment of a stroke depends on whether: a) thrombolytic therapy is given within 3 hours after symptoms began. b) the stroke occurs within the left or right hemisphere of the brain.

c) surgical intervention is performed to remove obstructive clots. d) medications are given to restore the function of infarcted cells. Answer - thrombolytic therapy is given within 3 hours after symptoms began.

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: a) acute hypoglycemia.

b) a ruptured cerebral artery. c) a complex partial seizure. d) an occluded cerebral artery. Answer - a ruptured cerebral artery.

Muscle control and body coordination are controlled by the:

a) cerebral cortex. b) cerebrum. c) cerebellum. d) brain stem. Answer - cerebellum.

A patient whose speech is slurred and difficult to understand is experiencing: a) aphasia.

b) dysphagia. c) paraplegia. d) dysarthria. Answer - dysarthria.

Which of the following MOST accurately describes the cause of an ischemic stroke?

A. Blockage of a cerebral artery B. Acute atherosclerotic disease

C. Rupture of a cerebral artery D. Narrowing of a carotid artery - Blockage of a cerebral artery Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should: A. place a bite block in her mouth in case she has a seizure and transport at once.

B. apply oxygen via a nonrebreathing mask, place her on her left side, and transport.

C. assist ventilations, perform a rapid exam, and prepare for immediate transport.

D. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test. Answer - assist ventilations, perform a rapid exam, and prepare for immediate transport.

Components of the Cincinnati Prehospital Stroke Scale include:

A. speech, pupil reaction, and memory.

B. arm drift, memory, and grip strength.

C. arm drift, speech, and facial droop.

D. facial droop, speech, and pupil size. Answer - arm drift, speech, and facial droop.

Which of the following conditions is NOT a common cause of seizures?

A. Poisoning or overdose B. Hypotension C. Acute hypoglycemia D. Acute alcohol withdrawal Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left

side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of: A. 12 B. 13

C. 14 D. 15 - 12 Muscle control and body coordination are controlled by the: A. cerebrum.

B. cerebellum.

C. brain stem.

D. cerebral cortex. Answer - cerebellum.

Which of the following medications would indicate that a patient has a history of seizures?

A. Enalapril (Vasotec)

B. Levetiracetam (Keppra) C. Hydromorphone (Dilaudid) D. Metformin (Glucophage) - Levetiracetam (Keppra) Successful treatment of a stroke depends on whether: A. surgical intervention is performed to remove obstructive clots.

B. medications are given to restore the function of infarcted cells.

C. the stroke occurs within the left or right hemisphere of the brain.

D. thrombolytic therapy is given within 3 hours of symptoms beginning. Answer thrombolytic therapy is given within 3 hours of symptoms beginning.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to: A. determine if the patient is a known alcohol abuser.

B. obtain a description of how the seizure developed.

C. determine when he was last seen by his physician.

D. ask her how long the patient has been taking his medication. Answer - obtain a description of how the seizure developed.

A 40-year-old patient without a history of seizures experiences a generalized (tonicclonic) seizure. The LEAST likely cause of this seizure is: A. epilepsy.

B. a brain tumor.

C. a serious infection.

D. intracranial bleeding. Answer - epilepsy.

A generalized (tonic-clonic) seizure is characterized by: A. severe twitching of all the body's muscles.

B. a blank stare and brief lapse of consciousness.

C. unconsciousness for greater than 30 minutes.

D. a core body temperature of greater than 103°F (40°C). Answer - severe twitching of all the body's muscles.

A patient who is experiencing aphasia is:

A. not able to swallow without choking.

B. experiencing a right hemispheric stroke.

C. unable to produce or understand speech.

D. usually conscious but has slurred speech. Answer - unable to produce or understand speech.

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

A. Unilateral hemiparesis B. Confusion and weakness

C. Nasal discharge of blood D. Sudden, severe headache - Sudden, severe headache A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His

blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include: A. assisting him with his migraine medication and transporting without lights and siren.

B. placing him in a supine position and transporting with lights and siren to a stroke center.

C. applying warm compresses to the back of his neck and transporting with lights and siren.

D. dimming the lights in the back of the ambulance and transporting without lights and siren.

Answer - dimming the lights in the back of the ambulance and transporting without lights and siren.

The anterior aspect of the cerebrum controls:

A. touch.

B. emotion.

C. movement.

D. vision. Answer - emotion.

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

A. A 3-month-old female who was born prematurely B. A 17-year-old male with anxiety C. A 35-year-old female in the later stages of AIDS D. An 88-year-old male with chronic renal problems - A 17-year-old male with anxiety Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

A. Sinus congestion

B. Neck stiffness or pain C. History of migraines D. Slow onset of symptoms - Neck stiffness or pain The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

A. always take oral medications to maintain normal blood glucose levels.

B. do not present with slurred speech or weakness to one side of the body.

C. are typically alert and attempt to communicate with health care providers.

D. usually have an altered mental status or decreased level of consciousness. Answer usually have an altered mental status or decreased level of consciousness.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: A. list all of the patient's current medications.

B. obtain a complete set of baseline vital signs.

C. administer glucose to rule out hypoglycemia.

D. ask his wife when she noticed the symptoms. Answer - ask his wife when she noticed the symptoms.

Status epilepticus is characterized by: A. generalized seizures that last fewer than 5 minutes.

B. an absence seizure that is not preceded by an aura.

C. profound tachycardia and total muscle flaccidity.

D. prolonged seizures without a return of consciousness. Answer - prolonged seizures without a return of consciousness.

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale and she is tachycardic. The EMT should suspect:

A. esophageal varices.

B. Mallory-Weiss tear.

C. esophagitis.

D. acute pancreatitis. Answer - B. Mallory-Weiss tear.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

A. protect her airway from aspiration.

B. rapidly transport her to the hospital.

C. give her high-flow supplemental oxygen.

D. keep her supine and keep her warm. Answer - A. protect her airway from aspiration.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

A. determine the exact location and cause of his pain.

B. transport him in a supine position.

C. assess his blood pressure to determine perfusion adequacy.

D. be alert for signs and symptoms of shock. Answer - D. be alert for signs and symptoms of shock.

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

A. request a paramedic unit to give the patient pain medication.

B. administer oxygen and prepare for immediate transport.

C. vigorously palpate the abdomen to establish pain severity.

D. place the patient in a sitting position and transport at once. Answer - B. administer oxygen and prepare for immediate transport.

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain?

A. Pancreas B. Gallbladder C. Kidney D. Liver - C. Kidney

An important aspect in the treatment of a patient with severe abdominal pain is to:

A. give 100% oxygen only if signs of shock are present.

B. provide emotional support en route to the hospital.

C. encourage the patient to remain in a supine position.

D. administer analgesic medications to alleviate pain. Answer - B. provide emotional support en route to the hospital.

For a patient with a gastrointestinal complaint, it is MOST important for the EMT to

.

A. determine the cause of the patient's complaint B. identify whether the patient requires rapid transport C. perform all interventions prior to transport D. avoid transporting the patient if the condition is minor - B. identify whether the patient requires rapid transport Most patients with abdominal pain prefer to:

A. sit fully upright because it helps relax the abdominal muscles.

B. sit in a semi-Fowler position with their knees slightly bent.

C. lie on their side with their knees drawn into the abdomen.

D. lie in a supine position with their knees in a flexed position. Answer - C. lie on their side with their knees drawn into the abdomen.

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called:

A. visceral pain.

B. radiating pain.

C. referred pain.

D. remote pain. Answer - C. referred pain.

Peritonitis may result in shock because:

A. severe pain causes systemic dilation of the vasculature.

B. intra-abdominal hemorrhage is typically present.

C. abdominal distention impairs cardiac contractions.

D. fluid shifts from the bloodstream into body tissues. Answer - D. fluid shifts from the bloodstream into body tissues.

Urinary tract infections are more common in

.

A. women B. active adults C. sedentary adults D. men - A. women When assessing a patient with abdominal pain, you should:

A. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area.

C. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

D. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. Answer - C. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

Which of the following helps filter the blood and has no digestive function?

A. Small intestine B. Spleen C. Stomach D. Large intestine - B. Spleen Which of the following is correct about the secondary assessment for a high- priority patient?

A. Never contact medical direction before completing the secondary assessment.

B. Never perform a secondary assessment on a high-priority patient.

C. You may not have time to complete a secondary assessment.

D. The secondary assessment must be performed prior to transport. Answer - C. You may not have time to complete a secondary assessment.

Which of the following may help reduce your patient's nausea?

A. Positive-pressure ventilation B. Low-flow oxygen C. Oral glucose D. Cricoid pressure - B. Low-flow oxygen Which of the following organs lies in the retroperitoneal space?

A. Pancreas B. Liver C. Gallbladder D. Spleen - A. Pancreas Which of the following statements regarding dialysis is correct?

A. Acute hypertension is a common adverse effect of dialysis.

B. Patients who miss a dialysis treatment often present with weakness.

C. The purpose of dialysis is to help the kidneys retain salt and water.

D. Hemodialysis is effective but carries a high risk of peritonitis. Answer - B. Patients who miss a dialysis treatment often present with weakness.

Which of the following statements regarding the acute abdomen is correct?

A. The initial pain associated with an acute abdomen tends to be vague and poorly localized.

B. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.

C. The most common cause of an acute abdomen is inflammation of the gallbladder and liver.

D. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. Answer - A. The initial pain associated with an acute abdomen tends to be vague and poorly localized.

Your patient complains of abdominal pain that occurs mostly at night or after eating fatty foods. You should suspect .

A. cholecystitis B. a hernia C. kidney stones D. appendicitis - A. cholecystitis Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect:

A. pneumonia.

B. peptic ulcer disease.

C. aortic aneurysm.

D. kidney stones. Answer - B. peptic ulcer disease.

Your partner notes blood in a patient's vomit. The medical term for this is:

A. hematemesis.

B. melena.

C. hematochezia.

D. steratorrhea. Answer - A. hematemesis.

You suspect upper gastrointestinal bleeding. All of the following fit into this category, EXCEPT?

A. Esophageal varices B. Ulcerative colitis C. Esophagitis

D. Mallory-Weiss tear - B. Ulcerative colitis What is the last vital sign to change in the setting of shock?

A. Heart rate B. Blood pressure C. Respiratory rate D. Pulse oximetry reading - B. Blood pressure three sections of the small intestine - duodenum: enzymatic breakdown of food jejunum: absorption of digested products illeum: more nutrient absorption peristalsis - involuntary movement of waste matter through the intestines spleen - part of the lymphatic system, helps filter blood and develops RBCs male reproductive organs - testes, epididymides, vasa deferentia, seminal vesicles, prostate gland, penis female reproductive organs - ovaries, fallopian tubes, uterus, cervix, vagina solid organs liver, spleen, kidneys, pancreas, ovaries in women hollow organs - gallbladder, stomach, small and large intestine, urinary bladder normal adult urine production - 1.5-2 L per day peritoneum - membrane that lines the abdominal cavity (parietal); responsive to pain membrane that covers the organs (visceral); controlled by ANS no localized pain peritonitis - inflammation of the peritoneum that will cause ileus (paralysis of the muscular contractions that normally propel material through the intestine)

signs of peritonitis - vomiting, nausea, tachycardia, hypotension, shock diverticulitis - inflammation in small pockets at weak areas in the muscle walls, LLQ abdominal pain signs are fever, malaise, aches, chills, nausea/vomiting cholecystitis inflammation of the gallbladder ulcers - the protective layer of the muscle erodes, allowing acid to eat the organ caused by bacterial infection, drugs, alcohol/smoking gallstones - constant severe pain in RUQ that may refer to the shoulder area, symptoms can appear 30 mins after a fatty meal or at night, can lead to cholecystitis pancreatitis - severe pain in RUQ and LUQ radiating to the back, pain can worsen after eating, may cause sepsis or hemorrhage hematemesis - vomiting blood, often seen in patients with upper GI bleeding esophagitis - inflammation of the esophagus caused by acid reflux (or GERD); will cause heartburn, nausea/vomiting and mouth sores esophageal varices - swollen varicose veins surrounding the esophagus, that can cause vessel dilation and esophagus leaking, can be gradual onset or varices rupture signs are similar to liver disease: fatigue, weight loss, jaundice, anorexia, abdominal edema, pain, nausea/vomiting Mallory-Weiss syndrome - tear of junction between the esophagus and stomach that can cause severe bleeding/death

higher risk in older adults/children, alcoholism, eating disorders vomiting is the principle symptom with signs of shock, abdominal pain, melena gatroenteritis - inflammation of the stomach and small intestine caused by bacteria/virus OR noninfectious conditions signs are bloody diarrhea, cramps, vomiting/nausea, fever, anorexia cystitis - inflammation of the bladder, AKA a UTI, more common in women, can be serious if infection spreads to the urethra or kidneys uremia - urine in the blood, caused by kidney failure kidney stones - crystallized chemicals in the urine that can cause blockage and swelling chronic kidney failure - irreversible, progressively develops over months/years, often caused by diabetes/hypertension, eventually dialysis or transplant is required. symptoms are altered LOC, seizure, coma, lethargy, nausea, headaches, cramps, edema in extremities and face abdominal aortic aneurysm (AAA) - a condition in which the walls of the aorta in the abdomen weaken and blood leaks into the layers of the vessel, causing it to bulge development is slow, pain is "tearing", hard to detect, pale/sweaty hernia - protrusion of an organ through a hole or opening into a body cavity where it doesn't belong incarcerated: cannot be pushed back in reducible hernias can be

check pulse on both arms - a difference in pulse strength may indicate an aortic dissection shock interventions - high flow O2, supine, keep PT warm signs of significant illness - pale/cool/diaphoretic, tachycardia, hypotension, altered LOC dialysis - definitive treatment for patients with end-stage renal disease or chronic renal failure filters/cleans the blood, eliminates waste and reduces excess fluid missing a treatment can lead to weakness and pulmonary edema A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop: Select one: A. irreversible renal failure.

B. severe insulin shock.

C. hypoxia and overhydration.

D. acidosis and dehydration. Answer - A. irreversible renal failure.

A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect?

Select one: A. Pulmonary embolism

B. Severe hypoglycemia C. Diabetic ketoacidosis D. Congestive heart failure - A. Pulmonary embolism

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one:

A. hyperglycemia.

B. hypoglycemia.

C. a heart attack.

D. an acute stroke. Answer - C. a heart attack.

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: Select one:

A. open and maintain her airway and assess breathing.

B. administer 100% oxygen via a nonrebreathing mask.

C. assess for the presence of a medical identification tag.

D. administer oral glucose between her cheek and gum. Answer - A. open and maintain her airway and assess breathing.

A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as .

Select one:

A. hyperosmolar hyperglycemic nonketotic coma B. hypoglycemic crisis C. hyperglycemic crisis D. diabetic ketoacidosis - D. diabetic ketoacidosis A patient with hypoglycemia will often present with which of the following signs/symptoms?

Select one:

A. Warm, red, and dry skin B. Deep, rapid respirations C. Pale, cool, and clammy skin

D. Hypertension - C. Pale, cool, and clammy skin Classic signs and symptoms of hypoglycemia include: Select one: A. cool, clammy skin; weakness; tachycardia; and rapid respirations.

B. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.

C. warm, dry skin; irritability; bradycardia; and rapid respirations.

D. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. Answer - A. cool, clammy skin; weakness; tachycardia; and rapid respirations.

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: Select one:

A. his blood clots too quickly.

B. he has thrombophilia.

C. he has hemophilia A. D. he has a thrombosis. Answer - C. he has hemophilia A. Excessive eating caused by cellular "hunger" is called: Select one:

A. dyspepsia.

B. polyphagia.

C. dysphasia.

D. polydipsia. Answer - B. polyphagia.

In contrast to type 1 diabetes, type 2 diabetes: Select one:

A. occurs when antibodies attack insulin-producing cells.

B. is caused by a complete lack of insulin in the body.

C. is caused by resistance to insulin at the cellular level.

D. is commonly diagnosed in children and young adults. Answer - C. is caused by resistance to insulin at the cellular level.

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

Select one: A. ensuring the absence of a gag reflex.

B. requesting permission from medical control.

C. checking the medication's expiration date.

D. assessing the patient's mental status. Answer - A. ensuring the absence of a gag reflex.

Symptomatic hypoglycemia will MOST likely develop if a patient: Select one: A. markedly overeats and misses an insulin dose.

B. takes too much of his or her prescribed insulin.

C. misses one or two prescribed insulin injections.

D. eats a regular meal followed by mild exertion. Answer - B. takes too much of his or her prescribed insulin.

The EMT should assess for hypoglycemia in small children with a severe illness or injury because: Select one:

A. children overproduce insulin during severe illness or injury.

B. children cannot store excess glucose as effectively as adults.

C. a child's cells do not uptake glucose as rapidly as adults' do.

D. illness or injury causes the pancreas to produce less insulin. Answer - B. children cannot store excess glucose as effectively as adults.

The main function of the endocrine system is to Select one: A. regulate blood flow

B. regulate glucose and calcium C. produce glandular secretions D. maintain homeostasis - D. maintain homeostasis The normal blood glucose level is between: Select one: A. 30 and 150 mg/dL.

B. 60 and 80 mg/dL. C. 160 and 200 mg/dL.

.

D. 80 and 120 mg/dL. Answer - D. 80 and 120 mg/dL. The two main types of cells contained in blood are called Select one: A. erythrocytes and leukocytes

.

B. transport and clotting C. platelets and plasma D. hemoglobin A and S - A. erythrocytes and leukocytes Which of the following conditions is the diabetic patient at an increased risk of developing?

Select one:

A. Alcoholism B. Hepatitis B C. Depression D. Blindness - D. Blindness Which of the following statements regarding glucose is correct? Select one: A. The brain requires insulin to allow glucose to enter the cells.

B. The brain requires glucose as much as it requires oxygen.

C. Blood glucose levels decrease in the absence of insulin.

D. Most cells will function normally without glucose. Answer - B. The brain requires glucose as much as it requires oxygen.

Which of the following statements regarding sickle cell disease is correct? Select one: A. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin.

D. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.

Answer - B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: Select one:

A. glucagon.

B. dextrose.

C. insulin.

D. oxygen. Answer - C. insulin.

D - When a foreign substance invades the body, the body will Select one: A. protect itself

.

B. go on alert C. attempt to inactivate the foreign substance D. All of these answers are correct.

B - The goal of invaders such as bacteria and viruses is to Select one: A. kill their human host

.

B. use a human body as a home C. spread disease and destruction D. cause an immune response D - Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to: Select one: A. raise the pulse rate and blood pressure.

B. inhibit an allergic reaction.

C. relieve bronchospasm.

D. All of these answers are correct.

B - The effects of epinephrine are typically observed within administration.

Select one:

following

A. 30 seconds B. 1 minute C. 30 minutes D.1 hour B - A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: Select one:

A. position her legs well above the level of her heart.

B. administer oxygen and transport her to the hospital.

C. request a paramedic unit to administer epinephrine.

D. advise her to see her physician as soon as possible.

B - When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so .

Select one:

A. quickly, within 30 seconds.

B. quickly, within 30 minutes.

C. slowly, over more than 30 minutes.

D. slowly, over several hours.

B - A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Select one:

A. Ask the patient if he has any diphenhydramine tablets that you can administer.

B. Administer oxygen, transport at once, and request a paramedic intercept.

C. Remain at the scene with the patient and request a paramedic ambulance.

D. Quickly determine if there are any bystanders who may carry epinephrine.

B - Which of the following sounds indicates swelling of the upper airway? Select one: A. Rales

B. Stridor C. Rhonchi D. Wheezing D - The adult epinephrine auto-injector delivers mg of epinephrine, and the infant-child autoinjector delivers mg.

Select one:

A. 0.1; 0.01 B. 0.01; 0.1 C. 0.03; 0.3 D. 0.3; 0.15 C - At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as .

Select one:

A. an uncomfortable depression in the skin B. a series of small, raised pustules C. a raised, well-defined area of the skin D. a large area of red, blotchy skin A - Anaphylaxis is not always life threatening, but it typically involves: Select one: A. multiple organ systems.

B. wheezing.

C. urticaria.

D. wheals.

A - Urticaria is the medical term for: Select one:

A. hives.

B. burning.

C. swelling.

D. a wheal.

C - Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?

Select one:

A. The patient's family history B. The patient's general physical appearance C. The environment in which the patient is found D. The time of year in which the exposure occurred A - Epinephrine stimulates the relieving bronchospasm.

Select one:

response, increasing blood pressure and

A. sympathetic B. parasympathetic C. cardiac D. respiratory A - You should not use tweezers or forceps to remove an embedded stinger because: Select one:

A. squeezing may cause the stinger to inject more venom into the wound.

B. the stinger may break off in the wound.

C. the tweezers are not sterile and may cause infection.

D. removing the stinger may cause bleeding.

C - Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

Select one:

A. Position the patient's airway and initiate positive-pressure ventilations.

B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary.

C. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature.

D. Routine spinal immobilization due to the potential for traumatic injury D - You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a woman approaches you holding her 7-year- old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child's mother has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be?

Select one:

A. 0.8 mg B. 0.5 mg C. 0.4 mg D. 0.15 mg B - The stinger from a honeybee should be: Select one:

A. left in place and covered.

B. scraped away from the skin.

C. squeezed with tweezers and removed.

D. irrigated with copious amounts of water.

D - Which of the following medications blocks the release of histamines? Select one: A. Albuterol (Ventolin)

B. Epinephrine (Adrenalin) C. Acetaminophen (Tylenol) D. Diphenhydramine (Benadryl) B - Anaphylaxis is MOST accurately defined as a(n): Select one: A. moderate allergic reaction that primarily affects the vasculature.

B. extreme allergic reaction that may affect multiple body systems.

C. severe allergic reaction that typically resolves without treatment.

D. allergic reaction that causes bronchodilation and vasoconstriction.

Which of the following statements regarding the Salmonella bacterium is correct?

A. The Salmonella bacterium itself causes food poisoning B. Symptoms of salmonellosis appear within 12 hours C. The Salmonella bacterium produces toxins that cause food poisoning D. Refrigeration of food will prevent salmonellosis - The Salmonella bacterium produces toxins that cause food poisoning The most important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:

A. Initiate CPR B. Apply high-flow oxygen C. Maintain the airway D. Avoid exposure yourself - Avoid exposure yourself Heroin is an example of a(n):

A. Sympathomimetic B. Opioid C. Cholinergic D. Hypnotic - Opioid Medical problems that may cause the patient to present as intoxicated include all of the following , EXCEPT:

A. Toxic reactions B. Head trauma C. Uncontrolled diabetes D. Syncope - Syncope

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. The patient is MOST likely experiencing:

A. Delirium tremens B. Alcohol intoxication C. Acute hypovolemia D. Acute schizophrenia - Delirium tremens The recommended treatment for absorbed or contact poisons includes

A. Transporting the patient to the emergency department with the poisonous substance in place B. Collecting and transporting the poisonous substance to the emergency department for identification C. Safely removing or diluting the poisonous substance

D. Neutralizing the poisonous substance with a chemical - Safely removing or diluting the poisonous substance "Nerve gases" overstimulate normal body functions that are controlled by parasympathetic nerves, causing:

A. Decreased urination B. Decreased lacrimation C. Increased salivation D. Pupil dilation - Increased salivation Most poisonings occur via the

A. Ingestion B. Absorption C. Injection D. Inhalation - Ingestion

route.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:

A. Addiction B. Withdrawal C. Dependence D. Tolerance - Tolerance Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance?

A. What type of substance was taken?

B. How long ago was the substance taken?

C. Why was the substance taken?

D. How much of the substance was taken? - Why was the substance taken?

Activated charcoal is given to patients who have ingested certain substance because it:

A. Decreases absorption of poisons into the lungs B. Binds to the substance and prevents absorption C. Induces vomiting and empties the stomach D. Is a direct antidote for many toxic substances - Binds to the substance and prevents absorption Which of the following is NOT considered a sign or symptom of alcohol withdrawal?

A. Seizures B. Fever and sweating C. Chest pain D. Agitation and restlessness - Chest pain In an apparent suicide attempt, a 19-year-old ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the

pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:

A. An increase in her blood pressure B. Seizures and cardiac arrhythmias C. Acute respiratory depression D. A sudden outburst of violence - Seizures and cardiac arrhythmias As you enter the residence of a patient who has possibly overdosed, you should:

A. Be alert for personal hazards B. Look for drug paraphernalia C. Quickly gain access to the patient D. Observe the scene for drug bottles - Be alter for personal hazards Which of the following statements regarding injected poisons is FALSE?

A. They are easily diluted once in the bloodstream B. You should remove rings, watches, and bracelets in areas of swelling C. They are frequently caused by drug overdose D. They may result in dizziness, fever, and chills - They are easily diluted once in the bloodstream How do poisons typically act to harm the body?

A. By interfering with normal neurologic function B. By changing the normal metabolism of cells or destroying them C. By causing burns and damage to either external or internal organs D. By causing a slowing of nearly all bodily functions - By interfering with normal neurologic function You are your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive,

his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include:

A. High-flow oxygen via a nonrebreathing mask B. Oxygen via a nasal cannula and atropine sulfate C. Assisted ventilation and naloxine (Narcan) D. Assisted ventilation and flumazebuk (Romazicon) - Assisted ventilation and naloxone (Narcan) When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

A. Delirium tremens (DTs) are commonly induced by physical trauma and can lead to lifethreatening seizures B. Signs and symptoms of shock may be masked by the stimulant effects produced by alcohol C. Internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot

D. Long bone fractures are likely because chronic alcohol consumption weakens the structures of the bones - Internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

A. Amphetamine sulfate (Benzedrine) B. Oxycodone (Percocet) C. Ecstasy D. Crack Cocaine - Oxycodon (Percocet) Of the four avenues of poisoning, generally terms of treatment to the EMS provider.

A. Injection B. Inhalation

is the most worrisome in

C. Absorption D. Ingestion - Injection If the victim of a toxicologic emergency vomits, an EMT should

.

A. Not approach the vomitus B. Safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary C. Use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care D. Have the patient enclose the vomitus in a container and take it to the emergency department Have the patient enclose the vomitus in a container and take it to the emergency department You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle to hydrocodone (Vicodin), which was refilled the day before. You should:

A. Preform a rapid head-to-toe exam B. Ventilate her with a BVM C. Contact poison control center D. Apply oxygen via a nonrebreathing mask - Ventilate her with a BVM Victims of inhaled poisoning will require which of the following?

A. Ventilation with a BVM B. An oropharyngeal or nasopharyngeal device to maintain an airway C. Suctioning to clear the airway D. Transport to an emergency department for evaluation - Transport to an emergency department for evaluation An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

A. Liver failure B. CNS depression C. Gastric ulcers D. Kidney failure - Liver failure You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair and several empty alcohol containers are present. She is breathing heavily.

You are able to arouse her consciousness for a short period of time. Which courses of action take priority?

A. cover her with a blanket to maintain body temperature B. Ask her why she attempted suicide C. Have her take activated charcoal while she is conscious D. Administer syrup of ipecac - Have her take activated charcoal while she is conscious A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: - delirium tremens.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: - tolerance Activated charcoal is given to patients who have ingested certain substances because it: - binds to the substance and prevents absorption.

An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause: - liver failure.

As you enter the residence of a patient who has possibly overdosed, you should: - be alert for personal hazards.

Heroin is an example of a(n): - opioid

How do poisons typically act to harm the body? - By changing the normal metabolism of cells or by destroying them Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: oxycodone (Percocet).

If the victim of a toxicologic emergency vomits, an EMT should .

Answer - use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care.

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: - seizures and cardiac arrhythmias.

Most poisonings occur via the

route. Answer - ingestion

Of the four avenues of poisoning, generally terms of treatment to the EMS provider. Answer - injection

is the most worrisome in

The recommended treatment for absorbed or contact poisons includes - safely removing or diluting the poisonous substance Victims of inhaled poisoning will require which of the following? - Transport to an emergency department for evaluation When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: - internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

.

Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance? - Why was the substance ingested?

Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose? - BP, 200/100 mm Hg; pulse, 150 beats/min Which of the following statements regarding the Salmonella bacterium is correct? - The Salmonella bacterium itself causes food poisoning.

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include: - assisted ventilation and naloxone (Narcan).

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: - ventilate her with a BVM. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:

A. restrain the patient with appropriate force in order to treat his injuries.

B. approach the patient and calm him by placing your hand on his shoulder.

C. request that the police officers arrest him and take him to the hospital.

D. try to gain the patient's trust by telling him that you see the vampires too. Answer - A

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should:

A. approach the patient with caution.

B. tell the patient that you want to help.

C. quickly tend to the bleeding wound.

D. calmly identify yourself to the patient. Answer - D A behavioral crisis interferes with which of the following?

A. Activities of daily living B. Behavior that is acceptable to the community C. Dressing, eating, or bathing D. All of these answers are correct. Answer - D A general impression of the patient is formed by an EMT:

A. speaking privately with the patient.

B. at a distance when the patient is first seen.

C. when the patient is in the ambulance.

D. speaking with family members or bystanders first. Answer - B Everyone exhibits some signs and symptoms of mental illness at some point in life .

A. but that does not mean a person is mentally ill B. and needs medication administered to control them C. and should be physically restrained for their own safety and the safety of the EMT D. because mental illness affects everyone - A From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:

A. 3 weeks.

B. 2 weeks.

C.1 week.

D.1 month. Answer - D Signs of excited delirium include:

A. subdued behavior, crying, and suicidal thoughts.

B. diaphoresis, tachycardia, and hallucinations.

C. pallor, hypotension, and constricted pupils.

D. slurred speech, bradycardia, and a high fever. Answer - B The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are .

A. organic brain syndrome and altered mental status B. functional and nonfunctional C. physical and psychological D. All of these answers are correct. Answer - C What is the most common misconception surrounding mental illness?

A. Feeling "bad" or "depressed" means that you must be "sick."

B. Many mental illnesses stem from drug or alcohol abuse.

C. All persons with mental disorders are physically violent and dangerous.

D. Everyone has some form of mental illness. Answer - A When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?

A. Any behaviors that are a violent threat to the patient, EMTs, or others B. Visual or auditory hallucinations C. Disruptions to activities of daily living D. Any behaviors unacceptable to the patient, family, or community - A

When caring for a patient experiencing excited delirium, the EMT should remember that:

A. most patients will have low blood pressure and hyperglycemia.

B. excited delirium is worsened by nervous system depressant drugs.

C. lights and siren are effective in redirecting the patient's behavior.

D. sudden death can occur if the patient's violence is not controlled. Answer - D Which of the following is a good guideline for physical examination of any patient?

A. Avoid touching without permission.

B. Complete the physical exam first, then check the ABCs. C. Examine extremities first.

D. Always work toe-to-head. Answer - A Which of the following is an example of a psychiatric emergency?

A. A person going on a week-long "bender" after losing a job B. A person who is experiencing a panic attack C. A person violently attacking family members D. A person who is depressed and no longer caring for himself - C Which of the following is considered an organic brain syndrome?

A. Depression B. Schizophrenia C. Alzheimer dementia D. Anxiety conditions - C Which of the following terms applies to a state of delusion in which the patient is out of touch with reality?

A. Schizophrenia

B. Psychosis C. Agitated delirium D. Suicidal - B Why might EMTs encounter a larger proportion of violent patients than the population at large?

A. EMTs respond to patients who, by definition, are having an emergency.

B. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large.

C. EMTs respond with law enforcement.

D. EMTs have to restrain patients. Answer - A You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

A. Have law enforcement place her in protective custody.

B. Ask the patient if she has developed a suicidal plan.

C. Leave the scene and have a neighbor check in on her.

D. Encourage the patient to remain quiet during transport. Answer - B You are attending to a 27-year-old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some medications. The patient did not take the pills and is alert and oriented. Despite all of your best efforts to convince her, the patient refuses to go to hospital for treatment. Based on this information, you should:

A. call for the police to attend the scene and, once they arrive, release responsibility for patient transport to them

B. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists

C. ensure that the patient is competent and completes the required documentation, and leave her in the care of her family.

D. restrain the patient and transport her to the hospital as she represents a threat to her safety.

Answer - B You are attending to a 32-year-old male patient. The patient's wife tells you that he returned from Afghanistan last year. While he initially seemed fine, lately he has become withdrawn and distanced himself from his family and friends. He does not talk about it, but she knows that he has been having terrible nightmares that wake him up. The most appropriate question to ask regarding his experience in Afghanistan is:

A. Have you ever been diagnosed with PTSD? B. Were you shot at or under fire?

C. Can you tell me about your experience?

D. Were you in combat? - B You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?

A. His shouting of obscenities B. His clenched fists C. The broken window D. His large body size - D The mental health care system in the United States functions on several levels. For patients with clinical depression, care is most often provided by: A. a professional counselor.

B. a psychologist.

C. a psychiatrist.

D. admission to a psychiatric unit. Answer - B

You are attending to a 24-year-old male patient who is delusional. His family tells you that his hallucinations started as a teenager and have gotten progressively worse over time. The patient is difficult to communicate with because his speech is erratic and he appears to have his own rules of logic. Based on this information, the patient is most likely suffering from: A. excited delirium.

B. organic brain syndrome.

C. schizophrenia.

D. bipolar disorder. Answer - C In which position should you restrain a physically uncooperative patient?

A. Prone B. With hands tied behind the back C. Lateral decubitus D. With arms and legs bound together - C Law enforcement personnel request your assistance for a 30-year-old man whom they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should: A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained.

B. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren.

C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay. Answer - C

t is MOST important for the EMT to remember that suicidal patients may:

A. inject illicit drugs.

B. be self-destructive.

C. be homicidal as well.

D. have a definitive plan. Answer - C Common causes of acute psychotic behavior include all of the following, EXCEPT:

A. intense stress.

B. schizophrenia.

C. Alzheimer disease.

D. mind-altering-substance use. Answer - C A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer disease 6 months ago.

The patient's speech is slurred and she is not alert to her surroundings. You should:

a. transport the patient to a psychiatric facility. b. inquire about the possibility of head trauma. c. conclude that the patient's blood sugar is high. d. allow the patient to refuse transport if she wishes - b When assessing a patient who is displaying bizarre behavior, the EMT should:

a. consider that an acute medical illness may be causing the patient's behavior. b. avoid asking questions about suicide because this may give the patient ideas. c. check his or her blood glucose level only if he or she has a history of diabetes. d. carefully document his or her perception of what is causing the patient's behavior.

Answer - a The term "behavioral crisis" is MOST accurately defined as:

a. a sudden, violent outburst of an otherwise mentally stable person toward a family member. b. any reaction that interferes with activities of daily living or is deemed unacceptable by others. c. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people. d. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications. Answer - b Any attempt to physically restrain a patient should involve

.

A. law enforcement B. sedatives C. ALS personnel D. All of these answers are correct. Answer - A When responding to a psychiatric emergency, it is recommended that the EMT obtain vital signs .

a. on each and every patient b. only when doing so will not exacerbate the patient's distress c. beginning with blood pressure d. without using pulse oximetry - b When investigating the chief complaint of a psychiatric emergency, the EMT should attempt to determine which of the following?

A. Are psychogenic circumstances or illnesses involved?

B. Are hallucinogens or other drugs or alcohol a factor?

C. Is the patient's central nervous system functioning properly?

D. All of these answers are correct. Answer - D Which of the following considerations is the most important for the EMT during the scene sizeup step of managing a psychiatric emergency?

a. Has the patient exhibited this behavior before? b. Do you need to call for law enforcement as additional resources? c. What can family or bystanders explain about this behavior? d. Are legal issues involved? - B Which of the following is an example of a psychiatric disorder?

A. Depression B. Hypoxia C. Low blood glucose D. All of these answers are correct. Answer - A A disorder in which the abnormal operation of an organ cannot be traced to an obvious change in the structure or physiology of the organ system is called .

A. organic brain syndrome B. altered mental status C. a psychiatric emergency D. a functional disorder - D A chronic feeling of sadness or despair is defined as:

A. a psychiatric emergency.

B. depression.

C. behavior.

D. a "bender." - B A person's response to their environment is defined as

A. behavior B. activities C. crisis D. emergency - A

.

Patients with mental health disorders are often

.

A. unmanageable B. violent C. misunderstood D. abusing drugs and/or alcohol - C Which of the following might help the EMT differentiate between "normal" depression and mental illness?

a. The age of the patient b. The amount of time that the patient remains feeling "blue" c. The patient's family support system d. The patient's vital signs - B During a psychiatric emergency, the EMT should be able to

.

a. determine what has caused the psychological crisis b. resolve the problem at the heart of the psychological crisis c. predict whether the patient will become violent d. physically restrain the patient without assistance – C Which of the following infections, when left untreated, may lead to infection of the blood and brain?

A. Bacterial vaginosis B. Gonorrhea C. Pelvic Inflammatory Disease D. Chlamydia - B. Gonorrhea The physical examination of a sexual assault victim should be:

A. performed in the presence of at least two police officers.

B. as detailed as possible so all injuries can be documented.

C. deferred until the patient can be evaluated by the physician.

D. limited to a brief survey for life-threatening injuries. Answer - D. limited to a brief survey for life-threatening injuries.

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?

A. Chlamydia B. Ovarian cysts C. Genital herpes D. Ectopic pregnancy - A. Chlamydia A patient with pelvic inflammatory disease will typically complain of:

A. aches and fever associated with urination B. nausea and vomiting associated with intercourse C. bleeding associated with stress D. abdominal pain associated with menustration - D. abdominal pain associated with menustration In cases of sexual assault, it is important to ensure that you do which of the following?

A. Immediately write down your observations of the scene before assessing the patient.

B. Call for a female EMT or ALS care provider if you yourself are not a female provider.

C. Discuss with law enforcement any suspicions that you may have about the perpetrator.

D. All of these answers are correct. Answer - B. Call for a female EMT or ALS care provider if you yourself are not a female provider.

It is common for young females who experience their first menstrual period to:

A. loose up to 500 mL of blood within the first 24 hours.

B. become so emotionally distraught that they contemplate suicide.

C. have a false positive home pregnancy test result.

D. experience abdominal cramping which may be misinterpreted. Answer - D. experience abdominal cramping which may be misinterpreted.

Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following?

A. Chlamydia B. Pelvic Inflammatory Disease C. Gonnorhea D. Bacterial vaginosis - B. Pelvic inflammatory disease Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should:

A. advise her that she cannot clean herself up because this will destroy evidence B. perform a limited hands-on assessment to detect life-threatening injuries.

C. provide emotional support and visually assess her for obvious trauma.

D. ask her if there is anyone you can contact, such as a friend or relative. Answer - C. provide emotional support and visually assess her for obvious trauma.

The - and - are folds of tissue that surround the urethral and vaginal openings.

A. labia majora; labia minora B. vagina; cervix C. fallopian tubes; uterus D. perineum; anus - A. labia majora; labia minora When caring for a female patient who has been sexually assaulted, you should:

A. place any bloodstained clothing or other articles in separate paper bags.

B. advise her that she will not be allowed to shower or change her clothes.

C. allow law enforcement to take her statement before you begin treatment.

D. ask the patient for a concise, detailed report of what happened to her. Answer - A. place any bloodstained clothing or other articles in separate paper bags.

Causes of vaginal bleeding include which of the following?

A. Ectopic pregnancy B. Vaginal trauma C. Spontaneous abortion D. All of these answers are correct. Answer - D. All of these answers are correct.

Which of the following drugs is commonly referred to as "roofies"?

A. GHB B. Ketamine C. MDMA D. Rohypnol - D. Rohypnol In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

A. directs blood flow to the vagina B. becomes engorged with blood C. sheds and is expelled externally D. thins and begins to seperate - B. becomes engorged with blood The connect(s) each ovary with the uterus.

A. fallopian tubes B. cervix C. egg D. abdomen - A. fallopian tubes During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following?

A. The amount of time since of the patent's last menstrual cycle B. The possibility that the patient may be pregnant C. If the patient is sexually active D. All of these answers are correct. Answer - D. All of these answers are correct.

Some women experience - during ovulation.

A. severe abdominal pain B. severe bleeding C. hypotension D. slight cramping - D. slight cramping A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:

A. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport.

B. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

D. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. Answer - C. administer high- flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

While the ages can vary, women typically experience menstruation from approximately - to years of age.

A. 10; 40 B. 11; 50 C. 10; 70

D. 20; 60 - B. 11; 50 In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

A. often presents with acute pain B. is typically not as severe C. may be relatively painless D. can be controlled in the field. Answer - C. may be relatively painless The EMT should ensure that vaginal bleeding is:

A. controlled directly by the patient B. taken seriously and the patient is transported for gynecologic evaluation.

C. severe enough to warrant transportation D. not caused by traumatic injury - B. taken seriously and the patient is transported for gynecologic evaluation.

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: - administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

A patient with pelvic inflammatory disease will typically complain of ... Answer - abdominal pain associated with menstruation Causes of vaginal bleeding include which of the following? - Ectopic pregnancy Vaginal trauma Spontaneous abortion During gynecologic emergencies, in addition to the standard Sample questions, the EMT should attempt to determine which of the following? - The amount of time since of the patient's last menstrual cycle

The possibility that the patient may be pregnant If the patient is sexually active In anticipation of receiving a fertilized ovum, the lining of the uterine wall: - becomes engorged with blood.

In cases of sexual assault, it is important to ensure that you do which of the following? Immediately write down your observations of the scene before assessing the patient.

Call for a female EMT or ALS care provider.

Discuss with law enforcement any suspicions that you may have about the perpetrator.

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: - may be relatively painless.

It is common for young females who experience their first menstrual period to: - experience abdominal cramping, which may be misinterpreted.

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: - provide emotional support and visually assess her for obvious trauma.

Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following? - Pelvic inflammatory disease Some women experience ... during ovulation. Answer - slight cramping The ... and ... are folds of tissue that surround the urethral and vaginal openings. Answer - labia majora; labia minora

The ... connect(s) each ovary with the uterus. Answer - fallopian tubes The EMT should ensure that vaginal bleeding is ... Answer - taken seriously and the patient is transported for gynecologic evaluation The physical examination of a sexual assault victim should be: - limited to a brief survey for lifethreatening injuries.

When caring for a female patient who has been sexually assaulted, you should: - place any bloodstained clothing or other articles in separate paper bags Which of the following conditions would most likely lead to pelvic inflammatory disease if left untreated? - Chlamydia Which of the following drugs is commonly referred to as "roofies"? - Rohypnol Which of the following infections, when left untreated, may lead to infection of the blood and brain? - Gonorrhea While the ages can vary, women typically experience menstruation from approximately ... to ... years of age. Answer - 11, 50 cervix - The lower third, or neck, of the uterus; it is the narrowest portion of the uterus and opens into the vagina. vagina - The outermost cavity of a woman's reproductive tract that connects the uterus with the vulva or the external female genitalia, the lower part of the birth canal. ovaries - The primary female reproductive organs that produce sex hormones and an ovum, or egg, that, if fertilized, will develop into a fetus. uterus - The muscular organ where the fetus grows, also called the womb; responsible for contractions during labor.

if a patient with vaginal bleeding presents with a rapid pulse and pale or cool skin, you should; place the patient in a supine position Left untreated, .......... can lead to premature birth or low birth weight in pregnant women. Answer - bacterial vaginosis Often the most important intervention for a sexual assault patient is ........................ and transport to a facility with a staff specially trained to deal with this scenario. Answer comforting reassurance Painful urination associated with burning and a yellowish discharge is associated with: gonorrhea what is the most common presenting sign or symptom of pelvic inflammatory disease or PID is lower abdominal pain You are called to the scene of a possible assault. Upon arrival, you are directed by police to a dark room where you find a 22 year old woman who says she was sexually assaulted by a coworker this afternoon. The patient tells you that she would really like to be transported to the hospital but refuses a physical examination. You should: - follow your system's refusal of treatment policy and respect the patient's wishes without judgement. your ....... is the best tool to gain the patient's confidence to seek medical help compassion ..... can cause significant blood loss and lead to hypovolemia - Vaginal bleeding ..... pregnancy and spontaneous abortion are two conditions that can cause vaginal bleeding in women who do not appear to be pregnant and may not even realize that they are pregnant. Answer - Ectopic Symptoms of ........ appear approximately 2 to 10 days after exposure – gonorrhea

A 12 yr-old- male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?

- Energy transmission to the spine A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is most important for you to: - stabilize her entire spine A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: Assess for an exit wound According to the American College of Surgeons Committee on Trauma (ACS- COT), an adult trauma patient should be transported to the highest level of trauma center if he or she: - has a GCS score of less than or equal to 13 with a mechanism attributed to trauma ****According to the Association of Air Medical Services, you should consider air medical transport of a trauma pt if: - Traffic conditions hamper the ability to get the pt to a trauma center by ground within the ideal time frame for the best clinical outcome ****Approximately 25% of severe injuries to the aorta occur during - Lateral collisions Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be most concerned with the possibility of: - intracranial bleeding Force acting over a distance is the definition of: - Work The index of suspicion is most accurately defined as: - Your awareness and concern for potentially serious underlying injuries

****When assessing a patient who experienced a blast injury, it is important to remember that: primary blast injuries are the most easily overlooked.

When assessing an elderly patient who fell, it is important to remember that: - Osteoporosis can cause a fracture that may have resulted in the fall.

When the speed of a motor vehicle doubles, the amount of kinetic energy: - Quadruples Which of the following destinations is most appropriate for a 41-year-old male patient who was involved in a rollover motor vehicle collision and is unconscious and unresponsive, assuming that travel times to each is equal? - A Level I or Level II trauma center Which of the following findings would be least suggestive of the presence of high- energy trauma? - Deployment of the air bag ****Which of the following injuries would most likely occur as a direct result of the third collision in a motor vehicle crash? - aortic rupture ****Which of the following interventions is the most critical to the outcome of a patient with multisystem trauma? - rapid transport to a trauma center ****Which of the following statements regarding gunshot wounds is correct? - The speed of a bullet has the greatest impact on producing injury.

Which types of motor vehicle collisions present the greatest potential for multiple impacts? Rotational and rollover While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be most suspicious that the child has experienced: - neck and facial injuries.

**** Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His Revised Trauma Score (RTS) is: - 9 Blunt trauma - Result of force to the body that causes injury but does not pierce soft tissue or internal organs and cavities Kinetic energy - Energy of a moving object Mechanism of injury or MOI - How trauma occurs Work - Force acting over a distance Potential energy - Product of mass, gravity, and height Cavitation - Emanation of pressure waves that can damage nearby structures Multisystem trauma - Significant MOI that causes injuries to more than one body system Penetrating trauma - Injury caused by objects that pierce the surface of the body A fall from more than

Times the patient's height is considered to be significant - 3

A patient complaining of chest tightness, coughing up blood, and subcutaneous emphysema following an explosion may be suffering from a: - pulmonary blast injury ****A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision? - The bike rider hitting his bike or the car Awareness of and concern for potentially serious obvious and underlying injuries is referred to as the: - index of suspicion.

Significant clues to the possibility of severe injuries in motor vehicle collisions include: - death of a passenger Which of the following is considered a type of motor vehicle collision? - Rollover A compression injury to the anterior portion of the brain and stretching of the posterior portion is called - coup-contrecoup brain injury Signs of a pulmonary blast injury include: A. multiple rib fractures.

B. coughing up blood.

C. an irregular pulse.

D. vomiting blood. Answer - B The cervical spine is MOST protected from whiplash-type injuries when the: A. air bag correctly deploys upon impact.

B. headrest is appropriately positioned.

C. rear end of the vehicle is initially struck.

D. patient tenses up at the time of impact. Answer - B What types of motor vehicle collisions present the greatest potential for multiple impacts?

A. Rear-end and rotational

B. lateral and rollover C. frontal and rotational D. rotational and rollover - D A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. experiences multiple impacts.

B. is ejected or partially ejected.

C. remains within the vehicle.

D. is wearing only a lap belt. Answer - B

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 9.

B. 7.

C. 8.

D. 10. Answer - B The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: A. transport to a community hospital.

B. transport to a trauma center.

C. a secondary assessment at the scene.

D. a focused exam of her forearm. Answer - B The energy of a moving object is called:

A. kinetic energy.

B. converted energy.

C. potential energy.

D. latent energy. Answer - A When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the when the air bag deploys upon impact.

A. windshield

B. dashboard C. steering wheel D. door - D While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On

the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma.

B. lower extremity fractures.

C. neck and facial injuries.

D. blunt trauma to the head. Answer - C When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion.

B. kinetic energy.

C. potential energy.

D. mechanism of injury. Answer - D Approximately 25% of severe injuries to the aorta occur during: A. rear-end collisions.

B. rollover collisions.

C. frontal collisions.

D. lateral collisions. Answer - D A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. auscultate bowel sounds.

B. apply a cervical collar.

C. assess for an exit wound.

D. obtain baseline vital signs. Answer - C Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact.

B. recognize if the driver hit the brakes before impact.

C. assess the severity of the third collision of the crash.

D. identify contact points and predict potential injuries. Answer - D

When treating a patient who experienced a pulmonary blast injury, you should: A. suspect an accompanying cardiac tamponade.

B. use a demand valve to ventilate the patient.

C. avoid giving oxygen under positive pressure.

D. administer large amounts of intravenous fluid. Answer - C A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?

A. Impact of the head against the steering wheel

B. Whiplash injury to the neck during the rollover C. Compression of the head against the roof D. Lateral bending of the neck during the crash - C When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. is thrust under the steering column onto the floorboard.

B. will decelerate at the same rate as the motor vehicle.

C. remains in motion until acted upon by an external force.

D. will most likely be thrown over the steering column. Answer - C Internal injuries caused by gunshot wounds are difficult to predict because:

A. the area of damage is usually smaller than the bullet.

B. the caliber of the bullet is frequently unknown.

C. the bullet may tumble or ricochet within the body.

D. exit wounds caused by the bullet are usually small. Answer - C Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash?

A. Caved-in passenger door

B. Collapsed dashboard C. Intrathoracic hemorrhage

D. Deformed steering wheel - D If one or more occupants in the same vehicle are killed in a crash, the EMT should: A. rapidly assess only the survivors who have experienced obvious trauma.

B. transport the survivors only if they have injuries or complain of pain.

C. allow the survivors to refuse transport if they have no obvious injuries.

D. suspect that all living occupants experienced the same serious trauma. Answer - D Which of the following statements regarding gunshot wounds is correct?

A. The size of a bullet has the greatest impact on producing injury.

B. High-velocity bullets will cause less severe internal injuries.

C. Low-velocity bullets will cause the greatest amount of trauma.

D. The speed of a bullet has the greatest impact on producing injury. Answer - D Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. lumbar and coccygeal spine.

B. thoracic and sacral spine.

C. thoracic and lumbar spine.

D. lumbar and sacral spine. Answer - C With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct?

A. It provides the least amount of information about the mechanism of injury.

B. It is the most dramatic part of the collision and may make extrication difficult.

C. It occurs when the unrestrained occupant collides with the interior of the vehicle.

D. It has a direct effect on patient care because of the obvious vehicular damage. Answer - B When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious.

B. primary blast injuries are the most easily overlooked.

C. solid organs usually rupture from the pressure wave.

D. primary blast injuries are typically the most obvious. Answer - B By what mechanism is a person injured when he or she falls from a significant height?

A. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact.

B. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact.

D. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. Answer - B Air bags are designed to: A. decrease the severity of deceleration injuries.

B. prevent the driver from sustaining head trauma.

C. be used with or without a shoulder harness.

D. prevent a second collision inside the car. Answer - A According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min.

B. was involved in a motor vehicle crash in which another patient in the same vehicle was killed.

C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury.

D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

Answer - D Which of the following findings would be LEAST suggestive of the presence of high-energy trauma?

A. Deployment of the air bag

B. Steering wheel deformity C. Intrusion into the vehicle

D. Dismounted seats - A Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8.

B. 11.

C. 9.

D. 10. Answer - C Which of the following statements regarding low-energy penetrating injuries is correct?

A. Exit wounds are typically easy to locate with low-energy penetrating injuries.

B. It is usually easy to differentiate between an entrance wound and an exit wound.

C. The area of injury is usually close to the path the object took through the body.

D. Internal injuries caused by low-velocity bullets are usually easy to predict. Answer - C If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave?

A. Impaled objects

B. Fractured bones C. Severe burns D. Stomach rupture - D The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. conversion.

B. congruent.

C. cavitation.

D. capitation. Answer - C When the speed of a motor vehicle doubles, the amount of kinetic energy: A. quadruples.

B. triples.

C. doubles.

D. is not affected. Answer - A When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. remember that it could still deploy and seriously injure you.

B. suspect that the patient may have experienced serious injuries.

C. realize that the air bag malfunctioned at the time of impact.

D. recognize that the force of impact was most likely not severe. Answer - A The index of suspicion is MOST accurately defined as: A. a predictable pattern that leads to serious injuries.

B. your concern for potentially serious underlying injuries.

C. the detection of less obvious life-threatening injuries.

D. the way in which traumatic injuries occur. Answer - B Which of the following patients has experienced the MOST significant fall?

A. A 5′0″ patient who fell 13′

B. A 5′9″ patient who fell 14′ C. A 4′6″ patient who fell 13′ D. A 4′8″ patient who fell 13′ - C A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub.

During your assessment, you should be MOST alert for: A. alterations in his mental status.

B. damage to internal structures.

C. potential airway compromise.

D. injury to the cervical spine. Answer - C A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. obtain baseline vital signs.

B. inspect the helmet for cracks.

C. stabilize her entire spine.

D. leave her bicycle helmet on. Answer - C When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was struck and pulled under the vehicle.

B. determine if the patient was propelled away from the vehicle.

C. approximate the speed of the vehicle that struck the pedestrian.

D. evaluate the vehicle that struck the patient for structural damage. Answer - C Two of the MOST common mechanisms of injury for blunt trauma are: A. motor vehicle collisions and stabbings.

B. low-caliber gunshot wounds and falls.

C. falls and motor vehicle collisions.

D. gunshot wounds and vehicle ejections. Answer - C Force acting over a distance defines the concept of: A. potential energy.

B. latent energy.

C. kinetic energy.

D. work. Answer - D When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall.

B. elderly patients who fall usually have a secondary head injury.

C. bilateral hip fractures usually occur when an elderly person falls.

D. any fall in the elderly is considered to be high-energy trauma - A While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. a lacerated coronary artery.

B. underlying cardiac disease.

C. bruising of the heart muscle.

D. traumatic rupture of the aorta. Answer - C

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma?

A. Rapid transport to a trauma center B. Elevation of the lower extremities C. Intravenous fluid administration

D. Early administration of oxygen - A Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash?

A. Forehead lacerations B. Extremity fractures

C. Aortic rupture D. Flail chest - C Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. the height of the fall.

B. the speed of the fall.

C. the surface struck.

D. the primary impact point. Answer - B In contrast to a Level III trauma center, a Level I trauma center must: A. be able to stabilize patients before transferring to a higher level facility.

B. be involved in trauma prevention programs.

C. have access to an emergency physician within 30 minutes.

D. have general surgeons that are in-house 24 hours a day. Answer - D During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the secondary phase.

B. during the primary phase.

C. as a direct result of the pressure wave.

D. during the tertiary phase. Answer - D

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. intracranial bleeding.

B. a fracture of the skull.

C. spinal cord injury.

D. airway compromise. Answer - A A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience?

A. Cardiac contusion

B. Head injury C. Multiple rib fractures D. Pulmonary contusion - B A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?

A. Energy transmission to the spine B. Secondary fall after the initial impact C. Direct trauma to the spinal column D. Lateral impact to the spine - A According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.

B. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.

C. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries.

D. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. Answer - A

Your awareness and concern for potentially serious obvious and underlying injuries is referred to as the: A. mechanism of injury.

B. index of suspicion.

C. scene size-up.

D. general impression. Answer - B The energy of a moving object is called:

A. potential energy.

B. thermal energy.

C. kinetic energy.

D. work. Answer - C Energy can be: A. created.

B. destroyed.

C. converted.

D. all of the above. Answer - C The amount of kinetic energy that is converted to do work on the body dictates the of the injury.

A. location

B. severity C. cause D. speed - B All of the following are considered types of motorcycle impacts EXCEPT: A. head-on collision.

B. angular collision.

C. controlled crash.

D. rear collision. Answer - D Which of the following is considered a type of impact from a motor vehicle collision?

A. Ejection B. Rollover C. Crush D. Peneration - B The three collisions in a frontal impact include all of the following EXCEPT:

A. car striking object.

B. passenger striking vehicle.

C. air bag striking passenger.

D. internal organs striking solid structures of the body. Answer - C Which of the following is NOT considered appropriate use of air medical services?

A. The distance to a trauma center is greater than 25 miles.

B. Traffic/road conditions make it unlikely to get the patient to the hospital in a timely manner.

C. There is a mass-casualty incident.

D. The closest trauma center is 10 minutes away by ground transport. Answer - D Medium-velocity penetrating injuries may be caused by a: A. knife.

B. military assault rifle.

C. handgun.

D. sling-shot. Answer - C In a motor vehicle collision, as the passenger's head hits the windshield, the brain continues to move forward until it strikes the inside of the skull, resulting in a injury.

A. compression B. laceration C. lateral D. motion - A Your quick primary assessment of the patient and evaluation of the to direct lifesaving care and provide critical information to the hospital staff.

A. environment

can help

B. index of suspicion C. mechanism of injury D. abdominal area - C A contusion to a patient's forehead along with a spider-webbed windshield suggests possible injury to the: A. nose B. brain C. face

D. heart - B Which of the following is the MOST common cause of death from a blast injury?

A. amputation

B. burns C. chest trauma D. head trauma - D Significant clues to the possibility of severe injuries in motor vehicle collisions include: A. death of a passenger

B. a blown out tires C. broken glass D. a deployed air bag - A Damage to the body that resulted from a pressure wave generated by an explosion is found in what type of blast: A. primary

B. secondary C. tertiary D. miscellaneous - A Air bags decrease injury to all of the following EXCEPT: A. chest B. heart C. face

D. head - B Optimally, on-scene time for critically injured patients should be less than minutes.

A. 5

B. 10 C. 15 D. 20 - B impacts are probably the number one cause of death associated with motor vehicle collisions.

A. Frontal

B. Lateral C. Rear-end D. Rollover - B The most common life-threatening event in a rollover is passenger from the vehicle.

A. vehicle intrusion

or partial ejection of the

B. centrifugal force C. ejection D. spinal cord injury - C A fall from more than significant.

A. two

times the patient's height is considered to be

B. three C. four D. five - B "For every action, there is an equal and opposite reaction" is: A. Newton's first law.

B. Newton's second law.

C. Newton's third law.

D. a false statement. Answer - C

A comprehensive regional resource capable of providing every aspect of trauma care from prevention through rehabilitation is the definition of a trauma center.

A. Level I B Level II C. Level III D. Level IV - A Which of the following is not considered a type of impact associated with a motorcycle crash?

A. Head-on B. Rotational C. Controlled D. Ejection - B Burns from hot gases and respiratory injuries from inhaling toxic gas are associated with which type of blast injury?

A. Primary B. Secondary C. Tertiary D. Miscellaneous - D A patient complaining of chest tightness, coughing up blood, and subcutaneous emphysema following an explosion may be suffering from a: A. myocardial blast injury.

B. ruptured tympanic membrane.

C. ruptured peritoneal cavity.

D. pulmonary blast injury. Answer - D Patients suffering from an open wound to the neck may suffer from all of the following EXCEPT: A. significant bleeding.

B. air embolism.

C. tension pneumothorax.

D. subcutaneous crepitation. Answer - C A young boy was riding his bicycle down the street when he hit a parked car. How many collisions took place?

A. 1 B. 2 C. 3 D. 4 - C A young boy was riding his bicycle down the street when he hit a parked car. What was the first collision?

A. The bike hitting the car.

B. The bike rider hitting his bike or the car.

C. The bike rider's internal organs against the solid structures of the body.

D. The bike rider striking the pavement. Answer - A A young boy was riding his bicycle down the street when he hit a parked car. What was the second collision?

A. The bike hitting the car.

B. The bike rider hitting his bike or the car.

C. The bike rider's internal organs against the solid structures of the body.

D. The bike rider striking the pavement. Answer - B A young boy was riding his bicycle down the street when he hit a parked car. What will rate your index of suspicion for this collision?

A. The mechanism of injury B. The type of bike C. How loudly he's crying D. A quick visual assessment - A Kinetic energy is a calculation of: A. weight and size.

B. weight and speed.

C. mass and weight.

D. speed and force. Answer - B

20-year-old man has major open facial injuries after his vehicle struck a tree head-on.

Which of the following findings within the car would MOST likely explain his injury pattern?

A. Deployed airbag B. Bent steering wheel C. Nonintact windshield

D. Crushed instrument panel - C Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash?

A. Extensive damage to the automobile B. Flail chest and lower extremity fractures C. Massive external trauma with severe bleeding D. Aortic rupture or compression injury to the brain D A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A. deployed airbags.

B. steering wheel deformity.

C. starring of the windshield.

D. a crushed instrument panel. Answer - B An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the

patient, you will MOST likely encounter: A. trauma to the pelvis.

B. blunt abdominal trauma.

C. a severe closed head injury.

D. penetrating thoracic trauma. Answer - A Whiplash injuries are MOST common following impacts.

A. rear-end B. rollover C. frontal D. lateral - A Death from a rollover motor vehicle crash is MOST often secondary to: A. crushing injuries.

B. airbag-related trauma.

C. multiple collisions to the interior of the car.

D. ejection of the patient from the motor vehicle. Answer - D Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact?

A. Head-on collision B. Angular collision C. Ejection D. Controlled crash - C When assessing a stab wound, it is important for the EMT to remember that: A. stabbings to an extremity are rarely associated with an exit wound.

B. the majority of the internal trauma will be near

the path of the knife.

C. most stabbings are unintentional and cause less severe internal injury.

D. more internal damage may be present than the external wound suggests. Answer - D A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury MOST likely occurred during the phase of the explosion.

A. blast B. primary C. secondary D. tertiary – D Which section of the heart receives deoxygenated blood? Select one: A. Left B. Right C. Ventricles D. Atria - B In older patients, the first indicator of non-traumatic internal bleeding may be: Select one: A. weakness or dizziness.

B. diaphoresis and pale skin.

C. a heart rate over 120 beats/min.

D. a low blood pressure. Answer - A Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?

Select one:

A. The patient has not eaten in 24 hours.

B. The patient had a stroke 5 years prior.

C. The patient has a history of hypertension.

D. The patient takes rivaroxaban (Xeralto). Answer - D Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one:

A. liver.

B. pancreas.

C. gallbladder.

D. spleen. Answer - D Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?

Select one:

A. Brain B. Gastrointestinal system C. Skeletal muscle D. Kidneys - B Which portion of the blood carries oxygen to and wastes away from body tissues? Select one: A. Platelets

B. Plasma C. White blood cells D. Red blood cells - D A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one:

A. acute appendicitis.

B. gastrointestinal bleeding.

C. intrathoracic hemorrhaging.

D. an aortic aneurysm. Answer - B Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. applying chemical ice pack.

B. applying a tourniquet.

C. keeping the patient warm.

D. splinting the extremity. Answer - D What mechanism(s) does the body use to control bleeding? Select one: A. Clotting

B. Coagulation C. Vasoconstriction D. All of these answers are correct. Answer - D Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed .

Select one:

A. coagulation B. perfusion C. hemorrhage D. hypoperfusion - B The severity of bleeding should be based on all of the following findings, EXCEPT: Select one:

A. clinical signs and symptoms.

B. poor general appearance.

C. the mechanism of injury.

D. systolic blood pressure. Answer - D If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:

Select one: A. a tourniquet proximal to the injury.

B. digital pressure to a proximal artery.

C. a splint and elevate the extremity.

D. additional sterile dressings. Answer - A A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. perform a secondary assessment.

B. apply a nonrebreathing mask.

C. assist the patient's ventilations.

D. obtain baseline vital signs. Answer - C A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. having the patient pinch his own nostrils and then lie supine.

B. pinching the patient's nostrils and having him lean forward.

C. packing both nostrils with gauze pads until the bleeding stops.

D. placing a rolled 4² × 4² dressing between his lower lip and gum. Answer - B If applying a dressing to control the bleeding of a patient's arm, the EMT should .

Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound C. cover the entire wound, above and below, with the dressing D. All of these answers are correct. Answer - D Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?

Select one: A. Vacuum splint B. Sling and swathe C. Cardboard splint D. Air splint - D Significant vital sign changes will occur if the typical adult acutely loses more than of his or her total blood volume.

Select one: A. 10% B. 5% C. 15% D. 20% - D Hypovolemic shock occurs when: Select one: A. the clotting ability of the blood is enhanced.

B. the patient's systolic blood pressure is less than 100 mm Hg. C. the body cannot compensate for rapid blood loss.

D. at least 10% of the patient's blood volume is lost. Answer - C Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first.

B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.

C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding.

D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control. Answer - B Which of the following statements regarding hemophilia is correct? Select one:

A. Hemophiliacs take aspirin to enhance blood clotting.

B. Patients with hemophilia may bleed spontaneously.

C. Approximately 25% of the population has hemophilia.

D. Hemophilia is defined as a total lack of platelets. – B A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: pinching the patient's nostrils and having him lean forward.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing: gastrointestinal bleeding.

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: - assist the patient's ventilations. circulation of blood within an organ or tissue in adequate amounts to meet the current needs of the cells - perfusion Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the: - spleen.

Hypovolemic shock occurs when: - the body cannot compensate for rapid blood loss.

If applying a dressing to control the bleeding of a patient's arm, the EMT should ...

- apply direct pressure first. use large or small gauze pads or dressings depending upon the size of the wound. cover the entire wound, above and below, with the dressing.

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: a tourniquet proximal to the injury. ******In older patients, the first indicator of nontraumatic internal bleeding may be - weakness or dizziness.

Internal bleeding into a fractured extremity is most often controlled by: - splinting the extremity.

Significant vital sign changes will occur if the typical adult acutely loses more than .... of his or her total blood volume. Answer - 20% *****The severity of bleeding should be based on all of the following findings, EXCEPT: systolic blood pressure.

What mechanism(s) does the body use to control bleeding? - Clotting Coagulation Vasoconstriction Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: - the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.

Which of the following findings would be the most significant when assessing a patient with possible internal bleeding? - The patient takes rivaroxaban or Xeralto.

RivaroxabanListen or Xarelto - prevent blood clots Which of the following splinting devices would be most appropriate to use for a patient who has an open fracture of the forearm with external bleeding? - air splint Which of the following statements regarding hemophilia is correct? - Patients with hemophilia may bleed spontaneously.

Which organ or organ system has the greatest tolerance for lack of perfusion or shock? Gastrointestinal system Which portion of the blood carries oxygen to and wastes away from body tissues? - Red blood cells Which section of the heart receives deoxygenated blood? - right .... is inadequate tissue perfusion - shock Significant blood loss demands your immediate attention as soon as the .......................... has been managed: - Controlling major external bleeding is always the priority The only require a minimal blood supply when at rest: - muscles You and your partner respond to a patient who has had his hang nearly severed by a drill press.

As you approach, you note that the patient is pale and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. After applying the tourniquet, you write .... and ................................................................................... on a piece of adhesive tape and apply it to the patients forehead. Answer - The letters TK and the exact time applies.

You respond to a 25-year-old man who has cut his arm with a circular saw. The bleeding appears to be bright red and spurting. The patient is alert and oriented and converses with you freely. He appears to be stable at this point. What is your first step in controlling his bleeding? - Following standard precautions. bleeding is any bleeding in a cavity or space inside the body - Internal The ............... only require a minimal blood supply when at rest. – muscles A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover of his BSA. Answer - 18%

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? - Cover it with moist, sterile gauze and secure with an occlusive dressing. Correct A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: - administer high-flow oxygen. Correct A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: - replace the avulsed flap to its original position and cover it with a sterile dressing. Correct A burn that is characterized by redness and pain is classified as a: - superficial burn. Correct A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): - contusion. Correct An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: - report the incident to the appropriate authorities. Correct As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: - open his airway and assess his breathing status. Correct

Burns to pediatric patients are generally considered more serious than burns to adults because: pediatric patients have more surface area relative to total body mass. Correct During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a: - shotgun. Correct In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: - an air embolism. Correct In which of the following patients should you remove an impaled object? - A pulseless and apneic patient with a knife impaled in the back Correct he sebaceous glands produce sebum, a material that: - waterproofs the skin and keeps it supple. Correct When caring for a patient whose arm is covered with a dry chemical, you should: - brush away the chemical before flushing with water. Correct Which of the following areas of the body has the thinnest skin? - Ears Correct Which of the following is a severe burn in a 65-year-old patient? - Partial-thickness burn to 20% of the BSA Correct Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? - Abrasion Correct Which of the following processes occurs during the inflammation phase of the healing process? The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. Correct

Which of the following statements regarding crush syndrome is correct? - Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. Correct You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: - assess distal circulation and readjust the bandage as needed. Correct The outermost layer of the skin is known as: A epidermis.

B dermis.

C subcutaneous layer.

D endodermis. Answer - epidermis Which of the following layers of the skin is rich with nerves, blood vessels, and specialized structures such as sweat glands?

A The epidermis B The dermis C The subcutaneous layer D The subdermis - the dermis Which of the following injuries is characterized by an intact dermis, ruptured blood vessels, and dead cells in the dermis?

A A contusion B A laceration C An incision D An avulsion - A contusion Which of the following is the most common type of blast injury? A Crush injuries

B Hematomas C Destruction of solid organs D Rupture of hollow organs - rupture of hollow organs A 45-year-old male was lifting an engine block on a winch when the mechanism fell and trapped his arm beneath it. The engine block was lifted from the arm before your arrival and now you note swelling, bruising, and pain in the extremity. The skin remains intact and there is no bleeding. Given this mechanism and the stated findings, you should suspect: A shock.

B open wounds.

C an amputation.

D a crush injury. Answer - a crush injury A 21-year-old male has an extensive abrasion on his right leg after crashing his motorcycle at moderate speed. After confirming that he has no further injuries, the goal of your care for this specific type of injury would be to: A stop the bleeding.

B prevent contamination of the wound.

C retrieve the severed part.

D replace the displaced tissue. Answer - prevent contamination of the wound.

A 22-year-old male has been shot in the neck. You find the patient awake, ambulatory, and note that the wound in not bleeding externally. Based on the location of the penetrating trauma and your current findings, you should suspect: A shock.

B airway issues.

C spinal injuries.

D brain injury. Answer - airway issues

A 20-year-old male has impaled himself on a 2-inch diameter fence post after a fall. The fence post has penetrated the patient's chest, but it is still attached to the fence. To best treat this patient, you should: A gently lift the patient off the fence post.

B cut the fence post and remove the object from the patient's chest.

C cut the fence post but leave the impaled object in place.

D rapidly pull the impaled object from the patient. Answer - cut the fence post but leave the impaled object in place.

A 50-year-old male has a large shard of glass impaled in his shoulder after a fall through a plate glass window. The area is bleeding heavily. To control the bleeding, you should first: A apply a tourniquet.

B remove the glass shard.

C apply pressure on top of the shard.

D apply pressure on either side of the object. Answer - apply pressure on either side of the object.

A 30-year-old male has been stabbed in the face with a steak knife. The knife remains in place.

You should remove the knife only if: A it is causing severe bleeding.

B it is causing severe pain.

C you can visualize both ends as it passes through the cheek.

D its distal end threatens to enter the posterior pharynx. Answer - you can visualize both ends as it passes through the cheek.

The skin is the largest organ of the body. It is composed of three layers, including the: A. superior dermis. B. subdermis.

C. epidermis.

D. sebaceous layer. Answer - epidermis You arrive on scene to a residence where you find a 16-year-old female patient who was shocked while plugging in an appliance in the garage. Her father states that he heard the shock and saw her get "thrown to the ground." The patient is awake and alert still lying on the ground.

Based on the patient's presentation, how should you manage this patient's injury?

A. Immediately place an AED on the patient. B. Evaluate the source of the electrical burn prior to assessing the patient. C. Withhold oxygen until you are able to perform a full assessment. D. This patient should be fully immobilized. Answer - This patient should be fully immobilized.

Which of the following is a guideline for the treatment of chemical burns? A. Wet the burned area with water and then let dry. B. Wash away the chemical with flowing water. C. Immediately flush dry chemicals off the skin with copious amounts of water. D. Brush a chemical out of the eye from the corner of the eye to the bridge of the nose. Answer Wash away the chemical with flowing water.

A bruise on the abdomen could indicate injury to which of the following? A. Lungs and trachea B.

Spleen, liver, or kidneys C. Reproductive organs D. Heart - Spleen, liver, or kidneys Your patient has sustained a chemical burn to her hands from dry lime. How is this treated in the field?

A. Use baby oil to flush the injury. B. Brush off the powder before using water to flush. C. Flush the patient immediately with water. D. Use only sterile water to flush the patient. Answer - Brush off the powder before using water to flush.

In a contusion, what remains intact? A. The dermis B. Blood vessels C. The epidermis D. Cells - the epidermis What is the primary risk for electrical injury patients? A. Massive burn injuries B. Orthopedic injuries C. Respiratory or cardiac arrest

D. Paralysis - respiratory or cardiac arrest In treating open wounds to the neck or abdomen, which type of dressing is preferred?

A. Hemostatic dressing B. Occlusive dressing C. Universal dressing D. Pressure dressing - occlusive dressing Burns pose greater risks to infants and children than to adults because: A. their skin is more porous and less resilient. B. they are more prone to airway obstructions. C. their body surface area is greater in relation to their total body size. D. they have little adipose tissue. Answer - their body surface area is greater in relation to their total body size.

What is an example of classifying a burn by agent and source? A. Thermal burn from excessively hot coffee B. Superficial burn of less than 50 percent total body area C. Partial thickness burn D. Superficial burn - Thermal burn from excessively hot coffee

Your patient has burns to the entire right arm and the anterior chest. What is the estimated surface area involved?

A. 16 percent B. 13.5 percent C. 9.5 percent D. 18 percent - 18 percent In treating a puncture wound of the eye, if you bandage both eyes, it is because: A. any light can damage both eyes in a puncture injury. B. you do not know whether the other eye is injured. C. you want to avoid sympathetic eye movement. D. you want to offer sympathetic care to the patient. Answer - you want to avoid sympathetic eye movement.

An internal injury with no open pathway from the outside is called: A. second degree.

B. simple.

C. closed.

D. partial. Answer - closed The sterile material that is placed directly on a wound is termed the: A. dressing.

B. bandage.

C. cravat.

D. self-adherent roller gauze. Answer - dressing To control bleeding, start with: A. a hemostatic dressing. B. direct pressure and elevation. C. a tourniquet.

D. an occlusive dressing. Answer - direct pressure and elevation.

The skin serves which of the following functions? A. RBC production B. Protection C. Gas exchange D. Respiration - protection You are dispatched to the scene of a construction site where a 33-year-old male has been impaled with a piece of rebar to his right anterior chest near the clavicle. The rebar is too long to allow transport of the patient. The patient is alert and seated on the ground. How should you manage this injury?

A. Contact medical control and ensure someone stabilizes the object while it is gently cut to the desired length.

B.

Immediately remove the rebar in a single motion. C. Summon a surgeon to the scene to manage this situation. D. Stabilize the rebar and transport the patient. Answer - Contact medical control and ensure someone stabilizes the object while it is gently cut to the desired length.

A swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel is: A. a contusion. B. a hematoma.

C. an ecchymosis. D. a blood blister. Answer - a hematoma.

You arrive on scene to an assault. Law enforcement has secured the scene. Your patient is a 23year-old male with a blood soaked shirt. The patient states that the assailant "slashed at him with a box opener." You expose the chest and note a jagged cut on his left anterior chest with steady, dark red hemorrhaging. Based on this assessment finding, the wound is MOST likely which of the following?

A. Laceration B. Abrasion C. Avulsion D. Contusion - laceration When assessing a patient, consider the possibility of closed soft-tissue injuries whenever there is swelling, pain, or deformity, as well as A.

signs of underlying fractures. B. a medical condition that would explain this presentation. C. penetrating trauma.

D. a mechanism of blunt trauma. Answer - a mechanism of blunt trauma.

A burn injury should be considered to be: A. primarily an emotionally scarring event. B. an airway problem in the most severe cases. C. an injury with the potential for many far-reaching effects. D. a simple issue of tissue damage. Answer - an injury with the potential for many far- reaching effects.

Swelling or deformity at the site of a bruise indicates a: A. possible rupture of the patient's liver, spleen, or kidneys. B. possible compression injury. C. possible underlying fracture. D. possible concussion. Answer - possible underlying fracture.

Possible injury to the cervical spine or brain could be indicated by: A. a contusion to the trunk. B. a bruise on the head or neck. C.

an avulsion of an extremity. D. a penetration of the sternum. Answer - a bruise on the head or neck.

The emotional and psychological damage from burn injuries: A. are not a concern for EMTs. B. usually occurs only with the most severe injuries. C. begins at the emergency scene. D. typically are not long lasting. Answer - begins at the emergency scene.

Burns to the face are considered critical because: A. of the potential for respiratory compromise or eye injury. B. they involve possible disfigurement. C. the patient's speech may be affected. D. a large surface is area involved. Answer - of the potential for respiratory compromise or eye injury.

A patient has partial-thickness burns over 35 percent of her body, including both feet. Which of the following classifications does this patient's burns fall under? A. Critical B. Minor C. Superficial D. Moderate - Critical

Partial-thickness burns involving over percent of the body would be considered critical. Burns to areas of the body that can result in a significant loss of function are also considered critical, independent of the total BSA involved. Answer - 30 You are assessing a patient and notice red discoloration with blisters on the legs. This type of burn would be classified as: A. subcutaneous. B. superficial.

C. full thickness. D. partial thickness. Answer - partial thickness.

White and dry to dark brown or black and charred skin is a sign of a: A. full thickness burn. B. superficial burn. C. second-degree burn. D. partial thickness burn. Answer - full thickness burn.

A way of identifying the seriousness of a burn is by its degree. Which of the following statements is TRUE? A. A first-degree burn is the most serious and the deepest. B. A second-degree burn is characterized by red, dry, smooth skin. C. A superficial burn is also called a second-degree burn. D.

A full-thickness burn is also known as a third-degree burn. Answer - A full-thickness burn is also known as a third-degree burn.

Your patient suffered a severe electrical burn injury. In your emergency care, you should always: A. assess for an entrance and an exit wound. B. pull the patient off the electrical source as soon as possible. C. hose the patient down to stop the burning reaction. D. administer oxygen by a positive-pressure ventilator. Answer - assess for an entrance and an exit wound.

Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to her anterior torso (chest and abdomen) and the anterior surface of her right arm. What is the estimated percentage of body surface burned?

A. 22.5 percent B. 27 percent C. 13.5 percent D. 18 percent - 22.5 percent When a flap of tissue is traumatically removed, this condition is called: A. a laceration. B. a puncture.

C. an incision.

D. an avulsion. Answer - an avulsion Damage to which of the following organs is LEAST likely in the case of abdominal bruising?

A. Lungs B. Liver C. Spleen D. Kidneys - lungs You are caring for a 15-year-old female who has sustained a laceration to her lower arm. It is spurting bright red blood uncontrollably. What personal protective equipment would be MOST preferred in managing this wound?

A. Gloves and a gown B. Gloves and a face shield C. Gloves only D. Gown and mask - Gloves and a face shield You are caring for a 46-year-old female who accidentally sustained burns to her left hand up to the wrist from boiling water. You arrive moments after the incident. Of the following, which should you do FIRST? A. Remove any rings or other jewelry from the patient's hand and wrist B. Check the patient's pulse and blood pressure in the affected extremity C. Cool the burned area to stop the burning process.

D. Apply a topical analgesic ointment to the burn area to reduce the pain - Cool the burned area to stop the burning process.

Generally when providing emergency care of open wounds, the first thing you would do is: A. clean the wound surface. B. bandage a dressing in place. C. expose the wound. D. control the bleeding. Answer - expose the wound You are performing a secondary assessment on your 19-year-old trauma patient with a severely bruised trunk and signs of damage to the ribs and sternum. He is coughing up frothy red blood and having difficulty breathing. What injury do these signs point to?

A. Damage to the cervical spine B. Damage to the brain C. A punctured lung D. Injury to abdominal organs - A punctured lung Which of the following statements about puncture wounds is correct? A. A puncture wound is not serious unless it is deep. B. If there is little external evidence of bleeding, internal bleeding is unlikely. C. Even insignificant-looking puncture wounds can cause devastating injuries.

D. Puncture wounds carry a much lower risk of infection than other open wounds. Answer - Even insignificant-looking puncture wounds can cause devastating injuries.

You are called to the scene of a metal fabrication plant where you are presented with a 30-yearold male patient complaining of bilateral severe eye pain. Upon examination, you notice both eyes are red and irritated. Patient states that one of the dyes he was working with splashed into his eyes. How would you manage this patient's injury?

A. Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.

B. Cover both eyes with dry, sterile dressing and transport immediately to the nearest appropriate facility.

C. Cover both eyes with a moist, sterile dressing. D. Neutralize the acid immediately with vinegar or baking soda. Answer - Irrigate both eyes with copious amounts of water for at least 20 minutes or until you arrive at the medical facility.

For a young child with isolated genital injuries, you should: A. consider the possibility of abuse and treat the child with sensitivity. B. challenge the parents directly about the possibility of child abuse. C. avoid questioning the child about the cause of the injuries so as not to embarrass the child.

D. withhold care until law enforcement arrives. Answer - consider the possibility of abuse and treat the child with sensitivity.

When crushed, the liver and spleen:

A. cause contusions on the surface of the skin. B. cause severe inflammation and sepsis. C. cause muscle, nerve, and tissue damage. D. bleed profusely and cause shock. Answer - bleed profusely and cause shock.

A patient who was injured by lightning is awake on your arrival but is not able to hear what you are saying. He can talk and is frightened because he does not know what happened. The patient was in a picnic area at a park and was thrown several feet to the ground when the lightning struck near him. Which of the following steps has the HIGHEST priority in this patient's assessment and treatment?

A. Evaluate the electrical burns. B. Fully immobilize the patient. C. Apply oxygen by nonrebreather mask at 12 to 15 lpm. D. Apply sterile dressings to the burn sites. Answer - Fully immobilize the patient.

How does the skin provide temperature regulation? A. By opening temperature pores in the skin B. By increasing or decreasing the metabolism within the skin structures C. By thickening or thinning the layers of the skin D. By altering the blood flow to the skin and by controlling perspiration - By altering the blood flow to the skin and by controlling perspiration In bandaging a hand wound, what important consideration is necessary?

A. The dressing does not need to be sterile because the hand is typically not clean. B. The arm should be wrapped with elastic gauze from the elbow toward the fingertips.

C. Bandage the lower arm, wrist, and hand, including the fingertips. D. Bandage the hand in the position of function. Answer - Bandage the hand in the position of function.

Which layer of the skin provides shock absorption and insulation? A. Dermis B. Adipose C. Subcutaneous D. Epidermis - subcutaneous In caring for an amputated part, it is important to: A. place the part in milk. B. wrap the part in sterile gauze and pack it in ice. C. place the part in ice water. D. wrap the part in sterile gauze and keep it cool. Answer - wrap the part in sterile gauze and keep it cool.

Burns involving the airway often lead to: A. respiratory compromise

B. hypoglycemia.

C. bradycardia.

D. hypertensive crisis. Answer - respiratory compromise All burns are to be treated as more serious if: A. they are from a thermal source. B. accompanied by other injuries or medical problems. C. they are accompanied by reddening of the skin. D. they involve the epidermis. Answer - accompanied by other injuries or medical problems.

A patient has partial thickness burns over 18 percent of his body, including both feet. Which of the following classifications does this patient's burns fall under? A. Moderate B. Minor C. Superficial D. Critical - Critical Your patient has a large bump on the forehead from being hit by a baseball. What type of injury is this?

A. Contusion B. Crush injury C.

Stellate D. Hematoma - Hematoma The layer of skin that is rich with blood vessels, nerves, and specialized structures is the: A. subcutaneous. B. fascia.

C. dermis.

D. epidermis. – dermis A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: - conjunctivitis. Correct A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: - transport her to the emergency department. Correct A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth.

A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: - fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: - rapidly transporting her to the hospital. Correct

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: - irrigate both eyes continuously for 20 minutes with plain water. Correct Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: - direct pressure using dry, sterile dressings. Correct Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: - a blowout fracture. Correct If your patient swallows blood following facial trauma, there is an increased risk of . Answer - vomiting Correct Significant trauma to the face should increase the EMT's index of suspicion for a(n): - spinal column injury. Correct The Adam's apple is: - the upper part of the larynx that is formed by the thyroid cartilage. Correct The MOST significant complication associated with facial injuries is: - airway compromise.

Correct The superficial temporal artery can be palpated: - just anterior to the tragus. Correct The upper jawbones are called the: - maxillae. Correct When a light is shone into the pupil: - it should become smaller in size. Correct When caring for a patient with an open facial injury, the EMT's immediate priority should be to: wear gloves and facial protection. Correct

When performing a full body scan, you should assess for DCAP- BTLS Correct

. Answer -

Which of the following statements regarding anterior nosebleeds is correct? - They usually originate from the septum area and bleed slowly. Correct Which of the following statements regarding the vitreous humor is correct? - It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.

Correct You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: - has a history of eye surgeries. Correct When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: - they may need to call a specialist to see the patient. Correct What is the function of the sternocleidomastoid muscle? - allows movement of the head The optic nerve endings are located within the: - retina.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: - tragus.

Which of the following statements regarding anterior nosebleeds is correct? - They usually originate from the septum area and bleed slowly.

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: - leaning him forward and pinching his nostrils together.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: - irrigating his right eye laterally.

The upper jawbones are called the. Answer - maxillae.

When caring for a patient with an open facial injury, the EMT must: - wear gloves and facial protection.

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced - a detached retina Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with - brain injury.

The lower jawbone is called the - mandible.

The superficial temporal artery can be palpated: - just anterior to the tragus.

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: - a specialist may need to be called.

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: - padding between the ear and the scalp.

The term "hyphema" is defined as - blood in the anterior chamber of the eye.

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: - a blowout fracture.

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further

assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: - apply direct pressure to her arm wound.

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: cover both of his eyes and transport to the hospital.

The cricoid cartilage: - is the only complete circular cartilage of the trachea.

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: - apply direct pressure above and below the wound.

The conjunctiva are kept moist by fluid produced by the: - lacrimal gland.

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: - conjunctiva.

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: - close her eyes and cover them with a moist dressing.

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: - avoid applying pressure to the globe when you are covering the eye.

The Adam's apple is - the upper part of the larynx that is formed by the thyroid cartilage.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry

bottles of sterile saline or water. You should: - irrigate both eyes continuously for 20 minutes with plain water.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: - has a history of eye surgeries.

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car.

During your assessment, he tells you that he wears soft contact lenses. You should: - carefully remove the contact lenses and then irrigate his eyes with saline.

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: - turn the backboard onto its side.

The MOST significant complication associated with facial injuries is: - airway compromise.

Facial injuries should be identified and treated as soon as possible because: - of the risk for airway problems.

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: - Conjunctivitis Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: - direct pressure using dry sterile dressings A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner assumes manual stabilization of her head, you should: - suction her oropharynx for 15 seconds

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your rapid trauma assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: - rapidly transporting her to the hospital.

The eyeball itself is referred to as the: - globe You are assessing a 59-year-old male who complains of diplopia. When obtaining the patient's medical history, it is MOST pertinent to ask him if he: - has a history of eye surgeries.

Which of the following statements regarding the vitreous humor is MOST correct?

- Vitreous humor is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost Which of the following statements regarding anterior epistaxis is MOST correct? - Anterior epistaxis usually originate from the septal area and bleed fairly slowly.

The light-sensitive area of the eye where images are projected is called the: - retina The conjunctiva is kept moist by fluid produced by the: - lacrimal gland The white portion of the eye is called the: - sclera Significant trauma to the face should increase the EMT's index of suspicion for a/an: - spinal cord injury A construction worker has a large sliver of metal impaled in his right eye. The MOST appropriate treatment for this injury includes: - stabilizing the object and covering both of his eyes Following direct trauma to the superior aspect of the throat, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a/an: - laryngeal fracture

You are transporting a 20-year-old male with a laceration to the left external jugular vein. You have successfully controlled bleeding from the wound.

Suddenly, he experiences an acute onset of labored breathing and cyanosis. You should suspect: an acute air embolism The skin and underlying tissues of the face: - have a rich blood supply and bleed profusely.

Which of the following findings would be LEAST suggestive of a closed head injury? - Briskly constricting pupils when exposed to light Approximately 80% of the eyeball is protected by the: - orbit When a light is shone into the pupil: - it should become smaller in size Frequent ongoing assessments in the patient with facial or throat injuries are MOST important because: - such injuries can affect the respiratory system The mastoid process is located approximately: - 1" posterior to the external opening of the ear.

In the normal, uninjured eye: - the pupils are equal in size and move together in the same direction.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her facial area and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: - apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: - pupil

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: - transport her to the emergency department which of the following findings would be the LEAST suggestive of a head injury?

- briskly constricting pupils when exposed to light A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of: Select one: A. distraction.

B. hyperflexion.

C. axial loading.

D. hyperextension. Answer - C. axial loading.

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response?

Select one:

A. 5 B. 3 C. 2 D. 4 - B. 3 A tight-fitting motorcycle helmet should be left in place unless: Select one: A. the patient complains of severe neck or back pain.

B. the helmet is equipped with a full face shield or visor.

C. it interferes with your assessment of the airway.

D. the patient must be placed onto a long backboard. Answer - C. it interferes with your assessment of the airway.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: Select one:

A. acute unilateral paralysis following the injury.

B. a progressively lowering blood pressure.

C. a rapid deterioration of neurologic signs.

D. an acute increase in the patient's pulse rate. Answer - C. a rapid deterioration of neurologic signs.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: Select one:

A. CSF leakage from the ears.

B. decerebrate posturing.

C. a rapid, thready pulse.

D. widening pulse pressure. Answer - C. a rapid, thready pulse.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: Select one:

A. assist his ventilations with a BVM. B. pack his nostrils to stop the drainage of blood.

C. suction his oropharynx for up to 15 seconds.

D. immobilize his spine and transport immediately. Answer - C. suction his oropharynx for up to 15 seconds.

Hyperextension injuries of the spine are MOST commonly the result of: Select one: A. diving.

B. hangings.

C. falls.

D. compression. Answer - B. hangings.

In contrast to a cerebral concussion, a cerebral contusion: Select one: A. involves physical injury to the brain tissue.

B. does not cause pressure within the skull.

C. usually does not cause a loss of consciousness.

D. results from a laceration to the brain tissue. Answer - A. involves physical injury to the brain tissue.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: Select one:

A. sensory and motor functions remain intact.

B. it causes a problem managing the airway.

C. lateral immobilization has been applied.

D. the patient adamantly denies neck pain. Answer - B. it causes a problem managing the airway.

The central nervous system (CNS) is composed of the: Select one: A. cerebrum and meninges.

B. brain and spinal cord.

C. cerebellum and brain.

D. meninges and spinal cord. Answer The five sections of the spinal column, in descending order, are the: Select one: A. thoracic, cervical, lumbar, coccygeal, and sacral.

B. cervical, coccygeal, thoracic, sacral, and lumbar.

C. coccygeal, sacral, lumbar, thoracic, and cervical.

D. cervical, thoracic, lumbar, sacral, and coccygeal. Answer - D. cervical, thoracic, lumbar, sacral, and coccygeal.

The Glasgow Coma Scale (GCS) is used to assess: Select one: A. verbal response, eye opening, and mental status.

B. eye opening, verbal response, and motor response.

C. sensory response, pupil reaction, and heart rate.

D. mental status, eye opening, and respiratory rate. Answer - B. eye opening, verbal response, and motor response.

The ideal procedure for moving an injured patient from the ground to a backboard is: Select one:

A. the four-person log roll.

B. the direct patient carry.

C. the use of a scoop stretcher.

D. the clothes drag. Answer - A. the four-person log roll.

What part of the nervous system controls the body's voluntary activities? Select one: A. Somatic

B. Autonomic C. Sensory D. Central - A. Somatic When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: Select one: A. pupillary constriction.

B. increase in heart rate.

C. dilation of the bronchiole smooth muscle.

D. shunting of blood to vital organs. Answer - A. pupillary constriction.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: Select one:

A. rupture of the tympanic membrane following diffuse impact to the head.

B. fractures to the internal structures of the ear following direct trauma.

C. a linear skull fracture and a significant increase in intracranial pressure.

D. significant pressure and bleeding in between the skull and dura mater. Answer - A. rupture of the tympanic membrane following diffuse impact to the head.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: Select one: A. the patient has been completely secured to the backboard.

B. an appropriately sized cervical collar has been applied.

C. the patient has been secured to the ambulance stretcher.

D. the head has been stabilized with lateral immobilization. Answer - A. the patient has been completely secured to the backboard.

Which of the following breathing patterns is MOST indicative of increased intracranial pressure?

Select one: A. Increased rate with a normal inspiratory time and a prolonged expiratory time B. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea C. Increased rate and depth with the distinct odor of acetone on the patient's breath D. Slow, shallow, occasional gasps that progress to prolonged periods of apnea - B. Irregular rate, pattern, and volume of breathing with intermittent periods of apnea Which of the following statements regarding secondary brain injury is correct? Select one: A. Because cerebral edema develops quickly, it is considered to be a primary brain injury.

B. Hypoxia and hypotension are the two most common causes of secondary brain injury.

C. Signs are often present immediately after an impact to the head.

D. It results from direct brain trauma following an impact to the head. Answer - B. Hypoxia and hypotension are the two most common causes of secondary brain injury.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: Select one: A. irregular.

B. weak.

C. rapid.

D. slow. Answer - D. slow.

A 28-year-old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should: - prepare for immediate transport.

A flail chest occurs when: - a segment of the chest wall is detached from the thoracic cage.

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect: - pulmonary contusion.

A simple pneumothorax: - is commonly caused by blunt chest trauma.

A spinal cord injury at the level of C7 would MOST likely result in: - paralysis of the intercostal muscles An open pneumothorax occurs when: - air enters the pleural space from outside the body.

Children are often "belly breathers" because muscles are not developed

. Answer - their intercostal

Closed chest injuries are typically caused by

. Answer - blunt trauma

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade? - Engorged jugular veins

If a patient with a chest injury is only able to inhale small amounts of air per breath, he or she: must increase his or her respiratory rate to maintain adequate minute volume.

Immediately life-threatening chest injuries must be found and managed during the . Answer - primary assessment In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a - pneumothorax.

Patients with chest injuries will often present with

. Answer - tachypnea

The thoracic cavity is separated from the abdominal cavity by the: - diaphragm.

When a person is lying supine at the end of exhalation, the diaphragm: - may rise as high as the nipple line.

Which of the following is most likely to cause immediate death? - Aortic rupture While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should: - administer oxygen and transport to the hospital.

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be MOST suspicious that this patient has experienced a: - laceration of the aorta.

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing

respiratory distress and tachycardia, and is developing cyanosis. You should: - partially remove the dressing.

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should: immediately request ALS support A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival.

Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately.

The MOST appropriate treatment for this patient includes: - A. applying direct pressure with a dry, sterile dressing.

Abdominal pain, vomiting, and fever are most likely due to

. Answer - B.

infection All of the following are hollow abdominal organs, EXCEPT the: - A. spleen.

Because the depth of an open abdominal wound is often difficult to determine: - B. prompt transport to the hospital is essential.

Compression injury is most likely due to which of the following? - A. Improperly placed lab belt Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: - A. diaphragm.

In pediatric patients, the liver and spleen are proportion to the abdomen Injuries to the external male genitalia

. Answer - B. larger in

. Answer - B. are rarely life-threatening

Placing a pregnant patient in a supine position during the third trimester of pregnancy: - D. may decrease the amount of blood that returns to the heart.

When a hollow organ is punctured during a penetrating injury to the abdomen: - C. peritonitis may not develop for several hours.

When a patient stiffens the muscles of the abdomen, it is known as Answer - A. guarding.

.

When should you visually inspect the external genitalia on your patient? - D. Only when there is a complaint of severe pain or other injury Which of the following is true regarding injury to the kidneys? - A. Injury to the kidneys usually indicates injury to other organs.

Which of the following organs would MOST likely bleed profusely when injured?

- C. Liver Which of the following statements regarding abdominal eviscerations is correct? D. The protruding organs should be kept warm and moist.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: - D. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM. You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: - B. closely monitor him and reassess him frequently.

You should suspect a kidney injury anytime the patient presents with Answer - D. a hematoma in the flank region

.

Your documentation on a sexual assault victim should objective and factual

. Answer - A. be

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: - A. control any external bleeding, administer oxygen, and transport at once.

An open fracture is MOST accurately defined as a fracture in which: A. a large laceration overlies the fracture.

B. a bullet shatters the underlying bone.

C. bone ends protrude through the skin.

D. the overlying skin is no longer intact. Answer - D. the overlying skin is no longer intact.

Chapter 31, page 1093, Musculoskeletal Injuries Crepitus and false motion are:

A. indicators of a severe sprain.

B. most common with dislocations.

C. positive indicators of a fracture.

D. only seen with open fractures. Answer - C. positive indicators of a fracture.

Chapter 31, page 1095, Musculoskeletal Injuries

Which of the following statements regarding compartment syndrome is correct?

A. Compartment syndrome typically develops within 6 to 12 hours after an injury.

B. In most cases, compartment syndrome develops within a few minutes after an injury.

C. Compartment syndrome occurs because of increased pressure within the bone cavity.

D. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

Answer - A. Compartment syndrome typically develops within 6 to 12 hours after an injury.

Chapter 31, page 1132, Compartment Syndrome Which of the following musculoskeletal injuries would MOST likely result in deformity?

A. Moderate sprain B. Displaced fracture C. Severe strain D. Hairline fracture - B. Displaced fracture Chapter 31, page 1093, Musculoskeletal Injuries A supracondylar or intercondylar fracture is also known as a fracture of the:

A. radial head.

B. distal humerus.

C. olecranon process.

D. proximal radius. Answer - B. distal humerus.

Chapter 31, page 1118, Specific Musculoskeletal Injuries When caring for a patient with a possible fracture of the scapula, the EMT should:

A. recognize that scapular fractures are life threatening.

B. assume that minimal force was applied to the back.

C. carefully assess the patient for breathing problems.

D. apply rigid board splints across the chest and back - C. carefully assess the patient for breathing problems.

Chapter 31, page 1116, Specific Musculoskeletal Injuries During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should:

A. log roll the patient onto a long backboard and transport at once.

B. stabilize the pelvis with a pelvic binder and protect the spine.

C. defer spinal immobilization and transport to a trauma center.

D. perform a focused physical exam with emphasis on the pelvis. Answer - B. stabilize the pelvis with a pelvic binder and protect the spine.

Chapter 31, pages 1114-1115, Emergency Medical Care A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should:

A. keep her knee flexed and secure it with padded board splints.

B. make one attempt to return the patella to its normal position.

C. flex her knee slightly more and assess for distal circulation.

D. gently straighten her knee and apply a padded board splint. Answer - A. keep her knee flexed and secure it with padded board splints.

Chapter 31, page 1129, Specific Musculoskeletal Injuries The musculoskeletal system refers to the:

A. bones and voluntary muscles of the body.

B. nervous system's control over the muscles.

C. connective tissue that supports the skeleton.

D. involuntary muscles of the nervous system. Answer - A. bones and voluntary muscles of the body.

Chapter 31, page 1087, Introduction A "hip" fracture is actually a fracture of the: A. pelvic girdle.

B. pubic symphysis.

C. proximal femur.

D. femoral shaft. Answer - C. proximal femur.

Chapter 31, page 1126, Specific Musculoskeletal Injuries Skeletal muscle is attached to the bone by tough, ropelike, fibrous structures called:

A. ligaments.

B. tendons.

C. fascia.

D. cartilage - B. tendons.

Chapter 31, pages 1087-1088, Anatomy and Physiology of the Musculoskeletal System During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:

A. carefully straighten the injured arm and secure it with padded board splints.

B. splint the elbow in the position of deformity and transport immediately.

C. make two or three attempts to restore distal circulation by manipulating the elbow.

D. apply gentle manual traction in line with the limb and reassess for a pulse. Answer - D. apply gentle manual traction in line with the limb and reassess for a pulse.

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:

A. administer oxygen and perform a rapid assessment.

B. stabilize her head and perform a primary assessment.

C. assess for a carotid pulse and assist her ventilations.

D. apply manual stabilization to both of her femurs. Answer - B. stabilize her head and perform a primary assessment.

Chapter 31, pages 1099-1100, Patient Assessment Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life?

A. Nondisplaced long bone fractures B. An amputated extremity C. Pelvic fracture with hypotension D. Bilateral femur fractures - C. Pelvic fracture with hypotension Chapter 31, page 1099, Musculoskeletal Injuries A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

A. control the bleeding and cover the wound with a sterile dressing.

B. manually stabilize the leg above and below the site of injury.

C. gently manipulate the injured leg until the numbness dissipates.

D. assess distal pulses as well as sensory and motor functions. Answer - A. control the bleeding and cover the wound with a sterile dressing.

Chapter 31, page 1103, Emergency Medical Care The MOST significant hazard associated with splinting is:

A. reduction in circulation distal to the injury site.

B. aggravation of the injury or worsened pain.

C. compression of nerves, tissues, and vasculature.

D. delaying transport of a critically injured patient. Answer - D. delaying transport of a critically injured patient.

Chapter 31, page 1115, Emergency Medical Care A fracture is MOST accurately defined as a(n):

A. abnormality in the structure of a bone.

B. total loss of function in a bone.

C. break in the continuity of the bone.

D. disruption in the midshaft of a bone. Answer - C. break in the continuity of the bone.

Chapter 31, page 1093, Musculoskeletal Injuries In general, musculoskeletal injuries should be splinted before moving the patient unless:

A. transport time is less than 15 minutes.

B. deformity and swelling are present.

C. the patient is clinically unstable.

D. the patient is in severe pain. Answer - C. the patient is clinically unstable.

Chapter 31, page 1104, Emergency Medical Care With regard to musculoskeletal injuries, the zone of injury is defined as the:

A. exact part of the bone or joint that was disrupted.

B. area of soft-tissue damage surrounding the injury.

C. part of the body that sustained secondary injury.

D. area of obvious deformity over the site of impact. Answer - B. area of soft-tissue damage surrounding the injury.

Chapter 31, page 1092, Musculoskeletal Injuries In which of the following situations should the EMT splint an injured limb in the position of deformity?

A. If resistance is encountered or the patient experiences severe pain B. If a traction splint will be used to immobilize the injured extremity C. If transport time to the hospital is greater than 20 to 30 minutes D. When distal circulation and neurological functions are absent - A. If resistance is encountered or the patient experiences severe pain A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

A. assess for a carotid pulse for up to 60 seconds B. apply an AED and assess his cardiac rhythm C. open his airway and give two rescue breaths D. apply checmical heaty packs to his groin and axillae - assess for a carotid pulse for up to 60 seconds.

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: A applying ice to the wound and transporting quickly B. elevating the lower extremities and giving antivenin C. transporting only with close, continuous monitoring D. supine positioning, splinting the leg, and transporting - D. supine positioning, splinting the leg, and transporting All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

A. frostnip B. trench foot C. immersion foot D. frostbite - D. frostbite Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A, hot, dry skin B. nausea C. headache D. tachycardia - A, hot, dry skin Drowning is MOST accurately defined as:

A) death beyond 24 hours after submersion in water B) death from suffocation after submersion in water C) water in the lungs following submersion in water D) temporary survival after submersion in water - B) death from suffocation after submersion in water In contrast to Lyme disease, Rocky Mountain spotted fever:

A) may be confused with rheumatoid arthritis B) causes painful joint swelling after a few days or weeks C) can cause paralysis and cardiorespiratory collapse D) presents with flu-like symptoms and a bull's-eye rash - C) can cause paralysis and cardiorespiratory collapse Most of the serious injuries associated with scuba diving are caused by:

A) too rapid of a descent B) too rapid of an ascent C) cold water temperature D) alcohol consumption - A) too rapid of a descent

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

A) convection B) evaporation C) radiation D) conduction - B) evaporation The EMT must assume that any unwitnessed water-related incident is accompanied by:

A) alcohol intoxication B) possible spinal injury C) cold-water immersion D) an air embolism - B) possible spinal injury The MOST prominent symptom of decompression sickness is:

A) abdominal or joint pain B) difficulty with vision C) tightness in the chest D) dizziness and nausea - A) abdominal or joint pain The venom of a black widow spider is toxic to the:

A) renal system B) cardiovascular system C) respiratory system D) nervous system - D) nervous system The venom of a black widow spider is toxic to the: nervous system When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

A) evaporation B) radiation C) convection D) conduction - D) conduction Which of the following is an early sign of pit viper envenomation?

A) syncope and bleeding at distal sites B) signs and symptoms of hypoperfusion C) local swelling and ecchymosis D) general weakness and diaphoresis - C) local swelling and ecchymosis Which of the following MOST accurately describes hyperthermia?

A) heat evaporates a significant amount of body water B) the body eliminates more heat than it can generate C) the body is exposed to more heat than it can lose D) the core body temperature exceeds 99.5 degrees (37C) - C) the body is exposed to more heat than it can lose You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head.

After calling for backup, you should:

A) recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries B) immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment C) assess the unrespoinsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible

D) focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest - C) assess the unrespoinsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

A) protect the affected part from further injury B) cover his foot with chemical heat compresses C) administer oxygen via a nonrebreathing mask D) rewarm his foot in 102F to 104F water - A) protect the affected part from further injury You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:

A) perform a head-to-toe assessment and look for signs of trauma B) place him in a sitting position and have him drink 1L of water C) load him into the ambulance and begin rapid cooling interventions D) administer one tube of oral glucose and reassess his mental status - C) load him into the ambulance and begin rapid cooling interventions You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth.

You should:

A) suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his breain, administer high flow oxygen, and transport to a hyperbaric chamber B) suction his mouth and nose, apply high flow oxygen, monitor the patients breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility C) place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department D) position him supine with his head elevated 30 degrees, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance - B) suction his mouth and nose, apply high flow oxygen, monitor the patients breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility Convection - heat loss that occurs from helicopter rotor blade down wash core temperature - temperature of the central part of the body conduction - heat loss resulting from standing in a cold room radiation heat loss resulting from standing in a cold room evaporation - heat loss resulting from sweating Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following, EXCEPT:

A) normal thirst B) cold, clammy skin with ashen pallor C) normal vital signs D) dizziness, weakness, or faintness - A) normal thirst Signs and symptoms of severe systemic hypothermia include all of the following, EXCEPT:

A) shivering B) coma Cvery slow respirations D) weak pulse - A) shivering The organs most severely affected by air embolism are the:

A) brain and lungs B) brain and heart C) heart and lungs D) brain and spinal cord - D) brain and spinal cord The rate and amount of heat loss by the body can be modified by all of the following, EXCEPT:

A) wearing insulated clothing B) increasing heat production C) moving to an area where heat loss is decreased D) increasing fluid intake - D) increasing fluid intake Treatment of drowning or near drowning begins with:

A) ventilation with 100% oxygen via a bag-mask device B) opening the airway B) rescue and removal from the water D) suctioning the lungs to remove the water - B) rescue and removal from the water Which of the following statements regarding the brown recluse spider is NOT true?

A) in venom is not neurotoxic B) it is larger than the black widow spider C) it lives mostly in the southern and central partys of the country

D0 bites rearely cause systemic sign and symptoms - B) it is larger than the black widow spider Most heat stroke cases occur when the temperature is around humidity is 80%. Answer - 80

°F and the

is the least common but most serious illness caused by heat exposure, occurring when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed. Answer - Heat stroke In the United States, the most common form of pit viper is the rattlesnake Never assume that a(n)

-

, pulseless patient is dead. Answer - cold

A person's ability to shiver is lost when his or her body temperature falls below:

A) 94F B) 90F C) 92F D) 95F - 90F (32C) An air embolism associated with diving occurs when:

A) high water forces air into the mediastinum B) the diver hyperventilates prior to entering the water C) the alveoli completely collapse due to high pressure D) the diver holds his or her breath during a rapid transport - D) the diver holds his or her breath during a rapid transport Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:

A) a relatively small surface area B) a smaller amount of body fat

C) a smaller overall muscle mass D) a decreased ability to shiver - A) a relatively small surface area Covering a patient's

will significantly minimize radiation heat loss.

A) head B) abdomen C) extremities D) chest - A) head Heat loss from the body through respiration occurs when:

A) air temperature is greater than body temperature B) the core body temperature is greater than 98F C) cool air is inhaled and displaces warm air D) warm air exhaled into the atmosphere - D) warm air exhaled into the atmosphere Heat stroke occurs when:

A) the ambient temperature exceeds 90F and the humidity is high B) the body's heat-eliminating mechanisms are overwhelmed C) a person becomes dehydrated secondary to excess water loss D) a person's core body temperature rises about 103F - B) the body's heat- eliminating mechanisms are overwhelmed High air temperature reduces the body's ability to lose heat by:

A) radiation B) convection C) evaporation D) conduction - A) radiation High humidity reduces the body's ability to lose heat through:

A) evaporation

B) radiation C) conduction D) convection - A) evaporation Hypothermia can worsen internal bleeding secondary to:

A) blood-clotting abnormalities B) a decreased heart rate C) cardiac arrhythmias D) severe muscular rigidity - A) blood-clotting abnormalities In contrast to the brown recluse spider, the black widow spider:

A) is large and has a red-orange hourglass mark on its abdomen B) has a bite that usually produces local pain but no systemic signs or symptoms C) is very small and has a violin-shaped marking on its back D) has a bite that is typically painless until a blister developes - A) is large and has a red-orange hourglass mark on its abdomen In order for sweating to be an effective cooling mechanism:

A) the body must produce at least 1 L per hour B) it must be able to evaporate from the body C) several layers of clothing must be worn D) the relative humidity must be above 90% - B) it must be able to evaporate from the body Patients with generalized hypothermia are at an increased risk of a local cold injury because:

A) blood is shunted away from the extremities to the body's core B) the patient is usually unable to escape the cold ambient temperature C) peripheral vasodilation brings warm blood to the skin's surface D) the major muscles of the body become rigid during hypothermia - A) blood is shunted away from the extremities to the body's core

The body's natural protective mechanisms against heat loss are: A Vasoconstriction and shivering B) respiration and vasoconstriction

C) vasocodialation and respiration D) shivering and vasodilation - A Vasoconstriction and shivering The two MOST efficient ways for the body to eliminate excess heat are:

A) hyperventilation and tachycardia B) respiration and bradycardia C) sweating and vasodilation D) perspiration and tachycardia - C) sweating and vasodilation To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

A) abdomen B) chest C) forehead D) neck - A) abdomen OST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

A) behind the patients knee B) under the patients tongue C) into the patient's rectum D) under the patients armpit - C) into the patient's rectum When the body loses sweat, it also loses:

A) plasma B) nutrients

C) electrolytes D) erythrocytes - C) electrolytes Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

A) hyperglycemia B) spinal cord injury C) severe infection D) head injury - A) hyperglycemia Which of the following medications increases a person's risk of a heat-related emergency?

A) motrin B)diuretics C) aspirin

D) tylenol - B) diuretics Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

A) stiff muscles

B) tachycardia C) confusion D) bradypnea - B) tachycardia You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:

A) accurate because shivering affects hemoglobin binding B) secondary to decreased perfusion in the extremities C) a direct reflection of his increased respiratory rate

D) accurate because he has signs of respiratory failure - B) secondary to decreased perfusion in the extremities Cardiorespiratory response when core body temperature falls into the range of 89ºF to 92ºF (31.7ºC to 33.3ºC) involves .

A) Constricted blood vessels and rapid breathing B) Slowing respirations and a slow pulse C) Weak pulse, dysrhythmias, very slow respirations D) Cardiac arrest - B) Slowing respirations and a slow pulse You arrive at the scene and find the patient sitting under a tree in his garden; he is conscious, but confused. His wife tells you that he has been working outside all day. She further states that he refused to take a break and drink some water. Your assessment finds a flushed appearance; weak and rapid radial pulses; and hot, moist skin. Based on this, you suspect that your patient is suffering from .

A) Heat cramps B) Heat exhaustion C) Heat stroke D) Heat asphyxia - C) heat stroke There are several clinical findings that indicate your patient is experiencing the most serious heat illness, heat stroke. Unlike other, less-severe forms of heat illness, patients with heat stroke have an altered LOC and flushed, hot skin. Your patient has both of these.

Hypothermia is diagnosed when the core body temperature falls below what temperature?

A) 90F B)98F C)95F

D)92F - C) 95F Shivering stops and muscle activity ceases once the body's core temp[erature reaches what?

A) 95F B)85F C)90F D)80F - 90F Rough handling of a patient with severe hypothermia may cause which of the following dysrhythmias?

A) Ventricular fibrillation B) Sinus bradycardia C) Asystole D) Sinus tachycardia - A) Ventricular fibrillation Rough handling of a patient with moderate to severe hypothermia may cause the heart to go into ventricular fibrillation.

In the context of an environment that is 90°F with 85% humidity, what does moist, pale, cool skin indicate?

A) The body can no longer regulate core temperature.

B) The patient is hypothermic.

C) There has been excessive fluid and salt loss.

D) Core body temperature and ambient temperature are equal. Answer - C) There has been excessive fluid and salt loss.

What is often the first sign of heat stroke?

A) Change in behavior

B) Muscle cramps C) Low pulse rate and blood pressure D) Profuse sweating - A) Change in behavior In which of the following environmental emergencies are you most likely to encounter laryngospasm?

A) After being bitten by a coral snake B) Drowning C) Hyperthermia D) A tick bite - B) Drowning What is the most dangerous, and most common, emergency in scuba diving?

A) Air embolism B) Decompression sickness C) Diving reflex D) Drowning - A) Air embolism You are treating a patient who was climbing a 10,000-foot mountain when he began to experience a severe, constant, throbbing headache; ataxia; and extreme fatigue. He is nauseated and, as you assess him, he loses consciousness. Which of the following should you suspect?

A) HACE B) HAPE C) Mountain sickness D) Rocky Mountain spotted fever - A) HACE You suspect that the patient you are treating was bitten by a rattlesnake. What should you do first?

A) Apply ice to the wound.

B) Catch the snake so you can take it to the ED. C) Place the patient is a supine position.

D) Apply suction to the wound to suck out the venom - C) Place the patient is a supine position.

A person who stands outside in windy, wintry weather and wears only lightweight clothing is experiencing heat loss mainly by what method?

A) Conduction B) Convection C) Evaporation D) Respiration - B) Convection A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should - Place her on her side, administer high-flow oxygen, and transport.

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: - An ectopic pregnancy A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: - 16 hours A nuchal cord is defined as an umbilical cord that: - Is wrapped around the baby's neck A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: - Pregnant patients have an overall increase in blood volume By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: Belly button

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: - Positive-pressure ventilations During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? - Apply gentle pressure to the baby's head as it delivers Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should - Firmly massage the uterine fundus with a circular motion From what internal female organ is the fetus expelled during delivery? - Uterus The amniotic fluid serves to - Insulate and protect the fetus If a baby is born at 7:52, the second Apgar score should be calculated at - 7:57 The presence of meconium in the amniotic fluid indicates - That the baby's airway may be obstructed Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect - Pulmonary embolism When determining the frequency of contractions, you should time the contractions from the Start of one to the start of the next When preparing a pregnant patient for delivery, you should position her - On a firm surface with her hips elevated 2 to 4 inches Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? - "have you had a sonogram?"

You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child.

The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: - respect the patients wishes, ensure that the appropriate documentation is completed, and transport the patient You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should - Continue your care in a private area, document any details regarding the scene and the incident and reassure her as you provide Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes - Placing the mother supine with her head down and pelvis elevated

1. The first stage of labor ends when: * 10/10 the presenting part of the baby is visible. contractions are less than 10 minutes apart. the mother experiences her first contraction. the amniotic sac ruptures and labor pains begin. Answer - the presenting part of the baby is visible.

2. A 23-year-old woman, who is 24 weeks pregnant with her first baby, complains of edema to her hands, a headache, and visual disturbances. When you assess her vital signs, you note that her blood pressure is 160/94 mm Hg. She is MOST likely experiencing: * 10/10 eclampsia. preeclampsia. a hypertensive crisis.

chronic water retention. Answer - preeclampsia

3. You are transporting a woman who is eight months pregnant. To prevent supine hypotensive syndrome, how should you position this patient? * 10/10 On her right side Supine Semi-Fowler's On her left side - On her left side

4. Immediately after delivery of the infant's head, you should: * 10/10 suction the baby's mouth and then nose. suction the baby's nose and then mouth. assess the baby's breathing effort and skin color. check the position of the umbilical cord - check the position of the umbilical cord.

5. Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should: * 10/10 immediately clamp and cut the cord. make one attempt to slide the cord over the head. keep the cord moist and transport as soon as possible. give the mother high-flow oxygen and transport rapidly. Answer - make one attempt to slide the cord over the head.

6. The need for and extent of newborn resuscitation is based on: * 10/10 the 1-minute Apgar score. the gestational age of the newborn. the newborn's response to oxygen. respiratory effort, heart rate, and color. Answer - respiratory effort, heart rate, and color.

7. The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min, a pink body but blue hands and feet, and rapid respirations. The baby

cries when the soles of its feet are flicked and resists attempts to straighten its legs. You should assign an Apgar score of: * 10/10 4.

6.

8.

9. - 8 8. The MOST effective way to prevent cardiopulmonary arrest in a newborn is to: * 10/10 rapidly increase its body temperature. allow it to remain slightly hypothermic. ensure adequate oxygenation and ventilation. start CPR if the heart rate is less than 100 beats/min. Answer - ensure adequate oxygenation and ventilation.

9. While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. She tells you that she feels the urge to push. You should: * 10/10 cover the arm with a sterile towel and transport immediately. encourage her to keep pushing as you prepare for rapid transport. insert your gloved fingers into the vagina and try to turn the baby. instruct the mother to keep pushing and give her high-flow oxygen. Answer - cover the arm with a sterile towel and transport immediately.

10. A newborn is considered to be "term" if it is born after weeks. * 10/10 34, 37 37, 42 38, 44 39, 43 - 37, 42

weeks and before

1) As the baby's head is delivered, you notice the amniotic sac still intact. Your next step should be to 4/4

.*

A) leave the sac intact until the entire body is delivered B) use the scissors in the obstetrics kit to cut the sac away from the baby's head C) use your gloved fingers to tear the sac away from the baby's face D) call medical direction before taking action - C) use your gloved fingers to tear the sac away from the baby's face

2) While doing a presentation to an emergency medical responder class on emergency childbirth you describe that the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients, is called the .* 4/4 A) amnion

B) uterus C) placenta D) cervix - C 3) A potentially life -threatening condition in which a fertilized egg implants and begins to develop in an area other than the uterus is called 4/4

.*

A) ectopic pregnancy B) abrupto placentae C) supine hypertensive syndrome D) preeclampsia - A 4) Your patient is eight months pregnant. She was involved in a motor vehicle crash, but you suspect no spinal injury. How should you position her on the gurney? * 4/4

A) Supine B) Left lateral recumbent C) Fowler's D) Right lateral recumbent - B

5) Your patient was involved in a motor vehicle crash. She is seven months pregnant and is complaining of neck pain. How should you prepare her for transport? * 4/4 A) Secure her to a back board with a pillow under her left side.

B) Do not secure her to a backboard.

C) Use a KED extrication device to immobilize her spine then lay her on your gurney.

D) Secure her to the board on her right side. Answer - C 6) You are called to care for a woman who started feeling dizzy and faint after lying down.

She is visibly pregnant and tells you that she is seven months along. As you take her blood pressure, you get an abnormally low reading. What do you suspect might be the reason for her condition? * 0/4

A) The weight of the fetus is putting pressure on her vena cava.

B) She is suffering from preeclampsia.

C) She may be diabetic and has become hyperglycemic.

D) The fetus may be preparing to spontaneously abort. Answer - A 7) You are called to treat a woman who started feeling dizzy and faint after lying down. She is visibly pregnant and tells you that she is seven months along. As you take her blood pressure, you get an abnormally low reading. How would you treat her? * 4/4

A) Have her stand and wait for her vitals to return to normal.

B) Immediately transport her on her back.

C) Roll her onto her left side, then recheck blood pressure.

D) Put her in the Trendelenburg position or elevate her feet. Answer - C 8) You are dispatched to an office complex for a patient in labor. You find a 26 - year-old patient who states she is 9 months pregnant with her first child. She has been having contractions for the past few hours and they are getting closer together. She denies her water breaking. While preparing her for transport, she

states she has to go to the restroom. Your best action in this situation would be to .* 4/4 A) allow her to use the bathroom, as it will make transport, and also delivery, more comfortable B) advise the mother that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible C) tell the mother she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital D) advise the mother that this could be a sign of a serious complication, have her lie on her left side, apply high-flow oxygen, and transport immediately - B

9) While evaluating whether to transport or prepare for imminent delivery, you should look for crowning, which occurs when 4/4

.*

A) bloody mucus is discharged B) the bag of waters ruptures C) the presenting part of the baby is visible at the vaginal opening D) the cervix is completely dilated - C 10) Your 24-year-old patient is in active labor. As you are preparing for delivery, her water breaks. Normally, the amniotic fluid should be 4/4

.*

A) clear and colorless B) thick, greenish-black in color C) thin, greenish-yellow in color D) containing blood and mucus - A 11) You have just assisted with the delivery of a baby girl. Both baby and mother are doing fine and you are preparing for the delivery of the placenta. Which of the following should you do as part of the third stage of labor? * 4/4 A) Forcibly pull on the umbilical cord to facilitate delivery of the placenta.

B) Collect the placenta and place in the plastic bag included in the OB kit.

C) Apply forceful upward pressure on the uterus to help the placenta detach.

D) Place the mother in a supine position with her knees elevated. Answer - B 12) A condition characterized by an attached placenta that obstructs the cervix is called . * 4/4

A) abruptio placentae B) ectopic pregnancy C) preeclampsia D) placenta previa - D 13) When preparing for an otherwise normal prehospital delivery the mother states that she feels the urge to push. You should 4/4

.*

A) have the mother squeeze her legs together to prevent a prehospital birth B) suggest that she use the restroom as this may relieve the urge to push C) check for crowning D) transport immediately - C 14) After delivery of the baby and placenta, it is normal for the mother to have some bleeding. To help control maternal bleeding following delivery, you should .* 4/4 A) carefully insert sterile gauze into the vaginal opening

B) massage the uterus until it is firm and grapefruit-sized C) not allow the infant to nurse D) have the mother squeeze her legs together - B 15) You have assisted with the delivery of a baby who is three weeks premature. The newborn girl is breathing adequately, although you note cyanosis throughout. The heart rate is 140 beats per minute. Your best course of immediate action should be to .* 4/4 A) place oxygen tubing near the infant's face B) place a neonatal nonrebreather on the infant's face C) perform ventilations with a bag-valve-mask device and supplemental oxygen

D) begin cardiopulmonary resuscitation - A 16) As the bag of waters breaks, you notice the presence of thick meconium. This alters your normal delivery process in that you must 4/4

.*

A) be prepared to suction the infant immediately before he takes a breath B) check for fever before suctioning the infant C) vigorously rub the infant's back immediately upon delivery to stimulate breathing D) be prepared for the possibility of multiple births - A 17) You are examining your patient for crowning when you notice that the umbilical cord is the presenting part. Your management of this prolapsed umbilical cord would include 4/4 A) placing the mother in a supine position with pillows under her shoulders B) immediately clamping the cord in two places and cutting it between the clamps

.*

C) placing the mother in a head-down position with shoulders lower than her hips D) using your gloved hand to push the umbilical cord back up through the cervix - C 18) You are called to a private residence for a woman in labor. Upon your arrival, you find a 28 -year-old patient lying on the bed. Her husband states she is pregnant with twins. All of the following are TRUE concerning prehospital delivery of twins EXCEPT . * 4/4

A) there will be two umbilical cords B) you will need to be prepared to care for three patients C) the infants will probably be smaller than a single infant and need special attention in keeping them warm D) there will always be two placentas - D

19) You are assessing a patient in active labor whose due date is still four weeks away. Which of the following statements is TRUE regarding premature infants? * 4/4

A) They can easily develop hyperthermia.

B) They are less susceptible to infection.

C) They are at risk for respiratory difficulty.

D) They will deliver fully developed up to six weeks premature. Answer - C) They are at risk for respiratory difficulty.

20) You have just assisted in the delivery of the baby and placenta. The mother is still bleeding. All of the following are appropriate methods for controlling postpartum bleeding EXCEPT .* 4/4 A) placing a sanitary napkin over the vaginal opening

B) massaging the uterus C) telling the mother to squeeze her legs together D) elevating the mother's feet - C 21) You have just assisted with the delivery of a baby boy. Before cutting the umbilical cord, you need to ensure that the 0/4 A) cord is clamped in three places B) cord is pulsating

.*

C) infant is breathing on his own D) cord has stopped pulsing - D 22) You have decided that birth is imminent and you need to prepare for field delivery.

How should you position the mother as you prepare for delivery? * 4/4 A) On her right side with legs apart

B) Supine with her knees drawn up and spread apart C) In a sitting position on the stretcher D) Prone in the knee-to-chest position - B 23) As you prepare for delivery, you should consider proper BSI precautions and put on a gown, cap, face mask, and eye protection for all of the following reasons EXCEPT 4/4

.*

A) there is a high probability of exposure to bodily fluids after the delivery B) this is considered appropriate for BSI C) there is a high probability of splashing fluids during delivery D) this helps you to give a professional appearance during delivery - D 24) Your assessment of a pregnant patient suggests imminent delivery. You appropriately prepare the expectant mother and yourself. As the baby is delivered, you should do all of the following EXCEPT .* 4/4

A) place your fingers in the armpit to assist with delivery of the shoulders B) position your gloved hands at the vaginal opening C) suction the mouth first, then the nose D) have someone stay at the mother's head, if possible - A 25) You are off duty and out on your morning jog when you encounter a patient in the park about to give birth. Although you call for an ambulance, the mother delivers before the unit's arrival. Which of the following would be the best choice for tying or clamping the umbilical cord? * 0/4

A) White cotton thread B) You should not cut or clamp the umbilical cord C) A clothespin D) A section of a wire coat hanger – B A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: Select one: - cool the child with tepid water and transport to the hospital.

A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the MOST indicative of decompensated shock?

Select one: - B. Blood pressure of 70/40 mm Hg

A viral infection that may cause obstruction of the upper airway in a child is called: Select one croup An infant with severe dehydration would be expected to present with: Select one: absent urine output.

Burns in children are commonly caused by all of the following, EXCEPT: Select one: entrapment in a structural fire.

Common causes of seizures in children include all of the following, EXCEPT: Select one: A. infection.

B. poisonings or ingestion.

C. hyperglycemia.

D. electrolyte imbalances. Answer - C. hyperglycemia.

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: Select one: - drooling or congestion.

Pale skin in a child indicates that the: Select one: - blood vessels near the skin are constricted.

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: Select one: - sunken fontanelles.

The first month of life after birth is referred to as the: Select one: - neonatal period.

The purpose of the pediatric assessment triangle (PAT) is to: Select one: - allow you to rapidly and visually form a general impression of the child.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: - at the feet.

When a child is struck by a car, the area of greatest injury depends MOSTLY on the: Select one: - age of the child and the size of the car that struck him or her.

When assessing an 8-year-old child, you should: Select one: - Talk to the child, not just the caregiver When caring for a female child who has possibly been sexually abused, you should: Select one: - have a female EMT remain with her if possible.

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence initially?

Select one: - Why did your child ingest the poison?

Which of the following findings is LEAST suggestive of child abuse? Select one: Consistency in the method of injury reported by the caregiver Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?

Select one - Death as a result of SIDS can occur at any time of the day or night.

While triaging patients at the scene of a motor-vehicle crash, you encounter a 5- year-old child who is unresponsive and apneic. After positioning his airway, you should: Select one: - palpate for a carotid pulse.

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-monthold female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

Select one - administering blow-by oxygen and transporting the child with her mother.

The first month of life after birth is referred to as the: A. neonatal period.

B. toddler period.

C. start of infancy.

D. premature phase. Answer - A. neonatal period.

Which of the following statements regarding a 3-month-old infant is correct?

A. The infant is unable to turn his or her head and focus.

B. The infant should be aroused easily from a sleeping state.

C. At this age, the infant typically sleeps for up to 8 hours a day.

D. A 3-month-old infant can distinguish a parent from a stranger. Answer - D. A 3-month- old infant can distinguish a parent from a stranger.

A child may begin to show signs of separation anxiety as early as: A. 6 months.

B. 12 months.

C. 18 months.

D. 24 months. Answer - A. 6 months.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: A. at the feet.

B. at the head.

C. in the ambulance.

D. en route to the hospital. Answer - A. at the feet.

Which of the following statements regarding preschool-age children is correct?

A. They realize that injuries are not a form of punishment.

B. Preschoolers are usually not fearful of pain or separation.

C. The preschool age begins after the child turns 2 years old.

D. They can usually identify painful areas when questioned. Answer - D. They can usually identify painful areas when questioned.

When assessing an 8-year-old child, you should:

A. refrain from taking a blood pressure.

B. talk to the child, not just the caregiver.

C. use a toe-to-head assessment approach.

D. rely solely on the parent for information. Answer - B. talk to the child, not just the caregiver.

When assessing or treating an adolescent patient, it is important to remember that: A. they usually do not wish to be observed during a procedure.

B. it is generally not necessary to explain procedures in advance.

C. they often request medication to help in the relief of severe pain.

D. they cannot understand complex concepts and treatment options. Answer - A. they usually do not wish to be observed during a procedure.

Which of the following statements regarding a pediatric patient's anatomy is correct?

A. The tracheal rings of a child are more rigid than an adult's.

B. A child's tongue is proportionately smaller than an adult's.

C. Children have a larger, rounder occiput compared to adults.

D. The child's epiglottis is less floppy and smaller than an adult's. Answer - C. Children have a larger, rounder occiput compared to adults.

The normal respiratory rate for a newborn should not exceed

breaths/min.

A. 50 B. 60 C. 70 D. 80 - B. 60 Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the: A. intercostal muscles are not well developed.

B. rib cage is rigid and provides little flexibility.

C. abdominal organs force the diaphragm upward.

D. upper airway is smaller and easily collapsible. Answer - A. intercostal muscles are not well developed.

Pale skin in a child indicates that the: A. child is in severe decompensated shock.

B. oxygen content in the blood is decreased.

C. blood vessels near the skin are constricted.

D. child's core body temperature is elevated. Answer - C. blood vessels near the skin are constricted.

Signs of vasoconstriction in the infant or child include:

A. warm, dry skin.

B. weak distal pulses.

C. a rapid heart rate.

D. brisk capillary refill. Answer - B. weak distal pulses.

Which of the following statements regarding spinal injuries in pediatric patients is correct?

A. Because of a child's proportionately large head, they are more prone to spinal cord injuries than adults.

B. The majority of cervical spine injuries in children are partial transections of the spinal cord, resulting in partial paralysis.

C. Most cervical spine fractures in infants and children occur between the first and second cervical vertebrae.

D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head. Answer - D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are:

A. proportionately larger and situated more anteriorly.

B. more vascular despite the fact that they are proportionately smaller.

C. spaced further apart, which causes them to shift following trauma.

D. lower in the abdominal cavity, where the muscles are not as strong. Answer - A. proportionately larger and situated more anteriorly.

The suture of the anterior fontanelle is typically closed by and the suture of the posterior fontanelle is typically closed by months of age.

months of age,

A. 2, 4 B. 6, 12 C. 12, 4 D. 18, 6 - D. 18, 6 The purpose of the pediatric assessment triangle (PAT) is to: A. determine if the child's vital signs are within the age-appropriate limits.

B. allow you to rapidly and visually form a general impression of the child.

C. facilitate a rapid head-to-toe assessment of the child by visualization only.

D. gather critical data by performing a rapid hands-on assessment of the child. Answer - B. allow you to rapidly and visually form a general impression of the child.

The components of the PAT are: A. appearance, work of breathing, and skin circulation.

B. mental status, heart rate, and systolic blood pressure.

C. skin condition, respiratory rate, and level of alertness.

D. activity, respiratory quality, and level of consciousness. Answer - A. appearance, work of breathing, and skin circulation.

After using the PAT to form your general impression of a sick or injured child, you should: A. evaluate the child's baseline vital signs.

B. obtain a SAMPLE history from the parents.

C. perform a hands-on assessment of the ABCs. D. assess the child's heart rate and skin condition. Answer - C. perform a hands-on assessment of the ABCs.

A normal level of consciousness in an infant or child is characterized by: A. normal interactiveness, awareness to time, and pink skin color.

B. awareness to place, pink and dry skin, and consistent eye contact.

C. crying or combativeness, good muscle tone, and awareness to time.

D. age-appropriate behavior, good muscle tone, and good eye contact. Answer - D. ageappropriate behavior, good muscle tone, and good eye contact.

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-monthold female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

A. requesting a paramedic ambulance to insert an advanced airway device.

B. separating the child from her mother and providing ventilatory assistance.

C. administering blow-by oxygen and transporting the child with her mother.

D. allowing the child to remain with her mother and applying a nasal cannula. Answer - C. administering blow-by oxygen and transporting the child with her mother.

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: A. cyanosis.

B. tachypnea.

C. retractions.

D. abnormal airway noise. Answer - A. cyanosis.

Before assessing the respiratory adequacy of an semiconscious infant or child, you must: A. routinely suction the mouth to remove oral secretions.

B. ensure that the airway is patent and clear of obstructions.

C. insert a nasopharyngeal or oropharyngeal airway adjunct.

D. ensure that his or her head is in a hyperextended position. Answer - B. ensure that the airway is patent and clear of obstructions.

You are dispatched to a local elementary school for an injured child. As you approach the child, you note

that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should: A. begin immediate rescue breathing.

B. stabilize his head and check for a pulse.

C. perform a head tilt-chin lift maneuver.

D. open his airway and look in his mouth. Answer - B. stabilize his head and check for a pulse.

Before positioning an infant or child's airway, you should: A. put padding behind his or her head.

B. thoroughly suction his or her airway.

C. rule out an injury to the spinal cord.

D. place him or her on a firm surface. Answer - D. place him or her on a firm surface.

To ensure that the airway of an infant or small child is correctly positioned, you may have to: A. place bulky padding behind his or her occiput.

B. place a towel or folded sheet behind the shoulders.

C. slightly flex the neck to prevent tracheal kinking.

D. hyperextend the neck to ensure adequate alignment. Answer - B. place a towel or folded sheet behind the shoulders.

When assessing an infant's ventilation status, you should:

A. observe the chest for rise and fall.

B. rule out hypoxia if cyanosis is absent.

C. palpate the abdomen for rise and fall.

D. give oxygen if the SpO2 is less than 90%. Answer - C. palpate the abdomen for rise and fall.

All of the following are normal findings in an infant or child, EXCEPT:

A. quiet breathing.

B. fear or anxiety.

C. belly breathing.

D. head bobbing. Answer - D. head bobbing.

Drawing in of the muscles between the ribs or of the sternum during inspiration is called: A. tenting.

B. retracting.

C. hyperpnea.

D. accessory muscle use. Answer - B. retracting.

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: A. stridor.

B. rhonchi.

C. grunting.

D. wheezing. Answer - A. stridor.

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or pulse.

A. radial

B. carotid C. femoral D. popliteal - C. femoral After determining that an infant or child has strong central pulses, you should: A. assume the child is hypertensive.

B. not rule out compensated shock.

C. conclude that the child is stable.

D. assess his or her respiratory effort. Answer - B. not rule out compensated shock.

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: A. 2 seconds.

B. 3 seconds.

C. 4 seconds.

D. 5 seconds. Answer - A. 2 seconds.

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: A. 4 years.

B. 6 years.

C. 8 years.

D. 10 years. Answer - B. 6 years.

Immediate transport is indicated for a child when he or she:

A. is experiencing mild to moderate pain.

B. falls from a height greater than 5′.

C. has a possible closed fracture of the radius.

D. has a history suggestive of a serious illness. Answer - D. has a history suggestive of a serious illness.

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: A. apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport.

B. insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center.

C. apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment.

D. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and

prepare for immediate transport to a trauma center. Answer - D. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

If the situation allows, a child should be transported in a car seat if he or she weighs less than lb.

A. 40 B. 50 C. 60

D. 70 - A. 40 Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?

A. sexual activity B. past medical history C. change in bladder habits D. duration of symptoms - A. sexual activity The secondary assessment of a sick or injured child:

A. is a rapid head-to-toe exam to detect life threats.

B. should be performed, regardless of the circumstances.

C. may not be possible if the child's condition is critical.

D. is most appropriate when your transport time is short. Answer - C. may not be possible if the child's condition is critical.

Blood pressure is usually not assessed in children younger than

years.

A. 3 B. 4 C. 5 D. 6 - A. 3 Which of the following represents a low normal systolic blood pressure for a 6- year-old child?

A. 82 mm Hg

B. 88 mm Hg C. 90 mm Hg D. 98 mm Hg - A. 82 mm Hg Early signs of respiratory distress in the child include:

A. cyanosis.

B. bradycardia.

C. restlessness.

D. decreased LOC. Answer - C. restlessness.

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:

A. grunting.

B. wheezing.

C. assuming a tripod position.

D. retracting the intercostal muscles. Answer - A. grunting.

The MOST ominous sign of impending cardiopulmonary arrest in infants and children is: A. pallor.

B. retractions.

C. nasal flaring.

D. bradycardia. Answer - D. bradycardia.

A viral infection that may cause obstruction of the upper airway in a child is called: A. croup.

B. asthma.

C. bronchitis.

D. epiglottitis. Answer - A. croup.

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

A. extreme restlessness.

B. drooling or congestion.

C. skin that is cool and dry.

D. acute respiratory distress. Answer - B. drooling or congestion.

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: A. wheezing.

B. a weak cough.

C. a cough that resembles the bark of a seal.

D. stridorous breathing. Answer - A. wheezing.

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

A. carefully look into his mouth and remove the object if you see it.

B. encourage him to cough, give oxygen as tolerated, and transport.

C. deliver a series of five back blows and then reassess his condition.

D. place the child in a supine position and perform abdominal thrusts. Answer - B. encourage him to cough, give oxygen as tolerated, and transport.

Signs of a severe airway obstruction in an infant or child include: A. pink, dry skin.

B. crying and anxiety.

C. an ineffective cough.

D. mild respiratory distress. Answer - C. an ineffective cough.

A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

A. perform abdominal thrusts.

B. visualize the child's airway.

C. perform a blind finger sweep.

D. give oxygen and transport at once. Answer - A. perform abdominal thrusts.

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless.

Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving highflow oxygen via a nonrebreathing mask. You should:

A. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

B. continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol.

C. begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles.

D. begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min. Answer - A. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to: A. estimate the child's weight based on age.

B. use a length-based resuscitation tape measure.

C. estimate the child's weight based on appearance.

D. ask a relative if he or she knows the child's weight. Answer - B. use a length-based resuscitation tape measure.

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:

A. depress the gag reflex.

B. cause the child to vomit.

C. result in airway swelling.

D. result in a soft-tissue injury. Answer - B. cause the child to vomit.

When inserting an oropharyngeal airway in an infant or child, you should: A. place padding under the child's head.

B. ensure that his or her neck is hyperextended.

C. insert it until the flange rests on the teeth.

D. depress the tongue with a tongue depressor. Answer - B. ensure that his or her neck is hyperextended.

Which of the following statements regarding the use of nasopharyngeal airways in children is correct?

A. They are rarely used in infants younger than 1 year.

B. It is the recommended adjunct for children with head trauma.

C. They are usually not well tolerated in children with a gag reflex.

D. Blanching of the nares after insertion indicates correct placement. Answer - A. They are rarely used in infants younger than 1 year.

If a nasopharyngeal airway is too long, it may: A. result in tachycardia.

B. push the tongue anteriorly.

C. stimulate the vagus nerve.

D. become obstructed by mucus. Answer - C. stimulate the vagus nerve.

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: A. an oral airway has been inserted.

B. his or her tidal volume is adequate.

C. his or her respirations are shallow.

D. he or she is breathing inadequately. Answer - B. his or her tidal volume is adequate.

Which of the following children would benefit the LEAST from a nonrebreathing mask?

A. a conscious 4-year-old male with adequate tidal volume B. a responsive 6-year-old male who responds appropriately C. an unresponsive 5-year-old male with shallow respirations

D. a semiconscious 7-year-old female with normal ventilation - C. an unresponsive 5-year-old male with shallow respirations When administering oxygen to a frightened child, it would be MOST appropriate to: A. place oxygen tubing through a hole in a paper cup.

B. tightly secure the oxygen mask straps to the face.

C. have a parent restrain the child as you give oxygen.

D. use a nasal cannula instead of a nonrebreathing mask. Answer - A. place oxygen tubing through a hole in a paper cup.

When ventilating a pediatric patient with a bag-mask device, the EMT should:

A. block the pop-off valve if needed to achieve adequate chest rise.

B. squeeze the bag 40 times/min when ventilating an infant.

C. ensure that he or she uses a neonatal device for children younger than 12 months.

D. ventilate the child with sharp, quick breaths at the appropriate rate. Answer - A. block the pop-off valve if needed to achieve adequate chest rise.

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to:

A. monitor the child's heart rate.

B. observe the child's skin color.

C. monitor the pulse oximeter reading.

D. observe the chest for adequate rise. Answer - D. observe the chest for adequate rise.

Cardiac arrest in the pediatric population is MOST commonly the result of: A. a complete airway obstruction.

B. respiratory or circulatory failure.

C. a congenital cardiovascular defect.

D. lethal cardiac rhythm disturbances. Answer - B. respiratory or circulatory failure.

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:

A. irritability of the left ventricle.

B. a sudden ventricular arrhythmia.

C. severe hypoxia and bradycardia.

D. acute hypoxia and tachycardia. Answer - C. severe hypoxia and bradycardia.

A common cause of shock in an infant is: A. a cardiac arrhythmia.

B. dehydration from vomiting and diarrhea.

C. excessive tachycardia.

D. cardiovascular disease. Answer - B. dehydration from vomiting and diarrhea.

Blood loss in a child exceeding significantly increases the risk of shock.

A. 5% B. 15% C. 25% D. 35% - C. 25%

of his or her total blood volume

Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?

A. heart rate B. blood pressure C. skin condition D. capillary refill - B. blood pressure Common causes of seizures in children include all of the following, EXCEPT: A. infection.

B. hyperglycemia.

C. electrolyte imbalances.

D. poisonings or ingestion. Answer - B. hyperglycemia.

Febrile seizures are MOST common in children between: A. 3 months and 4 years.

B. 6 months and 6 years.

C. 8 months and 8 years.

D. 18 months and 10 years. Answer - B. 6 months and 6 years.

In most children, febrile seizures are characterized by: A. a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase.

B. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase.

C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.

D. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase. Answer - C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.

Febrile seizures in a child: A. typically last less than 30 minutes.

B. occur after a week of a febrile illness.

C. are usually caused by viral meningitis.

D. may indicate a serious underlying illness. Answer - D. may indicate a serious underlying illness.

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: A. allow the mother to drive her daughter to the hospital.

B. attempt cooling measures, offer oxygen, and transport.

C. place the child in cold water to attempt to reduce her fever.

D. suspect that the child has meningitis and transport at once. Answer - B. attempt cooling measures, offer oxygen, and transport.

Which of the following groups of people is associated with the lowest risk of meningitis?

A. newborns B. females C. geriatrics D. children with shunts - B. females Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: A. sunken fontanelles.

B. headache and fever.

C. a stiff or painful neck.

D. an altered mental status. Answer - A. sunken fontanelles.

Children with N meningitides would MOST likely present with: A. cherry-red spots or a purplish rash.

B. a low-grade fever and tachycardia.

C. hypothermia and an irregular pulse.

D. a generalized rash with intense itching. Answer - A. cherry-red spots or a purplish rash.

The signs and symptoms of poisoning in children: A. vary widely, depending on the child's age and weight.

B. are more obvious than in the adult population.

C. usually present within the first 10 minutes of ingestion.

D. are most severe if the child ingested a poisonous substance. Answer - A. vary widely, depending on the child's age and weight.

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence?

A. What time did the ingestion occur?

B. Have you noticed any signs or symptoms?

C. Why did your child ingest the poison?

D. Do you know what substance was ingested? - C. Why did your child ingest the poison?

A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should: A. place her supine and elevate her legs.

B. monitor her airway and give oxygen.

C. determine why the ingestion occurred.

D. give 12.5 to 25 g of activated charcoal. Answer - B. monitor her airway and give oxygen.

Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?

A. 12.5 g B. 20 g C. 25 g D. 50 g - B. 20 g The MOST common cause of dehydration in pediatric patients is: A. high fever.

B. internal blood loss.

C. vomiting and diarrhea.

D. refusal to drink fluids. Answer - C. vomiting and diarrhea.

An infant with severe dehydration would be expected to present with: A. excessive tearing.

B. moist oral mucosa.

C. bulging fontanelles.

D. absent urine output. Answer - D. absent urine output.

Signs of severe dehydration in an infant include all of the following, EXCEPT: A. profound tachycardia.

B. slowed level of activity.

C. delayed capillary refill.

D. dry mucous membranes. Answer - B. slowed level of activity.

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours.

The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect: A. mild dehydration.

B. moderate dehydration.

C. severe dehydration.

D. hypovolemic shock. Answer - B. moderate dehydration.

The EMT should be MOST concerned when a child presents with fever and: A. chills.

B. a rash.

C. ear pain.

D. a headache. Answer - B. a rash.

Hyperthermia differs from fever in that it is an increase in body temperature: A. of more than 2°F to 3°F per hour.

B. secondary to a severe bacterial infection.

C. caused by inflammation of the spinal cord.

D. caused by the inability of the body to cool itself. Answer - D. caused by the inability of the body to cool itself.

Submersion injuries in the adolescent age group are MOST commonly associated with: A. alcohol.

B. child abuse.

C. hyperthermia.

D. swimming pools. Answer - A. alcohol.

Which of the following statements regarding pediatric trauma is correct?

A. Children are less likely than adults to be struck by a car.

B. A child's head is less frequently injured than an adult's.

C. Children are more likely to experience diving-related injuries.

D. Inexperience and poor judgment are rare causes of pediatric trauma. Answer - C. Children are more likely to experience diving-related injuries.

When a child is struck by a car, the area of greatest injury depends MOSTLY on the: A. speed at which the car was traveling when impact occurred.

B. size of the child and the height of the bumper upon impact.

C. age of the child and the size of the car that struck him or her.

D. height of the child and the speed at which the car was traveling. Answer - B. size of the child and the height of the bumper upon impact.

Which of the following is MORE common in children than in adults following a head injury?

A. spinal cord injury B. loss of consciousness C. seizures and hypoxia D. nausea and vomiting - D. nausea and vomiting When immobilizing an injured child in a pediatric immobilization device, you should: A. secure the head before the torso.

B. slide the device under the child.

C. pad underneath the child's head.

D. secure the torso before the head. Answer - D. secure the torso before the head.

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: A. older than 8 to 10 years.

B. complaining of severe back pain.

C. immobilized on a long backboard.

D. experiencing cardiopulmonary arrest. Answer - A. older than 8 to 10 years.

The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal

immobilization device if: A. the car seat is visibly damaged.

B. he or she has no visible injuries.

C. his or her vital signs are stable.

D. he or she even has a minor injury. Answer - A. the car seat is visibly damaged.

When a child experiences a blunt chest injury: A. the flexible rib cage protects the vital thoracic organs.

B. the flexible ribs can be compressed without breaking.

C. the sudden force against the ribs causes them to fracture.

D. there is usually obvious injury to the external chest wall. Answer - B. the flexible ribs can be compressed without breaking.

When a child experiences a blunt injury to the abdomen: A. he or she can compensate for blood loss better than adults.

B. his or her blood pressure falls with as little as 5% blood loss.

C. your assessment will most often reveal bruising to the abdomen.

D. delayed capillary refill indicates a state of decompensated shock. Answer - A. he or she can compensate for blood loss better than adults.

Burns in children are commonly caused by all of the following, EXCEPT: A. hot items on a stovetop.

B. scalding water in a bathtub.

C. exposure to caustic chemicals.

D. entrapment in a structural fire. Answer - D. entrapment in a structural fire.

Critical burns in children include: A. any superficial or partial-thickness burn that involves the legs or arms.

B. partial-thickness burns covering more than 20% of the body surface.

C. second-degree burns covering more than 10% of the body surface.

D. superficial burns covering more than 10% to 15% of the body surface. Answer - B. partial-thickness burns covering more than 20% of the body surface.

Greenstick fractures occur in infants and children because: A. the growth plate is commonly injured.

B. their bones are more brittle than an adult's.

C. their bones bend more easily than an adult's.

D. twisting injuries are more common in children. Answer - C. their bones bend more easily than an adult's.

Effective methods for providing pain relief to a child with an extremity injury include: A. separating the child from his or her parents.

B. positioning, ice packs, and emotional support.

C. avoiding the placement of a splint, if possible.

D. heat compresses and lowering the injured extremity. Answer - B. positioning, ice packs, and emotional support.

Which of the following findings is LEAST suggestive of child abuse?

A. evidence of alcohol consumption or drug use at the scene B. burns to the hands or feet that involve a glove distribution C. consistency in the method of injury reported by the caregiver D. an unexplained delay in seeking medical care after the injury - C. consistency in the method of injury reported by the caregiver Bruising to the A. shins B. back C. face D. buttocks - A. shins

is LEAST suggestive of child abuse.

Death caused by shaken baby syndrome is usually the result of: A. bleeding in the brain.

B. multiple open fractures.

C. intra-abdominal hemorrhage.

D. fracture of the cervical spine. Answer - A. bleeding in the brain.

With regard to the legal implications of child abuse: A. child abuse must be reported only if it can be proven.

B. EMTs must report all suspected cases of child abuse.

C. you should document your perceptions on the run form.

D. a supervisor can forbid you from reporting possible abuse. Answer - B. EMTs must report all suspected cases of child abuse.

When caring for a female child who has possibly been sexually abused, you should: A. encourage the child to urinate and take a shower.

B. have a female EMT remain with her if possible.

C. carefully examine the genitalia for signs of injury.

D. immediately report your suspicions to the parents. Answer - B. have a female EMT remain with her if possible.

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?

A. Certain cases of SIDS are predictable and therefore preventable.

B. SIDS is most commonly the result of an overwhelming infection.

C. Most cases of SIDS occur in infants younger than 6 months.

D. The cause of death following SIDS can be established by autopsy. Answer - C. Most cases of SIDS occur in infants younger than 6 months.

Which of the following is NOT a known risk factor of SIDS? A. mother younger than 20 years B. low birth weight C. putting a baby to sleep on his or her back D. mother smoked during pregnancy - C. putting a baby to sleep on his or her back Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: A. child abuse.

B. meningitis.

C. severe infection.

D. hyperglycemia. Answer - D. hyperglycemia.

During the attempted resuscitation of an infant with suspected SIDS: A. discourage the family from observing.

B. allow the family to observe if they wish.

C. a law enforcement officer must be present.

D. give detailed updates to the infant's parents. Answer - B. allow the family to observe if they wish.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma.

He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that: - B. the patient is experiencing delirious behavior, which suggests a new health problem A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n) - C. advance directive.

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect: - B. a systemic infection.

An abdominal aortic aneurysm: - B. is often the result of hypertension and atherosclerosis.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: - A. attempt to differentiate between chronic and acute problems Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: - B. renal insufficiency.

Clouding of the lenses of the eyes is called: - D. cataracts.

Common causes of depression in the elderly include all of the following, EXCEPT: - B. an acute onset of dementia.

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: - C. a decreased ability to cough. n contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: - C. the body is less able to adapt the BP to rapid postural changes.

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of elder abuse. Answer - D. physical Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: - C. pneumonia.

Talking about an elderly patient in front of him or her to other members of the family: - B. may cause the patient to think that he or she has no say in making decisions.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with: - A. tachypnea and paroxysmal nocturnal dyspnea.

The leading cause of death in the geriatric patient is: - B. heart disease.

The stooped posture of some older people, which gives them a humpback appearance, is called: D. kyphosis To minimize distractions and confusion when assessing an older patient, you should: - B. have only one EMT speak to the patient at a time.

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: - C. place blankets behind the patient's head.

Which of the following observations or statements represents the "E" in the GEMS diamond? - C. The patient's residence is cold due to a malfunctioning heater.

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow.

This patient's clinical presentation is MOST consistent with: - B. hyperosmolar hyperglycemic nonketotic syndrome.

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should: - D. disconnect the ventilator and apply a tracheostomy collar.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: - D. try repositioning the hearing aid or remove it and turn down the volume.

A person is said to be obese when he or she is weight. Answer - C. 30% or more

over his or her ideal

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): - D. colostomy.

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? - A. Check the mechanical ventilator for malfunction.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): - D. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

Because a tracheostomy tube bypasses the nose and mouth: - C. secretions can build up in and around the tube Cerebral palsy is characterized by poorly controlled Answer - D. body

movement.

Common complications associated with central venous catheters include all of the following, EXCEPT: - A. rupture of a central vein Down syndrome is a genetic defect that occurs as the result of: - B. a triplication of chromosome 21.

Spina bifida is defined as: - D. a birth defect caused by incomplete closure of the spinal column.

The purpose of a ventricular peritoneum shunt is to: - C. prevent excess cerebrospinal fluid from accumulating in the brain.

Under what circumstances is a left ventricular assist device used? - D. As a bridge to heart transplantation while a donor heart is being located When caring for a patient who is visually impaired, it is important to: - B. tell him or her what is happening, identify noises, and describe the situation and surroundings.

Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy? - . Seizure disorder Which of the following statements regarding autism is correct? - A. Most cases of autism are diagnosed by 3 years of age.

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? - A. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

Which of the following statements regarding patients with intellectual disabilities is correct? C. Patients with intellectual disabilities are susceptible to the same disease processes as other patients Which of the following would be the MOST practical method of communicating with a hearingimpaired patient until his or her hearing aids can be located? - D. Using a piece of paper and writing utensil to ask questions You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: D. avoid placing him in a supine position if possible and administer oxygen.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A. try repositioning the hearing aid or remove it and turn down the volume.

B. recognize that the batteries in his hearing aids are probably depleted.

C. remove both of his hearing aids and use pencil and paper to communicate.

D. remove his hearing aids, turn up the volume, and replace them in his ears. Answer - A. try repositioning the hearing aid or remove it and turn down the volume.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical.

B. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.

C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

D. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. Answer - C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

Which of the following would be the MOST practical method of communicating with a hearingimpaired patient until his or her hearing aids can be located?

A. Contacting dispatch and requesting a sign language interpreter B. Using a high-pitched voice while speaking directly into the ear C. Using a piece of paper and writing utensil to ask questions D. Attempting to use body language to determine the problem - C. Using a piece of paper and writing utensil to ask questions Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?

A. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness.

B. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition.

C. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

D. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. Answer - C. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

Under what circumstances is a left ventricular assist device used?

A. To permanently replace the function of one or both of the ventricles B. To ensure that the ventricles contract at an adequate and consistent rate C. As a bridge to heart transplantation while a donor heart is being located D. To reduce ventricular pumping force in patients with aortic aneurysms - C. As a bridge to heart transplantation while a donor heart is being located

Cerebral palsy is characterized by poorly controlled - movement.

A. eye B. body C. extremity D. neck - B. body A person is said to be obese when he or she is - over his or her ideal weight.

A. 30% or more B. 10% or more C. 20% or more D. 40% or more - A. 30% or more When caring for a patient who is visually impaired, it is important to: A. stand to the side of the patient when speaking if his or her peripheral vision is impaired.

B. tell him or her what is happening, identify noises, and describe the situation and surroundings.

C. leave items such as canes and walkers at the residence if the patient will be carried on a gurney.

D. allow a service dog to remain with the patient at all times, even if the patient is critically ill.

Answer - B. tell him or her what is happening, identify noises, and describe the situation and surroundings.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A. notify the receiving facility and advise them of the patient's weight and status.

B. perform a secondary assessment, focusing on his respiratory system and back.

C. avoid placing him in a supine position if possible and administer oxygen.

D. ask a member of your team to locate the best route to move him to the ambulance. Answer C. avoid placing him in a supine position if possible and administer oxygen.

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should: A. reset the ventilator by unplugging it for 30 to 60 seconds.

B. place a call to the home health agency treating this patient.

C. disconnect the ventilator and apply a tracheostomy collar.

D. attempt to troubleshoot the mechanical ventilator problem. Answer - C. disconnect the ventilator and apply a tracheostomy collar.

Which of the following statements regarding patients with intellectual disabilities is correct?

A. An intellectual disability differs from mental retardation in that it is the result of a congenital abnormality.

B. Most patients with intellectual disabilities have normal cognitive function, but abnormal physical features.

C. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.

D. Speaking with the patient's family is the least effective way to determine how much the patient understands. Answer - C. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.

Down syndrome is a genetic defect that occurs as the result of: A. a sperm that contains 24 chromosomes.

B. a separation of chromosome 21.

C. an extra pair of chromosomes.

D. a triplication of chromosome 21. Answer - D. a triplication of chromosome 21.

The purpose of a ventricular peritoneum shunt is to:

A. divert excess cerebrospinal fluid to the ventricles of the brain.

B. prevent excess cerebrospinal fluid from accumulating in the brain.

C. remove fluid from the abdomen of patients with right-sided heart failure.

D. monitor pressure within the skull in patients with a head injury. Answer - B. prevent excess cerebrospinal fluid from accumulating in the brain.

Spina bifida is defined as: A. congenital inflammation of the spinal cord, usually in the neck.

B. a birth defect in which the child is born without spinal vertebrae.

C. chronic pressure on the brain caused by excess cerebrospinal fluid.

D. a birth defect caused by incomplete closure of the spinal column. Answer - D. a birth defect caused by incomplete closure of the spinal column.

Which of the following statements regarding autism is correct?

A. Autism affects females four times greater than males.

B. The majority of patients with autism do not speak at all.

C. Impairment of motor activity is a classic sign of autism.

D. Most cases of autism are diagnosed by 3 years of age. Answer - D. Most cases of autism are diagnosed by 3 years of age.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): A. intestinal shunt.

B. gastric stoma.

C. colostomy.

D. gastrostomy. Answer - C. colostomy.

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?

A. Check the mechanical ventilator for malfunction.

B. Look for blood or other secretions in the tube.

C. Attempt to pass a suction catheter into the tube.

D. Listen to breath sounds to assess for a pneumothorax. Answer - A. Check the mechanical ventilator for malfunction.

Common complications associated with central venous catheters include all of the following, EXCEPT: A. rupture of a central vein.

B. bleeding around the line.

C. clotting of the line.

D. a local infection. Answer - A. rupture of a central vein.

Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy?

A. Seizure disorder B. Paralysis C. Type 2 diabetes D. Brain tumors - A. Seizure disorder Because a tracheostomy tube bypasses the nose and mouth: A. secretions can build up in and around the tube.

B. severe swelling of the trachea and bronchi can occur.

C. bleeding or air leakage may occur around the tube.

D. the risk of a local infection is significantly high. Answer - A. secretions can build up in and around the tube.

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