Emergency Medical Response: Roles, Patient Care, and Trauma Management, Exams of Nursing

Download Emergency Medical Response: Roles, Patient Care, and Trauma Management and more Exams Nursing in PDF only on Docsity! EMT Final Exam with all the correct verified answers (Actual test graded A+) __________ rays easily penetrate through the human body and require lead or several inches of concrete to prevent penetration. - Beta - Neutron - Gamma - Alpha - ANSGamma ____________ is what you can see of a person's response to the environment. - Neurosis - Psychosis - Affect - Behavior - ANSBehavior "Gastro" in the word "gastroenteritis" means: - tongue. - bowel. - stomach. - intestine. - ANSstomach "PASTE" is an alternate assessment tool for ___________. - respiratory patients - stroke patients - cardiac patients - seizure patients - ANSrespiratory patients A "hip" fracture is actually a fracture of the: - proximal femur. - femoral shaft. - pubic symphysis. - pelvic girdle. - ANSproximal femur. 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: - suspect that the child has meningitis and transport at once. - allow the mother to drive her daughter to the hospital. - place the child in cold water to attempt to reduce her fever. - cool the child with tepid water and transport to the hospital. - ANScool the child with tepid water and transport to the hospital. A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should: -reassure the child's mother that seizures in children are very common and that there is nothing to worry about -give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability -attempt to calm the child's mother, but avoid separating her from the child because this will increase her anxiety -ask the father to hold the child so you can assess him while your partner tries to calm the mother - ANSask the father to hold the child so you can assess him while your partner tries to calm the mother A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: - use tweezers to try to remove the object. - thoroughly flush her ear with sterile saline. - remove the peanut with a cotton-tipped swab. unresponsive, has slow and shallow respirations, and has bilaterally closed femur deformities. You should: - obtain baseline vital signs and transport at once. - stabilize her legs with long board splints. - direct your partner to begin ventilatory assistance. - apply oxygen via a nonrebreathing mask. - ANSdirect your partner to begin ventilatory assistance. A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: - continue to insert the airway as you suction her oropharynx. - insert the airway no further but leave it in place as a bite block. - remove the airway and be prepared to suction her oropharynx. - select a smaller oropharyngeal airway and attempt to insert it. - ANSremove the airway and be prepared to suction her oropharynx. 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: - administer oxygen and transport her to the hospital. - advise her to see her physician as soon as possible. - request a paramedic unit to administer epinephrine. - position her legs well above the level of her heart. - ANSadminister oxygen and transport her to the hospital. A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should: - transport him immediately and provide supportive care while en route. - repeat the epinephrine injection after consulting with medical control. - request a paramedic unit that is stationed approximately 15 miles away. - consider that he may actually be experiencing an acute asthma attack. - ANSrepeat the epinephrine injection after consulting with medical control. A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: - apply a tourniquet proximal to the wrist. - wrap the towel with pressure bandages. - administer high-flow supplemental oxygen. - apply pressure to the brachial artery. - ANSapply a tourniquet proximal to the wrist. 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. - 18% - 36% - 45% - 27% - ANS18% A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: - request a paramedic to give her a sedative. - provide reassurance and give oxygen as needed. - have her breathe into a paper or plastic bag. - position her on her left side and transport at once. - ANSprovide reassurance and give oxygen as needed. 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: - apply manual stabilization to both of her femurs. - administer oxygen and perform a rapid assessment. - stabilize her head and perform a primary assessment. - assess for a carotid pulse and assist her ventilations. - ANSstabilize her head and perform a primary assessment. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: - provide care after determining what Dilaudid is used for. - open the patient's airway and assess his respirations. - wait for the police to examine him before providing care. - ask the police to handcuff the patient for safety purposes. - ANSopen the patient's airway and assess his respirations. A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? - High-flow oxygen administration - Full immobilization of her spine - Intravenous fluid administration - Rapid transport to a trauma center - ANSRapid transport to a trauma center 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: 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: - epinephrine. - a beta-antagonist. - albuterol. - an antihistamine. - ANSepinephrine. 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: - apply chemical heat packs to his groin and axillae. - apply an AED and assess his cardiac rhythm. - assess for a carotid pulse for up to 60 seconds. - open his airway and give two rescue breaths. - ANSassess for a carotid pulse for up to 60 seconds. 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: - protect her airway from aspiration. - keep her supine and keep her warm. - rapidly transport her to the hospital. - give her high-flow supplemental oxygen. - ANSprotect her airway from aspiration. 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: - supine positioning, splinting the leg, and transporting. - transporting only with close, continuous monitoring. - elevating the lower extremities and giving antivenin. - applying ice to the wound and transporting quickly. - ANSsupine positioning, splinting the leg, and transporting. 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? - Irrigate it with sterile water and cover it with a dry dressing. - Cover the exposed bowel and keep his legs in a straight position. - Carefully replace the exposed bowel into the abdomen and transport. - Cover it with moist, sterile gauze and secure with an occlusive dressing. - ANSCover it with moist, sterile gauze and secure with an occlusive dressing. A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain and left leg pain. The vehicle is stable and no hazards are present. When removing this patient from his vehicle, you should: - apply a full leg splint prior to extrication. - use the rapid extrication technique. - maintain slight traction to his neck area. - immobilize him with a vest-style device. - ANSimmobilize him with a vest-style device. 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: - acidosis and dehydration. - irreversible renal failure. - severe insulin shock. - hypoxia and overhydration. - ANSirreversible renal failure. A 37-year-old male is found unresponsive in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of: - allergic reactions - heart disease - asthma - hypertension - ANSasthma 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? - Administer oxygen, transport at once, and request a paramedic intercept. - Remain at the scene with the patient and request a paramedic ambulance. - Ask the patient if he has any diphenhydramine tablets that you can administer. - Quickly determine if there are any bystanders who may carry epinephrine. - ANSAdminister oxygen, transport at once, and request a paramedic intercept. 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: - administer 100% supplemental oxygen. - elevate his legs and keep him warm. - apply direct pressure to the wound. - ensure that his airway is patent. - ANSapply direct pressure to the wound. 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: - palpate his radial pulses. - fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. - fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport. - apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport. - ANSfully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. 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: - control the bleeding and cover the wound with a sterile dressing. - assess distal pulses as well as sensory and motor functions. - gently manipulate the injured leg until the numbness dissipates. - manually stabilize the leg above and below the site of injury. - ANScontrol the bleeding and cover the wound with a sterile dressing. 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: - applying direct pressure with a dry, sterile dressing. - administering 100% oxygen via a nonrebreathing mask. - requesting a paramedic to administer pain medication. - covering the avulsion with moist, sterile dressings. - ANSapplying direct pressure with a dry, sterile dressing. A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: - carefully probe the wound to determine if the bleeding is venous or arterial. - thoroughly irrigate the wound with sterile water and cover it with a sterile dressing. - replace the avulsed flap to its original position and cover it with a sterile dressing. - carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. - ANSreplace the avulsed flap to its original position and cover it with a sterile dressing. A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is: - acute myocardial infarction. - cardiogenic hypoperfusion. - severe septic hypoperfusion. - a ruptured aortic aneurysm. - ANScardiogenic hypoperfusion. A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED) and he tells you that he does. You should: - ask him what he takes, how much, and when he last took it. - administer his nitroglycerin and then reassess his blood pressure. - recall that erectile ED drugs can cause significant hypertension. - avoid giving him nitroglycerin and transport him at once. - ANSask him what he takes, how much, and when he last took it. A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? - Acute pulmonary embolism - Rupture of the diaphragm - Exacerbation of his COPD - Spontaneous pneumothorax - ANSSpontaneous pneumothorax A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty and she is tachycardic. The EMT should suspect: - kidney stones. - aortic aneurysm. - strangulated hernia. - acute pancreatitis. - ANSaortic aneurysm. A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the MOST appropriate to ask him? - "Does the pain in your chest move to either of your arms?" - "Were you exerting yourself when the chest pain began?" - "Do you have any heart problems or take any medications?" - "Does the pain in your chest feel like a stabbing sensation?" - ANS"Do you have any heart problems or take any medications?" A 60-year-old man is found to be unresponsive, pulseless, and apneic. You should: - start CPR and transport immediately - begin CPR until an AED is available - determine if he has a valid living will - withhold CPR until he is defibrillated - ANSbegin CPR until an AED is available A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: - place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen. - place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. - perform oropharyngeal suctioning. - insert a nasopharyngeal airway. - apply oxygen via a nonrebreathing mask. - begin assisting the patient's ventilations. - ANSperform oropharyngeal suctioning. A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should: - begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg. - administer oxygen if needed, transport the patient, and monitor him for signs of deterioration. - avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe. - ask him if he has epinephrine and request approval from medical control to administer it to the patient. - ANSadminister oxygen if needed, transport the patient, and monitor him for signs of deterioration. 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: - hyperglycemia. - hypoglycemia. - an acute stroke. - a heart attack. - ANSa heart attack. 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: - because of her age and medical history, you should suspect Alzheimer disease. - dementia typically presents as an acute onset of deterioration of cognitive function. - her mental status is likely the result of hypoglycemia and you should give her sugar. - the patient is experiencing delirious behavior, which suggests a new health problem. - ANSthe patient is experiencing delirious behavior, which suggests a new health problem. A burn that is characterized by redness and pain is classified as a: - partial-thickness burn. - second-degree burn. - superficial burn. - full-thickness burn. - ANSsuperficial burn. A by-product of involuntary muscle contraction and relaxation is: - nitrogen. - oxygen. - lactic acid. - heat. - ANSheat A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): - crush injury. - abrasion. - contusion. - hematoma. - ANScontusion. A decrease in blood pressure may indicate: - increased blood volume. - loss of vascular tone. - arterial constriction. - forceful cardiac contraction. - ANSloss of vascular tone. A disruption of a joint in which the bone ends are no longer in contact is known as what? - Strain - Fracture - Dislocation - Sprain - ANSDislocation A dissecting aortic aneurysm occurs when: - the inner layers of the aorta become separated. - the aorta ruptures, resulting in profound bleeding. - all layers of the aorta suddenly contract. - a weakened area develops in the aortic wall. - ANSthe inner layers of the aorta become separated. 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: - flush both eyes with an alcohol-based solution and transport. - mix baking soda with water and irrigate his eyes with the solution. - irrigate both eyes continuously for 20 minutes with plain water. - neutralize the acid chemical in his eye with an alkaline chemical. - ANSirrigate both eyes continuously for 20 minutes with plain water. A flail chest occurs when: - a segment of fractured ribs bulges during the inhalation phase. - a segment of the chest wall is detached from the thoracic cage. - more than three ribs are fractured on the same side of the chest. - Severe pulmonary edema - Carbon monoxide poisoning - ANSCarbon monoxide poisoning A medical transport helicopter is incoming and you are responsible for setting up the landing zone (LZ). You should: - ask bystanders to stand at all four corners of the LZ. - use weighted cones to mark all four corners of the LZ. - use yellow caution tape to mark of the LZ perimeter. - place four flares 100 feet apart in an "X" pattern. - ANSuse weighted cones to mark all four corners of the LZ. A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: - 16 hours. - 4 hours. - 10 hours. - 8 hours. - ANS16 hours. A normal systolic blood pressure for a 30-year-old is between: - 70 and 140 mm Hg. - 80 and 120 mm Hg. - 90 and 140 mm Hg. - 60 and 120 mm Hg. - ANS90 and 140 mm Hg. A nuchal cord is defined as an umbilical cord that: - has separated from the placenta. - is lacerated due to a traumatic delivery. - is wrapped around the baby's neck. - has abnormally developed blood vessels. - ANSis wrapped around the baby's neck. A patient has a blood pressure of 130/70 mm Hg. The "130" in this measurement represents: - atrial contraction. - ventricular filling. - ventricular contraction. - ventricular relaxation. - ANSventricular contraction A patient has a large accumulation of blood in the sac surrounding the heart. Which type of shock would this condition cause? - Hypovolemic - Cardiogenic - Neurogenic - Obstructive - ANSobstructive A patient has fractured both femurs. Anatomically, these injuries would be described as being: - bilateral. - medial. - proximal. - unilateral - ANSbilateral 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 leave the vest in place. - remove the battery from the monitor and then remove the vest. - leave the battery attached to the monitor and remove the vest. - perform ventilations only and allow the vest device to defibrillate. - ANSremove 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? - Uncontrolled hypertension - Thoracic aortic aneurysm - Acute myocardial infarction - Obstructive lung disease - ANSAcute myocardial infarction A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a: - bag-valve mask. - nasal cannula. - mouth-to-mask device. - nonrebreathing mask. - ANSnonrebreathing mask. A patient whose speech is slurred and difficult to understand is experiencing: - dysphagia - aphasia - dysarthria - paraplegia - ANSdysarthria A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? - 2 - 5 - 4 - 3 - ANS3 A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation? - Transport the patient in a prone position on the stretcher - 30% or more - 20% or more - 40% or more - ANS30% or more A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: - addiction. - tolerance. - dependence. - withdrawal. - ANStolerance. A person who stands outside in windy, wintry weather and wears only lightweight clothing is experiencing heat loss mainly by what method? - Conduction - Convection - Evaporation - Respiration - ANSConvection A pleural effusion is MOST accurately defined as: - a bacterial infection of the lung tissue. - diffuse collapsing of the alveoli. - a unilaterally collapsed lung. - fluid accumulation outside the lung. - ANSfluid accumulation outside the lung. A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: - blood is shunted to the uterus and fetus during major trauma. - pregnancy causes vasodilation and a lower blood pressure. - pregnant patients can dramatically increase their heart rate. - pregnant patients have an overall increase in blood volume. - ANSpregnant patients have an overall increase in blood volume. A simple pneumothorax: - is commonly caused by blunt chest trauma. - heals on its own without any treatment. - often has a nontraumatic cause. - is caused by penetrating chest trauma. - ANSis commonly caused by blunt chest trauma. 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): - physician directive. - statute of care. - advance directive. - power of attorney. - ANSadvance directive. A spinal cord injury at the level of C7 would MOST likely result in: - paralysis of all the respiratory muscles. - paralysis of the intercostal muscles. - paralysis of the diaphragm. - immediate cardiac arrest. - ANSparalysis of the intercostal muscles. A strangulated hernia is one that: - spontaneously reduces without any surgical intervention. - is reducible if surgical intervention occurs within 2 hours. - can be pushed back into the body cavity to which it belongs. - loses its blood supply due to compression by local tissues. - ANSloses its blood supply due to compression by local tissues. A supervisor who has more than seven people reporting to him or her: - is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can accomplish more tasks. - has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person. - should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the tasks were carried out. - should regularly report to the incident commander (IC) to inform him or her of the functions that his or her team is performing. - ANShas exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person. A supracondylar or intercondylar fracture is also known as a fracture of the: - olecranon process. - radial head. - distal humerus. - proximal radius. - ANSdistal humerus. 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): - colostomy. - gastrostomy. - intestinal shunt. - gastric stoma. - ANScolostomy. A team of EMTs is caring for a critically injured patient. The team leader advises the EMT that transport will not begin until the patient's closed forearm fracture is splinted. Utilizing the crew resource management model, the EMT should: - repeat the request back to the team leader and then splint the patient's arm. - advise the team leader that immediate transport is more important than splinting. 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: - obtain baseline vital signs. - assist the patient's ventilations. - perform a secondary assessment. - apply a nonrebreathing mask. - ANSassist the patient's ventilations. Abdominal pain, vomiting, and fever are most likely due to _______. - evisceration - infection - hypovolemia - hemorrhage - ANSinfection Abdominal thrusts in a conscious child or adult with a severe upper airway obstruction are performed: - until he or she experiences cardiac arrest. - in sets of five followed by reassessment. - until he or she loses consciousness. - about 1 inch below the xiphoid process. - ANSuntil he or she loses consciousness. 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? - Check the mechanical ventilator for malfunction. - Attempt to pass a suction catheter into the tube. - Look for blood or other secretions in the tube. - Listen to breath sounds to assess for a pneumothorax. - ANSCheck the mechanical ventilator for malfunction. 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. - was involved in a motor vehicle crash in which another patient in the same vehicle was killed. - has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. - has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. - ANShas 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 patient if: - 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. - the patient requires advanced life support care and stabilization, and the nearest ALS- ground ambulance is more than 5 to 10 minutes away. - 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. - ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. - ANStraffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. According to the Emergency Medical Treatment and Active Labor Act (EMTALA): - all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. - all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. - a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department. - 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. - ANSall health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min? - Triage the patient as delayed. - Administer high-flow oxygen. - Assess his or her neurologic status. - Assess for bilateral radial pulses. - ANSAssess for bilateral radial pulses. According to the terminal drop hypothesis: - a person's physical health begins to decline after the age of 75 years. - most late-stage adults retain high brain function until 1 month before death. - most elderly patients experience depression after the death of a loved one. - mental function is presumed to decline in the 5 years preceding death. - ANSmental function is presumed to decline in the 5 years preceding death. Accounting for approximately 80% of all skull fractures, which of the following often present with no physical signs? - Basilar skull fractures - Depressed skull fracture - Linear skull fractures - Open skull fractures - ANSLinear skull fractures Activated charcoal comes in which medication form? - suspension - gel - solution - tablet - ANSsuspension After opening a patient's airway and confirming spontaneous respirations, you check for a pulse on his neck just lateral to the trachea. What artery are you palpating? - radial - femoral - brachial - carotid - ANScarotid After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: - assess respiratory rate, depth, and regularity. - place him or her in the recovery position. - provide positive-pressure ventilatory assistance. - suction as needed and insert an airway adjunct. - ANSsuction as needed and insert an airway adjunct. After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, EXCEPT: - recommendations for movement to the treatment area. - the total number of patients that have been triaged. - the number of patients in each triage category. - the recommended transport destination for each patient. - ANSthe recommended transport destination for each patient. After receiving online orders from medical control to perform a patient care interventiom, you should: -perform the intervention as ordered -confirm the order in your own words -repeat the order to medical control word for word -ask the physician to repeat the order - ANSrepeat the order to medical control word for word After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: - take standard precautions. - contact medical control. - notify law enforcement. - quickly access the patient. - ANStake standard precautions. After spiking a bag of IV fluid for the paramedic, the EMT notices that the drip chamber is too full. The EMT should: - invert the IV bag and squeeze the drip chamber. - replace the administration set with a new one. - squeeze the IV bag to force fluid into the tubing. - let the IV flow rapidly for 20 to 30 seconds. - ANSinvert the IV bag and squeeze the drip chamber. After taking diphenhydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n): - unpredictable effect. - therapeutic effect. - side effect. - untoward effect. - ANSside effect. After the AED has delivered a shock, the EMT should: - re-analyze the cardiac rhythm. - immediately resume CPR. - assess for a carotid pulse. - transport the patient at once. - ANSimmediately resume CPR. After you submit the electronic PCR for a call, you realize that you accidentally documented the wrong vital signs. What should you do? -say nothing and hope that the error goes unnoticed -leave the record as it is and seek legal advice -notify your agency's information technology department -follow your agency's directions for making an amendment - ANSfollow your agency's directions for making an amendment Age-related changes in the renal system result in: - a significant increase in filtration, which causes the excretion of large amounts of water from the body. - the formation of large amounts of urine secondary to an increase in kidney mass of up to 20%. - a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. - dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function. - ANSa decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. All of the following are hollow abdominal organs, EXCEPT the: - ureters. - bladder. - spleen. - stomach. - ANSspleen. All of the following are vesicant agents, EXCEPT: - phosgene oxime. - sarin. - lewisite. - sulfur mustard. - ANSsarin. - single-issue group. - doomsday cult. - ANSsingle-issue group. An elderly patient has fallen and hit her head. Your initial care should focus on: - airway, breathing, and circulation. - obtaining baseline vital signs. - providing immediate transport. - gathering medical history data. - ANSairway, breathing, and circulation An EMT may injure his or her back, even if it is straight, if the: - shoulder is aligned over the pelvis. - hands are held close to the legs. - force is exerted straight down the spine. - back is bent forward at the hips. - ANSback is bent forward at the hips. An extreme, life-threatening, systemic reaction that may include shock and respiratory failure is known as what? - Urticaria - Allergic reaction - Anaphylaxis - Angioedema - ANSAnaphylaxis An important aspect in the treatment of a patient with severe abdominal pain is to: - encourage the patient to remain in a supine position. - administer analgesic medications to alleviate pain. - give 100% oxygen only if signs of shock are present. - provide emotional support en route to the hospital. - ANSprovide emotional support en route to the hospital. An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: - an acute increase in the patient's pulse rate. - acute unilateral paralysis following the injury. - a rapid deterioration of neurologic signs. - a progressively lowering blood pressure. - ANSa rapid deterioration of neurologic signs. An infant or small child's airway can be occluded if it is overextended or overflexed because: - he or she has a long neck, which makes the trachea prone to collapse. - the back of the head is flat, which prevents a neutral position. - the tongue is proportionately small and can fall back into the throat. - the occiput is proportionately large and the trachea is flexible. - ANSthe occiput is proportionately large and the trachea is flexible. An infant with severe dehydration would be expected to present with: - excessive tearing. - moist oral mucosa. - absent urine output. - bulging fontanelles. - ANSabsent urine output. An infectious disease is MOST accurately defined as: - the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs. - a disease that can be spread from one person or species to another through a number of mechanisms. - any disease that enters the body via the bloodstream and renders the immune system nonfunctional. - a medical condition caused by the growth and spread of small, harmful organisms within the body. - ANSa medical condition caused by the growth and spread of small, harmful organisms within the body. An intoxicated 40-year-old male is found lying face down. How would you document his body's position? - Prone - Supine - Dorsal - Recumbent - ANSprone An obvious sign of death caused by discoloration of the body from pooling of the blood to the lower parts of the body is called what? -a presumptive sign -dependent lividity -rigor mortis -putrefaction - ANSdependent lividity An open fracture is MOST accurately defined as a fracture in which: - a bullet shatters the underlying bone. - a large laceration overlies the fracture. - bone ends protrude through the skin. - the overlying skin is no longer intact. - ANSthe overlying skin is no longer intact. An open pneumothorax occurs when: - a fractured rib perforates the tissue of the lung. - air enters the pleural space from outside the body. - extreme pleural pressure causes the lung to rupture. - air enters the pleural space from a perforated lung. - ANSair enters the pleural space from outside the body. An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause: - Identifying the underlying cause of the behavioral emergency - ANSDefusing/controlling the situation and providing transport As an EMT, what is your main role at the scene of an accident involving extrication of the patient? - To extricate the patients - To assess and provide immediate medical care - To provide safe entrance and access to the patients - To provide traffic control and direction - ANSTo assess and provide immediate medical care As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on: -medical director approval -the patient's condition -the transport time to the hospita -an order from a paramedic - ANSmedical director approval As you and your partner report for duty, you check your ambulance and begin talking about the possibility of a terrorist attack. The MOST effective and appropriate way to determine the likelihood of this happening is to: - check with local businesses to see if they have received any terrorist threats. - ask your immediate supervisor if he or she has been watching the local news. - know the current threat level issued by the Department of Homeland Security. - ascertain the current situation overseas with regard to the number of casualties. - ANSknow the current threat level issued by the Department of Homeland Security. 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. - perform an immediate head-to-toe assessment. - assess his pulse for rate, regularity, and quality. - apply high-flow oxygen and assess his injuries. - ANSopen his airway and assess his breathing status. As you are delivering the head during birth, you observe the umbilical cord is wrapped once around the neck. What should you do? - Ask the patient not to push, and prepare for immediate transport. - Try to slip the cord gently over the head. - Clamp and cut the cord, and remove the cord from around the neck. - Pull on the cord to speed the delivery. - ANSTry to slip the cord gently over the head. As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should: -inform the admissions clerk of the situatiom and then respond at once -respond only after guving a verbal patient report to a nurse or physician -leave a copy if the run form with a nurse and then respond to the call -place the patient in a high-visibility area and then respond to the call - ANSrespond only after guving a verbal patient report to a nurse or physician As you enter the residence of a patient who has possibly overdosed, you should: - be alert for personal hazards. - observe the scene for drug bottles. - quickly gain access to the patient. - look for drug paraphernalia. - ANSbe alert for personal hazards. As you radio the hospital to give a report on your patient, which of the following should you do? -speak as quickly as possible -provide as much detail as possible -remain objective and impartial -use code words to protect the patient's identity - ANSremain objective and impartial Assessment of a patient's blood pressure with an automatic BP cuff reveals that it is 204/120 mm Hg. The patient is conscious and alert and denies any symptoms. The EMT should: - conclude that she has hypertension. - obtain a manual blood pressure. - reassess her blood pressure in 5 minutes. - prepare for immediate transport. - ANSobtain a manual blood pressure. Asthma is caused by a response of the: - cardiovascular system. - immune system. - respiratory system. - endocrine system. - ANSimmune system. At a scene with downed electrical lines, the EMT should _________. - stabilize the patient in the danger (hot) zone - enter the danger (hot) zone for patient removal only - relocate the danger (hot) zone away from the patient - remain outside the danger (hot) zone - ANSremain outside the danger (hot) zone At present, the likelihood of a nuclear attack against the United States is very low because: - the United States has an effective early warning system to detect an incoming nuclear missile. - terrorist nations do not have the ability to deliver a nuclear weapon via missile or bomb. - Once the preliminary assessment is complete - ANSOnce the preliminary assessment is complete At what stage do vital signs begin to level off within adult ranges? - Neonate - Preschool - School-age - Adolescent - ANSAdolescent At what step in the ACS-COT/CDC updated field triage decision scheme would you assess mechanism of injury and evidence of high-energy impact? - Step 2 - Step 1 - Step 4 - Step 3 - ANSStep 3 Atherosclerosis is defined as ________. - dilation of the arteries - the blockage of a coronary artery - constriction of the blood vessels - the buildup of plaque inside blood vessels - ANSthe blockage of a coronary artery Battle sign is an indication of which of the following? - Concussion - Contusion - Skull fracture - Secondary injury - ANSSkull fracture Because a tracheostomy tube bypasses the nose and mouth: - secretions can build up in and around the tube. - the risk of a local infection is significantly high. - severe swelling of the trachea and bronchi can occur. - bleeding or air leakage may occur around the tube. - ANSsecretions can build up in and around the tube. Because of the complexity of the older patient and the vagueness of his or her complaint, you should: - rely exclusively on family members for the medical history. - perform a rapid assessment on all geriatric patients you treat. - limit your physical examination to the area of pain or injury. - attempt to differentiate between chronic and acute problems. - ANSattempt to differentiate between chronic and acute problems. Because the depth of an open abdominal wound is often difficult to determine: - the abdomen must be vigorously palpated. - prompt transport to the hospital is essential. - vital signs should be monitored frequently. - the EMT must perform a thorough exam. - ANSprompt transport to the hospital is essential. Between each chest compression, you should __________. - remove your hands from the chest - check for a pulse - allow full chest recoil - administer a breath - ANSallow full chest recoil Bile is produced by the liver and concentrated and stored in the: - stomach. - gallbladder. - kidneys. - pancreas. - ANSgallbladder Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: - ice packs and elevation of the patient's head. - pressure dressings and chemical ice packs. - digital pressure to an adjacent pulse point. - direct pressure using dry, sterile dressings. - ANSdirect pressure using dry, sterile dressings. Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: - pancreatic failure. - intentional overdose. - renal insufficiency. - splenic dysfunction. - ANSrenal insufficiency. Bruising over the right upper quadrant could indicate injury to which of the following? - Liver - Appendix - Kidney - Colon - ANSLiver Burns associated with lightning strikes are typically: - superficial. - full-thickness. - third-degree. - partial-thickness. - ANSsuperficial. Burns in children are commonly caused by all of the following, EXCEPT: - Nervous - Endocrine - Renal - ANSNervous Children are often "belly breathers" because _______. - they are routinely hypoxic - they are consciously controlling ventilations - their intercostal muscles are not developed - their diaphragm is not functional - ANStheir intercostal muscles are not developed Children of which age group are considered toddlers? - 1-3 years - 3-6 years - Over 6 years - 1 month to 1 year - ANS1-3 years Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. - hypoperfusion - coagulation - perfusion - hemorrhage - ANSperfusion Classic signs and symptoms of hypoglycemia include: - cool, clammy skin; weakness; tachycardia; and rapid respirations. - warm, dry skin; irritability; bradycardia; and rapid respirations. - warm, dry skin; hunger; abdominal pain; and deep, slow respirations. - cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. - ANScool, clammy skin; weakness; tachycardia; and rapid respirations. Clinical signs of compensated shock include all of the following, EXCEPT: - rapid, shallow breathing. - absent peripheral pulses. - cool and clammy skin. - restlessness or anxiety. - ANSabsent peripheral pulses. Closed chest injuries are typically caused by _______. - high-velocity weapons - penetrating trauma - blunt trauma - flying debris - ANSblunt trauma Clouding of the lenses of the eyes is called: - conjunctivitis. - cataracts. - retinitis. - glaucoma. - ANScataracts. Common causes of depression in the elderly include all of the following, EXCEPT: - alcohol abuse and dependence. - chronic medical conditions. - an acute onset of dementia. - prescription medication use. - ANSan acute onset of dementia. Common causes of seizures in children include all of the following, EXCEPT: - poisonings or ingestion. - electrolyte imbalances. - hyperglycemia. - infection. - ANShyperglycemia. Common complications associated with central venous catheters include all of the following, EXCEPT: - a local infection. - bleeding around the line. - clotting of the line. - rupture of a central vein. - ANSrupture of a central vein. Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT: -fear of medical personnel -history of chronic disease -assessment by the EMT -mental disorders - ANSassessment by the EMT Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: - suctioning of the upper airway. - positive-pressure ventilations. - some form of tactile stimulation. - thorough drying with a towel. - ANSpositive-pressure ventilations. Common safety equipment carried on the ambulance includes all of the following, EXCEPT: - turnout gear. - hazardous materials gear. - involves hands-on practice - occurs every 24 months - is self-paced and brief - ANSinvolves hands-on practice CPR should be initiated when: - the carotid pulse is very weak - signs of putrefaction are present - rigor mortis is obvious - a valid living will is unavailable - ANSa valid living will is unavailable CPR will NOT be effective if the patient is: - horizontal - on a firm surface - supine - prone - ANSprone Crackles (rales) are caused by _________. - narrowing of the upper airways - severe bronchoconstriction - air passing through fluid - mucus in the larger airways - ANSair passing through fluid Crepitus and false motion are: - positive indicators of a fracture. - most common with dislocations. - only seen with open fractures. - indicators of a severe sprain. - ANSpositive indicators of a fracture. Cushing triad in a patient is a sign of which of the following? - Concussion - Spinal cord damage - Intracranial pressure - Blood clot in the brain - ANSIntracranial pressure Deoxygenated blood from the body returns to the: - right ventricle. - left ventricle. - left atrium. - right atrium. - ANSright atrium. Diabetes is a metabolic disorder in which the body's ability to metabolize what is impaired? - Fats - Protein - Glucose - Electrolytes - ANSGlucose Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: - aorta. - diaphragm. - stomach. - spleen. - ANSdiaphragm. Distributive shock is the result of which of the following? - Rapid deoxygenation - Poor vessel function - Pump failure - Low fluid volume - ANSPoor vessel function Down syndrome is a genetic defect that occurs as the result of: - a separation of chromosome 21. - a sperm that contains 24 chromosomes. - a triplication of chromosome 21. - an extra pair of chromosomes. - ANSa triplication of chromosome 21. Drowning is MOST accurately defined as: - water in the lungs following submersion in water. - death from suffocation after submersion in water. - temporary survival after submersion in water. - death beyond 24 hours after submersion in water. - ANSdeath from suffocation after submersion in water. During an EMS call, you should take standard precautions: - after it has been determined that the patient is bleeding. - before you load the patient into the ambulance. - before exiting the ambulance and before actual patient contact. - immediately after completion of your primary assessment. - ANSbefore exiting the ambulance and before actual patient contact. 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 patent's last menstrual cycle - The possibility that the patient may be pregnant - If the patient is sexually active - make two or three attempts to restore distal circulation by manipulating the elbow. - ANSapply gentle manual traction in line with the limb and reassess for a pulse. 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. - .22-caliber pistol. - handgun. - .357 magnum. - ANSshotgun. During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates: - a lower airway obstruction. - swelling of the upper airway. - secretions in the airway. - fluid in the alveoli. - ANSa lower airway obstruction. During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you: -are in violation of HIPAA because you did not remove the PHI from the PCR beforehand -violated the patient's privacy because you should have discussed the information only with the EMTs involved -adequately safeguarded the patient's PHI because the cases were discussed internally -acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the case with others - ANSare in violation of HIPAA because you did not remove the PHI from the PCR beforehand 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: - assist his ventilations with a BVM. - suction his oropharynx for up to 15 seconds. - immobilize his spine and transport immediately. - pack his nostrils to stop the drainage of blood. - ANSsuction his oropharynx for up to 15 seconds. 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: - log roll the patient onto a long backboard and transport at once. - perform a focused physical exam with emphasis on the pelvis. - defer spinal immobilization and transport to a trauma center. - stabilize the pelvis with a pelvic binder and protect the spine. - ANSstabilize the pelvis with a pelvic binder and protect the spine. During your treatment of a patient having a stroke whose breathing is normal and oxygen saturation is 96%, you administer oxygen via a nonrebreathing mask at 10 to 15 L/min. This is an example of what? - knowledge-based error - rules-based error - therapeutic effect - skills-based error - ANSknowledge-based error 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? - Place your fingers in the vagina to assess for a nuchal cord. - Maintain firm pressure to the head until it completely delivers. - Apply gentle pressure to the baby's head as it delivers. - Tell the mother not to push and transport her immediately. - ANSApply gentle pressure to the baby's head as it delivers. Dyspnea is MOST accurately defined as: - shortness of breath or difficulty breathing. - labored breathing with reduced tidal volume. - a complete cessation of respiratory effort. - a marked increase in the exhalation phase. - ANSshortness of breath or difficulty breathing. Effective therapeutic communication skills require _________. -verbal and nonverbal communication techniques -supervision by advanced life support personnel -English-speaking patients or family members -correct use of complex medical terminology - ANSmaintaining communications equipment on the ambulance EMTs arrive at the scene of an ill person. The EMR, who arrived before the EMTs, advises that the patient had a syncopal episode. The patient is conscious and alert and remains so throughout transport. When transferring patient care to the emergency department nurse, the EMT should advise the nurse that: - she should contact the EMR about the incident. - the patient had a reported syncopal episode. - the EMR was probably mistaken about the episode. - there is no evidence to support the syncopal episode. - ANSthe patient had a reported syncopal episode. EMTs respond to a known heroin abuser who is unresponsive. If they give naloxone (Narcan) to this patient, the EMTs should recall that: - naloxone should be administered in increments of 2 mg. - naloxone should not be given if the patient's breathing is slow. 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 fracture of the skull. - airway compromise. - intracranial bleeding. - spinal cord injury. - ANSintracranial bleeding. 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 - A rapid, irregular pulse - Diminished breath sounds - Widening pulse pressure - ANSEngorged jugular veins 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: - gallbladder. - liver. - pancreas. - spleen. - ANSspleen. 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 lacerated globe. - optic vessel compression. - a ruptured eyeball. - ANSa blowout fracture. 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: - elevate her legs 6 to 8 inches and cover her with a blanket. - carefully insert a sterile trauma dressing into her vagina. - place her legs together and position her on her left side. - firmly massage the uterine fundus with a circular motion. - ANSfirmly massage the uterine fundus with a circular motion. Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should: - perform a rapid assessment to locate critical injuries. - ask a firefighter what the patient was exposed to. - begin some form of positive-pressure ventilation. - administer high-flow oxygen via a nonrebreathing mask. - ANSbegin some form of positive-pressure ventilation. Foods, medications, and insects are common causes of ________. - psychogenic shock - septic shock - neurogenic shock - anaphylactic shock - ANSanaphylactic shock For an adult, the normal resting pulse should be between: - 70 and 110 beats/min. - 50 and 70 beats/min. - 50 and 60 beats/min. - 60 and 100 beats/min. - ANS60 and 100 beats/min. For every emergency request, the dispatcher should routinely gather and record all of the following information, EXCEPT the: - caller's phone number. - nature of the call. - location of the patient(s). - patient's medical history. - ANSpatient's medical history. For which of the following would you use a DuoDote Auto-Injector? - Carbon monoxide poisoning - Acetaminophen overdose - Sarin gas attack - Morphine overdose - ANSSarin gas attack Force acting over a distance is the definition of: - kinetic energy. - latent energy. - work. - potential energy. - ANSwork. From what internal female organ is the fetus expelled during delivery? - Cervix - Vagina - Uterus - Perineum - ANSUterus Functions of the liver include: - Bacteria - Protozoa - ANSVirus How can gastric distention be prevented when performing artificial ventilations? - provide slow, gentle breaths during artificial ventilation over 3 seconds - provide rapid, forceful breaths during artificial ventilations over 3 seconds - provid slow, gentle breaths during artificial ventilation over 1 second - provide rapid, forceful breaths during artificial ventilation over 1 second - ANSprovide slow, gentle breaths during artificial ventilation over 1 second How do poisons typically act to harm the body? - By changing the normal metabolism of cells or by destroying them - By causing a slowing of nearly all bodily functions - By interfering with normal neurologic function - By causing burns and damage to either external or internal organs - ANSBy changing the normal metabolism of cells or by destroying them How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? - it pushes thick, infected pulmonary secretions into isolated areas of the lung - it forces the alveoli open and pushes oxygen across the alveolar membrane - it prevents albeolar collapse by pushing air into the lungs during inhalation - it decreases intrathoracic pressure, which allows more room for lung expansion - ANSit forces the alveoli open and pushes oxygen across the alveolar membrane How far away should you park your ambulance from the site of a cave-in or trench collapse? - 1000 feet - 20 feet - 500 feet - 100 feet - ANS500 feet How is a behavioral crisis defined? - A condition in which a person exhibits agitated behavior combined with disorientation, hallucinations, or delusions - A violent act intended to inflict harm - A mental disorder characterized by the loss of contact with reality - Any reaction to events that interferes with the activities of daily living - ANSAny reaction to events that interferes with the activities of daily living How is nitroglycerin usually given by the EMT? - Orally - Sublingually - Inhaled - Injected - ANSSublingually How many collisions are there in a typical vehicle impact? - 1 - 3 - 4 - 2 - ANS3 How soon do cells in the brain and spinal cord start to die without constant perfusion? - After 2-3 hours - Within 45 minutes - Within 15-20 minutes - Within 4-6 minutes - ANSWithin 4-6 minutes How would you identify a patient who does not have any apparent allergies? - NA - amb - AK - NKA - ANSNKA Hydroplaning of the ambulance on wet roads would MOST likely occur at speeds of greater than _____ mph. - 30 - 15 - 10 - 20 - ANS30 Hyperextension injuries of the spine are MOST commonly the result of: - diving. - falls. - compression. - hangings. - ANShangings. Hyperventilation during the preoxygenation phase of endotracheal intubation: - is acceptable if done for fewer than 2 minutes. - can cause gastric distention and hypotension. - will decrease the likelihood of aspiration. - provides a better oxygen reserve for the patient. - ANScan cause gastric distention and hypotension. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: - crack cocaine. If a patient's chest barely moves during inhalation, even if the patient's respiratory rate is normal, you should suspect that: - expiratory reserve volume is decreased. - inspiratory reserve is increased. - minute volume is decreased. - overall tidal volume is increased. - ANSminute volume is decreased If a pediatric patient begins seizing again during your care, which of the following would be your treatment priority? - Providing rapid transport - Stopping the seizure - Securing and clearing the airway - Maintaining the patient's body temperature - ANSSecuring and clearing the airway If a problem with a team member is not directly or immediately impacting patient care, the team leader should: - ignore the problem to avoid conflict. - engage the team member at once. - discuss the problem after the call. - contact the medical director at once. - ANSdiscuss the problem after the call. If a technical rescue team is required at the scene, but is not present when you arrive, you should: - check with the incident commander to ensure that the team is en route. - remain with your ambulance until the rescue team arrives at the scene. - don personal protective equipment and begin the rescue process. - have fire personnel initiate the rescue process if they are at the scene. - ANScheck with the incident commander to ensure that the team is en route. If a woman with vaginal bleeding reports syncope, the EMT should assume that she: - has an ectopic pregnancy. - is pregnant. - is in shock. - has an infection. - ANSis in shock. If amniotic fluid is green, what does this signify? - Maternal infection - Premature rupture of the placenta - The presence of meconium - Prolonged gestation - ANSThe presence of meconium If an object is visible in the unconscious patient's airway, you should __________. - comtinue chest compressions - remove it - place the patient on his or her side - leave it in place - ANSremove it 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 - All of these answers are correct. - ANSAll of these answers are correct. If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: - digital pressure to a proximal artery. - a tourniquet proximal to the injury. - additional sterile dressings. - a splint and elevate the extremity. - ANSa tourniquet proximal to the injury. If gastric distention begins to make positive-pressure ventilation difficult, you should: - reposition the patient's airway - increase the rate of ventilation - suction the patient's oropharynx - insert an oropharyngeal airway - ANSreposition the patient's airway If gastric distention begins to make positive-pressure ventilation difficult, you should: - reposition the patient's airway. - suction the patient's oropharynx. - increase the rate of ventilation. - insert an oropharyngeal airway. - ANSreposition the patient's airway. If PID is not treated, what can occur? - Ectopic pregnancy - Uterine collapse - Low-birth-weight babies - Arthritis - ANSEctopic pregnancy If the victim of a toxicologic emergency vomits, an EMT should _________. - not approach the vomitus. - have the patient enclose the vomitus in a container and take it to the emergency department. - safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary. - inform medical control of the situation. - ANSreassess the patient's airway and breathing. Immediately life-threatening chest injuries must be found and managed during the _______. - scene size-up - secondary assessment - primary assessment - patient history - ANSprimary assessment Immediately upon arriving at the scene of an emergency call involving a traumatic injury, you should notify the dispatcher of your arrival and then: - observe the scene for safety hazards. - carefully assess the mechanism of injury. - determine if additional units are needed. - quickly gain access to the patient. - ANSobserve the scene for safety hazards. In ___________ administration, you are administering medication to yourself or your partner. - EMT-administered - peer-assisted - paramedic-administered - patient-assisted - ANSpeer-assisted 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: - epidemics. - parasitic infection. - pandemics. - uncontrolled outbreaks. - ANSpandemics. In a normal adult, greater than 30% to 40% of blood volume loss significantly increases the risk of shock. What is the threshold of blood volume loss in children? - 30% - 25% - 50% - 45% - ANS25% In addition to asthma, which of the following conditions is associated with wheezing? - Bronchitis - Pulmonary embolism - Epiglottitis - Croup - ANSBronchitis In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to: - determine the underlying cause of the problem and offer advice. - diagnose the patient's problem and provide definitive treatment. - diffuse and control the situation and safely transport the patient. - transport the patient directly to a specialized psychiatric facility. - ANSdiffuse and control the situation and safely transport the patient. In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: - applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. - taking a blood pressure and determining if the patient is alert and oriented or confused. - checking the radial pulse and noting the color, temperature, and condition of the skin. - palpating the carotid pulse to determine the approximate rate and checking capillary refill time. - ANSchecking the radial pulse and noting the color, temperature, and condition of the skin. In addition to providing medical care to a rape victim, which of the following is the most critical thing you should do? - Refer the patient to a rape crisis center. - Do a full assessment of the victim's mental status to determine whether an assault has actually occurred. - Ask very specific questions to help identify the assailant. - Move the patient to a private location. - ANSMove the patient to a private location. In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: - an air embolism. - nerve fiber damage. - a spinal fracture. - an ischemic stroke. - ANSan air embolism. In an acute injury setting, neurogenic shock is commonly accompanied by: - tachycardia. - hypovolemia . - diaphoresis. - hypothermia. - ANShypothermia. 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. In contrast to Lyme disease, Rocky Mountain spotted fever: - presents with flu-like symptoms and a bull's-eye rash. - may be confused with rheumatoid arthritis. - causes painful joint swelling after a few days or weeks. - can cause paralysis and cardiorespiratory collapse. - ANScan cause paralysis and cardiorespiratory collapse. In contrast to the parietal peritoneum, the visceral peritoneum: - lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract. - is less likely to become inflamed or infected because it lines the abdominal organs themselves. - is supplied by the same nerves from the spinal cord that supply the skin of the abdomen. - is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation. - ANSis supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation. In contrast to type 1 diabetes, type 2 diabetes: - occurs when antibodies attack insulin-producing cells. - is caused by resistance to insulin at the cellular level. - is caused by a complete lack of insulin in the body. - is commonly diagnosed in children and young adults. - ANSis caused by resistance to insulin at the cellular level. In contrast to viral hepatitis, toxin-induced hepatitis: - can be prevented with a vaccination. - is not a communicable disease. - typically does not cause yellow skin. - is a far more transmittable disease. - ANSis not a communicable disease. In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: - any change in position causes blood to be shunted to the brain. - their red blood cells are destroyed at a faster than normal rate. - the body is less able to adapt the BP to rapid postural changes. - the aging process results in an overall increase in blood volume. - ANSthe body is less able to adapt the BP to rapid postural changes. In determining the potential for a terrorist attack, you should routinely observe all of the following on every call, EXCEPT: - victim's statements. - the type of call. - weather conditions. - the location type. - ANSweather conditions. In general, musculoskeletal injuries should be splinted before moving the patient unless: - deformity and swelling are present. - the patient is in severe pain. - the patient is clinically unstable. - transport time is less than 15 minutes. - ANSthe patient is clinically unstable. In general, what is the maximum amount of acute blood loss the adult body can tolerate? - 2 liters - 20% of total blood volume - 10% of total blood volume - 12 pints - ANS20% of total blood volume In general, which of the following does a prefix describe? - location and intensity - condition - movement - anatomic position - ANSlocation and intensity In most instances, you should move a patient on a wheeled ambulance stretcher by: - slightly lifting the stretcher to prevent unnecessary patient movement. - pushing the head of the stretcher while your partner guides the foot. - retracting the undercarriage and carrying the stretcher to the ambulance. - pushing the foot of the stretcher while your partner guides the head. - ANSpushing the head of the stretcher while your partner guides the foot. In older patients, the first indicator of nontraumatic internal bleeding may be: - diaphoresis and pale skin. - a low blood pressure. - weakness or dizziness. - a heart rate over 120 beats/min. - ANSweakness or dizziness. In order for efficient pulmonary gas exchange to occur: - the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. - the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. - there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. - oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane. - ANSoxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.