B15 FINAL

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What is the term used to describe interventions designed to improve the​ comfort, but not prolong the​ life, of a terminally ill​ patient?

Palliative care

Which of the following organs is LEAST likely to be injured in penetrating trauma to the​ abdomen?

Pancreas

What is​ "pins-and-needles" sensation​ called?

Paresthesia

Which unique finding may be noted in compartment syndrome as a result of compression damage to the nerves and vascular supply in the femoral​ region?

Paresthesia between the medial toes

Which adult patient would be considered to be moderate in terms of burn​ severity?

Partial thickness burns of the right hand and arm

Which adult patient would be considered to be critical in terms of burn​ severity?

Partial thickness burns over both legs

Which meningeal layer is closest to the​ brain?

Pia mater

During a wilderness rescue​ situation, what type of technique will a helicopter rescue agency use instead of more dangerous​ rappel-based rescue​ methods?

Short hauls

Which of the following pieces of equipment would most likely cause an amputation due to a shearing​ mechanism?

Sickle bar mower

Pelvic fractures can be​ life-threatening injuries due to what​ mechanism?

Significant blood loss

Which of the following can result in hemorrhagic​ shock?

Significant blood loss

A radio communications band that is widely available and penetrates concrete and steel well is​ the:

UHF band.

What is the most critical risk associated with the removal of an impaled object in the​ field?

Uncontrollable hemorrhage

Which statement regarding the reason the percentage of elderly Americans is increasing is​ true?

The mean survival rate of older persons is increasing.

Your patient is a​ 30-year-old pregnant woman at 36​ weeks' gestation. She was injured in a fall from a horse and is complaining of painful contractions. Her abdomen is tender to palpation over the​ uterus, and the uterus becomes firm with​ contractions, but she denies vaginal bleeding. The patient is​ anxious, but her skin is warm and dry. Her blood pressure is​ 112/70, her heart rate is​ 92, and her respirations are 24. Which of the following statements best describes this​ situation?

The mechanism and patient complaints are suspicious for abruptio placentae. Both the mother and the fetus are in jeopardy.

What structure helps to support the digestive​ tract?

The mesentery

How does the progression of shock for a woman in the late stages of pregnancy differ from the general ​population?

The mother can lose a greater blood volume prior to progressing through the stages of shock.

Which factor might warrant a call for air medical​ service?

The nearest appropriate trauma center is an hour away by ground transport.

What is the difference in the number of home health care agencies since​ 1963?

The number has enormously increased.

Which of the following variables can typically change at any time in an open​ incident?

The number of patients

Which of the following disaster resource coordination personnel would you least likely find at the​ MACC?

Unit leaders

You arrive at the scene of an altercation after the scene has been cleared by law enforcement. There you are faced with a​ 22-year-old female, unconscious on the​ sidewalk, with a bat nearby. The victim is without response to pain and has a large contusion in the area of the left zygomatic arch.​ Additionally, you note that her radial pulse is 68 and​ thready, her skin is warm and​ dry, and her right pupil is dilated. Based on her​ findings, do you believe there is significant internal​ bleeding?

Unlikely

How would the quality of the clot be described that is formed during the platelet phase of​ hemostasis?

Unstable

Which of the following is the most effective way for EMS personnel to protect themselves against exposure to biological agents of​ terrorism?

Use a HEPA mask.

If a​ disaster-level MCI results in a regional failure of communications​ systems, which of the following should be​ done?

Use message runners.

You and your partner are preparing to provide direct patient care during the disentanglement phase of a motor vehicle crash. What type of​ flame/flash protection is most​ appropriate?

Turnout gear

Which type of pelvic fracture does not involve the pelvic ring and includes avulsion fractures and those of the​ pubis, sacrum,​ coccyx, ischium, or iliac​ wing?

Type I

Units operating in a large city may transmit on ultrahigh frequency​ (UHF) radio frequencies​ because:

they penetrate concrete and steel well and are less susceptible to interference.

The use of video streaming in EMS to transmit patient images to medical​ direction:

is likely to be more beneficial in rural areas.

At the point of primary​ contamination, the​ contamination:

is limited.

One of the concepts introduced by Dr. R. Adams Cowley that helped to drive modern trauma care in the United States​ was:

the​ "Golden Hour."

The central space within the thoracic cavity that houses the heart is​ the:

mediastinum.

In the basic communication​ model, speaking face to​ face, sending a​ fax, leaving a voice​ message, or sending a written letter is known as​ a:

medium.

System status management​ (SSM) is a computerized personnel and ambulance deployment system designed​ to:

meet service demands.

The​ __________is a double peritoneal fold containing blood​ vessels, lymphatic​ vessels, nerves, and fatty tissue.

mesentery

Abdominal pain associated with ovulation is called _____

mittelschmerz

A female patient is experiencing lower quadrant pain on one side and her temperature is running slightly high. She tells you that she is in the midst of her menstrual cycle and experiencing some spotting. You​ suspect:

mittelschmerz.

Midcycle abdominal pain in a female that occurs in conjunction with follicle rupture or bleeding at the time of ovulation is also known​ as:

mittelschmerz.

Compared to a car that slides into a​ snowbank, an auto that strikes a concrete retaining wall will have a deceleration rate that​ is:

much greater.

Pulmonary agents attack​ the:

mucous membranes of the respiratory system.

A 2010 report by the National Public Safety Telecommunications Council predicted the development of new medical devices useful to EMS that will use radio waves to transmit data. Which device listed below was not​ predicted?

multiplex radio system device

The medical director for your agency is mandating simultaneous transmission of your verbal report and telemetry data on all cardiac patients. This will​ require:

multiplex technology.

he layer of the uterus that is responsible for contracting during the menstrual cycle and during labor is​ the;

myometrium.

The primary purpose of the Mark I kit is to treat both military and first responders for the effects​ of:

nerve agents including soman or tabun.

At a hazmat incident involving a chemical​ spill, paramedics are least likely​ to:

neutralize and clean up the spilled chemicals.

A condition in which chemotherapy creates a dangerously low level of neutrophils is​ called:

neutropenia.

Your​ agency's radio frequencies may be monitored by the public and media. You​ should:

not relay confidential patient information.

For a patient with muscular dystrophy​ (MD):

note the particular muscle groups that the patient cannot move.

A fracture that runs across the bone at an angle is​ a(n):

oblique fracture.

Because of the cost of air medical​ transport, it is incumbent on providers to ensure that air medical transport is​ used:

only for patients who stand to benefit from such care.

A plan​ should:

outline the SOPs and protocols for potential incidents.

Burn injuries associated with an explosion are​ typically:

partial thickness.

Members of the emergency medical system can most effectively impact morbidity and mortality of trauma victims​ by:

participating actively in prevention.

All of the following should be the fundamental elements of technical rescue training that paramedics should possess​ except:

performing disentanglement techniques for an entrapped victim.

As a paramedic functioning on the scene of a hazardous materials incident at a fixed​ facility, you may be asked​ to:

perform​ pre-entry and​ post-entry physical exams of the hazmat entry team.

The serous membrane that forms the outermost layer of the uterine wall is called the _____

perimetrium.

Cool and pale skin in the victim of hypovolemic shock is the result​ of:

peripheral vasoconstriction.

The fallopian tubes conduct the egg from the space around the ovaries into the uterine cavity​ via:

peristalsis.

The Federal Communications Commission​ (FCC) does not control and​ regulate:

personal conversations.

An obese patient presents with chest pain. You attempt to apply ECG​ pads, but the​ patient's adipose tissue presents an obstruction. You​ should:

place ECG monitoring electrodes on the arms and thighs instead of on the chest.

Your patient has a nontraumatic fracture of the left wrist. To splint this​ fracture, you​ first:

place a roll of bandaging in the​ patient's hand to maintain position of function.

Decreased respiratory​ volume, diminished cough​ reflex, and decreased mucociliary clearance all make the elderly more prone​ to:

pneumonia.

If you see rescuers about to use a frayed​ rope, you​ should:

point out the damage to the rescuers in a​ polite, professional manner

You are caring for a male patient who was involved in an industrial fall in which he landed in a straddle position on a steel beam. The patient has severe​ pain, disfigurement, and swelling to the genitalia. Patient care should include all of the following​ except:

position of comfort for transport.

Your​ 74-year-old patient has a cataract over her left eye. You​ should:

position yourself in view of her right eye.

Any victim of a blast injury exhibiting severe dyspnea that is associated with absent alveolar breath sounds should​ receive:

positive pressure ventilation.

You are caring for a patient who has been exposed to a nerve agent. Appropriate treatment of this patient would​ include:

pralidoxime chloride.

Until proven​ otherwise, you should assume that a missed or late menstrual period is due​ to:

pregnancy.

It is a​ clear, warm August afternoon when your squad is dispatched to a construction site for a​22-year-old male complaining of numbness and​ tingling, muscle​ cramps, and headache after operating a jackhammer all morning. Upon arrival you verify that the site is secure and then are led to the shady side of a concrete block wall where your victim is sitting on the ground with his head in his hands. As you approach and introduce​ yourself, your patient anxiously tells you that he feels like​ he's going to pass out. He is diaphoretic and very warm with a thready pulse of 98 and a respiratory rate of 16 and​ shallow, with a pulse ox of 99 percent on ambient air. He tells you he has no medical history or allergies. As you assist your patient to a supine​ position, you ask your partner​ to:

prepare an IV of normal saline.

A significant reduction in mortality rate associated with trauma can be realized by instituting a comprehensive program​ addressing:

prevention.

If an ambulance is deployed to a specific location to await any emergency​ calls, that is known as​ its:

primary area of responsibility.

What coordinated system determines the appropriate level of response to a call from someone who detects an emergency and summons​ EMS?

priority dispatching system

An emergency medical dispatcher uses established guidelines to determine the appropriate level of response. This is known​ as:

priority dispatching.

The pancreas is responsible​ for:

production of glucagon and insulin.

The first two weeks of the menstrual cycle are known as​ the:

proliferative phase.

In rural areas of the United​ States, the paramedic may find employment at alternative health care facilities that provide limited care and nonemergent medical treatment​ called:

prompt care facilities.

One example of the use of public education to reduce morbidity and mortality related to abdominal trauma​ is:

proper use of seat belts.

Patients presenting with isolated musculoskeletal injuries and who are stable should​ be:

provided a focused trauma assessment.

Proper​ restraints, waste disposal and inspecting for infection are all aspects​ of:

providing proper bed care.

The crew of an incoming helicopter notifies you that they are approximately five minutes from your location. You need​ to:

tell them when you can hear and see them.

Rescuers needing to carry fewer oxygen tanks because of rugged terrain is an environmental issue primarily​ affecting:

the use of ALS skills

Fluid overload in the geriatric patient is a risk of treating shock​ because:

their system cannot accommodate large fluctuations in fluid reserves.

The three methods the body utilizes to create heat are all types​ of:

thermogenesis.

In the​ body, perspiration and vasodilation are both mechanisms​ of:

thermolysis.

Ambulance manufacturing and design are standardized by​ the:

DOT KKK 1822F specs.

EMS providers must routinely communicate effectively​ with:

bystanders.

What is the definition of​ hematochezia?

Blood in the stool

What results from compression of the nerve roots at the lower end of the spinal​ cord?

Cauda equina syndrome

A larger and more disrupted entrance wound than the bullet caliber would suggest is an indicator that what has taken​ place?

Bullet tumbling or deformation

Which of the following patients is least likely to get a skin infection as a result of the use of home medical technology to manage a chronic​ condition?

A patient with a nasogastric tube at home for feedings

What law accounts for the fact that at different depths below sea​ level, the pressure of air will​ change?

Dalton's

You are considering air medial transport for a critical patient in need of care at a facility 60 miles away. It is​ 11:32 at night. What is the recommended minimum size of a night landing zone for a​ rotor-wing air​ambulance?

100 feet by 100 feet

What is the type of mechanism of injury that may occur if a hand gets entangled within a tractor​ PTO?

Wrap point

Hyperthermia is usually caused by which​ mechanism?

Heat transfer through vasodilation

Contributory factors that occur prior to an event and result in trauma are known​ as:

​pre-event factors.

The water rescue model​ is:

​reach-throw-row-go.

Which of the following statements regarding bariatric patients is​ accurate?

An obese person has an abnormal amount of body fat.

What is the purpose of a focused trauma​ assessment?

Assessment of a specific isolated injury

When communicating via​ radio, you should​ use:

"affirmative" and​ "negative."

What is the generic term or description that is used for legal documents that determine or direct health care providers on what to do when a person becomes incapacitated or is dying and is not capable of making decisions for himself or​ herself?

Advance directives

You are treating the victim of an automobile accident who is presenting with no open​ wounds, but a slightly distended abdomen. He was initially alert and well​ oriented, had a pulse of​ 100; respirations of 22 and a blood pressure of​ 88/70. During reassessment you note that he is still alert and well oriented but his vital signs are now a pulse of​ 110; respirations of 30 and a blood pressure of​ 84/70. What would the change in his Revised Trauma Score​ be?

-1

You are treating the victim of an automobile accident who is presenting with no open​ wounds, but a slightly distended abdomen. He is alert and well​ oriented, has a pulse of​ 100, respirations of​ 22, and a blood pressure of​ 88/70. What would his Revised Trauma Score​ be?

11

Which rib​ pair(s) have no anterior​ attachment?

11th and 12th ribs

An analysis of data collected by New York State over 22 years shows that during which hours of the day do ambulance collisions occur most​ frequently?

Daylight hours

What does​ Newton's second law of motion​ quantify?

Deceleration

According to the rule of​ nines, what would the involved surface area be for an adult victim who has received burns to his right arm and right anterior​ chest?

13.5 percent

Regardless of the length of the menstrual cycle, the period of time from ovulation to menstruation is typically how many days?

14

Which of the following is a common indicator of human​ trafficking?

A child has stopped attending school.

In which type of​ multiple-casualty incident have the injuries usually already occurred by the time you arrive on​ scene?

A closed incident

You are considering air medical transport for a patient at the site of a bridge collapse. There are power lines at the edge of the nearby field that would make the best landing zone for a helicopter. How far from​75-foot high power lines should the landing zone for a helicopter be​ located?

150 feet

What percentage of burn victims treated in the United States are​ hospitalized?

10 percent

How long does the remodeling process of​ soft-tissue healing typically​ take?

6 to 12 months

You find significant hypoglycemia is an unresponsive patient with a head injury. You​ administer:

25 mg of glucose and 100 mg of thiamine.

What percentage of motor vehicle deaths are due to thoracic​ trauma?

25 percent

For a Caucasian​ patient, how would you classify a very light pink or white appearance to the​ skin?

Pale

Which patient is most likely to sustain a pathological​ fracture?

A geriatric patient receiving radiation therapy for cancer

Which function is not mediated through the integumentary​ system?

Peripheral circulation

Which of the following is most accurate regarding assault rifles and hunting rifles of the same​ caliber?

A more severe wound track is typically encountered in a wound caused by hunting ammunition.

Approximately what percent of the blood volume can be added to arterial circulation by constriction of the venous​ system?

20 percent

What percentage of the population are the​ elderly, those over the age of​ 65, expected to represent by the year​ 2040?

20 percent

Your​ ten-year-old male patient was involved in a bicycle accident that lacerated his right calf and caused significant​ bleeding; he is showing signs of hypovolemia. When providing intravenous fluid replacement to this​ patient, fluid boluses should be administered at the rate​ of:

20​ mL/kg delivered a maximum of three times.

What percentage of burn occurrences are considered life​ threatening?

3 to 5 percent

At what age does the body begin to lose its ability to maintain bone​ structure?

40

The liver is injured​ ________ percent of the time with penetrating abdominal trauma.

40

What is the best method by which to reduce the morbidity and mortality associated with abdominal​trauma?

Prevention

What is the optimal way of dealing with musculoskeletal​ injuries?

Prevention

The symptoms of endometritis typically follow a miscarriage or gynecological procedure​ by:

48 to 72 hours.

You are caring for a patient with penetrating abdominal trauma secondary to an industrial explosion. The patient has an altered mental status and is found to be​ hypotensive, tachycardic, and tachypneic. During your fluid​ administration, what minimum systolic blood pressure do you wish to​ maintain?

80 mmHg

The Office of Emergency Communications​ (OEC) provides funds to states for developing a statewide communications interoperability plan. The OEC requires states to give​ _____ of the funds to local agency providers.

80%.

The mortality rate for​ cold-related disorders significantly increases for victims with a core body temperature​ below:

86 degrees.

As the reimbursement for air medical helicopter transport increased in​ 2010, approximately how many helicopter air ambulance​ (HAA) aircraft were flying in the United​ States?

900

Which of the following patients should be immediately transported to a trauma​ center?

A motorcyclist involved in a 35 mph collision with a car

You are dispatched to the scene of a propane tank fire. On your arrival you are directed to a​ 30-year-old male patient with partial thickness burns over the anterior side of both​ legs, the genital​ area, thorax, and face. As you approach the​ patient, you establish that he is conscious and well​ oriented, respirations are​22, his radial pulse is​ 96, and pulse ox shows 92 percent on room air. You immediately place him on​high-flow oxygen via nonrebreather mask. What oxygen saturation should you titrate your oxygen therapy​to?

96 percent

How much blood loss can occur in a​ third-trimester pregnant female before she will show signs or symptoms of​ hypovolemia?

30 percent

At what point does a trauma victim begin losing his ability to compensate for blood​ loss, placing his survival at​ risk?

30 to 40 percent of volume

As you approach a vehicle involved in a​ single-car accident involving a​ tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinal​ control, you introduce yourself and complete a primary assessment. His airway is open and his breathing seems​ adequate; you check the radial pulse and find a rate of​ 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer​ bleeding, but was responsible for a majority of his overt hemorrhaging. You initiate​ high-flow oxygen via a nonrebreather​ mask, quickly dress the​ scalp, and perform a rather lengthy extrication onto a spine board. After moving him you note that he is no longer speaking to​ you; his radial pulse is now 124 and​ thready, his respiratory rate has dropped to 6 and​shallow, and his abdomen appears to be slightly distended. What is now the maximum time interval between reassessments of your​ patient?

5 minutes

Based on the CUPS triage​ scheme, which of the following criteria represent the best description of a patient who would receive a​ "critical" designation?

A patient in whom you are unable to secure the​ airway, breathing, or circulation

Which of the following is most accurate regarding an assault rifle shooting military​ ammunition?

A bullet that does not tumble will likely pass through the body.

While ovarian cysts may be found during routine pelvic​ exams, in the field setting which of the following would likely assist the paramedic in differential​ diagnosis?

A complaint of​ one-sided moderate to severe abdominal pain that may radiate to the back

As it pertains to​ trauma, which definition of coagulopathy is most​ accurate?

A condition in which the​ blood's ability to clot is impaired

In accordance with the START triage​ system, which of the following victims would be transported last from a​ multiple-casualty incident?

A conscious and​ well-oriented 28-year-old female with a respiratory rate of 28 and a radial pulse of 100 who is able to walk

In accordance with the START triage​ system, which of the following victims would be transported from a​multiple-casualty incident in a delayed​ capacity?

A conscious and​ well-oriented 30-year-old male with a respiratory rate of 28 and a radial pulse of 100 who cannot walk

In accordance with the START triage​ system, which of the following victims would be transported first from a​ multiple-casualty incident?

A conscious​ 59-year-old male with a respiratory rate of 37 and a radial pulse of 95 who is capable of following commands

For which trauma patient should you not perform a trauma assessment during the secondary​assessment?

A critical patient with uncontrolled​ airway, breathing, or circulation problems

What is​ ADAMS?

A database

You are managing a bedbound obese patient whose PICC line insertion site appears reddened and inflamed. On​ arrival, the caregiver tells you that the patient has been running a fever for a​ week, but the site looked fine until today. The caregiver asks if this is a decubitis wound. You observe​ redness, swelling, purulent​ discharge, and warm skin at the insertion site. What is the most likely explanation for the​problem?

A decubitus wound

What is the most common outcome of blunt head​ trauma?

A diffuse injury

In developing an understanding of​ MCI, which of the following statements is most accurate regarding the response phase of a​ disaster?

A disaster is an event that overwhelms regional emergency response resources.

Which of the following statements about the general health of individuals living in rural locations is most​correct?

A disproportionate number of chronic health conditions are likely to exist.

If it becomes necessary to perform a physical exam of the genitalia of a female who was sexually​assaulted, who would best perform such an​ examination?

A female paramedic

What accurately reflects the pathophysiology of anterior cord​ syndrome?

A flexion-extension injury that results in damage to the vertebral artery through either disruption or compression by​ edema, leading to subsequent ischemia and infarction

You are responding to a fire at a chemical factory involving an unknown substance. Your partner opens the copy of the Emergency Response Guidebook you have in the ambulance. In the Emergency Response​ Guidebook, what information is provided within this reference​ book?

A list of hazardous materials substance​ names, placard​ identification, and evacuation distances for most substances

What might a victim suffering a concussion and epidural hematoma concurrently present with prior to an increase in intracranial​ pressure?

A lucid interval

Which of the following is a primary way in which TEMS varies from​ EMS?

A major priority in TEMS is extraction of the patient from the hot zone.

Who would be the best person to perform a physical exam of the genitalia of a male adolescent who was sexually assaulted if such an examination is​ necessary?

A male paramedic

Given the same injury and rate of blood​ loss, which patient would likely progress most slowly through the classes of​ hemorrhage?

A pregnant female in her third trimester

What does the use of a helmet in ATV collisions typically​ cause?

A reduced incidence of head injury

Which of the following is TRUE of abdominal​ trauma?

A significant amount of blood can accumulate in the abdominal cavity before signs and symptoms of abdominal injury appear.

Which of the following is true about a sloppy patient care​ report?

A sloppy PCR implies sloppy care.

Which of the following BEST describes incendiary​ agents?

A special subset of explosives with less explosive power and greater heat and burn potential

You respond to a farm accident to find a​ 22-year-old male patient who rode his ATV into a​ high-tensile electric fence. As you approach the​ victim, you notice that the ATV has passed through the fence into the​pasture, but the victim is lying supine on the ground outside the fence. His brother is holding his hand over his neck and a moderate amount of blood is oozing from below his hand. You begin questioning the victim and rapidly establish that he is alert and well oriented and has no difficulty breathing or speaking. While your partner stabilizes the​ victim's head you prepare a dressing so you can view the injury and replace the​ brother's hand. What type of dressing would be​ appropriate?

A sterile occlusive dressing covered by​ non-sterile gauze with direct pressure

Which incident would typically be termed a​ high-impact incident?

A tornado that destroys a shopping center

To correct the hypoxia of a drowning​ patient, what is the first​ step?

A trained rescue swimmer removes the patient from the water.

You are treating a patient who you suspect is a victim of a forced marriage as a result of human trafficking. The​ patient's spouse is hovering​ nearby, and you feel that his presence is influencing the​ patient's responses to your questions. What should you​ do?

Alert law enforcement immediately.

What should you do if you are administering care to a patient who is not prepared for transport and the scene becomes​ dangerous?

Abandon the patient

At what height does a fall become severe enough to necessitate trauma services based solely on the mechanism of​ injury?

About three times the​ patient's height

Approximately how many motor vehicle deaths can be attributed to thoracic trauma in the United States annually?

About​ 8,000

What is the term for placental detachment from the uterine wall that can occur from blunt abdominal trauma in the pregnant​ female?

Abruptio placentae

What is the temperature at which all molecular motion has​ stopped?

Absolute zero

Which of the following statements about abuse is most​ correct?

Abuse can occur in​ same-sex couples.

Which of the following statements is most accurate about access to emergency health care services for people living in rural​ America?

Access is diminished overall.

You are caring for a patient who was playing flag football at the park. The patient states that after a particular​ play, he was tackled and felt sharp pain in his left​ ankle, after which he was unable to bear weight on it. What tendon may have been injured in this​ situation?

Achilles

Which of the following can reduce the potential for abdominal​ injury?

All of the above

You are on your local 911​ ambulance, and you are called to the local emergency department to transport a patient to a cardiac center that is two hours away by ground. The ED doctor tells you that the patient is actively infarcting and needs catheterization. What other recommendation could you make to the ED staff for this​ patient?

Activate an HAA agency to complete the transfer.

What​ high-altitude disease typically presents with​ light-headedness, breathlessness,​ weakness, headache,​ nausea, and​ vomiting?

Acute mountain sickness

You are dispatched to the scene of a winter drowning in which a​ 10-year-old male patient was found by his parents floating in a hole in the ice on their farm pond. On​ arrival, you find the victim pulseless and apneic with CPR being performed by neighbors. You continue​ CPR, maintain the airway by​ intubation, administer 100 percent​ oxygen, and attach an ECG​ monitor, which shows ventricular fibrillation. What should your next action should​ be?

Administer defibrillation.

You suspect increased intracranial pressure in a patient with penetrating chest trauma. Which of the following is appropriate​ treatment?

Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg.

A patient has ingested a​ corrosive, can​ swallow, and is not drooling. How should you treat this​ patient?

Administer furosemide.

A patient inhales​ chlorine, which causes the patient to develop pulmonary edema. What is a specific means of treating this pulmonary​ edema?

Administering furosemide

What task does a hyperbaric chamber​ perform?

Administration of oxygen at greater than air pressure

Which of the following is not a commonly vulnerable population for human trafficking in the United​ States?

Adults aged 18 to 45

Which of the following may affect the pattern of injury in abdominal​ trauma?

All of the above

What is the term for using stereotypes to characterize older​ adults?

Ageism

Once bleeding is​ controlled, what is the most critical complication of bandaging a lateral neck​ injury?

Air emboli

You are dispatched to the scene of an automobile accident along with two other units. As you approach the​ scene, you see a compact car under the trailer of a​ semi-truck that turned in front of the car. The fire department has secured the area and is opening the​ driver's door of the car with jaws as you pull up. After the door is​ opened, you find a male​ victim, in the​ driver's seat, lying over the center console. You hear gurgling respirations that sound shallow at a rate of​ 20, and he is apparently​unresponsive, but you are unable to see his head from the​ driver's door. You are successful at ascertaining a pedal pulse with a rate of 70 and strong. A rescue worker informs you that they are unable to access the passenger side until the trailer is lifted​ off, as the wheels are in the way. As you are unable to take control of the cervical spine or administer any other type of​ care, you slide the victim​ out, feet​ first, supine along his long axis onto a long spine board and move him to the stretcher. You first inspect his​ head, noticing that there are no landmarks inferior to the supraorbital margin. His respirations are now​ shallow, at a rate of​ 10; he has a radial pulse of 60 and​ bounding; and the pulse ox is 93 percent. As you begin clearing blood and flesh from the​ oropharynx, your partner tells you that he sees no other significant injuries. From the facial injury and others​ signs, what will your initial care center​ on?

Airway maintenance

What should be avoided prior to spending time in a cold​ environment?

Alcohol

Which of the following is a special consideration when managing the pregnant trauma​ patient?

All of the above are special considerations.

What is the weakest form of​ radiation?

Alpha radiation

Which of the following statements is true of the kinetic energy involved in a​ stabbing?

Although the mass behind a knife​ blade's penetration may be significantly greater than a​ bullet's, the​ knife's velocity is less.

Some drugs that are used to facilitate rape​ (known as date rape​ drugs) have which of the following effects on the​ victim?

Amnesia

Which of these technologies does not now operate to provide a first response to an​ emergency?

An EMS Resource and Event Monitoring System

You are assessing a patient with blunt abdominal trauma. You note that the abdomen is slightly​distended, rigid to the​ touch, with an ecchymotic area surrounding the umbilicus. What does this finding​imply?

An abdominal injury that is likely several hours old

A vehicle impacts a car parked in a travel lane and is immediately struck from behind by a second vehicle. What is the impact by the second vehicle​ called?

An additional impact

What is a local effect of a chemical​ agent?

An effect involving the area around the immediate site of exposure

What is the expected trend for the use of medical technology in the​ home?

An increase

Which of the following has not been a major contributor to the increased number of people who live at home but are reliant on medical​ technology?

An increase in disease incidence

How does the progression of signs and symptoms of pediatric head injury differ from an​ adult?

An infant is more prone to direct injury but has a slower progression of increasing ICP.

Which of the following is an example of a place where an NFPA 704 placard should be​ expected?

An outdoor storage tank holding liquid oxygen

Which patient should be immediately transported to a trauma​ center?

An unrestrained child inside a vehicle involved in a 20 mph vehicle collision

You are called to the scene of a finger​ amputation; you bandage the hemorrhaging area but have not yet located the missing thumb. How should you​ proceed?

Assign others to continue searching and transport the victim to the ED.

Which syndrome results from bony fragments or pressure compressing arteries that perfuse the ventral aspect of the spinal​ cord?

Anterior cord syndrome

Which drug does not interfere with proper​ heat-generating mechanisms?

Antibiotics

In accordance with the rule of​ nines, how does the head of an infant compare with the head of an​ adult?

An​ infant's head and neck account for twice the total body surface area of an​ adult's.

Provide her with a list of local resources for victims of partner abuse

Apprehension abuse

You have called air medical transport for a patient with a spinal injury ejected from a car in an area of hilly terrain. The only place the helicopter can land is on a level portion of hillside near the summit. Which of these actions must be avoided in assisting at the landing​ zone?

Approach the helicopter from the uphill side of the landing zone.

What causes the spurting of blood in arterial​ bleeding?

Arterial blood pressure

Which one of the following is not a type of​ aphasia?

Articulation

You arrive at the scene of an altercation after the scene has been cleared by law enforcement. There you are faced with a​ 27-year-old female lying on the sidewalk who is bleeding from multiple lacerations to the left right hands and forearms and one cut to her face. Although you cannot see any other​ wounds, her​t-shirt is stained over the stomach. She complains of cold. What should you do in response to this​complaint?

As soon as possible after assessing her injuries and addressing life​ threats, cover her with a warm blanket.

Your patient was injured while working on a farm tractor. You find him sitting beside the rear wheel of the tractor holding his arm. The engine of the tractor is still​ running, but the equipment is not in gear. His adult son arrives as you approach. What should be your first​ action?

Ascertain whether the son knows how to turn off the tractor.

The greatest numbers of immigrants are coming to the United States​ from:

Asia and Latin America.

You are taking the history of a​ 78-year-old female patient with hypoglycemia. The patient has been answering your questions but seems to be growing tired. What should you​ do?

Ask the patient if she needs to stop and give her a break before continuing.

What medication would be least appropriate for premedicating a patient with an anterior ankle dislocation prior to attempting relocation to reduce the​ joint?

Aspirin

You are treating the victim of an auto accident who struck the steering wheel when the air bag failed to deploy. You notice severe bruising of the anterior chest but​ don't detect any rib fractures or displacement. When you arrived the patient was conscious and well oriented with respirations of 22 and a palpable radial pulse of 96. His SpO2 is​ 95; you immediately apply​ high-flow oxygen. After extrication and​ immobilization, you notice that the​ patient's breathing is more shallow but his rate remains about the same. His radial pulse is​ 114, his blood pressure is​ 96/70, and his SpO2 has dropped to 92 percent. In addition he appears to be developing some abdominal distention and is beginning to complain of dyspnea. You auscultate his lungs and find that they are diminished to absent in the lower lobes. What would your next actions​ include?

Assist ventilation with a BVM at the​ patient's current​ rate, initiate two​ large-bore IVs​ TKO, and expedite transport.

What is the most appropriate method for placement of an endotracheal tube in a facial gunshot wound victim who has lost all​ landmarks?

Attempt to visualize the larynx while another rescuer places pressure on the chest.

Which governing body in the U.S. General Service Administration issues the federal regulations to standardize the design and manufacturing​ requirements?

Automotive Commodity Center

You have been dispatched to an office complex with a report of multiple victims complaining of similar signs and symptoms of respiratory distress and nausea. What would you do​ first?

Avoid entering until the scene has been made safe.

You are dispatched to the scene of a shallow water diving accident. While en​ route, what would you consider to be the most likely result of this method of​ injury?

Axial loading of the cervical spine

What is the white matter of the spinal cord composed​ of?

Axons

Which of the following patients would be at the greatest risk for elder​ abuse?

A​ 71-year-old male who is confined to bed and is living with his​ son, who was just divorced from his wife

Which MOI would indicate the need to transport a child to a trauma​ center?

A​ bicycle-car collision

Which individual would you most likely assess and treat for​ heatstroke?

A​ high-school football player in the first few days of practice with temperatures in the 90s and high humidity

What should be attached to a personal flotation device​ (PFD) so that they are easily​ accessible?

A​ knife, strobe​ light, and whistle

Which incident would typically be termed a​ low-impact incident?

A​ three-car accident

What is one of the most consistent factors that can help to predict child​ abuse?

There is a history of physical violence in the home.

You are responding to a scene involving an overturned railway​ tanker, and you want to identify the material the tanker was transporting. Which of the following is a disadvantage of relying on shipping papers for information about a hazardous​ material?

Because they are kept onboard the vehicle​ (ship, train,​ tractor-trailer), they may be inaccessible in the event of a spill.

When does menarche usually occur for​ females?

Between the ages of 10 and 14

Which of the following statements regarding biological weapons is​ TRUE?

Biological weapons are difficult to detect right away.

What type of blunt thoracic trauma results from a chemical reaction that creates a pressure​ wave?

Blast injury

Your squad is dispatched to a local department store for a fall. When you arrive you are met by a panicked store manager and led to one of the aisles where a construction worker in his​ mid-20s has fallen approximately 20 feet through the roof and is lying on the floor after landing on a set of shelves. As you approach you note that the worker is unconscious and breathing at a rate of​ 10/min. He has a pulse rate of 72 and thready. You immediately start him on​ high-flow oxygen via a nonrebreather mask and perform a rapid trauma​ assessment, which reveals that he has no response to​ pain, apparent abdominal​distention, open bilateral tibia and fibula​ fractures, and a closed femur fracture on his left side. His blood pressure is​ 80/68. What care should be performed prior to​ transport?

Bleeding control and full immobilization on a long spine board

What term is defined as spasm of the​ eyelid?

Blepharospasm

A​ 30-year-old female patient presents with abdominal pain and rebound tenderness that you believe are because of an ovarian cyst. What would be the cause of this​ pain?

Blood released from the ruptured cyst irritating the peritoneum

Where do clotting factors provided by the extrinsic pathway come​ from?

Blood vessel walls

Which mechanism is said to occur when the energy of a nonpenetrating injury to the chest cavity damages​ tissue?

Blunt trauma

Which definition most accurately depicts the pathophysiology of a cerebral​ contusion?

Blunt trauma to local brain tissue that produces capillary bleeding into the​ brain's substance

What piece of​ equipment, seldom used in EMS a few years​ ago, are more and more EMS agencies providing for their employees as a measure to prevent​ injuries?

Body armor

Which organ is most tolerant of the compression and stretching associated with penetrating projectile injury?

Bowel

What is not a common sign or symptom of blunt cardiac​ injury?

Bradycardia

What more recent form of youth violence places victimized youth at increased risk for mental health problems such as depression and​ anxiety, psychosomatic complaints such as​ headaches, and poor school​ adjustment?

Bullying

Which of the following injury patterns is most suggestive of abuse to a​ 14-month-old infant?

Burns from the ankles down on both legs

When faced with a potential disaster such as a​ hurricane, how can the impact on resources best be​ reduced?

By advising people of safe routes out of the area to appropriate destinations

How can the injury potential of assault weapons be greatly​ increased?

By loading with hunting ammunition

How does a hyperbaric chamber treat​ dysbarism?

By redissolving nitrogen bubbles that have formed in the blood

Which of the following is one way in which rural EMS systems have been able to implement 911 systems in locations that previously had​ none?

By sharing the cost over multiple EMS jurisdictions

What is commotio​ cordis?

Ventricular fibrillation induced by a direct chest blow from blunt trauma

What is an appropriate reason to utilize air medical resources at the scene of an​ emergency?

Local EMS resources are exceeded.

Which of the following does current research indicate to be the most accurate statement about critical incident stress management​ (CISM)?

CISM does not appear to mitigate the effects of traumatic stress.

When performing​ CO-oximetry during the primary​ assessment, carbon monoxide poisoning should be considered to exist​ when:

CO levels exceed 10 percent.

Your EMS system permits care providers to treat patients with minor injuries and then release them to see their personal physician. After treating a patient for heat​ cramps, she seems to have recovered and she reports that the slight dizziness that she had been experiencing is gone. You determine that you can release this patient according to your​ system's local protocols. What do you need to​ do?

Carefully explain to this patient what heat emergency signs to watch out for and ensure she understands.

Which of the following is NOT part of the prehospital examination of the patient with suspected abdominal​ trauma?

Checking for blood in the urine

You respond to an airport for a report of several people with upper respiratory problems. As you enter the​ airport, you notice that there are multiple people coughing and vomiting throughout the ticketing area. This may indicate which of the following types of terrorist​ attack?

Chemical

A group of railway passengers presents with​ vomiting, diarrhea, watery​ eyes, and salivation. Which of the following is the likely cause of their​ symptoms?

Chemical agent

What is the name of the proteins and​ chemicals, released by cells that are damaged by trauma or​infection, that recruit cells responsible for consuming cellular​ debris?

Chemotactic factors

A patient who has lost 25 percent of his circulating blood volume would be displaying signs and symptoms associated with which class of​ hemorrhage?

Class II hemorrhage

You are dispatched to meet and assist a basic unit treating a​ 28-year-old male victim of a gunshot wound to the abdomen. Upon entering the BLS​ unit, you note that the victim is​ pale, cool, and diaphoretic with a distended​ abdomen; the EMT informs you that the victim is also anxious and becoming confused with a radial pulse of 128 and​ thready, a blood pressure of​ 92/82, and respirations of 22. What class hemorrhage is the patient displaying signs and symptoms​ of?

Class III

An analysis of data collected by New York State over 22 years shows that which of the following weather conditions has the greatest correlation to ambulance​ accidents?

Clear day

What type of bone injury is said to occur when the bone itself becomes​ fractured, but there is no penetration of sharp bone ends through the overlying​ skin?

Closed fracture

While treating the victim of a​ shooting, what is your next priority after patient​ care?

Crime scene preservation

In a hazardous materials​ incident, normal patient triage takes place in which​ zone?

Cold

What is the main component of scar​ tissue?

Collagen

Damage to what hollow organ can result in hemorrhage and content spillage into the​ retroperitoneal, peritoneal, or pelvic​ spaces?

Colon

Damage to which of the following organs is most likely to induce severe infection in the abdominal​ cavity?

Colon

What is the name of the surgical procedure by which the bowel is connected to an opening in the skin for the purpose of collecting feces outside of the​ body?

Colostomy

Which of the following functional areas of the NIMS system is ultimately responsible for dealing with an ​incident?

Command

Why is it important for all agencies and jurisdictions comprising a regional EMS system to be able to communicate with each other​ seamlessly?

Communication is not merely one aspect of an EMS​ response; it is the key link in the chain that results in the best possible patient outcome.

What single item is the cornerstone of the Incident Management System and must be established as early as​ possible?

Communications

You have a patient with a closed fracture of the femur. During​ assessment, you note that the area is very distended with taught skin circumferentially in the area of the injury. The patient states that he has no feeling distal to the injury​ site, and the distal pulse is absent. In addition to the fractured​ femur, what other type of condition may​ exist?

Compartment syndrome

What form of​ cold-related disorder exhibits signs and symptoms of hypothermia with a normal core temperature?

Compensated hypothermia

Which of these descriptions illustrates an expected​ age-related change in signs and symptoms associated with illnesses in the​ elderly?

Complaints of​ weakness, fatigue, and epigastric pain rather than of classic chest pain with myocardial infarction

In less than 10 minutes from arrival at the​ scene, what may EMS not be expected to​ do?

Complete transport to the destination facility.

You are caring for a​ 13-year-old girl who you believe is a victim of physical abuse. If this is​true, which of the following characteristics of the abused child would most likely not be​present?

Concern over a​ parent's absence

A patient has partial thickness burns over 35 percent of his​ body, including both feet. Which classification does this patient fall​ under?

Critical

What type of deafness is said to occur when sound waves cannot be transmitted to the middle ear from the outer ear​ canal?

Conductive deafness

How can a paramedic practice tactical​ options?

Consider tactical options on routine calls

You respond to a call for a​ 27-year-old female sexual assault victim. Which of the following guidelines is true regarding management of the sexual assault​ victim?

Consider the patient a crime scene and protect that scene.

Your victim is suffering from circumferential burns of the legs and impaired distal​ circulation; you are faced with an extended transport time to the ED. What should your treatment of the victim​ include?

Contact medical command for an emergency escharotomy.

​It's 2:00 am and you are transporting a trauma victim with significant injuries from an automobile accident. The local ED is closed for the​ night, and it will take approximately 1 hour for the staff to arrive. Which option should you​ consider?

Continue care and transport to a more distant trauma center about 1 hour away.

When the​ brain, floating in cerebrospinal fluid inside the​ cranium, "sloshes" toward the impact and then away from​ it, again impacting the cranial​ interior, what is the second injury​ called?

Contrecoup injury

Which​ "CUPS" criteria patient will not receive additional assessment beyond the primary​ assessment?

Critical

You are dispatched to the local outdoor gun range for an unknown​ injury; dispatch informs you that law enforcement is also responding. When you arrive you are waved around the building to the range by law enforcement officers who inform you that all guns were secured prior to their arrival. You approach the​victim, who is sitting at the range bench with his arm on the bench and his hand wrapped in a towel. The victim tells you he tried to fire a 30.06 rifle​ "from the​ hip" and the gun recoiled and hurt his finger. You prepare a dressing and remove the towel to find a degloving injury to the right index finger. How should you​ proceed?

Control bleeding and proceed with your assessment

In what form of heat loss does the body lose heat to cooler air currents that pass by the​ body?

Convection

Which of the following is the weapon of choice for terrorists​ worldwide?

Conventional explosives

As blood loss continues for the patient in compensated​ shock, what is the clinical result of blood being redirected to critical organs from the peripheral​ circulation?

Cool and pale skin

Side effects from which agents include​ hypertension, peptic​ ulcer, aggravation of diabetes​ mellitus, glaucoma, and increased risk of​ infection?

Corticosteroids

When faced with a decrease in the core​ temperature, what mechanism does the body use in response to​this?

Countercurrent heat exchange

What is the first thing you should do if you suddenly fall into​ swift-running water?

Cover your nose and mouth during entry.

Your patient is an​ 18-year-old man who was slashed across the abdomen with a machete. He has a mass of omentum and small bowel protruding from the wound. Which of the following is your primary concern with this​ patient?

Covering the wound with a​ sterile, saline-moistened dressing covered by an occlusive dressing

You are called to the scene of a fall down a concrete stairway. On arrival you note that the patient is unconscious and bleeding heavily from the nose and mouth. You note a respiratory rate of 24 and a radial pulse of 100. After​ suctioning, you are still unable to place an endotracheal​ tube, making it difficult to prevent blood from entering the lungs. How would you rate this​ victim's priority​ status?

Critical

Which of the injury types is most likely to be complicated by​ entrapment?

Crush injuries

You are treating a victim with his hips and legs trapped in a partial trench collapse. You have gained control of the​ airway, breathing, and circulation. What field diagnosis will your treatment plan be based on as the patient is released from his​ entrapment?

Crush syndrome

Which statement is accurate regarding the rapid administration of crystalloid solutions in the trauma​patient?

Crystalloid solutions should be warmed as close to body temperature as possible prior to administration.

During primary​ assessment, which of the following signs indicates​ hypoxia?

Cyanosis

Which of the following statements is most accurate about water​ temperature?

Water can cause heat loss 25 times faster than air.

What federal document specifies the way ambulances​ look?

DOT KKK 1822F specs

Which statement is most accurate when performing the collision analysis of a fall​ victim?

Deceleration forces are transmitted from the contact point toward the​ body's center of mass.

What is a change that results in the respiratory system with​ age?

Decreased chest wall compliance

What is a sign of deterioration during​ reassessment?

Decreasing pulse strength

What is the best description of an aortic​ dissection?

Degeneration of the walls of the aorta

Which soft tissue wound exposes a large area of tissue that often becomes severely​ contaminated?

Degloving injury

Which of the following is a common characteristic of an abusive relationship for both abusers and the​ abused?

Dependence on drugs or alcohol

Which tissue layer contains nerve​ endings, sebaceous​ glands, and sudoriferous​ glands?

Dermis

Which of the following statements is correct in assessing and treating a patient who is the recipient of home health care technology to manage a chronic​ condition?

Despite the presence of the home health care​ equipment, the patient may still have specific ​DNR/DNAR paperwork.

Which factor can predispose an individual to​ hypothermia?

Diabetes

What emerging technology is helping to ease the overcrowding of radio​ frequencies?

Digital equipment

What is the primary reason for digitalis toxicity in the​ elderly?

Digoxin has a low margin of safety and a narrow therapeutic index.

What is an advantage of air medical​ transport?

Direct flight at 100-140 MPH

You arrive at the scene of a female victim complaining of a severe laceration of the left forearm she received when a glass slipped from her hand and broke while she was placing it in the cupboard. You note as you approach the woman that she is sitting in a chair holding her hand over a wound that is freely hemorrhaging dark red blood between her fingers. She appears to be alert and well oriented. What method of bleeding control would you immediately​ attempt?

Direct pressure over a dressing

Which of the following activities on the scene of a technical rescue incident is limited to the active rescue​zone?

Disentanglement of the patient from a cause of entrapment

What type of orthopedic injury may have occurred when a joint is injured in such a way that it becomes fixed in an abnormal​ position, is resistive to​ motion, is extremely​ painful, and will likely have noticeable​deformity?

Dislocation

An example of effective communications between the EMS dispatcher and crew would​ be:

Dispatcher​: ​"Control to Unit​ 34, respond high priority to 783 Third​ Street, cross street​ Vine, on a possible heart​ attack." Unit 34​: ​"Control, Unit 34​ copy, responding high priority to 783 Third​ Street." Dispatcher​: ​"Unit 34, 1340​ hours."

What should the paramedic monitor after the application of a circumferential bandage on an​ extremity?

Distal circulation

You are sitting in front of your station when a car pulls up and a young mother gets out with her crying ​6-year-old daughter, who has her left hand wrapped in a​ blood-soaked cloth. The mother tells you that the girl attempted to cut open an orange by herself and cut the palm of her hand. After establishing that the girl is in no immediate​ danger, you turn your focus to the wound. After initial bleeding​ control, what is your next​ concern?

Distal circulation

While assessing a patient who was sexually​ assaulted, which of the following assessment principles should the paramedic​ follow?

Do not ask specific questions about the​ "who" and​ "why" aspects of the incident.

Your female patient has been sexually​ assaulted, and you need to remove some of her clothing to control the bleeding from a laceration of her abdomen. Which of the following is a guideline you should adhere to with respect to this​ clothing?

Do not cut through any holes in the clothing.

You are assigned to assist with a medical helicopter landing at the scene of a​ multiple-vehicle collision. Which of the following actions is​ correct?

Do not hold equipment over shoulder height.

Which of the following guidelines is correct regarding the assessment of conscious sexual assault​ victims?

Do not touch the patient unless given permission.

While caring for victims exposed to​ radiation, which of the following devices do rescuers wear to monitor the doses of radiation the victims are​ receiving?

Dosimeter

Which​ combination, utilizing a​ 230-grain bullet, would release the most energy on​ impact?

Doubling the speed of the round

You arrive at the scene of a single car accident to find that a bystander has placed a makeshift but effective tourniquet on the​ victim's leg to stem bleeding from an open femur fracture. There are no other apparent injuries. What should be included in treatment of this​ fracture?

Dress the​ wound, immobilize, and rapidly transport to the ED.

What would most significantly increase risk for soft tissue​ injuries?

Drug or alcohol abuse

Which of the following allows simultaneous​ two-way communication?

Duplex transmission

When treating a victim at a trauma scene following an​ MVC, when should you begin to establish the​MOI?

During scene​ size-up

A​ 25-year-old female patient has received severe blunt force trauma to the abdomen and genitalia. What is not a concern for the paramedic regarding this​ patient?

Dysfunctional uterine bleeding

Which person supervises all operations involved with patient care and​ transfer?

EMS branch director

The technician level of training in hazardous materials is equivalent​ to:

EMS level 2.

Which of these statements best describes the reason why EMS should be knowledgeable about chronic care​ patients?

EMS may be called when the chronic condition worsens or a medical device fails.

Which statement regarding weapon of mass destructions is​ true?

EMS personnel must be able to recognize various types of weapons of mass​ destruction, including​ biological, chemical, and radiologic agents.

You are a paramedic in a rural setting where the main source of income for many families is farming. One particular​ afternoon, you are summoned to a farm for a worker who became entangled in a piece of machinery. Other workers are frantically waving you over to their location as you exit the ambulance. What should you consider​ first?

EMS provider safety

Of the radio transmissions made by EMS providers during a typical emergency​ response, which of the following would least likely​ occur?

EMS providers​ (eg, paramedics) calling the person who detected the problem and summoned EMS to ask for details about the emergent event

Which of the following is not a common way in which rural EMS systems attempt to increase their recruitment of EMS​ providers?

Each agency keeping its resources only for its own needs

Why may the dark red or bluish discoloration associated with the damaged blood vessels at the site of a contusion go unreported to the​ ED?

Ecchymosis is a progressive process.

You are dispatched to the residence of a​ 17-year-old female complaining of severe​ left-sided abdominal pain radiating to her left shoulder. On your arrival you note that she is alert and well​ oriented, respirations are​ unlabored, and she has a palpable radial pulse of 118. As you begin to gather your focused​ history, she tells you that the pain has been present for several​ days, but this morning it suddenly became severe as she was getting out of bed. She also tells you that her period was about two weeks​ late, but she thinks it began this morning. Her vitals are respirations​ 22, blood pressure​ 92/70, and pulse ox 99 percent. The patient refuses to allow you to examine her to determine the amount of vaginal discharge. What is your field​ diagnosis?

Ectopic pregnancy

Which action contributes most to mortality in a rollover​ accident?

Ejection

What is a threat in a confined space that atmospheric monitoring would not​ detect?

Electricity

How do superficial scalp wounds provide a risk of infection that can involve the​ brain?

Emissary veins from the dural sinuses drain into superficial venous circulation.

You are called to help an elderly patient back into bed who has fallen out. While you are doing​ so, the​ man's daughter with whom he lives returns home from work. She is instantly angry and starts calling him​ dumb, stupid,​ useless, and a pain. What is the best description of this type of​ abuse?

Emotional

What type of abuse occurs when the abuser​ threatens, calls​ names, ignores, or swears at the abused person​ consistently?

Emotional abuse

You are working as a paramedic diver assisting a search and rescue team in locating a private aircraft that crash landed and rapidly sank in a local lake. You are searching in approximately 80 feet of water when you notice that your dive partner is beginning to act​ erratically, rapidly changing direction and swimming down into the bottom and stirring up silt. You suspect your partner is suffering from nitrogen narcosis. What should you​ do?

Encourage your partner to ascend to the​ surface, assuring that he stages his ascent.

You are called to the scene of an automobile accident in which the driver was wearing his shoulder belt improperly and struck his face on the steering wheel. As you approach the​ vehicle, you see the door has been opened and the driver is​ unconscious, with his head still against the wheel and blood flowing freely from his nose and mouth. His respirations are 18 and shallow and his pulse is 102 radially. To extricate this​ patient, how should you​ proceed?

Ensure that any providers assisting you are coordinated and understand what movement is to take place.

What is the primary consideration for a paramedic when responding to the scene of a​ shooting?

Ensure that the scene is secured by law enforcement.

Your male patient was attacked by a prostitute he was attempting to have sex with. The assailant managed to cut off a section of the​ man's penis with a knife she had hidden. Upon your​ arrival, the male patient is using direct pressure to stop the​ bleeding, and you see the amputated body part on the floor. The assailant has left the building. What should be the​ paramedic's first assessment​ action?

Ensure the patient has an open airway and adequate breathing.

Which is not a primary function of the​ FCC?

Ensuring that EMS communications systems are not planned as a​ "stovepipe" activity

Which tissue layer contains no​ vasculature?

Epidermis

What is the early stage of wound healing in which adjacent stratum germinativum cells migrate over the surface of the​ wound?

Epithelialization

A patient with vaginal bleeding shows signs a decreasing level of consciousness and appears to be going into shock. What intervention should the paramedic perform for this​ patient?

Establish an IV and administer normal saline.

You have a patient who was trapped beneath a truck along the freeway when he was trying to repair the brakes. By the time you​ arrive, the local fire department has already extricated the patient from underneath the​ truck, and he is currently immobilized. They advise you that the patient has a crushed​pelvis, an open fracture to the left​ femur, a distended​ abdomen, and vomitus in the airway. The patient suddenly became unresponsive when the weight of the truck was lifted from him. What should be your first priority of​ management?

Establish an open airway.

What should be performed in anticipation of freeing a patient who has been trapped for 40 minutes and is suffering from traumatic​ asphyxia? He is already receiving​ high-flow oxygen and respiratory assistance with a BVM.

Establish two​ large-bore IVs, consider 1​ mEq/kg of sodium​ bicarbonate, and prepare for immediate expedited transport.

What step begins the assessment of any soft tissue injury following the ruling out of potential​ hazards?

Establishing a likely MOI

You are dispatched to an unknown medical emergency near the city park. You arrive to find police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the​ manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped​ forward, unconscious. You also hear sonorous respirations and see a visible open femur fracture that is freely​ hemorrhaging, and blood dripping from her face or head. What is your first​ concern?

Establishing the safety of her location so you can initiate care

In the public​ five-step health​ model, what step is the repeating of surveillance in order to determine the effectiveness of an​ intervention?

Evaluation

At what intervals should vital signs be retaken on an unstable​ patient?

Every 5 minutes

What is meant by the​ "distance factor" in regard to decision making by paramedics who work in rural areas of the United​ States?

Every decision made must include consideration of the physical proximity of things.

Your patient has sustained a deep laceration to the anterior abdominal wall secondary to an industrial accident. When you remove his clothing during your​ assessment, you note that portions of the bowel are now protruding through the abdominal wall. What type of injury is this known​ as?

Evisceration

You are treating a patient who received a knife wound to the left anterior chest. You have initiated​high-flow oxygen and a​ large-bore IV. His vital signs are pulse​ 90, respirations​ 14, and blood pressure​110/74, and his lungs are clear bilaterally. After moving him to your​ stretcher, you notice that he is developing jugular vein distention that diminishes upon​ exhalation; a check of his radial pulse reveals that it has risen to​ 126, and you are barely able to detect it. His lungs are still clear​ bilaterally, but his heart sounds distant. What is your transport plan for this​ patient?

Expedited transport to the nearest ED

During your assessment and management of a female rape​ victim, she states that she feels​ "dirty" and "violated" after the​ attack, and she refuses to go to the hospital until she showers and changes her clothes. What should you do in this​ situation?

Explain that showering and changing may destroy importance evidence.

Which form of communication is used most often by EMS​ providers?

Face to face

What is responsible for the low survival rate for victims of commotio​ cordis?

Failure to initially recognize the condition

Which of the following reasons typically does not influence the hesitation or failure of a female victim to report crimes of abuse committed against​ her?

Failure to recognize abuse

Which condition is a primary predisposing factor for environmental​ injuries?

Fatigue

A paramedic suspects a patient who had a miscarriage three days earlier of having endometritis. The patient has severe lower abdominal pain and​ foul-smelling vaginal discharge. What other common symptom might the paramedic need to​ manage?

Fever

Which structure fixes the heart in the mediastinum and prevents kinking of the great​ vessels?

Fibrous pericardium

Shifting of expiratory air from an uninjured side of the thorax to the injured​ side, resulting in reduced tidal​volume, is a common result of which​ injury?

Flail chest

What condition occurs when three or more adjacent ribs fracture in two or more​ places?

Flail chest

Which of the following descriptions best reflects the purpose of the mutual aid coordination center​ (MACC)?

For exercising direction and control in an emergency or disaster

You arrive on scene where a patient is receiving medical care for a chronic condition. The patient is reliant of a ventilator for helping to breathe at night. On this particular​ evening, the ventilator is sounding an​ alarm, so the alarm company has notified EMS. When you​ arrive, the patient cannot talk owing to a full laryngectomy. If you have a question about how the ventilator​ operates, what is the best way for you to learn more about​ it?

From the primary care provider

If burned skin takes on a​ chalky, brown, or white appearance and is hard to the​ touch, then what level of burn depth is​ it?

Full thickness

What is the resulting injury called when the zone of coagulation penetrates the​ dermis?

Full thickness

Which depth of burn destroys the​ tissue's ability to​ regenerate?

Full thickness

Which accessory organ receives bile and stores it until it is needed during digestion of fatty​ food?

Gallbladder

Which precaution can maximize the ability of​ heat-generating mechanisms to replenish energy supplies when in cold​ environments?

Get plenty of rest.

Which of the following situations is least likely to be a warning sign of suicidal behavior in an elderly​patient?

Hanging onto cherished possessions desired by others

Which heat disorder is generally characterized by a body temperature of at least 105 ​F, central nervous system​ disturbances, and usually the cessation of​ sweating?

Heatstroke

What is the key requirement for EMS and law enforcement to interact well at a crime​ scene?

Good communication

Terrorist attacks are most likely to be targeted toward which of the​ following?

Government buildings

When obtaining a​ patient's obstetric​ history, which term would you use to describe the number of times the patient has been​ pregnant?

Gravida

What term is used to describe the number of times a woman has been pregnant?

Gravida (G)

What type of​ fracture, typically seen in pediatric​ bones, results in an incomplete​ break?

Greenstick fracture

Which of the following is a potential advantage of ground transportation over​ air?

Ground ambulances have fewer​ weather-related limitations than air ambulances.

Which type of head injury carries a 75 percent or higher mortality rate and is second in lethality after head injuries from auto​ crashes?

Gunshot wounds

What branch of medicine deals with the reproductive health needs of​ females?

Gynecology

What type of crimes are committed against a person solely on the basis of the​ individual's actual or perceived​ race, color, national​ origin, ethnicity,​ gender, disability, or sexual​ orientation?

Hate crimes

What are the tubes of a bone through which blood vessels travel​ called?

Haversian canals

You arrive on scene to transfer a paralyzed patient to the hospital from a nursing home to rule out pneumonia. While assessing the​ patient, you note that he has an elevated temperature and there is a​pus-like discharge from where his urinary catheter enters the meatus of the penis. What is the likely ​problem?

He also has a local infection around the urinary catheter insertion site.

What trauma injury is the most frequent cause of​ death?

Head injury

In accordance with the law of energy​ conservation, the energy of​ motion, as it pertains to driving an​ambulance, is converted to what form of energy during the normal braking at a traffic​ light?

Heat

In an abandoned strip mine in the corner of a state​ park, an ATV enthusiast has sustained a severe head injury from overturning his​ vehicle, and ground transport lacks protocols for rapid sequence intubation. What is the best option for this​ patient?

Helicopter transport

The use of which adjunct has reduced the occurrence of head injury in​ sports?

Helmets

In patients with rib​ fractures, what benefit does​ grunting, or partial expiration against a closed​ glottis, provide?

Helps limit atelectasis

Which of these statements regarding hemostasis following an amputation is​ true?

Hemorrhage is typically limited if the amputation is clean.

What is the initial step in the healing of a​ wound?

Hemostasis

Which medical term is defined as the complex​ three-step process that the body uses to control localized hemorrhage?

Hemostasis

What type of program or concept of care was developed to help keep the patient with a terminal illness as comfortable as possible at home until the person​ dies?

Hospice

What is the designated area at a hazardous materials incident where only the highest trained and equipped hazardous materials personnel are allowed to​ function?

Hot zone

The forced transport or trade of a person by such means as the threat or use of force or other forms of coercion is the definition of which of the​ following?

Human trafficking

You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which additional injury should you have a high level of​ suspicion?

Hyperflexion of the cervical spine

Which of the following findings from a physical examination or patient history is least likely to be present with a patient who is suspected to have​ PID?

Hypertension

You have been called to a home for​ "a child not​ breathing." When you​ arrive, you find a young woman who identifies herself as the​ child's babysitter. The child has a tracheostomy tube that is nearly obstructed by​ mucus, and the​ 3-year-old is moving very little air. What is the first step in your treatment of the​ child?

Hyperventilate the patient prior to suctioning the tube for 5 seconds.

Which term describes low or inadequate distribution of blood to body organs and tissues caused by​cardiac, vascular,​ neurogenic, or volume​ problems?

Hypoperfusion

Which term refers to the distribution of blood to the​ body's organs and​ tissues?

Hypoperfusion

What term refers to a drop in blood pressure caused by a reduction in blood pressure caused by​ cardiac, vascular,​ neurogenic, or volume problems to a level that is lower than normal for the​ patient?

Hypotension

What​ impact, if​ any, does hypothermia have on the utilization of oxygen at the cellular​ level?

Hypothermia can disrupt cellular oxygen use to decrease metabolism.

You are dispatched to an industrial accident for a​ 38-year-old female who had her lower arm amputated by a machine. The limb is still caught in the​ machine, and maintenance crews have been unable to retrieve it as of yet. On your​ arrival, the patient is lying on the floor next to her work station. Her arm had been crushed and severed immediately distal to her right elbow. As you approach you are advised by first responders that she is​ conscious, with a respiratory rate of 24 and a radial pulse of​ 118, and she is ashen. Your partner immediately starts her on​ high-flow oxygen via a nonrebreather mask while you attempt to control the still heavy bleeding from her severed​ limb, which the plant​ first-aid providers have been unable to control by direct pressure and elevation. You successfully apply a tourniquet and initiate an IV that your partner has​ prepared, and your patient is now packaged for transport. She now has a respiratory rate of​ 18, radial pulse of​ 96, and a blood pressure of​ 102/76; the pulse ox reads 98 percent on​ high-flow oxygen. What is the next step in your plan of​ care?

Immediate transport to a trauma center

You respond to a residence for a​ 22-year-old female who was standing in her yard when the​ neighbor's zero-turn mower ejected half a brick that was lying in the yard. The brick struck the victim in the left upper quadrant immediately inferior to her bottom rib. She tells you she did not fall or receive any other injury but the impact area aches​ "deep inside." Your primary assessment reveals normal respirations at a rate of 16 and a radial pulse of​ 100; the patient has a large hematoma at the impact location. What would your next step​ include?

Immediate transport with a focused assessment including inspection of the injury area

How would you prepare for the burn victim with suspected respiratory​ involvement?

Immediately provide​ high-flow oxygen and prepare to maintain the airway.

What intervention should be provided for a suspected rupture of a tendon attached near the knee so as to limit the amount of damage to the​ tendon?

Immobilization

Which of the following most accurately defines ectopic​ pregnancy?

Implantation of a fetus outside of the uterus

Which of the following statements is most accurate as it relates to a rescue​ situation?

In any rescue situation in which the patient can be safely​ accessed, treatment will begin before the patient is freed.

Which of the following guidelines applies to prehospital fluid resuscitation of hypotensive patients with intraabdominal​ hemorrhage?

In most​ cases, fluid administration should be limited to 3 liters.

In rural areas of the United States where health care access is​ limited, the​ paramedic's skills may be utilized in what capacity to help alleviate gaps in health​ care?

In prompt care facilities

Which condition do all forms of shock​ share?

Inadequate tissue perfusion

Why must treatment of blood loss in infants and small children be more aggressive than in​ adults?

Infant and child compensatory mechanisms are neither as well developed nor as effective as those of adults.

In a​ multiple-casualty incident, which person has full legal authority to deal with the​ situation?

Incident commander

What is the primary objective of the foreign or domestic terrorist using​ chemical, biological,​ radiologic, nuclear, and explosive​ (CBRNE) weapons?

Incite terror in the public.

What is the expected change in the occurrence of transporting trauma victims from a rural area to a larger urban​ facility?

Increase

What do the signs and symptoms of​ Cushing's triad​ include?

Increasing systolic blood​ pressure, slowing​ pulse, and irregular respirations

Which cause of abdominal trauma is on the​ rise?

Increasing violence in society

A properly restrained driver is involved in a​ head-on collision. Without contacting any internal structure in the​ car, he sustains a myocardial contusion. What principle of motion describes this​ injury?

Inertia

Which of the following is the most common mechanism of action in nerve​ agents?

Inhibit degradation of acetylcholine

You are dispatched to an industrial accident for a​ 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On​ arrival, you find the patient in the company​first-aid station supine on a​ cot, secured to a scoop​ stretcher, cervical collar in​ place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse​ 70, BP​ 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he has a bounding pulse of about 60 and is now only purposefully responsive to pain. What would your initial treatment and transport decisions​include?

Initiate rapid transport to a trauma center.

As you approach a vehicle involved in a​ single-car accident involving a​ tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinal​control, you introduce and identify​ yourself; he responds without difficulty. Since his airway is open and his breathing seems​ adequate, you check the radial pulse and find a rate of​ 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer​ bleeding, but was responsible for a majority of his overt hemorrhaging. What is your next​ step?

Initiate​ high-flow oxygen via a nonrebreather mask.

The family member of a patient asks what it means to modify the basic qualities of a hazard. What can you give as an​ example?

Install​ easy-to-reach stove​ dials, countertops, and storage areas.

You are called to treat an elderly patient who​ "fell while​ walking," according to the extended care facility staff where you picked him up. During your​ assessment, you find multiple injuries to different locations of his​ body, the patient looks malnourished and​ dirty, and you read in his medical records that he has a debilitating brain injury that rendered him unable to ambulate. What type of abuse may this​ be?

Institutional elder abuse

What best describes how​ Newton's first law of motion applies to penetrating​ trauma?

It explains both how a projectile delivers its energy to an object and how that object reacts to being impacted.

You are looking at the placard for a hazardous materials through binoculars and trying to spot the UN number. Which of the following best describes the United Nations identifier for hazardous​ materials?

It is a unique identifier for each chemical.

You respond to a residence and find the owner in the backyard sitting on a bench. He shows you a hematoma centrally located on the anterior of his left​ thigh, which he received when the hammer he was using slipped out of his hand and hit his leg. He tells you it startled him that it swelled up so​ fast, but it​ hasn't changed since he called and he no longer wants to be transported to the ED. The hematoma is approximately ​1" X ​2" and is swelled 1 inch above the surrounding leg​ area; after communicating your findings and vital signs to the​ ED, the physician indicates you can have the patient place cold packs on the area to help relieve swelling and release the patient. What instruction should you leave the patient​ with?

Instruct the patient to utilize cold packs in accordance with the​ doctor's recommendations and to seek​ follow-up care with his physician. Document your and medical​ command's instructions.

Which type of blood loss is most likely to continue unabated until it is halted by the normal clotting​process, a significant drop in blood​ pressure, exsanguination, or surgical​ intervention?

Internal blood loss into the abdomen

Your patient is a​ 60-year-old female restrained driver involved in a​ moderate-speed frontal impact collision. When you arrive at the​ scene, she is sitting up in the​ driver's seat with a chief complaint of a burning sensation in her face. You note abrasions from deployment of the airbag. After immobilizing the patient on a long​ backboard, you begin transport. As you perform a detailed​ examination, the patient complains of developing right shoulder pain. Which of the following should you​ suspect?

Intraabdominal bleeding

Which statement is true regarding pediatric head​ trauma?

Intracranial hemorrhage in the pediatric patient can contribute significantly to hypovolemia.

Which of the following does not result in hypovolemic​ shock?

Introduction of a foregin substance into the body that causes a massive histamine release

What condition exists when aggressive resuscitation restores blood pressure and pulse but organ failure continues​ unabated?

Irreversible shock

What causes the tissue edema resulting from an intracerebral​ hemorrhage?

Irritation of nervous tissue

Which of these questions is not appropriate to ask when a pregnant​ patient's chief complaint is of​ pain?

Is the​ patient's pain abdominal or in the pelvic​ region?

What does a system status management system do to help an EMS​ agency?

It acts as a personnel management and ambulance deployment system.

If energy can be neither created nor​ destroyed, what happens to the kinetic energy in a projectile during penetrating​ trauma?

It is primarily transferred to the penetrated object.

If a patient presents with what you suspect is a severe case of pelvic inflammatory disease with lower abdominal pain and rebound​ tenderness, which of the following statements is​ true?

It may be impossible for you to rule out appendicitis instead of PID.

What is the primary reason you can still be seriously injured or killed when wearing body​ armor?

It​ doesn't cover your entire body.

You are transporting a patient with chest pain to a local rural hospital. You have found ST elevation on two​ 12-lead ECGs that you obtained while en route. On arrival at the​ ED, you find out that their only​12-lead ECG machine is being repaired. What might you have to do in this​ situation?

Keep the patient on your cardiac monitor for the time being.

Body armor is typically manufactured from several layers​ of:

Kevlar.

The law of inertia and the law of energy conservation are the two basic principles of what​ concept?

Kinetics

What are the names for the two folds of fatty tissue that arise from the mons pubis and extend to the perineum, forming a cleft?

Labia majora

A victim of penetrating trauma to the neck can also become the victim of an air embolism due to which​mechanism?

Laceration of the internal jugular vein

Which of the following factors should not increase the​ paramedic's index of suspicion for medication noncompliance in an elderly​ patient?

Lack of sensory impairment

You and your partner are rural paramedics responding to an emergency in an area with one small hospital. What is one challenge that you may face that​ urban-based paramedics rarely have to be concerned​ with?

Lack of​ full-time ED staff at the receiving facility

During a fight with a​ knife-wielding assailant, your teenage patient was stabbed in the lower left abdominal​ quadrant, at roughly the 5​ o'clock position. Bleeding is​ minimal, and the patient is conscious and in extreme pain. Given this​ injury, what structure is most likely injured from the​ stabbing?

Large bowel

You are dispatched to the scene of a stabbing outside a downtown bar. After being cleared to approach the scene by law​ enforcement, you find a​ 21-year-old female with a single stab wound to the left upper​quadrant, immediately inferior to the rib​ cage, that she states she received from her boyfriend. You notice a​ 4" long​ knife, which is still lying on the ground beside​ her, with a small amount of blood. Which​organ/tissue is least likely to be in the wound​ track, given how a male would likely wield a​ knife?

Large intestine

Which statement is most accurate regarding a lateral impact vehicle​ accident?

Lateral compression may cause splenic injury to the driver and liver injury to the passenger.

In an automobile extrication​ situation, which type of glove provides the best protection against injury from jagged metal and broken​ glass?

Leather

You are on scene where a patient says that she was sexually assaulted by her new boyfriend. The boyfriend left the scene before your​ arrival, but he returned while you were still there. He starts to yell at you and​ screams, "Over my dead body you will take her out of​here! Now leave​ immediately!" What should you do​ next?

Leave the scene and call for police.

In a drowning​ incident, how much water typically enters the​ lungs?

Less than 30 mL

Which protective ensemble offers the highest level of respiratory and splash protection against unknown​substances?

Level A

What level of hazardous materials personal protective equipment provides chemically resistant splash​protection, but not full​ encapsulation, and includes​ SCBA?

Level B

What trauma center designation is given to a regional trauma​ center, usually a university teaching​ center, prepared and committed to handle all types of specialty​ trauma?

Level I

When population density does not permit a commitment to Level I trauma center​ requirements, what level of trauma center could best act as a regional trauma​ center?

Level II

A hospital that is most likely to attempt​ non-surgical stabilization of critical trauma patients prior to transporting them to a hospital with​ higher-level trauma capabilities has a trauma care rating​ of:

Level IV.

Which of the following is NOT a chemical nerve​ agent?

Lewisite

During your collision analysis of two vehicles striking head​ on, you note that the SRS system deployed in both​ cars, and the drivers are walking around the scene. Neither vehicle has a damaged windshield. What should your vehicle investigation also​ include?

Lift the air bag and look for dash or steering wheel damage.

What type of necrosis denatures proteins and​ collagen?

Liquefaction

Which abdominal organ is responsible for detoxifying​ blood, producing​ bile, storing​ glycogen, producing proteins utilized in the clotting​ process, and assisting in osmotic fluid​ regulation?

Liver

Which of the following organs would be expected to display the most damage resulting from the pressure wave of a​ high-velocity, penetrating​ object?

Liver

What is required by a TEMS unit in order for it to begin​ operations?

Local protocols and standing orders

Your squad is dispatched to a residence for a​ 9-year-old male patient with a head laceration. When you​ arrive, you are directed by another young boy to the​ kitchen, where you find the patient sitting at the table crying, with his mother standing behind him holding a kitchen towel over his left ear. You notice that there is a small amount of blood on the​ child's shirt also. As you approach the​ boy, he tells you that they were having a sword fight with plastic swords when the other boy struck him on the ear and he began bleeding. After establishing that the child does not appear to be in immediate​ danger, you prepare a dressing and bandaging materials and remove the cloth to inspect the laceration. During inspection you note that the laceration has horizontally bisected the outer ear at the level of the ear canal and lacerated the scalp in the mastoid area. Which method of bleeding control would you​ implement?

Loose gauze dressing to absorb blood

Hemorrhagic shock is typically initiated by what​ event?

Loss of blood from the vascular compartment

Which of these is an​ age-related change of the renal system that can change the elderly​ person's response to​ medications?

Loss of nephron function results in decreased efficiency of urine production and accumulation of medications and wastes in the blood.

What physiological differences most likely adversely affect an elderly​ patient's response to​ hemorrhage?

Lower fluid reserves and​ less-responsive compensatory mechanisms

What is an unintended consequence of fluid resuscitation in the trauma​ patient?

Lowering of the core body temperature

Which of the following is the site from which civil government officials exercise direction and control in an emergency or​ disaster?

MACC

What population is most at risk for head or spinal column​ injury?

Males aged 15-24

You arrive at the residence of a patient who is utilizing a piece of homecare equipment that is a cuirass resembling a tortoise shell strapped to his chest. The family states that they lost power several hours before and the battery​ back-up is now alarming. What should you be prepared to​ do?

Manually ventilate the patient.

When the​ body's compensatory mechanisms can no longer maintain the core temperature due to heat​loss, what​ happens?

Metabolic rate and cardiac output fall.

What injury would be classified as a diffuse brain​ injury?

Mild axonal injury

In​ 1970, the U.S. Congress passed the following​ act, which allowed the​ military-proven system of helicopter evacuation to augment the civilian EMS system with helicopter​ evacuation:

Military Assistance to Safety and Traffic

In which stage of hypothermia is the ability to shiver usually​ lost?

Moderate hypothermia

Which of the following conditions is contributing to the increase in ambulance collisions over the last​decade?

Modern automobiles are more sealed and​ soundproof, which makes it more difficult for drivers to hear the approaching ambulance.

You respond to a private residence for a​ 23-year-old female who told the dispatcher that her hysterectomy incision opened up when she sneezed. You arrive to find the patient lying on the couch with her robe opened​ up, displaying her open abdominal incision. There is no bleeding but a section of the small intestine is exposed. How would you address the dressing and bandaging of the​ wound?

Moisten a sterile abdominal bandage with sterile saline and place securely enough to hold the contents in​ place; monitor respirations.

Which of the following is TRUE of the epidemiology of abdominal​ trauma?

Morbidity and mortality due to blunt trauma are​ decreasing, but morbidity and mortality due to penetrating trauma are increasing.

Which of the following patients may not be suitable candidates for air medical transport in​ rotary-wing aircraft?

Morbidly obese patients

Which statement regarding musculoskeletal injuries is​ true?

Most patients who suffer multisystem trauma experience significant musculoskeletal injuries.

Which of the following statements concerning sexual assault is​ accurate?

Most sexual assaults are never reported.

A​ 68-year-old woman lives in an​ upper-floor, urban area apartment without air conditioning. In early​ May, an unseasonable heat wave​ occurs, with a sudden change in temperature into the​ mid-90s with high humidity. On the fourth day of the heat​ wave, the​ woman's neighbor finds her passed out. In your assessment of this​ patient, you find she is responsive only to pain and has​ hot, reddened, dry skin. What steps should your treatment of this patient​ include?

Move her to a cool​ environment, initiate active rapid​ cooling, give oxygen as​ required, run IV normal saline wide open​ initially, and initiate ECG monitoring.

If a​ hearing-impaired patient is having difficulty understanding you while you are seated behind the patient in the​ ambulance, what should you​ do?

Move to where the patient can see your face.

You are involved in the initial response to a nuclear detonation. Which of the following will likely be an early priority in managing this​ incident?

Moving survivors into structures to protect them from fallout

What is another name for cystic​ fibrosis?

Mucoviscidosis

Which of the following scenarios is MOST likely to be a potential terrorist​ incident?

Multiple explosions in an urban subway system

Why is crush syndrome particularly​ dangerous?

Myoglobin and other toxins flood the bloodstream when the crush pressure is released.

What are the discrete tissues and muscles of the body that are controlled by specific spinal nerve​ roots?

Myotomes

Developing workplace safety standards is the responsibility​ of:

NIOSH

What is the first sign that can reliably be attributed to a state of hypovolemic​ shock?

Narrowing pulse pressure

To help improve the quality of medical oversight and support that physicians can provide to urban and rural EMS​ systems, what national organization has developed​ physician-level courses specifically designed for​ this?

National Association of EMS Physicians

Which of the following incident management concepts is the comprehensive standard currently utilized since​ 9/11?

National Incident Management System​ (NIMS)

You are called by the police to a particular street address. When you​ arrive, you are directed to a police​ cruiser, where a​ 7- or​ 8-year-old boy is sitting in the back​ seat, covered with a wool blanket placed by the officer. The officer reports that the patient was found sitting outside in the cold with no winter​ coat, locked out of his house. As you evaluate this​boy, you find that he is unusually thin for his age and dirty. Which type of abuse best categorizes this​ patient?

Neglect

If a patient was to display some signs and symptoms of a Class I​ hemorrhage, what would they​ include?

Nervousness and marginally cool skin with a slight pallor

What is​ neovascularization?

New blood vessels generated from undamaged capillaries assist in healing and formation of new tissue.

You arrive at the scene of a flash fire that occurred when fumes from a pan of​ gasoline, in which the victim was cleaning​ parts, ignited. The​ victim, who is conscious and well​ oriented, received partial thickness and a few small full thickness burns to his hands and forearms. His vitals are currently respirations​ 18, pulse​ 100, blood pressure​ 120/76, and pulse ox 100 percent on room air. How should oxygen be administered to this​ patient?

No oxygen therapy at this time

In which type of accident can you immediately rule out a suspicion of the presence of hazardous ​materials?

No transportation accident

What role does psychological debriefing or diffusing provide within the scope of an​ MCI?

None

Enforcement of the workplace safety standards put forth by NIOSH is the responsibility​ of:

OSHA

What governing body ensures that ambulances carry items such as disinfecting agents and sharps collections​ containers?

OSHA

What is your best tactical response to​ violence?

Observation

What is a duty of the cover provider while the contact provider is delivering patient​ care?

Observes the scene for danger

Which of the following statements is most accurate regarding a wound from a​ handgun?

Only organs directly in the​ bullet's path are likely to be injured.

What is the critical responsibility of the logistics section of​ NIMS?

Operating the medical supply unit

Which impact occurs third during a vehicle​ collision?

Organ collision

You are treating an elderly patient who is displaying a behavioral​ problem, according to family members. They can provide no reason why their elderly​ relative's behavior​ changed; they just know that​ it's not right. In taking this​ patient's history, what sign or symptom would make you suspect drug​ abuse?

Orthostatic hypotension

Which of the following conditions occurs as a result of loss of minerals in bone​ tissue, leading to an increase in bone fractures if the elderly patient​ falls?

Osteoporosis

Your patient complains of severe abdominal pain on her right​ side, radiating to her back. She reports pains during intercourse and a delayed menstrual period when you take her history. What do you​ suspect?

Ovarian cysts

During scene​ size-up, what may alert you that a patient is receiving home​ care?

Oxygen equipment is in view when you enter the​ patient's residence.

Two teenagers are stranded on a large rock along with their overturned canoe in the middle of a rushing stream. Before you effect the​ rescue, which of the following PPE would be most appropriate to give to the​victims?

PFDs if they are not currently wearing them

You respond to a​ 78-year-old patient with a myocardial infarction who is bedridden in a nursing home. You discover when assessing the patient that she has a​ large, severe pressure ulcer on her lower back. Which consideration is inappropriate for this​ patient?

Pack the ulcer with dry woven gauze

What should be done with the information you receive from emergency medical responders and EMTs about the​ patient's condition and the care he received after you finish formulating a patient management​ plan?

Pass the information along to the ED.

Why is patient assessment provided by the contact​ provider?

Patient care duties can prevent observation of the scene by the cover provider.

You are dispatched to the scene of a shooting. While en​ route, dispatch directs you to a secure staging ​area, set up by law​ enforcement, half of a block from the incident. On​ arrival, you see two officers dragging another officer between them to your unit. You exit the unit and quickly pull the cot out of the​back, and the officers place the victim sitting up. They quickly explain that he was securing the perimeter when he was shot in the left shoulder by an unknown assailant. Your patient appears alert and well oriented and is complaining of severe left shoulder pain. You note a bullet hole in the front of his body​ armor, high on the left side. You cut off his vest and as you remove​ it, a bullet drops out of the vest onto the​ cot, and you also see an exit wound at the inferior edge of the left scapula with little blood exiting. You apply an occlusive dressing and lay the victim back on the cot. You then notice an entrance wound at the second intercostal​ space, also hemorrhaging​ slightly, and place an occlusive dressing there also. Your patient still appears well oriented but is very anxious and excited about what has happened. You quickly auscultate the lungs and find breath sounds equal and clear on both sides with a rate of 34. Your​ victim's pulse is 120 and easily palpable in his left radial​ artery, and the pulse ox reads 100 percent. While there appears to be no change in the injury site or​ respirations, he is now complaining of numbness and tingling in his fingers and toes. You opt to take his blood pressure and find it to be​ 138/76. As you continue your exam and​ care, how would you mentally note the​ patient's complaint of numbness and​ tingling?

Patient complains of numbness and tingling in the fingers and toes

Which of the following statements regarding operations within the hot zone is most​ inaccurate?

Patients found with compromised airways should be addressed before being moved to the warm zone.

What patient demographic is most likely to suffer a greenstick​ fracture?

Pediatric

What type of injury is most likely to result in frank​ hematuria?

Pelvic fracture

Your​ 26-year-old patient appears to be acutely ill and palpation of her lower abdomen produces severe pain. She has drawn her knees up to her chest because she says that this enables her to feel the most comfort. She says walking intensifies her pain. You suspect which of the​ following?

Pelvic inflammatory disease.

What type of trauma is most likely to cause vascular injuries to the​ abdomen?

Penetrating

Open chest wall injuries are almost entirely the result of what​ mechanism?

Penetrating trauma

You are dispatched to the scene of a house fire from which a​ 38-year-old woman was rescued. On your​arrival, fire department personnel inform you that she was extricated from the living room sofa near the point of outbreak where she was found​ unconscious, and she was placed on​ high-flow oxygen via a nonrebreather mask. The victim is currently unconscious with partial and a few full thickness burns of her​feet, ankles,​ hands, arms, and​ face; her hair is singed. Her vital signs are respirations 28 and shallow and labored with diffuse​ wheezing, pulse​ 100, and blood pressure​ 132/78. The pulse ox reads 88 percent. You evaluate her airway and find it too constricted from swelling for successful intubation. What would be the next appropriate step in your treatment​ plan?

Perform a cricothyrotomy.

What tissues form a slinglike structure that supports the internal pelvic organs and that is able to stretch during​ childbirth?

Perineum

A chemical that remains a liquid is poses a contact or absorption threat and is said to​ be:

Persistent

Which of the following is not a leading cause of trauma in the​ elderly?

Polypharmacy

You are first on the scene of a​ single-car vehicle crash. As you approach the​ scene, you notice that the car has sustained moderate​ front-end damage and the​ occupants, a​ middle-aged man and​ woman, are standing beside the car arguing. The woman has a bloody lip as well as a cut over one eye that is bleeding. Dispatch informs you that law enforcement is about 2 minutes out. How would you approach the scene if you decide it is safe to do​ so?

Position your vehicle to protect the​ scene, notify dispatch of the activity at the​ scene, and have your partner exit the vehicle and cautiously approach the couple while you remain in the vehicle.

You are dispatched to a possible shooting. While you are en​ route, your dispatcher informs you that law enforcement is on the​ scene, confirms the​ shooting, and tells you that the scene is secure. On your​arrival, you are led to a​ 24-year-old female who is conscious and well oriented. She tells you that she feels okay except for some difficulty breathing and severe pain along her right midaxillary line. She indicates a location on the right lateral aspect of her chest where you see a​ small-caliber bullet wound. There is no exit wound. You note that her pulse is 90 palpated radially and her respirations are​ 22/min. How would you rate this patient using the CUPS​ acronym?

Potentially unstable

Which finding is most critical to the paramedic regarding a genital injury to a female from​ assault?

Preserving physical evidence

You are dispatched for a fall at the local mall. When you arrive you are led by security to a location on the sidewalk where a​ 43-year-old male patient is lying on his back. He is alert and oriented and tells you that he was running to cross in front of a car when he tripped on the​ curb, striking his head on the sidewalk. He then rolled onto his back and can no longer move his​ hands, legs, or​ trunk, although he can still move his arms. You suspect a low cervical or high thoracic spinal injury. At what point in the assessment would you apply spinal stabilization to this​ patient?

Primary assessment

If you are utilizing the START system at an​ MCI, what type of evaluation are you​ performing?

Primary triage

What is an inexpensive vinyl tarp useful​ for?

Protection from​ water, weather, and most debris

Which statement is true regarding protective gear and sports​ injuries?

Protective gear can contribute to a sports injury.

You are assessing a female who was shoved down hard by her boyfriend during an argument. The police have the male in​ custody, and the female seems relatively unharmed. She has decided to not be transported to the hospital by ambulance. Before you​ leave, what should you​ consider?

Provide her with a list of local resources for victims of partner abuse

In​ 2008, the FCC established a new office to handle public safety​ issues, known as​ the:

Public Safety and Homeland Security Bureau.

What injuries are received during the primary blast​ phase?

Pulmonary injuries

What type of barotrauma is most likely to occur if a diver fails to breathe during​ ascent?

Pulmonary overpressure injury

Which wound type has the greatest tendency to conceal the actual extent of​ injury?

Puncture

What is the elevation of the body temperature above the normal temperature for that​ person, usually because of​ pathogens?

Pyrexia

Trauma triage criteria​ application, field skill​ performance, and response time are various system aspects studied​ by:

QI committees.

What blast injury type is severe burns associated​ with?

Quaternary

What is the typical cause of dysbarism when​ diving?

Rapid ascent

Your geriatric patient is experiencing a behavioral emergency. You believe that it is from delirium rather than dementia. Which of the following findings would support that delirium is​ present?

Rapid onset of behavior change

Which of the following describes definitive care of the patient with traumatic intraabdominal​ hemorrhage?

Rapid surgical intervention

Questioning a patient about respirophasic​ pain, or pain with breathing​ effort, would happen during what part of​ assessment?

Rapid trauma assessment

Which aspect of force is the primary cause of​ injury?

Rate of deceleration

In a​ disaster, if operations have begun to return people who have been evacuated to their homes and​ communities, then you are in which​ phase?

Recovery

The pathophysiology of​ high-altitude illness revolves around which​ condition(s)?

Reduced air pressure and oxygen availability

What procedure should be pursued when a MCI responder is not adapting to the disaster​ normally?

Refer the responder to a competent person.

Which of the following statements is true regarding​ endometriosis?

Regardless of its​ location, the tissue bleeds in a cyclic manner.

Which of the following is critical when multiple agencies respond to a single​ incident?

Reliable equipment designed to afford clear communication among all agencies within the system

You are the first on the scene of a​ single-vehicle crash late at night. During your windshield​ survey, you notice that damage to the car is​ minimal, the driver is slumped over the steering​ wheel, and the car trunk lid is ajar but not open. What would the most appropriate next step​ be?

Remain in your vehicle or bypass the accident until law enforcement arrives

You have a patient who is dependent on a home ventilator to stay alive. You were called to the scene by family members because the alarm on the​ patient's ventilator was sounding. The entire time you are​there, the ventilator is operating normally. You advise the patient to go to the hospital and have the ventilator​ checked, but the patient refuses to go. The patient is alert and understands the situation. What should you​ do?

Remain on scene until someone from the ventilator company arrives to test and possibly replace the ventilator.

You are treating the victim of a stab wound to the neck with the knife left in place. What field treatment would you pursue if you believe that the knife is significantly impinging on the​ airway?

Remove the object

You are requesting air medical transport at the scene of a collision involving two vehicles. You have several injured patients. What launch information should you be prepared to​ provide?

Requesting agency identity

What bodily activity that results from hypothermia robs the trauma victim of much needed metabolic resources?

Shivering

Which of the following statements regarding rescue situations is​ true?

Rescue is a​ patient-driven event.

How can your patient care reports be used for research​ purposes?

Researchers may use certain data elements to assess patient outcomes.

How should you respond if your female patient is reluctant to discuss the specifics of her gynecologic complaint with you in​ detail?

Respect her wishes and transport her to the ED for a more thorough assessment.

You are at the scene where a patient is receiving medication through a PICC line via an infusion pump. The patient has an altered mental​ status, and you ask questions about the​ patient's baseline mental status of the​ patient's home care​ provider, who you initially take to be a trained professional.​ However, the provider seems confused by your questions. What should you​ do?

Restate your questions in simpler terms.

As you approach the driver of a vehicle involved in an​ MVC, you notice that he is being belligerent with the passenger and sounds intoxicated. As you get​ closer, the driver turns his attention to you in the same​fashion, making you concerned for your safety. What should you​ do?

Retreat to the ambulance until law enforcement​ arrives, and be prepared to leave.

What is the first opportunity to begin the assessment​ process?

Review of dispatch information

You have not worked for a couple of months at the EMS station to which you are assigned. What is the most important thing you should do at the beginning of your​ shift?

Review the location of equipment to familiarize yourself with the ambulance.

In crush​ syndrome, crushed skeletal muscle tissue can undergo disintegration and as a result release metabolic byproducts. What is this degenerative process​ called?

Rhabdomyolysis

Early one​ morning, you are assessing a patient who states that she was at a party last night drinking and brought a male home with her. She further states that she fell asleep on the​ couch, although she​ doesn't remember when that​ happened, the man was gone in the​ morning, and she thinks she was raped. If she is​ right, which of the following drugs is likely to have been used to facilitate the​ rape?

Rohypnol

When conserving a wet garment worn by the victim of a​ crime, how should you store the​ item?

Roll the item in a paper​ bag, place it in a second paper​ bag, and place both bags in a plastic bag.

In addition to the traditional management of a patient with spinal injury and abdominal trauma who is immobilized on a​ backboard, what intervention should be provided for the​ 8-months-pregnant female with abdominal​ trauma?

Rotate the board 15 degrees to the left.

Which of the following injuries would be the result of a pressure wave associated with the detonation of an explosive​ device?

Ruptured eardrums

Which of the following statements regarding rural populations is​ true?

Rural areas have a higher percentage of people over age 65.

What is the condition in which EMS providers are unable to stay abreast of current standards or previously taught​ practices?

Rust out

Your patient presenting with nontraumatic vaginal bleeding passes a clot on the way to the hospital. How should you handle this​ clot?

Save it for evaluation.

You suspect the driver of a car in a motor vehicle collision​ (MVC) with airbag​ deployment, despite having no complaint of​ injury, might still have sustained a spinal injury based on the​ high-force mechanism of injury. At which point in the assessment would you develop this​ suspicion?

Scene​ size-up

A properly restrained driver is found unconscious in a utility van with moderate damage to the front of the​vehicle, after being involved in a frontal collision. The steering wheel is not​ deformed, nor does the windshield show signs of impact in front of the​ driver; however, the passenger side of the windshield is damaged. The​ driver's headrest appears to be at an appropriate height. Equipment and debris from the van is scattered in the roadway. What is the most likely cause of his decreased level of​ consciousness?

Secondary collisions

What causes burn injury in an explosive​ attack?

Secondary combustion

Patients can be exposed to an incredibly large number of chemicals. In any situation involving chemical​exposure, what should you do after ensuring your own​ safety?

See that all patients receive the necessary supportive measures.

Which part of the inner ear is responsible for​ equilibrium?

Semicircular canals

Which of the following is one of the 10 steps for injury prevention developed by William Haddon in​ 1972?

Separate the hazard and that which is to be protected by a barrier.

You are caring for a patient with an external fixation device with rods screwed into his femur in multiple locations to help immobilize the bone that was shattered in a motorcycle accident. The patient is displaying a slightly altered mental​ status, tachycardia, marginal blood​ pressure, and a fine rash on his body. The family states that the​ patient's condition has been getting worse over the last several days but that the patient would not go to be seen by a physician. What will be the most immediate likely outcome if the patient is not evaluated and treated for this​ condition?

Sepsis

Which statement is accurate regarding external blood​ loss?

Serious blood loss can be hidden from view due to clothing.

In an injury to the abdominal​ wall, visible ecchymosis and swelling typically takes how long to​ develop?

Several hours

It is five hours after a nuclear​ detonation, and several patients are beginning to present with​ nausea, fatigue, and malaise. The radiation exposure for these patients should be​ considered:

Severe

Which term is defined as a significant mechanical disruption of axons in both cerebral hemispheres with extension into the​ brainstem?

Severe diffuse axonal injury

Which of the following is TRUE of the patient with a suspected penetrating injury to or rupture of the​ diaphragm?

Shallow respirations may be due to abdominal contents in the thorax.

You are called to a party at a fraternity house where an​ 18-year-old girl was found in an upstairs bedroom passed out. When you walk​ in, you find the girl to be responsive to painful​ stimuli, she has dilated pupils and slow​ breathing, and she is naked from the waist down. No one at the party seems to know who she is. What may have happened to the​ patient?

She is likely a victim of a date rape drug.

What is the term for the mechanism of injury when a farmer loses the fingers of one hand while trying to work on a sickle bar mower while it is still​ running?

Shear point

Which of the following is most likely to occur as a result of rapid deceleration without actual contact between the​ patient's body and the interior of the​ vehicle?

Shearing injury of the liver

You suspect your elderly patient is suffering from a reaction to​ Lisinopril, an ACE​ inhibitor, in addition to diarrhea. Which​ sign/symptom would lead you to believe​ this?

Significant hypotension

What could be an early indicator of internal bleeding requiring intervention as part of your treatment​ plan?

Signs of poor peripheral perfusion

Which of the following statements is true about trauma in the​ elderly?

Signs of subdural hematoma in an older person can develop​ slowly, over time.

Which of the following is the cardinal sign of a toxic chemical​ release?

Similar signs and symptoms occurring rapidly in a group of individuals

Which of the following is a type of pulmonary​ injury?

Simple pneumothorax

You are a paramedic in a rural farming community. One particular​ afternoon, you are summoned to a farm for a worker who is pinned under a piece of heavy machinery he was working on. The local sheriff meets you near the location to guide you in and tells you to​ hurry, as the patient is reportedly unresponsive. What should you consider first when making patient​ contact?

Sizing up the scene to look for potential dangers

What are the two main subsystems of the musculoskeletal​ system?

Skeleton and muscles

Electrical burns typically deliver a heat burn resulting from the​ body's resistance to the flow of energy. Which part of the body typically receives the largest amount of​ burn-related damage?

Skin

What aspect of burn patient assessment gives the most information about the​ body's condition?

Skin condition

Which type of motorcycle collision occurs when an experienced rider trades severe injuries for minor to moderate injuries by placing the motorcycle between themselves and an​ object?

Sliding impact

Why is it important not only to provide proper care for a victim of elder​ abuse, but also to let the victim know about resources in the community for these types of​ situations?

So that the victim can learn better strategies to help avoid or stop the abuse

What​ is, by​ far, the most common type of trauma the body​ sustains?

Soft tissue injuries

Where did​ large-scale emergency organization first take​ place?

Southern California

Which body tissue would receive the most serious damage from the pressure wave of a​ high-velocity rifle​round?

Spleen

Which of the following organs is NOT part of the digestive​ system?

Spleen

When walking up to a​ residence, how should you position yourself relative to the door before knocking on​it?

Stand to the side of the door

In terms of reducing your exposure to an alpha radioactive​ source, what is the best​ method?

Standard Precautions

You and your partner arrive at the scene of a construction accident. The​ patient, a​ 43-year-old finish​carpenter, was cutting the edge off a trim board when the knife​ slipped, avulsing a large section of his anterior lower​ arm, including underlying musculature and veins. He is currently alert and​ oriented, and a coworker is successfully applying direct pressure over the avulsed flap to control bleeding. The​ patient's respirations are 12 and his right radial pulse is 84. Which form of bleeding control would you initially attempt to​ utilize?

Sterile dressing with a circumferential​ bandage, moderately wrapped to provide pressure

Internal intercostal​ muscles, along with the diaphragm and what other​ muscle(s), are the major muscles of​ inhalation?

Sternocleidomastoids

When removing an injured victim from rough​ terrain, the most appropriate device to package a patient and prepare for transport is​ a:

Stokes basket

The standard litter for transporting a patient across rough terrain is​ the:

Stokes basket.

What is the most common form of genital​ trauma?

Straddle injuries to females

The ambulance checklist for the beginning of a shift would normally not include which of the​ following?

Stretcher maintenance record review

Which of the following types of protective equipment offers the least amount of protection to hazardous materials​ exposure?

Structural firefighting gear

When palpating a​ patient, what does a​ "Rice Krispies" feel to the skin​ signify?

Subcutaneous emphysema

What is bleeding called that occurs within the​ meninges, specifically beneath the dura mater and within the subarachnoid​ space?

Subdural hematoma

You are dispatched to an unknown medical emergency near the city park. You arrive to find the fire department and police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the​ manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped​ forward, unconscious. You also note sonorous respirations and see a visible open femur fracture that is freely hemorrhaging and blood dripping from her face or head. The fire department has determined that the atmosphere in the manhole is​ safe, and you enter the space. Your partner repositions the airway while initiating manual spinal alignment. The sonorous respirations​ cease, but you note that she has audible gurgling and an apparent maxillary​ fracture; she is bleeding heavily from the mouth and nose. Which choice would be your next​ step?

Suction as​ required, place a mechanical​ airway, and assist ventilations as needed.

You are called to respond to an accident involving a hybrid vehicle. During the scene size up portion of your vehicle collision​ analysis, which considerations are specific to a hybrid​ vehicle?

Sudden vehicle acceleration or electrocution from the vehicle electrical system

Which adult patient would be considered to be minor in terms of burn​ severity?

Superficial burns to the anterior arms and anterior chest

Which adult patient would be considered to be moderate in terms of burn​ severity?

Superficial burns to the​ arms, legs, and torso

What is temporary hypotension caused by the weight of the gravid​ uterus, which occurs in the third trimester of​ pregnancy?

Supine hypotensive syndrome

You are dispatched to the scene of a hunting accident and arrive to find an​ 18-year-old male patient with an arrow through his right​ shoulder, the tip protruding anteriorly. He is conscious and well​ oriented, and has a respiratory rate of 14 and easy with clear bilateral lung​ sounds; his radial pulse is​ 74, and the pulse ox reads 99 percent on ambient air. You note only minimal bleeding from the wound sites. How would you prepare your patient for​ transport?

Support the arrow in place and place your patient on his left side.

Of all the different types of technical rescue​ situations, which of the following is most likely to not require the involvement of​ EMS?

Surface water rescues

What is the collection of data to identify the​ existence, significance, and characteristics of a disease​called?

Surveillance

Which methodology provides initial data collection for injury​ prevention, the trauma​ registry, and quality​improvement?

Surveillance

You respond to a call for a patient complaining of midcycle abdominal pain you field diagnose as mittelschmerz. Treatment of this patient should include which of the​ following?

Symptomatic treatment only

When observing the​ patient's respiratory effort and chest​ excursion, what are late signs of​ shock?

Tachypnea and air hunger

Which of the following is not a strategy that would help prevent the onset of a heat emergency such as heatstroke in a geriatric​ patient?

Taking a salt pill before attending an outside event

Which of the following best explains the role of EMS providers in preventing secondary contamination at a hazardous materials​ incident?

Taking initial actions to contain and isolate the hazardous material and patients

Which of the following best describes shear injuries to the abdominal​ organs?

Tearing of the organ in which the organ is fixed at its point of attachment but free to move otherwise

A home health aide is on the scene with a patient who has multiple pieces of medical equipment in the bedroom performing a variety of tasks. During this patient​ encounter, which of these actions by the paramedic would not be considered​ professional?

Tell the aide that you will take charge from here and the aide is no longer needed.

A patient experiences heavy vaginal bleeding in a public place that causes her to briefly faint. She feels humiliated. Which of the following is not an example of psychological support for this​ patient?

Tell the patient that no one is likely to judge her for what happened

An explosion collapses a parking​ garage, crushing the legs of a​ bystander; what type of injury would this​ be?

Tertiary

You are dispatched to the home for a pediatric patient who is on an apnea alarm. Dispatch advises you that the family reports that the alarm keeps going off. What should you consider prior to​ arrival?

That the patient might not be breathing

Your patient was sexually assaulted. Which of the following should you document on the PCR for this​ patient?

That the​ victim's clothing was torn

Which of the statements regarding the Glasgow Coma Scale is​ accurate?

The GCS is not a​ "perfect" means to accurately represent a​ patient's level of consciousness.

What is the name of the tool developed to identify risk elements associated with​ trauma?

The Haddon Matrix

Which of the following is true regarding the patient care​ report?

The PCR may be written or electronic.

Regardless of the type of Stokes basket selected for your​ service, these devices typically require which of the​ following?

The addition of adequate restraints

Which of the following statements is true about the typical budget for EMS services in rural areas of the United​ States?

The budget is typically too low.

What is indicated by the lack of an exit wound in a patient that suffered a​ GSW?

The bullet expended all its energy.

What is the difference in the energy delivered to soft tissue by a bullet that does not deform on impact when compared to a round of equal weight and speed that does​ deform?

The deformed round delivers more energy.

You are dispatched to an industrial accident for a​ 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On​ arrival, you find the patient in the company​first-aid station supine on a cot with a scoop stretcher and cervical collar in​ place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse​ 70, BP​ 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he is now only purposefully responsive to pain. When examining this​ patient's head, other than noting obvious signs of​ trauma, to where should you direct special​ attention?

The eyes

Which consideration is most pertinent when performing a collision analysis on an elderly​ victim?

The force required to fracture bones is much lower in the elderly.

What is the fibrous connective tissue sheet directly beneath the skin and covering the most superior surface of the​ head?

The galea aponeurotica

In which service or agency did the origin of incident management have its​ roots?

The fire service

Who often determines the course of an MCI​ event?

The first responders

Which definition most accurately reflects the meaning of the term​ "Golden Period"?

The goal for​ incident-to-surgery time for trauma patients

Which of the following changes is NOT of concern in the pregnant trauma​ patient?

The high likelihood of trauma to the uterus in the first trimester

As patients and their families assume greater responsibility for their own treatment and​ recovery, what is the implication of this for​ paramedics?

The likelihood of ALS intervention for the chronic care patient increases.

For an isolated​ mid-shaft femur​ fracture, when should you stop the application of​ traction?

The limb is immobilized and patient discomfort ceases.

Which statement concerning the golden period is​ true?

The paramedic cannot control many of the factors that consume the golden period.

You are summoned to a home for an​ "unknown medical​ emergency." On​ arrival, you find that the patient is receiving mechanical ventilation but looks cyanotic. Which of the following assessments relative to this would indicate an​ emergency?

The patient has no alveolar breath sounds.

You are called to the home of an elderly patient who is reliant on his daughter for ongoing care. His daughter is also on​ scene, having just arrived home from work. During your assessment of the​ patient, you find him to appear malnourished and​ dirty, and he has multiple areas on his body where ulcerations are forming. Despite your desire to transport​him, the daughter keeps​ stating, "Just leave him​ alone, he's fine.​ I'll make an appointment sometime​ soon, so just leave​ now." What should you conclude about this​ patient?

The patient is being neglected.

You arrive on scene for an unknown medical emergency. As you approach the front door of the ​residence, you see a sign in the window that reads​ "No Smoking. Oxygen in​ Use." From this​ information, what can you surmise about the​ patient?

The patient likely has a chronic pulmonary disease.

You are caring for a​ 77-year-old male who complains of​ nausea, weakness, puffy​ ankles, and trouble breathing. The complaints have been present for the past two hours. When​ questioned, the patient denies chest​ pain, abdominal​ pain, or headache. He has a history of diabetes and hypertension. After you transfer care to the emergency department​ staff, the physician advises you that​ ST-segment elevations were found on the​ patient's 12-lead​ ECG, signifying a possible heart attack. Which of the following best explains the absence of common associated signs and symptoms on​ scene?

The patient may have had a​ "silent" myocardial infarction.

You are caring for a person who is on vacation and was seriously injured at night. The closest hospital is 2.5 hours away by​ ground, so you decide to use the local HAA program for transport. In which of the following situations may this not be the best idea for​ transport?

The patient was injured while completing a nighttime hike through the woods.

An elderly male refuses to be transported to the hospital after he was physically abused by his son following an argument. His injuries are​ minor, but the elderly man does not want to be transported because of the cost associated with it. What is most important thing to document about this​ call?

The patient was physically abused.

In the process of attempting to rescue a fellow worker from a chemical​ tank, additional workers were exposed to the same product through contact with the original worker. For gross decontamination of these​ workers, what is the first​ step?

The patients remove all clothing and​ jewelry, including shoes and socks.

What procedure should be followed if a collision during a sporting event leads to a period of unconsciousness or decreased level of awareness in a​ participant?

The person should be seen in the ED prior to returning to the game.

You are dispatched to the scene of a house fire from which a​ 42-year-old woman was rescued. On your​arrival, fire department personnel inform you that she was extricated from a​ second-floor bedroom where she was found​ unconscious, and she was placed on​ high-flow oxygen via a nonrebreather mask. The victim is currently unconscious with partial thickness burns of her​ feet, ankles,​ hands, and forearms. Her vital signs are respirations 32 and​ shallow, pulse​ 128, and blood pressure​ 102/78. The pulse ox reads 100 percent. There is no apparent swelling of the​ airway, and you opt to continue​ high-flow oxygen via the nonrebreather mask. What should you also immediately consider regarding her continued​ treatment?

The potential for cyanide poisoning

Why is accurate assessment of the geriatric trauma victim especially essential to proper​ treatment?

The problem may be masked or confused by signs and symptoms of preexisting disease.

What is the​ lung's sole fixation point in the thoracic​ cage?

The pulmonary hilum

What have improved building​ codes, safer construction​ techniques, sprinkler​ systems, and smoke detector use done to the mortality rate due to​ burns?

The rate has been declining for decades in the United States and other developing countries.

What is the degree of deformity of an​ automobile, involved in an​ accident, most indicative​ of?

The strength and direction of forces experienced by the occupants

What is the most direct result of alveolar shunting caused by atelectasis in the drowning​ victim?

The return of deoxygenated blood to the bloodstream

Immediately after​ impact, at what rate of speed will the unrestrained driver continue to move forward in a frontal impact vehicle​ collision?

The same speed as the vehicle

What position is responsible for being in charge of a specific functional area of the​ NIMS?

The section chief

Which patient would be the best candidate for the administration of​ mannitol?

The severe head injury patient exhibiting signs of herniation with a systolic BP over 90

Which of the following statements regarding the skin of an elderly patient is​ false?

The skin perspires less often.

What is not a reason that the​ atlas/axis joint is the site of the majority of fatal spine​ injuries?

The spinal cord roots exit the spinal column at this point.

Which statement regarding incident impact is most​ accurate?

The techniques and tools used to respond to a​ multiple-patient MVC can also be used to manage a more extensive MCI.

Who is responsible for arranging movement of patients from treatment areas at the scene of an MCI to area​ hospitals?

The transportation unit supervisor

You arrive at the scene of a patient who is having difficulty breathing and find that he is a traumatic brain injury patient who has just been released to home for care and is dependent on a mechanical ventilator. The ventilator is sounding an alarm and indicating​ "Low FiO2." What is the first thing you should​ check?

The ventilator oxygen source

Tetanic convulsions can accompany electric shock from household current. How do these convulsions contribute to prolonged exposure to the​ current?

The victim may be unable to break contact with the electric source.

For what reason would an obese patient fare worse than the general population when progressing through the stages of shock due to blood​ loss?

The volume of circulating blood is based on a​ patient's ideal​ weight, not actual weight.

You respond to the scene of an entrapment and find a​ middle-aged maintenance worker with his legs and abdomen trapped in a steel press. Workers have an overhead crane in place and are feverishly working to remove the​ dogs, which hold the press plate in place. Your primary exam reveals that the victim is​alert, well​ oriented, and normotensive but has no feeling from his chest down. Employees are confident that they will be ready to lift the plate in about​ ½ hour. What might you anticipate happening to the patient when the plate is​ lifted?

There may be severe and​ difficult-to-control hemorrhage.

Why are recreational emergencies at a destination lake typically a strain on EMS​ systems?

They are often​ seasonal, and sudden population changes can stress the rural department.

What do metal​ clipboards, chemical​ agents, and other tools have in common for the TEMS​ medic?

They can be used as defensive weapons.

What is not an advantage of​ fixed-wing aircraft?

They can land almost anywhere.

Which of the following is true regarding simplex radio​ communications?

They can transmit and​ receive, but not both simultaneously.

Which of the following is true regarding modern​ ambulances?

They drive like a large truck

Use of recreational vehicles​ (ATVs) has significantly increased. What impact has this increase had on recreational vehicle​ injuries?

They have significantly increased also.

Which of the following is an accurate statement regarding culturally diverse​ patients' choice whether to receive emergency care by​ paramedics?

They have the right to make care decisions for themselves.

Which of the following is true regarding fragmenting ballistic​ rounds?

They increase in profile and damage potential.

Which of the following statements is true regarding treatment of obese​ patients?

They may blame unrelated signs and symptoms on their weight.

Which of the following is a significant limitation in the use of​ fixed-wing aircraft for air medical​ transport?

They must utilize established airports.

Which of the following is true regarding wireless 911​ calls?

They present challenges that the EMS system is still trying to address.

Which statement concerning contact sports is most​ accurate?

They remain a significant cause of injury.

In accordance with the START triage​ system, what should the disposition be for patients who respond to your request to come to​ you?

They should be confined to one area.

Which statement is most accurate when considering spinal precautions as part of your primary​assessment?

They should be immediately employed when an MOI or patient condition warrants it and discontinued if the patient is completely cleared.

Which statement is true regarding the Golden​ Period?

The​ 1-hour incident to surgery time has not been substantiated.

Which of the following would be a reason that paramedics may be called to the home of a patient receiving chronic home health​ care?

The​ patient's condition suddenly worsened.

You are communicating with the pilot of a helicopter approaching the emergency scene. Which of the following information should not be provided when communicating with the pilot of an approaching​ helicopter?

The​ patient's most current vital signs

You are treating a patient with AIDS for mild hypothermia. What precautionary measures should you​ take?

Those required by departmental policy

How many compartments is the abdominal cavity divided​ into?

Three

How many layers of connective tissue are there between the cranium and the​ brain?

Three

What is not part of the basic IMS organization at many EMS​ incidents?

Timing

What is the purpose of the lymphatic​ system?

To collect some of the fluid delivered to the cells by the circulatory​ system, filter​ it, and return it to the venous system

Why is it most important to repeat orders from medical​ direction?

To confirm understanding

Why is a list of medications important to​ gather, if​ available, during the assessment of a critically injured trauma​ patient?

To determine whether there are any medications that may affect coagulation

Which of the following is a legitimate reason to touch a sexual assault​ victim?

To obtain vital signs

What is the goal of performing EMS at a crime​ scene?

To provide​ high-quality patient care while preserving evidence

What is the basic function of a TEMS​ unit?

To work as medical adjuncts to the police or military

In comparison with the adult​ patient, what type of fracture would the pediatric patient be more prone​ to?

Torus

What possible result of relieving crushing pressure on an extremity after a prolonged period of entrapment could require a​ paramedic's immediate​ intervention?

Toxins entering circulation

You arrive at the scene of an ATV accident and establish that the rider collided with a​ high-tensile wire fence that penetrated his neck. What neck structures are the most often injured from penetrating​ trauma?

Trachea and major blood vessels

Your​ patient, the​ 52-year-old driver of a vehicle that struck a​ tree, is complaining of chest pain and severe difficulty breathing. As you​ approach, you notice that he is​ cyanotic, has​ hemoptysis, and is visibly panicked. During your primary​ assessment, you note that his respirations are 22 and​ shallow, his radial pulse is​ 128, and his SpO2 is 83 percent. He has pervasive subcutaneous emphysema. You immediately start him on​ high-flow oxygen via a nonrebreather mask. His lung sounds are equal but diminished bilaterally. What initial field diagnosis will you base your treatment plan​ on?

Tracheobronchial disruption

You are transporting a​ 28-year-old patient complaining of abdominal pain and unusual vaginal bleeding for the past several days. The patient tells you that the bleeding is slowly increasing over​ time, and she is using about one pad per hour. Her last period was two weeks ago. Her vital signs are pulse​ 78, respirations​ 16, and blood pressure​ 128/74. What would your mode of transport​ be?

Transport the patient in a position of​ comfort, absorbing blood flow without packing the vagina.

Helicopters were first introduced into EMS to assist with treating which type of​ patients?

Trauma

What is the health care surveillance process utilized in trauma systems​ called?

Trauma registry

Which of the following patients is not a candidate for medical helicopter transportation from a crash scene to a trauma​ center?

Traumatic cardiac arrest

Which of the following activities on the scene of a hazardous materials incident is not considered a role of the​ paramedic?

Treating and transporting contaminated patients

What functional area of the NIMS EMS branch is activated when there are not enough ambulances to transport the​ injured?

Treatment

Which of the following disaster resource people would you not likely find at the mutual aid coordination center​ (MACC)?

Triage personnel

Which patient would receive a GCS score of 3 for verbal​ response?

Uses inappropriate words​ (irritable)

You are dispatched to assist a​ 21-year-old female who was shot in the left arm as she sat in her car in a parking lot. The police are already on the scene. When you approach the​ patient, she indicates that she is deaf. What is the best way for a health care provider who does not sign to communicate with this​patient?

Use​ hand-written notes.

You are evaluating a​ 32-year-old female in her third trimester after being called to her residence for a fall. During your​ exam, she tells you she is having​ contractions, which you are unable to feel by palpation. The abdomen also feels​ "soft." What has likely​ occurred?

Uterine rupture

What method should the paramedic use to address core body temperature concerns when transporting the victim of severe to moderate​ burns?

Utilize blankets to prevent heat loss.

A radio communications band that is widely available and travels far and well over varied terrain is​ the:

VHF band.

What is the primary underlying pathophysiology behind deaths associated with traumatic​ asphyxia?

Vascular compression

One​ afternoon, you are called by a remote alarm company to the home of a patient who has a history of traumatic brain injury and has a stoma. He uses a ventilator to assist his​ breathing, which is currently sounding an alarm. You are unfamiliar with this ventilator and​ currently, his​ wife, who is his primary care​ provider, is not at home. The patient is displaying an altered mental status and is unresponsive. Being unfamiliar with the​ patient's history, what should you be prepared to​ do?

Ventilate the patient if his SpO2 falls.

What has contributed heavily to an increase in thoracic trauma in urban​ areas?

Violent crime

Helicopters used for medevac missions typically employ what type of flight​ rules?

Visual flight rules

If a program needs at least 3 miles of visibility to fly its​ aircraft, it is probably using which flight​ rules?

Visual flight rules

Which activity is an example of the EMS system taking an active role in public accident​ prevention?

Voluntary home inspection

Which of the following items would not be part of a typical​ vehicle-equipment checklist?

Weather conditions

A patient has accidentally ingested a hydrocarbon solvent and may have inhaled fumes from the solvent as well. Which of the following statements about hydrocarbon solvents is most​ incorrect?

When the patient has ingested a​ solvent, you should give the patient ipecac syrup and induce vomiting.

When should any significant findings of the rapid or focused trauma assessment be​ rechecked?

Whenever you note any change in the​ patient's condition

What determines whether you utilize the CAB or ABC approach to the primary assessment of the trauma​victim?

Whether or not the patient is in cardiac arrest

You are directed to approach the scene of a shooting by a local security officer at a shopping mall. What should your initial consideration be when approaching the​ patient?

Whether or not the patient is still armed

A patient is experiencing a problem with a GI tract device. You note stomach contents spontaneously moving up into the​ patient's nasogastric tube. The patient is conscious and appears alert but is having trouble speaking. The home care provider is present. What can you expect to learn from the​ provider?

Whether the patient has experienced similar complications before

Which of the following is an example of an incendiary agent or​ device?

White phosphorus

What type of additional training should be provided to a rural paramedic who works near the borders of a large mountainous state​ park?

Wilderness rescue

Which environmental factor would predispose a person to heat or cold​ disorders?

Wind

You are transporting a​ 21-year-old male who amputated three fingers of his left hand with a circular saw. While you prepare your​ patient, family members locate the amputated digits and look to you for instruction on packaging them for transport. Which procedure is most​ appropriate?

Wrap the amputated parts in gauze dampened with lactated​ Ringer's solution and place them in a plastic bag immersed in cold water.

Which of the following statements is most accurate regarding the paramedic treating a patient from a different ethnic​ background?

You are required to care for all patients in the same manner as you would a patient from your own background.

Which of the following statements is true regarding communication with developmentally disabled ​patients?

You may not immediately recognize the disability.

What is the most important rule to maximize the effectiveness of body​ armor?

You must wear it.

You respond to an emergency involving a patient injured while servicing a wind turbine on a stretch of farmland 20 miles away from the nearest town. Which of the following should you expect for this call that you​ wouldn't in an urban​ environment?

You will be in contact with this patient for a longer period of time.

For what demographic are burns the second leading cause of​ death?

Young children

Among which demographic group has there been a significant increase in commission of acts of violence over the past two​ decades?

Youth

In working around smooth or swift​ water, the most important PPE to utilize​ is:

a Type III PFD.

You are assessing an elderly patient at the request of his daughter. The patient is 98 years old and has been living with his daughter for the past three years. She tells you that he has become increasingly more erratic in his behavior and withdrawn​ lately, and tonight his mental status is significantly altered from​usual, causing him to withdraw to his room and refuse to let his daughter​ inside, and he seems confused. This may​ indicate:

a affective disorder.

Several patients complaining of the same illness and presenting with the same signs and symptoms should raise suspicion​ of:

a biological attack.

The most important reason paramedics should not wear rings or other jewelry while on duty is because of the risk​ of:

a degloving injury.

As you arrive on scene of a multiple vehicle​ rear-end crash with one vehicle partially off the​ roadway, you observe a large amount of fluid on the roadway coming from the rear of one of the vehicles. Your greatest concern should​ be:

a flammability hazard created by leaking fuel.

To receive a Revised Trauma Score of 4 for respiratory rate the patient must be breathing​ at:

a minimum of 10 breaths per minute.

When you suspect a patient has a serious traumatic injury to the body and are inclined to transport him quickly to the trauma​ center, you should​ perform:

a rapid trauma assessment.

Collision of a​ medium-velocity bullet with the body after striking Kevlar body armor is​ considered:

a secondary impact.

Multiple wound tracks from a single gunshot is likely caused​ by:

a shotgun.

The most common cause of nontraumatic vaginal bleeding is _____.

a spontaneous abortion.

A biotoxin​ is:

a toxin that is produced by living organisms but that is itself not alive.

The inadvertent mixing of blood samples at a crime scene will result​ in:

a useless sample.

Joints that allow some very limited movement​ are:

amphiarthroses.

Abdominal pain with external vaginal hemorrhage in the​ near-term trauma victim is primarily indicative​ of:

abruptio placentae.

A patient presents with nontraumatic vaginal bleeding of an unknown cause. The​ paramedic's goal in managing this​ patient's bleeding should be​ to:

absorb the flow.

Lower salt concentrations in perspiration and increased fluid reserves are benefits​ of:

acclimatization.

At a hazmat​ incident, paramedics​ may:

activate the Incident Command System​ (ICS).

The contents of a Mark I kit are most effective when they​ are:

administered intravenously.

You are a paramedic who maintains an EMS level 1 in hazardous materials. The incident commander assigns you to immediately initiate lifesaving care for a patient who is in the warm zone who is being prepared for decontamination. You​ should:

advise the incident commander that you do not meet the training qualifications.

One of the first things an elderly person has to overcome after retiring is the societal effect​ of:

ageism.

You are caring for a patient who fell down some steps while leaving church on Sunday morning. Assessment reveals an open fracture to the right tibia with minor bleeding that is easily controlled. The patient has no other injuries from the fall and is presenting as stable. Care for the injured limb would begin​ with:

aligning the limb.

An emergency responder who may perform patient care in the warm zone on patients who still present a significant risk of secondary contamination​ describes:

an EMS level​ 2, or the technician level responder.

Developing accurate indices of suspicion for injury pathways of occupants from an automobile accident requires:

an accurate collision analysis.

A​ patient's jugular veins are​ flat, suggesting hypovolemic​ shock, and you can see signs of hemorrhaging. Serious hemorrhaging from the neck should be addressed aggressively​ because, in addition to​exsanguination, the victim of a neck injury may be subject​ to:

an air emboli.

A​ fixed-wing aircraft is defined​ as:

an airplane that uses fixed wings to generate lift.

Rigid splints are not constructed​ from:

an airtight fabric bag.

During the absence of perfusion that occurs distally from the application of a​ tourniquet, the body forms lactic acid with potassium liberation. The chemicals formed are known​ as:

anaerobic metabolites.

According to​ OSHA, a confined space​ is:

any space with limited​ ingress/egress that is not designed for human occupancy or habitation.

The respirator designed for use in conjunction with Level C protective equipment that can be utilized during transport of patients with the potential of secondary contamination​ is:

an​ air-purifying respirator​ (APR).

The maintenance of a continuum of patient care is reliant​ upon:

appropriate interactions between EMS system members.

For retreating to be​ effective, the paramedic​ should:

at least be concealed from sight.

The original ICS was developed for​ use:

at major fires.

A patient has been exposed to a pesticide through accidental ingestion. The primary treatment for this patient should​ be:

atropinization.

When advised of the potential for violence en route to the​ scene, the paramedic​ should:

await law enforcement before approaching the area.

A shallow diving accident may result in compression force on the cervical spine known​ as:

axial loading.

You are dispatched to a motor vehicle accident. On​ arrival, you discover four​ victims, all of whom require ALS. Dispatch indicates that is will take another 10 minutes to get additional ambulances to your location. This incident typically be categorized​ as:

a​ low-impact incident.

Potential significant internal hemorrhage may first reveal itself during the primary assessment in the form​of:

a​ rapid, thready pulse.

Capillary hemorrhage generally oozes from the wound and​ is:

bright red.

When decontaminating a patient exposed to solid​ corrosives, first:

brush off dry particles.

You respond to a diving accident in which the victim tells you that she was descending and began suffering from severe middle ear pain and​ dizziness, which improved after she returned to the surface. She tells you that she has been recovering from an upper respiratory infection but thought she was well enough to swim. This type of injury is a form​ of:

barotrauma.

During a mass casualty​ incident, mental health personnel​ should:

be available on site for rescuers and victims.

You are performing triage at an MCI. A victim who is breathing but lacks a palpable pulse​ should:

be categorized red.

When gathering the history of an elderly​ patient, you​ should:

be prepared to spend time and give the patient opportunities to rest.

Injury control and prevention of the patient home care environment​ begins:

before the patient returns to the home.

As you are dispatched and begin your response to a potentially​ high-risk confined-space​ incident, you should​ immediately:

begin​ size-up of the situation before even arriving at the scene.

The exchange of information between patient care providers​ should:

be​ rapid, thorough, and accurate.

Toxic substances being metabolized through the liver is a process​ called:

biotransformation.

The EMT can differentiate between superficial burns and partial thickness burns based​ on:

blister formation.

Mortality resulting from a hemothorax is primarily attributable​ to:

blood loss.

Helicopters offer more support to ground EMS on accident scenes in comparison to​ fixed-wing aircraft because​ helicopters:

can land practically anywhere.

Pulse oximetry is an effective indicator of respiratory and cardiovascular effectiveness in the burn victim​unless:

carbon monoxide is involved.

High-energy penetrating wounds create a wound track much larger than the projectile size due to a phenomenon known​ as:

cavitation.

A generally​ non-life-threatening infection at the cellular level is known​ as:

cellulitis.

The uterus has two major parts called the body and​ the:

cervix.

The female external genitalia include​ the:

clitoris.

The​ body's process of causing platelets to adhere to the vessel wall and other​ platelets, forming a platelet plug and reducing blood flow​ or, in small​ vessels, stopping it​ altogether, is​ called:

clotting.

The process by which acid burns disrupt the cell wall and damage the tissues is known​ as:

coagulation necrosis.

​Hematemesis, an indicator of internal​ bleeding, may present with the appearance​ of:

coffee grounds.

A​ __________ radio device is capable of automatically selecting the strongest​ radio, cellular, or satellite channel when the user initiates communication.

cognitive

A​ religious-based practice of rubbing a coin over the skin of an ill person that may make marks across the chest or back similar to those of abuse is​ called:

coining.

The ability of the body to maintain blood pressure in the face of hypovolemia by reduction of the venous compartment is a form​ of:

compensation.

A​ 78-year-old male complains of a headache that he calls a migraine. The headache began about four hours ago and has gotten worse. He is also starting to feel nauseated and is having​ "foggy" thinking. You question the patient and determine that he has never had a history of migraines. He tells​ you, "No, this is the first​ one, but​ it's a​ doozy!" You suspect this patient might be experiencing a stroke. You​ should:

complete a stroke assessment.

The act of evading​ someone's view behind convenient objects to escape danger is known​ as:

concealment.

During a vehicle​ collision, lap belt and shoulder strap use prevents the wearer​ from:

continuing to move.

You have arrived on the scene of a trench​ cave-in where two injured but conscious workers are partially trapped at the bottom of a​ 10-foot trench. You​ should:

control as many hazards as possible that are within your training.

When an injury occurs directly at the point of impact as the brain moves toward and collides with the interior of the​ skull, this is called​ a(n):

coup injury.

The act of evading someone by moving behind solid impenetrable objects to escape an armed encounter is known​ as:

cover.

Structural collapse and industrial or agricultural incidents are common causes​ of:

crush injuries.

You are called to the residence of a​ 20-year-old female patient complaining of abdominal​ pain, burning with​ urination, and trouble starting and stopping her urinary stream. Her urine is also​ blood-tinged. She is likely suffering​ from:

cystitis.

If a chemical agent release is small and​ contained, then:

evacuate the immediate area.

The data elements that are collected on the PCR and how they are interpreted are defined in​ a:

data dictionary.

In a violent frontal​ collision, the use of a shoulder strap without the lap belt may result​ in:

decapitation.

When proteins break down due to​ heat, the action of the heat on the​ proteins:

denatures them.

Failure of the bone to support weight can be the result​ of:

devascularization.

In decontaminating a patient who has been exposed to a liquid​ chemical, application of large quantities of water best​ describes:

dilution.

Immune senescence refers​ to:

diminished immune response.

Wounds like those caused by​ arrows, knives, and other relatively​ slow-moving objects primarily cause injury​ by:

direct contact.

Damage to the body that is limited to the pathway of a projectile is known​ as:

direct injury.

Virtually all external bleeding encountered in the field can be controlled​ by:

direct pressure.

A weapon of mass destruction that is constructed to disperse radiologic contamination is best defined as ​a:

dirty bomb.

The​ bullet's exchange of energy with the body leaves various​ tissues:

disrupted and injured.

You are preparing to transport a young female patient who was​ assaulted, raped, and left unresponsive in her​ apartment, where she lives alone. You are preparing to transport the patient when the family shows up. They tell you that they will bring with them to the hospital the clothing that you had to remove during your assessment. By not keeping that clothing in your​ custody, you​ have:

disrupted the chain of evidence.

On​ arrival, the incident commander​ (IC) will:

do a windshield survey of the scene.

In the case of sexual assault, the paramedic should _____

do all of the above.

In a​ single-car accident a vehicle collides with a tree near the​ roadway; during your collision​ analysis, a lack of skid marks would indicate that​ the:

driver was prevented from braking.

The injury in which abdominal organs protrude through a​ large, deep laceration of the abdominal wall is best described​ as:

evisceration.

It is a​ hot, sunny summer day with an outdoor temperature in the 90s. You and your partner are dispatched to a residence for a female in her 40s. Her husband told the dispatcher that he came home from work to find her in bed. She moves when he arouses her but acts drugged. On your arrival you verify the safety of the scene and are led by the frantic husband into the house toward a bedroom. As you move through the house you note that the temperature indoors is probably in the​ 60s; the husband tells you that since his wife started her new hypothyroid medication she is always hot and turns down the thermostat when he leaves in the morning. His wife is lying on the​ bed, on top of the​bedspread, wrapped in a towel with her hair still wet from an apparent shower. As you approach the bed you call her name and she mouths a few unintelligible syllables without opening her eyes. You move to check her pulse and note that she is pale and her skin feels cold and firm. She has a radial pulse of 58 and a respiratory rate of 8. You are unable to obtain a blood​ pressure, and her pupils are dilated. You ask her husband if she has any medical​ history, and he tells you that she is only being treated for the hypothyroidism. You place the patient on​ high-flow oxygen and an ECG​ monitor, where you note that she has atrial fibrillation and J waves. Knowing you are only 10 minutes from the​hospital, your preliminary treatment plan will​ include:

drying and covering with​ blankets, applying oxygen as​ needed, elevating the ambulance interior​ temperature, assessing glucose​ level, providing rapid but gentle​ transport, and initiating an IV.

The higher standard expected of ambulance drivers is known​ as:

due regard.

When a​ female's egg becomes fertilized but implants in a location outside of the​ uterus, it is known as​ a(n):

ectopic pregnancy.

A horizontal current that flows around large​ objects, creating an upstream flow around the downside of the object that in some cases can move a victim or rescuers toward the shore edge best​ defines:

eddies.

Decreasing​ P, QRS, and T amplitude with every other cardiac cycle seen in the​ 12-lead ECG of a person with a significant MOI for chest trauma and resulting pericardial tamponade may​ be:

electrical alternans.

Of the following​ list, which concept does not apply to the communications component of an EMS​ system?

emergency medical system slang

Diabetes mellitus is more common in the elderly with a greater possibility of hyperglycemia because of changes in​ the:

endocrine system.

A worker who has entered a grain elevator and then has fallen into the grain and is completely buried has become a victim​ of:

engulfment.

If severe hemorrhage continues and hypotension​ occurs, the reduced blood pressure at the hemorrhage site subsequently limits blood flow and the rate of​ hemorrhage, and:

enhances clot development.

An athlete who twisted his leg completing a long jump now displays signs of potentially severe​ muscle, tendon, and ligament soft tissue injury to his left thigh. The patient complains of significant pain at the knee and​ hip, and there is inflammation and swelling at these joints. You suspect at least a Grade II sprain of the knee and the hip. The​ athlete's coach is advising him to walk it​ off, which your patient seems to be trying to convince himself is the right thing to do. He seems to be about to get up to comply with what his coach wants. You should​ first:

ensure the patient places no additional stress on the injured leg.

When providing emergency care to the pregnant​ victim, you should place special emphasis​ on:

ensuring an adequate​ airway, ventilation, and circulation.

The outermost layer of the skin is​ the:

epidermis.

Myocardial aneurysm or rupture occurs almost exclusively​ in:

extreme blunt thoracic trauma.

You are en route to the scene of a​ bow-hunting accident where a​ 32-year-old male was accidently shot in the upper leg by his​ 14-year-old son. While mentally reviewing possible injuries and the equipment that will most likely assist you​ initially, you understand​ that:

extremity injuries are rarely fatal unless a major blood vessel is​ involved, so you need to be prepared for bleeding control.

The most common cause of trauma resulting in activation of the EMS system​ is:

falls.

External venous hemorrhage from small vessels can almost always​ be, and is preferred to​ be, controlled​by:

firmly bandaging a dressing in place

When communicating patient information to the​ hospital, it is helpful​ to:

follow the standard reporting​ format, emphasizing the information most relevant to your patient.

Lacerations that run perpendicular to the​ skin's tension lines tend​ to:

gape open.

In responding to a reported terror incident involving the release of a biological​ agent, the least amount of personal protective equipment should​ be:

gloves and a​ well-fitted HEPA filter mask.

What area does a safety officer​ (SO) not monitor for safety​ compliance?

government agencies

You are managing a patient with an anterior knee dislocation with neurovascular compromise following a bicycle wreck. You should​ first:

have another care provider immobilize the femur firmly in position.

As the hazmat entry team completes the decontamination​ process, they doff their personal protective equipment and move to the cold zone for you to conduct their​ post-entry evaluation. Because the hazmat incident is occurring in​ July, your greatest concern for the entry team members​ is:

heat stress.

The basic goal of splinting is​ to:

help reduce or eliminate movement of an injured extremity.

One of the considerations in using an air ambulance that could be burdensome to the family is​ the:

high cost of the transport.

When approaching a scene at night with a​ flashlight, you​ should:

hold the light out to your side.

The process of maintaining constant suitable conditions within the body is​ called:

homeostasis.

Capillary fluids are pushed into the interstitial spaces​ by:

hydrostatic pressure.

Because of a loss of elasticity and hardening of​ arteries:

hypertension is common among the elderly.

The wall of the left ventricle may thicken and enlarge by as much as 25 percent in an elderly​ patient, a process​ called:

hypertrophy.

When a​ person's core body temperature drops below​ 95°F, they are considered to​ be:

hypothermic.

When identifying a​ patient's level of​ consciousness, you should at a​ minimum:

identify the​ patient's level of consciousness using the AVPU mnemonic.

You are treating the victim of a knife wound to the chest who is displaying​ hypotension, muffled heart​sounds, and jugular venous distention. Field treatment of this victim should​ include:

immediate and rapid transport to the ED.

You and your partner have been dispatched by law enforcement to a report of several residents who have been exposed to the hazardous substances inside a confirmed meth lab. You​ should:

immediately don protective equipment before making patient contact.

What is an echo​ procedure?

immediately repeating each transmission received during radio communications to confirm accurate reception and understanding.

You are acting as transportation supervisor at a MCI. One of your first actions should be​ to:

implement a​ patient-tracking system.

The flexibility of the IMS is based​ on:

implementation of only those areas necessary to address the incident.

In the public health care​ model, the act of placing a particular intervention into practice is​ called:

implementation.

The transition between decompensated and irreversible shock​ is:

impossible to differentiate using signs and symptoms.

Morbidity and mortality for various abdominal injuries has been on the decline due​ to:

improved surgical and critical care techniques.

You are taking the history of a morbidly obese patient who tells you he has chronic hypoxemia. This is likely a result​ of:

inadequate ventilation.

Devices such as napalm that are designed to induce damage and injury through combustion are said to​be:

incendiary.

The main objective of terrorist acts is​ to:

incite fear in the public.

The increased intracranial pressure associated with HACE is attributable​ to:

increased fluid in the brain from being at a high altitude that one is not acclimated for.

Operation of a helicopter at the scene of an​ emergency:

increases the overall risk to rescue personnel.

The DOT KKK 1822F specs standardize the way ambulances look and​ also:

influence safety standards.

Care must be exercised when considering further competition after a sports injury​ because:

injuries that present with minimal pain may be significantly worsened by the stress of further competition.

Most motor vehicle accident deaths that are attributable to thoracic trauma result​ from:

injury to the heart and great vessels.

When an aircraft is using instruments to​ fly, this condition is known​ as:

instrument flight rules.

Your auto accident victim is alert and​ oriented, has no obvious injuries other than a tender​ abdomen, and displays vital signs of pulse​ 100, respirations​ 24/deep, and blood pressure​ 110/84; her skin is​ cool, slightly​ pale, and clammy. She appears anxious and​ restless, and she complains of being thirsty. You​suspect:

internal bleeding.

Fasciculations are a symptom of nerve agent exposure best described​ as:

involuntary muscle contractions.

In​ trauma, the incidence of musculoskeletal injury is second only to that​ of:

soft tissue injuries.

You arrive on scene of a traffic accident in which a passenger car has struck and severed a utility pole. There are lines down on the ground but not actually touching the vehicle. You​ should:

isolate and stay away from the vehicle and wait for the utility department to declare that the electrical hazard is mitigated.

A trained rescue team has just placed shoring in a trench to protect an injured worker who is buried to his waist in soil and clay. Before placing the rescue​ shoring, the most appropriate action would​ be:

isolating the area from bystanders and other workers until the area around the trench is made safe.

Blood loss in the​ chest, abdomen, and pelvis can continue​ until:

it clots or is surgically repaired.

Following a nuclear​ explosion, a patient presents with​ nausea, fatigue, and malaise. You​ should:

keep the patient warm and hydrated.

A patient with cystitis asks if it will just go away if left alone. The paramedic responds that if left untreated cystitis can progress to involve​ the:

kidneys.

An injury to the lower chest that lacerates the diaphragm is unlikely to also injure​ the:

kidneys.

A person who cannot understand spoken or written communication has a disorder​ involving:

language.

The process by which alkali burns disrupt the cell wall and damage the tissues is known​ as:

liquefaction necrosis.

You respond to a call for a​ 13-year-old female sexual assault victim and transport the patient to a trauma center. You​ should:

list any evidence turned over to hospital staff on the patient care report.

The risk of becoming a victim to a​ heat-related disorder can be most practically reduced​ by:

maintaining an adequate fluid intake.

Evacuation​ and/or relocation of uninjured victims of a disaster should be conducted with the primary goal ​of:

maintaining social groupings.

A​ 22-year-old female​ patient's presentation is consistent with pelvic inflammatory disease. The patient is not hypoxic by pulse ox and shows no signs of sepsis or shock. The primary goal of the prehospital management of this patient is​ to:

make the patient as comfortable as possible.

Routine detailed shift checks can minimize the issues associated with risk management​ by:

making it less likely that equipment will fail.

Drugs that prevent thrombosis or emboli in patients with heart or vascular​ disease:

may prolong active external hemorrhage.

You respond to a call for a patient presenting with severe abdominal pain that you field diagnose as ovarian cysts. The​ patient's pulse ox is 98 percent. Your management should consist​ of:

providing supportive care and analgesia to manage the​ patient's pain.

The management of most sexual assault cases centers​ around:

psychological and emotional support.

The most common and serious explosion injuries​ are:

pulmonary injuries.

Unwanted sexual contact that includes penile penetration of the genitalia or rectum is​ called:

rape.

Supplemental restraint systems​ (SRS) produce a cushion to absorb the energy exchange​ of:

rapid deceleration.

The most important step in any treatment plan for victims suspected of internal hemorrhage​ is:

rapid transport with monitoring for signs and symptoms of shock.

Musculoskeletal injuries to the upper​ extremities:

rarely threaten life to the same degree that lower extremity injuries often do.

The most significant variable in a fall​ is:

rate of deceleration

Assessment of a trauma victim whenever you note a change in condition or you perform a significant intervention is​ called:

reassessment.

You are examining a patient who was involved in a motor vehicle collision and has been extracted from the vehicle and immobilized. In palpating the first quadrant of the​ patient's abdomen, you notice a pain response as you release the pressure of your hand. This​ is:

rebound tenderness.

Awareness training imparts enough knowledge about rescue operations to EMS personnel that they​ can:

recognize hazards and realize the need for additional expertise at the scene.

If a patient has a severe cognitive​ disability, you may need​ to:

rely on others to obtain the chief complaint and history.

During the disentanglement process of any technical​ rescue, the paramedic has all the following responsibilities​ except:

remaining with the patient even if the paramedic cannot fulfill the requirements of the operation due to his or her own limitations.

Your​ 24-year-old male patient was riding an ATV through the woods and impaled himself on a dead tree branch. The​ 1" in diameter branch went in through his mouth and out his right cheek before breaking from the tree. On your​ arrival, the patient is bleeding heavily into his mouth and is struggling to breathe unless he is leaning forward. In order to gain control of his bleeding and thereby his​ airway, you​ should:

remove the object.

A patient has been exposed to some sort of pulmonary agent and is​ coughing, wheezing, and exhibiting inflammation and pulmonary edema. After ensuring your safety and donning necessary​ PPE, you first need to​ :

remove the patient from the environment.

As you are performing a​ pre-entry physical on the assigned entry​ team, you assess a team member who is exhibiting abnormal vital signs that are outside of the allowable parameters of the​ department's SOPs. You should​ immediately:

report your findings to either the safety officer or the incident commander.

Vehicle collisions in which there is a personal injury or over​ $1,000 in damage are​ called:

reportable collisions.

If you feel that a​ victim, in the custody of​ police, may be​ armed, you​ should:

request that the victim be searched.

Most open soft tissue​ injuries:

require simple care and limited suturing.

As an awareness level responder to hazardous materials​ incidents, you respond to an incident involving the release of a corrosive substance from a derailed train tanker car. Your first priority should​ be:

rescuer safety.

The ability to muster additional crews when all ambulances are on call or when a​ system's resources are taxed by a​ multiple-casualty incident is​ called:

reserve capacity.

During the​ post-entry physical, you discover that an entry team member has an altered level of ​consciousness, hypotension, and tachycardia. You​ should:

restrict the team member from being allowed to reenter the hot zone.

A large region of cortical disruption may cause confusion and affect the​ patient's mental​ status, such as the patient forgetting the circumstances leading up​ (before) the incident​ itself, which is​ called:

retrograde amnesia.

When treating an open chest wound resulting from a​ gunshot, the occlusive dressing should​ be:

sealed on 3 sides.

Protection against water movement through the skin is provided​ by:

sebum.

It is not a function of the vagina​ to:

secrete the hormones estrogen and progesterone.

Which is a primary function of the​ FCC?

secure radio communications.

Loss of distal circulation due to an acute injury that may be prone to compartment​ syndrome:

seldom occurs in the field with proper bandaging.

During the rapid trauma assessment for a patient with an extremity fracture or muscular​ injury, you should assess the distal​ pulses, capillary​ refill, temperature, muscle​ tone, and, if the patient is​ conscious:

sensation and motor function.

A​ 33-year-old female patient presents with nontraumatic vaginal bleeding that is apparently the result of menorrhagia. The paramedic should be on the alert​ for:

shock.

The ultimate killer of all trauma and medical patients​ is:

shock.

You clock in in the morning and are immediately dispatched to the scene of a domestic dispute by law enforcement after a​ man's wife, who fled the scene the previous​ night, stabbed a​ 52-year-old male in the abdomen. You are directed to the man lying in the kitchen in a supine​ position, with a distended abdomen and large kitchen knife still in place. The greatest danger for this patient​ is:

shock.

When assessing a patient you suspect of being abused by her domestic​ partner, you​ must:

show a willingness to hear what the patient has to say.

In accordance with​ Henry's law, as a diver descends deeper into the​ water:

significantly more nitrogen is dissolved in the blood.

A product created from the fermentation of stored crops that poses a particular inhalation risk to paramedics​ is:

silo gas.

The problem of elder abuse is expected to grow alone with​ the:

size of the elder population.

As a paramedic trained to the hazardous materials awareness​ level, you should be able​ to:

size up the​ incident, assess the toxicologic​ risk, and activate the incident management system.

Storing salts needed for metabolism is primarily the job of​ the:

skeleton.

Sources of musculoskeletal injuries do not​ include:

smoking.

You respond to a call for a patient in hospice care. The first thing you must do​ is:

speak to the home health care worker.

In addition to trauma​ centers, certain medical facilities offer very specific procedures or equipment for the treatment of trauma​ victims; these hospitals are designated​ as:

specialty centers.

Extreme​ exertion, fatigue, and direct trauma commonly contribute​ to:

sports injuries.

While you are responding to a motor vehicle accident involving a tanker​ truck, the dispatcher notifies you that passing motorists are reporting that there are numerous bystanders experiencing acute respiratory distress. With this​ information, you​ should:

stage at a safe distance off​ site, uphill and upwind of the​ incident, and attempt to view the incident scene using binoculars.

You are approaching the scene of a​ night-time incident involving the release of an unknown chemical from a train tank car. Several people were exposed who are complaining of burning to the​ eyes, respiratory ​tract, and skin. You​ should:

stage initially at least​ 2,000 feet​ away, uphill and​ upwind, until the product can be identified.

Once at the burn​ patient, your initial quick survey should be​ to:

stop the burning process.

An injury that occurs when muscle fibers are overstretched by forces that exceed the​ fiber's strength is called​ a:

strain.

A particularly serious finding when evaluating a burn​ victim's airway would​ be:

stridor.

Tertiary blast injuries can result​ from:

structural building collapse.

Sweat is secreted onto the​ skin's surface​ by:

sudoriferous glands.

The collection of data to identify the​ existence, significance, and characteristics of disease​ is:

surveillance.

The only way to recognize which trauma care practices benefit patients​ is:

surveillance.

You have gained access to the patient and are preparing to initiate care with the goal of providing psychological support to the patient throughout the operation. As you establish rapport with the​ patient, you should consider all of the following tips​ except:

telling the patient that rescue is doubtful.

A laceration that transects tension​ lines:

tends to pull open.

To be in​ hospice, a patient must​ be:

terminally ill.

Expert information regarding diving emergencies can be provided​ by:

the Divers Alert Network.

Protocols and procedures for the use of air medical support are determined​ by:

the EMS system.

Structures of all types can contain hazardous substances. A visual recognition aid used to identify hazardous materials within a fixed facility​ is:

the NFPA 704 System.

Helicopter transport of patients was responsible for not only transport but also improved treatment of wounded soldiers due to​ in-flight care​ during:

the Vietnam War.

Signs and symptoms that a patient exhibits shortly after an exposure to a hazardous material are best described​ as:

the acute effects of a hazardous material.

In considering which type of personal protective equipment to use at a hazmat​ incident, you should base your decision​ on:

the chemical or substance involved.

EMS systems can actively participate in trauma prevention by following the example​ of:

the fire service.

In the​ ICS, the command staff report​ to:

the incident commander.

You and your partner are responding to an explosion at a large office building that appears to be a terrorist incident. When searching the area for​ victims, you should be aware​ of:

the likelihood of secondary explosions.

Submersion of the face in cold water can​ trigger:

the mammalian reflex.

Within the basic communication​ model, semantics refer​ to:

the meaning of words.

As you approach a​ scene, you note a male patient lying unconscious next to a stepladder that has overturned. Bystanders indicate that none of them actually saw what happened. You determine to proceed as if the patient has fallen from the stepladder. The fall would then be​ considered:

the mechanism of injury.

The suspicion of blunt abdominal trauma should be based primarily​ on:

the mechanism of injury.

Which of the following is not usually part of the EMS response communication​ sequence?

the patient calls the medical direction physician to ask for help

Of the following personnel the paramedic may communicate with during a typical​ shift, which one would be least likely to be part of an EMS​ run?

the police supervisor

Primary blast injuries most commonly result from superheated gases created by the instantaneous combustion of the explosive​ agent, known​ as:

the pressure wave.

Extrication is best defined​ as:

the process of physically removing a patient from an entrapment.

The term​ "force" as it relates to penetrating injuries can be practically defined​ as:

the rate of deceleration of a penetrating object on impact.

When approaching a motorcycle​ collision, it is important to remember​ that:

the rider is often ejected and may not be near the vehicle.

You respond to a call for a patient complaining of vaginal bleeding with no known cause. Management of nontraumatic vaginal bleeding is dependent​ on:

the severity of the situation and the​ patient's status.

The potential for injury decreases​ as:

the time of deceleration increases.

A standard set of data is collected by regional trauma centers and analyzed to describe the types of patients and injuries that EMS responds to. This is used to determine how well the system is performing and to identify factors that may either lessen or increase patient survival. This process is referred to​ as:

the trauma registry.

In the case of topical​ absorption, a toxic substance has entered the​ body:

through the skin.

An EMS agency has an ALS system that responds when requested to assist on ALS calls. The paramedic unit arrives within 8 minutes of the call and assists the first responders. This type of system is called​ a:

tiered response system.

You are treating a​ late-term, pregnant trauma victim who requires spinal immobilization. When​transporting, the backboard should​ be:

tilted 15 degrees.

You notice that your patient with a tracheostomy has an overinflated cuff and reduce the cuff pressure. This patient may​ have:

tissue necrosis.

Your ambulance has just arrived at a hazmat scene where incident command has established​ hot, warm, and cold zones. Both you and your partner are hazmat awareness level trained. Your most likely duty assignment will​ be:

to perform triage and treatment in the cold zone.

A small surgical opening in the anterior​ neck, below the laryngeal​ structures, by which the patient draws air into the lungs and​ exhales, is known as​ a:

tracheostomy.

A dislocation at the sternoclavicular joint should be immobilized with​ a:

traction splint.

One of the most rapidly expanding areas of air medical transport​ is:

transfer of patients between health care facilities.

You are dispatched to treat the​ 32-year-old victim of a​ robbery, and you are cleared to proceed to the site by law enforcement. On arrival you are shown to the​ victim, who is sitting in the back of a​ cruiser, holding a gauze pad to her right​ cheek; she tells you that after she surrendered her purse at knifepoint the perpetrator lacerated her cheek to​ "teach her a​ lesson." Removal of the bandage reveals a​ 1" long laceration that has almost completely stopped hemorrhaging. She denies any other injuries. After properly dressing the​ wound, you​ should:

transport her to the nearest ED.

Your patient was doing body work on his car when his sander slipped and left a deep abrasion ​2" X ​3" on his upper thigh. There is no significant bleeding or other related​ injury, so after bandaging the wound you​ should:

transport him to the nearest ED.

The leading killer of persons between the ages of 1 and 44​ is:

trauma.

During your​ assessment, whenever CO poisoning is​ suspected, consider the administration of hydroxocobalamin​ to:

treat cyanide poisoning.

If you are caring for a patient who you suspect was sexually​ abused, you​ should:

treat the patient and the situation as a crime scene.

Triage personnel report directly to​ the:

triage unit leader.

You and your partner have arrived on the scene of a motor vehicle crash involving a hybrid electric vehicle. The easiest way for you to inactivate the​ high-voltage component is​ to:

turn the ignition off and remove the keys.

There has been a dramatic increase in violence among youth in the​ past:

twenty years.

Early in vehicle rescue involving multiple​ vehicles, set​ up:

two circles of​ operation, one for the actual rescue and one for staging.

Initial information you receive from emergency medical responders and EMTs about the​ patient's condition and the care he received should​ be:

used in developing your initial patient impression and then formulating a patient management plan.

The majority of the​ body's blood volume is located in​ the:

venous system.

You must carefully limit radio transmission of any information that might identify a particular patient. This includes such things as​ name, race, financial​ status, and similar descriptors. Transmission of such information does not enhance patient care and will most​ likely:

violate patient confidentiality laws including the Health Insurance Portability and Accountability Act.

The female external genitalia are known collectively as the _____

vulva.

Body armor has a higher level of​ performance:

when it is dry.

Pressure waves from an explosion may concentrate energy and cause areas of increased mortality at a further distance than expected from the​ epicenter:

when the explosion occurs in a confined space.

It is not unusual for endometriosis to be​ diagnosed:

when the patient is being evaluated for infertility.

During a roadside​ emergency, when approaching the vehicle from the​ rear, you should not move forward of the C post​ until:

you are sure there are no threats in the rear seat.

You are communicating with a helicopter pilot on final approach and see that a vehicle has entered the landing zone area and is driving diagonally across it. What would be best to communicate to the​ pilot?

​"Abort landing!"

Your female patient was forced to participate in​ oral-genital sex by an assailant. During your assessment and​ management, which of the following questions must you answer​ "No" should the patient​ ask?

​"Can I brush my teeth before we​ leave?"

You respond to a call for a​ 19-year-old female patient who was sexually assaulted at a college party where she was drinking. She appears to be slightly intoxicated. She is wearing high​ heels, a short​ skirt, and a​ low-cut halter top. What is an appropriate question to ask this​ patient?

​"Can you tell me where you are​ injured?"

You are treating a patient who was just sexually assaulted. Which of the following statements made by this patient is most likely to be​ true?

​"I know who did this to​ me."

Which of the following statements by a female patient may indicate that she was slipped a date rape​ drug?

​"I was at dinner last night with​ him, and​ that's the last thing I​ remember."

Your patient has a body mass index of 42 kg/m2. In completing the PCR, which medical expression would be an appropriate way to document that the patient is overweight?

​"The patient is morbidly​ obese."

You are gathering a past medical history of a patient who you​ suspect, on the basis of physical findings and clues you have noticed on​ scene, was sexually assaulted by her​boyfriend, who fled the scene. During this​ process, which of the following questions should you​ ask?

​"Were you sexually assaulted by​ him?"

If a patient reports vaginal discharge and​ bleeding, what is an appropriate​ follow-up question?

​"What is the amount and frequency of the​ bleeding?"

You are on scene with an elderly patient who lives alone and is complaining of dizziness and weakness. The patient also states that she has had a depressed appetite for the past week. What should you say to the patient if she is considering not getting transported​ now?

​"Your complaints are common for an elderly​ person, but you should still be seen at the hospital to make sure everything is​ okay."

Which of the following patients may have trauma to abdominal​ organs? 1. A​ 30-year-old construction worker who fell from a​ second-story roof but managed to land on his feet 2. A​ 17-year-old male with a gunshot wound to the right buttock 3. A​ 50-year-old male with a stab wound 4 cm inferior to the right scapula 4. A​ 45-year-old female restrained driver of an SUV with a​ moderate-speed frontal impact

​1, 2,​ 3, 4

Your patient is a​ 17-year-old male driver of a vehicle that received a lateral impact at the​ driver's side door. There are no​ side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door. Your patient is complaining of left shoulder pain and pain​ "in his left​ side." He has a contusion on the left shoulder and deformity of the left clavicle. He has erythema over the left lateral thorax from ribs 6 through 12 with crepitus on palpation. Which of the following injuries should you​ suspect? 1. Blunt trauma to the spleen 2. Blunt trauma to the liver 3. Penetrating trauma to the spleen 4. Penetrating trauma to the liver 5. Left pneumothorax 6. Fracture of the left clavicle

​1, 5, 6

What demographic group has the highest arrest rates for​ homicide, rape,​ robbery, and aggravated​assault?

​15- to​ 34-year-olds

You are completing a rapid trauma assessment of a fall victim and suspect a pelvic fracture. What amount of blood loss would you estimate to be​ involved?

​2,000 mL

Approximately what percentage of EMS calls involve the​ elderly?

​>35 percent

What has been defined as the​ best-known form of​ dementia?

​Alzheimer's

You are called to the home of a chronic home care patient with a VAD and a mechanical ventilator attached to a trach tube. The ventilator is displaying a message that reads​ "vent inoperative-service ​required." The patient is cyanotic and bradycardic. Which of these will be required for you to be able to ventilate a patient through the trach​ tube?

​Bag-valve device without the mask

Ascending from a dive too rapidly can create gas bubbles in the blood and​ tissues; these gas bubbles can then grow in size as the pressure is​ reduced, in accordance​ with:

​Boyle's law.

What results from penetrating injury that affects one side of the​ cord?

​Brown-Sequard syndrome

The acronym that will help you remember the functional areas of NIMS​ is:

​C-FLOP

While monitoring the victim of a brain injury during the secondary​ assessment, you should be especially watchful​ for:

​Cushing's triad.

Which items are initially considered Step One as part of the CDC Guidelines for Field Triage of Injured​ Patients?

​GCS, blood​ pressure, and respiratory rate

Major diving emergencies while at the bottom of the dive often involve nitrogen​ narcosis, a state of​ stupor, commonly called​ "raptures of the​ deep." This is due to the effect of nitrogen on cerebral function. What gas law explains the occurrence of nitrogen​ narcosis?

​Henry's law

Which illness is caused by an increase in pulmonary pressure and hypertension precipitated by changes in blood flow that occur at high​ altitudes?

​High-altitude pulmonary edema

A​ 34-year-old male patient received a​ small-caliber gunshot wound to the right anterior chest at the third intercostal on the midclavicular line. He is conscious and well oriented and complaining of pain at the wound site and difficulty breathing. His respirations are 22 and seem​ shallow, his radial pulse is​ 110, and his SpO2 is 92. He has reduced breath sounds on his right​ side, but percussion of the chest seems equal on both sides. What would your initial treatment​ include?

​High-flow oxygen and application of a​ one-way valve dressing

What treatment should be performed in the prehospital setting for divers who display signs of​ dysbarism, prior to placement in a hyperbaric​ chamber?

​High-flow oxygen therapy

You are dispatched to the scene of an industrial accident for a​ 42-year-old dockworker pinned between a​semi-trailer wall and a forklift. As you pull up to the​ dock, you note that the victim has been extricated by his coworkers and placed in a supine position with his legs drawn up. He is​ alert, well​ oriented, pale, and diaphoretic with a thready radial pulse of 120 and clear respirations of​ 26; his abdomen is distended but he does not appear to be in severe pain as long as his knees are bent. What would you include in your initial treatment plan for this​ victim?

​High-flow oxygen, rapid spinal​ immobilization, rapid transport to the​ highest-level trauma center​ available, initiate​ large-bore IVs en​ route, and reassess at​ 5-minute intervals.

Which of the following is NOT a typical indication of exposure to a chemical nerve​ agent?

​Hot, dry skin

Which states in the Northeast United States have large rural​ populations?

​Maine, New​ Hampshire, and Vermont

Which femur fracture is most likely to be immobilized with a traction​ splint?

​Mid-shaft femur fracture

What are the signs of the release of epinephrine and norepinephrine in a​ patient?

​Nervousness, marginally cool​ skin, and slight pallor

Which set of vital signs MOST indicates that your patient is beginning to enter hemorrhagic​ shock?

​P-98; BP-102/86;​ R-16

Which division of incident command support is responsible for ensuring that resource sharing between involved departments is​ fulfilled?

​Planning/intelligence section

Which population has the highest risk for soft tissue​ injuries?

​School-age children

Which of the following is not an effect produced by pericardial​ tamponade?

​Strong, bounding pulse

Trauma-related hypothermia occurs in relation to​ the:

​fight-or-flight response.

Your​ high-altitude HEMS team is dispatched to the​ 14,000-foot level of the West Buttress route of Mount McKinley for a climber who fell unconscious could not be awakened. As your team proceeds to the​location, you consider that the likely cause​ is:

​high-altitude cerebral edema​ (HACE).

Body armor offers little or no protection​ against:

​high-velocity bullets.

Hazardous terrain that consists of steep slopes that may have rocks or boulders as obstructions is known​as:

​low-angle.

A patient who has undergone field decontamination prior to receiving medical treatment is best described as​ a:

​semi-decontaminated patient requiring a more invasive decon process.

Before approaching a potentially violent​ scene, you​ should:

​stop, listen, and observe for signs of danger.


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