EMT Practice Test

What is the most important thing to manage in a seriously injured child who is not in cardiac arrest? Airway and breathing Control of major bleeding Splinting of long bone fractures Cervical stabilization

**Airway and breathing Airway and breathing are the most important components to manage on any patient that is not in cardiac arrest. Remember that an assessment goes A-B-C-D-E. Breathing cannot occur before you have an airway. If the patient is in cardiac arrest, beginning CPR is the most important intervention

At the scene of a workplace shooting, how would you triage the following three patients: Patient 1, shot in the right arm, with bleeding controlled and is capable of walking. Patient 2, with chest pain and a respiratory rate of 35 breaths per minute. Patient 3, shot in the right thigh with bleeding uncontrolled. 1 green, 1 yellow, 1 red 2 yellow, 1 red 1 green, 2 red 3 red

* 1 green, 2 red Patient 1 is able to walk and is categorized green. Patient 2 has a respiratory rate over 30, which categorizes them as red. Patient 3 has uncontrolled bleeding making them red. If you struggled with these, look up and review START triage.

You are called to the scene of a bar fight where your 34-year-old male patient has suffered a head injury. During your physical exam, you note Battle's sign. Battle's sign is indicated by what? Bruising in the back of the head Swelling under the eyes Bruising behind the ears Bruising under the eyes

* Bruising behind the ears Battle's sign is a common term that describes bruising behind the ears. It typically indicates a fracture of the skull.

You arrive on scene to find a 75-year-old female who caretakers say broke her hand during a ground level fall. On examination, you note a 1-inch laceration on the dorsal surface of the hand, as well as a large accumulation of blood under the skin. The patient has no musculoskeletal pain and has full range of motion. You are most likely dealing with which of the following problems, rather than a fractured hand? Myeloma Hematoma Melanoma Hemangioma

* Hematoma The accumulation of blood under the skin should tip you off that this is a hematoma rather than any of the other answers.

You are called to a private residence where an 85-year-old female has fallen. She reports intense pain in her right hip and leg. After checking CMS, you discover that the patient has a pedal pulse, but does not have full motor or sensation ability. The right leg is rotated inward and the knee is bent. While "packaging" the patient for transport, it is important to? Apply pressure to the iliac crest Immobilize the limb with pillows or rolled blankets Perform a detailed physical exam Search the residence for a DNR order

* Immobilize the limb with pillows or rolled blankets The patient probably has a hip dislocation, so you should immobilize the right leg before transporting. Do NOT apply pressure to the iliac crest, as this would be extremely painful and may cause further damage to the joint.

You and your partner have been called to a home for pregnancy problems. Dispatch information indicates your patient is a 34-year-old female in labor with crowning present. Upon your arrival, you quickly assemble your supplies while your partner performs a physical exam. Crowning is still present and the head deliveries quickly. With the delivery of the head, you notice that the umbilical cord is wrapped tightly around the fetus' neck. This is called? Normal presentation Umbilical cord prolapse Nuchal cord Umbilical cord asphyxia

* Nuchal cord When the head delivers and the umbilical cord is wrapped around the fetus' neck, it is called nuchal cord. It can become a life-threatening situation if not dealt with promptly. Attempt to unwrap the cord from around the neck. If you are unsuccessful, clamp and cut the cord.

You are dispatched to a confused 74-year-old male. He is drooling at the mouth and unable to sit up in bed. His grips are weak and his speech is slurred. Vitals: BP - 182/96, P - 110, R -20, SpO2 - 96%. What is your first priority? Administer oxygen Alert closest stroke hospital Obtain a CBG Have police respond

* Obtain a CBG The patient has an oxygen saturation above 94% and we can rule 'administering oxygen' out as an answer. He may very well be having a stroke, but you must rule out an issue with their blood sugar first because hypoglycemia symptoms can mimic those of a stroke. Take a quick CBG reading and then proceed from there.

While ventilating your unresponsive patient, you suddenly notice that the ventilations are becoming difficult to administer. What is the most appropriate action? Squeeze the bag harder Perform CPR Perform abdominal thrusts and a finget sweep Reposition the head and reattempt ventilation

* Reposition the head and reattempt ventilation Anytime you are ventilating a patient and ventilation becomes difficult, you should immediately reposition the head and attempt to ventilate again.

Your crew has been dispatched to an unknown trauma. Your patient is a 30-year-old male who has cut his upper thigh with a chain saw. There seems to be a large amount of blood pooled in the house and your patient is lying in bed with blankets wrapped around his leg. They are soaked red. He is pale, shivering and has a pulse of 120 bpm and respirations of 20 per minute. Why would the patient have this appearance and what would be the best thing to do for him? He is suffering from hemorrhagic shock as a result of the blood loss. He should get high flow O2 and rapid transport. He is in cardiogenic shock as a result of the heart pumping the blood out of the body through the wound. Direct pressure should be applied. He is in thermolytic shock as a result of the blood loss. His body is unable to maintain adequate temperature which causes the shivering. Apply direct pressure to the wound and blankets to warm him. He is in hypovolemic shock as a result of blood loss. The blood loss should be stopped and the patient should be treated for shock.

***He is in hypovolemic shock as a result of blood loss. The blood loss should be stopped and the patient should be treated for shock. The patient is likely in shock as a result of fluid loss. He is low on blood volume. The most appropriate treatment would be to stop the bleeding using pressure; if that does not stop the bleeding, application of a tourniquet is indicated.

Your patient is suffering from a head injury. You determine a Glasgow Coma score of 13. You should re-determine the GCS score every ____ minutes, with ongoing assessment. 2 5 7 10

*5 A patient with a score between 13 and 15 is considered to have a mild head injury. When a patient has a GCS less than 15, the GSC score should be determined every 5 minutes.

When assessing patients with chemical burns, it is important to know the biochemical makeup of the agent causing the injury. The process by which acids burn skin that makes them less injurious than alkalis is called? Liquefaction necrosis Coagulation necrosis Avascular necrosis Radiation necrosis

*Coagulation necrosis As an acid burns tissues by dissolving proteins, a thick mass called a coagulum is formed that limits the depth with which the injury pattern proceeds. Alkalis destroy cell membranes through a process called liquefaction necrosis, which effectively digest the cell membrane. This process allows the alkali to penetrate deeply into tissues.

Maternal blood volume can increase by how much during pregnancy? It doesn't increase It increases by as much as 1.5 times normal blood volume It increases by as much as 2 times normal blood volume It increases by as much as 3 times normal blood volume

*It increases by as much as 1.5 times normal blood volume The increase in blood volume helps with fetal circulation as well as adjustment for blood loss during and after delivery.

You are called to a private residence where an 80-year-old female has fallen down the stairs. She reports intense pain in her right hip. After checking CMS, you discover that the patient does have a pedal pulse, but does not have full motor or sensation on the right side. It is important that this patient be transported using a? Portable stretcher Basket stretcher Scoop (orthopedic) stretcher Long spine board

*Long spine board The patient has suffered a traumatic injury from a significant MOI. Therefore, full spinal precautions must be taken. The scoop stretcher would ONLY be appropriate if spinal injury was conclusively ruled out (here, it is not). PREVIOUS

You are called to the scene of a single car MVA with one patient. The patient is a 32-year-old male who is unconscious. He has been placed on a backboard, but has profuse bleeding inside his mouth. What would be the best way to help this patient? Keep him supine to avoid further injury, suction mouth and then his nose Keep him supine to avoid further injury, suction no more than 20 seconds Roll him on his side while backboarded and suction his airway Unstrap the patient for easier access, roll him and suction

*Roll him on his side while backboarded and suction his airway While 15 seconds is the most appropriate time for suctioning vomitus or bile from a patient's mouth, it is also important to roll them into the recovery position to avoid aspiration. However, DO NOT unstrap him. This could compromise his spinal integrity. You should have at least two people help you roll him onto his side while he is back-boarded and suction as needed. PREVIOUS

The midaxillary line is what to the midline of the body? Anterior Posterior Lateral Medial

Lateral The midaxillary line is an imaginary line that parallels the midline and passes thru the center of the armpit (also known as the axilla). The term lateral indicates that the line is away from the middle of the body.

Unresponsiveness, shallow breathing, and constricted pupils are indicative of which type of drug overdose? A) Narcotic B) Marijuana C) Barbiturate D) Amphetamine

A Signs of a narcotic (opiate) overdose from drugs such as heroin, morphine (Astromorph, Duramorph), meperidine (Demerol), and codeine include altered mental status; slow, shallow breathing; pupillary constriction (miosis), hypotension; and bradycardia. Narcotics are central nervous system depressants that, when taken in excess, suppress the vital functions necessary for life, such as breathing, heart rate, and blood pressure. Barbiturates produce the same effects; however, the pupils are typically dilated (mydriasis), not constricted. Marijuana and amphetamine drugs are central nervous system stimulants and, therefore, would cause the patient to become restless or even combative.

A 58-year-old man is found unresponsive by his wife. According to his wife, he was complaining of a "dull ache" in his chest the day before, but refused to allow her to call 911. His blood pressure is 70/50 mm Hg, his pulse is 120 beats/min and weak, and his respirations are 28 breaths/min and labored. Further assessment reveals that his skin is cool, pale, and clammy. You should suspect: A) cardiogenic shock. B) hypovolemic shock. C) acute septic shock. D) pulmonary embolism. .

A The patient in this scenario likely experienced an acute myocardial infarction the day before. However, because he refused medical care, the infarction has likely damaged a significant portion of his heart, resulting in cardiogenic shock. Cardiogenic shock occurs when the heart fails as a pump and can no longer meet the metabolic needs of the body; it has a very high mortality rate. The patient's labored breathing is likely caused by pulmonary edema, which occurs when blood backs up into the lungs because the heart cannot effectively pump. There is no evidence of hypovolemia (ie, poor skin turgor) or sepsis (ie, fever). A pulmonary embolism typically presents with an acute onset of pleuritic (sharp) chest pain and difficulty breathing, and is also commonly associated with cyanosis

You are caring for a conscious patient whom you believe is having an acute ischemic stroke. After administering oxygen (if needed), your next priority should include: A) providing prompt transport for possible fibrinolytic therapy. B) determining whether the patient has prescribed nitroglycerin. C) closely monitoring the blood pressure every 15 to 20 minutes. D) administering 1 tube of oral glucose to rule out hypoglycemia.

A Fibrinolytic (clot-buster) therapy is critical to a patient who is having a stroke if it is initiated within 3 hours after the onset of symptoms. It is critical to ask a family member or bystander when the patient was last seen in a normal state. In addition to providing supplemental oxygen (if hypoxemic), transport the patient without delay so that she may receive fibrinolytic therapy (if she is a candidate) at the hospital. Because fibrinolytic therapy decreases the blood's ability to clot, its use is limited to patients with ischemic strokes. It would increase intracerebral bleeding in patients with hemorrhagic stroke; therefore, fibrinolytic therapy is contraindicated for these patients. Hypoglycemia can easily be ruled out by assessing the patient's blood glucose level with a glucometer. Nitroglycerin is of no relevance in this scenario because the patient is not suspected of having a cardiac event. Monitor the patient's vital signs every 5 to 15 minutes, or as dictated by her clinical condition, while en route to the hospital.

Your patient has a large laceration to her forearm from a sheet of glass falling on it. You have applied direct pressure but you notice that the blood continues to soak through the gauze and pool onto the ground. You should next? Remove the blood-soaked dressing and apply another dressing Apply a tourniquet to the extremity Apply pressure to the proximal artery Nothing because the bleeding will stop on its own

A tourniquet should be applied if bleeding from an extremity is not controlled by direct pressure. Application of a tourniquet should not be delayed to apply arterial pressure. Blood-soaked dressings should be covered, but NEVER removed.

You have been dispatched for a 11-year-old male presenting with altered mental status. The patient's teacher originally thought he was day dreaming in class but realized that he was unconscious. She described his behavior as "the lights were on but nobody was home." Your patient is acting normally now. What do you think is wrong with your patient? There is nothing wrong with your patient. He was daydreaming Simple partial seizure Absence seizure Complex partial seizure

An absence seizure is a generalized seizure that occurs for a brief period of time (usually less than a minute). It is characterized by altered mental status that passes quickly enough that the patient and bystanders may not know that anything happened.

An unresponsive patient with multi-system trauma has slow, shallow breathing; weak radial pulses; and severe bleeding from a lower extremity wound. You should direct your partner to: A) radio for a paramedic ambulance to respond to the scene. B) assist the patient's ventilations while you control the bleeding. C) apply oxygen via nonrebreathing mask while you control the bleeding. D) prepare the long spine board and straps for rapid spinal immobilization.

B An unresponsive patient with slow, shallow breathing is not breathing adequately and should be treated with ventilatory assistance, not a nonrebreathing mask. As your partner is managing the patient's airway and providing ventilatory assistance, you should apply direct pressure (or a tourniquet, if needed) to the extremity wound to control the bleeding. It is important for you and your partner to work together so that all life threats can be corrected as soon as possible.

You are responding as a part of a strike team to a bombing at a college stadium. You are driving a type III ambulance with lights and sirens on. What type of apparatus would be responding with you in your strike team? Fire engines Police cars Special rescue teams Ambulances

A strike team is organized to include the same kind and type of resource. Each strike team should have a designated leader and have the ability to communicate between all single resources in the team. A strike team may be a part of a task force. PREVIOUS

You have been dispatched as the initial responding unit for a multi-vehicle crash. Dispatch information indicates that a large boat being pulled behind a truck came unhitched while traveling at highway speeds. The boat hit four vehicles, including a semi, before coming to a stop. Additional resources are en route and it is reported that there are 12 patients with varying levels of injury. You are assigned to begin triaging patients. According to START triage, which of the following patients should be categorized as "RED" or "IMMEDIATE"? 6-year-old female with penetrating chest trauma. She is unconscious with slow, agonal respirations after repositioning her airway 32-year-old female complaining of severe abdominal pain. She is 30 weeks pregnant and is extremely distressed because she can't move her legs or feel anything below her waist 34-year-old male with gross fracture of right humerus. He is in extreme pain but has self-extricated and is trying to reach his daughter and wife in the car 27-year-old female with partial amputation of her right leg above the knee. She is conscious but very disoriented with an absent radial pulse and respiratory rate of 40

According to START triage, patients are categorized based upon respirations, perfusion, and mental status. The 27-year-old female meets "RED" or "IMMEDIATE" criteria in all three categories. Her respiratory rate is greater than 30, she has no radial pulse, and she is altered. Although the 32-year-old female is pregnant with abdominal pain as a result of trauma, she is alert and oriented. However, she cannot move so she should be categorized as "YELLOW" or "DELAYED". The 34-year-old male has self-extricated and is up walking around (walking wounded). He should be categorized as "GREEN" or "MINOR". Despite the 6-year-old female appearing to have spontaneous respirations, it is important to recognize that she still has agonal respirations AFTER repositioning her airway. This patient should be triaged as "BLACK" or "DECEASED".

A 30-year-old man sustained partial-thickness burns to the anterior chest and both anterior arms. Based on the Rule of Nines, what percentage of his body surface area has been burned? A) 0.09 B) 0.18 C) 0.27 D) 0.36

According to the adult Rule of Nines, the anterior trunk (chest and abdomen) accounts for 18% of the total body surface area (TBSA) and each entire arm accounts for 9%. Therefore, the anterior chest, which is one half of the trunk, would account for 9% of the TBSA, and both anterior arms (4.5% each) would account for 9% TBSA, for a total of 18% TBSA burned.

Your patient is a 14-year-old female who has swallowed an entire 60-pill bottle of Ibuprofen. The patient states she just wants to die and screams at you to leave her alone. She tells you she thinks she took the pills 30 minutes ago after she calms down. Her VS are currently stable. Which of the following medications should you consider administering? Narcan Activated Charcoal Zofran Promethazine

Activated Charcoal This question is testing you on your ability to recognize the most appropriate treatment for your scope. While the other medications may have their place for certain overdoses and/or treating the side effects of an overdose, the best answer here is activated charcoal.

How does activated charcoal eliminate ingested poisons? Through the blood stream Through absorption Through adsorption By chemically neutralizing them

Adsorption is the process of binding something to itself. Activated charcoal will adsorb poisons to the body of its molecule and hold them through the digestive processes so they are not absorbed by the system.

A 25-year-old female appears to have urticaria and other histamine responses. She also appears to be having a hard time breathing, and has a decreasing blood pressure. Of the following options, which is she most likely experiencing? Neurogenic Shock Hypovolemic Shock Anaphylactic Shock Cardiogenic Shock

All but one of these signs would point to an allergic reaction. However, since the BP has dropped you now have cardiac compromise which is the first sign the patient is in anaphylactic shock.

All of the following are considered types of connective tissue EXCEPT: Mucous Blood Skin Nerves

All tissues in the body are considered connective tissue except tissues of the CNS (Central Nervous System). Blood is considered a viscous connective tissue because it contains cells and a matrix called the plasma.

***Based on GCS alone, which of the following patients would be considered a candidate for aeromedical transport? 9 11 13

Ans: 9 A GCS of less than 10 may mean that a patient would benefit from aeromedical transport. PREVIOUS

A 70-year-old female fell and struck her head two days ago, but did not seek medical attention. Today, she is confused, is vomiting, and has slurred speech. The EMT should suspect a/an: A) epidural hematoma. B) subdural hematoma. C) intracerebral hematoma. D) acute ischemic stroke.

B This case is classic for a subdural hematoma. A subdural hematoma occurs when bleeding occurs between the dura mater (the outer meningeal layer) and the surface of the brain; it is typically caused by venous bleeding. As such, subdural hematomas often do not present with symptoms until several hours, or even days, have past since a head injury. By contrast, epidural hematoma, bleeding between the skull and dura mater, is usually caused by arterial bleeding; patients with this type of injury usually present with symptoms immediately following the injury. Intracerebral hemorrhage, bleeding within the brain itself, would also be expected to produce immediate symptoms. While acute ischemic stroke could also explain this patient's symptoms, the fact that she recently experienced a head injury makes the diagnosis of a subdural hematoma more likely.

A 50-year-old man's implanted defibrillator has fired twice within the last hour. He is conscious and alert and complains of a "sore chest." Further assessment reveals that his chest pain is reproducible to palpation and is localized to the area of his implanted defibrillator. Treatment for him should include: A) application of the AED and transport to the hospital. B) prompt transport with continuous monitoring en route. C) deactivating his defibrillator by running a magnet over it. D) up to three doses of nitroglycerin and prompt transport.

B Patients who are at high risk for lethal cardiac dysrhythmias (ie, V-Fib, V-Tach) may have an automated implantable cardioverter/defibrillator (AICD). This small device is usually implanted in the upper left chest, just below the left clavicle. The AICD detects cardiac dysrhythmias and rapidly delivers a shock. When treating a patient whose AICD has fired, you should determine the number of times the device fired, administer supplemental oxygen if the patient is hypoxemic, obtain vital signs, and transport to the hospital with continuous monitoring en route. Application of the AED is not indicated; however, if the patient develops cardiac arrest, you should use the AED as you normally would (remember to apply the pads at least 1 inch away from the implanted device). The pain that the patient is experiencing, which is reproducible and localized near his AICD, is likely musculoskeletal pain as the result of his AICD shocking him; therefore, nitroglycerin is not indicated. Because the AICD works so quickly (much faster than you can apply an AED), you should not make any attempt to deactivate it.

You are called to an unknown injury that occurred during a domestic dispute. You arrive to find a woman severely wounded by a blunt object. The police are talking to the man who assaulted the patient. As you are about to leave, you turn and punch the man in the face. What type of legal charges could you face from your actions? ngIf: meta.question.image_file * Battery * Assault * Negligence * Abuse

Battery is the actual, intentional striking of someone, with intent to harm. Assault is carried out by a threat of bodily harm.

All of the following are main sources that drugs can be made from, except? Synthetic engineering Plants Animals Petroleum

Petroleum The main sources of drugs come from synthetics, plants, animals, and minerals.

Heroin overdose-> You get a pen light out of your kit and assess the patient's pupils. How would you expect the patient's pupils to present? Blown, unequal Normal, equal Dilated, equal Pinpoint, equal

Pinpoint, equal Pinpoint pupils are characteristic of narcotic/opioid overdoses.

Damaged small blood vessels beneath the skin following blunt trauma cause: A) mottling. B) cyanosis. C) hematoma. D) ecchymosis.

D Feedback : When small blood vessels beneath the skin are damaged, blood seeps into the soft tissues. This manifests as a bruise, also referred to as ecchymosis. A hematoma develops when larger blood vessels are ruptured and the internal bleeding forms a "lump." Cyanosis is a blue or purple discoloration of the skin and signifies a low content of oxygen in the blood. Mottling occurs when the skin takes on a blotched, purple appearance and is a sign of shock (hypoperfusion).

You are treating a 23-year-old male that had a 1" diameter branch go into his abdomen. The patient's shirt is saturated with blood. How should you proceed? Remove the object and cover with gauze to control bleeding Expose the area, control bleeding, stabilize the object in place with bulky gauze Transport while manually securing the object Expose the area and remove the object if it interferes with the patient lying supine on the bed, otherwise, leave it in place

Expose the area, control bleeding, stabilize the object in place with bulky gauze When an object is impaled, make every effort to keep it in place, unless there is a life-threatening priority to remove it (i.e. chest compressions, airway). Use a bulky dressing to secure it in place and transport. The patient does not need to be transported supine unless there is spinal compromise. PREVIOUS

Radioactive material that has traveled from a nuclear detonation and can result in radioactive exposure is known as? Dust Fallout Particulate Sediment

Fallout is generated from the detonation of a nuclear device. It can travel great distances and unknowingly expose people who were far from the actual detonation. PREVIOUS

Which antibody is responsible for causing an anaphylactic reaction? IgA IgE IgG Ig<

IgE is the antibody is responsible for causing anaphylactic reactions.

In contrast to the contractions associated with true labor, Braxton-Hicks contractions: A) do not increase in intensity and are alleviated by a change in position. B) may be intensified by activity and are accompanied by a pink discharge. C) generally follow rupture of the amniotic sac and occur with regularity. D) consistently become stronger and are not alleviated by changing position.

Feedback : During pregnancy, the mother may experience false labor, or Braxton-Hicks contractions, in which there are contractions but they do not represent true labor. Unlike true labor contractions, Braxton-Hicks contractions do not increase in intensity, are not regular, and are typically alleviated by activity or a change in position. The contractions associated with true labor, once they begin, consistently get stronger and closer together and are regular; a change in position does not relieve the contractions. True labor is also commonly followed by, or in some cases preceded by, a rupture of the amniotic sac (bag of waters) and a pink or red vaginal discharge that is generally accompanied by mucus (bloody show). ID#EMT-320 How sure are you?? (1 = Guessing; 5 = Confident; Far Left = Not Applicable) 12345 ← PREVIOUSPAUSE/END TESTNEXT →

Which of the following assessment findings is LEAST suggestive of a cardiac problem? A) Rapid, irregular heart rate B) Anxiety and pale, cool skin C) Palpable pain to the chest D) Nausea and epigastric pain

Feedback : Signs and symptoms of cardiac compromise include nonreproducible pain, pressure, or discomfort in the chest or epigastric region; nausea; pale, cool, clammy (diaphoretic) skin; and an irregular pulse that is either fast or slow. Pain of cardiac origin typically is not reproducible by palpation. Palpable pain to the chest suggests a musculoskeletal problem, not a cardiac problem. However, because some patients with a cardiac problem present atypically, you should transport any patient with chest pain, pressure, or discomfort to the hospital.

You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be: A) preparing to treat her for a febrile seizure. B) taking her temperature to see how high it is. C) assessing the need for ventilation assistance. D) determining if the child has a history of croup.

Feedback : The child is clearly experiencing respiratory distress and probably has croup (laryngotracheobronchitis), a viral upper airway infection. The presence of stridor (high-pitched sound heard during inhalation) indicates swelling of the upper airway. Your most immediate concern should be assessing the adequacy of her breathing and determining if ventilation assistance is necessary. If signs of respiratory failure are present (eg, signs of physical exhaustion, bradycardia, bradypnea [slow respirations]), you must begin assisting her ventilations with a bag-valve-mask device; otherwise, she will likely deteriorate and develop cardiac arrest. She may experience a febrile seizure if her fever acutely spikes; although this is a concern, it is not the most immediate concern in a child with an airway or breathing problem.

The wall that separates the left and right sides of the heart is called the: A) carina. B) septum. C) pericardium. D) mediastinum.

Feedback : The septum is the wall that separates the left and right sides of the heart. There is a septum for both the atria and the ventricles. The carina is the bifurcation point of the trachea, and the mediastinum is the space between the lungs in which the heart, great vessels, and a portion of the esophagus lie. The pericardium is the sac that surrounds the heart and contains pericardial fluid.

Which of the following signs or symptoms is MOST suggestive of a systemic reaction following ingestion of a poison? A) Nausea and vomiting B) Burns around the mouth C) Tachycardia and hypotension D) Painful or difficult swallowing

Feedback : C Once an ingested poison gets into the body, it can affect multiple organ systems. Signs that this is occurring include tachycardia or bradycardia, hypotension or hypertension, weakness, restlessness, and an altered level of consciousness, among others. Local effects of an ingested poison include nausea and vomiting as the poison irritates the gastric lining, burns in and around the mouth, and painful or difficult swallowing (dysphagia).

You are dispatched to an imminent delivery. When you arrive, the patient is walking around the house and tells you her membranes just ruptured before she called 911. How should you proceed? HAVE HER LIE DOWN AND PREPARE FOR IMMINENT DELIVERY. HAVE HER LIE ON THE GURNEY AND DO A QUICK EXAM FOR EXCESSIVE VAGINAL BLEEDING, TRANSPORT IMMEDIATELY. HAVE HER LIE THE GURNEY IN A POSITION OF COMFORT AND TRANSPORT. PLACE THE PATIENT ON HIGH-FLOW O2, TRANSPORT IMMEDIATELY.

HAVE HER LIE THE GURNEY IN A POSITION OF COMFORT AND TRANSPORT. Ruptured membranes is also known as the water breaking, or rupture of the amniotic sac. Although it is an indication that labor has begun, it doesn't mean that delivery is imminent, especially if the patient is walking around. O2 isn't indicated unless there is some respiratory signs and symptoms associated with the birth.

Your 23-year-old female patient just delivered a baby. As you assess the neonate, you note that he is having trouble breathing. You discover his pulse to be 50 bpm, and cyanosis around the lips and fingers. What is your first intervention? Suction the airway Start compressions Administer breaths via BVM Allow the baby to begin feeding

In a neonate, the key number is 60. If their heart rate is below 60, start compressions immediately. If the heart rate is 60-100, assist the patient with ventilations via BVM. Start compressions

What are the dimensions of an ideal landing zone for a medical helicopter transport? At least 25 feet x 25 feet At least 50 feet x 50 feet At least 75 feet x 75 feet At least 100 feet x 100 feet

If possible, a landing zone that measures at least 100 feet x 100 feet should be cleared for the helicopter. A night time landing may require a larger landing zone.

Which of the following diseases is not a bloodborne pathogen? Lyme disease Herpes HIV Influenza

Influenza is spread through the air via drops or particles from the infected person.

Which sensory pathways carry information from the brain and spinal cord to the rest of the body? Motor Neurons Sensory Neurons Central Nervous System Purkinje Fibers

Motor Neurons Motor and sensory neurons are part of the peripheral nervous system. Sensory neurons take the information from the body to the brain and the motor neurons, just the opposite. Purkinje fibers are part of the heart's conduction system.

You are assessing a 23-year-old female with abdominal pain, fever, pain on urination, and lethargy. What do you suspect is occurring? PID DIVERTICULITIS MENSTRUAL CRAMPS FOODBORNE ILLNESS

PID, or pelvic inflammatory disease, is an infection and inflammation of the upper female genital tract. Often there will be no symptoms other than abdominal pain, but often progresses when women do not receive treatment. Diverticulitis is inflammation of the digestive tract, which could present with abdominal pain and fever, but most likely not painful urination.

During a trauma assessment, you may examine the chest wall to see if one section falls on inspiration while the rest of the chest rises. This is called? PARADOXICAL MOTION JUGULAR VENOUS DISTENTION RETRACTIONS SUBCUTANEOUS EMPHYSEMA

Paradoxical motion generally means you have a flail chest segment. This is an immediate life-threat, requires treatment, and rapid transport.

4. The patient is a 6 year old girl whose mother says has been sick for a few days and then started having breathing problems this morning. Upon assessment, you notice the child is flaring her nostrils and has a hoarse voice when talking. What is she most likely suffering from and what should you do? She could have epiglottitis and needs to be transported with high flow O2 on an NRB She could have croup and needs to be transported with a nasal cannula at 4 rpm Incorrect She could have tonsillitis and will require transport to the hospital in a position of comfort She could have SARS and should be transported wearing a HEPA mask

Rationale: Epiglottitis is known to strike children in this age group. Croup is usually in younger children. Transporting with airway support is the best answer.

8. Your patient is an 18 month old boy who, as reported by his mother, is "acting strange". You arrive to find the child reclined in his mother's arms. "I don't know what's wrong with him," she says. "I came out of the bathroom and he started making odd sounds and had spit running out of his mouth." What is the first thing you should do? Roll the child into a recovery position and begin suctioning the oropharynx. Get a general impression of the child by visually assessing the quality of his respirations, his skin color, and his appearance. Insert a properly measured OPA to secure the airway. Pad the child's shoulders to align the airway. Notify the pediatric ward at the hospital of the situation and do a rapid transport with high flow O2 via NRB.

Rationale: Initially, you want to form a general impression of the patient using the pediatric assessment triangle. (PAT) PAT is Work of Breathing, Skin Circulation, Appearance. The pediatric assessment triangle is used to form a rapid general impression of a child without making physical contact. Look at the child's appearance and muscle tone. Look at the work of breathing for signs of respiratory distress. Tachypnea or retractions of sternum and or intercostal muscles is a sign of respiratory difficulty. Look at the skin as a quick reference for circulation. Pallor can be a sign of poor circulation.

5. You arrive on scene with your partner to a restaurant where a man was reported to be choking. You enter and find an unconscious cyanotic male on the floor. He is supine with BBQ sauce on his mouth and a napkin in his hand. What would you do for this patient? Verify apnea, give two slow breaths with high flow O2, and administer back thrusts until the object has been removed. Ask the bystanders what happened. Verify no pulse, and attach the AED. Tell everyone to stand back, and hit analyze, following the prompts. Head tilt, chin lift, verify apnea and begin Administer abdominal thrusts, followed by a finger sweep, and then administer high flow O2. Monitor patient while transporting. Incorrect Compressions. Upon completion of the compressions, give two slow breaths looking for chest rise and fall.

Rationale: Open the airway and check to see if they are breathing, if not, begin compressions first. After completing the initial set of compressions, give two slow breaths looking for chest rise and fall. Continue this sequence until the object has been removed.

7. You arrive on scene with your partner Elija to a multiple vehicle accident where you are the 2nd ambulance to arrive. Scene size up indicates there are 7 patients in 3 cars all requiring extrication. In the first car is a 27 year old woman who is 32 weeks pregnant, conscious, and crying, a 12 year old girl who is screaming and complaining of back pain, and an 8 year old boy who has a facial laceration and open fracture of the tibia who is also conscious but breathing very shallow. In the second car is an 86 year old man who is slumped against the steering wheel with no pulse and has a piece of metal impaled through his head. In the third car are 3 teenagers 17 years of age. The two in the front seat are complaining of neck pain and appear to have an altered level of consciousness. Neither of them were wearing a seatbelt and both have contusions on their foreheads. In the back seat is the last occupant, a girl who said she was having a seizure and vomiting earlier so her friends were taking her to the hospital. She was wearing her seat belt and has no sign of injury. Who should be receiving treatment first? The 8 year old boy The pregnant woman The vomiting teenager The 86 year old man

Rationale: The 86 year old man shows signs that resuscitation would be futile. The eight year old boy has similar injuries to the other patients, but is the only one having breathing difficulties.

All of the following are possible locations to obtain a patient's temperature. Which is the most accurate (closest to core body temperature)? Axillary Oral Rectal Tympanic

Rectal A rectal temperature is the most accurate temperature recording. Some thermometers have different color sheaths for different locations - remember to use the correct color! PREVIOUS

You are exceeding the speed limit while driving with your lights and sirens to the report of a cardiac arrest at a local gym. Which of the following regarding your response is true? You are responding to a life-threatening emergency and can exceed the speed limit by up to 10mph Regardless of lights and sirens or life-threatening emergencies, you must always drive with due regard You have always have the right away because you have your lights and sirens on During emergency response, you will not be at fault if an accident occurs because of your driving

Regardless of lights and sirens or life-threatening emergencies, you must always drive with due regard

***Which of the following triage systems utilizes the RPM (respirations, pulse, mentation) acronym? START TREAT TIME STEMI

START triage

What should be your first priority in the treatment of a psych patient? Scene safety Airway Circulation Having police present

Scene safety Always be aware of your surrounding. Not all calls need police assistance, but all calls need continual evaluation of scene safety.

A radio's frequency refers to the number of times per ______________ a radio wave oscillates? Millisecond Second Minute Ampere

Second

You respond to the scene of a fight at a local bar. Upon arrival, you find a male with a knife protruding from his upper right abdomen. Treatment for this patient includes all the following except? Removal of the impaled object Administration of oxygen Initiate transport to a trauma hospital Securing the impaled object in place

Securing the impaled object in place You should never attempt to remove an impaled object from any body part. This can result in massive bleeding which may have been prevented by the object staying in place. You should always secure the object in place with a bulky dressing to prevent it from moving and causing further damage. Trauma patients should receive supplemental oxygen and be transported to a trauma center. Administer pain medication according to your scope of practice and local protocols.

The plane that separates the body into anterior and posterior sections is called the? Frontal Plane Horizontal Plane Median Plane Axial Plane

The frontal plane, or coronal plane, divides the body into anterior and posterior sections. *What is the axial plane????

Myocardium is the muscle of the heart (my/o = muscle). The thickness of the myocardium is dependent on the function of each heart structure. Which structure of the heart has the thickest myocardial section? Right atria Right ventricle Left atria Left ventricle

The left ventricle is responsible for pumping blood to the body. It needs a much larger myocardium to achieve this task. The pulmonary circuit, involving the right atrium and ventricle, is under significantly less pressure than the systemic circuit, which involves the left atrium and ventricle.

There are how many thoracic vertebrae in the spinal column? 7 9 12 5

There are 12 vertebrae that compose the thoracic area of the spine. This is also the majority of the back.

Your patient is a 45-year-old male who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding has slowed considerably before your arrival. The patient is agitated, confused, pale, diaphoretic and cool to the touch. He lacks a radial pulse and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this patient? He is in compensated shock He is in decompensated shock He is in irreversible shock None of the above are certain

This situation could turn even worse- FAST. The patient is in decompensated shock. The body is unable to compensate for the blood loss. Hence the fast, shallow breathing and weak rapid pulse. This patient could enter into irreversible shock in a matter of minutes. PREVIOUS

When performing rapid triage via the START method, what three criteria are you assessing? Airway, breathing, circulation Respirations, perfusion, mental status Scene safety, c-spine, major bleeding Motor, verbal, eyes PREVIOUS

Triage is the quick assessment of a patient's respirations, perfusion (usually cap refill), and mental status (ability to follow commands). The main goal is to prioritize patients needing the greatest level of care when there are limited resources.

You respond to a 76-year-old male who had a syncopal episode. He is sitting upright on the toilet when you arrive. He stated that he was having a bowel movement and than blacked out. You should suspect the cause of the syncope is? Ventricular arrhythmia Myocardial ischemia Vasovagal episode Hypoglycemia

Vasovagal episode syncope def-temporary loss of consciousness caused by a fall in blood pressure. Having a bowel movement or bearing down to have a bowel movement can stimulate the vagus nerve, and can slow down the heart rate enough to cause a syncope.

What is the diff bet. Trendeleburg position and shock position?

When a patient is supine, they are lying on their back. Trendeleburg position places the patient's feet 6 to 12 inches above their head. Shock position raises only the lower extremity above the heart 6-12 inches. Recovery position is a side laying position.

You respond to a 33-year-old male who was burned while working under his car. He suffered burns to his face and entire abdomen/chest. What percentage of his body surface area was burned? 10 percent 22.5 percent 36 percent 49 percent

You can throw the 49 percent answer out right away because the stomach and face do not represent half of the body surface area. Using the rule of nines, you know that the head is 9 percent and we need half of that for just the face. You also know that the anterior and posterior torso are each 18 percent, but we just need the anterior part. 4.5 + 18 = 22.5 percent.

10. You have just arrived at the scene to find a 27-year-old female complaining of anxiety and breathing difficulties. Which of the following questions would be most appropriate to ask first? How long have you been having trouble breathing? What is your name? What day is today? Do you have a history of panic attacks?

Your Answer: How long have you been having trouble breathing? Incorrect Correct Answer is: What is your name?Rationale: When performing patient assessment, the first thing after your scene size-up is to do the primary survey (also called primary assessment). The first step of the primary survey is to form a general impression, followed by level of consciousness, then Airway, Breathing, and Circulatory status, and finally identify life threats during that process. While all of those questions are proper to ask at some point during an assessment, the best choice is to ask the patient her name first. This is critical information because it allows you to know who you are interacting with and helps to determine a general impression of the patient, according to their proper or improper response, and then determine airway status. This sets the stage for the rest of your assessment. You should always introduce yourself and ask for your patient's name at the beginning of your assessment. The other questions come during the history taking part of your assessment.

9. What would be the correct sequence of treatment for a 76 year old female with a pulse of 142. The patient is also cyanotic around the lips and nail beds? Ventilate her with a BVM and transport Continue assessing en route to the hospital and apply high flow O2 Continue assessment to determine cause and call ALS Perform a rapid trauma assessment and transport rapidly

Your Answer: Ventilate her with a BVM and transport Incorrect Correct Answer is: Continue assessing en route to the hospital and apply high flow O2 Rationale: Getting the patient some oxygen is priority number one under these circumstances. Doing so on the way to the hospital without delay would be necessary.

symptoms of severe brain trauma

decreased LOC, hypertension, bradycardia, irregular breathing, posturing