EMT Practice Test Questions
dosage of nitroglycerin:
0.4 mg
fist size hemotoma causes how much blood loss?
10% blood loss
abdomen loss with 1 inch distention:
1000-2000 mL
Femur Blood Loss:
1500 mL
what ratio should 2 person cpr on a child be done at?
15:2
dosage of aspirin:
162-324 mg; 81 mg each baby aspriin
flail chest:
2 or more ribs broken loose in 2 places; paradoxical movement; split
If a patient is unresponsive with a pulse you:
2 quick rescue breaths then breaths 10-12 every minute
dosage of albuterol in neb form:
2.5 mg/ml
Pelvic blood loss:
2000 mL
what is the correct treatment for someone undergoing aphyxial cardiac arrest?
5 cycles of CPR prior to retrieving the AED or emergency response system
What is the rate of CPR in breaths and compressions:
6 breaths and 110 compressions in a minute
how many bones are in the cervical spine?
7
what is the normal heart rate for a child
70-110 beats per minute
what is a normal systolic blood pressure for a child?
80-110
hypoglycemia:
BGL <50; insulin shot; rapid progression
differences in geriatric patient:
BP drops sooner; decreased cough reflex; hypertensive patients may have normal BP during shock
most common vertebrae injuries for elderly:
C1 and C2
treatment for bronchitis:
CPAP
what is contraindicated in a pnemothorax:
CPAP; you must use a bvm
What is considered bradycardic for an adult?
Heart rate less than 60
kussmaul sign:
JDV during inhalation and returns to normal during exhalation; indicates severely increased pressure in chest or around the heart
cardiognic pulmonary edema:
LEFT sided heart failure; decreased blood flow increased pressure in pulmonary capillaries; fluid leaks into alveoli
what is whooping cough:
UPPER airway infection; highly contagious; starts as cold can progress to pneumonia
ecchymosis is:
a bruise; deoxygenated blood in the tissue
s/s of peritonitis:
abdominal pain; lack of appitite, fever and chills; markle test/heel jar test
inspiration:
active; pressure drops, air is sucked in
What is another name for a heart attack?
acute myocardial infarction
respiratory distress:
adequate tidal volume but difficulty breathing
rescue breathing guidelines:
adult: 1 breath every 5-6 seconds; child: 1 breath every 3-5 seconds
pneumothorax:
air between pleural linings; lungs cant fully inflate leading to a collapsed lung
side effects of oral glucose:
airway obstruciton
what causes pancreatis:
alcohol, gall stones, infection
AVPU stands for what?
alert, verbal, pain, unconciousness
what type of chemical burn is worse, acid or alkali?
alkali is worse
contraindications of aspirin:
allergy; patient with bleeding ulcers/internal bleeding
complex partial:
altered mental status; awake but in daze and unaware
indications for oral glucose:
altered mental status; diabetes history; ability to swallow
contraindications for activated charcoal:
altered mental status; swallowed acids or alkalis
a graph used in hemiodilis is:
an artificial connection between a vein and an artery
thoracic aortic aneurysm/dissection:
aneuryms: occurs when weakened section of aortic wall begins to dilate; pulsating mass dissection: sharp tearing pain; felt in back flank or arm; NO aspirin
pediatric assessment triangle:
appearance: overall mental status; work of breathing: circulation to skin
what are the 5 steps to stop internal bleeding?
assess for shock, splint PRN, monitor Vital signs, rapid transport
common conditions where wheezing is present:
asthma, emphysema, chronic bronchitis, COPD
4 phases of a seizure:
aura; tonic; clonic; postictial
what regulatory system regulates peristalsis:
autonomic
subdural hematoma:
below the dura mater; usually from slowly expanding venous bleed; slowly develops over hours to days
epidural hematoma:
blood "pocket"; above the dura mater, usually from a rapidly expanding arterial bleed
what is an ischemic stroke?
blood flow being cut off from part of the brain
hemothorax:
blood in chest; bleeding in pleural space forming a pocket of blood at bases of lung; decreased lung expansion
hematemisis signs:
blood in vomit
grand mal seizures (primary):
both hemishperes of the brain; lasts only a few minues; loss of conciousness
hematochezia signs:
bright red blood in feces; indicates a bleed in the lower GI tract
crackles/rales:
bubbly osund during inhalation; fluid surrounding or filling the bronchioles/alveoli; base of lungs exhibit first
atherosclerosis:
buildup of fat and cholesterol;
what is congestive heart failure
bulidup of fluid in the body resulting from the pump failure of the heart
s/s of ulcer:
burning pain; LUQ; hematemis; hematochezia; melena
indication of nitroglycerin
cardiac chest pain
s/s of angia pectoris:
cardiac chest pain; radiating; cool clammy anxiety, diaphroesis; treat with nitro
tension headaches:
caused by contraction of muscles of neck/scalp; most common; radiates to neck/shoulders
DKA (type 1) hyperglycemia:
cells burn fat for energy as glucose collects in blood; fruity breath; dehydration; 3 p's; kussmaul respiration
decreased CO2, effect in intracranial pressure
cerebral vessels constrict; decreasing blood flow
increased CO2 affect in intracranial pressure
cerebral vessels dilate;Increased blood flow
what are the three things always present in a pulmonary embolism:
chest pain, dyspnea, tachypnea
wernicke korsakoff sydnrome:
chronic brain sydnrome resulting from toxic effect of alchol ;paralysis of the eys, dementia, hypothermia; eventual coma
thrombus:
clot forms and blocks off circulation
what type of breathing is present in bronchitis:
coarse rhonchi; wheezes, scattered rales
subcutaneous emphysema:
collection of air in the subcutaneous layers
epiglottis:
common in pediatrics; inflammation of the UPPER airway
what is the difference between compensatory and decompensatory stages of shock?
compensatory: normal blood pressure decompensatory: Systemic blood pressure decreases and altered mental status
ischemic chest pain
constant; not changing with movement or palpation; indication of myociaridal ischemia; causes referred pain bc heart has no sensory nerves
what type of breathing is found in pneumonia:
crackles wheezing rhonchi
s/s of CHF:
crackles, rales, rhonchi in airway; high blood pressure; altered mental status; wants to sit upright;
s/s of acute coronary syndromes:
crushing, pressure, squeezing, radiate ot arm, shoulder back; constant; pale cool skin; nausea, dizziness, synocpe; abnormla heart beats; shortness of breath
Melena signs:
dark red blood in feces; indicates a bleed in the upper respiratory tract
head trauma level 2 signs/symptoms:
decerebrate posturing; extension of upper extremities; torso and legs; pupils mid sized and fixed; central neurogenic hyperventilation
head trauma level 1 signs/symptoms:
decorticate posturing; pupils mid sized and reactive; cheyne-stokes breathing
s/s of depressants:
decrease hr, bp, rr; depress mental status; cool clammy and pale bc poor perfusion from hypotension
pulsus paradoxus:
decrease in pulse and blood pressure when inhalation occurs
s/s of a pneumothorax:
decreased lung sounds on one side; respiratory distress; maybe bubbling chest wound
HHNS (type 2) hyperglycemia:
dehyrdation; some insulin is being produced so some blucose is getting to cells therefore there is no large ketone buildup; NO kussmaul's respirations or fruity breath
what is emphysema
destruction of alveolar walls which reduce gas exchange
non cardiogenic pulmonary edema:
destruction of capillary beds; inflammation, alveolar/capillary walls destroyed; fluid moves in and around alvelli
s/s of stimulant drugs:
dilated pupils; elevated heart rate; agitation/excitation; unresponsiveness to pn
what are the 5 steps to stop external bleeding?
direct pressure, tourniquet, pressure bandage, shock treatment (oxygen, elevation, blanket), rapid transport
what are the 4 forces acting on a bullet?
drag, profile, cavitation, fragmentation
s/s of epiglottis
dyspnea; fever; sore throat; cyanosis
appendicitis s/s
early:dull pain at umbilicus; later: RLQ at mcburney point; positive markle test
increasing ICP causes:
edema, ischemia, hemmorage
thoracic contusions (bruising)
either bruise to lung; or bruise to heart; AMI like chest pain, arrhythmias and disturbances
seizures are caused by:
electrical overload of the brain
coupe/contra coupe:
entire brain shifts forward hitting frontal bone and snapping veins/arteries; anterior and posterior bleeds
When do you change roles during CPR?
every two minutes
acute subdural hematoma:
expands rapidly due to size of vessel; develops in a few hours
syncope:
fainting; usually occurs when a person is standing; place supine
s/s of hyperventilation syndrome
fatigue nervous dizzy; calcium levels decrease so mucles in hands and feet cramp
s/s of pneumonia:
fever, cough, dyspnea, tachypnea; tachycardia; localized chest pain; shallow respirations; altered mental status
head trauma level 3 signs/symptoms:
flaccid, no reaction to pain, pupils fixed and dilated
what is the postion of comfort for respiratory emergencys?
flowlers
what is the only way out of the skull?
foramen magnum
hyperglycemia:
glocose builds up in blood because cannot enter cells fast enough; BGL 200-500 mg/dL;
what increases sugar levels:
glucagen and epinephrine
s/s of abdominal aortic aneurysm
gradual onset; "tearing sensation"; pulsating mass; cool/cyanotic legs and feet;
clustur headaches
have vascular origin; excruciating pain on one side; drooping eyelids
respiratory failure in pedis:
head bobbing, see saw breathing; core cyanosis; loss of muscle tone; bradycardia; absent breath sounds; hypotention
up and over crashes injur:
head, neck, chest, abdomen
what is a silent MI
heart attack; common in women, elderly, diabetics; no chest pain; but yes shortnes of breath, nasuea, lightheadedness and weakness
What is considered tachycardic for an adult?
heart rate more than 100
tension pneumothorax:
hearts pumping ability is diminished; great vessels are bent and blood flow is hindered
preeclampsia signs
high blood pressure; diabetes; blurred vision, headaches, edema
wheezing:
high pitched whistling; constriction of bronchioles; LOWER airway; treat with albuterol
conscious patient order:
history, secondary assessment, vital signs
s/s of hypoglycemia:
hunger, weakness, salivation, dilated pupils; tachycardia
indications for epinephrine:
hypertension; alterned mentation, breathing problems
what happens if a patient has preeclampsia?
hypertensive; extremely high blood pressure and swelling in extremeties; susceptible to seizures
s/s of cyanide poisoning:
hypoxia at a cellular level; confusion; agitation; burning in mouth; dyspnea; bitter almonds?
hypoxia vs hypoxemia:
hypoxia is decreaesd oxygen in tissues/cells; hypoxemia: decreased oxygne in blood stream
When is nitroglycerin not advised to be administered?
if the systolic blood pressure is less than 100
sebecuous glands are found:
in the dermis layer
side effects of epinephrine:
increased heart rate, pale skin, dizziness, chest pain, headache, nausea, vommiting, anxiousness, excitiability
what does beta 1 receptors do?
increases HR/contractility
action of oral glucose:
increases blood sugar and brain sugar levels
When cells are deprived of oxygen and die they are called?
infarcted cells
what is pneumonia:
infection of lungs where theres fluid or pus in the alveoli; poor gas exchange
cholecystitis:
inflammation of the gallbladder; Fat, fourty, fertile, farty, female
peritonitis:
inflammation of the peritoneum from blood/pus and bacteria that leaked into the cavity;
what is bronchitis:
inflammation, swelling , thickening of bronchioles, recurrent infections;
myocardial ischemia:
insufficient fuels getting to heart cells; causes irritation
what hormone is produced by the pancreas:
insulin
what lowers sugar levels?
insulin
thirst is an indicator of what?
internal bleeding
what is asthma:
irritatants/allergens causing bronchospasm; swelling of inner airways
what does placing a folded towel underneath a childs shoulders do?
it aids in aligning the childs airway
What is the function of the carotid artery?
it carries blood from the heart to the head
what does DKA cause?
it causes frequent urination in an attempt to rid the body of excess acid buildup
Where does blood flow after it leaves the left ventricle?
it flows to the aortic arch
what does a sphygmonometer measure?
it measures blood pressure
What does diastolic blood pressure refer to?
it refers to the pressure of the vessels during the relaxation phase; bottom of the blood pressure
down and under crash injury:
knees, femurs, hips, pelvis, spine
what is the Don Juan Syndrome?
landing feet first; bilateral heel fractures; ankle fractures; distal tibia/fibula fractures; knee dislocations; femur fractures, hip injuries, spine compression fractures
absence seizure:
loss of awareness characterized by a blank stare; mistaken for daydreaming
What happens when someone has a pericardial tamponade?
low blood pressure; muffled heart sound; weak pulse due to the hearts struggles to pump
if an object is impaled what do you do?
manually secure; control bleeding and stabilize object
actions of epinephrine:
mimics response of sympathetic nervous system; constricts blood vessels to improve blood pressure; relaxes smooth muscles to improve breathing; stimulates heartbeat; reverses swelling and hives
conditions that must be met before administering nitroglycerin:
minimum systolic of 9ommhg; heart rate should be between 50-100; max of 3
position of comfort for anphylyactic shock
modified trendelenburg
abdominal eviscerations:
moist, sterile, fiber free occlusive dressing; treat for shock
becks triad:
narrowing pulse pressure; JVD, muffled heart sounds; pulsus pardoxus
What medication is Erectile Dysfunction medications a contraindication?
nitroglycerin
What does nitroglycerin do?
nitroglycerin dilates the vessels to reduce the hearts preload
type 1 diabetes:
no significant isulin production; requires doses of insulin; DKA ->hyperglycemic condition
type 2 diabetes
non insulin dependent (adult onset);
contraindications of albuterol:
not responsive enough to use; precautuions when chest pain; hr>150
treatments for closed head injury
o2, ppv 12-16 bpm; capnography, monitor LOC, maybe reverse trendelenburg, c-spine precautions
what is a pulmonary embolism:
obstruction of blood flow in the pulmonary arteries leading to hypoxia; blood cannot get to the lungs
how do you treat a chest impalement?
occlusive dressing on 3 sides
how do you treat a neck injury?
occlusive dressing on 4 sides; consider c collar
what do you do if an internal organ is exposed?
occlusive dressing x4; flex hips/knees if no spinal injury
secondary seizure:
occur as a result of "insult" to the body
vascular headaches:
occur bc of dilation or distention of vessels or inflamation in the cranium
Are open ended or close ended questions better to ask?
open ended questions; it avoids the yes/no answer
ulcer:
open wound/sore in the GI tract; breakdown of protective lining may lead to bleeding/perforation
what do you focus on during secondary assessments of the abdomen?
pain, rigidity, medical devices, distentions, scars
what is pulmonary edema:
patient commonly has cardiac disypfuction there are two types; cardiogenic and non cardiogenic
inidactions of Asprin:
patient having chest pain; may keep vessels that deliver blood to the heart from completely shutting off; suggestive of a heart attack
what is hyperventilation syndrom
patient is really excited and breaths faster and deeper
PASG indications:
pelvic fracture, HYPOtension,
pericardial tamponade:
pericardium does not stretch; bleeding between sac and heart muscle reduces the hearts pumping/filling ability; becks triad
what does right sided heart failure lead to:
perifpehral edema; JVD; liver enlargement; respiratory distress
how do you place a patient that is pregnant:
place the patient on the left side; this prevents uterus compression
common conditions where rhonchi is present:
pneumonia; aspiration; chronic bronchitis, emphysema
indications for activated charcoal:
poison ingested by mouth within two hours time
treatment for crackles rales:
ppv/bvm/cpap
compartment syndrome:
pressure in space around the capillaries exceeds the pressure in needed to perfuse the tissues; blood flow is cut off and cells are hypoxic; extremity may feel hard and pulses may be normal
s/s of bronchitis:
productive cough; overweight, JVD; peripheral edema; clubbing nails
status seizure
prolonged seizure that lasts greater than ten minutes; hypoxia is a threat;
what is cystic fibrosis:
pulmonary disfunction as well as changes in mucus secreting glands that block airway;
what does left sided heart failure lead to
pulmonary edema
PASG contraindications:
pulmonary edema (absolute); penetrating thoracic, eviseration, pregnancy, impaled abdomen
common conditions where crackles/rales are present:
pulmonary edema, pneumonia, CHF
basilar skull fracture signs/symptoms:
raccoon eyes; bruising behind ears; blood and CSF from ears/nose
s/s of a heart attack:
radiating chest discomfort; anxiety; dyspnea; sense of impending doom; diaphresis; vommiting; rapid and irregular pulse; JDV; edema
exhalation:
relaxed; pressure rises and air is forced out
reassessment consists of:
repeat primary survey, check vital signs , review chief complaint, check interventions
what is the most common reason for cardiac arrest in children?
respiratory arrest
apnea:
respiratory arrest; no longer breathing
s/s of a tension pneumothorax:
respiratory distress; dropping bp; jdv, tracheial deviation is a late sign; 3 side occlusive dressing
respiratory distress in pedis:
retractions are an early sign; grunting; see-saw breathing, increased accessory muscle use
reperfusion:
return of blood to an area that was once ischemic; increased o2 increases number of free radicals which lead to cell death; use nasal cannula 2lmp
the five "rights"
right patient, right medication, right dose, right time, right route of administration
what side of heart failure does pulmonary embolism lead to?
right sided heart failure
pneumothorax
rupter of protion of lung where air enteres the pleural cavity;
hemmorhagic:
rupture of an artery that causes bleeding in the brain
aneurysm:
ruptured blood vessel leading to massive hemmorage
s/s of cholecystitis:
ruq pain/tenderness; radiates to right shoulder; onset after a fatty meel
indications for albuterol:
s/s of dyspnea with bronchoconstriction, wheezing
dilantin and tegral are used to treat what?
seizures
abruptio placentae:
separation of the placentae from the uterine wall; can result from traumatic injury; administer oxygen 100%
dyspnea
shortness of breath
What type of heart attack is extremely common in elderly?
silent heart attack
capillary bleed:
slow, even flow; dark to intermediate red
What is the parasympathetic system responsible for?
slowing the heart rate and intestinal activity
what are the actions of nitroglycerin
smooth muscle relaxation, reduces cardiac workload, dilates coronary arteries, and dilates systemic arteries
rhonchi:
snoring/rattling; thick mucuous secretion; sound changes when cough and move
embolism:
something floats into and clogs the cerebral circulation
what are three things to check if suspicious of a stroke?
speech, facial droop, arm drift
arterial bleed:
spurting, pulsating flow; bright red
venus bleed:
steady slow flow; dark red
what type fo breathing is found in epiglottis:
stridor
s/s of pneumothorax:
sudden SOB; sharp stabbing pain; decreased breath sounds on ONE side; subcutaneous empheysema
s/s of asthma
sudden dyyspnea, cough, wheezing, tachypnea, tachycardia, use of assessory muscles, feever, pulsus paradoxus,
s/s of pulmonary embolism:
sudden unexplained dyspnea; localized stabbing sharp chest pain; tachynea; tachycardia; syncope; cool moist skin; anxiety cyanosis; crackles
contraindications of nitroglycerin
systolic lower than 90; cannot take with erectile dysfunciton medications; allergy
s/s of pulmonary edema
tachycardia; anxiety; tripod; crackles, cyanosis, JVD
angia pectoris:
temporary interruption of fuel; "chest pain"
thrombophillia:
tendency to develop blood clots
what does the term lumen refer to in EMS?
the diameter of a tube
What is pericardial tamponade?
the heart is impeded by fluid in the pericardium
what delivers blood to the right atrium?
the superior and inferior vena cava
s/s of cystic fibrosis:
thick mucus when coughing; gastrointestional complaints; ab pain; malnutrition; malaise; reoccuring cough
What is arteriosclerosis?
thickening of arterial walls
s/s of emphysema:
thin barrel chest; nonproductive cough; pursed lips; pink complexion; tachypnea, tachycardia; tripod position
respiratory failure:
tidal volume and/or breakthing rate inadequate
transverse divides the body:
top and bottom
TIA
transient ischemic attack; same s/s as a stroke patient but can recover completely in 24 hours; not purminant
What is TIA
transient ischemic attack; this is where vessels in the brain are blocked for a few minutes
stages of alcohol withdrawl:
tremors; hallucinagens; seizures; delerium tremors (high felever, severe confusion, tachycardia)
contraindications for oral glucose:
unconcsious; inability to swallow
two types of frontal impact is:
up and over or down and under
s/s of pancreatis:
upper quad pain; pain that radiates to the back; mild jaundice
what does alpha 1 receptors do?
vasoconstricts/shunts blood
what does nitroglycerin do?
vasodilator; drops your preload to help the heart pump; reduces workload; drops blood pressure
neurogenic shock:
warm, red, dry skin and maybe low BP; caused by injury to thoracic or above; decreased pulse
what is an AAA?
weakened ballooned enlarged area of the wall of the ab. aorta;
what type of breathing is found in asthma:
wheezing
what type of breathing is present in emphysema:
wheezing and rhonchi
what is the paper bag effect?
when a victim takes a deep breath before impact and the air trapped in the lungs is compressed; may cause a pneumothorax
ischemic shock:
when cerebral artery is blocked by clot or foreign matter; CAN recieve fibriniolytic
simple partial:
will remain concious;
fibrile
young age; due to rapid temperature increase
