EMT quizzes 1-7
When you assess capillary refill time (CRT) in an infant, normal color to the tested area should return within: A. 2 seconds B. 4 seconds C. 3 seconds D. 1 Second
A. 2 seconds
An unstable patient should be reassessed at least every: A. 5 minutes B. 10 minutes C. 20 minutes D. 15 minutes
A. 5 minutes
Which of he following descriptions most accurately portrays energies like medical services (EMS)? A. A team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured B. A system composed exclusively of emergency medical responders (EMRs) and emergency medical technicians (EMTs) who are responsible for providing care to sick and injured patients C. A team of paramedics and emergency physicians who are responsible for providing emergency care to critically injured patients D. A vast network of advance life support (ALS) providers who provide definitive emergency care in the prehospital setting
A. A team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured
Which of the following patients would MOST likely require insertion of an oropharyngeal airway? A. A 51 year old confused patient with severely labored respirations B. A 33 year old semiconscious patient with reduced tidal volume C. A 40 year old unconscious patient with slow, shallow respirations D. A 64 year 9d conscious patient with rapid and deep respirations
C. A 40 year old unconscious patient with slow, shallow respirations
Which o the following scenarios most accurately depicts informed consent? A. A patient advises an EMT I'd shy he or she is refusing care B. An EMT initiates immediate care for an unconscious adult C. An EMT advises a patient of the risks of receiving treatment D. A patient is advised by an EMT of the risks of refusing care
C. An EMT advises a patient of the risks of receiving treatment
You are called for a 35 year old female motorcycle passenger with neck pain following an accident. Upon arrival, she is found to be walking around with one hand on her head and the other being used to hold her cell phone. She tells you she is taking her insurance company. You should: A. Realize that if she is able to walk, she doesn't need any evaluation or medical assistance B. Realize that if she is able to walk, she should be led over to the stretcher C. Approach her form the front and apply manual stabilization of her cervical spine D. Approach her form the rear and apply manual stabilization of her cervical spine
C. Approach her form the front and apply manual stabilization of her cervical spine
When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located you should: A. Notify the coroner immediately B. Contact medical control first C. Begin resuscitation at once D. Determine the patient's illness
C. Begin resuscitation at once
The central nervous system is composed of the A. Spinal cord and sensory nerves B. Brain and sensory nerves C. Brain and spinal cord D. Motor and sensory nerves
C. Brain and spinal cord
The primary waste product of metabolism is: A. Lactic acid B. Pyruvic acid C. Carbon dioxide D. Adenosine triphosphate
C. Carbon dioxide
Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called: A. Eupneic respirations B. Atonal respirations C. Cheyne Stokes respirations D. Ataxic respirations
C. Cheyne Stokes respirations
Prior to using a stair chair transport, the patient should be: A. Be given the opportunity to walk up or down the stairs B. First fitted for a cervical collar C. Conscious and cooperative D. Taken have their oxygen supply shut down
C. Conscious and cooperative
Prior to using a stair chair transport, the patient should be: A. Be given the opportunity to walk up or down the stairs B. Taken off them oxygen supply C. Conscious and cooperative D. First fitted for a cervical collar
C. Conscious and cooperative
An appropriate demonstration of professionalism when your patient is frightened, demanding, or unpleasant is to: A. Ignore the patient's feelings and focus on his or her medical complaint B. Demand the patient to be quiet and cooperative during transport C. Continue to be nonjudgmental, compassionate and respectful D. Reassure him or her that everything will be all right even if it will not be
C. Continue to be nonjudgmental, compassionate and respectful
Enroute to an ambulance call: A. B. Disregard radio chatter regarding downed power lines C. Don the appropriate PPE prior to departing the ambulance D. Only wear a seatbelt if you are driving the emergency response vehicle
C. Done the appropriate PPE prior to departing the ambulance
You should not attempt to lift a patient who weighs more than 250 with fewer than ___________ rescuers, regardless of individual strength A. Six B. Five C. Four D. Three
C. Four
All of the following will help minimize the risk of gastric distinction when ventilating an apneic patient with a bag mask device EXCEPT: A. Ensuring the appropriate airway position B. Ventilating the patient at the appropriate rate C. Increasing the amount of delivered tidal volume D. Delivering each breath over 1 Second
C. Increasing the amount of delivered tidal volume
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. Back of he neck B, Dortmund of the hand C. Lips, sclera or oral mucosa D. Forehead and face
C. Lips, sclera or oral mucosa
Which of the following is the most appropriate device to use when immobilizing a patient with a suspected spinal injury? A. Portable stretcher B. Scoop stretcher C.Long backboard D. Wheeled stretcher
C. Long backboard
Continuing education in EMS serves to: A. Provide an ongoing review and audit of the EMS system B, provide research and statistical findings in prehospital care C. Maintain, update and expand your knowledge and skills D. Enforce mandatory attendance to agency specific training
C. Maintain, update and expand your knowledge and skills
The topographic term used to describe the location of the body parts are closer toward the midline or center of the body is: A. Lateral B. Midaxillary C. Medial D. Mid clavicular
C. Medial
When moving a conscious, weak patient down a flight of stairs, you should: A. Secure the patient to a scoop stretcher and carry him or her headfirst down the stairs to the awaiting stretcher B. Collapse the undercarriage of the wheeled stretcher and carefully carry the patient down the stairs on the stretcher C. Place the shelled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair D. Assist the patient in walking down the stairs and place him or her on the wheeled stretcher at the bottom of the stairs
C. Place the shelled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair
A palpable pulse is created by: A. Electrical conduction in the heart producing ventricular contraction B. The pressure that is caused when venous blood returns to the heart C. Pressure waves through the arteries caused by cardiac contraction D. The pressure of circulating blood against the walls of the arteries
C. Pressure waves through the arteries caused by cardiac contraction
When using a blanket drag, you should A. Always use stormy secure the patient's hands B. Pull the blanket from the patient's feet C. Pull the blanket from the patient's head D. First out a backboard on the blanket
C. Pull the blanket from the patient's head
A pulse with a consistent pattern is considered to be: A. weak. B. strong. C. regular. D. irregular
C. Regular
A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: A. Select a smaller oropharyngeal airway and attempt to insert it B. Continue to insert the airway as you suction her oropharynx C. Remove the airway and be prepared to suction her oropharynx D. Insert the airway no further but leave it in place as a bite block
C. Remove the airway and be prepared to suction her oropharynx
Which of the following is most characteristic of adequate breathing in an adult ? A. Respiration of 30 breaths/min and reduced tidal volume B. Use of the accessory muscles in the neck and cyanosis C. Respirations of 20 breaths/ min and bilateral chest movement D. Cool, clammy skin and retractions above the clavicles
C. Respirations of 20 breaths/ min and bilateral chest movement
All are EMS immobilization devices except A. Short board B. Kendrick Extrication Device (KED) C. Stair chair D. Long board
C. Stair chair
To safely lift and carry a patient, all should be done except: A. You wait for enough personnel before moving a heavy patient B. Your team should understand every move C. Stair chair straps are not necessary for a cooperative patient D. Explain to the patient what you are going to do, before doing it
C. Stair chair straps are not necessary for a cooperative patient
The standards for prehospital emergency care and the individuals who provide it are typically regulated by the: A. American Heart Association B. Regional trauma center C. State office of EMS D. National Registry of EMTs
C. State office of EMS
Proper technique for suctioning the oropharynx of an adult patient includes: A. Removing large, solid objects with a tonsil tip suction catheter B. Continuously suctioning patients with copious oral secretions C. Suctioning while withdrawing the catheter from the oropharynx D. Suctioning for up to 1 minute if the patient is well oxygenated
C. Suctioning while withdrawing the catheter from the oropharynx
What is the most common cause of airway obstruction in an unconscious patient? A. Vomit B. Aspirated fluid C. The tongue D. Blood clots
C. The tongue
As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on: A. The patient's condition B. The transport time to the hospital C. Your local EMS protocols D. An order from a paramedic
C. You local EMS protocols
The femoral head forms a ball-and-socket joint with the: A. Acetabulum B. Ilium C. Femoral condyle D. Ischium
A. Acetabulum
The major artery that supplies all other arteries with blood is the: A. Aorta B. Carotid C. Brachial D. Femoral
A. Aorta
When palpating the carotid pulse of a responsive older patient, you should: A. Avoid compressing both carotid arteries simultaneously B. Firmly compress the artery because the pulse is often weak C. Ensure that his or her head is a hyperextended position D. Avoid gentle pressure so that weak pulses can be detected
A. Avoid compressing both carotid arteries simultaneously
The most appropriate carrying device to use when moving a patient across rough or uneven terrain is the: A. Basket stretcher B. Wheeled stretcher C. Scoop stretcher D. Stair chair
A. Basket stretcher
A protocol is: A. Detailed written set of instructions to guide the care of a patient based on your evaluation B. Lit of things that need to be done before responding to a call C. List of what not to do D. Information that is used for research
A. Detailed written set of instructions to guide the care of a patient based on your evaluation
A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the: A. Distal forearm B. Proximal forearm C. Dorsal forearm D. Superior forearm
A. Distal forearm
A 37-year-old male has an apparent foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes: A. Encouraging him to cough and transporting B. Finger sweeps to remove the obstruction C. Performing a series of abdominal thrusts D. A series of back blows and chest thrusts
A. Encouraging him to cough and transporting
When approaching a 32 year old male who is complaining of traumatic neck pain, you should: A. Ensure that the patient can see you approaching him B. Assess his mental status by having him move his head C. Stand behind him and immediately stabilize his head D. Approach him from behind and ask him not to move
A. Ensure that the patient can see you approaching him
Upon arriving at a potentially unsafe scene, initially you should: A. Ensure that you are safe B. Remove all bystanders C. Move the patient to safety D. Request another ambulance
A. Ensure that you are safe
The leaf-shaped structure located superior to the larynx is called the: A. Epiglottis B. Thyroid cartilage C. Vallecula C. Cricoid ring
A. Epiglottis
You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should: A. Explain the seriousness of the situation to him, but avoid causing undue alarm B. Proceed to treat him because the stress f the situation has impaired his thinking C. tell him that he is having a heart attack and that he needs to go to the hospital D. Reassure him that he will not receive a bill for the EMS call if he cannot pay
A. Explain the seriousness of the situation to him, but avoid causing undue alarm
Which of the following findings indicates that your patient had a patent airway? A. Forceful coughing B. Audible breathing C. Unresponsiveness D. Inspiratory stridor
A. Forceful coughing
Which of the following is an example of a symptom: A. Headache B. Tachycardia C. Hypertension D. Cyanosis
A. Headache
The elbow is an example of a ____________ joint. A. Hinge B. Saddle C. Ball and socket D. Gliding
A. Hinge
The most significant complication associated its oropharyngeal suctioning is: A. Hypoxia due to prolonged suction attempts B. Oral abrasions from vigorous suctioning C. Clogging of the catheter it's thick secretions D. Vomiting from stimulating the anterior airway
A. Hypoxia due to prolonged suction attempts
The continuous quality improvement (CQI) process is designed to: A. Identify areas f improvement and provide remedial training if needed B. Provide punitive action to EMTs who do not follow local protocol C. Ensure that all EMTs maintain licensure through the state EMS office D, focus specifically on the quality of emergency care provided to the patient
A. Identify areas f improvement and provide remedial training if needed
If you cannot palpate a pulse in an unresponsive patient, you should: A. Immediately begin cardiopulmonary resuscitation (CPR) B. Attach an automated external defibrillator (AED) at once C. Palpate at another pulse site D. Assess for adequate breathing
A. Immediately begin cardiopulmonary resuscitation (CPR)
Which of the following statements regarding the power lift is correct? A. It is the safest and must powerful method of lifting a patient B. The leg muscles should remain relaxed during the power lift C. It is not recommended for people with weak knees or thighs D. It involves using your lower back instead fo your legs to lift
A. It is the safest and must powerful method of lifting a patient
The proper technique for using the power grip is to: A. Lift with your palms up B. Position your hands about 6" apart C. Hold the handle with your fingers D. Rotate your palms down
A. Lift with your palms up
The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the: A. Medical director B. Shift supervisor C. Field training officer D. EMS administrator
A. Medical director
Which of the following abnormal breath sounds indicates obstruction of the upper airway? A. Stridor B. Cackles C. Ronchi D. Rales
A. Stridor
The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. Systolic pressure B. Blood pressure C. Diastolic pressure D. Pulse pressure
A. Systolic pressure
In which of the following circumstances can the EMT legally release confidential patient information? A. The patient is competent and signs a release form B. Media representative inquires about the patient C. The family requests a copy for insurance purposes D. A police officer requests a copy to place on file
A. The patient is competent and signs a release form
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: A. 52% B. 35% C. 24% D. 44%
D. 44%
An adult at rest should have a respiratory rate that ranges between: A. 16 and 24 breaths/min B. 12 and 20 breaths/min C. 10 and 18 breaths/min D. 8 and 15 breaths/min
B. 12 and 20 breaths/min
The normal respiratory rate for an adult should range from A. 24 to 28 breaths per minute B. 12 to 20 breaths per minute C. 18 to 24 breaths per minute D. 10 to 15 breaths per minute
B. 12 to 20 breaths per minute
With proper technique, you and your partner should be able to safely lift a patient who weighs up to ______ lb. A. 150 B. 220 C. 175 D. 190
B. 220
An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: A. Providing immediate transport B. Airway, breathing and circulation C. Gathering medical history data D. Obtaining baseline vital signs
B. Airway breathing and circulation
A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway? A. Provide continuous ventilation with a bag mask device to minimize hypoxia B. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation C. Insert a nasopharyngeal airway and provide suction and assisted ventilation D. Suction his oropharynx with a rigid catheter until all secretions are removed
B. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation
Which of the following statements regarding the EMS medical director and an EMTs scope of practice is correct? A. An EMTs scope of practice is exclusively regulated by the state EMS office not the EMS medical director B. An EMTs scope of practice may be expanded by the medical director after the proper training and state approval C. The EMS medical director can expand the EMTs scope of practice but can't limit it without the state approval D. The EMS medical director can expand or limit an individual EMTs scope of practice without state approval
B. An EMTs scope of practice may be expanded by the medical director after the proper training and state approval
The jaw-thrust maneuver is used to open the airway of patients with suspected: A. Copious oral secretions B. Cervical spine injuries C. Upper airway swelling D. Mandibular fractures
B. Cervical spine injuries
The determination that prompt surgical care in the hospital is more important than performing time-consuming procedures in the field on a major trauma patient is based MOSTLY on: A. Local protocols B. EMS research C. The lead EMTs decision D. Regional trauma guidelines
B. EMS research
A 56-year-old female is found supine in a narrow hallway of her mobile home. She complains of severe weakness and dizziness, and states that she is unable to walk. There is no evidence of trauma and the patient states that she did not fall. How should you and your partner move this patient to a more spacious area? A. Direct carry B. Extremity lift C. Emergency move D. Scoop stretcher
B. Extremity lift
You arrive at the scene of a motorcycle accident. The rider is unresponsive and is still wearing his helmet. Treatment should include A. No need to stabilize his cervical spine since the helmet provides cervical spine protection B. Having two trained rescuers remove his helmet C. Fitting a cervical collar prior to removing the helmet D. Lifting him to the stretcher with an extremity lift
B. Having two trained rescuers remove his helmet
A single EMT managing an apneic patient's airway the preferred initial method of providing ventilations is the: A. One person bag mask device B. Mouth to mask technique with a one way valve C. Manually triggered ventilation device D. Mouth to mouth technique
B. Mouth to mask technique with a one way valve
A patient who is suspected of being hypoxia and is breathing adequately should be given supplemental oxygen with a: A. Bag mask device B. Nonrebreathing mask C. Nasal cannula D. Mouth to mask device
B. Nonrebreathing mask
To minimize the risk of litigation, the EMT should always: A. Utilize a least four personnel when moving a patient B. Provide competent care that meets current standards C. Use universal precautions with every patient encounter D. Transport patients to the hospital of their choice
B. Provide competent care that meets current standards
In which of the following situations is an emergency patient move indicated? A. The EMT has to gain access to lesser injured patients B. The EMT is unable to protect the patient form scene hazards C. A patient has an altered mental status or is in shock D. A significant mechanism of injury is involved
B. The EMT is unable to protect the patient form scene hazards
Twelve pairs of ribs attach to what section of the spinal column? A. Coccyx B. Thoracic C. Lumbar D. Sacral
B. Thoracic
During an EMS call, you should take standard precautions: A. Any time before you load the patient into the ambulance B. Upon exiting the ambulance, but before actual patient contact C. After it had been determined that the patient is bleeding D. Immediately after completion of your primary assessment
B. Upon exiting the ambulance, but before actual patient contact
The inferior cartilaginous tip of the sternum is called the: A. Sternal notch B. Xiphoid process C. Angle of Louis D. Jugular notch
B. Xiphoid process
In contrast to inhalation, exhalation: A. requires muscular effort to effectively expel air from the lungs. B. is a passive process caused by increased intrathoracic pressure. C. occurs when the diaphragm lowers and expels air from the lungs. D. is an active process caused by decreased intrathoracic pressure.
B. is a passive process caused by increased intrathoracic pressure.
Which of the following statements regarding the one person bag mask device technique is correct? A. Bag mask ventilations should be delivered every 2 seconds when the device is being operated by one person B. The bag mask device delivers more tidal volume and a higher oxygen concentration than the mouth to mask technique C. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag mask device D. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag mask device
D. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag mask device
The purpose of quality assurance/ quality improvement (QA/QI) is to: A. Refusal of medical attention review B. Protocol appropriate treatment C. Time of dispatch to arrival of ambulance D. All of the above
D. All of the above
According to the National EMS Scope of Practice Model, an EMT should be able to: A. Insert a peripheral intravenous (IV) line and infused fluids B. Interpret a basic electrocardiograph (ECG) rhythm and treat accordingly C. administer epinephrine via the subcutaneous route D. Assist a patient with certain prescribed medications
D. Assist a patient with certain prescribed medications
Contraction of the right ventricle causes: A. Ejection of blood into the systemic circulation B. A return of blood from the pulmonary veins C. Closure of the mitral and aortic valves D. Blood flow into the pulmonary circulation
D. Blood flow into the pulmonary circulation
The spread of HIV and hepatitis in the health care setting can usually be traced to: A. Excessive blood splashing B. Getting too close to the patient C. A lack of proper immunizations D. Careless handling of sharps
D. Careless handling of sharps
The most distal four spinal vertebrae, which are fused together, form the: A. Ischium B. Ilium C. Sacrum D. Coccyx
D. Coccyx
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A. Enlarging B. Fluttering C. Dilating D. Constricting
D. Constricting
The medical director: A. Decides which driving laws need to be followed hand responding to an emergency B. Is responsible for department vehicle rolling order C. Decides if the nature of the call warrants an ambulance to be dispatched D. Determines the appropriate care for injury, condition or illness
D. Determines the appropriate care for each injury, condition or illness
Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should: A. Apply a cervical collar and quickly remove the patient with a clothes drag B. Apply a vest style extraction device before attempting to move the patient C. Slide a long backboard under his buttocks and lay him sideways on the board D. Direct your partner to apply manual in line support of the patient's head
D. Direct your partner to apply manual in line support of the patient's head
The leaf-shaped flap of tissue that prevents food and liquid from entering the trachea during swallowing is called: A. Vallecula B. Pharynx C. Uvula D. Epiglottis
D. Epiglottis
A patient is in a semireclined position with the head elevated to facilitate breathing is the _________ position A. Prone B. Supine C. Recovery D. Fowler's
D. Fowler's
The goal of the primary assessment is to: A. determine if the patient's problem is medical or trauma. B. identify patients that require transport to a trauma center. C. determine the need to perform a head-to-toe assessment. D. identify and rapidly treat all life-threatening conditions
D. Identify and rapidly treat all life-threatening conditions
Obtaining continuing medical education is the responsibility of the: A. EMS medical director B. EMS training officer C. State bureau of EMS D. Individual EMT
D. Individual EMT
When carrying a patient on a backboard up or down stairs: A. Carry the patient headfirst B. Keep your palms facing down C. Keep the foot end elevated D. Keep the head end elevated
D. Keep the head end elevated
To minimize the risk of injuring yourself when lifting or moving a patient, you should: A. Avoid the use of log rolls or body drags B. Use a direct carry whenever possible C. Flex at the waist instead of hips D. Keep the weight as close to your body as possible
D. Keep the weight as close to your body as possible
What type of medical direction do standing orders and protocols describe? A. Online B. Radio C. Direct D. Offline
D. Offline
The exocrine gland of the pancreas secretes: A. Glucose B. Bile C. Insulin D. Pancreatic juice
D. Pancreatic juice
In relation to the wrist, the elbow is: A. Lateral B. Distal C. Medial D. Proximal
D. Proximal
In responsive patients that are older than 1 year of age, you should palpate the pulse at the ________ artery. A. Brachial By femoral C. Carotid D. Radial
D. Radial
How does respiration differ from ventilation A. Respiration occurs when the diaphragm and intercostal muscles contract, whereas ventilation occurs when those same muscles relax B. Respiration occurs when oxygen is derived to the cells of the body, whereas ventilation occurs when carbon dioxide is removed C. Ventilation occurs when air is forced into the lungs, whereas respiration occurs when air is drawn or sucked into the lungs D. Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment
D. Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment
You have inserted an oral airway and are ventilating an apneic woman with a bag-mask device. She suddenly begins regurgitating large amounts of vomit. You should FIRST: A. Perform a finger sweep of her mouth B. Remove the oral airway and suction her oropharynx C. Insert a nasal airway and then suction her mouth D. Roll her onto her side and remove the oral airway
D. Roll her onto her side and remove the oral airway
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. Diastolic blood pressure B. Cardiac output pressure C. Pulse pressure D. Systolic blood pressure
D. Systolic blood pressure
Hypoxia is MOST accurately defined as: A. low venous oxygen levels. B. a decrease in arterial oxygen levels. C. an increase in carbon dioxide in the blood. D. inadequate oxygen to the tissues and cells.
D. inadequate oxygen to the tissues and cells.
All are components of the EMT system except: A. Public education B. Primary prevention C. Personal EMS education D. Participating in election campaigns
D.Participating in election campaigns
What is the MOST appropriate method to use when moving a patient from his or her bed to the wheeled stretcher? A. Draw sheet method B. Log roll C. Direct carry D. Extremity carry
Draw sheet method
Research studies show the usual order of stages of grieving are
denial, anger, bargaining, depression, acceptance
