NREMT PRACTICE QUESTIONS #1
A 34 y/o female is complaining of shortness of breath after eating shellfish. She has hives on her face, arms, chest, and back and her tongue is swollen. What is the first intervention you should perform? a). 0.3 mg epinephrine 1:1,000 IM b). 1 mg epinephrine 1:10,000 IV c). 50 mg diphenhydramine IV d). 2 ampules of nebulized albuterol
a). 0.3 mg epinephrine 1:1,000 IM. (The very first intervention for any adult patient that is conscious and experiencing an allergic reaction to this degree is 0.3 mg epinephrine 1:1000 IM. 1 mg epinephrine 1:10,000 is used in cardiac arrest or in severe asthma attacks, it is not used in allergy as its half-life is too short. The diphenhydramine and albuterol may both be indicated, but only after the epinephrine).
A 30 week pregnant female is the restrained driver of a vehicle that struck a power pole at 25 mph. She is conscious and alert, complaining of severe abdominal pain. Your only assessment finding reveals she is bleeding heavily vaginally. Which of the following conditions should you suspect? a). Abruptio placenta b). Spontaneous abortion c). Uterine rupture d). Eclampsia
a). Abruptio placenta. (A pregnant patient that is involved in a traumatic accident may experience separation of the placenta from the uterine wall. This causes serious bleeding internally and externally. Excess blood loss can lead to shock and possible death of the mother or baby. If bleeding occurs after the delivery and blood loss cannot be controlled. The best treatment pre-hospital is to stabilize spine and a rapid safe transport to an appropriate facility).
The partial or full detachment of the placenta at more than 20 weeks of gestation is known as what? a). Abruptio placentae b). Ectopic pregnancy c). Placenta previa d). Uterine rupture
a). Abruptio placentae. (When the placenta separates from the uterus, its abruptio placentae, which is Latin for "a sudden breaking away of the placenta)."
What is the initial management for a patient that has experienced a seizure during pregnancy? a). Airway, apply high flow O2, transport on left side, reassure patient. b). Request ALS intercept. c). Apply AED and analyze the patients rhythm and assist ventilations. d). Seizures can alter the airway, insert an LMA for airway control.
a). Airway, apply high flow O2, transport on left side, reassure patient. (Assuming the seizure is over...the patient is likely experiencing toxemia and should be evaluated at the hospital. Transporting the patient in the left lateral recumbent position while reassuring the mother).
You are dispatched to a patient who has had a chainsaw accident. You arrive on scene to find a 33-year-old male with a large laceration to the left thigh. He has bright red blood spurting from the wound. Your patient is alert and oriented, but diaphoretic. What should be done first for this patient? a). Apply direct pressure b). Start 2 large-bore IVs with fluids running wide open. c). Place a tourniquet 2 inches below the wound. d). Stabilize the leg with padded board splints.
a). Apply direct pressure. The patient has an airway, is breathing, and is alert and oriented; so your priority should be controlling the bleeding. Apply direct pressure first. If bleeding continues apply a tourniquet).
You are called to see a child who has possibly eaten a packet of laundry detergent. You should first: a). Assess the child's airway, breathing, and circulation. b). Induce vomiting. c). Call Poison Control for an antidote. d). Give the child a laxative suppository.
a). Assess the child's airway, breathing, and circulation. (The "ABC" or management--Airway, Breathing, Circulation--always come first. Inducing vomiting may be dangerous and is no longer a standard of care of accepted current practice. Laxatives and other elimination enhancers are later considerations under the monitoring of a physician).
An important gathering that occurs 24 to 72 hours after an event for emergency personnel involved in a stressful incident is called a : a). Critical incident stress debriefing b). Post Disaster follow up c). Scene management d). Psychological evaluation
a). Critical incident stress debriefing. (Critical incident stress debriefing CISD is a process in which a team of trained peer counselors and mental health professionals meet with rescuers who have been involved in a major incident. The meeting usually occurs 24 to 72 hours after the incident).
Which of the following diseases is a form of inflammatory bowel disease that has been linked to immune system dysfunction and can result in fistulas, rectal bleeding, persistent diarrhea, and joint pain? a). Crohn's disease b). Grave's disease c). Addison's disease d). Rheumatoid arthritis
a). Crohn's disease, (Crohn's disease is a form of inflammatory bowel disease that has been linked to immune system dysfunction and can result in fistulas, rectal bleeding, persistent diarrhea, and joint pain).
What is the role of epinephrine in the treatment of patients experiencing a severe asthma attack? a). Epinephrine is used in asthma attacks that are refractory to other medications b). Epinephrine provides long term bronchodilation for asthmatics c). Epinephrine is contraindicated in asthmatic patients d). Epinephrine is a first line medication for patients experiencing severe asthma attacks
a). Epinephrine is used in asthma attacks that are refractory to other medications. (Unlike patients experiencing a systemic allergic response, patients experiencing an asthma attack will benefit more from initial interventions such as nebulized bronchodilators, CPAP, and magnesium sulfate than they will from epinephrine. There are many precautions that must be taken before administering IM epinephrine to a patient experiencing a severe asthma attack).
There are multiple components of the National Incident Management System (NIMS). As a component of NIMS, what is the principal goal of Communications and Information Management? a). Establishing and maintaining situational awareness and ensuring accessibility and voice and data interoperability. b). Communications between on-scene command and tactical personnel and cooperating agencies and organizations. c. Communicating with the public, including emergency protective measures. d). Monitoring and gathering information and firsthand accounts of incident impacts.
a). Establishing and maintaining situational awareness and ensuring accessibility and voice and data interoperability. (Establishing and maintaining situational awareness and ensuring accessibility and voice and data interoperability are the principal goals of the Communications and Information Management component).
Who is the final arbiter when deciding to use an emergency or urgent patient move? a). First responders. b). Medical control. c). EMS supervisors. d). Fire department personnel.
a). First responders. (It is up to the medical provider to ultimately decide when to use emergent and urgent moves during patient care. When it is implemented for necessary circumstances, it can be the difference between life and death).
You are on a detail working a high school football game. You are called to the bench after one of the players starts complaining of dizziness with a headache. Assessment reveals hot and diaphoretic skin, shallow breathing, and general weakness. He has a strong radial pulse of 110, BP 120/80, and is breathing at 20 times a minute. Which of the following conditions is most consistent with your findings? a). Heat exhaustion b). Heat cramps c). Heat stroke d). Rising intracranial pressure
a). Heat exhaustion. (The vitals reveal that the patient is compensating, but stable, thus indicating heat exhaustion. On the other hand, the classic heat emergency of "heat stroke," or non-exertional hyperthermia, is common in the elderly or ill, due to a failure of the cooling systems in the body. Certain drugs, often taken by the elderly, contribute to this condition. Also, heat stroke usually involves a core temperature > 104º F).
You are called to standby at a residential (non-hazmat) fire. You're the first on scene and see someone lying in the front yard of the burning residence. There seems to be no immediate threat to you or your crew. What should you do? a). Immediately move the patient. b). Request dispatch to send the local rescue squad. c). Wait for the local fire department. d). Call to them to see if they can walk.
a). Immediately move the patient. (This patient is a prime candidate for an emergency move. In a situation where the patient's life is in immediate danger, there is a high probability of the scene deteriorating, and the patient can be accessed and moved with a reasonable expectation of the rescuer not becoming an additional casualty are all key determinants of when to make an emergency move).
Which of the following describes the appropriate management of a tibia/fibula fracture? a). Immobilization from the distal area of the femur to the foot. b. Immobilization from the proximal tibia/fibula to the foot. c. Immobilization from the distal femur to the distal tibia/fibula. d). Immobilization from the proximal tibia/fibula to the distal tibia/fibula.
a). Immobilization from the distal area of the femur to the foot. (The correct answer is immobilizing from the distal femur to the foot, as this is the only choice that immobilizes the joint above and below the fracture site. Be sure to check pulse, motor, and sensory before and after the splint is applied).
You have been called to a residence by a third-party caller for a man down after he was working in his yard. The patient is a 68-year-old male found unconscious and tachycardic with hot, dry skin and shallow respirations. Which of the following is the most beneficial intervention for this patient? a). Initiate rapid cooling b). Give large amounts of fluids by mouth c). Administer Lasix to increase the functioning of the kidneys. d). Administer high flow oxygen.
a). Initiate rapid cooling. (This patient is possibly dehydrated and having a heat stroke. He should receive O2 as needed, fluids, and rapid active cooling measures to reduce body temperature. Of the options listed the rapid cooling (by ice packs or cooled IV fluids if available) is the most beneficial possible intervention).
When lifting a stretcher from the lowest position, you should: a). Lock your back in position. b). Lift as quickly as possible. c). Bend at the waist. d). Avoid the power grip.
a). Lock your back in position. (When lifting a stretcher from the lowest position or the ground, you should lock your back into a position. This will increase your lifting potential. Bending at the waist or lifting quickly will increase your risk of injury. The "power grip" technique should be used).
You are treating a patient who is coughing up blood and has a high fever. Which of the following would be the MOST appropriate protective equipment to use in this case? a). Mask b). Gown c). Foot protection d). SCBA
a). Mask. (Though gloves are typically worn, a mask is the best protection for airborne pathogens. The other items are not as beneficial).
You are treating a 32-year-old male with a fractured femur after an MVC. You cannot palpate any pulses distal to the injury. You decide to apply a traction splint. As part of the application, which of the following would you do FIRST? a). Measure the device b). Hold manual traction c). Attach ankle strap d). Secure the device to the injured extremity
a). Measure the device. (The first step in applying a traction splint is to ensure it will fit the patient. You can do this quickly by measuring it against the unaffected leg if possible. Once you have measured it, the next step is to have someone pull manual traction, and then reassess PMS (Pulse, Motor, Sensation) before applying/securing the splint. If you get a return of pulses distally, you have the correct amount of traction. Once applied, reassess PMS).
You are called to evaluate a pesticide industry employee who is complaining of his skin burning. Your inspection reveals a fine-misted product on his clothing. After assuring scene safety, removing clothing, and flushing the skin, which complication should you also be concerned with? a). Poisoning by inhalation. b). Third degree burns. c). Scarring of the skin. d). Tachycardia.
a). Poisoning by inhalation. (The fine mist on his clothing means the pesticide toxin was aerosolized, making inhalation a prime suspect. Burn severity is usually mitigated by flushing. Scarring, also. Tachycardia is usually a complication of anticholinergic toxicity, whereas cholinergic toxicity from pesticides usually causes bradycardia).
What is the biggest difference between arterial, capillary, and venous bleeding? a). Rate of bleeding b). Color of blood c). Ability to progress to hypovolemic shock d). Likelihood to be missed on primary survey.
a). Rate of bleeding. (The rate of flow is the key difference between the three types of bleeding. Arterial blood is under high pressure, resulting in "spurts" of blood when arteries are severed, and a driving force (the heart) that pushes it out quickly. Venous and capillary bleeding are more apt to present as "oozing" or slow blood flow. The color of blood tends to be similar in all 3, though arterial blood is often claimed to have a brighter red hue. However, arterial blood can become darker with hypoxia, so in the field this is not reliable. All 3 types of bleeding can progress to hypovolemic shock depending on the size of the injury, but arterial loss will make this happen the quickest due to the "rate of bleeding," as is cited in the correct answer choice. Likewise, all 3 can be missed on primary survey, which is why it is vital to always assess every body surface area of your patient if you suspect bleeding and to be on the lookout for the signs of internal bleeding!).
Your patient is a 34-year-old female complaining of shortness of breath after eating shellfish. She has hives on her face, arms, chest, and back and her tongue is swollen. What is the first intervention you should perform? a). 1 mg epinephrine 1:10,000 IV b). 0.3 mg epinephrine 1:1000 IM c). 50 mg diphenhydramine IV d). 125 mg methylprednisolone IV
b). 0.3 mg epinephrine 1:1000 IM. (The very first intervention for any adult patient that is conscious and experiencing an allergic reaction to this degree is 0.3 mg epinephrine 1:1000 IM. 1 mg epinephrine 1:10000 is not indicated for this patient. The diphenhydramine and methylprednisolone are both indicated, but only after the epinephrine).
When managing a long bone fracture, what is the best location to attach a splint? a). As close as possible to the fracture site b). Above the proximal joint and below the distal joint c). At the most distal and proximal locations possible on the limb d). At the joint proximal to and as close distal to the site of the fracture
b). Above the proximal joint and below the distal joint. (Securing fractures of the long bones requires securing the joints above and below the injured bone. The injured site between secured joints is the only area that requires immobilization. This minimizes potential force on the fracture site from the patient attempting to move despite the injury. It also provides the ideal level of mechanical strength for the sprint. Just distal to each joint is best, as securing a splint too close or too far from the fracture site reduces the strength of the splint and should be avoided).
Which of the following techniques would require two responders to lift a patient from a supine position by lifting their torso and legs? a). Direct ground lift. b). Extremity lift. c). Blanket lift. d). Modified firefighter's carry
b). Extremity lift. (The urgent extremity lift is performed most often by a two person team on a patient that is lying on their back and in need of an immediate movement for life-saving care or immediate transport. The first team member performs the beginning steps of the the direct ground lift, positioning themselves behind the patient and interlacing the patient's arms with their own. The second team member can assist this portion of the move by grasping the patient's upper arms and pulling the patient to a sitting position as the first team member supports the patient's back and gets into proper position. Once the first team member is in position and ready, the second team member stands between the ankles or knees of the patient grasping whichever he/she decides to stand between. While making sure to communicate the timing, the team lifts both the upper and lower body of the patient at the same time and facilitates placement of the patient onto the stretcher or other patient movement device).
Fertilization of an egg by sperm occurs in the: a). Ovary. b). Fallopian tube. c). Uterus. d). None of the above.
b). Fallopian tube. (Midway in the Fallopian tube journey the ascending horde of spermatozoa meet it and once a single sperm penetrates the egg's covering, a reaction around the egg prevents further penetration by other sperm).
Which of the following symptoms is one of the first to appear in a patient who is beginning to suffer from mild blood loss secondary to an injury? a). Diaphoresis b). Headache c. Nausea d). Hypotension
b). Headache. (Headache is one of the first symptoms to appear with blood loss, likely due to constriction of blood vessels in the brain and body. Diaphoresis (sweating), cold clammy skin, and nausea may appear next. While confusion, fatigue, tachycardia, and hypotension are late signs that show severe loss has occurred).
You are called to a local factory for a 28-year-old male patient who has passed out in an overheated room. He has cool, diaphoretic skin, pulse of 124, and BP 88/40. Which of the following would you MOST suspect based on this information? a). Heat stroke. b). Heat exhaustion. c). Heat cramps. d). Septic shock.
b). Heat exhaustion. (Cool, diaphoretic skin is the important part that tells you this is heat exhaustion. If it were heat stroke, frequently the skin is warm and dry, to fit the definition of heat stroke a temperature of over 104 degrees or confusion are also required to be present. Heat cramps do not cause syncope and there is not enough information here to assume sepsis. Syncope can occur in both heat exhaustion and heat stroke).
Toxins enter the body through all of the following routes except? a). Ingestion. b). Lymphatics. c).Skin. d). Blood vessels.
b). Lymphatics. (Toxins principally are absorbed via ingestion, through the skin (cutaneous), injection (blood vessels--veins), and inhalation (lungs). Toxicity is due to toxins being delivered throughout the body by blood vessels after entering via the above routes).
The permanent end of menstruation, occurring between the ages of 35 to 60 years and accompanied by hormonal deficiency changes is which of the following? a). Menarche b). Menopause c). Curettage d). Ovulation
b). Menopause. (Menopause marks the permanent end of menstruation, occurring between the ages of 35 to 60 years and accompanied by hormonal changes due to estrogen deficiencies. The average age of menopause is 52. Anything < 35-40 is considered "premature menopause)."
Which of the following is NOT one of the four key principles of communications and information systems? a). Resilience and Redundancy b). Status Reports c). Security d). Interoperability
b). Status Reports. (The four key principles of communications and information systems are: 1. Inter-operability; 2. Reliability, Scalability, and Portability; 3. Resilience and Redundancy; and 4. Security).
A large hurricane strikes a coastal city and destroys a large amount of communication and transport infrastructure. The national guard provides air and sea resources under the national incident management system (NIMS). As an emergency medical services professional working in the field, how will this situation impact your pattern of practice? a). You will be assigned to one of the helicopters or watercraft b). The helicopters and watercraft will transport patients to you c). The helicopters and watercraft will bring resources that allow you to overcome poor transport conditions d). You will continue to respond to calls on-scene as usual
b). The helicopters and watercraft will transport patients to you. (Large scale disaster that requires activation of the NIMS will almost always cause a significant disruption in ground ambulances ability to respond to the scene of injured patients requiring transport. Specialized resources are generally used to extradite patients from the scene to a central staging area where traditional ground transport can take them to receiving facilities).
Resilience and redundancy in communications help to ensure which of the following? a). The standardized assignment of radio channels. b). The uninterrupted flow of information. c). Information communicated from, among, and to incident personnel is protected. d). The duplication of services.
b). The uninterrupted flow of information. (Resilience and Redundancy in communications help to ensure the uninterrupted flow of information).
You are called to see a 78-year old man complaining of chest pain. His wife says this is the first time he's complained of this. Before pharmacological intervention, what should you ask about? a). The need for any cholesterol medications b). The use of erectile dysfunction medications c). The need for any blood pressure medications d). The need for any medications to treat asthma
b). The use of erectile dysfunction medications. (You should ask about his sex life, specifically, the need to take sildenafil Viagra, tadalafil Cialis, vardenafil Levitra, or other nitrates for ED. If given in conjunction with Nitro these medications can cause profound hypotension).
What is the primary mechanism of action of a nitrate? a). Vasoconstriction b). Vasodilation c). Antiemetic d). Sedation
b). Vasodilation. (Nitrates like Nitroglycerin vasodilate. Nitrates nitroglycerin are potent vasodilators used to reduce cardiac chest pain. They are also frequent ingredients in meds for erectile dysfunction ASK!).
You are on scene with a 55-year-old female that fell off the curb and has an obvious ankle fracture. Immediately after immobilizing above and below the fracture you should check for all of the following EXCEPT: a). pulse b). paresthesia c). motor d). sensation
b). paresthesia. (Immediately after applying a splint you need to check for distal pulse, motor, and sensation. Assessing for paresthesias is not required as these are more difficult to assess in the setting of an acutely painful distracting injury).
Which of the following is the recommended dose of aspirin (ASA) to give during a suspected acute myocardial infarction? a). 81 mg. b.) 100 mg. c). 324 mg. d). 500 mg.
c). 324 mg. (Chewing a 324 mg aspirin is recommended for patients with suspected ACS who aren't on antiplatelet or anticoagulation therapy. 81 mg is a daily dose that is given to patients with a high risk of ACS that do not currently have symptoms. Higher doses than 324 mg are rarely given in the EMS setting).
A young boy has fallen and sustained a superficial wound on his right thigh. It is bright red with spots of blood and straw-colored drainage. What intervention, if any, is indicated in this patient? a). Surgical intervention to remove gas producing bacteria b). Prolonged direct pressure to limit subcutaneous bleeding c). Application of dressings and bandages over the wound d). No intervention is indicated
c). Application of dressings and bandages over the wound. (Abrasions require little more than application of proper dressings. These superficial wounds rarely become infected and only minimally bleed. An isolated abrasion is rarely, if ever, an indication for transport in an otherwise healthy patient).
Which type of vessels does nitroglycerin dilate? a). Exclusively arterial vessels b). Exclusively venous vessels c). Both arterial and venous vessels d). Neither arterial and venous vessels
c). Both arterial and venous vessels. (Nitroglycerin is a potent vasodilator that effects both the arterial and venous vessels. Besides being a venodilators, it is a potent coronary artery vasodilator).
Ensuring you are following your agency's protocols and there are no contraindications, which of the following should be given for suspected acute coronary syndrome? a). Aspirin alone. b). Nitroglycerin alone. c). Both aspirin and nitroglycerin d). Neither aspirin nor nitroglycerin until a 12-lead ECG is performed.
c). Both aspirin and nitroglycerin. (If protocols indicate that there are no contraindications, both aspirin and nitroglycerin NTG should be given in suspected acute coronary syndrome ACS. Be sure to obtain a good set of vital signs and note the patient's blood pressure PRIOR to nitroglycerine administration. This can cause significant hypotension in a patient that is experiencing a right-sided myocardial infarction MI. For anything less than ~100mmHg systolic agency protocols may vary between 90mmHg-120mmHg you should withhold nitroglycerin unless directed by online medical control with other interventions readily available. Regardless, always monitor your patient and their vital signs after any medication administration. For an ALS provider, a 12-lead would be indicated in conjunction with ASA but prior to NTG administration in the event it is an inferior MI where NTG administration must be given cautiously).
A patient is found unconscious on a golf course during a particularly hot and humid day. There is no obvious trauma visible. Which of the following is the best initial treatment for this patient? a). Removal of clothing b).Applying ice packs to the groin and axillae c). Evaluate ABCs and move the patient to a cool environment d). Placement in the recovery position
c). Evaluate ABCs and move the patient to a cool environment. (The salient point in the prompt is that this golfer is UNCONSCIOUS! Management of an unconscious victim of hyperthermia: if the patient is unconscious, evaluating their ABCs is PRIMARY. Once this is done, then move them to a cool place for further care and reassessment. Continually reassess their ABCs during this move especially if you must move them in a supine position. For some patients, vomiting may be brought on by even slight movements so be mindful of this and if possible, place them in the recovery position to ensure you are protecting their airway. Remember any time a patient is unconscious there is an increased risk of aspiration that must be considered. You don't want one emergency to turn into two emergencies!).
Your patient has a small knife impaled in his leg, what is NOT a part of the normal treatment for this patient? a). Control bleeding b). Administer high flow O2 via a NRB c). Gently remove the knife so wound care can be initiated d). Prepare to treat the patient for shock
c). Gently remove the knife so wound care can be initiated. (Never remove a impaled object unless it is in the way when performing lifesaving techniques).
You are called to see a pregnant woman who is unresponsive. Her family states she has not had a convulsion. She is not bleeding. After initial vitals are documented, your best NEXT step is to: a). Listen for fetal heart tones. b). Check for patellar reflexes and clonus. c). Get a blood sugar determination. d). Try to awaken her with an ammonia inhalant.
c). Get a blood sugar determination. (Any evaluation of a pregnant woman showing any changes in affect or alertness requires a blood sugar determination and an IV).
During a MCI, where would most arriving EMS personnel be stationed? a). The communications group b). The rescue/extrication group c). In the treatment group d. EMS is not usually stationed or assigned to an MCI, they are in and out with patients
c). In the treatment group. (Most arriving EMS personnel will be assigned to a treatment/triage group in order to do the most good for the most people).
When performing the primary triage on patients of a small scale mass casualty incident, what is the only treatment the EMT should initiate, before tagging them and moving on the next patient? a). Open the airway and provide ventilatory support b). Open the airway and apply O2 via NRB @ 15 lpm c). Open the airway and control life-threatening hemorrhage d). Open the airway and attach the EKG to visually monitor the patient while tending to others
c). Open the airway and control life threatening hemorrhage. (The only 2 interventions that the EMT should initiate during the primary triage is to open a closed airway and quickly control any life threatening hemorrhage before moving on to the next patient. These intervention may not be appropriate either in the case of a large scale MCI with limited personnel on scene).
You are on scene with a 5-year-old male that has ingested an unknown substance. This situation should prompt which action on your part? a). Induce vomiting with Syrup of Ipepac. b). Begin using activated charcoal. c). Rapid transport. d). Applying an AED.
c). Rapid transport. (Ensuring the stability of ABCs, rapid transport, and contacting poison control are the mandatory steps when dealing with an unknown ingestion toxicity. Because it is unknown, activated charcoal may be contraindicated acids, alkalis; also, applying an AED is determined by the cardiac status when indicated. Induction of vomiting is not only contraindicated with an unknown substance but contraindicated in general).
Where does normal fertilization occur? a). The vagina. b). The uterus. c). The Fallopian tube. d). The ovary.
c). The Fallopian tube. (Fertilization anywhere else would result in an ectopic pregnancy. This can also occur if the fertilized egg gets stuck in the Fallopian tube and doesn't progress toward implantation in the uterus).
Fertilization occurs in: a). The vagina. b). The uterus. c). The Fallopian tube. d). The ovary.
c). The Fallopian tube. (Fertilization occurs in the fallopian tube and then the fertilized egg travels down to the uterus for implantation).
An Initial Size-Up report occurs when, which of the following, arrives at the scene of an incident and assesses the situation? a). The Fire Chief. b). The Incident Commander. c). The first arriving official. d). The Emergency Operation Center Director.
c). The first arriving official. (Initial Size-Up/Rapid Assessment occurs when the official who is the first to arrive at the scene of an incident assesses the situation and provides his/her findings to dispatch or other incident support organizations).
Our goal for treating ingested toxins is to prevent the toxin from reaching which of the following areas? a). The stomach. b). The brain. c). The small intestine. d). The liver.
c). The small intestine. (The ultimate goal is to prevent absorption of any toxin. Absorption occurs primarily in the small intestine).
An egg, if unfertilized, travels through: a). The Fallopian tube. b). The uterus. c).Both the Fallopian tube and the uterus. d). The urethra.
c).Both the Fallopian tube and the uterus. (If an egg remains unfertilized, it is ejected during menses via the Fallopian tube and the uterus).
You are on scene with a 10-year-old patient who has fallen on an outstretched arm and now has an angulated fracture of the radius-ulna proximal to the wrist. There are no radial pulses felt. You should: a). splint the arm as found and transport immediately. b). sling and swath the arm as found and transport immediately. c).pull gentle traction to straighten and attempt restore pulses prior to splinting. d). splint the arm as found then pull gentle traction until pulses are restored
c).pull gentle traction to straighten and attempt restore pulses prior to splinting. (In an angulated fracture gentle traction to straighten it may be used prior to splinting if there is a loss of sensation/circulation distal to the injury. If you encounter significant resistance, splint the joint in the position found. Remember this is very painful to the patient and analgesics should be used if protocols allow prior to realignment, however, do not delay treatment if an ALS unit is not close to your location).
You are called to transport an active tuberculosis patient from a local rehabilitation center to the hospital for direct admission. Which of the following should be part of the transport/treatment of this patient? a). Complete BSI protection including gown and eye protection b). No special BSI needs c). Apply a mask to the patient d). Apply a mask to the patient and crew
d). Apply a mask to the patient and crew. (TB is airborne disease that can be easily transmitted with normal breathing. A mask should be placed on the patient and the crew when transporting a TB patient).
You arrive on scene to find a 45-year-old female with hives/urticaria over much of her body, inspiratory/expiratory stridor, and severe difficulty breathing. Her husband says she was stung by a hornet but has no prior history of allergies. Which of the following interventions is MOST appropriate? a). Complete a rapid assessment including vital signs and apply oxygen b). Apply oxygen while preparing to administer epinephrine if BP is < 100 mmHg/palp c). Apply oxygen and administer epinephrine if BP is > 100 mmHg/palp d). Apply oxygen and administer epinephrine regardless of the BP
d). Apply oxygen and administer epinephrine regardless of the BP. (The patient is experiencing signs and symptoms of anaphylaxis, so time is of the essence. It is imperative to reverse the reaction with the rapid administration of epinephrine, regardless of the patient's blood pressure. Epinephrine is never contraindicated in anaphylaxis).
What personal protective equipment (PPE) are appropriate for managing emergency childbirth? a). Gloves b). Gloves and face shield c). Gloves, goggles and N95 mask d). Gloves, face shield, and gown
d). Gloves, face shield, and gown.
During a call, the patient who is acting intoxicated spits on you. The patient is walking down the street, uncooperative, and using profanity while yelling at you. There is no immediate risk of harm to you or the team. What should you do when the police arrive on the scene? a). Tell the police officers they are clear to leave; you do not need any help. b). Hit the patient with an oxygen cylinder in "self-defense." C). Turn the patient over to the police department and clear the scene. d). Have everyone apply face/eye protection and continue to offer patient care in a professional manner.
d). Have everyone apply face/eye protection and continue to offer patient care in a professional manner. (The key to dealing with this type of call is recognizing that there could be a medical reason for the patient's behavior. The best way to proceed once the police have arrived is to make sure you are safe. You should ask the police to stay around in case they are needed, but protecting yourself and the crew from exposure is your highest priority. Remember that continuing patient care once it is safe to do so is crucial).
A patient is brought in after hiking all day in the Arizona desert with complaints of dizziness, nausea, diffuse muscle cramps, and slight confusion about where he is. He cannot remember when he began feeling ill. Which of the following conditions should the EMS professional expect? a). Hypothermia b). Food poisoning c). Venomous animal bite d). Hyperthermia
d). Hyperthermia. (Hyperthermia traditionally presents with the constellation of symptoms described above. It has no localized symptoms and patients rarely notice it occurring as it is slowly progressive, often masked by the subtle mental status changes it induces. SIGNS & SYMPTOMS of a heat emergency are • sweaty or dry skin, • flushing, • dizziness, • weakness, • nausea, • rapid heart rate, • muscular cramping, and • decreased levels of consciousness. These signs and symptoms can sometimes be subtle, especially in the elderly.)
Oral glucose administration is indicated for which of the following? a). ACS. b). Hypoglycemia of < 90 mg/dL. c). Hypoglycemia of < 75 mg/dL. d). Hypoglycemia of < 60 mg/dL.
d). Hypoglycemia of < 60 mg/dL. (Oral glucose should be administered to patients that have a blood-glucose level of less than 60 mg/dL).
You are attending a woman who is pregnant in her third trimester. She has nausea and vomiting and complains of right upper quadrant pain, radiating to her right shoulder blade. You notice numerous bruises on her arms and legs. You should: a). Check for clonus. b). Ask her about physical abuse. c). Ask her about alcohol abuse. d). Immediately prepare her for transport to an obstetrical hospital with intensive care capabilities after documenting her condition.
d). Immediately prepare her for transport to an obstetrical hospital with intensive care capabilities after documenting her condition. (Immediately prepare her for transport to an obstetrical hospital with intensive care capabilities after documenting her condition. These are signs and symptoms of HELLP H- hemolysis, EL- elevated liver enzymes, LP- low platelet count) syndrome and is an OB emergency).
What is the primary function of aspirin in chest pain? a). Pain relief b). Vessel dilation c). Clot dissolution d). Inhibit platelet aggregation
d). Inhibit platelet aggregation. (Aspirin is a thromboxane A2 inhibitor, and we give it in chest pains primarily to stop new platelets from sticking together to old clots and preventing new ones. Aspirin will not take apart an already formed clot, but you are trying to prevent further damage by inhibiting new clots from forming and old clots from growing. Platelets want to stick together, but aspirin makes it harder for them to do so).
You have responded to an incident involving multiple jurisdictions. As a matter of public safety, which of the following communications should you use? a). Only use the codes that are defined by the incident commander. b). Use the codes or jargon specific to your organization. c). Use codes specific to your region. d). Plain language and clear text.
d). Plain language and clear text. (Using plain language and clear text, not codes, in incident management is a matter of public safety, especially the safety of incident personnel and those affected by the incident).
What is the purpose of the START triage method? a). To communicate with medical personnel. b). To ensure access of responding units to the mass casualty site. c). To coordinate efforts of multiple response units to a mass casualty incident. d). To quickly triage a large number of patients safely.
d). To quickly triage a large number of patients safely. (Simple Triage And Rapid Treatment is designed to triage large numbers of people as quickly as possible ensuring that those with life-threatening but survivable injuries will not be left waiting for care for a significant amount of time).
You are called to treat a patient complaining of bloody diarrhea. Upon assessment, you identify colicky pain in the lower quadrants, nausea, and vomiting. The MOST likely field diagnosis would be: a).Diverticulitis. b). Gastroenteritis. c). Hemorrhoids. d). Ulcerative colitis.
d). Ulcerative colitis. (Bleeding with stool is suggestive of a lower GI bleed or an inflammatory process. The presence of colicky pain (pain that is made worse by lying still) is suggestive of an inflammatory bowel disease such as chrons or ulcerative colitis. Hemorrhoids and gastritis typically do not cause copious amounts of bleeding or diarrhea).
Which of the following can involve the structures from the mouth to the anus, but usually not the rectum? a). Crohn disease. b). Ulcerative colitis. c). Diverticulitis. d). Megacolon.
a). Crohn disease. (CD can be anywhere from the mouth to anus, but it usually spares the rectum; also, CD extends via a tendency to skip areas and appear according to a non-contiguous spread. UC usually involves the rectum first/foremost, and spreads by direct extension into adjacent areas "contiguous" spread).
Which of the following is NOT considered an Inflammatory Bowel Disease? a). Irritable Bowel Syndrome. b). Ulcerative colitis. c). Crohn's Disease. d). Inflammation of the mucosal layer of the colon or its entire wall.
a). Irritable Bowel Syndrome. (Irritable bowel syndrome IBS is a constellation of symptoms without a specific identifiable cause. Inflammatory bowel disease (IBD) is one of two conditions, ulcerative colitis and chrons, are diseases that have identifiable causes and pathology that stem from inflammation).
Which of the following screenings is mandated by most employers? a). Tuberculosis. b). Hepatitis B. c). Influenza. d). Measles, Mumps, and Rubella.
a). Tuberculosis.
Your 5-year-old patient is allergic to bees and was stung twice. He is conscious and alert but is beginning to experience inspiratory wheezing and there is evidence of urticaria. Per MCP, you can assist the patient with their epi-pen as long as it is the proper dose. Which of the following dosages would you expect to see in a pediatric epi-pen? a). 0.10 mg/kg b). 0.15 mg c). 0.25 mg d). 0.50 mg/kg
b). 0.15 mg. (Pediatric epi-pens, sometimes referred to as "epi-pen Jr's," deliver a dose of 0.15mg as opposed to 0.3mg and are indicated for small /young patients that are under 15kg in total weight).
Nitroglycerin during an acute coronary syndrome (ACS) is best given by which route? a). PO (swallowing). b). Sublingual. c). Subcutaneously. d). Intramuscularly.
b). Sublingual. (Nitroglycerin during an acute coronary syndrome (ACS) is best given sublingually at a dose of 0.4 mg).
Which type of drag would employ the use of items readily available to place under the patient to perform the drag? a). The curtain drag. b). The firefighter's drag. c). The blanket drag. d). The clothing drag.
c). The blanket drag. (The blanket drag is performed again after recognition of a life-threatening event, by either positioning the patient fully on a sturdy blanket (often by a log-roll if possible) and then pulling the patient as if on a sled away from the danger and to safety, or by threading a rolled blanket behind the patient's back and under their arms, allowing for a sling-type of tool to pull the patient to safety).
