Adv. Prac 2
Chp 4
1. One of the major differences between laws and ethics is that laws: C) have sanctions for violation that are enforceable.
Chp 5
1. When providing patient care, it is MOST important that you maintain effective communication with: D) your partner.
9. An unconscious, adequately breathing patient should be placed in the recovery position, which is: D) laterally recumbent.
10. Which of the following describes the shock position? A) The head and torso are supine and the legs are elevated 6" to 12".
99. An organism will be biologically male if the 23rd chromosome pair in the zygote is: D) XY.
100. The process in which glucose is broken down to yield lactic or pyruvic acid is called: D) glycolysis.
100. When caring for any patient, it is important to remember that: D) your moral standards may conflict with the patient's best interests.
101. Ethics related to the practice and delivery of health care is called: A) bioethics.
101. The study of the body functions in a diseased state is called: D) pathophysiology.
102. Relative to the wrist, the elbow is: C) proximal.
102. Which of the following general statements is correct? C) The EMT code of ethics simply amplifies the concept of being concerned for the welfare of others.
103. Patient autonomy is MOST accurately defined as the: B) patient's right to direct his or her own care and to decide how end-of-life care should be provided.
103. Which of the following are typically found in the muscle cells, and provide cell movement and contraction via interaction with actin and myosin? B) Microfilaments
104. Antibodies made by the liver that make up about 36% of the plasma proteins are called: D) globulins.
104. If a patient makes a decision regarding his or her own health care and the paramedic does not agree with that decision, the paramedic should: D) respect the patient's wishes, assuming he or she has decision-making capacity.
105. If a paramedic receives an order from a physician that he or she feels is detrimental to the patient's best interests, the paramedic should: D) immediately discuss with the physician why the paramedic feels that way.
105. Any vertical plane that is parallel to the median plane and divides the body into unequal left and right parts is called the: A) sagittal plane.
106. The process in which malignant cells travel to other organs or tissue and establish secondary tumors is called: B) metastasis.
106. If a physician insists that you perform an intervention that you are not properly trained to perform, it would be MOST appropriate to: B) ask the physician if he or she can suggest another alternative.
107. People who call 9-1-1 at the moment of a loved one's death MOST often need: A) information and support.
107. Which of the following statements regarding anaerobic metabolism is correct? B) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes.
108. A patient is placed in the Fowler's position. In this position, the body is: B) in a semireclining position.
108. A DNR order is MOST accurately defined as a: A) written order designed to tell health care providers when resuscitation is or is not appropriate.
109. Health care powers of attorney are also called "durable" powers of attorney because they: C) remain in effect once a patient loses decision-making capacity.
10. The ability of multiple agencies or systems to share the same radio frequency is called: B) trunking.
11. Biotelemetry is MOST accurately defined as: D) the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.
10. Assault on a patient occurs when the EMS provider: D) instills the fear of immediate bodily harm in a patient.
11. Transporting a competent adult patient without his or her consent would MOST likely result in allegations of: C) false imprisonment.
109. When asking a patient to supinate his or her hand, you would expect him or her to: D) place the hand palm up.
110. The cell membrane is selectively permeable, which means that it: A) allows only certain substances to pass through it.
110. Although the technicalities of EMS DNR orders vary from state to state, they all: C) are designed to tell EMS providers when resuscitation is or is not appropriate.
111. The surrogate decision maker: B) is legally obligated to make decisions as the patient would want.
111. The movement of a solute from an area of higher concentration to an area of lower concentration is called: D) diffusion.
112. The separation of the intracellular and extracellular areas by a selectively permeable membrane helps to maintain: B) homeostasis.
112. A person wishes to be an organ donor. He or she must: D) have witnessed informed consent, usually in writing.
113. If a patient experiences prolonged hypotension or requires prolonged CPR, his or her _________ would be inappropriate for organ or tissue donation. D) kidneys
113. Osmosis is the movement of a: A) solvent from an area of low solute concentration to one of high concentration.
114. The movement of a substance against a concentration or gradient that requires energy is called: C) active transport.
114. If a mortally injured patient's wishes regarding organ donation are not known: A) Consent should be obtained from a family member.
115. Current bioethical guidelines regarding the decision not to initiate resuscitation efforts rely mainly on the use of: C) common sense and reasonable judgment.
115. If too much water moves out of a cell, the cell shrinks abnormally. This process is called: B) crenation.
116. The metabolic breakdown of stored carbohydrates, fats, or proteins in order to provide energy is called: D) catabolism.
116. Interventions that have been proven by studies to be of no benefit to the patient in cardiac arrest: B) are not medically or ethically indicated.
117. Resuscitation efforts would MOST likely be ceased in the prehospital setting on a patient with: A) blunt trauma arrest.
117. What type of tissue fills body spaces, stores fat, and produces blood cells? A) Connective
118. Cardiac muscle comprises the heart. This muscle is: C) nonstriated and involuntary.
118. A Medical Order for Life-Sustaining Treatment (MOLST) would MOST likely apply to a patient: D) with impending pulmonary failure but who is not in cardiac arrest.
119. The first rule of medical practice is to: A) do no harm.
11. Movement of an extremity toward the midline of the body is called: C) adduction.
12. The most common solvent in the body, in which solutes or other substances will dissolve, is: B) water.
119. The basic structure of nervous tissue that responds to environmental changes by transmitting impulses is the: B) neuron.
120. Which type of nerve cells conduct electrical impulses away from the cell body? A) Axons
120. Conducting EMS research studies on critically ill or injured patients without their informed consent is: C) a true ethical dilemma.
121. Which of the following statements regarding ethics in the workplace is correct? B) Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general.
121. Which of the following is NOT a function of the skin? D) Production of antibodies to foreign organisms
122. How do the blood vessels of the skin respond to cold temperatures? B) Constriction, which diverts blood away from the skin
122. You are caring for a 66-year-old man with terminal cancer. He is conscious and alert without evidence of mental incapacitation. You offer him oxygen, but he refuses to accept it, stating "Just let me die with dignity!" You should: B) respect the patient's wishes and ask him if he wants to be transported to the hospital.
123. The husband of a terminally ill woman called 9-1-1 because he thinks his wife is about to die. The patient has a valid living will and an out-of-hospital DNR order. You should: D) treat the husband and his wife with respect and provide emotional support.
123. Which of the following structures comprise the axial skeleton? A) Skull, face, thoracic cage, vertebral column
124. The three small bones in the middle ear are the: B) incus, malleus, and stapes.
124. A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order; however, the document expired 3 months ago. You should: A) begin CPR only and contact medical control for further guidance.
125. During the attempted resuscitation of a 79-year-old man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the patient has entrusted him to make all of his medical decisions. You should: A) continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.
125. Leakage of cerebrospinal fluid from the nose following severe head trauma suggests: C) fracture of the cribriform plate.
126. A fracture of the orbital bone is commonly referred to as a: A) blowout fracture.
127. The parathyroid glands produce and secrete a hormone that: D) maintains normal levels of calcium in the blood.
126. A fracture of the orbital bone is commonly referred to as a: A) blowout fracture.
126. You arrive at the scene of a major motor vehicle crash. The patient, a 29-year-old man, is in cardiac arrest from a severe head injury and has been receiving bystander CPR for approximately 10 minutes. A law enforcement official advises you that the patient's driver's license identifies him as an organ donor. You should: C) begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting.
127. You have been attempting resuscitation of a middle-aged woman for approximately 15 minutes; however, she has not responded to any of your treatment. There is no evidence of hypothermia or drug ingestion, and the cardiac monitor shows asystole. You should: B) consider terminating your resuscitative efforts.
12. Documenting a false statement that injures a person's good name or reputation constitutes: A) libel and defamation.
13. Which of the following is an example of slander? B) Telling the receiving facility that a patient is drunk
129. A projection of the second cervical vertebra (C2) that fits into the vertebral foramen of the first cervical vertebra (C1) is called the: C) odontoid process.
130. How many pairs of ribs are attached directly to the sternum? C) 7
131. A trauma patient complains of pain to the costovertebral angle (CVA) during palpation. The organ MOST likely injured is the: A) kidney.
132. Which of the following organs occupy all four abdominal quadrants? D) Small intestine and colon
133. The ilium is defined as the: B) bony prominences of the pelvis.
134. Which of the following is NOT part of the pelvis? A) Trochanter
135. A 2-year-old child has experienced a proximal humeral fracture involving the growth plate. This plate is also called the: C) epiphyseal plate.
136. The diencephalon, a region of the brain, contains which of the following structures? D) Thalamus and hypothalamus
137. The _______________ is a deep ridge of nerve fibers, which is separated by a layer of dura mater and connects the two cerebral hemispheres. B) corpus collosum
138. The limbic system, a portion of the cerebrum and diencephalon, contains structures that: B) influence emotions and mood.
13. Substances that release ions when dissolved in water are called: D) electrolytes.
14. If too much water enters a cell during osmosis, it will burst. This process is called: C) lysis.
139. What portion of the brain is a relay center that filters important signals from routine signals? A) Thalamus
140. Beginning with the outermost layer, the three meningeal layers of the central nervous system are the: C) dura mater, arachnoid, and pia mater.
141. Efferent nerves of the peripheral nervous system are responsible for: D) carrying commands from the brain to the muscles.
142. Of the 12 cranial nerves, which 2 do NOT exit from the brainstem? B) Olfactory and optic
143. Which of the following is a function of the oculomotor nerve (CN III)? B) Innervates the muscles that cause motion of the eyeballs
144. In response to shock or stress, sympathetic nervous system stimulation causes: A) vasoconstriction.
145. All of the following are functions of the parasympathetic nervous system, EXCEPT: C) decreased gastrointestinal function.
146. The gap that lies between each neuron is called the: B) synapse.
147. What body system is comprised of various glands located throughout the body? B) Endocrine system
148. Examples of steroid hormones are: B) cortisol and testosterone.
14. The initial complaint filed against a paramedic or EMS system by a dissatisfied patient: B) may not contain specific information about what the patient thinks went wrong.
15. Because a lawsuit may not begin until several years after the paramedic cares for a patient: D) it is essential to maintain good documentation on any call.
14. Cellular telephones are more advantageous than regular two-way radios in that cellular telephones: B) incorporate GPS technology to help rescuers find the patient.
15. In order for the paramedic to talk and transmit an ECG simultaneously on one frequency, a __________ system is required. D) multiplex
149. Molecules that bind to a receptor's cells and trigger a response by that cell, thereby resulting in some kind of action or biologic effect, are called: C) agonists.
150. What is the action of adrenocorticotropic hormone (ACTH)? A) Controls hormone secretion from the adrenal cortex
153. Glycogenolysis is the physiologic process in which: B) glycogen is converted to glucose.
154. What physiologic reaction occurs when a person's blood sugar level falls? C) Glucagon production is increased.
155. The outer adrenal cortex produces which of the following substances? A) Aldosterone
156. Human chorionic gonadotropin (HCG) is a major female hormone that: B) is manufactured by the developing embryo to sustain the pregnancy.
157. Which of the following processes initiates urine formation? D) Glomerular filtration
158. In the bloodstream, _____________ reacts with the plasma protein angiotensinogen to form angiotensin I. A) renin
15. Any cell that ingests microorganisms or other cells is called a(n): A) phagocyte.
16. The substance that contains all the cellular contents between the cell membrane and the nucleus is called the: B) cytoplasm.
159. When activated, fibrinogen is converted to: A) fibrin.
160. A person with type A+ blood could receive which of the following blood types? A) A+
161. During an allergic reaction, basophils release histamines and heparin. What respective roles do these chemicals play? B) Increase tissue inflammation and inhibit blood clotting
162. What occurs during the initial phase of hemostasis? D) Local vasoconstriction and platelet activation occur.
163. The middle muscular layer of the heart is called the: B) myocardium.
164. Which layer of the heart would be penetrated during an emergent medical procedure in order to remove fluid? C) Pericardium
165. The atrioventricular valves of the heart include the: A) tricuspid and mitral.
166. The semilunar valves of the heart function by: D) preventing backflow of blood into the ventricles.
167. Closure of the tricuspid and mitral valves occur during: B) ventricular contraction.
168. A bruit differs from a murmur in that a bruit: C) is auscultated over a main blood vessel.
16. Radio transmission distances from a mobile transceiver are reduced: B) over mountainous areas.
17. A(n) __________ receives a weak signal and retransmits it at a higher power on another frequency. C) repeater
16. Most civil cases are resolved during a settlement process because: B) it is expensive and time-consuming to take the case to trial.
17. Every decision regarding patient care that a paramedic makes should be based on the: A) standards of good medical care.
169. The heart's primary pacemaker, which is located in the right atrium, is the: B) SA node.
170. As an electrical impulse travels down the electrical conduction system, it transiently slows at the: A) AV node.
171. As electricity travels down the left and right bundle branches, it first stimulates the: D) intraventricular septum.
172. The term inotropy refers to the: C) strength of myocardial contraction.
173. A medication that possesses a positive chronotropic effect is one that: B) increases heart rate.
174. What is the function of a baroreceptor? A) Monitoring changes in arterial pressure
175. What happens when systemic vasoconstriction occurs? B) Afterload increases.
176. What is the cardiac output of a person with a stroke volume of 60 mL and a heart rate of 90 beats/min? D) 5.4 L
177. With regard to the heart, ejection fraction is defined as the: C) percentage of blood ejected from the heart.
178. Which layer of the blood vessel wall is composed of elastic tissue and smooth muscle cells? B) Tunica media
17. When oxygen levels are low or absent, the cells revert to a process of: B) anaerobic metabolism.
18. What type of tissue covers and lines internal organs? C) Epithelial
179. What are the three layers of the blood vessel, starting with the outer layer? A) Tunica adventitia, tunica media, tunica intima
180. The left main coronary artery rapidly divides into the: B) left anterior descending and circumflex arteries.
181. The _______________ withstands the highest pressures of any vessel in the body. D) ascending aorta
182. The aorta divides into the two common iliac arteries at the level of the: B) 5th lumbar vertebra.
183. The femoral artery gives rise to all of the following arteries, EXCEPT the: A) iliac arteries.
184. A specialized part of the venous system that filters the blood and metabolizes various drugs is called the: D) hepatic portal system.
185. The term perfusion is BEST defined as: C) adequate circulation of blood to the body's cells.
186. What is the function of the lymphatic system? B) Filtration of debris and bacteria from the blood
187. The epiglottis can be BEST described as: A) a valve that covers the trachea during swallowing.
188. The layer of tissue that lines the inside of the chest cavity is called the: C) parietal pleura.
18. If you must deviate from your protocols because of unusual circumstances, you should FIRST: C) notify medical control.
19. Which of the following statements regarding the paramedic-physician relationship is correct? A) The paramedic will be held accountable for his or her own actions.
18. A base station decoder within the emergency department: C) translates a telemetry signal into an oscilloscope tracing.
19. Which of the following statements regarding the use of cellular telephones and landline telephones is MOST correct? A) Cellular and landline telephones overcome problems caused by overcrowded EMS radio frequencies.
189. The process of moving air into and out of the lungs is called: D) ventilation.
190. The primary respiratory stimulus in a healthy adult is a(n): B) increased arterial carbon dioxide level.
191. Oxygen and carbon dioxide pass across the alveolar capillary membrane through a process called: A) diffusion.
192. What happens when the PaCO2 of the arterial blood increases? D) pH decreases and respirations increase
193. What are the functions of the pancreas? D) Production of insulin and certain enzymes that aid in digestion
194. Severe injuries to the liver are life-threatening because it is: C) highly vascular and very fragile.
195. The majority of the body's total body water is contained within the: B) intracellular space.
196. Which of the following statements regarding interstitial fluid is correct? A) It is located in the extracellular space and between the cells.
197. Urea is a result of: C) amino acid catabolism.
198. A pH of 7.30 indicates: D) acidosis.
151. The hormones tetraiodothyronine and triiodothyronine are synthesized by the: B) thyroid gland.
2. In addition to facilitating the uptake of sugar into the cells, insulin is responsible for: D) the chemical conversion of glucose to glycogen.
1. The topographic term used to describe the location of body parts that are closer to the midline is: B) medial.
2. Topographically, the term distal means: C) farther from the trunk.
19. All of the following are voluntary muscles, EXCEPT: B) smooth muscle.
20. The projection of the neurons that receives electrical impulses from other neurons is called a(n): A) dendrite.
20. When communicating medical information via radio, you should be: D) simple, brief, and direct.
21. The FIRST principle of communicating by radio is: A) clarity.
20. Generally, the paramedic is not at liberty to disregard a physician's order unless: D) carrying out the order will cause harm to the patient.
21. Which of the following is an example of a protocol? B) Standing orders
21. The integumentary system includes all of the following structures, EXCEPT: D) blood vessels.
22. The average total body water content of an adult is approximately ____% of his or her body weight. B) 60
22. A bystander physician who assists the paramedic at the scene is not required to accompany the patient in the ambulance unless the physician: C) has performed procedures above the paramedic's level.
23. If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should: C) contact medical control to seek resolution.
22. When transmitting information via radio, you should: B) use a normal conversational tone of voice
23. When transmitting data over the radio, you should NOT disclose the patient's: C) HIV status.
24. EMS-enabling legislation: A) defines how EMS is structured.
24. EMS-enabling legislation: A) defines how EMS is structured.
23. The base of the epidermis, which continuously produces new cells that rise to the skin's surface, is called the: C) germinal layer.
24. The brain and spinal cord are connected through a large opening at the base of the skull called the: A) foramen magnum.
24. Which of the following words would be the MOST difficult to hear over the radio? A) Yes
25. When transmitting your radio report to the hospital, you should: D) not be sitting right next to the patient.
25. What is the cribriform plate? D) Horizontal bone through which the olfactory nerve filaments pass
26. All of the following are facial bones, EXCEPT the: B) parietal.
26. A reasonable paramedic should follow the same ______________ that another paramedic in a B) standard of care
27. Provisions of the medical practice act include all of the following, EXCEPT: A) assigning medical directors to EMS systems.
28. Which aspect of the HIPAA is MOST pertinent to the paramedic? C) Ensuring that the patient's privacy is protected
27. Provisions of the medical practice act include all of the following, EXCEPT: A) assigning medical directors to EMS systems.
26. The use of ten-codes over the radio: B) is not recommended by the National Incident Management System (NIMS).
27. When relaying medical information to a physician in person, you should: A) include information that you did not provide during your radio report.
27. Which of the following statements regarding the thyroid cartilage is correct? A) It is the anterior part of the larynx.
28. Which portion of the spinal column articulates with the pelvis? B) Sacral
28. Which of the following patient data is NOT typically communicated during your radio report to the hospital? C) The patient's ethnicity
29. When a panicked person calls 9-1-1 for help: A) he or she needs immediate confirmation of having reached the right number.
2. A backup communication system is especially critical when dealing with: A) mass-casualty incidents.
3. Notification of EMS usually occurs when: B) a bystander notifies the dispatcher via telephone.
2. The BEST legal protection for the paramedic is to: B) provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
3. The judicial branch at the state level is responsible for: D) resolving disputes based on interpretation of law.
29. The point where the first cervical vertebra (C1) articulates with the base of the skull is called the: A) atlanto-occipital joint.
30. The upper section of the sternum is called the: D) manubrium.
30. Which of the following is addressed in the EMTALA? D) Preventing medical facilities from denying medical screening and stabilization
31. Historically, most EMTALA violations occurred when: A) the patient did not have medical insurance.
30. Which of the following details is of LEAST importance for the EMD to obtain from the caller? D) The patient's last known oral intake
31. If the EMD suspects that your patient has a life-threatening emergency, the EMD should make you aware of the situation and then: B) give prearrival instructions to the caller.
31. The first and second cervical vertebrae are called the: B) atlas and axis.
32. Which of the following organs/structures lie(s) in the retroperitoneal space of the abdomen? C) Kidneys
32. When transferring a patient between medical facilities, it is MOST important for the paramedic to: D) ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice.
33. A hospital that is in violation of EMTALA: C) could forfeit all of its Medicare funding.
32. Before you begin to transmit over the radio, you should check the volume and then: B) listen to make sure that the channel is clear of traffic.
33. Using the NATO phonetic alphabet, how should you spell Dr. "Wilson"? A) WHISKEY-INDIA-LIMA-SIERRA-OSCAR-NOVEMBER
33. The shoulder joint is a ball-and-socket joint B) glenoid fossa.
34. The shoulders and hips are examples of __________ joints. B) triaxial
34. Repeating the key parts of a patient's responses to your questions demonstrates: B) active listening.
35. When a patient thanks you, your MOST appropriate response should be: D) "You're welcome."
34. Which of the following statements regarding emergency vehicle laws is correct? B) All state statutes require emergency vehicles to be operated in a safe and prudent manner.
35. When an ambulance collides with a citizen's vehicle at an intersection: B) the driver of the ambulance may be charged criminally.
35. The midbrain, pons, and medulla oblongata collectively form the: D) brainstem.
36. The reticular activating system is located in the __________ and regulates: C) midbrain, consciousness.
36. If a paramedic is on duty and receives a 9-1-1 call in his or her jurisdiction: A) he or she is not covered by the Good Samaritan law.
37. The Good Samaritan law was originally passed in order to: C) encourage the public to help at emergency scenes.
36. When a patient repeatedly apologizes to you because he or she is incontinent, you should say: C) "You don't have to apologize that's what we're here for."
37. When functioning at a noisy scene, communication will be MOST effective if you: A) move the patient to the ambulance as soon as you can.
37. A patient with a left-hemispheric stroke would be expected to have: B) ipsilateral facial drooping.
38. Cerebrospinal fluid is manufactured in the: B) ventricles of the brain.
38. If you want reliable answers to personal questions, you should: B) manage the scene so you can ask such questions quietly and privately.
39. Conveying calm, unmistakable, genuine concern for someone you have never met before is the MOST essential challenge as a(n): D) therapeutic communicator.
38. According to the qualified immunity doctrine, the paramedic can be held liable only if: D) the plaintiff proves that the paramedic violated a clearly established law about which he or she should have known.
39. Which of the following situations is an example of an act of commission? B) A paramedic sutures a patient's lacerated arm.
3. Which of the following structures comprise different types of tissues that work together to perform a particular function? B) Organs
4. Compared to the frontal region of the skull, the occiput is: D) posterior.
39. Tiny particles that compose elements and vary in size and weight are called: A) atoms.
40. The most important nerve of the cervical plexus, which innervates the diaphragm, is the: A) vagus nerve.
40. Which of the following is NOT a required element needed to prove negligence? B) The patient's condition was life threatening.
41. A legal obligation of public and certain other ambulance services to respond to a call for help in their jurisdiction is called: A) duty.
40. Which of the following statements regarding ten-codes is correct? B) They should be avoided during a mass-casualty situation.
41. Which of the following actions demonstrates that the paramedic has his or her emotions under control? C) Speaking close to the patient's ear in a calm voice in an extremely noisy situation
41. The olfactory nerve (CNI) is responsible for: C) smell.
42. The sympathetic and parasympathetic nerves arise from the: B) autonomic nervous system.
42. If a patient is reluctant to communicate because he or she feels threatened, the paramedic should: A) cautiously approach the patient and use open posturing.
43. All of the following are external factors that can affect communication with a patient, EXCEPT: A) lack of empathy.
42. If an off-duty paramedic stops at the scene of a motor vehicle crash, the paramedic: C) has a legal obligation to provide patient care.
43. If a volunteer paramedic has signed up to work a shift for an EMS system: D) he or she is obligated to respond to calls during the shift.
43. During your assessment of a patient, you note that he is bradycardic, hypotensive, and salivating. These clinical findings suggest: B) parasympathetic nervous system stimulation.
44. Stimulation of alpha receptors of the sympathetic nervous system results in: D) peripheral vasoconstriction.
44. Maintaining eye contact with a patient enables the paramedic to: D) evaluate the patient's neurologic status.
45. Interpersonal communication is MOST accurately defined as the: B) exchange of information between two or more persons.
44. If an EMS agency's call volume is too heavy to allow response within an appropriate time frame: B) the agency is obligated to use mutual aid resources.
45. When determining whether or not a paramedic's actions were consistent with the standard of care, the court would be LEAST likely to: B) talk to patients to whom the paramedic has provided care in the past.
45. The catecholamine epinephrine (adrenaline) has an affinity for: A) alpha and beta receptors.
46. All of the following are endocrine glands, EXCEPT the: C) sweat glands.
46. Which of the following questions is the MOST effective when inquiring about a patient's chest pain? C) "Can you describe the pain to me?"
47. It is important to remember that if a patient is not personally sensitive to modesty because of an impaired mental state: B) the patient's family likely will be.
47. Which of the following stimulate(s) hormone secretion and influence(s) sodium and water movements in the kidney, helping to regulate blood pressure? B) Prostaglandins
48. Decreased levels of antidiuretic hormone (ADH) result in: C) polyuria and diabetes insipidus.
48. Which of the following statements regarding the harm element of a negligence lawsuit is MOST correct? C) A loss of earning capacity is a form of harm that the patient may claim.
49. Abandonment occurs when: C) care of a patient was terminated without his or her consent.
48. The purpose of a closed-ended question is to: A) elicit a specific response from the patient.
49. Which of the following questions would be appropriate to ask a patient who has no medical training? A) "Do you have any breathing or heart problems?"
4. A _____________ receives a weak signal and retransmits it at a higher power on another frequency. A) repeater
5. The combination of two or more signals, which allows the paramedic to talk and transmit an ECG simultaneously on one frequency, is called a: C) multiplex system.
4. When a person experiences an injury and seeks redress for that injury: A) the judicial process must determine who was responsible.
5. Which of the following general statements regarding medical law is correct? C) The patient or survivor must prove all elements of negligence before a lawsuit will be successful.
49. In the pregnant patient, the secretion of oxytocin causes: A) uterine smooth muscle contraction.
50. The thyroid gland is responsible for the: D) metabolic rate.
50. What is the main legal risk of providing a tiered-response EMS system? B) Exposure to liability if the BLS crew makes an improper determination that a patient does not need ALS care
51. An advance directive is MOST accurately defined as a: A) written document that expresses the wants, needs, and desires of a patient in reference to his or her future medical care.
50. Which of the following is NOT an example of an open-ended question? D) "Does the pain radiate to your arm or jaw?"
51. It would be MOST appropriate to ask a patient a closed-ended question when: C) you are trying to obtain medical history information.
51. Insulin and glucagon are produced in specialized groups of cells in the pancreas known as the: B) islets of Langerhans.
52. A patient is found to have a high blood sugar level (hyperglycemia). What is a cause of this? C) Deficient insulin levels in the blood
52. Which of the following questions would MOST likely reveal a hidden medical condition when communicating with a patient who has a severe headache? B) "What happened the last time you felt this way?"
53. If a patient avoids answering a specific question, you should: B) redirect him or her to the question to elicit a response.
52. If a severely injured patient who will likely not survive is identified as being an organ donor, the paramedic: D) should contact medical control for guidance as to how to proceed.
53. Which of the following statements regarding certification is correct? A) Certification is evidence that an individual has a certain level of credentials based on hours of training and examination.
53. Which of the following substances are vital in the function of the sympathetic nervous system? A) Epinephrine and norepinephrine
54. All of the following are formed components of the blood, EXCEPT: A) plasma.
54. If a patient provides a confusing or disorganized response to your question, you should: A) rephrase the patient's comments with simpler terms and ask if he or she agrees with your synopsis.
55. If a patient asks for your advice regarding a treatment decision that his or her physician made, you should: D) advise the patient to consult with his or her physician.
54. When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. This is a part of: A) due process.
55. The concept of consent refers to all of the following, EXCEPT the: C) severity of the patient's injury.
55. What is the total blood volume for a man who weighs 75 kg? B) 5.3 L
56. The ongoing process by which red blood cells are made is called: D) erythropoiesis.
56. If the wife of a critically ill man asks you if her husband is going to die, the MOST appropriate response should be: D) "He is very sick, but we are doing everything we can to help him."
57. If a patient provides an inappropriate response to a paramedic's question, it should be assumed that the patient: C) has impaired cerebral function.
56. Patients with decision-making capacity: B) have the right to refuse all or part of the emergency medical care offered to them.
57. Informed consent involves: B) ensuring that a patient understands the potential risks involved in performing a particular procedure.
57. Which of the following organs contain(s) the greatest number of lymphocytes? C) Spleen
58. Which of the following statements regarding type O blood is correct? A) It contains no surface antigens.
58. A patient states, "I can't catch my breath," and the paramedic responds, "You say you can't catch your breath, ma'am'?" This is an example of: B) reflection.
59. Eye-to-eye contact with a patient reinforces: A) trust and honesty.
58. A patient who rolls up his or her sleeve so that you can take his or her blood pressure has given you __________ consent. D) expressed
59. Implied consent is based on the premise that a patient: A) would consent to care because of the seriousness of his or her injury.
5. If the body is sliced so the result is a top and bottom portion, this is referred to as the: A) transverse plane.
6. During your assessment of a trauma patient, you note the presence of bilateral femur fractures. This means that: B) both femurs are broken.
59. A protein of the immune system that recognizes foreign substances is called a(n): D) antibody.
60. Which of the following is NOT a type of white blood cell? D) Histamine
60. When touching a patient as a form of reassurance, the paramedic should: A) touch the patient on a neutral part of his or her body.
61. An elderly man states that he is sad and depressed because his wife recently died of cancer. Which of the following statements from the paramedic demonstrates empathy? C) "I'm sorry, sir. I don't know how I would feel in your situation, but I am sure it would be similar."
60. Because minors have no legal status: A) they can neither consent to nor refuse medical care.
61. Which of the following patients is NOT an emancipated minor? C) 17-year-old woman who goes to college and lives with her parents
61. Phagocytosis is the process by which: C) monocytes digest microbes.
62. The body's ability to spontaneously cease bleeding is called: B) hemostasis.
62. Statements such as, "Please say more," or, "Please feel welcome to tell me about that," are examples of: D) facilitation.
63. After asking a patient a question about how he is feeling today, you sense that he is having difficulty putting his feelings into words. You should: B) be patient and give the patient time to express his feelings.
62. The BEST way for the paramedic to evaluate a patient's decision-making capacity is to: B) talk to the patient to determine if he or she understands what is happening.
63. If a conscious patient with decision-making capacity refuses care for a potentially life-threatening condition: B) he or she cannot be treated without a court order.
63. Approximately two thirds of the heart muscle lies within a space in the thoracic cavity called the: A) mediastinum.
64. The thick fibrous membrane that surrounds the heart is called the: A) pericardium.
64. If a mentally competent adult refuses emergency medical treatment, your FIRST action should be to: D) try to determine why he or she is refusing treatment.
65. Before asking a patient to sign a refusal form, the paramedic must: C) ensure the patient is aware of the risks of his or her refusal.
64. If a patient mentions something in passing or avoids answering a specific question, you should: B) politely redirect his or her attention to that question.
65. If a patient is unable to tell you who he or she is, where he or she is, and what day of the week it is: A) you should suspect decreased blood flow to the brain.
65. Blood enters the right atrium of the heart from the: D) vena cavae and coronary sinus.
66. What type of valves are the aortic and pulmonic valves? C) Semilunar
66. General criteria for determining a patient's mental competence include all of the following, EXCEPT: A) the absence of cardiac dysrhythmias.
67. If a patient has a potentially life-threatening illness or injury and there is any doubt as to his or her decision-making capacity, the paramedic should: A) treat and transport, even if it is against the patient's will.
66. Stereotyping an elderly, very young, or hostile patient during your attempt to communicate with him or her: C) works against effective communication.
67. Which of the following statements is an example of providing false reassurance? C) "I'm sure that you will be fine, but let us take you to the hospital just to be on the safe side."
67. Freshly oxygenated blood is returned to the left atrium through the: A) pulmonary veins.
68. The second heart sound (S2) represents: D) closure of the semilunar valves.
69. The myocardium is the only muscle that can generate its own electrical impulses. This process is called: A) automaticity.
68. The second heart sound (S2) represents: D) closure of the semilunar valves.
68. Which of the following statements regarding a psychiatric patient who is refusing transport is MOST correct? B) If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient.
69. If a paramedic is attacked by a violent patient: D) the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.
68. If the paramedic is unable to defuse a hostile patient's anger, the paramedic should: D) request law enforcement assistance if needed.
69. When communicating with older patients, it is MOST important to remember that: B) their illnesses may be more complex because they may have more than one disease process and may be taking several medications concurrently.
6. The wrongful act that gives rise to a civil suit is called: A) a tort.
7. In a medical liability suit involving a paramedic, the plaintiff: C) usually seeks compensation for the injury he or she sustained.
6. Under the instructions of a good EMD, a layperson should be able to: D) perform chest compressions.
7. Which of the following statements regarding 12-lead ECG telemetry is correct? C) Most newer systems use facsimile technology to allow transmission of 12-lead ECGs.
70. Which of the following general statements regarding violent patients is correct? C) Benzodiazepines are acceptable to use as a means of chemical restraint.
71. When determining the most appropriate hospital to which to transport a patient, the paramedic's FIRST consideration should be: A) the patient's clinical condition.
71. Excessive stimulation of the parasympathetic nervous system will result in: B) bradycardia.
72. Afterload is defined as the: C) degree of pressure against which the left ventricle pumps.
70. If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should: B) communicate the situation to the emergency department physician and document it accurately.
72. When communicating with a patient whose cultural background differs from the paramedic's, it is MOST important for the paramedic to: C) treat the patient with the utmost respect at all times.
72. When functioning at a crime scene, it is important for the paramedic to: C) use caution and not disturb the scene unnecessarily.
73. Prior to administering nitroglycerin to a patient with chest pain, the patient denies the use of erectile dysfunction (ED) drugs when asked, even though he took an ED drug a few hours earlier. After being given the nitroglycerin, the patient experiences severe hypotension and almost dies. Which of the following could the paramedic use as a potential defense if the patient attempts to sue? B) Contributory negligence
71. When the paramedic encounters a patient who has difficulty communicating, he or she should: A) enlist the help of a family member or primary caregiver.
73. Touching a conscious elderly patient in a nursing home without his or her permission: A) is nonverbally communicating, "You are not important enough or mentally competent enough to be asked for permission."
73. Ventricular muscle contraction and the pumping of blood throughout the body occur during: A) systole.
74. Cardiac output is equal to: D) stroke volume multiplied by heart rate.
74. What hand gesture is interpreted in many Arabic and some Latin American cultures as the equivalent of an extended middle finger? D) The thumbs-up sign
75. Many _________ believe that touching the head may put their soul in jeopardy. B) Asians
74. Most states require the paramedic to report all of the following cases, EXCEPT: A) injury to the elderly.
75. Which of the following scenarios is considered by most states to be a medical examiner case? A) Any violent or unexpected death
75. Increased myocardial contractility secondary to stretching of the myocardial walls is called the: B) Frank-Starling effect.
76. Which of the following lists, in the correct order, the return of blood from the systemic circulation to the heart? A) Capillaries, venules, veins, vena cava
76. Islamic and Hindu cultures avoid: B) touching with the left hand.
77. When attempting to interview a patient with a behavioral crisis, you should: B) approach the patient cautiously, while maintaining eye contact.
76. While caring for a conscious and alert 49-year-old man with a suspected myocardial infarction, you start an IV prior to obtaining the patient's consent. This action constitutes: C) battery.
77. Without obtaining her consent, you transport a mentally competent young woman to the hospital because you suspect she is experiencing internal bleeding. This action: B) constitutes false imprisonment.
77. The pulmonary circulation is responsible for: C) ensuring that blood gets reoxygenated.
78. Which of the following vessels or structures is NOT part of the pulmonary circulation? B) Descending aorta
78. Which of the following statements would be inappropriate when documenting your care of a patient with an emotional problem? D) "The patient's actions suggest the use of illicit drugs."
79. While caring for a critically injured patient at the scene of a motor vehicle crash, an emergency physician bystander stops at the scene to assist. Which of the following procedures performed by the physician would require the physician to accompany the patient to the hospital in the ambulance? B) A pericardiocentesis
7. The most inferior portion of the heart is called the: B) apex.
8. Which of the following directional terms describes the front surface of the body? B) Ventral
79. The first artery to branch from the aortic arch is the: A) brachiocephalic artery.
80. A slight dilation at the carotid bifurcation, called the ________________, contains structures that are important in regulating blood pressure. D) carotid sinus
80. A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a patient in the field. However, because the EMS system's medical director does not permit paramedics to perform a needle cricothyrotomy, the paramedic: A) performed outside his or her scope of practice.
81. While providing care to a seriously ill public official who is semiconscious, a media representative arrives at the scene and inquires about the patient's condition. You should: C) tell the media representative that you cannot disclose any information.
81. The subclavian artery gives rise to the: C) vertebral arteries.
82. The two major veins that drain the head and neck of blood are the: B) jugular veins.
82. Which of the following scenarios reflects a violation of EMTALA? C) A hospital transfers an unstable patient to another facility.
83. While en route to the scene of a patient in cardiac arrest, the driver of the vehicle in front of you does not hear your siren or see your lights. You should: D) remain at a safe distance behind the vehicle and then pass the vehicle on the left side when it is safe to do so.
83. The longest portion of the aorta, which subdivides into the thoracic and abdominal aorta, is the: D) descending aorta.
84. What physiologic response occurs when a person loses blood? A) Vessels constrict and myocardial contractility increases.
85. Ordinarily, approximately _____% of the cardiac output passes through the liver each minute. A) 25
86. The main pacemaker for breathing that is responsible for initiating respiration is called the: C) dorsal respiratory group.
86. While attempting to resuscitate a middle-aged woman in cardiac arrest, you perform effective CPR but do not evaluate the patient's cardiac rhythm until 10 minutes into the resuscitation attempt. When the cardiac monitor is finally applied, the patient is in asystole. The patient is transported but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is correct? A) The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death.
87. You deliver a 61-year-old man with abdominal pain to a busy emergency department. A staff nurse instructs you to take the patient to the triage area where he will be tended to later. She further tells you that after you leave a copy of your patient care report with the clerk, you are free to leave. You should: C) advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient.
87. As blood enters the lungs, it enters the alveoli by passing across the: B) pulmonary capillary.
88. Tidal volume is defined as the volume of air that: B) is moved into or out of the lungs during a single breath.
88. Which of the following scenarios MOST accurately depicts abandonment? A) A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day.
89. You respond to a skilled nursing facility for a patient who is not breathing. When you arrive, you assess the patient, a 78-year-old man, and confirm apnea. However, the patient has a rapid carotid pulse. The charge nurse advises you that, according to the patient's family, the patient is not to be resuscitated. You should: D) maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility.
8. Most lawsuits against EMS providers result from: B) ambulance collisions.
9. Criminal laws most likely to apply to paramedics include all of the following, EXCEPT: D) inadequate patient care.
8. The term "frequency," as it applies to radio communications, is MOST accurately defined as: A) how frequently a radio wave recurs in a given time.
9. Low-band frequencies: B) are unpredictable because changes in ionospheric conditions may cause losses in communication.
89. Decreases in the PaCO2 result in _____________ pH levels in the respiratory center and a(n) _____________ in ventilation. D) increased, decrease
90. The respiratory center of the brain is located in the: A) medulla.
90. A patient's wife called 9-1-1 because the patient was complaining of a severe headache and nausea. The patient is conscious and alert, but obviously upset that his wife called 9-1-1 without consulting with him first. As you present the blood pressure cuff, the patient folds his arms and turns away from you. From this patient's actions, you should conclude that: B) you do not have consent to treat him.
91. A 39-year-old man with severe dehydration requires IV fluid therapy to treat his condition. The patient is conscious, alert, and oriented to person, place, time, and event. You should: A) ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy.
91. The hypoxic drive, a backup system to control breathing, is stimulated when: A) arterial PaO2 levels decrease.
92. Normal inhalation is the result of: C) negative pressure in the thoracic cavity.
92. You arrive at the scene of a motor-vehicle-versus-pedestrian accident. The patient is a 12-year-old girl who was struck by a car while riding her bike. She is conscious but combative. She has a large hematoma on her leg and several hematomas to her forehead. As a police officer attempts to contact the child's parents, you should: C) assume that her parents would consent to emergency treatment and initiate the appropriate care for the child.
93. A 17-year-old woman presents with acute abdominal pain while at a party with her husband. You arrive at the scene, assess the patient, and advise her of the need for EMS treatment and transport. However, the patient, who is conscious and alert, refuses EMS treatment and transport and states that her husband will transport her in his car. You should: A) advise her of the potential risks of refusing EMS treatment and transport.
93. Detoxification of toxic substances, production of bile, and production of certain clotting factors are all functions of the: B) liver.
94. The first portion of the small intestine that receives food from the stomach is the: A) duodenum.
94. A 40-year-old man presents with bizarre behavior. His speech is slurred and he is very belligerent. His blood glucose level is 35 mg/dL. The patient tells you to get out of his house. You should: D) remain professional and advise the patient that he is not legally capable of refusing EMS treatment.
95. You are called to a community center for a 40-year-old woman who is "acting strange." Upon your arrival, you assess the patient and determine that she is conscious, alert, and oriented to person, place, time, and event. She does not appear to be mentally impaired. Her oxygen saturation is 99% on room air and her blood glucose level is 112 mg/dL. The patient's husband tells you that his wife has bipolar disorder and takes medication for it. The patient tells you that she is fine and does not want to go to the hospital. You should: B) recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.
95. A newborn's total body water content is approximately: D) 80% of total body weight.
96. Extracellular fluid accounts for what percentage of all body fluid? C) 25%
96. While en route to a call for an emotionally disturbed patient, law enforcement notifies you by radio that the patient has become extremely violent. You should: B) wait for law enforcement to advise you that they have the patient under control.
97. You arrive at the scene of a shooting. The patient, a 19-year-old man, has a gunshot wound to the side of his head with a large amount of exposed brain matter. Further assessment reveals that the patient is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should: C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.
97. A(n) ___________ is a substance that can absorb or donate hydrogen. B) buffer
98. Which of the following physiologic responses would you expect to see in a patient with a pH of 7.50? C) Decreased respirations
98. While caring for an 80-year-old man with a possible fractured arm, you discover other injury patterns that are suggestive of abuse. The patient is conscious and alert. You should: A) splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician.
99. Ethics is MOST accurately defined as: A) the philosophy of right and wrong, of moral duties, and of ideal professional behavior.
12. All of the following factors may cause distortion of an ECG signal, EXCEPT: C) severe tachycardia.
A13. At minimum, sending the 12-lead ECG of a patient with chest pain to the emergency department physician via telemetry would: A) decrease the time from diagnosis to treatment. ns: C Page: 125
46. A paramedic's actions are considered to be grossly negligent if he or she: D) willfully or wantonly deviates from the standard of care.
Ans: D Page: 1047. Proximate cause is MOST accurately defined as: A) a link between the paramedic's improper action and the patient's injury.
84. While on duty, a paramedic unit stops at the scene of a traffic accident to which it has not been dispatched. During the course of providing patient care, one of the paramedics purposely manipulates the patient's neck to elicit a painful response. This paramedic: B) is not a Good Samaritan and did not perform as any other paramedic with similar training would have performed.
While off duty and outside of your jurisdiction, you encounter a motor vehicle crash. You can see one patient lying motionless on the ground near her overturned vehicle. As an off-duty paramedic, you: B) may feel an ethical obligation to stop and assist.
