B15 FINAL
What is the term used to describe interventions designed to improve the comfort, but not prolong the life, of a terminally ill patient?
Palliative care
Which of the following organs is LEAST likely to be injured in penetrating trauma to the abdomen?
Pancreas
What is "pins-and-needles" sensation called?
Paresthesia
Which unique finding may be noted in compartment syndrome as a result of compression damage to the nerves and vascular supply in the femoral region?
Paresthesia between the medial toes
Which adult patient would be considered to be moderate in terms of burn severity?
Partial thickness burns of the right hand and arm
Which adult patient would be considered to be critical in terms of burn severity?
Partial thickness burns over both legs
Which meningeal layer is closest to the brain?
Pia mater
During a wilderness rescue situation, what type of technique will a helicopter rescue agency use instead of more dangerous rappel-based rescue methods?
Short hauls
Which of the following pieces of equipment would most likely cause an amputation due to a shearing mechanism?
Sickle bar mower
Pelvic fractures can be life-threatening injuries due to what mechanism?
Significant blood loss
Which of the following can result in hemorrhagic shock?
Significant blood loss
A radio communications band that is widely available and penetrates concrete and steel well is the:
UHF band.
What is the most critical risk associated with the removal of an impaled object in the field?
Uncontrollable hemorrhage
Which statement regarding the reason the percentage of elderly Americans is increasing is true?
The mean survival rate of older persons is increasing.
Your patient is a 30-year-old pregnant woman at 36 weeks' gestation. She was injured in a fall from a horse and is complaining of painful contractions. Her abdomen is tender to palpation over the uterus, and the uterus becomes firm with contractions, but she denies vaginal bleeding. The patient is anxious, but her skin is warm and dry. Her blood pressure is 112/70, her heart rate is 92, and her respirations are 24. Which of the following statements best describes this situation?
The mechanism and patient complaints are suspicious for abruptio placentae. Both the mother and the fetus are in jeopardy.
What structure helps to support the digestive tract?
The mesentery
How does the progression of shock for a woman in the late stages of pregnancy differ from the general population?
The mother can lose a greater blood volume prior to progressing through the stages of shock.
Which factor might warrant a call for air medical service?
The nearest appropriate trauma center is an hour away by ground transport.
What is the difference in the number of home health care agencies since 1963?
The number has enormously increased.
Which of the following variables can typically change at any time in an open incident?
The number of patients
Which of the following disaster resource coordination personnel would you least likely find at the MACC?
Unit leaders
You arrive at the scene of an altercation after the scene has been cleared by law enforcement. There you are faced with a 22-year-old female, unconscious on the sidewalk, with a bat nearby. The victim is without response to pain and has a large contusion in the area of the left zygomatic arch. Additionally, you note that her radial pulse is 68 and thready, her skin is warm and dry, and her right pupil is dilated. Based on her findings, do you believe there is significant internal bleeding?
Unlikely
How would the quality of the clot be described that is formed during the platelet phase of hemostasis?
Unstable
Which of the following is the most effective way for EMS personnel to protect themselves against exposure to biological agents of terrorism?
Use a HEPA mask.
If a disaster-level MCI results in a regional failure of communications systems, which of the following should be done?
Use message runners.
You and your partner are preparing to provide direct patient care during the disentanglement phase of a motor vehicle crash. What type of flame/flash protection is most appropriate?
Turnout gear
Which type of pelvic fracture does not involve the pelvic ring and includes avulsion fractures and those of the pubis, sacrum, coccyx, ischium, or iliac wing?
Type I
Units operating in a large city may transmit on ultrahigh frequency (UHF) radio frequencies because:
they penetrate concrete and steel well and are less susceptible to interference.
The use of video streaming in EMS to transmit patient images to medical direction:
is likely to be more beneficial in rural areas.
At the point of primary contamination, the contamination:
is limited.
One of the concepts introduced by Dr. R. Adams Cowley that helped to drive modern trauma care in the United States was:
the "Golden Hour."
The central space within the thoracic cavity that houses the heart is the:
mediastinum.
In the basic communication model, speaking face to face, sending a fax, leaving a voice message, or sending a written letter is known as a:
medium.
System status management (SSM) is a computerized personnel and ambulance deployment system designed to:
meet service demands.
The __________is a double peritoneal fold containing blood vessels, lymphatic vessels, nerves, and fatty tissue.
mesentery
Abdominal pain associated with ovulation is called _____
mittelschmerz
A female patient is experiencing lower quadrant pain on one side and her temperature is running slightly high. She tells you that she is in the midst of her menstrual cycle and experiencing some spotting. You suspect:
mittelschmerz.
Midcycle abdominal pain in a female that occurs in conjunction with follicle rupture or bleeding at the time of ovulation is also known as:
mittelschmerz.
Compared to a car that slides into a snowbank, an auto that strikes a concrete retaining wall will have a deceleration rate that is:
much greater.
Pulmonary agents attack the:
mucous membranes of the respiratory system.
A 2010 report by the National Public Safety Telecommunications Council predicted the development of new medical devices useful to EMS that will use radio waves to transmit data. Which device listed below was not predicted?
multiplex radio system device
The medical director for your agency is mandating simultaneous transmission of your verbal report and telemetry data on all cardiac patients. This will require:
multiplex technology.
he layer of the uterus that is responsible for contracting during the menstrual cycle and during labor is the;
myometrium.
The primary purpose of the Mark I kit is to treat both military and first responders for the effects of:
nerve agents including soman or tabun.
At a hazmat incident involving a chemical spill, paramedics are least likely to:
neutralize and clean up the spilled chemicals.
A condition in which chemotherapy creates a dangerously low level of neutrophils is called:
neutropenia.
Your agency's radio frequencies may be monitored by the public and media. You should:
not relay confidential patient information.
For a patient with muscular dystrophy (MD):
note the particular muscle groups that the patient cannot move.
A fracture that runs across the bone at an angle is a(n):
oblique fracture.
Because of the cost of air medical transport, it is incumbent on providers to ensure that air medical transport is used:
only for patients who stand to benefit from such care.
A plan should:
outline the SOPs and protocols for potential incidents.
Burn injuries associated with an explosion are typically:
partial thickness.
Members of the emergency medical system can most effectively impact morbidity and mortality of trauma victims by:
participating actively in prevention.
All of the following should be the fundamental elements of technical rescue training that paramedics should possess except:
performing disentanglement techniques for an entrapped victim.
As a paramedic functioning on the scene of a hazardous materials incident at a fixed facility, you may be asked to:
perform pre-entry and post-entry physical exams of the hazmat entry team.
The serous membrane that forms the outermost layer of the uterine wall is called the _____
perimetrium.
Cool and pale skin in the victim of hypovolemic shock is the result of:
peripheral vasoconstriction.
The fallopian tubes conduct the egg from the space around the ovaries into the uterine cavity via:
peristalsis.
The Federal Communications Commission (FCC) does not control and regulate:
personal conversations.
An obese patient presents with chest pain. You attempt to apply ECG pads, but the patient's adipose tissue presents an obstruction. You should:
place ECG monitoring electrodes on the arms and thighs instead of on the chest.
Your patient has a nontraumatic fracture of the left wrist. To splint this fracture, you first:
place a roll of bandaging in the patient's hand to maintain position of function.
Decreased respiratory volume, diminished cough reflex, and decreased mucociliary clearance all make the elderly more prone to:
pneumonia.
If you see rescuers about to use a frayed rope, you should:
point out the damage to the rescuers in a polite, professional manner
You are caring for a male patient who was involved in an industrial fall in which he landed in a straddle position on a steel beam. The patient has severe pain, disfigurement, and swelling to the genitalia. Patient care should include all of the following except:
position of comfort for transport.
Your 74-year-old patient has a cataract over her left eye. You should:
position yourself in view of her right eye.
Any victim of a blast injury exhibiting severe dyspnea that is associated with absent alveolar breath sounds should receive:
positive pressure ventilation.
You are caring for a patient who has been exposed to a nerve agent. Appropriate treatment of this patient would include:
pralidoxime chloride.
Until proven otherwise, you should assume that a missed or late menstrual period is due to:
pregnancy.
It is a clear, warm August afternoon when your squad is dispatched to a construction site for a22-year-old male complaining of numbness and tingling, muscle cramps, and headache after operating a jackhammer all morning. Upon arrival you verify that the site is secure and then are led to the shady side of a concrete block wall where your victim is sitting on the ground with his head in his hands. As you approach and introduce yourself, your patient anxiously tells you that he feels like he's going to pass out. He is diaphoretic and very warm with a thready pulse of 98 and a respiratory rate of 16 and shallow, with a pulse ox of 99 percent on ambient air. He tells you he has no medical history or allergies. As you assist your patient to a supine position, you ask your partner to:
prepare an IV of normal saline.
A significant reduction in mortality rate associated with trauma can be realized by instituting a comprehensive program addressing:
prevention.
If an ambulance is deployed to a specific location to await any emergency calls, that is known as its:
primary area of responsibility.
What coordinated system determines the appropriate level of response to a call from someone who detects an emergency and summons EMS?
priority dispatching system
An emergency medical dispatcher uses established guidelines to determine the appropriate level of response. This is known as:
priority dispatching.
The pancreas is responsible for:
production of glucagon and insulin.
The first two weeks of the menstrual cycle are known as the:
proliferative phase.
In rural areas of the United States, the paramedic may find employment at alternative health care facilities that provide limited care and nonemergent medical treatment called:
prompt care facilities.
One example of the use of public education to reduce morbidity and mortality related to abdominal trauma is:
proper use of seat belts.
Patients presenting with isolated musculoskeletal injuries and who are stable should be:
provided a focused trauma assessment.
Proper restraints, waste disposal and inspecting for infection are all aspects of:
providing proper bed care.
The crew of an incoming helicopter notifies you that they are approximately five minutes from your location. You need to:
tell them when you can hear and see them.
Rescuers needing to carry fewer oxygen tanks because of rugged terrain is an environmental issue primarily affecting:
the use of ALS skills
Fluid overload in the geriatric patient is a risk of treating shock because:
their system cannot accommodate large fluctuations in fluid reserves.
The three methods the body utilizes to create heat are all types of:
thermogenesis.
In the body, perspiration and vasodilation are both mechanisms of:
thermolysis.
Ambulance manufacturing and design are standardized by the:
DOT KKK 1822F specs.
EMS providers must routinely communicate effectively with:
bystanders.
What is the definition of hematochezia?
Blood in the stool
What results from compression of the nerve roots at the lower end of the spinal cord?
Cauda equina syndrome
A larger and more disrupted entrance wound than the bullet caliber would suggest is an indicator that what has taken place?
Bullet tumbling or deformation
Which of the following patients is least likely to get a skin infection as a result of the use of home medical technology to manage a chronic condition?
A patient with a nasogastric tube at home for feedings
What law accounts for the fact that at different depths below sea level, the pressure of air will change?
Dalton's
You are considering air medial transport for a critical patient in need of care at a facility 60 miles away. It is 11:32 at night. What is the recommended minimum size of a night landing zone for a rotor-wing airambulance?
100 feet by 100 feet
What is the type of mechanism of injury that may occur if a hand gets entangled within a tractor PTO?
Wrap point
Hyperthermia is usually caused by which mechanism?
Heat transfer through vasodilation
Contributory factors that occur prior to an event and result in trauma are known as:
pre-event factors.
The water rescue model is:
reach-throw-row-go.
Which of the following statements regarding bariatric patients is accurate?
An obese person has an abnormal amount of body fat.
What is the purpose of a focused trauma assessment?
Assessment of a specific isolated injury
When communicating via radio, you should use:
"affirmative" and "negative."
What is the generic term or description that is used for legal documents that determine or direct health care providers on what to do when a person becomes incapacitated or is dying and is not capable of making decisions for himself or herself?
Advance directives
You are treating the victim of an automobile accident who is presenting with no open wounds, but a slightly distended abdomen. He was initially alert and well oriented, had a pulse of 100; respirations of 22 and a blood pressure of 88/70. During reassessment you note that he is still alert and well oriented but his vital signs are now a pulse of 110; respirations of 30 and a blood pressure of 84/70. What would the change in his Revised Trauma Score be?
-1
You are treating the victim of an automobile accident who is presenting with no open wounds, but a slightly distended abdomen. He is alert and well oriented, has a pulse of 100, respirations of 22, and a blood pressure of 88/70. What would his Revised Trauma Score be?
11
Which rib pair(s) have no anterior attachment?
11th and 12th ribs
An analysis of data collected by New York State over 22 years shows that during which hours of the day do ambulance collisions occur most frequently?
Daylight hours
What does Newton's second law of motion quantify?
Deceleration
According to the rule of nines, what would the involved surface area be for an adult victim who has received burns to his right arm and right anterior chest?
13.5 percent
Regardless of the length of the menstrual cycle, the period of time from ovulation to menstruation is typically how many days?
14
Which of the following is a common indicator of human trafficking?
A child has stopped attending school.
In which type of multiple-casualty incident have the injuries usually already occurred by the time you arrive on scene?
A closed incident
You are considering air medical transport for a patient at the site of a bridge collapse. There are power lines at the edge of the nearby field that would make the best landing zone for a helicopter. How far from75-foot high power lines should the landing zone for a helicopter be located?
150 feet
What percentage of burn victims treated in the United States are hospitalized?
10 percent
How long does the remodeling process of soft-tissue healing typically take?
6 to 12 months
You find significant hypoglycemia is an unresponsive patient with a head injury. You administer:
25 mg of glucose and 100 mg of thiamine.
What percentage of motor vehicle deaths are due to thoracic trauma?
25 percent
For a Caucasian patient, how would you classify a very light pink or white appearance to the skin?
Pale
Which patient is most likely to sustain a pathological fracture?
A geriatric patient receiving radiation therapy for cancer
Which function is not mediated through the integumentary system?
Peripheral circulation
Which of the following is most accurate regarding assault rifles and hunting rifles of the same caliber?
A more severe wound track is typically encountered in a wound caused by hunting ammunition.
Approximately what percent of the blood volume can be added to arterial circulation by constriction of the venous system?
20 percent
What percentage of the population are the elderly, those over the age of 65, expected to represent by the year 2040?
20 percent
Your ten-year-old male patient was involved in a bicycle accident that lacerated his right calf and caused significant bleeding; he is showing signs of hypovolemia. When providing intravenous fluid replacement to this patient, fluid boluses should be administered at the rate of:
20 mL/kg delivered a maximum of three times.
What percentage of burn occurrences are considered life threatening?
3 to 5 percent
At what age does the body begin to lose its ability to maintain bone structure?
40
The liver is injured ________ percent of the time with penetrating abdominal trauma.
40
What is the best method by which to reduce the morbidity and mortality associated with abdominaltrauma?
Prevention
What is the optimal way of dealing with musculoskeletal injuries?
Prevention
The symptoms of endometritis typically follow a miscarriage or gynecological procedure by:
48 to 72 hours.
You are caring for a patient with penetrating abdominal trauma secondary to an industrial explosion. The patient has an altered mental status and is found to be hypotensive, tachycardic, and tachypneic. During your fluid administration, what minimum systolic blood pressure do you wish to maintain?
80 mmHg
The Office of Emergency Communications (OEC) provides funds to states for developing a statewide communications interoperability plan. The OEC requires states to give _____ of the funds to local agency providers.
80%.
The mortality rate for cold-related disorders significantly increases for victims with a core body temperature below:
86 degrees.
As the reimbursement for air medical helicopter transport increased in 2010, approximately how many helicopter air ambulance (HAA) aircraft were flying in the United States?
900
Which of the following patients should be immediately transported to a trauma center?
A motorcyclist involved in a 35 mph collision with a car
You are dispatched to the scene of a propane tank fire. On your arrival you are directed to a 30-year-old male patient with partial thickness burns over the anterior side of both legs, the genital area, thorax, and face. As you approach the patient, you establish that he is conscious and well oriented, respirations are22, his radial pulse is 96, and pulse ox shows 92 percent on room air. You immediately place him onhigh-flow oxygen via nonrebreather mask. What oxygen saturation should you titrate your oxygen therapyto?
96 percent
How much blood loss can occur in a third-trimester pregnant female before she will show signs or symptoms of hypovolemia?
30 percent
At what point does a trauma victim begin losing his ability to compensate for blood loss, placing his survival at risk?
30 to 40 percent of volume
As you approach a vehicle involved in a single-car accident involving a tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinal control, you introduce yourself and complete a primary assessment. His airway is open and his breathing seems adequate; you check the radial pulse and find a rate of 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer bleeding, but was responsible for a majority of his overt hemorrhaging. You initiate high-flow oxygen via a nonrebreather mask, quickly dress the scalp, and perform a rather lengthy extrication onto a spine board. After moving him you note that he is no longer speaking to you; his radial pulse is now 124 and thready, his respiratory rate has dropped to 6 andshallow, and his abdomen appears to be slightly distended. What is now the maximum time interval between reassessments of your patient?
5 minutes
Based on the CUPS triage scheme, which of the following criteria represent the best description of a patient who would receive a "critical" designation?
A patient in whom you are unable to secure the airway, breathing, or circulation
Which of the following is most accurate regarding an assault rifle shooting military ammunition?
A bullet that does not tumble will likely pass through the body.
While ovarian cysts may be found during routine pelvic exams, in the field setting which of the following would likely assist the paramedic in differential diagnosis?
A complaint of one-sided moderate to severe abdominal pain that may radiate to the back
As it pertains to trauma, which definition of coagulopathy is most accurate?
A condition in which the blood's ability to clot is impaired
In accordance with the START triage system, which of the following victims would be transported last from a multiple-casualty incident?
A conscious and well-oriented 28-year-old female with a respiratory rate of 28 and a radial pulse of 100 who is able to walk
In accordance with the START triage system, which of the following victims would be transported from amultiple-casualty incident in a delayed capacity?
A conscious and well-oriented 30-year-old male with a respiratory rate of 28 and a radial pulse of 100 who cannot walk
In accordance with the START triage system, which of the following victims would be transported first from a multiple-casualty incident?
A conscious 59-year-old male with a respiratory rate of 37 and a radial pulse of 95 who is capable of following commands
For which trauma patient should you not perform a trauma assessment during the secondaryassessment?
A critical patient with uncontrolled airway, breathing, or circulation problems
What is ADAMS?
A database
You are managing a bedbound obese patient whose PICC line insertion site appears reddened and inflamed. On arrival, the caregiver tells you that the patient has been running a fever for a week, but the site looked fine until today. The caregiver asks if this is a decubitis wound. You observe redness, swelling, purulent discharge, and warm skin at the insertion site. What is the most likely explanation for theproblem?
A decubitus wound
What is the most common outcome of blunt head trauma?
A diffuse injury
In developing an understanding of MCI, which of the following statements is most accurate regarding the response phase of a disaster?
A disaster is an event that overwhelms regional emergency response resources.
Which of the following statements about the general health of individuals living in rural locations is mostcorrect?
A disproportionate number of chronic health conditions are likely to exist.
If it becomes necessary to perform a physical exam of the genitalia of a female who was sexuallyassaulted, who would best perform such an examination?
A female paramedic
What accurately reflects the pathophysiology of anterior cord syndrome?
A flexion-extension injury that results in damage to the vertebral artery through either disruption or compression by edema, leading to subsequent ischemia and infarction
You are responding to a fire at a chemical factory involving an unknown substance. Your partner opens the copy of the Emergency Response Guidebook you have in the ambulance. In the Emergency Response Guidebook, what information is provided within this reference book?
A list of hazardous materials substance names, placard identification, and evacuation distances for most substances
What might a victim suffering a concussion and epidural hematoma concurrently present with prior to an increase in intracranial pressure?
A lucid interval
Which of the following is a primary way in which TEMS varies from EMS?
A major priority in TEMS is extraction of the patient from the hot zone.
Who would be the best person to perform a physical exam of the genitalia of a male adolescent who was sexually assaulted if such an examination is necessary?
A male paramedic
Given the same injury and rate of blood loss, which patient would likely progress most slowly through the classes of hemorrhage?
A pregnant female in her third trimester
What does the use of a helmet in ATV collisions typically cause?
A reduced incidence of head injury
Which of the following is TRUE of abdominal trauma?
A significant amount of blood can accumulate in the abdominal cavity before signs and symptoms of abdominal injury appear.
Which of the following is true about a sloppy patient care report?
A sloppy PCR implies sloppy care.
Which of the following BEST describes incendiary agents?
A special subset of explosives with less explosive power and greater heat and burn potential
You respond to a farm accident to find a 22-year-old male patient who rode his ATV into a high-tensile electric fence. As you approach the victim, you notice that the ATV has passed through the fence into thepasture, but the victim is lying supine on the ground outside the fence. His brother is holding his hand over his neck and a moderate amount of blood is oozing from below his hand. You begin questioning the victim and rapidly establish that he is alert and well oriented and has no difficulty breathing or speaking. While your partner stabilizes the victim's head you prepare a dressing so you can view the injury and replace the brother's hand. What type of dressing would be appropriate?
A sterile occlusive dressing covered by non-sterile gauze with direct pressure
Which incident would typically be termed a high-impact incident?
A tornado that destroys a shopping center
To correct the hypoxia of a drowning patient, what is the first step?
A trained rescue swimmer removes the patient from the water.
You are treating a patient who you suspect is a victim of a forced marriage as a result of human trafficking. The patient's spouse is hovering nearby, and you feel that his presence is influencing the patient's responses to your questions. What should you do?
Alert law enforcement immediately.
What should you do if you are administering care to a patient who is not prepared for transport and the scene becomes dangerous?
Abandon the patient
At what height does a fall become severe enough to necessitate trauma services based solely on the mechanism of injury?
About three times the patient's height
Approximately how many motor vehicle deaths can be attributed to thoracic trauma in the United States annually?
About 8,000
What is the term for placental detachment from the uterine wall that can occur from blunt abdominal trauma in the pregnant female?
Abruptio placentae
What is the temperature at which all molecular motion has stopped?
Absolute zero
Which of the following statements about abuse is most correct?
Abuse can occur in same-sex couples.
Which of the following statements is most accurate about access to emergency health care services for people living in rural America?
Access is diminished overall.
You are caring for a patient who was playing flag football at the park. The patient states that after a particular play, he was tackled and felt sharp pain in his left ankle, after which he was unable to bear weight on it. What tendon may have been injured in this situation?
Achilles
Which of the following can reduce the potential for abdominal injury?
All of the above
You are on your local 911 ambulance, and you are called to the local emergency department to transport a patient to a cardiac center that is two hours away by ground. The ED doctor tells you that the patient is actively infarcting and needs catheterization. What other recommendation could you make to the ED staff for this patient?
Activate an HAA agency to complete the transfer.
What high-altitude disease typically presents with light-headedness, breathlessness, weakness, headache, nausea, and vomiting?
Acute mountain sickness
You are dispatched to the scene of a winter drowning in which a 10-year-old male patient was found by his parents floating in a hole in the ice on their farm pond. On arrival, you find the victim pulseless and apneic with CPR being performed by neighbors. You continue CPR, maintain the airway by intubation, administer 100 percent oxygen, and attach an ECG monitor, which shows ventricular fibrillation. What should your next action should be?
Administer defibrillation.
You suspect increased intracranial pressure in a patient with penetrating chest trauma. Which of the following is appropriate treatment?
Administer fluid resuscitation to maintain a systolic blood pressure of 90 mmHg.
A patient has ingested a corrosive, can swallow, and is not drooling. How should you treat this patient?
Administer furosemide.
A patient inhales chlorine, which causes the patient to develop pulmonary edema. What is a specific means of treating this pulmonary edema?
Administering furosemide
What task does a hyperbaric chamber perform?
Administration of oxygen at greater than air pressure
Which of the following is not a commonly vulnerable population for human trafficking in the United States?
Adults aged 18 to 45
Which of the following may affect the pattern of injury in abdominal trauma?
All of the above
What is the term for using stereotypes to characterize older adults?
Ageism
Once bleeding is controlled, what is the most critical complication of bandaging a lateral neck injury?
Air emboli
You are dispatched to the scene of an automobile accident along with two other units. As you approach the scene, you see a compact car under the trailer of a semi-truck that turned in front of the car. The fire department has secured the area and is opening the driver's door of the car with jaws as you pull up. After the door is opened, you find a male victim, in the driver's seat, lying over the center console. You hear gurgling respirations that sound shallow at a rate of 20, and he is apparentlyunresponsive, but you are unable to see his head from the driver's door. You are successful at ascertaining a pedal pulse with a rate of 70 and strong. A rescue worker informs you that they are unable to access the passenger side until the trailer is lifted off, as the wheels are in the way. As you are unable to take control of the cervical spine or administer any other type of care, you slide the victim out, feet first, supine along his long axis onto a long spine board and move him to the stretcher. You first inspect his head, noticing that there are no landmarks inferior to the supraorbital margin. His respirations are now shallow, at a rate of 10; he has a radial pulse of 60 and bounding; and the pulse ox is 93 percent. As you begin clearing blood and flesh from the oropharynx, your partner tells you that he sees no other significant injuries. From the facial injury and others signs, what will your initial care center on?
Airway maintenance
What should be avoided prior to spending time in a cold environment?
Alcohol
Which of the following is a special consideration when managing the pregnant trauma patient?
All of the above are special considerations.
What is the weakest form of radiation?
Alpha radiation
Which of the following statements is true of the kinetic energy involved in a stabbing?
Although the mass behind a knife blade's penetration may be significantly greater than a bullet's, the knife's velocity is less.
Some drugs that are used to facilitate rape (known as date rape drugs) have which of the following effects on the victim?
Amnesia
Which of these technologies does not now operate to provide a first response to an emergency?
An EMS Resource and Event Monitoring System
You are assessing a patient with blunt abdominal trauma. You note that the abdomen is slightlydistended, rigid to the touch, with an ecchymotic area surrounding the umbilicus. What does this findingimply?
An abdominal injury that is likely several hours old
A vehicle impacts a car parked in a travel lane and is immediately struck from behind by a second vehicle. What is the impact by the second vehicle called?
An additional impact
What is a local effect of a chemical agent?
An effect involving the area around the immediate site of exposure
What is the expected trend for the use of medical technology in the home?
An increase
Which of the following has not been a major contributor to the increased number of people who live at home but are reliant on medical technology?
An increase in disease incidence
How does the progression of signs and symptoms of pediatric head injury differ from an adult?
An infant is more prone to direct injury but has a slower progression of increasing ICP.
Which of the following is an example of a place where an NFPA 704 placard should be expected?
An outdoor storage tank holding liquid oxygen
Which patient should be immediately transported to a trauma center?
An unrestrained child inside a vehicle involved in a 20 mph vehicle collision
You are called to the scene of a finger amputation; you bandage the hemorrhaging area but have not yet located the missing thumb. How should you proceed?
Assign others to continue searching and transport the victim to the ED.
Which syndrome results from bony fragments or pressure compressing arteries that perfuse the ventral aspect of the spinal cord?
Anterior cord syndrome
Which drug does not interfere with proper heat-generating mechanisms?
Antibiotics
In accordance with the rule of nines, how does the head of an infant compare with the head of an adult?
An infant's head and neck account for twice the total body surface area of an adult's.
Provide her with a list of local resources for victims of partner abuse
Apprehension abuse
You have called air medical transport for a patient with a spinal injury ejected from a car in an area of hilly terrain. The only place the helicopter can land is on a level portion of hillside near the summit. Which of these actions must be avoided in assisting at the landing zone?
Approach the helicopter from the uphill side of the landing zone.
What causes the spurting of blood in arterial bleeding?
Arterial blood pressure
Which one of the following is not a type of aphasia?
Articulation
You arrive at the scene of an altercation after the scene has been cleared by law enforcement. There you are faced with a 27-year-old female lying on the sidewalk who is bleeding from multiple lacerations to the left right hands and forearms and one cut to her face. Although you cannot see any other wounds, hert-shirt is stained over the stomach. She complains of cold. What should you do in response to thiscomplaint?
As soon as possible after assessing her injuries and addressing life threats, cover her with a warm blanket.
Your patient was injured while working on a farm tractor. You find him sitting beside the rear wheel of the tractor holding his arm. The engine of the tractor is still running, but the equipment is not in gear. His adult son arrives as you approach. What should be your first action?
Ascertain whether the son knows how to turn off the tractor.
The greatest numbers of immigrants are coming to the United States from:
Asia and Latin America.
You are taking the history of a 78-year-old female patient with hypoglycemia. The patient has been answering your questions but seems to be growing tired. What should you do?
Ask the patient if she needs to stop and give her a break before continuing.
What medication would be least appropriate for premedicating a patient with an anterior ankle dislocation prior to attempting relocation to reduce the joint?
Aspirin
You are treating the victim of an auto accident who struck the steering wheel when the air bag failed to deploy. You notice severe bruising of the anterior chest but don't detect any rib fractures or displacement. When you arrived the patient was conscious and well oriented with respirations of 22 and a palpable radial pulse of 96. His SpO2 is 95; you immediately apply high-flow oxygen. After extrication and immobilization, you notice that the patient's breathing is more shallow but his rate remains about the same. His radial pulse is 114, his blood pressure is 96/70, and his SpO2 has dropped to 92 percent. In addition he appears to be developing some abdominal distention and is beginning to complain of dyspnea. You auscultate his lungs and find that they are diminished to absent in the lower lobes. What would your next actions include?
Assist ventilation with a BVM at the patient's current rate, initiate two large-bore IVs TKO, and expedite transport.
What is the most appropriate method for placement of an endotracheal tube in a facial gunshot wound victim who has lost all landmarks?
Attempt to visualize the larynx while another rescuer places pressure on the chest.
Which governing body in the U.S. General Service Administration issues the federal regulations to standardize the design and manufacturing requirements?
Automotive Commodity Center
You have been dispatched to an office complex with a report of multiple victims complaining of similar signs and symptoms of respiratory distress and nausea. What would you do first?
Avoid entering until the scene has been made safe.
You are dispatched to the scene of a shallow water diving accident. While en route, what would you consider to be the most likely result of this method of injury?
Axial loading of the cervical spine
What is the white matter of the spinal cord composed of?
Axons
Which of the following patients would be at the greatest risk for elder abuse?
A 71-year-old male who is confined to bed and is living with his son, who was just divorced from his wife
Which MOI would indicate the need to transport a child to a trauma center?
A bicycle-car collision
Which individual would you most likely assess and treat for heatstroke?
A high-school football player in the first few days of practice with temperatures in the 90s and high humidity
What should be attached to a personal flotation device (PFD) so that they are easily accessible?
A knife, strobe light, and whistle
Which incident would typically be termed a low-impact incident?
A three-car accident
What is one of the most consistent factors that can help to predict child abuse?
There is a history of physical violence in the home.
You are responding to a scene involving an overturned railway tanker, and you want to identify the material the tanker was transporting. Which of the following is a disadvantage of relying on shipping papers for information about a hazardous material?
Because they are kept onboard the vehicle (ship, train, tractor-trailer), they may be inaccessible in the event of a spill.
When does menarche usually occur for females?
Between the ages of 10 and 14
Which of the following statements regarding biological weapons is TRUE?
Biological weapons are difficult to detect right away.
What type of blunt thoracic trauma results from a chemical reaction that creates a pressure wave?
Blast injury
Your squad is dispatched to a local department store for a fall. When you arrive you are met by a panicked store manager and led to one of the aisles where a construction worker in his mid-20s has fallen approximately 20 feet through the roof and is lying on the floor after landing on a set of shelves. As you approach you note that the worker is unconscious and breathing at a rate of 10/min. He has a pulse rate of 72 and thready. You immediately start him on high-flow oxygen via a nonrebreather mask and perform a rapid trauma assessment, which reveals that he has no response to pain, apparent abdominaldistention, open bilateral tibia and fibula fractures, and a closed femur fracture on his left side. His blood pressure is 80/68. What care should be performed prior to transport?
Bleeding control and full immobilization on a long spine board
What term is defined as spasm of the eyelid?
Blepharospasm
A 30-year-old female patient presents with abdominal pain and rebound tenderness that you believe are because of an ovarian cyst. What would be the cause of this pain?
Blood released from the ruptured cyst irritating the peritoneum
Where do clotting factors provided by the extrinsic pathway come from?
Blood vessel walls
Which mechanism is said to occur when the energy of a nonpenetrating injury to the chest cavity damages tissue?
Blunt trauma
Which definition most accurately depicts the pathophysiology of a cerebral contusion?
Blunt trauma to local brain tissue that produces capillary bleeding into the brain's substance
What piece of equipment, seldom used in EMS a few years ago, are more and more EMS agencies providing for their employees as a measure to prevent injuries?
Body armor
Which organ is most tolerant of the compression and stretching associated with penetrating projectile injury?
Bowel
What is not a common sign or symptom of blunt cardiac injury?
Bradycardia
What more recent form of youth violence places victimized youth at increased risk for mental health problems such as depression and anxiety, psychosomatic complaints such as headaches, and poor school adjustment?
Bullying
Which of the following injury patterns is most suggestive of abuse to a 14-month-old infant?
Burns from the ankles down on both legs
When faced with a potential disaster such as a hurricane, how can the impact on resources best be reduced?
By advising people of safe routes out of the area to appropriate destinations
How can the injury potential of assault weapons be greatly increased?
By loading with hunting ammunition
How does a hyperbaric chamber treat dysbarism?
By redissolving nitrogen bubbles that have formed in the blood
Which of the following is one way in which rural EMS systems have been able to implement 911 systems in locations that previously had none?
By sharing the cost over multiple EMS jurisdictions
What is commotio cordis?
Ventricular fibrillation induced by a direct chest blow from blunt trauma
What is an appropriate reason to utilize air medical resources at the scene of an emergency?
Local EMS resources are exceeded.
Which of the following does current research indicate to be the most accurate statement about critical incident stress management (CISM)?
CISM does not appear to mitigate the effects of traumatic stress.
When performing CO-oximetry during the primary assessment, carbon monoxide poisoning should be considered to exist when:
CO levels exceed 10 percent.
Your EMS system permits care providers to treat patients with minor injuries and then release them to see their personal physician. After treating a patient for heat cramps, she seems to have recovered and she reports that the slight dizziness that she had been experiencing is gone. You determine that you can release this patient according to your system's local protocols. What do you need to do?
Carefully explain to this patient what heat emergency signs to watch out for and ensure she understands.
Which of the following is NOT part of the prehospital examination of the patient with suspected abdominal trauma?
Checking for blood in the urine
You respond to an airport for a report of several people with upper respiratory problems. As you enter the airport, you notice that there are multiple people coughing and vomiting throughout the ticketing area. This may indicate which of the following types of terrorist attack?
Chemical
A group of railway passengers presents with vomiting, diarrhea, watery eyes, and salivation. Which of the following is the likely cause of their symptoms?
Chemical agent
What is the name of the proteins and chemicals, released by cells that are damaged by trauma orinfection, that recruit cells responsible for consuming cellular debris?
Chemotactic factors
A patient who has lost 25 percent of his circulating blood volume would be displaying signs and symptoms associated with which class of hemorrhage?
Class II hemorrhage
You are dispatched to meet and assist a basic unit treating a 28-year-old male victim of a gunshot wound to the abdomen. Upon entering the BLS unit, you note that the victim is pale, cool, and diaphoretic with a distended abdomen; the EMT informs you that the victim is also anxious and becoming confused with a radial pulse of 128 and thready, a blood pressure of 92/82, and respirations of 22. What class hemorrhage is the patient displaying signs and symptoms of?
Class III
An analysis of data collected by New York State over 22 years shows that which of the following weather conditions has the greatest correlation to ambulance accidents?
Clear day
What type of bone injury is said to occur when the bone itself becomes fractured, but there is no penetration of sharp bone ends through the overlying skin?
Closed fracture
While treating the victim of a shooting, what is your next priority after patient care?
Crime scene preservation
In a hazardous materials incident, normal patient triage takes place in which zone?
Cold
What is the main component of scar tissue?
Collagen
Damage to what hollow organ can result in hemorrhage and content spillage into the retroperitoneal, peritoneal, or pelvic spaces?
Colon
Damage to which of the following organs is most likely to induce severe infection in the abdominal cavity?
Colon
What is the name of the surgical procedure by which the bowel is connected to an opening in the skin for the purpose of collecting feces outside of the body?
Colostomy
Which of the following functional areas of the NIMS system is ultimately responsible for dealing with an incident?
Command
Why is it important for all agencies and jurisdictions comprising a regional EMS system to be able to communicate with each other seamlessly?
Communication is not merely one aspect of an EMS response; it is the key link in the chain that results in the best possible patient outcome.
What single item is the cornerstone of the Incident Management System and must be established as early as possible?
Communications
You have a patient with a closed fracture of the femur. During assessment, you note that the area is very distended with taught skin circumferentially in the area of the injury. The patient states that he has no feeling distal to the injury site, and the distal pulse is absent. In addition to the fractured femur, what other type of condition may exist?
Compartment syndrome
What form of cold-related disorder exhibits signs and symptoms of hypothermia with a normal core temperature?
Compensated hypothermia
Which of these descriptions illustrates an expected age-related change in signs and symptoms associated with illnesses in the elderly?
Complaints of weakness, fatigue, and epigastric pain rather than of classic chest pain with myocardial infarction
In less than 10 minutes from arrival at the scene, what may EMS not be expected to do?
Complete transport to the destination facility.
You are caring for a 13-year-old girl who you believe is a victim of physical abuse. If this istrue, which of the following characteristics of the abused child would most likely not bepresent?
Concern over a parent's absence
A patient has partial thickness burns over 35 percent of his body, including both feet. Which classification does this patient fall under?
Critical
What type of deafness is said to occur when sound waves cannot be transmitted to the middle ear from the outer ear canal?
Conductive deafness
How can a paramedic practice tactical options?
Consider tactical options on routine calls
You respond to a call for a 27-year-old female sexual assault victim. Which of the following guidelines is true regarding management of the sexual assault victim?
Consider the patient a crime scene and protect that scene.
Your victim is suffering from circumferential burns of the legs and impaired distal circulation; you are faced with an extended transport time to the ED. What should your treatment of the victim include?
Contact medical command for an emergency escharotomy.
It's 2:00 am and you are transporting a trauma victim with significant injuries from an automobile accident. The local ED is closed for the night, and it will take approximately 1 hour for the staff to arrive. Which option should you consider?
Continue care and transport to a more distant trauma center about 1 hour away.
When the brain, floating in cerebrospinal fluid inside the cranium, "sloshes" toward the impact and then away from it, again impacting the cranial interior, what is the second injury called?
Contrecoup injury
Which "CUPS" criteria patient will not receive additional assessment beyond the primary assessment?
Critical
You are dispatched to the local outdoor gun range for an unknown injury; dispatch informs you that law enforcement is also responding. When you arrive you are waved around the building to the range by law enforcement officers who inform you that all guns were secured prior to their arrival. You approach thevictim, who is sitting at the range bench with his arm on the bench and his hand wrapped in a towel. The victim tells you he tried to fire a 30.06 rifle "from the hip" and the gun recoiled and hurt his finger. You prepare a dressing and remove the towel to find a degloving injury to the right index finger. How should you proceed?
Control bleeding and proceed with your assessment
In what form of heat loss does the body lose heat to cooler air currents that pass by the body?
Convection
Which of the following is the weapon of choice for terrorists worldwide?
Conventional explosives
As blood loss continues for the patient in compensated shock, what is the clinical result of blood being redirected to critical organs from the peripheral circulation?
Cool and pale skin
Side effects from which agents include hypertension, peptic ulcer, aggravation of diabetes mellitus, glaucoma, and increased risk of infection?
Corticosteroids
When faced with a decrease in the core temperature, what mechanism does the body use in response tothis?
Countercurrent heat exchange
What is the first thing you should do if you suddenly fall into swift-running water?
Cover your nose and mouth during entry.
Your patient is an 18-year-old man who was slashed across the abdomen with a machete. He has a mass of omentum and small bowel protruding from the wound. Which of the following is your primary concern with this patient?
Covering the wound with a sterile, saline-moistened dressing covered by an occlusive dressing
You are called to the scene of a fall down a concrete stairway. On arrival you note that the patient is unconscious and bleeding heavily from the nose and mouth. You note a respiratory rate of 24 and a radial pulse of 100. After suctioning, you are still unable to place an endotracheal tube, making it difficult to prevent blood from entering the lungs. How would you rate this victim's priority status?
Critical
Which of the injury types is most likely to be complicated by entrapment?
Crush injuries
You are treating a victim with his hips and legs trapped in a partial trench collapse. You have gained control of the airway, breathing, and circulation. What field diagnosis will your treatment plan be based on as the patient is released from his entrapment?
Crush syndrome
Which statement is accurate regarding the rapid administration of crystalloid solutions in the traumapatient?
Crystalloid solutions should be warmed as close to body temperature as possible prior to administration.
During primary assessment, which of the following signs indicates hypoxia?
Cyanosis
Which of the following statements is most accurate about water temperature?
Water can cause heat loss 25 times faster than air.
What federal document specifies the way ambulances look?
DOT KKK 1822F specs
Which statement is most accurate when performing the collision analysis of a fall victim?
Deceleration forces are transmitted from the contact point toward the body's center of mass.
What is a change that results in the respiratory system with age?
Decreased chest wall compliance
What is a sign of deterioration during reassessment?
Decreasing pulse strength
What is the best description of an aortic dissection?
Degeneration of the walls of the aorta
Which soft tissue wound exposes a large area of tissue that often becomes severely contaminated?
Degloving injury
Which of the following is a common characteristic of an abusive relationship for both abusers and the abused?
Dependence on drugs or alcohol
Which tissue layer contains nerve endings, sebaceous glands, and sudoriferous glands?
Dermis
Which of the following statements is correct in assessing and treating a patient who is the recipient of home health care technology to manage a chronic condition?
Despite the presence of the home health care equipment, the patient may still have specific DNR/DNAR paperwork.
Which factor can predispose an individual to hypothermia?
Diabetes
What emerging technology is helping to ease the overcrowding of radio frequencies?
Digital equipment
What is the primary reason for digitalis toxicity in the elderly?
Digoxin has a low margin of safety and a narrow therapeutic index.
What is an advantage of air medical transport?
Direct flight at 100-140 MPH
You arrive at the scene of a female victim complaining of a severe laceration of the left forearm she received when a glass slipped from her hand and broke while she was placing it in the cupboard. You note as you approach the woman that she is sitting in a chair holding her hand over a wound that is freely hemorrhaging dark red blood between her fingers. She appears to be alert and well oriented. What method of bleeding control would you immediately attempt?
Direct pressure over a dressing
Which of the following activities on the scene of a technical rescue incident is limited to the active rescuezone?
Disentanglement of the patient from a cause of entrapment
What type of orthopedic injury may have occurred when a joint is injured in such a way that it becomes fixed in an abnormal position, is resistive to motion, is extremely painful, and will likely have noticeabledeformity?
Dislocation
An example of effective communications between the EMS dispatcher and crew would be:
Dispatcher: "Control to Unit 34, respond high priority to 783 Third Street, cross street Vine, on a possible heart attack." Unit 34: "Control, Unit 34 copy, responding high priority to 783 Third Street." Dispatcher: "Unit 34, 1340 hours."
What should the paramedic monitor after the application of a circumferential bandage on an extremity?
Distal circulation
You are sitting in front of your station when a car pulls up and a young mother gets out with her crying 6-year-old daughter, who has her left hand wrapped in a blood-soaked cloth. The mother tells you that the girl attempted to cut open an orange by herself and cut the palm of her hand. After establishing that the girl is in no immediate danger, you turn your focus to the wound. After initial bleeding control, what is your next concern?
Distal circulation
While assessing a patient who was sexually assaulted, which of the following assessment principles should the paramedic follow?
Do not ask specific questions about the "who" and "why" aspects of the incident.
Your female patient has been sexually assaulted, and you need to remove some of her clothing to control the bleeding from a laceration of her abdomen. Which of the following is a guideline you should adhere to with respect to this clothing?
Do not cut through any holes in the clothing.
You are assigned to assist with a medical helicopter landing at the scene of a multiple-vehicle collision. Which of the following actions is correct?
Do not hold equipment over shoulder height.
Which of the following guidelines is correct regarding the assessment of conscious sexual assault victims?
Do not touch the patient unless given permission.
While caring for victims exposed to radiation, which of the following devices do rescuers wear to monitor the doses of radiation the victims are receiving?
Dosimeter
Which combination, utilizing a 230-grain bullet, would release the most energy on impact?
Doubling the speed of the round
You arrive at the scene of a single car accident to find that a bystander has placed a makeshift but effective tourniquet on the victim's leg to stem bleeding from an open femur fracture. There are no other apparent injuries. What should be included in treatment of this fracture?
Dress the wound, immobilize, and rapidly transport to the ED.
What would most significantly increase risk for soft tissue injuries?
Drug or alcohol abuse
Which of the following allows simultaneous two-way communication?
Duplex transmission
When treating a victim at a trauma scene following an MVC, when should you begin to establish theMOI?
During scene size-up
A 25-year-old female patient has received severe blunt force trauma to the abdomen and genitalia. What is not a concern for the paramedic regarding this patient?
Dysfunctional uterine bleeding
Which person supervises all operations involved with patient care and transfer?
EMS branch director
The technician level of training in hazardous materials is equivalent to:
EMS level 2.
Which of these statements best describes the reason why EMS should be knowledgeable about chronic care patients?
EMS may be called when the chronic condition worsens or a medical device fails.
Which statement regarding weapon of mass destructions is true?
EMS personnel must be able to recognize various types of weapons of mass destruction, including biological, chemical, and radiologic agents.
You are a paramedic in a rural setting where the main source of income for many families is farming. One particular afternoon, you are summoned to a farm for a worker who became entangled in a piece of machinery. Other workers are frantically waving you over to their location as you exit the ambulance. What should you consider first?
EMS provider safety
Of the radio transmissions made by EMS providers during a typical emergency response, which of the following would least likely occur?
EMS providers (eg, paramedics) calling the person who detected the problem and summoned EMS to ask for details about the emergent event
Which of the following is not a common way in which rural EMS systems attempt to increase their recruitment of EMS providers?
Each agency keeping its resources only for its own needs
Why may the dark red or bluish discoloration associated with the damaged blood vessels at the site of a contusion go unreported to the ED?
Ecchymosis is a progressive process.
You are dispatched to the residence of a 17-year-old female complaining of severe left-sided abdominal pain radiating to her left shoulder. On your arrival you note that she is alert and well oriented, respirations are unlabored, and she has a palpable radial pulse of 118. As you begin to gather your focused history, she tells you that the pain has been present for several days, but this morning it suddenly became severe as she was getting out of bed. She also tells you that her period was about two weeks late, but she thinks it began this morning. Her vitals are respirations 22, blood pressure 92/70, and pulse ox 99 percent. The patient refuses to allow you to examine her to determine the amount of vaginal discharge. What is your field diagnosis?
Ectopic pregnancy
Which action contributes most to mortality in a rollover accident?
Ejection
What is a threat in a confined space that atmospheric monitoring would not detect?
Electricity
How do superficial scalp wounds provide a risk of infection that can involve the brain?
Emissary veins from the dural sinuses drain into superficial venous circulation.
You are called to help an elderly patient back into bed who has fallen out. While you are doing so, the man's daughter with whom he lives returns home from work. She is instantly angry and starts calling him dumb, stupid, useless, and a pain. What is the best description of this type of abuse?
Emotional
What type of abuse occurs when the abuser threatens, calls names, ignores, or swears at the abused person consistently?
Emotional abuse
You are working as a paramedic diver assisting a search and rescue team in locating a private aircraft that crash landed and rapidly sank in a local lake. You are searching in approximately 80 feet of water when you notice that your dive partner is beginning to act erratically, rapidly changing direction and swimming down into the bottom and stirring up silt. You suspect your partner is suffering from nitrogen narcosis. What should you do?
Encourage your partner to ascend to the surface, assuring that he stages his ascent.
You are called to the scene of an automobile accident in which the driver was wearing his shoulder belt improperly and struck his face on the steering wheel. As you approach the vehicle, you see the door has been opened and the driver is unconscious, with his head still against the wheel and blood flowing freely from his nose and mouth. His respirations are 18 and shallow and his pulse is 102 radially. To extricate this patient, how should you proceed?
Ensure that any providers assisting you are coordinated and understand what movement is to take place.
What is the primary consideration for a paramedic when responding to the scene of a shooting?
Ensure that the scene is secured by law enforcement.
Your male patient was attacked by a prostitute he was attempting to have sex with. The assailant managed to cut off a section of the man's penis with a knife she had hidden. Upon your arrival, the male patient is using direct pressure to stop the bleeding, and you see the amputated body part on the floor. The assailant has left the building. What should be the paramedic's first assessment action?
Ensure the patient has an open airway and adequate breathing.
Which is not a primary function of the FCC?
Ensuring that EMS communications systems are not planned as a "stovepipe" activity
Which tissue layer contains no vasculature?
Epidermis
What is the early stage of wound healing in which adjacent stratum germinativum cells migrate over the surface of the wound?
Epithelialization
A patient with vaginal bleeding shows signs a decreasing level of consciousness and appears to be going into shock. What intervention should the paramedic perform for this patient?
Establish an IV and administer normal saline.
You have a patient who was trapped beneath a truck along the freeway when he was trying to repair the brakes. By the time you arrive, the local fire department has already extricated the patient from underneath the truck, and he is currently immobilized. They advise you that the patient has a crushedpelvis, an open fracture to the left femur, a distended abdomen, and vomitus in the airway. The patient suddenly became unresponsive when the weight of the truck was lifted from him. What should be your first priority of management?
Establish an open airway.
What should be performed in anticipation of freeing a patient who has been trapped for 40 minutes and is suffering from traumatic asphyxia? He is already receiving high-flow oxygen and respiratory assistance with a BVM.
Establish two large-bore IVs, consider 1 mEq/kg of sodium bicarbonate, and prepare for immediate expedited transport.
What step begins the assessment of any soft tissue injury following the ruling out of potential hazards?
Establishing a likely MOI
You are dispatched to an unknown medical emergency near the city park. You arrive to find police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped forward, unconscious. You also hear sonorous respirations and see a visible open femur fracture that is freely hemorrhaging, and blood dripping from her face or head. What is your first concern?
Establishing the safety of her location so you can initiate care
In the public five-step health model, what step is the repeating of surveillance in order to determine the effectiveness of an intervention?
Evaluation
At what intervals should vital signs be retaken on an unstable patient?
Every 5 minutes
What is meant by the "distance factor" in regard to decision making by paramedics who work in rural areas of the United States?
Every decision made must include consideration of the physical proximity of things.
Your patient has sustained a deep laceration to the anterior abdominal wall secondary to an industrial accident. When you remove his clothing during your assessment, you note that portions of the bowel are now protruding through the abdominal wall. What type of injury is this known as?
Evisceration
You are treating a patient who received a knife wound to the left anterior chest. You have initiatedhigh-flow oxygen and a large-bore IV. His vital signs are pulse 90, respirations 14, and blood pressure110/74, and his lungs are clear bilaterally. After moving him to your stretcher, you notice that he is developing jugular vein distention that diminishes upon exhalation; a check of his radial pulse reveals that it has risen to 126, and you are barely able to detect it. His lungs are still clear bilaterally, but his heart sounds distant. What is your transport plan for this patient?
Expedited transport to the nearest ED
During your assessment and management of a female rape victim, she states that she feels "dirty" and "violated" after the attack, and she refuses to go to the hospital until she showers and changes her clothes. What should you do in this situation?
Explain that showering and changing may destroy importance evidence.
Which form of communication is used most often by EMS providers?
Face to face
What is responsible for the low survival rate for victims of commotio cordis?
Failure to initially recognize the condition
Which of the following reasons typically does not influence the hesitation or failure of a female victim to report crimes of abuse committed against her?
Failure to recognize abuse
Which condition is a primary predisposing factor for environmental injuries?
Fatigue
A paramedic suspects a patient who had a miscarriage three days earlier of having endometritis. The patient has severe lower abdominal pain and foul-smelling vaginal discharge. What other common symptom might the paramedic need to manage?
Fever
Which structure fixes the heart in the mediastinum and prevents kinking of the great vessels?
Fibrous pericardium
Shifting of expiratory air from an uninjured side of the thorax to the injured side, resulting in reduced tidalvolume, is a common result of which injury?
Flail chest
What condition occurs when three or more adjacent ribs fracture in two or more places?
Flail chest
Which of the following descriptions best reflects the purpose of the mutual aid coordination center (MACC)?
For exercising direction and control in an emergency or disaster
You arrive on scene where a patient is receiving medical care for a chronic condition. The patient is reliant of a ventilator for helping to breathe at night. On this particular evening, the ventilator is sounding an alarm, so the alarm company has notified EMS. When you arrive, the patient cannot talk owing to a full laryngectomy. If you have a question about how the ventilator operates, what is the best way for you to learn more about it?
From the primary care provider
If burned skin takes on a chalky, brown, or white appearance and is hard to the touch, then what level of burn depth is it?
Full thickness
What is the resulting injury called when the zone of coagulation penetrates the dermis?
Full thickness
Which depth of burn destroys the tissue's ability to regenerate?
Full thickness
Which accessory organ receives bile and stores it until it is needed during digestion of fatty food?
Gallbladder
Which precaution can maximize the ability of heat-generating mechanisms to replenish energy supplies when in cold environments?
Get plenty of rest.
Which of the following situations is least likely to be a warning sign of suicidal behavior in an elderlypatient?
Hanging onto cherished possessions desired by others
Which heat disorder is generally characterized by a body temperature of at least 105 F, central nervous system disturbances, and usually the cessation of sweating?
Heatstroke
What is the key requirement for EMS and law enforcement to interact well at a crime scene?
Good communication
Terrorist attacks are most likely to be targeted toward which of the following?
Government buildings
When obtaining a patient's obstetric history, which term would you use to describe the number of times the patient has been pregnant?
Gravida
What term is used to describe the number of times a woman has been pregnant?
Gravida (G)
What type of fracture, typically seen in pediatric bones, results in an incomplete break?
Greenstick fracture
Which of the following is a potential advantage of ground transportation over air?
Ground ambulances have fewer weather-related limitations than air ambulances.
Which type of head injury carries a 75 percent or higher mortality rate and is second in lethality after head injuries from auto crashes?
Gunshot wounds
What branch of medicine deals with the reproductive health needs of females?
Gynecology
What type of crimes are committed against a person solely on the basis of the individual's actual or perceived race, color, national origin, ethnicity, gender, disability, or sexual orientation?
Hate crimes
What are the tubes of a bone through which blood vessels travel called?
Haversian canals
You arrive on scene to transfer a paralyzed patient to the hospital from a nursing home to rule out pneumonia. While assessing the patient, you note that he has an elevated temperature and there is apus-like discharge from where his urinary catheter enters the meatus of the penis. What is the likely problem?
He also has a local infection around the urinary catheter insertion site.
What trauma injury is the most frequent cause of death?
Head injury
In accordance with the law of energy conservation, the energy of motion, as it pertains to driving anambulance, is converted to what form of energy during the normal braking at a traffic light?
Heat
In an abandoned strip mine in the corner of a state park, an ATV enthusiast has sustained a severe head injury from overturning his vehicle, and ground transport lacks protocols for rapid sequence intubation. What is the best option for this patient?
Helicopter transport
The use of which adjunct has reduced the occurrence of head injury in sports?
Helmets
In patients with rib fractures, what benefit does grunting, or partial expiration against a closed glottis, provide?
Helps limit atelectasis
Which of these statements regarding hemostasis following an amputation is true?
Hemorrhage is typically limited if the amputation is clean.
What is the initial step in the healing of a wound?
Hemostasis
Which medical term is defined as the complex three-step process that the body uses to control localized hemorrhage?
Hemostasis
What type of program or concept of care was developed to help keep the patient with a terminal illness as comfortable as possible at home until the person dies?
Hospice
What is the designated area at a hazardous materials incident where only the highest trained and equipped hazardous materials personnel are allowed to function?
Hot zone
The forced transport or trade of a person by such means as the threat or use of force or other forms of coercion is the definition of which of the following?
Human trafficking
You respond to the scene of an explosion to treat a victim with a penetrating injury to the occipital area from shrapnel. For which additional injury should you have a high level of suspicion?
Hyperflexion of the cervical spine
Which of the following findings from a physical examination or patient history is least likely to be present with a patient who is suspected to have PID?
Hypertension
You have been called to a home for "a child not breathing." When you arrive, you find a young woman who identifies herself as the child's babysitter. The child has a tracheostomy tube that is nearly obstructed by mucus, and the 3-year-old is moving very little air. What is the first step in your treatment of the child?
Hyperventilate the patient prior to suctioning the tube for 5 seconds.
Which term describes low or inadequate distribution of blood to body organs and tissues caused bycardiac, vascular, neurogenic, or volume problems?
Hypoperfusion
Which term refers to the distribution of blood to the body's organs and tissues?
Hypoperfusion
What term refers to a drop in blood pressure caused by a reduction in blood pressure caused by cardiac, vascular, neurogenic, or volume problems to a level that is lower than normal for the patient?
Hypotension
What impact, if any, does hypothermia have on the utilization of oxygen at the cellular level?
Hypothermia can disrupt cellular oxygen use to decrease metabolism.
You are dispatched to an industrial accident for a 38-year-old female who had her lower arm amputated by a machine. The limb is still caught in the machine, and maintenance crews have been unable to retrieve it as of yet. On your arrival, the patient is lying on the floor next to her work station. Her arm had been crushed and severed immediately distal to her right elbow. As you approach you are advised by first responders that she is conscious, with a respiratory rate of 24 and a radial pulse of 118, and she is ashen. Your partner immediately starts her on high-flow oxygen via a nonrebreather mask while you attempt to control the still heavy bleeding from her severed limb, which the plant first-aid providers have been unable to control by direct pressure and elevation. You successfully apply a tourniquet and initiate an IV that your partner has prepared, and your patient is now packaged for transport. She now has a respiratory rate of 18, radial pulse of 96, and a blood pressure of 102/76; the pulse ox reads 98 percent on high-flow oxygen. What is the next step in your plan of care?
Immediate transport to a trauma center
You respond to a residence for a 22-year-old female who was standing in her yard when the neighbor's zero-turn mower ejected half a brick that was lying in the yard. The brick struck the victim in the left upper quadrant immediately inferior to her bottom rib. She tells you she did not fall or receive any other injury but the impact area aches "deep inside." Your primary assessment reveals normal respirations at a rate of 16 and a radial pulse of 100; the patient has a large hematoma at the impact location. What would your next step include?
Immediate transport with a focused assessment including inspection of the injury area
How would you prepare for the burn victim with suspected respiratory involvement?
Immediately provide high-flow oxygen and prepare to maintain the airway.
What intervention should be provided for a suspected rupture of a tendon attached near the knee so as to limit the amount of damage to the tendon?
Immobilization
Which of the following most accurately defines ectopic pregnancy?
Implantation of a fetus outside of the uterus
Which of the following statements is most accurate as it relates to a rescue situation?
In any rescue situation in which the patient can be safely accessed, treatment will begin before the patient is freed.
Which of the following guidelines applies to prehospital fluid resuscitation of hypotensive patients with intraabdominal hemorrhage?
In most cases, fluid administration should be limited to 3 liters.
In rural areas of the United States where health care access is limited, the paramedic's skills may be utilized in what capacity to help alleviate gaps in health care?
In prompt care facilities
Which condition do all forms of shock share?
Inadequate tissue perfusion
Why must treatment of blood loss in infants and small children be more aggressive than in adults?
Infant and child compensatory mechanisms are neither as well developed nor as effective as those of adults.
In a multiple-casualty incident, which person has full legal authority to deal with the situation?
Incident commander
What is the primary objective of the foreign or domestic terrorist using chemical, biological, radiologic, nuclear, and explosive (CBRNE) weapons?
Incite terror in the public.
What is the expected change in the occurrence of transporting trauma victims from a rural area to a larger urban facility?
Increase
What do the signs and symptoms of Cushing's triad include?
Increasing systolic blood pressure, slowing pulse, and irregular respirations
Which cause of abdominal trauma is on the rise?
Increasing violence in society
A properly restrained driver is involved in a head-on collision. Without contacting any internal structure in the car, he sustains a myocardial contusion. What principle of motion describes this injury?
Inertia
Which of the following is the most common mechanism of action in nerve agents?
Inhibit degradation of acetylcholine
You are dispatched to an industrial accident for a 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On arrival, you find the patient in the companyfirst-aid station supine on a cot, secured to a scoop stretcher, cervical collar in place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse 70, BP 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he has a bounding pulse of about 60 and is now only purposefully responsive to pain. What would your initial treatment and transport decisionsinclude?
Initiate rapid transport to a trauma center.
As you approach a vehicle involved in a single-car accident involving a tree, you see through the window that the patient has a large amount of blood covering his face. While your partner initiates manual spinalcontrol, you introduce and identify yourself; he responds without difficulty. Since his airway is open and his breathing seems adequate, you check the radial pulse and find a rate of 100/min and strong. At the same time you note that a severe laceration of his scalp is no longer bleeding, but was responsible for a majority of his overt hemorrhaging. What is your next step?
Initiate high-flow oxygen via a nonrebreather mask.
The family member of a patient asks what it means to modify the basic qualities of a hazard. What can you give as an example?
Install easy-to-reach stove dials, countertops, and storage areas.
You are called to treat an elderly patient who "fell while walking," according to the extended care facility staff where you picked him up. During your assessment, you find multiple injuries to different locations of his body, the patient looks malnourished and dirty, and you read in his medical records that he has a debilitating brain injury that rendered him unable to ambulate. What type of abuse may this be?
Institutional elder abuse
What best describes how Newton's first law of motion applies to penetrating trauma?
It explains both how a projectile delivers its energy to an object and how that object reacts to being impacted.
You are looking at the placard for a hazardous materials through binoculars and trying to spot the UN number. Which of the following best describes the United Nations identifier for hazardous materials?
It is a unique identifier for each chemical.
You respond to a residence and find the owner in the backyard sitting on a bench. He shows you a hematoma centrally located on the anterior of his left thigh, which he received when the hammer he was using slipped out of his hand and hit his leg. He tells you it startled him that it swelled up so fast, but it hasn't changed since he called and he no longer wants to be transported to the ED. The hematoma is approximately 1" X 2" and is swelled 1 inch above the surrounding leg area; after communicating your findings and vital signs to the ED, the physician indicates you can have the patient place cold packs on the area to help relieve swelling and release the patient. What instruction should you leave the patient with?
Instruct the patient to utilize cold packs in accordance with the doctor's recommendations and to seek follow-up care with his physician. Document your and medical command's instructions.
Which type of blood loss is most likely to continue unabated until it is halted by the normal clottingprocess, a significant drop in blood pressure, exsanguination, or surgical intervention?
Internal blood loss into the abdomen
Your patient is a 60-year-old female restrained driver involved in a moderate-speed frontal impact collision. When you arrive at the scene, she is sitting up in the driver's seat with a chief complaint of a burning sensation in her face. You note abrasions from deployment of the airbag. After immobilizing the patient on a long backboard, you begin transport. As you perform a detailed examination, the patient complains of developing right shoulder pain. Which of the following should you suspect?
Intraabdominal bleeding
Which statement is true regarding pediatric head trauma?
Intracranial hemorrhage in the pediatric patient can contribute significantly to hypovolemia.
Which of the following does not result in hypovolemic shock?
Introduction of a foregin substance into the body that causes a massive histamine release
What condition exists when aggressive resuscitation restores blood pressure and pulse but organ failure continues unabated?
Irreversible shock
What causes the tissue edema resulting from an intracerebral hemorrhage?
Irritation of nervous tissue
Which of these questions is not appropriate to ask when a pregnant patient's chief complaint is of pain?
Is the patient's pain abdominal or in the pelvic region?
What does a system status management system do to help an EMS agency?
It acts as a personnel management and ambulance deployment system.
If energy can be neither created nor destroyed, what happens to the kinetic energy in a projectile during penetrating trauma?
It is primarily transferred to the penetrated object.
If a patient presents with what you suspect is a severe case of pelvic inflammatory disease with lower abdominal pain and rebound tenderness, which of the following statements is true?
It may be impossible for you to rule out appendicitis instead of PID.
What is the primary reason you can still be seriously injured or killed when wearing body armor?
It doesn't cover your entire body.
You are transporting a patient with chest pain to a local rural hospital. You have found ST elevation on two 12-lead ECGs that you obtained while en route. On arrival at the ED, you find out that their only12-lead ECG machine is being repaired. What might you have to do in this situation?
Keep the patient on your cardiac monitor for the time being.
Body armor is typically manufactured from several layers of:
Kevlar.
The law of inertia and the law of energy conservation are the two basic principles of what concept?
Kinetics
What are the names for the two folds of fatty tissue that arise from the mons pubis and extend to the perineum, forming a cleft?
Labia majora
A victim of penetrating trauma to the neck can also become the victim of an air embolism due to whichmechanism?
Laceration of the internal jugular vein
Which of the following factors should not increase the paramedic's index of suspicion for medication noncompliance in an elderly patient?
Lack of sensory impairment
You and your partner are rural paramedics responding to an emergency in an area with one small hospital. What is one challenge that you may face that urban-based paramedics rarely have to be concerned with?
Lack of full-time ED staff at the receiving facility
During a fight with a knife-wielding assailant, your teenage patient was stabbed in the lower left abdominal quadrant, at roughly the 5 o'clock position. Bleeding is minimal, and the patient is conscious and in extreme pain. Given this injury, what structure is most likely injured from the stabbing?
Large bowel
You are dispatched to the scene of a stabbing outside a downtown bar. After being cleared to approach the scene by law enforcement, you find a 21-year-old female with a single stab wound to the left upperquadrant, immediately inferior to the rib cage, that she states she received from her boyfriend. You notice a 4" long knife, which is still lying on the ground beside her, with a small amount of blood. Whichorgan/tissue is least likely to be in the wound track, given how a male would likely wield a knife?
Large intestine
Which statement is most accurate regarding a lateral impact vehicle accident?
Lateral compression may cause splenic injury to the driver and liver injury to the passenger.
In an automobile extrication situation, which type of glove provides the best protection against injury from jagged metal and broken glass?
Leather
You are on scene where a patient says that she was sexually assaulted by her new boyfriend. The boyfriend left the scene before your arrival, but he returned while you were still there. He starts to yell at you and screams, "Over my dead body you will take her out ofhere! Now leave immediately!" What should you do next?
Leave the scene and call for police.
In a drowning incident, how much water typically enters the lungs?
Less than 30 mL
Which protective ensemble offers the highest level of respiratory and splash protection against unknownsubstances?
Level A
What level of hazardous materials personal protective equipment provides chemically resistant splashprotection, but not full encapsulation, and includes SCBA?
Level B
What trauma center designation is given to a regional trauma center, usually a university teaching center, prepared and committed to handle all types of specialty trauma?
Level I
When population density does not permit a commitment to Level I trauma center requirements, what level of trauma center could best act as a regional trauma center?
Level II
A hospital that is most likely to attempt non-surgical stabilization of critical trauma patients prior to transporting them to a hospital with higher-level trauma capabilities has a trauma care rating of:
Level IV.
Which of the following is NOT a chemical nerve agent?
Lewisite
During your collision analysis of two vehicles striking head on, you note that the SRS system deployed in both cars, and the drivers are walking around the scene. Neither vehicle has a damaged windshield. What should your vehicle investigation also include?
Lift the air bag and look for dash or steering wheel damage.
What type of necrosis denatures proteins and collagen?
Liquefaction
Which abdominal organ is responsible for detoxifying blood, producing bile, storing glycogen, producing proteins utilized in the clotting process, and assisting in osmotic fluid regulation?
Liver
Which of the following organs would be expected to display the most damage resulting from the pressure wave of a high-velocity, penetrating object?
Liver
What is required by a TEMS unit in order for it to begin operations?
Local protocols and standing orders
Your squad is dispatched to a residence for a 9-year-old male patient with a head laceration. When you arrive, you are directed by another young boy to the kitchen, where you find the patient sitting at the table crying, with his mother standing behind him holding a kitchen towel over his left ear. You notice that there is a small amount of blood on the child's shirt also. As you approach the boy, he tells you that they were having a sword fight with plastic swords when the other boy struck him on the ear and he began bleeding. After establishing that the child does not appear to be in immediate danger, you prepare a dressing and bandaging materials and remove the cloth to inspect the laceration. During inspection you note that the laceration has horizontally bisected the outer ear at the level of the ear canal and lacerated the scalp in the mastoid area. Which method of bleeding control would you implement?
Loose gauze dressing to absorb blood
Hemorrhagic shock is typically initiated by what event?
Loss of blood from the vascular compartment
Which of these is an age-related change of the renal system that can change the elderly person's response to medications?
Loss of nephron function results in decreased efficiency of urine production and accumulation of medications and wastes in the blood.
What physiological differences most likely adversely affect an elderly patient's response to hemorrhage?
Lower fluid reserves and less-responsive compensatory mechanisms
What is an unintended consequence of fluid resuscitation in the trauma patient?
Lowering of the core body temperature
Which of the following is the site from which civil government officials exercise direction and control in an emergency or disaster?
MACC
What population is most at risk for head or spinal column injury?
Males aged 15-24
You arrive at the residence of a patient who is utilizing a piece of homecare equipment that is a cuirass resembling a tortoise shell strapped to his chest. The family states that they lost power several hours before and the battery back-up is now alarming. What should you be prepared to do?
Manually ventilate the patient.
When the body's compensatory mechanisms can no longer maintain the core temperature due to heatloss, what happens?
Metabolic rate and cardiac output fall.
What injury would be classified as a diffuse brain injury?
Mild axonal injury
In 1970, the U.S. Congress passed the following act, which allowed the military-proven system of helicopter evacuation to augment the civilian EMS system with helicopter evacuation:
Military Assistance to Safety and Traffic
In which stage of hypothermia is the ability to shiver usually lost?
Moderate hypothermia
Which of the following conditions is contributing to the increase in ambulance collisions over the lastdecade?
Modern automobiles are more sealed and soundproof, which makes it more difficult for drivers to hear the approaching ambulance.
You respond to a private residence for a 23-year-old female who told the dispatcher that her hysterectomy incision opened up when she sneezed. You arrive to find the patient lying on the couch with her robe opened up, displaying her open abdominal incision. There is no bleeding but a section of the small intestine is exposed. How would you address the dressing and bandaging of the wound?
Moisten a sterile abdominal bandage with sterile saline and place securely enough to hold the contents in place; monitor respirations.
Which of the following is TRUE of the epidemiology of abdominal trauma?
Morbidity and mortality due to blunt trauma are decreasing, but morbidity and mortality due to penetrating trauma are increasing.
Which of the following patients may not be suitable candidates for air medical transport in rotary-wing aircraft?
Morbidly obese patients
Which statement regarding musculoskeletal injuries is true?
Most patients who suffer multisystem trauma experience significant musculoskeletal injuries.
Which of the following statements concerning sexual assault is accurate?
Most sexual assaults are never reported.
A 68-year-old woman lives in an upper-floor, urban area apartment without air conditioning. In early May, an unseasonable heat wave occurs, with a sudden change in temperature into the mid-90s with high humidity. On the fourth day of the heat wave, the woman's neighbor finds her passed out. In your assessment of this patient, you find she is responsive only to pain and has hot, reddened, dry skin. What steps should your treatment of this patient include?
Move her to a cool environment, initiate active rapid cooling, give oxygen as required, run IV normal saline wide open initially, and initiate ECG monitoring.
If a hearing-impaired patient is having difficulty understanding you while you are seated behind the patient in the ambulance, what should you do?
Move to where the patient can see your face.
You are involved in the initial response to a nuclear detonation. Which of the following will likely be an early priority in managing this incident?
Moving survivors into structures to protect them from fallout
What is another name for cystic fibrosis?
Mucoviscidosis
Which of the following scenarios is MOST likely to be a potential terrorist incident?
Multiple explosions in an urban subway system
Why is crush syndrome particularly dangerous?
Myoglobin and other toxins flood the bloodstream when the crush pressure is released.
What are the discrete tissues and muscles of the body that are controlled by specific spinal nerve roots?
Myotomes
Developing workplace safety standards is the responsibility of:
NIOSH
What is the first sign that can reliably be attributed to a state of hypovolemic shock?
Narrowing pulse pressure
To help improve the quality of medical oversight and support that physicians can provide to urban and rural EMS systems, what national organization has developed physician-level courses specifically designed for this?
National Association of EMS Physicians
Which of the following incident management concepts is the comprehensive standard currently utilized since 9/11?
National Incident Management System (NIMS)
You are called by the police to a particular street address. When you arrive, you are directed to a police cruiser, where a 7- or 8-year-old boy is sitting in the back seat, covered with a wool blanket placed by the officer. The officer reports that the patient was found sitting outside in the cold with no winter coat, locked out of his house. As you evaluate thisboy, you find that he is unusually thin for his age and dirty. Which type of abuse best categorizes this patient?
Neglect
If a patient was to display some signs and symptoms of a Class I hemorrhage, what would they include?
Nervousness and marginally cool skin with a slight pallor
What is neovascularization?
New blood vessels generated from undamaged capillaries assist in healing and formation of new tissue.
You arrive at the scene of a flash fire that occurred when fumes from a pan of gasoline, in which the victim was cleaning parts, ignited. The victim, who is conscious and well oriented, received partial thickness and a few small full thickness burns to his hands and forearms. His vitals are currently respirations 18, pulse 100, blood pressure 120/76, and pulse ox 100 percent on room air. How should oxygen be administered to this patient?
No oxygen therapy at this time
In which type of accident can you immediately rule out a suspicion of the presence of hazardous materials?
No transportation accident
What role does psychological debriefing or diffusing provide within the scope of an MCI?
None
Enforcement of the workplace safety standards put forth by NIOSH is the responsibility of:
OSHA
What governing body ensures that ambulances carry items such as disinfecting agents and sharps collections containers?
OSHA
What is your best tactical response to violence?
Observation
What is a duty of the cover provider while the contact provider is delivering patient care?
Observes the scene for danger
Which of the following statements is most accurate regarding a wound from a handgun?
Only organs directly in the bullet's path are likely to be injured.
What is the critical responsibility of the logistics section of NIMS?
Operating the medical supply unit
Which impact occurs third during a vehicle collision?
Organ collision
You are treating an elderly patient who is displaying a behavioral problem, according to family members. They can provide no reason why their elderly relative's behavior changed; they just know that it's not right. In taking this patient's history, what sign or symptom would make you suspect drug abuse?
Orthostatic hypotension
Which of the following conditions occurs as a result of loss of minerals in bone tissue, leading to an increase in bone fractures if the elderly patient falls?
Osteoporosis
Your patient complains of severe abdominal pain on her right side, radiating to her back. She reports pains during intercourse and a delayed menstrual period when you take her history. What do you suspect?
Ovarian cysts
During scene size-up, what may alert you that a patient is receiving home care?
Oxygen equipment is in view when you enter the patient's residence.
Two teenagers are stranded on a large rock along with their overturned canoe in the middle of a rushing stream. Before you effect the rescue, which of the following PPE would be most appropriate to give to thevictims?
PFDs if they are not currently wearing them
You respond to a 78-year-old patient with a myocardial infarction who is bedridden in a nursing home. You discover when assessing the patient that she has a large, severe pressure ulcer on her lower back. Which consideration is inappropriate for this patient?
Pack the ulcer with dry woven gauze
What should be done with the information you receive from emergency medical responders and EMTs about the patient's condition and the care he received after you finish formulating a patient management plan?
Pass the information along to the ED.
Why is patient assessment provided by the contact provider?
Patient care duties can prevent observation of the scene by the cover provider.
You are dispatched to the scene of a shooting. While en route, dispatch directs you to a secure staging area, set up by law enforcement, half of a block from the incident. On arrival, you see two officers dragging another officer between them to your unit. You exit the unit and quickly pull the cot out of theback, and the officers place the victim sitting up. They quickly explain that he was securing the perimeter when he was shot in the left shoulder by an unknown assailant. Your patient appears alert and well oriented and is complaining of severe left shoulder pain. You note a bullet hole in the front of his body armor, high on the left side. You cut off his vest and as you remove it, a bullet drops out of the vest onto the cot, and you also see an exit wound at the inferior edge of the left scapula with little blood exiting. You apply an occlusive dressing and lay the victim back on the cot. You then notice an entrance wound at the second intercostal space, also hemorrhaging slightly, and place an occlusive dressing there also. Your patient still appears well oriented but is very anxious and excited about what has happened. You quickly auscultate the lungs and find breath sounds equal and clear on both sides with a rate of 34. Your victim's pulse is 120 and easily palpable in his left radial artery, and the pulse ox reads 100 percent. While there appears to be no change in the injury site or respirations, he is now complaining of numbness and tingling in his fingers and toes. You opt to take his blood pressure and find it to be 138/76. As you continue your exam and care, how would you mentally note the patient's complaint of numbness and tingling?
Patient complains of numbness and tingling in the fingers and toes
Which of the following statements regarding operations within the hot zone is most inaccurate?
Patients found with compromised airways should be addressed before being moved to the warm zone.
What patient demographic is most likely to suffer a greenstick fracture?
Pediatric
What type of injury is most likely to result in frank hematuria?
Pelvic fracture
Your 26-year-old patient appears to be acutely ill and palpation of her lower abdomen produces severe pain. She has drawn her knees up to her chest because she says that this enables her to feel the most comfort. She says walking intensifies her pain. You suspect which of the following?
Pelvic inflammatory disease.
What type of trauma is most likely to cause vascular injuries to the abdomen?
Penetrating
Open chest wall injuries are almost entirely the result of what mechanism?
Penetrating trauma
You are dispatched to the scene of a house fire from which a 38-year-old woman was rescued. On yourarrival, fire department personnel inform you that she was extricated from the living room sofa near the point of outbreak where she was found unconscious, and she was placed on high-flow oxygen via a nonrebreather mask. The victim is currently unconscious with partial and a few full thickness burns of herfeet, ankles, hands, arms, and face; her hair is singed. Her vital signs are respirations 28 and shallow and labored with diffuse wheezing, pulse 100, and blood pressure 132/78. The pulse ox reads 88 percent. You evaluate her airway and find it too constricted from swelling for successful intubation. What would be the next appropriate step in your treatment plan?
Perform a cricothyrotomy.
What tissues form a slinglike structure that supports the internal pelvic organs and that is able to stretch during childbirth?
Perineum
A chemical that remains a liquid is poses a contact or absorption threat and is said to be:
Persistent
Which of the following is not a leading cause of trauma in the elderly?
Polypharmacy
You are first on the scene of a single-car vehicle crash. As you approach the scene, you notice that the car has sustained moderate front-end damage and the occupants, a middle-aged man and woman, are standing beside the car arguing. The woman has a bloody lip as well as a cut over one eye that is bleeding. Dispatch informs you that law enforcement is about 2 minutes out. How would you approach the scene if you decide it is safe to do so?
Position your vehicle to protect the scene, notify dispatch of the activity at the scene, and have your partner exit the vehicle and cautiously approach the couple while you remain in the vehicle.
You are dispatched to a possible shooting. While you are en route, your dispatcher informs you that law enforcement is on the scene, confirms the shooting, and tells you that the scene is secure. On yourarrival, you are led to a 24-year-old female who is conscious and well oriented. She tells you that she feels okay except for some difficulty breathing and severe pain along her right midaxillary line. She indicates a location on the right lateral aspect of her chest where you see a small-caliber bullet wound. There is no exit wound. You note that her pulse is 90 palpated radially and her respirations are 22/min. How would you rate this patient using the CUPS acronym?
Potentially unstable
Which finding is most critical to the paramedic regarding a genital injury to a female from assault?
Preserving physical evidence
You are dispatched for a fall at the local mall. When you arrive you are led by security to a location on the sidewalk where a 43-year-old male patient is lying on his back. He is alert and oriented and tells you that he was running to cross in front of a car when he tripped on the curb, striking his head on the sidewalk. He then rolled onto his back and can no longer move his hands, legs, or trunk, although he can still move his arms. You suspect a low cervical or high thoracic spinal injury. At what point in the assessment would you apply spinal stabilization to this patient?
Primary assessment
If you are utilizing the START system at an MCI, what type of evaluation are you performing?
Primary triage
What is an inexpensive vinyl tarp useful for?
Protection from water, weather, and most debris
Which statement is true regarding protective gear and sports injuries?
Protective gear can contribute to a sports injury.
You are assessing a female who was shoved down hard by her boyfriend during an argument. The police have the male in custody, and the female seems relatively unharmed. She has decided to not be transported to the hospital by ambulance. Before you leave, what should you consider?
Provide her with a list of local resources for victims of partner abuse
In 2008, the FCC established a new office to handle public safety issues, known as the:
Public Safety and Homeland Security Bureau.
What injuries are received during the primary blast phase?
Pulmonary injuries
What type of barotrauma is most likely to occur if a diver fails to breathe during ascent?
Pulmonary overpressure injury
Which wound type has the greatest tendency to conceal the actual extent of injury?
Puncture
What is the elevation of the body temperature above the normal temperature for that person, usually because of pathogens?
Pyrexia
Trauma triage criteria application, field skill performance, and response time are various system aspects studied by:
QI committees.
What blast injury type is severe burns associated with?
Quaternary
What is the typical cause of dysbarism when diving?
Rapid ascent
Your geriatric patient is experiencing a behavioral emergency. You believe that it is from delirium rather than dementia. Which of the following findings would support that delirium is present?
Rapid onset of behavior change
Which of the following describes definitive care of the patient with traumatic intraabdominal hemorrhage?
Rapid surgical intervention
Questioning a patient about respirophasic pain, or pain with breathing effort, would happen during what part of assessment?
Rapid trauma assessment
Which aspect of force is the primary cause of injury?
Rate of deceleration
In a disaster, if operations have begun to return people who have been evacuated to their homes and communities, then you are in which phase?
Recovery
The pathophysiology of high-altitude illness revolves around which condition(s)?
Reduced air pressure and oxygen availability
What procedure should be pursued when a MCI responder is not adapting to the disaster normally?
Refer the responder to a competent person.
Which of the following statements is true regarding endometriosis?
Regardless of its location, the tissue bleeds in a cyclic manner.
Which of the following is critical when multiple agencies respond to a single incident?
Reliable equipment designed to afford clear communication among all agencies within the system
You are the first on the scene of a single-vehicle crash late at night. During your windshield survey, you notice that damage to the car is minimal, the driver is slumped over the steering wheel, and the car trunk lid is ajar but not open. What would the most appropriate next step be?
Remain in your vehicle or bypass the accident until law enforcement arrives
You have a patient who is dependent on a home ventilator to stay alive. You were called to the scene by family members because the alarm on the patient's ventilator was sounding. The entire time you arethere, the ventilator is operating normally. You advise the patient to go to the hospital and have the ventilator checked, but the patient refuses to go. The patient is alert and understands the situation. What should you do?
Remain on scene until someone from the ventilator company arrives to test and possibly replace the ventilator.
You are treating the victim of a stab wound to the neck with the knife left in place. What field treatment would you pursue if you believe that the knife is significantly impinging on the airway?
Remove the object
You are requesting air medical transport at the scene of a collision involving two vehicles. You have several injured patients. What launch information should you be prepared to provide?
Requesting agency identity
What bodily activity that results from hypothermia robs the trauma victim of much needed metabolic resources?
Shivering
Which of the following statements regarding rescue situations is true?
Rescue is a patient-driven event.
How can your patient care reports be used for research purposes?
Researchers may use certain data elements to assess patient outcomes.
How should you respond if your female patient is reluctant to discuss the specifics of her gynecologic complaint with you in detail?
Respect her wishes and transport her to the ED for a more thorough assessment.
You are at the scene where a patient is receiving medication through a PICC line via an infusion pump. The patient has an altered mental status, and you ask questions about the patient's baseline mental status of the patient's home care provider, who you initially take to be a trained professional. However, the provider seems confused by your questions. What should you do?
Restate your questions in simpler terms.
As you approach the driver of a vehicle involved in an MVC, you notice that he is being belligerent with the passenger and sounds intoxicated. As you get closer, the driver turns his attention to you in the samefashion, making you concerned for your safety. What should you do?
Retreat to the ambulance until law enforcement arrives, and be prepared to leave.
What is the first opportunity to begin the assessment process?
Review of dispatch information
You have not worked for a couple of months at the EMS station to which you are assigned. What is the most important thing you should do at the beginning of your shift?
Review the location of equipment to familiarize yourself with the ambulance.
In crush syndrome, crushed skeletal muscle tissue can undergo disintegration and as a result release metabolic byproducts. What is this degenerative process called?
Rhabdomyolysis
Early one morning, you are assessing a patient who states that she was at a party last night drinking and brought a male home with her. She further states that she fell asleep on the couch, although she doesn't remember when that happened, the man was gone in the morning, and she thinks she was raped. If she is right, which of the following drugs is likely to have been used to facilitate the rape?
Rohypnol
When conserving a wet garment worn by the victim of a crime, how should you store the item?
Roll the item in a paper bag, place it in a second paper bag, and place both bags in a plastic bag.
In addition to the traditional management of a patient with spinal injury and abdominal trauma who is immobilized on a backboard, what intervention should be provided for the 8-months-pregnant female with abdominal trauma?
Rotate the board 15 degrees to the left.
Which of the following injuries would be the result of a pressure wave associated with the detonation of an explosive device?
Ruptured eardrums
Which of the following statements regarding rural populations is true?
Rural areas have a higher percentage of people over age 65.
What is the condition in which EMS providers are unable to stay abreast of current standards or previously taught practices?
Rust out
Your patient presenting with nontraumatic vaginal bleeding passes a clot on the way to the hospital. How should you handle this clot?
Save it for evaluation.
You suspect the driver of a car in a motor vehicle collision (MVC) with airbag deployment, despite having no complaint of injury, might still have sustained a spinal injury based on the high-force mechanism of injury. At which point in the assessment would you develop this suspicion?
Scene size-up
A properly restrained driver is found unconscious in a utility van with moderate damage to the front of thevehicle, after being involved in a frontal collision. The steering wheel is not deformed, nor does the windshield show signs of impact in front of the driver; however, the passenger side of the windshield is damaged. The driver's headrest appears to be at an appropriate height. Equipment and debris from the van is scattered in the roadway. What is the most likely cause of his decreased level of consciousness?
Secondary collisions
What causes burn injury in an explosive attack?
Secondary combustion
Patients can be exposed to an incredibly large number of chemicals. In any situation involving chemicalexposure, what should you do after ensuring your own safety?
See that all patients receive the necessary supportive measures.
Which part of the inner ear is responsible for equilibrium?
Semicircular canals
Which of the following is one of the 10 steps for injury prevention developed by William Haddon in 1972?
Separate the hazard and that which is to be protected by a barrier.
You are caring for a patient with an external fixation device with rods screwed into his femur in multiple locations to help immobilize the bone that was shattered in a motorcycle accident. The patient is displaying a slightly altered mental status, tachycardia, marginal blood pressure, and a fine rash on his body. The family states that the patient's condition has been getting worse over the last several days but that the patient would not go to be seen by a physician. What will be the most immediate likely outcome if the patient is not evaluated and treated for this condition?
Sepsis
Which statement is accurate regarding external blood loss?
Serious blood loss can be hidden from view due to clothing.
In an injury to the abdominal wall, visible ecchymosis and swelling typically takes how long to develop?
Several hours
It is five hours after a nuclear detonation, and several patients are beginning to present with nausea, fatigue, and malaise. The radiation exposure for these patients should be considered:
Severe
Which term is defined as a significant mechanical disruption of axons in both cerebral hemispheres with extension into the brainstem?
Severe diffuse axonal injury
Which of the following is TRUE of the patient with a suspected penetrating injury to or rupture of the diaphragm?
Shallow respirations may be due to abdominal contents in the thorax.
You are called to a party at a fraternity house where an 18-year-old girl was found in an upstairs bedroom passed out. When you walk in, you find the girl to be responsive to painful stimuli, she has dilated pupils and slow breathing, and she is naked from the waist down. No one at the party seems to know who she is. What may have happened to the patient?
She is likely a victim of a date rape drug.
What is the term for the mechanism of injury when a farmer loses the fingers of one hand while trying to work on a sickle bar mower while it is still running?
Shear point
Which of the following is most likely to occur as a result of rapid deceleration without actual contact between the patient's body and the interior of the vehicle?
Shearing injury of the liver
You suspect your elderly patient is suffering from a reaction to Lisinopril, an ACE inhibitor, in addition to diarrhea. Which sign/symptom would lead you to believe this?
Significant hypotension
What could be an early indicator of internal bleeding requiring intervention as part of your treatment plan?
Signs of poor peripheral perfusion
Which of the following statements is true about trauma in the elderly?
Signs of subdural hematoma in an older person can develop slowly, over time.
Which of the following is the cardinal sign of a toxic chemical release?
Similar signs and symptoms occurring rapidly in a group of individuals
Which of the following is a type of pulmonary injury?
Simple pneumothorax
You are a paramedic in a rural farming community. One particular afternoon, you are summoned to a farm for a worker who is pinned under a piece of heavy machinery he was working on. The local sheriff meets you near the location to guide you in and tells you to hurry, as the patient is reportedly unresponsive. What should you consider first when making patient contact?
Sizing up the scene to look for potential dangers
What are the two main subsystems of the musculoskeletal system?
Skeleton and muscles
Electrical burns typically deliver a heat burn resulting from the body's resistance to the flow of energy. Which part of the body typically receives the largest amount of burn-related damage?
Skin
What aspect of burn patient assessment gives the most information about the body's condition?
Skin condition
Which type of motorcycle collision occurs when an experienced rider trades severe injuries for minor to moderate injuries by placing the motorcycle between themselves and an object?
Sliding impact
Why is it important not only to provide proper care for a victim of elder abuse, but also to let the victim know about resources in the community for these types of situations?
So that the victim can learn better strategies to help avoid or stop the abuse
What is, by far, the most common type of trauma the body sustains?
Soft tissue injuries
Where did large-scale emergency organization first take place?
Southern California
Which body tissue would receive the most serious damage from the pressure wave of a high-velocity rifleround?
Spleen
Which of the following organs is NOT part of the digestive system?
Spleen
When walking up to a residence, how should you position yourself relative to the door before knocking onit?
Stand to the side of the door
In terms of reducing your exposure to an alpha radioactive source, what is the best method?
Standard Precautions
You and your partner arrive at the scene of a construction accident. The patient, a 43-year-old finishcarpenter, was cutting the edge off a trim board when the knife slipped, avulsing a large section of his anterior lower arm, including underlying musculature and veins. He is currently alert and oriented, and a coworker is successfully applying direct pressure over the avulsed flap to control bleeding. The patient's respirations are 12 and his right radial pulse is 84. Which form of bleeding control would you initially attempt to utilize?
Sterile dressing with a circumferential bandage, moderately wrapped to provide pressure
Internal intercostal muscles, along with the diaphragm and what other muscle(s), are the major muscles of inhalation?
Sternocleidomastoids
When removing an injured victim from rough terrain, the most appropriate device to package a patient and prepare for transport is a:
Stokes basket
The standard litter for transporting a patient across rough terrain is the:
Stokes basket.
What is the most common form of genital trauma?
Straddle injuries to females
The ambulance checklist for the beginning of a shift would normally not include which of the following?
Stretcher maintenance record review
Which of the following types of protective equipment offers the least amount of protection to hazardous materials exposure?
Structural firefighting gear
When palpating a patient, what does a "Rice Krispies" feel to the skin signify?
Subcutaneous emphysema
What is bleeding called that occurs within the meninges, specifically beneath the dura mater and within the subarachnoid space?
Subdural hematoma
You are dispatched to an unknown medical emergency near the city park. You arrive to find the fire department and police on the scene and are directed to an opening in the sidewalk where a manhole cover had been removed. You note that there is blood spatter on the edge of the manhole, and at the bottom of the ladder you see a young female in jogging clothes with her back against the wall and head slumped forward, unconscious. You also note sonorous respirations and see a visible open femur fracture that is freely hemorrhaging and blood dripping from her face or head. The fire department has determined that the atmosphere in the manhole is safe, and you enter the space. Your partner repositions the airway while initiating manual spinal alignment. The sonorous respirations cease, but you note that she has audible gurgling and an apparent maxillary fracture; she is bleeding heavily from the mouth and nose. Which choice would be your next step?
Suction as required, place a mechanical airway, and assist ventilations as needed.
You are called to respond to an accident involving a hybrid vehicle. During the scene size up portion of your vehicle collision analysis, which considerations are specific to a hybrid vehicle?
Sudden vehicle acceleration or electrocution from the vehicle electrical system
Which adult patient would be considered to be minor in terms of burn severity?
Superficial burns to the anterior arms and anterior chest
Which adult patient would be considered to be moderate in terms of burn severity?
Superficial burns to the arms, legs, and torso
What is temporary hypotension caused by the weight of the gravid uterus, which occurs in the third trimester of pregnancy?
Supine hypotensive syndrome
You are dispatched to the scene of a hunting accident and arrive to find an 18-year-old male patient with an arrow through his right shoulder, the tip protruding anteriorly. He is conscious and well oriented, and has a respiratory rate of 14 and easy with clear bilateral lung sounds; his radial pulse is 74, and the pulse ox reads 99 percent on ambient air. You note only minimal bleeding from the wound sites. How would you prepare your patient for transport?
Support the arrow in place and place your patient on his left side.
Of all the different types of technical rescue situations, which of the following is most likely to not require the involvement of EMS?
Surface water rescues
What is the collection of data to identify the existence, significance, and characteristics of a diseasecalled?
Surveillance
Which methodology provides initial data collection for injury prevention, the trauma registry, and qualityimprovement?
Surveillance
You respond to a call for a patient complaining of midcycle abdominal pain you field diagnose as mittelschmerz. Treatment of this patient should include which of the following?
Symptomatic treatment only
When observing the patient's respiratory effort and chest excursion, what are late signs of shock?
Tachypnea and air hunger
Which of the following is not a strategy that would help prevent the onset of a heat emergency such as heatstroke in a geriatric patient?
Taking a salt pill before attending an outside event
Which of the following best explains the role of EMS providers in preventing secondary contamination at a hazardous materials incident?
Taking initial actions to contain and isolate the hazardous material and patients
Which of the following best describes shear injuries to the abdominal organs?
Tearing of the organ in which the organ is fixed at its point of attachment but free to move otherwise
A home health aide is on the scene with a patient who has multiple pieces of medical equipment in the bedroom performing a variety of tasks. During this patient encounter, which of these actions by the paramedic would not be considered professional?
Tell the aide that you will take charge from here and the aide is no longer needed.
A patient experiences heavy vaginal bleeding in a public place that causes her to briefly faint. She feels humiliated. Which of the following is not an example of psychological support for this patient?
Tell the patient that no one is likely to judge her for what happened
An explosion collapses a parking garage, crushing the legs of a bystander; what type of injury would this be?
Tertiary
You are dispatched to the home for a pediatric patient who is on an apnea alarm. Dispatch advises you that the family reports that the alarm keeps going off. What should you consider prior to arrival?
That the patient might not be breathing
Your patient was sexually assaulted. Which of the following should you document on the PCR for this patient?
That the victim's clothing was torn
Which of the statements regarding the Glasgow Coma Scale is accurate?
The GCS is not a "perfect" means to accurately represent a patient's level of consciousness.
What is the name of the tool developed to identify risk elements associated with trauma?
The Haddon Matrix
Which of the following is true regarding the patient care report?
The PCR may be written or electronic.
Regardless of the type of Stokes basket selected for your service, these devices typically require which of the following?
The addition of adequate restraints
Which of the following statements is true about the typical budget for EMS services in rural areas of the United States?
The budget is typically too low.
What is indicated by the lack of an exit wound in a patient that suffered a GSW?
The bullet expended all its energy.
What is the difference in the energy delivered to soft tissue by a bullet that does not deform on impact when compared to a round of equal weight and speed that does deform?
The deformed round delivers more energy.
You are dispatched to an industrial accident for a 38-year-old male patient who was struck in the head by a steel beam being shuttled on an overhead crane. On arrival, you find the patient in the companyfirst-aid station supine on a cot with a scoop stretcher and cervical collar in place, and a hematoma in the right parietal area. The EMT tells you that the patient walked in and lay down on the cot but now he is less responsive. The vital signs he provides are pulse 70, BP 140/88, and respirations 10 with good volume. You approach the patient and quickly establish that he is now only purposefully responsive to pain. When examining this patient's head, other than noting obvious signs of trauma, to where should you direct special attention?
The eyes
Which consideration is most pertinent when performing a collision analysis on an elderly victim?
The force required to fracture bones is much lower in the elderly.
What is the fibrous connective tissue sheet directly beneath the skin and covering the most superior surface of the head?
The galea aponeurotica
In which service or agency did the origin of incident management have its roots?
The fire service
Who often determines the course of an MCI event?
The first responders
Which definition most accurately reflects the meaning of the term "Golden Period"?
The goal for incident-to-surgery time for trauma patients
Which of the following changes is NOT of concern in the pregnant trauma patient?
The high likelihood of trauma to the uterus in the first trimester
As patients and their families assume greater responsibility for their own treatment and recovery, what is the implication of this for paramedics?
The likelihood of ALS intervention for the chronic care patient increases.
For an isolated mid-shaft femur fracture, when should you stop the application of traction?
The limb is immobilized and patient discomfort ceases.
Which statement concerning the golden period is true?
The paramedic cannot control many of the factors that consume the golden period.
You are summoned to a home for an "unknown medical emergency." On arrival, you find that the patient is receiving mechanical ventilation but looks cyanotic. Which of the following assessments relative to this would indicate an emergency?
The patient has no alveolar breath sounds.
You are called to the home of an elderly patient who is reliant on his daughter for ongoing care. His daughter is also on scene, having just arrived home from work. During your assessment of the patient, you find him to appear malnourished and dirty, and he has multiple areas on his body where ulcerations are forming. Despite your desire to transporthim, the daughter keeps stating, "Just leave him alone, he's fine. I'll make an appointment sometime soon, so just leave now." What should you conclude about this patient?
The patient is being neglected.
You arrive on scene for an unknown medical emergency. As you approach the front door of the residence, you see a sign in the window that reads "No Smoking. Oxygen in Use." From this information, what can you surmise about the patient?
The patient likely has a chronic pulmonary disease.
You are caring for a 77-year-old male who complains of nausea, weakness, puffy ankles, and trouble breathing. The complaints have been present for the past two hours. When questioned, the patient denies chest pain, abdominal pain, or headache. He has a history of diabetes and hypertension. After you transfer care to the emergency department staff, the physician advises you that ST-segment elevations were found on the patient's 12-lead ECG, signifying a possible heart attack. Which of the following best explains the absence of common associated signs and symptoms on scene?
The patient may have had a "silent" myocardial infarction.
You are caring for a person who is on vacation and was seriously injured at night. The closest hospital is 2.5 hours away by ground, so you decide to use the local HAA program for transport. In which of the following situations may this not be the best idea for transport?
The patient was injured while completing a nighttime hike through the woods.
An elderly male refuses to be transported to the hospital after he was physically abused by his son following an argument. His injuries are minor, but the elderly man does not want to be transported because of the cost associated with it. What is most important thing to document about this call?
The patient was physically abused.
In the process of attempting to rescue a fellow worker from a chemical tank, additional workers were exposed to the same product through contact with the original worker. For gross decontamination of these workers, what is the first step?
The patients remove all clothing and jewelry, including shoes and socks.
What procedure should be followed if a collision during a sporting event leads to a period of unconsciousness or decreased level of awareness in a participant?
The person should be seen in the ED prior to returning to the game.
You are dispatched to the scene of a house fire from which a 42-year-old woman was rescued. On yourarrival, fire department personnel inform you that she was extricated from a second-floor bedroom where she was found unconscious, and she was placed on high-flow oxygen via a nonrebreather mask. The victim is currently unconscious with partial thickness burns of her feet, ankles, hands, and forearms. Her vital signs are respirations 32 and shallow, pulse 128, and blood pressure 102/78. The pulse ox reads 100 percent. There is no apparent swelling of the airway, and you opt to continue high-flow oxygen via the nonrebreather mask. What should you also immediately consider regarding her continued treatment?
The potential for cyanide poisoning
Why is accurate assessment of the geriatric trauma victim especially essential to proper treatment?
The problem may be masked or confused by signs and symptoms of preexisting disease.
What is the lung's sole fixation point in the thoracic cage?
The pulmonary hilum
What have improved building codes, safer construction techniques, sprinkler systems, and smoke detector use done to the mortality rate due to burns?
The rate has been declining for decades in the United States and other developing countries.
What is the degree of deformity of an automobile, involved in an accident, most indicative of?
The strength and direction of forces experienced by the occupants
What is the most direct result of alveolar shunting caused by atelectasis in the drowning victim?
The return of deoxygenated blood to the bloodstream
Immediately after impact, at what rate of speed will the unrestrained driver continue to move forward in a frontal impact vehicle collision?
The same speed as the vehicle
What position is responsible for being in charge of a specific functional area of the NIMS?
The section chief
Which patient would be the best candidate for the administration of mannitol?
The severe head injury patient exhibiting signs of herniation with a systolic BP over 90
Which of the following statements regarding the skin of an elderly patient is false?
The skin perspires less often.
What is not a reason that the atlas/axis joint is the site of the majority of fatal spine injuries?
The spinal cord roots exit the spinal column at this point.
Which statement regarding incident impact is most accurate?
The techniques and tools used to respond to a multiple-patient MVC can also be used to manage a more extensive MCI.
Who is responsible for arranging movement of patients from treatment areas at the scene of an MCI to area hospitals?
The transportation unit supervisor
You arrive at the scene of a patient who is having difficulty breathing and find that he is a traumatic brain injury patient who has just been released to home for care and is dependent on a mechanical ventilator. The ventilator is sounding an alarm and indicating "Low FiO2." What is the first thing you should check?
The ventilator oxygen source
Tetanic convulsions can accompany electric shock from household current. How do these convulsions contribute to prolonged exposure to the current?
The victim may be unable to break contact with the electric source.
For what reason would an obese patient fare worse than the general population when progressing through the stages of shock due to blood loss?
The volume of circulating blood is based on a patient's ideal weight, not actual weight.
You respond to the scene of an entrapment and find a middle-aged maintenance worker with his legs and abdomen trapped in a steel press. Workers have an overhead crane in place and are feverishly working to remove the dogs, which hold the press plate in place. Your primary exam reveals that the victim isalert, well oriented, and normotensive but has no feeling from his chest down. Employees are confident that they will be ready to lift the plate in about ½ hour. What might you anticipate happening to the patient when the plate is lifted?
There may be severe and difficult-to-control hemorrhage.
Why are recreational emergencies at a destination lake typically a strain on EMS systems?
They are often seasonal, and sudden population changes can stress the rural department.
What do metal clipboards, chemical agents, and other tools have in common for the TEMS medic?
They can be used as defensive weapons.
What is not an advantage of fixed-wing aircraft?
They can land almost anywhere.
Which of the following is true regarding simplex radio communications?
They can transmit and receive, but not both simultaneously.
Which of the following is true regarding modern ambulances?
They drive like a large truck
Use of recreational vehicles (ATVs) has significantly increased. What impact has this increase had on recreational vehicle injuries?
They have significantly increased also.
Which of the following is an accurate statement regarding culturally diverse patients' choice whether to receive emergency care by paramedics?
They have the right to make care decisions for themselves.
Which of the following is true regarding fragmenting ballistic rounds?
They increase in profile and damage potential.
Which of the following statements is true regarding treatment of obese patients?
They may blame unrelated signs and symptoms on their weight.
Which of the following is a significant limitation in the use of fixed-wing aircraft for air medical transport?
They must utilize established airports.
Which of the following is true regarding wireless 911 calls?
They present challenges that the EMS system is still trying to address.
Which statement concerning contact sports is most accurate?
They remain a significant cause of injury.
In accordance with the START triage system, what should the disposition be for patients who respond to your request to come to you?
They should be confined to one area.
Which statement is most accurate when considering spinal precautions as part of your primaryassessment?
They should be immediately employed when an MOI or patient condition warrants it and discontinued if the patient is completely cleared.
Which statement is true regarding the Golden Period?
The 1-hour incident to surgery time has not been substantiated.
Which of the following would be a reason that paramedics may be called to the home of a patient receiving chronic home health care?
The patient's condition suddenly worsened.
You are communicating with the pilot of a helicopter approaching the emergency scene. Which of the following information should not be provided when communicating with the pilot of an approaching helicopter?
The patient's most current vital signs
You are treating a patient with AIDS for mild hypothermia. What precautionary measures should you take?
Those required by departmental policy
How many compartments is the abdominal cavity divided into?
Three
How many layers of connective tissue are there between the cranium and the brain?
Three
What is not part of the basic IMS organization at many EMS incidents?
Timing
What is the purpose of the lymphatic system?
To collect some of the fluid delivered to the cells by the circulatory system, filter it, and return it to the venous system
Why is it most important to repeat orders from medical direction?
To confirm understanding
Why is a list of medications important to gather, if available, during the assessment of a critically injured trauma patient?
To determine whether there are any medications that may affect coagulation
Which of the following is a legitimate reason to touch a sexual assault victim?
To obtain vital signs
What is the goal of performing EMS at a crime scene?
To provide high-quality patient care while preserving evidence
What is the basic function of a TEMS unit?
To work as medical adjuncts to the police or military
In comparison with the adult patient, what type of fracture would the pediatric patient be more prone to?
Torus
What possible result of relieving crushing pressure on an extremity after a prolonged period of entrapment could require a paramedic's immediate intervention?
Toxins entering circulation
You arrive at the scene of an ATV accident and establish that the rider collided with a high-tensile wire fence that penetrated his neck. What neck structures are the most often injured from penetrating trauma?
Trachea and major blood vessels
Your patient, the 52-year-old driver of a vehicle that struck a tree, is complaining of chest pain and severe difficulty breathing. As you approach, you notice that he is cyanotic, has hemoptysis, and is visibly panicked. During your primary assessment, you note that his respirations are 22 and shallow, his radial pulse is 128, and his SpO2 is 83 percent. He has pervasive subcutaneous emphysema. You immediately start him on high-flow oxygen via a nonrebreather mask. His lung sounds are equal but diminished bilaterally. What initial field diagnosis will you base your treatment plan on?
Tracheobronchial disruption
You are transporting a 28-year-old patient complaining of abdominal pain and unusual vaginal bleeding for the past several days. The patient tells you that the bleeding is slowly increasing over time, and she is using about one pad per hour. Her last period was two weeks ago. Her vital signs are pulse 78, respirations 16, and blood pressure 128/74. What would your mode of transport be?
Transport the patient in a position of comfort, absorbing blood flow without packing the vagina.
Helicopters were first introduced into EMS to assist with treating which type of patients?
Trauma
What is the health care surveillance process utilized in trauma systems called?
Trauma registry
Which of the following patients is not a candidate for medical helicopter transportation from a crash scene to a trauma center?
Traumatic cardiac arrest
Which of the following activities on the scene of a hazardous materials incident is not considered a role of the paramedic?
Treating and transporting contaminated patients
What functional area of the NIMS EMS branch is activated when there are not enough ambulances to transport the injured?
Treatment
Which of the following disaster resource people would you not likely find at the mutual aid coordination center (MACC)?
Triage personnel
Which patient would receive a GCS score of 3 for verbal response?
Uses inappropriate words (irritable)
You are dispatched to assist a 21-year-old female who was shot in the left arm as she sat in her car in a parking lot. The police are already on the scene. When you approach the patient, she indicates that she is deaf. What is the best way for a health care provider who does not sign to communicate with thispatient?
Use hand-written notes.
You are evaluating a 32-year-old female in her third trimester after being called to her residence for a fall. During your exam, she tells you she is having contractions, which you are unable to feel by palpation. The abdomen also feels "soft." What has likely occurred?
Uterine rupture
What method should the paramedic use to address core body temperature concerns when transporting the victim of severe to moderate burns?
Utilize blankets to prevent heat loss.
A radio communications band that is widely available and travels far and well over varied terrain is the:
VHF band.
What is the primary underlying pathophysiology behind deaths associated with traumatic asphyxia?
Vascular compression
One afternoon, you are called by a remote alarm company to the home of a patient who has a history of traumatic brain injury and has a stoma. He uses a ventilator to assist his breathing, which is currently sounding an alarm. You are unfamiliar with this ventilator and currently, his wife, who is his primary care provider, is not at home. The patient is displaying an altered mental status and is unresponsive. Being unfamiliar with the patient's history, what should you be prepared to do?
Ventilate the patient if his SpO2 falls.
What has contributed heavily to an increase in thoracic trauma in urban areas?
Violent crime
Helicopters used for medevac missions typically employ what type of flight rules?
Visual flight rules
If a program needs at least 3 miles of visibility to fly its aircraft, it is probably using which flight rules?
Visual flight rules
Which activity is an example of the EMS system taking an active role in public accident prevention?
Voluntary home inspection
Which of the following items would not be part of a typical vehicle-equipment checklist?
Weather conditions
A patient has accidentally ingested a hydrocarbon solvent and may have inhaled fumes from the solvent as well. Which of the following statements about hydrocarbon solvents is most incorrect?
When the patient has ingested a solvent, you should give the patient ipecac syrup and induce vomiting.
When should any significant findings of the rapid or focused trauma assessment be rechecked?
Whenever you note any change in the patient's condition
What determines whether you utilize the CAB or ABC approach to the primary assessment of the traumavictim?
Whether or not the patient is in cardiac arrest
You are directed to approach the scene of a shooting by a local security officer at a shopping mall. What should your initial consideration be when approaching the patient?
Whether or not the patient is still armed
A patient is experiencing a problem with a GI tract device. You note stomach contents spontaneously moving up into the patient's nasogastric tube. The patient is conscious and appears alert but is having trouble speaking. The home care provider is present. What can you expect to learn from the provider?
Whether the patient has experienced similar complications before
Which of the following is an example of an incendiary agent or device?
White phosphorus
What type of additional training should be provided to a rural paramedic who works near the borders of a large mountainous state park?
Wilderness rescue
Which environmental factor would predispose a person to heat or cold disorders?
Wind
You are transporting a 21-year-old male who amputated three fingers of his left hand with a circular saw. While you prepare your patient, family members locate the amputated digits and look to you for instruction on packaging them for transport. Which procedure is most appropriate?
Wrap the amputated parts in gauze dampened with lactated Ringer's solution and place them in a plastic bag immersed in cold water.
Which of the following statements is most accurate regarding the paramedic treating a patient from a different ethnic background?
You are required to care for all patients in the same manner as you would a patient from your own background.
Which of the following statements is true regarding communication with developmentally disabled patients?
You may not immediately recognize the disability.
What is the most important rule to maximize the effectiveness of body armor?
You must wear it.
You respond to an emergency involving a patient injured while servicing a wind turbine on a stretch of farmland 20 miles away from the nearest town. Which of the following should you expect for this call that you wouldn't in an urban environment?
You will be in contact with this patient for a longer period of time.
For what demographic are burns the second leading cause of death?
Young children
Among which demographic group has there been a significant increase in commission of acts of violence over the past two decades?
Youth
In working around smooth or swift water, the most important PPE to utilize is:
a Type III PFD.
You are assessing an elderly patient at the request of his daughter. The patient is 98 years old and has been living with his daughter for the past three years. She tells you that he has become increasingly more erratic in his behavior and withdrawn lately, and tonight his mental status is significantly altered fromusual, causing him to withdraw to his room and refuse to let his daughter inside, and he seems confused. This may indicate:
a affective disorder.
Several patients complaining of the same illness and presenting with the same signs and symptoms should raise suspicion of:
a biological attack.
The most important reason paramedics should not wear rings or other jewelry while on duty is because of the risk of:
a degloving injury.
As you arrive on scene of a multiple vehicle rear-end crash with one vehicle partially off the roadway, you observe a large amount of fluid on the roadway coming from the rear of one of the vehicles. Your greatest concern should be:
a flammability hazard created by leaking fuel.
To receive a Revised Trauma Score of 4 for respiratory rate the patient must be breathing at:
a minimum of 10 breaths per minute.
When you suspect a patient has a serious traumatic injury to the body and are inclined to transport him quickly to the trauma center, you should perform:
a rapid trauma assessment.
Collision of a medium-velocity bullet with the body after striking Kevlar body armor is considered:
a secondary impact.
Multiple wound tracks from a single gunshot is likely caused by:
a shotgun.
The most common cause of nontraumatic vaginal bleeding is _____.
a spontaneous abortion.
A biotoxin is:
a toxin that is produced by living organisms but that is itself not alive.
The inadvertent mixing of blood samples at a crime scene will result in:
a useless sample.
Joints that allow some very limited movement are:
amphiarthroses.
Abdominal pain with external vaginal hemorrhage in the near-term trauma victim is primarily indicative of:
abruptio placentae.
A patient presents with nontraumatic vaginal bleeding of an unknown cause. The paramedic's goal in managing this patient's bleeding should be to:
absorb the flow.
Lower salt concentrations in perspiration and increased fluid reserves are benefits of:
acclimatization.
At a hazmat incident, paramedics may:
activate the Incident Command System (ICS).
The contents of a Mark I kit are most effective when they are:
administered intravenously.
You are a paramedic who maintains an EMS level 1 in hazardous materials. The incident commander assigns you to immediately initiate lifesaving care for a patient who is in the warm zone who is being prepared for decontamination. You should:
advise the incident commander that you do not meet the training qualifications.
One of the first things an elderly person has to overcome after retiring is the societal effect of:
ageism.
You are caring for a patient who fell down some steps while leaving church on Sunday morning. Assessment reveals an open fracture to the right tibia with minor bleeding that is easily controlled. The patient has no other injuries from the fall and is presenting as stable. Care for the injured limb would begin with:
aligning the limb.
An emergency responder who may perform patient care in the warm zone on patients who still present a significant risk of secondary contamination describes:
an EMS level 2, or the technician level responder.
Developing accurate indices of suspicion for injury pathways of occupants from an automobile accident requires:
an accurate collision analysis.
A patient's jugular veins are flat, suggesting hypovolemic shock, and you can see signs of hemorrhaging. Serious hemorrhaging from the neck should be addressed aggressively because, in addition toexsanguination, the victim of a neck injury may be subject to:
an air emboli.
A fixed-wing aircraft is defined as:
an airplane that uses fixed wings to generate lift.
Rigid splints are not constructed from:
an airtight fabric bag.
During the absence of perfusion that occurs distally from the application of a tourniquet, the body forms lactic acid with potassium liberation. The chemicals formed are known as:
anaerobic metabolites.
According to OSHA, a confined space is:
any space with limited ingress/egress that is not designed for human occupancy or habitation.
The respirator designed for use in conjunction with Level C protective equipment that can be utilized during transport of patients with the potential of secondary contamination is:
an air-purifying respirator (APR).
The maintenance of a continuum of patient care is reliant upon:
appropriate interactions between EMS system members.
For retreating to be effective, the paramedic should:
at least be concealed from sight.
The original ICS was developed for use:
at major fires.
A patient has been exposed to a pesticide through accidental ingestion. The primary treatment for this patient should be:
atropinization.
When advised of the potential for violence en route to the scene, the paramedic should:
await law enforcement before approaching the area.
A shallow diving accident may result in compression force on the cervical spine known as:
axial loading.
You are dispatched to a motor vehicle accident. On arrival, you discover four victims, all of whom require ALS. Dispatch indicates that is will take another 10 minutes to get additional ambulances to your location. This incident typically be categorized as:
a low-impact incident.
Potential significant internal hemorrhage may first reveal itself during the primary assessment in the formof:
a rapid, thready pulse.
Capillary hemorrhage generally oozes from the wound and is:
bright red.
When decontaminating a patient exposed to solid corrosives, first:
brush off dry particles.
You respond to a diving accident in which the victim tells you that she was descending and began suffering from severe middle ear pain and dizziness, which improved after she returned to the surface. She tells you that she has been recovering from an upper respiratory infection but thought she was well enough to swim. This type of injury is a form of:
barotrauma.
During a mass casualty incident, mental health personnel should:
be available on site for rescuers and victims.
You are performing triage at an MCI. A victim who is breathing but lacks a palpable pulse should:
be categorized red.
When gathering the history of an elderly patient, you should:
be prepared to spend time and give the patient opportunities to rest.
Injury control and prevention of the patient home care environment begins:
before the patient returns to the home.
As you are dispatched and begin your response to a potentially high-risk confined-space incident, you should immediately:
begin size-up of the situation before even arriving at the scene.
The exchange of information between patient care providers should:
be rapid, thorough, and accurate.
Toxic substances being metabolized through the liver is a process called:
biotransformation.
The EMT can differentiate between superficial burns and partial thickness burns based on:
blister formation.
Mortality resulting from a hemothorax is primarily attributable to:
blood loss.
Helicopters offer more support to ground EMS on accident scenes in comparison to fixed-wing aircraft because helicopters:
can land practically anywhere.
Pulse oximetry is an effective indicator of respiratory and cardiovascular effectiveness in the burn victimunless:
carbon monoxide is involved.
High-energy penetrating wounds create a wound track much larger than the projectile size due to a phenomenon known as:
cavitation.
A generally non-life-threatening infection at the cellular level is known as:
cellulitis.
The uterus has two major parts called the body and the:
cervix.
The female external genitalia include the:
clitoris.
The body's process of causing platelets to adhere to the vessel wall and other platelets, forming a platelet plug and reducing blood flow or, in small vessels, stopping it altogether, is called:
clotting.
The process by which acid burns disrupt the cell wall and damage the tissues is known as:
coagulation necrosis.
Hematemesis, an indicator of internal bleeding, may present with the appearance of:
coffee grounds.
A __________ radio device is capable of automatically selecting the strongest radio, cellular, or satellite channel when the user initiates communication.
cognitive
A religious-based practice of rubbing a coin over the skin of an ill person that may make marks across the chest or back similar to those of abuse is called:
coining.
The ability of the body to maintain blood pressure in the face of hypovolemia by reduction of the venous compartment is a form of:
compensation.
A 78-year-old male complains of a headache that he calls a migraine. The headache began about four hours ago and has gotten worse. He is also starting to feel nauseated and is having "foggy" thinking. You question the patient and determine that he has never had a history of migraines. He tells you, "No, this is the first one, but it's a doozy!" You suspect this patient might be experiencing a stroke. You should:
complete a stroke assessment.
The act of evading someone's view behind convenient objects to escape danger is known as:
concealment.
During a vehicle collision, lap belt and shoulder strap use prevents the wearer from:
continuing to move.
You have arrived on the scene of a trench cave-in where two injured but conscious workers are partially trapped at the bottom of a 10-foot trench. You should:
control as many hazards as possible that are within your training.
When an injury occurs directly at the point of impact as the brain moves toward and collides with the interior of the skull, this is called a(n):
coup injury.
The act of evading someone by moving behind solid impenetrable objects to escape an armed encounter is known as:
cover.
Structural collapse and industrial or agricultural incidents are common causes of:
crush injuries.
You are called to the residence of a 20-year-old female patient complaining of abdominal pain, burning with urination, and trouble starting and stopping her urinary stream. Her urine is also blood-tinged. She is likely suffering from:
cystitis.
If a chemical agent release is small and contained, then:
evacuate the immediate area.
The data elements that are collected on the PCR and how they are interpreted are defined in a:
data dictionary.
In a violent frontal collision, the use of a shoulder strap without the lap belt may result in:
decapitation.
When proteins break down due to heat, the action of the heat on the proteins:
denatures them.
Failure of the bone to support weight can be the result of:
devascularization.
In decontaminating a patient who has been exposed to a liquid chemical, application of large quantities of water best describes:
dilution.
Immune senescence refers to:
diminished immune response.
Wounds like those caused by arrows, knives, and other relatively slow-moving objects primarily cause injury by:
direct contact.
Damage to the body that is limited to the pathway of a projectile is known as:
direct injury.
Virtually all external bleeding encountered in the field can be controlled by:
direct pressure.
A weapon of mass destruction that is constructed to disperse radiologic contamination is best defined as a:
dirty bomb.
The bullet's exchange of energy with the body leaves various tissues:
disrupted and injured.
You are preparing to transport a young female patient who was assaulted, raped, and left unresponsive in her apartment, where she lives alone. You are preparing to transport the patient when the family shows up. They tell you that they will bring with them to the hospital the clothing that you had to remove during your assessment. By not keeping that clothing in your custody, you have:
disrupted the chain of evidence.
On arrival, the incident commander (IC) will:
do a windshield survey of the scene.
In the case of sexual assault, the paramedic should _____
do all of the above.
In a single-car accident a vehicle collides with a tree near the roadway; during your collision analysis, a lack of skid marks would indicate that the:
driver was prevented from braking.
The injury in which abdominal organs protrude through a large, deep laceration of the abdominal wall is best described as:
evisceration.
It is a hot, sunny summer day with an outdoor temperature in the 90s. You and your partner are dispatched to a residence for a female in her 40s. Her husband told the dispatcher that he came home from work to find her in bed. She moves when he arouses her but acts drugged. On your arrival you verify the safety of the scene and are led by the frantic husband into the house toward a bedroom. As you move through the house you note that the temperature indoors is probably in the 60s; the husband tells you that since his wife started her new hypothyroid medication she is always hot and turns down the thermostat when he leaves in the morning. His wife is lying on the bed, on top of thebedspread, wrapped in a towel with her hair still wet from an apparent shower. As you approach the bed you call her name and she mouths a few unintelligible syllables without opening her eyes. You move to check her pulse and note that she is pale and her skin feels cold and firm. She has a radial pulse of 58 and a respiratory rate of 8. You are unable to obtain a blood pressure, and her pupils are dilated. You ask her husband if she has any medical history, and he tells you that she is only being treated for the hypothyroidism. You place the patient on high-flow oxygen and an ECG monitor, where you note that she has atrial fibrillation and J waves. Knowing you are only 10 minutes from thehospital, your preliminary treatment plan will include:
drying and covering with blankets, applying oxygen as needed, elevating the ambulance interior temperature, assessing glucose level, providing rapid but gentle transport, and initiating an IV.
The higher standard expected of ambulance drivers is known as:
due regard.
When a female's egg becomes fertilized but implants in a location outside of the uterus, it is known as a(n):
ectopic pregnancy.
A horizontal current that flows around large objects, creating an upstream flow around the downside of the object that in some cases can move a victim or rescuers toward the shore edge best defines:
eddies.
Decreasing P, QRS, and T amplitude with every other cardiac cycle seen in the 12-lead ECG of a person with a significant MOI for chest trauma and resulting pericardial tamponade may be:
electrical alternans.
Of the following list, which concept does not apply to the communications component of an EMS system?
emergency medical system slang
Diabetes mellitus is more common in the elderly with a greater possibility of hyperglycemia because of changes in the:
endocrine system.
A worker who has entered a grain elevator and then has fallen into the grain and is completely buried has become a victim of:
engulfment.
If severe hemorrhage continues and hypotension occurs, the reduced blood pressure at the hemorrhage site subsequently limits blood flow and the rate of hemorrhage, and:
enhances clot development.
An athlete who twisted his leg completing a long jump now displays signs of potentially severe muscle, tendon, and ligament soft tissue injury to his left thigh. The patient complains of significant pain at the knee and hip, and there is inflammation and swelling at these joints. You suspect at least a Grade II sprain of the knee and the hip. The athlete's coach is advising him to walk it off, which your patient seems to be trying to convince himself is the right thing to do. He seems to be about to get up to comply with what his coach wants. You should first:
ensure the patient places no additional stress on the injured leg.
When providing emergency care to the pregnant victim, you should place special emphasis on:
ensuring an adequate airway, ventilation, and circulation.
The outermost layer of the skin is the:
epidermis.
Myocardial aneurysm or rupture occurs almost exclusively in:
extreme blunt thoracic trauma.
You are en route to the scene of a bow-hunting accident where a 32-year-old male was accidently shot in the upper leg by his 14-year-old son. While mentally reviewing possible injuries and the equipment that will most likely assist you initially, you understand that:
extremity injuries are rarely fatal unless a major blood vessel is involved, so you need to be prepared for bleeding control.
The most common cause of trauma resulting in activation of the EMS system is:
falls.
External venous hemorrhage from small vessels can almost always be, and is preferred to be, controlledby:
firmly bandaging a dressing in place
When communicating patient information to the hospital, it is helpful to:
follow the standard reporting format, emphasizing the information most relevant to your patient.
Lacerations that run perpendicular to the skin's tension lines tend to:
gape open.
In responding to a reported terror incident involving the release of a biological agent, the least amount of personal protective equipment should be:
gloves and a well-fitted HEPA filter mask.
What area does a safety officer (SO) not monitor for safety compliance?
government agencies
You are managing a patient with an anterior knee dislocation with neurovascular compromise following a bicycle wreck. You should first:
have another care provider immobilize the femur firmly in position.
As the hazmat entry team completes the decontamination process, they doff their personal protective equipment and move to the cold zone for you to conduct their post-entry evaluation. Because the hazmat incident is occurring in July, your greatest concern for the entry team members is:
heat stress.
The basic goal of splinting is to:
help reduce or eliminate movement of an injured extremity.
One of the considerations in using an air ambulance that could be burdensome to the family is the:
high cost of the transport.
When approaching a scene at night with a flashlight, you should:
hold the light out to your side.
The process of maintaining constant suitable conditions within the body is called:
homeostasis.
Capillary fluids are pushed into the interstitial spaces by:
hydrostatic pressure.
Because of a loss of elasticity and hardening of arteries:
hypertension is common among the elderly.
The wall of the left ventricle may thicken and enlarge by as much as 25 percent in an elderly patient, a process called:
hypertrophy.
When a person's core body temperature drops below 95°F, they are considered to be:
hypothermic.
When identifying a patient's level of consciousness, you should at a minimum:
identify the patient's level of consciousness using the AVPU mnemonic.
You are treating the victim of a knife wound to the chest who is displaying hypotension, muffled heartsounds, and jugular venous distention. Field treatment of this victim should include:
immediate and rapid transport to the ED.
You and your partner have been dispatched by law enforcement to a report of several residents who have been exposed to the hazardous substances inside a confirmed meth lab. You should:
immediately don protective equipment before making patient contact.
What is an echo procedure?
immediately repeating each transmission received during radio communications to confirm accurate reception and understanding.
You are acting as transportation supervisor at a MCI. One of your first actions should be to:
implement a patient-tracking system.
The flexibility of the IMS is based on:
implementation of only those areas necessary to address the incident.
In the public health care model, the act of placing a particular intervention into practice is called:
implementation.
The transition between decompensated and irreversible shock is:
impossible to differentiate using signs and symptoms.
Morbidity and mortality for various abdominal injuries has been on the decline due to:
improved surgical and critical care techniques.
You are taking the history of a morbidly obese patient who tells you he has chronic hypoxemia. This is likely a result of:
inadequate ventilation.
Devices such as napalm that are designed to induce damage and injury through combustion are said tobe:
incendiary.
The main objective of terrorist acts is to:
incite fear in the public.
The increased intracranial pressure associated with HACE is attributable to:
increased fluid in the brain from being at a high altitude that one is not acclimated for.
Operation of a helicopter at the scene of an emergency:
increases the overall risk to rescue personnel.
The DOT KKK 1822F specs standardize the way ambulances look and also:
influence safety standards.
Care must be exercised when considering further competition after a sports injury because:
injuries that present with minimal pain may be significantly worsened by the stress of further competition.
Most motor vehicle accident deaths that are attributable to thoracic trauma result from:
injury to the heart and great vessels.
When an aircraft is using instruments to fly, this condition is known as:
instrument flight rules.
Your auto accident victim is alert and oriented, has no obvious injuries other than a tender abdomen, and displays vital signs of pulse 100, respirations 24/deep, and blood pressure 110/84; her skin is cool, slightly pale, and clammy. She appears anxious and restless, and she complains of being thirsty. Yoususpect:
internal bleeding.
Fasciculations are a symptom of nerve agent exposure best described as:
involuntary muscle contractions.
In trauma, the incidence of musculoskeletal injury is second only to that of:
soft tissue injuries.
You arrive on scene of a traffic accident in which a passenger car has struck and severed a utility pole. There are lines down on the ground but not actually touching the vehicle. You should:
isolate and stay away from the vehicle and wait for the utility department to declare that the electrical hazard is mitigated.
A trained rescue team has just placed shoring in a trench to protect an injured worker who is buried to his waist in soil and clay. Before placing the rescue shoring, the most appropriate action would be:
isolating the area from bystanders and other workers until the area around the trench is made safe.
Blood loss in the chest, abdomen, and pelvis can continue until:
it clots or is surgically repaired.
Following a nuclear explosion, a patient presents with nausea, fatigue, and malaise. You should:
keep the patient warm and hydrated.
A patient with cystitis asks if it will just go away if left alone. The paramedic responds that if left untreated cystitis can progress to involve the:
kidneys.
An injury to the lower chest that lacerates the diaphragm is unlikely to also injure the:
kidneys.
A person who cannot understand spoken or written communication has a disorder involving:
language.
The process by which alkali burns disrupt the cell wall and damage the tissues is known as:
liquefaction necrosis.
You respond to a call for a 13-year-old female sexual assault victim and transport the patient to a trauma center. You should:
list any evidence turned over to hospital staff on the patient care report.
The risk of becoming a victim to a heat-related disorder can be most practically reduced by:
maintaining an adequate fluid intake.
Evacuation and/or relocation of uninjured victims of a disaster should be conducted with the primary goal of:
maintaining social groupings.
A 22-year-old female patient's presentation is consistent with pelvic inflammatory disease. The patient is not hypoxic by pulse ox and shows no signs of sepsis or shock. The primary goal of the prehospital management of this patient is to:
make the patient as comfortable as possible.
Routine detailed shift checks can minimize the issues associated with risk management by:
making it less likely that equipment will fail.
Drugs that prevent thrombosis or emboli in patients with heart or vascular disease:
may prolong active external hemorrhage.
You respond to a call for a patient presenting with severe abdominal pain that you field diagnose as ovarian cysts. The patient's pulse ox is 98 percent. Your management should consist of:
providing supportive care and analgesia to manage the patient's pain.
The management of most sexual assault cases centers around:
psychological and emotional support.
The most common and serious explosion injuries are:
pulmonary injuries.
Unwanted sexual contact that includes penile penetration of the genitalia or rectum is called:
rape.
Supplemental restraint systems (SRS) produce a cushion to absorb the energy exchange of:
rapid deceleration.
The most important step in any treatment plan for victims suspected of internal hemorrhage is:
rapid transport with monitoring for signs and symptoms of shock.
Musculoskeletal injuries to the upper extremities:
rarely threaten life to the same degree that lower extremity injuries often do.
The most significant variable in a fall is:
rate of deceleration
Assessment of a trauma victim whenever you note a change in condition or you perform a significant intervention is called:
reassessment.
You are examining a patient who was involved in a motor vehicle collision and has been extracted from the vehicle and immobilized. In palpating the first quadrant of the patient's abdomen, you notice a pain response as you release the pressure of your hand. This is:
rebound tenderness.
Awareness training imparts enough knowledge about rescue operations to EMS personnel that they can:
recognize hazards and realize the need for additional expertise at the scene.
If a patient has a severe cognitive disability, you may need to:
rely on others to obtain the chief complaint and history.
During the disentanglement process of any technical rescue, the paramedic has all the following responsibilities except:
remaining with the patient even if the paramedic cannot fulfill the requirements of the operation due to his or her own limitations.
Your 24-year-old male patient was riding an ATV through the woods and impaled himself on a dead tree branch. The 1" in diameter branch went in through his mouth and out his right cheek before breaking from the tree. On your arrival, the patient is bleeding heavily into his mouth and is struggling to breathe unless he is leaning forward. In order to gain control of his bleeding and thereby his airway, you should:
remove the object.
A patient has been exposed to some sort of pulmonary agent and is coughing, wheezing, and exhibiting inflammation and pulmonary edema. After ensuring your safety and donning necessary PPE, you first need to :
remove the patient from the environment.
As you are performing a pre-entry physical on the assigned entry team, you assess a team member who is exhibiting abnormal vital signs that are outside of the allowable parameters of the department's SOPs. You should immediately:
report your findings to either the safety officer or the incident commander.
Vehicle collisions in which there is a personal injury or over $1,000 in damage are called:
reportable collisions.
If you feel that a victim, in the custody of police, may be armed, you should:
request that the victim be searched.
Most open soft tissue injuries:
require simple care and limited suturing.
As an awareness level responder to hazardous materials incidents, you respond to an incident involving the release of a corrosive substance from a derailed train tanker car. Your first priority should be:
rescuer safety.
The ability to muster additional crews when all ambulances are on call or when a system's resources are taxed by a multiple-casualty incident is called:
reserve capacity.
During the post-entry physical, you discover that an entry team member has an altered level of consciousness, hypotension, and tachycardia. You should:
restrict the team member from being allowed to reenter the hot zone.
A large region of cortical disruption may cause confusion and affect the patient's mental status, such as the patient forgetting the circumstances leading up (before) the incident itself, which is called:
retrograde amnesia.
When treating an open chest wound resulting from a gunshot, the occlusive dressing should be:
sealed on 3 sides.
Protection against water movement through the skin is provided by:
sebum.
It is not a function of the vagina to:
secrete the hormones estrogen and progesterone.
Which is a primary function of the FCC?
secure radio communications.
Loss of distal circulation due to an acute injury that may be prone to compartment syndrome:
seldom occurs in the field with proper bandaging.
During the rapid trauma assessment for a patient with an extremity fracture or muscular injury, you should assess the distal pulses, capillary refill, temperature, muscle tone, and, if the patient is conscious:
sensation and motor function.
A 33-year-old female patient presents with nontraumatic vaginal bleeding that is apparently the result of menorrhagia. The paramedic should be on the alert for:
shock.
The ultimate killer of all trauma and medical patients is:
shock.
You clock in in the morning and are immediately dispatched to the scene of a domestic dispute by law enforcement after a man's wife, who fled the scene the previous night, stabbed a 52-year-old male in the abdomen. You are directed to the man lying in the kitchen in a supine position, with a distended abdomen and large kitchen knife still in place. The greatest danger for this patient is:
shock.
When assessing a patient you suspect of being abused by her domestic partner, you must:
show a willingness to hear what the patient has to say.
In accordance with Henry's law, as a diver descends deeper into the water:
significantly more nitrogen is dissolved in the blood.
A product created from the fermentation of stored crops that poses a particular inhalation risk to paramedics is:
silo gas.
The problem of elder abuse is expected to grow alone with the:
size of the elder population.
As a paramedic trained to the hazardous materials awareness level, you should be able to:
size up the incident, assess the toxicologic risk, and activate the incident management system.
Storing salts needed for metabolism is primarily the job of the:
skeleton.
Sources of musculoskeletal injuries do not include:
smoking.
You respond to a call for a patient in hospice care. The first thing you must do is:
speak to the home health care worker.
In addition to trauma centers, certain medical facilities offer very specific procedures or equipment for the treatment of trauma victims; these hospitals are designated as:
specialty centers.
Extreme exertion, fatigue, and direct trauma commonly contribute to:
sports injuries.
While you are responding to a motor vehicle accident involving a tanker truck, the dispatcher notifies you that passing motorists are reporting that there are numerous bystanders experiencing acute respiratory distress. With this information, you should:
stage at a safe distance off site, uphill and upwind of the incident, and attempt to view the incident scene using binoculars.
You are approaching the scene of a night-time incident involving the release of an unknown chemical from a train tank car. Several people were exposed who are complaining of burning to the eyes, respiratory tract, and skin. You should:
stage initially at least 2,000 feet away, uphill and upwind, until the product can be identified.
Once at the burn patient, your initial quick survey should be to:
stop the burning process.
An injury that occurs when muscle fibers are overstretched by forces that exceed the fiber's strength is called a:
strain.
A particularly serious finding when evaluating a burn victim's airway would be:
stridor.
Tertiary blast injuries can result from:
structural building collapse.
Sweat is secreted onto the skin's surface by:
sudoriferous glands.
The collection of data to identify the existence, significance, and characteristics of disease is:
surveillance.
The only way to recognize which trauma care practices benefit patients is:
surveillance.
You have gained access to the patient and are preparing to initiate care with the goal of providing psychological support to the patient throughout the operation. As you establish rapport with the patient, you should consider all of the following tips except:
telling the patient that rescue is doubtful.
A laceration that transects tension lines:
tends to pull open.
To be in hospice, a patient must be:
terminally ill.
Expert information regarding diving emergencies can be provided by:
the Divers Alert Network.
Protocols and procedures for the use of air medical support are determined by:
the EMS system.
Structures of all types can contain hazardous substances. A visual recognition aid used to identify hazardous materials within a fixed facility is:
the NFPA 704 System.
Helicopter transport of patients was responsible for not only transport but also improved treatment of wounded soldiers due to in-flight care during:
the Vietnam War.
Signs and symptoms that a patient exhibits shortly after an exposure to a hazardous material are best described as:
the acute effects of a hazardous material.
In considering which type of personal protective equipment to use at a hazmat incident, you should base your decision on:
the chemical or substance involved.
EMS systems can actively participate in trauma prevention by following the example of:
the fire service.
In the ICS, the command staff report to:
the incident commander.
You and your partner are responding to an explosion at a large office building that appears to be a terrorist incident. When searching the area for victims, you should be aware of:
the likelihood of secondary explosions.
Submersion of the face in cold water can trigger:
the mammalian reflex.
Within the basic communication model, semantics refer to:
the meaning of words.
As you approach a scene, you note a male patient lying unconscious next to a stepladder that has overturned. Bystanders indicate that none of them actually saw what happened. You determine to proceed as if the patient has fallen from the stepladder. The fall would then be considered:
the mechanism of injury.
The suspicion of blunt abdominal trauma should be based primarily on:
the mechanism of injury.
Which of the following is not usually part of the EMS response communication sequence?
the patient calls the medical direction physician to ask for help
Of the following personnel the paramedic may communicate with during a typical shift, which one would be least likely to be part of an EMS run?
the police supervisor
Primary blast injuries most commonly result from superheated gases created by the instantaneous combustion of the explosive agent, known as:
the pressure wave.
Extrication is best defined as:
the process of physically removing a patient from an entrapment.
The term "force" as it relates to penetrating injuries can be practically defined as:
the rate of deceleration of a penetrating object on impact.
When approaching a motorcycle collision, it is important to remember that:
the rider is often ejected and may not be near the vehicle.
You respond to a call for a patient complaining of vaginal bleeding with no known cause. Management of nontraumatic vaginal bleeding is dependent on:
the severity of the situation and the patient's status.
The potential for injury decreases as:
the time of deceleration increases.
A standard set of data is collected by regional trauma centers and analyzed to describe the types of patients and injuries that EMS responds to. This is used to determine how well the system is performing and to identify factors that may either lessen or increase patient survival. This process is referred to as:
the trauma registry.
In the case of topical absorption, a toxic substance has entered the body:
through the skin.
An EMS agency has an ALS system that responds when requested to assist on ALS calls. The paramedic unit arrives within 8 minutes of the call and assists the first responders. This type of system is called a:
tiered response system.
You are treating a late-term, pregnant trauma victim who requires spinal immobilization. Whentransporting, the backboard should be:
tilted 15 degrees.
You notice that your patient with a tracheostomy has an overinflated cuff and reduce the cuff pressure. This patient may have:
tissue necrosis.
Your ambulance has just arrived at a hazmat scene where incident command has established hot, warm, and cold zones. Both you and your partner are hazmat awareness level trained. Your most likely duty assignment will be:
to perform triage and treatment in the cold zone.
A small surgical opening in the anterior neck, below the laryngeal structures, by which the patient draws air into the lungs and exhales, is known as a:
tracheostomy.
A dislocation at the sternoclavicular joint should be immobilized with a:
traction splint.
One of the most rapidly expanding areas of air medical transport is:
transfer of patients between health care facilities.
You are dispatched to treat the 32-year-old victim of a robbery, and you are cleared to proceed to the site by law enforcement. On arrival you are shown to the victim, who is sitting in the back of a cruiser, holding a gauze pad to her right cheek; she tells you that after she surrendered her purse at knifepoint the perpetrator lacerated her cheek to "teach her a lesson." Removal of the bandage reveals a 1" long laceration that has almost completely stopped hemorrhaging. She denies any other injuries. After properly dressing the wound, you should:
transport her to the nearest ED.
Your patient was doing body work on his car when his sander slipped and left a deep abrasion 2" X 3" on his upper thigh. There is no significant bleeding or other related injury, so after bandaging the wound you should:
transport him to the nearest ED.
The leading killer of persons between the ages of 1 and 44 is:
trauma.
During your assessment, whenever CO poisoning is suspected, consider the administration of hydroxocobalamin to:
treat cyanide poisoning.
If you are caring for a patient who you suspect was sexually abused, you should:
treat the patient and the situation as a crime scene.
Triage personnel report directly to the:
triage unit leader.
You and your partner have arrived on the scene of a motor vehicle crash involving a hybrid electric vehicle. The easiest way for you to inactivate the high-voltage component is to:
turn the ignition off and remove the keys.
There has been a dramatic increase in violence among youth in the past:
twenty years.
Early in vehicle rescue involving multiple vehicles, set up:
two circles of operation, one for the actual rescue and one for staging.
Initial information you receive from emergency medical responders and EMTs about the patient's condition and the care he received should be:
used in developing your initial patient impression and then formulating a patient management plan.
The majority of the body's blood volume is located in the:
venous system.
You must carefully limit radio transmission of any information that might identify a particular patient. This includes such things as name, race, financial status, and similar descriptors. Transmission of such information does not enhance patient care and will most likely:
violate patient confidentiality laws including the Health Insurance Portability and Accountability Act.
The female external genitalia are known collectively as the _____
vulva.
Body armor has a higher level of performance:
when it is dry.
Pressure waves from an explosion may concentrate energy and cause areas of increased mortality at a further distance than expected from the epicenter:
when the explosion occurs in a confined space.
It is not unusual for endometriosis to be diagnosed:
when the patient is being evaluated for infertility.
During a roadside emergency, when approaching the vehicle from the rear, you should not move forward of the C post until:
you are sure there are no threats in the rear seat.
You are communicating with a helicopter pilot on final approach and see that a vehicle has entered the landing zone area and is driving diagonally across it. What would be best to communicate to the pilot?
"Abort landing!"
Your female patient was forced to participate in oral-genital sex by an assailant. During your assessment and management, which of the following questions must you answer "No" should the patient ask?
"Can I brush my teeth before we leave?"
You respond to a call for a 19-year-old female patient who was sexually assaulted at a college party where she was drinking. She appears to be slightly intoxicated. She is wearing high heels, a short skirt, and a low-cut halter top. What is an appropriate question to ask this patient?
"Can you tell me where you are injured?"
You are treating a patient who was just sexually assaulted. Which of the following statements made by this patient is most likely to be true?
"I know who did this to me."
Which of the following statements by a female patient may indicate that she was slipped a date rape drug?
"I was at dinner last night with him, and that's the last thing I remember."
Your patient has a body mass index of 42 kg/m2. In completing the PCR, which medical expression would be an appropriate way to document that the patient is overweight?
"The patient is morbidly obese."
You are gathering a past medical history of a patient who you suspect, on the basis of physical findings and clues you have noticed on scene, was sexually assaulted by herboyfriend, who fled the scene. During this process, which of the following questions should you ask?
"Were you sexually assaulted by him?"
If a patient reports vaginal discharge and bleeding, what is an appropriate follow-up question?
"What is the amount and frequency of the bleeding?"
You are on scene with an elderly patient who lives alone and is complaining of dizziness and weakness. The patient also states that she has had a depressed appetite for the past week. What should you say to the patient if she is considering not getting transported now?
"Your complaints are common for an elderly person, but you should still be seen at the hospital to make sure everything is okay."
Which of the following patients may have trauma to abdominal organs? 1. A 30-year-old construction worker who fell from a second-story roof but managed to land on his feet 2. A 17-year-old male with a gunshot wound to the right buttock 3. A 50-year-old male with a stab wound 4 cm inferior to the right scapula 4. A 45-year-old female restrained driver of an SUV with a moderate-speed frontal impact
1, 2, 3, 4
Your patient is a 17-year-old male driver of a vehicle that received a lateral impact at the driver's side door. There are no side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door. Your patient is complaining of left shoulder pain and pain "in his left side." He has a contusion on the left shoulder and deformity of the left clavicle. He has erythema over the left lateral thorax from ribs 6 through 12 with crepitus on palpation. Which of the following injuries should you suspect? 1. Blunt trauma to the spleen 2. Blunt trauma to the liver 3. Penetrating trauma to the spleen 4. Penetrating trauma to the liver 5. Left pneumothorax 6. Fracture of the left clavicle
1, 5, 6
What demographic group has the highest arrest rates for homicide, rape, robbery, and aggravatedassault?
15- to 34-year-olds
You are completing a rapid trauma assessment of a fall victim and suspect a pelvic fracture. What amount of blood loss would you estimate to be involved?
2,000 mL
Approximately what percentage of EMS calls involve the elderly?
>35 percent
What has been defined as the best-known form of dementia?
Alzheimer's
You are called to the home of a chronic home care patient with a VAD and a mechanical ventilator attached to a trach tube. The ventilator is displaying a message that reads "vent inoperative-service required." The patient is cyanotic and bradycardic. Which of these will be required for you to be able to ventilate a patient through the trach tube?
Bag-valve device without the mask
Ascending from a dive too rapidly can create gas bubbles in the blood and tissues; these gas bubbles can then grow in size as the pressure is reduced, in accordance with:
Boyle's law.
What results from penetrating injury that affects one side of the cord?
Brown-Sequard syndrome
The acronym that will help you remember the functional areas of NIMS is:
C-FLOP
While monitoring the victim of a brain injury during the secondary assessment, you should be especially watchful for:
Cushing's triad.
Which items are initially considered Step One as part of the CDC Guidelines for Field Triage of Injured Patients?
GCS, blood pressure, and respiratory rate
Major diving emergencies while at the bottom of the dive often involve nitrogen narcosis, a state of stupor, commonly called "raptures of the deep." This is due to the effect of nitrogen on cerebral function. What gas law explains the occurrence of nitrogen narcosis?
Henry's law
Which illness is caused by an increase in pulmonary pressure and hypertension precipitated by changes in blood flow that occur at high altitudes?
High-altitude pulmonary edema
A 34-year-old male patient received a small-caliber gunshot wound to the right anterior chest at the third intercostal on the midclavicular line. He is conscious and well oriented and complaining of pain at the wound site and difficulty breathing. His respirations are 22 and seem shallow, his radial pulse is 110, and his SpO2 is 92. He has reduced breath sounds on his right side, but percussion of the chest seems equal on both sides. What would your initial treatment include?
High-flow oxygen and application of a one-way valve dressing
What treatment should be performed in the prehospital setting for divers who display signs of dysbarism, prior to placement in a hyperbaric chamber?
High-flow oxygen therapy
You are dispatched to the scene of an industrial accident for a 42-year-old dockworker pinned between asemi-trailer wall and a forklift. As you pull up to the dock, you note that the victim has been extricated by his coworkers and placed in a supine position with his legs drawn up. He is alert, well oriented, pale, and diaphoretic with a thready radial pulse of 120 and clear respirations of 26; his abdomen is distended but he does not appear to be in severe pain as long as his knees are bent. What would you include in your initial treatment plan for this victim?
High-flow oxygen, rapid spinal immobilization, rapid transport to the highest-level trauma center available, initiate large-bore IVs en route, and reassess at 5-minute intervals.
Which of the following is NOT a typical indication of exposure to a chemical nerve agent?
Hot, dry skin
Which states in the Northeast United States have large rural populations?
Maine, New Hampshire, and Vermont
Which femur fracture is most likely to be immobilized with a traction splint?
Mid-shaft femur fracture
What are the signs of the release of epinephrine and norepinephrine in a patient?
Nervousness, marginally cool skin, and slight pallor
Which set of vital signs MOST indicates that your patient is beginning to enter hemorrhagic shock?
P-98; BP-102/86; R-16
Which division of incident command support is responsible for ensuring that resource sharing between involved departments is fulfilled?
Planning/intelligence section
Which population has the highest risk for soft tissue injuries?
School-age children
Which of the following is not an effect produced by pericardial tamponade?
Strong, bounding pulse
Trauma-related hypothermia occurs in relation to the:
fight-or-flight response.
Your high-altitude HEMS team is dispatched to the 14,000-foot level of the West Buttress route of Mount McKinley for a climber who fell unconscious could not be awakened. As your team proceeds to thelocation, you consider that the likely cause is:
high-altitude cerebral edema (HACE).
Body armor offers little or no protection against:
high-velocity bullets.
Hazardous terrain that consists of steep slopes that may have rocks or boulders as obstructions is knownas:
low-angle.
A patient who has undergone field decontamination prior to receiving medical treatment is best described as a:
semi-decontaminated patient requiring a more invasive decon process.
Before approaching a potentially violent scene, you should:
stop, listen, and observe for signs of danger.