Emergency medical technician crash course by Chris Coughlin, Ph.D. Practice test

Continuous positive airway pressure (CPAP) can reduce respiratory distress by: A. helping to keep the alveoli open. B. stimulating sleep apnea. C. relieving foreign body airway obstruction. D. increasing the need for intubation.

(A) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:CPAP helps to keep the alveoli open. CPAP is a treatment for sleep apnea and can help avoid intubation. CPAP does not relieve FBAO. See chapter 9 for additional information.

Which of the following is true during inhalation of a spontaneously breathing patient? A. There is a drop in pressure within the thorax. B. There is an increase in pressure within the thorax. C. Air is being pushed into the lungs. D. The diaphragm and intercostal muscles are relaxed.

(A) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:During inhalation of a spontaneously breathing patient, the diaphragm and intercostal muscles are contracting. There is a drop in pressure within the thorax and air is pulled in, not pushed. See chapter 7 for additional information.

Your patient is a construction worker who fell from a residential rooftop. He is responsive to pain. Breaths are shallow and irregular. You should: A. provide artificial ventilations with a bag-mask device and high flow oxygen. B. obtain an SaO2 reading before determining if oxygen is necessary. C. apply a nonrebreather mask with high flow oxygen. D. apply a nasal cannula and reassess the patient.

(A) ·Topic:Airway and Ventilation ·Rationale:This patient has a significant mechanism of injury, decreased LOC, and shallow, irregular breaths. BVM ventilations are indicated. Do not withhold ventilations to obtain a pulse oximeter reading. The NRB and nasal cannula are inappropriate for patients with inadequate ventilations. See chapters 9 and 12 for additional information.

You are dispatched for a possible CVA. Upon arrival, you determine the patient is responsive to painful stimuli. Which of the following should be assessed first for this patient? A. airway. B. blood pressure. C. pulses. D. skin.

(A) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Assessment ·Rationale:Responsive patients should be assessed using the ABC sequence during the primary assessment. Airway should be assessed before pulses, skin, or blood pressure. Circulation is not assessed first (CAB sequence) because responsive patients do not need CPR. See chapter 12 for additional information.

You are caring for an apneic patient with a suspected overdose. You have loaded the patient into the ambulance and entered the patient compartment. You should first: A. put on your seat belt. B. reassess vital signs. C. assess the patient's SaO2. D. contact medical direction.

(A) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:Personal safety is the EMT's first priority. See chapter 3 for additional information.

Nerve agents and choking agents are examples of: A. chemical agents. B. nuclear weapons. C. biological agents. D. radiological weapons.

(A) ·Topic:EMS Operations ·Rationale:Nerve agents and choking agents are examples of chemical agents. Biological agents are intended to cause disease, not choking. Nuclear and radiological agents are intended to cause injury by blast, radiation, or thermal burns. See chapter 38 for additional information.

You are called for a 6-month-old infant with respiratory distress. Which of the following is true about patients in this age group? A. infants are obligate nose breathers. B. infants require forceful ventilations with the BVM. C. infants are more resistant to hypoxia than adults. D. infants rarely develop bradycardia due to hypoxia.

(A) ·Topic:Medical, OB, GYN ·Emphasis:Pediatrics ·Rationale:Infants typically breathe through their nose. Infants to not require forceful ventilations with a BVM and are more susceptible to hypoxia than adults. Hypoxia is a common cause of bradycardia in infants. See chapter 31 for additional information.

Which of the following signs of hypoxia is more commonly found in pediatric patients? A. seesaw respirations B. cyanosis C. tachypnea D. altered level of consciousness

(A) ·Topic:Medical, OB, GYN ·Emphasis:Pediatrics ·Rationale:Seesaw breathing is more common in pediatric patients. Cyanosis, tachypnea, and altered LOC may be seen in hypoxic patients of any age. See chapter 9 for additional information.

You are transporting a pregnant patient from an urgent care center to a high-risk OB facility. The transferring physician tells you the patient may have an abruptio placenta. This means: A. the placenta is prematurely separating from the uterine wall. B. the amniotic sac is ruptured and leaking amniotic fluid. C. the patient is going into labor prematurely. D. the placenta is covering the cervical opening.

(A) ·Topic:Medical, OB, GYN ·Rationale:Abruptio placenta is the premature separation of the placenta from the uterine wall. Placenta previa is when the placenta partially of completely covers the cervical opening. See chapter 30 for additional information.

A 19-year-old female is found unconscious in her apartment living room. While surveying the apartment, your partner yells from the patient's bedroom "she has an SVN machine in here". This suggests the patient has a history of: A. respiratory problems. B. heart disease. C. drug abuse. D. sleep apnea.

(A) ·Topic:Medical, OB, GYN ·Rationale:An SVN machine is used to nebulize bronchodilator medications. This indicates a probable history of respiratory problems. See chapter 11 for additional information.

When caring for a patient with a behavioral emergency, remember: A. the behavior may be caused by a physiological condition. B. treatment is not needed if there are no physiological abnormalities. C. any conscious patient can refuse treatment and transport. D. the patient must be restrained if he/she verbalizes suicidal thoughts.

(A) ·Topic:Medical, OB, GYN ·Rationale:Many behavioral emergencies are caused by a physiological condition. Behavioral patients frequently require further evaluation and treatment. Patients must be competent to refuse treatment, not just conscious. Patient restraint is not automatic due to verbalization of suicidal thoughts. See chapter 21 for additional information.

You are caring for a 22-year-old female who complains of respiratory distress after exercising. She is alert, speaking full sentences, and has a persistent cough. She is most likely experiencing: A. Respiratory distress with adequate breathing. B. Respiratory distress with inadequate breathing. C. Respiratory paralysis. D. Respiratory arrest.

(A) ·Topic:Medical, OB, GYN ·Rationale:The patient is alert and speaking full sentences. These signs indicate the patient is breathing adequately. Respiratory paralysis and respiratory arrest are not possible because the patient is alert and speaking. See chapters 9 and 14 for additional information.

Life-threatening bleeding should be found and treated during the: A. Primary assessment. B. Scene size up. C. Secondary assessment. D. Patient history.

(A) ·Topic:Trauma ·Emphasis:Assessment ·Rationale:Life-threatening bleeding should be found and managed during the primary assessment. Interventions, such as control of bleeding, are not part of the scene size up. Significant bleeding should be addressed before the secondary assessment and the patient history. See chapter 12 for additional information.

You are called for a drowning victim at a family barbecue. Upon arrival, two family members approach you yelling, swearing, and demanding to know what took so long. One of the family members pushes you. You should: A. retreat and request immediate assistance from law enforcement. B. explain to the family where you responded from and why you were delayed. C. order the family members to back off and take you to the patient. D. tell the family that assaulting an EMS provider is a felony.

(A) ·Topic:Trauma ·Emphasis:Safety ·Rationale:Scene safety is the EMT's first priority. This scene is not safe and rescuers should withdraw from the scene until it is. See chapter 3 for additional information.

A 30-year-old male was stabbed in the abdomen during an assault. The knife is impaled in his the right lower abdominal quadrant. It is important to: A. stabilize the knife in place. B. remove the knife and apply direct pressure. C. place the patient on his side. D. transport the patient in a seated position.

(A) ·Topic:Trauma ·Rationale:Impaled objects should be stabilized in place unless they obstruct management of the airway or prevent CPR. This patient would most likely be transported in the Trendelenburg position to assist in the treatment of shock. See chapter 23 for additional information.

Your patient has a partial thickness burn to his anterior chest. It is about the size of the palm of his hand. What is the approximate total body surface area of the burn? A. 1% B. 3% C. 5% D. 7%

(A) ·Topic:Trauma ·Rationale:The palm of a person's hand approximates 1% of his or her total body surface area. See chapter 24 for additional information.

Your patient was injured during an industrial accident. He has an abdominal laceration with internal organs protruding. You should apply: A. a moist, sterile dressing. B. a dry, sterile dressing. C. a tourniquet. D. an ice-pack.

(A) ·Topic:Trauma ·Rationale:The patient has an abdominal evisceration. Proper treatment includes a moist sterile dressing covered by an occlusive dressing. Use of a tourniquet or ice-pack would not be appropriate. See chapter 23 for additional information.

You are caring for a confused and restless 16-year-old female with blunt chest trauma following a single vehicle accident. She complains of dyspnea and orthopnea. You note a reduced tidal volume, cyanosis and tachycardia. Which of the following should be done first? A. Begin positive pressure ventilations. B. Perform a rapid scan. C. Perform a secondary exam. D. Obtain a pulse oximeter (SaO2) reading.

(A) ·Topic:Trauma ·Rationale:The patient has inadequate ventilations. Positive pressure ventilations should be initiated before other assessments are performed. See chapters 9 and 12 for additional information.

The hypoxic respiratory drive works by monitoring: A. oxygen levels. B. carbon dioxide levels. C. blood glucose levels. D. the pulse oximetry (SaO2) reading.

(A) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:The hypoxic drive is the body's backup system to the CO2 drive. It monitors oxygen levels in the blood, not CO2 or blood glucose. The pulse oximeter is an external patient monitoring device. See chapter 9 for additional information.

Which of the following signs of hypoxia is more common in pediatric patients? A. bradycardia B. anxiety C. tachycardia D. restlessness

(A) ·Topic:Airway and Ventilation ·Emphasis:Pediatrics ·Rationale:Bradycardia is a more common sign of hypoxia in pediatric patients. Anxiety, tachycardia, and restlessness are common signs of hypoxia in patients of all ages. See chapters 9 and 31 for additional information.

Which of the following adult patients is breathing adequately? A. a patient with respirations at 16 per minute and equal chest rise and fall. B. a patient with rapid, shallow respirations. C. a patient with shallow respirations at 8 per minute. D. a patient with snoring respirations and cyanosis.

(A) ·Topic:Airway and Ventilation ·Rationale:A normal respiratory rate and equal chest rise are signs of adequate breathing. Shallow respirations, cyanosis, and abnormally fast or slow respirations are signs of inadequate breathing. See chapter 9 for additional information.

While working out at the gym, you witness someone collapse. The patient is apneic with a pulse. You begin performing mouth-to-mask ventilations. What percentage of oxygen is your patient receiving? A. 16% B. 21% C. 44% D. 60%

(A) ·Topic:Airway and Ventilation ·Rationale:Exhaled air contains about 16% oxygen; consequently, a patient receiving mouth to mask ventilations without supplemental oxygen will receive about 16% oxygen. Atmospheric air contains 21% oxygen. See chapter 9 for additional information.

When there are signs and symptoms that your patient is hypoxic, you should: A. Administer oxygen at 15 lpm via nonrebreather mask. B. Always obtain a pulse oximeter reading before administering oxygen. C. Contact medical direction to determine the correct oxygen therapy. D. Assess baseline vitals before determining how oxygen should be administered.

(A) ·Topic:Airway and Ventilation ·Rationale:Patients with signs of hypoxia should be placed on supplemental oxygen. Oxygen administration should not be delayed in order to obtain a pulse oximeter reading when there are signs of hypoxia. See chapter 9 for additional information.

A 36-year-old female presents with a sudden onset of difficulty breathing. She is anxious, has intercostal retractions and nasal flaring. Her respiratory rate is 24 breaths per minute. You do not have a pulse oximeter. You should: A. administer oxygen via nonrebreather mask at 15 lpm. B. withhold oxygen until a pulse oximeter reading is obtained. C. apply a nasal cannula at 4 lpm. D. begin positive pressure ventilations.

(A) ·Topic:Airway and Ventilation ·Rationale:Patients with signs of hypoxia should be placed on supplemental oxygen. The NRB mask is the preferred method of oxygen administration for patients with respiratory distress with adequate breathing and no pulse oximeter reading. See chapter 9 for additional information.

An elderly female reportedly had a severe headache for the last 24 hours. She was recently found unconscious in bed. Her family reports she has a history of hypertension and transient ischemic attacks (TIAs). The patient's current condition is most likely due to: A. a hemorrhagic stroke. B. a cardiac emergency. C. another TIA. D. a migraine headache.

(A) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The patient's signs and symptoms are consistent with a stroke, not a cardiac emergency or migraine headache. Signs of a TIA are similar to a stroke but resolve within 24 hours. See chapter 16 for additional information.

Coordinating efforts through a unified command system at a mass casualty incident will likely: A. reduce duplication of effort and freelancing. B. make communications more difficult. C. delay patient care and transport. D. run efficiently even without prior practice

(A) ·Topic:EMS Operations ·Rationale:A unified command system can reduce duplication of effort and freelancing. It should not complicate communications or delay patient care; however, it does require practice. See chapter 37 for additional information.

Which of the following is true regarding the Emergency Response Guide (ERG): A. The ERG helps identify the evacuation distance for specific hazardous materials. B. The ERG provides off-line medical direction for emergency responders. C. The ERG identifies all additional resources needed for a hazardous materials incident. D. The ERG describes the triage protocol for a hazardous materials incident.

(A) ·Topic:EMS Operations ·Rationale:The ERG will provide the evacuation distance for various hazardous materials. The ERG cannot provide off-line medical direction or identify all necessary resources for a hazardous materials incident. See chapter 36 for additional information.

Which of the following medications is intended to decrease myocardial workload and increase myocardial blood flow? A. Nitroglycerin B. Activated charcoal C. Aspirin D. Epinephrine

(A)·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Nitroglycerin is a vasodilator, so it can increase blood flow to the heart and reduce systemic vascular resistance. Activated charcoal is an adsorbent, aspirin is an anti-platelet aggregate, and epinephrine is a sympathomimetic. See chapter 11 for additional information.

Which of the following findings indicates partial obstruction of the upper airway? A. rales. B. stridor. C. rhonchi. D. wheezes.

(B) ·Topic:Airway and Ventilation ·Rationale:Stridor occurs in the upper airway. Rales, rhonchi and wheezes occur in the lower airway. See chapter 9 for additional information.

Which of the following interventions should be performed first for an unresponsive patient with a suspected spinal cord injury? A. Head-tilt, chin-lift. B. Jaw thrust maneuver. C. Oropharyngeal airway. D. Nasopharyngeal airway.

(B) ·Topic:Airway and Ventilation ·Rationale:The head-tilt, chin-lift is contraindicated for patients with suspected spinal injury. Manual airway techniques, in this case the jaw thrust maneuver, should be performed before inserting a mechanical airway adjunct. See chapter 9 for additional information.

How should you open the airway of an unresponsive patient with an unknown mechanism of injury? A. log roll technique B. jaw-thrust maneuver C. head tilt-chin lift D. tongue-jaw lift

(B) ·Topic:Airway and Ventilation ·Rationale:The jaw-thrust maneuver is indicated for unresponsive patients with a potential spinal injury. The remaining interventions do not facilitate simultaneous opening of the airway with cervical spine precautions. See chapter 12 for additional information.

You are treating a patient with respiratory distress. He has a history of multiple myocardial infarctions. Lung sounds indicate pulmonary edema. You note the patient does NOT have any JVD or pedal edema. The patient is most likely experiencing: A. angina. B. left heart failure. C. right heart failure. D. asthma.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Pulmonary edema indicates possible left heart failure. Pedal edema and JVD indicate possible right heart failure. The patient's presentation is not consistent with angina or asthma. See chapter 15 for additional information.

The left side of the heart receives oxygenated blood from the: A. pulmonary arteries. B. pulmonary veins. C. superior venae cavae. D. inferior venae cavae.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The left side of the heart receives oxygenated blood from the pulmonary veins. The right side of the heart receives deoxygenated blood from the venae cavae. Deoxygenated blood leaves the right heart through the pulmonary arteries. See chapter 7 for additional information.

Which of the following conditions would most likely cause hypovolemic shock? A. a spinal cord injury. B. laceration of the liver. C. insulin shock. D. appendicitis.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The liver is a solid organ and can bleed profusely when injured. Laceration of the liver would likely lead to hypovolemic shock. A spinal cord injury would most likely lead to distributive shock due to vasodilation. Insulin shock is not a common cause of hypovolemia (DKA is). Appendicitis is more likely to lead to septic shock. See chapter 13 for additional information.

Which of the following is considered a normal capillary refill time for infants and children? A. Less than 1 second B. Less than 2 seconds C. Less than 4 seconds D. Less than 6 seconds

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Pediatrics ·Rationale:Normal capillary refill occurs in 2 seconds or less. See chapter 10 for additional information.

You are the first ambulance on the scene of a motor vehicle accident. Your first action upon arrival should be to: A. determine if extrication is needed. B. assess the scene for hazards. C. identify the number of patients. D. ask bystanders what happened.

(B) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:Personal safety is the EMT's first priority. You should assess the scene for hazards first. See chapters 3 and 34 for additional information.

Treatment should begin at a mass casualty incident: A. once law enforcement has collected evidence. B. after triage has been completed. C. after advanced life support providers arrive. D. before additional resources are requested.

(B) ·Topic:EMS Operations ·Rationale:Treatment should not begin until triage has been completed. Treatment should not be delayed for the collection of evidence or the arrival of ALS personnel. Treatment should not begin before additional resources are requested. See chapter 37 for additional information.

Epinephrine stimulates which of the following physiological effects? A. bradypnea. B. tachycardia. C. peripheral vasodilation. D. sedation.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale: Epinephrine stimulates the sympathetic nervous system. This causes tachycardia and peripheral vasoconstriction. It does not have a sedative affect. See chapter 11 for additional information.

Which of the following accurately describes supine hypotensive syndrome? A. compression of the descending aorta by the uterus. B. compression of the inferior vena cava by the uterus. C. compression of the heart by the pericardial sac. D. compression of the lung due to air in the thorax.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Supine hypotensive syndrome occurs when the weight of the fetus and uterus compresses the inferior vena cava. This reduces the return of blood to the heart, reducing cardiac output and blood pressure. See chapter 30 for additional information.

You arrive at a residence for an ill person. A child opens the door and says his dad is locked in the bedroom with his gun. You should: A. ask the child to get his dad. B. retreat to safety and request law enforcement. C. attempt to communicate with the child's father. D. restrain the father and secure any weapons.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Safety ·Rationale:Personal safety is the EMT's first priority. Retreating and requesting law enforcement is the safest course of action. All other options increase the risk to you and/or the child. See chapter 3 for additional information.

You are considering administration of oral glucose to your diabetic patient. This drug is contraindicated when it: A. is not prescribed to the patient. B. poses a significant risk of harm. C. produces undesired effects. D. is likely to relieve the patient's symptoms.

(B) ·Topic:Medical, OB, GYN ·Rationale:Medications are contraindicated when the risks outweigh the potential benefits. Oral glucose does not require a prescription. Some undesired effects (side effects) do not contraindicate use of a drug. See chapter 11 for additional information.

Which of the following physiological responses helps protect the body from overheating: A. shivering. B. peripheral vasodilation. C. peripheral vasoconstriction. D. syncope.

(B) ·Topic:Trauma ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Peripheral vasodilation helps the body dissipate body heat. Peripheral vasoconstriction helps the body conserve body heat. Shivering helps generate body heat. Syncope can result from overheating; it is not a protective mechanism. See chapter 29 for additional information.

The foramen magnum: A. connects the forearm to the humerus. B. is an opening at the base of the skull. C. attaches the patella to the knee joint. D. allows lateral movement of the head.

(B) ·Topic:Trauma ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The foramen magnum is a large opening at the base of the skull that allows the brain and spinal cord to connect. The atlas (C1) and axis (C2) allow for lateral movement of the head. See chapter 7 for additional information.

You are caring for a multi-system trauma patient with possible internal bleeding. Select the correct statement about the rapid scan for a multi-system trauma patient: A. The rapid scan is used to identify all injuries. B. The rapid scan is used to identify life-threatening conditions. C. The rapid scan is another term for the secondary exam. D. The rapid scan is not required on conscious patients.

(B) ·Topic:Trauma ·Emphasis:Assessment ·Rationale:The rapid scan is part of the primary assessment and is meant to identify any lift-threatening conditions not already discovered. It is not used to identify low priority injuries, this should be done during the secondary assessment. Any patient with the potential for life threatening conditions, conscious or unconscious, should receive a rapid scan. See chapter 12 for additional information.

Your patient has severe bleeding to her forearm. If direct pressure does not control the bleeding, you should immediately: A. transport the patient. B. apply a tourniquet. C. apply pressure to the proximal artery. D. replace the blood-soaked dressing.

(B) ·Topic:Trauma ·Rationale:A tourniquet should be applied if bleeding from an extremity is not controlled by direct pressure. Application of a tourniquet should not be delayed to apply arterial pressure or for transport. Blood-soaked dressings should be covered, NOT removed. See chapter 23 for additional information.

Shallow respirations and bradypnea will likely cause: A. easier visibility of chest rise and fall. B. a decrease in minute volume. C. a rise in pulse oximetry (SaO2) readings. D. reduced carbon dioxide levels.

(B) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:Shallow respirations and bradypnea can both contribute to a decrease in minute volume. Neither will improve visibility of chest rise, an increased pulse oximeter reading, or reduced carbon dioxide levels. See chapter 9 for additional information.

A 16-year-old male is unconscious following an assault. When you insert an OPA, the patient begins gagging. You should: A. continue to insert the airway and prepare to suction as needed. B. remove the airway and prepare to suction as needed. C. insert a smaller OPA. D. insert an advanced oral airway.

(B) ·Topic:Airway and Ventilation ·Emphasis:Pediatrics ·Rationale:If a patient gags while inserting an OPA, it should immediately be removed and the airway suctioned as needed. Do not continue inserting the OPA as this will likely induce vomiting. An OPA that is not properly sized should not be used. Advanced airways will also stimulate the patient's gag reflex. See chapter 9 for additional information.

You are ventilating a patient with a stoma. You note air is escaping from the mouth and nose with each breath. You should: A. perform a jaw thrust maneuver. B. manually seal the mouth and nose. C. open the airway using a head tilt-chin lift. D. reduce the tidal volume of each ventilation.

(B) ·Topic:Airway and Ventilation ·Rationale:The mouth and nose should be sealed when ventilating a patient with a stoma to prevent air leak. The jaw thrust and head tilt-chin lift will not prevent air leak. Reducing tidal volume may lead to inadequate ventilations. See chapter 9 for additional information.

An elderly patient reportedly collapsed on a golf course almost 10 minutes ago. You assess her level of consciousness and determine she is unresponsive. Which of the following should you do first: A. open the airway and insert an OPA. B. assess pulse and begin CPR if needed. C. providing ventilations with high flow oxygen. D. attach the AED.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Assessment ·Rationale:Unresponsive patients should be assessed using the CAB sequence to ensure chest compressions are initiated as soon as possible when indicated. The AED should not be applied until cardiac arrest is confirmed. See chapter 13 and the 2010 AHA guidelines for additional information.

You respond to a preschool facility for an ill child. Upon arrival, you find an unresponsive 8-month-old. The infant has a palpable pulse of 50 beats per minute. Your next action should be to: A. open the airway and assess breathing. B. begin chest compressions. C. immediately transport the child. D. attach the AED.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Pediatrics ·Rationale:CPR, beginning with chest compressions, is indicated for unresponsive children with a pulse rate below 60. This should be done before transport. The AED is not indicated for patients with a pulse. For additional information, review the 2010 American Heart Association guidelines.

In unresponsive patients over one year of age, you should palpate the: A. radial pulse B. carotid pulse C. brachial pulse D. femoral pulse

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Rationale:Circulation in unresponsive patients over one year of age should be assessed at the carotid artery. The brachial artery should be used for patients under one year of age. See chapter 12 and 2010 AHA guidelines for additional information.

When a pulse oximeter is available, how should oxygen be administered to a patient experiencing chest pain? A. Administer oxygen to maintain a pulse oximeter reading of 93% or less. B. Administer oxygen to maintain a pulse oximeter reading of at least 94%. C. Always administer oxygen at 15 lpm via nonrebreather mask. D. Contact medical direction to determine the correct oxygen therapy.

(B) ·Topic:Cardiology, Resuscitation, Stroke ·Rationale:Oxygen should be administered as needed to maintain a pulse oximeter of at least 94%. High flow oxygen is no longer recommended for patients with no signs of hypoxia and a pulse oximeter reading of at least 94%. See chapter 9 and the 2010 AHA guidelines for additional information.

You are caring for an unresponsive diabetic patient with deep, rapid respirations. The patient's blood glucose is 480 mg/dL. What is the most likely cause of this patient's hyperventilations? A. This patient is likely hyperventilating due to severe alkalosis. B. This patient is likely hyperventilating due to severe acidosis. C. This patient's hyperventilations will increase CO2 levels in the blood. D. This patient's hyperventilations will rapidly lower the blood glucose level.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:This patient is presenting with signs of DKA and Kussmaul ventilations. The hyperventilations are most likely due to severe acidosis. Hyperventilations will likely reduce CO2 levels. Hyperventilations cannot rapidly lower blood glucose levels. See chapters 7 and 17for additional information.

You are dispatched for a homeless person found unresponsive. You find the patient prone on the sidewalk unresponsive to pain. You should first: A. assess the blood glucose level. B. log roll the patient into a supine position. C. auscultate lung sounds. D. expose the patient and check the back for apparent injuries.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Assessment ·Rationale:The first priority for an unresponsive patient is to initiate CPR if needed. To do this, the patient must be supine. All other options would delay assessment of circulation. See chapter 12 and 2010 AHA guidelines for additional information.

Your 67-year-old patient recently began taking a new medication. He is complaining of a sudden onset of severe respiratory distress. He quickly becomes semi-conscious and unable to follow verbal commands. His pulse oximeter (SaO2) is 89%. You should: A. insert an oropharyngeal airway. B. assist ventilations with a BVM. C. apply a continuous positive airway pressure (CPAP) device. D. apply high-flow oxygen via NRB.

(B) ·Topic:Medical, OB, GYN ·Emphasis:Assessment ·Rationale:The patient has respiratory distress with inadequate breathing. The patient requires positive pressure ventilations. CPAP and an OPA are not appropriate for a semi-conscious patient. See chapter 9 for additional information.

You are conducting a primary assessment on an elderly fall victim who complains of hip pain. While assessing circulation, you should check: A. skin condition, pulse oximetry and capillary refill. B. pulses, external bleeding and skin condition. C. distal pulses in the lower extremities. D. pulses, motor function and sensation.

(B) ·Topic:Trauma ·Emphasis:Assessment ·Rationale:Pulses, bleeding, and skin condition are three components of circulation that should be included in the primary assessment. Pulse oximetry, lower extremities, motor function, and sensation are not part of the circulatory component of the primary assessment. See chapter 12 for additional information.

You are caring for a patient who was ejected during a single vehicle rollover. The patient responds incoherently to verbal commands. You should first: A. perform a secondary assessment. B. determine the pulse rate. C. assess the patient's airway. D. log roll the patient onto a spine board.

(C) ·Topic:Airway and Ventilation ·Emphasis:Patient assessment ·Rationale:Responsive patients should be assessed using the ABC sequence during the primary assessment. Airway should be assessed before performing a secondary exam or placing the patient on a spine board. Circulation is not assessed first (CAB sequence) because responsive patients do not need CPR. See chapter 12 for additional information.

You are dispatched to the local jail for a prisoner found unresponsive in her cell. Her airway is clear. Respirations are rapid and shallow. The pulse oximeter (SaO2) reads 90%. Your first action should be to: A. check the blood glucose level. B. initiate immediate transport. C. begin positive pressure ventilations. D. assess the blood pressure.

(C) ·Topic:Airway and Ventilation ·Rationale:This patient requires artificial ventilations based on inadequate ventilations, a low pulse oximeter, and a decreased LOC. This should take place before assessing the blood glucose, blood pressure, or patient transport. See chapter 12 for additional information.

Which of the following statements about distributive shock is correct? A. Distributive shock is caused by impaired cardiac function. B. Distributive shock is caused by severe bleeding. C. Distributive shock is caused by widespread vasodilation. D. Distributive shock is caused by severe hypoglycemia.

(C) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Distributive shock is caused by systemic vasodilation. Impaired cardiac function leads to cardiogenic shock. Severe bleeding leads to hypovolemic shock. Severe hypoglycemia leads to insulin shock. See chapter 13 for additional information.

Which of the following provides oxygenated blood directly to the heart? A. cerebral arteries. B. carotid arteries. C. coronary arteries. D. femoral arteries.

(C) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The coronary arteries provide oxygenated blood to the heart. The carotid and cerebral arteries provide blood to the brain. The femoral arteries are located in the leg. See chapter 7 for additional information.

To determine if CPR is indicated for an unresponsive patient less than one year of age, you should assess the: A. radial pulse. B. carotid pulse. C. brachial pulse. D. femoral pulse.

(C) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Pediatrics ·Rationale:Pulses should be assessed at the brachial artery for patients less than one year of age. See chapter 12 and 2010 AHA guidelines for additional information.

Shock is caused by: A. hyperactivity of a major organ. B. the body's maintenance of homeostasis. C. inadequate tissue perfusion. D. systemic constriction of the blood vessels.

(C) ·Topic:Cardiology, Resuscitation, Stroke ·Rationale:Shock (hypoperfusion) develops as a result of inadequate tissue perfusion and disrupts the body's homeostasis. It is not typically caused by hyperactivity of an organ or systemic vasoconstriction. See chapter 13 for additional information.

The primary assessment of an adult with chest pain includes: A. Identifying the specific cause of the patient's pain. B. Ensuring the scene is safe. C. Determine the transport priority. D. Reassessing vital signs.

(C) ·Topic:Cardiology,Resuscitation,Stroke ·Emphasis:Assessment ·Rationale:Determining the patient's transport priority is a component of the primary assessment. Scene safety is determined during the scene size up. Determining specifics about the patient's pain and reassessing vitals are done later in the assessment process. See chapter 12 for additional information.

You are first on the scene of a motor vehicle collision involving multiple vehicles. Which of the following should you do first: A. Start the triage process. B. Begin extrication of trapped patients. C. Request additional resources. D. Perform a primary assessment.

(C) ·Topic:EMS Operations ·Emphasis:Assessment ·Rationale:Requesting additional resources is part of the scene size up. Rescuers should request additional resources as quickly as possible, before triage, extrication, or the primary assessment. See chapter 12 for additional information.

Which of the following is the first priority at a hazardous material incident? A. identify the hazardous material. B. request additional resources. C. ensure your own safety. D. evacuate bystanders.

(C) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:The EMT's own safety is his or her first priority. See chapters 3 and 36 for additional information.

You are dispatched to a soccer game for a 12-year-old female with signs and symptoms of an allergic reaction. Upon arrival, the patient's mother hands you an epinephrine auto-injector. You should: A. direct the mother to administer the epi-pen. B. administer the epi-pen. C. begin the primary assessment. D. contact the physician that prescribed the epi-pen.

(C) ·Topic:Medical, OB, GYN ·Rationale:A primary assessment must be conducted before determining if an epi-pen should be administered. EMTs receive medical direction from their medical director(s), not the patient's physician. See chapter 12 for additional information.

Which of the following describes the purpose of administering aspirin to a suspected myocardial infarction patient? A. Aspirin dilates the coronary arteries. B. Aspirin will eliminate cardiac related chest pain. C. Aspirin reduces platelet aggregation in the coronary arteries. D. Aspirin reduces the risk of metabolic acidosis.

(C) ·Topic:Medical, OB, GYN ·Rationale:Aspirin reduces platelet aggregation in the coronary arteries. Aspirin does not dilate coronary arteries, reduce chest pain due to MI, or reduce acidosis. See chapter 11 for additional information.

A patient with an isolated concussion injury will likely: A. get progressively worse over time. B. lose consciousness for long periods. C. progressively improve over time. D. require an extended hospital stay.

(C) ·Topic:Medical, OB, GYN ·Rationale:Concussion patients typically improve over time, they do NOT typically get worse. A head injury patient that loses consciousness for long periods or requires an extended hospital stay likely has injuries beyond a concussion. See chapter 26 for additional information.

Which of the following patients should be your highest transport priority? A. an adult with a superficial burn that covers 15% of the total body surface area. B. any 1st degree burn to the hands or feet of a pediatric patient. C. a partial-thickness burn with respiratory compromise. D. any burn with severe pain over 10% total body surface area.

(C) ·Topic:Trauma ·Rationale:Any burn patient with respiratory compromise should be considered a high transport priority. Patients with first degree (superficial) burns or pain would be considered a lower transport priority in comparison. See chapter 24 for additional information.

While attempting to restrain a combative patient, your partner was bitten on the arm. Which of the following is true of bite wounds? A. Human bites pose little risk of infection. B. Human saliva carries strong anticoagulant enzymes. C. Human bites pose a high risk of infection. D. Human bites are not dangerous if all vaccines are up to date.

(C) ·Topic:Trauma ·Rationale:Human bites can be highly infectious. Vaccines do not prevent the risk of infection from a bite wound. Human saliva does not contain anticoagulant enzymes. See chapter 23 for additional information.

Your patient has partial-thickness burns over a large surface area. You should: A. immerse the burn area in water. B. leave the burn area exposed. C. apply a dry, sterile burn sheet. D. offer the patient ice-packs to reduce pain.

(C) ·Topic:Trauma ·Rationale:Partial thickness burns should be covered with a sterile burn sheet. Immersing a burn over a large surface area in water or applying ice increases the risk of hypothermia. Leaving the burn area exposed increases the risk of infection. See chapter 24 for additional information.

While assessing an unresponsive patient, you discover a penetrating wound to the anterior chest. You should first: A. apply a trauma dressing. B. continue your assessment. C. apply an occlusive dressing. D. assess the blood pressure.

(C) ·Topic:Trauma ·Rationale:Penetrating chest wounds should be covered with an occlusive dressing before applying a trauma dressing. This should be done before performing continuing the assessment of assessing vitals. See chapters 12 and 27 for additional information.

You are caring for a 3-year-old patient in cardiac arrest. What is the correct compression to ventilation ratio for two-person CPR on this patient? A. 3 compressions to 1 ventilation. B. 5 compressions to 1 ventilation. C. 15 compressions to 2 ventilations. D. 30 compressions to 2 ventilations.

(C) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Pediatrics ·Rationale:The correct compression to ventilation ratio for two-person CPR on a pediatric patient is 15:2. One-person CPR is always 30:2. See chapter 13 and 2010 AHA guidelines for additional information.

You are first on the scene of an overturned container truck. You note a placard, but do not recognize the ID number. There is fluid leaking from the vehicle. You should: A. position the ambulance downhill from the overturned vehicle. B. determine if the driver has exited the vehicle. C. notify your dispatcher a hazardous materials team is needed. D. begin containing the fluid leaking from the vehicle.

(C) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:Personal safety is the EMT's first priority. You should not enter the scene until trained personnel determine it is safe to do so. Rescuers should not position themselves downhill from a hazardous materials incident. See chapters 3 and 36 for additional information.

The rapid extrication technique should be used at a motor vehicle accident when: A. the scene is not safe. B. the mechanism of injury is minor and the patient denies injury. C. the patient has life-threatening injuries. D. there is a high risk of spinal injury and no life-threatening conditions.

(C) ·Topic:EMS Operations ·Rationale:Rapid extrication is indicated for patients with potential life-threatening injuries. It should not be used when the scene is not safe or for patients with isolated cervical spine injuries. It is not necessary for patients with no obvious injuries. See chapter 35 for additional information.

You are dispatched to a neighborhood park on a warm day for an 8-year-old with difficulty breathing. You find the patient breathing adequately but with some accessory muscle use. You note expiratory wheezes and a persistent cough. You suspect the patient is experiencing: A. exercise induced pulmonary edema. B. a severe airway obstruction. C. an asthma attack. D. heat exhaustion.

(C) ·Topic:Medical, OB, GYN ·Emphasis:Pediatrics ·Rationale:Dyspnea, accessory muscle use, wheezing, and a cough are signs common signs and symptoms of asthma. Pulmonary edema is not common in pediatric patients and would likely cause rales, not wheezes. The patient would not be breathing adequately with a severe airway obstruction. The signs and symptoms of heat exhaustion would not be primarily respiratory in nature. See chapter 14 for additional information.

You are treating a 35-year-old man who was stung by a bee. He is allergic to bees and has a prescribed epinephrine auto-injector. His breath sounds are clear and non-labored. His BP is 130/82. How should you manage this patient? A. Administer the epinephrine and transport rapidly. B. Begin immediate transport and administer the epinephrine en route. C. Assess the patient for signs of hypoxia, administer oxygen as needed, and transport. D. Let medical control know your anaphylactic patient needs his epinephrine.

(C) ·Topic:Medical, OB, GYN ·Rationale:This patient's condition does not indicate the need for an epi-pen. His lungs are clear, breathing is non-labored, and BP is adequate. See chapters 11 and 13 for additional information.

Your 8-year-old patient has blunt chest trauma after being struck by a car. The patient is alert. His airway is clear, breathing is adequate, and pulses are present but weak at 110 beats per minute. Which of the following should you do next? A. ask the patient for consent to transport. B. insert an oropharyngeal airway. C. perform a rapid scan. D. assess the patient's pulse oximetery (SaO2).

(C) ·Topic:Trauma ·Emphasis:Pediatrics ·Rationale:The next action should be a rapid scan to assess for life threatening injuries. This is more important than a pulse oximeter reading. A minor patient cannot provide consent. An OPA is not indicated for a responsive patient. See chapter 12 for additional information.

Carbon monoxide exposure is dangerous because it: A. collapses red blood cells. B. causes pulmonary edema. C. stimulates bronchial constriction. D. reduces delivery of oxygen.

(D) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:Carbon monoxide binds with hemoglobin more readily than oxygen, which prevents delivery of oxygen to the body. See chapter 19 for additional information.

Your pediatric patient has spontaneous respirations. This means the patient is breathing: A. at a normal rate. B. with adequate tidal volume. C. without difficulty. D. without assistance.

(D) ·Topic:Airway and Ventilation ·Emphasis:Pediatrics ·Rationale:Spontaneous breaths are unassisted breaths taken by the patient. Spontaneous breaths may occur at any rate or tidal volume and with or without difficulty. See chapter 9 for additional information.

A nonrebreather mask should be administered to patients who: A. have slow, shallow respirations. B. have a reduced tidal volume. C. are breathing inadequately. D. are breathing adequately with signs of hypoxia.

(D) ·Topic:Airway and Ventilation ·Rationale:A nonrebreather mask is indicated for spontaneously breathing patients with adequate ventilations and signs of hypoxia. Patients with inadequate, slow, or shallow ventilations should be ventilated. See chapter 9 for additional information.

Which of the following is the most frequent cause of airway obstruction? A. fluid. B. toys. C. vomit. D. the tongue.

(D) ·Topic:Airway and Ventilation ·Rationale:The tongue is the most common cause of airway obstruction. See chapter 9 for additional information.

Which of the following vessels carries deoxygenated blood? A. aorta. B. renal artery. C. pulmonary veins. D. pulmonary arteries.

(D) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The pulmonary arteries are the only arteries which carry deoxygenated blood. The pulmonary veins are the only veins which carry oxygenated blood. See chapter 7 for additional information.

Your 5-year-old patient is unresponsive. A carotid pulse is present at 40 beats per minute. Breaths are shallow at six per minute. You should immediately: A. Apply a nonrebreather mask. B. Begin artificial ventilations. C. Place the patient in the recovery position. D. Begin chest compressions.

(D) ·Topic:Cardiology, Resuscitation, Stroke ·Emphasis:Pediatrics ·Rationale:CPR, beginning with chest compressions, is indicated for unresponsive children with a pulse rate below 60. For additional information, review the 2010 American Heart Association guidelines.

Your patient has been exposed to a chemical that over-stimulates the parasympathetic nervous system. You would expect this patient to exhibit: A. dilated pupils. B. dry mouth. C. hypertension. D. vomiting.

(D) ·Topic:Medical, OB, GYN ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:The parasympathetic nervous system exerts control over digestive functions. Over stimulation can lead to vomiting. Dilated pupils, dry mouth, and hypertension are more likely caused by stimulation of the sympathetic nervous system. See chapters 7 and 19 for additional information.

You are called for a 40-year-old female with a severe headache. She is 32 weeks pregnant. The patient history reveals she also has nausea, blurred vision and sudden edema in her face and hands. Her blood pressure is 156/96. The patient is most likely experiencing: A. an absence seizure. B. a spontaneous abortion. C. eclampsia. D. preeclampsia.

(D) ·Topic:Medical, OB, GYN ·Rationale:The patient has many of the classic signs and symptoms of preeclampsia. Eclampsia includes seizure activity. The signs and symptoms of an absence seizure and spontaneous abortion are very different than those presented in this question. See chapter 30 for additional information.

Your patient is unresponsive following blunt trauma to the head. Which of the following is the EMT's first priority for an unresponsive patient? A. Assess respiratory rate. B. Open the airway. C. Perform a SAMPLE history. D. Determine if CPR is indicated

(D) ·Topic:Trauma ·Emphasis:Assessment ·Rationale:Unresponsive patients should be assessed using the CAB sequence. Circulation is assessed first in order to begin CPR as quickly as possible if needed. See chapter 12 and the 2010 AHA guidelines for additional information.

Your 6-year-old patient jumped from a swing and injured his right leg. You note deformity to the right leg above the ankle. The patient most likely has a fracture to the: A. proximal radius. B. distal ulna. C. proximal fibula. D. distal tibia.

(D) ·Topic:Trauma ·Emphasis:Pediatrics ·Rationale:The radius and ulna are located in the arm, not the leg. A proximal fibula injury would be closer to the knee, not the ankle. See chapter 7 for additional information.

Your patient exhibits crepitus to the thorax, paradoxical motion and signs of hypoxia. You should suspect: A. a ruptured spleen. B. bilateral femur fractures. C. anaphylaxis. D. a flail chest.

(D) ·Topic:Trauma ·Rationale:Crepitus to the thorax and paradoxical motion are classic signs of a flail chest and can lead to hypoxia. A ruptured spleen and femur fractures would likely lead to hypovolemia, not hypoxia. Crepitus and paradoxical motion are not signs of anaphylaxis. See chapter 27 for additional information.

Inadequate oxygen delivery to the body's tissues is called: A. hypercarbia. B. hypoperfusion. C. shock. D. hypoxia.

(D) ·Topic:Airway and Ventilation ·Emphasis:Anatomy/physiology/pathophysiology ·Rationale:Inadequate oxygen delivery to the body is hypoxia. Hypercarbia is abnormally high carbon dioxide levels. Shock and hypoperfusion both refer to inadequate tissue perfusion. See chapter 9 for additional information.

An oropharyngeal airway is indicated for which of the following patients? A. a 35-year-old semiconscious patient. B. a 14-year-old conscious patient. C. a 22-year-old confused patient with dyspnea. D. a 44-year-old unconscious patient.

(D) ·Topic:Airway and Ventilation ·Rationale:OPAs are for unresponsive patients without a gag reflex. Three of the four options refer to patients that are not unresponsive. See chapter 9 for additional information.

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He is unable to speak, has a faint inspiratory stridor and cyanosis around the lips. You should: A. encourage him to cough as forcefully as he can. B. deliver up to five back blows and reassess him. C. place him in a supine position and open his airway. D. stand behind him and administer abdominal thrusts.

(D) ·Topic:Cardiology, Resuscitation, Stroke ·Rationale:The patient is presenting with signs of a nearly complete foreign body airway obstruction. Conscious abdominal thrusts should be administered immediately. Encouraging the patient to cough is appropriate for a partial airway obstruction with adequate air exchange. Back blows are used for conscious infants with an airway obstruction, not adults. The patient should not be placed supine unless he loses consciousness. See 2010 AHA guidelines for additional information.

You are on the scene of a motor vehicle accident. The driver is trapped in a vehicle that is leaking an unknown fluid. When is it appropriate to enter the vehicle and begin patient care? A. enter the vehicle immediately if the patient's condition is unstable. B. disconnect the vehicle's battery and then enter. C. enter the vehicle immediately after you confirm it is in park. D. do not enter until trained rescuers determine the vehicle is safe to enter.

(D) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:EMTs should not enter a vehicle until it is safe to do so. EMTs without specialized training should not attempt to disconnect a vehicle's battery following a collision. See chapter 3 and 35 for additional information.

You and your partner are preparing to lift the stretcher into the ambulance with a 300-pount patient. To protect yourself from injury, you should: A. keep your feet close together. B. lift with your palms facing down. C. keep your legs straight and bend at the waist. D. keep your back straight and bend at the knees.

(D) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:Lifting should be done using the legs, not the back. The back should be straight and the legs bent. The feet should be shoulder width apart and palms should be facing up. See chapter 3 for additional information.

During a hazardous materials incident, you should take standard precautions: A. just prior to any invasive procedures. B. only if the patient is actively bleeding. C. once you determine the patient is unresponsive. D. before making contact with the patient.

(D) ·Topic:EMS Operations ·Emphasis:Safety ·Rationale:Standard precautions should be taken before making contact with the patient. Patient contact is required before assessing LOC, bleeding, or the need for invasive procedures. See chapter 3 for additional information.

The most common weapon of mass destruction used by terrorists is: A. nuclear weapons. B. biological weapons. C. chemical weapons. D. explosive weapons.

(D) ·Topic:EMS Operations ·Rationale:Explosives are the most commonly used weapons of mass destruction. See chapter 38 for additional information.

You are treating an unresponsive patient with slow, shallow respirations and pinpoint pupils. Which of the following conditions is most likely? A. myocardial infarction. B. hyperglycemia. C. amphetamine overdose. D. narcotic overdose.

(D) ·Topic:Medical, OB, GYN ·Emphasis:Anatomy, physiology, pathophysiology ·Rationale:Bradypnea,shallow respirations, and pinpoint pupils are common signs with a narcotic overdose. This combination is not typical with an MI, hyperglycemia, or an amphetamine overdose. See chapter 19 for additional information.

Your adult patient reportedly smoked an unknown substance and passed out. The patient has inadequate ventilations and your partner begins ventilating with the BVM. Which of the following is the best indicator your patient is being ventilated adequately? A. a ventilatory rate of at least 20 breaths per minute. B. poor compliance when squeezing the BVM. C. a pulse oximeter (SaO2) of 90%. D. adequate bilateral chest rise and fall during BVM ventilation.

(D) ·Topic:Medical, OB, GYN ·Rationale:Bilateral chest rise and fall is the best indicator that the patient is being adequately ventilated. The patient should be ventilated at 10-12 breaths per minute. Poor BVM compliance and a low pulse oximeter reading are signs of inadequate ventilation. See chapter 9 for additional information.

You are caring for a 12-year-old who was injured at the neighborhood skate park. He was not wearing a helmet and is responsive to pain. You note snoring respirations and deformity to the left ankle. You should: A. suction the airway and insert an OPA. B. secure the patient to a long board and transport. C. immediately splint the injured ankle. D. open the airway using a jaw-thrust maneuver.

(D) ·Topic:Trauma ·Emphasis:Assessment ·Rationale:The patient's airway should be opened manually with the jaw thrust maneuver before suctioning the airway, securing to a spine board, or applying a splint. See chapters 9 and 12 for additional information.

You are caring for a six-year-old patient with respiratory distress. The pulse oximeter (Sa02) reads 93%. Your management of the patient should include: A. Withhold oxygen until the patient develops accessory muscle use. B. Contacting the patient's pediatrician prior to transport. C. Administering a metered dose inhaler if prescribed to a parent or sibling. D. Administer sufficient oxygen to maintain a pulse oximeter reading of at least 94%.

D) ·Topic:Airway and Ventilation ·Emphasis:Pediatrics ·Rationale:Oxygen is indicated for patients with signs or symptoms of hypoxia, including a pulse oximeter below 94%. EMTs should not withhold oxygen from a patient with a pulse oximeter below 94%. EMTs do not contact the patient's physician for medical direction, nor do they administer MDIs which are not prescribed to the patient. See chapter 9 for additional information.