EMT midterm
A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should: Select one: A. give her high-flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport. B. recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs. C. transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin. D. assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions.
recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs.
A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patient? Select one: A. Gentle palpation of the pelvis B. Application of a cervical collar C. Rapid head-to-toe exam D. Treating her for possible shock
A. Gentle palpation of the pelvis
An intoxicated 40-year-old male is found lying face down. How would you document his body's position? Select one: A. Prone B. Dorsal C. Recumbent D. Supine
A. Prone
A 17-year-old male was shot in the right anterior chest during an altercation. As your partner is applying oxygen, you perform a rapid assessment and find an open chest wound with a small amount of blood bubbling from it. You should: Select one: A. apply an occlusive dressing to the wound and continue your assessment. B. direct your partner to assist the patient's ventilations with a BVM. C. control the bleeding from the wound and prepare to transport at once. D. place a sterile dressing over the wound and apply direct pressure.
A. apply an occlusive dressing to the wound and continue your assessment
After your partner assumes manual in-line stabilization of the patient's head, you should: Select one: A. assess distal neurovascular status in the extremities. B. thoroughly palpate the patient's head for deformities. C. apply an appropriately sized rigid cervical collar. D. use four people to log roll the patient onto a backboard.
A. assess distal neurovascular status in the extremities.
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: A. assess the adequacy of his respirations. B. administer up to 324 mg of baby aspirin. C. administer up to three doses of nitroglycerin. D. obtain vital signs and a SAMPLE history.
A. assess the adequacy of his respirations.
A 37-year-old male is found unresponsive in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of: Select one: A. asthma. B. hypertension. C. heart disease. D. allergic reactions.
A. asthma.
A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: Select one: A. avoid applying pressure to the globe when you are covering the eye. B. apply firm direct pressure to the injured eye and cover the opposite eye. C. carefully examine her eye and remove any foreign objects if needed. D. ask her to move the injured eye to assess the integrity of the optic nerve.
A. avoid applying pressure to the globe when you are covering the eye.
You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should: Select one: A. begin CPR, apply the AED, and deliver a shock if it is indicated. B. perform CPR only and wait for the manual defibrillator to arrive. C. apply the AED while your partner provides rescue breathing. D. begin CPR and have your partner update the responding paramedics.
A. begin CPR, apply the AED, and deliver a shock if it is indicated.
You are off duty at a park when you witness an apparently healthy 12-year-old child suddenly collapse. There are no bystanders around and your mobile phone is in your car. After confirming that the child is in cardiac arrest, you should: Select one: A. call 9-1-1 and then return to begin CPR on the child. B. perform CPR for 2 minutes and then call 9-1-1. C. deliver five rescue breaths before starting chest compressions. D. perform chest compressions only until a bystander arrives.
A. call 9-1-1 and then return to begin CPR on the child.
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is: Select one: A. cardiogenic hypoperfusion. B. severe septic hypoperfusion. C. a ruptured aortic aneurysm. D. acute myocardial infarction.
A. cardiogenic hypoperfusion.
You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a: Select one: A. combination of a medical and trauma emergency. B. medical emergency. C. combination of a psychiatric and trauma emergency. D. trauma emergency.
A. combination of a medical and trauma emergency.
A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the ____________ forearm. Select one: A. distal B. superior C. proximal D. dorsal
A. distal
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should: Select one: A. document this finding on your patient care report and advise the emergency department staff of what the child's parents told you. B. acknowledge and respect this practice as a cultural belief, but advise the child's parents that it has no healing power. C. advise the child's parents that this is a harmful practice and is considered a form of child abuse in the United States. D. advise the emergency department physician that you feel as though the child was intentionally abused by his parents.
A. document this finding on your patient care report and advise the emergency department staff of what the child's parents told you.
When immobilizing a patient on a long backboard, you should: Select one: A. ensure that you secure the torso before securing the head. B. have the patient exhale before fastening the torso straps. C. secure the torso and then center the patient on the board. D. follow the commands of the person at the patient's torso.
A. ensure that you secure the torso before securing the head.
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first: Select one: A. follow appropriate standard precautions. B. place the patient on high-flow oxygen. C. apply direct pressure to the wound. D. perform a rapid head-to-toe assessment.
A. follow appropriate standard precautions.
A 16-year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should: Select one: A. inquire about the possibility of pregnancy in private, if possible. B. avoid asking questions that she will feel uncomfortable answering. C. recall that patients in this age group prefer not to be treated as adults. D. obtain the majority of your information from one of her parents.
A. inquire about the possibility of pregnancy in private, if possible.
A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: Select one: A. is ejected or partially ejected. B. remains within the vehicle. C. experiences multiple impacts. D. is wearing only a lap belt.
A. is ejected or partially ejected.
ou arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: Select one: A. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. B. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. C. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. D. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.
A. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.
You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should: Select one: A. monitor her airway and breathing status and assess her blood glucose level. B. administer one tube of oral glucose and prepare for immediate transport. C. place her in the recovery position and transport her with lights and siren. D. give her small cups of water to drink and observe for further seizure activity.
A. monitor her airway and breathing status and assess her blood glucose level.
While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: Select one: A. neck and facial injuries. B. blunt trauma to the head. C. lower extremity fractures. D. open abdominal trauma.
A. neck and facial injuries.
You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: Select one: A. perform CPR for 5 minutes before applying the AED. B. initiate CPR and attach an AED as soon as possible. C. assess the patient for a facial droop and hemiparesis. D. obtain a blood glucose sample to rule out hypoglycemia.
A. perform CPR for 5 minutes before applying the AED.
A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: Select one: A. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. B. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg. C. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. D. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher.
A. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.
While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should: Select one: A. remove the CPAP device and ventilate him with a bag-valve mask. B. remove the CPAP device and apply oxygen by nonrebreathing mask. C. increase the amount of pressure that the CPAP device is delivering. D. decrease the amount of pressure that the CPAP device is delivering.
A. remove the CPAP device and ventilate him with a bag-valve mask.
You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she: Select one: A. responds to her name but is fearful of your presence. B. has bulging fontanelles secondary to severe dehydration. C. will readily allow you to separate her from her mother. D. is unable to track your movements with her eyes.
A. responds to her name but is fearful of your presence.
You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: Select one: A. retreat at once and call law enforcement. B. calm him down so you can assess him. C. contact medical control for instructions. D. be assertive and talk the patient down.
A. retreat at once and call law enforcement.
You and your partner are preparing to apply a traction splint to a patient's deformed thigh. As you apply manual traction, the patient resists your efforts and states that the pain is getting worse. You should: Select one: A. stop and splint the leg in the deformed position. B. gently massage the thigh muscles to relax them. C. assess distal pulses and continue pulling traction. D. flex the knee and place a pillow under the thigh
A. stop and splint the leg in the deformed position.
While you are on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should: Select one: A. tell your partner to stop and report the incident to your supervisor. B. tell your partner to quit kidding around and focus on the job. C. notify law enforcement personnel and have your partner arrested. D. warn your partner that you will report him or her if it happens again.
A. tell your partner to stop and report the incident to your supervisor.
At the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should: Select one: A. use the mobile radio in the ambulance to contact dispatch. B. make another attempt to contact dispatch from an area of higher terrain. C. place both patients in the ambulance and transport them at once. D. ask a police officer to call dispatch with his portable radio.
A. use the mobile radio in the ambulance to contact dispatch.
A young male is unresponsive after overdosing on an opioid. He is not breathing and his pulse is weak. The EMT should immediately: Select one: A. ventilate with a BVM. B. request an ALS ambulance. C. begin chest compressions. D. administer naloxone.
A. ventilate with a BVM.
You are caring for a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate? Select one: A. "This is nothing to worry about. Please try to stay calm. The physician at the hospital will probably not find any signs of a heart problem." B. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow." C. "We need to take you to the ED stat. We will give you ASA and NTG en route and then reassess your vitals. Do you have any questions?" D. "I notice that you are a retired paramedic, so I'm sure you will understand all of the things that we will be doing to you."
B. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."
A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway? Select one: A. Suction his oropharynx with a rigid catheter until all secretions are removed. B. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation. C. Insert a nasopharyngeal airway and provide suction and assisted ventilations. D. Provide continuous ventilations with a bag-valve mask to minimize hypoxia.
B. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Contact medical control and request permission to defibrillate. B. Deliver the shock followed by immediate resumption of CPR. C. Continue CPR and transport the patient to the closest appropriate hospital. D. Avoid defibrillation as this will damage the patient's AICD.
B. Deliver the shock followed by immediate resumption of CPR.
A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? Select one: A. Secondary fall after the initial impact B. Energy transmission to the spine C. Lateral impact to the spine D. Direct trauma to the spinal column
B. Energy transmission to the spine
A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should: Select one: A. administer high-flow supplemental oxygen. B. administer 15 g of activated charcoal. C. contact medical control for guidance. D. give the child milk to absorb the Tylenol.
B. administer 15 g of activated charcoal.
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: Select one: A. obtain a SAMPLE history and contact medical control for advice. B. administer oxygen, give her 324 mg of aspirin, and assess her further. C. give her high-flow oxygen, attach the AED, and transport at once. D. give her one nitroglycerin and reassess her systolic blood pressure.
B. administer oxygen, give her 324 mg of aspirin, and assess her further.
When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar: Select one: A. before manually stabilizing the patient's head. B. after assessing distal neurovascular functions. C. after moving the patient to a long backboard. D. after the torso has been adequately secured.
B. after assessing distal neurovascular functions.
A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should: Select one: A. suspect a severe hemopneumothorax. B. aggressively manage his airway. C. request a paramedic ambulance. D. perform a secondary assessment.
B. aggressively manage his airway.
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should: Select one: A. carefully restrain the patient and transport at once. B. ask the daughter how her father normally behaves. C. conclude that the patient has Alzheimer disease. D. advise the patient that his behavior is unacceptable.
B. ask the daughter how her father normally behaves.
You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: Select one: A. place a pillow under his arm and apply a swathe. B. assess distal pulse, motor, and sensory functions. C. gently attempt to move his arm toward his body. D. flex his arm at the elbow and then apply a sling.
B. assess distal pulse, motor, and sensory functions.
A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: Select one: A. auscultate bowel sounds. B. assess for an exit wound. C. apply a cervical collar. D. obtain baseline vital signs.
B. assess for an exit wound.
A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should: Select one: A. manually stabilize the leg above and below the site of injury. B. control the bleeding and cover the wound with a sterile dressing. C. gently manipulate the injured leg until the numbness dissipates. D. assess distal pulses as well as sensory and motor functions.
B. control the bleeding and cover the wound with a sterile dressing.
During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: Select one: A. a ruptured spleen. B. intra-abdominal bleeding. C. a severe liver laceration. D. rupture of a hollow organ.
B. intra-abdominal bleeding.
A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed and she complains of severe pain. You should: Select one: A. gently straighten her knee and apply a padded board splint. B. keep her knee flexed and secure it with padded board splints. C. flex her knee slightly more and assess for distal circulation. D. make one attempt to return the patella to its normal position.
B. keep her knee flexed and secure it with padded board splints.
A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: Select one: A. apply a cervical collar and suction his airway. B. open his airway with the jaw-thrust maneuver. C. apply a pressure dressing to the patient's arm. D. tilt the patient's head back and lift up on his chin.
B. open his airway with the jaw-thrust maneuver.
A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: Select one: A. wait for the police to examine him before providing care. B. open the patient's airway and assess his respirations. C. ask the police to handcuff the patient for safety purposes. D. provide care after determining what Dilaudid is used for.
B. open the patient's airway and assess his respirations.
A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for: Select one: A. a thoracic spine fracture. B. posterior hip dislocation. C. fracture of the tibia or fibula. D. anterior hip dislocation.
B. posterior hip dislocation.
You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should: Select one: A. treat the patient where he is so that you do not destroy any evidence. B. quickly move the coffee table so you can access and treat the patient. C. drag the patient into a larger area so that you can begin treatment. D. obtain permission from law enforcement before moving anything.
B. quickly move the coffee table so you can access and treat the patient.
A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should: Select one: A. apply insulated gloves and assume manual control of his c-spine. B. rapidly assess the patient after ensuring that the power line is not live. C. manually stabilize his head as your partner assesses for breathing. D. quickly but carefully move the patient away from the power line.
B. rapidly assess the patient after ensuring that the power line is not live.
You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: Select one: A. attempt to replace her dentures so that they fit tightly and resume ventilations. B. remove her dentures, resume ventilations, and assess for adequate chest rise. C. remove her dentures at once and increase the rate and volume of your ventilations. D. leave her dentures in place, but carefully monitor her for an airway obstruction.
B. remove her dentures, resume ventilations, and assess for adequate chest rise.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: Select one: A. administer a nebulized bronchodilator to improve the status of her breathing. B. request permission from medical control to give another dose of epinephrine. C. crush up an antihistamine tablet and place it in between her cheek and gum. D. monitor her en route to the hospital and call medical control if she worsens.
B. request permission from medical control to give another dose of epinephrine.
A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment reveals that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect: Select one: A. posterior dislocation of the shoulder. B. separation of the acromioclavicular joint. C. dislocation of the glenohumeral joint. D. multiple fractures of the proximal humerus.
B. separation of the acromioclavicular joint.
You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that: Select one: A. the infant's proportionately small tongue often causes an airway obstruction. B. small infants are nose breathers and require clear nasal passages at all times. C. an infant's head should be placed in a flexed position to prevent obstruction. D. assisted ventilations in infants often need to be forceful to inflate their lungs
B. small infants are nose breathers and require clear nasal passages at all times.
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should: Select one: A. administer 100% supplemental oxygen. B. immediately evaluate his airway. C. apply direct pressure to the wound. D. assess the rate and quality of his pulse.
C. apply direct pressure to the wound.
Your priority in caring for a patient with a surface contact poisoning is to: Select one: A. move the patient to a safe area. B. obtain and maintain a patent airway. C. avoid contaminating yourself. D. decontaminate the patient's skin.
C. avoid contaminating yourself.
A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: Select one: A. assess for entry and exit wounds. B. begin CPR and transport at once. C. begin CPR and apply the AED. D. fully immobilize his spinal column.
C. begin CPR and apply the AED.
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: Select one: A. immediately apply the AED pads and analyze his cardiac rhythm. B. perform two-rescuer CPR for 5 minutes and request ALS backup. C. begin high-quality CPR and apply the AED as soon as possible. D. have your partner perform CPR while you question the bystanders.
C. begin high-quality CPR and apply the AED as soon as possible.
Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to: Select one: A. ventilate her with a bag-valve mask. B. administer high-flow oxygen. C. check her airway for obstructions. D. move her to the ambulance stretcher.
C. check her airway for obstructions.
You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: Select one: A. have the EMTs stop CPR and assess for a pulse. B. request a paramedic unit and quickly attach the AED. C. feel for a pulse while compressions are ongoing. D. quickly attach the AED and push the analyze button.
C. feel for a pulse while compressions are ongoing.
A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should: Select one: A. position the patient on his side and transport. B. administer naloxone via the intramuscular route. C. insert a nasal airway and ventilate with a BVM. D. administer naloxone via the intranasal route.
C. insert a nasal airway and ventilate with a BVM.
You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: Select one: A. apply oxygen via a nonrebreathing mask and transport at once. B. insert an oropharyngeal airway and perform oral suctioning. C. insert a nasopharyngeal airway and begin assisted ventilation. D. place her in the recovery position and monitor for vomiting.
C. insert a nasopharyngeal airway and begin assisted ventilation
A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: Select one: A. acute pancreatitis. B. renal insufficiency. C. liver dysfunction. D. gallbladder disease.
C. liver dysfunction.
You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: Select one: A. load him into the ambulance, begin transport, and perform all treatment en route to the hospital. B. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible. C. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit D. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly.
C. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.
A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty and she is tachycardic. The EMT should suspect: Select one: A. strangulated hernia. B. acute pancreatitis. C. kidney stones. D. aortic aneurysm.
D. aortic aneurysm.
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: Select one: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen. C. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. D. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
D. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should: Select one: A. perform a detailed head-to-toe assessment and apply a cervical collar. B. slide a scoop stretcher under his buttocks and rotate him laterally. C. maintain manual stabilization of his head and grasp him by the clothes. D. apply a cervical collar and immobilize him with a vest-style device.
D. apply a cervical collar and immobilize him with a vest-style device.
A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: Select one: A. apply chemical heat packs to his groin and axillae. B. apply an AED and assess his cardiac rhythm. C. open his airway and give two rescue breaths. D. assess for a carotid pulse for up to 60 seconds.
D. assess for a carotid pulse for up to 60 seconds.
You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: Select one: A. requesting a paramedic to administer naloxone (Narcan). B. assisting his ventilations with a bag-valve mask device. C. asking law enforcement to place handcuffs on the patient. D. attempting to calm him and giving him oxygen if tolerated.
D. attempting to calm him and giving him oxygen if tolerated.
You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: Select one: A. attach the AED immediately. B. obtain baseline vital signs. C. apply a nonrebreathing mask. D. begin ventilatory assistance.
D. begin ventilatory assistance.
A 39-year-old female experienced a severe closed head injury. She is unresponsive with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: Select one: A. irrigate her eyes with water to prevent mucosal drying. B. inspect her eyes and gently remove impaled objects. C. secure her eyes open so you can reassess her pupils. D. close her eyes and cover them with a moist dressing.
D. close her eyes and cover them with a moist dressing.
You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to: Select one: A. obtain baseline vital signs and a medical history. B. provide emotional support regarding her sister. C. advise her that she needs to go to the hospital. D. determine if she was injured when she fainted.
D. determine if she was injured when she fainted.
A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should: Select one: A. perform a rapid head-to-toe exam and immobilize his spine. B. allow him to refuse transport if his vital signs remain stable. C. obtain a Glasgow Coma Score value and give him oxygen. D. immobilize his spine and perform a focused secondary exam.
D. immobilize his spine and perform a focused secondary exam.
A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: Select one: A. nitroglycerin for her chest pain. B. ventilations with a BVM. C. oxygen at 2 L/min via nasal cannula. D. placing her in an upright position.
D. placing her in an upright position.
A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" three years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should: Select one: A. repeat the primary assessment. B. inquire about his family history. C. perform a head-to-toe assessment. D. prepare for immediate transport.
D. prepare for immediate transport.
You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: Select one: A. cover his foot with chemical heat compresses. B. administer oxygen via a nonrebreathing mask. C. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water. D. protect the affected part from further injury.
D. protect the affected part from further injury.
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: Select one: A. position her on her left side and transport at once. B. have her breathe into a paper or plastic bag. C. request a paramedic to give her a sedative. D. provide reassurance and give oxygen as needed.
D. provide reassurance and give oxygen as needed.
When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, you should: Select one: A. recognize that the force of impact was most likely not severe. B. realize that the air bag malfunctioned at the time of impact. C. suspect that the patient may have experienced serious injuries. D. remember that it could still deploy and seriously injure you.
D. remember that it could still deploy and seriously injure you.
You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely: Select one: A. accurate because he has signs of respiratory failure. B. a direct reflection of his increased respiratory rate. C. accurate because shivering affects hemoglobin binding. D. secondary to decreased perfusion in the extremities.
D. secondary to decreased perfusion in the extremities.
A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: Select one: A. inspect the helmet for cracks. B. obtain baseline vital signs. C. leave her bicycle helmet on. D. stabilize her entire spine.
D. stabilize her entire spine.
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should: Select one: A. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.
D. stabilize her head and perform a primary assessment.
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should: Select one: A. administer one tube of oral glucose and transport. B. assist her ventilations with a bag-valve mask. C. insert an oral airway, apply oxygen, and transport. D. suction her oropharynx and transport immediately.
D. suction her oropharynx and transport immediately.
A female patient with a suspected head injury has slow, shallow breathing. The MOST appropriate treatment for her includes: Select one: A. ventilation assistance to maintain an oxygen saturation of 90%. B. hyperventilating her at 30 breaths/min. C. administering oxygen via a nonrebreathing mask. D. ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.
D. ventilation assistance to maintain an ETCO2 of 30 to 35 mm Hg.
A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should: A. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer. B. let them know that because of the circumstances of their child's death, they will not be permitted to see him at this time. C. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. D. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside.
advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.
A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should: Select one: A. have the patient sign a refusal form and return him to his office. B. assess whether the patient's mental condition is impaired. C. document the patient's request but continue to transport him. D. request that the police place the patient under protective custody.
b. assess whether the patient's mental condition is impaired.
You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: Select one: A. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber. B. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility. C. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance. D. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department.
B. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.
A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: Select one: A. applying ice to the wound and transporting quickly. B. supine positioning, splinting the leg, and transporting. C. elevating the lower extremities and giving antivenin. D. transporting only with close, continuous monitoring.
B. supine positioning, splinting the leg, and transporting.
You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include: Select one: A. assisted ventilation with a BVM. B. thoroughly suctioning her oropharynx. C. performing a rapid secondary assessment. D. requesting a paramedic to give her atropine.
B. thoroughly suctioning her oropharynx.
You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control? Select one: A. Give her half the dose of her epinephrine in case her allergic reaction is delayed. B. Begin immediate transport and request an intercept with a paramedic ambulance. C. Begin transport to the hospital and closely monitor her condition while en route. D. Administer her epinephrine, reassess her condition, and transport her promptly. Feedback
C. Begin transport to the hospital and closely monitor her condition while en route.
An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the MOST appropriate method of immobilizing this patient? Select one: A. Immobilize her in a supine position on a long backboard and secure her with straps. B. Apply a cervical collar and place her in a sitting position on the wheeled stretcher. C. Leave her on her side and use blanket rolls to immobilize her to the long backboard. D. Move her to a supine position and immobilize her with a scoop stretcher and padding.
C. Leave her on her side and use blanket rolls to immobilize her to the long backboard.
You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. Which of the following should be your MOST appropriate action? Select one: A. Perform a rapid assessment and then move the patients from their residence. B. Request another ambulance to assist with lifting and moving the patients. C. Rapidly remove the patients from their residence using a blanket or clothes drag. D. Quickly exit the residence and request the fire department to move the patients.
C. Rapidly remove the patients from their residence using a blanket or clothes drag.
You are transporting a 67-year-old female patient to the hospital for investigation of abdominal pain. The patient care record indicates that the patient has a history of AAA. Based on this information, the patient care record includes an abbreviation for: Select one: A. acute abdominal aneurysm . B. acute abdominal assessment. C. abdominal aortic aneurysm. D. against ambulance advice.
C. abdominal aortic aneurysm.
A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: Select one: A. assist her ventilations with a bag-valve mask. B. perform a secondary assessment and then begin treatment. C. insert a nasal airway in case her mental status decreases. D. administer oxygen via a nonrebreathing mask.
D. administer oxygen via a nonrebreathing mask.
You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: Select one: A. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. B. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. C. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. D. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital.
C. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.
You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: Select one: A. instruct the patient to keep her eyes open and then repeat the arm drift test. B. repeat the arm drift test and ensure that her palms are facing downward. C. repeat the arm drift test, but move the patient's arms into position yourself. D. defer this part of the test and assess her for facial droop and slurred speech.
C. repeat the arm drift test, but move the patient's arms into position yourself.
A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should: Select one: A. subdue the family member until the police arrive. B. tell the family member that it is not your fault. C. retreat and notify law enforcement personnel. D. ignore the family member and assess the patient.
C. retreat and notify law enforcement personnel.
A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would MOST likely control the bleeding? Select one: A. Apply a pelvic binder device to stabilize the pelvis B. Position the patient with his injured side down C. Apply chemical ice packs to the wound and transport D. Apply a topical hemostatic agent with direct pressure
D. Apply a topical hemostatic agent with direct pressure
You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which type of consent is her agreement considered? Select one: A. Implied B. Informed C. Minor's D. Expressed
D. Expressed
A 70-year-old man presents with a severe nosebleed. His medical history includes COPD, depression, and a hemorrhagic stroke 3 years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today? Select one: A. His prescribed albuterol B. Diabetic complications C. Hemorrhagic stroke D. High blood pressure
D. High blood pressure
You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system? Select one: A. An irregular pulse B. Excessive tearing or crying C. Consistent eye contact D. Rapid eye movement
D. Rapid eye movement
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: A. Acute pulmonary embolism B. Rupture of the diaphragm C. Exacerbation of his COPD D. Spontaneous pneumothorax
D. Spontaneous pneumothorax
