EMT MIDTERM

49. A 73-year-old man presents with a generalized rash, which he thinks might have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should: A) administer oxygen if needed, transport the patient, and monitor him for signs of deterioration. B) ask him if he has epinephrine and request approval from medical control to administer it to the patient. C) avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe. D) begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.

A) administer oxygen if needed, transport the patient, and monitor him for signs of deterioration.

93. 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: A) apply direct pressure to the wound. B) provide high-flow oxygen. C) cover the patient with a blanket. D) obtain baseline vital signs.

A) apply direct pressure to the wound.

23. External bleeding from an extremity can usually be controlled initially by: A) applying direct pressure. B) elevating the extremity. C) applying a tourniquet. D) applying chemical ice packs.

A) applying direct pressure.

61. You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: A) assist her ventilations with a bag-valve mask. B) apply a pulse oximeter and assess her vital signs. C) administer oxygen via a nonrebreathing mask. D) obtain a complete list of all of her medications.

A) assist her ventilations with a bag-valve mask.

7. When faced with a situation in which a patient is in cardiac arrest and a valid living will or DNR order cannot be located, you should: A) begin resuscitation at once. B) contact medical control first. C) determine the patient's illness. D) notify the coroner immediately.

A) begin resuscitation at once.

28. You are treating a middle-aged man with chest discomfort. He has a history of three previous heart attacks and takes nitroglycerin as needed for chest pain. You have standing orders to administer aspirin to patients with suspected cardiac-related chest pain or discomfort. While your partner is preparing to give oxygen to the patient, you should: A) confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given. B) contact medical control, apprise him or her of the patient's chief complaint and vital signs, and request permission to give him aspirin. C) ensure that the patient's systolic blood pressure is at least 100 mm Hg as aspirin dilates the blood vessels and can cause a drop in blood pressure. D) assist the patient in taking one of his prescribed nitroglycerin, assess his vital signs, and give him aspirin if he is still experiencing chest discomfort.

A) confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given.

53. You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert but in obvious pain. He tells you that he did not call 9-1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should: A) ensure that he is aware of the risks of refusing medical care. B) err in the best interest of the patient and transport him at once. C) have him sign a refusal of care form and then return to service. D) tell him that he is having a heart attack and needs medical care.

A) ensure that he is aware of the risks of refusing medical care.

11. Calming and reassuring an anxious patient can be facilitated by: A) maintaining eye contact with the patient whenever possible. B) using medical terminology to ensure the patient understands. C) positioning yourself at a level that is higher than the patient. D) withholding unpleasant information until arrival at the hospital.

A) maintaining eye contact with the patient whenever possible.

22. You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, in obvious respiratory distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate life-saving treatment, you should: A) perform a detailed head-to-toe exam and prepare for immediate transport. B) assess her vital signs, secure her to a backboard, and transport her immediately. C) fully immobilize her spine, load her into the ambulance, and assess her vital signs. D) identify the specific areas of her injuries and focus your assessment on those areas.

A) perform a detailed head-to-toe exam and prepare for immediate transport.

42. An absence seizure is also referred to as a: A) petit mal seizure. B) grand mal seizure. C) total body seizure. D) generalized motor seizure.

A) petit mal seizure.

87. A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes: A) preparing for immediate transport. B) applying oxygen via nasal cannula. C) performing a focused physical exam. D) a detailed assessment of his abdomen.

A) preparing for immediate transport.

32. A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is hot and moist. You should be most suspicious that she is experiencing: A) septic shock. B) pump failure. C) a local infection. D) decompensated shock.

A) septic shock.

57. With increasing age, the heart must work harder to move the blood effectively because: A) the blood vessels become stiff. B) the arteries dilate significantly. C) diastolic blood pressure decreases. D) the blood thickens as a person ages.

A) the blood vessels become stiff.

41. Prompt transport of a patient with a suspected AMI is important because: A) the patient may be eligible to receive thrombolytic therapy. B) 90% of the cardiac cells will die within the first 30 minutes. C) nitroglycerin can only be given in the emergency department. D) many patients with an AMI die within 6 hours.

A) the patient may be eligible to receive thrombolytic therapy.

21. When the shoulder girdle is aligned over the pelvis during lifting: A) the weight is exerted straight down the vertebrae. B) the hands can be held further apart from the body. C) the muscles of the back experience increased strain. D) the risk of back injuries is significantly increased.

A) the weight is exerted straight down the vertebrae.

18. Infants are often referred to as "belly breathers" because: A) their rib cage is less rigid, and the ribs sit horizontally. B) an infant's ribs are brittle and are less able to expand. C) their intercostal muscles are not functional. D) their diaphragm does not receive impulses from the brain.

A) their rib cage is less rigid, and the ribs sit horizontally.

33. Abdominal thrusts in a conscious child or adult with a severe upper airway obstruction are performed: A) until he or she loses consciousness. B) in sets of five followed by reassessment. C) about 1 inch below the xiphoid process. D) until he or she experiences cardiac arrest.

A) until he or she loses consciousness.

59. In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion. A) 1 B) 2 C) 3 D) 4

B) 2

84. What is the approximate blood volume of an 80-kg adult male? A) 5.25 L B) 6.0 L C) 6.25 L D) 6.50 L

B) 6.0 L

9. Which of the following scenarios is an example of informed consent? A) A patient advises an EMT of why he or she is refusing care. B) An EMT advises a patient of the risks of receiving treatment. C) An EMT initiates immediate care for an unconscious adult. D) A patient is advised by an EMT of the risks of refusing care.

B) An EMT advises a patient of the risks of receiving treatment.

1. Which of the following skills or interventions is included at every level of prehospital emergency training? A) Oral glucose for hypoglycemia B) Automated external defibrillation C) Intranasal medication administration D) Use of a manually triggered ventilator

B) Automated external defibrillation

44. Which of the following statements regarding gastrointestinal bleeding is correct? A) In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. B) Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself. C) Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome. D) Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

B) Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

47. A 50-year-old man with diabetes has an altered mental status and cannot tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning, and you cannot determine his blood glucose level. Which of the following clinical signs would most likely lead you to the correct diagnosis? A) Rapid and weak pulse B) Deep and rapid breathing C) Restlessness and irritability D) Hypotension and tachycardia

B) Deep and rapid breathing

91. A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing but is bleeding significantly from the wound. You should: A) ensure the patient has a patent airway. B) control the bleeding with direct pressure. C) apply oxygen with a nonrebreathing mask. D) apply a tourniquet proximal to the wound.

B) control the bleeding with direct pressure.

73. Hemoptysis is defined as: A) vomiting blood. B) coughing up blood. C) abnormal blood clotting. D) blood in the pleural space.

B) coughing up blood.

64. The principal symptom in both infectious and noninfectious gastroenteritis is: A) vomiting. B) diarrhea. C) dysuria. D) high fever.

B) diarrhea.

48. Common signs and symptoms of an allergic reaction include all of the following, except: A) abdominal cramps. B) drying of the eyes. C) flushing of the skin. D) persistent dry cough.

B) drying of the eyes.

46. Patients with uncontrolled diabetes experience polyuria because: A) they drink excess amounts of water due to dehydration. B) excess glucose in the blood is excreted by the kidneys. C) low blood glucose levels result in cellular dehydration. D) high blood sugar levels cause permanent kidney damage.

B) excess glucose in the blood is excreted by the kidneys.

79. An effective team leader should: A) command his or her team. B) help the team accomplish goals. C) perform all difficult interventions. D) refrain from any direct patient care.

B) help the team accomplish goals.

13. Enlargement of the liver is called: A) nephritis. B) hepatomegaly. C) hydrocephalus. D) pneumonitis.

B) hepatomegaly.

27. You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed, and he is not moving. Your first action should be to: A) palpate for the presence of a carotid pulse. B) log roll him as a unit to a supine position. C) assess the rate and quality of his breathing. D) open his airway with a jaw-thrust maneuver.

B) log roll him as a unit to a supine position.

76. When a patient experiences a severe spinal injury, he or she: A) will likely be paralyzed from the neck down. B) might lose sensation below the level of the injury. C) most commonly has a palpable spinal deformity. D) often loses motor function on one side of the body.

B) might lose sensation below the level of the injury.

26. A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face, and his respirations are slow and shallow. The EMT must immediately: A) insert a nasopharyngeal airway. B) perform oropharyngeal suctioning. C) apply oxygen via a nonrebreathing mask. D) begin assisting the patient's ventilations.

B) perform oropharyngeal suctioning.

16. Relative to an adult's airway anatomy, the child's: A) tongue takes up less space in the pharynx. B) pharynx is smaller and less deeply curved. C) trachea is smaller, softer, and less flexible. D) mouth and nose are proportionately larger.

B) pharynx is smaller and less deeply curved.

97. A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: A) having the patient pinch his own nostrils and then lie supine. B) pinching the patient's nostrils and having him lean forward. C) placing a rolled 4 × 4-inch dressing between his lower lip and gum. D) packing both nostrils with gauze pads until the bleeding stops.

B) pinching the patient's nostrils and having him lean forward.

24. Observations made when forming a general impression of a patient would include all of the following, except: A) appearance. B) pulse strength. C) race and gender. D) level of distress.

B) pulse strength.

50. An EMT's primary responsibility to the patient who has been poisoned is to: A) administer the appropriate antidote. B) recognize that a poisoning occurred. C) administer 25 g of activated charcoal. D) contact poison control immediately.

B) recognize that a poisoning occurred.

68. You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should: A) ask the husband to attempt to reason with his wife. B) remain in a safe place and request law enforcement. C) get in your ambulance and leave the scene immediately. D) go upstairs with caution and attempt to talk to the patient.

B) remain in a safe place and request law enforcement.

5. You have been working at the scene of a major building collapse for 8 hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is most effectively managed by: A) providing large amounts of caffeine to the rescue workers. B) requesting a CISM team to provide on-scene peer support. C) conducting a critical incident stress debriefing the next day. D) allowing each worker to sleep in 15- to 30-minute increments.

B) requesting a CISM team to provide on-scene peer support.

88. After blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the: A) kidneys. B) spleen. C) pancreas. D) gallbladder.

B) spleen.

62. A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: A) defibrillate with the AED while continuing transport to the hospital. B) stop the ambulance, begin CPR, and attach the AED as soon as possible. C) perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. D) alert the receiving hospital and perform CPR for the duration of the transport.

B) stop the ambulance, begin CPR, and attach the AED as soon as possible.

96. You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is most important to recall that: A) the patient might be significantly hypertensive. B) the patient is at risk for vomiting and aspiration. C) a detailed exam is needed to determine the cause. D) many medications interfere with blood clotting.

B) the patient is at risk for vomiting and aspiration.

35. Which of the following is not a BLS intervention? A) Abdominal thrusts B) Chest compressions C) Cardiac monitoring D) Automated defibrillation

C) Cardiac monitoring

4. Your partner, a veteran EMT with whom you have worked regularly for the past 4 years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do? A) Remain quiet and simply request another partner. B) Report the incident to your EMS medical director. C) Discreetly report your suspicions to your supervisor. D) Tell your partner that he must seek professional help.

C) Discreetly report your suspicions to your supervisor.

69. Which of the following is an example of a functional behavioral disorder? A) Head trauma B) Drug addiction C) Schizophrenia D) Alzheimer disease

C) Schizophrenia

98. Which of the following findings would be the most significant when assessing a patient with possible internal bleeding? A) The patient had a stroke five years prior. B) The patient has not eaten in 24 hours. C) The patient takes rivaroxaban (Xarelto). D) The patient has a history of hypertension.

C) The patient takes rivaroxaban (Xarelto).

3. Which of the following statements regarding the different stages of the grieving process is correct? A) The grieving process typically begins with severe depression. B) It is rare that people will jump back and forth between stages of the grieving process. C) The stages of the grieving process may occur simultaneously. D) Bargaining is the most unpleasant stage of the grieving process.

C) The stages of the grieving process may occur simultaneously.

31. Which of the following clinical signs is unique to anaphylactic shock? A) Pallor B) Dizziness C) Wheezing D) Hypotension

C) Wheezing

95. If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: A) additional sterile dressings. B) a splint and elevate the extremity. C) a tourniquet proximal to the injury. D) digital pressure to a proximal artery.

C) a tourniquet proximal to the injury.

39. You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect: A) acute pulmonary edema. B) right-sided heart failure. C) acute pulmonary embolism. D) spontaneous pneumothorax.

C) acute pulmonary embolism.

75. Subcutaneous emphysema is an indication that: A) at least half of one lung has completely collapsed. B) your patient is experiencing a pericardial tamponade. C) air is escaping into the chest wall from a damaged lung. D) blood is slowly accumulating within the tissue of the lung.

C) air is escaping into the chest wall from a damaged lung.

38. When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A) note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. B) pay special attention to the exhalation phase because this is when you will likely hear rales or rhonchi. C) auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D) start at the lower lung fields and determine at which level you start hearing clear breath sounds.

C) auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D) start at the lower lung fields and determine at which level you start hearing clear breath sounds.

65. In contrast to hypoglycemia, hyperglycemia: A) is rapidly reversible if oral glucose is given. B) commonly results in excess water retention. C) can only be corrected in the hospital setting. D) is a rapidly developing metabolic disturbance.

C) can only be corrected in the hospital setting.

89. In nontrauma patients, an early indicator of internal bleeding is: A) a rapid, thready pulse. B) rapid, shallow breathing. C) dizziness upon standing. D) a decreasing blood pressure.

C) dizziness upon standing.

86. A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing: A) an aortic aneurysm. B) acute appendicitis. C) gastrointestinal bleeding. D) intrathoracic hemorrhaging.

C) gastrointestinal bleeding.

52. If a person is partially immune to a particular disease, he or she: A) is not protected from a new infection if exposed to another individual. B) must be revaccinated at least every 18 months to avoid infection. C) might develop illness from germs that lie dormant from the initial infection. D) will not experience future illness, even if his or her immune system is stressed.

C) might develop illness from germs that lie dormant from the initial infection.

40. The left ventricle has the thickest walls because it: A) pumps blood to the lungs to be reoxygenated. B) uses less oxygen than other chambers of the heart. C) pumps blood into the aorta and systemic circulation. D) receives blood directly from the systemic circulation.

C) pumps blood into the aorta and systemic circulation.

10. Typical components of an oral patient report include all of the following, except: A) the chief complaint or mechanism of injury. B) important medical history not previously given. C) the set of baseline vital signs taken at the scene. D) the patient's response to treatment you provided.

C) the set of baseline vital signs taken at the scene.

6. If you are exposed to a patient's blood or other bodily fluid, your first action should be to: A) report the incident to the infection control officer. B) abandon patient care and seek medical attention. C) transfer care of the patient to another EMS provider. D) vigorously clean the area with soap and water.

C) transfer care of the patient to another EMS provider.

80. External bleeding from a vein is relatively easy to control because: A) veins carry deoxygenated blood. B) veins hold smaller blood volume. C) veins are under a lower pressure. D) blood typically oozes from a vein.

C) veins are under a lower pressure.

12. A 60-year-old man complains of chest pain. He is conscious, alert, and denies shortness of breath. Which of the following questions would be the most appropriate to ask him? A) "Were you exerting yourself when the chest pain began?" B) "Does the pain in your chest move to either of your arms?" C) "Does the pain in your chest feel like a stabbing sensation?" D) "Do you have any heart problems or take any medications?"

D) "Do you have any heart problems or take any medications?"

83. Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. A) 5% B) 10% C) 15% D) 20%

D) 20%

2. Which of the following statements regarding the EMS medical director and an EMT's scope of practice is correct? A) The EMS medical director can expand the EMT's scope of practice but cannot limit it without state approval. B) The EMS medical director can expand or limit an individual EMT's scope of practice without state approval. C) An EMT's scope of practice is exclusively regulated by the state EMS office, not the EMS medical director. D) An EMT's scope of practice may be expanded by the medical director after proper training and state approval.

D) An EMT's scope of practice may be expanded by the medical director after proper training and state approval.

99. 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? A) Position the patient with his injured side down. B) Apply a pelvic binder device to stabilize the pelvis. 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.

20. Which of the following steps is not proper procedure when performing an emergency move? A) Using a long-axis body drag during the move B) Pulling the patient on a blanket or similar object C) Pulling the patient's clothing in the shoulder area D) Lifting the patient by the belt to move him or her

D) Lifting the patient by the belt to move him or her

56. How does respiration differ from ventilation? A) Ventilation occurs when air is forced into the lungs, whereas respiration occurs when air is drawn or sucked into the lungs. B) Respiration occurs when the diaphragm and intercostal muscles contract, whereas ventilation occurs when those same muscles relax. C) Respiration occurs when oxygen is delivered to the cells of the body, whereas ventilation occurs when carbon dioxide is removed. D) Respiration is the process of gas exchange, whereas ventilation is the movement of air between the lungs and the environment.

D) Respiration is the process of gas exchange, whereas ventilation is the movement of air between the lungs and the environment.

34. Which of the following statements regarding ventricular fibrillation (VF) is correct? A) VF is a state of rapid ventricular contraction. B) Most patients in VF have a weak carotid pulse. C) Defibrillation is only indicated for witnessed VF. D) VF results in an absence of forward blood flow.

D) VF results in an absence of forward blood flow.

55. The term "supraventricular tachycardia" means: A) a slow heart rate that originates from within the ventricles. B) a rapid heart rate that originates from within the ventricles. C) a slow heart rate that originates from above the ventricles. D) a rapid heart rate that originates from above the ventricles.

D) a rapid heart rate that originates from above the ventricles.

67. It is most important to determine a patient's weight when asking questions pertaining to a toxic ingestion because: A) you might need additional lifting and moving assistance. B) this will allow you to determine if the exposure is lethal. C) naloxone is contraindicated if the patient is very obese. D) activated charcoal is given based on a patient's weight.

D) activated charcoal is given based on a patient's weight.

90. A young male was shot in the abdomen by an unknown type of gun. Law enforcement personnel have ensured that the scene is safe. The patient is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: A) obtain baseline vital signs. B) apply a nonrebreathing mask. C) perform a secondary assessment. D) assist the patient's ventilations.

D) assist the patient's ventilations.

100. Perfusion is most accurately defined as the: A) effective transfer of oxygen from the venules across the systemic capillary membrane walls. B) ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C) effective removal of carbon dioxide and other metabolic waste products from the body's cells. D) circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

D) circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

81. Perfusion is most accurately defined as the: A) effective transfer of oxygen from the venules across the systemic capillary membrane walls. B) ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C) effective removal of carbon dioxide and other metabolic waste products from the body's cells. D) circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

D) circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

51. The EMT certification exam is designed to: A) rank EMTs based on performance on the certification exam. B) identify those EMTs who are prepared for advanced levels of training. C) provide EMTs with the best possible wage once certification is achieved. D) ensure that EMTs are competent and have the same level of knowledge and skills.

D) ensure that EMTs are competent and have the same level of knowledge and skills.

94. After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should: A) replace the dressing with another dressing. B) apply a tourniquet proximal to the wound. C) splint the arm and keep it below heart level. D) place additional dressings over the wound.

D) place additional dressings over the wound.

66. A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to: A) reassess his breathing and blood pressure in 15 minutes. B) visualize his airway to assess for oropharyngeal swelling. C) notify medical control of the patient's response to your treatment. D) record the time and dose of the injection and transport promptly.

D) record the time and dose of the injection and transport promptly.

78. A 30-year-old female was robbed and assaulted as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A) begin immediate ventilatory assistance. B) visualize her mouth for obvious wounds. C) apply oxygen via a nonrebreathing mask. D) suction her oropharynx for 15 seconds.

D) suction her oropharynx for 15 seconds.

77. Common signs of a skull fracture include all of the following, except: A) mastoid process bruising. B) ecchymosis around the eyes. C) noted deformity to the skull. D) superficial scalp lacerations.

D) superficial scalp lacerations.

8. Your best protection against legal liability when a patient with decision-making capacity refuses EMS care and transport is to: A) advise medical control of the situation. B) err on the side of caution and transport. C) ensure that the family is aware of the risks. D) thoroughly document the entire event.

D) thoroughly document the entire event.

74. A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: A) apply full spinal motion restriction precautions. B) keep him on his side but gently straighten his legs. C) place him supine but allow him to keep his knees bent. D) transport him in the position in which you found him.

D) transport him in the position in which you found him.

101. You respond to a patient who has sustained a stab wound to the left upper thorax. She is barely responsive, pale and diaphoretic. Which of the following is the most appropriate for transport? a) Stair chair b) Long board with spinal motion restriction c) Scoop stretcher d) Short immobilization device

c) Scoop stretcher

25. What is the alveolar minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? A) 5,600 mL B) 6,000 mL C) 7,400 mL D) 8,000 mL

A) 5,600 mL

71. Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct? A) A decreased level of consciousness is not a normal part of the aging process. B) Most elderly patients have some deterioration in their level of consciousness. C) A decreased level of consciousness is most often the result of chronic dementia. D) The AVPU scale is an ineffective tool when assessing an elderly patient's level of consciousness.

A) A decreased level of consciousness is not a normal part of the aging process.

15. Which of the following statements regarding smooth muscle is correct? A) A person has no voluntary control over smooth muscle. B) Smooth muscle is found exclusively within blood vessels. C) The biceps and quadriceps are examples of smooth muscle. D) Smooth muscle is under control of the voluntary nervous system.

A) A person has no voluntary control over smooth muscle.

70. If you could only take two pieces of equipment with you to a patient's side, in addition to the jump kit, you should choose the: A) AED and portable suction unit. B) BVM and portable oxygen. C) cervical collar and long backboard. D) oral airways and sterile dressings.

A) AED and portable suction unit.

85. In which of the following situations would external bleeding be the most difficult to control? A) Femoral artery laceration and a blood pressure of 140/90 mm Hg B) Jugular vein laceration and a systolic blood pressure of 90 mm Hg C) Carotid artery laceration and a systolic blood pressure of 60 mm Hg D) Antecubital vein laceration and a blood pressure of 138/92 mm Hg

A) Femoral artery laceration and a blood pressure of 140/90 mm Hg

36. Which of the following statements regarding hepatitis A is correct? A) Hepatitis A can only be transmitted by a patient who has an acute infection. B) Infection with hepatitis A causes chronic illness with a high mortality rate. C) Hepatitis A is primarily transmitted via contact with blood or other body fluids. D) Although there is no vaccine against hepatitis A, treatment is usually successful.

A) Hepatitis A can only be transmitted by a patient who has an acute infection.

29. Which of the following medication routes has the slowest rate of absorption? A) Oral B) Rectal C) Inhalation D) Sublingual

A) Oral

82. An organ or tissue might better resist damage from hypoperfusion if the: A) body's demand for oxygen is markedly increased. B) body's temperature is considerably less than 98.6°F (37.0°C). C) systolic arterial blood pressure is at least 60 mm Hg. D) heart rate is maintained at more than 100 beats/min.

B) body's temperature is considerably less than 98.6°F (37.0°C).

14. The areas of the spinal column, in descending order, are: A) cervical, thoracic, sacral, lumbar, and coccyx. B) cervical, thoracic, lumbar, sacral, and coccyx. C) cervical, thoracic, coccyx, lumbar, and sacral. D) cervical, lumbar, thoracic, sacral, and coccyx.

B) cervical, thoracic, lumbar, sacral, and coccyx.

54. All information recorded on the PCR must be: A) typewritten or printed. B) considered confidential. C) a matter of public record. D) reflective of your opinion.

B) considered confidential.

19. You have two patients who were involved in a motor vehicle crash when their SUV struck a tree—one with neck and back pain, and the other with a deformed left femur. The patient with the deformed femur states that he does not want to be placed on a hard board, nor does he want a collar around his neck. What is the most appropriate and practical method of securing these patients and placing them into the ambulance? A) Immobilize both patients with a cervical collar and long backboard based on the mechanism of injury; place one on the wheeled stretcher and the other on the squad bench. B) Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench. C) Immobilize the patient with neck and back pain on a long backboard and place him on the squad bench; allow the patient with the deformed femur to sit on the wheeled stretcher. D) Apply a traction splint to the patient with the deformed femur and place him on the wheeled stretcher; place the patient with neck and back pain on the squad bench immobilized with a cervical collar and scoop stretcher.

B) Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench.

30. When gathering a patient's medications, you find the following: Isordil, Lasix, Nexium, and digoxin. Which of these medications can be obtained over-the-counter (OTC)? A) Lasix B) Nexium C) Isordil D) Digoxin

B) Nexium

72. Which of the following statements regarding abdominal trauma is correct? A) Most of the vital abdominal organs lie within the retroperitoneal space. B) The absence of abdominal pain does not rule out intra-abdominal bleeding. C) The liver is well protected and is rarely injured during a traumatic event. D) Hollow abdominal organs are vascular and bleed profusely when injured.

B) The absence of abdominal pain does not rule out intra-abdominal bleeding

58. What is the most common cause of airway obstruction in an unconscious patient? A) Vomitus B) The tongue C) Blood clots D) Aspirated fluid

B) The tongue

43. You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has most likely experienced: A) acute hypoglycemia. B) a ruptured cerebral artery. C) a complex partial seizure. D) an occluded cerebral artery.

B) a ruptured cerebral artery.

17. When assessing an 80-year-old patient in shock, it is important to remember that: A) it is common to see a more significant increase in heart rate than what would be expected in younger adults. B) age-related changes in the cardiovascular system might make the patient less able to compensate for decreased perfusion. C) the patient's cardiac output is able to increase by nearly 200% in response to the decrease in perfusion. D) in older adults, it is especially common to observe a significant decrease in heart rate in response to shock.

B) age-related changes in the cardiovascular system might make the patient less able to compensate for decreased perfusion.

63. An area of swelling or enlargement in a weakened arterial wall is called: A) a thrombus. B) an aneurysm. C) an embolism. D) atherosclerosis.

B) an aneurysm.

45. Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: A) ileus. B) an ulcer. C) appendicitis. D) cholecystitis.

B) an ulcer.

37. A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED), and he tells you that he does. You should: A) avoid giving him nitroglycerin and transport him at once. B) ask him what he takes, how much, and when he last took it. C) recall that erectile dysfunction (ED) drugs can cause significant hypertension. D) administer his nitroglycerin and then reassess his blood pressure.

B) ask him what he takes, how much, and when he last took it.

60. After establishing that an adult patient is unresponsive, you should: A) manually open the airway. B) assess for breathing and a pulse. C) immediately begin chest compressions. D) apply the AED and deliver a shock, if needed.

B) assess for breathing and a pulse.