emt midterm ch 1-23

: 6-8 3 Copyright © 2018 Pearson Education, Inc. 9) When lifting or moving any patient, the EMT must remember to primarily use the muscles of his or her: A) Legs B) Abdomen C) Back D) Arms

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: 6-3 3) Kyphosis is best described as: A) An exaggerated forward curvature of the thoracic spine B) A pronounced lateral curvature of the thoracic spine C) The exaggerated curvature of the lumbar spine D) A distinct lateral curvature of the cervical spine

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: 6-9 20) An elderly patient is being cared for at home by family members and lies in a hospital-type bed in the living room. After providing necessary care, you prepare to move her from the bed to the stretcher. There is no mechanism that suggests a head, neck, or spinal injury. Which method would be most appropriate in this situation? A) Draw sheet method B) Direct lift C) Extremity lift D) Direct carry method

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: 6-2 11 Copyright © 2018 Pearson Education, Inc. 40) You are at the scene of a motorcycle accident on a rural road. The EMS captain has set up a landing zone and the local helicopter EMS agency has just landed; the aircraft is still running with both rotors turning. Which observation would cause you to take immediate action? A) You see a new EMT start walking toward the aircraft as if he is going to open a door B) The patient was removed from the ambulance on the wheeled cot in anticipation of the flight crew arrival C) The EMTs who will be helping to transfer the patient to the aircraft are removing their hats and sunglasses D) The flight crew has exited the aircraft and are walking toward you while the main and tail rotor blades of the aircraft are still rotating

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: 6-13 41) You and your partner have just been dispatched to the local children's hospital to pick up the neonatal transport team and the neonatal isolette so that you can transport them to a small community hospital 2 hours away and retrieve a neonate who is in distress. While driving to the children's hospital, which statement from your partner demonstrates he understands how to transport a patient with in an isolette? A) "Once we get to the children's hospital, I will remove the wheeled cot so we can load the neonatal isolette." B) "I realize that if I'm driving to the community hospital, I will not use the lights and sirens." C) "I hate taking these types of transports because it is so boring having to sit in the front of the ambulance." D) "If you are the one in the back with the transport team on our way back to the children's hospital with the patient, make sure you turn the heat up to the highest level so the neonate stays warm."

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: 1-9 17) To be a medical director of an ambulance service, which requirement must the interested individual satisfy? A) Licensed physician B) Emergency physician with surgical experience C) Physician who was a paramedic D) Physician with a college degree in EMS

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: 7-25 91) Which term refers to how the parts of the body function and interact? A) Physiology B) Anatomy C) Aerobic metabolism D) Biome

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: 6-14 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 7 Anatomy, Physiology, and Medical Terminology 1) A 23-year-old male patient has been shot with a rifle by an assailant standing in front of him. The bullet entered the victim's chest just above the left nipple and exited his body laterally left of his fourth lumbar vertebrae. Proper documentation of this injury would include: A) Entry wound to the anterior thorax B) Exit wound to the posterior thorax C) Entry wound to the abdomen D) Exit wound to the posterior torso

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: 7-7 56) What is a function of the skeletal system? A) Producing blood cells B) Protecting all of the abdominal organs C) Providing structure and points of attachment to blood vessels D) Forming the vital organs of the body

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: 7-5 60) Degenerative disk disease to the vertebrae is characterized by damage to which structure(s) between the vertebrae? A) Intervertebral disks B) Spinal joints C) Spinal cord D) Vertebral nerve endings

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: 7-20 13 Copyright © 2018 Pearson Education, Inc. 54) A patient has experienced a burn to the skin. Based on the function of the skin, he is now more susceptible to: A) Infection B) Fluid overload C) Heart problems D) Endocrine disorders

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: 7-22 71) Which statement regarding the integumentary system is true? A) The skin protects the body against bacteria and other organisms B) The skin contains four layers: epidermal, dermal, subcutaneous, and nerve layer C) The epidermis is the thickest and most important layer of the skin D) The dermal layer is the outermost layer of the skin and contains sensory nerves

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: 7-19 90) Which organ(s) is (are) responsible for production and secretion of the primary female hormone progesterone? A) Ovaries B) External genitals C) Testes D) Uterus

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: 1-7 11) Why is EMS in a unique position to contribute significantly to mobile integrated health care? A) EMS providers are familiar with and capable of functioning in the out-of-hospital environment B) Ambulances are easily identified C) The community trusts uniformed health care providers D) EMS providers are familiar with the many routes of medication administration

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: 7-27 18 Copyright © 2018 Pearson Education, Inc. 77) Pain that is described as "caustic" by the patient is: A) Burning B) Sharp C) Stabbing D) Achy

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: 7-5 80) A patient with dentalgia is suffering from a(n): A) Painful tooth B) Throat infection C) Inflammation of the tongue D) Sinus infection

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: 8-5 16) The EMT would document an FDO2 level when the patient is: A) Assisting breathing with a bag-valve-mask device B) Inserting a nasopharyngeal airway C) Providing oxygen at greater than 10 liters per minute D) Using a nonrebreather face mask that delivers high-concentration O2

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: 8-9 30) A 100-kilogram patient with a 500-milliliter tidal volume, breathing 16 times each minute, would have a minute ventilation of how many milliliters? A) 8000 mL B) 1200 mL C) 1600 mL D) 2400 mL

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: 8-10 28) What is the primary stimulus to breathe in human beings without pulmonary diseases? A) Level of CO2 in the body B) Amount of oxygen required by the body C) Level of oxygen in the body D) Amount of nitrogen in air

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: 8-11 36) What is the primary way in which oxygen is transported to the cells? A) Red blood cells B) White blood cells C) Plasma D) Platelets

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: 8-17 59) The body will initially compensate for a decrease in cardiac output by: A) Increasing systemic vascular resistance B) Increasing the respiratory rate C) Dilating to arteries, veins, and capillaries D) Decreasing the heart rate

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: 9-10 27) Puberty is best described as: A) Maturation of the sexual organs B) A milestone developmental stage in school-age children C) A two- to three-year growth spurt in adolescents D) A developmental stage that occurs earlier in males than in females

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: 9-2 5 Copyright © 2018 Pearson Education, Inc. 16) An EMT would recognize and categorize a 15-year-old female patient as a(n): A) Adolescent B) School-age child C) Young adult D) Pubescent

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: 9-6 11) You have received a grant to promote healthy living habits among the 20- to 40-year-old age group. Given the most common cause of death within this age group, which topic should be the focus of your program? A) Safe driving B) Cancer screening C) Safe sex practices D) Healthy heart living

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: 9-7 12) A common concern about the well-being of a female patient in the 41- to 60-year-old age group is: A) Cancer B) Drug overdose C) Accidental death D) Low cholesterol levels

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: 9-9 33) Which statement is true regarding the maximum life span? A) Almost all persons die before reaching the maximum life span B) The maximum life span is different for every person and takes into account health status and occupation C) The maximum life span is approximately 100 years of age D) The maximum life span is the average years a person is expected to live based on health status

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: 10-6 3) Which of these patients should the EMT recognize as having a potential occlusion of the upper airway? A) A 3-year-old male with a fever and swelling of the larynx B) A 45-year-old female with spasm of the bronchioles C) A 61-year-old male with a piece of fruit stuck in his trachea D) A 78-year-old female with a large mucus plug in her bronchi

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: 10-13 110) In a healthy patient, for air to be exhaled from the lungs, what must occur? A) The diaphragm must relax B) The CO2 levels must be low C) The pressure is the lungs must be low D) The intercostals muscles must contract

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: 10-3 31 Copyright © 2018 Pearson Education, Inc. 120) On arrival at a lethargic patient's side, you note her to have gurgling respirations. What is the best treatment for this condition? A) Suction B) Head-tilt, chin-lift maneuver C) Oropharyngeal airway D) Jaw-thrust maneuver

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: 10-10 14 Copyright © 2018 Pearson Education, Inc. 51) You are observing an EMT insert an oropharyngeal airway into the airway of a 36-year-old male patient who has overdosed on a street drug. Which observation indicates a correct technique? A) The airway is inserted into the mouth upside-down, and then turned 180 degrees once it contacts the soft palate B) The EMT uses a tongue depressor to press the back of the tongue downward, and then inserts the oral airway upside-down C) The airway is inserted in its normal anatomic position until the flange of the airway is 1 cm above the lips D) The oral airway is introduced sideways into the mouth, and then rotated 180 degrees once it has reached the base of the tongue

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: 10-18 104) When administering continuous positive airway pressure (CPAP) to a patient, you would recognize that the patient is benefiting from the treatment when the: A) Patient states he is breathing easier B) Heart rate increases from baseline by 10 percent C) Systolic blood pressure drops below 100 mmHg D) Patient can resume control of his airway

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: 2-3 21) Organisms that cause diseases are called: A) Pathogens B) Toxins C) Antigens D) Antibodies

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: 10-10 58) Which of these statements best describes the EMT's understanding of oxygen? A) It is a gas classified as a drug B) It is a highly flammable substance C) It is an odorless cloudy gas when pressurized D) It is a moist gas that supports cellular activity

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: 10-24 20 Copyright © 2018 Pearson Education, Inc. 76) When monitoring a patient receiving oxygen through a nasal cannula, which of these observations warrants immediate intervention? A) Oxygen flow rate of 15 liters per minute B) Prongs in the nostrils curving posteriorly into the nose C) Tubing positioned over the ears and under the chin D) Breathing normally with the nasal cannula in place

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: 2-3 3) The EMT practice of protecting oneself from disease transmission through exposure to blood and other body fluids is referred to as: A) Standard Precautions B) Exposure control C) Personal protective equipment D) Body Fluid Precautions

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: 10-12 18 Copyright © 2018 Pearson Education, Inc. 68) Which action should you perform when attaching a therapy regulator to a new oxygen tank? A) Open the cylinder valve for 1 second prior to attaching the regulator B) Tighten the regulator to the oxygen cylinder with an oxygen wrench C) Stand the tank upright on the floor for 2 minutes prior to attaching the regulator D) Lubricate the stem of the cylinder with oil prior to attaching the regulator

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: 11-7 19) Which of these characteristics would be considered a pulse "quality" factor? A) Strength B) Rate C) Regularity D) Tone

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: 11-12 55) A blood pressure is reported as 116/68 mmHg. Given this finding, which of these statements is true? A) The systolic blood pressure is 116 mmHg B) The top number reflects the diastolic blood pressure C) The systolic pressure is determined by subtracting 68 from 116 D) The diastolic blood pressure is 116 mmHg

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: 11-11 64) Your partner states that he wants to palpate the blood pressure. Which equipment would you hand him? A) Blood pressure cuff B) Stethoscope C) Blood pressure cuff and stethoscope D) Stethoscope and pulse oximeter

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: 11-8 95) When you are obtaining the blood pressure of a patient in a standing position, the patient states that he suddenly feels weak and is going to pass out. Your immediate action should be to: A) Place the patient back into bed B) Determine the blood pressure by palpation C) Ask the patient if he is having chest pain D) Hold the patient upright until the blood pressure is obtained

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: 11-15 82) How should the EMT document a pulse oximetry reading on the prehospital care report? A) 97% SpO2 B) 97% O2 C) 97% PO D) 97% PO2

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: 11-17 111) Which of these is an example of an open-ended question? A) "Why did you call 911?" B) "Does your chest hurt?" C) "Are you dizzy?" D) "Did you take your medications today?"

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: 11-19 112) A patient with chest pain informs you that the pain is greater when he takes a deep breath. The EMT is using the active listening technique of "facilitation" and "clarification" when he responds by saying: A) "I see. Can you describe what the pain feels like?" B) "I understand it hurts. Please go on." C) "Hmmm. That really seems to hurt a lot." D) "So what you are saying is that it hurts more when you breathe?"

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: 12-2 4) Which personal protective equipment must the EMT take on every call? A) Gloves B) Gloves and face shield C) Gloves, gown, and goggles D) Goggles and gown

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: 12-6 6) What is the most common potential hazard an EMT faces on scene? A) Blood and body fluids B) Aggressive patients C) Upset family members D) Unfamiliar settings

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: 12-1 19) At the scene of a motor vehicle collision involving two vehicles on a narrow two-lane road, which actions would be most appropriate to ensure rescuer and patient safety? A) Place flares in each direction from the collision scene B) Remove reflective clothing to avoid distracting passing vehicles C) Turn your reflective back to oncoming traffic so those drivers are aware of your presence D) Treat the patients between the vehicles so all rescuers can see each other

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: 2-11 10 Copyright © 2018 Pearson Education, Inc. 36) A 38-year-old male is complaining of generalized weakness and fatigue. Assessment findings include abdominal pain, fever, and yellowing of the eyes. Given these signs and symptoms, you would be suspicious of: A) Hepatitis B) Tuberculosis C) AIDS D) West Nile virus

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: 13-1 31) You have just determined that a 92-year-old female patient found in bed is unresponsive, but still has a carotid pulse. Your next action would be to: A) Open the airway manually B) Check for a radial pulse C) Determine the past medical history D) Immediate transport

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: 13-7 9 Copyright © 2018 Pearson Education, Inc. 32) Near the end of a workday, a construction worker fell 10 feet from scaffolding, landing on his head and left shoulder. He is found to be spontaneously alert, but confused. His airway is open and his breathing is adequate. Coworkers state that he was unresponsive for a period of 2 minutes following the fall and is on medications for depression and heart problems. Based on this information, the EMT should initially classify him as which kind of patient? A) Trauma B) Trauma and behavioral C) Medical and trauma D) Medical, trauma, and behavioral

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: 13-9 2 Copyright © 2018 Pearson Education, Inc. 5) You have been dispatched to an apartment for an elderly male complaining of shortness of breath. When do you start the process of forming a general impression about this patient? A) As you and your partner approach him B) After completing the primary assessment C) As soon as you obtain his chief complaint D) Following the completion of vital signs

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: 2-11 39) The primary personal threat to a person with AIDS is: A) Infection B) Organ damage C) Heart failure D) Weight loss

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: 13-8 4 Copyright © 2018 Pearson Education, Inc. 13) You are by the side of a patient who complains of shortness of breath and has a history of heart problems, including congestive heart failure (CHF). When assessing the airway, which of these observations best indicates that it is still patent? A) The patient easily tells you that she is having chest pain B) The patient is sitting in an upright position because she cannot lie flat C) The patient can speak only in extremely short sentences D) The patient is lethargic and confused to person, place, and time

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: 13-9 22) The EMT would recognize which of these patients as having a normal breathing rate? A) An 8-year-old male breathing 24 times per minute B) A 44-year-old male breathing 6 times per minute C) A 6-month-old infant breathing 58 times per minute D) A 22-year-old female breathing 26 times per minute

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: 13-4 57) A 43-year-old male patient has called 911 with the complaint of difficulty breathing. Once on scene, you note he is breathing at a rate of 18 breaths/min. He also exhibits intercostal retractions and nasal flaring. The pulse oximeter reads 93% on room air. The EMT should document this patient's breathing as: A) Dyspneic B) Apneic C) Tachypneic D) Bradypneic

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: 2-13 43) Which organism is classified as multi-drug resistant? A) Methicillin/oxacillin-resistant Staphylococcus aureus B) Hepatitis B virus C) Human immunodeficiency virus D) Zika virus

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: 13-13 51) Which capillary refill time is considered the upper limit of normal for an adult female? A) 3 seconds B) 2 seconds C) 6 seconds D) 4 seconds

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: 2-1 22) A reference tool that should be placed in every emergency vehicle for use when responding to a possible "hazmat" incident is: A) The Emergency Response Guidebook B) The Physician's Desk Reference C) The Merck Manual D) A list of chemicals processed by local industries

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: 13-14 76) When assessing the breath sounds (during a rapid secondary exam) of a critical trauma patient, it is best to auscultate each lung in at least how many places? A) 2 B) 1 C) 4 D) 3

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: 13-15 106) Which numeric evaluation tool is scored and added to the Trauma Scale to determine the Revised Trauma Score? A) Glasgow Coma Scale B) AVPU C) Pulse pressure D) Primary Assessment Score

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: 14-6 24) In which form is activated charcoal administered? A) Suspension B) Syrup C) Aerosolized powder D) Tablet

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: 14-2 35) Which of these medications would the EMT administer PO? A) Aspirin B) Nitroglycerin C) Albuterol D) Epinephrine

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: 14-3 3) A patient with difficulty breathing has a metered-dose inhaler (MDI). Which of these would be a likely type of medication contained in the MDI? A) Albuterol B) Steroids C) Oxygen D) Epinephrine

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: 14-2 39) Which of these medications may be administered by a mucosal atomizer device (MAD) by the EMT if the EMT has authorization from medical direction to do so? A) Naloxone hydrochloride B) Epinephrine hydrochloride C) Glucose D) Activated charcoal

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: 14-10 8 Copyright © 2018 Pearson Education, Inc. 29) The EMT should consider aspirin for a patient with: A) Chest discomfort B) Headache C) Shortness of breath D) Fever

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: 14-9 18) Which of these is one of the five rights of medication administration? A) Right dose B) Right EMT C) Right allergies D) Right physician

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: 15-1 14) A patient has just gone into cardiac arrest. His heart is most likely in which rhythm? A) Ventricular fibrillation B) Ventricular asystole C) Ventricular tachycardia D) Ventricular PEA

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: 15-15 3 Copyright © 2018 Pearson Education, Inc. 9) Which of these is considered a benefit of the automated external defibrillator? A) The ease and speed with which it can be used B) Elimination of the need for a primary assessment C) Its ability to identify and confirm cardiac arrest D) The need for little-to-no CPR training to use the device

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: 16-18 76) You are starting to assess a patient's breath sounds and have just listened to the upper right back. You would next listen to the: A) Left upper back B) Left anterior chest C) Right lower back D) Left lateral chest

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: 16-13 48) When auscultating breath sounds, the EMT should recognize rhonchi when he hears which type of sound? A) Rattling-like noises that change when the patient coughs B) Crowing-like sounds that are accompanied by a high-pitched cough C) High-pitched whistling-like noises heard more on expiration D) Crackling-like noises heard in the upper portion of the lung

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: 16-1 10 Copyright © 2018 Pearson Education, Inc. 34) A 36-year-old patient has overdosed on an unknown drug and is unresponsive. His breathing is shallow, with a rate of 6 breaths/min. He has cyanosis around his lips and to his fingertips. His skin is cool to the touch, and his radial pulse is rapid. His breath sounds are diminished but clear. The EMT should recognize which respiratory condition from this assessment? A) Hypoxia B) Tachypnea C) Bronchospasm D) Apnea

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: 16-15 22) You have been called for a patient who complains of shortness of breath. On scene, you find the 41-year-old woman sitting upright in bed with nasal flaring and wheezing. A metered-dose inhaler (MDI) is lying on the nightstand next to her. To assist her with the MDI, which criteria must be met? A) The MDI must be prescribed for the patient B) The pulse oximeter reading must be less than 90% C) High-concentration oxygen must be administered first for 5 minutes D) The patient must display altered mental status

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: 16-15 4 Copyright © 2018 Pearson Education, Inc. 13) While you are obtaining a medical history for a patient with generalized weakness and fatigue, she hands you a list of all the medications she is currently taking. Which of these medications should the EMT recognize as a bronchodilator for which the EMT could assist in its administration? A) Metaproterenol B) Mucomyst C) Prednisone D) Metformin

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: 16-16 14) The medication contained within a metered-dose inhaler is in which form? A) Aerosolized B) Compressed tablet C) Pressurized liquid D) Viscous gel

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: 1-8 23) You work in a community that has an "enhanced" 911 system. Given this, which is true about such a system? A) The physical location of the landline used to make the 911 call is displayed to the call taker B) The EMS system uses EMTs, Advanced EMTs, and paramedics C) The fire department responds simultaneously with EMS D) The total response time for EMS will rarely exceed 9 minutes

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: 16-17 10) As compared to an adult, how would you describe the respiratory rate of an infant? A) Faster than an adult's rate B) Slower than an adult's rate C) Same as an adult's rate D) Normally slower than an adult's rate, unless dyspnea is present

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: 16-6 55) The EMT is correctly assessing a patient for subcutaneous emphysema when he: A) Palpates the anterior and posterior chest B) Listens posteriorly for breath sounds C) Observes the chest for abnormalities D) Examines the neck veins for distention

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: 17-2 68) The primary pacemaker site of the heart is the: A) Sinoatrial node B) Brainstem C) Right atrium D) Ventricular node

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: 17-2 65) All arteries: A) Carry blood away from the heart B) Have lower pressure than veins C) Carry oxygen-rich blood D) Are located in the torso of the body

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: 17-16 29) Prior to administering nitroglycerin to a patient with chest pain, the EMT must ensure that: A) The nitroglycerin is prescribed for the patient B) The patient rates his chest pain as 10 out of 10 C) The patient's systolic blood pressure is greater than 110 mmHg D) The patient is standing in an upright position

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: 17-11 21) For the EMT to administer aspirin in the prehospital setting, which of these criteria must be met? A) Approval from medical direction B) Patient has a prescription for aspirin C) Age younger than 65 years D) Systolic blood pressure greater than 100 mmHg

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: 3-12 7 Copyright © 2018 Pearson Education, Inc. 22) For negligence to be proven, what must be present? A) Duty to act, breach of duty, injury, proximate cause B) Duty to act, breach of duty, battery, foreseeability C) Assault, breach of duty, damage, and then abandonment D) Harm to the patient, false imprisonment, duty to act

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: 18-3 36) Which of these statements shows that the EMT has an accurate understanding of altered mental status? A) "It describes any change away from a normal state of mental function." B) "It applies only when the patient is not responsive to verbal or painful stimuli." C) "It should be suspected only when the patient is on medications that can cause confusion." D) "It is any mental state experienced by a person with diabetes or other serious chronic disease."

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: 18-12 9 Copyright © 2018 Pearson Education, Inc. 33) Which one of these describes the typical signs and symptoms of a transient ischemic attack (TIA)? A) Temporary, with many TIAs lasting less than 15 minutes B) Persistent, with most TIAs lasting more than 1 hour but less than 24 hours C) Mild, but permanent D) Severe and debilitating

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: 18-7 2 Copyright © 2018 Pearson Education, Inc. 5) When assessing a patient with a suspected stroke, the order of the exam would be: A) Primary assessment, then secondary assessment including a stroke scale B) Level of consciousness, facial droop, arm drift, airway, and then secondary assessment C) Abnormal speech, facial droop, arm drift, primary assessment, and then secondary assessment D) Secondary assessment, primary assessment, stroke exam, and then SAMPLE history

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: 18-7 17) When a patient smiles, the left side of the face shows significantly less movement than the right side of the face. The EMT would describe this finding as: A) Left-side facial droop B) Right-side facial droop C) Left-side facial paralysis D) Right-side facial paralysis

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: 3-16 11 Copyright © 2018 Pearson Education, Inc. 36) The EMT recognizes that the Health Insurance Portability and Accountability Act (HIPAA) limits the EMT's ability to: A) Share patient-specific medical information with others B) Bill for services provided by the Emergency Medical Services system C) Obtain refusals of care from patients who do not have medical insurance D) Transport patients to the hospitals of their choice

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: 3-13 66) You have extricated a male patient who was entrapped in a rollover car wreck. During your immediate on-scene management, you removed the patient's clothing and started CPR. During this time, a police officer retrieved the driver's license from the patient's pants and advises you that he is an organ donor. Given this information, which statement is true? A) The patient should be treated in the same way en route to the hospital as a nondonor B) The patient cannot be an organ donor now since he arrested prior to reaching the hospital C) The EMTs should initiate cooling measures to increase the longevity of the patient's organs D) The patient should be hyperventilated and hyperoxygenated along with receiving CPR to increase the longevity of his organs

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: 19-5 45) An 86-year-old male patient has experienced a sudden change in mental status and is repeatedly striking a fist against his leg. When you question him, he does not respond. This presentation is most consistent with which condition? A) Seizure B) Dementia C) Diabetes D) Delirium

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: 1-3 2 Copyright © 2018 Pearson Education, Inc. 5) An Emergency Medical Responder (EMR) approaches you and states that he is interested in becoming an EMT. Specifically, he asks what he will be able to do as an EMT that he cannot presently do as an EMR. You respond by saying he will be able to: A) Administer some medications B) Assist in emergency childbirth C) Use an automated external defibrillator D) Obtain vital signs

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: 20-11 54) Long-term complications of diabetes commonly include: A) Kidney disease B) Asthma C) Mental retardation D) Coma

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: 20-11 8) What is a glucometer used to evaluate? A) Glucose levels B) Insulin levels C) Glucogen levels D) Insulin and glucose levels

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: 20-5 4 Copyright © 2018 Pearson Education, Inc. 13) How would an EMT best describe a confused and combative patient with labored respirations and a blood glucose level of 33 mg/dL? A) Hypoglycemic B) Altered blood glucose C) Hyperglycemic D) Hyper-insulinemic

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: 20-8 26) In which form is oral glucose packaged? A) Gel B) Liquid C) Powder D) Sugar granules

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: 21-1 11) If signs and symptoms of anaphylaxis occur rapidly in a patient, the EMT must realize that: A) The reaction will likely be severe B) The reaction will likely be localized C) An increased amount of antigens is present in the patient's body D) Epinephrine will not be effective

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: 21-8 15 Copyright © 2018 Pearson Education, Inc. 53) Within the body, the release of histamine causes dilation of the: A) Blood vessels B) Small airways C) Upper airway D) Salivary glands

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: 21-6 21) You are called to an outpatient surgery center for a patient who developed an allergic reaction while receiving an intravenous (IV) antibiotic. How would you would document the route of exposure? A) Injection B) Contact C) Ingestion D) Topical

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: 20-10 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 21 Allergic and Anaphylactic Reactions 1) A panicked and anxious patient tells you that he is allergic to peanuts and thinks he may have accidentally eaten some. He states that the last time he ate peanuts he almost died and needed to have a "tube put in his throat." When assessing this patient, which of these signs or symptoms would provide the best evidence that the patient is having an allergic, and possibly an early anaphylactic, reaction? A) Hives on his chest B) Panic and anxiety C) Elevated blood pressure D) Cool and dry skin

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: 21-7 5) During the primary assessment, which of these findings would most lead the EMT to suspect an allergic reaction? A) Hives to the face and neck B) Blood pressure of 100/60 mmHg C) Heart rate of 112 beats/min D) Complaint of dizziness

: A Diff: 1 Page Ref: 636

: 21-9 25) After you assist a patient with his epinephrine auto-injector, which of these statements made by the patient best indicates that the epinephrine is working and the patient is improving? A) "My breathing feels a lot easier." B) "My heart feels as though it is racing." C) "I am getting a little bit of a headache." D) "I am more relaxed and getting sleepy."

: A Diff: 1 Page Ref: 640

: 21-9 27) How should an EMT assist a patient in taking his epinephrine auto-injector? A) Press the injector onto the lateral thigh, and wait for it to automatically inject B) Place the injector against the deltoid muscle in the arm, and push the plunger to slowly inject the medication C) Pinch the skin on the anterior thigh, press the injector against the skin, and wait until it activates D) Pinch the skin on the lateral thigh, press the injector against the skin, and rapidly push the plunger to inject the medication

: A Diff: 1 Page Ref: 643-644, Figure 21-6

: 22-3 8) A 44-year-old male patient had a pesticide splashed into his eyes. Aside from local irritation and damage to the eyes, he developed systemic complications when the pesticide entered and circulated throughout his body. When completing the prehospital care report, the EMT would note the route of exposure as: A) Absorption B) Visual C) Injection D) Topical

: A Diff: 1 Page Ref: 652

: 22-5 18) A confused female patient states that she was intoxicated and accidentally drank a glass of household bleach. When transporting this patient, which complication would you continually assess for? A) Vomiting B) Chest pain C) Headache D) Diaphoresis

: A Diff: 1 Page Ref: 654

: 22-7 31) Medical direction has ordered the administration of activated charcoal to an adult patient who has overdosed on several unspecified medications. Prior to administering the medication, the EMT must: A) Shake the medication thoroughly to mix it B) Determine whether the patient has a prescription for the medication C) Determine whether the patient has a history of diabetes D) Ask the patient if he has had diarrhea over the past two weeks

: A Diff: 1 Page Ref: 657, Figure 22-3

: 22-11 81) A 56-year-old male patient has been exposed to fumes containing cyanide. Why should the EMT call for advanced life support assistance? A) Paramedics may be able to administer a cyanide antidote B) IV fluids are needed to flush the cyanide from the patient's body C) Oxygen will make this patient worse if given by the EMT D) Paramedics can induce vomiting, so as to rid the body of the cyanide

: A Diff: 1 Page Ref: 668

: 22-11 49) You have been called for a young female patient who overdosed on several drugs. What is the most essential step for the EMT to perform while caring for this patient? A) Identify and correct the loss of vital function(s) B) Identify the drug(s) and amount(s) taken C) Determine whether the patient has a history of drug abuse D) Identify medical conditions that may be worsened by the drug(s)

: A Diff: 1 Page Ref: 678

: 22-16 95) When treating a patient for an overdose, the highest priority of care is placed on: A) Managing the airway and breathing B) Determining what and how much drug was taken C) Establishing the patient's risk for suicide D) Contacting law enforcement

: A Diff: 1 Page Ref: 678

: 22-6 68) You are en route for a possible heroin overdose. As an EMT, you would recognize heroin fits best into which drug category based on its effects? A) Sedatives B) Hallucinogens C) Psychedelics D) Stimulants

: A Diff: 1 Page Ref: 686

: 23-2 11) The EMT knows that the abdomen is located: A) Between the diaphragm and the top of the pelvis B) From the mid-chest to the umbilicus C) Between the nipple line and the coccyx of the spine D) From the bottom of the rib cage to the pelvis

: A Diff: 1 Page Ref: 697

: 23-2 8) The spleen of a patient has ruptured following a traumatic injury. Because it is a solid organ, the EMT recognizes that the primary threat to life is: A) Blood loss B) Pain C) Infection D) Inflammation

: A Diff: 1 Page Ref: 698

: 1-4 10 Copyright © 2018 Pearson Education, Inc. 36) Which statement accurately describes the hospital emergency department? A) It is a health care destination staffed by physicians, nurses, and others designed to evaluate and stabilize patients, preparing them for further care B) It requires patients to make an appointment to be seen by a physician, unless they arrive by ambulance C) It is the only health care destination to which EMS can transport patients with a medical emergency D) It provides lifesaving care instructions to callers accessing the 911 system

: A Diff: 1 Page Ref: 7

: 23-6 87) What is the major threat to life for a patient with an unstable abdominal aortic aneurysm? A) Hemorrhage B) Infection C) Hypoxia D) Organ compression

: A Diff: 1 Page Ref: 705-706

: 23-7 28 Copyright © 2018 Pearson Education, Inc. 109) When assessing a patient with chronic anemia, the EMT would expect which of these findings? A) Pale skin B) Yellow skin C) Joint pain D) Flushed skin

: A Diff: 1 Page Ref: 713

: 23-15 99) When differentiating chronic renal failure from acute renal failure, the EMT realizes: A) Chronic renal failure often requires long-term dialysis B) Acute renal failure is often permanent C) Chronic renal failure is reversible with IV fluid administration D) Acute renal failure is treated with a kidney transplant

: A Diff: 1 Page Ref: 721

: 23-13 26 Copyright © 2018 Pearson Education, Inc. 101) The wife and primary care provider of a disabled male patient tells you that he has a suprapubic catheter in place. Upon assessment of the patient, which of these findings would you expect? A) Surgical tube coming out of the pelvic area B) Tubes coming from the back in the area of the kidneys C) Tubing coming from the urethra of the patient's penis D) Surgical tubing coming from the patient's rectum

: A Diff: 1 Page Ref: 723

: 1-6 9 Copyright © 2018 Pearson Education, Inc. 32) You have arrived at the scene of a medical emergency and find a woman lying on the floor of a grocery store. As you approach her, you know that your first priority as an EMT is: A) Personal safety B) Patient care C) Public safety D) Patient advocacy

: A Diff: 1 Page Ref: 8

: 5-13 43) Your portable radio was accidently dropped at the scene of a car wreck and has become soiled with dirt and mud. How should you clean the portable prior to putting it back into service? A) Wipe it down with a damp cloth B) Run it under warm water to rinse off the mud C) Clean it with multiple alcohol preps from the ambulance D) Return it to the station so it can soak in disinfectant solution, and obtain a replacement radio

: A Diff: 1 Page Ref: 87

: 5-4 22) When providing a lengthy radio report, the most important reason to pause every 30 seconds is so that: A) Other people can use the radio for emergency transmissions that may arise B) The repeater can process and transmit all that you are saying C) The person receiving the message has time to think about what you are saying D) The person receiving the message can write down what you are saying

: A Diff: 1 Page Ref: 88

: 5-14 27) Your ambulance was dispatched for a patient complaining of shortness of breath at 1512. You arrived on scene at 1523 and left at 1538. You arrived at the hospital with the patient at 1557 and were back in service at 1622. Given this information, which is true? A) Your scene time was 15 minutes B) You arrived on the scene at 5:23 P.M. C) The call took place in the morning D) The time spent at the hospital was 16 minutes and 22 seconds

: A Diff: 1 Page Ref: 92

: 5-1 9 Copyright © 2018 Pearson Education, Inc. 33) Which of these is an open-ended question? A) "Can you describe the pain to me?" B) "What time did the pain begin?" C) "Did you get sweaty when the pain started?" D) "Who is your primary care physician?"

: A Diff: 1 Page Ref: 97

: 4-7 30) A patient care report reads: "c/o chest pain with associated DOE; PMH of IDDM." Regarding this description, which interpretation is most accurate? A) The patient has diabetes B) The patient is breathing easily C) The patient takes no medications D) The patient took insulin

: A Diff: 1 Page Ref: Table 4-2 Abbreviations

: 6-9 17) A patient must be removed immediately from a structure that is on the verge of collapse following an explosion. He is lying on the ground and dressed in shorts and a T-shirt. You are by yourself and have no other supplies or equipment. Which type of move would be most appropriate in this situation? A) The armpit-forearm drag B) The extremity lift C) The pants drag D) The blanket drag

: A Diff: 2 Page Ref: 107

: 6-12 27) When you must push an object, it is important to: A) Push using muscles between your waist and your shoulders B) Push from an overhead position C) Keep your elbows straight and locked D) Push with your hands spread as far apart as you can

: A Diff: 2 Page Ref: 109

: 1-14 47) Which attribute of a person would not likely work out well in the EMS profession? A) Inability or no desire to "take charge" B) Being able to make good decisions with minimal information C) Being able to adapt to a situation when things become chaotic D) Willingness to hold what is learned about patients, good and bad, in confidence

: A Diff: 2 Page Ref: 11

: 6-11 24) Your coworkers would like to purchase a scoop (orthopedic) stretcher with some grant money. Before the purchase can be authorized, you have been asked to inform the purchasing committee of how this piece of equipment will benefit the service as well as enhance patient care. Your response would be: A) "The scoop stretcher is good for moving patients from confined areas." B) "The scoop stretcher does not require straps to secure the patient." C) "The scoop stretcher is considered the best device for patients with a possible spinal injury." D) "The scoop stretcher is much more comfortable than a wheeled stretcher."

: A Diff: 2 Page Ref: 115

: 6-11 34) Which patient is appropriately positioned for transport? A) An alert 67-year-old woman with nausea in a sitting position B) A critically injured 18-month-old child in a car seat C) A hypotensive 48-year-old man in Fowler's position D) A 23-year-old pregnant woman in a supine position

: A Diff: 2 Page Ref: 116

: 6-10 31) You and your partner are preparing to move a trauma patient down a flight of stairs using a portable stretcher. As you begin the move, a third EMT shows up and asks to help. Which instructions would be most appropriate to ensure a safe move for both the patient and crew? A) "Please stand behind the EMT at the foot end and count steps for her." B) "You can help by grasping the right side of the stretcher to keep it balanced." C) "Come up and help me with the head end, since most of the weight is here." D) "Stand behind us at the top of the stairs and let us know if you see any obstacles."

: A Diff: 2 Page Ref: 118

: 7-25 22 Copyright © 2018 Pearson Education, Inc. 96) You are reading a patient care report written by your partner. Which sentence would cause you to tell your partner that you have found an error? A) "The patient was placed in a face-up prone position." B) "The patient was in a lateral recumbent position so as to allow airway monitoring while en route to the hospital." C) "The patient was placed in Fowler's position with the upper body elevated 45 degrees." D) "The patient was found in a supine position with his hips and legs flexed toward the core."

: A Diff: 2 Page Ref: 129-130

: 1-9 6 Copyright © 2018 Pearson Education, Inc. 20) Before the EMT contacts medical direction for authorization to assist a patient with shortness of breath in using her metered-dose inhaler, protocols state that the EMT must first attempt to provide relief by administering oxygen if the pulse oximeter reading is less than 94%. You recognize that the administration of oxygen is best described as a(n): A) Standing order B) On-line medical direction C) Direct permission D) Quality improvement

: A Diff: 2 Page Ref: 13

: 7-4 7) Which plane would show the liver, stomach, and spleen? A) Transverse plane B) Midline plane C) Abdominal plane D) Sagittal plane

: A Diff: 2 Page Ref: 131

: 7-1 11) A patient informs you that he injured a tendon in his knee three years ago and has had a difficult time walking since then. You recognize that this injury involves a structure that: A) Connects muscles to the knee B) Connects the muscles together surrounding the knee C) Holds and secures the bones of the knee D) Attaches a ligament to the knee

: A Diff: 2 Page Ref: 132

: 7-7 18) The bones of the upper extremities include the: A) Humerus and radius B) Humerus and calcaneus C) Phalanges and tibia D) Radius, ulna, and tarsals

: A Diff: 2 Page Ref: 138

: 7-9 4 Copyright © 2018 Pearson Education, Inc. 14) A female patient has a muscular disease and cannot walk, so she requires a wheelchair. Because the patient cannot ambulate by her own will, you would recognize that the muscles involved are: A) Voluntary B) Involuntary C) Cardiac D) Smooth

: A Diff: 2 Page Ref: 141

: 7-12 28) The infant airway differs from the adult airway in that: A) The infant's tongue takes up proportionately more space in the mouth B) The infant's trachea is highly rigid and less flexible to movement C) All of the infant's respiratory structures are proportionally smaller and more easily obstructed D) The infant's epiglottis is smaller and located behind the esophagus

: A Diff: 2 Page Ref: 147

: 7-17 12 Copyright © 2018 Pearson Education, Inc. 50) In the healthy heart, the electrical impulses that cause normal contraction of the cardiac muscle are initiated in the: A) Sinoatrial node B) Left atrium C) Bundle branches D) Ventricles

: A Diff: 2 Page Ref: 151

: 7-15 42) The pressure exerted on the walls of the arteries as the left ventricle contracts is called: A) Systolic B) Arterial C) Diastolic D) Osmotic

: A Diff: 2 Page Ref: 155

: 1-15 46) In the public health continuum, what is the first responsibility that public health officials must satisfy to improve the health of a community? A) Identify problems that affect the health of the population in question B) Design a plan for remediating the disturbances that cause a population's health to decline C) Integrate their work with EMS services to provide outpatient home care services designed to improve health D) Meet with city administrators to determine which type of public health budget will be provided so cost-effective plans can be established

: A Diff: 2 Page Ref: 16

: 1-3 26) Which be an EMS public health initiative? A) Educating the public on the benefit of wearing seat belts B) Volunteering time to help raise money for a sick child and his family C) Providing volunteer emergency ambulance service 24 hours a day, 7 days a week D) Purchasing new equipment to better help those persons who experience a medical emergency

: A Diff: 2 Page Ref: 16

: 7-21 17 Copyright © 2018 Pearson Education, Inc. 73) A patient informs you that he has had his gallbladder surgically removed. Based on the physiology of the gallbladder, which statement is most true regarding this patient? A) He may have difficulty digesting large amounts of fats B) He cannot store glycogen produced by the liver C) He will be more prone to gastric ulcers D) He must avoid meals high in complex carbohydrates

: A Diff: 2 Page Ref: 163

: 8-3 2) When cells undergo normal metabolism in the body, which byproduct(s) is (are) produced? A) Heat, carbon dioxide, and water B) Lactic acid C) Protein, carbon dioxide, and water D) Adenosine monophosphate

: A Diff: 2 Page Ref: 179

: 8-2 5 Copyright © 2018 Pearson Education, Inc. 18) A young patient is experiencing epiglottitis. He is working hard to breathe, has stridorous respirations, and is extremely hypoxic. His skin is cyanotic and his pulse is rapid but strong. What is the most likely cause (not result) of the poor delivery of oxygen to the cells? A) Partial occlusion of the airway B) Impaired transfer of O2 between the lungs and blood C) Poor function of the heart as a pump D) Elevation of the heart rate

: A Diff: 2 Page Ref: 183

: 8-6 77) Which gas law is disrupted when a patient sustains a spinal cord injury resulting in paralysis to the diaphragm and intercostal muscles? A) Charles' law B) Boyle's law C) Henry's law D) Dalton's law

: A Diff: 2 Page Ref: 183-184

: 8-8 76) Which process of ventilation is correctly adhering to Boyle's law as it relates to ventilation? A) When the diaphragm contracts, it creates a negative intrathoracic pressure causing air to enter the lungs B) When the diaphragm relaxes, it creates a negative intrathoracic pressure causing air to enter the lungs C) When the diaphragm contracts, it creates a positive intrathoracic pressure causing air to enter the lungs D) When the diaphragm relaxes, it creates a positive intrathoracic pressure causing air to enter the airways

: A Diff: 2 Page Ref: 183-184

: 8-10 23) What situation could impair a patient's respiratory status by directly damaging the central chemoreceptors of the body? A) Brainstem stroke or injury B) Lung cancer C) Aerobic metabolism D) Collapsed lung

: A Diff: 2 Page Ref: 187

: 8-12 41) A patient has failure of the left side of his heart. Consequently, his blood is backing up into the pulmonary artery and seeping into the lung tissue, causing the patient to be short of breath and moderately hypoxic. The EMT should recognize this condition as a product of: A) Increased hydrostatic pressure B) Decreased circulating blood volume C) Increased osmotic pressure D) Decreased pulmonary perfusion

: A Diff: 2 Page Ref: 194

: 8-4 11) A patient is hemorrhaging internally within his colon, which in turn is impairing perfusion to the cells of his body. Aside from the bleeding, the patient has no other problems. In this scenario, the problem impairing adequate perfusion would be: A) Decreased blood volume B) Inability to get oxygen to the alveoli C) Poor myocardial pump function D) Inadequate ventilation to eliminate carbon dioxide

: A Diff: 2 Page Ref: 194

: 8-16 49) What definition best describes the concept of afterload? A) Pressure that the left ventricle must pump blood against to open the aortic valve B) Ability of the heart to adequately contract and pump blood out of the pulmonic valve C) Amount of blood that a person has in the arteries at any given moment D) Amount of blood returned to the lungs for oxygenation by the right ventricle

: A Diff: 2 Page Ref: 195

: 8-17 55) The EMT would most likely see a narrowed pulse pressure in a patient who: A) Is bleeding internally B) Has a fever C) Has diabetes D) Has an irregular heartbeat

: A Diff: 2 Page Ref: 198

: 9-1 22) You are caring for an 18-day-old boy with inadequate respirations. Which instruction would you provide to your new partner as she is ventilating him with the bag-valve mask? A) "Squeeze the bag just enough so that you get a nice rise and fall of his chest." B) "Do not be afraid to give a little extra pressure since his lungs are not fully developed." C) "Since he is so small and does not need a lot of oxygen, just give 4 breaths per minute." D) "Let's breathe for him until his heart rate gets above 60; then we can stop."

: A Diff: 2 Page Ref: 205-206

: 2-14 18) You are transporting a 58-year-old female with terminal breast cancer. While in the ambulance, she becomes tearful yet agitated, and repeatedly asks, "Why me?" As a knowledgeable EMT, you recognize that she is in which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression

: A Diff: 2 Page Ref: 21

: 10-1 108) Which of these statements is true regarding the form or function of the alveoli? A) The alveoli permit gas exchange between the lungs and bloodstream B) The alveoli are thin walled and covered by smooth muscle C) The alveoli are air passages that permit ventilation of the lung D) The alveoli are covered with small arteries that allow gas exchange

: A Diff: 2 Page Ref: 220

: 10-4 6) If an injured patient has lost all use of his diaphragm, the EMT should recognize that the patient: A) Has lost a major portion of his ability to breathe B) Is breathing adequately but most likely will complain of chest pain C) Requires immediate cardiopulmonary resuscitation and frequent suctioning D) Requires supplemental oxygen with a nonrebreather face mask

: A Diff: 2 Page Ref: 221

: 10-3 3 Copyright © 2018 Pearson Education, Inc. 9) Which of these patients is most likely to lose neurologic control and regulation of the respiratory system? A) A 31-year-old patient with a severe head injury B) A 44-year-old patient who smokes and is nauseated C) A 56-year-old patient with heart problems and chest pain D) A 61-year-old patient diagnosed with diabetes

: A Diff: 2 Page Ref: 222

: 10-4 16) Which of these patients would benefit from the head-tilt, chin-lift manual airway maneuver as opposed to any other initial airway management technique? A) A 39-year-old male who just had a seizure and has snoring respirations B) A 45-year-old female who is alert and vomiting blood C) A 67-year-old female who fell down a flight of stairs and is unresponsive D) An 85-year-old female who hit her head on a tree limb and is now responsive to painful stimuli

: A Diff: 2 Page Ref: 229

: 10-6 89) A patient who inhaled superheated steam in an industrial fire is most likely to exhibit which abnormal upper airway noise? A) Stridor B) Wheezing C) Gurgling D) Snoring

: A Diff: 2 Page Ref: 229

: 2-14 7 Copyright © 2018 Pearson Education, Inc. 24) You have worked with the same partner for several years and know him well. Over the past three months, the two of you have had four horrific pediatric calls with death as the outcome of each. Which observation would make you the most suspicious that your partner is experiencing a possible stress reaction that might encumber his ability to work as an EMT? A) Excessive and uncharacteristic irritability B) Request to be scheduled for night shifts C) Interest in going back to school to study accounting D) Statement that he intends to drop to part-time status

: A Diff: 2 Page Ref: 23

: 2-2 27) After a particularly disturbing call the previous day, your partner is unusually angry and having a difficult time concentrating on his work. Which type of stress reaction would you suspect? A) Acute stress reaction B) Posttraumatic stress reaction C) Physical stress reaction D) Cumulative stress reaction

: A Diff: 2 Page Ref: 23

: 10-7 22) The EMT is correctly performing the jaw-thrust airway maneuver when she: A) Places her hands on the side of the patient's head and lifts the jaw upward B) Maintains the patient's head in a neutral position and slightly tilts the head backward C) Opens the patient's airway by slightly extending the head and thrusting the jaw upward D) Places one hand on the patient's forehead and lifts the jaw upward with her other hand

: A Diff: 2 Page Ref: 231

: 10-6 121) Which type of portable suction unit has the lowest potential for problems during its use? A) Hand powered B) Battery powered C) Oxygen powered D) Air powered

: A Diff: 2 Page Ref: 234

: 10-9 26) A young child with multiple physical and developmental abnormalities has a severe nosebleed. You must suction his nasopharynx to decrease the amount of blood he is swallowing. Which action should be part of this care? A) Insert a soft catheter into the nose the same length as the distance from the patient's nose to the tip of his ear B) Place the patient on his side and gently insert a rigid-tip catheter 1 inch into each nostril, starting with the right nostril C) Insert the soft catheter through the nose past the base of the tongue D) Irrigate the nostrils with water to thin and loosen the blood prior to suctioning with a rigid catheter

: A Diff: 2 Page Ref: 235

: 10-9 8 Copyright © 2018 Pearson Education, Inc. 29) You must suction frothy secretions from the mouth and pharynx of a 31-year-old male patient whose respiration rate is 4 breaths/min. Which process to do so is most appropriate given the patient's condition? A) Suction for no more than 15 seconds at a time, followed by 2 minutes of positive pressure ventilation B) Forego suctioning and continue to provide positive pressure ventilation, as frothy secretions rarely complicate the airway C) Place the patient into a side-lying position and alternate 30 seconds of suctioning and ventilation D) Use a soft-tip catheter and suction for no more than 30 seconds before providing additional oxygen with a nonrebreather face mask

: A Diff: 2 Page Ref: 235

: 10-10 54) While the EMT is inserting an oropharyngeal airway, the patient gags. The EMT should: A) Remove the airway and maintain the head-tilt, chin-lift maneuver B) Lubricate the oropharyngeal airway and reattempt insertion C) Reattempt insertion using a smaller oropharyngeal airway D) Use a tongue depressor to better place the oral airway

: A Diff: 2 Page Ref: 237

: 10-14 40) A 52-year-old male patient with a brain tumor has gone into respiratory arrest, but still has a pulse and obtainable blood pressure. You assign the task of artificially ventilating the patient with the bag-valve mask to a new Emergency Medical Responder. How will you instruct him to ventilate the patient? A) Deliver 10 breaths per minute B) Give the patient 20 breaths per minute C) Administer 8 breaths per minute D) Give the patient 24 breaths per minute

: A Diff: 2 Page Ref: 247

: 10-8 122) Proper positioning of the airway with the head-tilt, chin-lift maneuver during ventilation can help reduce gastric inflation by: A) Reducing airway resistance B) Allowing slower ventilation C) Reducing the volume of exhaled air D) Obstructing the esophagus

: A Diff: 2 Page Ref: 247

: 10-14 31) You have opened an apneic patient's airway using the head-tilt, chin-lift maneuver and are ready to ventilate with a pocket mask. The first ventilation you attempt is unsuccessful. You should immediately: A) Reposition the patient's head B) Use a jaw-thrust maneuver C) Ventilate over 3 seconds D) Provide five abdominal thrusts

: A Diff: 2 Page Ref: 252

: 10-9 37) Which description demonstrates the EMT knows how to correctly position the BVM on the patient's face? A) "I place the narrow part of the mask over the bridge of the nose, and the bottom part in the cleft above the chin." B) "If two rescuers are using the BVM, the mask needs to be placed only over the mouth and the nose pinched closed." C) "The wide portion of the mask is placed at the top of the nose and the narrow part below the lower lip." D) "The mask is properly positioned when the top portion lies over the bridge of the nose and the lower portion below the chin."

: A Diff: 2 Page Ref: 254-255

: 10-15 41) You are artificially ventilating an adult male patient who is in respiratory arrest with a bagvalve mask. Which finding would demonstrate that you are ventilating this patient properly? A) Adequate chest rise and fall B) Ability to fully deflate the self-inflating bag C) Clear and equal breath sounds D) Ventilation rate of 20 breaths per minute

: A Diff: 2 Page Ref: 255

: 10-14 45) Which statement about the flow-restricted, oxygen-powered ventilation device is true? A) "It can be used to ventilate spontaneously breathing patients whose breathing is too shallow." B) "It is an effective tool by which children can be ventilated when they are apneic." C) "It has a safety valve that prevents lung damage from overinflation." D) "It is very easy to use and has almost no complications associated with its use."

: A Diff: 2 Page Ref: 257

: 10-17 46) The EMT shows that he is correctly using the flow-restricted, oxygen-powered ventilation device when he: A) Stops ventilating as soon as the patient's chest begins to rise B) Administers each ventilation over a 2- to 3-second period C) Ventilates the patient at a rate of 20 breaths per minute D) Increases pressure if the air enters the stomach instead of the lungs

: A Diff: 2 Page Ref: 258

: 10-24 79) Which of these statements about an automatic transport ventilator (ATV) is true? A) It can help minimize gastric distention associated with positive pressure ventilation B) When it is in use, there is no need for a face-to-mask seal C) It eliminates the need for a head-tilt, chin-lift maneuver or jaw-thrust maneuver D) The EMT can more readily identify an increase or decrease in the patient's lung compliance

: A Diff: 2 Page Ref: 258

: 2-12 15) Preincident stress education, one-on-one support, and disaster support services are all part of: A) A comprehensive CISM program B) A balanced work environment C) Burnout prevention programs D) Stress reduction techniques

: A Diff: 2 Page Ref: 26

: 2-8 33) A tornado ripped through a small town, killing 5 people and seriously injuring 21, including several young children. At a defusing session, which action is most appropriate? A) Allow the rescuers to vent their emotions B) Evaluate and critique the rescue effort C) Provide information on stress reduction techniques D) Have a mental health professional available to talk with the rescuers

: A Diff: 2 Page Ref: 26

: 10-24 85) You are starting to ventilate a patient with a laryngectomy and stoma. As you provide the first few ventilations, you note that the air passes easily into the patient, but does not cause the chest to rise. Your next action should be to: A) Seal the patient's mouth and nose B) Suction the tracheostomy tube C) Perform a head-tilt, chin-lift maneuver D) Ventilate through the mouth and nose

: A Diff: 2 Page Ref: 264-265

: 10-14 13 Copyright © 2018 Pearson Education, Inc. 47) Which of these is a correct statement about the ventilation of a nonbreathing patient through a stoma? A) The EMT should ventilate through the stoma with a child-sized face mask attached to a bagvalve mask B) A head-tilt, chin-lift maneuver or jaw-thrust airway maneuver is still needed to open the airway C) Mouth-to-stoma ventilation is an easy and safe procedure to perform on a nonbreathing patient D) A nasal airway should be inserted into the stoma prior to any attempt at ventilating the patient

: A Diff: 2 Page Ref: 265

: 10-22 62) You arrive at work and note that the portable oxygen tank in the ambulance is now yellow instead of green, as during the previous shift. As a knowledgeable EMT, you should: A) Remove the tank and retrieve a green cylinder B) Recognize the addition of more effective synthetic oxygen C) Determine that your service has switched to the new lightweight oxygen tank D) Realize that a yellow color indicates a new-style tank that holds more oxygen

: A Diff: 2 Page Ref: 267

: 10-11 24 Copyright © 2018 Pearson Education, Inc. 92) A patient complaining of shortness of breath and a history of asthma has the following vital signs: pulse, 96; respirations, 20 breaths/min; blood pressure, 132/86 mmHg; and SpO2, 92% on room air. Mild wheezing is noted bilaterally, and the patient states that she has run out of her rescue inhaler (albuterol). Regarding the patient's respiratory status, how should you initially administer oxygen? A) 2 lpm O2 through a nasal cannula B) 4 lpm O2 through a nasal cannula C) 12 lpm O2 through a nonrebreather mask D) 15 lpm O2 through a nonrebreather mask

: A Diff: 2 Page Ref: 268

: 2-10 53) You are at a long-term care facility at the bedside of an 89-year-old female with an infected area on her back. The staff members state that they are fearful that the patient has a MRSA infection, so they have requested transport to the emergency department for further evaluation. To decrease your chance of acquiring MRSA, what should you, as an EMT, do? A) Wash your hands following patient contact B) Place a mask on the patient C) Wash the infected area with an alcohol sanitizer prior to transporting the patient D) Avoid unnecessarily touching the patient

: A Diff: 2 Page Ref: 28

: 11-17 75) You notice that your partner routinely takes only one set of vital signs when treating and transporting patients. When asked, he states that he gets just baseline vital signs because they are most important, as they provide information related to the patient's clinical status at the time of the EMS call. How would you respond? A) "Examining several sets of vital signs can also indicate the effectiveness of your treatment." B) "You must at least get a pulse rate every 15 minutes, since this is the most important vital sign." C) "Documenting several sets of vital signs is the only way to get full reimbursement from insurance companies for the EMS call." D) "You must get at least two sets of vital signs because that is what the national standard calls for."

: A Diff: 2 Page Ref: 288

: 11-2 4) Emergency Medical Responders inform you that a 27-year-old male patient with altered mental status has an open airway and is breathing 9 times every 30 seconds. His pulse rate is 40 beats/min, and he has bruises to his chest. Based on this vital sign and presentation information, the EMT should recognize the: A) Respiratory rate as normal B) Heart as beating adequately C) Blood pressure as normal D) Heart rate as irregular

: A Diff: 2 Page Ref: 288

: 11-2 15) Which of these statements concerning assessment of the pulse is correct? A) "The heart rate can be determined by doubling the number of beats counted in 30 seconds." B) "To get the most accurate rate, the EMT should place a stethoscope over the pulse site and count the number of beats in 1 minute." C) "A brachial pulse should be felt first in any patient younger than 6 years of age." D) "After much experience, an EMT can calculate the pulse rate by just feeling it for a few seconds."

: A Diff: 2 Page Ref: 292

: 11-7 21) When evaluating a patient's skin color, the EMT should: A) Observe the nail beds and/or mucous membranes inside the eyelids B) Examine the change in skin color when applying, then releasing pressure to the nail beds C) Look at the skin on the upper chest and feel it for warmth D) Examine the skin color of the face and compare it with the color of the arms

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: 11-9 31) A patient with liver cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition as: A) Jaundice B) Cyanotic C) Pallor D) Flushed

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: 11-2 7 Copyright © 2018 Pearson Education, Inc. 25) Which of these statements made by an EMT indicates an accurate understanding of checking a patient's skin temperature? A) "Checking the skin temperature is not precise, but provides a good estimate of abnormally high or low body temperatures." B) "To properly evaluate a patient's skin temperature during the primary assessment, the EMT needs a thermometer." C) "Flushed skin always indicates a high body temperature." D) "With experience, the EMT can precisely determine a patient's body temperature by feeling the skin."

: A Diff: 2 Page Ref: 294

: 11-9 36) For which of these patients would a capillary refill time of 3 seconds be most indicative of poor perfusion? A) A 4-year-old male B) A 24-year-old female C) A 67-year-old female D) An 81-year-old male

: A Diff: 2 Page Ref: 294

: 11-10 43) Assessment of a patient who is unresponsive reveals pupils that are both large at 6 millimeters and do not change size in response to light. The EMT would best document this finding as: A) Bilateral dilation of the pupils, unresponsive to light B) Constricted pupils bilaterally, nonreactive to light C) Bilateral midsize pupils that are reactive to light D) Nonreactive pupils of decreased size bilaterally

: A Diff: 2 Page Ref: 295

: 11-2 11 Copyright © 2018 Pearson Education, Inc. 41) You are assessing a patient who is in bright sunlight after collapsing in the hot sun at a picnic. If you cannot immediately move the patient out of the sun, assessment of the pupils will be made more accurate by: A) Shading the patient's eyes B) Using a blue-tinged light C) Retracting the eyelid D) Hydrating the eyes with saline drops first

: A Diff: 2 Page Ref: 295

: 11-1 15 Copyright © 2018 Pearson Education, Inc. 57) When obtaining a blood pressure for a patient, the radial pulse disappears when the gauge reads 130 mmHg. When deflating the cuff, the EMT hears a pulse at 118 mmHg. The pulse disappears at 76 mmHg. Given this, which of these statements is true? A) The systolic blood pressure is 118 mmHg B) The diastolic blood pressure is 130 mmHg C) The systolic blood pressure is 76 mmHg D) The diastolic blood pressure is 118 mmHg

: A Diff: 2 Page Ref: 298

: 11-12 16 Copyright © 2018 Pearson Education, Inc. 61) Which of these would be an indication to palpate the blood pressure? A) Noisy environment B) Normal pulse rate C) Tachycardic pulse rate D) Non-life-threatening condition

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: 11-12 50) You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step? A) Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt B) Inflate the cuff to 300 mmHg, and then leave the cuff inflated for 30 seconds prior to deflation C) Inflate the cuff to a reading of 300 mmHg, and then deflate the cuff slowly until you hear a pulse D) Inflate the cuff to three times the patient's age and listen for a heartbeat

: A Diff: 2 Page Ref: 298

: 11-15 86) You are trying to get a pulse oximeter reading on an 18-month-old child with difficulty breathing. Every time you place the sensor on the child's finger, he becomes upset and removes it. What is your best course of action? A) Place the sensor on the child's toe B) Restrain the child until a reading is obtained C) Place the sensor on the other hand D) Attach the sensor to his neck

: A Diff: 2 Page Ref: 299

: 11-15 103) The EMT is correctly using a noninvasive blood pressure monitor when she: A) Auscultates a blood pressure before applying and activating the device B) Alternates arms for each blood pressure reading that is obtained with the device C) Confirms each reading on the device by palpating a pressure in the opposite arm D) Places the cuff of the noninvasive BP monitor on the patient's forearm

: A Diff: 2 Page Ref: 301-302

: 11-16 32 Copyright © 2018 Pearson Education, Inc. 126) You believe a patient for whom you are caring is starting to experience respiratory failure. Which of these findings is supportive of this suspicion? A) ETCO2 of 56 mmHg B) SpO2 of 94% C) Heart rate of 118 beats/min D) Bilateral wheezing on exhalation only

: A Diff: 2 Page Ref: 302-303

: 11-18 108) You have been called to a bar for a patient who was involved in an altercation and is complaining of abdominal pain. Law enforcement is present. The patient has been handcuffed and is sitting on the sidewalk. He has an odor of alcohol on his breath, his speech is slurred, and he is angrily yelling at the police officers. Which action would be most appropriate for the EMT to take when talking to the patient? A) Maintain eye contact to help establish a rapport B) Place your hand on the patient's shoulder to keep him subdued C) Stand and communicate with the patient from 3 to 4 feet away D) Stand above the patient to establish authority

: A Diff: 2 Page Ref: 304

: 11-20 68) A 69-year-old man complains of weakness to the left arm and leg. He also states that he is nauseated and has a headache. The patient's past medical history includes stroke and diabetes. In relation to this information, which of these statements is true? A) The headache is a symptom related to the chief complaint B) The history of diabetes is a sign related to the chief complaint C) The dizziness is a sign indicating the severity of the chief complaint D) The history of diabetes is a contributing symptom of the chief complaint

: A Diff: 2 Page Ref: 305

: 11-12 17 Copyright © 2018 Pearson Education, Inc. 65) Which of these questions would be asked when obtaining a medical history, using the SAMPLE mnemonic, for a female patient who is crying and complaining of dizziness? A) "What were you doing when the dizziness started?" B) "Who is your doctor and when was your last office visit?" C) "Why exactly did you call the ambulance today?" D) "You seem upset. Do you want to talk about it?"

: A Diff: 2 Page Ref: 307

: 11-18 30 Copyright © 2018 Pearson Education, Inc. 118) When using the OPQRST mnemonic, the EMT is getting information as it applies to the "P" category when she asks: A) "Do you feel more short of breath when you are lying down?" B) "Does the chest pain spread to your back?" C) "What time did the symptoms start?" D) "Can you rate the pain on a scale of 1 to 10?"

: A Diff: 2 Page Ref: 307

: 12-3 3 Copyright © 2018 Pearson Education, Inc. 9) On scene, frantic family members direct you into the basement where their 67-year-old mother has shot herself in the chest with a small handgun. She is unresponsive and breathing 6 times per minute. The gun remains in her hand by her side. Which action should you take immediately? A) Pick up the gun by the edge of the grip and carefully remove it, and advise the police of your action B) Do not touch the patient or gun until the police arrive on scene C) Leave the gun in the patient's hand and start providing emergency care D) Determine whether the gun contains ammunition and remove it if it is loaded

: A Diff: 2 Page Ref: 323

: 12-7 22) You have been called to a bar full of intoxicated patrons for a 46-year-old man who fell off his stool, injuring his left arm. As you assess his arm, the patient screams in pain. Several of the patrons get angry and yell for you to give him something for pain. Someone in the back throws a bottle in your direction. What should you do next? A) Leave the scene and return only when police have made it safe to do so B) Ignore the yelling and continue to care for the patient as you would anyone else with a similar injury C) Inform the patrons that you are a medical professional and will care for the patient as you have been educated to do so D) Contact medical command for permission to give aspirin as a pain medication

: A Diff: 2 Page Ref: 324

: 12-4 11) You are providing care to a patient with altered mental status amid a large crowd gathered for a concert. Which characteristic of the crowd should concern you the most in relation to personal safety? A) An angry mood developing within the crowd B) A growing number of people making up the crowd C) The arrival of news vans to "cover" the story D) The presence of alcohol and possibly drugs in the crowd

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: 12-7 26) You arrive on the scene at an extended care facility where you see the facility employees removing the residents via wheelchairs and hospital beds. As you exit the ambulance, an employee walks up to you and identifies herself as the night-shift charge nurse. She states that the facility had a furnace malfunction and the carbon monoxide alarms are sounding. There are probably 30 residents already in the parking lot a safe distance away, and there are reportedly 15 more inside who are unresponsive. Given the number of patient overall, the EMT should: A) Alert dispatch of the need for additional resources B) Put on a TB mask and gain entry into the facility to remove the unresponsive patients C) Send his partner into the facility with another employee to start rendering care where the patients are lying D) Continue to supervise the actions of the facility employees until all the residents are removed from the facility

: A Diff: 2 Page Ref: 329

: 2-9 7) A patient with human immunodeficiency virus (HIV) infection is complaining of chest pain. In this situation, which personal protective equipment, at a minimum, is required to be donned prior to contact with the patient? A) Gloves and eyewear B) Gloves and gown C) Gloves, gown, and N-95 respirator D) Gloves, gown, goggles, and mask

: A Diff: 2 Page Ref: 33-34

: 13-3 4) You arrive at the scene of a fall, where a 42-year-old woman fell backward off a stepladder while cleaning her kitchen windows. She is seated on the floor and complains of pain to her ankle. She tells you, "If I had just gone to work today instead of using vacation time, this would have never happened!" Based on information thus far, what can you conclude? A) The patient is alert with an open airway B) Her pulse rate is within normal limits C) She does not require rapid transport D) She does not have any other injuries

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: 13-3 7) You have been called for an adult patient who suffered a seizure. He is sitting on the floor, and looks at you as you enter the room. When questioned, he knows his name but cannot remember the date, what happened, or where he is. This patient's mental status can best be described as: A) Alert but confused B) Lethargic and agitated C) Obtunded and altered D) Agitated and verbally disoriented

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: 13-8 12) An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals the child to be extremely irritable, crying weakly, and resistant to being touched by the EMT. Which description best describes this infant's mental status? A) Alert B) Lethargic C) Verbal D) Obtunded

: A Diff: 2 Page Ref: 342

: 13-9 23) Which finding individually would most likely indicate that a patient is breathing inadequately? A) An SpO2 of less than 94% B) A respiratory rate of 20 breaths/min in an adult C) Numbness and tingling of the fingers and toes D) Shortness of breath during exercise

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: 13-10 27) You are by the side of a 64-year-old male patient who collapsed at home. After assessing his level of consciousness, airway, and breathing, you determine that he is unresponsive with an open airway, but not breathing. The patient still has a weak carotid pulse. Which instruction should you immediately give to your partner? A) "Let's attempt placement of an OPA or NPA and start ventilations." B) "Please check the patient's blood pressure and apply the pulse oximeter." C) "Go ahead and apply the automated external defibrillator." D) "We will need to start cardiopulmonary resuscitation."

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: 13-12 41) You must check the circulation of an 8-year-old child with a high fever who has been vomiting for the past 2 hours. The child is very frightened and crying. Given the situation, you should: A) Palpate the radial artery B) Obtain a carotid pulse C) Feel for a brachial pulse D) Listen to the heart with a stethoscope

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: 13-12 53) Your patient is 82 years old and has diabetes. Which assessment parameter is the least reliable sign indicating this patient's peripheral circulatory status? A) Capillary refill B) Skin color C) Skin temperature D) Pulse strength

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: 13-13 47) When performing the primary assessment of a 45-year-old patient, which of these skin findings should concern the EMT? A) Cool and moist skin B) 1-second capillary refill C) Pink color to the nail beds D) Skin that is warm to the touch

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: 13-18 84) At a continuing education seminar being taught by your medical director, the instructor asks the group for one reason why the secondary assessment is beneficial to perform on the trauma patient. Which of these responses is most appropriate? A) "It is useful in finding additional injuries and guiding additional care." B) "It is a good tool that allows the EMT to determine whether critical interventions such as positive pressure ventilation or CPR are needed." C) "It is an effective means to determine the exact mechanism of injury." D) "It is the best assessment for detecting problems with the airway, breathing, or circulation."

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: 13-14 73) Assessment of a patient's neck reveals that the trachea is deviated to the left. Based on this assessment finding, the EMT should suspect an injury located to the patient's: A) Chest B) Abdomen C) Cervical spine D) Head

: A Diff: 2 Page Ref: 360

: 13-20 29 Copyright © 2018 Pearson Education, Inc. 109) You are completing the secondary assessment of a conscious patient with chest discomfort and a medical history of coronary artery disease. While assessing the cardiovascular system specifically, which one of these assessments should be performed? A) Pulse pressure value B) Blood glucose level C) Analysis by the AED of the patient's heart rhythm D) Assessment of the expiration date of the patient's prescribed nitroglycerin

: A Diff: 2 Page Ref: 366

: 13-28 99) You are transporting a 31-year-old male patient who was severely injured in a motor vehicle collision. He is unresponsive and being ventilated by your partner with a bag-valve mask. How will you conduct the rapid secondary assessment on this patient? A) Perform a head-to-toe exam B) Focus on the chest and abdomen C) Palpate the body parts but do not auscultate them D) Focus on the head and torso

: A Diff: 2 Page Ref: 368

: 13-14 17 Copyright © 2018 Pearson Education, Inc. 63) When teaching a group of Emergency Medical Responders (EMRs) about the mechanism of injury, which point should you stress? A) The more significant the mechanism of injury, the greater the chance the patient has been injured B) The mechanism of injury is no longer considered in the assessment because research has shown this information causes many patients to be over-treated C) The mechanism of injury is the sole criterion on which an EMT decides whether immediate transport is required D) The mechanism of injury can be used to dictate the order in which the primary assessment is conducted

: A Diff: 2 Page Ref: 368-369

: 13-25 89) An unresponsive 54-year-old male patient was found by family in his bed. They state that he has not been feeling well and complained of chest pain before going to bed approximately 1 hour ago. According to family, he has no prior medical history and does not take any medications. The primary assessment reveals no life-threatening conditions. When performing the secondary assessment on this patient, the EMT should: A) Start by examining the patient's head B) Contact the patient's family doctor C) Determine whether the chest pain still exists D) Focus the examination on the chest

: A Diff: 2 Page Ref: 392

: 14-7 7 Copyright © 2018 Pearson Education, Inc. 25) What is the best reason why the EMT administers or assists with the administration of medications? A) To help stabilize a patient's medical condition B) To prevent illness and injury C) To justify a lights-and-siren transport D) To expand the scope of the EMT's practice

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: 14-4 6) As an EMT, you may assist patients in taking which kind of prescribed medication? A) Inhalers used for difficulty breathing B) Medications for high blood pressure C) Drugs for heart-rhythm disorders D) Seizure-control medications

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: 14-4 7) A patient with chest pain tells you that he feels the same now as when he had a heart attack 2 years ago. He is diaphoretic, nauseated, and vomiting; he has a pulse of 84, respirations of 16 breaths/min, and a blood pressure of 78/50 mmHg. The patient is allergic to aspirin. He asks you to assist him in taking one of his nitroglycerin pills because his arthritis makes it too hard for him to open the medication bottle. Which of the assessment findings represents a contraindication to the nitroglycerin? A) Blood pressure of 78/50 mmHg B) Heart rate less than 100 C) Nausea and vomiting D) Allergy to aspirin

: A Diff: 2 Page Ref: 429

: 14-11 15) A patient who is short of breath and has a history of right arm paralysis from a stroke has asked you to help him use his metered-dose inhaler containing albuterol. Since your medical director requires on-line authorization for albuterol, you would: A) Contact medical direction for authorization B) Withhold the medication and transport the patient C) Advise the hospital that the patient will need albuterol D) Administer the medication and document this treatment accordingly

: A Diff: 2 Page Ref: 430

: 14-9 14) Which of these descriptions on a patient care report best illustrates how the EMT should document the administration of a medication? A) 325 mg of aspirin administered orally at 1325 hours B) 0.4 of nitroglycerin administered sublingually at 0800 hours C) Medical direction (Dr. Coyle) ordered albuterol at 1245 hours. Given as ordered D) Assisted patient with administration of medication via metered-dose inhaler

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: 15-4 59) Which of these condition(s) is (are) as the most probable cause of cardiogenic shock? A) Myocardial infarction B) Severe vomiting and diarrhea C) Gastrointestinal bleed D) Systemic infection

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: 15-9 80) Which of these remarks made by the patient best reinforces your suspicion that he is in the early stages of hypovolemic shock? A) "I have had diarrhea for the past four days." B) "I fell last night and think I hurt my belly; see the bruise?" C) "I must have fallen and hit my head. I am very confused and restless." D) "I have been coughing up green mucus and feel weak."

: A Diff: 2 Page Ref: 438

: 15-4 18 Copyright © 2018 Pearson Education, Inc. 66) You are treating a patient with severe crushing chest pain. She has had two heart attacks in the past, and you believe that she is currently in cardiogenic shock. Blood pressure is 86/66 mmHg, respirations are 20 breaths/min, heart rate is 102 beats/min, and room-air pulse oximetry reading is 91%. Which intervention is the most appropriate next action in this case? A) Supplemental oxygen B) Application of the AED C) Administration of nitroglycerin D) Rapid transport with the patient supine

: A Diff: 2 Page Ref: 445

: 15-7 72) A patient fell 20 feet from a ladder, and is now confused and anxious. Which of these signs/symptoms suggests that the patient is in shock? A) Heart rate of 110 beats/min B) Deformity to the left arm C) Contusion to his head D) Constricted pupils

: A Diff: 2 Page Ref: 449

: 15-2 71) When performing the primary assessment, which sign or symptom best indicates that the patient is in hypovolemic shock? A) Cool and diaphoretic skin B) Radial pulse of 72 beats/min C) Crackles heard in both lungs D) Constricted pupils

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: 15-10 3) A patient arrests at 1313 hours. E-911 is activated and dispatches an ambulance at 1315 hours. The ambulance arrives on scene at 1319 hours, and the EMTs reach the patient's side and start care at 1321 hours. After transporting the patient, the patient is transferred to the ED staff at 1346 hours. Based on that information, which of these statements would be considered correct? A) Down time is 8 minutes B) Total down time is 31 minutes C) Down time is 25 minutes D) Total down time is 6 minutes

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: 15-5 94) You arrive on the scene of an "unknown medical emergency." The local fire department EMRs arrive simultaneously, so you now have five providers at the scene to help. The on-scene police officer tells you the patient is an elderly man who has attempted suicide by shooting himself in the head. As you enter the patient's room, you see the male patient with an extensive skull injury. A large portion of his right temporal and parietal skull is gone, and there are blood splatter and brain tissue on the wall behind him. Given this information, what should you do? A) Withhold resuscitation B) Start CPR, since you have ample help to treat and transport the patient C) Do nothing until you get advice from online medical direction D) Start BLS care, but withhold ALS care

: A Diff: 2 Page Ref: 453

: 15-8 24 Copyright © 2018 Pearson Education, Inc. 87) Which of these is most appropriate when two EMTs are performing CPR on an adult patient? A) At least 100 compressions per minute B) Airway reassessment after every 30 compressions C) Compression to ventilation rate of 15:2 D) Delivery of ventilations while compressions are being provided

: A Diff: 2 Page Ref: 454

: 15-17 49) You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do? A) Ensure that no rescuer is touching the stretcher B) Move the patient from the metal stretcher to a nonmetal surface C) Withhold all shocks because metal will conduct the shock into the ambulance D) Stop the ambulance and have all rescuers exit prior to shocking the patient with the AED

: A Diff: 2 Page Ref: 457

: 15-17 30) Which of these unresponsive patients would the EMT recognize as in cardiac arrest? A) A female who has an occasional gasp for a breath but no palpable carotid pulse B) A male with a heart rate of 16 beats/min and agonal respirations C) A female who is not breathing and has a heart rate of 24 beats/min D) A male with an absent radial pulse but breathing 20 times per minute

: A Diff: 2 Page Ref: 459

: 15-9 28) You have arrived at the residence of a 66-year-old female patient who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which of these statements should you make at this time? A) "Let's stop CPR so I can check the airway, breathing, and circulation." B) "Let's stop CPR so I can put the electrodes of the AED on her chest." C) "Let's continue CPR for another 2 minutes, and then I will put the AED on." D) "Let's continue CPR while I talk with the family to see if they want us to continue."

: A Diff: 2 Page Ref: 459

: 15-5 32) You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of these instructions is appropriate to give at this time? A) "Stop CPR and clear the patient." B) "Stop chest compressions but continue ventilation." C) "Continue CPR until we see if a shock is advised." D) "Stop CPR but continue to check for a pulse."

: A Diff: 2 Page Ref: 461

: 15-15 12 Copyright © 2018 Pearson Education, Inc. 43) A patient in cardiac arrest has regained a pulse after two shocks, but is still apneic. Which action would be appropriate next? A) Transport the patient supine and secured to a long spine board as treatment is continued B) Remove the AED once it is determined that a pulse has returned and initiate transport C) Reanalyze the patient's heart rhythm with the AED every 5 minutes D) Cancel the ALS assistance request and proceed directly to the hospital

: A Diff: 2 Page Ref: 462

: 15-15 52) You are instructing a first-aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. Which point would you emphasize to the employees to help them avoid the most common cause of AED failure? A) "The batteries must be checked regularly." B) "An extra set of electrodes should be kept in the AED." C) "The AED should be kept clean and undamaged." D) "Always check the electrode wires for cracks."

: A Diff: 2 Page Ref: 466

: 15-22 98) One of the benefits of utilizing an automated chest compression device is that: A) It frees up EMS providers to tend to other patient care tasks B) It provides a similar cardiac output as a spontaneously beating heart does C) It avoids the need to simultaneously ventilate the patient D) The survival rate when using automated chest compression devices is almost 90%

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: 3-16 49) You have been called to a local emergency department to transfer a 67-year-old male to another facility. At the hospital, the emergency physician informs you that the patient and his family have requested the transfer because his doctor is affiliated with the other hospital. At the patient's bedside, you see that the patient is receiving an antibiotic through an IV. Although your state does allow EMTs to perform nonemergent transports of patients receiving normal saline through an IV, it does not allow transport of patients receiving IV medications. When informed of this restriction, the physician states that the antibiotic will be done in 10 minutes and that he will give written permission to start the transport while the medication is infusing. Which EMT action would be most appropriate at this time? A) Transfer the patient once all the medication is infused B) Stop the IV infusion and transport the patient C) Follow the doctor's order as long as he writes and signs it D) Recognize a HIPAA violation and refuse the transport

: A Diff: 2 Page Ref: 47

: 3-2 2) You have moved to another state and wish to work as an EMT. In your previous state of employment, EMTs were allowed to administer a specific set of drugs. To determine whether EMTs can administer drugs in your new state of residence, you should review the: A) State Emergency Medical Technicians' Scope of Practice B) National EMS Scope of Practice Model C) National EMS Education Standards D) State Emergency Medical Services Act

: A Diff: 2 Page Ref: 47

: 16-4 33) A 48-year-old male patient is short of breath and confused. His airway is open, and his breathing is fast. A radial pulse is easily palpated. His skin is warm to cool and dry. Your partner reports the following vital signs: pulse, 124; respirations, 24 breaths/min; blood pressure, 158/86 mmHg; and SpO2, 89% on room air. The patient's lung sounds indicate slight wheezing. Based on this information, which of these conditions poses the most immediate threat to this patient's well-being? A) Hypoxia B) Elevated blood pressure C) Possible infection D) Increased heart rate

: A Diff: 2 Page Ref: 475

: 16-8 86) A patient has a medical problem characterized by an increase of interstitial fluid in and around his alveoli. This condition would disrupt normal oxygen and carbon dioxide exchange by creating which type of disturbance? A) A gas exchange disturbance B) A ventilation disturbance C) A perfusion disturbance D) A neurological disturbance

: A Diff: 2 Page Ref: 476

: 16-6 37) You are treating a patient who states that he has been short of breath for the past month. Tonight, his breathing just "got too bad" and he decided to call 911. The 67-year-old male patient is alert and oriented and has a patent airway. He appears to have an adequate tidal volume. His pulse is strong and regular, and his skin is warm. Vital signs are pulse, 92; respirations, 22 breaths/min; blood pressure, 128/66 mmHg; and SpO2, 93% while on home oxygen at 2 lpm. Which instruction would you give to your partner regarding this patient's care? A) "Let's try 4 lpm through a nasal cannula." B) "The patient seems pretty stable; we can refer him to his family doctor." C) "Why don't we see how the patient tolerates a nasal airway?" D) "Let's go ahead and put the patient on 15 lpm of oxygen."

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: 3-1 62) A state's Good Samaritan law would NOT protect the health care provider(s) in which of these situations? A) When an EMT is working for a volunteer EMS system and performs an act of gross negligence B) When an EMT is off duty, but stops to assist at a motor vehicle collision and functions in good faith C) When the EMT stops to help a collapsed person at a park while off duty by providing CPR, but the patient still dies D) When a nurse or physician who is off duty stops to assist at an EMS call where paid EMTs are present, but the patient still dies

: A Diff: 2 Page Ref: 48

: 16-2 16 Copyright © 2018 Pearson Education, Inc. 57) You are administering positive pressure ventilation to an elderly male patient with a history of chronic obstructive pulmonary disease (COPD). Which point must you keep in mind as you care for this patient? A) Use of a CPAP may rupture the lung tissue and cause a pneumothorax B) High concentrations of oxygen will damage the lungs and must be avoided C) Ventilations must be given with greater force to overcome natural stiffening of the rib cage D) High-concentration oxygen is contraindicated for this patient

: A Diff: 2 Page Ref: 483

: 16-8 82) An alert and distressed 72-year-old male patient with a history of pulmonary edema from heart failure is in severe respiratory distress, breathing 28 to 32 times per minute. His airway is patent, respirations are labored, crackles are heard in the bases of the lungs, and skin is found to be diaphoretic with a rapid radial pulse. Other vital signs are pulse, 136; blood pressure, 202/110 mmHg; and SpO2, 83%. Cyanosis is evident in the fingertips. The best treatment for this patient's breathing difficulty would be: A) CPAP B) Albuterol MDI C) Supplemental oxygen via nasal cannula D) Nasal airway with high-concentration O2

: A Diff: 2 Page Ref: 486

: 16-13 71) You are transporting a 4-year-old female patient whom you found sitting in a chair with labored respirations, inspiratory stridor, and drooling. Which sign or symptom would warrant immediate reassessment? A) The stridor ceases B) The drooling continues. C) The SpO2 drops from 96% to 95% D) The patient remains dyspneic

: A Diff: 2 Page Ref: 489

: 16-4 62) You arrive on scene for a 9-year-old female patient with a severe cough. Her mother states that she has spoken to her pediatrician, who believes that the child may have whooping cough and should be taken to the hospital for evaluation. Her mother is unsure if her daughter has had all her immunizations. Which of these statements would be most appropriate in regard to the care of this patient? A) "She may be contagious, so let's put a surgical mask on her." B) "Since this condition is caused by a virus, she is not contagious and we just need to transport her." C) "She is probably contagious, so we need to each put on a gown and goggles to protect ourselves." D) "Let's get a full set of vital signs, since this disease can cause heart problems, especially in the young."

: A Diff: 2 Page Ref: 489

: 3-3 57) Your legal right to function as an EMT is contingent upon: A) Following standing orders and protocols, as approved by medical direction B) Avoiding civil liability C) Completing an approved EMT program D) Gaining paid employment by a public EMS system

: A Diff: 2 Page Ref: 49

: 16-15 20) You are administering a medication through a metered-dose inhaler (MDI) using a spacer. Which of these actions would be most appropriate? A) Administer the medication into the spacer and then have the patient inhale B) Instruct the patient to inhale slowly just prior to the medication being placed in the spacer C) Administer the medication into the spacer and then have the patient exhale D) Instruct the patient to exhale slowly as you place the medication into the spacer

: A Diff: 2 Page Ref: 495

: 16-14 32) A 911 call was placed for a 3-year-old child with difficulty breathing. On scene, you note that the child is upright with slight stridor upon inspiration. He is alert and breathing at a rate of 30 breaths/min. His skin is warm and dry, and his radial pulse strong and regular. His breath sounds are clear and equal. His mother states that he was fine all day until 15 minutes ago, when he was playing with friends in the playroom and suddenly started having difficulty breathing. As an EMT, you should suspect which condition? A) Foreign body airway obstruction B) Epiglottitis C) Croup D) Bronchial asthma

: A Diff: 2 Page Ref: 498

: 16-17 8 Copyright © 2018 Pearson Education, Inc. 28) On scene, you find a 2-year-old male patient in significant respiratory distress. He is responsive to painful stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths/min. His pulse is rapid. Assessment of the skin shows it to be cool and diaphoretic, with cyanosis to the extremities and around the mouth. What is the immediate priority for this patient? A) Start positive pressure ventilation B) Insert an oropharyngeal airway C) Apply oxygen through a pediatric nonrebreather mask D) Move the patient to the ambulance for immediate transport

: A Diff: 2 Page Ref: 498

: 3-10 16) In a community park near his home, a 10-year-old boy has fallen from the top of a slide. His right wrist is deformed and he is in pain. He states that he lives with his mother and she is working. He does not know her work number. The EMT's best action would be to: A) Treat the patient under the guidelines of implied consent B) Do not treat the patient until his mother can be contacted C) Obtain permission from the park director D) Have the police take custody of the boy and give permission to treat

: A Diff: 2 Page Ref: 50

: 3-11 8) You have been dispatched to a residence for an 88-year-old female who is in and out of consciousness. The family provides you with a valid "Do Not Resuscitate" (DNR) order. Assessment of the patient shows her to be very confused with a low blood pressure and low oxygen level. Which action would be appropriate given the situation? A) Administer supplemental oxygen B) Provide transport but no additional care C) Provide care only if the patient's heart stops beating D) Have the patient or family member sign a refusal of care form and clear the scene

: A Diff: 2 Page Ref: 50

: 16-18 7) A 67-year-old male patient complains of shortness of breath. The patient cannot remember how many times he used his inhaler prior to your arrival, but he knows it has been multiple times. He is tachypneic and tachycardic. After administering oxygen, what should be your next action? A) Call medical direction for advice B) Assist the patient in the self-administration of his inhaler C) Transport the patient to the hospital D) Auscultate the patient's lung sounds and administer the inhaler if you hear wheezing

: A Diff: 2 Page Ref: 503

: 16-10 45) A patient who is nonverbal from a previous stroke is in severe respiratory distress. A family member states that she has multiple medical problems, including high blood pressure, diabetes, and heart failure. When assessing this patient, which sign or symptom would raise your suspicion that the patient has heart failure? A) Pulmonary crackles B) Diaphoresis C) Edema to left foot D) Pursed lip breathing

: A Diff: 2 Page Ref: 504, Table 16-8

: 16-18 7 Copyright © 2018 Pearson Education, Inc. 24) Auscultation of breath sounds in a patient complaining of shortness of breath reveals wheezing. Which condition is responsible for this finding? A) Bronchiole constriction B) Significant hypoxia C) Swelling in the throat D) Mucus in the lungs

: A Diff: 2 Page Ref: 507

: 16-5 22 Copyright © 2018 Pearson Education, Inc. 79) The best way to gauge the effectiveness of oxygen therapy is to monitor the: A) Pulse oximetry B) Respiratory rate C) Heart rate D) Mental status

: A Diff: 2 Page Ref: 507

: 16-17 6) An alert and oriented 45-year-old female patient complains of shortness of breath. Although her respiratory volume and rate are satisfactory, you note cyanosis in her fingertips and you cannot get the pulse oximeter to show a reading. What should be your next action? A) Administer supplemental oxygen B) Assist respirations with the bag-valve mask C) Place a nasopharyngeal airway and assist respirations D) Move the patient to the stretcher for immediate and rapid transport

: A Diff: 2 Page Ref: 509

: 17-17 103) Failure to promptly treat ventricular tachycardia can result in myocardial cell hypoxia and ischemia, which then contributes to the rhythm deteriorating to: A) Ventricular fibrillation B) Pulseless electrical activity C) Sinus rhythm D) Asystole

: A Diff: 2 Page Ref: 529

: 3-12 19) A 46-year-old man who is conscious and has the capacity to make a rational decision is refusing treatment despite crushing chest pain and shortness of breath. He states that the hospital will not do anything for him and he does not want you to treat or transport him. The EMT should recognize that the: A) Patient has a right to refuse treatment and transport B) Police will need to be called so the patient can be transported in custody C) Patient will need to be transported against his will D) Patient's family can give consent to transport the patient

: A Diff: 2 Page Ref: 53

: 17-18 56) Which of these statements regarding cardiac compromise or acute coronary syndrome should the EMT recognize as true? A) Cardiac compromise should be suspected for any patient with chest discomfort B) Patients suffering from acute coronary syndrome will have pain, not discomfort C) If the pain does not radiate to the arms, then the cause is not typically the heart D) The onset of acute coronary syndrome typically occurs with physical activity

: A Diff: 2 Page Ref: 530

: 17-10 37) You have been called for a patient with angina. On scene, the 67-year-old man reports that he has a history of angina and the pain started when he was moving firewood from the garage into his house. Unfortunately, the pain has yet to go away, despite three nitroglycerin tablets and 20 minutes of rest. Your next action should be to: A) Check the patient's vital signs B) Administer a nitroglycerin tablet and aspirin C) Attach the AED but do not turn it on D) Provide supplemental oxygen via nonrebreather

: A Diff: 2 Page Ref: 532

: 17-12 88) Regarding women and cardiac compromise, with which of these statements would you agree? A) "The death rate for women suffering a heart attack is higher than that for men." B) "Although the risk of MI decreases with age, women should take daily aspirin as they get older." C) "Most women, unless they are diabetic, will suffer from chest discomfort as opposed to pain when having an MI." D) "Most women have right-sided chest pain without dyspnea or palpitations when having an MI."

: A Diff: 2 Page Ref: 534

: 17-19 16 Copyright © 2018 Pearson Education, Inc. 58) Which of these statements made by the patient should cause the EMT to suspect an abdominal aortic aneurysm? A) "I have belly pain that I also feel in my back." B) "My heart is beating so hard, you can feel it on my chest." C) "The pain is sharp and spreads to both arms." D) "I seem to be vomiting up some blood."

: A Diff: 2 Page Ref: 534

: 17-14 90) You are approached by an EMR who informs you that last week, he was on a call in which a patient with chest pain and a known history of coronary artery disease was not given oxygen by the EMTs. You would reply: A) "It has been shown that oxygen given to a patient with an acceptable pulse oximetry reading can be harmful." B) "That may have been an oversight, given that chest pain is caused by a lack of oxygen-rich blood delivery through the coronary arteries." C) "Since extra oxygen slows the respiratory rate, it also causes the body to retain CO2, which is not beneficial for heart patients." D) "If the patient also had a history of COPD, oxygen was most likely withheld since it would be contraindicated."

: A Diff: 2 Page Ref: 535

: 17-14 95) A patient with chest pain has an SpO2 of 90% on room air. How would you start providing oxygen to this patient? A) Nasal cannula 2 lpm B) Nasal cannula 4 lpm C) Nasal cannula 6 lpm D) Nonrebreather 15 lpm

: A Diff: 2 Page Ref: 535

: 17-15 44) The pathophysiology of heart failure that causes the common signs and symptoms of cardiogenic shock is: A) Inadequate ejection of blood from the left ventricle B) Poor gas exchange in the lungs C) Fluid accumulation within the lung tissue D) Backup of fluid in the lower extremities

: A Diff: 2 Page Ref: 535-536

: 17-2 75) Chronic and untreated hypertension will affect which part of the heart first? A) Left ventricle B) Aorta C) Right atrium D) Vena cava

: A Diff: 2 Page Ref: 536

: 3-10 12) The EMT gains the greatest protection from consent-related legal issues by: A) Documenting the patient's consent for treatment on the prehospital care report B) Notifying the emergency physician or medical direction of the patient's consent C) Having his or her partner serve as a witness to the consent D) Asking the patient twice if it is okay to assess and treat him or her

: A Diff: 2 Page Ref: 54

: 3-8 19 Copyright © 2018 Pearson Education, Inc. 65) If an individual is bringing a lawsuit against your EMS system for perceived improper care, which type of liability action will it probably be? A) Civil B) State C) Criminal D) Federal

: A Diff: 2 Page Ref: 55

: 18-4 70) Your partner is using the AEIOU-TIPPSS mnemonic to assess for common causes of altered mental status in a geriatric patient. During this process, your partner forgets what the "T" stands for. You would remind him that it means: A) Trauma B) Tumor C) Tachycardia D) Toxicology

: A Diff: 2 Page Ref: 559

: 3-14 25) While transferring a patient from her house to the ambulance on the wheeled cot, one of the EMTs slips on a patch of ice and falls. The stretcher overturns, and the patient suffers a broken wrist as a result. She files a lawsuit in civil court alleging negligence. For the patient, what will be the most difficult component of negligence to prove? A) Proximate cause B) Duty to act C) Damage D) Implied consent

: A Diff: 2 Page Ref: 56

: 3-9 33) A local politician has been involved in a motor vehicle collision. Witnesses state that they saw this man leave a bar, and repeatedly stumbled until he got to his vehicle. Then, just two miles down the road, he struck a utility pole head on. On scene and throughout transport, the patient is confused and combative. When you are leaving the hospital, a reporter asks you what happened. You state that it looks as though the politician may be drunk, but you are not sure. Your statement is printed in the newspaper. Later, it is determined that the man was not drunk, but rather has diabetes and had low blood sugar at the time of the accident. Which charge could the politician levy against you? A) Slander B) Assault C) Battery D) Litigation

: A Diff: 2 Page Ref: 56

: 18-11 18 Copyright © 2018 Pearson Education, Inc. 68) Rapid recognition of stroke signs and symptoms by the public is part of which assessment system? A) AHA's Stroke Chain of Survival B) S.T.R.O.K.E. assessment C) RACE exam D) AEIOU-TIPPSS

: A Diff: 2 Page Ref: 560

: 18-5 71) To better fulfill the AHA's Stroke Chain of Survival goals, which assessment mnemonic was developed to better prepare the public and EMS to recognize stroke? A) F.A.S.T B) RACE C) S.T.R.O.K.E. D) AEIOU-TIPPSS

: A Diff: 2 Page Ref: 560

: 18-12 20) For the patient with stroke to be eligible for a fibrinolytic agent, the patient must be brought to the hospital emergency department within how many hours of the onset of stroke symptoms? A) 2 B) 3 C) 6 D) 24

: A Diff: 2 Page Ref: 561

: 18-12 22) Assessment reveals a drooling 48-year-old male patient to have gurgling speech and left-arm paralysis. The EMT's immediate priority treatment is to: A) Suction the airway B) Protect the left arm C) Determine risk factors for stroke D) Determine the time of onset

: A Diff: 2 Page Ref: 568

: 3-6 13 Copyright © 2018 Pearson Education, Inc. 44) A 22-year-old female has been sexually assaulted and taken to the emergency department. With regard to the release of confidential medical information, which individual would most likely be allowed to receive information related to the patient's injuries without her consent? A) State police B) Patient's mother C) Patient's boyfriend D) Crisis counselor

: A Diff: 2 Page Ref: 57

: 18-11 67) When the EMT evaluates a patient with the RACE stroke scale, the score is 3 points. This score would infer: A) The patient has likely experienced a stroke B) The patient has not likely experienced a stroke C) The stroke scale was incorrectly performed, as the minimum score is at least 5 points D) A stroke has likely not occurred if the corresponding GCS score is 12 points or higher

: A Diff: 2 Page Ref: 573

: 18-12 13 Copyright © 2018 Pearson Education, Inc. 49) A 56-year-old patient is in bed and unable to speak. Family members state that he had a stroke in the past and has been bedridden since then, but has always been able to talk, until a few hours ago when his speech became garbled. They also state that the last stroke left him paralyzed on his left side. Your assessment reveals that the patient is unable to speak, but has an open airway, adequate respirations, and a strong radial pulse. Additionally, you note that he is unable to move his right arm. Vital signs are within normal limits. What would be an appropriate step in the care on this patient? A) Rapid transport to a stroke center B) Suction the mouth and then place an NPA C) Administer positive pressure ventilation D) Insert an oropharyngeal airway

: A Diff: 2 Page Ref: 577

: 19-1 21) Status epilepticus is best differentiated from a generalized seizure by the: A) Duration of the seizure B) Length of the postictal period C) Presence of an aura prior to seizing D) Preexisting seizure history

: A Diff: 2 Page Ref: 587

: 19-7 58) You are on the scene of a patient who just experienced a seizure. The patient is still in the postictal phase and is not fully oriented. Family members state that he has a history of diverticulitis, gastric ulcers, and diabetes. Your partner asks you if you think he should obtain a blood glucose level. Your response should be: A) "Yes, that is a good idea since he has a history of diabetes." B) "Yes, because if we don't, the hospital may get angry with us." C) "No, since the seizure has stopped, it is not from a blood sugar abnormality." D) "No, because even if the sugar is too high or too low, there is nothing we can do about it."

: A Diff: 2 Page Ref: 587

: 19-2 5 Copyright © 2018 Pearson Education, Inc. 16) You have been called to a public bus station for a behavioral emergency. On scene, you find a disheveled male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he was just sitting on a bench watching people walk by, when suddenly he got up and began to stumble around, shouting obscenities, and then fell to the ground shaking. From this description, the EMT should be suspicious of which condition? A) Generalized seizure B) Alcohol intoxication C) Absence seizure D) Syncopal episode

: A Diff: 2 Page Ref: 588

: 19-5 54) The EMT would recognize a simple partial seizure when she observes: A) Jerky muscular activity of a single extremity B) Repetitive actions such as lip smacking or finger rolling C) Blank staring that begins and ends abruptly D) Abrupt personality changes, including fits of rage

: A Diff: 2 Page Ref: 590-591

: 19-8 3) While you are providing free blood pressure readings at a community health fair, you are taking the blood pressure of a mother of two young twin boys. One of the boys tells you that his twin brother suffers from seizures and asks what he can do if he sees his brother convulsing. Your response would be: A) "Move any movable objects and furniture away from him." B) "Hold him securely to the floor until he stops seizing or the EMTs arrive." C) "Insert a spoon into his mouth to keep him from swallowing his tongue." D) "Tell your parents immediately, and then try to hold him as still as possible until the ambulance arrives."

: A Diff: 2 Page Ref: 592

: 19-7 5) After a lengthy response time in a rural community, you arrive at the home of a 62-year-old female patient who is still seizing. Your immediate action would be to: A) Assess the patient's airway and breathing B) Determine if the patient has a seizure history C) Determine the total duration of the seizure D) Move the patient to the ambulance for assessment and initiate transport

: A Diff: 2 Page Ref: 592-593

: 19-7 7) A postictal patient is awake and can communicate with you, but has trouble answering your questions correctly. Given this presentation, the EMT would recognize that: A) The airway is open B) Another seizure is coming C) The patient has a seizure history D) High-concentration oxygen is indicated

: A Diff: 2 Page Ref: 592-593

: 19-6 25) You arrive on scene and find Emergency Medical Responders with a seizing patient. Which of these questions should you ask first? A) "How long has the patient been seizing?" B) "What are the patient's vital signs?" C) "Did the patient lose control of his bladder?" D) "Do you know which medications the patient is taking?"

: A Diff: 2 Page Ref: 597

: 19-10 33) A patient who experienced an apparent syncopal episode refuses transport to the hospital. Prior to the patient signing a refusal, which of these statements should you make to the patient? A) "Syncope may indicate a serious underlying condition, so please follow up with a doctor." B) "The most common cause of syncope is diabetes, so follow up with your doctor." C) "People who experience a syncopal episode are not allowed to drive unless they go on medication." D) "Syncope is not dangerous and affects almost everyone, but it is still important to follow up with your doctor."

: A Diff: 2 Page Ref: 600

: 20-5 10) With which of these patients would the EMT have the strongest suspicion of a diabetic emergency? A) A confused patient with a blood glucose of 58 mg/dL B) An alert and oriented patient with diabetes and generalized weakness C) A combative patient with a blood glucose level of 122 mg/dL D) A patient with diabetes who complains of chest pain and shortness of breath

: A Diff: 2 Page Ref: 608

: 3-19 59) Your EMS station has been designated a Baby Safe-Haven. As such, you know that: A) A mother or father can drop a baby off and leave with no questions asked B) You are legally required to provide basic supplies (e.g., bottles and diapers) to the mother or father C) A mother or father can bring a baby to the station for basic care issues D) You are legally required to provide the mother or father with resources to assist in the care of the baby

: A Diff: 2 Page Ref: 61

: 20-2 39) An unresponsive patient presents with a blood sugar of 30 mg/dL. What is the major threat to this patient's well-being? A) Brain damage B) Dehydration C) Cardiac compromise D) Glucose toxicity

: A Diff: 2 Page Ref: 610

: 20-3 2) An elderly patient has an altered mental status. On scene, the patient's son informs you that his father has type 1 diabetes. Based on this information, you would understand that the patient: A) Needs to take insulin B) Has a history of high blood pressure C) Requires daily oral glucose to maintain his blood sugar D) Has a chronically low blood sugar level

: A Diff: 2 Page Ref: 610

: 20-7 15) Which individual finding would most lead the EMT to suspect that a patient has hypoglycemia? A) A rapid onset of altered mental status B) A slow pulse rate and low blood pressure C) A blood glucose reading of 256 mg/dL D) Warm and dry skin with a blood glucose of 90 mg/dL

: A Diff: 2 Page Ref: 610

: 20-1 27) What would be the priority action to take prior to administering oral glucose to a young female patient? A) Determine the patient's blood glucose level B) Make sure the patient has insulin available if needed C) Ask whether the patient is allergic to glucose D) Determine whether the patient is pregnant

: A Diff: 2 Page Ref: 612

: 20-9 61) A patient exhibits signs and symptoms of diabetes, but he informs you that he has not been diagnosed with the disease. You decide to check his blood sugar. If the patient truly has diabetes, which of these readings would you expect? A) 465 mg/dL B) 110 mg/dL C) 0 mg/dL D) 70 mg/dL

: A Diff: 2 Page Ref: 614

: 3-14 16 Copyright © 2018 Pearson Education, Inc. 54) Involuntary consent would most likely apply to: A) A 23-year-old prisoner with a laceration to the right cheek and refusing care B) An alert and oriented 34-year-old male who is coughing up blood and refusing care C) A 3-year-old boy found wandering in the street with abrasions and cuts on his bare feet D) A confused elderly woman who is in the presence of the person with her acting power of attorney

: A Diff: 2 Page Ref: 62

: 20-11 47) The wife of a 43-year-old male patient has called 911 because her husband was difficult to wake up and now is lethargic with garbled speech. She reports a history of diabetes, stroke, renal failure, and high blood pressure. The patient's airway is patent, respirations are tachypneic but adequate, and radial pulse is rapid. Your partner reports the following vital signs: pulse, 136; respirations, 22 breaths/min; blood pressure, 106/62 mmHg; SpO2, 92%; and blood glucose, 642 mg/dL. What would be the most appropriate action in the care of this patient? A) Administer supplemental oxygen B) Administer oral glucose C) Encourage the patient to drink water D) Assist the patient with taking his insulin

: A Diff: 2 Page Ref: 622

: 21-5 50) Regarding the pathophysiology underlying anaphylaxis, which of these statements is true? A) Histamine causes the capillaries to become leaky and bronchioles to constrict B) High blood pressure forces blood from the blood vessels, resulting in airway edema C) Immunoglobulin E molecules make antibodies that cause bronchoconstriction and vasodilation D) Smooth muscle dilation in the lungs impairs the exchange of oxygen

: A Diff: 2 Page Ref: 631-632

: 21-3 42) What is the primary difference between an anaphylactic reaction and an anaphylactoid reaction? A) An anaphylactoid reaction may occur without prior sensitization to the antigen; anaphylaxis requires prior sensitization B) Anaphylactoid reactions are less severe than anaphylactic reactions C) Epinephrine is contraindicated in anaphylactoid reactions, but not in anaphylactic reactions D) Anaphylactoid reactions are commonly caused by environmental substances; anaphylactic reactions are most commonly caused by foods

: A Diff: 2 Page Ref: 632-633

: 21-6 9) When assessing a patient with a suspected anaphylactic reaction, which of these findings would you expect? A) Weak, rapid radial pulse B) Rapid and strong carotid pulse C) Normal to slightly increased blood pressure D) Slow and bounding radial pulse

: A Diff: 2 Page Ref: 634

: 21-4 47) A patient with an allergy to bees and a prescribed EpiPen was working in the garden when she noted swelling to the right side of her face. Assessment reveals swelling that is red and hot to the right cheek area. Her airway is patent, respirations easy and adequate, and radial pulse strong. Her vital signs are pulse, 76; respirations, 16 breaths/min; blood pressure, 156/62 mmHg; and SpO2, 99%. What should be the EMT's action at this time? A) Perform a secondary assessment B) Assist the patient with her EpiPen C) Treat the patient's condition as an anaphylactoid reaction D) Provide immediate and rapid transport

: A Diff: 2 Page Ref: 635

: 21-8 7) When reassessing a patient whom you are treating for an anaphylactic reaction, which of these findings would be of the greatest concern? A) Respiratory rate change from 28 to 10 breaths/min with increasing patient lethargy B) Red, warm, and dry skin, with the patient becoming increasingly agitated C) Pulse oximetry reading of 95% via high-concentration oxygen D) New hives appearing on the chest that were not there upon your arrival

: A Diff: 2 Page Ref: 639

: 21-2 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 22 Toxicologic Emergencies 1) Which of these statements about poisonings is correct? A) A poison is any substance that impairs a person's health by its chemical action B) All toxins are poisonous when in contact with the human body C) The majority of poisonings are intentional and result in homicide or suicide D) The number one cause of poisoning in the United States is medications

: A Diff: 2 Page Ref: 651

: 22-1 12) An 11-year-old boy with a history of mild developmental delays has possibly ingested parts of a household plant; his mother states that she found him eating the plant, then immediately called 911. You note that the plant has been overturned and is missing a considerable number of leaves. Assessment reveals the boy to be lethargic and confused; he complains of abdominal pain, accompanied by nausea and vomiting. His airway is patent and his respirations are adequate. Which of these assessment findings would be most suggestive that the poison from the plant leaves has been absorbed into the patient's body? A) Confusion and lethargy B) Nausea and vomiting C) Abdominal pain D) Leaves missing from the plant

: A Diff: 2 Page Ref: 654

: 22-22 23 Copyright © 2018 Pearson Education, Inc. 78) You suspect food poisoning in a 51-year-old male patient with nausea, vomiting, diarrhea, and fever. He is alert and oriented with no life threats to his airway, breathing, or circulation. His vital signs are pulse, 124; respirations, 20 breaths/min; blood pressure, 198/98 mmHg; and SpO2, 93% on room air. The patient has a history of COPD and hypertension, for which he did not take his medications today. In this situation, what would be the appropriate initial care? A) Oxygen at 2 lpm through a nasal cannula B) Encourage water by mouth for rehydration C) Take the blood pressure pill that the patient missed earlier D) Follow up with his family doctor

: A Diff: 2 Page Ref: 656

: 22-4 24) An alert and oriented 5-year-old child drank some ammonia that was placed in a cup in the garage. He is very scared and complains of abdominal pain, but states that he has not vomited. Assessment shows ammonia in and around his mouth as well as on his breath. He has an open airway and is breathing adequately. His pulse and skin show no abnormalities. Appropriate care for this patient would include: A) Rinsing his face and mouth with water B) Inducing vomiting C) Initiating positive pressure ventilation D) Administering activated charcoal

: A Diff: 2 Page Ref: 656

: 22-5 29) A 42-year-old patient weighs 154 pounds (70 kg). How much activated charcoal would you administer to him? A) 70 grams B) 100 grams C) 154 grams D) 500 grams

: A Diff: 2 Page Ref: 657, Figure 22-3

: 4-5 36) You are involved in a lawsuit over a stabbing that occurred six months ago. Since you work in a busy EMS system and some time has passed, your recollection of the incident in spotty. In this situation, your best means of remembering what occurred would be to: A) Review the prehospital care report B) Meet and discuss the incident with other witnesses C) Confer with your partner at the time D) Obtain and review the police report

: A Diff: 2 Page Ref: 66

: 22-9 13 Copyright © 2018 Pearson Education, Inc. 44) A 32-year-old female patient calls 911 to say that she injected herself with some heroin 15 minutes ago, which she just bought from "some guy" on the street. She has never tried heroin and is now scared about what she has done. Assessment reveals her to be conscious and well oriented. Her airway is open and she is breathing 14 times a minute. Her pulse is moderate in strength and her skin is warm and dry. What would be the appropriate care for this patient? A) Monitor her and initiate transport B) Place a warm pack to the injection site C) Administer intranasal naloxone D) Apply a tourniquet above the site of injection

: A Diff: 2 Page Ref: 661

: 22-17 45) At the scene of an industrial accident, you are presented with a male patient who was exposed to a powerful pesticide in powder form. The patient states that he was moving sacks of the pesticide when one broke open, creating a cloud of powder that surrounded him, and which he then inhaled. During the incident, his face and arms became covered with the powder. At the present time, he complains of difficulty breathing and burning of his skin on his face and arms. You note that some of the pesticide remains on these areas of the body. Your first action in caring for this patient would be to: A) Apply supplemental oxygen B) Brush off the remaining pesticide C) Flush the pesticide with copious amounts of water D) Obtain vital signs and a medical history

: A Diff: 2 Page Ref: 662

: 22-11 25 Copyright © 2018 Pearson Education, Inc. 86) You have been called for a 28-year-old male patient with a history of behavioral problems. He responds to painful stimuli with garbled speech. His airway is patent, but breathing is inadequate. His radial pulse is rapid and his skin cool and moist. He has crackles at the bases of both lungs and the following vital signs: pulse, 108; respirations, 6 breaths/min and shallow; blood pressure, 98/64 mmHg; and SpO2, 92%. A friend informs you that the patient may have drunk a considerable amount of antifreeze, possibly up to 12 hours ago, in a suicide attempt. The first thing you should do is: A) Start positive pressure ventilation B) Call poison control C) Look for confirmation that the antifreeze was ingested D) Provide low-flow oxygen to increase the pulse oximeter reading to 94%

: A Diff: 2 Page Ref: 671

: 22-9 109) When the EMT contacts the Poison Control Center for a female patient who accidentally overdosed on her blood pressure medications when she misread the label, which additional information would the center personnel most likely need to determine care options for the patient? A) The patient's weight B) The patient's birthday C) The most recent bowel/bladder characteristics D) The type of container in which the medication was found

: A Diff: 2 Page Ref: 672

: 22-4 54) On the scene of a drug-related emergency, the 22-year-old patient tells you that he has been taking amphetamines because he likes the way that they make him feel. Over the past two days, he has been taking more and more, and today he feels as though his heart is racing. He also tells you that he recognizes he has a problem and wants to get help. When you are assessing the patient, which sign or symptom would provide further evidence that the patient has been abusing amphetamines? A) Increased blood pressure B) Auditory hallucinations C) Constricted pupils D) Fatigue and prolonged sleep

: A Diff: 2 Page Ref: 676

: 22-16 74) For which of these patients is a "talk down" technique indicated? A) A 26-year-old who took LSD and is panicked because spiders are after him B) An 18-year-old who is having a "bad trip" after taking his parent's antihypertensive medication to get "high" C) A 59-year-old whose heart is racing after trying cocaine D) A 47-year-old who has chronic alcoholism and is demanding help

: A Diff: 2 Page Ref: 678

: 22-17 91) A 19-year-old female patient with diabetes is unresponsive after drinking a large amount of alcohol and trying some "pills" that her friend provided. She has snoring respirations and an intact radial pulse. Emergency Medical Responders are maintaining her airway with a head-tilt, chin-lift maneuver, which has eliminated the snoring respirations. Vital signs are pulse, 116; respirations, 14 breaths/min; minimal chest wall motion with absent breath sounds in the bases; and SpO2, 92%. Advanced life support has been contacted for assistance. Your next action would be to: A) Administer oxygen through positive pressure ventilation B) Identify the pills that the patient took C) Attempt to contact the parents for permission to treat D) Determine the patient's blood glucose level

: A Diff: 2 Page Ref: 678

: 22-2 93) Which of these guidelines would the EMT follow when talking down a patient with a drugrelated emergency? A) Calmly explain to the patient that this is a consequence of abusing drugs B) Be authoritative and tell the patient to follow your directions C) Inform the patient that restraints will be used if he does not listen to you D) Make frequent physical contact with the patient to establish trust

: A Diff: 2 Page Ref: 680

: 22-16 20 Copyright © 2018 Pearson Education, Inc. 67) You have been called for a "drunk" male patient at a halfway house known to provide living quarters to persons with drug and alcohol problems. Residents tell you that the patient is a heavy drinker and must have had too much last night. This morning he was found "passed out" with alcohol on his breath. Quick assessment of the scene reveals the patient to be prone on a dirty bed in a room littered with liquor containers. Aside from the alcohol, which of these observations would be most significant to the EMT? A) Glucometer on the table B) Smell of urine in the room C) Dried vomit on the floor D) An empty fast-food bag on the bedside table

: A Diff: 2 Page Ref: 683

: 22-22 60) The EMT is transporting a patient with the diagnosis of Wernicke-Korsakoff syndrome. The EMT recognizes that this patient has a past medical history of: A) Alcoholism B) Drug abuse C) Pancreatic failure D) Liver failure

: A Diff: 2 Page Ref: 683

: 22-18 30 Copyright © 2018 Pearson Education, Inc. 104) Emergency Medical Responders (EMRs) respond to a female patient who was found by her husband in their second-floor bedroom. When the responders arrived, she was lying on her bed, with a tourniquet on her arm. They also found a syringe, with unknown contents, lying on the floor next to the bed. Her husband denies that she abuses any drugs. The EMRs have removed the tourniquet and inserted a nasopharyngeal airway, and they are providing positive pressure ventilations at the rate of 10 breaths/min with a bag-valve-mask device and supplemental oxygen. You note the woman to be unresponsive, with a pulse rate of 52, and apneic. What would your initial proper care include? A) Seek an order to administer naloxone B) Apply the AED C) Extricate the patient from the bedroom D) Immediately move the patient to a firm surface

: A Diff: 2 Page Ref: 687, Figure 22-21

: 22-17 90) A 17-year-old female patient was at a party where she tried a Percocet pill (narcotic pain reliever). After taking the pill, she became scared that she was going to die and is now crying. At the present time, she feels slightly nauseated, but has no other complaints. There are no life threats and her vital signs are pulse, 88; respirations, 14 breaths/min; blood pressure, 108/68 mmHg; and SpO2, 98% on room air. The patient has no medical history but is allergic to peanuts, for which she has a prescribed epinephrine auto-injector. Appropriate care for this patient would include: A) Nonemergent transport B) Talk-down technique C) Asking if she has an epinephrine auto-injector with her D) Supplemental oxygen via a nasal cannula at 2 lpm

: A Diff: 2 Page Ref: 688

: 22-19 98) You believe that a male patient has ingested bath salts. Given the nature of this drug, which sign or symptom would help confirm this suspicion? A) Tachycardia B) Hypotension C) Hyperglycemia D) Hypothermia

: A Diff: 2 Page Ref: 688

: 22-16 64) Which of these complaints would the EMT expect from a person who has just used crack cocaine for the first time? A) "I have chest pain." B) "My heart feels slow." C) "I see spiders." D) "My nose feels raw."

: A Diff: 2 Page Ref: 689

: 22-15 111) Your EMS unit has arrived on the scene of a male patient who is experiencing auditory and visual illusions after smoking "medical grade" marijuana. While on scene with the conscious patient, your partner leans over to you and whispers, "This is just another pothead trying to get us to think he needs this stuff." Despite your partner's impression, which of these pieces of information would be an indication to you that the patient is actually using the marijuana for prescribed medicinal purposes? A) The patient is currently receiving chemotherapy for cancer B) The patient has a history of high blood pressure C) The patient states he has type 2 diabetes D) The patient lives in a state where marijuana is legal to use

: A Diff: 2 Page Ref: 690

: 22-20 112) You are on the scene with a geriatric patient who is semi-responsive and lying in bed. EMS was alerted when a family member went to check on the patient. The patient appears confused when questioned, the skin is cool and dry, the heart rate is 42 beats/min, blood pressure is 96/68 mmHg, and respirations are 12 breaths/min. The family member states the patient just started a new medication yesterday-perhaps that is causing these findings. Which of these medications, if recently prescribed to the patient, could be the cause of the patient's symptoms? A) Calcium channel blocker B) Inhaled bronchodilator C) Oral steroid D) Prescribed dose of acetaminophen

: A Diff: 2 Page Ref: 691

: 23-2 13) The EMT understands the major function of most organs in the abdomen when he states: A) "The major function of the organs in the abdominal cavity is digestion." B) "The basic function of the abdominal organs is the storage of fat for reserve energy." C) "The primary role of the organs in the abdominal cavity is the utilization of oxygen." D) "The fundamental role of the organs in the abdomen is the cleansing and filtering of blood."

: A Diff: 2 Page Ref: 698

: 4-10 7) Which item would the EMT place in the administrative information section of the prehospital care report? A) BLS Unit 51-20; Incident # 67-8971-90 B) Patient: Henry, Steven M C) "Patient found supine on the porch." D) Blue State Insurance #425-22892; GRP# 456298

: A Diff: 2 Page Ref: 70

: 4-5 3 Copyright © 2018 Pearson Education, Inc. 9) When asked, an alert and oriented 44-year-old male tells you that he called 911 because "my chest is hurting." The man is also sweating and feels as if he is going to vomit. He has a history of high blood pressure and states that this pain "feels just like my heart attack two years ago." His pulse is 88 beats per minute, respirations are 18 breaths per minute, and blood pressure is 156/92 mmHg. On room air, he has an oxygen saturation level of 95 percent. Based on this information, how would you document his chief complaint on the patient care report? A) "My chest is hurting." B) Possible heart attack C) Myocardial infarction D) Chest pain with an elevated BP

: A Diff: 2 Page Ref: 70

: 23-2 6) You have been called for a patient with abdominal pain. The patient states that he recently had his gallbladder removed. As an EMT, you realize that: A) His ability to digest fats properly is impaired B) He cannot filter blood normally through the liver C) His ability to absorb nutrients from the intestines is decreased D) He has a more difficult time urinating due to ureter stenosis

: A Diff: 2 Page Ref: 700, Table 23-2

: 23-2 3) You have been called to transfer a male patient from an outpatient clinic to the hospital. The patient has been diagnosed with peritonitis and requires transport to the hospital for definitive care. As a knowledgeable EMT, you would recognize which of these statements as true? A) The lining of the patient's abdominal cavity is inflamed B) The patient's kidneys and pancreas are infected C) The patient is actively hemorrhaging and requires blood D) The abdominal aorta is inflamed and in danger of rupture

: A Diff: 2 Page Ref: 701

: 23-3 5 Copyright © 2018 Pearson Education, Inc. 18) A middle-aged female patient has dialed 911 for an abdominal emergency. On scene, she informs you she has a "bad gallbladder" and it has been increasingly bothering her, so she needs transport to the hospital for further care. Your assessment reveals tenderness and mild discomfort to the right upper quadrant of the abdomen. The patient also states that her right shoulder is aching. Given the patient's complaint, the EMT would recognize the shoulder pain as: A) Referred pain B) Shadow pain C) Vascular pain D) Muscular pain

: A Diff: 2 Page Ref: 701

: 23-13 77) You have been dispatched to a residence for a patient experiencing an exacerbation of chronic pancreatitis. Which chief complaint do you anticipate the patient having? A) Severe pain B) Chronic diarrhea C) Bloody stool D) Altered mental status

: A Diff: 2 Page Ref: 702

: 23-6 21 Copyright © 2018 Pearson Education, Inc. 80) A patient with abdominal pain shows you black and loosely formed stool in the toilet. You would advise the hospital that the patient has: A) Melenic stool B) Hematemesis. C) Bile-like stool D) Hematochezia

: A Diff: 2 Page Ref: 703

: 23-6 24) Which of these assessment findings is of most concern with a 46-year-old male patient who complains of severe abdominal pain? A) Blood pressure of 90/64 mmHg B) Respiratory rate of 22 breaths/min C) Heart rate of 96 beats/min D) Increased tenderness to the right upper quadrant with palpation

: A Diff: 2 Page Ref: 708

: 23-6 25) A 42-year-old female patient is crying and states that she has sharp abdominal pain that she localizes to her right lower quadrant. When assessing this patient's abdomen, the EMT would: A) Start palpating in the left upper quadrant B) Avoid palpating the entire abdomen C) Start palpating in the right lower quadrant D) Avoid palpating the right lower quadrant

: A Diff: 2 Page Ref: 709

: 23-6 27) When assessing a patient with abdominal pain, you note that his abdomen feels rigid. What should you do next as part of the abdominal assessment? A) Ask the patient to take a deep breath and then relax, while you repalpate the rigid area B) Note that the patient has guarding and obtain a blood pressure C) Gently massage the abdominal muscles until they relax D) Increase the pressure of palpation until the rigid muscles relax

: A Diff: 2 Page Ref: 709

: 23-6 33) While assessing a patient with acute abdominal pain, you note that his abdomen is very rigid. When asked to relax his stomach muscles, he does. The EMT would recognize this patient as demonstrating: A) Voluntary guarding B) Rebound guarding C) False rigidity D) Involuntary rigidity

: A Diff: 2 Page Ref: 709

: 4-7 44) A pertinent negative would be illustrated by: A) "Nausea without vomiting." B) "Hypertension and taking medication." C) "Dizziness for three days without notifying the doctor." D) "Short of breath with history of lung problems."

: A Diff: 2 Page Ref: 71

symptom D) Provoking factor

: A Diff: 2 Page Ref: 71

: 23-7 112) You are treating a male patient with a sickle cell crisis. Vital signs are pulse, 124; respirations, 22 breaths/min; blood pressure, 156/92 mmHg; breathing, unlabored; and SpO2, 91%. Which instruction would you provide to other EMTs in the care of this patient? A) "Let's place the patient on a nasal cannula with 2 lpm of oxygen." B) "I need someone to administer aspirin so we can thin his blood and get it moving." C) "The best thing we can do is just to transport the patient to the emergency department." D) "Remember that using a blood pressure cuff can cause significant bruising."

: A Diff: 2 Page Ref: 713

: 23-7 115) A 19-year-old patient with hemophilia and behavioral problems has intentionally cut his right wrist. Assessment indicates an open airway, adequate breathing, and profound bleeding from the self-inflicted laceration. Which instructions would you provide to other EMTs taking care of this patient? A) "Let's use normal bleeding-control procedures and see how that works." B) "Let's elevate the patient's arm and place a tourniquet distal to the cut." C) "Since control of bleeding is virtually impossible, we need to transport the patient immediately." D) "We need to quickly apply a tourniquet directly above the cut."

: A Diff: 2 Page Ref: 713

: 23-1 58) The primary assessment of a 27-year-old female patient who has been raped reveals no life threats to the airway, breathing, or circulation. The patient complains of pain in the vaginal area, but a focused assessment of her genitalia indicates no remarkable findings. When caring for this patient, which of these statements would be most therapeutic? A) "Please be assured that you are safe from harm here in the ambulance." B) "I know that this is difficult, but you will need to be tested for HIV and other STDs." C) "I need to look one more time at your genital area to see if there is anything looks different." D) "It may set you at ease to hear that in most cases, the attacker is apprehended by authorities."

: A Diff: 2 Page Ref: 715

: 23-8 91) A female patient, who has been sexually assaulted, has called 911 for assistance. She states that she does not know the assailant and showered immediately after the assault. The police have not yet been notified. Which of these statements would be appropriate in the care of this patient? A) "Where are the clothes that you were wearing?" B) "Why did you feel the need to shower?" C) "Do you think that you can identify the person who assaulted you?" D) "It is unfortunate that you showered; it will be harder to get evidence now."

: A Diff: 2 Page Ref: 715

: 23-1 61) A 44-year-old female patient states that she has a history of endometritis. The EMT would recognize that this patient has: A) An infection of the endometrial lining B) An infection of the ovaries C) Endometrial tissue that is growing outside of the uterus D) Absence of a menstrual period

: A Diff: 2 Page Ref: 716

: 23-10 60) Which of these statements made by a 27-year-old female patient would make the EMT highly suspicious of mittelschmerz? A) "I had some sharp belly pain, but it seems to be going away now." B) "My menstrual flow seems heavier than normal." C) "I finished my period yesterday and now I am nauseated." D) "It seems that I have had a yellow vaginal discharge for two days."

: A Diff: 2 Page Ref: 716

: 23-8 57) Pelvic inflammatory disease is best described as: A) An infection of the female reproductive structures B) An ovarian cyst that has ruptured C) A particularly painful menstrual period D) Pain experienced as a female ovulates

: A Diff: 2 Page Ref: 716-717

: 23-6 19 Copyright © 2018 Pearson Education, Inc. 72) A patient with a kidney stone would most likely complain of: A) Severe abdominal pain B) Chest discomfort with dyspnea C) Excessive urination D) Nausea and vomiting

: A Diff: 2 Page Ref: 721

: 23-12 69) A 26-year-old female patient has called 911 because of lower abdominal pain. Your findings are consistent with a urinary tract infection. The patient has a history of urinary tract infections as well as asthma. Her vital signs are pulse, 116; respirations, 14 breaths/min and adequate; blood pressure, 108/56 mmHg; SpO2; 99%; and temperature, 101.6°F. What is the priority of care? A) Nonemergent transport B) Aspirin for fever control C) Albuterol via her metered-dose inhaler D) Advanced life support assistance

: A Diff: 2 Page Ref: 725

: 23-12 73) When transporting a patient whom you suspect has a kidney stone to the hospital, in which position should the patient be placed if no contraindications exist? A) Position of comfort B) Trendelenburg position C) Prone position D) Semi-sitting position

: A Diff: 2 Page Ref: 725

: 4-2 33) You have been called for a 2-year-old female with an arm injury. The child presents with deformity and bruising to her left forearm. When asked, the mother states that the child fell from the bed, but the father states that his daughter fell down the stairs. Given the inconsistent stories, you are suspicious of child abuse. Which narrative would be most appropriate when documenting this situation? A) "Patient fell off of bed injuring left arm-per mother; patient fell down stairs injuring left arm- per father." B) "Mother and father cannot agree on how their daughter got the bruise and deformity to the arm." C) "Patient has injuries consistent with child abuse; the mother and father cannot determine how the patient was injured." D) "Patient appears to be abused; the police will be called and the physician in the ED will be notified."

: A Diff: 2 Page Ref: 78

C) A: Assessment D) P: Plan

: A Diff: 2 Page Ref: 78

: 1-7 38) How would the Americans with Disabilities Act (ADA) be satisfied for a pregnant emergency medical dispatcher (EMD) who suffers from paralysis of both legs and requires the use of a wheelchair? A) Wheelchair accessibility to and from dispatch B) Hourly pay rate 10 percent above that of the other EMDs C) Scheduled shifts during daylight hours only D) Transport by your service to and from work

: A Diff: 2 Page Ref: 8

: 1-15 4 Copyright © 2018 Pearson Education, Inc. 12) You have arrived on the scene of a motor vehicle collision. A car has gone off the road and into a utility pole. The pole is broken and wires are hanging just above the car. You do not see any sparking or arcing of the wires. The driver of the car is slumped over the steering wheel and not moving. Several bystanders around the car are yelling for you to help. Which steps represent the correct order of your response? A) Clear the bystanders, allow the fire department to secure the wires, access the patient, extricate the patient, transport B) Access the patient, clear the bystanders, allow the fire department to secure the wires, extricate the patient, transport C) Clear the bystanders, access the patient, extricate the patient, transport, allow the fire department to secure the wires D) Access the patient, allow the fire department to secure the wires, clear the bystanders, extricate the patient, transport

: A Diff: 2 Page Ref: 8-9

: 5-4 12 Copyright © 2018 Pearson Education, Inc. 45) During which situation is it typically NOT necessary for the EMT to contact dispatch first with a request or question? A) When the EMT needs to get medical approval to administer a medication B) If the patient is entrapped and a structural collapse rescue team is needed C) If the scene suddenly turns unsafe and police backup is required D) The patient is acutely deteriorating and ALS intercept is necessary

: A Diff: 2 Page Ref: 89

: 1-7 10) An ambulance with two EMTs arrives in front of a house for an unknown medical emergency. On scene, bystanders report that a female patient was beaten by her husband in the driveway and then dragged back into the house. They state that the patient appeared unconscious and was bleeding from the head. Which action would the EMTs perform next? A) Do not enter the scene until it has been controlled by law enforcement B) Quietly enter the home and quickly move the patient to the ambulance C) Remove the husband from the house, then provide emergency care to the wife D) Enter the home to protect the patient while waiting for the police to arrive

: A Diff: 2 Page Ref: 9

: 5-12 16) Medical direction has advised you to place a patient who is obese and extremely short of breath in a supine position. Knowing that doing so may cause the patient to become even more short of breath, your best action would be to: A) Explain your concern to the physician and ask for clarification B) Place the patient in the supine position and expedite transport C) Contact a different hospital and transport the patient there D) Ask your partner what she would do

: A Diff: 2 Page Ref: 90

: 5-5 4) Why should the EMT provide the physician or nurse with an oral report when transferring care to the hospital emergency department (ED)? A) To summarize patient assessment and treatment information B) To provide an opportunity for the ED staff to critique the care provided C) To inform them of whether they need to see the patient immediately D) To provide input on additional medical care to be given in the ED

: A Diff: 2 Page Ref: 91

: 5-7 20) Why is using a standard format for relaying medical information to the emergency department important? A) A standard format reduces the opportunities for forgetting important medical information B) A standard format assists the EMT in maintaining his or her assessment skills C) Dispatch is better able to monitor and constructively critique the radio traffic to hospitals D) The EMS agency can increase its reimbursement from health care insurance companies

: A Diff: 2 Page Ref: 91

: 5-10 42) Which phrase best illustrates the EMT using the summary technique of therapeutic communication with a patient experiencing depression? A) "From your story, it seems that you have been depressed for several weeks now." B) "Since you are depressed, we need to transport you to the hospital." C) "I know how you feel; my brother suffers from depression." D) "Since you are not in a normal state of mind, we have to transport you to the ED."

: A Diff: 2 Page Ref: 93

: 5-7 8 Copyright © 2018 Pearson Education, Inc. 29) A patient denies difficulty breathing, but displays signs of respiratory distress. You state, "I know that you said you are breathing fine, but you cannot speak more than two to three words at a time without gasping for air." Your response is an example of: A) Confrontation B) Empathy C) Contradiction D) Explanation

: A Diff: 2 Page Ref: 94

: 5-13 11) You are treating a 2-year-old girl who fell off her bike. She is scared, continues to cry, and will not answer any of your questions. What would be a good strategy to help find out where the girl hurts? A) Have the girl's mother ask your questions for you B) Tell the patient she will be okay if she tells you what hurts C) Promise the girl a reward like ice cream if she answers the questions D) Use an adult-like stern voice and tell the girl she needs to answer the questions

: A Diff: 2 Page Ref: 99

: 4-2 39) You document the following on the prehospital care report: "c/o H/A with associated n/v; pt. denies existing CNS problems or history of the same; states positive history of AAA and ETOH abuse." Regarding this narrative, which interpretation would be most accurate? A) The patient has a headache B) The patient has a history of illegal drug use C) The patient is nauseated but not vomiting D) The patient has a history of migraines

: A Diff: 2 Page Ref: Table 4-2 Abbreviations

: 6-5 7) In preparing the schedule, you have been instructed to pair EMTs in a way that decreases the chance of injury when lifting and moving patients. Given this directive, who would make the best partner for a tall and very strong EMT? A) A tall and very strong EMT B) A short and very strong EMT C) A short and weaker EMT D) A tall and weaker EMT

: A Diff: 3 Page Ref: 103

: 7-6 12) You have been called to transport a patient who has an illness that has impaired the involuntary muscles' ability to contract. What condition would you expect with this patient? A) Decreased peristaltic movement of the large intestine B) Decreased heart rate and increased blood pressure C) Difficulty in walking and grasping objects with the hands D) Difficulty in maintaining an upright posture

: A Diff: 3 Page Ref: 141

: 7-9 65) Which statement best describes the difference between cardiac and smooth muscle? A) Cardiac muscle can generate its own electrical impulse; smooth muscle cannot B) Cardiac muscle is able to extend; smooth muscle can only contract C) Cardiac muscle relies on an electrical impulse to be stimulated; smooth muscle does not D) Cardiac muscle does not need a blood supply; smooth muscle does

: A Diff: 3 Page Ref: 141

: 7-10 6 Copyright © 2018 Pearson Education, Inc. 23) A patient has severe swelling of the leaf-shaped flap that helps to prevent food from entering the lower respiratory system while swallowing. Knowing that the suffix "itis" refers to inflammation, what is this patient's condition? A) Epiglottitis B) Tracheitis C) Pharyngitis D) Bronchitis

: A Diff: 3 Page Ref: 146

: 7-14 33) A patient has a total occlusion of the left femoral artery. With this condition, which assessment finding would the EMT expect? A) Pale skin to the left foot B) Swelling in the legs C) Difficulty moving the left arm D) Decreased radial pulse

: A Diff: 3 Page Ref: 151

: 7-15 35) A patient complains of extreme dizziness, headache, and other "stroke-like" symptoms. Which condition is most likely to be responsible for these symptoms? A) Occlusion of the carotid arteries B) Clot in the abdominal aorta C) Rupture of the radial vein D) Occlusion of the popliteal vein

: A Diff: 3 Page Ref: 151

: 7-13 101) Which division of the peripheral nervous system is responsible for increasing gastric juice secretions after a person eats a meal? A) Autonomic B) Voluntary C) Sympathetic D) Somatic

: A Diff: 3 Page Ref: 157-158 Fig 7-35

: 7-3 94) A psychologically disturbed patient decided to kill himself by shooting himself in the head. The bullet entered the right temporal lobe and exited the skull on the opposite side. If this patient is unresponsive, what is the most likely cause? A) Both cerebral hemispheres are damaged B) The cerebellum is damaged C) The patient has likely lost too much blood D) The endocrine system (hypothalamus) has failed

: A Diff: 3 Page Ref: 159

: 8-3 5) A patient's brain cells are undergoing anaerobic metabolism. As a result, those cells: A) Are becoming dysfunctional in an environment that is increasingly acidic B) Have too much adenosine triphosphate to function properly C) Are producing elevated quantities of carbon dioxide (CO2) as a result of aerobic metabolism D) Cannot make any energy in the form of ATP due to a lack of glucose

: A Diff: 3 Page Ref: 179

: 8-16 18 Copyright © 2018 Pearson Education, Inc. 74) A confused and lethargic 24-year-old male patient has intentionally overdosed on a narcotic medication. His vital signs are as follows: pulse, 36; respirations, 10 breaths/min; blood pressure, 50/20 mmHg; and SpO2, 88% with 15 liters per minute of oxygen applied by Emergency Medical Responders. What is the greatest danger to this patient's well-being? A) Decreased cellular perfusion B) Altered mental status C) Increased sympathetic nervous system stimulation D) Left ventricular heart failure

: A Diff: 3 Page Ref: 181

: 8-4 75) What is the result of an opening developing that allows air into the space between the visceral and parietal pleura of the thorax? A) Progressive collapse of the lung B) Hyperventilation C) Hypocarbia D) Left ventricular heart failure

: A Diff: 3 Page Ref: 185

: 8-4 68) A patient with asthma is extremely short of breath and hypoxic. Related to the ventilation/perfusion ratio (V/Q), the EMT would recognize the problem as related to: A) Inadequate oxygen in the alveoli B) Decreased cardiac output to circulate oxygen C) Inadequate oxygen in the ambient air D) Decreased blood volume to carry oxygen

: A Diff: 3 Page Ref: 191

: 8-13 39) Which condition must be met for carbon dioxide to move from the cell to the bloodstream? A) The perfusing blood must be low in carbon dioxide B) The sodium-potassium pump must be functional C) There must be a large amount of oxygen in the blood D) There must be a large number of red blood cells in the blood

: A Diff: 3 Page Ref: 193

: 8-15 43) While completing some clinical time in the hospital for his EMT class, an EMT student observed a patient being administered an IV fluid with a high oncotic pressure. Once this fluid is in the patient's body, the EMT student would expect which action to occur? A) Fluid from the tissues will move into the bloodstream B) Fluid will move evenly from the bloodstream into the cells C) Fluid from the IV will move into the cells and rehydrate them D) The patient's blood pressure will decrease dramatically

: A Diff: 3 Page Ref: 194

: 8-17 46) What would be a direct result of increasing a patient's preload? A) Increased cardiac output B) Increased oxygen delivery into the lungs C) Decreased blood pressure D) Decreased myocardial contraction

: A Diff: 3 Page Ref: 195

: 8-15 16 Copyright © 2018 Pearson Education, Inc. 66) Which condition would directly compromise the average patient's cardiac output? A) Heart rate of 190 beats/min B) Circulatory volume of 5 liters C) Increased number of circulating WBCs D) Blood pressure of 118/52 mmHg

: A Diff: 3 Page Ref: 196

: 9-1 6 Copyright © 2018 Pearson Education, Inc. 20) Five minutes have passed since you assisted in the delivery of a full-term baby boy. Based on your knowledge of physiological changes in the neonate, which finding would be most concerning? A) Heart rate of 88 beats/min B) Respiratory drop from 52 to 38 breaths/min C) Rectal temperature of 99.8°F D) Systolic blood pressure of 70 mmHg

: A Diff: 3 Page Ref: 206

: 9-2 4) The mother of a 9-month-old baby informs you that her child has yet to make any sounds that resemble words or speech. She asks you if this is normal. What is your best response? A) "Babies typically begin making words at 6 months. It may be a good idea to call your pediatrician for additional information." B) "It usually takes 10 to 12 months for babies to begin talking. Give it time. This is normal." C) "To be honest, all babies develop at their own pace; this is likely fine." D) "Why don't you take him to your pediatrician to find out what is wrong."

: A Diff: 3 Page Ref: 207

: 9-3 2 Copyright © 2018 Pearson Education, Inc. 5) When assessing a 5-month-old baby girl, you note that she cries when her mother holds her, but is quiet and at peace when her father takes her. Assessment reveals no outward problems. Based on your knowledge of psychosocial development, what is a likely explanation? A) The father is most likely the baby's primary caregiver B) Female babies tend to bond more closely with their father C) The baby was most likely breast-fed by the mother D) There is a problem with the baby's normal development

: A Diff: 3 Page Ref: 207

: 10-12 25 Copyright © 2018 Pearson Education, Inc. 95) A listless and lethargic 84-year-old male patient responds to physical stimuli with garbled speech. His respirations show poor effort and are rapid and labored, with a room-air SpO2 of 84%. Additionally, you cannot appreciate breath sounds in his right lung. The best form of oxygen therapy for this patient would be: A) Positive pressure ventilation B) High-concentration oxygen via a nonrebreather mask C) Oxygen at 2 lpm via nasal cannula initially and increase the liter flow as needed D) Continuous positive airway pressure (CPAP)

: A Diff: 3 Page Ref: 224

: 10-7 18) You have arrived on the scene of an assault in which several people were injured. You are directed to assist another crew with a patient who has been shot once. As you approach, you are told that the patient has slow and irregular breathing that is inadequate. You observe the patient being ventilated with a bag-valve mask while another EMT maintains her airway with the jawthrust maneuver. Based on your observation, where might you expect that this patient was shot? A) Head B) Lower abdomen C) Chest D) Pelvis

: A Diff: 3 Page Ref: 231

: 2-4 51) Your supervisor has assigned you the task of designing a program that provides for stress management and health promotion within the department. Which program would accomplish this task in the best way? A) Complementary passes to a local fitness center B) Mandatory monthly meetings for all EMS personnel with a mental health counselor C) Doughnuts and coffee every morning for all EMS personnel D) A weekly night out for beer, wings, and other snacks at a local eatery

: A Diff: 3 Page Ref: 24

: 10-18 100) Which of these statements made by another crew member would cause you to disregard the use of continuous positive airway pressure (CPAP) for a patient? A) "His respirations are agonal and slow." B) "He had bleeding stomach ulcers two years ago." C) "His SpO2 has fallen from 92% to 88%." D) "His blood pressure is 186/108 mmHg."

: A Diff: 3 Page Ref: 261

: 10-3 30 Copyright © 2018 Pearson Education, Inc. 116) When administering oxygen to a hypoxic patient with Alzheimer's disease, which of these findings would seemingly indicate that the patient's hypoxic status is improving? A) The patient has an SpO2 reading of 94% B) The patient becomes more restful and wants to sleep C) The blood pressure increases from 136/78 to 150/86 mmHg D) The respirations slow from 24 to 22 breaths/min

: A Diff: 3 Page Ref: 269

: 11-8 34) A patient presents with skin that is cool to the touch. The EMT shows he understands this condition when he states: A) "This may indicate a problem with the patient's blood circulation." B) "The patient must have an infection somewhere in his body." C) "We should check his breath sounds; the patient probably has a lung infection, such as pneumonia." D) "The patient most likely has a past medical history of hypertension."

: A Diff: 3 Page Ref: 294

: 11-11 59) An EMT has an accurate understanding of diastolic blood pressure when she tells you that diastolic pressure: A) Is the pressure in the arteries when the heart is not contracting B) Can be estimated as one-third of the systolic blood pressure C) Can be easily obtained by palpating the blood pressure D) Should always be rounded to the nearest 10

: A Diff: 3 Page Ref: 296

: 11-11 24 Copyright © 2018 Pearson Education, Inc. 93) An 86-year-old female patient has called 911 for rectal bleeding. There is a large amount of dark red blood and clots in the toilet and on the patient's clothing. The Emergency Medical Responder reports a blood pressure of 84/68 mmHg with a heart rate of 124 beats/min. Given this information, the EMT should expect findings of: A) A narrowed pulse pressure and possible shock B) Normal blood pressure since the patient is alert and oriented C) Diastolic hypertension and risk for stroke D) A normal heart rate given the patient's age

: A Diff: 3 Page Ref: 297

: 11-7 91) Which of these blood pressure readings is normal for a 7-year-old male? A) 114/62 mmHg B) 120/80 mmHg C) 76/50 mmHg D) 94/30 mmHg

: A Diff: 3 Page Ref: 297

: 11-15 22 Copyright © 2018 Pearson Education, Inc. 85) In patients with which of these conditions would the EMT most likely get an inaccurate pulse oximeter reading despite proper application of the sensor? A) Low blood pressure B) Elevated body temperature C) Unresponsiveness D) Increased heart rate

: A Diff: 3 Page Ref: 300

: 13-5 18) You are an assistant instructor for an Emergency Medical Responder course. One of the students asks you how the head-tilt, chin-lift airway maneuver works to open the airway. Your response is: A) "It opens the airway by lifting the tongue from the back of the throat." B) "It creates an open airway by separating the lips, allowing air to enter." C) "It stimulates the patient to begin taking deeper breaths, thereby moving air into the lungs." D) "It opens the airway by relaxing and expanding the size of the throat."

: A Diff: 3 Page Ref: 345

: 13-22 72) When assessing breath sounds during the secondary assessment, the EMT shows he is employing a correct technique when he listens: A) At the left second intercostal space, followed by the right second intercostal space B) First to the apex and base of the right lung, and then to the apex and base of the left lung C) To the base of the lung by placing the stethoscope at the third intercostal space laterally D) Over the left and right lateral wall while instructing the patient to take fast and shallow breaths

: A Diff: 3 Page Ref: 361

: 13-18 61) A 44-year-old male patient was cutting limbs from high in a tree when he fell. He is found to be unresponsive with snoring respirations. His breathing is inadequate at a rate of 8 breaths/min and his carotid pulse is weak and difficult to locate. Following the primary assessment and initial management of life threats, which of these actions will the EMT complete while performing the secondary assessment? A) Obtain vital signs and get a past medical history from the family B) Start positive pressure ventilation with a bag-valve mask C) Place an oral airway and cervical collar on the patient D) Perform a trauma jaw-thrust maneuver to open the airway

: A Diff: 3 Page Ref: 382

: 13-15 110) While completing the secondary assessment of an unresponsive patient with a history of diabetes and hypotension, how often should you repeat the patient's vital signs? A) Every 5 minutes B) Every 10 minutes C) Every 15 minutes D) Every 20 minutes

: A Diff: 3 Page Ref: 384

: 13-26 91) The EMT is using the OPQRST mnemonic to gather information from a patient with abdominal pain. Which of these patient statements is a response to the "P" component of this memory aid? A) "It hurts worse when I take a deep breath." B) "My pulse feels as though it is racing." C) "I have a past history of asthma." D) "The pain started about 2 hours ago."

: A Diff: 3 Page Ref: 399

: 15-9 67) You are assessing an elderly patient with a decreased level of consciousness. Your assessment reveals the patient to have a patent airway, labored respirations, and weak, rapid pulses. The skin is pale, cool, and cyanotic in the extremities. You also observe diaphoresis and a delayed capillary refill. Vital signs for this patient are heart rate, 136 beats/min; blood pressure, 66/40 mmHg; and respirations, 40 and shallow. Auscultation of the lungs reveals profound rales located throughout each lung. The patient's temperature is 99°F and there is obvious jugular vein distention and pedal edema. Additionally, family states that the patient has an extensive cardiac and diabetic history. Based on this information, you should suspect which kind of shock? A) Cardiogenic B) Hypovolemic C) Hypotensive D) Obstructive

: A Diff: 3 Page Ref: 441

: 15-4 23 Copyright © 2018 Pearson Education, Inc. 83) A 44-year-old male patient has been shot in the abdomen. Which assessment findings would lead you to believe that the patient is in compensated shock? A) Alert and anxious, pulse 102, BP 114/88 mmHg, pale and cool skin B) Slightly confused, pulse 116, BP 102/56 mmHg, warm skin that is flushed C) Confused and anxious, pulse 144, BP 82/palpation, cool skin that is mottled D) Confused, pulse 44, BP 110/68 mmHg, cool and cyanotic skin

: A Diff: 3 Page Ref: 448

: 15-7 85) At a continuing education seminar on shock, the presenter asks if there is a point where someone cannot recover from shock. Which statement made by an EMT is correct? A) "Even with treatment, if shock has reached the final stage when multiple organs start to fail, death will result." B) "If the pupils are dilated and pulse is rapid, the patient cannot recover." C) "The patient probably cannot recover if the radial pulse is weak, even if the carotid pulse remains strong." D) "To survive severe shock, the patient needs a large amount of IV fluids immediately or a blood transfusion at the hospital."

: A Diff: 3 Page Ref: 448-449

: 15-1 2 Copyright © 2018 Pearson Education, Inc. 5) When presenting information on cardiac arrest and automated external defibrillation to a community group, a man asks why people should perform CPR prior to the arrival of EMS if the EMS responders will provide a shock after they arrive. Your response would be: A) "Immediate CPR can prolong the period in which the heart can be successfully shocked into a perfusing rhythm following cardiac arrest." B) "In many cases, CPR can reverse the cardiac arrest, making a shock by the AED unnecessary since the shock may further damage the heart." C) "In the American Heart Association's Chain of Survival, CPR is the most important link in surviving cardiac arrest that occurs outside the hospital." D) "CPR is needed to keep blood flowing through the body so the EMTs can give the patient IV medications when they arrive."

: A Diff: 3 Page Ref: 452

: 15-13 12) Why is defibrillation in the first few minutes of cardiac arrest so critical? A) If cardiac arrest is not treated within the first few minutes, ventricular fibrillation will convert to asystole, a nonshockable heart rhythm B) Research has shown that a heart in cardiac arrest will continue to pump blood for a few minutes before cardiac output drops to zero C) In the first few minutes of cardiac arrest, the blood pressure is still normal, but will drop quickly, making successful defibrillation less likely D) In the first few minutes of cardiac arrest, the heart is still warm, but it begins to cool rapidly, which makes it less receptive to a defibrillatory shock

: A Diff: 3 Page Ref: 454

: 15-15 19) Your service has a new AED. During the in-service program on the new device, the instructor informs you that it is a semi-automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that: A) The new AED will defibrillate the patient with smaller amounts of electrical energy B) The EMT will not need to press a "shock" button to shock the patient C) The new AED will defibrillate the patient with larger amounts of electrical energy D) Less energy but more shocks will be needed to treat cardiac arrest

: A Diff: 3 Page Ref: 456

: 15-19 8) The AED should never be applied to a patient who is not in cardiac arrest because some patients in: A) Ventricular tachycardia may still have a pulse B) Ventricular fibrillation may still be conscious and alert C) Ventricular fibrillation may still have a pulse D) Asystole may still have a pulse

: A Diff: 3 Page Ref: 457

: 15-18 38) When should the EMT transport the patient with cardiac arrest? A) After three "no shock advised" messages are received B) Immediately upon determining that the patient is in cardiac arrest C) After one shock has been delivered and the patient remains in cardiac arrest D) Before delivering the first shock when a "shock advised" message is received

: A Diff: 3 Page Ref: 462

: 15-11 25 Copyright © 2018 Pearson Education, Inc. 91) You are preparing to attach an AED when you notice that the patient has an implanted pacemaker. What should you do? A) Apply the AED, but avoid placing the electrodes over the pacemaker B) Call for ALS backup with a manual defibrillator C) Forego the AED and transport the patient immediately while continuing CPR D) Call medical command and request permission to perform a precordial thump

: A Diff: 3 Page Ref: 466

: 3-15 30) While off duty, an EMT happens upon the scene of a motor vehicle collision in which a car rolled over the side of an embankment. A young man has been seriously injured; he appears unresponsive, and is bleeding from the head and face. The EMT is alone with his infant baby daughter in the car and cannot leave her to provide help. Therefore, the EMT alerts 911 of the emergency and remains in his car with his daughter until EMS arrives. Later in the week, he finds out that the patient died. Which statement is true regarding this incident? A) The EMT had no duty to act and cannot be held liable for the man's death B) The EMT had a legal obligation to help and can be held liable for the death C) The EMT violated the state standard of care by not providing some form of care D) The EMT must go to court and explain that he did not help because of his daughter

: A Diff: 3 Page Ref: 48

: 3-3 52) You are an off-duty EMT and have come across a motor vehicle collision. A car has crashed head-on into a utility pole. There is moderate damage to the vehicle and the driver is walking about the scene. You stop and assess the patient. He has a large bruise on his arm and is complaining of abdominal pain where the seat belt contacted his body. Emergency Medical Responders (EMRs) are on scene, and a responding ambulance has a 2-minute ETA. At this point, you realize that: A) You cannot leave until another EMT or paramedic arrives to assume care B) You can leave the scene since the patient is stable and EMS is 2 minutes away C) You can only transfer care to a paramedic once he or she arrives on scene D) You can transfer care to EMRs since EMS has been notified and an ambulance is 2 minutes from the scene

: A Diff: 3 Page Ref: 48

: 17-12 63) You are treating a patient who complains of altered mental status, shortness of breath, and chest pain. A paramedic has just administered a medication that causes the sympathetic nervous system to increase its influence in the body. Which finding should you anticipate after this treatment? A) Increased heart rate B) Decreased blood pressure C) Decreased heart rate D) Increased heart rate and decreased blood pressure

: A Diff: 3 Page Ref: 522

: 17-2 3) A patient has pulmonary hypertension, which has increased the resistance in the pulmonary blood vessels. In response, what will most likely occur over a long period of time? A) The right side of the heart will weaken B) The heart muscle will become stronger C) The left side of the heart will weaken and fail D) The aorta will weaken and potentially rupture

: A Diff: 3 Page Ref: 522

: 17-2 74) An obstruction of the pulmonary artery will cause: A) Backup of blood in the right side of the heart B) Increased blood flow through the aorta C) Backup of blood in the left side of the heart D) Increased blood flow through the vena cava

: A Diff: 3 Page Ref: 522

: 17-1 26 Copyright © 2018 Pearson Education, Inc. 100) A 64-year-old male patient presents with a blood pressure of 210/132 mmHg. Which of these statements made by this patient would you recognize as most concerning and most likely associated with the elevated blood pressure? A) "I have a history of left-sided heart failure." B) "I feel very thirsty right now." C) "My hair has become very brittle." D) "I have this bruising on my arms and legs."

: A Diff: 3 Page Ref: 523

: 17-4 80) The EMT understands diastolic blood pressure when he defines it as: A) "The pressure in the arteries between cardiac contractions." B) "The pressure in the arterial system when the heart contracts." C) "The pressure needed to move blood through the cardiovascular system." D) "The pressure in the venous system when the heart is at rest."

: A Diff: 3 Page Ref: 529

: 17-19 84) Which of these patients is most likely to suffer a silent MI? A) A 55-year-old female with diabetes B) A 72-year-old male with a syncopal episode C) A 60-year-old female with colon cancer D) A 48-year-old male with undiagnosed hypertension

: A Diff: 3 Page Ref: 532

: 17-11 41) You are assessing a patient in heart failure. Which sign or symptom seemingly indicates that the left ventricle is the cause of the heart failure? A) Crackles in the bases of both lungs B) SpO2 of 95% with no supplemental oxygen C) Difficulty breathing when in an upright position D) Heart rate of 62 beats/min

: A Diff: 3 Page Ref: 536

: 18-12 16 Copyright © 2018 Pearson Education, Inc. 61) An elderly male patient with a history of COPD, hypertension, and diabetes presents as lethargic and confused. His airway is patent, and breathing is adequate. His skin is hot and his radial pulse is strong, regular, and bounding. Vital signs are pulse, 112; respirations, 20 breaths/min; blood pressure, 108/64 mmHg; SpO2, 94%; and temperature, 102.8°F. Also noted is swelling to his right lower leg. Given these assessment findings, the EMT should suspect which condition is responsible for the patient's altered presentation? A) Infection B) Peripheral edema C) Hypoxia D) Tachycardia

: A Diff: 3 Page Ref: 556

: 18-5 39) Assessment of a 56-year-old male patient reveals him to be responsive to verbal stimuli with garbled speech. Which of these statements made by the patient's wife suggests that the patient's problem may be toxic-metabolic? A) "He has bad kidneys." B) "He had a stroke two years ago." C) "He fell and hit his head yesterday." D) "He was diagnosed last year with Alzheimer's disease."

: A Diff: 3 Page Ref: 556

: 18-11 47) You have been called to a long-term care facility for a 77-year-old female patient who was found unresponsive in her wheelchair by staff. The nurse reports that the patient complained of a headache earlier in the day and was given 600 mg of Motrin. Your assessment shows the patient to be unresponsive with a patent airway, slow and irregular respirations, and a weak radial pulse. Her lips are cyanotic, and your partner reports the following vital signs: pulse, 44; respirations, 6 breaths/min; and blood pressure, 228/116 mmHg. Which action should be your next priority? A) Start positive pressure ventilation B) Check the patient's blood glucose level C) Attach the pulse oximeter to get a SpO2 reading D) Perform a prehospital stroke screen

: A Diff: 3 Page Ref: 557

: 19-7 52) Regarding a generalized tonic-clonic seizure, which of these statements is true regarding the different stages? A) The aura comes before a loss of consciousness B) The patient is postictal prior to convulsion activity C) A loss of consciousness occurs after the clonic (convulsion) phase D) The patient becomes postictal just before the hypertonic phase

: A Diff: 3 Page Ref: 588-589

: 19-5 44) Which of these statements about seizures is true? A) Simple partial seizures do not cause an alteration in mental status B) The cause of most seizures is easily identified C) Generalized seizures always last longer than partial seizures D) Complex partial seizures involve both cerebral hemispheres

: A Diff: 3 Page Ref: 590

: 19-11 10 Copyright © 2018 Pearson Education, Inc. 36) A man comes into your station and tells you that he was just diagnosed by his physician as having multiple syncopal episodes the previous week. More specifically, he asks you to explain why he keeps fainting. Which of these statements would be your best response? A) "For some reason, there was a temporary decrease in the flow of blood to your brain." B) "A small clot formed in a blood vessel in your brain, but was quickly broken down by the body." C) "Your blood sugar most likely dropped very quickly, causing you to faint." D) "A syncopal episode is a small seizure that runs its course very quickly."

: A Diff: 3 Page Ref: 598

: 20-5 50) You have been called for a 32-year-old female patient with altered mental status. On scene, you find the patient lethargic and confused. Although information is sketchy, it appears that she has a history of diabetes as well as renal failure for which she receives dialysis. You note no deficits in the primary assessment and the vital signs are pulse, 124; respirations, 28 breaths/min; blood pressure, 106/68 mmHg; and SpO2, 97%. Your partner reports a blood sugar reading of 774 mg/dL. Based on this information, the EMT would understand that definitive care of this patient would involve the administration of which medication at the hospital? A) Insulin B) Glucose C) Intravenous fluids D) Oxygen

: A Diff: 3 Page Ref: 605

: 20-9 57) Within the human body, what effect does insulin have? A) Decreases the level of glucose in the bloodstream B) Carries glucose from the digestive tract into the bloodstream C) Frees stored glucose from the liver so as to elevate the blood glucose level D) Turns carbohydrates into glucose, which can pass into the cells

: A Diff: 3 Page Ref: 606

: 20-9 43) A patient informs you that she takes Januvia pills for her diabetes. Which of these statements about this patient and her diabetes is true? A) Her pancreas still produces some insulin B) The pills contain insulin for use by the body C) Her body needs glucose that is provided by the pills D) The pills decrease her craving for sugary foods

: A Diff: 3 Page Ref: 609-610

: 21-8 18) A patient informs you that whenever she is exposed to a particular soap, she experiences a mild allergic reaction. As a knowledgeable EMT, you should recognize that: A) The soap contains an antigen B) The patient's airway will swell shut if she inhales the soap C) The soap contains antibodies that react in the patient's body D) She must have been exposed to the soap as an infant

: A Diff: 3 Page Ref: 630

: 21-8 5 Copyright © 2018 Pearson Education, Inc. 16) Which of these statements indicates that the EMT understands airway management in a patient suffering from anaphylaxis? A) "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues." B) "Epinephrine will help the patient's blood pressure, but not the swollen tissue in the airway." C) "The best way to open the airway in a patient with upper airway edema is to place the patient in an upright position." D) "If an oral or nasal airway is used, the airway will be opened and positive pressure ventilation will not be needed."

: A Diff: 3 Page Ref: 634

: 22-7 10 Copyright © 2018 Pearson Education, Inc. 34) You are preparing to administer activated charcoal to a patient who has ingested a poison. The activated charcoal authorized by your medical director also contains a cathartic. Which of these statements would you make to the patient regarding this additive? A) "You may experience diarrhea after taking the charcoal." B) "This charcoal will most likely give you a slight headache." C) "The additive in the charcoal may cause you to vomit." D) "If you have a heart condition, I cannot give you this medication."

: A Diff: 3 Page Ref: 656

: 22-7 37) Which of these statements made by an EMT indicates an accurate understanding of inhalation poisonings? A) "The onset of signs and symptoms associated with an inhalation poisoning are often rapid." B) "Inhalation poisons affect the lungs, but they do not circulate throughout the body." C) "It is probably safe to enter the scene of an inhalation emergency if I do not smell anything." D) "Most inhalation poisonings are easily identified by residue or burns around the patient's mouth."

: A Diff: 3 Page Ref: 658

: 22-5 48) You have been called to a residence for a 31-year-old patient who is complaining of confusion, nausea, vomiting, and a headache. His symptoms started this morning and have been getting worse all day. Despite lying in bed and resting all day, he is more fatigued than before. Which of these statements made by the patient would the EMT recognize as most important in relation to the patient's present complaint? A) "I just turned the furnace on last night." B) "I tried some raw seafood last week." C) "My wife is taking penicillin, to which I am allergic." D) "I have not been sleeping well the past few nights."

: A Diff: 3 Page Ref: 666-667

: 22-17 21 Copyright © 2018 Pearson Education, Inc. 71) You have been called to an alcoholism rehabilitation center. On scene, one of the counselors tells you that the patient is a 44-year-old woman who just came to the center this morning. She has not had any alcohol for 24 hours and is now sweating profusely and has an elevated heart rate and blood pressure. Based on this information, the EMT would recognize that the patient is: A) Physically dependent on alcohol B) Experiencing delirium tremens C) Psychologically dependent on alcohol D) Experiencing alcohol tolerance

: A Diff: 3 Page Ref: 684

: 23-6 41) You suspect a patient with right lower quadrant pain may have appendicitis. The patient states that he has no health insurance and wants to refuse care and transport. He asks you what can happen if his condition is appendicitis and he does not go to the hospital. What is your best response? A) "Your appendix could rupture, causing a major infection and shock." B) "The inflammation of the appendix will gradually subside, but in the meantime, the pain will be terrible." C) "If you do not get care, blood may clot in the intestine, causing an obstruction." D) "The pain will most likely subside in a few hours. You may want to try an anti-inflammatory like Motrin."

: A Diff: 3 Page Ref: 702

: 23-6 83) Which sign or symptom would reinforce the EMT's suspicion that a patient with a history of pancreatitis is having an exacerbation of the disease? A) Upper abdominal pain that radiates to the back B) Nausea, vomiting, and diarrhea C) Right upper quadrant pain with referral to the right shoulder D) Decreased heart rate and elevated blood pressure

: A Diff: 3 Page Ref: 702

: 23-6 49) A patient informs you that he was recently diagnosed with an abdominal aortic aneurysm (AAA). The surgeon did not want to operate on the aneurysm immediately because he felt it was stable and not worth the risks that surgery posed. Tonight, the patient states that he suddenly developed abdominal pain and wants to be evaluated in the hospital to see if the AAA has increased in size. Given this history, which of these assessment findings would cause the EMT to suspect that the AAA is the cause of the abdominal pain? A) "Tearing" pain located to the lower back B) Temperature of 101°F C) Pain that subsides when the patient lies still D) Inability to urinate

: A Diff: 3 Page Ref: 705-706

: 23-1 9 Copyright © 2018 Pearson Education, Inc. 34) You are called to a long-term care facility for a patient with abdominal pain per staff. On scene, you find an 81-year-old female patient whom staff said complained of abdominal pain and then began to vomit several times. The patient has dementia and is occasionally confused and sometimes lethargic, which staff says is her normal status. Assessment reveals her to be confused, breathing 22 times a minute, with a pulse rate of 88 beats per minute. Her blood pressure is 118/68 mmHg and she has an SpO2 of 97% on room air. Staff states that her temperature is 100.8°F and she did not get her medication for dementia today. When treating and transporting this patient, what would most likely represent the EMT's greatest concern during transport? A) Risk for vomiting B) Temperature of 100.8°F C) Respiratory rate of 22 breaths/min D) Not getting her antidementia medications

: A Diff: 3 Page Ref: 710

: 23-10 95) In discussing patients with chlamydia and gonorrhea with a group of EMT students, you would inform them that: A) These coinfections are treated with antibiotic therapy B) These coinfections often result in the need for surgery C) These coinfections require antiviral agents to be cured D) These coinfections tend to be caused by a parasite

: A Diff: 3 Page Ref: 717

: 5-2 2) You are returning from a call when you pass an apartment building with flames coming from several windows on the top story. You see several occupants trapped and hanging out of the windows, screaming for help. Which radio transmission is most appropriate when advising dispatch of the situation? A) "Central communications from Unit 118, how do you copy?" B) "Central communications be advised of a working structure fire on Third Street and Raven with occupants trapped." C) "Central communication, be advised there is a structure fire with people trapped." D) "Central communications I need the fire department and additional ambulances for a working structure fire on the north side of town."

: A Diff: 3 Page Ref: 88

: 5-17 10 Copyright © 2018 Pearson Education, Inc. 37) As you drive the ambulance with lights and sirens activated to the hospital, the paramedic asks you to notify the receiving hospital since he is busy caring for the patient, who is critical. The paramedic tells you to specifically let the emergency department know that the patient's blood sugar is 15 mg/dL (very low). There is no history of diabetes. How should you state this information to the hospital? A) "Be advised that the blood sugar is 15-that is, one-five mg/dL." B) "The blood sugar is 15. Be advised that the paramedic, not I, checked the blood sugar." C) "The patient is not a diabetic but has a low blood sugar." D) "We have a blood sugar that is 15. I think that the patient is very critical."

: A Diff: 3 Page Ref: 91

: 5-3 14) A 42-year-old female complains of shortness of breath. Which question would best assist you in getting additional information about the patient's chief complaint? A) "You appear to be short of breath. Are you also having other problems?" B) "Why did you wait 2 hours to call for an ambulance?" C) "Did you get diaphoretic when the shortness of breath started?" D) "Have you ever had a myocardial infarction before?"

: A Diff: 3 Page Ref: 97

: 6-2 39) While teaching a continuing education class on the lifting and moving of patients, which points would you constantly emphasize? A) Keeping the legs straight while lifting any heavy object to the cot or into the ambulance B) Maintaining a normal inward curve in the lower back while moving patients or equipment C) Lifting a patient or equipment should always occur with the wrists hyperextended D) Do not rely on equipment to help you lift, as the equipment often fails and results in patient injury

: B Diff: 1 Page Ref: 102

: 6-4 2 Copyright © 2018 Pearson Education, Inc. 5) To improve your physical fitness and decrease the risk of injury when lifting and moving patients, you should combine proper body mechanics with: A) Vitamin supplements B) Proper nutrition C) Protein drinks D) Caffeine substitutes

: B Diff: 1 Page Ref: 103

: 6-7 12) When lifting the stretcher with a patient secured to it, the EMT must avoid which action? A) Maintaining a straight back B) Bending over at the waist C) Contracting the abdominal muscles D) Lifting with the thigh muscles

: B Diff: 1 Page Ref: 105

: 6-14 9 Copyright © 2018 Pearson Education, Inc. 33) You are correctly using the blanket drag to move a patient when you: A) Place the patient in a blanket and drag him by grasping his forearms B) Secure the patient in a blanket and drag him head first toward you C) Place the patient in the blanket in a prone position and drag him toward you D) Secure the patient in a supine position and drag him feet first along the ground

: B Diff: 1 Page Ref: 107-108

: 6-5 32) You have been called to assist a pediatric physician, a pediatric nurse, and a respiratory therapist in the transfer of a 2-week-old baby who is very sick. The baby is to be transferred in an isolette to a large metropolitan teaching hospital in a nearby city, where specialized care can be provided. The isolette is secured to the stretcher, and the stretcher is loaded into the ambulance. The physician, nurse, and respiratory therapist will provide all patient care. Prior to departing the hospital, it is essential that you: A) Advise the family of the baby's critical condition B) Make sure the stretcher is secured in the ambulance C) Mix and prepare the medications needed for transport D) Disinfect the outside of the isolette

: B Diff: 1 Page Ref: 118

: 1-13 8 Copyright © 2018 Pearson Education, Inc. 28) You are by the side of a confused patient who has diabetes and a low blood sugar level. You know that the patient needs orally administered sugar, so following your service's guidelines, you call the physician on duty at the hospital emergency department and request permission to administer it. This request is an example of: A) Standing orders B) On-line medical direction C) Medical cooperation D) Off-line medical direction

: B Diff: 1 Page Ref: 12

: 1-9 18) As an EMT, which requirement must be met so that you can provide routine and emergency medical care to the sick and injured, as an extension of the medical director's authority? A) Prior medical experience B) A service medical director C) A knowledgeable partner D) A safe driving record

: B Diff: 1 Page Ref: 12

: 7-1 9) Which statement best describes the anatomic position? A) Supine position with arms at the side and palms facing downward B) Standing with the arms down at the side and palms facing forward C) Prone position with arms upward and palms facing upward D) Upright and facing backward with the arms raised and legs straight

: B Diff: 1 Page Ref: 129

: 7-5 6) After you apply and use the automated external defibrillator, a patient regains his pulse and has adequate respirations. The paramedic asks you to place the patient in a lateral recumbent position. How should you position this patient? A) On his back B) On his left side C) On his stomach D) Supine with his head turned left

: B Diff: 1 Page Ref: 129

: 7-27 4) A paramedic tells you that a patient with a probable spine injury still retains his plantar reflexes. As a knowledgeable EMT, you should understand that the patient has reflex activity in which part of the body? A) Hands B) Feet C) Arms D) Fingers

: B Diff: 1 Page Ref: 131

: 7-16 45) The terms "occipital," "parietal," and "frontal" can refer collectively to which part of the body? A) Chest B) Cranium C) Pelvis D) Spine

: B Diff: 1 Page Ref: 134

: 7-6 15 Copyright © 2018 Pearson Education, Inc. 63) A patient suffering a carpal fracture would most likely complain of pain in her: A) Ankle B) Wrist C) Knee D) Elbow

: B Diff: 1 Page Ref: 138

: 7-2 97) Which type of joint provides the greatest amount of free motion? A) Hinged joint B) Ball-and-socket joint C) Gliding joint D) Saddle joint

: B Diff: 1 Page Ref: 140

: 7-13 22) The structure containing a person's "voice box" is termed the: A) Pharynx B) Larynx C) Trachea D) Sternum

: B Diff: 1 Page Ref: 146

: 7-10 25) As you arrive on scene, an Emergency Medical Responder informs you that the patient has agonal respirations. Based on this description, you would expect the patient's breathing to be: A) Irregular and deep B) Occasional and gasping C) Rapid and shallow D) Deep and fast

: B Diff: 1 Page Ref: 150

: 7-11 29) The EMT shows correct understanding of the circulatory system when he identifies the primary function of the heart as: A) Transferring oxygen to the cells B) Pumping blood throughout the body C) Oxygenating blood in the lungs D) Maintaining the volume of blood

: B Diff: 1 Page Ref: 150

: 7-15 8 Copyright © 2018 Pearson Education, Inc. 32) What is the primary function of the left atrium? A) It receives blood from the vena cava B) It receives blood from the pulmonary veins C) It pumps blood to the lungs D) It pumps blood to the body

: B Diff: 1 Page Ref: 150

: 7-15 36) What is the major artery of the thigh called? A) Carotid artery B) Femoral artery C) Radial artery D) Brachial artery

: B Diff: 1 Page Ref: 151

: 7-20 53) In which body system are the thyroid glands, adrenal glands, pituitary glands, and gonads located? A) Nervous B) Endocrine C) Hormonal D) Respiratory

: B Diff: 1 Page Ref: 162

: 7-24 76) You are using cryotherapy to treat a deformed and painful ankle. This treatment involves the use of: A) Compression B) Ice C) Massage D) Heat

: B Diff: 1 Page Ref: 170, Table 7-2

: 7-27 86) Acrocyanosis is best described as a bluish discoloration of the patient's: A) Head B) Extremities C) Chest D) Abdomen

: B Diff: 1 Page Ref: 170, Table 7-2

: 7-21 84) An enlarged liver is best documented as: A) Hepatitis B) Hepatomegaly C) Ascites D) Gastric distention

: B Diff: 1 Page Ref: 171, Table 7-2

: 7-24 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 8 Pathophysiology 1) Normal cellular metabolism can be defined as: A) Oxygenated B) Aerobic C) Glycolytic D) Anaerobic

: B Diff: 1 Page Ref: 178

: 8-4 15) For a patient breathing in room air, the EMT would estimate the FiO2 to be: A) 0.15 B) 0.21 C) 0.55 D) 1.00

: B Diff: 1 Page Ref: 181

: 8-10 29) What is the best description of minute ventilation? A) Number of breaths a patient breathes in 1 minute B) Amount of air moved into and out of the lungs in 1 minute C) Total milliliters of air moving into and out of the lungs in one breath D) Amount of oxygen needed by the body in 1 minute

: B Diff: 1 Page Ref: 185

: 8-12 38) Which condition would most likely account for an elevated CO2 level in a patient's body? A) Renal failure B) Lung disease C) Liver injury D) Endocrine stem dysfunction

: B Diff: 1 Page Ref: 192-193

: 8-17 56) Which blood pressure reading best indicates a narrowed pulse pressure? A) 120/76 mmHg B) 108/88 mmHg C) 210/138 mmHg D) 88/58 mmHg

: B Diff: 1 Page Ref: 198

: 9-3 6) You must assess a crying 7-month-old baby who is vomiting. To best assess this patient, you should: A) Wait for the baby to stop crying B) Allow the mother to hold the baby C) Secure the baby to the cot and then assess her D) Have the mother leave the room

: B Diff: 1 Page Ref: 207

: 9-6 30) During which stage of life do most chronic illnesses typically become evident? A) Early adulthood B) Middle adulthood C) Late adulthood D) Adolescence

: B Diff: 1 Page Ref: 212

: 9-7 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 10 Airway Management, Artificial Ventilation, and Oxygenation 1) Which of these sequences best describes the path that oxygen must travel to get into the cells of the body? A) Nasopharynx, oropharynx, carina, trachea, alveoli B) Oropharynx, larynx, trachea, carina, bronchioles C) Nose, pharynx, esophagus, bronchi, alveoli D) Pharynx, larynx, trachea, alveoli, bronchioles

: B Diff: 1 Page Ref: 219-220

: 10-14 38) You are teaching a group of firefighters who are taking classes to become Emergency Medical Responders. The topic is artificial ventilation with the bag-valve mask (BVM). Which point related to use of the BVM is it important to emphasize? A) It is better to ventilate too quickly than too slowly B) Maintaining a good mask-to-face seal is difficult C) The BVM is useless unless it is hooked to supplemental oxygen D) The bag must be fully squeezed to give the proper amount of volume with each breath

: B Diff: 1 Page Ref: 253

: 10-23 65) When providing oxygen via nonrebreather face mask, which piece of equipment is essential for the EMT to have? A) Oxygen humidifier B) Therapy regulator C) D or E oxygen cylinder D) High-pressure regulator

: B Diff: 1 Page Ref: 267

: 2-1 2 Copyright © 2018 Pearson Education, Inc. 4) An EMT is correct when he describes a communicable disease as: A) Any of a number of diseases that are deadly once contracted B) A disease that can be spread from one person to another C) Any disease that is caused and spread by a viral agent D) A disease for which no immunization exists

: B Diff: 1 Page Ref: 27

: 2-8 34) If you have questions regarding the steps to take when exposed to an infectious disease, your best resource would be: A) The U.S. Department of Health and Human Services B) Your service's written exposure control plan C) Your service's medical director D) Your primary care physician or ED physician

: B Diff: 1 Page Ref: 27

: 10-24 74) What is the preferred method of providing high-concentration oxygen to a breathing patient in the prehospital setting? A) Nasal cannula B) Nonrebreather face mask C) Simple face mask D) Venturi mask

: B Diff: 1 Page Ref: 271

: 11-1 71) You have assisted the patient in taking one of his nitroglycerin tablets due to cardiac-type chest pain. Five minutes later, you note the patient's blood pressure is 108/74 mmHg. To determine if the nitroglycerin has affected the blood pressure, the EMT should: A) Take another blood pressure measurement in five minutes B) Compare this finding to the baseline blood pressure C) Ask the patient if he feels his blood pressure has changed D) Retake the blood pressure and compare it to a normal BP of 120/80 mmHg

: B Diff: 1 Page Ref: 288

: 11-10 48) To assess a patient's blood pressure, the EMT will need a: A) Pulse oximeter B) Sphygmomanometer C) Pulse oximeter and stethoscope D) Pair of gloves and stethoscope

: B Diff: 1 Page Ref: 288

: 11-21 123) The EMT is correctly palpating a central pulse when he palpates the: A) Radial pulse B) Femoral pulse C) Brachial pulse D) Posterior tibial pulse

: B Diff: 1 Page Ref: 290

: 11-7 17) The EMT recognizes which heart rate would be considered normal for a 24-year-old male patient who is resting comfortably? A) 54 beats/min B) 62 beats/min C) 110 beats/min D) 124 beats/min

: B Diff: 1 Page Ref: 292

: 11-11 94) A mother has called 911 because her 2-year-old daughter is fussy and not eating. When assessing the toddler, what would be the best indication of her perfusion status? A) Heart rate B) Skin color and temperature C) Palpated blood pressure D) Auscultation of breath sounds

: B Diff: 1 Page Ref: 293-294

: 11-1 60) Which pulse site is commonly palpated during the process of obtaining a blood pressure by the palpation technique? A) Brachial B) Radial C) Carotid D) Pedal

: B Diff: 1 Page Ref: 298

: 11-13 99) When you are applying the pulse oximeter sensor to a patient's finger, he asks you what this device is for. Your response would be: A) "It provides us with the most accurate measure of your heart rate." B) "It measures the amount of oxygen being carried by your blood cells." C) "It tells us how well your heart is pumping blood." D) "It allows us to monitor your blood pressure and respiratory status."

: B Diff: 1 Page Ref: 299-300

: 1-2 2) Most authorities agree that the modern-day EMS system evolved after the release of which document? A) The Emergency Medical Services Act of 1973 B) The white paper "Accidental Death and Disability: The Neglected Disease of Modern Society" in 1966 C) The American Heart Association's Guidelines for Cardiac Resuscitation D) Emergency Medical Services: Agenda for the Future, in 1996

: B Diff: 1 Page Ref: 3

: 11-15 81) A pulse oximetry reading obtained on room air is considered normal when it is: A) 100 percent B) Greater than 97 percent C) Greater than 90 percent D) Greater than 75 percent

: B Diff: 1 Page Ref: 300

: 11-6 124) The EMT is reviewing a patient care report and finds the following documentation "ETCO2 is 43 mmHg." What does this mean? A) The patient is intubated B) The exhaled carbon dioxide level is normal C) The hemoglobin saturation with carbon dioxide is normal D) The patient is hypoxic and in need of oxygen

: B Diff: 1 Page Ref: 302

: 11-17 110) An alert and oriented 87-year-old female patient has fallen and suffered a 3-cm laceration to the back of her head. According to the patient, her walker became caught in the carpet, causing her to trip. When obtaining a medical history, who should the EMT address first? A) Family members B) The patient C) EMRs on scene D) The patient's primary care doctor

: B Diff: 1 Page Ref: 304

: 11-20 116) The EMT is appropriately using the SAMPLE mnemonic when he asks which question? A) "Who is your doctor?" B) "When did you eat last?" C) "Have you thought about stopping smoking?" D) "Why did you call for the ambulance?"

: B Diff: 1 Page Ref: 307

: 11-14 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 12 Scene Size-Up 1) You are entering the scene where a 32-year-old intoxicated male has fallen down 13 stairs leading to the basement. He is seated on the floor of the basement, holding a bloody towel over his face. During the initial scene size-up, what is it essential that the EMT quickly identify? A) The patient's level of consciousness B) Possible need for additional personnel C) Status of the patient's airway and breathing D) Amount of alcohol consumed by the patient

: B Diff: 1 Page Ref: 315

: 12-3 16) A 67-year-old male patient, who has a history of diabetes and previous heart attack, fell down three stairs. His chief complaint is pain and deformity to his right wrist. The EMT would initially classify this patient as a: A) Medical patient B) Trauma patient C) Medical and trauma patient D) Special needs patient

: B Diff: 1 Page Ref: 326

: 12-6 6 Copyright © 2018 Pearson Education, Inc. 21) You have been called to a residence of a woman who fell down the stairs. On scene, you find the patient on the couch with a large laceration to her forehead. As you begin assessing and treating her, she states that she did not fall down the stairs, but rather was assaulted by her exboyfriend after inviting him into her home. He has since left the residence prior to your arrival. In this situation, which statement would be most appropriate? A) "What is the name of your ex-boyfriend?" B) "Aside from your head, do you hurt anywhere else?" C) "I am not going to bandage your head so we can preserve evidence." D) "Why did you invite your ex-boyfriend over to your house?"

: B Diff: 1 Page Ref: 326

: 2-13 38) A patient with a history of hepatitis C has called 911 because he has a headache. Given the complaint and medical history, which personal protective equipment, at a minimum, is most appropriate? A) Goggles B) Gloves C) Gloves and gown D) No protection is needed.

: B Diff: 1 Page Ref: 33

: 13-10 35) When assessing an adult trauma patient's circulation status during the primary assessment, the EMT's assessment should include: A) Carotid pulse, capillary refill, blood pressure, and skin color B) Radial and/or carotid pulse, skin characteristics, and presence of external bleeding C) Skin color, pulse rate, blood pressure, and skin temperature D) Pulse rate, blood pressure, capillary refill, and skin condition

: B Diff: 1 Page Ref: 350; Table 13-6

: 13-12 14 Copyright © 2018 Pearson Education, Inc. 52) Which capillary refill time is considered normal for a 5-year-old child? A) 3 seconds B) 2 seconds C) 5 seconds D) 4 seconds

: B Diff: 1 Page Ref: 353

: 13-14 16 Copyright © 2018 Pearson Education, Inc. 60) A patient has been shot once in the left hand. After performing the primary assessment, the EMT quickly focuses his attention on the patient's left hand and begins a specific assessment of the injury. Which type of exam is the EMT performing? A) Extremity B) Focused C) Specific D) Rapid

: B Diff: 1 Page Ref: 356

: 13-14 77) Which of these physical findings is least consistent with an injured extremity? A) Deformities B) Vomiting C) Contusions D) Crepitation

: B Diff: 1 Page Ref: 364

: 13-14 80) A 40-year-old male patient has crashed his motorcycle. He complains of pain to his right leg. When palpating his leg, you are assessing for: A) Sensation B) Crepitation C) Bruising D) Rigidity

: B Diff: 1 Page Ref: 364

: 13-26 24 Copyright © 2018 Pearson Education, Inc. 90) The EMT recognizes that the best source of information for a responsive medical patient with a specific chief complaint and no known medical history is: A) The patient's vital signs B) The patient C) Medical direction D) The family

: B Diff: 1 Page Ref: 398

: 13-28 103) En route to the hospital, you start the reassessment of a 22-year-old trauma patient. You should begin this assessment by: A) Rechecking vital signs B) Repeating the primary assessment C) Checking all interventions D) Assessing for additional injuries

: B Diff: 1 Page Ref: 402

: 14-3 2) Which of these medications is included in the EMT scope of practice? A) Pepcid B) Oxygen C) 50% dextrose (D50) D) Benadryl

: B Diff: 1 Page Ref: 421

: 13-23 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 14 General Pharmacology and Medication Administration 1) Which of these medications is included in the EMT scope of practice? A) Tylenol B) Oral glucose C) Motrin D) Benadryl

: B Diff: 1 Page Ref: 422

: 14-8 28) What is the most likely indication for the administration of oral glucose to a patient with diabetes? A) Chest pain B) Low blood sugar C) Diabetic history D) Headache

: B Diff: 1 Page Ref: 422

: 14-6 36) The route by which the EMT would administer epinephrine is: A) Oral B) Intramuscular C) Sublingual D) Topical

: B Diff: 1 Page Ref: 425

: 14-13 22) When reviewing a prehospital care report, you note that a patient received nitroglycerin sublingually. As an EMT, you should recognize that this medication was a: A) Mist inhaled into the lungs B) Tablet placed under the tongue C) Medication injected into a muscle D) Tablet chewed or swallowed whole

: B Diff: 1 Page Ref: 427

: 14-8 16) Which of these medications can be administered by the EMT only if the patient has a prescription for it? A) Aspirin B) Nitroglycerin C) Oxygen D) Oral glucose

: B Diff: 1 Page Ref: 430

: 14-13 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 15 Shock and Resuscitation 1) Immediately following the onset of cardiac arrest, brain cells begin to die after: A) 1 minute B) 5 minutes C) 10 minutes D) 15 minutes

: B Diff: 1 Page Ref: 452

: 16-8 58) When auscultating the lungs of an elderly patient, you note rhonchi-like noises in the upper regions of both lungs. As a knowledgeable EMT, you would recognize that this finding is caused by: A) Fluid accumulation in the alveoli B) Accumulation of mucus in the bronchi C) Narrowing of the larger airways D) Edema to the bronchioles

: B Diff: 1 Page Ref: 475

: 16-18 36) When assessing a patient who complains of shortness of breath but has an open airway, which action should the EMT perform next? A) Ascertain whether the patient has used an MDI B) Assess the adequacy of the patient's breathing C) Get the patient's SpO2 to 100% D) Determine the cause of the shortness of breath

: B Diff: 1 Page Ref: 476-477

: 3-20 42) During orientation, an EMT is told that owing to the nature of her employment, she is covered by sovereign immunity. Based on this statement, the EMT must: A) Be immune from claims of negligence B) Work for a public EMS agency C) Work for a nonprofit, privately owned hospital D) Provide services for a volunteer EMS agency

: B Diff: 1 Page Ref: 48-49

: 16-5 84) An acute infectious disease caused by bacterium or a virus that affects the lower respiratory tract and causes lung inflammation resulting in dyspnea is: A) Chronic bronchitis B) Pneumonia C) Emphysema D) Asthma

: B Diff: 1 Page Ref: 483-484

: 1-4 35) What would the EMT recognize as an advantage of the 911 universal number? A) It is able to track the locations of all emergency vehicles in an EMS system B) It is a common number through which to request EMS, law enforcement, and fire services C) It is less expensive to operate than a 7- or 10-digit telephone number D) It is the most easily remembered 3-digit combination of numbers

: B Diff: 1 Page Ref: 5

: 3-2 5) A 77-year-old female is unresponsive, but breathing and with a pulse. On scene, a family member hands you an official document stating that the patient does not want feeding tubes, ventilators, or other long-term life support equipment to keep her alive. There is no mention of whether to administer lifesaving drugs or withhold cardiopulmonary resuscitation. The EMT would recognize this document as a(n): A) Durable power of attorney B) Living will document C) "Do Not Resuscitate" (DNR) order D) "Involuntary Resuscitation" order

: B Diff: 1 Page Ref: 50

: 16-3 21 Copyright © 2018 Pearson Education, Inc. 75) The EMT is correctly accessing for accessory muscle use when he examines which part of the body? A) Nares B) Chest C) Back D) Inner mouth

: B Diff: 1 Page Ref: 500

: 16-4 78) A patient with a history of COPD is breathing 32 times a minute. Her vital signs are pulse, 140; blood pressure, 168/102 mmHg; and SpO2, 98% on room air. You would classify this patient's condition as: A) Apnea B) Dyspnea C) Bradypnea D) Hypoxia

: B Diff: 1 Page Ref: 508

: 17-3 69) The primary control or automaticity of the heart rate originates in the: A) Brainstem B) Heart C) Nervous system D) Endocrine system

: B Diff: 1 Page Ref: 521

: 17-2 64) After blood enters the right ventricle, it next moves into the: A) Left ventricle B) Pulmonary artery C) Left atrium D) Aorta

: B Diff: 1 Page Ref: 522

: 17-2 3 Copyright © 2018 Pearson Education, Inc. 9) When treating a patient with chest discomfort, the EMT's primary goal is to: A) Determine whether chest discomfort is originating from the heart B) Recognize the possibility of cardiac compromise and provide proper emergency care C) Provide immediate care to eliminate the chest discomfort, and then transport the patient to the hospital D) Administer fibrinolytic drugs with the permission of medical direction

: B Diff: 1 Page Ref: 529

: 17-9 106) Which structure of the neck would the EMT examine on a patient she believes to be in congestive heart failure? A) Trachea B) Neck veins C) Lateral muscles D) Clavicles

: B Diff: 1 Page Ref: 536

: 17-11 15) You are caring for a 62-year-old female patient with chest discomfort and shortness of breath. She is alert and oriented with an open airway. Her breathing is adequate and radial pulse strong. Her skin is warm and dry. What should you do next? A) Perform a secondary assessment B) Obtain the patient's heart rate and blood pressure C) Assist the patient to the ambulance for immediate transport D) Assist the patient in taking a nitroglycerin tablet

: B Diff: 1 Page Ref: 544

: 18-3 59) A male patient has altered mental status secondary to a brain tumor. The EMT would classify the brain tumor as which type of cause? A) Central B) Structural C) Metabolic D) Internal

: B Diff: 1 Page Ref: 556

: 18-6 19 Copyright © 2018 Pearson Education, Inc. 72) What is the pathophysiology underlying a TIA and its typically rapid resolution? A) Vasodilation of the cerebral blood vessel that was constricted tightly enough to stop blood flow B) Agents in the bloodstream bust apart the cerebral clot that is causing the signs and symptoms C) Blood flow from nearby vascular beds start to perfuse those regions cut off by the TIA ministroke D) Neurons from the areas surrounding the TIA's origin start to assume the functions of the brain region affected by the TIA

: B Diff: 1 Page Ref: 565-566

: 18-1 2) Which of these conditions places the patient at the greatest risk for an acute neurologic deficit? A) Acute myocardial infarction (AMI) B) Transient ischemic attack (TIA) C) Chronic obstructive pulmonary disease (COPD) D) New onset of type 2 diabetes (NIDDM)

: B Diff: 1 Page Ref: 567

: 18-12 11) With the Cincinnati Prehospital Stroke Scale, which of these patient parameters is assessed? A) Blood glucose level B) Facial droop C) Time of symptom onset D) Age of the patient

: B Diff: 1 Page Ref: 570

: 18-12 51) The EMT shows that he is performing the Los Angeles Prehospital Stroke Screen (LAPSS) correctly when he asks which of these questions? A) "May I assess your pupils?" B) "How old are you?" C) "Did you lose control of your bladder?" D) "Do you know where you are right now?"

: B Diff: 1 Page Ref: 570

: 18-3 6) When using a stroke scale to assess a patient for abnormal speech, the EMT should: A) Observe verbal ability during assessment B) Ask the patient to repeat a specific but common phrase C) Question family members about the patient's ability to talk D) Write questions on note cards for the patient to read

: B Diff: 1 Page Ref: 571, Figure 18-7

: 18-11 66) During a continuing education program, the lecturer is talking about the RACE scale as a newer tool the EMT can use to help determine whether a neurologic problem is present. Which neurologic problem does the RACE scale address? A) Structural versus metabolic cause of unresponsiveness B) Large-vessel occlusion stroke C) Seizures that are due to an organic cause versus metabolic cause D) Stroke stemming from a smaller blood vessel above the circle of Willis

: B Diff: 1 Page Ref: 572-573

: 3-17 38) A young male patient has suffered a gunshot wound to the head. Realizing that there is little chance for survival, the EMT notes that the patient is a potential organ donor. The patient is unresponsive and breathing 4 times per minute on scene. The EMT initiates positive-pressure ventilation. En route to the hospital, the patient stops breathing and loses a pulse. Since the patient is a potential organ donor, the EMT should: A) Stop any and all resuscitation measures since this is a trauma arrest B) Provide the same resuscitation as for a person who is not an organ donor C) Ventilate the patient but not provide chest compressions D) Perform CPR but not use the automated external defibrillator

: B Diff: 1 Page Ref: 58

: 3-20 12 Copyright © 2018 Pearson Education, Inc. 40) The highest priority for the EMT working on a patient when approaching the scene of a crime is: A) Preserving potential evidence B) Ensuring personal safety C) Administering quality patient care D) Providing medical information to law enforcement

: B Diff: 1 Page Ref: 60

: 20-5 52) The EMT would describe diabetes as a disease state in which: A) Not enough sugar is provided to the body B) There is a problem with the transport of glucose into the cells C) A tumor on the pancreas causes too much insulin to be released D) The body cannot store and maintain sugar reserves

: B Diff: 1 Page Ref: 605

: 20-7 5 Copyright © 2018 Pearson Education, Inc. 17) You determine a patient's blood glucose level to be 289 mg/dL. You would document this result on the prehospital care report as: A) Normal B) Hyperglycemic C) Depressed D) Hypoglycemic

: B Diff: 1 Page Ref: 608

: 20-2 3) The EMT should suspect that a patient has diabetes when which medication is found on the scene? A) Nitrostat B) Metformin C) Ecotrin D) Lexapro

: B Diff: 1 Page Ref: 621, Table 20-3

: 21-8 10) What is the most severe form of an allergic reaction called? A) Hypersensitivity B) Anaphylaxis C) Antigen response D) Rhinorrhea

: B Diff: 1 Page Ref: 630

: 21-8 48) A patient develops an allergic reaction after taking penicillin. In this case, the penicillin would be recognized by the body as: A) A form of immunoglobulin E B) An antigen C) A mast cell D) An antibody

: B Diff: 1 Page Ref: 630

: 21-1 20) What is the most common cause of an allergic reaction in which the antigen was ingested? A) Bee stings B) Medications C) Food D) Pollen

: B Diff: 1 Page Ref: 633

: 21-7 2 Copyright © 2018 Pearson Education, Inc. 4) A patient is covered with hives. He is responsive to painful stimuli but has labored respirations with an inspiratory stridor sound, bilateral wheezing, and a weak and rapid pulse. His vital signs are pulse, 128; respirations, 24 breaths/min; and blood pressure, 80/50 mmHg. Given this presentation, the EMT should suspect that the patient has: A) Sensitization B) Anaphylaxis C) Hypersensitivity D) Localized allergic reaction

: B Diff: 1 Page Ref: 636-637

: 22-3 3 Copyright © 2018 Pearson Education, Inc. 9) When assessing a patient who has been exposed to a poisonous substance, it is essential to understand: A) Vomiting indicates that the poison has not yet been absorbed into the body B) The signs and symptoms of toxic exposure will vary depending on the specific poison C) The route of entry into the body will determine the signs and symptoms D) Absorption into the body has not occurred if the signs of illness are not apparent within 15 minutes

: B Diff: 1 Page Ref: 652

: 22-5 4) What is the most common route by which a poison enters the body? A) Inhalation B) Ingestion C) Exposure D) Topical

: B Diff: 1 Page Ref: 652

: 22-8 6) A 44-year-old patient was found unresponsive at home. Based on his mental status and the fact that he was burning a kerosene heater in an enclosed room, you suspect carbon monoxide poisoning. Based on this information, which route of exposure would you recognize as responsible for the poisoning? A) Nasal-oral B) Inhalation C) Ingestion D) Absorption

: B Diff: 1 Page Ref: 652

: 22-21 15) A frantic mother called 911 because she found her 18-month-old daughter playing with a bottle of drain cleaner. When assessing this patient, what would provide the strongest evidence that the child ingested some of the liquid? A) Persistent crying B) Burns to her mouth C) Garbled speech D) Elevated heart rate

: B Diff: 1 Page Ref: 654

: 22-5 8 Copyright © 2018 Pearson Education, Inc. 26) Medical direction has ordered you to administer activated charcoal to a patient who ingested a large amount of poison. When looking in your medical kit, which medication would you prepare and administer? A) Nitrostat B) Actidose C) Glyburide D) Ecotrin

: B Diff: 1 Page Ref: 656

: 22-14 69) A patient informs you that he smoked marijuana all night and now has great anxiety, hunger, and tremors to both hands. The EMT would recognize marijuana is best described as: A) A hallucinogen B) A cannabis product C) An appetite stimulant D) A sedative

: B Diff: 1 Page Ref: 689

: 4-2 22) The medical director for your service has put you in charge of designing a new prehospital care report form. He states that it must contain the "minimum data set" as set forth by the U.S. Department of Transportation. In completing this task, you realize that incorporating these data into your report form will: A) Increase EMS funding received from the federal and state governments B) Allow easier comparison of specific EMS data between various types of emergency systems C) Work toward creating a single report form for all EMS systems that handle emergency calls D) Permit easier tracking of motor-vehicle collisions so that hazardous roads and intersections can be identified

: B Diff: 1 Page Ref: 69-70

: 22-19 76) You have been called to a party by friends of a 14-year-old female patient with a decreased level of consciousness. On scene, the partygoers state that they were "huffing" when their friend suddenly complained of a headache and then passed out. In reference to the term "huffing," you would recognize this behavior as: A) Injecting drugs intravenously B) Inhaling fumes or vapors C) Smoking methamphetamine D) Sampling multiple prescription drugs

: B Diff: 1 Page Ref: 691

: 4-4 3) Which item is included in the U.S. Department of Transportation minimum data set? A) Insurance and billing information B) Vital signs and skin condition C) Address and type of the call D) Patient's occupation

: B Diff: 1 Page Ref: 70

: 23-1 52) During a normal pregnancy process, within which structure does the sperm and egg typically meet during fertilization? A) Ovary B) Fallopian tube C) Vagina D) Uterus

: B Diff: 1 Page Ref: 714

: 23-10 17 Copyright © 2018 Pearson Education, Inc. 63) Which of these descriptions best fits a female patient with a problem related to her urinary system? A) Infection of the fallopian tubes B) Swelling of the ureter C) Damage to the vaginal canal D) Cancerous lesion to the ovary

: B Diff: 1 Page Ref: 720

: 23-11 64) In the human body, the urethra: A) Prevents urine from flowing back up and into the kidney B) Passes urine from the bladder to the outside of the body C) Stores urine in the body until it can be eliminated D) Refines the urine produced by the kidney

: B Diff: 1 Page Ref: 720

: 23-13 75) You are dispatched for a patient with an unknown medical problem at a dialysis center. When you arrive, you are directed to a patient who is sitting in a chair, with a dialysis technician holding a dressing on his arm very tight. You can see blood seeping through the dressing and on the hands of the technician. Given this limited information, what is likely the problem? A) The patient fell and has an open fracture to his arm B) The dialysis graft is bleeding C) The patient has a diabetic ulcer that broke open D) The patient was accidentally cut by a scalpel used by the dialysis technician

: B Diff: 1 Page Ref: 722-723

: 4-1 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 5 Communication 1) When using your portable radio, you must push the "press to talk" button and wait one second before speaking. This is essential to effective communication because your EMS system uses: A) Digital equipment B) Repeaters C) Portable transmitter/receiver D) Cellular telephone links

: B Diff: 1 Page Ref: 84

: 5-16 12) What role does the Federal Communications Commission (FCC) play in EMS? A) The FCC regulates only the radio communication systems that are used by police, fire, and EMS B) The FCC establishes and enforces regulations related to the use of radio operations C) The FCC determines the essential information that EMTs must relay to a receiving hospital about patient care D) The FCC approves maintenance and repair contracts for communication equipment used by EMS systems

: B Diff: 1 Page Ref: 87

: 5-4 44) What should be an expected reason why a portable radio suddenly fails to operate normally while on the scene of an emergency? A) Cracked antennae B) Dead battery C) Clogged mic D) Repeater failure

: B Diff: 1 Page Ref: 87

: 1-12 44) At a bare minimum, which type of personal protective equipment should be worn by EMS providers at any emergency scene involving a shooting? A) Face mask B) Gloves C) Gown D) Goggles

: B Diff: 1 Page Ref: 9

: 1-5 8) Which statement made by an EMT requires immediate intervention by a superior or the service supervisor? A) "I always wear my seat belt whenever I am in the patient compartment of the ambulance, unless I have to remove it to care for a patient." B) "I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or injured according to dispatch information." C) "When I am driving with lights and sirens, I instruct my partner that he will need to handle all radio communications." D) "I put exam gloves on for every patient I contact, even if he or she does not have a known or suspected infectious disease."

: B Diff: 1 Page Ref: 9

: 1-7 13) Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the: A) Rescuers B) Patient C) Family D) Bystanders

: B Diff: 1 Page Ref: 9

: 5-5 24) A patient who was complaining of a headache is being transported to the hospital. After you provide a report to the emergency department, the patient begins to unexpectedly seize. The seizure lasts for 1-2 minutes and then stops, but now you notice the patient's eyes have become unequal in size. You are still 5 minutes from the hospital. After providing care for the seizure, your next action should be to: A) Continue care and transport to the hospital B) Call the hospital and inform its staff of the seizure C) Contact family via cell phone and determine whether the patient has a history of seizures D) Document the seizure on the prehospital care report

: B Diff: 1 Page Ref: 91

: 5-11 28) Throughout a radio transmission to the dispatch center, the EMT periodically uses the term "break." You should recognize this to mean she is: A) Completing her transmission B) Purposely pausing her transmission C) Awaiting a response from the dispatcher D) Taking time to get her thoughts together

: B Diff: 1 Page Ref: 92

: 5-13 32) An advantage to asking the patient close-ended questions is that this practice offers a(n): A) Opportunity to get a detailed response from the patient B) Ability to get medical information very quickly C) Chance to get a significant amount of information D) Opportunity for the patient to elaborate about the medical complaint

: B Diff: 1 Page Ref: 97

: 4-7 29) A patient care report reads: "PMH includes ESRF and (+) DNR; (+) ASA pta of EMS." Regarding this description, which interpretation is most accurate? A) The patient is alert and oriented B) The patient has kidney disease C) The patient desires resuscitation D) EMS administered aspirin to the patient

: B Diff: 1 Page Ref: Table 4-2 Abbreviations

: 6-1 2) When transferring a patient from a bed to a wheeled stretcher, an EMT uses proper body mechanics when he or she: A) Primarily uses the muscles of his back to move the patient B) Aligns his shoulder, hips, and feet when moving the patient C) Transfers the patient to the stretcher all at once, not in stages D) Keeps his arms locked and the patient away from his body during the transfer

: B Diff: 2 Page Ref: 102

: 6-10 19) An EMT would perform an urgent move when: A) The patient exhibits no problems with the airway, breathing, or circulation B) The patient has a life-threatening injury C) The scene contains an immediate threat to the patient and EMT D) The patient is stable but has pain

: B Diff: 2 Page Ref: 108

: 6-7 15) A patient has fallen in his upstairs bathroom and is lying on the floor. Assessment indicates no life threats to the airway, breathing, or circulation; however, the patient does have pain, deformity, and bruising to his right hip. In this situation, the EMT should recognize the need for which type of move? A) Emergency B) Non-urgent C) Urgent D) Passive

: B Diff: 2 Page Ref: 109

: 6-5 8 Copyright © 2018 Pearson Education, Inc. 30) A patient has developed chest pain while working in his basement wood shop. After EMTs have assessed and provided care to the patient, the chest pain remains, although his vital signs are normal. To get him to the ambulance, the EMTs must first go up a short flight of stairs from the basement to the first floor, where the front door is located. Which action would be the safest for both the patient and crew? A) The two EMTs grasp the sides of the portable stretcher and move the patient up the stairs B) The stronger of the EMTs takes the head of the portable stretcher, and the EMTs carry the patient up the stairs head first C) The patient carefully walks up the stairs under the watchful assistance of the EMTs D) The patient is carried up the stairs on the stair chair feet first, with the stronger EMT carrying the back of the device

: B Diff: 2 Page Ref: 118

: 1-9 21) If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to contact an emergency department physician first before administering additional aspirin. The act of contacting the emergency department physician by phone or radio for permission to administer additional aspirin is an example of: A) Quality improvement B) On-line medical direction C) Off-line medical direction D) Indirect medical control

: B Diff: 2 Page Ref: 13

: 7-9 15) A patient has fractured bones in his left leg. Which bones could be involved in this injury? A) Acetabulum, calcaneus, or carpals B) Femur, tibia, or fibula C) Orbit, lumbar, or shin D) Radius, ulna, humerus, or carpals

: B Diff: 2 Page Ref: 136

: 7-22 55) You are assessing a patient with an obvious left midshaft femur fracture. The most immediate threat to this patient's survival is: A) Infection B) Blood loss C) Pain D) Nerve damage

: B Diff: 2 Page Ref: 140

: 7-8 98) An example of a pivot joint of the body would be: A) Where the femur joints the pelvis B) Where the radius and ulna meet the humerus C) Where the first and second vertebrae meet D) Where the ankle meets the tibia and ulna

: B Diff: 2 Page Ref: 140

: 7-9 13) Involuntary or smooth muscles are found in the walls of which types of structures? A) Muscles of the arms and legs B) Blood vessels and intestines C) Spinal cord D) Heart and brain

: B Diff: 2 Page Ref: 141

: 7-2 21 Copyright © 2018 Pearson Education, Inc. 92) Understanding physiology will allow the EMT to understand that bronchoconstriction will have which effect on breathing? A) There will be a decrease in the work of breathing B) There will be an increase in the work of breathing C) There will be an increase in the flow of air through the bronchioles D) There will be a decrease in the patient's respiratory rate

: B Diff: 2 Page Ref: 146

: 7-8 99) Based on the anatomic and physiological differences between an infant and an adult, which finding would suggest respiratory distress in an infant, but would be less likely to be observed in an adult? A) Nasal flaring during exhalation B) Excessive abdominal wall motion C) Increased respiratory rate D) Breathing with the mouth open

: B Diff: 2 Page Ref: 148

: 7-15 39) Following radiation therapy for breast cancer, a female patient has a low white blood cell count. Which condition does this factor place her at risk to acquire? A) Hypoxia B) Infection C) Bleeding D) Low blood pressure

: B Diff: 2 Page Ref: 154

: 7-17 44) A patient's blood glucose (sugar) level begins to drop. Which organ would be affected first due to its heavy reliance on circulating glucose? A) Spleen B) Brain C) Muscles D) Heart

: B Diff: 2 Page Ref: 157

: 7-20 16 Copyright © 2018 Pearson Education, Inc. 68) Which finding is a beta-1 sympathetic (adrenergic) effect? A) Bronchodilation B) Increased heart rate C) Vasodilation D) Vasoconstriction

: B Diff: 2 Page Ref: 162

: 7-20 67) A patient who has had both her thyroid and parathyroid glands removed would most likely have difficulty with: A) Producing the hormones that govern sex characteristics B) Maintaining strong and healthy bones C) Regulating blood sugar D) Maintaining an adequate blood pressure

: B Diff: 2 Page Ref: 162

: 7-22 72) Which assessment finding should the EMT expect after administering epinephrine to a patient? A) Slowing of the heart rate B) Increased blood pressure C) Labored breathing D) Generalized weakness

: B Diff: 2 Page Ref: 162

: 7-8 61) Assessment of a patient who was involved in a motor vehicle collision reveals tenderness over ribs 9-12 on the lateral right side. Based on this injury, the EMT should be alert for which additional concern? A) Damage to the heart B) Injury to the liver C) Pain from possible rib fractures D) Damage to the false ribs

: B Diff: 2 Page Ref: 163

: 7-27 81) A patient described as dysphagic presents as: A) Having difficulty breathing B) Having difficulty swallowing C) Being unable to speak D) Exhibiting a painful cough

: B Diff: 2 Page Ref: 171, Table 7-2

: 8-5 17) A patient with a low blood sugar is unresponsive with snoring respirations. His breathing is labored and his pulse is rapid and weak. Examination of the skin reveals it to be cool and diaphoretic. Your partner informs you of the following vital signs: pulse, 120; respirations, 18 breaths/min; blood pressure, 132/60 mmHg; and SpO2 at 84% on room air. Which action would you perform first? A) Administer oral glucose B) Perform a head-tilt, chin-lift maneuver C) Provide high-concentration oxygen D) Start positive pressure ventilation

: B Diff: 2 Page Ref: 182

: 8-10 27) For a patient who relies on the hypoxic drive to breathe, the respiratory rate will increase when: A) CO2 levels increase B) O2 levels decrease C) CO2 levels decrease and O2 levels increase D) O2 and CO2 levels both increase

: B Diff: 2 Page Ref: 188

: 8-1 33) Which statement about the ventilation/perfusion (V/Q) ratio in a healthy person is true? A) Blood flow and amount of ventilation are equal throughout the lungs B) The upper portion of the lungs has wasted ventilation C) The amount of blood perfusion throughout the lungs is greater than the amount of oxygen in the lungs D) The lower portion of the lungs has more oxygen than perfusion

: B Diff: 2 Page Ref: 189-190

: 8-17 47) A patient has a blood pressure of 140/98 mmHg. What can the EMT ascertain from this reading? A) The pulse pressure is narrowed B) The afterload is increased C) The preload is diminished D) The SpO2 level must be abnormal

: B Diff: 2 Page Ref: 195-196

: 8-1 50) What is the best way to decrease a patient's afterload? A) Slow the heart rate B) Reduce the blood pressure C) Administer intravenous fluids D) Provide supplemental oxygen

: B Diff: 2 Page Ref: 196

: 8-17 54) Which situation would most likely cause a patient to have a simple episode of syncope (fainting)? A) Increase in systemic vascular resistance B) Parasympathetic stimulation C) Activation of the sympathetic nervous system D) Sudden release of norepinephrine

: B Diff: 2 Page Ref: 197

: 8-19 15 Copyright © 2018 Pearson Education, Inc. 62) A drop in blood pressure below a critical threshold is a threat to the body because it directly impairs: A) Anaerobic metabolism B) Cellular perfusion C) Airway patency D) The sympathetic nervous system

: B Diff: 2 Page Ref: 199

: 9-10 15) You have been called for a 2-week-old male patient whose mother feels as though he is "sick." When assessing this patient and obtaining a history from the mother, which finding would be most concerning? A) He has lost weight since he was born B) The fontanelles are lower than the level of the skull C) The father states that the baby feeds every 2 to 3 hours D) You observe that the baby seems to breathe only through his nose

: B Diff: 2 Page Ref: 207

: 9-2 2) A young new mother has called 911 because her baby will not stop crying. On scene, you find a 6-month-old baby who alternates between crying and sleep. Which statement to the mother would be most appropriate given the infant's crying? A) "Is there a possibility of child abuse?" B) "Does this cry seem different to you?" C) "Has the baby had all his immunizations?" D) "It is normal for babies to cry and he seems to be sleeping well."

: B Diff: 2 Page Ref: 207

: 2-2 19) A reaction to death or dying where the patient asserts "Not me!" is recognized as which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression

: B Diff: 2 Page Ref: 21

: 2-2 6 Copyright © 2018 Pearson Education, Inc. 20) What statement would you expect to hear from a patient who has accepted the fact that he is terminally ill and will die sooner than later? A) "It is just not fair." B) "It's okay. I am not afraid." C) "I have no energy to even think anymore." D) "I cannot go on like this any longer."

: B Diff: 2 Page Ref: 21

: 9-4 8) A 7-year-old child has fallen and exhibits deformity of his left wrist. He will not cooperate with you as you attempt a closer examination of the wrist. Which statement would be appropriate given the patient's age and behavior? A) "This will not hurt you at all. Please let me see your wrist." B) "I know that you are scared, but I need to see your hand." C) "The doctor is going to get upset with me if you do not let me see what is wrong." D) "You can trust me. If I can see your wrist, I will get you kid's stickers at the hospital."

: B Diff: 2 Page Ref: 210

: 9-6 8 Copyright © 2018 Pearson Education, Inc. 28) A 16-year-old female patient has a history of bulimia. As a knowledgeable EMT, you would realize that bulimia is: A) A normal stage of adolescence and often is self-limiting B) Probably rooted in a concern related to her body image C) Most often related to a developing taste and distaste for certain foods D) Driven by a drive for maximum health and fitness

: B Diff: 2 Page Ref: 211

: 9-8 4 Copyright © 2018 Pearson Education, Inc. 13) You have been asked to speak to a local EMT class about caring for patients older than age 60 years. When presenting your material, which point would you emphasize? A) All persons older than age 60 have chronic health problems B) Older adults often do not want to give up their independent lifestyle even if medical conditions necessitate it C) Most persons older than age 70 are in assisted living facilities or nursing homes D) Most persons older than age 60 now reside with their grown children

: B Diff: 2 Page Ref: 213

: 2-7 26) You have just been instructed to stop emergency care on an unresponsive and pulseless 61- year-old man found by his wife in the bathroom. When you tell his wife that there is nothing more that can be done, she erupts in an episode of rage and starts screaming that there must be something else that can be done and you are not doing your job well enough. In this situation, which action is best? A) Resume resuscitation for another 5 minutes B) Be tolerant of the angry reaction C) Leave the scene immediately D) Contact medical direction for advice

: B Diff: 2 Page Ref: 22

: 10-2 28 Copyright © 2018 Pearson Education, Inc. 107) The structure that lies between the trachea and bronchi is the: A) Larynx B) Carina C) Bronchioles D) Cricoid cartilage

: B Diff: 2 Page Ref: 220

: 10-3 8) When a person's diaphragm contracts and the intercostal muscles pull the ribs upward, what will occur relative to the exchange of air and/or gases? A) Oxygen will leave the body B) Air will flow into the lungs C) Pressure inside the chest will increase D) Carbon dioxide will be exhaled

: B Diff: 2 Page Ref: 221

: 10-4 115) Which body system or structure is responsible for the control and regulation of a person's breathing? A) Lungs B) Brain C) Spinal cord D) Alveoli

: B Diff: 2 Page Ref: 222

: 10-5 15) The EMT believes that a patient is mildly hypoxic based on findings from the primary assessment. Which other sign could the EMT use to confirm his suspicion of mild hypoxia? A) Cyanosis B) Restlessness C) Responsive to verbal stimuli D) Sleepy appearance

: B Diff: 2 Page Ref: 223

: 2-5 50) Regarding "burnout" and the emergency medical services, what statement is most accurate? A) Employers are required to have a written plan addressing EMT burnout B) Burnout can diminish an EMT's ability to provide competent care C) Research indicates that burnout affects all EMS personnel within a five-year period D) Burnout often tends to resolve on its own over time

: B Diff: 2 Page Ref: 23

: 10-7 19) Why is the jaw-thrust maneuver indicated for a patient with a possible spinal injury? A) It is a permanent airway intervention that does not require a mechanical airway if performed correctly B) It manipulates the head and cervical spine less than the head-tilt, chin-lift maneuver C) It is less painful for the patient since he is already in pain from the injury D) It is the EMT's preference as to whether to use the head-tilt, chin-lift maneuver or the jawthrust maneuver

: B Diff: 2 Page Ref: 231

: 10-1 23) You arrive at a residence for a male patient who is unresponsive. As you enter the room, you observe an obese man lying on a recliner. His eyes are closed, and he has gurgling respirations. While your partner is quickly performing a primary assessment, you should immediately prepare to: A) Auscultate breath sounds B) Suction the airway C) Administer high-concentration oxygen D) Insert an oropharyngeal airway

: B Diff: 2 Page Ref: 233

: 10-14 10 Copyright © 2018 Pearson Education, Inc. 36) You have arrived next to a patient who reportedly had a seizure. Assessment reveals him to be apneic with vomitus in the airway. He has a radial pulse, and his skin is cool and diaphoretic. What should you do immediately? A) Start artificial ventilation B) Suction the airway C) Check breath sounds D) Apply a nonrebreather mask

: B Diff: 2 Page Ref: 233

: 10-9 27) You are caring for a 46-year-old male patient who is unresponsive. Which statement made by your partner indicates the need to immediately stop suctioning the patient's airway and resume positive pressure ventilation? A) "He is starting to have gurgling respirations." B) "His heart rate is 48 beats per minute." C) "You have been suctioning now for 10 seconds." D) "His pulse oximeter has dropped 2 percentage points."

: B Diff: 2 Page Ref: 235

: 10-14 48) The EMT has just placed an oropharyngeal airway in a patient. By doing so, what has the EMT accomplished? A) Protected the airway from vomit or other secretions B) Displaced the tongue away from the back of the airway C) Obtained a patent airway by preventing closure of the mouth D) Minimized the risk of vomiting by closing off the esophagus

: B Diff: 2 Page Ref: 236

: 10-10 15 Copyright © 2018 Pearson Education, Inc. 55) You are transferring an unresponsive patient from her house to the ambulance on the stretcher. An oral airway has been placed and ventilations with the bag-valve mask are being administered. Suddenly, the patient regains consciousness and starts to gag. Your immediate action should be to: A) Leave the airway in but stop ventilations B) Remove the oral airway C) Suction the airway D) Reassure and calm the patient

: B Diff: 2 Page Ref: 237

: 10-24 71) You are assessing a patient with altered mental status. Which of these assessment findings contraindicates the use of the nonrebreather face mask? A) Confusion B) Respiratory rate of 18 breaths/min, with poor tidal volume C) Clear and equal breath sounds D) Respiratory rate of 24 breaths/min

: B Diff: 2 Page Ref: 240

: 10-7 4 Copyright © 2018 Pearson Education, Inc. 13) You have been called for a patient who has overdosed on drugs and alcohol. The patient is responsive to painful stimuli, has shallow respirations and is breathing at a rate of 8 times per minute, but exhibits no cyanosis. What is the priority treatment? A) Adequate breathing; administer oxygen at 15 lpm through a nonrebreather face mask B) Inadequate respirations; start positive pressure ventilation with supplemental oxygen C) Adequate breathing; initiate positive pressure ventilation with supplemental oxygen D) Inadequate breathing; administer oxygen at 15 lpm through a nonrebreather face mask

: B Diff: 2 Page Ref: 242

: 10-16 123) A 6-year-old boy has gotten into his mother's prescribed medications and ingested a large number of her opioid tablets. The patient is now found unresponsive and apneic, but he still has a weak palpable carotid pulse. You would instruct your partner to ventilate this patient in which manner? A) 6 times a minute B) 10 times a minute C) One ventilation every 2 seconds D) One ventilation every 6 seconds

: B Diff: 2 Page Ref: 247

: 2-15 15 Copyright © 2018 Pearson Education, Inc. 56) Your friend and coworker got married a little more than a year ago, and then shortly thereafter she became an EMT and started working with you. On your shifts, she complains that her new husband doesn't like the fact she is an EMT, saying that the job is "too risky." Which bit of advice could you provide to your partner to help her calm the nerves of her new husband? A) Explain to her husband that EMS is "just a job" and is not any risker than other occupations B) Let the husband know about all the training EMTs have to complete and which types of safety precautions they take on each call C) Tell your partner that you personally would like to talk to her husband to let him know that you have been in EMS for years without any incident or injury D) Do not tell the husband about the types of calls or situations encountered in EMS so that he starts to believe it's becoming safer

: B Diff: 2 Page Ref: 25

: 10-9 30) Which statement made by an EMT with whom you are working for the first time shows he understands the use of the pocket mask? A) "Although the pocket mask is very effective at ventilating a patient, the EMT is directly exposed to secretions from the patient." B) "In comparison to the bag-valve mask, the pocket mask can deliver just as good, if not better, tidal volume." C) "When using the pocket mask to ventilate a patient, the EMT must make sure that the reservoir bag is in place." D) "The EMT must remove the oral airway and replace it with a nasal airway when ventilating with a pocket mask."

: B Diff: 2 Page Ref: 251

: 10-14 9 Copyright © 2018 Pearson Education, Inc. 32) When using a pocket mask to ventilate an unresponsive adult patient, the EMT must always: A) Deliver 1 breath every 3 seconds B) Maintain the head-tilt, chin-lift maneuver or jaw-thrust maneuver C) Ventilate at twice the patient's normal rate of breathing D) Provide each breath over 3 seconds

: B Diff: 2 Page Ref: 252

: 10-14 11 Copyright © 2018 Pearson Education, Inc. 39) Which tip should you give a new EMT about artificially ventilating a patient with the bagvalve mask? A) "If the patient has dentures, they should be removed so a better mask-to-face seal can be achieved." B) "It is important to maintain the head-tilt, chin-lift maneuver or the jaw-thrust maneuver while ventilating the patient." C) "To direct air into the lungs and away from the stomach, flex the patient's head forward when ventilating with the BVM." D) "Always remove the oropharyngeal airway. If it is in place when you are ventilating with a BVM, it may be pushed deep into the airway."

: B Diff: 2 Page Ref: 253

: 10-14 35) Which statement about the bag-valve mask (BVM) is true? A) Oxygen must be attached so that the squeezable bag will reinflate B) A 15/22 mm adapter allows the BVM to be attached to an advanced airway such as the endotracheal tube C) The nonrebreather valve prevents the EMT from being exposed to possible pathogens in the patient's exhaled air D) The oxygen reservoir should deflate by one-third every time a breath is given

: B Diff: 2 Page Ref: 254

: 10-14 33) You are assessing a young male patient who was ejected from an automobile at a high rate of speed. He responds to painful stimuli by posturing and displays agonal breathing. His pulse is weak and thready, and his skin is cool and diaphoretic. When addressing this patient's airway and breathing, the EMT must immediately: A) Administer oxygen at 15 lpm with a nonrebreather face mask B) Perform the jaw-thrust maneuver and begin artificial ventilations with the bag-valve mask C) Immobilize the patient on a long spine board, and then start positive pressure ventilation D) Open the patient's airway using the head-tilt, chin-lift maneuver and begin ventilations with the bag-valve mask attached to supplemental oxygen

: B Diff: 2 Page Ref: 256

: 10-18 105) When administering continuous positive airway pressure (CPAP) to a patient in respiratory distress, which of these statements made by the patient would be most concerning? A) "The mask is too tight." B) "I feel nauseated." C) "My mouth is getting dry." D) "My nose hurts from the mask."

: B Diff: 2 Page Ref: 261

: 10-19 98) To receive treatment with continuous positive airway pressure (CPAP), the patient must exhibit: A) Minor to moderate respiratory distress B) Ability to breathe on his own adequately C) SpO2 between 90% and 100% D) Inability to maintain his airway

: B Diff: 2 Page Ref: 261

: 10-14 86) A patient with a stoma and tracheostomy tube is responsive to painful stimuli. He has shallow respirations and is breathing at a rate of 6 times per minute. He has cyanosis of the fingertips and a weak, rapid radial pulse. Which strategy should be used in providing respiratory care to this patient? A) Remove the tracheostomy tube, place a child-size mask on the bag-valve device, and ventilate the patient through the stoma B) Attach the bag-valve device directly to the tracheostomy tube C) Use a continuous positive airway pressure device over the stoma D) Place a tracheostomy mask over the tube and administer high-concentration oxygen

: B Diff: 2 Page Ref: 264

: 10-21 61) You are watching an EMT prepare the ambulance for the upcoming shift. In regard to oxygen cylinders and equipment, which action requires immediate intervention? A) The EMT lays tanks on the floor when they are removed from the ambulance B) The EMT cleans a dirty oxygen tank by spraying it with a petroleum-based agent cleanser C) The EMT ensures that the temperature in the oxygen storage room is less than 100°F D) The EMT makes certain that all valves on the empty oxygen tanks are closed

: B Diff: 2 Page Ref: 267

: 10-24 81) What is a benefit of using a humidification system when administering oxygen? A) Humidification reduces the chances of respiratory infection B) Oxygen therapy is less drying to the upper respiratory tract C) Increased diffusion of oxygen occurs across the respiratory membrane D) A higher flow rate can be used with a nasal cannula when humidification is added

: B Diff: 2 Page Ref: 268

: 10-6 90) Which of these statements, when made by the EMT, reflects correct knowledge regarding the use of oxygen in a patient with a suspected acute coronary syndrome who denies dyspnea, has a pulse oximeter reading of 96%, and has acceptable vital signs? A) "Aside from patients with chest pain, stroke, and trauma, oxygen is no longer used in emergency care." B) "Oxygen administration is no longer considered standard therapy for this patient." C) "Oxygen administration should be used in such a way that a patient's SpO2 reaches 97% to 100% if he or she is having chest pain." D) "Over-oxygenating a patient is not an issue for EMS, given the short amount of time we have patient contact."

: B Diff: 2 Page Ref: 268

: 10-4 11) You have been called to a long-term nursing care facility for a 77-year-old female patient with Parkinson's disease. According to the nursing staff, she is more confused than normal and is to be transported to the emergency department for evaluation. Since the patient neither understands nor can answer any of your questions, which sign provides the best evidence that her breathing is adequate? A) Respiratory rate of 18 breaths/min B) Pulse oximeter reading at 98% C) Clear bronchiole breath sounds D) Strong radial pulse

: B Diff: 2 Page Ref: 269

: 10-2 113) A patient with a heavy smoking history and chronic obstructive pulmonary disease (emphysema) presents in marked respiratory distress with cyanosis noted to her fingertips. When administering oxygen to this patient, the EMT would remember that: A) Oxygen should be provided at the same level as the patient receives at home B) High-concentration oxygen must be provided if the patient's condition warrants such therapy C) Oxygen must be administered only through a nasal cannula D) High-concentration oxygen will be toxic to the patient and must be avoided

: B Diff: 2 Page Ref: 270

: 10-24 78) Which of these statements regarding the use of a nasal cannula is true? A) "I can adjust the oxygen flow rate anywhere from 1 to 8 lpm, depending on how much oxygen the patient needs." B) "When the nasal cannula is set to the highest appropriate oxygen flow rate, a large portion of the air inspired by the patient is still ambient air." C) "The nasal cannula is preferred over the nonrebreather mask because it gives the oxygen through the nose instead of the mouth." D) "It is best to see how the patient tolerates the nasal cannula before attempting to place a nonrebreather mask on the patient."

: B Diff: 2 Page Ref: 272

: 11-15 83) You have arrived by the side of a cyanotic patient who is responsive only to painful stimuli and exhibiting stridorous respirations. What is the most appropriate action by the EMT? A) Prepare and apply the pulse oximeter before administering oxygen B) Provide positive pressure ventilation with supplemental oxygen C) Obtain a full set of vital signs, excluding the patient's temperature D) Attempt to determine what happened to the patient or any existing medical problems

: B Diff: 2 Page Ref: 289

: 11-15 87) You are caring for a 5-year-old male patient with a complaint of difficulty breathing. Your assessment indicates that the patient is tachypneic with labored breathing. While gaining more information about the patient's respiratory function, which finding would you recognize as most important? A) Nasal congestion and runny nose B) Skin retractions between the ribs during inhalation C) Skin that is hot and dry D) Systolic blood pressure of 92 mmHg

: B Diff: 2 Page Ref: 289

: 11-3 3 Copyright © 2018 Pearson Education, Inc. 8) A young female patient has been stung by a bee and complains that her "throat is closing up." She states that she is allergic to bee stings; the last time this happened, she had to have a "tube put into my windpipe." She is struggling to breathe and can speak only a few words at a time. Knowing that allergic reactions can cause swelling in the pharynx and the larynx, what airway sound would indicate that the patient indeed has swelling in this area? A) Gurgling B) Stridor C) Snoring D) Wheezing

: B Diff: 2 Page Ref: 289

: 11-2 10) When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would: A) Listen to the pulse with a stethoscope B) Count the number of beats that occur in 1 minute C) Double the number of beats counted in 30 seconds D) Feel the carotid pulse for 30 seconds and multiply by 2

: B Diff: 2 Page Ref: 292

: 11-7 90) When obtaining vital signs for a 67-year-old male patient with dizziness and nausea, your partner states that the pulse seems to disappear periodically when the patient takes a deep breath. As a knowledgeable EMT, your best response would be: A) "Given the patient's age, that is a typical finding and not an immediate concern." B) "That is an important finding. We will have to let the doctor know about it." C) "Let's move the patient to the stretcher for transport. That is an early sign of cardiac arrest." D) "That finding is important because it suggests the radial artery is partially blocked."

: B Diff: 2 Page Ref: 292

: 11-2 22) You are assessing a confused dark-skinned patient who complains of a headache. When checking his skin color, you should: A) Examine the skin around his ears and nose B) Evaluate the palms of his hands or conjunctiva C) Observe the skin on his forehead D) Look at and feel the skin on his neck and chest

: B Diff: 2 Page Ref: 293

: 11-8 28) Assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify: A) Pallor caused by a decrease in blood flow to the tissues B) Cyanosis caused by inadequate oxygenation of the tissues C) Erythema caused by a decrease in body temperature D) Jaundice caused by an increase in blood flow to the extremities

: B Diff: 2 Page Ref: 293

: 11-8 26) To test a pediatric patient's capillary refill, the EMT will: A) Apply gentle pressure to the radial pulse and watch color changes to the hand B) Firmly compress and then release pressure on the nail bed C) Examine the inside lining of one or both eyelids D) Apply pressure to an arm and then release that pressure

: B Diff: 2 Page Ref: 294

: 11-9 32) Which of these patients should the EMT recognize as having a normal skin temperature? A) A 25-year-old female who is dizzy with cool skin B) A 36-year-old male complaining of nausea with warm skin C) A 47-year-old female with chest pain and warm-to-hot skin D) An 88-year-old male who is weak with cool and dry skin

: B Diff: 2 Page Ref: 294

: 11-10 44) Which of these would indicate a normal pupillary exam has occurred? A) One pupil dilates and the other constricts in response to light B) Both pupils constrict when light is directed into one eye C) The patient reflexively closes the eyes to light D) The pupils are equal and do not change shape in response to light

: B Diff: 2 Page Ref: 295

: 11-11 54) You observe your partner correctly obtaining a patient's blood pressure when he: A) Inflates the cuff maximally prior to slowly deflating and listening for a pulse B) Deflates the cuff 2 mmHg per second while listening with a stethoscope C) Stops inflation and starts deflation as soon as the carotid pulse disappears D) Places the stethoscope under the cuff and deflates it

: B Diff: 2 Page Ref: 298

: 11-12 25 Copyright © 2018 Pearson Education, Inc. 97) Medical direction has asked that you obtain orthostatic vital signs for a 54-year-old female patient who complains of dizziness and weakness. Her baseline vital signs obtained while she was sitting in a chair were pulse, 84; respirations, 26 breaths/min; blood pressure, 118/62 mmHg; and SpO2, 95%. Which one set of vital signs upon reassessment would indicate that this patient has a positive orthostatic test? A) Supine blood pressure of 100/64 mmHg and respirations of 22 breaths/min B) Standing blood pressure of 92/54 mmHg and heart rate of 106 beats/min C) Standing pulse of 88 with the additional complaint of nausea D) Standing SpO2 of 88% and heart rate of 96 beats/min

: B Diff: 2 Page Ref: 299

: 11-12 104) The fire department has requested your assistance at a residence where the family's carbon monoxide (CO) detector has been going off. There are three patients. You first assess a 28-yearold female patient who states she has a sinus headache but otherwise feels fine. Her vital signs are pulse, 90; respirations, 16 breaths/min; blood pressure, 118/60 mmHg; and SpO2, 100%. Given these assessment findings, you should immediately: A) Inform her that the CO detector has malfunctioned B) Administer high-concentration oxygen C) Call for advanced life support assistance D) Recheck the oxygen saturation on the patient's opposite hand

: B Diff: 2 Page Ref: 300

: 11-15 26 Copyright © 2018 Pearson Education, Inc. 101) You cannot obtain a reading on the pulse oximeter after applying the sensor to the patient's finger. What would be the most common reason for this difficulty? A) The patient's pulse is faster than 100 beats per minute B) The patient's hands are cold C) The patient is hypertensive D) The patient's oxygen saturation is less than 90%

: B Diff: 2 Page Ref: 300

: 11-17 106) A 43-year-old female has accidentally taken too much of her antidepressant medication and is now confused. Emergency Medical Responders are on scene and providing the patient with high-concentration oxygen. As you arrive at the patient's side, your first action should be to: A) Obtain vital signs B) Perform a primary assessment C) Get a pulse oximeter reading D) Determine the type of medication taken

: B Diff: 2 Page Ref: 303

: 11-17 74) A female patient called 911 when she noticed blood in her stool, and became scared and anxious. Her pulse rate is 124 and her blood pressure is 88/60 mmHg. After you get her vital signs, she nervously asks you how they are. Given her anxiety, you should: A) Change the subject B) Inform her of the vital signs C) Tell her they are normal D) Reassure her that she is fine

: B Diff: 2 Page Ref: 304

: 11-18 114) When using the SAMPLE mnemonic, which of these statements made by the patient would be categorized under the letter "M"? A) "I was diagnosed and treated for breast cancer." B) "I take Zocor, but I am not sure why." C) "I have never had a surgical procedure." D) "My doctor's name is Dr. Hansen."

: B Diff: 2 Page Ref: 307

: 11-21 121) A patient who appears to be intoxicated has fallen and is complaining of pain to his right arm. He is loud and using profane language. What should be your initial approach to the patient? A) "If you do not quiet down, I will call the police and they will arrest you." B) "Let me put an ice pack on your wrist. It will help it feel better." C) "Stop yelling or I will have to strap you to the stretcher." D) "I cannot help you if you keep yelling like that!"

: B Diff: 2 Page Ref: 309

: 2-13 10) You have been told that you must get your purified protein derivative (PPD) test for tuberculosis (TB). As a knowledgeable EMT, you recognize that the PPD test will: A) Provide continued immunity to tuberculosis B) Need to be repeated annually C) Reveal whether you need a TB immunization D) Determine the effectiveness of treatment for TB

: B Diff: 2 Page Ref: 32

: 12-4 8) A 67-year-old male patient who lives in an extremely "bad" neighborhood is experiencing chest pain. There are vacant homes throughout the area, including the homes to either side of his residence. Additionally, parked/abandoned cars have forced you to park three houses away, making it necessary to walk and carry supplies to the residence. Which action is most appropriate as you approach and/or gain access to the patient's house? A) Stand in front of the door while knocking to make your presence known B) Walk single file with your partner behind you carrying the medical bag C) Walk on the sidewalk instead of the grass to ensure steadier footing D) Hold a lit flashlight in front of you to illuminate shrubbery and trash cans

: B Diff: 2 Page Ref: 322

: 12-5 14) When would an EMT enter the scene of a crime to provide care to the patient? A) When an additional crew arrives on scene B) When all hazards have been addressed C) When the police return their guns to their holsters D) When the dispatcher informs the crew to enter

: B Diff: 2 Page Ref: 322

: 12-6 10) It is nighttime and you have been dispatched for a vehicle on the shoulder of the interstate with a driver slumped over the steering wheel. When pulling up onto the scene, how should you best position the ambulance? A) In front of the car with the white strobe lights activated B) Behind the car with your high-beams on C) Next to the car to block one lane of traffic D) Behind the car with the ambulance wheels turned toward the guard rail

: B Diff: 2 Page Ref: 324

: 12-7 24) To best determine the type and extent of injuries sustained by a patient who has fallen, the EMT should consider which of these pieces of information? A) The reason that the patient fell B) The distance fallen and the type of surface landed on C) The patient's past medical history D) Vital signs obtained during the assessment

: B Diff: 2 Page Ref: 327

: 13-2 3) Which of these statements made by the EMT indicates that he has appropriately initiated the first phase of patient assessment? A) "I have placed an oral airway in the patient." B) "The scene appears to be free of hazards." C) "Blood pressure is 124/80 mmHg." D) "Can you tell me why you called the ambulance?"

: B Diff: 2 Page Ref: 335

: 13-3 33) Forming a general impression is essential in the assessment of any patient because it: A) Indicates whether a primary assessment is required B) Helps to determine the clinical status of a patient C) Determines the stability or instability of a patient D) Reveals the injuries the patient has suffered

: B Diff: 2 Page Ref: 336

: 13-10 30) A 28-year-old female patient has fallen 20 feet from the roof a house. She is lying supine and does not appear to be conscious or breathing. On arrival at her side, what should the EMT do first? A) Open her airway using a head-tilt, chin-lift maneuver B) Apply manual in-line spinal motion restriction C) Start positive pressure ventilation after placing an OPA or NPA D) Open her airway and assess her circulation

: B Diff: 2 Page Ref: 338-339

: 13-12 42) As you approach a patient who was involved in a motor vehicle crash, you note that he has dark, oozing blood coming from an open fracture to his lower left tibia. The patient was removed from the car by bystanders and is being held by a family member. What should you do immediately? A) Assess and open the airway B) Take manual in-line spine motion restriction C) Apply direct pressure to the bleeding D) Provide supplemental oxygen

: B Diff: 2 Page Ref: 338-339

: 13-6 5 Copyright © 2018 Pearson Education, Inc. 17) A conscious and alert 64-year-old female patient complains of chest pain and mild shortness of breath. She appears to have no difficulty speaking and states that the pain suddenly started about 2 hours ago. Her daughter on scene advises you there is a history of blood clots in the lungs of her family, and she is scared and would like her mother to be evaluated. Which of these steps should you take first? A) Consider administering oxygen to the patient B) Determine the adequacy of the patient's breathing C) Place the patient on the stretcher for transport D) Perform a secondary assessment on the patient

: B Diff: 2 Page Ref: 340

: 13-8 11) You are assessing a 4-year-old patient whose panicked mother states that she cannot wake him. The child is breathing but his eyes are closed. To best determine the child's mental status, you should first: A) Apply pressure to the child's nail beds B) Say loudly, "Open your eyes!" C) Ask the mother how long the child has been asleep D) Identify the child as unresponsive

: B Diff: 2 Page Ref: 342

: 13-8 3 Copyright © 2018 Pearson Education, Inc. 9) A 36-year-old patient who has overdosed on an unknown drug presents in a seemingly unresponsive state as you walk into the room. Given this, what should you do first? A) Check the patient's vital signs B) Assess the patient's mental status C) Determine whether a radial pulse is present D) Ask bystanders which drug was taken

: B Diff: 2 Page Ref: 342

: 13-10 6 Copyright © 2018 Pearson Education, Inc. 21) Which of these patients would the EMT identify as having the most adequate breathing, free from any respiratory distress? A) A 61-year-old confused female breathing at a rate of 8 breaths/min B) A 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall C) A 19-year-old male breathing 16 times per minute with slight wheezing in the lungs D) A 67-year-old female breathing 26 times per minute with good chest rise and fall

: B Diff: 2 Page Ref: 348-349

: 13-9 8 Copyright © 2018 Pearson Education, Inc. 28) You arrive on the scene of a motor vehicle collision and are presented with a patient who complains of chest pain after striking his chest on the steering wheel. On-scene Emergency Medical Responders are maintaining cervical spine motion restriction manually. The patient is alert and oriented and has a patent airway. His respirations are 24 breaths/min with good chest rise and fall, and his skin is warm and dry. He describes some shortness of breath, his heart rate is 96 beats/min, and his SpO2 is 92% on room air. At this time you should: A) Apply a cervical collar B) Provide oxygen via nasal cannula at 2-4 liters per minute C) Obtain a blood pressure and medical history D) Start positive pressure ventilation

: B Diff: 2 Page Ref: 349

: 13-12 11 Copyright © 2018 Pearson Education, Inc. 40) You have been called for a 6-month-old male patient with a high fever who has seized. Currently, the patient is not seizing and appears to be sleeping. When performing the primary assessment on this patient, which of these actions would be most appropriate? A) Evaluate the pulse before examining the breathing B) Check for the presence of a pulse in the brachial artery C) Move the patient to the ambulance before performing the primary assessment D) Obtain a blood pressure when checking the patient's circulation status

: B Diff: 2 Page Ref: 350

: 13-12 13 Copyright © 2018 Pearson Education, Inc. 48) A 62-year-old female patient who has been working in her garden has hot, dry skin. You should recognize this finding as a possible sign of: A) Heart problems B) Heat exposure C) Hypoperfusion D) Stroke

: B Diff: 2 Page Ref: 352-353

: 13-12 54) Which of these patients is considered the lowest priority for a rapid secondary exam and immediate transport? A) A 32-year-old woman who is unresponsive B) A 72-year-old man complaining of leg pain for a week C) A 7-year-old boy who has had severe abdominal pain for 4 hours D) A 55-year-old woman with difficulty breathing

: B Diff: 2 Page Ref: 353

: 13-5 45) At a nursing home, you find an elderly patient extremely short of breath. To best determine whether this patient is cyanotic, you should: A) Press and release the skin on the palm B) Examine the lining of the lips and mouth C) Look at and feel the skin on the back of the hand D) Inspect the skin on the fingers and nail beds

: B Diff: 2 Page Ref: 360

: 2-10 12 Copyright © 2018 Pearson Education, Inc. 44) Which rationale best explains the reason for wearing a high-visibility safety vest at the scene of a motor vehicle collision? A) Wearing the vest makes you easily identifiable as an EMT B) The use of the vest can increase your visibility to passing drivers at the scene of an accident C) Federal law requires that you wear the vest or the EMS system can be fined D) The vest increases your visibility to bystanders and protects you from blood and body fluids

: B Diff: 2 Page Ref: 37

: 2-8 5 Copyright © 2018 Pearson Education, Inc. 16) You are dispatched to a motor vehicle collision on a remote country road. It is night, and your scene size-up reveals a heavily damaged car that rolled several times. The driver has been ejected and is lying prone in the middle of the road. In this situation, which type of protective clothing is it most essential that you don prior to making patient contact? A) Rubber-soled boots B) Reflective vest C) Protective helmet D) Leather gloves

: B Diff: 2 Page Ref: 37

: 13-21 108) After manual spine motion restriction is established, it should never be released until: A) Self-restriction is initiated B) The patient is secured on a stretcher C) All interventions are checked D) The patient has been assessed for additional injuries

: B Diff: 2 Page Ref: 370

: 13-22 67) When performing the secondary assessment, the EMT would likely find which of these injuries first? A) Deformity to the left thigh B) Bruising to the abdomen C) Unstable pelvis D) Decreased pulse in the left foot

: B Diff: 2 Page Ref: 373

: 13-22 68) When you assess the lower back of an elderly patient who fell, he grimaces and tells you that it hurts when you palpate the injury site. The perception by the patient of increased pain upon palpation of an injured site is known as: A) Pain B) Tenderness C) Instability or crepitation D) Ecchymosis

: B Diff: 2 Page Ref: 373

: 13-22 69) You are performing a secondary assessment on an unrestrained adult passenger who was involved in a motor vehicle collision in which the car rolled end over end several times at a high rate of speed. The patient is responsive to painful stimuli and in a state of shock. When assessing the patient's head, which of these would be appropriate for you to do? A) Clean a laceration of the scalp B) Check the pupils with a penlight C) Perform a blind finger sweep to check the airway D) Apply pressure to a depressed area of the skull

: B Diff: 2 Page Ref: 374

: 13-26 95) A 20-year-old female patient is found unresponsive. The first step of the secondary assessment for this patient is to: A) Obtain vital signs B) Conduct a rapid medical assessment C) Gather a SAMPLE history from the family D) Contact medical direction for advisement

: B Diff: 2 Page Ref: 392

: 13-18 26 Copyright © 2018 Pearson Education, Inc. 97) You have been summoned to a retail store, where you are directed to a middle-aged woman who was found in the bathroom on the toilet. Your assessment shows her to be responsive to painful stimuli with an open airway and labored breathing. Her pulse is fast and regular, and her skin is warm to the touch. The primary assessment has been completed and the appropriate care given. As the stretcher is prepared, you perform the secondary assessment. When assessing her chest, you note the presence of crackles to both lungs. What should you do next? A) Place the patient on the stretcher B) Assess the abdomen C) Obtain vital signs D) Evaluate the head and neck

: B Diff: 2 Page Ref: 399

: 1-7 39) A young man wishes to become an EMT and asks you what he will need to do to become certified. You would reply that he must first: A) Volunteer with an ambulance service to gain experience B) Complete a course that meets the requirements of the U.S. Department of Transportation C) Demonstrate that he has prior medical experience D) Attend classes at a local community college

: B Diff: 2 Page Ref: 4

: 13-14 81) While you are performing a secondary assessment on a male patient who was ejected from his motorcycle, the patient suddenly states that it has become very hard to breathe. You would: A) Make a mental note and continue with your exam B) Stop your exam and evaluate the patient's new complaint C) Reassess the patient, beginning with the head D) Reconsider the mechanism of injury and look for a chest injury

: B Diff: 2 Page Ref: 401

: 13-26 102) A male patient was found in cardiac arrest by coworkers. On arrival at the scene, you determined him to be in cardiac arrest and started CPR. The AED was quickly placed and you shocked the patient once, restoring a heartbeat. During transport, the patient remains unresponsive, but is breathing and has a pulse. When conducting the reassessment of this patient, which action should you complete? A) Perform a trauma assessment B) Recheck vital signs C) Remove the oropharyngeal airway D) Obtain a blood pressure every 20 minutes

: B Diff: 2 Page Ref: 403

: 14-12 3 Copyright © 2018 Pearson Education, Inc. 9) A patient with a history of diabetes is confused and irritable. According to family members, he accidentally took too much insulin this morning and did not eat breakfast. Since he is conscious with an intact gag reflex, medical direction orders you to administer oral glucose. Which component of this situation best represents the indication for the medication? A) Medical command authorization B) Confusion and irritability C) History of diabetes D) High blood sugar

: B Diff: 2 Page Ref: 422

: 14-4 31) The EMT shows she understands the difference between a metered-dose inhaler (MDI) and a small-volume nebulizer (SVN) when she states: A) "The MDI uses oxygen to administer the medication; the SVN does not." B) "The MDI provides medication during one or two of the patient's breaths; the SVN provides a continuous flow of medication until gone." C) "The MDI uses a mask to administer the medication; the SVN merely requires the patient to hold the device in his mouth and inhale." D) "The MDI requires the EMT to set up and prepare the medication for administration; the SVN does not."

: B Diff: 2 Page Ref: 423

: 14-6 40) You are treating a patient who has a history of gout, hypertension, diabetes, emphysema, and high cholesterol. As you review his medications, you notice that one of his pill bottles has the name "levalbuterol" on its label. You would recognize this name as: A) The trade name for glutose B) The generic name for Xopenex C) The generic name for Narcan Nasal Spray D) The chemical name for acetylsalicylic acid

: B Diff: 2 Page Ref: 427, Table 14-1

: 14-6 23) After you assist a patient with use of his metered-dose inhaler, the patient's son asks why his father cannot take the medication in the form of a pill. Which of these responses would be most appropriate? A) "It would be best if you asked the doctor because I cannot legally answer that question." B) "By giving the medication into the lungs, the medicine goes directly to where it's needed." C) "Your father could take this medication by spraying it under his tongue. Check with his doctor?" D) "There are only a few medications that come in pill form, and this is not one of them."

: B Diff: 2 Page Ref: 427-428

: 14-1 8) After you assist a patient with use of her EpiPen, she tells you that it is much easier for her to breathe. However, her heart rate has increased from 92 to 118 beats/min. Regarding the epinephrine, the EMT recognizes the increased heart rate as a(n): A) Therapeutic effect B) Side effect C) Contraindication D) Allergy

: B Diff: 2 Page Ref: 429

: 14-10 19) What is the best description of the purpose of the five rights of drug administration? A) Makes medication administration easier B) Decreases the risk of a medication error C) Ensures therapeutic benefit to the patient D) Prevents clinical deterioration of the patient

: B Diff: 2 Page Ref: 431

: 14-10 20) A patient with severe chest pain hands you a bottle of nitroglycerin. After reading the label, you determine that the prescribed dose is two pills when chest pain is present, but the medication expired almost a month ago. You should: A) Administer two of the nitroglycerin tablets B) Withhold the medication and transport the patient C) Administer the nitroglycerin orally D) Place one tablet under the patient's tongue

: B Diff: 2 Page Ref: 431

: 14-11 42) During a lecture you are attending that covers the pharmacology information often used by EMS providers, the lecturer references a drug source you know to be incorrectly stated. Which of these is a fictitious or incorrect name for an information source? A) American Hospital Formulary Services B) CDC Guide to Pharmacology C) Physician's Desk Reference D) AMA Drug Evaluation

: B Diff: 2 Page Ref: 432

: 15-4 17 Copyright © 2018 Pearson Education, Inc. 62) Which statement made by a patient's family member would cause the EMT to suspect that a patient is experiencing hypovolemic shock? A) "He has had a rash for the past three days." B) "He cannot stop throwing up." C) "He has been taking an antibiotic for a chest cold." D) "He got up this morning and was having a hard time breathing."

: B Diff: 2 Page Ref: 441

: 15-2 65) A patient in shock with abdominal pain indicates he noticed a lot of blood in the toilet after having a bowel movement this morning. The EMT should suspect which type of shock? A) Septic hypovolemic B) Hemorrhagic hypovolemic C) Hypoxic hypovolemic D) Nonhemorrhagic hypovolemic

: B Diff: 2 Page Ref: 443

: 15-6 20 Copyright © 2018 Pearson Education, Inc. 73) A patient has fallen down a flight of stairs, and is now restless and confused. His airway is open, and he is adequately breathing, 22 times per minute, with a pulse oximetry reading of 90%. He has a radial pulse of 92 beats/min, which is moderate in strength. Emergency Medical Responders are maintaining manual spine motion restriction. What should your next action be? A) Check the blood pressure and assess for injuries causing blood loss B) Administer supplemental oxygen C) Insert an oral airway and start positive pressure ventilation D) Complete spinal motion restriction interventions by placing the patient on a long spine board with a cervical collar applied, and then applying straps

: B Diff: 2 Page Ref: 451

: 15-9 21 Copyright © 2018 Pearson Education, Inc. 76) A driver was ejected from his vehicle in a rollover-type collision. Assessment findings reveal the patient to be unresponsive, with bruising to the abdominal and pelvic areas as well as an open femur fracture. The patient has an open airway and is breathing 32 times per minute. When you listen to breath sounds, you find them to be absent over the alveolar areas of the lungs. The patient's skin is cool and clammy and the radial pulses weak. Manual spine motion restriction is being maintained. What should your next intervention be? A) Obtain a blood pressure B) Assist respirations C) Examine the fracture site D) Apply a cervical collar

: B Diff: 2 Page Ref: 451

: 15-9 78) While cleaning a gun, a 44-year-old patient accidentally shot himself in the abdomen. On arrival, you observe the patient on the floor lying on his side, with his legs drawn to his chest. His blood pressure and pulse oximetry reading are low, and his heart rate and respirations are high. Blood is evident on his shirt and pants. Which of these indicates the correct sequence of events when caring for this patient? A) Perform primary and secondary assessments, move the patient to the stretcher for immediate transport, start positive pressure ventilation en route to the hospital B) Perform the primary assessment, administer supplemental oxygen, perform a rapid secondary assessment, transfer the patient to the stretcher, provide rapid transport C) Transfer the patient to the ambulance, provide rapid transport, perform the primary assessment and oxygen therapy en route to the hospital D) Transfer the patient to the ambulance, perform the primary assessment and rapid secondary assessment, provide oxygen therapy, provide rapid transport

: B Diff: 2 Page Ref: 451

: 15-18 41) You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient just collapsed moments ago. An AED is located less than 1 minute from your location. The nearest EMT is 5 minutes from your location. What should you do immediately? A) Start CPR and wait for the AED B) Retrieve the nearby AED C) Call for assistance and start CPR, continuing it until the other EMT arrives D) Perform manual in-line spinal stabilization

: B Diff: 2 Page Ref: 453-454

: 15-15 18) Which of these statements about the AED and its use in the treatment of cardiac arrest is true? A) AEDs have simplified the treatment of cardiac arrest to the point where the EMT does not have to be worried about inappropriately shocking a patient B) Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual defibrillator C) To use an AED, the EMT must be able to identify some basic cardiac arrest heart rhythms so that he or she can tell the AED to shock or not shock the patient D) The AED is advantageous in that it will determine if a patient is in cardiac arrest and whether or not to shock the patient

: B Diff: 2 Page Ref: 455

: 15-17 5 Copyright © 2018 Pearson Education, Inc. 17) Because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of these statements indicates an understanding of how this policy will affect the EMTs? A) "Cardiopulmonary resuscitation will no longer be needed." B) "The AED will let us know whether to shock the patient." C) "EMTs will now be able to shock all patients in cardiac arrest." D) "EMTs will have to learn how to interpret ECG tracings."

: B Diff: 2 Page Ref: 455

: 15-21 21) It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock could: A) Cause the patient extreme pain B) Cause the beating heart to go into cardiac arrest C) Cause the patient to lose his eyesight D) Produce full-thickness burns and lead to a deadly infection

: B Diff: 2 Page Ref: 457

: 15-17 25) You have arrived at a residence where a 4-month-old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the patient's side. You have an AED with adult pads with you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac arrest, you would: A) Continue CPR and transfer the patient to the stretcher for transport B) Place the AED on the patient and follow all prompts C) Continue CPR for 2 more minutes before placing the AED on the patient D) Discuss with the parents whether they want to proceed with use of the AED

: B Diff: 2 Page Ref: 458

: 15-17 10 Copyright © 2018 Pearson Education, Inc. 35) After you applied the AED to a patient in cardiac arrest, it delivered a shock. Immediately after the shock, what should you do next? A) Check the patient for a pulse and reanalyze the rhythm if no pulse is present B) Provide 2 minutes of CPR, and then check the patient for a pulse C) Check the patient for a pulse and start CPR if no pulse can be located D) Provide five cycles of single-rescuer CPR with a ratio of 15 compressions to 2 ventilations

: B Diff: 2 Page Ref: 461

: 15-17 34) The AED has just been applied to a female patient in cardiac arrest. After analyzing the heart rhythm, it provides a "no shock advised" message. The EMT should immediately: A) Reanalyze the patient's heart rhythm B) Resume cardiopulmonary resuscitation C) Check the electrodes for proper placement D) Check the patient for a pulse and blood pressure

: B Diff: 2 Page Ref: 461

: 15-18 44) You are transporting an unresponsive 31-year-old female patient who suffered cardiac arrest. On scene, Emergency Medical Responders (EMRs) shocked the patient once with the AED and she regained a pulse. She remains unresponsive and has shallow respirations. Ventilation is being provided with a bag-valve mask. An EMR has agreed to ride to the hospital with you to provide assistance in caring for the patient. Which set of instructions given to the EMR next is most appropriate? A) "Place the patient in semi-Fowler's position so her airway is clear if she vomits." B) "Leave the AED on the patient, even though she is breathing and has a pulse." C) "Please check the patient's breathing and pulse every 5 minutes." D) "Place the patient on a nonrebreather mask with 15 liters per minute of oxygen."

: B Diff: 2 Page Ref: 462

: 15-21 53) The EMT realizes that the best means of preventing failure of the AED is to: A) Make sure that the AED is kept clean and free of damage B) Check the AED battery and its supplies at the beginning of each shift C) Check the electrodes monthly and replace them when expired D) Obtain a second set of batteries when the original set is no longer functional

: B Diff: 2 Page Ref: 466

: 16-15 23) You are called to a motor vehicle collision. A 26-year-old female states that she was unrestrained and struck the steering column with her chest after the car she was driving hit another car from behind. She is somewhat confused, and complains of chest pain and difficult and painful breathing when she inhales. Her airway is patent and her breathing is adequate. Assessment of the radial pulse reveals it to be rapid and very irregular and weak. The patient has cyanosis in her nose and fingertips. Her breath sounds are clear and equal, and her skin is moist and pale. The patient informs you that she has asthma and has a metered-dose inhaler (MDI). What is your best initial action in treating this patient? A) Assist the patient with her MDI B) Apply supplemental oxygen if indicated C) Apply CPAP and transport the patient expediently D) Transport the patient in a supine position on a long spine board

: B Diff: 2 Page Ref: 477

: 16-18 35) A son has called 911 for his father, who is having difficulty breathing. On scene, the 81-yearold patient is lying on a couch in the living room, lethargic, and in obvious respiratory distress. He is confused, but has an open airway. His respirations are 38 breaths/min and shallow, and his skin is extremely diaphoretic with cyanosis in the fingertips. At this time, the EMT should: A) Suction the airway of secretions B) Start positive pressure ventilation C) Assess the patient's breath sounds D) Determine the patient's past medical history

: B Diff: 2 Page Ref: 477

: 16-15 8) A confused, lethargic, and nonverbal 50-year-old female patient has altered mental status. You are told she has a history of chronic obstructive pulmonary disease (COPD). The primary assessment reveals a respiration rate of 6 breaths/min and cool, clammy skin with cyanosis around the lips. What should be your priority management? A) Administer oxygen by nasal cannula at 15 lpm B) Assist respirations with positive pressure ventilation C) Administer oxygen by nonrebreather mask at 15 lpm D) Sit the patient up, assess lung sounds, and obtain a blood pressure

: B Diff: 2 Page Ref: 480-481

: 16-2 24 Copyright © 2018 Pearson Education, Inc. 87) During an asthma attack, three main pathological changes lead to hypoxia in the patient. Which of these changes is not one of these three? A) Bronchospasm B) Decreased alveolar perfusion C) Increased edema to bronchiole walls D) Heavy mucus secretion and airway plugging

: B Diff: 2 Page Ref: 481

: 3-11 4 Copyright © 2018 Pearson Education, Inc. 10) What action best indicates that informed consent has been obtained? A) The EMT administers oxygen because the patient is having chest pain and appears short of breath B) The patient agrees to oxygen therapy after being told it may help decrease his chest pain but may dry his nose, causing discomfort C) The EMT tells the patient that he will need oxygen because he is having chest pain, which could be a sign of a heart attack D) The patient is given oxygen because he is having chest pain and was the one who placed the 911 call for help

: B Diff: 2 Page Ref: 49

: 3-7 64) What is the primary difference between ethics and morals? A) Ethics are what the EMT should do, whereas morals are what the EMT will do B) Ethics is a branch of philosophy that studies morality, whereas morals are concepts of "right and wrong" C) Morals are what the EMT should do, whereas ethics are what the EMT will do D) Morals define the expectations for professional occupations, whereas ethics are regulations written into state law defining what those expectations are

: B Diff: 2 Page Ref: 49

: 16-14 20 Copyright © 2018 Pearson Education, Inc. 72) You have been called to an industrial warehouse for a young adult male patient who was exposed to an unknown chemical gas. The patient was immediately removed from the environment and presents to you with a patent airway, burning to the throat with inspiration, and complaint of shortness of breath. His vital signs are pulse, 120; respirations, 28 breaths/min; blood pressure, 164/60 mmHg; and SpO2, 90%. In addition, you note bilateral wheezing to the lungs. What should be your first action in caring for this patient? A) Initiate manual spinal motion restriction B) Administer supplemental oxygen C) Identify the chemical to which the patient was exposed D) Administer a saline mist through a small-volume nebulizer

: B Diff: 2 Page Ref: 491-492

: 16-15 16) You are assisting a patient in taking her metered-dose inhaler for the first time. Which of these statements about the side effects of the medication would be most appropriate? A) "You will probably not even remember taking the medication." B) "You may feel anxious and your heart rate may increase." C) "You may experience a runny nose and increase in saliva." D) "The medication may cause you to become very tired and fatigued."

: B Diff: 2 Page Ref: 493, Table 16-6

: 16-15 18) A patient requires several doses of medication from her metered-dose inhaler. At a minimum, how long should the EMT wait between administrations? A) 30 seconds B) 2 minutes C) 5 minutes D) 10 minutes

: B Diff: 2 Page Ref: 495

: 16-11 50) The EMT is properly using a small-volume nebulizer when she: A) Places a spacer on the nebulizer B) Attaches the nebulizer to oxygen at 8 to 10 lpm C) Shakes the medication canister for 30 seconds prior to administration D) Instructs the patient to breathe deeply through his nose

: B Diff: 2 Page Ref: 495, Figure 16-11

: 16-17 54) A 4-year-old female patient with a decreased level of consciousness is in respiratory distress. Her airway is patent and respirations are 12 per minute. Breath sounds are diminished bilaterally, and there is noted accessory muscle use with inspiration and expiration. Her pulse is 84 and SpO2 88%. What should be your immediate action? A) Recheck the SpO2 on another finger B) Start positive pressure ventilation C) Apply CPAP D) Initiate immediate transport to the hospital

: B Diff: 2 Page Ref: 497-498

: 16-17 2 Copyright © 2018 Pearson Education, Inc. 5) The mother of a 5-year-old female patient states that her daughter has been "sick" with a sore throat and fever for several days. The mother became concerned tonight and called 911 because the child was "making funny noises" and could not breathe well. Your assessment reveals a lethargic, well-developed child sitting upright and with high-pitched tracheal noises when she breathes in. What should be the priority action for the EMT? A) Placing an oropharyngeal airway B) Administering supplemental oxygen if indicated C) Inspecting the airway with a tongue depressor D) Performing abdominal thrusts

: B Diff: 2 Page Ref: 498

: 16-17 3) When assessing a 3-year-old male patient in respiratory distress, the EMT should recognize "see-saw" breathing when he observes: A) Alternate breathing through the nose and mouth B) Movement of the chest and abdomen in opposite directions C) Retraction of the muscles between the ribs D) Up-and-down motion of the head as the patient breathes

: B Diff: 2 Page Ref: 498

: 16-6 27) A 6-year-old female patient is in acute respiratory distress and is still breathing adequately but will not keep the nonrebreather face mask on her face. In this situation, the EMT should: A) Secure the mask with tape to the patient's face B) Have the mother hold the mask near her daughter's face C) Start positive pressure ventilation D) Immediately transport the patient without oxygen therapy

: B Diff: 2 Page Ref: 498

: 1-3 30) The county dispatch center where you work employs emergency medical dispatchers (EMDs) as call takers. Using EMDs as opposed to a person who is just a "call taker" enables the dispatch center to: A) Process all emergency calls, including those asking for police, fire, and EMS assistance B) Provide medical instructions to the caller prior to the arrival of EMS personnel C) Use computer technology when dispatching the closest ambulance D) Properly utilize an enhanced 911 call-taking system

: B Diff: 2 Page Ref: 5

: 1-4 7 Copyright © 2018 Pearson Education, Inc. 24) Which patient would most benefit from calling an enhanced 911 system from the home phone? A) Patient with chest pain B) Patient with sudden onset of confusion C) Patient requiring advanced medical care D) Patient who cannot reach the phone

: B Diff: 2 Page Ref: 5

: 3-10 11) A 62-year-old male is short of breath. The EMT asks the patient if it would be okay to assess him, including taking his vital signs. The patient agrees by nodding the head "yes." As such, which is true? A) Informed consent has been obtained by the EMT B) The EMT has obtained expressed consent C) The patient can be transported without further permission D) The EMT has gained implied consent

: B Diff: 2 Page Ref: 50

: 3-11 13) Which patient may be treated under the guideline of implied consent? A) A 2-year-old boy who fell down a flight of stairs and whose parents want him taken to the hospital B) An unresponsive 33-year-old female who is suspected of taking recreational drugs C) An adult patient with chest pain and shortness of breath who is refusing treatment and transport by EMS D) A 47-year-old female with severe abdominal pain who is refusing transport after placing the call to 911 for help

: B Diff: 2 Page Ref: 50

: 16-18 40) When assessing an adult patient with difficulty breathing, which of these signs or symptoms would be of most immediate concern? A) Temperature of 101.3°F B) Blue coloration to the lips C) Rate between 20 and 24 breaths/min D) Cyanosis to the fingernails

: B Diff: 2 Page Ref: 503

: 16-18 41) You are having a hard time getting the past medical history of a patient who is short of breath. Which piece of information would lead the EMT to believe that the patient has a history of chronic lung disease, such as emphysema or chronic bronchitis? A) She takes a daily aspirin B) Her chest is barrel shaped C) Her respirations are tachypneic D) She continually coughs

: B Diff: 2 Page Ref: 504, Table 16-8

: 16-10 91) During your reassessment of the respiratory system and oxygenation status of a patient with a chronic pulmonary condition, which of these would most likely not be part of this reassessment process? A) Breath sounds B) Blood glucose level C) Mental status D) Vital signs

: B Diff: 2 Page Ref: 509

: 16-6 11 Copyright © 2018 Pearson Education, Inc. 38) A confused and cyanotic patient is breathing 8 times per minute with poor chest rise and fall. Which instruction would you give your partner about the respiratory care of this patient? A) "Deliver a ventilation with the bag-valve mask only when he breathes." B) "Ventilate him at 10 times per minute." C) "Ventilate him with the bag-valve mask in between each of his breaths." D) "Since he is breathing, let's go ahead and put him on a nonrebreather mask with 15 lpm of oxygen."

: B Diff: 2 Page Ref: 511, Figure 16-17B

: 16-16 60) As you enter a room for an unknown medical emergency, you find an unresponsive male with snoring respirations lying supine in bed. Which action should you take immediately? A) Take manual spinal motion restriction precautions B) Perform a head-tilt, chin-lift maneuver C) Start positive pressure ventilation D) Suction the airway of fluids

: B Diff: 2 Page Ref: 512, Figure 16-18

: 17-6 4) Which portion of the heart, when weakened by a heart attack, is responsible for causing fluid to back up into the alveoli? A) Right atrium B) Left ventricle C) Right ventricle D) Pulmonary vein

: B Diff: 2 Page Ref: 523

: 17-1 7) A patient has a low platelet count. Based on this finding, which complication is he most at risk for? A) Clot formation B) Bleeding C) Hypotension D) Angina

: B Diff: 2 Page Ref: 527

: 17-6 20 Copyright © 2018 Pearson Education, Inc. 76) A patient who is chronically hypoxic because of anemia most likely has a problem with which component of the cardiovascular system? A) Platelets B) Red blood cells C) Pulmonary arteries D) White blood cells

: B Diff: 2 Page Ref: 527

: 17-7 11) You are interviewing a patient whom you suspect has an acute coronary syndrome. Which question is most appropriate initially? A) "Are you having any pain in your chest?" B) "Are you having any chest discomfort?" C) "Does it hurt when I press on your chest?" D) "Does your chest hurt when you breathe?"

: B Diff: 2 Page Ref: 530

: 17-10 12) You have arrived at a residence to help another crew with a 62-year-old woman who is complaining of fatigue, chest discomfort, and diaphoresis. The EMTs on scene report that she has a history of hypertension from atherosclerosis, for which she takes a blood pressure pill, and is also prescribed nitroglycerin. She reports an allergy to aspirin. Vital signs are pulse, 64; respirations, 16 breaths/min; blood pressure, 128/86 mmHg; and SpO2, 97% on room air. Which of these statements made by your EMT partner would require immediate correction on your part? A) "I am not going to attach the AED, because the patient is conscious and has a pulse." B) "I am going to put the patient on high-concentration oxygen because she has chest discomfort." C) "I will contact medical direction for permission to administer the patient's nitroglycerin." D) "I am not going to give the patient any aspirin, because she says that she is allergic to it."

: B Diff: 2 Page Ref: 532

: 17-12 61) A patient informs you that he has a history of an abdominal aortic aneurysm. To best assess the status of this condition, you should: A) Auscultate the lower abdominal quadrants B) Assess the abdomen C) Examine the back for bruising D) Palpate the flanks and back

: B Diff: 2 Page Ref: 533-534

: 17-14 91) On scene, you are treating a 62-year-old female patient with chest pain, diaphoresis, and nausea. She has a history of heart problems as well as diabetes, for which she takes medications. She is allergic to penicillin and iodine. She is alert, oriented, and calm, and there are no threats to the airway, breathing, or circulation. The patient took 81 mg of aspirin this morning, as she always does. Her vital signs are pulse, 100; respirations, 16 breaths/min; blood pressure, 118/90 mmHg; and SpO2, 97% on room air. In overseeing the care of this patient, which of these actions would demand immediate and corrective intervention? A) Palpating the chest wall for tenderness B) Applying oxygen through a nasal cannula C) Determining the patient's blood glucose D) Administering three baby aspirins to the patient

: B Diff: 2 Page Ref: 535

: 17-14 94) You are treating a 67-year-old male patient with chest pain and a history of prior heart attacks as well as diabetes and hypertension. The patient has taken three nitroglycerin tablets, which have decreased his pain from 7/10 to 4/10; however, the pain persists. Initially, his SpO2 was 91% on room air. Oxygen was applied by nasal cannula and now, on 3 lpm O2, his SpO2 is 97%. How would you address the oxygen administration, given that the patient still has chest pain? A) Increase the oxygen flow to 4 lpm B) Decrease the oxygen flow to 2 lpm C) Leave the oxygen flow unchanged D) Discontinue oxygen therapy

: B Diff: 2 Page Ref: 535

: 17-17 43) You suspect that a patient with a history of chronic obstructive pulmonary disease (COPD) is has right ventricular failure. In your assessment, which finding would reinforce this suspicion? A) Elevated blood pressure B) Edema to the feet C) Crackles in both lungs D) Bounding radial pulse

: B Diff: 2 Page Ref: 536

: 17-16 34) Which action is it essential that the EMT take prior to assisting the patient in taking his nitroglycerin tablet? A) Determine whether the patient had a stroke within the last 6 months B) Evaluate the patient's systolic blood pressure and heart rate C) Inquire about whether the patient is allergic to sulfa drugs D) Determine the presence or absence of a headache

: B Diff: 2 Page Ref: 538

: 17-18 48) Which of these statements made by the patient should the EMT associate with the condition of congestive heart failure? A) "I noticed that I am having a hard time breathing and have a fever." B) "I have a hard time breathing when I am lying down." C) "When I walk, I feel very weak and get quite dizzy." D) "I can feel my heart pounding in my head and I have a throbbing headache."

: B Diff: 2 Page Ref: 538

: 17-16 10 Copyright © 2018 Pearson Education, Inc. 35) A patient has chest pain, and you have just assisted him in taking his nitroglycerin tablet. Which of these statements made by the patient is the cause for greatest concern? A) "It is easier to breathe now." B) "The chest pain does not feel any different." C) "I seem to be getting a headache." D) "My tongue is stinging and burning."

: B Diff: 2 Page Ref: 539

: 17-16 33) You have been called for a 56-year-old female patient who complains of chest pain. She informs you that she takes nitroglycerin and asks you to get it from the top of her refrigerator. You find it is a clear glass jar hand-labeled "nitroglycerin." What of these statements, based on this observation, would be the most appropriate one to make to the patient? A) "You should keep your nitroglycerin in the refrigerator since it will keep longer in the cold." B) "It is best to keep the nitroglycerin in a dark container since light will inactivate it." C) "The heat from the refrigerator will cause the nitroglycerin to lose its effectiveness." D) "Keeping the nitroglycerin on top of the refrigerator may make it difficult for you to reach it in an emergency."

: B Diff: 2 Page Ref: 539

: 17-16 9 Copyright © 2018 Pearson Education, Inc. 31) A 44-year-old male patient is experiencing chest pain. He has a history of angina and is prescribed nitroglycerin, which he has not taken yet. He is also taking another medication. Which of these medications is a contraindication to the administration of nitroglycerin? A) Coumadin B) Levitra C) Methadone D) Albuterol

: B Diff: 2 Page Ref: 540

: 17-18 15 Copyright © 2018 Pearson Education, Inc. 54) You have just arrived by the side of a male patient who is in cardiac arrest. Emergency Medical Responders have been on scene for 6 minutes performing CPR. Advanced life support (ALS) has been contacted and is 1 minute out. What should you do immediately? A) Continue CPR and wait for ALS care B) Apply and use the automated external defibrillator C) Check the heart rate, blood pressure, and SpO2 D) Place the patient on the stretcher so ALS can provide care en route

: B Diff: 2 Page Ref: 542

: 17-8 17) You are assisting a paramedic in the transport of a patient from a community hospital emergency department to a large medical center. The patient was diagnosed with an acute myocardial infarction and received fibrinolytic therapy in the ED. Currently, you are transporting the patient with the fibrinolytic medication infusing through an IV. In regard to the fibrinolytic therapy, you know that during this transport, you will need to closely monitor the patient for which complication? A) Respiratory arrest B) Internal bleeding C) Hypoglycemia D) Hypertension

: B Diff: 2 Page Ref: 543

: 17-8 57) You are transporting a patient with chest pain to the hospital emergency department. In regard to possible fibrinolytic therapy, what should you relay during your hospital report as a possible relative contraindication to this therapy? A) Blood glucose level of 80 mg/dL B) Use of anticoagulant medication C) History of previous heart attack D) Allergy to aspirin and penicillin

: B Diff: 2 Page Ref: 543-544

: 17-14 4 Copyright © 2018 Pearson Education, Inc. 13) You have been called to an office building for a 47-year-old male patient complaining of chest pain. He is alert, oriented, and complaining of mild pain in his chest that came on suddenly about 15 minutes ago. Airway, breathing, and circulation are intact, and his skin is diaphoretic and cool. What should you do first? A) Apply supplemental oxygen through a nasal cannula B) Obtain a heart rate, respiratory rate, blood pressure, and SpO2 reading C) Determine if there is a family history of cardiac illness D) Administer the first of up to three nitroglycerin tablets

: B Diff: 2 Page Ref: 544

: 17-6 82) A 67-year-old male patient with a history of coronary artery disease and COPD called 911 for chest discomfort and mild dyspnea. When you are at the patient's side, he states that the pain started when he was cleaning out his garage, but after a period of rest, the pain has resolved. His airway is patent, breathing adequate, radial pulse irregular, and skin warm and dry. He has a past medical history of atrial fibrillation (irregular heartbeat), coronary artery disease, and diabetes, for which he takes insulin. Vital signs are pulse, 68; respirations, 16 breaths/min; blood pressure, 148/88 mmHg; and SpO2, 97% on room air. The patient took 81 mg of aspirin as prescribed this morning on awakening. What should you do first? A) Administer another aspirin B) Assess breath sounds C) Assist the patient with taking nitroglycerin D) Provide supplemental oxygen

: B Diff: 2 Page Ref: 544

: 17-9 7 Copyright © 2018 Pearson Education, Inc. 23) The EMT shows she is correctly administering aspirin to a patient with chest pain when she provides: A) 325 mg of enteric-coated aspirin and instructs the patient to swallow it B) 325 mg of baby aspirin and instructs the patient to chew it C) 325 mg of baby aspirin and instructs the patient to let it dissolve under the tongue D) 160 mg of baby aspirin and instructs the patient to swallow it with a glass of water

: B Diff: 2 Page Ref: 547, Figure 17-19

: 3-12 21) A patient who has the capacity to make rational decisions, although he is dizzy, complains of a headache, and then vomits, declines your care and will not sign the refusal of care form. What is your best action? A) Document that the patient refuses to sign and leave B) Have a family member sign as a witness to the refusal C) Have your partner sign on behalf of the patient D) Inform the patient that by law he must sign the form

: B Diff: 2 Page Ref: 55

: 18-12 44) You have just arrived by the side of a 46-year-old male patient who receives dialysis for endstage renal failure. He is positioned in his living room recliner, unresponsive with snoring respirations, and appears to have ineffective ventilations. What is your priority intervention at this time? A) Provide mechanical ventilations B) Manually open the airway C) Find out when he last received dialysis D) Inquire when the symptoms started

: B Diff: 2 Page Ref: 557

: 18-3 35) You have been called to the house of a young adult male patient who is unresponsive. The man lives by himself, so no family is present. In trying to determine the origin of the patient's altered mental status, which of these would most likely provide the best information, assuming it is available to you? A) Contact with medical direction B) Examination of patient medications (prescribed and recreational) C) Interpretation of physical assessment findings D) Observation of the living conditions in the house

: B Diff: 2 Page Ref: 557

: 18-1 10 Copyright © 2018 Pearson Education, Inc. 37) When performing a secondary assessment on an elderly male patient who is confused and combative, which of these assessment findings should be of most concern to the EMT? A) Respirations of 20 breaths/min B) Pulse of 164 C) Bruising to the back of the hand D) Pulse oximeter reading of 94% on room air

: B Diff: 2 Page Ref: 558

: 17-9 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 18 Altered Mental Status, Stroke, and Headache 1) Which of these conditions would the EMT recognize as most likely signaling a neurologic deficit? A) Hypoglycemia B) Paralysis C) Constricted pupils D) Headache

: B Diff: 2 Page Ref: 559-560

: 3-15 28) Despite a patient's protest that he does not want his blood pressure taken, the EMT places a BP cuff on his arm and takes his blood pressure. The EMT states: "See? It is just as I suspected- your blood pressure is sky high. You really need to be seen in the emergency department." The patient states he did not realize that his blood pressure was that high. In terms of battery, which statement is true? A) Since the BP was elevated and treatment must be provided, battery cannot be charged B) The patient could charge the EMT with battery, regardless of his blood pressure reading C) The patient could charge the EMT with assault, not battery D) Because the patient knows the result of the BP, the EMT is safe from battery

: B Diff: 2 Page Ref: 56

: 18-12 27) Patients with an altered mental status due to a stroke may not be able to control their own airways because of: A) Enlargement and swelling of the epiglottis B) Paralysis or weakness of the throat muscles C) Hypersensitivity of the gag reflex D) Increased oral secretions

: B Diff: 2 Page Ref: 568

: 3-16 35) A woman calls the station and asks if you transported a patient named Patricia Gardner earlier in the day. She says that she is her friend and wants to know if she is okay. An appropriate response would be: A) "I can tell you that she was transported to the hospital, but I cannot tell you why." B) "Although I do not doubt that you are her friend, I cannot release that information." C) "I cannot tell you that, but her family is at home and they can give you more information." D) "She was treated for chest pain, but I cannot release her diagnosis for admission."

: B Diff: 2 Page Ref: 57

: 3-17 14 Copyright © 2018 Pearson Education, Inc. 48) You are approached by a college student who states that his college is working with a physician on a project that examines the types of violent trauma occurring within your jurisdiction. He then asks you if he may see copies of all patient care reports that involved patients who were either stabbed or shot. Who would be the best person to contact regarding this request? A) Your service's medical director B) Your service's privacy officer C) The physician overseeing the research project D) The state department of EMS

: B Diff: 2 Page Ref: 57

: 18-12 17 Copyright © 2018 Pearson Education, Inc. 64) The MEND exam for a stroke does not include which assessment parameter? A) Mental status B) BGL assessment C) Cranial nerve function D) Motor and sensory function of the limbs

: B Diff: 2 Page Ref: 570

: 18-11 9) Which question would it be critical that the EMT ask the family of a patient who cannot speak and is suspected of having a stroke? A) "Does your mother have a history of heart problems?" B) "What time did the weakness and dizziness start?" C) "Which medications is your mother taking?" D) "Does your mother have any pain in her arms or legs?"

: B Diff: 2 Page Ref: 574

: 18-12 50) A male patient suddenly found himself unable to talk and with profound weakness to his right arm and leg. Currently he is responsive to verbal stimuli and has the following vital signs: pulse, 88; respirations 14 breaths/min and adequate; and blood pressure, 210/80 mmHg. When transporting this patient to the hospital, in which position should you place him? A) Immobilized to a long board B) Left lateral recumbent C) Prone with head elevated D) Supine with feet elevated

: B Diff: 2 Page Ref: 576

: 18-12 7 Copyright © 2018 Pearson Education, Inc. 24) A 73-year-old female patient is responsive to painful stimuli and cannot move her arm or leg on one side of her body. You suspect she is having a stroke. What is the best transport position for this patient? A) Supine with head elevated 30 degrees B) Left lateral recumbent position C) Supine with left arm and leg flexed D) Prone with left arm and leg flexed

: B Diff: 2 Page Ref: 576

: 18-2 62) On scene, a confused 68-year-old female patient with possible stroke has a SpO2 of 91% on room air. Regarding oxygen therapy and the adjunct by which to provide it, which of these represents the most desirable target SpO2 reading for the amount of oxygen delivered? A) SpO2 98% with 12 lpm O2 via nonrebreather mask B) SpO2 95% with 2 lpm O2 via nasal cannula C) SpO2 100% with 15 lpm O2 via nonrebreather mask D) SpO2 100% with 6 lpm O2 via nasal cannula

: B Diff: 2 Page Ref: 576

: 18-14 15 Copyright © 2018 Pearson Education, Inc. 57) A 30-year-old patient with a history of migraine headaches has called 911 for a suspected migraine headache. She says the headache follows her usual pattern of headaches, the pain is a 10/10, and she is nauseated. Her vital signs are pulse, 108; respirations, 18 breaths/min; and blood pressure, 154/90 mmHg. Which of these treatments is indicated in the care of this patient? A) 81 to 162 mg aspirin by mouth B) Providing a darkened environment during transport C) Emergent transport with lights and sirens D) Requesting orders for sublingual nitroglycerin

: B Diff: 2 Page Ref: 581

: 19-6 23) Which of these patients is most at risk for problems to the airway and breathing? A) A 32-year-old male who has stopped taking his seizure medications and experienced a 2- minute seizure B) A 23-year-old female with a history of seizures who has been seizing for 24 minutes C) An 11-year-old postictal boy with no history of seizures but with developmental delays D) A 76-year-old female who takes anticonvulsant medications and just began seizing

: B Diff: 2 Page Ref: 587

: 19-8 6 Copyright © 2018 Pearson Education, Inc. 20) The initial phase of a generalized seizure experienced by some patients, in which they may experience an odd smell or something auditory, is called the: A) Syncopal stage B) Aura C) Clonic phase D) Postictal state

: B Diff: 2 Page Ref: 588

: 18-9 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 19 Seizures and Syncope 1) You are summoned to a grocery store for a female patient found having a "fit" by store employees. Upon arrival, you are escorted to the side of an alert but mildly confused 41-year-old woman who is diaphoretic and appears exhausted. After 2-3 more minutes, she becomes more alert and informs you that she has a history of seizures and just had a generalized seizure. Despite your urging, she refuses transport to the hospital. Your safest action would be to: A) Transport the patient despite her refusal to consent B) Advise medical direction of the situation C) Contact law enforcement so your transport of the patient is legal D) Recognize a seizure history and have patient sign a refusal form

: B Diff: 2 Page Ref: 589

: 19-1 19) Friends of a male patient who experienced a generalized seizure while at a picnic are worried because he cannot remember the seizure. You should inform them that this is: A) A concern, because most people can remember the seizure B) A normal finding that is common among those who suffer this type of seizure C) An important piece of information that warrants immediate transport of the patient to the hospital D) Unrelated to the seizure and may indicate a more serious medical problem

: B Diff: 2 Page Ref: 591

: 19-4 13) When performing the secondary assessment on a confused patient who was reportedly unresponsive just prior to your arrival, which of these findings would be most suggestive of a seizure? A) Bruises to the arms B) Bleeding tongue C) Pinpoint pupils D) Warm skin

: B Diff: 2 Page Ref: 592

: 19-5 15 Copyright © 2018 Pearson Education, Inc. 56) You have been called for a 71-year-old male patient with seizure activity. When you reach the patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression-only CPR. In this situation, your immediate action would be to: A) Open the airway and begin positive pressure ventilation B) Ask the provider to stop CPR and feel for a carotid pulse C) Take over CPR and attach the automated external defibrillator D) Continue CPR and call for advanced life support assistance

: B Diff: 2 Page Ref: 592

: 19-2 29) Which of these patients should be categorized as the highest priority for transport? A) A child with a history of seizures whose mother calls EMS due to a fever of 102°F B) A pregnant female with no history of seizures who is seizing C) A postictal patient who has stopped taking his seizure medication D) An adolescent patient who states he recalls seizing earlier in the day

: B Diff: 2 Page Ref: 593

: 19-7 6) You find a patient, who seized for approximately 2 minutes, supine on the kitchen floor. He responds to painful stimuli and has snoring respirations. Emergency Medical Responders are holding manual in-line spinal stabilization, and they report the patient's heart rate is 124 beats/min and his pulse oximetry is 89% on room air. The patient has cool and clammy skin. What should you do first? A) Suction the airway B) Perform a jaw-thrust maneuver C) Provide supplemental oxygen D) Initiate positive pressure ventilation

: B Diff: 2 Page Ref: 593

: 19-7 48) A 20-year-old patient is unresponsive with snoring respirations. She is in a public restroom and has no family or friends with her. After addressing the airway, breathing, and circulation, you begin the secondary assessment. Which of these signs most likely indicates the patient experienced a seizure? A) Snoring respirations B) Urinary incontinence C) Altered mental status D) Constricted pupils

: B Diff: 2 Page Ref: 595

: 19-12 35) Which of these statements made by a patient would reinforce your suspicion of syncope? A) "I think that I may have had a seizure." B) "Once I hit the floor, I was out for only a few seconds." C) "I have had a low-grade fever for the past three days." D) "I was lying on the bed when I passed out."

: B Diff: 2 Page Ref: 598

: 1-5 6) You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical Responders (EMRs) are on scene. In your community, all EMS practitioners are trained according to the National EMS Scope of Practice Model. Given this, which type of care do you expect the EMRs to be providing? A) Emergency medication administration B) Automated external defibrillation C) Intravenous therapy D) Reading an electrocardiogram

: B Diff: 2 Page Ref: 6

: 19-11 41) Which sign or symptom would be most helpful in determining that a patient had a syncopal episode rather than a seizure? A) The extremities twitched, but only for a few moments B) There was no period of confusion after the event C) The patient never had a seizure before D) The patient complained of headache before the event

: B Diff: 2 Page Ref: 600

: 19-3 9 Copyright © 2018 Pearson Education, Inc. 32) Which of these statements made by a patient who experienced a syncopal episode should concern the EMT most? A) "I seemed to get very warm just before passing out." B) "My chest felt really funny right before I passed out." C) "I remember feeling faint right before I passed out." D) "The doctor told me to get out of bed slowly, but I didn't."

: B Diff: 2 Page Ref: 600

: 20-1 13 Copyright © 2018 Pearson Education, Inc. 49) Which of these patients has a normal fasting glucose level? A) A 53-year-old female who is alert and oriented with a glucose level of 117 mg/dL B) A 37-year-old female who is weak and dizzy with a glucose level of 81 mg/dL C) A 67-year-old male with no complaints and a glucose level of 127 mg/dL D) A 12-year-old male with a blood glucose level of 38 mg/dL

: B Diff: 2 Page Ref: 608

: 20-8 28) Prior to the administration of oral glucose, a patient's blood glucose level was 49 mg/dL. After administering the oral glucose, the patient is alert and oriented. Which repeat blood glucose levels would the EMT expect with this clinical presentation? A) "Low" B) 155 mg/dL C) 30 mg/dL D) "High"

: B Diff: 2 Page Ref: 608

: 20-4 11 Copyright © 2018 Pearson Education, Inc. 41) You know an EMT is correctly using a glucometer when she performs which procedural step? A) Avoids cleaning the finger with alcohol prior to pricking it with a lancet B) Wastes the first drop of blood obtained from the patient's finger C) Asks the patient to hold his hand above his head prior to pricking a finger for blood D) Uses a lancet to prick an artery or vein for the blood sample

: B Diff: 2 Page Ref: 609, Table 20-1

: 20-6 12 Copyright © 2018 Pearson Education, Inc. 45) To which of these patients would the EMT elect to administer oral glucose? A) An alert and oriented 32-year-old female with a blood sugar of 52 mg/dL and no history of diabetes B) A confused 44-year-old male with a history of diabetes who is able to swallow C) An unresponsive 24-year-old male with a blood sugar of 24 mg/dL and a history of diabetes D) A confused male patient with a blood sugar reading of 96 mg/dL and a history of diabetes

: B Diff: 2 Page Ref: 612

: 20-11 22) You are transporting a patient with diabetes who has low blood sugar. En route, you receive orders to administer oral glucose. Which piece of emergency equipment is most important to have readily available during this procedure? A) Nasopharyngeal airway B) Suction device C) Oropharyngeal airway D) Automated external defibrillator

: B Diff: 2 Page Ref: 613

: 20-11 24) A patient with diabetes is alert but confused. You have decided to administer oral glucose. Which of these descriptions indicates the proper way to administer the glucose? A) Squeeze the glucose under the patient's tongue B) Place the glucose between the patient's cheek and gum C) Use a tongue depressor to place the glucose on the back of the tongue D) Have the patient slowly swallow the glucose

: B Diff: 2 Page Ref: 613

: 20-8 23) Five minutes after administering oral glucose to a confused patient with diabetes, you do not see any improvement in her mental status. Which action should you take? A) Administer a second dose of oral glucose B) Continue to monitor the patient C) Recheck the expiration date on the oral glucose D) Contact medical direction for further orders

: B Diff: 2 Page Ref: 613

: 20-8 8 Copyright © 2018 Pearson Education, Inc. 29) When administering oral glucose to a patient with diabetes, the EMT must take precautions to prevent which adverse effect? A) High blood glucose level B) Airway obstruction C) Low blood glucose level D) Increased blood pressure

: B Diff: 2 Page Ref: 613, Figure 20-6

: 20-7 34) A patient with diabetes presents as alert but irritable and confused. His airway is patent with an intact gag reflex and breathing is adequate. You do not have a glucometer available and are not sure if his blood sugar is high or low. In this situation, what would be your next best action? A) Insert a nasal airway B) Administer oral glucose C) Have the family members administer his insulin D) Provide emergency transport

: B Diff: 2 Page Ref: 617

: 20-3 7) Your partner reports that he has found some small areas of bruising to the abdomen of a patient who takes insulin. He is puzzled by the finding. Which response would be most appropriate? A) "The patient must have been involved recently in a car crash or suffered some other sort of trauma." B) "There could be several reasons for the bruising, but insulin injections are often administered to the abdomen." C) "That is a concerning finding. Since patients with diabetes are prone to GI bleeds, we should treat her as having one." D) "Why don't we contact the patient's primary care physician and see if there are additional medical issues we are not aware of?"

: B Diff: 2 Page Ref: 622

: 20-9 19) You have been called to a residence for a patient with altered mental status. On arrival, a neighbor informs you that he saw the patient washing windows several minutes earlier and then suddenly saw him lying on the ground. He also mentions that the patient has diabetes and has been in and out of the hospital lately because his blood sugar has been dropping suddenly. Your scene size-up reveals the patient to be lying next to a ladder propped up to the second-story window. Water from a bucket is spilled on the side of the house and yard. The patient is supine and unresponsive. What should be your next most immediate action? A) Insert a nasopharyngeal airway B) Take manual spine motion restriction precautions C) Check the glucose level and administer oral glucose if needed D) Open the airway with the jaw-thrust maneuver

: B Diff: 2 Page Ref: 625, Figure 20-13

: 21-8 3 Copyright © 2018 Pearson Education, Inc. 8) A 23-year-old male patient has called EMS for swollen lips and hives. Upon entering the scene, which of these observations would make the EMT suspicious that the patient is having an allergic reaction? A) A glucometer on a table in the living room B) A new container of penicillin on a table with two pills missing C) Other family members complaining of similar symptoms D) A bottle of expired nitroglycerin on the kitchen counter

: B Diff: 2 Page Ref: 633

: 21-2 44) You are providing bag-valve-mask ventilations to a patient in anaphylactic shock. There is increasing resistance to ventilation, despite your use of proper ventilation technique. What is the best way to address this situation? A) Stop ventilations and administer an albuterol metered-dose inhaler B) Occlude the pop-off valve on the bag-valve mask and continue ventilations C) Increase both the ventilatory rate and the force of ventilation D) Turn the patient to her side and apply manual pressure over the epigastrium

: B Diff: 2 Page Ref: 634

: 21-8 13 Copyright © 2018 Pearson Education, Inc. 45) You have been called to a kindergarten class for a 5-year-old boy who is allergic to peanuts. He ate some peanuts in the form of a birthday treat brought to school by a classmate who is celebrating a birthday. From the door of the classroom, you note the patient to have swollen lips and hives to his face and arms. The patient also looks unresponsive. As you begin the primary assessment, what should be a priority action? A) Contact the patient's parents for permission to treat him B) Inspect the inside of the patient's mouth and assure an open airway C) Determine how many peanuts the patient ingested D) Check breath sounds for wheezing and assess the vital signs

: B Diff: 2 Page Ref: 634

: 21-8 13) A young female patient, who is allergic to peanuts, was just exposed to peanut butter in a sandwich at a church picnic. Assessment reveals her to be alert and oriented, with swollen lips and hives on her face. She is breathing adequately at a rate of 18 breaths/min and has a heart rate of 82 beats/min. Your partner advises you that her blood pressure is 118/72 mmHg and room-air SpO2 is 92%. The patient states that she also has asthma, for which she uses an inhaler. What should you do first? A) Assist the patient with her inhaler B) Provide supplemental oxygen C) Start positive pressure ventilation D) Determine the amount of peanut butter consumed

: B Diff: 2 Page Ref: 634

: 21-9 24) After assisting a patient with the use of an epinephrine auto-injector, you note that the patient's blood pressure has improved. As a knowledgeable EMT, you realize that this effect occurred due to epinephrine's ability to: A) Relax the smooth muscle of the blood vessels B) Constrict blood vessels C) Increase the number of circulating red blood cells D) Increase the oxygen-carrying capacity of the red blood cells

: B Diff: 2 Page Ref: 640

: 21-9 11 Copyright © 2018 Pearson Education, Inc. 37) You have been called for a male patient experiencing a severe allergic reaction. The patient is very confused and having great difficulty breathing. He has an epinephrine auto-injector, but your service does not have protocols related to its use. Fortunately, in your EMT class, you learned about and passed a test on the use of an epinephrine auto-injector for allergic reactions. In this case, you should: A) Assist the patient with his epinephrine auto-injector and then contact medical control B) Provide oxygen and respiratory support as needed, followed by immediate transport C) Assist the patient with his epinephrine using implied consent as justification D) Contact the physician prescribing the medication for permission to use the auto-injector

: B Diff: 2 Page Ref: 643, Figure 21-6

: 21-9 36) Prior to assisting a patient with his epinephrine auto-injector, the EMT must ensure that: A) The patient is improving B) On-line or off-line medical direction for epinephrine administration exists C) The medication is yellow in color D) The patient's heart rate and blood pressure are stable

: B Diff: 2 Page Ref: 643, Figure 21-6

: 22-4 11) Which of these statements regarding antidotes is correct? A) There are many antidotes for a large number of poisons and toxic substances B) An antidote will neutralize or counteract the effects of a poison or toxic substance C) Antidotes are beneficial because they will remove the poison from the body D) An antidote can only be given in the emergency department by the physician or nurse

: B Diff: 2 Page Ref: 653

: 22-5 14) A confused and lethargic patient reports that she took a large number of antianxiety pills because she was angry with her husband. Her airway is patent and her breathing adequate. Her pulse is normal and her skin is warm and dry. During the reassessment, the patient reports that she is now dizzy and feels extremely nauseated. The EMT would immediately: A) Perform a jaw-thrust maneuver B) Place the patient in a lateral recumbent position C) Prepare the suction device D) Check the patient's vital signs

: B Diff: 2 Page Ref: 654

: 22-5 6 Copyright © 2018 Pearson Education, Inc. 19) You have been summoned to a residence for a child who ingested a liquid pesticide. On scene, the worried parents inform you that their 4-year-old son and some friends were playing in the garage and apparently found some pesticide, which their son says he tasted. Assessment indicates that he is alert, oriented, and crying and has some white powder around his mouth. After performing the initial assessment and finding no life-threatening conditions, it is imperative that the EMT make which question or statement: A) "Do you think this was an intentional act?" B) "I need to see the other children." C) "Are all of his shots up-to-date?" D) "These chemicals need to be put out of reach."

: B Diff: 2 Page Ref: 654

: 22-5 22) After determining that a patient intentionally overdosed on blood pressure medications, which of these questions would be most appropriate? A) "Why did you take so many pills?" B) "How many pills did you take?" C) "Were you confused about the proper dose?" D) "Are you on other medications?"

: B Diff: 2 Page Ref: 654-655

: 22-11 83) You have been called to a residence for a cognitively challenged 32-year-old female patient who drank from a bottle of floor cleaner. She is unconscious, exhibits snoring respirations, and is having a difficult time breathing due to swelling from burns in her mouth. Which of these steps should be included in the initial care for this patient? A) Contact poison control B) Insert a nasal airway C) Suction the airway D) Apply high-flow oxygen via nonrebreather

: B Diff: 2 Page Ref: 655

: 22-20 106) You are a new EMT in a very busy urban EMS system. Before joining this agency, you worked as a volunteer in a rural EMS system, where you did not experience many EMS calls. You are working with a seasoned EMT when you are requested to respond to a residential home for an unresponsive 13-year-old male patient. Upon your arrival, the family escorts you into the garage, where the boy is being cradled by his crying mother. The boy is unresponsive. As you draw nearer to the boy, your partner says to you, "Hey, you smell that moth ball smell? I know what might be going on." Given your partner's statement, how might the odor be related to the patient's condition? A) Chloral hydrate overdose B) Camphor overdose C) Organophosphate overdose D) Acetone overdose

: B Diff: 2 Page Ref: 655, Table 22-1

: 22-5 25) Which set of instructions given to another EMT would be most appropriate when managing a patient who ingested numerous household cleaners in an attempt to kill himself? A) "I need you to write down all of the cleaners he may have taken so we can let the hospital know." B) "Let's gather up all of the containers of the chemicals he may have taken and take them with us." C) "We need to pour a sample of each cleaner that he may have taken into containers and take the samples with us." D) "Before we leave, please call the hospital and tell them what he took so that they will know."

: B Diff: 2 Page Ref: 656

: 22-7 9 Copyright © 2018 Pearson Education, Inc. 30) Medical direction has ordered the administration of activated charcoal to a 3-year-old boy. Which of these doses would be most appropriate? A) 100 mg B) 1 gram/kg C) 50 grams D) 0.5 mg/kg

: B Diff: 2 Page Ref: 657, Figure 22-3

: 22-8 42) A patient working at an ice plant is trapped in a room filled with sulfur dioxide. You don a self-contained breathing apparatus and enter the room, finding the patient unresponsive on the floor. The room remains filled with the gas. Your immediate priority in caring for this patient is to: A) Assess the airway, breathing, and circulation B) Remove the patient from the immediate environment C) Start positive pressure ventilation D) Loosen all tight-fitting clothing

: B Diff: 2 Page Ref: 658-659

: 22-4 40) Firefighters have pulled a 62-year-old male patient from a bedroom that was on fire. According to the firefighters, the patient was smoking in bed and fell asleep. They found him supine on the floor. Assessment reveals him to be responsive to painful stimuli, with soot in his airway. He is breathing rapidly, but has no evidence of burns to his body. His pulse is 124 beats/min, respirations are 24 breaths/min, blood pressure is 146/90 mmHg, and SpO2 is 95%. After providing the appropriate care, which of these questions would be the most important to ask the firefighters prior to transport? A) "How did the fire start?" B) "How long was the patient trapped in the room?" C) "Which materials were burning in the room?" D) "How fast was the patient breathing when you found him?"

: B Diff: 2 Page Ref: 659

: 4-2 11 Copyright © 2018 Pearson Education, Inc. 38) The medical director states that it seems as if the number of patients suffering from shortness of breath with a history of congestive heart failure (CHF) has increased. She adds that she is thinking about modifying the protocols, but first must know the number of patients seen with this condition over the past year. To best determine the number of patients treated for this condition, you would: A) Question the emergency department physicians and nurses B) Review the previous prehospital care reports C) Have employees complete a form anytime they treat a patient with CHF D) Have all employees complete a survey regarding the increase

: B Diff: 2 Page Ref: 66

: 4-8 21) Which statement regarding a PCR is accurate? A) "The PCR is a public record that becomes part of the patient's permanent medical record." B) "Aside from providing a record of the care given, the PCR also may be used for education and research." C) "National standards allow the EMT to complete the PCR up to three days after the call as long as a verbal report was given to the physician." D) "The EMT should document only the direct care he or she provided, but not the care by EMRs since their report will reflect this care."

: B Diff: 2 Page Ref: 66

: 4-8 6 Copyright © 2018 Pearson Education, Inc. 20) You have transported a confused 46-year-old male who overdosed on an unknown drug to a busy emergency department. After giving an oral report to the ED nurse, your partner informs you that he wants to hurry back to the station so that he can watch the end of the football game; therefore, he is going to complete the patient care report (PCR) at a later time. How should you respond? A) "Make sure that you give the nurse the telephone number to the station so she can call if there are any questions about the patient or our care." B) "If you do not complete and leave the PCR, the ED staff may not otherwise have access to information contained in the PCR." C) "You really need to complete it before we leave. The hospital will not be able to get the patient's insurance information without the PCR." D) "If you do not leave the PCR, the emergency department staff will not know how to treat the patient."

: B Diff: 2 Page Ref: 66

: 22-9 108) Which of these actions should you and your partner take when you arrive on the scene at a large factory where an unresponsive patient was subjected to a powdered chemical that contacted large portions of his unprotected skin? A) Do not enter the scene until all buildings that make up the factory complex have been evacuated B) Ensure that you are properly protected with gloves and protective gear to prevent the powder from contacting your skin C) Wrap the patient up in a large sheet of plastic to minimize the risk of the powder contaminating other surfaces D) Allow your partner to enter the scene while you remain behind so as to offer "buddy-rescue" should he become overwhelmed by the toxic powder

: B Diff: 2 Page Ref: 662

: 22-8 85) You are caring for a patient who intentionally drank a compound containing a high percentage of methanol. He is confused and lethargic, but has no obvious deficits to his airway, breathing, or circulation. En route to the hospital, the patient states that he is very nauseated and thinks that he is going to vomit. Your immediate action would be to: A) Check the patient's breath sounds B) Turn the patient on his side C) Assess the patient's abdomen D) Prepare the suction

: B Diff: 2 Page Ref: 669-670

: 22-19 101) After a 911 call hang-up, you are dispatched to the caller's residence. When you enter the room with a police escort, you find an unresponsive female patient with a bag over her head. A person in the neighboring apartment tells you that the patient has depression and warned that "there is going to be a death today." Your immediate action would be to: A) Remove the bag and assess for airway occlusion B) Leave the room until it is cleared by the fire department C) Move the patient out to the ambulance before initiating care D) Provide manual spine motion restriction precautions

: B Diff: 2 Page Ref: 672

: 22-14 52) A 49-year-old patient with alcoholism has fallen down a flight of stairs after consuming twofifths of whiskey. He presents with confused and slurred speech and the smell of alcohol on his breath. Family states that he is "hopeless" and has been drinking more and more every night. They also say that he must be more drunk than usual because he usually does not slur his speech. Assessment reveals his airway to be open, breathing adequate, and circulation intact. He has a hematoma from the fall to the left side of his head and complains of pain to his left wrist. Given these assessment findings, the EMT would be most concerned about the: A) Amount of alcohol consumed B) Possible brain injury C) Possible wrist fracture D) Lack of family support

: B Diff: 2 Page Ref: 675

: 22-14 65) Which of these patients would the EMT recognize as a drug abuser? A) A 41-year-old male who tried marijuana for the first time B) A 39-year-old female who takes pain medications even though she is not in pain C) A 46-year-old female who used cocaine for 10 years but has not used it in 5 years D) A 56-year-old male who accidentally took an additional dose of blood pressure medication

: B Diff: 2 Page Ref: 684

: 22-16 19 Copyright © 2018 Pearson Education, Inc. 63) You have been called for a patient with alcoholism who is experiencing a medical emergency. On scene, a home health nurse informs you that the patient is experiencing delirium tremens. As an EMT, you recognize that: A) The patient is extremely intoxicated and in danger of dying B) This is a life-threatening condition requiring rapid transport C) The patient is in the early stages of alcohol withdrawal D) The patient will require the administration of glucose

: B Diff: 2 Page Ref: 684

: 22-18 57) You are assessing a young male patient who was found in an alley by sanitation workers. Assessment reveals the patient responds to painful stimuli by opening his eyes, but then closes them once you stop pinching the muscles on his neck. His airway is open and his breathing is shallow. His skin is cool and diaphoretic, and his pupils are constricted and do not react to light. Based on these assessment findings, the EMT would be suspicious of: A) Stroke or hypoglycemia B) Narcotic overdose C) Traumatic assault D) Methamphetamine overdose

: B Diff: 2 Page Ref: 685-686

: 22-14 17 Copyright © 2018 Pearson Education, Inc. 56) You are responding to a drug-related emergency. While you are en route to the scene, the dispatcher informs you that the patient has overdosed on an unspecified narcotic. Which of these statements made by your partner indicates an understanding of overdoses with narcotic drugs? A) "We will have to be careful because narcotic overdoses can cause hallucinations, and the patient may be violent." B) "When performing the primary assessment, we need to be alert for respiratory depression and have the naloxone ready." C) "If the patient is conscious, we will have to ask about chest pain since narcotics can increase the heart's workload." D) "We need to look at the pupils. If they are constricted, the patient has most likely taken a narcotic and we will have to administer naloxone intravenously."

: B Diff: 2 Page Ref: 686

: 22-13 97) You have been summoned to an apartment complex for an unknown medical call. At the scene, the police meet you and inform you that the 24-year-old male patient smoked some "bath salts" and is acting erratically. As an EMT, you recognize that bath salts are: A) Drugs that depress the central nervous system B) Drugs that increase circulating norepinephrine C) Drugs made synthetically from bath and shower cleaners D) Drugs that sedate and slow the respiratory drive when taken in excess

: B Diff: 2 Page Ref: 688

: 22-18 105) You are dispatched on a call to a "rave" for a possible ecstasy overdose. Law enforcement is already at the scene and has established scene safety so you can enter. Which kind of signs and symptoms would you expect to find with this type of overdose? A) Signs and symptoms related to CNS depression B) Signs and symptoms related to brain injury or damage C) Signs and symptoms related to hypothermia D) Signs and symptoms related to digestive disorders

: B Diff: 2 Page Ref: 689

: 22-4 28 Copyright © 2018 Pearson Education, Inc. 96) The Poison Control Center has advised you to administer milk to a patient who has overdosed on a medication. Given this information, you would: A) Administer the milk as ordered B) Contact medical command to confirm this treatment C) Transport the patient immediately instead and arrange for ALS intercept D) Contact ALS backup and wait on scene until they arrive

: B Diff: 2 Page Ref: 694

: 23-2 3 Copyright © 2018 Pearson Education, Inc. 9) A female patient has developed bacterial peritonitis after sustaining blunt trauma to the abdomen. Damage to which organ was most likely responsible for this condition? A) Spleen B) Small intestine C) Liver D) Ovary

: B Diff: 2 Page Ref: 698

: 3-19 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 4 Documentation 1) What would be considered an objective patient assessment finding? A) Complaint of nausea B) Blood pressure 114/68 mmHg C) Patient rates pain as 10 out of 10 D) Complaint of headache for past 12 hours

: B Diff: 2 Page Ref: 70

: 23-4 2 Copyright © 2018 Pearson Education, Inc. 5) A patient informs you that he previously had a section of his small intestine removed due to cancer. You recognize that with the removal of small intestine, the patient is less able to: A) Digest food B) Absorb nutrients C) Secrete insulin D) Break down fats

: B Diff: 2 Page Ref: 700, Table 23-2

: 23-3 12 Copyright © 2018 Pearson Education, Inc. 43) You have been dispatched for a patient with severe abdominal pain. On scene, the 57-yearold male patient informs you that he has a past medical history of chronic pancreatitis, which has "flared up again." Which precipitating factor would you identify as the most likely cause of the exacerbation? A) Recent upper respiratory infection B) Consumption of six beers this afternoon at a picnic C) Dehydration after working outside for several hours D) Use of antibiotic medication for a respiratory infection

: B Diff: 2 Page Ref: 702

: 23-3 48) You have been dispatched for a male patient who is "sick." While you are en route, Emergency Medical Responders inform you via radio that the patient has esophageal varices, which appear to have ruptured. You would inform your partner to prepare which materials or piece of equipment? A) Automated external defibrillator B) Suction machine C) Trauma dressings D) Long spinal board

: B Diff: 2 Page Ref: 703

: 23-6 8 Copyright © 2018 Pearson Education, Inc. 30) Which of these assessment findings for a patient complaining of abdominal and back pain would raise the most concern in the EMT? A) Surgical scar in the right upper quadrant B) Pulsating mass above the umbilicus C) History of gallbladder disease D) Increased bowel sounds associated with diarrhea

: B Diff: 2 Page Ref: 706

: 23-13 106) The EMT would recognize a hematologic condition in which of these patients? A) A patient with a large hematoma to the scalp after falling B) A patient with an elevated white blood cell count due to leukemia C) A patient with antibodies in her bloodstream capable of casing anaphylaxis D) A patient with pneumonia who is profoundly hypoxic

: B Diff: 2 Page Ref: 710

: 23-6 29) When an EMT inspects the abdomen of a patient with pain to his right upper quadrant, it appears large and possibly distended. To determine if the abdomen is indeed distended, the EMT would ask: A) "Do you feel sick to your stomach at this time, as if you are going to vomit?" B) "Does your belly normally seem to be this size?" C) "Have you been doing any abdominal exercises or heavy lifting recently?" D) "Did you eat spicy food last night, or food containing a lot of sodium?"

: B Diff: 2 Page Ref: 710

: 23-7 23 Copyright © 2018 Pearson Education, Inc. 88) A severely distressed patient has bright red rectal bleeding and in lethargic. His pulse is 136, respirations are 24 breaths/min, blood pressure is 72/58 mmHg, and SpO2 is 95%. His skin is moist, pale, and clammy, and his mental status is deteriorating. At this time, your priority intervention would be to: A) Apply pressure over the rectum with sterile dressings to control bleeding B) Apply supplemental oxygen C) Apply the AED, but do not turn it on yet D) Transfer the patient to the stretcher for immediate transport

: B Diff: 2 Page Ref: 710

: 23-7 110) You have been called for a patient with a sickle cell crisis. In reviewing the pathophysiology of sickle cell anemia, you understand that the underlying problem is: A) Blood that is thick and cool, and has difficulty circulating B) Abnormal hemoglobin formation that means the blood cannot carry oxygen as efficiently C) An abnormally elevated number of white blood cells, which causes microemboli in the capillary beds D) A decreased amount of circulating RBCs that do not release O2

: B Diff: 2 Page Ref: 713

: 23-7 114) Hemophilia is a blood disorder in which the: A) Platelets are unable to transport oxygen B) Blood is unable to form clots properly C) Red blood cells are malformed and do not form clots D) Blood is thin and bleeding is difficult to control

: B Diff: 2 Page Ref: 713

: 23-10 16 Copyright © 2018 Pearson Education, Inc. 59) A patient who has just been raped states that she will not go with you to the hospital until she showers and cleans herself up. As an EMT, what is your best response? A) "You may shower, but you must then go with us to the emergency department." B) "If you shower, you will destroy evidence needed to help identify the rapist." C) "Instead of showering, I will clean the wounds with sterile water on the way to the hospital." D) "Showering will only delay the care that you can get at the hospital, including medications for pain."

: B Diff: 2 Page Ref: 715

: 23-1 62) You are treating a woman who has heavy vaginal bleeding. When estimating the blood loss, which information will be most useful to the EMT? A) Length of time the patient has been bleeding B) Total number of sanitary napkins used C) If associated with abdominal pain the bleeding is considered heavy D) Examination of the present color and rate of bleeding

: B Diff: 2 Page Ref: 718

: 23-10 25 Copyright © 2018 Pearson Education, Inc. 96) A 21-year-old female patient has called EMS for severe right-sided abdominal pain. Which of these questions should be asked before the others? A) "Have you had a kidney stone before?" B) "When was your last normal period?" C) "Does the pain radiate into your back?" D) "Have you had any vaginal bleeding in the past?"

: B Diff: 2 Page Ref: 718

: 23-6 97) The EMT would recognize the profession of urology as applying to: A) All organs in the pelvic cavity B) The kidneys, ureters, bladder, and urethra C) A female's urinary and reproductive organs D) The urinary organs as well as the penis and vagina

: B Diff: 2 Page Ref: 719

: 23-2 2) If a patient has a retroperitoneal infection, which organ is most likely involved? A) Bladder B) Kidney C) Gallbladder D) Small intestine

: B Diff: 2 Page Ref: 720

: 23-12 18 Copyright © 2018 Pearson Education, Inc. 68) A patient with a history of frequent urinary tract infections (UTI) complains of lower abdominal pain and feels as though she has a UTI again. Which assessment findings would cause you to question that the problem is a UTI? A) Temperature of 101.3°F B) Vaginal bleeding C) Flank pain D) Cloudy urine

: B Diff: 2 Page Ref: 721

: 23-6 74) On scene, a 57-year-old female patient has profuse hemorrhage coming from the dialysis graft located on her left arm. To control the bleeding, you would immediately: A) Place a tourniquet over the graft B) Apply direct pressure to the graft C) Place a tourniquet above the graft D) Avoid contact with the graft and transport the patient

: B Diff: 2 Page Ref: 722

: 23-14 27 Copyright © 2018 Pearson Education, Inc. 105) You have been called to a local dialysis center for a patient with a bleeding fistula on her right upper arm. Despite all care at the center, the site continues to bleed. Your best choice in the initial care of the patient would be: A) To apply a constricting band above the fistula B) To place a pressure dressing over the fistula C) Lowering the patient's arm during transport D) To allow site the bleed to wash bacteria from the fistula

: B Diff: 2 Page Ref: 722-723

: 4-3 24) Your partner states that he is the "world's worst speller" and has great difficulty using medical terms. How would you respond to this statement? A) "Ask the emergency physician or nurse how to spell the words of which you are unsure." B) "Use everyday language if you are unsure of how to apply or spell a medical term." C) "Consider abbreviating medical terms that you are unsure how to spell." D) "Do not document information that requires medical terms you are unsure of."

: B Diff: 2 Page Ref: 75

: 4-9 15) An alert and oriented male patient with chest discomfort refuses treatment and transport to the hospital. He is angry with his family for calling 911 and refuses to sign the refusal of care form despite several requests. Which of these is your next best action? A) Contact the police to place the patient into protective custody B) Have a family member sign as a witness to the father's refusal C) Call dispatch on a recorded telephone line and notify the dispatcher of the situation prior to departing the scene D) Carefully restrain the patient and place him on the stretcher for transport

: B Diff: 2 Page Ref: 75-76

: 4-9 5 Copyright © 2018 Pearson Education, Inc. 17) When getting a refusal from a patient who does not want the services of EMS providers, it is critical for the EMT to complete which step? A) Make sure that the patient is younger than 65 years B) Have the patient sign and date the refusal form C) Make sure that the hospital is notified D) Make sure the patient has another way to get to the hospital

: B Diff: 2 Page Ref: 76

: 4-3 4 Copyright © 2018 Pearson Education, Inc. 13) Two days after a call, you realize that you forgot to document that you checked a patient's blood glucose prior to him refusing transport and signing the refusal form. At that time, you did contact medical direction and provide this information to the doctor, prior to him authorizing the patient to refuse. What is now your best course of action? A) Complete a new refusal form and return to the patient's residence to have him sign this form B) Add an addendum to the report with the correct information, the current date, and the EMT's initials C) Report the error to the State Department of Emergency Medical Services D) Disregard the mistake since the patient was not transported to the hospital and medical direction was aware of the blood glucose reading

: B Diff: 2 Page Ref: 77

: 5-15 18) While you are returning from lunch, a frantic woman flags you down and states that she just found a young child on the roadside who appears to have been hit by a car. She is not sure if the child is breathing. You should immediately: A) Grab equipment and get to the child's location B) Advise dispatch that you have been flagged down for a possible emergency, and identify your location C) Call for paramedic assistance and await that unit's arrival D) Inform the woman that she will need to call 911 first

: B Diff: 2 Page Ref: 89

: 5-7 7) Which statement is most appropriate to relay after establishing radio contact with the destination emergency department to which you are transporting a patient? A) "Inbound with a 52-year-old suffering from a myocardial infarction." B) "En route to your facility with a 73-year-old male complaining of dizziness." C) "Five minutes out with Mr. John Panzer, who called us today for high blood pressure." D) "En route with a drug addict who has overdosed on an unspecified amount of heroin."

: B Diff: 2 Page Ref: 91

: 5-11 48) As your ninth emergency call during a 12-hour shift, you are summoned to a dance club at 0215 hours for a "drunk person." While on scene, your partner stands with arms crossed, looking down at the floor, and shaking her head negatively as you try to gather the SAMPLE history. Her nonverbal behavior may be interpreted by the patient or bystanders as: A) Fear B) Anger C) Acceptance D) Sincerity

: B Diff: 2 Page Ref: 92

: 5-1 34) A 31-year-old female with a history of depression took some pills in a suicide attempt. Her husband is visibly upset and her three young children are crying as you place her into the ambulance. The patient is conscious and stable as you transport her to the hospital. During the transport, she tearfully states she did not mean to take the pills and asks if she is going to die. In regard to therapeutic communication, what would be your best response? A) "You are going to be fine, don't worry." B) "You are stable right now and we are transporting you for continued care so you can get better." C) "If you do not want to die, why did you take the pills?" D) "I think that you have a loving family and you need to be more considerate of them."

: B Diff: 2 Page Ref: 97

: 5-8 5 Copyright © 2018 Pearson Education, Inc. 17) You pull up to the scene of a one-car motor vehicle collision and find an off-duty emergency department physician from a local hospital treating the patient. What is the best way to initially communicate with the doctor? A) "Thank you, doctor, you can go now; we will take over." B) "Hello, doctor. We are EMTs. How can we help?" C) "We will be in the ambulance if you need us." D) "The law requires you to let us handle the situation."

: B Diff: 2 Page Ref: 97

: 5-12 10) You have been called for a 23-year-old male who is completely deaf. To best communicate with this patient, you should: A) Stand in front of the patient and speak loudly B) Write questions on a note pad C) Use gestures when asking questions D) Have the emergency department get the needed information

: B Diff: 2 Page Ref: 99

: 4-7 25) You are reviewing a prehospital care report (PCR) and note the following entry: "Pt. took PCN TID PO for 5 days." You would interpret this as the patient took: A) Penicillin injections for five days in a row, three injections a day B) Penicillin was taken orally three times a day for five days straight C) Three penicillin pills were taken every other day for five days D) Antibiotic injections three times a day for five days

: B Diff: 2 Page Ref: Table 4-1 Abbreviations

: 4-7 9 Copyright © 2018 Pearson Education, Inc. 31) Your protocol reads: "O2 via NC prn if symptomatic for CP / SOB and SpO2 < 94%." To follow this order, you should do perform which action? A) Call medical direction to administer oxygen if the pulse oximeter reading is greater than 94% B) Consider oxygen for a patient complaining of chest pain if the SpO2 is 92% C) Administer oxygen via face mask if the patient denies a complaint and has a pulse oximeter reading of 98% D) Administer oxygen through a nasal cannula at 3 liters per minute if the pulse oximeter reads 94%

: B Diff: 2 Page Ref: Table 4-2 Abbreviations

: 6-9 16) A small car and a tanker truck loaded with gasoline have collided. The car is lodged under the tanker, the car engine is smoking, and the threat of fire is significant. After being waved in by the fire department, assessment reveals the patient to be unresponsive with a patent airway, but breathing with difficulty at 8 times per minute. In caring for this patient, your immediate action should be to: A) Promptly open the airway and suction prior to moving the patient B) Rapidly extricate the patient and provide care away from the wreckage C) Quickly obtain vital signs and then extricate the patient from the car D) Immediately start positive pressure ventilation and place a vest immobilization device for extrication

: B Diff: 3 Page Ref: 108

: 6-12 7 Copyright © 2018 Pearson Education, Inc. 26) Which position would be most appropriate for an alert and oriented patient complaining of shortness of breath? A) Prone B) Supine with the head elevated C) Supine with the feet elevated D) Left lateral recumbent position

: B Diff: 3 Page Ref: 116

: 7-16 47) A patient has experienced a stroke that has permanently injured his brainstem. Which sign or symptom might the EMT expect to find as a result of this condition? A) Confusion B) Abnormal respirations C) Blindness D) Muscle spasms

: B Diff: 3 Page Ref: 157

: 7-14 51) A patient has taken a medication that increases the activity of his sympathetic nervous system. Given this treatment, which sign or symptom would the EMT expect to find? A) Decreased heart rate B) Dilated pupils C) Low blood pressure D) Dry and flushed skin

: B Diff: 3 Page Ref: 160, Figure 7-35

: 8-9 7) What happens after a cell in anaerobic metabolism breaks down glucose and creates energy in the form of adenosine triphosphate (ATP)? A) Oxygen and water are created B) Lactic acid is formed C) Carbon dioxide and water are formed D) Electrolytes in the cell become balanced

: B Diff: 3 Page Ref: 179

: 8-20 12) What is required for normal perfusion to occur? A) Airway patency, proper amounts of carbon dioxide, and adequate glucose levels B) Adequate breathing, sufficient numbers of red blood cells, and sufficient heart function C) Intact breathing, an ample number of red blood cells, and body temperature of 98.6°F D) Patent airway, sufficient breathing, high amounts of glucose, and good heart function

: B Diff: 3 Page Ref: 180

: 8-7 21) Assessment of a hypoxic patient who is showing signs of fatigue and has a history of lung disease reveals him to be using well-developed accessory muscles to exhale. As an EMT, you should recognize that the patient: A) Is inadequately exhaling oxygen from his lungs, which is causing hypoxia B) Is using energy to exhale and is in danger of respiratory failure if hypoxia continues C) Has a problem with the red blood cells' ability to transport oxygen, which is causing hypoxia D) Is adequately compensating for the problem with his breathing so he does not become hypoxic

: B Diff: 3 Page Ref: 185

: 8-11 69) A patient has been shot three times in the abdomen and has massive internal hemorrhage and blood loss. Which treatment will give this patient the best chance at survival? A) High-concentration oxygen B) Stopping the bleeding C) Positive pressure ventilation D) Paramedic intervention for pain management

: B Diff: 3 Page Ref: 191

: 8-19 63) A patient with cancer is receiving chemotherapy. As a side effect of the treatment, her white blood cell count is critically low. Given this situation, which sign or symptom should the EMT find particularly concerning? A) History of diabetes B) Oral temperature of 102.7°F C) Complaint of weakness D) Blood pressure of 102/64 mmHg

: B Diff: 3 Page Ref: 193

: 8-18 73) A 35-year-old male patient is lethargic and dehydrated after working at a construction site for 12 hours on a very hot day. You obtain the following vital signs: pulse, 136; respirations, 22 breaths/min; blood pressure, 102/88 mmHg; and SpO2, 100% with supplemental oxygen. As a knowledgeable EMT, you would recognize: A) Widened pulse pressure to circulate more blood B) Elevated heart rate to increase cardiac output C) Rapid respirations to decrease CO2 loss D) Low blood pressure to conserve the body's energy

: B Diff: 3 Page Ref: 200

: 8-8 79) Why would a drop in the oxygen content of the blood stream cause an increase in the patient's blood pressure? A) Parasympathetic stimulation of the pulmonary system improves oxygen on-loading to the red blood cells passing through the alveoli B) Sympathetic stimulation of the cardiovascular system improves oxygen delivery to the brain and tissues C) Vasoconstriction caused by the parasympathetic nervous system causes oxygenated blood to be shunted from the peripheral capillary beds and to the brain D) Vasodilation will allow more blood flow to reach the lungs, thereby increasing the oxygen content of the blood and providing for better perfusion to the brain and body

: B Diff: 3 Page Ref: 201

: 9-2 18) Which statement made by a 49-year-old female patient describes a situation common to those in this life stage? A) "I have never felt better than I do now. I am in the best shape of my life!" B) "I do not have time to see the doctor about my blood pressure. I am too busy taking care of my parents." C) "Life is very enjoyable at this stage since I have managed to accomplish all the goals I set for myself." D) "I am very careful when I drive since it is well known that car accidents pose the greatest risk to people my age."

: B Diff: 3 Page Ref: 212

: 2-3 47) A young girl with end-stage cancer is unresponsive, not breathing, and pulseless. Her mother and father are by her side, both crying as you start resuscitation. Which statement indicates the most appropriate thing you could say to the parents as you begin? A) "I think that it would be best for you both to leave the room so we can care for your daughter." B) "If you feel comfortable, it's okay to stay and watch how we care for your daughter." C) "It is important not to cry since she may still be able to hear you and needs you to be strong for her." D) "I can show you how to do chest compressions so that you can take part in caring for your daughter."

: B Diff: 3 Page Ref: 22

: 2-5 31) You would be concerned about cumulative stress when an EMS provider informs you that she: A) Is physically tired and would like one week of unpaid leave to recuperate B) Drinks a small amount of alcohol every night to help her sleep C) Is taking prescribed antidepressants to treat mild depression D) Is bothered by a call she had yesterday and does not feel like talking

: B Diff: 3 Page Ref: 23-24

: 10-18 97) The EMT would recognize that administering continuous positive airway pressure (CPAP) at a pressure that is too high can cause: A) Hypertension B) Lung collapse C) Pulmonary edema D) Oral cavity pressure trauma

: B Diff: 3 Page Ref: 263

: 11-12 72) Which of these statements is true regarding vital signs obtained from a patient with nausea and vomiting? A) If the vital signs are within normal limits, it is safe to let the patient refuse transport B) The vital signs will help the EMT determine the relative stability or instability of the patient C) The patient's complaint is considered significant only if accompanied by abnormal vital signs D) The vital signs will allow the EMT to diagnose the cause of the nausea and vomiting

: B Diff: 3 Page Ref: 288

: 11-8 38) A patient who was shoveling snow developed chest pain, immediately sat down in a nearby bus shelter, and called 911. Prior to moving him into the ambulance, your partner performs a primary assessment and reports that the patient's capillary refill is 5 seconds. Which of these would be an appropriate statement for you to make? A) "That is a significant finding. We really need to get him on oxygen and get moving to the hospital." B) "The cold temperature may cause the capillary refill to be 5 seconds; we should assess further." C) "That finding likely indicates he has lost blood and the skin is not being adequately perfused." D) "If his skin is also warm and moist, then the patient is most likely in shock."

: B Diff: 3 Page Ref: 294

: 11-9 39) Which of these statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient? A) "Capillary refill is a very reliable sign of shock in any patient between the ages of 18 and 65 years." B) "Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescents or adults." C) "The possibility of chronic circulatory diseases makes the capillary refill test an excellent sign of circulation in the adult patient." D) "If a delayed capillary refill is observed in a patient of any age, there is a high probability he or she is in shock."

: B Diff: 3 Page Ref: 294

: 11-2 46) A 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right pupil only, while looking at both pupils. What would be a normal finding? A) Dilation of the right pupil only B) Constriction of the right and left pupils C) Dilation of the left pupil only D) Constriction of the right pupil only

: B Diff: 3 Page Ref: 295

: 11-1 56) An EMT has an accurate understanding of systolic blood pressure when he tells you that systolic blood pressure is: A) Represented by the bottom number B) Produced when the heart contracts C) The pressure in the veins D) Caused by constriction of the arteries

: B Diff: 3 Page Ref: 296

: 11-12 14 Copyright © 2018 Pearson Education, Inc. 53) An EMT student asks you if it matters whether the blood pressure cuff seems too small for a patient, if a reading can still be obtained. You should respond: A) "As long as the reading is obtained, it should be accurate." B) "Cuffs that are too small provide inaccurately high readings." C) "Using a cuff that is too small can cause damage to the blood vessels." D) "As long as the radial pulse remains intact, the cuff size is irrelevant."

: B Diff: 3 Page Ref: 298

: 2-9 11) Which statement made by an EMT demonstrates that he has an accurate understanding of hepatitis C? A) "It is important to get the hepatitis C vaccine to decrease my chance of contracting the disease if exposed to the virus." B) "Wearing gloves and washing hands are the best means by which to prevent the transmission of hepatitis C to health care workers." C) "Since hepatitis C is primarily transmitted in the spring and summer, more precautions are needed during that time." D) "Respiratory droplets are the primary means by which hepatitis C is transmitted, making a mask necessary when caring for patients with this disease."

: B Diff: 3 Page Ref: 33

: 13-21 30 Copyright © 2018 Pearson Education, Inc. 113) You are assessing a trauma patient who was ejected from a car when it overturned. Currently he opens his eyes to painful stimuli, demonstrates no verbal response to questioning, and exhibits decerebrate rigidity in response to pain. What is this patient's Glasgow Coma Scale score? A) 3 B) 5 C) 7 D) 9

: B Diff: 3 Page Ref: 372, Table 13-9

: 2-15 55) A coworker is constantly tired and asks you for advice on how to better sleep after a busy night shift. Which response would best address this situation? A) "A small amount of alcohol can be relaxing and effective in helping you to sleep." B) "Try to make your bedroom dark and keep the temperature cool." C) "Research has shown that exercising prior to bed helps you fall asleep faster." D) "Try eating a meal before going to bed, since digestion makes you drowsy."

: B Diff: 3 Page Ref: 40-41

: 15-4 16 Copyright © 2018 Pearson Education, Inc. 58) A patient with a severe gastrointestinal bleeding is in shock. Which ALS or hospital interventions would best correct the patient's underlying problem? A) Intravenous fluids B) Blood replacement C) High-concentration oxygen via endotracheal tube D) Replacement of lost electrolytes by intravenous infusion

: B Diff: 3 Page Ref: 438

: 15-6 84) You are reassessing a young female who sustained blunt trauma to the chest in a motor vehicle collision. Which of these assessment findings best indicates that she is deteriorating and in the decompensatory phase of shock? A) Heart rate of 100 beats/min B) Blood pressure of 88/50 mmHg C) Blood continuing to ooze from an abdominal laceration D) Restless and confused mental status

: B Diff: 3 Page Ref: 448

: 15-13 4 Copyright © 2018 Pearson Education, Inc. 13) Which of these statements about the heart rhythm of ventricular fibrillation is true? A) Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be felt B) When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body C) The most effective treatment for converting ventricular fibrillation to a normal heart rhythm is CPR D) The AED is designed to identify ventricular tachycardia and give a "no shock advised" message when it is present

: B Diff: 3 Page Ref: 452

: 15-1 4) You have been asked to describe the American Heart Association's Chain of Survival to a group of Emergency Medical Responder students. Which of these is the best description of this concept? A) A sequence of care that provides instructions on how to use an AED B) A sequence of events that, if enacted quickly, gives the patient the best chance of surviving cardiac arrest C) A treatment plan that helps to prevent and treat cardiac arrest in the general population D) A treatment plan, that if followed, almost guarantees the survival of a patient with cardiac arrest

: B Diff: 3 Page Ref: 453

: 15-17 90) You are dispatched to a residence for an 82-year-old female who is not breathing. On arrival, the husband directs you to a second-floor bedroom. As you make patient contact, you note that she is rigored. What should your next step be? A) Start CPR B) Withhold CPR and contact medical command C) Start positive pressure ventilation with high-concentration oxygen D) Place the patient on the stretcher for immediate and emergent transport

: B Diff: 3 Page Ref: 453

: 15-8 96) What is the primary difference between the 2015 American Heart Association's "Chain of Survival" for the adult patient versus the pediatric patient? A) The adult chain allows the use of the AED, whereas use of this device is discouraged in the pediatric chain B) The pediatric chain emphasizes strategies for arrest prevention C) The pediatric chain emphasizes ALS treatment as the first link D) The adult chain includes a 30:2 compression/ventilation ratio, whereas the pediatric chain uses a 15:1 compression/ventilation ratio

: B Diff: 3 Page Ref: 453-454

: 15-17 26) An unrestrained 37-year-old female patient is in cardiac arrest after her vehicle struck a tree head-on at a high rate of speed. Assessment reveals that the patient suffered massive blunt trauma to the chest and abdomen. The patient is quickly extricated from the vehicle and placed in a supine position on the ground. It is estimated that the patient has been in cardiac arrest for approximately 10 minutes, during which time CPR was not performed. At this time, the EMT would: A) Withhold CPR and perform a focused trauma assessment B) Perform CPR and contact medical command for permission to use the AED C) Administer CPR for 2 minutes prior to applying the AED D) Apply electrodes to the patient's chest and follow the AED's instructions

: B Diff: 3 Page Ref: 458

: 15-17 89) You are by the side of an unresponsive 6-month-old child with a history of congenital heart disease. The patient's airway is patent, but he is not breathing. A heart rate of 24 beats/min is noted. At this time, it is essential that you: A) Apply the AED with pediatric pads B) Start cardiopulmonary resuscitation with compressions and ventilations C) Start positive pressure ventilation with high-concentration oxygen D) Place the patient on the stretcher for immediate and emergent transport

: B Diff: 3 Page Ref: 459

: 15-17 36) Which of these statements made by your EMT partner regarding care for the adult patient in cardiac arrest is accurate? A) "It is important to always check for a pulse immediately after the AED has delivered a shock." B) "When using an AED, the machine should be turned on before applying the electrodes." C) "When checking for a patient's pulse, the EMT should take no more than 5 seconds." D) "If two EMTs are performing CPR, a ratio of 15 compressions to 2 ventilations can be used."

: B Diff: 3 Page Ref: 460

: 3-1 18 Copyright © 2018 Pearson Education, Inc. 61) What is the primary difference between the EMT's scope of practice and the EMT's standard of care? A) The scope is what the EMT should do; the standard is what the EMT is legally bound to do B) The scope includes which actions the EMT can legally take, while the standard of care is what a EMT should do in an EMS system with similar training and protocols C) The scope of practice is decided by the medical director, while the standard of care is defined by state regulations D) There is no clinically relevant difference between the scope of practice and the standard of care, as both define what the EMT should do in the exact same situation

: B Diff: 3 Page Ref: 47

: 3-2 2 Copyright © 2018 Pearson Education, Inc. 4) The EMT shows understanding of the standard of care when he states: A) "The standard of care is a state law that describes which actions the EMT can and cannot legally perform." B) "The standard of care is a measure of whether the right assessment and care have been provided to the patient." C) "The standard of care is a document that outlines the curriculum to which all EMT programs in the United States must subscribe." D) "The standard of care is state law that requires the EMS to respond and render care in emergency and nonemergency situations."

: B Diff: 3 Page Ref: 47

: 3-13 56) Regarding an EMT's duty to act, the relationship between an EMT and a patient starts: A) Once the EMT is dispatched to the call B) Once the EMT makes physical contact with the patient C) Once the patient consents to be treated D) Once the EMT begins to provide physical care

: B Diff: 3 Page Ref: 48

: 3-9 15 Copyright © 2018 Pearson Education, Inc. 51) A pregnant woman is choking inside a local restaurant. Who has the most compelling legal duty to act? A) An off-duty EMT who just finished eating and is headed to the bathroom B) EMTs from another county eating lunch after dropping off a patient at a local hospital C) An EMS supervisor who just came into the restaurant and is on a week's vacation D) A retired paramedic who just finished eating and is paying his bill

: B Diff: 3 Page Ref: 48

: 16-18 44) A 71-year-old female patient complains of the sudden onset of shortness of breath and rapid breathing. She also states that she is experiencing some chest pain that seems to worsen when she takes a deep breath. The primary assessment shows her to be alert and oriented with a patent airway and rapid breathing that is adequate. Her pulse rate is 92 and her blood pressure is 116/68 mmHg. When obtaining a history, which of these statements made by the patient should raise your suspicion that the patient may be experiencing a pulmonary embolism? A) "I think that I may also have a fever." B) "I had leg surgery five days ago." C) "I just started a new blood pressure medication today." D) "I had a headache earlier and took an aspirin."

: B Diff: 3 Page Ref: 484-485

: 16-9 25 Copyright © 2018 Pearson Education, Inc. 90) A new employee of your EMS system is about to take a protocol test in front of the EMS supervisor. As he is reviewing the protocol from memory, he gets confused about which amount of oxygen to administer to a patient with a suspected pulmonary embolism. How would you respond if he asks you for help? A) "Administer 2 liters per minute by nasal cannula to all patients with suspected pulmonary embolism." B) "Administer supplemental oxygen to the patient of sufficient amount to maintain the pulse oximeter reading at or greater than 94%." C) "Since a pulmonary embolism is a vascular problem rather than lung problem, administer oxygen to maintain a pulse oximeter reading of greater than 95%." D) "A patient with a pulmonary embolism has a perfusion deficit, not a ventilation deficit, so oxygen will not change things. Simply start ventilations and transport the patient."

: B Diff: 3 Page Ref: 485

: 16-18 19 Copyright © 2018 Pearson Education, Inc. 68) You are delivering positive pressure ventilations to a patient who is breathing poorly and has absent breath sounds in the right lung. Which of these instructions would you provide to those responders who are ventilating the patient? A) "Make sure to really get those ventilations into his good lung. He needs the oxygen." B) "Use the minimal tidal volume possible, just enough to make the chest rise and fall." C) "If his SpO2 is 85% or greater, let's stop the ventilations and put him on high-concentration oxygen with a face mask." D) "Let's use just room air for the ventilations. We don't want to cause a tension pneumothorax by giving pure oxygen."

: B Diff: 3 Page Ref: 487

: 16-14 18 Copyright © 2018 Pearson Education, Inc. 65) You have been dispatched to a home for a 16-year-old female patient with shortness of breath. On scene, you find the patient in bed with her mother at her side. Her mother states that her daughter has a fever with a past medical history of cystic fibrosis; she would like to have her daughter transported to the hospital for evaluation of possible pneumonia. As a knowledgeable EMT, you know that the underlying pathophysiology of cystic fibrosis is a: A) Contagious disease in which the lungs are damaged by bacteria and excessive coughing B) Condition in which excessive and thick mucus often plugs the airways C) Disease in which lifelong antibiotic medications are needed for survival D) Hereditary disease in which the lungs are malformed and smaller than normal

: B Diff: 3 Page Ref: 490

: 16-6 29) You have been dispatched for a young child with difficulty breathing. As you enter the apartment, which scene size-up clue would best indicate that the patient is experiencing a problem in her upper airway? A) Grunting with exhalation B) Stridorous noises with inspiration C) Low-pitched sobbing and crying D) Audible wheezing on expiration

: B Diff: 3 Page Ref: 498

: 3-11 9) The EMT shows she understands "Do Not Resuscitate" (DNR) orders and living wills when she states: A) "A living will is a form of DNR; only a living will states exactly how the patient wants to be resuscitated." B) "A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart ceases to beat, whereas a living will pertains to long-term life support care and equipment." C) "If a patient has a valid DNR, the EMT should withhold all care and transport the patient to the hospital. If a living will is present, the EMT should do exactly what it says." D) "If the patient has a living will, it can legally be used as a substitute for a DNR order by the EMT as long as it is properly dated and signed."

: B Diff: 3 Page Ref: 50

: 17-2 2) The tricuspid valve prevents blood from: A) Regurgitating between the right and left ventricles B) Flowing from the right ventricle into the right atrium C) Bypassing the pulmonary vessels and entering the left heart D) Flowing backward through the left atrium

: B Diff: 3 Page Ref: 522

: 17-2 72) Sympathetic nervous system stimulation will cause the heart to: A) Lower the systolic blood pressure B) Increase the heart rate C) Decrease automaticity D) Decrease in rate

: B Diff: 3 Page Ref: 522

: 17-4 79) On an ECG, the QRS represents: A) Contraction of the atria B) Contraction of the ventricles C) Contraction of both the atria and the ventricles D) The heart at rest following contraction

: B Diff: 3 Page Ref: 528

: 17-5 27 Copyright © 2018 Pearson Education, Inc. 104) You have been called to a residence for an obese 52-year-old male patient who complains of chest pain. When obtaining a history from the patient, which of these statements made by the patient would you find most concerning? A) "I started taking an antianxiety medication last week." B) "The pain came on suddenly when I was reading the paper." C) "I have had chest pain on and off for years now." D) "I occasionally feel that my heart seems to skip a beat."

: B Diff: 3 Page Ref: 530-531

: 17-16 36) When obtaining a medical history, which of these statements made by the patient seemingly indicates that he is suffering from classic angina? A) "I took five nitroglycerin tablets over 20 minutes to get rid of the pain." B) "When I stopped cutting the grass, the pain went away." C) "The pain started when I was sitting down reading the paper." D) "The pain lasted about 45 minutes before gradually going away."

: B Diff: 3 Page Ref: 531

: 17-13 23 Copyright © 2018 Pearson Education, Inc. 89) A 56-year-old female patient with a smoking history and COPD complains of the sudden onset of shortness of breath and diaphoresis. Her history indicates no cardiac diagnosis but previous drug abuse 8 years ago. Vital signs are pulse, 96; respirations, 18 breaths/min and mildly labored; blood pressure, 168/102 mmHg; and SpO2, 96% on home oxygen at 4 lpm, which she wears for COPD. The patient's lung sounds are clear but diminished bilaterally. What is your best action? A) Administer aspirin, monitor the patient, and transport B) Turn down the oxygen to 2 lpm, monitor, and transport C) Administer the patient's MDI and transport her to the hospital D) Assist the patient is trying her husband's nitroglycerin

: B Diff: 3 Page Ref: 535

: 17-19 6 Copyright © 2018 Pearson Education, Inc. 19) A patient with chest pain and shortness of breath informs you that the last time he had a heart attack, he went into heart failure. When performing your secondary assessment, which sign or symptom is most indicative that the patient is in heart failure again? A) Flat neck veins B) Crackles in the lungs C) Hypertension D) Shortness of breath

: B Diff: 3 Page Ref: 536

: 17-16 14 Copyright © 2018 Pearson Education, Inc. 50) You have been called for a 58-year-old male patient with an unknown medical emergency. On scene, you find the alert and oriented patient complains of headache as well as weakness and "tingling" to his right arm and leg. He has diabetes and high blood pressure, for which he takes the appropriate medications. When asked, he reports that he may have passed out earlier in the day, immediately after taking his morning dose of insulin. His pulse is 96, respirations 16 breaths/min, and blood pressure 180/106 mmHg. Based on this presentation, you should treat the patient for: A) High blood sugar B) Stroke C) Hypertensive emergency D) Syncope

: B Diff: 3 Page Ref: 538

: 17-15 101) You have been called for a 4-year-old female patient who told her mother that her chest hurts. On scene, the child is crying and points to her chest when asked if she has pain. Her airway is patent, respirations slightly labored, pulse rapid and regular, and skin warm and pale. Vital signs are pulse, 132; respirations, 28 breaths/min; blood pressure, 108/74 mmHg; and SpO2, 89%. The mother denies any medical history, medications, or allergies for her daughter. Your first action would be to: A) Contact medical direction B) Apply oxygen C) Give the patient one-half nitroglycerin tablet D) Administer one baby aspirin

: B Diff: 3 Page Ref: 539

: 3-10 17) An adult patient with the capacity to make his own decisions has cardiac-type chest pain and is refusing all treatment. What would be the EMT's most appropriate response? A) "I will need to have you sign this refusal of care form and a family member sign as a witness." B) "Before you refuse, I need to tell you that this could be a heart attack and you could die." C) "Since you are oriented and rational, it is your right to refuse. Please sign this refusal of care form." D) "I am sorry, but since 911 was called, we must transport you to the hospital. You can refuse treatment there."

: B Diff: 3 Page Ref: 54

: 17-19 18) Which of these statements from a patient should the EMT recognize as an absolute contraindication to the use of fibrinolytic medications in the emergency department? A) "I have high blood pressure for which I take medication." B) "Two months ago, I had a stroke on the left side of my brain." C) "My doctor told me to take a baby aspirin every day." D) "I had my appendix removed six months ago."

: B Diff: 3 Page Ref: 543

: 18-12 5 Copyright © 2018 Pearson Education, Inc. 18) Which of these patients would be most eligible to receive a fibrinolytic medication for stroke if no other contraindications are found? A) A 37-year-old female diagnosed in the emergency department with a hemorrhagic stroke 2 hours after its onset B) A 48-year-old male whose symptoms started while watching the 6 P.M. news, at which time he dialed 911 C) An 81-year-old male who awoke with stroke symptoms after an 8-hour sleep D) A 62-year-old female whose stroke symptoms started at 8 A.M. and disappeared half an hour later

: B Diff: 3 Page Ref: 561

: 18-8 29) The EMT demonstrates she understands hemorrhagic stroke when she states: A) "It occurs when clots form in blood vessels within the brain." B) "It occurs when a blood vessel ruptures and bleeds within the brain." C) "Its signs and symptoms generally resolve within 24 hours." D) "It can sometimes be treated by clot-destroying medications."

: B Diff: 3 Page Ref: 564

: 18-11 12) When attempting to distinguish a spinal injury from a stroke, the EMT should remember that: A) Spinal injuries often result in weakness to one side of the body B) Stroke typically results in weakness or paralysis to one side of the body C) Stroke does not cause paralysis, while spinal injuries typically do D) Stroke usually causes weakness to all extremities; spinal injuries do not

: B Diff: 3 Page Ref: 569

: 18-1 16) Which of these statements made by your new EMT partner demonstrates an understanding of assessment findings related to stroke? A) "For a stroke to be suspected, both arms must be equally weak." B) "If one arm is weak, a stroke should be suspected." C) "A stroke should be suspected only when one arm is paralyzed, not weak." D) "If one arm is weak, stroke should be suspected only if the blood pressure is also elevated."

: B Diff: 3 Page Ref: 570

: 18-14 54) A 41-year-old female patient has called 911 for a headache. Which of these assessment findings should make the EMT suspicious that the patient has a migraine headache? A) Bright light increases the patient's discomfort B) The pain was preceded by an aura C) Her blood pressure is 192/124 mmHg D) She rates the pain as an 8/10

: B Diff: 3 Page Ref: 577

: 19-7 49) The EMT would recognize that a 49-year-old male patient has experienced a primary seizure when his wife states: A) "He has never had a seizure before-this is his first seizure." B) "He had seizures in the past, but they are not sure what causes them." C) "The doctors said that his seizures come from one spot in his brain." D) "His arms and legs were jerking and he would not talk to me."

: B Diff: 3 Page Ref: 586

: 19-12 38) Which of these is the best explanation of why a patient who experiences a syncopal episode often regains consciousness after falling? A) The act of falling causes the heart rate to decrease B) The supine position allows better perfusion to the brain C) The trauma of falling causes the blood glucose level to increase D) The seizure stops once the patient is supine

: B Diff: 3 Page Ref: 598

: 20-3 56) The EMT would recognize dehydration as a concern in a patient with diabetes owing to: A) Decreased desire to drink water B) Excessive urine production and elimination C) Persistent diarrhea from elevated sugar levels D) Vomiting leading to fluid loss

: B Diff: 3 Page Ref: 609

: 20-3 2 Copyright © 2018 Pearson Education, Inc. 5) You are reviewing a prehospital care report for a patient with altered mental status that occurred after he took too much insulin. Based on this information, you should assume that at the time of EMS contact, the patient's blood sugar level was probably: A) High B) Low C) Normal D) Concentrated

: B Diff: 3 Page Ref: 610

: 20-9 16 Copyright © 2018 Pearson Education, Inc. 62) You are sitting next to a 24-year-old female patient with diabetes who has altered mental status and a blood sugar reading of 31 mg/dL. Family members state that she took her normal amount of insulin this morning and ate her breakfast as usual. Which additional statement would the EMT recognize as contributing to her current condition? A) "She has been taking Motrin every 6 hours for ankle pain." B) "She likes to stay in shape and ran 4 miles after breakfast." C) "She did not take her nighttime insulin last night." D) "She did not eat anything sweet for breakfast this morning."

: B Diff: 3 Page Ref: 610

: 20-8 46) What is the primary reason to administer oral glucose to a patient? A) Help sugar get into the brain cells B) Increase the amount of circulating glucose in the bloodstream C) Stimulate the body to release insulin from the pancreas D) Improve the patient's level of consciousness

: B Diff: 3 Page Ref: 612

: 21-9 40) Why would the patient experiencing an allergic reaction tell you that it is easier to breathe following administration of epinephrine? A) Drying of mucus in the airways B) Dilation of the bronchioles C) Increased blood flow to the lungs D) Decreased blood pressure

: B Diff: 3 Page Ref: 644, Figure 21-6

: 23-1 20) After performing a Markle test on a 31-year-old female patient with abdominal pain, she locates pain to her left lower quadrant. How would the EMT interpret this result? A) A positive result indicating appendicitis as the cause of the patient's pain B) Additional evidence that the patient has peritonitis C) A negative result indicating that the patient's condition is not life-threatening D) Realization that the gallbladder is the cause of the patient's discomfort

: B Diff: 3 Page Ref: 702

: 23-6 45) A patient states that about two hours following dinner, she developed right upper quadrant abdominal pain that radiated to her shoulder. As a knowledgeable EMT, you would recognize this characteristic pain pattern as most suggestive of: A) Urinary tract infection B) Gallbladder inflammation C) Intestinal obstruction D) Gastric ulcer

: B Diff: 3 Page Ref: 702-703

: 23-1 81) At the side of a distressed patient with active and severe esophageal varices, you realize that the priority of care will be: A) Stopping the hemorrhage B) Airway management C) Rapid transportation D) Monitoring the blood pressure

: B Diff: 3 Page Ref: 703

: 23-4 22 Copyright © 2018 Pearson Education, Inc. 84) You are by the side of an 80-year-old male patient whose wife called EMS because he had tearing-type abdominal pain. The patient states that he was just discharged from the hospital this morning after being treated for gastroenteritis. When questioned further, he states that he remains nauseated, but the medications for the vomiting and diarrhea seem to be working, as he is no longer experiencing either of those symptoms. Since he was just in the hospital, the patient states that he would like to refuse transport and continue his recovery at home. What is your best response? A) "I agree that the medications are working, but be safe and call your family doctor." B) "I don't know; your symptoms don't seem to be related to gastroenteritis." C) "I think you are right about getting better; it is up to you if you want to go back." D) "I am not comfortable with this; it sounds as if your gastroenteritis is not any better."

: B Diff: 3 Page Ref: 705-706

: 4-6 10) An intoxicated patient will not leave the oxygen mask on. What would be the most appropriate way to document this behavior on the prehospital care report? A) The patient is intoxicated and will not cooperate with oxygen therapy B) The patient continually removes the oxygen mask despite continued reapplication C) The patient will not cooperate with care provided by EMS D) The patient appears to be in a drunk-like state and will not cooperate with care provided by EMS

: B Diff: 3 Page Ref: 71

: 23-6 39) During transport, a 27-year-old female drug addict with acute abdominal pain tells you that she is scared and starts crying. What would your best response be? A) "Don't worry, there is probably nothing wrong. My guess is that you probably ate something bad, but the hospital will let you know for sure." B) "I know that you are in pain. We are 5 minutes from the hospital and I have already called the emergency department and let them know we are coming. They will be prepared for us." C) "This probably has something to do with the drugs you are on. It is very important that you quit." D) "There is nothing more I can do since we are not allowed to give medications for pain. Let's just see what happens at the hospital."

: B Diff: 3 Page Ref: 710

: 23-9 90) Which of these statement is true regarding a female who has had both ovaries removed? A) Her eggs must now be fertilized in the fallopian tubes B) She cannot produce any eggs for fertilization C) She is at higher risk for a tubal pregnancy D) She will experience hematuria

: B Diff: 3 Page Ref: 714

: 23-10 54) A 26-year-old female patient complains of abdominal pain. The pain is generalized to her abdomen and worsens when walking. She also tells you that she is having a foul-smelling, yellow-colored vaginal discharge. The primary assessment reveals no threats to the airway, breathing, or circulation. Her vital signs are pulse, 104; respirations, 16 breaths/min; blood pressure, 108/60 mmHg; and oral temperature of 102.1°F. She finished her last menstrual period three days ago. Which condition do you suspect? A) Ovarian cyst B) Pelvic inflammatory disease C) Ectopic pregnancy D) Mittelschmerz

: B Diff: 3 Page Ref: 716-717

: 23-6 70) The EMT would recognize that the pain associated with a kidney stone is caused by: A) Inability to empty the bladder of urine B) Passage of the stone through the ureter C) Infection of the bladder and ureter D) Formation of the stone in the kidney

: B Diff: 3 Page Ref: 721

: 23-13 103) You are preparing to transport a patient with an indwelling urinary catheter. The bag is full and your partner starts to empty it. Which of these statements would be appropriate to make to your partner? A) "Let's leave it full so the hospital can check the urine for infection." B) "Let's make sure that we measure the amount prior to disposing of it." C) "For the catheter to work properly, the bag must be left half-full." D) "We should leave it as is so the hospital can determine the volume."

: B Diff: 3 Page Ref: 723

: 23-13 20 Copyright © 2018 Pearson Education, Inc. 76) Assessment of a confused and lethargic patient with diabetes and renal failure reveals her to be lying in bed with notable significant edema to the face, torso, and extremities. Her respirations are extremely labored and associated with a "grunting" sound. Her airway is patent, radial pulse weak, and skin cool and diaphoretic with cyanosis noted to the fingers. Oxygen has been applied by Emergency Medical Responders (EMRs). Your next action would be to: A) Obtain vital signs B) Sit the patient upright C) Place a nasal airway D) Check her blood glucose level

: B Diff: 3 Page Ref: 723

: 4-7 12 Copyright © 2018 Pearson Education, Inc. 42) Last week, on a computer-generated report, you accidentally documented that a patient suffered from hypertension when, in fact, he did not. Unfortunately, the report has been locked by the computer and cannot be changed; however, it can be printed. Your first action would be to: A) Retype the entire report and include the change B) Print the report and draw a line through the error C) Contact the hospital and have the staff there change the information in the patient's medical record D) Notify the medical director so that he or she can fix the error

: B Diff: 3 Page Ref: 77

: 5-8 39) When relying on a cell (mobile) phone for medical communications, the EMT realizes that: A) He can relay his diagnosis of the patient's problem to the emergency department B) He should use the same format of communication as used for radio transmissions C) He is free to relay personal and confidential information not allowed over the radio D) He can talk more casually and not in as structured a manner as when using the radio

: B Diff: 3 Page Ref: 89

: 5-2 36) A patient does not speak English and no family members are available to translate. Which other options are available to you to facilitate communication with the patient? A) Write questions on a pad B) Check with dispatch or use a toll-free interpreter line C) Proceed with your primary exam D) Treat the patient as if he is unconscious

: B Diff: 3 Page Ref: 99

: 6-6 4 Copyright © 2018 Pearson Education, Inc. 14) When an EMT places his palm and all fingers in contact with the object being lifted, he is using the: A) Power lift B) Lock grip C) Power grip D) Squat grip

: C Diff: 1 Page Ref: 105

: 7-3 88) Accurately communicating patient injury information to other health care professionals is most reliant upon: A) A strong radio signal B) Properly placed cellular towers C) A good knowledge of proper anatomic terminology D) Good handwriting

: C Diff: 1 Page Ref: 129

: 7-5 2) An 89-year-old female patient has fallen in her living room and has pain in her left hip. As you approach, you note that she is on her back with her left leg turned inward. When relaying this information to the receiving hospital, how would you describe her position? A) Supine with lateral rotation of the left lower extremity B) Lateral recumbent with dorsal rotation of the left leg C) Supine with medial rotation of the left lower extremity D) Supine with left rotation of the right leg

: C Diff: 1 Page Ref: 129

: 7-1 3 Copyright © 2018 Pearson Education, Inc. 10) Which line divides the body into right and left halves when viewing it from the front? A) Midaxillary line B) Anterior axillary line C) Midline D) Midclavicular line

: C Diff: 1 Page Ref: 131

: 7-5 2 Copyright © 2018 Pearson Education, Inc. 5) Another EMT informs you that a patient has been stabbed once with a knife in the right midaxillary region. Which description best identifies where is this injury located? A) Right chest B) Right shoulder C) Right lateral chest D) Right side of the abdomen

: C Diff: 1 Page Ref: 131

: 7-17 48) Which body system protects internal organs of the chest and provides for movement of the extremities? A) Endocrine B) Nervous C) Musculoskeletal D) Immune

: C Diff: 1 Page Ref: 132

: 7-6 57) Emergency Medical Responders inform you that a 73-year-old female patient has fallen and has a hematoma to the occipital area of her head. Based on this description, you should expect to find the injury in which area of the head? A) Top B) Side C) Back D) Front

: C Diff: 1 Page Ref: 133, Figure 7-4

: 7-5 59) A patient experiencing pain in the thoracic region of his spinal column has pain in his: A) Neck B) Lower back C) Upper back D) Tailbone

: C Diff: 1 Page Ref: 135

: 7-15 9 Copyright © 2018 Pearson Education, Inc. 37) Which structure or vessel carries oxygen-depleted blood to the right atrium? A) Posterior tibial B) Internal jugular C) Vena cava D) Aorta

: C Diff: 1 Page Ref: 151

: 7-2 89) Which components of the nervous system must be functional for a patient to be conscious? A) Both cerebral hemispheres B) One cerebral hemisphere and the pineal gland C) One cerebral hemisphere and the reticular activating system D) The RAS and pineal gland

: C Diff: 1 Page Ref: 159

: 7-18 102) What is the name of the structure in males and females that transports the urine from the kidneys to the urinary bladder? A) Urethra B) Vulva C) Ureters D) Renal pelvis

: C Diff: 1 Page Ref: 165

: 7-5 83) A tachypneic patient is breathing: A) Slowly B) Deeply C) Rapidly D) Shallowly

: C Diff: 1 Page Ref: 172, Table 7-3

: 8-4 4 Copyright © 2018 Pearson Education, Inc. 14) The EMT is administering oxygen at 95% through a nonrebreather face mask. He would document this as a FiO2 of: A) 0.21 B) 0.50 C) 0.95 D) 1.00

: C Diff: 1 Page Ref: 181

: 8-13 10 Copyright © 2018 Pearson Education, Inc. 40) A patient who is weak informs you that she has a history of her "iron being too low." This should concern the EMT because iron is needed to: A) Manufacture the white blood cells required for fighting infection B) Help the blood to clot C) Carry oxygen throughout the body D) Maintain an adequate blood pressure in the body

: C Diff: 1 Page Ref: 192

: 8-19 61) What is baroreceptors' role in the body? A) Monitor the heart rate B) Ensure adequate oxygenation of the red blood cells C) Monitor the blood pressure D) Stimulate the production of red blood cells

: C Diff: 1 Page Ref: 199

: 9-3 7) You are assessing a 4-year-old child with a fever and cough. The child is very calm and receptive to your presence. Given this, which action would be most appropriate during your ongoing assessment? A) Ask the mother to leave until the assessment is complete B) Take the child to the ambulance for assessment C) Have the mother remain with the child for the assessment D) Refrain from touching the patient until in the ambulance

: C Diff: 1 Page Ref: 209

: 9-9 35) Due to the body systems operating at optimal level and because typically individuals in this age bracket are in excellent physical condition, risky behavior and accidents are the leading causes of death in which stage of development? A) Preschool-age children B) Adolescence C) Early adulthood D) Late adulthood

: C Diff: 1 Page Ref: 211

: 9-8 19) The average years of life remaining based on an individual's date of birth is called: A) Life span development B) Maximum life span C) Life expectancy D) Physiological expectancy

: C Diff: 1 Page Ref: 212

: 10-10 50) For which of these patient is placement of an oropharyngeal airway indicated? A) A responsive but confused patient with stridorous respirations B) A patient who responds to painful stimuli by moaning and has vomited C) An unresponsive patient who has no gag or cough reflex D) A patient with snoring respirations who coughs as the oral airway is placed into his mouth

: C Diff: 1 Page Ref: 236

: 10-10 52) While assisting with the review of airway skills with new EMT hires, which of these statements from a new EMT demonstrates he knows how to properly size an oral airway prior to placement? A) "It is better to have an oral airway that is too large, rather than one that is too small." B) "To select an appropriately sized oral airway, you must estimate the patient's height and weight." C) "The airway should approximate the distance from the front teeth to the angle of the jaw." D) "An appropriately sized oral airway can be selected by looking in the patient's mouth and estimating the length of the tongue."

: C Diff: 1 Page Ref: 236

: 10-10 57) The EMT is appropriately sizing the nasal airway when she measures the: A) Distance from the mouth to the angle of the jaw B) Diameter of the larger nostril C) Distance from the tip of the nose to earlobe D) Diameter of the patient's little finger

: C Diff: 1 Page Ref: 237-238

: 2-4 29) A prospective student is interested in becoming an EMT, but is unsure how it will affect his family. He says that his wife is very worried about the danger associated with EMS and has never had to deal with him being gone for 24 hours at a time. What is the most appropriate response? A) "The long hours actually make things easier since there is less time to argue." B) "I have found that the family becomes used to it and things are okay after about six months." C) "It may help to bring your wife here so she can see what we do and the safety precautions we take." D) "I would just tell her that everything will be okay and avoid talking about work when you are home."

: C Diff: 1 Page Ref: 25

: 2-14 23) To ensure your own safety and the safety of your crew, you should: A) Request police assistance on all calls B) Search each and every patient for weapons C) Evaluate every scene for danger before entering D) Ensure the availability of a paramedic for most medical calls

: C Diff: 1 Page Ref: 26

: 10-21 59) Which of these statements about different sizes of oxygen cylinders is true? A) H tanks are the smallest oxygen cylinders B) D cylinders hold the most oxygen C) G and E tanks have the same psi when full D) M tanks are the easiest to carry on the stretcher

: C Diff: 1 Page Ref: 266

: 10-22 70) When properly using a nonrebreather face mask, which of these statements is true? A) The air exhaled by the patient will be recycled with oxygen B) The mask is comfortable and well tolerated by all patients when properly applied C) The concentration of inhaled oxygen will be approximately 90% D) Oxygen is delivered into the lungs even when the patient is not inhaling

: C Diff: 1 Page Ref: 271

: 10-5 22 Copyright © 2018 Pearson Education, Inc. 84) Which of these statements best describes the purpose of a Venturi mask? A) The device is used to deliver positive pressure ventilation B) It allows a 100% concentration of oxygen to be delivered without a leak between the patient's face and mask C) Precise concentrations of oxygen can be delivered with this device D) It provides a seal over the larynx, preventing aspiration during positive pressure ventilation

: C Diff: 1 Page Ref: 273

: 2-13 35) You have just transferred care of a patient to an emergency department nurse. There is no blood, fluid, or dirt on your gloves. After taking them off, your best action would be to: A) Use an alcohol-based hand sanitizer B) Disinfect the stretcher and equipment C) Wash your hands with soap and water D) Complete the prehospital care report

: C Diff: 1 Page Ref: 28-29

: 10-15 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 11 Vital Signs, Monitoring Devices, and History Taking 1) Which of these patient descriptions contains only vital signs? A) Chief complaint of dizziness; skin, cool and clammy; respiratory rate, 16 breaths/min B) Chief complaint of dizziness; BP, 110/76 mmHg; breath sounds, clear and equal C) Skin, warm and dry; heart rate, 74 beats/min; pupils equal and reactive D) Heart rate, 88 beats/min; respiratory rate, 14 breaths/min; blood glucose level, 98 mg/dL

: C Diff: 1 Page Ref: 288

: 11-18 70) The EMT is correct when he identifies baseline vital signs as: A) A set of vital signs most close to normal B) The most important set of vital signs C) The first set of vital signs obtained D) Any change in two consecutive sets of vital signs

: C Diff: 1 Page Ref: 288

: 11-3 88) Where would the EMT palpate for a popliteal pulse? A) Posterior ankle B) Upper arm C) Behind the knee D) Top of foot

: C Diff: 1 Page Ref: 290

: 11-6 5 Copyright © 2018 Pearson Education, Inc. 16) You determine a patient's heart rate to be 48 beats/min. That heart rate would be categorized as: A) Tachypneic B) Normal C) Bradycardic D) Tachycardic

: C Diff: 1 Page Ref: 291-292

: 11-6 14) During the primary assessment of a geriatric patient complaining of shortness of breath and fever, you quickly locate the radial pulse. What should you do next? A) Assess the patient's breathing B) Obtain a blood pressure C) Determine the rate and quality of the pulse D) Establish the patient's level of consciousness

: C Diff: 1 Page Ref: 292

: 11-9 35) You are assessing a female patient with a complaint of shortness of breath. When assessing her skin, which finding should be recognized as abnormal? A) Dry B) Pink C) Moist D) Warm

: C Diff: 1 Page Ref: 294

: 11-13 98) Correctly assessing orthostatic vital signs involves: A) Taking the blood pressure and heart rate three times, 2 minutes apart B) Determining whether the patient's pulse disappears during deep inspiration C) Taking the blood pressure in the supine, seated, and standing positions D) Determining whether the patient's respirations and heart rate are within normal limits

: C Diff: 1 Page Ref: 299

: 11-15 102) Which step should be taken by the EMT to obtain an accurate pulse oximetry measurement? A) Elevate the patient's hand above his heart B) Secure the probe to the patient's finger with tape C) Remove nail polish from the patient's fingernail if present D) Administer oxygen before assessing the oxygen saturation

: C Diff: 1 Page Ref: 300

: 11-20 117) The purpose of the OPQRST mnemonic is to guide the EMT in: A) Getting a past medical history B) Determining the stability of vital signs C) Exploring the patient's chief complaint D) Establishing any allergies to medications

: C Diff: 1 Page Ref: 307-308

: 11-21 31 Copyright © 2018 Pearson Education, Inc. 122) You are transporting a depressed patient who states that she is thinking of killing herself by taking a "whole bunch of pills." After providing you this information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. Which of these statements would be most appropriate for you to make at this time? A) "I don't understand why you won't talk. You called 911 for help, didn't you?" B) "Has the cat got your tongue? If you talk to me, I can help you." C) "I understand if you do not want to talk. I will be sitting here if you need anything." D) "I need you to talk to me. I cannot help you if you refuse to talk to me."

: C Diff: 1 Page Ref: 309

: 12-2 3) When should the EMT evaluate the scene of an emergency for hazards that may threaten or harm him? A) Prior to leaving the ambulance B) After completing the primary assessment C) Throughout the entire call D) Before responding to the call

: C Diff: 1 Page Ref: 315

: 12-6 20) A young male patient was playing hockey on an ice-covered pond and became injured; he remains on the ice. As you arrive on scene, a park ranger informs you that the ice is 12 inches thick and poses no danger of collapse. In this situation, which action would be most appropriate to help keep you safe while accessing and extricating the patient? A) Have a teammate assist the injured player to your location B) Apply salt to the ice to provide traction C) Place tarps on the ice to walk over to the injured player D) Take small slow steps while walking on the ice

: C Diff: 1 Page Ref: 320

: 12-8 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 13 Patient Assessment 1) When assessing a sick or injured patient, which of these indicates the appropriate order in which this assessment should occur? A) Primary assessment; reassessment, secondary assessment B) Scene size-up, secondary assessment, primary assessment C) Scene size-up, primary assessment, secondary assessment D) Scene size-up, history, secondary assessment, primary assessment

: C Diff: 1 Page Ref: 335

: 13-11 58) Forming the general impression starts during which phase of patient assessment? A) Reassessment B) Secondary assessment C) Primary assessment D) Care transfer in the emergency department

: C Diff: 1 Page Ref: 336

: 2-13 41) You are by the side of a patient whom you suspect has severe acute respiratory syndrome (SARS). What is an effective way to prevent transmission of the disease from the patient to you? A) Use eye protection or a face shield B) Use an alcohol-based hand sanitizer frequently during transport C) Place a surgical mask on the patient D) Sterilize all equipment used in the care of the patient

: C Diff: 1 Page Ref: 34

: 13-9 19) To stabilize the cervical spine of a trauma patient while simultaneously opening the airway, how should you position her head? A) Tilted slightly forward B) Tilted slightly back C) Neutral and in-line D) In the position found

: C Diff: 1 Page Ref: 341

: 13-10 7 Copyright © 2018 Pearson Education, Inc. 25) To best evaluate the adequacy of breathing in an unresponsive adult, the EMT should: A) Assess the skin color B) Check the pupils C) Observe the chest rise D) Look for cyanosis

: C Diff: 1 Page Ref: 349

: 13-12 37) What is the purpose of assessing the pulse on an unresponsive patient during the primary assessment? A) To calculate the precise heart rate B) To decide whether the breathing is adequate C) To determine the presence of a heartbeat D) To establish whether the patient requires oxygen

: C Diff: 1 Page Ref: 350

: 13-2 38) When performing the primary assessment of a conscious adult, you typically palpate which pulse first? A) Carotid B) Femoral C) Radial D) Brachial

: C Diff: 1 Page Ref: 350

: 13-14 75) Which of these assessment findings indicates that the patient has intact motor function in his lower extremities? A) The skin of his toes is pink and warm B) He does not complain of pain to his lower extremities C) He can wiggle his toes when instructed D) He states that he can feel you touching his toe

: C Diff: 1 Page Ref: 364

: 13-14 21 Copyright © 2018 Pearson Education, Inc. 78) What does the "S" in SAMPLE stand for? A) Significance B) Severity C) Sign D) Seriousness

: C Diff: 1 Page Ref: 367

: 13-24 83) The EMT recognizes that for a trauma patient who is alert and oriented, he should obtain the patient's medical history during which component of patient assessment? A) Primary assessment B) Scene size-up C) Secondary assessment D) Reassessment

: C Diff: 1 Page Ref: 368

: 13-21 115) A trauma patient currently has a blood pressure of 82/60 mmHg, a heart rate of 112 beats/min, respirations of 24 breaths/min and unlabored, and a pulse oximeter reading of 94% on 4 liters of oxygen via nasal cannula. His computed GCS score is 12 points. When computing his revised trauma score, which value would you assign? A) 7 B) 9 C) 11 D) 13

: C Diff: 1 Page Ref: 389, Table 13-2

: 2-14 45) What action taken by an EMT illustrates an effort toward maintaining well-being in the field of EMS? A) Taking a body-building class B) Avoiding all alcohol and fatty foods C) Creating a healthy balance between work and family life D) Establishing a relationship with a mental health professional

: C Diff: 1 Page Ref: 41

: 14-2 34) Which medical emergency would most likely be treated with the use of epinephrine by the EMT? A) Cardiac arrest B) Asthma C) Bee sting D) Hypoglycemia

: C Diff: 1 Page Ref: 424-425

: 14-10 27) You have administered Xopenex to a patient, using a small-volume nebulizer. You then notify medical direction that you have administered the drug. This is an example of which type of medical control? A) On-line B) Direct C) Off-line D) Retrospective

: C Diff: 1 Page Ref: 430

: 14-5 11 Copyright © 2018 Pearson Education, Inc. 41) Which piece of information regarding drug administration by the EMT according to protocol is not necessary to document on the patient care report? A) The dose of the drug given B) The patient's response to the drug given C) The family's reaction to the need for the medication to be administered D) The side effects, both desired and undesired, that occurred following administration

: C Diff: 1 Page Ref: 431

: 14-12 6 Copyright © 2018 Pearson Education, Inc. 21) What is the most reliable source of information about a medication? A) Nurses who routinely administer medications B) Paramedics and Advanced EMTs C) Physician's Desk Reference (PDR) D) EMS-related magazines and websites

: C Diff: 1 Page Ref: 432

: 15-15 10) Which link of the American Heart Association's Chain of Survival must occur first, if a patient is to survive cardiac arrest? A) Early CPR B) Early defibrillation C) Early activation D) Early advanced life support

: C Diff: 1 Page Ref: 453

: 15-14 6) Which cardiac arrest rhythm is the AED designed to shock? A) Asystole B) Pulseless electrical activity C) Ventricular fibrillation D) Bradycardia

: C Diff: 1 Page Ref: 454

: 15-19 47) An EMT has just received a "shock advised" message from the AED. Just before delivering the shock, the EMT must: A) Press the analyze button once more B) Hold the patient's head to avoid injury when shocking C) Ensure that all rescuers are clear of the patient D) Remove the oral airway to prevent possible choking

: C Diff: 1 Page Ref: 457

: 3-2 3) What best illustrates the EMT's failure to meet the standard of care when treating a patient with chest pain? A) Failing to assist the patient in taking her heart palpitation medication B) Failing to notify the patient's primary care physician C) Failing to give the patient oxygen D) Failing to start an IV on the patient

: C Diff: 1 Page Ref: 47

: 16-7 89) You are at an extended care facility for the elderly to assess and transport a patient suspected of having pneumonia to the hospital for evaluation. During your pulmonary assessment, which breath sound would you expect to hear that would be most specific to pneumonia versus other pulmonary conditions? A) Bilateral rhonchi B) Inspiratory stridor C) Localized wheezing to one side of the chest D) Inspiratory and expiratory crackles to the tops of both lungs

: C Diff: 1 Page Ref: 484

: 3-6 43) In discussing an EMS response that involved potential negligence, your medical director asks you to determine whether the statute of limitations is active. As a knowledgeable EMT, you understand that you will need to determine which of these? A) The exact action committed that is the basis for a negligence charge B) If there is a proximate cause that can be linked to the bad outcome C) If the allowed time for the patient to file a lawsuit has passed D) The amount of money that can be awarded to the patient and family

: C Diff: 1 Page Ref: 49

: 16-15 6 Copyright © 2018 Pearson Education, Inc. 21) Your medical director's written protocol instructs you to obtain on-line medical direction prior to assisting a patient with a metered-dose inhaler (MDI). Given this protocol, you must contact: A) The patient's family doctor before assisting with the MDI B) The medical director after assisting with the MDI C) An emergency physician before assisting with the MDI D) No one; physician direction is not required when assisting with the MDI

: C Diff: 1 Page Ref: 494

: 16-18 2) What is the most common cause of cardiac arrest in infants and children? A) Heart birth defect B) Accidental overdose C) Respiratory compromise D) Abuse and neglect

: C Diff: 1 Page Ref: 497

: 16-18 3 Copyright © 2018 Pearson Education, Inc. 9) What is the typical resting respiratory rate for an elderly patient? A) 10 breaths/min B) 15 breaths/min C) 20 breaths/min D) 30 breaths/min

: C Diff: 1 Page Ref: 502

: 16-18 56) Which of these statements regarding ventilation in a healthy patient is true? A) Inspiration requires little energy; expiration requires much energy B) Both inspiration and expiration require the same amount of energy C) Inspiration is an active process that requires energy; expiration requires little to no energy D) Inspiration and expiration require no energy in a healthy person

: C Diff: 1 Page Ref: 506

: 17-2 67) The three primary components of the cardiovascular system are best described as: A) Arteries, veins, and capillaries B) Heart, lungs, and blood vessels C) Heart, blood vessels, and blood D) Heart, blood vessels, and brainstem

: C Diff: 1 Page Ref: 521

: 16-19 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 17 Cardiovascular Emergencies 1) The primary function of the heart is to: A) Store blood B) Oxygenate blood C) Circulate blood D) Produce blood

: C Diff: 1 Page Ref: 522

: 17-17 99) What are the protein strands that strengthen a clot called? A) Thrombin B) Platelets C) Fibrin D) Plaque

: C Diff: 1 Page Ref: 527

: 17-16 8 Copyright © 2018 Pearson Education, Inc. 27) You are completing the prehospital care report and are documenting the fact that you assisted a patient in taking his nitroglycerin pill. How will you document the route of administration? A) Oral B) Topical C) Sublingual D) Buccal

: C Diff: 1 Page Ref: 538

: 17-18 49) The EMT should most suspect a patient has angina when he takes which medication? A) Lasix B) Aspirin C) Nitroglycerin D) Glucophage

: C Diff: 1 Page Ref: 538

: 17-16 53) You have just arrived by the side of a 68-year-old male patient who complains of chest pain. After determining his airway is patent and breathing adequate, it is imperative that you perform which action next? A) Auscultate his breath sounds B) Determine whether he takes nitroglycerin C) Check his radial pulse D) Obtain a full set of vital signs

: C Diff: 1 Page Ref: 542

: 18-14 58) For altered mental status to occur, which body system must be affected? A) Cardiovascular B) Respiratory C) Central nervous D) Endocrine

: C Diff: 1 Page Ref: 556

: 18-7 31) A patient has an altered mental status accompanied by loss of motor function on one side of the body. The EMT must suspect which condition as the cause of this presentation? A) Seizure B) Hypoglycemia C) Stroke D) Syncope

: C Diff: 1 Page Ref: 566

: 18-11 7) When assessing a patient for a facial droop, the EMT should: A) Palpate the face one side at a time B) Gently lift and then let go of the skin over the cheeks C) Ask the patient to show you his teeth or smile D) Observe the patient's ability to turn his head to the right and then to the left

: C Diff: 1 Page Ref: 571, Figure 18-7

: 18-11 14 Copyright © 2018 Pearson Education, Inc. 53) Which of these statements made by the EMT indicates a correct understanding of caring for someone with a headache? A) "Unless the patient has some sort of past medical history, a headache is not a true emergency." B) "If a patient calls 911 for a headache, it is most likely a life-threatening condition." C) "Assessment is essential in determining if a patient's headache represents a life-threatening condition." D) "In general, a headache is considered serious only if the pain is felt throughout the entire head."

: C Diff: 1 Page Ref: 579

: 3-18 67) You have responded to a "man down" call one winter morning. Upon arrival, you find an elderly male patient lying parallel to the sidewalk, in a bank of shoveled snow. It appears as if the man was walking and either tripped or fell into the snowbank. The patient is in cardiac arrest. In this scenario, which finding would NOT be considered a presumptive sign of death? A) Closed eyes B) No pupillary response C) Low body temperature D) Absent reflexes

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: 19-11 42) You have been called to an alcoholic rehabilitation center for a 56-year-old male patient whose left arm suddenly began to shake uncontrollably. He is alert and oriented, and he is terrified that he cannot stop his arm from moving. Which type of seizure should you suspect? A) Complex partial B) Generalized C) Simple partial D) Psychomotor

: C Diff: 1 Page Ref: 590

: 19-2 31) Which type of seizure occurs in children and is caused by a high core temperature? A) Idiopathic B) Hypoglycemic C) Febrile D) Eclamptic

: C Diff: 1 Page Ref: 590

: 19-7 11) How would you transport a patient experiencing a seizure who is strongly suspected of having a cervical spine cord injury? A) Supine on the stretcher with straps loosely applied B) In lateral recumbent position with a cervical collar in place C) With spine motion restriction precautions applied and a cervical collar in place D) In semi-sitting position with a cervical collar in place

: C Diff: 1 Page Ref: 595

: 19-8 2 Copyright © 2018 Pearson Education, Inc. 4) As a general rule, a postictal patient should be placed on the stretcher and transported in which position? A) Supine B) Semi-Fowler's C) Lateral recumbent D) Prone

: C Diff: 1 Page Ref: 595

: 1-1 4) As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners include: A) Ambulance drivers B) EMS medical director C) Paramedics D) Emergency medical dispatchers

: C Diff: 1 Page Ref: 6-7

: 3-20 41) EMS providers must report which of these suspected events to law enforcement? A) Alcohol abuse and child abuse B) Drug addiction and drug-related crimes C) Physical and mental abuse D) Refusal of EMS services

: C Diff: 1 Page Ref: 60

: 20-1 14 Copyright © 2018 Pearson Education, Inc. 53) The most common complaint of patients with diabetes for which EMS is summoned is: A) Desire for sugary foods B) Difficulty breathing C) Altered mental status D) Nausea and vomiting

: C Diff: 1 Page Ref: 605

: 20-4 15 Copyright © 2018 Pearson Education, Inc. 58) A glucometer is a tool the EMT can use to measure: A) Insulin levels B) Glycogen levels C) Blood sugar levels D) Carbohydrate levels

: C Diff: 1 Page Ref: 608

: 20-11 12) You are instructing EMT students on how to obtain a blood sample for use in a glucometer. You are providing accurate information when you state: A) "It is best to check the blood three times and then use the highest reading." B) "Approximately 15 mL of blood will be needed for an accurate result." C) "A small drop of blood obtained from the patient's fingertip is sufficient." D) "Have the patient raise his or her arm in the air before you obtain the blood sample."

: C Diff: 1 Page Ref: 609, Table 20-1

: 20-8 30) Medical direction has ordered you to administer one dose of oral glucose to a patient with diabetes who is exhibiting confusion. Which of these best describes what you should do? A) Repeat and question the order to medical direction B) Place half the contents of the tube of glucose in the patient's mouth C) Carefully administer the entire tube of glucose D) Have the patient swallow all of the glucose in the tube

: C Diff: 1 Page Ref: 613, Figure 20-6

: 19-9 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 20 Acute Diabetic Emergencies 1) You suspect that an unresponsive female patient may be diabetic. To help confirm this suspicion, where would you send your partner to look for vials of insulin? A) Bathroom B) Bedside table C) Refrigerator D) Nightstand

: C Diff: 1 Page Ref: 627

: 21-9 29) You have assisted an adult patient with his epinephrine auto-injector. When giving a report to the emergency department nurse, you should inform her that which dose of epinephrine was administered? A) 0.1 mg B) 0.25 mcg C) 0.3 mg D) 0.3 mcg

: C Diff: 1 Page Ref: 640

: 22-1 2) Which of these correctly identifies the routes by which a poison can enter the human body? A) Exposure, ingestion, inhalation, injection B) Topical, inhalation, nasal-oral, absorption C) Ingestion, inhalation, injection, absorption D) Inhalation, injection, nasal-oral, visual

: C Diff: 1 Page Ref: 652

: 22-4 10) Which of these is the EMT's highest priority when presented with a patient who has been exposed to a poisonous substance? A) Identify the poison B) Induce vomiting C) Perform a primary assessment D) Administer activated charcoal

: C Diff: 1 Page Ref: 653-654

: 22-11 5 Copyright © 2018 Pearson Education, Inc. 16) You have been called to a residence for a 14-year-old male patient, who states that he intentionally took some medication to kill himself. Assessment indicates that he is alert and oriented, and has an open airway and adequate breathing. Given the situation, the EMT's next action should be to: A) Ask the patient if he feels nauseated B) Determine what was taken C) Check the radial pulse and skin characteristics D) Inquire why the patient took the medication

: C Diff: 1 Page Ref: 655

: 22-8 70) A drug addict informs you that he has been taking OxyContin and now requires more and more of the drug to take his chronic back pain away. The EMT would recognize this patient as experiencing: A) Overdose B) Dependence C) Tolerance D) Adverse reaction

: C Diff: 1 Page Ref: 682

: 4-4 7 Copyright © 2018 Pearson Education, Inc. 23) Which statement describes an advantage of computerized documentation? A) A computerized reporting system is less expensive initially when compared to a system using handwritten PCRs B) A computer system does not need special maintenance; a system using handwritten run reports does C) Large amounts of data can be stored and retrieved much more easily than with handwritten PCRs D) There is much less documentation involved with electronic systems than with handwritten reports

: C Diff: 1 Page Ref: 69

: 22-21 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 23 Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies 1) When palpating the anterior portion of a patient's abdomen, you note tenderness to the left upper quadrant. As a knowledgeable EMT, you would recognize that which organ is most likely to be involved? A) Kidney B) Gallbladder C) Spleen D) Liver

: C Diff: 1 Page Ref: 698

: 23-2 12) The pancreas would best be described as which type of organ? A) Vascular B) Hollow C) Solid D) Perforated

: C Diff: 1 Page Ref: 699, Figure 23-1

: 23-10 56) Which of these statements is true concerning the functions of the vagina? A) The vagina allows for the passage of a baby during delivery and the outlet of urine from the bladder B) The vagina permits the outflow of menstrual blood and is the site of fertilization for the egg and sperm C) The vagina serves as a passage for the fetus during delivery as well as an outlet for blood during menstruation D) The vagina allows for the excretion of urine from the bladder and accommodates the penis during intercourse

: C Diff: 1 Page Ref: 714

: 1-13 43) Which item of protective gear is appropriate to wear at an automobile collision? A) Gown B) A HEPA mask C) Reflective clothing D) SCBA gear

: C Diff: 1 Page Ref: 9

: 5-6 46) While going through your probationary period as a new EMT with the community-based EMS system, you are learning all the numeric codes the department uses during radio traffic. What is NOT a benefit of using and relying on radio codes? A) Use of radio codes shortens the air time during verbal transmissions B) Use of radio codes allows transmission of sensitive information in a format likely not understood by the patient or public C) The complexity involved in remembering all the radio codes helps assure that everyone using the radio is a knowledgeable EMT D) The radio codes can provide clear and concise information

: C Diff: 1 Page Ref: 92

: 5-9 26) Haptics is the study of: A) Maintaining eye contact B) Nonverbal response C) Touching D) Asking questions

: C Diff: 1 Page Ref: 96

: 4-7 28) A patient care report reads: "c/o fall with (R) hip pain; FROM to (R) low. ext." Based on this, you should recognize that the patient's: A) Right hip appears broken B) Right hip is dislocated, but not fractured C) Right leg can be moved normally D) Right leg is not broken, but cannot be moved freely

: C Diff: 1 Page Ref: Table 4-2 Abbreviations

: 5-17 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 6 Lifting and Moving Patients 1) Which statement accurately describes the concept of body mechanics? A) Body mechanics refers to an exercise program designed to increase strength and prevent injuries when lifting or moving patients B) Body mechanics describes the personal maintenance of a proper weight and posture so that on-the-job injuries are minimized C) Body mechanics refers to methods that promote using your body in the safest and most efficient way when moving objects or patients D) Body mechanics describes a process by which the EMT can gauge or estimate the type of injuries sustained in a traumatic incident

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: 6-3 28) When reaching forward to perform a logroll, the EMT should: A) Keep the back flexed B) Lean from the waist C) Use the shoulder muscles D) Reach no more than 30 inches

: C Diff: 2 Page Ref: 106

: 6-7 11) You have been charged with writing a policy regarding reaching for equipment. In that policy, you indicate that the maximum distance an EMT should reach is no more than: A) One arm's length in front of her body B) 10 to 12 inches in front of her body C) 15 to 20 inches in front of her body D) 30 inches in front of her body

: C Diff: 2 Page Ref: 106

: 6-8 5 Copyright © 2018 Pearson Education, Inc. 18) A patient involved in a motor vehicle collision has critical injuries and must be removed from the car for care and transport to the hospital. Prior to removing the patient from the vehicle, what must be done? A) Application of a vest-type immobilization device B) Completion of the primary and secondary exams C) Application of a cervical collar D) Completion of the primary assessment and vital signs

: C Diff: 2 Page Ref: 108

: 6-10 36) You are trying to convince the equipment committee to purchase a hydraulic power cot. When discussing advantages of this device over a more traditional stretcher, which point would you emphasize? A) It is considered much safer for transporting a child car seat B) It is much lighter, more durable, and easier to maneuver C) It will be easier to lift and lower when it is loaded with a patient D) It enables one EMT to safely move the stretcher, freeing another for patient care

: C Diff: 2 Page Ref: 112

: 6-11 23) Which observation demonstrates that the EMTs and EMRs are correctly using the stair chair? A) The wheels of the stair chair touch each and every step B) The stair chair slides down the stairs while tilted forward C) The patient is carried down the stairs feet first D) The stair chair is carried down the stairs with the chair tilted forward

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: 6-3 29) After providing spinal motion restriction to an elderly female patient who fell in her bathroom, you prepare to carry her down a flight of stairs on a backboard. Which verbal instructions would be most appropriate to give to your partner? A) "Make sure to hold the board 6 inches from your body so that you get maximum stabilization." B) "It is best if we do not talk so that we can concentrate on safely moving her down the stairs." C) "I can take the head if you want the foot end, and then we will carry her down the stairs feet first." D) "Let's have the patient hold onto the stair railing to prevent the board from getting off balance."

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: 1-10 5 Copyright © 2018 Pearson Education, Inc. 16) You are interviewing for the position of EMT with a busy urban service. This morning you are to meet with the service's medical director. You have been told that she likes it when applicants ask questions about her role as the medical director. Related to her responsibilities as medical director, which question is most appropriate? A) "How do you determine the wages that the EMTs are paid?" B) "How do you determine the number and location of ambulances within the system?" C) "How often are the emergency care protocols updated?" D) "Do you assign the daily chores that must be completed around the stations?"

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: 1-7 14) You have been asked to sit on your service's quality improvement (QI) committee. As a knowledgeable EMT, you recognize that in this role you will be involved in projects that are primarily designed to: A) Communicate with insurance companies for increased reimbursement B) Recruit and educate EMTs about the Emergency Medical Services profession C) Develop ways in which the delivery of emergency care can be improved D) Identify and reeducate EMTs who routinely do not provide proper care

: C Diff: 2 Page Ref: 13

: 7-7 17) A patient complains of pain to the upper jaw. This would be documented as pain in the: A) Mandible B) Zygoma C) Maxilla D) Mastoid

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: 7-7 64) Knowing that muscular dystrophy affects the voluntary muscles, which additional problem should you expect to be a direct effect of the disease? A) Constipation B) Slow heart rate C) Inability to walk D) Vasodilation

: C Diff: 2 Page Ref: 141

: 7-7 5 Copyright © 2018 Pearson Education, Inc. 19) Occlusion to which pulmonary structure would cause total cessation of airflow into and out of the lungs? A) Right bronchi B) Nasopharynx C) Trachea D) Esophagus

: C Diff: 2 Page Ref: 146

: 7-10 21) The alveoli of a patient's lungs are filled with fluid and pus secondary to pneumonia. How does this disturbance place the patient at risk? A) Decreased movement of air into the lungs B) Decreased movement of the diaphragm C) Decreased absorption of oxygen into the body D) Collapse of the trachea and bronchi

: C Diff: 2 Page Ref: 147

: 7-2 93) For the lungs to oxygenate blood, there must be blood flow provided by the right ventricle to the alveoli. This is an example of which principle? A) Anatomy B) Pathophysiology C) Physiology D) Anatomic actions

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: 7-14 30) Which portion of the heart is in failure when it can no longer effectively pump blood to the lungs? A) Left atrium B) Left ventricle C) Right ventricle D) Pulmonary vein

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: 7-7 11 Copyright © 2018 Pearson Education, Inc. 46) Assessment of an elderly male patients reveals that he is confused. His family states that this status is normal for him because he has a disease of his brain that has affected his ability to remember things. Based on this information, in which area of the brain is this disease located? A) Pons B) Brainstem C) Cerebrum D) Cerebellum

: C Diff: 2 Page Ref: 157

: 7-18 52) As a patient provides you with her past medical history, which condition should you recognize as directly related to the endocrine system? A) Blockage of the gallbladder B) Failure of the kidneys C) Removal of the thyroid D) Enlargement of the appendix

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: 7-21 69) A patient with asthma is short of breath because her small airways are constricted. For this patient, the best medication is one that has which sympathetic (adrenergic) properties? A) Alpha-1 B) Beta-1 C) Beta-2 D) Alpha-2

: C Diff: 2 Page Ref: 162

: 7-23 75) A patient with kidney failure has lost his ability to: A) Produce all hormones B) Absorb nutrients C) Filter and excrete wastes D) Digest fatty foods

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: 7-27 78) A patient with bronchitis is experiencing: A) Fluid in the trachea and bronchioles B) Infection of the alveoli C) Inflammation of the bronchi D) Accumulation of mucus in the trachea

: C Diff: 2 Page Ref: 170, Table 7-2

: 7-27 85) Nephritis indicates which kind of infection? A) Urinary tract B) Bladder C) Kidney D) Digestive

: C Diff: 2 Page Ref: 171, Table 7-2

: 8-3 3) Under normal circumstances, carbon dioxide is excreted from the body through the: A) Kidneys B) Urinary tract C) Lungs D) Sweat ducts

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: 8-3 3 Copyright © 2018 Pearson Education, Inc. 10) Perfusion is best described as: A) Availability of oxygen in the lungs for movement into the blood B) An adequate number of white blood cells to carry oxygen to the cells C) Delivery of essential products and nutrients to the cell for its use D) Exchange of oxygen and carbon dioxide between the lungs and blood

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: 8-9 8 Copyright © 2018 Pearson Education, Inc. 31) An unresponsive patient with a pulse is breathing with very shallow respirations at a rate of 6 breaths per minute. Which intervention would be most beneficial for this patient? A) Positive pressure ventilation with supplemental O2 at a rate of 30 breaths/min and a tidal volume of 200 mL B) Oxygen at 15 liters per minute delivered through a nonrebreather face mask and then reevaluate in 60 seconds C) Positive pressure ventilation with a rate of 12 breaths/min and a tidal volume of 500 mL D) Oral airway and positive pressure ventilation at 40 breaths/min, supplemental O2, and a tidal volume of 100 mL

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: 8-10 24) Which condition is most likely to cause acidosis? A) Irregular heart rhythm B) Hypothyroidism C) Depressed respirations D) Low blood glucose level

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: 8-3 2 Copyright © 2018 Pearson Education, Inc. 6) A patient's lungs are full of fluid and cannot transfer oxygen to the blood. As a result, she is undergoing anaerobic metabolism. She has a decreased level of consciousness with a patent upper airway and inadequate respirations. Her pulse is rapid and weak. Which prehospital treatment would best address this situation? A) High-concentration oxygen through a nonrebreather face mask B) Administration of one tube of oral glucose by the EMT C) Positive pressure ventilation with supplemental oxygen D) Insertion of a nasal airway and delivery of oxygen through a nasal cannula

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: 8-11 34) Which condition is recognized as one that will affect the ventilation component of the ventilation/perfusion ratio? A) Blood clot in the pulmonary blood vessels B) Loss of blood plasma from dehydration C) Infection and pus in the distal airways and alveoli D) Decreased amount of hemoglobin in the blood

: C Diff: 2 Page Ref: 190-191

: 8-15 42) On scene, a 43-year-old male states that he has a history of liver failure and does not produce enough of the protein albumin. Given this condition, which finding(s) would you expect? A) Elevated temperature and signs of infection B) Low SpO2 reading from significant edema C) Swelling of the extremities and abdomen D) Decreased heart rate and signs of hypoxia

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: 8-16 45) Paramedics have administered a medication to a patient with heart failure. The medication specifically causes the veins (only) to dilate, thereby decreasing the amount of blood that returns to the heart for pumping. The EMT would recognize this action as decreasing: A) Afterload B) Pulse pressure C) Preload D) Systemic vascular resistance

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: 8-17 53) If a patient's blood pressure cannot be increased by adding volume, then which other action would most likely be successful in increasing it? A) Blocking beta actions of the sympathetic nervous system B) Decreasing the patient's preload C) Vasoconstriction of the body's arteries D) Decreasing the patient's afterload

: C Diff: 2 Page Ref: 196-197

: 8-16 13 Copyright © 2018 Pearson Education, Inc. 52) A patient with a temperature of 105.4°F is experiencing systemic vasodilation. Which finding would be consistent with this condition? A) Slow heart rate B) Elevated afterload C) Decreased blood pressure D) Pale and cool skin

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: 8-17 14 Copyright © 2018 Pearson Education, Inc. 57) When a patient has a narrowed pulse pressure, what is occurring? A) The heart rate is decreasing B) The veins and arteries are dilating C) The blood vessels are constricting D) The blood is being pumped more quickly

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: 9-3 3) When assessing a sick 3-week-old baby, which finding would be most concerning? A) Fontanelle level with the skull B) Soft spot to the top of the head C) Mucus occluding both nares D) Rectal temperature of 99.4°F

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: 9-1 17) When assessing a neonate, which finding would deserve closer investigation? A) Intermittent crying B) Temperature of 99.6°F C) Heart rate of 82 beats per minute D) Respirations of 40 breaths/min

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: 9-1 7 Copyright © 2018 Pearson Education, Inc. 24) You are caring for a 6-month-old male patient who is fussy and crying, and who has a fever. Which action would be most appropriate? A) Talk to the parents rather than the baby, since a stranger's voice is upsetting B) Wait for the baby to stop crying so that you can properly assess him C) Keep the parents calm even though you are actually caring for the baby D) Distract the baby with a small toy or ball so that you can assess him

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: 9-4 26) A 3-year-old child is very fearful when you listen to his breathing and lungs with the stethoscope. Your best course of action would be to: A) Forego listening to the boy's breath sounds B) Listen to the breath sounds regardless of the boy's reaction C) Have the boy watch as you listen to his father's lungs D) Tell the patient that you must listen to his lungs and then do it

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: 9-5 3 Copyright © 2018 Pearson Education, Inc. 9) You are en route to a home for an 8-year-old child with "noisy" breathing and a cough. As you respond, which piece of advice would you give your partner, a new EMT? A) "We will need to be careful. Children of this age group tend to throw tantrums, and we could get hurt if we are not careful." B) "The scene probably will be chaotic, so let's just get the patient out to the ambulance and assess him there." C) "Although most children of this age are trusting of authority, let's approach slowly and make the scene work for us." D) "Most children in this age group have a short attention span, so we need to assess him as quickly as possible before he gets angry or upset."

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: 2-3 2) You are doing CPR on a male patient who is unresponsive, not breathing, and pulseless. Emergency Medical Responders (EMRs) were on scene first and applied the AED, which did not deliver a shock to the patient. The patient's wife is crying and asks how her husband is doing. Your response would be: A) "I have to be honest, he is probably dead, but we are going to take him to the hospital so the doctor can examine him and make sure." B) "Why don't we wait until we get to the hospital to talk about your husband's condition?" C) "Right now he is not breathing and his heart is not beating, but we are doing everything we possibly can for him." D) "I am not a doctor, but his current condition is very grave and he will likely die, based on my previous experiences."

: C Diff: 2 Page Ref: 22

: 10-3 7) The EMT exhibits an accurate understanding of breathing when he states: A) "When a person inhales, carbon dioxide is drawn into the lungs, and when he exhales, oxygen leaves the body." B) "Respiration is best described as the process of moving air into and out of the body." C) "Inhalation requires energy, while exhalation for most patients is a passive process." D) "In between breaths, the epiglottis protectively closes over the trachea."

: C Diff: 2 Page Ref: 221-222

: 10-23 67) Which of these statements indicates that the EMT has a correct understanding of the use of oxygen in the prehospital setting? A) "Oxygen should be withheld from a patient with chronic obstructive pulmonary disease." B) "If the patient has a poor tidal volume, oxygen should be administered at 15 lpm through a nonrebreather mask." C) "Oxygen should never, ever be withheld from a patient whom you think may need it." D) "If providing positive pressure ventilation, lower concentrations of oxygen may be used."

: C Diff: 2 Page Ref: 223

: 10-5 4) Which statement indicates that the EMT has an accurate understanding of the bronchioles? A) "They are large structures that pass oxygen from the lungs directly into the bloodstream." B) "They are small air sacs located just before the alveoli." C) "They are small passages located in the lower airway that have smooth muscle surrounding them." D) "They are large airways located after the carina and are supported by cartilage."

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: 10-20 118) Which of these conditions would result in the greatest decrease in oxygen delivery to the cells? A) Heart rate greater than 120 beats/ min B) Diastolic blood pressure greater than 100 mmHg C) Decreased amount of circulating hemoglobin D) Temperature greater than 103°F

: C Diff: 2 Page Ref: 224-225

: 2-3 49) As an EMT, you would recognize what situation as having the greatest potential for causing emotional stress? A) Lifting and moving an obese patient from a second-floor bedroom B) Being required to show up for a shift 15 minutes prior to its start C) Caring for a child whose parents have appeared to have neglected him D) Responding to many EMS calls during the course of a shift

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: 2-4 8 Copyright © 2018 Pearson Education, Inc. 28) A coworker is suffering from posttraumatic stress. Which statement made by you would be the most appropriate and beneficial to the coworker? A) "It would be best to take a few weeks off from work." B) "Maybe you can get the medical director to write a prescription for some medication." C) "I think that it would be best if you saw a mental health professional." D) "How about taking a Benadryl before bed to promote restful sleep?"

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: 10-7 20) Which statement regarding airway management in the trauma patient is correct? A) The jaw-thrust maneuver is useful in the trauma patient, but only if he or she is complaining of head or neck pain B) Research has shown that the jaw-thrust maneuver is easier to perform and, therefore, is indicated for the more critical trauma patient C) Performing the head-tilt, chin-lift maneuver on a patient with a possible spinal injury could further injure or paralyze the patient D) Trauma patients should always have their airway opened with the jaw-thrust maneuver, whereas medical patients should receive the head-tilt, chin-lift only

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: 10-6 24) While you are transporting a patient with altered mental status, he suddenly vomits partially digested food along with large blood clots. The vomitus is too big for the rigid suction catheter. The EMT should immediately place the patient on his side and: A) Use a soft suction catheter B) Administer abdominal thrusts C) Perform a finger sweep D) Encourage the patient to cough

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: 10-8 7 Copyright © 2018 Pearson Education, Inc. 25) You must suction the oropharynx of a male patient who has a decreased ability to swallow secondary to a previous stroke. He also has a history of smoking and lung cancer. What would be the most appropriate suction catheter for use with this patient? A) Soft B) Texas C) Yankauer D) French

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: 10-11 87) A 21-year-old female patient has overdosed on an unknown drug. She has snoring respirations and an intact gag reflex. She has weak respiratory effort and is slightly cyanotic. Given these assessment findings, your care should include: A) placement of an oropharyngeal airway B) oxygen via nonrebreather face mask C) insertion of a nasal airway D) transport of the patient in the lateral recumbent (recovery) position

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: 10-14 34) Which configuration on the bag-valve mask (BVM) will enable the EMT to deliver the highest concentration of oxygen to the patient? A) BVM with room-air oxygen being used by two EMTs B) BVM attached to oxygen at 15 lpm C) BVM with oxygen reservoir attached, receiving oxygen at 15 lpm D) BVM with oxygen reservoir attached

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: 2-4 9 Copyright © 2018 Pearson Education, Inc. 32) A shooting at a public mall leaves three people dead and nine injured, several critically. As operations wind down, many rescuers are physically and emotionally upset. Which event may be most appropriate at this specific time? A) A critical incident stress debriefing session (CISD) B) A discussion on how to reduce cumulative stress C) A gathering that allows the rescuers to vent their emotions D) Providing information about mental health programs

: C Diff: 2 Page Ref: 26

: 10-17 26 Copyright © 2018 Pearson Education, Inc. 99) For which of these disease processes would continuous positive airway pressure (CPAP) be most beneficial? A) Asthma with mild shortness of breath B) Stroke with agonal respirations C) CHF with moderate to severe dyspnea D) Altered mental status with history of COPD

: C Diff: 2 Page Ref: 261

: 10-18 27 Copyright © 2018 Pearson Education, Inc. 103) Typically, the highest continuous positive airway pressure (CPAP) pressure used by the EMT without special permission from medical direction is: A) 2 cmH2O B) 5 cmH2O C) 10 cmH2O D) 20 cmH2O

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: 10-24 82) A patient was eating dinner when a piece of food became caught in his throat. Although coughing has failed to remove the food, he remains able to move an adequate amount of air into and out of his lungs. A nasal cannula has been applied and vital signs are stable. During transport, the patient suddenly begins to exhibit stridorous respirations. Your immediate action should be to: A) Continue care and transport B) Start positive pressure ventilation C) Perform abdominal thrusts D) Place the patient supine and suction his airway

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: 10-12 91) A patient with chest discomfort has the following vital signs: pulse, 88; respirations, 14 breaths/min; blood pressure, 154/84 mmHg; and SpO2, 97% on room air. In this situation, the EMT would address oxygen therapy by: A) Using a nasal cannula with flow of 4 lpm B) Administering blow-by oxygen at 5 lpm C) Withholding the use of oxygen D) Providing oxygen via a nonrebreather at 15 lpm

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: 10-23 17 Copyright © 2018 Pearson Education, Inc. 64) You are checking the D oxygen tank in the ambulance and note that the reading on the pressure regulator is 1000 psi. You should recognize that the tank is: A) Leaking B) Overfilled C) Half full D) Almost empty

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: 10-2 29 Copyright © 2018 Pearson Education, Inc. 112) Which of these conditions would the EMT associate with a hypoxic respiratory drive? A) Congestive heart failure B) Pneumonia C) Chronic obstructive pulmonary disease D) Diabetes

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: 10-12 73) Despite coaching and explaining the benefits of a nonrebreather face mask, a hypoxic patient with moderate shortness of breath in conjunction with lung cancer states that she cannot tolerate the mask over her face. The more she panics, the worse the shortness of breath becomes. What is your best course of action? A) Remove the nonrebreather mask and apply a simple face mask B) Decrease the oxygen flow rate entering the nonrebreather face mask C) Disconnect the nonrebreather mask and replace it with a nasal cannula D) Discontinue oxygen therapy and continually monitor the patient's breath sounds during transport

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: 10-24 75) Which oxygen administration systems will provide the patient with the greatest amount of oxygen? A) Nasal cannula at 15 liters per minute of oxygen B) Simple face mask at 12 liters per minute of oxygen C) Nonrebreather face mask at 15 liters per minute of oxygen D) Venturi face mask set to deliver 40% oxygen

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: 10-11 19 Copyright © 2018 Pearson Education, Inc. 72) Assessment findings for an alert and oriented patient complaining of shortness of breath reveal an open airway and strong radial pulse, accompanied by skin that is cool and diaphoretic. The depth of respirations is adequate, and breath sounds include wheezing throughout the lungs. Vital signs are a pulse of 124, respiratory rate of 24 breaths/min, blood pressure of 146/82 mmHg, and SpO2 of 93%. The patient has a history of asthma, for which he takes medications. How should you initiate oxygen therapy on this patient? A) Nonrebreather mask B) Venturi mask C) Nasal cannula D) Bag-valve mask

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: 10-24 77) An elderly male patient who is short of breath is on home oxygen. He is wearing a nasal cannula connected to an oxygen tank with the flow regulator set to 3 liters per minute. As a knowledgeable EMT, you should recognize that the patient is getting approximately what percentage of oxygen with each breath? A) 20% B) 24% C) 32% D) 40%

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: 2-9 5) What is the single best technique that the EMT can use to prevent the spread of infection? A) Disinfecting equipment B) Wearing gloves C) Washing hands D) Getting immunizations

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: 11-4 6) Which of these statements made by your EMT partner indicates that he understands assessment of a patient's breathing? A) "As long as the patient is breathing more than 20 times per minute, he is getting enough oxygen in his body." B) "If the respiratory rate is normal, the patient is breathing adequately and getting enough oxygen." C) "A rate less than 8 times per minute may allow adequate breathing, but requires further evaluation and assessment." D) "To determine if a patient is adequately breathing, the EMT must get a full set of vital signs."

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: 2-9 6) The EMT is correctly performing routine handwashing when she: A) Uses an alcohol-based hand sanitizer without water B) Rinses with hot water after using a disinfectant soap C) Lathers and scrubs with plain soap for 20 seconds D) Dries hands thoroughly for 30 seconds with a reusable towel

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: 11-6 13) You are assessing a 61-year-old male patient who is confused. During the primary assessment, you cannot locate a radial pulse. Your immediate action should be to: A) Apply the AED B) Call for ALS assistance C) Check for a carotid pulse D) Start CPR

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: 11-6 6 Copyright © 2018 Pearson Education, Inc. 20) You determine a patient's radial pulse is readily palpable, but has uneven intervals between beats. This finding would best be documented on the prehospital care report as: A) Bounding and regular B) Prominent and bounding C) Strong and irregular D) Thready and regular

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: 11-2 23) An EMT has accurately checked the skin color of a dark-skinned patient. How would this finding be best documented on a patient care report? A) "Warm skin noted on the upper arm." B) "Forehead and face show pink skin color." C) "Pale color noted to the conjunctiva." D) "Thoracic and abdominal skin normal in color."

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: 11-8 24) Which of these methods most accurately assesses a patient's skin temperature? A) Placing the tips of two fingers on the patient's wrist B) Using the palm to feel the patient's forehead C) Placing the back of the hand on the patient's abdomen D) Placing the inside of the EMT's arm against the patient's arm

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: 11-8 40) When assessing a patient's pupils, the EMT should: A) Shine a light in one eye and watch for the pupil to dilate B) Cover one eye and shine a light in the other eye, watching for changes to the size of the pupil C) Determine the size of the pupil and then look for a change in pupillary size while shining a light in the eye D) Instruct the patient to blink several times and observe the size of the pupils

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: 11-12 92) Which of these blood pressures represents diastolic hypertension in an adult patient? A) 240/88 mmHg B) 158/44 mmHg C) 136/92 mmHg D) 246/Palpation

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: 11-12 51) You are observing a new EMT just hired by your EMS agency. You know he has correctly positioned the blood pressure cuff on the patient's arm when: A) The cuff is placed over the antecubital space and elbow B) The cuff is centered over the top of the radial artery C) The cuff is on the same level as the patient's heart D) The cuff covers one-third of the patient's upper arm

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: 11-2 20 Copyright © 2018 Pearson Education, Inc. 76) A female patient with a history of asthma called 911 with a complaint of shortness of breath. On scene, you assisted her with the administration of her metered-dose inhaler containing albuterol. What can the EMT do to best determine if this patient's condition is improving? A) Ask the patient if she finds it easier to breathe B) Inquire if the patient feels the need for another dose of albuterol C) Obtain a pulse oximetry reading and breath sounds every 5 minutes D) Re-obtain a SAMPLE history and look for new information

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: 11-16 125) Your EMT student has a good understanding of end-tidal carbon dioxide monitoring when she states: A) "The normal value should be 45 to 55 mmHg." B) "End-tidal carbon dioxide monitoring should be used only when the patient is being artificially ventilated." C) "Any disturbance to the breathing, circulation, or metabolic state of the patient can alter the reading." D) "Only paramedics and AEMTs are allowed to utilize end-tidal capnography."

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: 11-15 27 Copyright © 2018 Pearson Education, Inc. 105) You have been dispatched to a residence for a 14-year-old female patient complaining of abdominal pain. As you enter the living room, you see the conscious patient lying on a couch with her father and an Emergency Medical Responder at her side. Which action should the EMT perform first? A) Determine the chief complaint B) Ask her father to leave the room C) Introduce yourself and your partner D) Get permission to treat the patient

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: 11-17 28 Copyright © 2018 Pearson Education, Inc. 109) You have been dispatched to a residence for a female patient with unknown injuries. At the patient's side, you quickly become aware that the 43-year-old female was assaulted by her husband. The husband comes into the room and states, "Don't you touch her, or I will take care of you, too!" What should be the EMT's immediate action? A) Control any active bleeding, and then leave the house B) Stay with the patient and contact law enforcement C) Leave the house immediately, taking the patient with you, if possible D) Restrain the husband so that you can care for the patient

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: 11-20 67) Which of these descriptions would be obtained when asking about the "A" component of the SAMPLE history? A) Abdomen soft B) History of asthma C) Allergy to penicillin D) Airway is open

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: 11-5 77) The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states: A) "The SAMPLE mnemonic helps EMTs diagnose a patient's medical problem." B) "It is important to use the SAMPLE mnemonic because the emergency department will need the information." C) "After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care." D) "The SAMPLE mnemonic is important because it will give the EMT the patient's exact chief complaint."

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: 2-12 3 Copyright © 2018 Pearson Education, Inc. 8) The hospital staff has just returned the long spine board that you used to immobilize a patient from a minor motor vehicle collision. There is no blood on the board, but your service policy states that all equipment is to be disinfected anytime that it is used. To properly disinfect the long spine board, which type of product should you use? A) Soap and water B) Sterilizing solution C) Germicidal solution D) Superheated steam

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: 12-2 7) Dispatch has sent you to a residence for a female patient with a possible broken arm. On scene, you find the patient seated in a chair holding her left arm. Her arm appears deformed and she has blood and bruises on her face. She tells you that an intruder, whom she believes lives in her neighborhood, broke into her home and robbed her. Prior to fleeing, he beat her, leaving her as you find her. With this information, you would immediately: A) Leave the patient and scene and wait in the ambulance until the police arrive B) Determine the identity of the intruder and contact and direct the police to his location C) Contact law enforcement, assess the patient, and initiate care D) Recognize a crime scene and not touch the patient to avoid altering any evidence

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: 12-7 5 Copyright © 2018 Pearson Education, Inc. 17) You and your partner are first on the scene of a bleacher collapse at a local raceway. As you exit the ambulance, you note several patients seated throughout the debris from the collapsed structure. In this situation, which action would you perform first? A) Determine the severity of injuries B) Wait for additional units to arrive C) Determine the number of patients D) Notify the local hospitals of a mass-casualty incident

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: 12-4 15) If a scene becomes unsafe after you have entered, you should first: A) Attempt to neutralize the threat B) Call for assistance on the radio C) Remove yourself from the scene D) Notify the EMS supervisor

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: 12-6 12) An intoxicated patient is complaining of a severe headache and a large bruise to the left side of his face after accidentally being struck with a baseball bat during a family picnic softball game. In this situation, being struck with the baseball bat is called the: A) Nature of illness B) Chief complaint C) Mechanism of injury D) Differential diagnosis

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: 13-7 15 Copyright © 2018 Pearson Education, Inc. 56) You are interviewing a prospective candidate for an EMT position with your service. During the interview, you ask the applicant to describe the purpose of the primary assessment. Which of these statements best describes that purpose? A) "Establish a chief complaint and gather the past medical history." B) "Determine whether the patient's vital signs are stable." C) "Identify and treat life-threatening conditions." D) "Perform an exam focused on the patient's chief complaint."

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: 13-8 8) An Emergency Medical Responder informs you that a 59-year-old female patient is responsive to verbal stimuli. What would be the most accurate representation of this status? A) She is able to answer all questions appropriately when asked B) She cannot be awakened when her name is called C) Her eyes are closed, but she will open them if asked D) She is awake, but having difficulty telling you her name and where she is

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: 13-4 34) Which of these patients should receive oxygen via an oxygenation adjunct such as an NRB or nasal cannula? A) A 39-year-old male with a sprained ankle who is breathing 16 times per minute B) An 18-year-old female who overdosed on a drug and is unresponsive and breathing 4 times per minute C) A 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute D) A 61-year-old male who is unresponsive, with a foreign body airway obstruction that cannot be removed with abdominal thrusts

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: 13-6 43) An intoxicated 19-year-old female patient has fallen through a large plate glass window. As you approach, you note her to be sitting up and holding her hand over a large laceration on her opposite arm that is still spurting bright red blood. In this situation, you would immediately: A) Provide high-concentration oxygen and treat for shock B) Determine the presence and rate of the carotid pulse C) Apply direct pressure to the laceration D) Assess the airway for patency and breathing for adequacy

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: 13-13 12 Copyright © 2018 Pearson Education, Inc. 44) A patient has called 911 for abdominal pain and generalized weakness. On arrival, you note that the patient's skin is a yellow-orange color. Which disease revealed to you during the history would best correlate to this patient's skin? A) Lung cancer B) Stroke C) Liver disease D) Diabetes

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: 13-4 59) You have completed the primary assessment on a patient who was thrown from a motorcycle and landed on his head and back on the nearby sidewalk. After initiating spine motion restriction and finding no life threats during the primary assessment, which action should you take first when starting a secondary assessment? A) Determine the patient's SAMPLE history B) Obtain baseline vital signs C) Conduct a physical exam D) Load the patient into the ambulance

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: 13-18 65) For which of these patients should the EMT perform a rapid head-to-toe secondary assessment, as opposed to a focused secondary assessment? A) A 22-year-old male who is alert and oriented with a deformed ankle that occurred when he tripped playing basketball and landed hard B) A 36-year-old construction worker who was shot in the hand with a nail gun; the nail remains impaled in his hand and bleeding is minor C) A 24-year-old male with stable vitals who is alert and oriented and is complaining of chest pain secondary to a motor vehicle collision in which the passenger was killed D) A 46-year-old roofer with a history of coronary heart disease, who complains of a burn to his left lower leg after being splashed with hot tar

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: 13-22 100) You are transporting an 18-year-old male patient who was injured in a motor vehicle collision. He has a decreased level of consciousness and has injuries to his head, chest, and lower right leg. While you are conducting the reassessment of the patient's head and neck, which of these actions is most appropriate? A) Maintaining the patient's airway with the head-tilt, chin-lift maneuver B) Placing a sterile dressing in the patient's right ear canal, which is oozing blood C) Taking time to carefully re-palpate the patient's face and scalp D) Carefully removing the cervical collar to reassess the back of the patient's neck

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: 13-19 64) While treating a patient who was assaulted by a mob of angry people in a bar, the EMT finds the patient to be confused, tachycardic, with cool skin and a poor capillary refill. Based on this information, how would you categorize this patient? A) Stable B) Potentially unstable C) Unstable D) Potential high priority

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: 13-23 107) A patient has a GCS of 14, is oriented, and converses and opens his eyes when asked. When asked, he will squeeze your fingers and wiggle his toes. How would you describe this patient's motor response? A) Has a positive Babinski sign B) Localizes pain C) Obeys verbal commands D) Withdraws from pain

: C Diff: 2 Page Ref: 389, Table 13-12

: 13-25 96) You have been called for an 83-year-old female patient who is having difficulty breathing. She informs you that she has congestive heart failure and feels as though she is filling up with fluid. The primary assessment shows her to be alert and oriented with inadequate breathing. Her pulse is rapid and weak, and her skin is cool and dry. When performing a secondary assessment, which sign related to heart failure would you specifically look for when examining this patient's neck? A) Bruising to the neck B) Deviated trachea C) Jugular vein distention D) Posterior tenderness on palpation

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: 13-17 92) During assessment of a responsive medical patient, you gather a medical history using the memory aid SAMPLE. To obtain information related to the "M" component, which question should you ask? A) "Do you have any past medical problems?" B) "Are you allergic to any medications?" C) "Are you currently taking any medications?" D) "Can you point to where it hurts the most?"

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: 3-17 87) A 31-year-old male is complaining of left-side flank pain that radiates into his groin. He is alert and oriented, and the primary assessment reveals no life-threatening conditions. Given the patient's status, your next step should be to: A) Gather medical information from the family B) Perform a rapid head-to-toe exam C) Obtain a medical history from the patient D) Repeat the primary assessment

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: 1-1 29) Which statement about emergency medical services in the United States is true? A) The EMS system is controlled and governed by the National Highway Transport and Safety Administration (NHTSA) B) The federal government oversees all aspects of EMS in the United States C) Each state has governmental control of its own EMS system, independent of the federal government D) The U.S. Department of Health and Human Services establishes curricula for all levels of EMS education

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: 1-3 11 Copyright © 2018 Pearson Education, Inc. 40) The functions of a state EMS agency include: A) Determination of the number of EMRs, EMTs, AEMTs, and paramedics allowed in the state B) Review of patient care reports (PCRs) to ensure proper care C) Planning and coordination of the statewide EMS system D) Encouraging fair wages for the different levels of EMS providers

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: 2-11 54) You are attempting to increase your cardiovascular endurance in an effort to better perform your job as an EMT. Which action would be most appropriate in working toward this goal? A) Increasing sleep to 8 to 10 hours per day B) Weight lifting with attention to the upper body C) Walking on a treadmill 3 to 4 times per week D) Doing stretching exercises every 4 hours while awake

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: 14-1 4) Which of these is a generic drug name? A) Albuterol B) Advil C) Aspirin D) Acetylsalicylic acid

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: 14-2 4 Copyright © 2018 Pearson Education, Inc. 13) Medical direction has ordered you to administer 162 mg of aspirin to a patient with chest pain. Your best response to this order would be: A) "Confirmed. I will recontact you with any changes in the patient's condition." B) "Copy. I will administer the medication as per your instruction." C) "Received. I will administer 162 mg of aspirin orally." D) "Affirmative. The patient has no allergies so I will administer the aspirin orally."

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: 14-9 5 Copyright © 2018 Pearson Education, Inc. 17) The label on a patient's prescribed metered-dose inhaler reads as follows: "Administer three puffs as needed for shortness of breath." Your protocols state that you can assist with only two puffs without medical direction consultation. The patient is extremely short of breath. What should you do? A) Administer three puffs B) Do not administer the medication C) Contact medical direction for orders to administer three puffs D) Administer two puffs

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: 14-2 26) Which of these statements, made by the EMT, shows an understanding of medication administration and drug dosages? A) "It is best to administer a little less than the required dose to decrease the chance of an allergic reaction." B) "If the patient is very sick, the dose of a medication can be increased to help the patient recover faster." C) "The proper dose of a medicine should be administered unless medical direction orders otherwise." D) "If a patient has chest pain with shortness of breath, the dose of a medication must be increased."

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: 15-2 64) Which of these conditions could be responsible for causing obstructive shock? A) Infection throughout the body B) Loss of blood in the urine C) Blood clots in the lungs D) Poor transfer of oxygen at the capillary level

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: 15-3 82) You have been called to transport a patient in septic shock from the emergency department of a local hospital to the critical care unit of another hospital. Two nurses will be accompanying you. As a knowledgeable EMT, you recognize that this state of shock has been caused by: A) Failing heart B) Blood loss C) Infection D) Fluid volume loss

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: 15-9 74) You suspect that a patient involved in a motor vehicle collision is in shock. Which sign or symptom of shock would you expect to see last? A) Tachycardia B) Increased respirations C) Decreased blood pressure D) Pale and diaphoretic skin

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: 15-3 68) As you approach a seemingly unresponsive patient, you observe a 1- to 2-inch circle of dark blood on his shirt. He also appears pale and diaphoretic. What should you do first? A) Apply oxygen B) Cut his shirt C) Assess his airway D) Treat for shock

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: 15-9 19 Copyright © 2018 Pearson Education, Inc. 69) You believe that a young male patient, who has been shot in the lower abdomen, is bleeding internally and is in the early stage of shock. Which of these descriptions includes appropriate prehospital care of this patient? A) Semi-Fowler's position and direct pressure over the injury site B) "Shock" position and administration of water by mouth C) Oxygen therapy and rapid transport to the hospital D) Oxygen therapy and warm packs to the abdomen

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: 15-12 11) A patient goes into cardiac arrest at 11:40 A.M. Which of these treatments gives the patient the best chance for recovery? A) CPR at 11:42 A.M. and advanced cardiac drugs at 11:48 A.M. B) Defibrillation at 11:46 A.M., followed by ALS (ACLS) at 11:51 A.M. C) CPR at 11:41 A.M. and defibrillation at 11:43 A.M. D) Defibrillation at 11:44 A.M., followed by CPR at 11:49 A.M.

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: 15-7 86) When comparing the pediatric Chain of Survival to the adult Chain of Survival, the EMT would note that the pediatric version differs in which way? A) Emphasis on ventilations over compressions B) Less attention to post-resuscitation care C) Prevention of cardiac arrest D) Emphasis on ALS over BLS

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: 15-15 6 Copyright © 2018 Pearson Education, Inc. 20) As you arrive at a metal scrap yard for an unknown medical emergency, you observe a male supine on the ground with AED electrodes on his chest. The AED operator has just ordered coworkers to clear the patient because the AED is going to shock. Within seconds, the AED delivers a shock without the operator pressing a "shock" button. The EMT should recognize that which type of AED is being used? A) Semi-automated B) Manual C) Fully automated D) Biphasic

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: 15-17 7 Copyright © 2018 Pearson Education, Inc. 24) A 7-year-old boy choked on a grape at school. By the time the obstruction was removed, assessment revealed him to be in cardiac arrest. When you arrive, teachers are performing CPR. The school nurse informs you that CPR has been in progress for 6 minutes. You have an AED, but do not have a pediatric conversion device that reduces the energy of defibrillation from that of an adult to that of a child. What should you do immediately? A) Perform five abdominal thrusts and then 1 minute of CPR before using the AED B) Continue CPR and transfer the boy to the stretcher for immediate transport C) Place the adult AED electrodes on the boy's chest and follow the AED's prompts D) Instruct the teachers to continue CPR for 2 additional minutes before applying the AED

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: 15-15 33) After analyzing the heart rhythm of a patient in cardiac arrest, the AED provides a "deliver shock" message. After clearing the patient, the EMT's next step should be to: A) Press the shock button, and then check for the return of a pulse B) Press the shock button, and then allow the AED to analyze the heart rhythm C) Press the shock button, and then perform CPR for 2 minutes D) Check for a pulse, and then press the shock button if a pulse is not present

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: 15-17 11 Copyright © 2018 Pearson Education, Inc. 39) A "no shock advised" message is provided by the AED. The EMT understands that this could mean: A) The patient is in ventricular fibrillation B) The electrodes may be loose C) The patient has regained a pulse D) CPR is no longer needed

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: 15-17 42) After two cardiac arrests occurred on its premises over the last 6 months, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be: A) "The AED will prompt you to recheck the pulse." B) "You will need to reanalyze the heart rhythm." C) "The AED will automatically charge and shock the patient." D) "You will need to press the shock button after the system charges."

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: 15-17 40) After the AED gives a "no shock advised" message, it is determined that the patient has a weak pulse and slow and shallow respirations. You would immediately: A) Transfer the patient to the stretcher for transport B) Provide 2 minutes of CPR C) Start positive pressure ventilation D) Obtain a blood pressure

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: 15-15 51) You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which of these factors would most likely be responsible for this message? A) Obese chest and abdomen B) History of asthma C) Hairy chest D) AED pads placed too far to the left

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: 15-20 14 Copyright © 2018 Pearson Education, Inc. 50) Which of these actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest? A) The EMT places the AED pads 2 inches away from a transdermal medication patch on the patient's chest B) The EMT intentionally withholds a shock on a patient in cardiac arrest who has an implantable defibrillator C) The EMT places, then quickly removes, a set of electrodes in an attempt to remove excessive hair from a patient's chest D) The EMT applies one electrode over the top of the power source for a pacemaker located on the patient's chest

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: 15-21 56) The owner of a day care center for adults with Alzheimer's disease calls you to ask about an AED at her facility. Specifically, she asks if she will need a physician to oversee the AED program. Your reply should be: A) "If you intend to use the AED on anyone younger than 50 years, a medical director will be needed." B) "A medical director is needed only if you are going to bill insurance companies for the provision of care; if you are not, a medical director is not needed." C) "You will need to have a physician medical director since the AED can be used only with his or her permission under his or her license." D) "If you get a semi-automated AED, you will need a physician medical director. Since fully automated AEDs are easier to use, a medical director is not needed."

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: 15-22 92) Mechanical external compression devices are recommended: A) By AHA 2015 guidelines as a preferred substitute for manual CPR B) Because patient ventilation is not required C) When high-quality manual compressions are not possible D) For short-term use only

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: 16-3 74) The EMT understands adequate breathing when he states: A) "If the respiratory rate is between 10 and 20 breaths/min, the breathing is most likely adequate." B) "If the patient is breathing faster than 22 breaths/min, it is inadequate." C) "Normal and adequate breathing is specific to the patient and is determined by assessment." D) "If the respiratory rate is between 10 and 20 breaths/min, with an intact airway and clear breath sounds, it is adequate."

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: 16-11 23 Copyright © 2018 Pearson Education, Inc. 83) A patient with an unknown medical problem is responsive to painful stimuli and breathing poorly at a rate of 8 breaths/min. The airway is patent and the skin warm and moist. The patient's radial pulse is strong and irregular. Breath sounds are absent over the bases of the lungs. Vital signs are pulse, 84; blood pressure, 256/120 mmHg; and SpO2, 81%. The best treatment for this patient's breathing difficulty would be: A) High-concentration oxygen through a nonrebreather mask B) Continuous positive airway pressure (CPAP) C) Positive pressure ventilation D) 2 to 4 liters of oxygen through a nasal cannula

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: 16-4 14 Copyright © 2018 Pearson Education, Inc. 49) You are by the side of a 77-year-old male patient with a complaint of shortness of breath. Auscultation of his lungs indicates crackles in the bases. In addition, both of his feet are swollen. His SpO2 on room air is 82%. The remainder of his vital signs are pulse, 144; respirations, 26 breaths/min; and blood pressure 168/90, mmHg. The patient reports lower back pain with a history of a "pinched nerve" in that area. He states that he always has this pain. He has difficulty finishing his sentences without gasping for air. What is the most appropriate care for this patient after initiating oxygen? A) Apply the AED in case he arrests en route to the hospital B) Initiate a bronchodilator through a small-volume nebulizer C) Transport him in a sitting position D) Provide spinal motion precautions and secure him to a long spine board for back pain

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: 16-12 69) Assessment of a 67-year-old male patient reveals absent lung sounds to the right lung, accompanied by sharp chest pain to the same side. When obtaining a history, which of these statements made by the patient's wife would the EMT recognize as most important? A) "He did not take his medications today." B) "He had a fever last night." C) "He has emphysema." D) "He has been in bed for 12 hours."

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: 16-12 47) You have arrived on scene to find a 32-year-old male patient who complains of rapid breathing, light-headedness, tachycardia, and numbness and tingling to his lips and hands. Family on scene report that he had just received bad advice from his attorney about a pending divorce when the symptoms started. The patient denies chest pain as well as any other past medical history. His pulse is 124, respirations are 52 breaths/min, and his blood pressure is 158/68 mmHg. What is your first course of action in treating this patient? A) Apply a nonrebreather face mask with low-flow oxygen, allowing the patient to rebreathe his exhaled carbon dioxide B) Monitor for spasms of the hand muscles and administer nitroglycerin C) Instruct the patient to close his mouth and breathe through his nose D) Have the patient breathe into a paper bag for approximately 5 minutes

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: 16-4 30) A 4-year-old boy in respiratory distress is sitting upright in bed and drooling. His mother states that he complained of a sore throat throughout the day, and tonight became severely short of breath and started drooling. He is alert with adequate breathing. His skin is very warm to the touch. Vital signs are pulse, 132; respirations, 28 breaths/min; and SpO2, 90% on room air. Which is your first action in caring for this child? A) Insert an oral airway and start ventilations B) Suction the airway of secretions C) Apply supplemental oxygen D) Use a tongue depressor to inspect for a foreign body obstruction

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: 16-14 64) Which of these pieces of information would heighten the EMT's suspicion that a child with a persistent cough may have whooping cough? A) Chest pain while coughing B) Cough for the past six months C) Never had childhood immunizations D) Cough worse during the day

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: 3-16 46) A patient who was transported by EMS for a laceration on her arm is suing the service and the hospital because her laceration became infected, resulting in loss of the extremity. However, it becomes known that the patient was appropriately treated by EMS and the emergency department, but failed to seek follow-up medical care at a health clinic and did not take the antibiotics that were prescribed to her. Which element would most likely be used by the medical community as a defense in this case? A) Res ipsa loquitor B) Proximate cause C) Contributory negligence D) Intentional tort

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: 3-5 10 Copyright © 2018 Pearson Education, Inc. 32) Which action best illustrates an EMT upholding a high ethical standard? A) Administering oxygen to patients who are short of breath B) Providing care that goes beyond the scope of practice C) Treating alcoholics and drug addicts with respect D) Informing other health care providers of patients in the community with AIDS

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: 3-5 63) In any situation in which a question arises regarding the scope or direction of care the EMT should provide to a patient, the EMT should: A) Notify the on-duty EMS supervisor B) Provide no treatment so as to "not cause harm," and transport the patient C) Contact medical direction at the receiving facility to which the patient is being transported D) Summon an ALS intercept and allow the paramedics to make the care decisions

: C Diff: 2 Page Ref: 49

: 16-14 15) Medical direction has ordered you to assist a patient in taking his metered-dose inhaler (MDI). After placing the patient's lips on the mouthpiece, which instruction would be most appropriate? A) "Please hold your breath and I will administer the medication." B) "Please inhale, then hold your breath, and I will give you the medication." C) "Please inhale slowly and I will administer the medication, then hold your breath." D) "Please exhale, hold your breath, and I will administer the medication."

: C Diff: 2 Page Ref: 493

: 16-15 15 Copyright © 2018 Pearson Education, Inc. 53) You have been called for a 3-year-old male patient who is "not breathing right." Aside from a notable expiratory wheeze, which of these findings would be a cause of great concern? A) Respiratory rate of 24 breaths/min B) Clinging to his mother and crying C) Prolonged and forced expiration D) Abdominal wall movement with inspiration

: C Diff: 2 Page Ref: 497

: 16-17 11) Which of these is considered an early sign of inadequate breathing in children? A) Blue-gray skin B) Barrel chest C) Nasal flaring D) Crying

: C Diff: 2 Page Ref: 497

: 16-6 26) You have been called for a 2-year-old male patient who is sick and having a difficult time breathing. On scene, you find the patient in his mother's arms. He appears to have labored breathing and skin that is warm to the touch. Which of these additional assessment findings would you recognize as the most serious? A) Continual crying accompanied by a fever of 99.4°F B) Respiratory rate of 28 breaths/min C) Grunting noise heard as the child exhales D) Slight abdominal movement with breathing

: C Diff: 2 Page Ref: 497-498

: 1-4 25) A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators are also emergency medical dispatchers, what sort of assistance will they be able to provide? A) Simultaneous notification of the hospital B) Whether the EMS response is covered by medical insurance C) Instructions on how to control bleeding D) The names of the EMTs who are responding

: C Diff: 2 Page Ref: 5

: 3-1 6) You have been called to a home for an alert and oriented female with terminal lung cancer. At the home, the daughter, who has her mother's durable power of attorney, states that she wants her mother transported to the hospital. The patient, who is alert and oriented, does not want to go. Which statement indicates that the EMT is acting both appropriately and legally in this conflict? A) "Since your daughter has the durable power of attorney, she has the legal right to make all decisions; therefore, we have to take you to the hospital." B) "As the person with your durable power of attorney, your daughter has the legally vested right to make your decisions; however, let us ask your husband what he thinks." C) "I know that you have the durable power of attorney, but your mother is alert and oriented so we cannot legally take her against her will." D) "Since it appears there is a conflict of opinion here, I will need to call the police so that they can determine what to do."

: C Diff: 2 Page Ref: 50

: 3-10 15) You have been dispatched for a 15-year-old female with a headache. On scene, you find the patient holding her 6-month-old son in her arms. This young mother states that she has had a migraine headache for two days and would like to be transported to the hospital for further evaluation. As an EMT, you should: A) Obtain a parent's consent to treat the patient, given her age B) Refuse transport since the patient does not have a true emergency C) Assess and transport the patient as she desires D) Treat the patient under the doctrine of implied consent

: C Diff: 2 Page Ref: 50

: 3-8 60) The EMT correctly understands a "Physician Orders for Life-Sustaining Treatment" document when he states: A) "A POLST must be signed by the court system and the patient and is valid for a period of no more than 5 years." B) "A POLST legally empowers another person to make health care decisions for the patient in the event he or she cannot do so." C) "A POLST is designed to allow a patient to choose the desired type of care prior to the need for resuscitation." D) "A POLST is the same as a 'Do Not Resuscitate' order, with the difference being that the physician does not have to sign it."

: C Diff: 2 Page Ref: 50-51

: 16-4 17 Copyright © 2018 Pearson Education, Inc. 61) The EMT indicates that he is properly assessing the patient's breath sounds when he gives which of these instructions to the patient? A) "Please take a deep breath and gently cough as I listen to your lungs." B) "Please sit upright and take a deep breath through your nose as I listen to your lungs." C) "Please breathe deeply through your mouth as I listen to your lungs." D) "I need to listen to your right lung first and then compare it to your left."

: C Diff: 2 Page Ref: 506

: 15-23 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 16 Respiratory Emergencies 1) When arrive on scene, a family member directs you to a bedroom where a 62-year-old male patient is in respiratory distress. During the scene size-up, which finding would most strongly suggest that the patient suffers from a chronic respiratory disease? A) Furnace turned on high with the humidifier running B) Bottles of aspirin and nitroglycerin on the nightstand C) Patient in a chair in tripod position and has a barrel-shaped chest D) Smell of cigarettes in house and the patient is obese

: C Diff: 2 Page Ref: 508

: 16-8 12 Copyright © 2018 Pearson Education, Inc. 42) You have been called to a residence for a patient with altered mental status and shortness of breath. On scene, an Emergency Medical Responder meets you and states that he believes the patient had a stroke and is unresponsive. As you enter the room, you see the patient lying in bed with snoring respirations. Oxygen at 15 liters per minute has been applied. Your immediate action when you reach the patient's side would be to: A) Place a nasal airway and suction B) Start positive pressure ventilation C) Perform the head-tilt, chin-lift maneuver D) Determine whether the patient has a pulse

: C Diff: 2 Page Ref: 512, Figure 16-18

: 17-2 73) Which of these identifies the major elements of the pathway that blood takes through the heart in the correct sequence? A) Aorta, left atrium, left ventricle, pulmonary capillary B) Pulmonary vein, pulmonary capillary, pulmonary artery, right ventricle C) Vena cava, right ventricle, pulmonary artery, left ventricle, aorta D) Right atrium, left atrium, left ventricle, right ventricle

: C Diff: 2 Page Ref: 522-523

: 17-9 2 Copyright © 2018 Pearson Education, Inc. 5) If a clot occludes the blood flow through the coronary artery, what will be the detrimental effect? A) The flow of oxygen-rich blood through the peripheral arteries will cease B) Blood will not be able to flow between the left atrium and the left ventricle C) The flow of oxygen-rich blood to the muscle of the ventricle will be decreased D) Blood and fluid will back up into the lung tissue, causing pulmonary edema

: C Diff: 2 Page Ref: 527

: 17-2 8) A patient has been diagnosed with high blood pressure. A medication that can effectively serve to lower this patient's blood pressure is one that: A) Increases the heart rate B) Dilates the coronary arteries C) Dilates the arteries D) Constricts the veins

: C Diff: 2 Page Ref: 529

: 17-9 10) A TV reporter has been assigned to your ambulance for a ride-along. He is doing a segment on the local EMS system for EMS Week. In your down time, the reporter tells you that his wife was diagnosed with atherosclerosis. He is unsure what this condition is and asks you to explain it to him. Your response would be: A) "Atherosclerosis affects the arteries of the heart and is caused by a heart attack." B) "The walls of the coronary arteries lose elasticity, which can lead to a heart attack." C) "The coronary arteries become damaged and narrowed by fat deposits." D) "Atherosclerosis affects the veins in the body and is caused by untreated high blood pressure."

: C Diff: 2 Page Ref: 529-530

: 17-12 17 Copyright © 2018 Pearson Education, Inc. 62) For a patient with a history of an unstable abdominal aortic aneurysm, the EMT should recognize and prepare for: A) Vomiting and airway occlusion B) Hypoxia caused by lung compression C) Massive internal bleeding D) Decreased perfusion to the upper extremities

: C Diff: 2 Page Ref: 533

: 17-14 24 Copyright © 2018 Pearson Education, Inc. 92) When administering oxygen to a patient with chest pain, which of these should be used a guide to its use and maintenance? A) Patient rating of pain B) The respiratory rate C) Pulse oximetry reading D) The heart rate

: C Diff: 2 Page Ref: 535

: 17-10 14) After being dispatched for a male patient experiencing dyspnea, you arrive to find the confused 67-year-old man sitting upright at his kitchen table in severe respiratory distress. You also note remarkable swelling to his lower legs and feet. He has an open airway, but cannot speak more than two to three words without attempting to breathe. His breathing is extremely labored, with inspiratory crackles heard upon auscultation. His skin is cool, diaphoretic, and dusky in color. A family member at the scene reports a history of hypertension, congestive heart failure, and angina, for which the patient takes nitroglycerin. The baseline vital signs are acceptable and the room-air pulse oximeter reading is 45%. What is your immediate action in caring for this patient? A) Assist the patient with his nitroglycerin B) Apply but do not turn on the AED C) Apply continuous positive airway pressure (CPAP) D) Obtain vital signs and give aspirin

: C Diff: 2 Page Ref: 537

: 17-11 26) You are transporting a patient who had an episode of chest pain. On scene, you assisted him in taking his nitroglycerin medication, which completely alleviated the chest pain. En route to the hospital, the patient asks you why the nitroglycerin took the chest pain away. Beyond telling the patient that nitroglycerin can increase coronary artery blood flow, you would add: A) "It causes the heart rate to decrease, which relaxes it and decreases pain." B) "It has a sedative effect on the brain, making you less aware of the pain." C) "It dilates the blood vessels, which decreases the workload of the heart." D) "It causes the body to relax, decreasing the need for oxygen."

: C Diff: 2 Page Ref: 538

: 17-6 51) You are treating a patient for mild chest pain but notice that his blood pressure is elevated. Which of these statements made by the patient would make you suspect he has acute hypertension? A) "The doctor said that my blood pressure is high because my kidneys are bad." B) "I have to take two blood pressure medications at the same time to get my pressure down." C) "The doctor checks my blood pressure regularly and it's not normally that high." D) "My high blood pressure caused my heart to go bad."

: C Diff: 2 Page Ref: 538

: 3-12 6 Copyright © 2018 Pearson Education, Inc. 18) An intoxicated 72-year-old male with an alcoholic history has fallen at home and has a laceration on the back of his head. He states that he does not want treatment and becomes combative when you try to talk to or assess him. What is your next best course of action? A) Transport him against his will, but do not provide treatment B) Have him sign a refusal of care form C) Contact medical direction D) Transport him by permission of family

: C Diff: 2 Page Ref: 54

: 17-8 13 Copyright © 2018 Pearson Education, Inc. 46) You are assessing a 73-year-old male patient who complains of altered mental status and shortness of breath. The patient is conscious, but confused. His pulse is rapid and weak, and his skin cool and diaphoretic. An Emergency Medical Responder provides you with the following vital signs: pulse, 136; respirations, 20 breaths/min; blood pressure, 168/88 mmHg; and SpO2, 89%. A family member states that the patient has diabetes and takes insulin. He also has a history of hypertension, colon cancer, irregular heartbeat, and transient ischemic attacks (TIA). Which action should the EMT take next? A) Check the patient's blood sugar B) Perform the secondary exam C) Apply supplemental oxygen D) Administer oral glucose

: C Diff: 2 Page Ref: 542

: 17-18 83) To save additional heart muscle from dying when a patient suffers an acute myocardial infarction (heart attack), which treatment must occur? A) Increasing the heart rate B) Lowering the blood pressure C) Relieving the obstruction in the coronary arteries D) Opening blood flow between the atria and ventricles

: C Diff: 2 Page Ref: 543

: 18-3 38) What does the first "I" in the AEIOU-TIPPSS mnemonic stand for? A) Influenza B) Infection C) Insulin D) Ischemia

: C Diff: 2 Page Ref: 559, Table 18-1

: 3-14 8 Copyright © 2018 Pearson Education, Inc. 26) You have arrived at the emergency department with a patient complaining of nausea. The department is extremely busy and you are waiting to give a verbal report to the nurse or doctor. While waiting, dispatch contacts you over the radio and states that you are needed for a critically injured child that was hit by a car. Your best action would be to: A) Take the call and come back to give the report at a later time B) Provide the certified nurse's aide with a report of the patient's condition C) Go to the nurse's station and provide the registered nurse with a quick oral report D) Leave the patient in the emergency department and respond to the call

: C Diff: 2 Page Ref: 56

: 18-9 3) When assessing a patient with a possible stroke, what is the priority? A) Identifying risk factors for stroke B) Determining a family history of stroke C) Recognizing the signs of a stroke D) Determining the type of stroke

: C Diff: 2 Page Ref: 560

: 18-12 19) For the patient with stroke to be eligible for a fibrinolytic agent, the therapy must be given within: A) 3 hours of EMS arrival at the scene B) 4 hours after the diagnosis of stroke is officially made C) 3 hours of the onset of stroke symptoms D) 4 hours of the first signs and/or symptoms started

: C Diff: 2 Page Ref: 561

: 18-8 30) A patient with stroke cannot move his left arm or leg. Based on this presentation, the EMT should strongly suspect that the stroke has occurred in which part of the central nervous system? A) Left side of the brain B) Left side of the spinal cord C) Right side of the brain D) Right and left sides of the brain

: C Diff: 2 Page Ref: 566

: 18-11 4 Copyright © 2018 Pearson Education, Inc. 14) You are called for a 69-year-old male patient with altered mental status. Assessment reveals that he is confused and has left-sided weakness. During transport, you note that the patient is now completely oriented and the weakness has resolved. Which condition would you suspect this patient has? A) Stroke B) Low blood sugar C) Transient ischemic attack D) Syncope

: C Diff: 2 Page Ref: 567

: 3-15 34) There has been a very serious motor vehicle collision involving a high-profile judge seeking reelection. The judge's car was traveling at a high rate of speed and crossed the center line, striking and killing a motorcyclist. Newspaper reporters are on location, asking you to describe what happened. Which statement is most appropriate? A) "The judge was involved, but I cannot tell you anything that happened." B) "The judge was in the car that hit and killed the motorcyclist." C) "There has been a serious accident in which a person was killed." D) "The accident was not bad, so please leave the scene."

: C Diff: 2 Page Ref: 57

: 18-7 32) When assessing a patient with stroke-like signs and symptoms, it is critical that the EMT also suspect and rule out which condition? A) Narcotic overdose B) Syncope C) Hypoglycemia D) Shock

: C Diff: 2 Page Ref: 573

: 18-3 48) You are treating an unresponsive patient. Which piece of information given to you by the patient's family is most important in relation to a possible stroke? A) "He forgot to take his blood thinner last night." B) "We think that he had too much to drink last night." C) "We noticed him acting oddly about 7 P.M." D) "He took some ibuprofen last night for a fever and cough."

: C Diff: 2 Page Ref: 574

: 18-12 26) When transporting an alert but nonverbal patient with stroke and a blood pressure of 210/110 mmHg, the EMT should: A) Dim the lights and remain out of the patient's sight to avoid unnecessary stimulation B) Touch the patient only when absolutely necessary, such as when obtaining vital signs C) Make an effort to explain everything that is happening or being done while trying to help the patient feel at ease D) Remain in the patient's sight but avoid talking or stimulating the patient

: C Diff: 2 Page Ref: 577

: 18-12 3 Copyright © 2018 Pearson Education, Inc. 10) You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this scenario, what should you do immediately? A) Administer oral glucose or sugar water B) Attach the automated external defibrillator (AED) C) Check the patient's blood glucose level (if local protocol allows) D) Administer oxygen via a nasal cannula at 2 lpm

: C Diff: 2 Page Ref: 577

: 3-16 37) You are pulling into the ambulance bay at a local hospital. On board, you have a patient with behavioral problems who continually seeks treatment at this particular hospital. Before the patient can be unloaded, the physician comes out and states that the patient must be taken to another hospital. As an EMT, you should: A) Take the patient to the facility specified by the doctor B) Call the supervisor to report a HIPAA violation C) Recognize a violation of the EMTALA statute D) Ask the patient which hospital he wants to be taken to

: C Diff: 2 Page Ref: 58

: 18-13 56) A patient with a headache informs you that his physician has diagnosed him with cluster headaches. He states that his current pain feels just like the last cluster headache that he suffered. The primary assessment reveals no life threats. His vital signs are pulse, 104; respirations, 16 breaths/min; blood pressure, 124/68 mmHg; and SpO2, 98%. You note no neurologic deficits. Based on this information, what is indicated in the treatment of this patient? A) Massage the patient's neck and obtain a refusal for transport if the pain is alleviated B) Administer supplemental oxygen at 15 liters per minute C) Place the patient on the cot and allow him to assume a position of comfort D) Immediately transport the patient to the hospital for possible stroke

: C Diff: 2 Page Ref: 581

: 19-8 30) Which of these statements about seizures is true? A) Patients who have seizures are at increased risk for stroke B) All seizures are caused by some form of brain injury C) Seizures may be caused by a variety of medical conditions D) If the cause of a seizure is unknown, it is classified as status epilepticus

: C Diff: 2 Page Ref: 585-586

: 19-7 27) While you are transporting a 41-year-old woman who is not feeling well, she begins to seize. She has no history of seizures, and the seizure lasts approximately 90 seconds. After 30 seconds of being postictal and totally unresponsive, the woman suddenly seizes again for the remainder of the 12-minute transport. The EMT should recognize that the patient is experiencing which emergency condition? A) Undiagnosed epilepsy B) Hypoglycemic-induced seizures C) Status epilepticus D) Partial-motor seizure

: C Diff: 2 Page Ref: 587

: 19-7 15) You are caring for a postictal male patient with a known history of seizures. He is confused and cannot remember his 8-year-old son's name. His son tearfully asks you if his father will ever remember him. Your response would be: A) "I do not know. We will have to let the doctor help him first." B) "I am not sure, but at least your mother remembers your name." C) "Although he is confused now, he should remember your name in a little bit." D) "I do not feel comfortable in telling you yes, since there is a chance he may not."

: C Diff: 2 Page Ref: 589

: 19-5 46) A 72-year-old male patient with a history of elevated thyroid function and a brain tumor is experiencing a psychomotor seizure. When you enter the room, he is standing up and walking in a circle. He is awake but does not respond to your questions. Family members state that he has had three similar episodes over the past six months, which his physician diagnosed as complex partial seizures. Vital signs are pulse, 112; respirations, 16 breaths/min; blood pressure, 166/68 mmHg; and SpO2, 98%. Which action would be most appropriate in the care of this patient? A) Determine if a durable power of attorney exists B) Restrain the patient and apply high-concentration oxygen C) Proceed with a nonemergency transport D) Insert a nasopharyngeal airway to ensure airway patency

: C Diff: 2 Page Ref: 590

: 19-7 10) While you are placing a 52-year-old female patient, whose complaint is a headache, on the stretcher, she begins to seize. Your immediate action would be to: A) Quickly move her to the ambulance for rapid transport B) Perform a jaw-thrust maneuver and insert an oropharyngeal airway C) Raise the side rails and do not apply the straps very tightly D) Remove the patient from the stretcher and place her on the ground

: C Diff: 2 Page Ref: 592

: 19-7 2) You have been called for a seizure emergency. On scene, you find an adult female patient actively seizing with bystanders attempting to restrain her. You would: A) Place a padded tongue blade into the patient's mouth and then instruct the bystanders to release her B) Loosen any restrictive clothing the patient is wearing, and then summon ALS backup C) Instruct the bystanders to release the patient while you protect her head with your hands D) Have bystanders continue restraining the patient while you complete the primary assessment

: C Diff: 2 Page Ref: 592

: 19-7 9) When obtaining a medical history from the family of a patient experiencing seizure, which of these questions is most important for the EMT to ask first? A) "How long has he had his seizure condition?" B) "Has he ever been hospitalized for seizures?" C) "Does he take his seizure medications as prescribed?" D) "Was he grunting and breathing hard during the seizure?"

: C Diff: 2 Page Ref: 595

: 1-7 34) At a public 911 center meeting, a concerned woman asks whether voice over Internet Protocol (VoIP) can be used to access the community emergency operations center. You would inform her that: A) Internet providers are encouraged to provide 911 access, but are not required by law, so the dispatch center may have to get an address from the caller B) Internet providers are required to provide their own 911 call-taker service to subscribers C) Internet providers must provide a callback number and physical location of the phone from which the 911 call was placed D) Internet providers are required to employ EMDs who can provide medical instructions prior to arrival of EMS

: C Diff: 2 Page Ref: 6

: 19-10 37) You are dispatched to a local mall, where you are met by bystanders who state that the patient was talking to a customer representative when she "passed out." You find an alert and oriented 55-year-old female patient lying supine on the tile floor. The patient tells you that the back of her head is hurting, her neck now hurts, and her arms and legs feel very weak. Which action should you perform first? A) Open her airway with a jaw-thrust maneuver B) Obtain a full set of vital signs C) Take manual cervical spine motion restriction D) Assess the back of the patient's head for injury

: C Diff: 2 Page Ref: 600

: 20-10 16) A patient's glucometer measurement reads 39 mg/dL. The patient is alert, but confused. The patient's son states that he has a friend who becomes unresponsive when his sugar is less than 50 mg/dL; therefore, the reading for his father cannot be correct. Which of these statements would be your best response? A) "You are probably right; I feel comfortable in having him sign a refusal." B) "I agree. Anyone with a blood sugar less than 50 mg/dL should be unconscious." C) "The response to a low blood sugar can vary from patient to patient." D) "I agree. Just to be safe, I am not going to give him any oral glucose."

: C Diff: 2 Page Ref: 610

: 20-6 44) A patient who is unresponsive has a blood glucose level of 28 mg/dL. Her family states that she took her insulin in the morning 3 hours ago. Which of these statements made by the family would make sense in regard to the patient's current blood sugar level? A) "She is going to the bathroom all of the time." B) "She smoked a cigarette just before becoming unresponsive." C) "She did not eat after taking her insulin." D) "She ate a lot of cake and ice cream last night."

: C Diff: 2 Page Ref: 610

: 20-11 7 Copyright © 2018 Pearson Education, Inc. 25) Which of these patients is a candidate for oral glucose? A) An unresponsive patient with diabetes and a rapid heart rate B) A combative patient with no history of diabetes C) An alert but confused patient with diabetes and cool skin D) A patient who is newly diagnosed with diabetes and who is responsive to painful stimuli

: C Diff: 2 Page Ref: 612

: 20-1 10 Copyright © 2018 Pearson Education, Inc. 37) You have been called for a patient who is confused and slightly combative. Which of these assessment findings would make you suspicious that the patient has hyperglycemia? A) Decreased appetite according to family members B) Patient's statement that he has not urinated for some time C) Increased respirations with a sweet smell to the patient's breath D) Comment by family that the patient may have taken too much insulin

: C Diff: 2 Page Ref: 616

: 20-5 11) A 17-year-old patient is unresponsive. A medical identification bracelet states that he has diabetes. Which action should you perform first? A) Administer oral glucose B) Determine the type of diabetes C) Assess the airway D) Check for a pulse

: C Diff: 2 Page Ref: 622

: 20-8 32) You have been called for an adult male patient who is hypoglycemic and responsive to painful stimuli. The family has oral glucose and wants you to administer it. However, at this time, your medical director has not authorized this agent's use and there are no protocols regarding its use. Given the patient's condition and the family's request, which action should you take? A) Contact ALS backup and remain on scene until they arrive so they can give glucose via the IV line B) Instruct the family to administer the oral glucose C) Initiate transport of the patient to the emergency department D) Carefully administer the oral glucose at the family's request

: C Diff: 2 Page Ref: 622

: 21-8 52) A mother has called you for her 9-year-old daughter, who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be allergic, although she has never been stung before. Assessment of the patient reveals a red, painful, and swollen area on the back of the girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older daughter's epinephrine auto-injector. You would: A) Administer the epinephrine into the patient's thigh B) Ask the mother to administer the auto-injector into the patient's thigh C) Wash the patient's hand with soap and water D) Contact medical direction for permission to use the epinephrine auto-injector

: C Diff: 2 Page Ref: 631

: 21-6 22) What is the best explanation of why patients experiencing an anaphylactic reaction have difficulty breathing? A) Allergens use the available oxygen molecules B) Antibodies depress the brain's respiratory center C) Histamine constricts the bronchioles D) Antigens increase the body's need for oxygen

: C Diff: 2 Page Ref: 631-632

: 21-3 51) Which of these statements is true regarding both anaphylactic and anaphylactoid reactions? A) Anaphylaxis is caused by medications; anaphylactoid reactions are not B) Administering epinephrine in an anaphylactoid reaction can be fatal C) Both anaphylactoid and anaphylactic reactions are treated in the same way D) Anaphylactoid reactions seldom involve the airway; anaphylaxis does

: C Diff: 2 Page Ref: 633

: 21-8 15) An awake but confused patient experiencing an allergic reaction begins to exhibit stridorous respirations. The EMT knows that the underlying condition responsible for this presentation is: A) Constriction of the small airways B) Spasm of the lower airway C) Swelling to the upper airway D) Loss of the gag reflex

: C Diff: 2 Page Ref: 634

: 21-8 17) You are responding to a call for an allergic reaction. Your partner is a new EMT and this is his first call. When prepping him on how the scene and the patient may present, which instruction regarding the assessment and treatment of an allergic reaction and/or anaphylaxis would be correct? A) "If the allergic reaction was caused by exposure to chocolate or eggs, we will not be able to administer epinephrine." B) "Epinephrine really should be given to any patient experiencing even a mild allergic reaction to prevent anaphylaxis." C) "Our first priority will not be to determine what caused the allergic reaction, but to treat the patient according to his or her symptoms." D) "If the allergic reaction was caused by food, we will need to administer activated charcoal."

: C Diff: 2 Page Ref: 634

: 21-7 2) A patient states that he is allergic to poison ivy and was burning it yesterday while clearing brush off his farm when he accidentally inhaled some of the smoke. Today, he awoke and found a red rash to the back of his left hand and called 911. Assessment reveals him to be alert and oriented, with easy respirations and a blood pressure of 128/70 mmHg. Your next action would be to: A) Provide immediate and rapid transport B) Assist the patient with his epinephrine auto-injector C) Obtain a full SAMPLE and OPQRST history D) Call for advanced life support (ALS) assistance

: C Diff: 2 Page Ref: 635-636

: 21-9 38) Which of these assessment findings would indicate that the patient is experiencing an anaphylactic reaction after a bee sting and requires immediate intervention? A) Hives to the arm that was stung and a heart rate of 96 beats/min B) Localized swelling around the site of the bee sting C) Swollen lips and oral mucosa, with a blood pressure of 84/50 mmHg D) Edema to the feet, with an SpO2 of 93% on room air and mild dyspnea

: C Diff: 2 Page Ref: 638

: 21-8 4 Copyright © 2018 Pearson Education, Inc. 12) On scene, you assisted a patient with his epinephrine auto-injector after he was stung multiple times by bees. You are now transporting the patient to the hospital. As you reassess the patient, which of these findings would best indicate that the epinephrine is benefiting the patient? A) Increasing heart rate B) Complaint of fatigue C) Decreasing wheezing D) Decreasing blood pressure

: C Diff: 2 Page Ref: 644, Figure 21-6

: 21-9 10 Copyright © 2018 Pearson Education, Inc. 33) You have just assisted a patient with his epinephrine auto-injector. The patient states that he has never taken epinephrine before. What would be the appropriate EMT response about how the drug may make him feel? A) "The epinephrine may make you drowsy, so just close your eyes." B) "Be prepared to feel dizzy and nauseated. These effects are common when taking epinephrine." C) "You may feel a little shaky, but that is normal and will pass." D) "If you pass out, that is normal. I will just give you some oxygen if that happens."

: C Diff: 2 Page Ref: 644, Figure 21-6

: 22-14 51) You are respond to an "unknown/unresponsive" emergency called in by a bystander. On scene, you find the female patient to be conscious but confused and extremely nauseated; she has vomited twice. Examination of the vomitus reveals fragments of different pills. Her past medical history includes diabetes and alcoholism. En route to the hospital, the patient vomits again and suddenly becomes unresponsive. Your first action would be to: A) Get another set of vital signs B) Contact medical command C) Position the patient on her side D) Check the patient's blood sugar

: C Diff: 2 Page Ref: 653

: 22-4 21) A middle-aged male with behavioral problems states that he drank some "chemicals" to kill the bugs in his body. The patient is alert and oriented and shows no life-threatening conditions to the airway, breathing, or circulation. At this point, which of these questions should the EMT ask? A) "Have you thrown up?" B) "When did you drink it?" C) "Do you know exactly what it was you drank?" D) "Are you taking other medications?"

: C Diff: 2 Page Ref: 654-655

: 22-7 28) The family of a 31-year-old female patient reports that she has taken an overdose of her father's diabetes medication. Assessment reveals her to be unresponsive, lying on the floor, with snoring respirations. Her pulse is rapid and her skin is cool to the touch. The patient has no history of diabetes but is allergic to penicillin. It is believed that she took the medication within the past hour. Your initial intervention in caring for this patient would be to: A) Administer activated charcoal B) Induce vomiting C) Perform a jaw-thrust maneuver D) Administer glycogen or intranasal naloxone

: C Diff: 2 Page Ref: 655

: 22-7 27) For which of these patients would activated charcoal be indicated given the type of poisoning? A) A 24-year-old female who was sniffing glue and now complains of a headache B) A 17-year-old male who drank bleach 30 minutes ago C) A 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago D) A 53-year-old female who took an overdose of antidepressants earlier in the day

: C Diff: 2 Page Ref: 656

: 22-7 35) You are transporting a patient who overdosed on medications from a community emergency department (ED) to a large medical center for continued care. In the ED, the patient received two doses of activated charcoal. When performing your reassessment of the patient, which of the findings would be most concerning? A) Dark black stool B) Nausea C) Red-colored stool D) Diarrhea

: C Diff: 2 Page Ref: 657, Figure 22-3

: 22-8 11 Copyright © 2018 Pearson Education, Inc. 38) You have been called to a railroad yard for an unknown emergency. When you arrive on scene, you are directed to a tanker car, where two men are lying on the ground next to the railcar. The men are mechanics for the railroad company and were performing some type of repair work on the valves for the tanker car. The only other person around is a security guard, who saw the men suddenly collapse on a surveillance video camera and called 911 immediately. He has an automated external defibrillator (AED) at his side. Your initial action would be to: A) Quickly retrieve the patients and move them to safety B) Take manual spine motion restriction of the head and neck and assess the ABCs for each patient C) Remain at a safe distance and call for fire department assistance D) Determine which chemical the tanker contains and assess the leaks

: C Diff: 2 Page Ref: 658-659

: 22-14 18 Copyright © 2018 Pearson Education, Inc. 59) You have arrived at a home where the parents found their 13-year-old son in the garage inhaling propane from the family grill. Your assessment reveals the patient to be alert and oriented, with an open airway. His breathing is labored, and his pulse is rapid for his age. When conducting the secondary assessment, which of these findings or history would be of the greatest concern? A) Chemical burn to the right hand B) Abdominal pain C) Bilateral wheezing D) Suicide attempt two years ago

: C Diff: 2 Page Ref: 659

: 22-8 12 Copyright © 2018 Pearson Education, Inc. 41) A 44-year-old male patient was using an industrial drain cleaning solvent to clean the drains in his house. The solvent corroded through the pipes on the second floor, spilling into the walls and filling the house with fumes. The patient was in the house for several minutes prior to getting himself out. The primary assessment reveals him to be alert and oriented with a patent airway. He is complaining of dizziness and has rapid respirations. His radial pulse is fast and strong, and his skin is warm and pink. Which action should the EMT take first? A) Insert a nasopharyngeal airway B) Start positive pressure ventilation C) Administer supplemental oxygen D) Provide rapid transport with the patient in semi-Fowler's position

: C Diff: 2 Page Ref: 659

: 4-2 37) A patient states that he has suffered from chronic neck pain ever since an accident. Further, he states that he is filing a lawsuit against the EMTs since they failed to put a cervical collar on him at the time; in his eyes, this is the reason he has daily neck and back pain. The EMT can remember the incident well and remembers putting a collar on the patient. As such, his best defense would be: A) Presentation of the emergency department chart in court B) Testimony from the supervisor stating that the EMTs always place a cervical collar C) Written documentation of collar placement on the PCR D) Presentation of the standard of care showing that a cervical collar is indicated

: C Diff: 2 Page Ref: 66

: 22-5 79) Which of these descriptions is most characteristic of carbon monoxide? A) It generally takes several days for a toxic level of carbon monoxide to accumulate in the body B) Carbon monoxide poisoning symptoms mimic the flu, but it tends to cause a higher fever than the flu C) Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia D) Carbon monoxide is a tasteless gas that is produced by household appliances such as electric furnaces

: C Diff: 2 Page Ref: 666

: 22-11 24 Copyright © 2018 Pearson Education, Inc. 82) What is the greatest risk related to the ingestion of cyanide? A) Gastrointestinal damage B) High fever C) Widespread hypoxia D) Lung damage

: C Diff: 2 Page Ref: 667

: 22-5 84) A 44-year-old male patient who works at a petroleum-refining plant inhaled a significant amount of hydrocarbon fumes and now complains of a headache with associated dizziness and nausea, as well as mild shortness of breath. He is alert and oriented, and there are no life threats to his airway, breathing, or circulation. Which of these steps should be included in his assessment and care? A) Aspirin for the headache B) Intranasal naloxone C) Continuous high-concentration oxygen D) Head-to-toe decontamination

: C Diff: 2 Page Ref: 669

: 22-12 102) Emergency Medical Responders have removed a female patient from her bedroom, where she was found lying on her bed with a suicide bag over her head. The bag is removed and you note the woman to be unresponsive, pulseless, and apneic. Given the use of a suicide bag and the presentation of the patient, which of these statements indicates proper initial care? A) "Do not apply the AED since the arrest was not caused by a cardiac event." B) "I need someone to assess the patient's blood glucose level." C) "Let's open the airway manually first." D) "I need someone to get a pulse oximetry reading immediately!"

: C Diff: 2 Page Ref: 672

: 22-4 88) Family members have called EMS after finding their brother in a highly agitated state. When assessing this patient, which of these findings would raise your suspicion that the patient took a stimulant? A) Pinpoint pupils B) Decreased body temperature C) Blood pressure of 196/104 mmHg D) Slurred speech

: C Diff: 2 Page Ref: 677

: 22-5 17) You have been called for an unresponsive patient. When you arrive at the scene, hysterical family members direct you to an unresponsive 32-year-old woman who is lying on the bedroom floor. Her husband says that she left a note saying that she wanted to kill herself and took an unspecified poison. Assessment reveals a green-colored liquid in her mouth and respirations that are rapid, shallow, and gurgling. The patient's pulse is weak, and her skin is cool and dry with cyanosis to her fingertips. Your immediate action would be to: A) Start positive pressure ventilation B) Extricate the patient and provide care en route to the hospital C) Manually open the patient's airway and perform suction D) Read the note for clues to what the patient took

: C Diff: 2 Page Ref: 678

: 22-14 94) You are transporting a patient who wants help to rid herself of an addiction to pain medications. She says she has not taken any pain medications since yesterday, and needs help. Which of these findings would you recognize as a sign of withdrawal? A) Her mental status decreases B) Her body temperature falls C) She starts to become agitated D) She begins to cry uncontrollably

: C Diff: 2 Page Ref: 684

: 22-16 62) You are called to an alcoholic crisis center to transport a patient experiencing delirium tremens. When assessing the patient, which signs or symptoms would you associate with this condition? A) Seizure activity, memory impairment, bradycardia, tremors B) Constricted pupils, hypothermia, confusion, hypotension C) Loss of memory, hallucinations, fever, dilated pupils D) High fever, seizure activity, sweating, lethargy

: C Diff: 2 Page Ref: 684

: 22-12 103) What is the typical dosage for intranasal administration of naloxone? A) 2 mg repeated every 5 minutes only if the patient responds to the initial dose B) 1 mg every 10 minutes C) 1 mg in each nostril D) 2 mg every 5 minutes until the patient regains consciousness

: C Diff: 2 Page Ref: 687, Figure 22-21

: 4-5 2) While moving a 67-year-old male who complains of dizziness from his residence on the stretcher, you stumble backward and knock a vase from a table, causing it to break. The patient and family are very upset with the damage. In the process, you hurt your ankle and are having a hard time walking. When completing the prehospital care report (PCR), what should be included? A) The fact that property damage occurred B) A factual account of your ankle injury C) The patient's insurance or billing information D) An objective statement about the family's displeasure

: C Diff: 2 Page Ref: 69-70

: 23-2 15) The EMT would identify which of these patients as having an acute abdomen? A) A 71-year-old female in respiratory distress and complaining of nausea B) A 37-year-old male with history of drug abuse and liver disease C) A 62-year-old male with no medical history with sudden pain to the lower abdomen D) A 17-year-old female who is pregnant with twins and whose delivery date is next month

: C Diff: 2 Page Ref: 697

: 23-3 16) Of these statements, which best demonstrates that the EMT has an accurate understanding of acute abdominal pain? A) "Abdominal pain is more of an emergency when the patient has a medical history related to the abdominal organs." B) "If the abdominal pain is not sharp in nature, it is most likely not a life-threatening condition." C) "Sometimes the cause of abdominal pain will be obvious, but often the cause will not be that apparent." D) "If the patient complains of 'crampy' or colicky pain, the EMT should suspect that a solid organ has ruptured and is bleeding."

: C Diff: 2 Page Ref: 697

: 23-6 78) Which of these conditions involves an infection in the retroperitoneal portion of the abdomen? A) Gastroenteritis B) Hepatitis C) Pancreatitis D) Inflamed spleen

: C Diff: 2 Page Ref: 697

1) What is a primary purpose of the modern-day EMS system? A) Provide a means of transport to and from the hospital B) Ensure that all members of society have equal access to hospitals C) Decrease the incidence of death and disability related to injury and illness D) Provide emergency health care services to medically underserved areas

: C Diff: 2 Page Ref: 7

: 1-3 31) A 40-year-old man has been seriously injured in a car crash. He is unresponsive and has what you believe to be a collapsed lung. Additionally, his left leg is severely deformed with heavy bleeding and his vital signs are unstable. A passenger in the car informs you that the patient has diabetes and significant heart problems. Given this information, what is the best destination for this patient, assuming all of the facilities are the same distance away? A) Cardiac center B) Spine injury center C) Trauma center D) Stroke center

: C Diff: 2 Page Ref: 7

: 23-3 17) Which of these statements made by the patient would most likely be associated with parietal or somatic pain? A) "I feel as though I have to throw up but can't." B) "It seems to hurt all over my belly and back." C) "It really hurts right here, beside my belly-button." D) "The pain seems to be dull and achy."

: C Diff: 2 Page Ref: 700

: 23-3 32) Which of these assessment findings would increase the EMT's suspicion of a gastrointestinal bleed that is likely occurring slowly? A) Sudden onset of constipation B) Watery and foul-smelling diarrhea C) Black semi-formed stool D) Sharp left lower quadrant pain

: C Diff: 2 Page Ref: 703

: 23-6 13 Copyright © 2018 Pearson Education, Inc. 47) A 56-year-old male patient informs you that he has gastric ulcers. He has had them for several months, but recently the pain has been steadily increasing. If the cause of the abdominal pain is the gastric ulcers, how would you expect the patient to describe the pain? A) Stabbing pain that radiates into both legs B) Sharp pain near the umbilicus that radiates to the right lower quadrant C) Burning pain located to the left upper quadrant D) Achy pain occurring all throughout the abdomen

: C Diff: 2 Page Ref: 704

: 23-9 71) You are by the side of a patient who thinks he has a kidney stone. After assessing the patient, which of these findings would force you to consider an alternative pathology for the patient's pain? A) Blood-tinged urine B) Frequent urge to urinate C) Tearing pain in the abdomen D) Flank pain that radiates into the groin

: C Diff: 2 Page Ref: 706

: 23-6 21) When EMS enters the room of a 62-year-old female patient with an unknown medical complaint, which of these clues observed during the scene size-up would increase the EMT's suspicion that the patient has an acute abdominal condition? A) The patient is in her nightgown and the air conditioning is turned on "high" B) A portable commode is next to the bed, with a large amount of urine inside C) The patient is lying on her side, with her knees drawn to her chest D) The patient is wearing a nasal cannula attached to oxygen at 2 lpm

: C Diff: 2 Page Ref: 708

: 4-4 4) A nauseated patient with fever and abdominal pain states that he has not vomited. Which description best represents how that fact should be documented? A) As a treatment finding B) As a subjective finding C) As a pertinent negative D) This fact would not be documented.

: C Diff: 2 Page Ref: 71

: 23-6 10 Copyright © 2018 Pearson Education, Inc. 37) An alert but confused patient called 911 with the complaint of abdominal pain. Assessment reveals her to be nauseated with pain that she localizes to the right lower quadrant of the abdomen. She states that she was not able to take her blood pressure medication this morning and wants to take it now with a small glass of juice. You would: A) Allow her to take the medication with juice B) Crush the medication and mix it in a small amount of water C) Tell her that she should not take her medication or drink juice D) Provide her some water instead of juice to take with her medications

: C Diff: 2 Page Ref: 710

: 23-6 36) While you are transporting a 44-year-old female patient with abdominal pain in low Fowler's position, she starts to vomit. Your immediate action would be to: A) Examine the vomit for blood B) Palpate the patient's abdomen C) Place the patient in a left lateral recumbent position D) Place some vomit in a specimen bag for the hospital

: C Diff: 2 Page Ref: 710

: 23-7 111) A patient with sickle cell crisis will most likely complain of: A) High fever B) Diarrhea C) Severe pain D) Blood-tinged urine

: C Diff: 2 Page Ref: 713

: 23-8 53) A 38-year-old female patient was violently raped at a party where drugs were being abused. The patient is conscious, upset, and actively bleeding from the vaginal canal. As an EMT, your best care would involve: A) Cleansing the vaginal area to prevent infection B) Carefully placing a sterile dressing into the vagina to control the hemorrhage C) Applying a bulky dressing and gentle pressure to the external genitalia D) Avoiding physical contact with the vaginal area so not to destroy evidence

: C Diff: 2 Page Ref: 715

: 23-1 93) Which of these assessment findings would help convince the EMT that a patient with abdominal pain and vaginal bleeding is experiencing a spontaneous abortion (miscarriage)? A) History of dysmenorrhea B) Upper abdominal cramping C) Last menstrual period six weeks ago D) Pain start acutely this morning

: C Diff: 2 Page Ref: 716

: 23-6 89) The most common complaint(s) associated with a gynecologic emergency is (are): A) Vaginal discharge B) Upper abdominal pain and vaginal bleeding C) Lower abdominal pain D) Nausea and vaginal discharge

: C Diff: 2 Page Ref: 717-718

: 23-1 98) A patient with a history of renal failure, among other things, has an impairment in the ability to: A) Control urination B) Retain adequate fluids C) Regulate electrolytes D) Maintain a normal blood sugar

: C Diff: 2 Page Ref: 720

: 23-12 67) Which of these complaints would raise the EMT's suspicion that a female patient has a urinary tract infection (UTI)? A) Urinating constantly with associated great thirst B) Pain in the back that spreads into the legs C) Burning sensation every time she urinates D) Vaginal discharge that is greenish in color

: C Diff: 2 Page Ref: 721

: 23-14 104) When transporting a patient with an indwelling catheter and bag, which of these actions is appropriate? A) Have the caregiver remove it to decrease the risk of infection B) Ensure that it remains on the lap of the patient at all times C) Position the bag below the level of the patient's bladder D) Deflate the balloon to decrease the risk of accidental removal

: C Diff: 2 Page Ref: 723

: 4-7 32) Immediately after giving a prehospital care report to the nurse in the emergency department, dispatch informs you that there are no more ambulances available and you must immediately leave the hospital to cover another portion of the county. Since your service uses a computerized documentation system and there is no time to complete your report, your best course of action should be to: A) Give a verbal report to the ED physician B) Repeat your assessment findings and treatment to the nurse C) Complete an abbreviated transfer-of-care report D) Leave and return to complete the report as soon as possible

: C Diff: 2 Page Ref: 77

: 4-10 6) After oxygen therapy, the patient's SpO2 improves from 90% to 99%. Using the CHEATED method of documentation, this information would be placed in which category? A) C: Chief complaint B) H: History C) E: Evaluation D) D: Disposition

: C Diff: 2 Page Ref: 79

: 1-7 3 Copyright © 2018 Pearson Education, Inc. 9) Which statement shows that the EMT has a good understanding of her role and responsibilities related to being an EMT? A) "The patient's needs come before anyone else's needs." B) "At the scene of an emergency, my responsibility is to get to the patient no matter what." C) "My safety comes first, and then the patient's safety." D) "As an EMT, I recognize that the public's safety comes before the safety of me or my partner."

: C Diff: 2 Page Ref: 8-9

: 5-6 19) An effective and reliable communication system is essential to the EMT and the EMS system because: A) It has been shown to decrease the number of lawsuits against EMS providers B) EMTs are better able to assess patients C) It allows hospitals to better prepare for the arrival of a patient D) The safety of an EMT is guaranteed at a dangerous scene

: C Diff: 2 Page Ref: 91

: 5-7 2 Copyright © 2018 Pearson Education, Inc. 5) Which statement is most appropriate to start with when transferring a patient to the emergency department and giving the oral report? A) "This is Mr. Hedger. He has the state insurance plan." B) "Mr. Hedger has high blood pressure and appears to be having a heart attack." C) "Mr. Hedger called us today because he was having chest pain." D) "Please refer to the recording of my radio report for specific information about Mr. Benton and his chest pain."

: C Diff: 2 Page Ref: 91

: 5-9 6) Which important piece of information has been omitted from the following report: "Salem Community Hospital, we are en route with a 61-year-old male complaining of generalized weakness. He states that he was cutting the grass when he suddenly became hot and weak, forcing him to sit down. He has a history of diabetes and prostate cancer, but takes no medications. Right now he is alert and oriented and has the following vital signs: pulse 96, respirations 18, and blood pressure 156/82 mmHg, and room-air pulse ox was 92%. We have placed him on 2 liters of oxygen by nasal cannula and are transporting in semi-Fowler position. He states that the weakness is starting to resolve. Do you have questions or orders?" A) Patient's family physician B) Location of the incident C) ETA to the hospital D) Medications the patient is taking

: C Diff: 2 Page Ref: 91

: 5-13 30) When interviewing a patient with a medical emergency, the EMT is using the technique of summary when she says: A) "With one finger, can you point to where it hurts?" B) "Did you also have diarrhea with the nausea and vomiting?" C) "So the nausea and vomiting started two days ago, correct?" D) "I know how you feel. I had the same thing last week."

: C Diff: 2 Page Ref: 93

: 5-7 8) What is an effective way to improve communication with patients from most cultures? A) Have the patient look up at you B) Speak clearly and loudly C) Maintain eye contact D) Use medical terminology

: C Diff: 2 Page Ref: 96

: 7-12 7 Copyright © 2018 Pearson Education, Inc. 27) Which action produces inhalation and contributes to airflow into the lungs? A) The intercostal muscles relax B) The chest cavity decreases in size C) The diaphragm contracts D) The pressure in the chest increases

: C Diff: 3 Page Ref: 148

: 7-15 38) A patient is experiencing the backup of blood and fluid in her lung tissue. Failure of which of the heart's valves is likely responsible for this condition? A) Tricuspid B) Right C) Bicuspid D) Pulmonary

: C Diff: 3 Page Ref: 150

: 8-6 19 Copyright © 2018 Pearson Education, Inc. 78) A patient has sustained a gunshot injury to his right thorax. When you listen to his breath sounds, they are diminished over the right thorax. What is the most logical explanation for this finding? A) The gunshot wound has damaged the brainstem, causing the patient to stop breathing B) The pressure between the visceral pleura and the lung tissue has become higher than the atmospheric pressure C) The negative pressure between the pleural linings has been lost, causing the lung tissue to collapse D) The pressure between the parietal pleura and the rib cage has become lower than the atmospheric pressure

: C Diff: 3 Page Ref: 185

: 8-10 7 Copyright © 2018 Pearson Education, Inc. 26) Which statement is true of a patient who relies on the hypoxic drive to breathe? A) The primary gas affecting the respiratory rate is carbon dioxide B) The peripheral chemoreceptors have become less sensitive to oxygen C) The respiratory rate is set according to the level of O2 in the body D) The central chemoreceptors are the primary influence on the respiratory rate

: C Diff: 3 Page Ref: 188

: 8-4 13) A patient who has lost one liter of blood is conscious with a patent airway, but her extremities are pale and cold to the touch. Vital signs are as follows: pulse is 130, respirations are 22 breaths/min and adequate, blood pressure is 74/56 mmHg, and SpO2 is 95% on room air. What is most needed by this patient to increase perfusion to the cells? A) Increased blood pressure as a result of paramedics administering IV fluids B) Administration of oxygen via nonrebreather mask C) Increased number of red blood cells and plasma volume D) Keeping the patient warm by covering her with a blanket

: C Diff: 3 Page Ref: 192

: 8-14 64) A patient with liver disease has a low platelet count. Which additional finding would the EMT directly correlate to this condition? A) Pale skin color B) SpO2 of 90% C) Excessive bruising to arms D) Heart rate of 92 beats/min

: C Diff: 3 Page Ref: 193

: 8-4 17 Copyright © 2018 Pearson Education, Inc. 70) A patient with a severe infection is very sick. Circulating toxins from bacteria in his blood have decreased his systemic vascular resistance (SVR). Which blood pressure change would the EMT correlate to this condition? A) Blood pressure of 174/126 mmHg B) Diastolic blood pressure greater than 200 mmHg C) Blood pressure of 64/26 mmHg D) Systolic blood pressure of 160 mmHg

: C Diff: 3 Page Ref: 197

: 8-17 72) For a patient who is acutely bleeding, what is the immediate response of the human body? A) Vasoconstriction caused by the parasympathetic nervous system B) Increased production of red blood cells and hemoglobin C) Vasoconstriction caused by the sympathetic nervous system D) Increased pulse pressure to promote better circulation of oxygen

: C Diff: 3 Page Ref: 200

: 9-10 25) The systolic blood pressure of a 4-year-old female patient is 110 mmHg. Her mother is concerned because last year at the pediatrician's office the systolic blood pressure was 92 mmHg and now it is higher. How would you respond? A) "Her blood pressure is most likely increased because she is sick." B) "This is normal; not only will the blood pressure increase with age, but so will her heart rate." C) "Her blood pressure will increase naturally. This is normal and healthy." D) "I agree; that is a little bit of a jump in blood pressure. It very well could be the reason she is not feeling well."

: C Diff: 3 Page Ref: 208

: 9-1 34) You are at the residence of an alert and oriented 87-year-old female patient who is very short of breath but is refusing to go to the hospital. Instead, she wants you to treat her at home and then leave when she feels better. As an EMT knowledgeable of the characteristics and behaviors of this age group, you would become suspicious that her request is based on the fact that she: A) May have Alzheimer's dementia and has yet to be diagnosed B) Is concerned that she does not have the money to pay for the ambulance transport C) Is concerned that she may be giving up the independence of living in her home D) Does not trust those who are younger in age to take care of her

: C Diff: 3 Page Ref: 213

: 10-19 106) Which of these statements is most correct regarding the difference between respiration and ventilation? A) Ventilation describes the absorption of O2 into the cells, while ventilation is the excretion of CO2 from the cells B) Ventilation describes the exchange of gases at the cellular level, while respiration describes the same process between the lungs and the external environment C) Respiration describes the exchange of O2 and CO2, while ventilation describes the movement of air that carries them into and out of the body D) Respiration and ventilation are similar terms that both describe normal and healthy breathing in the living organism

: C Diff: 3 Page Ref: 218

: 2-3 13 Copyright © 2018 Pearson Education, Inc. 48) A patient with terminal lung cancer has called EMS for shortness of breath. At the request of your paramedic partner, you are obtaining the patient's blood pressure. While inflating and then deflating the blood pressure cuff, the patient angrily shouts, "That thing is too tight! What are you trying to do-send me to the funeral home early?" Your best reply would be: A) "I have to get your blood pressure. The paramedic needs it." B) "Why are you so mad at me? I am just trying to help you." C) "I know that this is tight and uncomfortable, but I am almost done now." D) "Do not yell at me. There is no need for yelling and I do not appreciate it."

: C Diff: 3 Page Ref: 22

: 10-20 117) The EMT recognizes a late sign of hypoxia in a patient in a coma when he observes: A) Restlessness and agitation B) Elevation in blood pressure C) Cyanosis in the fingers D) Complaint of a headache

: C Diff: 3 Page Ref: 223

: 10-4 12) Your medical director is holding an in-service program focusing on the prehospital management of adult patients with respiratory complaints. He asks the group to explain how they can determine if the patient is breathing adequately. Which response is most appropriate? A) "A patient is breathing adequately if the depth of breathing is shallow, but the rate is increased above normal." B) "If the pulse oximeter reads 94% or greater, then the patient is breathing adequately." C) "For an adult patient to be breathing adequately, the rate should be within 8 to 24 breaths/min with a full chest rise with each breath." D) "The EMT can assume breathing is adequate if the patient has an open airway and a normal respiratory rate."

: C Diff: 3 Page Ref: 242

: 10-14 42) While a 61-year-old female patient in cardiac arrest receives emergency care, you note that her abdomen grows larger with each ventilation provided from a bag-valve mask. Which instructions should you provide to your partner? A) "Try delivering each ventilation over 3 seconds, and let's slow down the rate." B) "The ventilation rate and force of ventilation need to be increased so air goes into the lungs." C) "Let's slow the ventilation rate to 10 per minute, providing each breath over 1 second." D) "I need another rescuer to apply firm pressure over the stomach, while we ventilate this patient."

: C Diff: 3 Page Ref: 256

: 10-12 94) You are by the side of a patient who fell 5 feet from a ladder, landing on a concrete porch and hitting his lower back and buttocks. Assessment reveals an intact airway, adequate respirations, rapid radial pulse, and skin that is pale, cool, and diaphoretic. The patient complains of lower back and left leg pain. No deformity to the extremity is noted; however, the lower back is tender on palpation. The following vital signs are obtained: pulse, 132; respirations, 20 breaths/min; blood pressure, 102/88 mmHg; and SpO2, 97% on room air. Regarding oxygen therapy, you would: A) Provide 2 lpm O2 through a nasal cannula B) Start positive pressure ventilation to support breathing C) Administer oxygen at 15 lpm through a nonrebreather mask D) Recognize a normal SpO2 and forego oxygen therapy

: C Diff: 3 Page Ref: 269

: 11-3 7) A family has called 911 for a 41-year-old male family member whom they cannot wake up. They state he has been threatening to kill himself and believe that he may have intentionally overdosed on his pain medications. As you enter the patient's bedroom, you observe him supine on the floor with his eyes closed. As he breathes, you hear snoring respirations. As a knowledgeable EMT, you recognize that this condition is likely caused by: A) The nasopharynx being blocked by mucus or heavy secretions B) The airway swelling shut C) The tongue partially blocking the airway D) The respiratory rate being less than 10 breaths/min

: C Diff: 3 Page Ref: 290, Table 11-2

: 11-9 8 Copyright © 2018 Pearson Education, Inc. 29) A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are pulse, 118; respirations, 18 breaths/min; blood pressure, 102/86 mmHg; and SpO2, 96%. Which complaint would make the most sense given this clinical presentation? A) Persistent cough B) Fever C) Rectal bleeding D) Headache

: C Diff: 3 Page Ref: 293

: 11-10 12 Copyright © 2018 Pearson Education, Inc. 45) The EMT is correct when he makes which of these statements about assessment of the pupils? A) "Dilated pupils are less of a concern than pupils that are constricted." B) "If a patient's pupils are dilated but react to light, the pupillary exam is considered normal." C) "Some people naturally have unequal pupils, but both should react to light." D) "Constricted pupils are less of a concern than are dilated pupils."

: C Diff: 3 Page Ref: 295

: 11-1 13 Copyright © 2018 Pearson Education, Inc. 49) Your partner is having a difficult time determining normal and abnormal blood pressures for a child. Which of these statements will help him most? A) "Since pediatric emergencies are less common than adult emergencies, it is best to call medical direction and ask what is normal." B) "Any systolic blood pressure of less than 100 mmHg in a child is an emergency." C) "A minimally acceptable systolic pressure can be estimated by doubling the child's age and adding it to 70." D) "It is helpful to ask the parent or caregiver what is normal for the child and compare your reading to that."

: C Diff: 3 Page Ref: 297

: 11-11 63) Which of these statements indicates an appropriate understanding of palpating a blood pressure? A) "A palpated blood pressure is recorded when the brachial pulse fades out as the BP cuff is deflated." B) "Palpated blood pressure is the technique of choice when the patient has a cardiac complaint." C) "A palpated blood pressure is typically a little lower than a blood pressure obtained by auscultation." D) "It is best to determine a palpated blood pressure using a stethoscope and pulse oximeter."

: C Diff: 3 Page Ref: 298

: 11-16 128) You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. How often should vital signs be reassessed on this patient? A) Once at the scene and once en route to the ED B) Only baseline vital signs are required C) Every 5 minutes D) Every 15 minutes

: C Diff: 3 Page Ref: 299

: 11-18 79) After you apply the pulse oximeter to a patient who complains of chest discomfort, she asks you what you are assessing. You would respond by telling her that the pulse oximeter: A) Provides the most accurate evaluation of the true heart rate B) Is a tool used to see if the airway needs to be opened C) Provides information about the amount of oxygen circulating in the blood D) Can tell how much carbon dioxide she is exhaling with each breath

: C Diff: 3 Page Ref: 299

: 11-16 127) You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. The patient still has a good pulse and acceptable blood pressure. The pulse oximeter reads 95% and the ETCO2 monitor reads 28 mmHg. Given these findings, the EMT should: A) Administer a tube of oral glucose since the patient's airway is protected B) Increase the amount of oxygen being delivered to the BVM reservoir C) Ask the EMT student ventilating the patient to slow the ventilatory rate D) Place the patient in semi-Fowler's position to help reduce intracranial pressure

: C Diff: 3 Page Ref: 302-303

: 2-11 4 Copyright © 2018 Pearson Education, Inc. 12) While you are assessing a patient with abdominal pain, the patient informs you that he is a chronic carrier of hepatitis B. His skin is not jaundiced, nor does he have a fever. As an EMT, you realize: A) The patient has the disease but is not infectious B) The hepatitis B vaccine will not protect you if you are exposed to the virus C) The patient's blood and body fluids are infectious D) A mask must be placed over the patient's mouth

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: 13-9 16) A 26-year-old male patient has been ejected from a car after it rolled several times in the median of the interstate. As you perform the primary assessment, you find him prone and unresponsive. Your immediate action is to: A) Assess his breathing B) Apply a cervical collar C) Logroll him into supine position D) Place an oral airway

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: 13-11 24) You have been called to the side of a 37-year-old female patient whose chief complaint is confusion, anxiety, and chest tightness. Assessment shows her airway to be patent, respirations are 46 breaths/min, heart rate is 134 beat/min, blood pressure is 128/54 mmHg, and SpO2 is 93%. In regard to the respiratory rate, you would recognize: A) It will result in too much air being placed in the lungs B) It is not a concern because the patient is still getting oxygen C) It does not allow the lungs enough time to adequately fill D) It will cause damage to the lungs if not corrected

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: 13-12 50) A 5-year-old boy has been vomiting profusely for two days. Your assessment indicates that his airway is open, respirations adequate, and radial pulse fast and weak. His skin is cool and moist, and the capillary refill time is 5 seconds. This patient is most likely: A) Hypoxic B) Malnourished C) Poorly perfused D) Feverous

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: 13-7 71) You are performing a secondary assessment and are assessing the patient's chest. Which of these findings would you associate most with fracture of the ribs? A) Ecchymosis to the chest wall B) Decreased breath sounds C) Paradoxical chest wall motion D) Jugular venous distention

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: 13-14 20 Copyright © 2018 Pearson Education, Inc. 74) A 41-year-old male patient has fallen from a second-story roof. He complains of right leg pain and pain to his pelvic region. When performing the secondary assessment on this patient, which of these should the EMT intentionally not perform? A) Palpation of the patient's abdomen B) Securing the patient to a long spine board C) Palpation of the pelvic region D) Transporting the patient supine

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: 13-21 114) You are a field supervisor for your EMS system and are working with a new EMT during his probationary period. Both of you are currently on the scene of a 10-month-old pediatric patient for what dispatch describes as "an unknown medical emergency." Upon arrival, the parents state the infant is "just not acting right." Currently the infant opens his eyes when you shout his name suddenly, he can localize painful stimuli when applied, and he is grunting with each respiration. He was born 3 weeks premature. His capillary refill is 2 seconds. You ask your new EMT to calculate the pediatric GCS score. The EMT should respond with which numeric value? A) 6 B) 8 C) 10 D) 12

: C Diff: 3 Page Ref: 372, Table 13-10

: 13-20 112) You are assessing a medical patient whom you suspect has experienced a stroke. Currently he can open his eyes to verbal commands, his verbal responses are incomprehensible sounds, and he is able to localize painful stimuli when applied. What is this patient's Glasgow Coma Scale score? A) 6 B) 8 C) 10 D) 12

: C Diff: 3 Page Ref: 372, Table 13-9

: 14-2 12) A 59-year-old male patient has summoned EMS for crushing chest pain. He states that he needs his nitroglycerin, but it is in his car in a nearby parking lot. A friend of the patient explains that he also takes nitroglycerin and hands you his bottle of nitroglycerin. The patient appears very ill, and he says that this chest pain is the worst he's ever experienced. Given the patient's condition, your best action would be to: A) Administer the friend's nitroglycerin B) Have the patient retrieve his nitroglycerin from the car C) Ask the friend to get the patient's nitroglycerin from his car quickly D) Administer his friend's nitroglycerin now, but retrieve patient's nitroglycerin bottle from his car so you have proof and verification that this medication was appropriate to administer

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: 15-4 60) When paramedics administer IV fluids as treatment for hemorrhagic shock, the fluids will: A) Stabilize the shock by restoring needed fluid and electrolytes to the intravascular volume B) Enable the lungs to better oxygenate the blood by increasing the hemoglobin level in the bloodstream C) Not be able to increase the oxygen-carrying capability of the blood D) Reverse the shock by increasing the blood pressure and inhibit anaerobic metabolism

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: 15-11 26 Copyright © 2018 Pearson Education, Inc. 95) You are treating a 4-year-old child who sustained trauma after being ejected from a motor vehicle rollover. Your assessment has revealed a blood pressure of 72/52 mmHg, a heart rate of 118 beats/min, and respirations of 28 breaths/min and unlabored. The pulse oximetry reading on ambient air is 92%. How would you describe these findings? A) Acceptable vital signs for this age bracket B) Elevation of all vital signs C) Shock findings for this age D) Normal vital signs with an abnormally low pulse oximeter reading

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: 15-2 2) Resuscitation, when started during which phase of cardiac arrest, provides the patient with the best chance of survival? A) Circulatory B) Metabolic C) Electrical D) Bradycardic

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: 15-16 15) Within 2 minutes of going into cardiac arrest, an AED is applied, the patient is shocked, and a pulse is restored. The EMT should recognize that the patient's heart was in: A) Ventricular fibrillation and now is in cardiac arrest B) Asystole and now is in an organized rhythm C) Ventricular fibrillation and now is in an organized rhythm D) Ventricular fibrillation and now is in asystole

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: 15-15 22) If a cardiac arrest patient were in asystole, which message would the AED provide? A) "Shock advised" B) "Check electrodes" C) "No shock advised" D) "Press analyze"

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: 3-4 50) A paramedic was late in reregistering and now, according to the state EMS agency, must function as an EMT until all of the reregistration requirements are satisfied. As an EMT, she is on the scene of a motor vehicle accident and taking care of a critically injured teenager. While waiting for a paramedic to arrive, she starts an IV, but does not hang the IV fluid that will be used to help stabilize the patient. This is immediately done by a paramedic once he arrives. As such, which of these is true? A) The paramedic/EMT violated the scope of practice but cannot be held accountable since the patient was stabilized by her actions B) The paramedic/EMT did not violate the scope of practice since she is experienced with IV therapy C) The paramedic/EMT violated the scope of practice and can be held accountable even though the patient survived D) The paramedic/EMT did not violated the scope of practice since the patient was critically injured and required lifesaving care

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: 16-19 80) A patient in respiratory distress is exhibiting pursed lip breathing. You realize that he is doing this to: A) Exhale increased amounts of CO2 B) Inhale additional amounts of oxygen C) Keep the small airways open D) Prevent the loss of vapor with exhalation

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: 17-2 77) Which of these statements regarding contraction of the heart is true? A) The two ventricles contract simultaneously, moving blood into the atria B) The right atria and ventricle contract together, moving blood to the left side C) Both atria contract together just before both ventricles contract together D) When the left ventricle contracts, it sends blood into the lungs for oxygenation

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: 17-2 21 Copyright © 2018 Pearson Education, Inc. 81) A patient is very dizzy and has an altered mental status. Vital signs are pulse, 84; respirations, 16 breaths/min; blood pressure, 74/32 mmHg; and SpO2, 93%. Medical direction has ordered the paramedic to start an IV infusion of a medication that causes blood vessel constriction. You would recognize that the medication is benefiting the patient when you observe: A) The heart rate increase to 92 beats/min B) The respirations increase to 24 breaths/min C) The blood pressure increase to 110/64 mmHg D) The SpO2 increase to 94%

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: 17-10 38) Which of these statements would the EMT expect from a patient with unstable angina? A) "When I stop what I am doing, the pain goes away." B) "If I take a nitroglycerin tablet, the pain stops." C) "The chest pain awakens me from my nighttime sleep." D) "The antacid my doctor prescribed seems to take the pain away."

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: 17-11 40) A patient with a past medical history of angina is now complaining of chest discomfort. When assessing this patient, which sign or symptom should alert the EMT that the patient is probably experiencing an acute myocardial infarction and not an anginal attack? A) Pain radiates into the left arm B) The patient complains of mild shortness of breath C) Chest discomfort is not relieved by nitroglycerin D) The patient's skin is not diaphoretic

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: 17-17 86) When assessing an elderly patient with upper back pain, which of these assessment findings would make you very suspicious of a thoracic aortic dissection? A) Lower back pain described as a constant ache B) Dizziness when going from a supine to standing position suddenly C) Different blood pressure readings in each arm D) History of hypertension and lower back injury

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: 17-17 102) A mother has called 911 because her 6-year-old son told her he had chest pain. On scene, the mother informs you that her son suffers from a congenital heart defect called aortic coarctation. The boy admits to chest pain and appears distressed. His airway is patent, breathing adequate, and radial pulse present and regular. Vital signs are pulse, 108; respirations, 24 breaths/min; blood pressure, 148/92 mmHg; and SpO2, 98%. Your next action would be to: A) Give one baby aspirin B) Try one nitroglycerin for pain relief C) Contact medical command for advice D) Administer high-concentration oxygen

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: 17-16 30) Which of these statements made by the EMT indicates a safe understanding of the administration of nitroglycerin in the prehospital setting? A) "I always check for an allergy to sulfa, since most people with an allergy to sulfa also have an allergy to nitroglycerin." B) "Since nitroglycerin constricts the blood vessels, you must always check the blood pressure before and after giving it." C) "A total of three nitroglycerin tablets may be administered in the prehospital setting, and this includes what the patient recently took prior to EMS arrival." D) "If the patient with chest pain also has a headache, the EMT should contact medical command prior to administering nitroglycerin."

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: 17-9 22) When administering aspirin to a patient with chest discomfort that is suggestive of a heart attack, the EMT recognizes that this medication will benefit the patient by: A) Breaking up the blood clot that is occluding the coronary artery B) Treating the headache that may occur when nitroglycerin is administered C) Decreasing the ability of the platelets in the blood to form clots D) Decreasing the chest pain caused by the possible heart attack

: C Diff: 3 Page Ref: 547, Figure 17-19

: 17-19 97) Which of these scene size-up observations would make you suspicious that a patient who complains of shortness of breath has congestive heart failure? A) Dramatic edema to the right arm B) Home oxygen tank in the bedroom C) Multiple pillows stacked at the head of the patient's bed D) Patient in dirty pajamas and appears unkempt

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: 3-14 24) A patient's spouse, who is a doctor, states that an EMT is negligent because he put his wife on low-concentration oxygen when she should have gotten high-concentration oxygen. The patient was having chest pain that was later determined to be caused by anxiety. She was released from the emergency department later in the day. Which statement is true? A) Negligence can be proven because the protocol states high-concentration oxygen should be given B) Negligence cannot be proven since the EMT responded to the call and did render care C) The EMT cannot be proven negligent because that patient suffered no harm or damage D) Negligence is a distinct possibility since the patient was transported and treated in the emergency department

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: 18-3 12 Copyright © 2018 Pearson Education, Inc. 45) A 78-year-old male patient was found lying on his bathroom floor. Emergency Medical Responders report that the patient is unresponsive, with unequal pupils, and vital signs are as follows: pulse, 78; respirations, 20 breaths/min and snoring; blood pressure, 210/106 mmHg; SpO2, 99%. The EMRs have applied oxygen by nonrebreather mask, and also report that the patient has a hematoma on the back of his head. What should you do first? A) Replace the nonrebreather mask with a nasal cannula B) Quickly apply a cervical collar C) Ensure an open airway with a jaw-thrust maneuver D) Lift the patient onto the stretcher for transport

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: 18-2 40) You have been called for a patient who suddenly became confused. Which of these assessment findings should concern you most? A) Blood pressure of 110/72 mmHg B) Pupils fully dilated and sluggishly reactive to light C) Heart rate of 180 beats/min but regular D) Blood glucose level of 72 mg/dL

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: 18-12 23) A patient who is responsive only to painful stimuli has a patent airway, inadequate respirations at 28 breaths/min and irregular, and a strong radial pulse with skin that is warm and dry. The patient is not moving his right arm or leg and is incontinent of urine. What is the priority for the EMT at this time? A) Insert an oropharyngeal airway B) Administer oxygen by nonrebreather mask C) Administer positive pressure ventilation D) Check the blood glucose level

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: 19-3 50) A 36-year-old male patient with diabetes and hypertension has experienced a secondary seizure. The patient responds to verbal stimuli with garbled speech, and his airway, breathing, and circulation are intact. Vital signs are pulse, 128; respirations, 20 breaths/min and adequate; blood pressure, 158/96 mmHg; and SpO2, 97% on room air. At this time, it is important that the EMT: A) Administer oral glucose as a precautionary measure B) Position the patient supine on the stretcher and transport C) Check the patient's blood sugar with a glucometer D) Administer supplemental oxygen at 2 lpm to maintain the oxygen saturation at its current level

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: 19-6 22) The EMT shows that she understands the danger posed by status epilepticus when she states: A) "Status epilepticus is an extremely dangerous condition because the patient can go into shock from blood loss." B) "If the patient does not have a history of seizures, he is at greater risk for status epilepticus." C) "The longer the seizure continues, the greater the opportunity for permanent brain damage." D) "Status epilepticus indicates that the medications a patient is taking have reached toxic levels in the body."

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: 19-4 18) A female patient with a history of seizures has experienced a seizure in a public area and is now refusing further assessment and transport. As you leave, a witness to the entire event tells you that he thinks the patient is "crazy in the head" because immediately before she seized, she looked up toward the ceiling and kept repeating, "Do you see the birds?" As a knowledgeable EMT, you should recognize that the bystander is describing which condition? A) Postictal confusion B) Side effects of seizure medications C) An aura D) Syncopal episode

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: 19-4 53) You believe that a patient experienced a simple partial (focal motor) seizure. Which of these statements made by the patient would reinforce this suspicion? A) "I cannot remember anything that happened. I must have passed out." B) "I think that I may have lost control of my bladder and bit my tongue." C) "My left arm would not stop shaking. I did not know what was happening." D) "I remember my arms and legs shaking, and then I can't remember anything else."

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: 20-8 36) Your medical director is providing a review of diabetic emergencies and asks you to describe glucose. Which of these statements would be your most appropriate response? A) "It is a medication that will lower the blood sugar." B) "It is a hormone produced by the pancreas." C) "It is a sugar that is the body's main source of energy." D) "It is a toxin that accumulates in the blood of a patient with diabetes."

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: 20-7 40) You are assisting a paramedic who is administering glucagon to a patient. Based on your understanding of how glucagon works in the human body, what is the therapeutic goal of this treatment? A) Increases insulin release from the liver B) Helps red blood cells carry the glucose C) Raises the amount of circulating blood glucose D) Rapidly decreases a high amount of circulating glucose

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: 20-2 6) Family members have called you for a young female patient with a history of diabetes who took insulin earlier in the day. She is confused and combative. Which of these questions is most important for the EMT to immediately ask the family? A) "How long has she had diabetes?" B) "Do you think that her blood sugar is high?" C) "Did she eat after taking the insulin?" D) "Did she take any drugs or drink alcohol?"

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: 20-9 64) A patient with diabetes is noncompliant with taking insulin. On scene, your assessment indicates this patient has an open airway, rapid and deep respirations, and a rapid radial pulse. His skin is warm and flushed. Vital signs are pulse, 120; respirations, 40 breaths/min; blood pressure, 108/86 mmHg; and SpO2, 98%. The patient's blood sugar reads "high" on your glucometer. Which of these instructions to other caregivers indicates proper care of this patient? A) "We need to apply supplemental oxygen at 15 liters per minute through a nonrebreather mask." B) "Someone needs to start positive pressure ventilation to slow his hyperventilation." C) "Do not worry about his breathing rate, it is actually helping him right now." D) "We need to see if his insulin is here so we can help him administer it to himself."

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: 20-9 65) Altered mental status resulting from a hypoglycemic episode in a patient with diabetes typically: A) Benefits from Kussmaul respirations B) Is accompanied by a "fruity" breath odor C) Has a sudden onset D) Follows a history of polyuria

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: 21-1 6 Copyright © 2018 Pearson Education, Inc. 19) The EMT exhibits an understanding of allergic reactions and anaphylaxis when she makes which of these statements? A) "An allergic reaction occurs only when the patient ingests or inhales an allergen; anaphylaxis occurs when the allergen is injected." B) "Allergic reactions are caused by pollen and food; anaphylactic reactions are caused by venoms and medications." C) "Anaphylaxis is a severe allergic reaction that will lead to death without emergency care." D) "Anaphylaxis describes a severe allergic reaction that occurs the first time a person is exposed to an allergen."

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: 21-9 12 Copyright © 2018 Pearson Education, Inc. 41) You have been called to a residence for a female patient who awoke with swollen lips and a rash to her arms and abdomen. In addition, she exhibits a mild expiratory wheeze in all lung fields. She called her doctor, who advised her to take some Benadryl and call 911 for emergency care. How will the Benadryl, acting as an antihistamine, benefit this patient? A) It helps the patient's immune system to deactivate the allergen B) It acts as an allergen to stop the allergic reaction through histamine stimulation C) It inhibits the constriction of the patient's small airways by blocking histamine D) It dilates the patient's blood vessels and delivers more blood to the brain

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: 22-3 2 Copyright © 2018 Pearson Education, Inc. 5) You have been called for a 13-year-old boy who was caught sniffing glue by his parents. The boy is lethargic and confused, complains of "burning" in his mouth and nose, and has nausea and vomiting. Based on the clinical presentation and mechanism of illness, how has this poison affected the patient's brain? A) Being absorbed through the small intestine into the bloodstream and then going to the brain B) Directly contacting the brain by crossing the mucous membranes of the mouth and nose C) Crossing from the lungs into the bloodstream and then circulating to the brain D) Absorbing fumes through the skin, nose, and eyes and then going on to the brain

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: 22-7 33) A patient who has ingested a toxic substance is to receive activated charcoal. The EMT knows that the charcoal will benefit the patient by: A) Coating the small intestine, limiting absorption of the poison B) Neutralizing the poison in the bloodstream C) Adsorbing the poisonous substance in the stomach D) Causing vomiting, thereby removing the poison from the body

: C Diff: 3 Page Ref: 657, Figure 22-3

: 22-16 73) You have been called for a 41-year-old female patient who is confused. According to her husband, she is an alcoholic who has been in and out of rehabilitation programs for the past five years. Assessment reveals her airway to be open and her breathing adequate. Her pulse is regular and strong. Which finding would cause the EMT to classify and treat this patient as a high priority? A) Blood pressure of 108/72 mmHg and complaint of nausea B) Smell of alcohol on the breath and complaint of headache C) Complaint of nausea and a temperature of 103.6°F D) Irritable and uncooperative with your effort to treat her

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: 22-17 66) Which of these statements indicates that the EMT understands the condition of withdrawal? A) "Withdrawal is typically not a life-threatening situation and is easily managed by EMS." B) "Withdrawal indicates that a patient is addicted to a drug and is presently overdosed on that drug." C) "Withdrawal from drugs or alcohol can be just as serious a medical emergency as an overdose." D) "Withdrawal is a term that is applied to the cessation of street drugs to which the patient is addicted, not prescription drugs."

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: 22-19 99) A 42-year-old female patient is lying in bed with anxiety after smoking some bath salts 30 minutes earlier. As you enter the bedroom, which finding poses the greatest danger to rescuers, given the nature of this medication? A) Respiratory burns from vapors B) Residual fumes from the drugs C) Patient aggression or violence D) Potential explosion from materials

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: 22-14 55) You have been called for a 46-year-old male patient who just smoked crack cocaine. In reviewing his past medical history, which of these conditions would be most of most concern? A) Alcoholism B) Migraine headaches C) Heart disease D) Diabetes

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: 23-6 42) Which of these statements made by the patient regarding abdominal pain would lead the EMT to suspect appendicitis? A) "The stabbing pain started in the right side of my belly and spread up toward my stomach." B) "I had back pain for about a week, and now the pain is all throughout my belly." C) "The pain started around my belly button and slowly spread down to the right side of my belly." D) "The pain comes and goes and is more noticeable on the left side of my stomach."

: C Diff: 3 Page Ref: 702

: 23-6 82) You have been called to a local nursing home for a restless patient with a four-day history of diarrhea. The primary assessment reveals an open airway, rapid breathing, and a weak and rapid radial pulse. Vital signs are pulse, 124; respirations, 24 breaths/min; blood pressure, 100/86 mmHg; and SpO2, 95%. The patient is confused with a history of Alzheimer's dementia. For this patient, it is most important to evaluate for: A) Intestinal obstruction B) Cause of confusion C) Dehydration D) Blood in the diarrhea

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: 23-4 6 Copyright © 2018 Pearson Education, Inc. 22) Which of these statements indicates that the EMT correctly understands the goal of assessing a geriatric patient with abdominal pain? A) "It is important to determine whether the liver is the cause of pain, since that is the most lifethreatening condition." B) "If the patient has tenderness on palpation of the abdomen, the EMT should assume bleeding is the cause." C) "It is more important to recognize a possible abdominal emergency, as opposed to determining the exact cause, because pain perception may be distorted." D) "To appropriately treat the patient, the EMT must identify the exact cause of the patient's pain."

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: 23-7 30 Copyright © 2018 Pearson Education, Inc. 117) Along with immunocompromised patients, which other age group(s) may have a vague presentation of an abdominal pathology due specifically to a depressed inflammatory response? A) Adult patients B) School-age patients C) Geriatric patients D) Teenager patients

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: 23-6 28) Upon your arrival at the scene of a patient with severe abdominal pain, an Emergency Medical Responder tells you that he is concerned because the patient's blood pressure is 146/88 mmHg and the patient has no history of high blood pressure. He states that it may be a good idea to treat the patient for hypertension as well as the abdominal pain. Your best response would be: A) "Thank you, you are right. We will call for ALS assistance right away." B) "That is concerning. We will have to see if anyone has blood pressure pills the patient can take." C) "Sometimes pain can naturally increase the blood pressure. I will take another reading so we can compare it with the baseline reading." D) "If the patient does not have a history of hypertension, then we will have to transport using lights and sirens."

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: 23-7 107) A patient with generalized weakness informs you that she has a history of iron-deficient anemia. You recognize that this patient has a history of: A) An overabundance of RBCs not capable of carrying oxygen B) Problems transferring oxygen from the lungs to the RBCs C) A decreased amount of hemoglobin available to carry oxygen D) Malformed RBCs that have a difficult time carrying oxygen

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: 23-10 94) A patient with lower abdominal pelvic pain, vaginal discharge, and elevated temperature has summoned EMS. In getting a medical history from this patient, which of these findings is the most important piece of information to relay to the receiving emergency department? A) Removal of her gallbladder three months ago B) Surgical removal of a twisted ovary eight years ago C) Internal procedure on her uterus yesterday by the gynecologist D) History of anemia and hypertension

: C Diff: 3 Page Ref: 718

: 4-9 18) Which statement shows an accurate understanding of the legal aspects of the prehospital care report (PCR)? A) "The PCR is considered a legal document only when it describes a crime or act of violence." B) "A PCR can be used in a lawsuit only if that lawsuit is filed within six months." C) "The PCR may be subpoenaed even if the lawsuit centers on alleged negligence that occurred in the emergency department." D) "A copy of the PCR should be forwarded to the police anytime law enforcement is involved in the call."

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: 5-5 23) What is the primary reason why emergency services communications (phone or radio) are recorded? A) The state EMS agency will use the recording to determine if care was appropriate B) The federal government requires that all communications be recorded C) Communications can become part of a legal record if need be D) The Federal Communications Commission reviews all recordings for communication appropriateness

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: 5-5 40) The wife of a 57-year-old male called 911 because her husband had chest pain. Which piece of information would be included in your SBAR report to the hospital during transport? A) "The call originated at the address to which we responded." B) "The police were called after a neighbor complained about where the ambulance was parked." C) "I am thinking that the patient would benefit from 324 mg of aspirin." D) "His wife also has a history of high blood pressure, so it appears to run in the family."

: C Diff: 3 Page Ref: 90

: 5-7 38) Over the radio, medical direction has given the following order for an unstable patient you suspect is having a heart attack: "Have the patient chew four baby aspirin, each one at 81 mg, and transport as soon as possible." You would show reception of this order by stating: A) "Copy. We will administer the aspirin as ordered and begin immediate transport." B) "Copy. We will start transport and administer 324 mg of aspirin en route." C) "Copy. We will have the patient chew four baby aspirin, each one at 81 mg, and transport ASAP." D) "Copy, Dr. Nash. We will follow the orders as received and transport to your facility."

: C Diff: 3 Page Ref: 90

: 4-9 43) A patient with asthma is using his inhaler TID and prn. You would recognize that: A) The patient is prescribed his inhaler for use only three times a day B) The patient is suffering asthmatic attacks three times a week C) The patient uses an inhaler at least three times a day D) The patient uses his inhaler only when the symptoms are bad

: C Diff: 3 Page Ref: Table 4-1 & 4-2 Abbreviations

: 4-7 40) Consider the following narrative from a patient care report: "pt. transported 3 days ago for suspected STEMI; pt. currently denies CP and SOB; PMH of HTN and CAD; pt. currently in NAD." Which of these interpretations is most accurate? A) The patient is short of breath B) The patient suffers from hypotension C) The patient has heart problems D) The patient is in moderate distress

: C Diff: 3 Page Ref: Table 4-2 Abbreviations

: 6-13 38) The safest and most efficient way of using your body to gain mechanical advantage is: A) The power lift B) To call for backup C) To reduce the distance an object must be used D) Body mechanics

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: 6-7 10) When carrying equipment in the right hand, the EMT should: A) Lean to the left side for compensation B) Bend backward for counterbalance C) Tilt his body to the right side D) Keep his or her back straight as best possible

: D Diff: 1 Page Ref: 105

: 7-27 20 Copyright © 2018 Pearson Education, Inc. 87) What is the term that refers to the structure of the body? A) Physiology B) Metabolism C) Combining forms D) Anatomy

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: 1-9 19) It has been some time since you were involved in the care of a pediatric patient. You decide to review the assessment and treatment basics that your medical director requires. To review this information, which resource should you consult first? A) Emergency Medical Responders B) Reputable websites C) Emergency department nurses D) Service protocols

: D Diff: 1 Page Ref: 13

: 7-27 19 Copyright © 2018 Pearson Education, Inc. 82) Which term is most closely related to the elbow? A) Acetabular B) Tibial C) Calcaneal D) Cubital

: D Diff: 1 Page Ref: 133, Figure 7-4

: 7-5 14 Copyright © 2018 Pearson Education, Inc. 58) A patient with an orbital fracture is most likely to complain of: A) Pain around the ear B) Difficulty swallowing C) Pain when moving his lower jaw D) Pain around the eye

: D Diff: 1 Page Ref: 134

: 7-6 49) The spinal column is composed of which sections, described in order from most superior to most inferior? A) Cervical, lumbar, thoracic, sacral, and coccyx B) Coccyx, lumbar, thoracic, cervical, and sacral C) Thoracic, lumbar, cervical, coccyx, and sacral D) Cervical, thoracic, lumbar, sacral, and coccyx

: D Diff: 1 Page Ref: 135-136

: 7-23 62) A patellar fracture affects which part of the body? A) Tibia B) Hip C) Elbow D) Knee

: D Diff: 1 Page Ref: 136

: 7-27 79) A patient with a calcaneal fracture has a broken: A) Foot B) Thigh C) Knee D) Heel

: D Diff: 1 Page Ref: 138

: 7-10 20) What is the basic function of the respiratory system? A) Transport oxygen throughout the body B) Provide nutrients to the cells absorbed into the bloodstream C) Release oxygen from the body via hemoglobin sites D) Exchange oxygen and carbon dioxide with the environment

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: 7-15 34) When palpating a pulse on top of the foot, the EMT is assessing blood flow in which vessel? A) Posterior tibial vein B) Femoral vein C) Coronary artery D) Dorsalis pedis artery

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: 7-15 10 Copyright © 2018 Pearson Education, Inc. 41) What is the name of the fluid that carries blood cells and nutrients? A) Platelet fluid B) Hemoglobin C) Total body water D) Plasma

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: 7-15 43) The nervous system is structurally subdivided into the: A) Brain and vertebral column B) Involuntary and voluntary nervous systems C) Skull and vertebral column D) Central and peripheral nervous systems

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: 8-3 4) The patient in anaerobic metabolism is deficient in/of: A) Glucose (sugar) B) Protein C) Lactic acid D) Oxygen

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: 8-16 12 Copyright © 2018 Pearson Education, Inc. 48) A chronically elevated afterload increases the patient's chance for developing which pathological condition? A) Liver disease B) Hypotension C) Diabetes D) Heart failure

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: 9-3 21) You are transporting a 3-week-old male patient who has a fever and cough to the hospital. When making your radio report, you would advise the emergency department that you are bringing in a(n): A) Infant B) Baby C) Toddler D) Neonate

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: 9-10 23) Which of these patients would be categorized as a toddler? A) 6-month-old female B) 48-month-old male C) 4½-year-old female D) 28-month-old male

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: 9-10 31) A female patient informs you that she has already gone through menopause. You would realize that: A) Her menstrual periods are irregular and she cannot have a baby B) She has stopped outright menstrual periods but can still become pregnant C) She will still have menstrual periods but is incapable of pregnancy D) She has stopped menstrual periods and can no longer become pregnant

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: 10-22 114) When does hypoxia occur? A) When carbon dioxide accumulates within the body B) If the respiratory rate decreases to less than 12 breaths per minute C) When carbon dioxide is excreted too rapidly from the lungs D) If inadequate amounts of O2 are available to the cells

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: 10-3 2) You are assessing an unresponsive patient who overdosed on a narcotic pain medication. Given the situation, what is the greatest concern regarding potential airway occlusion? A) Spasm of the epiglottis B) Swelling of the carina C) Collapse of the bronchi D) Relaxation of the tongue

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: 10-6 23 Copyright © 2018 Pearson Education, Inc. 88) What is obstructing the airway when snoring is heard? A) Fluid in the upper airway B) Swelling of the larynx C) Bronchospasm D) The tongue

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: 10-7 6 Copyright © 2018 Pearson Education, Inc. 21) The EMT should use the jaw-thrust maneuver to open the airway for the patient with which type of presentation? A) Overdose with snoring respirations B) Stroke with gurgling respirations C) Cardiac arrest in bed D) Unresponsive after falling from a porch

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: 10-10 53) The EMT should recognize that the oropharyngeal airway has been appropriately inserted when: A) It cannot be dislodged by the EMT B) The respiratory rate returns to normal C) Vomiting is no longer occurring D) Its flange rests on the teeth

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: 10-10 56) When inserting a nasopharyngeal airway, the EMT should remember that: A) The patient cannot be responsive or have a gag reflex B) An oil-based lubricant is needed for smooth insertion C) The head-tilt, chin-lift maneuver or jaw-thrust maneuver is not needed after insertion D) The nasal mucosa may bleed even with proper insertion

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: 2-5 25) Changes in your lifestyle that may help you manage stress include: A) Eating a high-protein and fatty diet B) Concentrating on your job 24 hours a day C) Self-medication with over-the-counter medicines D) Practicing relaxation techniques such as meditation

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: 10-6 83) When providing an in-service program on ventilating the geriatric patient, you should emphasize which point in regard to a patient who has dentures? A) It is always best to remove dentures, regardless of whether they are loose B) It is best to leave the top appliance in place, but remove the bottom one C) Removal of dentures enables the EMT to maintain a better face to mask seal D) Loose appliances should be removed if they interfere with the airway or the seal between the mask and face

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: 2-7 14 Copyright © 2018 Pearson Education, Inc. 52) An EMT has an understanding of the different types of pathogens when she states: A) "Bacteria tend to be larger than viruses and can be seen without a microscope." B) "Protozoa are considered parasitic worms and can live within the human body." C) "Fungal infections typically attack the immune systems of healthy persons." D) "Viruses are resistant to antibiotics because they live within the body's cells."

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: 11-14 3) The EMT is correctly calculating a patient's respiratory rate when he or she: A) Counts the number of breaths in 1 minute and divides by 4 B) Obtains a pulse oximetry reading and divides it by 3 C) Assesses the patient for any sign of respiratory difficulty D) Counts the number of breaths for 30 seconds and multiplies by 2

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: 11-6 4 Copyright © 2018 Pearson Education, Inc. 12) You have been called to assess a conscious and alert 5-year-old child whose chief complaint is nausea and vomiting over the last 2 hours. When assessing his pulse, you should first check which pulse? A) Brachial B) Carotid C) Pedal D) Radial

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: 11-7 11) What is the name of the pulse that is palpated in the groin area? A) Carotid B) Inguinal C) Pedal D) Femoral

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: 11-6 23 Copyright © 2018 Pearson Education, Inc. 89) Which of these patients should the EMT recognize as tachycardic for his or her age bracket? A) An 86-year-old male with chest pain and a heart rate of 96 B) A 2-year-old female with vomiting and a heart rate of 116 C) A 24-year-old female with diabetic complications and a heart rate of 54 D) A 37-year-old male with a complaint of fatigue and a heart rate of 104

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: 11-3 9) An EMT is correctly assessing a patient's radial pulse when he: A) Uses the palm of his hand to feel the pulse on the upper arm B) Simultaneously checks for a heart rate on both sides of the neck C) Uses his thumb to feel for the pulse on the patient's lower arm, near the base of the thumb D) Uses his fingertips to feel for a pulse on the anterior and lateral aspects of the patient's wrist

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: 11-2 27) The EMT should recognize normal skin color in a healthy patient as: A) White B) Warm C) Red D) Pink

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: 11-11 58) Your partner reports that a patient's blood pressure is 156/78 mmHg. From this reading, you realize: A) The pulse pressure is 224 mmHg B) The systolic blood pressure is 78 mmHg C) The constant pressure in the veins is 156 mmHg D) The diastolic blood pressure is 78 mmHg

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: 11-12 52) When obtaining a blood pressure, the EMT listens for a pulse over which blood vessel? A) Radial artery B) Antecubital vein C) Carotid vessel D) Brachial artery

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: 11-15 21 Copyright © 2018 Pearson Education, Inc. 80) When using a pulse oximeter on an adult patient, the EMT knows that the sensor is most often attached to the patient's: A) Chest B) Forehead C) Ear D) Finger

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: 11-5 84) When should the EMT use the pulse oximeter? A) Only on patients who complain of shortness of breath B) On any and all patients 1 year of age and older C) Only if the patient has a history of lung disease D) Routinely on all patients with a medical or trauma complaint

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: 11-17 107) You are attempting to get a history from a 56-year-old female patient who is short of breath. When you ask questions, the daughter continually answers for the patient. To best handle this situation, you should: A) Have the Emergency Medical Responders remove the daughter B) Move the patient to the ambulance for the rest of the assessment C) Contact medical direction for advisement D) Explain to the daughter it is important for the patient to answer whenever possible

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: 11-20 115) Which of these pieces of information would be obtained by the EMT when getting a history using the SAMPLE mnemonic? A) Pulse, 144; respiration, 16 breaths/min; BP, 132/88 mmHg B) No life threats to the airway, breathing, or circulation C) Reason for calling for an ambulance D) Sensation of dizziness prior to falling

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: 11-20 66) When obtaining a medical history using the SAMPLE mnemonic, which of these statements relates to the "P" component? A) "The physician is Dr. Coleman." B) "The pulse is 116 beats per minute." C) "The pain is rated at 8/10." D) "There is a history of pancreatitis."

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: 11-20 120) When assessing a patient who does not speak the same language as you or your partner, the best approach in the immediate care of the patient is to: A) Contact medical direction to get physician input B) Transport the patient to a hospital with interpreters for her language C) Try to find a neighbor who speaks the patient's language D) Request that a family member act as an interpreter

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: 12-8 18) Which of these emergency responders have articles of personal protective equipment in place? A) An EMT with gloves, gown, and eye protection B) An Emergency Medical Responder with leather gloves and steel-toed boots C) A firefighter with a self-contained breathing apparatus unit on D) All the responders have personal protective equipment in place.

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: 12-6 23) When deciding whether to transport a patient to the hospital using lights and sirens to the hospital, which information carries the most weight in your decision? A) Mechanism of injury B) Index of suspicion C) Past medical history D) Assessment findings

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: 12-7 7 Copyright © 2018 Pearson Education, Inc. 25) You have been directed to a car that struck another vehicle at a moderate rate of speed. You note deformity and starring of the windshield on the driver's side. What should you do to determine whether the deformity to the windshield was caused by the driver hitting his head or by the air bags? A) Determine if a seat belt was used B) Ask the front-seat passenger C) Determine if the air bags deployed D) Assess the patient's head

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: 13-1 2) You have been dispatched to a residence for an 89-year-old female patient with a nonspecific complaint. When assessing this patient, what should you do first to develop an initial impression regarding emergency? A) Obtain the patient's vital signs and current medications B) Gather a medical history including allergy information C) Contact medical direction for advice D) Determine whether the complaint is medical or trauma related

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: 2-10 11 Copyright © 2018 Pearson Education, Inc. 40) In the field setting, the best way to avoid becoming infected with human immunodeficiency virus (HIV) is: A) Avoid unnecessarily touching patients with confirmed HIV infection B) Always ask patients if they have HIV infection or AIDS C) Always wear gloves, goggles, and a gown for all patient contacts D) Use the appropriate protective personal equipment

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: 13-18 55) As you perform the primary assessment on an unresponsive patient, you discover vomitus in her airway. What should you do next? A) Check the breathing B) Start positive pressure ventilation C) Apply supplemental oxygen D) Suction the airway

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: 13-9 15) On scene, you find a 91-year-old female patient who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respirations. Which instruction should you immediately give your partner after manual spinal motion restriction is applied? A) "Please perform the head-tilt, chin-lift maneuver to open the airway." B) "Check her breathing and let me know the rate." C) "Let's move her to the stretcher and get moving to the hospital." D) "Get the suction out and clear out her airway."

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: 13-11 29) Which characteristic regarding breathing rates must the EMT remember when assessing the respirations of a pediatric patient? A) Respirations in a pediatric patient are similar to those of an adult B) Respirations in a pediatric patient are typically slower than those of an adult C) Respirations in a pediatric patient are not significant in the assessment of breathing adequacy D) Respirations in a pediatric patient are usually faster than those of an adult

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: 13-12 39) You are assessing an 8-month-old child whose mother states that he has been vomiting for two days and not eating or drinking normally. When assessing the pulse, you should check which site? A) Temporal B) Radial C) Femoral D) Brachial

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: 13-12 46) During your primary assessment, you note the patient's skin to be warm, pink, and dry. This finding would seem to indicate: A) Possible shock B) Possible fever C) Poor oxygenation D) Normal circulation

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: 13-17 79) A 66-year-old female patient was involved in a vehicle rollover. While evaluating her abdomen, which of these abdominal assessment parameters should you be least concerned about? A) Rigidity B) Distention C) Guarding D) Bowel sounds

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: 13-1 85) When performing a secondary assessment on an alert and oriented female patient with a deformed left leg, the EMT should: A) Describe to the patient your findings and the injuries as you encounter them B) Reassure the patient that she will be okay and the injury is nothing to worry about C) Inform the patient that if you assess her, she must submit to all treatment by EMS providers D) Explain to the patient what you are doing before and during the assessment

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: 13-17 93) The EMT determines the medications a patient takes during which phase of the patient assessment? A) Primary assessment B) OPQRST exam C) Chief complaint D) SAMPLE history

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: 13-18 23 Copyright © 2018 Pearson Education, Inc. 86) When assessing a stable patient with a medical complaint, which piece of information will typically be obtained first? A) Vital signs B) Chief complaint C) Level of consciousness D) Past medical history

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: 13-26 98) When you are caring for a patient with either a medical complaint or a traumatic injury, you should typically perform the reassessment: A) Before the secondary assessment B) When a life-threatening condition is found C) Immediately following the primary assessment D) While transporting the patient to the hospital

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: 13-27 104) Trends in a patient's condition are best noted during which phase of patient assessment? A) Secondary assessment B) Primary assessment C) General impression D) Reassessment

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: 14-10 30) Atrovent, if prescribed to the patient, is indicated for: A) Headache B) Chest discomfort C) Nausea or vomiting D) Difficulty breathing

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: 14-12 11) You are assisting a patient with her metered-dose inhaler (MDI). In an effort to determine the exact name of the medication, it would be best for the EMT to: A) Ask the patient the name of the medication B) Contact and describe the MDI to medical direction C) Look up the medication using the Physician's Desk Reference (PDR) D) Find the medication name on the label of the MDI

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: 15-3 61) Which of these are some of the major categories of shock that the EMT will likely encounter? A) Hemorrhagic, distributive, anoxic, and obstructive B) Burn, hypovolemic, distributive, and hypoxic C) Hypoglycemic, obstructive, distributive, and hypovolemic D) Hypovolemic, cardiogenic, obstructive, and distributive

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: 15-17 8 Copyright © 2018 Pearson Education, Inc. 27) You have been dispatched to a residence for a male patient with a cardiac history who is complaining of chest pain. On scene, you find a 52-year-old man sitting in a chair. He is alert and oriented. He states that his chest pain feels like the last time he had a heart attack. He reports that in the hospital his heart stopped and the health care personnel had to shock him twice before it restarted. He is breathing adequately and has a strong radial pulse. Which of these actions would be appropriate in the assessment and/or management of this patient? A) Apply the AED to the patient but do not turn it on B) Provide positive pressure ventilation with high-concentration oxygen C) Open the patient's airway using the head-tilt, chin-lift maneuver D) Obtain the patient's heart rate, respiratory rate, and blood pressure

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: 15-15 7) The EMT should request advanced life support (ALS) backup for a patient in cardiac arrest because: A) Paramedics must be present for the EMT to use the AED B) Patients with cardiac arrest must be transported by ALS personnel C) ALS care is superior to basic life support care, even when the AED is available D) ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred

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: 15-17 16) A 47-year-old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to: A) Perform CPR at a ratio of 30 ventilations to 2 compressions B) Assist you in making sure that the AED is ready for application C) Perform a primary and secondary assessment D) Perform CPR until the AED is ready

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: 15-21 55) Your ambulance service director has given you permission to replace an old fully automated AED with a new semi-automated AED produced by a different manufacturer. Before making the purchase, you must receive authorization to do so from the: A) Shift supervisor B) Old manufacturer C) American Heart Association D) EMS system's medical director

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: 16-7 43) You realize the EMT is properly ventilating an unresponsive adult male patient when: A) He ventilates smoothly at a rate of 24 breaths/min B) He flexes the patient's head as ventilations are administered C) He allows 2 seconds between each ventilation D) You observe the pulse oximeter trending upward

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: 17-11 6) In the blood, which component is largely responsible for the formation of blood clots? A) Red blood cells B) White blood cells C) Plasma D) Platelets

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: 17-11 20) You are caring for an alert and oriented patient with chest pain. Emergency First Responders have initiated supplemental oxygen, and your EMT partner assisted in the administration of aspirin and two nitroglycerin tablets. Currently, the patient's vital signs are pulse, 76; respirations, 16 breaths/min; blood pressure, 110/56 mmHg; and SpO2, 95%. When transporting this patient on the stretcher, which position is best? A) Semi-Fowler's position B) Supine with head elevated C) Lateral recumbent D) Position of comfort

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: 17-9 98) A patient informs you that he has a hard time breathing when he lies in bed. You would best document this report as: A) Dyspnea B) Tachypnea C) Nocturnal dyspnea D) Orthopnea

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: 17-16 28) Which instruction given by an EMT indicates the proper administration of nitroglycerin? A) "Breathe in when I spray the nitroglycerin into your mouth." B) "This pill will go between your cheek and gum." C) "Please chew and swallow this pill." D) "Let this pill dissolve under your tongue."

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: 17-18 55) A patient complains of chest pain that radiates into his neck and arms. The primary assessment reveals a patent airway, adequate breathing, and a strong, regular radial pulse. The patient's skin is warm and dry, and reveals no signs of inadequate perfusion. What should you do next? A) Start the secondary assessment B) Attach the AED C) Provide oxygen D) Check vital signs

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: 18-10 34) You have gathered and written down all of the medications, including narcotic pain medications, that a confused 46-year-old male patient currently takes. The patient is placed on the stretcher for transport. At this time, how would you handle the medications? A) Return them to their original places B) Give them to a family member C) Turn them over to the police D) Transport them with the patient

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: 18-10 15) A 49-year-old male patient is unable to speak. You would document this finding as: A) Apnea B) Dysarthria C) Dysplegia D) Aphasia

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: 19-6 7 Copyright © 2018 Pearson Education, Inc. 24) Which of these patients would be classified as having status epilepticus? A) A 16-year-old male who experienced a partial motor seizure for 7 minutes B) An 89-year-old male who seized immediately upon getting out of bed C) A 19-year-old female who briefly seized but has been postictal for 20 minutes D) A 57-year-old female at a group home who seized during the entire evening movie that was shown in the common living room, according to other group home residents

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: 3-7 17 Copyright © 2018 Pearson Education, Inc. 58) You have been called for a 96-year-old female with altered mental status. At the scene, you find that the patient is unresponsive, not breathing, and pulseless. The family provides you with a valid DNR order. What could you document as a presumptive sign of her death? A) Closed eyes B) Poor or weak reflexes C) Dilated pupils D) Absent blood pressure

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: 19-7 13 Copyright © 2018 Pearson Education, Inc. 47) Which of these medications is most closely associated with a history of seizures? A) Celexa B) Prozac C) Xopenex D) Depakote

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: 1-2 3) An Emergency Medical Responder comes to you and states that he would like to work for your emergency ambulance service on a full-time basis. Knowing the National EMS Scope of Practice Model, you inform him of which element? A) He will be able to take care of only patients with non-life-threatening complaints B) He will first need approval from your ambulance service's medical director C) He will be able to work only with an Advanced EMT or paramedic D) He will first have to become an Emergency Medical Technician

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: 20-2 55) With normal metabolism, what happens after a healthy patient ingests food? A) Glucose levels in the body drop quickly B) The liver releases stored glucose C) Excess glucose is released in the urine D) Blood levels of insulin rise

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: 20-5 3 Copyright © 2018 Pearson Education, Inc. 9) A glucometer reads 50 mg/dL. The EMT would recognize this reading as: A) High B) Normal C) Average D) Low

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: 20-9 51) Which assessment finding is the best means by which to delineate hypoglycemia from hyperglycemia? A) Determine the rate at onset B) Examine the signs and symptoms C) Analyze the vital signs D) Evaluate the patient's blood sugar

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: 21-5 43) You have been summoned to an apartment for a 58-year-old female who complains of hives on her chest and abdomen. When asked, she states that she has had several episodes of the hives over the past six months, but allergy testing has not been able to pinpoint a cause. Based on this information, how would you best classify the cause of the patient's reaction? A) Iatrogenic B) Anaphylactoid C) Anaphylactic D) Idiopathic

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: 21-9 32) In which of these situations would the EMT contact medical direction prior to administering epinephrine to a patient who is experiencing an anaphylactic reaction? A) The patient has an allergy to chocolate or eggs B) The patient's heart rate is 144 beats/min C) The patient is hypotensive and tachycardic D) The patient is not prescribed an auto-injector

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: 21-8 34) When administering epinephrine to an infant or child, the EMT would place the injector at which site? A) Outer buttock B) Hip muscle C) Upper arm D) Lateral thigh

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: 21-9 28) For the EMT to achieve the best results when assisting a patient with epinephrine treatment, the medication should be properly injected into: A) An artery B) The skin C) A vein D) A muscle

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: 22-3 7) A 31-year-old female patient was stung by a hornet while golfing. Your assessment reveals her to be confused with stridorous respirations. Her skin is warm and flushed and covered with hives. A stinger is located on the back of her neck. Based on this information, you would recognize that the route of poisoning for this patient is: A) Absorption B) Anaphylactic C) Topical D) Injection

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: 22-7 32) Which action indicates that the EMT is correctly administering activated charcoal to a patient who has ingested a toxic substance? A) The charcoal is mixed with milk B) Sugar is added to make the charcoal taste better C) The charcoal is squirted into the mouth D) The patient drinks the charcoal through a straw

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: 23-4 10) Which of these conditions would the EMT recognize as an acute abdominal emergency? A) Inflammation of the lower portion of the right lung B) Swelling of the brain and spinal cord C) Infection of the lining surrounding the heart D) Rupture of the bladder

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: 1-5 7) An EMT with your service states that she desires to become a paramedic because she wants to provide advanced care. Under the National EMS Scope of Practice Model, which one of these types of care will she be able to provide as a paramedic that she cannot provide as an EMT? A) Automated blood pressure monitoring B) Assistance with emergency childbirth C) Interfacility transports D) IV therapy

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: 23-4 7) Which of these definitions best describes the structure and function of the stomach? A) A vascular abdominal organ that filters nutrients from the blood B) A hollow organ that allows the absorption of nutrients into the bloodstream C) A solid organ that regulates the balance of water in the body D) A hollow organ that secretes digestive enzymes and churns food

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: 23-2 4) A patient complains of severe and sharp pain to the right lower abdominal quadrant. Based on location, which organ or structure is most likely involved? A) Liver B) Kidney C) Spleen D) Appendix

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: 23-7 14 Copyright © 2018 Pearson Education, Inc. 51) When you are obtaining a medical history from a female patient with abdominal pain, she tells you that she has endometriosis. As an EMT, you know that this condition describes: A) Infection of the uterine lining B) Bacterial infection of the bladder C) Infection of the ovaries and/or fallopian tubes D) Endometrial tissue located outside of the uterus

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: 23-12 66) The most common cause of urinary tract infections is: A) Poor handwashing B) Overuse of antibiotics C) Frequent urination D) Bacterial invasion

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: 5-3 4 Copyright © 2018 Pearson Education, Inc. 13) Your partner accidentally uses a profane word when talking to dispatch. Which agency has the power to fine him and the ambulance service? A) County Board of Commissioners B) Department of Homeland Security C) Local police department's division of communications D) Federal Communications Commission

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: 5-7 7 Copyright © 2018 Pearson Education, Inc. 25) You have arrived at the scene of a medical emergency. As you enter the room where the patient is located, you note that he is sitting up and talking without difficulty. Emergency Medical Responders (EMRs) are on scene and providing basic care for the patient. What should you do first? A) Place the patient on your stretcher and transfer him to the ambulance B) Ask the patient's family if he has any past medical problems C) Get the patient's pulse and respiratory rate, along with his blood pressure D) Get a report from the EMRs

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: 5-15 15) How should the EMT respond when first making contact with an alert and oriented patient who complains of chest pain? A) "Did you call for an ambulance? I am here to help." B) "I am an EMT. Do you want to go to the hospital?" C) "I am here to help you. Do you have chest pain?" D) "My name is Charles Smith, and I am an EMT. Can I help you?"

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: 4-4 8 Copyright © 2018 Pearson Education, Inc. 27) A prehospital care report reads: "GSW to LLQ." Based on this, you should recognize that the patient sustained a(n): A) Puncture to the left chest B) Injury to the left torso C) Bullet injury to the left chest D) Gunshot to the lower left abdomen

: D Diff: 1 Page Ref: Table 4-2 Abbreviations

: 6-11 21) One advantage of using the wheeled stretcher is: A) It rolls smoothly over rough terrain B) It can be safely moved by one EMT with a patient on it C) It cannot become unbalanced on a slope or rough terrain D) It can be adjusted to different positions or heights

: D Diff: 1 Page Ref: Table 6-2

: 1-11 33) A female jogger has collapsed on a trail at a public park. A crowd of curious onlookers have collected and are watching as the EMT examines the patient for any life-threatening conditions. After determining that there are none and the patient is stable, the EMT acts as a patient advocate by: A) Informing the crowd that the patient appears to be okay B) Transporting the patient to the hospital using lights and sirens C) Continuing care despite the crowd's presence D) Asking curious onlookers to leave the scene

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: 6-1 4) You have been asked to present a continuing education session on body mechanics and posture. In your presentation, you would advise the participants that proper posture is achieved when your: A) Ears, shoulders, and feet are vertically aligned when sitting B) Abdomen and buttocks are positioned slightly to the posterior when standing C) Body weight is evenly distributed over the thoracic spine when sitting D) Ears, shoulders, and hips are vertically aligned when standing

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: 6-4 6) An obese patient cannot ambulate and must be carried down several flights of stairs. Carrying the patient alone exceeds your physical capabilities; however, your partner is very strong and physically fit. Which statement, made by you, indicates the best means to safely lift and move the patient as well as minimize the likelihood of either of you suffering an injury? A) "When we move him, let's go slowly down the stairs." B) "As long as I lean backward when moving him, we will be okay." C) "When we go down the steps, you take the 'head' end and I'll carry the legs and go down the steps first." D) "We must call for assistance to get the patient from this location."

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: 6-5 8) A large patient has been placed on the stretcher, and you and your partner are preparing to raise the stretcher using the power lift. Which observation of your partner would cause you to pause the lift to correct his technique? A) Both feet are turned slightly outward B) His hands are approximately 10 inches apart C) Both feet are flat on the ground D) Both feet are positioned closely together

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: 6-6 13) Which set of instructions would you give to a new EMT who is preparing to use a squat lift to raise a patient secured to a stretcher? A) "Make sure to place your weaker leg slightly back." B) "Try not to use a power grip when performing the squat lift." C) "Support yourself with your stronger leg and push up with your weaker one." D) "Make sure that you push yourself up with your stronger leg."

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: 1-1 22) At the scene of a minor motor vehicle collision, you are attending to a female patient who complains of head and neck pain. A crowd has gathered to watch the action. What will the observing public most likely remember about the role EMS portrayed? A) The number of emergency vehicles that showed up B) The color of the ambulances C) If the EMTs were all wearing the same color uniforms D) EMTs who were yelling and cursing loudly at the fire department to hurry up and get the patient out of the car

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: 6-11 25) You are caring for a young male patient who has overdosed on an unknown medication and has a decreased level of consciousness. When positioning the patient on the stretcher, which instructions will you give to the Emergency Medical Responders assisting you? A) "When you put him on the stretcher, elevate his head and chest." B) "He will need to be positioned flat on his back when on the stretcher." C) "Place him in a supine position and then carefully elevate his feet." D) "When you move him to the stretcher, put him on his left side."

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: 6-12 35) A large female patient has fallen in a parking lot between two cars. She must be moved on the backboard to the waiting stretcher, which is located approximately 200 feet from your location. Four rescuers are present. How would they best be used to promote the safest movement of the patient? A) One at the head, two at the feet, and the fourth to act as a spotter during the move B) The strongest person at the head, and the other three at the foot end C) Two at the head, two at the feet, with all rescuers using their right hand to carry the backboard D) One at the head, one at the feet, and the other two on opposite sides on the backboard

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: 7-1 8) Which statement about the human anatomy is true? A) The hand is proximal to the elbow B) The shoulder is distal to the hand C) The hip is distal to the knee D) The knee is proximal to the ankle

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: 7-4 3) A female patient has suffered a stroke to the right side of her brain and has paralysis to the contralateral portion of the body. Which description of this condition is correct? A) She is paralyzed on the right side of her body B) Her left and right legs are paralyzed C) She cannot move her arms or legs D) She cannot move her left arm and leg

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: 7-7 16) The segment of the spinal column that forms the posterior pelvis is the: A) Thoracic spine B) Cervical vertebrae C) Lumbar segment D) Sacral vertebrae

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: 1-10 15) What would be a logical project to be undertaken and developed by a quality improvement (QI) committee? A) Termination of EMTs who are chronically late to work B) A program by which pay raises are based on performance and attitude C) Community fundraiser to raise money for new EMS equipment D) Monthly continuing education programs in which seldom-used skills are practiced

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: 1-11 42) Which statement best summarizes the underlying benefit of using evidence-based medicine? A) Formulates emergency care guidelines that have been reviewed by the legal community B) Improves patient care while simultaneously reducing the costs associated with EMS C) Provides for legal representation in the quality improvement process D) Allows the use of research and evidence in determining which care is effective

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: 1-14 27) Your service's medical director would like to explore the idea of EMTs using special transport ventilators when caring for patients who require assistance with their breathing. When using an evidence-based medicine approach, what should you do first? A) Go to a local hospital to see which kind of ventilators it uses B) Contact vendors that sell ventilators and ask for price quotations C) Select specific EMTs to conduct a field trial of particular ventilators D) Search the medical literature for research related to this topic

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: 1-3 41) What actions place the patient at greatest risk for a medical mistake? A) Driving to an emergency department at night B) Backing the ambulance into the ambulance bay at the hospital C) Responding to a call in an "unsafe" neighborhood D) Transferring care from one EMT to another

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: 7-10 24) What represents the correct sequence for the passage of air into the lungs, when starting from outside the body? A) Nose, bronchi, larynx, trachea, pharynx, air sacs B) Larynx, esophagus, trachea, bronchi, alveoli C) Epiglottis, trachea, cricoid, bronchi, air sacs D) Mouth, pharynx, trachea, bronchi, alveoli

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: 7-12 26) When the diaphragm and intercostal muscles relax, which phase of the respiratory cycle happens next? A) Inhalation B) Retraction C) Expansion D) Exhalation

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: 7-11 23 Copyright © 2018 Pearson Education, Inc. 100) Which individual finding in a patient is the most reliable indicator that the patient is breathing inadequately? A) Respiratory rate of 22 breaths/min in an elderly patient B) Chest wall motion outward of 1 inch during inhalation in an adult patient C) Respiratory rate of 16 breaths/min in a child D) Shallow breathing at a rate of 30 breaths/min in an infant

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: 7-15 40) You are assessing a patient who informs you that her body abnormally forms blood clots, even when they are not needed to stop bleeding. Which condition could you expect the patient to have that contributes to the blood clotting? A) Low red blood cell count B) High white blood cell count C) Decreased clotting factors D) Elevated number of platelets

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: 7-21 70) An abrasion affects which part of the skin? A) Epidermis B) Dermal layer C) Dermal and subcutaneous layers D) Epidermal and dermal layers

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: 7-23 74) A patient informs you that he must sprinkle artificial digestive enzymes on all his foods before eating them. Based on this information, which endocrine gland should you assume is dysfunctional? A) Thyroid B) Adrenal C) Spleen D) Pancreas

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: 7-19 95) What is the name of the male reproductive structure that stores sperm? A) Testes B) Vas deferens C) Seminal vesicles D) Epididymis

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: 1-12 12 Copyright © 2018 Pearson Education, Inc. 45) Which of these tasks has not been identified as one that could be provided by a mobile integrated health care system? A) Manage patients who are at a high risk for hospital readmission B) Assist in the ongoing home management of chronic conditions C) Provide preventive services and check up on patients after discharge D) Conduct health screening and provide minor outpatient surgical services

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: 8-3 8) For cells to undergo the process of aerobic metabolism, the cells require: A) Water and oxygen B) Sugar (glucose) and protein C) Adenosine triphosphate (ATP) and lactic acid D) Oxygen and glucose

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: 8-16 67) You and the critical care transport team are taking a critically ill patient to another hospital. Among many IV infusions and monitors, the patient is also on a ventilator. You note that the FDO2 is set at 0.50. What does this mean? A) Fifty percent of the patient's respirations are provided by the ventilator B) Ventilations are provided when the patient breathes fewer than 50 times per minute C) Oxygen is not provided by the ventilator until the patient's pulse oximetry drops below 50% D) The provided oxygen concentration is set at 50 percent

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: 8-2 19) A 20-year-old female patient has called 911 for chest pain. On scene, you find that she has shallow breathing with an SpO2 reading of 91% on room air. She states she was in a car crash yesterday and diagnosed in the hospital with broken ribs. Her pain is right where the ribs are broken, and she rates the pain as a 10/10. Breath sounds are present bilaterally. In this situation, the EMT should attribute the hypoxia to which cause? A) The fractured ribs have pierced the lung, causing it to collapse B) Swelling from the rib fractures has compressed the lung C) The patient is bleeding into the lungs, compressing the alveoli D) Pain from rib injury prevents full expansion of the chest cage

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: 8-9 20) A patient who is hypoxic has a pulmonary disease that involves low lung compliance. With this condition, you realize that: A) The lung tissue is easily inflated and can be damaged B) Oxygen and carbon dioxide cannot be exchanged across the alveolar wall C) The patient has tremendous swelling of the small airways D) Ventilation with a bag-valve mask will likely require more effort

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: 8-2 25) Which statement about chemoreceptors in the human body is true? A) The central chemoreceptors are located in the lungs and provide the primary stimulus to breathe B) The peripheral chemoreceptors are extremely sensitive to oxygen and are located in the brain C) The central chemoreceptors constantly monitor the oxygen levels in the body and increase the rate when more O2 is needed D) The peripheral chemoreceptors are more sensitive to oxygen than carbon dioxide

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: 8-11 9 Copyright © 2018 Pearson Education, Inc. 35) A patient's SpO2 increased from 89% to 95% after he received a bronchodilating drug for his asthma. Where did the patient's problem most likely originate? A) Perfusion portion of the V/Q ratio B) Minute volume of the V/Q ratio C) Cellular perfusion portion of the V/Q ratio D) Ventilation portion of the V/Q ratio

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: 8-9 32) What is the best description of the ventilation/perfusion (V/Q) ratio? A) The ability of the red blood cells to offload oxygen to the cells of the body B) The amount of blood and the pressure at which it carries oxygen throughout the body C) The amount of air that is moved into and out of the lungs in 1 minute D) The ability of the body to exchange gases across the alveolar capillary membrane

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: 8-18 80) A patient has a pulmonary condition known as asthma that results in significant bronchoconstriction. If this patient is found to be hypoxic during an asthma attack, which type of disturbance is most likely causing the hypoxia? A) Neurological disturbance B) Perfusion disturbance C) Myocardial disturbance D) Ventilation disturbance

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: 8-12 37) What is the actual site of attachment of oxygen in the red blood cell? A) Oxygen dissolves into the liquid portion of the red blood cell for transport B) On oxygen receptor sites on the surface of the red blood cell C) Within the nucleus of the red blood cell D) Iron sites on hemoglobin within the red blood cell

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: 8-15 11 Copyright © 2018 Pearson Education, Inc. 44) A patient with high blood pressure takes a medication to slow his heart rate, thereby lowering his blood pressure. The EMT would recognize this action as impacting: A) Preload B) Afterload C) Systemic vascular resistance D) Cardiac output

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: 8-17 58) What is the protective mechanism underlying a narrowed pulse pressure? A) Increase the amount of oxygen entering the lungs B) Stop the loss of blood internally or externally C) Increase the oxygen-carrying capacity of the red blood cells D) Maintain an adequate blood pressure for perfusion

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: 8-17 60) When a healthy person has a sudden increase in blood pressure, what will occur next? A) Chemoreceptors will increase the rate and depth of breathing B) Baroreceptors will directly stimulate the parasympathetic nervous system C) The heart rate will increase and blood vessels will constrict D) Baroreceptors will signal the brain to decrease the heart rate

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: 8-20 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 9 Life Span Development 1) A mother has called 911 for medical assistance. She states that her 3-month-old son has a rectal temperature of 99.7°F and is not feeding. Which statement would be appropriate when talking with the mother about the infant's temperature? A) "You are right, he does have a fever. Have you given him any Tylenol?" B) "Fever in babies is always a concern. Has he ever had a febrile seizure?" C) "Why don't we get him undressed so we can cool him down?" D) "Given his age, a temperature of 99.7°F is normal."

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: 9-5 10) When assessing and treating a 15-year-old female patient for abdominal pain, the EMT must remember that: A) The patient probably will be scared and most likely to answer questions when her mother or father is present B) There is no need to ask about sexual activity since the complaint is abdominal pain C) If the patient has experienced menstruation, the EMT should leave the assessment to the emergency physician at the hospital D) A parent's or guardian's consent should be obtained prior to assessment and treatment

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: 9-9 14) After you transfer care of a 77-year-old female patient to the ED nurse, the patient informs the nurse that she has a history of heart problems and is having chest pain. On scene and throughout transport, the patient denied any complaint, despite your repeated inquiry. This has greatly upset your partner since he feels the patient made him look foolish in front of the emergency department staff. Based on your knowledge of the patient's age group, which explanation would you give your partner? A) "It is very common for patients in this age group not to tell you everything because most have some form of early dementia." B) "In the older population, most do not trust young people with personal information, such as their medical history." C) "This happens very frequently with people in this age group, so you must accept it and not get upset." D) "Many times persons in this age group will not be forthcoming with all that is going on because they fear losing their independence."

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: 1-8 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 2 Workforce Safety and Wellness of the EMT 1) A distraught husband awoke to find his 26-year-old wife not breathing and cold to the touch. Since your assessment indicates that the woman has been dead for some time, you contact medical direction for authorization to withhold emergency care. The medical director agrees and the coroner is notified. At this time, your immediate responsibility is: A) Establishing the time of death B) Preparing for the next call C) Determining the cause of death D) Providing supportive care to the husband

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: 10-13 111) In a healthy person, the primary stimulus to breathe is: A) Lung pressures B) Oxygen levels in the arteries C) Diaphragm position D) Carbon dioxide levels in the bloodstream

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: 10-2 119) You must immobilize a 6-year-old male patient who was involved in a motor vehicle accident. Regarding the airway, why should you consider placing padding under his shoulders and back? A) The child's cricoid cartilage is prone to collapse B) The child's diaphragm is lower and more difficult to move C) The child's tongue is larger and weaker than an adult's D) The child's occipital skull is larger in proportion to his body

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: 10-5 10) When completing a primary assessment, what would be a good indication that the patient has an open airway? A) The patient is conscious B) The breath sounds are clear C) The respiratory rate is normal D) The patient speaks with ease

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: 10-7 5 Copyright © 2018 Pearson Education, Inc. 17) A 2-year-old boy who just seized must have his airway opened. When performing the headtilt, chin-lift airway maneuver, the EMT must remember: A) The head must be flexed forward B) The head must be hyperextended C) A towel roll should be placed under the head D) If necessary, the head should be only slightly extended

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: 10-9 28) Which statement made by an EMT shows that she understands how to suction patients in a field setting? A) "When caring for a young child, I suction for a minimum of 5 seconds." B) "To thoroughly suction a patient, I insert the rigid-tip catheter past the base of the tongue and into the pharynx." C) "It is helpful to pour sterile water into the patient's mouth to further liquefy vomit and make it easier to suction." D) "I activate the suction device only when I am withdrawing the suction catheter."

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: 10-10 49) The EMT shows that she understands how to use an oropharyngeal airway when she states: A) "Once this airway has been placed, the head-tilt, chin-lift maneuver is no longer needed." B) "If this airway is too small, it could push the epiglottis over the opening of the trachea." C) "This airway protects the patient from aspirating vomit or other secretions." D) "I must remain alert for vomiting or spasm of the vocal cords even with proper insertion."

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: 10-14 44) You arrive at a residence to assist another crew with a patient in cardiac arrest. As you enter the room, a brand-new EMT informs you that he is having difficulty maintaining the mask seal to the patient's face while ventilating with the BVM. Which response shows that you understand and can help with the problem? A) "I will check breath sounds to see if air is reaching the lungs." B) "Why don't you try using a larger adult mask and flex the head forward?" C) "I will administer some cricoid pressure. That should help." D) "Let me maintain the face-to-mask seal while you squeeze the bag."

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: 10-16 12 Copyright © 2018 Pearson Education, Inc. 43) You are having a difficult time getting air from the bag-valve mask to pass into the lungs of a patient with suspected stroke. What should your first action be? A) Perform a finger sweep of the airway B) Administer abdominal thrusts C) Turn the patient on his side and try ventilations again D) Perform the head-tilt, chin-lift maneuver again

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: 10-24 21 Copyright © 2018 Pearson Education, Inc. 80) You are using an automatic transport ventilator (ATV) for a patient who has an insufficient respiratory effort. What is the best indicator of adequate artificial ventilation by the ATV? A) The preset tidal and minute volumes on the ATV are being used B) There is no air leak between the mask and the patient's face C) The inspiratory to expiratory ratio is 2 seconds to 1 second D) The patient's chest rises and falls with each mechanical ventilation

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: 2-6 30) You and your partner were among several rescuers on a call involving a house fire in which a 4-year-old girl died. That night, your partner states that he did not sleep well and is extremely bothered by the little girl's death. The next day he calls you and states that he is so upset that he is now having chest pain. What is the most appropriate response? A) "Why don't you request a week off of work to get things sorted out?" B) "Maybe you should get an appointment with a behavioral health professional." C) "Perhaps we need to have a critical incident stress debriefing so we can all talk." D) "You really need to get yourself to the emergency department to get checked out."

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: 10-22 63) A paramedic has asked you to place the patient on a nonrebreather mask at 15 liters per minute. To administer oxygen at this flow rate, you should: A) Attach a high-pressure regulator to the oxygen cylinder B) Adjust the tank pressure to 15 psi C) Slowly decrease the tank pressure valve until 15 psi is achieved D) Select "15" on the oxygen therapy regulator

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: 10-23 66) When using a therapy regulator, what can be readily observed by the EMT? A) Temperature of oxygen in the cylinder B) Liters of oxygen remaining in the oxygen cylinder C) Concentration of oxygen received by the patient D) Liter flow (flow rate) of oxygen leaving the cylinder

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: 10-22 69) Which of these actions indicates that the EMT is correctly using a nonrebreather face mask on an adult patient? A) He ensures that the reservoir fully collapses with each breath B) He instructs the patient to take deeper breaths when the mask is on C) He sets the oxygen flow rate to between 6 and 16 liters per minute D) He fully inflates the reservoir prior to placing the mask on the patient

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: 11-4 2 Copyright © 2018 Pearson Education, Inc. 5) Which of these findings related to breathing would be most concerning to the EMT in an adult patient? A) Respiratory rate of 18, complaint of weakness B) Respiratory rate of 22, normal chest wall expansion C) Respiratory rate of 10, chest expansion of about 1 inch D) Respiratory rate of 20, use of accessory muscles

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: 11-7 18) When assessing a patient's pulse, you can locate the right radial pulse, but not the left. What is the most likely explanation for this finding? A) The patient is in the early stage of cardiac arrest B) The left radial artery is extremely large C) There is a problem with the patient's veins D) The left radial artery may be occluded

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: 11-9 9 Copyright © 2018 Pearson Education, Inc. 33) You are called to a long-term care facility to assess and transport a patient with a high fever. You do not have a thermometer on your unit. Which alternative sign should you use to confirm the patient's increased body temperature? A) Cyanotic skin around the mouth B) Decreased heart rate and flushed skin C) Fingertips that are cool and blue D) Skin on the abdomen that is hot and flushed

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: 11-8 10 Copyright © 2018 Pearson Education, Inc. 37) You are called for a 2-year-old female child who is sick. When testing her capillary refill, what would be the greatest cause for concern? A) Immediate return of color B) 1-second capillary refill time C) 2-second capillary refill time D) 3-second capillary refill time

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: 11-10 47) As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, what do you expect to see when you reach the patient's side? A) Both pupils are large and change shape in response to light B) The patient must wear corrective lenses C) The patient has a past medical history of blindness D) Neither pupil will react when light is directed into the eyes

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: 11-12 62) While reviewing a patient care report for a quality assurance process, the EMT should recognize that a blood pressure has been palpated when she sees: A) Palp: 178/118 mmHg B) P / 118 C) 118/178 (palpated) D) 178 / P

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: 11-13 96) You are unable to auscultate a blood pressure in a patient's right arm. What should you do next to obtain the most accurate baseline assessment of this patient's vital signs? A) Move the blood pressure cuff down to the forearm B) Palpate the blood pressure in the right arm C) Use an automatic blood pressure monitor D) Auscultate the blood pressure in the left arm

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: 11-1 2) You are transporting a depressed patient who states that she is thinking of killing herself by taking a "whole bunch of pills." After providing this information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. How often should vital signs be reassessed? A) Once at the scene and once en route to the ED B) Only baseline vital signs are required C) Every 5 minutes D) Every 15 minutes

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: 11-15 100) You have applied the pulse oximeter to a 73-year-old male patient who complains of weakness and heart palpitations. Your partner reports that the patient's breath sounds are clear and equal, with a respiratory rate of 16 breaths/min and skin that is warm but pale in color. He then states the following vital signs: pulse, 92; blood pressure, 168/70 mmHg; and SpO2, 92% on room air. Given this information, which of these instructions would be most appropriate? A) "Let's recheck the SpO2 in 2 minutes for any change." B) "The reading must be wrong since he displays no cyanosis." C) "The SpO2 is probably normal for him since he is very pale." D) "Let's initiate oxygen at 2 liters per minute via a nasal cannula."

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: 11-2 19 Copyright © 2018 Pearson Education, Inc. 73) An obese female patient has called you with a complaint of abdominal pain. The regular adult cuff will not fit around her arm, so you retrieve the large adult cuff from your supplies. Embarrassed, the woman says, "My arm is so fat. Do you really need to roll up my sleeve to get my blood pressure?" Your best response would be: A) "If you do not want me to take your blood pressure, I do not have to." B) "I have seen plenty of big arms, and yours is nothing compared to some of them." C) "I am getting your blood pressure, not measuring your arm, but you really need to lose some weight." D) "I am not concerned with the size of your arm. I am interested in your blood pressure."

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: 11-18 18 Copyright © 2018 Pearson Education, Inc. 69) A patient states that he is short of breath, is light-headed, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open airway, adequate breathing, and a rapid pulse of 120 beats/min. The patient's skin is hot to the touch, and he has a blood pressure of 116/84 mmHg. The patient informs you that he was diagnosed with pneumonia 3 days ago and has not been taking the prescribed antibiotics. Which of these assessment findings would the EMT best recognize as a sign related to the patient's chief complaint? A) Chest pain that worsens with inspiration B) Recent diagnosis of pneumonia C) Complaint of light-headedness D) Blood pressure of 116/84 mmHg

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: 11-19 29 Copyright © 2018 Pearson Education, Inc. 113) Which of these statements made by a patient would the EMT regard as a symptom? A) "I have a history of high blood pressure that I take medicine for." B) "There is a bruise to my left elbow." C) "I slipped and fell down the stairs." D) "My pain is sharp, the worst I've ever felt."

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: 11-20 119) Which of these questions would the EMT ask when using the OPQRST mnemonic? A) "Do you have any medical conditions?" B) "Have you ever had any surgeries?" C) "Did you take any medications today?" D) "Does the pain feel dull or sharp?"

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: 11-20 78) You are assessing a 49-year-old male patient who complains of lower back pain. Which finding would be pertinent medical information related to the back pain that the EMT will obtain using the SAMPLE mnemonic? A) Heart rate of 48 and cool, clammy skin B) Childhood case of measles C) Last tetanus shot 5 years ago D) Arthritis in the spine and pelvis

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: 12-5 2) It has been reported that two people have been shot in an alleyway. As you pull up to the scene, you see a police officer standing over a person with blood on his shirt and pants. In this situation, what is your first priority? A) Assessing the patient's airway for patency B) Determining the number of patients on scene C) Considering the need for additional resources D) Determining the overall safety of the scene

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: 12-1 2 Copyright © 2018 Pearson Education, Inc. 5) You have been dispatched for an 89-year-old female patient who fell in her kitchen and was found by family members several hours later. Should something go awry on scene, which of these serves to give you the most safety and security? A) Notifying dispatch that you are at the residence B) Ensuring that lights are on throughout the residence C) Backing the ambulance into the driveway for rapid egress D) Carrying a portable radio with you into the house

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: 2-9 9) Which immunization should the EMT receive annually? A) Purified protein derivative B) Measles, mumps, and rubella vaccine C) Hepatitis B vaccine D) Influenza vaccine

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: 12-7 4 Copyright © 2018 Pearson Education, Inc. 13) Dispatch has sent you to the scene of a fight at a local sporting event. Since the EMS system is busy and there are very few ambulances available, dispatch has instructed you to call for additional units after arrival on scene. On scene, you find that the police are present and what appear to be 10 to 12 people are seated or lying on the ground, many with blood on their faces and clothing. When would you call for additional ambulances? A) Once all patients have been triaged B) After assessing and treating life-threatening injuries C) Once the exact number of patients has been determined D) Before getting out of the ambulance

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: 2-10 37) You are accidentally stuck with a needle used to administer a medication to a patient with a known history of hepatitis B. You have already completed your hepatitis B vaccine series. In this case, which statement is true? A) You have complete protection from hepatitis B and no further action is needed B) You have two weeks from the time of exposure to start medical care for a potential infection C) You will have to get another series of three vaccines to give you protection in the future D) You need to report the needle stick to your supervisor as soon as possible

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: 2-13 13) You are treating a patient with active tuberculosis. What will afford you the best protection from the disease while you care for the patient? A) Surgical mask with a face shield B) Purified protein derivative injection C) Gloves, gown, and goggles D) High-efficiency particulate aspirator mask

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: 2-12 14) A patient informs you that he was recently diagnosed with the human immunodeficiency virus (HIV) infection, but has yet to develop AIDS. Given this information, which statement is true? A) Until the patient develops AIDS, he is not infectious B) Family members should not share the patient's hand towels or utensils C) The hepatitis B and C vaccines provide the EMT with limited protection from transmission of HIV D) Gloves and eye protection will be enough protection under most conditions unless body fluids are present

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: 13-4 6) The EMT shows she understands the importance and reason for forming a general impression when she states: A) "The general impression permits a rapid diagnosis of the patient's problem." B) "Forming a general impression allows me to fully assess the emergency situation." C) "The general impression enables me to rule out any life-threatening conditions." D) "Forming a general impression provides me with a rough idea of the patient's overall status."

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: 13-22 19 Copyright © 2018 Pearson Education, Inc. 70) When assessing the chest of a patient who was shot multiple times, you find a gunshot wound to the third intercostal space on the left lateral chest. What should you do immediately? A) Check for equality of breath sounds B) Initiate positive pressure ventilation with oxygen C) Roll the patient and look for an exit wound D) Cover the opening with a gloved hand

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: 13-8 10) Which of these patients would be classified as unresponsive? A) A 39-year-old-female who is confused B) A 52-year-old male who cannot answer your questions C) A 70-year-old female who has experienced a stroke D) A 46-year-old-male who does not respond when his fingers are pinched

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: 3-9 14) As you arrive by the side of a 64-year-old unresponsive female patient, you hear snoring respirations. Your immediate action would be to: A) Suction the mouth and airway B) Determine the chief complaint C) Administer supplemental oxygen D) Perform a manual jaw-thrust maneuver

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: 13-6 20) During the primary assessment, how should you best determine the adequacy of a patient's breathing? A) Determine the patient's mental status B) Compare the respirations and pulse rate C) Calculate the number of breaths per minute D) Examine the rise and fall of the chest

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: 2-11 42) You have been called to transport a patient from one medical facility to another. The patient is infected with vancomycin-resistant enterococci (VRE), but does not have any open wounds and is medically stable. Given this information, which action is most appropriate? A) Place a surgical mask on the patient B) Place a surgical mask on the patient and yourself C) Use an N-95 respirator or HEPA mask D) Use the appropriate personal protective equipment and handwashing

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: 13-12 10 Copyright © 2018 Pearson Education, Inc. 36) You cannot locate a radial pulse on a 54-year-old male patient who is alert, confused, and breathing adequately. What should you do immediately? A) Start cardiopulmonary resuscitation B) Attach the automated external defibrillator (AED) C) Start positive pressure ventilation D) Check for the carotid pulse

: D Diff: 2 Page Ref: 350

: 13-13 22 Copyright © 2018 Pearson Education, Inc. 82) An 18-year-old female patient with a history of diabetes twisted her right ankle while playing volleyball. She is alert and oriented and states that the pain is excruciating. The primary assessment is complete and yields no life-threatening conditions. What should you do next? A) Perform a head-to-toe exam B) Apply ice to the ankle C) Check her blood sugar D) Assess the right ankle and foot

: D Diff: 2 Page Ref: 356

: 13-27 28 Copyright © 2018 Pearson Education, Inc. 105) Information concerning the extent of injury can be related to findings of the complete headto-toe exam by: A) The ED B) An accurate primary assessment C) Forming a general impression D) Utilizing the body system approach

: D Diff: 2 Page Ref: 366

: 13-16 111) You are treating a 17-year-old patient who fell out of a tree from a height of approximately 6-8 feet and landed against a wooden picket fence that was near the tree trunk. The patient landed with his right lateral chest striking the fence. The patient is alert and oriented, complains of respiratory distress, and has absent breath sounds over his right thorax. The vital signs reveal a blood pressure of 112/72 mmHg, a heart rate of 102 beats/min and regular, respirations of 20 breaths/min, pulse oximetry of 90% on ambient air, and intact peripheral perfusion. Your partner asks you if he should call for ALS intercept. You respond "yes" for which reason? A) The patient's fall height was "critical" B) The patient has a narrow pulse pressure C) The patient's heart rate is more than 100 beats/min D) You suspect the patient may have a pneumothorax

: D Diff: 2 Page Ref: 370

: 13-14 18 Copyright © 2018 Pearson Education, Inc. 66) When assessing a critically injured patient, the EMT should detect which of these injuries or conditions when performing the secondary assessment? A) Decreased level of consciousness B) Weak carotid pulse and clammy skin C) Inadequate respiratory effort D) Bruising and tenderness to the abdomen

: D Diff: 2 Page Ref: 373

: 2-14 17) As EMTs leave a house where the patient refused care, a panicked boy approaches them and states that some men just shot his friend in a house two doors up the street. The EMTs' immediate action should be to: A) Instruct the boy to carry the patient from the house to the yard B) Gather basic equipment and go to the home to care for the patient C) Notify dispatch and proceed to the home to care for the patient D) Contact the police and move the ambulance from the immediate area

: D Diff: 2 Page Ref: 39

: 13-17 25 Copyright © 2018 Pearson Education, Inc. 94) An alert and oriented 69-year-old female patient complains of low, right-sided abdominal pain. She describes the pain as "knife-like" and states that it started suddenly 1 hour ago. Her only medical history is hypertension, for which she takes the medication Lisinopril. Which of these assessment findings shows that the EMT is appropriately assessing this patient given the chief complaint? A) No trauma noted to the head B) No pain on palpation to the chest C) No deformity to the upper extremities D) No abdominal guarding noted

: D Diff: 2 Page Ref: 399

: 13-22 27 Copyright © 2018 Pearson Education, Inc. 101) A responsive patient complains of a migraine headache; she has a known medical history of this condition. Which assessment parameter would be most appropriate to address while conducting her secondary exam? A) Auscultate breath sounds B) Assess for pedal edema C) Look for jugular venous distention D) Assess her visual acuity

: D Diff: 2 Page Ref: 399

: 13-25 88) A 69-year-old male patient called 911 because of a sudden onset of pain and then numbness in his left leg. He states that he has a history of blood clots that form in the leg and the pain feels exactly as it did the last time that this occurred. He denies any trauma to the extremity. You perform the primary assessment and find the patient to be alert and oriented with no lifethreatening deficits to the airway, breathing, or circulation. When initiating the secondary assessment on this patient, what would be appropriate to do? A) Perform a rapid head-to-toe exam B) Initiate immediate transport C) Place a nasal airway as a precautionary measure D) Perform a physical exam of the leg

: D Diff: 2 Page Ref: 399

: 14-5 2 Copyright © 2018 Pearson Education, Inc. 5) You are by the side of an alert and oriented 56-year-old male patient who complains of generalized weakness and a pounding headache. His pulse is 104, respirations are 18 breaths/min, and blood pressure is 218/110 mmHg. He has a history of high blood pressure, for which he takes lisinopril. He states that he has not taken the Lisinopril for 2 weeks and hands you a container with the medication inside. You would: A) Assist the patient in taking the lisinopril B) Ensure that it is the patient's medication and then administer it C) Contact medical direction to request an order for lisinopril administration by you D) Continue treatment and transport the patient to the hospital

: D Diff: 2 Page Ref: 420

: 14-8 10) After administering oral glucose to a patient with altered mental status, which of these findings best indicates a positive therapeutic effect or response to the medication? A) Blood pressure decrease from 156/90 to 120/80 mmHg B) No signs or symptoms of an allergic reaction C) Pulse oximeter reading of 99% without supplemental oxygen D) Mental status that is now alert and oriented

: D Diff: 2 Page Ref: 422

: 14-6 10 Copyright © 2018 Pearson Education, Inc. 37) Which of these actions would be most important when administering aspirin to a patient with chest pain? A) Instructing the patient to chew the medication prior to swallowing B) Giving the patient water with the aspirin C) Determining that the patient has a prescription for the aspirin D) Ensuring that the patient can follow directions and has an intact gag reflex

: D Diff: 2 Page Ref: 427

: 14-6 38) A patient with a cardiac history complains of chest pain. He already took four baby aspirins, and medical direction has given you permission to assist the patient with his nitroglycerin dose. After you administer nitroglycerin to the patient, he complains of a headache. What would be your most appropriate next step? A) Inform the patient that he is allergic to nitroglycerin B) Administer additional aspirin for the headache C) Recognize that the patient has a contraindication to the administration of nitroglycerin D) Realize that the headache is an undesirable side effect of the nitroglycerin and continue care

: D Diff: 2 Page Ref: 429

: 15-6 81) A patient has been involved in a very serious motor vehicle collision and is in shock. Assessment findings indicate that he sustained blunt trauma to the abdominal and pelvic areas. Which type of shock is the patient most likely suffering? A) Obstructive B) Cardiogenic C) Distributive D) Hypovolemic

: D Diff: 2 Page Ref: 440-441

: 15-3 63) The underlying pathophysiology of distributive shock is: A) Poor fluid intake B) Loss of blood volume C) Damaged heart with poor contractility D) Dilation of the blood vessels

: D Diff: 2 Page Ref: 441

: 15-17 9 Copyright © 2018 Pearson Education, Inc. 31) When in shock, the body has a slightly delayed compensation mechanism that utilizes: A) Hyperventilation B) Vasodilation C) Nerve stimulation D) The release of hormones

: D Diff: 2 Page Ref: 446

: 15-23 93) When the body is in a shock state, which hormone released from the adrenal glands stimulates primarily alpha-1 and beta-1 receptors, but has no effects on beta-2 receptor sites? A) Biepinephrine B) Pseudoepinephrine C) Coepinephrine D) Norepinephrine

: D Diff: 2 Page Ref: 446

: 15-9 22 Copyright © 2018 Pearson Education, Inc. 79) A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also note bruising to her chest and abdomen. What should you do immediately? A) Determine the blood pressure B) Administer supplemental oxygen C) Evaluate for shock D) Suction the airway

: D Diff: 2 Page Ref: 451

: 15-9 77) A 28-year-old male patient was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and has shallow breathing, with a rate of 28 breaths/min. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual spine motion restriction. His respirations are sonorous. Based on these assessment findings, which of these instructions would you next provide to the EMRs? A) "The patient has snoring respirations, so let's go ahead and open the airway with the head-tilt, chin-lift maneuver." B) "Do not cover the patient with a blanket, because that will cause his blood vessels to dilate and drop his BP." C) "Let's elevate the patient's legs 8 to 12 inches so more blood gets to his vital organs." D) "Let's take off the oxygen mask and try manually opening the airway."

: D Diff: 2 Page Ref: 451

: 15-14 88) Proper care of cardiac arrest for a 6-year-old pediatric patient when there are no available pediatric AED pads would include: A) Two EMTs providing a 15:1 ratio of compressions to ventilations B) CPR with no AED placement due to lack of pediatric pads C) Compressing the chest to a maximum depth of 1½ inches D) Placement and use of the adult pads with adult energy levels

: D Diff: 2 Page Ref: 459

: 15-17 29) You have been called for an elderly male patient who suddenly collapsed. On scene, you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. What should you do immediately? A) Determine the "down time" B) Apply the AED C) Start cardiopulmonary resuscitation D) Check for a carotid pulse

: D Diff: 2 Page Ref: 459

: 15-16 23) When a 52-year-old male patient collapsed on his front porch, his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. What should you do immediately? A) Contact medical direction for permission to use the AED given the down time B) Perform five cycles of CPR at a ratio of 15 compressions to 2 ventilations C) Withhold CPR so that the AED can be applied D) Start CPR while the AED is applied and readied for use

: D Diff: 2 Page Ref: 460

: 15-20 48) You have been called to a public pool for an unresponsive patient. On arrival, you find lifeguards performing CPR with a pocket mask and oxygen on a 67-year-old male swimmer. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. The lifeguards estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. What should be your first response? A) "Stop CPR and let's apply the AED." B) "We need to quickly dry him from head to toe before applying the AED." C) "Let's start ventilation with a bag-valve mask and oxygen." D) "Resume CPR and let's take a towel and dry off his chest so we can apply the AED electrodes."

: D Diff: 2 Page Ref: 460

: 15-17 37) While using the AED to treat a patient in cardiac arrest, your partner informs you that he can feel a carotid pulse. What should you do immediately? A) Obtain a heart rate and blood pressure B) Reanalyze the patient's heart rhythm C) Insert an oropharyngeal airway and begin positive pressure ventilation D) Assess the patient's airway and breathing adequacy

: D Diff: 2 Page Ref: 461

: 15-18 45) You are transporting a 57-year-old male patient who went into cardiac arrest at home. After two shocks and CPR, he regained a pulse, but he remains unresponsive and in respiratory arrest. During transport, your reassessment reveals the absence of a carotid pulse. What should you do first? A) Reapply the AED and analyze the heart rhythm B) Provide five cycles of CPR prior to using the AED C) Start CPR and continue emergency transport D) Stop the ambulance and analyze the heart rhythm with the AED

: D Diff: 2 Page Ref: 462

: 15-18 13 Copyright © 2018 Pearson Education, Inc. 46) A 51-year-old male patient who experienced cardiac arrest has regained a pulse after one shock from the AED. The dispatcher informs you that the paramedic unit you have requested for assistance is coming from the eastern end of the county and has a 20-minute ETA. The hospital is 15 minutes west of your location. Which action would be most appropriate given this situation? A) Load the patient and meet the paramedic unit at a halfway point B) Wait on scene for the paramedic unit to arrive C) Load the patient in the ambulance and wait on scene for the paramedic unit D) Start transport to the hospital and inform the ALS dispatcher of your intent

: D Diff: 2 Page Ref: 463

: 15-21 15 Copyright © 2018 Pearson Education, Inc. 54) Which activity related to the use of an AED would a medical director carry out? A) Overseeing repairs to AEDs that are in need of service or repair B) Responding to calls in which the EMT is using the AED C) Obtaining funding for supplies such as batteries, razors, and electrodes D) Reviewing cases in which an AED was used but no shock was advised

: D Diff: 2 Page Ref: 466

: 2-6 1 Copyright © 2018 Pearson Education, Inc. Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 3 Medical, Legal, and Ethical Issues 1) A patient with diabetes has an elevated blood sugar (545 mg/dL) and, based on your assessment of his condition, will require an injection of insulin. Your EMT partner also has diabetes and administers insulin injections to himself throughout the day as needed. Although the Scope of Practice lists nothing about EMTs giving insulin, your partner administers the insulin injection to the patient. The patient's blood sugar comes down and her condition improves. Given this information, which statement is true? A) It was permissible for your partner to give the insulin since he has diabetes and knows how to give the injections B) Since the patient benefited from the insulin, your partner acted appropriately C) Because your partner used the patient's insulin rather than his own, he cannot be reprimanded D) Your partner violated the Scope of Practice and may have his certification revoked

: D Diff: 2 Page Ref: 47

: 16-18 81) Pursed lip breathing is most commonly observed when a patient has: A) Pneumonia B) Croup C) Upper airway obstruction D) COPD

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: 3-3 31) In which situation would the Good Samaritan law protect the EMT? A) The EMT forgets to provide oxygen to a patient with chest pain and the patient suffers a heart attack as a result B) A patient is paralyzed from the waist down because an off-duty EMT did not take the appropriate measures in caring for him C) A paramedic orders an EMT to administer a medication that the EMT legally may not give, and the patient dies as a result D) An off-duty EMT stops at the scene of an auto collision and provides proper care, but the patient dies anyway

: D Diff: 2 Page Ref: 48

: 16-11 13 Copyright © 2018 Pearson Education, Inc. 46) You have been called to a home for an 18-year-old male patient, who informs you that he experienced a sudden onset of shortness of breath and back pain while watching television. He has a history of spontaneous pneumothorax, and the current symptoms he is experiencing are identical to those he felt with a previous pneumothorax. Assessment reveals the patient to be slightly dyspneic with breath sounds clear and intact bilaterally. During transport, what is most critical to continually monitor on this patient? A) Blood pressure B) Mental status C) Spasms to the hands D) Breath sounds

: D Diff: 2 Page Ref: 487

: 16-4 70) On scene, you suspect that a young female patient is suffering from hyperventilation syndrome. Which additional finding would best assist you in confirming this suspicion? A) Heart rate of 64 beats/min B) Urinary incontinence C) Breathing through the mouth D) Spasm of the hands

: D Diff: 2 Page Ref: 487-488

: 16-14 63) You suspect a patient of being infected with pertussis. While performing the primary assessment, you note a deep cough with clear breath sounds. Her vital signs are pulse, 108; respirations, 16 breaths/min; and SpO2, 96% on room air. Given this scenario, which action by the EMT would be most appropriate? A) Assist with use of a metered-dose inhaler B) Administer oxygen via nasal cannula C) Encourage the patient not to cough D) Monitor the patient and transport

: D Diff: 2 Page Ref: 489-490

: 16-14 66) You have been called to a residence for an 18-year-old female patient with shortness of breath and a history of cystic fibrosis. On scene, you find the patient to be very thin and sick looking. Her airway is patent and breathing adequate, although slightly labored. Her radial pulse is strong, and she has a constant cough, which occasionally produces green- and yellow-colored mucus. Auscultation of the lungs reveals rhonchi to the upper portion of both lungs. Vital signs are pulse, 108; respirations, 20 breaths/min; blood pressure, 98/56 mmHg; and SpO2, 92%. Based on these findings, appropriate care should include: A) Suctioning of the lower airway to remove mucus B) Gentle abdominal thrusts to help the patient expectorate the mucus C) A bronchodilator administered via small-volume nebulizer D) Humidified oxygen via nasal cannula starting at 2 liters per minute

: D Diff: 2 Page Ref: 490

: 16-15 5 Copyright © 2018 Pearson Education, Inc. 17) After you administer a medication through a metered-dose inhaler (MDI) and the patient has inhaled the medication, it is important that the patient: A) Exhale through pursed lips B) Pant for 10 seconds C) Exhale as forcefully as possible D) Hold her breath for several seconds

: D Diff: 2 Page Ref: 493

: 16-17 12) Within minutes of administering Proventil (albuterol) to a patient through her metered-dose inhaler (MDI), the patient is breathing easier and states that she feels much better. An Emergency Medical Responder on scene asks you how the medication in the MDI helped the patient. Which of these responses would be most appropriate? A) "The medication travels to the brain and forces the respiratory rate to increase." B) "The medication in the MDI relaxes the throat, allowing more oxygen to enter." C) "The medication is an anti-inflammatory and decreases swelling in the lung tissue." D) "The medication in the inhaler relaxes and opens up the small airways in the lungs."

: D Diff: 2 Page Ref: 493

: 16-15 19) At a health fair, a patient informs you that she has just been prescribed a metered-dose inhaler (MDI) for her asthma. She is confused about how to take the medication when needed. Which of these statements about the MDI would be most appropriate for you to make? A) "Take it every 4 hours around the clock, even if you feel fine." B) "Make sure to store the metered-dose inhaler in your refrigerator." C) "You should take the medication only after calling your doctor." D) "It is important to shake the inhaler vigorously before taking the medication."

: D Diff: 2 Page Ref: 494

: 16-4 59) When administering albuterol to a patient with shortness of breath, the EMT realizes that the therapeutic effect of this medication is achieved by: A) Decreasing mucus production B) Opening the large airways C) Decreasing inflammation D) Dilating the small airways

: D Diff: 2 Page Ref: 494-495, Figure 16-11

: 16-15 52) When instructing a patient on how to use a small-volume nebulizer, which of these statements would be correct? A) "Breathe about 20-30 times per minute so the medication gets into your lungs." B) "As I depress the trigger on the canister, take in a deep breath." C) "Take nice slow and deep breaths, and try not to cough the medicine out." D) "It is really important to occasionally cough during the treatment."

: D Diff: 2 Page Ref: 495, Figure 16-11

: 16-15 51) After administering a bronchodilator to a patient through a small-volume nebulizer, which of these statements made by the patient should be of most concern to an EMT? A) "I feel shaky." B) "My mouth is really dry." C) "I suddenly feel nervous." D) "My chest feels heavy."

: D Diff: 2 Page Ref: 496, Figure 16-11

: 16-17 4) When a child starts to become hypoxic, the pulse will initially: A) Decrease B) Not change C) Become irregular D) Increase

: D Diff: 2 Page Ref: 497

: 16-4 77) Which audible respiratory sounds would make you suspicious of an upper airway problem? A) Wheezing B) Crackles C) Rhonchi D) Stridor

: D Diff: 2 Page Ref: 498

: 3-11 3 Copyright © 2018 Pearson Education, Inc. 7) A patient with a terminal disease is unresponsive, not breathing, and without a pulse. The family states that the patient has a "Do Not Resuscitate" (DNR) order signed by her medical doctor, but they cannot find the current one. All they can find is a previous DNR that expired 8 months ago. The EMT should: A) Wait for family to locate the DNR B) Pronounce the patient deceased C) Have the family sign a refusal of care form D) Start cardiopulmonary resuscitation

: D Diff: 2 Page Ref: 50

: 16-6 39) As you enter the living room of an adult patient who called 911 for shortness of breath, you observe the patient sitting upright in a chair with a panicked look on her face, struggling to breathe, with obvious suprasternal retractions. Her breathing rate appears to be fast and her tidal volume poor. You can hear rhonchi from her lungs without the aid of a stethoscope. Once at her side, your initial care should be to: A) Apply oxygen immediately B) Auscultate lung sounds C) Establish her rate of breathing D) Assess her airway

: D Diff: 2 Page Ref: 502

: 16-14 67) A 26-year-old male patient has summoned EMS after lifting a heavy box and suddenly experiencing shortness of breath and sharp pain to the left side of his chest that worsens with deep inspiration. Given this description, you immediately become suspicious of a pneumothorax. Which action should you perform next to help confirm this suspicion? A) Inquire about past lung problems B) Obtain an SpO2 reading C) Palpate the chest for subcutaneous emphysema D) Auscultate breath sounds

: D Diff: 2 Page Ref: 504, Table 16-8

: 17-2 18 Copyright © 2018 Pearson Education, Inc. 66) Which sign or symptom should the EMT expect in a patient who has a chronically low white blood cell count? A) Bruising to the extremities B) SpO2 of 91% on room air C) Blood pressure of 156/100 mmHg D) Temperature of 103.4°F

: D Diff: 2 Page Ref: 527

: 17-3 70) Dysfunction of the heart's electrical conduction cells from ischemia or infarction may cause: A) Blood loss B) Lung collapse C) Hyperventilation D) Irregular heartbeats

: D Diff: 2 Page Ref: 528

: 17-9 25) You are by the side of a patient who complains of severe chest pain that radiates into his right arm and neck. He is alert and oriented, with an open airway and adequate breathing. His radial pulse is strong, and his skin is cool and diaphoretic. Your partner reports his pulse rate is 84, respirations are 18 breaths/min, blood pressure is 86/62 mmHg, and SpO2 is 98% on room air. You have obtained a medical history and performed the secondary assessment. The patient states that he has had two heart attacks in the past and is allergic to aspirin and sulfa medications. What should you do next? A) Assist the patient in taking a nitroglycerin tablet B) Administer baby aspirin to the patient C) Administer oxygen and nitroglycerin, and then transport the patient D) Transfer the patient to the stretcher and begin transport

: D Diff: 2 Page Ref: 533

: 17-12 59) A patient has called 911 for chest pain that he describes as "tearing" and radiating between his shoulders. His airway is patent, breathing accelerated but adequate, and radial pulse intact. Your partner reports the following vital signs: pulse, 120; respirations, 22 breaths/min; blood pressure, 88/64 mmHg; and SpO2, 96% on room air. At this time, you should: A) Assist the patient with his nitroglycerin B) Provide the patient with 325 mg of aspirin C) Encourage the patient to take an antacid such as Maalox D) Recheck the blood pressure in the other arm

: D Diff: 2 Page Ref: 534

: 17-12 60) A patient complaining of shortness of breath and dizziness has called 911. Her history includes chronic obstructive pulmonary disease (COPD). When assessing the patient, which of these findings would cause you to immediately prepare the patient for transport? A) SpO2 of 94% despite supplemental oxygen B) Wheezing noted in the bases of both lungs C) Heart rate of 84 beats/min D) Pulsating mass in the abdomen

: D Diff: 2 Page Ref: 534

: 17-14 93) On room air, which of these patients requires supplemental oxygen? A) 66-year-old female; generalized weakness; history of diabetes; SpO2, 97% B) 52-year-old male; chest pain; history of MI; SpO2, 95% C) 39-year-old male; complaint of tingling in hands; headache; respirations, 30 breaths/min; SpO2, 98% D) 47-year-old female; temperature 100.3°F; denies dyspnea; SpO2, 91%

: D Diff: 2 Page Ref: 535

: 17-15 45) An alert and oriented patient presents with shortness of breath, crackles in both lungs, jugular venous distention, and edema to the feet and ankles. Her pulse is 132, respirations 26 breaths/min, blood pressure 160/86 mmHg, and SpO2 at 88%. Based on these findings, the EMT should suspect: A) Left ventricular failure B) Hypertensive emergency C) Right ventricular failure D) Congestive heart failure

: D Diff: 2 Page Ref: 536

: 17-7 105) Which sign or symptom would the EMT typically associate with congestive heart failure? A) Edema to the left arm B) Feeling of palpitations C) Rhonchi to both lungs that is cleared by a cough D) Crackles in both lungs

: D Diff: 2 Page Ref: 536

: 17-9 12 Copyright © 2018 Pearson Education, Inc. 42) You are caring for a 69-year-old male patient who is short of breath and in acute congestive heart failure. He is alert, anxious, and panicked, with an open airway and rapid shallow respirations. His heart rate is tachycardic, and his skin is cool and diaphoretic, with cyanosis noted to the lips and fingers. There are crackles noted in both lungs, as well as pedal edema in both feet. The patient denies chest pain or discomfort, but is having a difficult time speaking due to the shortness of breath. When caring for this patient, you should: A) Administer four baby aspirins B) Place the patient in the shock position C) Insert a nasal airway D) Apply continuous positive airway pressure (CPAP)

: D Diff: 2 Page Ref: 537

: 3-12 20) Your best protection when an alert and oriented patient with the capacity to make rational decisions refuses EMS care or transport is to: A) Inform the patient's family physician of what happened B) Have your partner sign the refusal form as a witness C) Contact the patient at a later time to see how she is doing D) Completely and thoroughly document the incident

: D Diff: 2 Page Ref: 54

: 17-16 32) A 67-year-old male patient has chest pain. After you assist him with taking two of his nitroglycerin tablets, his chest pain remains 7 out of 10 and he is still diaphoretic. His vital signs are as follows: pulse, 72; respirations, 18 breaths/min and adequate; blood pressure, 82/60 mmHg; and SpO2, 97% on 2 lpm of oxygen. You should: A) Administer a third nitroglycerin tablet B) Increase the oxygen to 4 lpm C) Administer half of a nitroglycerin tablet D) Transfer the patient to the stretcher and begin transport

: D Diff: 2 Page Ref: 540

: 17-6 52) Immediately after assisting a patient with diabetes to take her nitroglycerin, she states that she feels weak, dizzy, and nauseated. What should the EMT do next? A) Position her in an upright position B) Inform her that this feeling is normal C) Check her blood glucose level D) Check her blood pressure

: D Diff: 2 Page Ref: 540

: 17-14 25 Copyright © 2018 Pearson Education, Inc. 96) Which of these therapies is the best option for definitively treating a known myocardial infarction (AMI)? A) Oxygen B) Fibrinolytics C) Oxygen, aspirin, and nitroglycerin D) Angioplasty

: D Diff: 2 Page Ref: 543

: 17-18 47) A 71-year-old female patient is lying in bed and complaining of respiratory distress. She exhibits moderate dyspnea, crackles in both lungs, and edema to the abdomen and lower extremities. Supplemental oxygen is being provided to the patient by Emergency Medical Responders. Her vital signs are as follows: pulse, 132; respirations, 18 breaths/min; blood pressure, 138/86 mmHg; and SpO2, 95%. Which of these actions would be of the most immediate benefit to the patient? A) Administer four baby aspirins B) Elevate both legs to decrease swelling C) Obtain a medical history and test the blood glucose D) Position the patient in a sitting upright position

: D Diff: 2 Page Ref: 545

: 17-9 24) When assessing a patient in the prehospital setting, which of these does the EMT recognize as an indication for aspirin? A) Complaint of a headache after taking nitroglycerin B) An aspirin taken daily for cardiovascular disease C) Systolic blood pressure greater than 100 mmHg D) Chest discomfort that is suggestive of a heart attack

: D Diff: 2 Page Ref: 547, Figure 17-19

: 3-14 23) Which of these actions constitutes a breach of the EMT's duty, placing him or her at risk for the charge of negligence? A) Transporting an alert and oriented patient who does not want transport to the hospital B) Applying oxygen to a patient who is not complaining of shortness of breath C) Obtaining an informed and signed refusal of care form from an alert and oriented patient with abdominal pain D) Obtaining a refusal of care from a patient without obtaining vital signs

: D Diff: 2 Page Ref: 55-56

: 18-2 60) A male patient is confused and combative for no apparent reason. There are no life threats to his airway, breathing, or circulation, and his vital signs are pulse, 88; respirations, 16 breaths/min and adequate; blood pressure, 144/68 mmHg; and SpO2, 93% on room air. When addressing the patient's oxygenation status, which of these treatments would be appropriate? A) Oxygen at 6 lpm via nasal cannula B) Oxygen at 15 lpm via a nonrebreather mask C) Positive pressure ventilation with room air D) Oxygen at 2 lpm via nasal cannula

: D Diff: 2 Page Ref: 557

: 3-15 27) You are by the side of a female patient who has overdosed on a drug. She is conscious but very combative and noncompliant with your requests. Which statement made by the EMT best suggests the EMT is committing assault? A) "You win. I cannot get your blood pressure and the doctor is going to yell at me. I am going to blame you." B) "If that is the way you are going to behave, then I am no longer going to try to get your blood pressure." C) "If you throw up in the back of my ambulance, I will use your shirt to clean it up. Just think about that for a minute." D) "If you do not let me get your blood pressure, I will take off the oxygen and you will suffocate."

: D Diff: 2 Page Ref: 56

: 3-15 9 Copyright © 2018 Pearson Education, Inc. 29) A homeless patient is sick and is refusing transport. The patient is alert and clearly has the capacity to understand her situation and make a rational decision, but the temperature tonight will be near zero. The EMT picks up the patient and puts her on the cot. The patient continues to refuse to allow treatment and transport, despite the EMT's explanation that it will be warm in the hospital and she will be fed. The patient is transported. What could the EMT be charged with? A) Assault B) Abandonment C) Negligence D) False imprisonment

: D Diff: 2 Page Ref: 56

: 3-16 45) A male EMT was discussing a patient's medical condition with a female EMT from a different service. The woman then repeated this information to others, which eventually made its way back to the patient. Regarding issues of confidentiality, which of the statements would be is true? A) The male EMT could be changed with slander B) The female EMT committed an EMTALA violation C) Both EMTs violated EMTALA regulations D) The male EMT violated the HIPAA law

: D Diff: 2 Page Ref: 57

: 18-11 52) The EMT shows that he recognizes the benefit of using the Cincinnati Prehospital Stroke Scale or Los Angeles Prehospital Stroke Screen when he makes which of these statements? A) "The screening allows the EMT to identify the patient at risk for stroke." B) "The screening allows the EMT to differentiate the type of stroke a patient is having." C) "The screen is very predictive in determining whether the patient will die from stroke." D) "The screening helps to identify stroke, even when it is not the patient's chief complaint."

: D Diff: 2 Page Ref: 570

: 18-3 13) Assessment of a 63-year-old female patient reveals a patent airway, adequate breathing, and strong radial pulse. She has no difficulty speaking and no facial droop, but exhibits a slight left arm drift and has a headache. The EMT should interpret these specific findings as: A) Not suggestive of a stroke B) Minimally suggestive that a stroke may be occurring C) Moderately suggestive that a stroke may be occurring D) Highly suggestive that a stroke may be occurring

: D Diff: 2 Page Ref: 570

: 18-3 46) Which of these questions would the EMT ask when performing the Los Angeles Prehospital Stroke Screen? A) "Do you take blood thinners?" B) "Are your hand grips weak?" C) "Do you smoke cigarettes?" D) "Have you ever had a seizure?"

: D Diff: 2 Page Ref: 570

: 18-11 8) Which one of these instructions to a patient with possible stroke indicates proper assessment for an arm drift? A) "Hold out your arms and count to 10 while keeping your eyes open." B) "Grab my fingers and squeeze with both hands as hard as you can for 5 seconds, and I mean squeeze hard." C) "Raise your hands above your head and close your eyes while counting backward from 20." D) "Close your eyes and hold your arms straight out for 10 seconds."

: D Diff: 2 Page Ref: 571, Figure 18-7

: 18-4 43) An 82-year-old male patient presents with right-hand weakness and garbled speech. Which question should the EMT ask first to the patient or a reliable family member who is present? A) "Is he allergic to anything?" B) "Does he take any blood thinners?" C) "Does he have a history of high blood pressure?" D) "What time did these signs start?"

: D Diff: 2 Page Ref: 574

: 18-12 25) An alert and oriented 69-year-old male patient has slight right-arm weakness but exhibits no deficits to the right leg. The EMT should consider this patient to be a: A) Non-priority transport since no paralysis exists B) Priority only if the patient also has a low blood glucose level C) Non-priority since he is alert and oriented D) Priority for transport to a hospital with a stroke center

: D Diff: 2 Page Ref: 577

: 18-13 55) Which of these statements made by a patient suggests that he is suffering from a tension headache? A) "The pain starts at the top of my head and spreads down my back." B) "I get so nauseated with the pain." C) "The light really seems to bother my eyes when I get these headaches." D) "The pain seems to get worse as the day goes on."

: D Diff: 2 Page Ref: 578

: 3-6 47) You have been called to transfer a trauma patient from a rural hospital emergency department to the emergency department of a large urban medical center. Which action will best decrease your chance of becoming involved in an EMTALA violation? A) Obtaining a copy of the patient's insurance and billing information B) Taking vital signs every 5 minutes during transport C) Determining the exact location to which the patient is to be transported D) Assessing the patient for stability prior to transfer

: D Diff: 2 Page Ref: 58

: 19-9 14 Copyright © 2018 Pearson Education, Inc. 51) When treating a patient who has had a seizure, the most important aspect of providing care is to: A) Ensure that the patient does not bite his or her tongue B) Identify the type and duration of seizure, as well as any history of seizures C) Provide supplemental oxygen during the seizure to ensure adequate oxygenation of the brain D) Assess for and manage any life-threatening condition found

: D Diff: 2 Page Ref: 585

: 19-7 4 Copyright © 2018 Pearson Education, Inc. 12) You are called to a residence to assess a child. The panicked parents state that their 3-yearold son was playing with his brother when he suddenly "blanked out" and would not respond to them for several seconds. When asked, they deny any convulsing-type movement as well as a history of medical problems. Based on this description, you would be suspicious that the patient experienced which type of seizure? A) Febrile B) Simple partial C) Grand mal D) Absence

: D Diff: 2 Page Ref: 589-590

: 19-5 12 Copyright © 2018 Pearson Education, Inc. 43) You are transporting a patient who has a history of simple partial seizures. During transport, she experiences a simple partial seizure involving her right arm. Her pulse is 92, respirations are 14 breaths/min and adequate, blood pressure is 168/88 mmHg, and SpO2 is 98%. Your primary concern would be: A) Administering supplemental oxygen via nasal cannula B) Loss of bowel or bladder control C) Placing the patient's arm tightly in a sling to prevent injury D) Progression to a generalized seizure

: D Diff: 2 Page Ref: 590-591

: 19-7 14) When an EMT performs the secondary assessment on a postictal patient with a known history of seizures, which of these assessment findings would be of most concern? A) Confused mental status B) Heart rate of 116 beats/min C) Loss of bladder control D) New contusion noted to the forehead

: D Diff: 2 Page Ref: 592

: 19-7 3 Copyright © 2018 Pearson Education, Inc. 8) You are preparing to transport a 46-year-old male patient who has had multiple seizures throughout the morning, according to the family. Currently, he is on your stretcher and is postictal. He has a history of seizures for which he takes anticonvulsant medications. He also has diabetes and kidney failure. Of the equipment listed here, which is the most essential to have ready during transport of this patient? A) Immobilization equipment B) Automated external defibrillator C) Oral glucose D) Suction device

: D Diff: 2 Page Ref: 593

: 19-7 57) A young male patient with a seizure history is postictal in his bed. His airway is patent, breathing labored, and radial pulse strong and fast. Vital signs are pulse, 140; respirations, 20 breaths/min; blood pressure, 158/92 mmHg; and SpO2, 96% on room air. At this time, which action would be most appropriate? A) Provide supplemental oxygen B) Insert an oropharyngeal airway C) Start positive pressure ventilation D) Place the patient in a lateral recumbent position

: D Diff: 2 Page Ref: 595

: 19-7 26) A patient has been actively seizing for 17 minutes. He is cyanotic with shallow and ineffective respirations. Which immediate care should you provide to this patient? A) Determine if he has a history of seizures B) Place him in the lateral recumbent position and apply oxygen C) Apply the automated external defibrillator D) Attempt to open the airway and begin positive pressure ventilation

: D Diff: 2 Page Ref: 596

: 3-18 39) A 20-year-old male has been stabbed in the abdomen. Assessment reveals him to be unresponsive with shallow breathing and a low blood pressure. Which instructions will you provide to your new EMT partner given that the patient has been involved in a crime? A) "I am not worried about potential evidence. I am just worried about the patient." B) "Do not worry about documenting the crime scene in your report. The police report will reflect that information." C) "We are not to move the patient to the stretcher until the police are done photographing the scene." D) "When cutting his shirt off, make sure not to cut through the area where the knife penetrated."

: D Diff: 2 Page Ref: 60

: 19-11 40) You are called to a residence for seizure activity. On scene, the patient's daughter tells you that her father, who has diabetes, stated that he suddenly felt dizzy and then fell to the floor. Within a few seconds, he began asking what had happened and why he was on the floor. Based on this description, the EMT should recognize which condition? A) Generalized seizure B) Diabetic reaction C) Aura of a pending seizure D) Syncopal episode

: D Diff: 2 Page Ref: 600

: 19-12 34) You have been called for a 57-year-old female patient who has "passed out." As you enter the patient's apartment, you find her supine on the living room floor with a cool washcloth on her forehead. She states that she was standing and talking on the telephone when everything went dark. When she came to, she was on the floor. What should you do next? A) Immediately sit the patient upright while gathering the SAMPLE history B) Insert a nasopharyngeal airway and apply supplemental oxygen C) Move the patient to the ambulance for immediate transport, and call for an ALS intercept D) Complete the primary assessment, and then obtain vital signs while the patient is supine

: D Diff: 2 Page Ref: 600

: 19-10 11 Copyright © 2018 Pearson Education, Inc. 39) You are an EMT who finds an adult male patient on his living room floor after the police department had to force the door open. The scene size-up reveals a very cluttered home that smells of urine. On an end table, you find a container of phenytoin (Dilantin) with the patient's name on it. When you pinch his shoulder, the patient responds by moaning and trying to remove your hand from his neck. Based on this information, which of these conditions would you suspect? A) Syncope B) Allergic reaction C) Behavioral emergency D) Seizure

: D Diff: 2 Page Ref: 600, Table 19-4

: 20-1 59) To decrease the possibility of a faulty glucometer reading, you would: A) Use the first drop of blood obtained B) Use venous blood only for testing C) Avoid the use of alcohol as an antiseptic D) Make sure test strips are not expired

: D Diff: 2 Page Ref: 608

: 20-5 42) You have been called for a 33-year-old male patient who complains of weakness and dizziness. When getting the history, which of these statements made by the patient would raise your suspicion that the patient has undiagnosed diabetes? A) "I feel the need to eat sugar throughout the day." B) "I get very weak just after eating a meal." C) "I feel very weak in the morning after getting up." D) "I find myself urinating all of the time."

: D Diff: 2 Page Ref: 609

: 20-11 20) You have arrived on the scene of a 64-year-old patient with diabetes. He is supine in bed and exhibits snoring respirations. Family members state that they just tested his blood sugar and it is 25 mg/dL. What should be your immediate action? A) Prepare and administer oral glucose B) Have the family recheck the blood sugar C) Determine what the patient has eaten D) Open the airway with a manual technique

: D Diff: 2 Page Ref: 612

: 20-11 6 Copyright © 2018 Pearson Education, Inc. 21) After you administer oral glucose to a patient with diabetes, his level of conscious deteriorates and he becomes unresponsive with snoring respirations. Which action should you take immediately? A) Administer half a second tube of glucose B) Provide high-concentration oxygen via a nonrebreather mask C) Administer a full second dose of oral glucose D) Manually open the airway

: D Diff: 2 Page Ref: 612

: 20-8 9 Copyright © 2018 Pearson Education, Inc. 33) After you administer oral glucose to a confused and combative patient, she gradually becomes calmer and fully oriented. As a knowledgeable EMT, you would recognize that this patient: A) Had a high blood sugar level B) Now has a decreasing blood sugar level C) Will need a second dose of oral glucose D) Had a low blood sugar level

: D Diff: 2 Page Ref: 613

: 20-11 31) An alert but confused patient with diabetes is complaining of weakness. Your service carries oral glucose, which has been authorized through off-line medical direction. In this case, you should: A) Contact the patient's primary care physician B) Transport the patient for further evaluation in the hospital C) Contact medical direction for authorization to administer the oral glucose D) Prepare and administer the oral glucose

: D Diff: 2 Page Ref: 613, Figure 20-6

: 20-5 18) You are called to an outpatient clinic to transfer a 39-year-old male patient in diabetic ketoacidosis (DKA) to an acute-care hospital. When assessing this patient, which sign or symptom would you expect to find? A) Slow and shallow respirations B) Slow heart rate and high blood pressure C) Blood glucose level of 50 mg/dL D) Fruity or acetone odor on his breath

: D Diff: 2 Page Ref: 616

: 21-6 14 Copyright © 2018 Pearson Education, Inc. 49) A patient has just taken her first dose of Zocor for high cholesterol. Within minutes, she begins to develop hives, shortness of breath, and low blood pressure. In this case, the EMT would recognize that the patient is experiencing: A) A sensitized immune response B) Anaphylaxis C) A hypersensitivity reaction D) An anaphylactoid reaction

: D Diff: 2 Page Ref: 632-633

: 21-8 14) You have arrived by the side of a lethargic patient who is allergic to latex and was exposed to it when she spilled a latex-containing powder on her right hand. She is able to speak only a few words with each breath, and a quick glance at the pulse oximeter reveals the saturation is in the 80-90% range. Additionally, the patient's tongue is swollen and her respirations are rapid, labored, and noisy. Which action is your immediate priority? A) Insert an oropharyngeal airway B) Wash the latex powder from the patient's hand C) Obtain a heart rate and blood pressure D) Start positive pressure ventilation

: D Diff: 2 Page Ref: 634

: 21-7 6) A patient who is severely short of breath and covered with hives states that she is allergic to crab. Despite her allergy, she tried some crab dip 10 minutes ago, since it had been "years and years" since she had her last allergic reaction. Which question should the EMT ask first? A) "How many allergic reactions have you had?" B) "Why did you eat the dip if you are allergic to crab?" C) "Which medications are you currently taking?" D) "Do you have an epinephrine auto-injector?"

: D Diff: 2 Page Ref: 635

: 21-8 3) A 39-year-old female patient, who is allergic to shellfish, thinks that she may have accidentally ingested some that was mixed into her food at a restaurant. When assessing her, which of these statements made by the patient would be suggestive that she is in the early stages of an anaphylactic reaction? A) "I feel as though I am getting a fever." B) "My heart suddenly feels as though it is skipping some beats." C) "I feel dizzy and weak." D) "I suddenly feel like a have a lump in my throat."

: D Diff: 2 Page Ref: 636

: 21-8 46) A patient has been stung by a bee. Which of these findings would be present in anaphylaxis, but not in a local allergic reaction? A) Anxiousness B) Swelling at the site of the sting C) Hives D) Hypotension

: D Diff: 2 Page Ref: 638

: 21-4 7 Copyright © 2018 Pearson Education, Inc. 23) The EMT shows he understands the use of an epinephrine auto-injector for treating a patient with an anaphylactic reaction when he makes which of these statements? A) "The epinephrine auto-injector is used only when a patient is stung by a bee or bitten by an insect." B) "It is critical that the EMT identify the cause of the allergic reaction prior to administering epinephrine through the auto-injector." C) "The epinephrine auto-injector should never be used if the patient developed the allergic reaction after eating chocolate." D) "Epinephrine administered through an auto-injector can be used for all anaphylactic and anaphylactoid reactions, regardless of the cause."

: D Diff: 2 Page Ref: 639

: 21-9 9 Copyright © 2018 Pearson Education, Inc. 30) A football player in full uniform has been stung by a bee. Your assessment reveals him to be confused with stridorous respirations and weak radial pulses. His skin is warm and flushed and covered with hives. Vital signs are pulse, 164; respirations, 28 breaths/min; blood pressure, 74/58 mmHg; and SpO2, 87%. The coach notifies you that the patient is allergic to bees and hands you the patient's epinephrine pen. Your next action would be to: A) Completely expose the patient and administer the epinephrine into his anterior thigh B) Lift the shirt over the patient's abdomen and administer the epinephrine into his abdomen below the umbilicus C) Lift the patient's shoulder pads and shirt and administer the epinephrine into his upper arm muscle D) Administer the epinephrine through a pad-less area of the patient's pants over the side of his thigh

: D Diff: 2 Page Ref: 640

: 21-9 31) You are staffing an information booth at the county fair when a mother and her 15-year-old son approach. The mother informs you that her son is severely allergic to bee stings and had an epinephrine auto-injector prescribed to him when he was 5 years old. She hands you the 0.15 mg auto-injector and notes that it expired several years ago. Which of these statements would be most appropriate for you to make? A) "Call your doctor as soon as possible for a new injector because this one is out of date." B) "We have some auto-injectors on the ambulance. I can get one for you to have until you are able to get a new one from your doctor." C) "Make sure to call the doctor since this is out of date. Also ask the doctor if he wants to add a steroid to the injector." D) "Call your doctor to get a new injector and ask him if he wants to change the dose."

: D Diff: 2 Page Ref: 643, Figure 21-6

: 21-8 8 Copyright © 2018 Pearson Education, Inc. 26) Five minutes after you assist a patient with her epinephrine auto-injector, the patient states that she feels much better and would like to refuse additional care and transport to the hospital. Which of these statements by the EMT would be most appropriate given this situation? A) "If you feel better now, there is probably no need to go to the hospital. I will get the refusal form for you to sign." B) "Once we help you take your epinephrine, the law requires that you be transported to a hospital for additional care." C) "Epinephrine can make you very sleepy. You can refuse to be transported, but just make sure that someone is here to keep an eye on you." D) "The epinephrine will start to wear off in 10 or so minutes. Let's see how you are doing then before thinking about refusing transport."

: D Diff: 2 Page Ref: 644, Figure 21-6

: 21-9 35) Five minutes after assisting a patient with his epinephrine auto-injector, you determine that the patient is getting progressively worse. The patient has a second auto-injector available; however, written protocols do not address the administration of a second dose. What is the priority action the EMT should take at this time? A) Request advanced life support (ALS) assistance B) Administer the second dose of epinephrine C) Continue to monitor the patient D) Contact medical direction for further orders

: D Diff: 2 Page Ref: 644, Figure 21-6

: 22-3 3) A 53-year-old female patient has intentionally ingested a large amount of Valium. This medication is primarily absorbed into the body through which structure? A) Stomach B) Esophagus C) Large intestine D) Small intestine

: D Diff: 2 Page Ref: 652

: 22-4 20) You have assessed a 25-year-old female who states that she took a large number of antidepressants and other medications in an effort to end her life. The primary assessment reveals no life-threatening conditions. Why is it important to get the patient's medical history at this time, rather than later on in the assessment or during transport? A) Patients are generally scared early on and more truthful with information B) Further assessment may not be needed if there is no past medical history C) The police on scene will need the information prior to transport from the scene D) The patient may become confused and be unable to provide information

: D Diff: 2 Page Ref: 654

: 22-5 4 Copyright © 2018 Pearson Education, Inc. 13) The grandfather of an alert and oriented 2-year-old girl found her on the floor playing with pills from his open bottle of Digoxin (a heart medication that slows the heart rate). He cannot remember how many pills were in the bottle, but he thinks that some are missing and suspects that his granddaughter may have eaten them thinking that they were candy. Assessment reveals the patient's airway to be open and breathing adequate. Her pulse is appropriate for a child her age and her skin warm and dry. Her grandfather is not sure of how long ago she may have taken the pills. Given the assessment findings, the EMT would assume: A) Not enough Digoxin was taken to harm the child B) The child apparently did not take any Digoxin C) The child must have spit the pills out before swallowing them D) The Digoxin pills have yet to be absorbed into the body

: D Diff: 2 Page Ref: 654

: 22-11 14 Copyright © 2018 Pearson Education, Inc. 47) Following a large wedding that occurred the previous night, health authorities announce that some of the food was contaminated with Salmonella. Consequently, your EMS service receives notice that it may receive a significant number of calls involving food poisoning. A new EMT asks you how to treat patients with food poisoning. What is your best response? A) "After assessing the patient, the administration of activated charcoal can be effective if there are no obvious contraindications." B) "The primary role of EMS in this situation is just to transport the patient to the hospital." C) "If the patient has a fever, we can administer a medication to make him vomit so as to get the food out of his system." D) "You should treat the patient based on his signs and symptoms, just like a patient who ingested any other poison."

: D Diff: 2 Page Ref: 655

: 22-7 36) An 18-year-old female patient has eaten a poisonous mushroom. Medical direction has ordered you to administer activated charcoal. Immediately following administration, the patient vomits the medication. She remains alert and oriented with no current life threats to the airway, breathing, or circulation. Your next action would be to: A) Administer a glass of milk B) Place the patient supine C) Reassess and continue transport D) Readminister the activated charcoal

: D Diff: 2 Page Ref: 657, Figure 22-3

: 22-22 77) A 16-year-old male patient has been inhaling paint fumes to "feel good." His grandmother called 911 when she found him doing this in the basement and he said he was having a hard time breathing. The patient is alert and oriented, with a patent airway and adequate breathing. His radial pulse is strong and his skin warm and dry. Your partner reports mild wheezing in both lungs. Vital signs are pulse, 92; respirations, 20 breaths/min; blood pressure, 148/62 mmHg; and SpO2, 96% on room air. The patient has no medical history. Appropriate initial care would include: A) Positive pressure ventilation with supplemental oxygen B) Oxygen by nasal cannula at 8 liters per minute C) Breathing treatment with a metered-dose inhaler prescribed to the grandmother D) High-concentration oxygen through a nonrebreather mask

: D Diff: 2 Page Ref: 659

: 22-4 39) A worker at a chemical plant was working on a high-pressure tank containing chlorine gas when the valve broke, filling the room with chlorine gas and throwing the patient forcefully against the wall. He was unresponsive and trapped in the room for 10 minutes, until being pulled out by firefighters. When the patient is brought to your location, he appears unresponsive. Your first action in caring for this patient would be to: A) Assess breathing and auscultate breath sounds B) Open the airway using the head-tilt, chin-lift maneuver C) Determine the presence or absence of a pulse D) Take manual spine motion restriction of the head and neck and perform the jaw-thrust maneuver

: D Diff: 2 Page Ref: 659

: 4-9 35) Just before the end of their shift, EMTs transported a young male who bystanders state "passed out" and then had a seizure. Now, an hour later, the patient has been stabilized and the physician asks the nurse if she knows what the seizure looked like. To easily answer this question, she would: A) Contact and question the bystanders B) Call the EMTs at home C) Question the patient D) Check the prehospital care report

: D Diff: 2 Page Ref: 66

: 22-6 31 Copyright © 2018 Pearson Education, Inc. 107) You are on scene in a remote part of a local park, where an unresponsive female patient was found by a passing security guard. The female patient, who looks to be in her 20s, has needle tracks on her arms; an empty syringe was found nearby. You have initiated spine motion restriction precautions, inserted a nasal airway, and alerted dispatch for ALS backup. The patient is currently breathing adequately and has a blood pressure of 102/78 mmHg, a heart rate of 68 beats/min, and respirations of 12 breaths/min. While awaiting arrival of the ALS unit, which of these steps is most appropriate? A) Administer 1 mg of Narcan either intramuscularly or subcutaneously B) Lay the patient on her side and administer one tube of oral glucose C) Repeat the reassessment and vital signs every 15 minutes D) Administer oxygen so as to maintain a pulse oximeter reading of 94% or greater

: D Diff: 2 Page Ref: 661

: 22-8 43) A 17-year-old male patient was stung by an unidentified insect. On scene, the sting site to his right forearm showed some redness and mild swelling. During the reassessment, which statement made by the patient would indicate that venom from the sting is being absorbed into the bloodstream? A) "The bite seems to be hurting worse now." B) "I think that my arm is more swollen." C) "The area around the bite feels numb." D) "I feel sick to my stomach and dizzy."

: D Diff: 2 Page Ref: 661

: 22-10 46) While he was changing the battery on a truck, acid from the battery splashed into a 66-yearold man's right eye. The patient now complains of burning pain to his right eye and is having a hard time keeping it open. He is alert and oriented and has no problems with his airway, breathing, or circulation. Your next action would be to: A) Cover both eyes and provide immediate and rapid transport B) Rinse the eye with a mixture of sterile water and sodium bicarbonate C) Place a cold pack to the eye and immediately transport the patient to the hospital D) Irrigate the eye with water for a minimum of 20 minutes

: D Diff: 2 Page Ref: 662

: 22-11 80) For which of these patients would you be most concerned about accidental exposure to cyanide? A) An auto mechanic working near exhaust fumes B) A coal miner working long hours in a mine C) A worker who paints cars in an auto body shop D) A firefighter battling a smoky structure fire

: D Diff: 2 Page Ref: 667

: 22-11 87) You have been called to a dilapidated residence for a 26-year-old female patient complaining of generalized weakness. After applying gloves, you enter the home and find the patient on a couch in minimal distress. Your assessment reveals no life threats, but you do note track marks to both hands and arms. When asked about the marks, she states that she is an IV drug user and has hepatitis C. Given this information, you would: A) Apply goggles B) Apply goggles and a gown C) Place a HEPA mask on yourself D) Continue care with gloves

: D Diff: 2 Page Ref: 674

: 22-2 27 Copyright © 2018 Pearson Education, Inc. 92) A female patient in her forties has overdosed and is lying at the bottom of some stairs. Her husband reluctantly informs you that she is addicted to pain medications and was chewing a fentanyl (narcotic pain reliever) patch this evening. She was having difficulty standing up and fell down the stairs. The husband is so frustrated with her that he immediately leaves the scene. The patient has snoring respiration and is incontinent of urine. You first step in caring for this patient would be to: A) Check her pupils for signs of a narcotic overdose B) Open the airway with a head-tilt, chin-lift maneuver C) Apply supplemental oxygen D) Take manual spine motion restriction precautions

: D Diff: 2 Page Ref: 675

: 22-5 15 Copyright © 2018 Pearson Education, Inc. 50) You are by the side of a young female college student who is unresponsive. Friends say that she is normally not a heavy drinker, but tonight she drank an excessive amount of alcohol because her boyfriend broke up with her at the party. She responds to painful stimuli and has snoring respirations. Her respiratory rate is 8 breaths/min and her radial pulse is weak. Your immediate action would be to: A) Apply oxygen via a nonrebreather mask B) Administer positive pressure ventilation C) Determine whether drugs are also involved D) Perform a manual airway maneuver

: D Diff: 2 Page Ref: 675

: 22-5 7 Copyright © 2018 Pearson Education, Inc. 23) A 14-year-old female patient has taken an excessive amount of Tylenol with codeine. Family members were asleep when they heard a crash and found her at the bottom of the stairs. When they asked the adolescent if she was okay, she replied that her boyfriend broke up with her and she saw no point in going on with her life, so she took an overdose. When you arrive by the patient's side, you note that she is responsive to verbal stimuli with eye opening and is breathing, has an intact airway, and is breathing somewhat shallow but still adequately. Your first action would be to: A) Open the airway with the head-tilt, chin-lift maneuver B) Determine exactly how much medication she took C) Start positive pressure ventilation with oxygen D) Take manual spine motion restriction precautions

: D Diff: 2 Page Ref: 675

: 22-19 26 Copyright © 2018 Pearson Education, Inc. 89) A patient has been found unresponsive on her bedroom floor. When assessing her, the EMT would have the highest index of suspicion for a narcotic overdose when he notes: A) Dilated pupils B) Bottle of Valium next to her C) A glass pipe with a sticky residue in it D) Shallow and slow respirations

: D Diff: 2 Page Ref: 677

: 22-13 32 Copyright © 2018 Pearson Education, Inc. 110) Generally speaking, which technique should the EMT use first when confronted with a patient in a drug or alcohol abuse situation who is experiencing a "bad trip" and expressing some potentially violent tendencies? A) The "take down" technique B) The "assessment down" technique C) The "patient restraint" technique D) The "talk down" technique

: D Diff: 2 Page Ref: 678

: 22-14 16 Copyright © 2018 Pearson Education, Inc. 53) On arrival at a tailgate party in a parking lot near a college, you observe a crowd around a young man who is seizing. As you get equipment from the ambulance and make your way to the patient, his friends tell you that the patient has been up all night "partying" by drinking alcohol and smoking crack cocaine. At the patient's side, you note that he is no longer seizing, but is unresponsive and has snoring respirations. His respirations are labored at 16 breaths/min and his radial pulse is strong. His skin is cool and diaphoretic. Friends also inform you that he has diabetes; about an hour ago, they heard him say that he thought his blood sugar was becoming low. Which of these interventions would most likely be included in your care? A) Open the airway, provide oxygen, and administer oral glucose B) Open the airway, check the blood glucose level, and administer oral glucose C) Insert an oral airway, provide positive pressure ventilation, and administer oral glucose D) Open the airway, provide oxygen, and give rapid transport to the hospital

: D Diff: 2 Page Ref: 678

: 22-19 29 Copyright © 2018 Pearson Education, Inc. 100) An alert and oriented 36-year-old male patient is panicked and complaining of chest pain and shortness of breath after snorting some bath salts. He has no past medical history and takes no prescribed medications. The primary assessment is unremarkable with the exception of some expiratory wheezing heard upon auscultation. The vital signs are pulse, 124; respirations, 22 breaths/min; blood pressure, 144/66 mmHg; and SpO2, 92%. To best treat this patient, you would initially: A) Attach the AED B) Administer an albuterol MDI C) Give activated charcoal D) Provide supplemental oxygen

: D Diff: 2 Page Ref: 678

: 22-16 72) The EMT accurately understands alcoholism when he states: A) "The diagnosis of alcoholism is applied to a person who drinks hard liquor, not beer or wine." B) "Surprisingly, in the late stages of their condition, persons with alcoholism are very functional and able to hold down a job and maintain good family relations." C) "Alcohol is classified as a drug on which the addict becomes psychologically dependent, not physically dependent." D) "Aside from the excessive amounts of alcohol, much of the health deterioration that accompanies alcoholism comes from malnutrition."

: D Diff: 2 Page Ref: 683

: 22-17 58) A patient who is agitated and hyperactive with dilated pupils and tachypnea has most likely ingested: A) Heroin B) Hallucinogens C) Methadone D) Crack cocaine

: D Diff: 2 Page Ref: 689

: 23-2 4 Copyright © 2018 Pearson Education, Inc. 14) The EMT has an accurate understanding of the solid organs contained within the abdomen when she states: A) "Solid organs contain less blood than hollow organs, but will still bleed if injured." B) "Solid organs like the gallbladder are covered by a thick fibrous capsule for protection." C) "Solid organs are structures in the abdomen that break down and absorb nutrients into the blood." D) "Solid organs may receive a lot of blood flow and may bleed excessively if injured."

: D Diff: 2 Page Ref: 698

: 23-4 79) An EMR tells you that a patient has pain just above the umbilicus, but just below the rib cage. You would document this condition as pain in the: A) Right lower quadrant B) Hypogastric area C) Left upper quadrant D) Epigastric area

: D Diff: 2 Page Ref: 699, Figure23-2(b)

: 4-7 26) What would be the best reason for a policy that requires all crew members to synchronize their watches with dispatch at the beginning of each shift? A) Ensures that all EMS staff are on time and ready for the shift B) Allows the supervisor to make sure that all EMTs have a watch C) Provides the best opportunity for the EMT to end the shift on time D) Promotes accurate system-wide time record keeping throughout the shift

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: 23-6 11 Copyright © 2018 Pearson Education, Inc. 40) You are providing continuing education for a group of EMTs. The topic is acute abdominal pain. Which of these points would you stress when discussing the EMT's treatment of the patient with acute abdominal pain? A) The EMT can provide more appropriate care for the patient if he or she is able to identify the cause of the abdominal pain B) It is okay to spend extended time on scene while working to identify the exact cause of the abdominal pain C) Patients complaining of nausea and vomiting without pain rarely have life-threatening conditions and can go to the hospital by private vehicle D) Definitive care for patients with abdominal pain is hospital evaluation and possible surgical intervention

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: 23-3 19) Your partner is performing the Markle test on a patient who complains of abdominal pain. Which instructions should be provided to the patient to ensure that she performs the test correctly? A) "Please raise each leg one at a time. I will need to know if you feel any pain, especially in your heels when you put pressure back on them." B) "I am going to gently press inward on your belly and then quickly release the pressure." C) "I am going to press on your belly with my hands. Please tell me if you suddenly feel pain in your ankles." D) "I need you to stand on the tips of your toes, then on my command drop onto your heels."

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: 23-6 44) When you are obtaining information for the medical history, which of these findings would be significant for a patient with suspected cholecystitis? A) Start of a new medication for high blood pressure B) History of recent unexplained weight loss C) Abstinence from alcohol over the past six months D) Fried chicken and potato salad for dinner

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: 23-6 86) A 23-year-old male patient has extreme pain in his lower right groin with a protruding mass noted in the same area. In discussing this patient with your partner, which statement would be most accurate? A) "I am worried about an abdominal aneurysm; we should palpate gently." B) "I don't think that the mass is related to his pain since it is not pulsating." C) "Are you thinking appendicitis since he does have a low-grade fever?" D) "He really needs to be evaluated; he may have a hernia, obstruction, or something worse."

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: 23-3 50) While performing the secondary assessment on a patient's abdomen, you note a pulsating mass just above the umbilicus. Your next action would be to: A) Increase the pressure of palpation to determine whether there is pain related to deep organs B) Check the blood pressure in both arms C) Determine the exact size of the pulsating mass D) Palpate the remainder of the abdomen gently

: D Diff: 2 Page Ref: 705-706

: 23-5 23) You have been dispatched for a patient with abdominal pain. On scene, you find the patient lying supine and complaining of severe pain to his lower abdomen. He is pale and has a look of distress on his face as he answers your questions. Which action should the EMT take after assuring the airway and breathing are adequate? A) Inspect the patient's abdomen B) Obtain the patient's blood pressure C) Palpate the patient's abdomen D) Check the patient's pulse

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: 23-6 7 Copyright © 2018 Pearson Education, Inc. 26) A patient with a history of upper gastrointestinal bleeding is complaining of weakness and abdominal pain. He informs you that he vomited 5 minutes before you arrived. Which of these questions is most important that the EMT ask first regarding the vomit? A) "Did you eat anything that made you vomit?" B) "Are you allergic to any foods or medications?" C) "Did you take an antacid over the past 24 hours?" D) "Was the vomit red or did it look like coffee grounds?"

: D Diff: 2 Page Ref: 708

: 4-6 8) You have placed a 67-year-old female patient on low-concentration oxygen with a nasal cannula. Under which section of the prehospital care report (PCR) would you document this information? A) Administrative B) Patient data C) Patient narrative D) Treatment

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: 23-4 35) Assessment of a 21-year-old female patient reveals her to have severe abdominal pain localized to the right upper quadrant. She is alert and oriented, and her vital signs are stable. After you place her supine on the stretcher, the patient quickly assumes a lateral recumbent position with her knees drawn up to her chest. Which response from the EMT would be appropriate? A) "It would be best if you stay on your back. That position will help decrease the pain." B) "You can stay on your side, but I will need you to keep your legs straight. That will help decrease the pain." C) "I need you to stay on your back and with your head up. If you vomit, that will prevent you from aspirating." D) "You seem more comfortable in that position. If you are, you should stay on your side."

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: 23-6 38) You have completed the initial assessment on a 62-year-old male patient who complains of the sudden onset of epigastric pain. His airway is patent, his breathing is fast but still adequate, and his radial pulse is weak and barely palpable with a delayed capillary refill. His pulse is 124 beats/min and his skin is cool and moist to the touch. Your next action would be to: A) Obtain a blood pressure in both arms B) Perform a secondary assessment C) Place the patient on the stretcher and move him to the ambulance D) Apply supplemental oxygen

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: 23-6 116) A 26-year-old patient with hemophilia fell in his garage, cutting his arm on a nail protruding from a door frame. Emergency Medical Responders are on scene holding a bloodsoaked towel on his right forearm that is still bleeding. The patient is alert and oriented with a pale complexion. The EMRs report a pulse of 98, respirations of 18 breaths/min, blood pressure of 142/66 mmHg, and SpO2 of 99% on room air. Your initial priority in caring for this patient is: A) Providing supplemental oxygen B) Immediate transport to the hospital C) Replacing the towel with a sterile dressing D) Stopping the bleeding

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: 23-7 108) The fundamental problem associated with anemia is: A) Thickened blood consistency B) Elevated blood pressure C) Predisposition to infection D) Cellular hypoxia

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: 23-9 15 Copyright © 2018 Pearson Education, Inc. 55) You are transporting a visibly upset female patient who was raped after she let a male stranger into her house. Which of these questions would be appropriate for the EMT to ask? A) "Why would you let someone in your house you did not know?" B) "Do you have any history of a sexually transmitted disease?" C) "Have you ever been sexually assaulted or raped before?" D) "Please tell me where you are hurting."

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: 23-10 24 Copyright © 2018 Pearson Education, Inc. 92) A 50-year-old female states that she has gone through menopause and no longer experiences menstrual periods. Using appropriate medical terms for documentation, the EMT would describe this status as: A) Pre-menses B) Dysmenorrhea C) Pro melena D) Post menarche

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: 23-11 65) A patient has a tumor that has compressed and obstructed her left ureter. Which complication may result from this condition? A) The bladder cannot be completely emptied B) The patient is more prone to urinary tract infections C) The kidneys are impaired in their ability to make urine D) The urine will back up into the left kidney

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: 23-13 100) A patient informs you that she has a dialysis fistula on her left arm. You would: A) Clean the fistula with alcohol prior to getting a blood pressure on the arm B) Realize that it is impossible to obtain a blood pressure on the patient C) Immediately wrap the site with roller gauze D) Avoid performing a blood pressure measurement on the patient's left arm

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: 23-14 102) If a patient missed his last dialysis appointment, which complaint would you anticipate? A) Bleeding from the fistula B) Hypotension C) Generalized abdominal pain and fever D) Shortness of breath

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: 4-8 19) You have transferred care of a 21-year-old woman who overdosed on an unknown drug. For the patient, which best describes who is permitted access to the prehospital care report (PCR)? A) The emergency physician but not the nurse B) The patient's mother but not brothers or sisters C) An on-duty police officer who is a friend of the patient D) The health care provider assuming care of the patient

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: 4-9 16) After a patient, who is short of breath, signs a refusal of service form, which statement would be appropriate prior to leaving the residence? A) "We will leave this oxygen for you; call us when you feel better." B) "Try taking an aspirin and get a good night's rest; you will probably feel better." C) "Call our dispatch in the morning to let us know how you made out." D) "If you change your mind at any time and want to be transported to the hospital, call 911 again."

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: 4-6 12) When completing a paper-based prehospital care report, you accidentally write that a laceration was on the left side of a patient's face when it was actually on the right side of the face. Correcting this mistake would include which step? A) Color over the term "left" with black ink and write the word "right" next to it B) Start the entire prehospital care report over from the beginning C) Carefully use White-Out to cover the term "left" but nothing else in the narrative D) Draw a single line through the term "left" and write the word "right" next to it

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: 4-9 10 Copyright © 2018 Pearson Education, Inc. 34) You have been called to the house of a patient with altered mental status. You encounter a 41-year-old male who exhibits slurred speech, an unsteady gait, and an odor resembling that of alcohol on his breath. His wife states that he is an alcoholic and needs help to get better. When documenting this information, which statement would be best? A) Alcoholic history disclosed to EMS B) Patient with history of alcoholism C) Family member states patient ETOH D) Per wife-patient has alcoholic history

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: 5-7 6 Copyright © 2018 Pearson Education, Inc. 21) Which of following is a disadvantage in using a cell (or mobile) phones as an emergency backup communication system? A) Cell (mobile) phones do not offer high-quality sound B) There is less privacy when using cell phones, as compared to radios C) Cell (mobile) phone use is not monitored by the FCC D) Cell (mobile) phones may not be effective in disaster situations

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: 5-5 3) Which statement reflects the most appropriate way to alert a receiving hospital that you are en route with a patient? A) "Inbound with a 76-year-old male complaining of dizziness." B) "St. Margaret's, can you take a report on a person with chest pain?" C) "Dr. Jackson, this is EMT Mike Bennet, can you hear me?" D) "St. Elizabeth Hospital, this is BLS ambulance 104. How do you copy?"

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: 5-10 47) While reviewing patient care reports as part of a quality assurance program, which trip time documented by an EMT would indicate that the EMT needs refresher education regarding proper military time utilization? A) "Call dispatched at 2233 hours" B) "Medication administered at 0814 hours" C) "Departed scene with patient at 1000 hours" D) "Intercepted with ALS at 0032 hours"

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: 5-12 3 Copyright © 2018 Pearson Education, Inc. 9) You are treating an 82-year-old female who is having trouble hearing some of your questions. Which technique would be most helpful in obtaining her medical history? A) Enlist the help of a neighbor B) Speak with a loud and higher-pitched voice C) Defer further questions until en route to the hospital D) Speak clearly and slowly

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: 5-13 31) You have arrived by the side of an 82-year-old male complaining of generalized weakness. After you introduce yourself, the patient states, "My name is Edward Burns, but everyone calls me Eddy." What would be your most appropriate response back to him? A) "Okay, Eddy, let's see what is going on with you." B) "Okay, Edward. We need to know which hospital you want to go to." C) "Okay, Mr. Burns. Is it okay if we get your blood pressure?" D) "Do you want us to call you Eddy as well?"

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: 5-14 13 Copyright © 2018 Pearson Education, Inc. 49) You are conducting a verbal interview with a patient who is not very forthcoming with information. If you fail to continue to try to motivate the patient to talk, what would be the most undesirable outcome? A) The patient will not pay the ambulance bill when it arrives B) The hospital emergency department will likely be mad at the EMS providers for failing to gather necessary information C) The family will assume you are not truly interested in helping the patient D) You may not gain valuable information that could impact your patient care decisions

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: 5-16 50) In which situation should the EMT honor the wishes of the patient's family rather than the patient's wishes regarding treatment and transport decisions? A) When the family, rather than the patient, is responsible for paying the ambulance and hospital bill B) When the patient is a child or is an adult who does not have the capacity to make his or her own decisions C) When the family's decision about treatment and transport coincides with the EMT's decision, even if the patient disagrees D) If the patient is an adopted family member from another culture who has not yet become accustomed to normal practices in the United States

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: 6-11 6 Copyright © 2018 Pearson Education, Inc. 22) You and two other EMTs are preparing to move a patient down several flights of stairs using a stair chair. After assigning one rescuer to hold the chair at the head and another to hold the chair at the foot facing the patient, you should: A) Assist the EMT at the patient's head B) Direct movement from behind the EMT at the head C) Assist the EMT at the patient's feet D) "Spot" by standing behind the EMT at the feet

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: 6-11 10 Copyright © 2018 Pearson Education, Inc. 37) You are moving a critically injured patient to a helicopter for rapid transport to a trauma center. The rotors are spinning so that the aircraft can immediately take off. As team leader, which instruction would you provide? A) "Let's get many people around the backboard so we can safely load the patient into the aircraft." B) "I need someone to hold the IV bag in the air while we load so the patient continues to get IV fluids." C) "Will someone please lay the O2 tank on the patient's legs so he continues to get oxygen as we load?" D) "Will someone please securely cover the patient's eyes so that they are not struck with flying dirt?"

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: 7-15 31) The left side of a patient's heart is in severe failure, causing blood to back up behind it. Which sign or symptom are you most likely to observe first? A) Swelling in the feet B) Decreased respirations C) Bone pain in the legs D) Crackles in the lungs

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: 7-9 66) Which statement regarding the endocrine system is most correct? A) It includes the thyroid, parathyroid, adrenal, and salivary glands B) It is a system of glands that releases hormones via ducts into the bloodstream C) It is a system of glands that regulates consciousness D) It is made up of several glands whose secretions cause specific actions in specific organs

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: 8-3 9) Failure of the sodium-potassium pump can result in: A) Accumulation of acidic wastes B) Excess amounts of sodium outside the cell C) Large amounts of potassium inside the cell D) Cellular damage, swelling, and rupture

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: 8-7 6 Copyright © 2018 Pearson Education, Inc. 22) A patient with a high fever has an accelerated metabolism and is producing abnormally large amounts of carbon dioxide at the cellular level. To compensate for this effect, what will occur? A) Decreased levels of acid in the blood B) Decreased respiratory rate C) Decreased depth of breathing D) Increased respiratory rate

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: 8-14 65) You are caring for a 66-year-old male patient who is severely dehydrated. How does severe dehydration affect the cardiovascular system? A) It reduces the hemoglobin available to carry oxygen B) It impairs the ability of oxygen to diffuse from the lungs to the blood C) It slows the production of white blood cells to fight the infection D) It decreases the blood volume available for circulation

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: 8-16 51) A slightly confused but conscious 61-year-old female patient with generalized weakness has a heart rate of 190 beats/min. She has a history of high blood pressure and diabetes. Her blood pressure is 78/56 mmHg, and she has a pulse oximetry reading of 93%. Which disturbance would best explain this patient's presentation? A) Unrecognized hemorrhage B) Hypoglycemia C) Hypoxia D) Excessive tachycardia

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: 8-17 71) What blood pressure change as most likely to cause left ventricular failure? A) Chronically elevated systolic blood pressure between 140 and 160 mmHg B) Chronically decreased diastolic blood pressure between 30 and 50 mmHg C) Chronically decreased systolic blood pressure between 60 and 80 mmHg D) Chronically elevated diastolic pressure between 120 and 140 mmHg

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: 9-10 29) A 16-year-old male was killed after driving at excessive speeds and then losing control of his car. He was not wearing a seat belt. In an attempt to understand why such a tragedy would occur, you would recognize that: A) During this stage of life, the "right versus wrong" part of the brain is not fully developed B) Adolescent boys have a drive to compete with their peers C) Within the adolescent period, there exists a strong desire to show independence and selfsufficiency D) Common to this age group is a perceived sense of strength and invulnerability

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: 9-8 9 Copyright © 2018 Pearson Education, Inc. 32) You have been dispatched to a residence for an 82-year-old female with unknown medical problems. En route to the scene, your partner states, "At 82 years old, she probably has a ton of medical problems." Your response would be: A) "You are probably right since more than half of persons older than 60 years have heart disease." B) "I am guessing she does not, given her age and the fact she is not in a nursing home." C) "As we were taught in school, it is middle adulthood where people have the most medical problems." D) "Maybe not, since in late adulthood there is such a wide variety of health status."

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: 2-15 46) After 20 minutes of performing CPR on a 65-year-old female with end-stage multiple sclerosis, your medical director orders you to stop resuscitation and inform the family that the patient has died. The family members are upset and crying. You notice the patient's daughter holding her hand. Your immediate response would be: A) "It's okay to hold her hand, but you should really use gloves like we do." B) "It's important not to touch her since she may be infectious from her disease." C) "I know that you are upset, but it is best not to touch her since she just passed." D) "It's okay to hold her hand."

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: 10-1 109) A young male patient has been stabbed in the right lateral chest. Regarding the respiratory system, which finding presents the greatest danger to his well-being? A) Loss of serous fluid from membranes in the chest B) Fracture of the rib and predisposition to a pulmonary infection C) Loss of oxygen from the lungs through the stab wound D) Collection of air between the pleural and visceral membranes

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: 10-5 14) Which of these patients should the EMT suspect as being mildly hypoxic? A) A 24-year-old female breathing 8 times per minute with cyanosis of the lips B) A 36-year-old female with asthma, breathing 22 times per minute, with cyanosis of the fingertips C) A 44-year-old male breathing 28 times per minute who is confused and has an SpO2 of 97% D) An 18-year-old male who is restless, has shallow respirations and is breathing at a rate of 16 times per minute, with no cyanosis

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: 10-1 2 Copyright © 2018 Pearson Education, Inc. 5) Assessment findings on an elderly patient with congestive heart failure indicate that her failing heart is causing fluid to collect and fill her alveoli. Based on this pathophysiology, for which pulmonary complication should the EMT treat the patient? A) Decreased blood pressure B) Collapse of the bronchi C) Swelling of the tongue D) Decreased gas exchange

: D Diff: 3 Page Ref: 226

: 10-11 96) Your paramedic partner has applied continuous positive airway pressure (CPAP) to a patient in respiratory distress from congestive heart failure (CHF). As an EMT, you realize that this treatment should benefit the patient by: A) Collapsing portions of the diaphragm B) Causing the diaphragm to relax during inspiration C) Removing air from the lungs during exhalation D) Displacing fluid in the alveoli back into the bloodstream

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: 10-17 102) After 2 minutes of continuous positive airway pressure (CPAP) at 4 cmH2O, you see no improvement in the patient's respirations or SpO2 level. What is your next step? A) Stop the CPAP and begin to provide positive pressure ventilation B) Place an oral airway and continue the continuous positive airway pressure C) Continue the CPAP as is and monitor the patient for another 5 minutes D) Increase the continuous positive airway pressure by 2 cmH2O and reassess the patient

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: 10-18 101) The EMT is properly applying continuous positive airway pressure (CPAP) when he: A) Checks and documents the pulse oximetry reading every 15 minutes B) Places a confused patient receiving CPAP in a lateral recovery position C) Adjusts the ventilation rate to between 16 and 18 breaths/min D) Places the mask over the patient's mouth and nose and tightens it to the face

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: 10-21 16 Copyright © 2018 Pearson Education, Inc. 60) You must transport a patient with carbon monoxide poisoning to a specialized facility for treatment. Transport time is estimated at 1.5 hours. The patient is on a nonrebreather face mask with a continuous oxygen flow of 15 lpm. In the ambulance, you have a G tank with 1100 psi inside. Knowing that the cylinder constant is 2.41, which action should the EMT take in relation to the amount of available oxygen and transport time? A) Return to the EMS station so you can replace the G cylinder with a full one B) Decrease the oxygen flow to 10 lpm for the transport C) Apply a nasal cannula at 8 lpm for the transport D) Complete the transport, and replace the G cylinder when back at the station

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: 10-12 93) You are administering oxygen at 2 lpm through a nasal cannula to a confused patient. During transport, you note the SpO2 to be 91%, up from 90% on scene. The patient remains confused. What would your next action be? A) Keep the oxygen flow at 2 lpm and continue to monitor B) Administer oxygen at 15 lpm through a nonrebreather mask C) Start positive pressure ventilation with supplemental oxygen D) Increase the oxygen flow to 4 lpm

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: 11-9 30) A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which skin color would the EMT expect given this status? A) Bluish-gray B) Pale and cyanotic C) Pinkish and flushed D) Yellow-orange

: D Diff: 3 Page Ref: 293

: 11-10 42) Friends called 911 for a 37-year-old female who intentionally overdosed on a narcotic drug at a college party. Which eye-related findings would reinforce that the patient did indeed take a narcotic? A) Pupils that constrict to light B) Bloodshot eyes with large pupils C) Nonreactive pupils that are unequal D) Pupils that are constricted

: D Diff: 3 Page Ref: 295, Table 11-6

: 13-10 26) The patient's family states that their 16-year-old daughter has a history of asthma and has been complaining of shortness of breath for the past two days. She has been taking her metereddose inhaler with some relief, but this morning, they found her lethargic and struggling to breathe. Your assessment reveals the patient to be responsive to verbal stimuli with an open airway and shallow respirations of 44 breaths/min. You hear minimal wheezing in both lungs. What is your immediate action in caring for this patient? A) Insert an oral airway B) Apply a nonrebreather mask C) Position her on her side D) Start positive pressure ventilation

: D Diff: 3 Page Ref: 348-349

: 13-12 49) Which of these statements made by an EMT student shows he correctly understands capillary refill? A) "Capillary refill is a reliable sign of perfusion in adults, but not as reliable in infants and children." B) "Red flushed skin in the adult is a normal finding when assessing capillary refill." C) "A capillary refill of 4 or more seconds in a patient of any age indicates that he or she is well oxygenated." D) "For a capillary refill test to be normal for a child, it must be assessed at room temperature and be less than 2 seconds."

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: 13-16 62) A 62-year-old female patient was struck by a car traveling approximately 45 miles per hour. After being struck, she was thrown 15 feet onto the sidewalk, impacting the pavement with her head and chest. The primary assessment has been completed, spine motion restriction precautions have been provided, and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, what should the EMT do first? A) Examine the head and chest for other life-threatening injuries B) Obtain a full set of vital signs including a pulse oximeter reading C) Ask the family member if the patient has any past medical history D) Perform a rapid head-to-toe physical assessment

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: 14-7 32) A beta-2 medication benefits a patient by: A) Diminishing the need for oxygen B) Slowing the respiratory and heart rate C) Eliminating chest pain D) Dilating the small airways

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: 14-12 9 Copyright © 2018 Pearson Education, Inc. 33) A 66-year-old male patient is complaining of chest pain. The EMT is considering assisting with the patient's prescribed nitroglycerin. Which of these statements made by the patient is most relevant to the EMT at this time? A) "I forgot to take my high blood pressure medication this morning." B) "I accidentally took five, not four, baby aspirins when the chest pain first started." C) "I took a nitroglycerin pill yesterday for the pain and it didn't do anything." D) "My urologist just started treating me for problems I am having with sex."

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: 15-9 70) When a person is in shock, what is occurring in the body? A) The cells are getting glucose and other nutrients, but not oxygen B) The amount of oxygen to the cells is adequate, but CO2 is not being eliminated C) The blood carries an adequate amount of oxygen, but not enough nutrients for cell survival D) The cells are not getting enough oxygen, and waste products are accumulating

: D Diff: 3 Page Ref: 436-437

: 15-21 57) A patient in early shock informs the EMT that he has had severe diarrhea and vomiting over the past four days. Given this history, the EMT should recognize the pathophysiology of the shock as: A) Loss of red blood cells B) Decreased formed elements in the blood C) Leakage of the capillaries D) Loss of plasma volume

: D Diff: 3 Page Ref: 438

: 15-6 75) Which of these statements made by your EMT partner best indicates an understanding of the prehospital role in caring for the patient in shock? A) "The job of the EMT is to recognize that a person is in shock and get him or her to the hospital so treatment can be started." B) "Because shock is a life-threatening condition, it is important that the EMT identify the exact cause so the proper care can be given." C) "If shock is in the compensatory or early stage, it is not yet life-threatening and the EMT can take his time in assessing and treating the patient." D) "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport the patient."

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: 15-12 97) You are treating a pediatric patient in cardiac arrest. The patient has a long congenital cardiac history and had a pacemaker implanted a year ago. How will this information change the EMT's use of the AED during arrest management? A) In a pediatric patient, the use of an AED is contraindicated if the patient has an implanted pacemaker B) The AED can be used, with the adhesive pads being placed over, or beside, the implanted pacemaker C) The AED can be used, but only half of the normal pediatric energy level should be used during defibrillatory shocks D) The AED can be used, but the adhesive pad should not be placed directly over the pacemaker

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: 16-9 85) Why would a patient with COPD have a higher percentage of red blood cells than a healthy person without COPD? A) To better fight lung infections B) To make the blood "thinner" C) To help prevent spontaneous bleeding in the lungs D) To carry additional oxygen to the cells

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: 16-7 88) While talking to your partner one day in between emergency calls, he tells you he has recently read a CE article on pulmonary embolisms. Which of these statements indicates that your partner understands the underlying pathophysiology of how a pulmonary emboli can cause hypoxia? A) "During an embolic process, the alveoli become inflamed and the walls of the alveoli thicken and prevent oxygen transfer, resulting in hypoxia." B) "A pulmonary emboli occurs when a small bronchiole of a lung becomes plugged by mucus or a clot in the bloodstream, blocking the movement of air into the alveoli, which results in hypoxia." C) "The primary cause of a pulmonary emboli is a blood clot from the legs that lodges in the pulmonary veins and prevents blood exiting the alveolar capillary beds from reaching the heart." D) "When the pulmonary vasculature becomes blocked by an emboli, then blood cannot reach the alveoli for gas exchange, and hypoxia can result."

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: 16-14 9 Copyright © 2018 Pearson Education, Inc. 31) Following a call in which you treated a pediatric patient with croup, a new EMT who is in orientation asks you how you can differentiate croup from epiglottitis. Which of these responses would be most appropriate? A) "The swelling associated with epiglottitis typically decreases with exposure to cool air; the swelling with croup does not." B) "Epiglottitis is accompanied by a cough; croup is not associated with a cough." C) "Croup is typically associated with wheezing; epiglottitis is typically associated with crackles in the lungs." D) "The child with epiglottitis is typically drooling; the child with croup rarely, if ever, drools."

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: 16-14 73) You have been called for a 6-year-old male patient with shortness of breath. On scene, you find the patient with a runny nose and mucus coming from the right nare. Breath sounds are clear and his SpO2 is 99% on room air. When asked, the patient states that his throat is very sore. His vital signs are pulse, 124; respirations, 20 breaths/min; and temperature, 98.9°F. There is no medical history, according to the mother. Which statement or instruction would be most appropriate for this situation? A) "Why don't we give him an aspirin for his fever and then you can follow up at your pediatrician's office." B) "I am very concerned he may have epiglottitis, so we are going to take him to the hospital with lights and siren." C) "Let's give him some oxygen since the heart rate is most likely elevated because his oxygen is low." D) "He is stable, but we will take him to the hospital. The danger lies in the infection spreading to the lungs."

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: 16-1 25) A 4-year-old female patient is having great difficulty breathing. She is responsive to verbal stimuli and has an open airway. Her respiratory rate is 40 breaths/min, and she has an SpO2 reading of 88%, which has dropped from 90% despite high-concentration oxygen through a pediatric nonrebreather mask. Her pulse is rapid, and her skin cool to the touch. As a knowledgeable EMT, you would recognize these findings as associated with which condition? A) Respiratory distress B) Cardiopulmonary arrest C) Respiratory arrest D) Respiratory failure

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: 3-10 5 Copyright © 2018 Pearson Education, Inc. 14) An alert and oriented patient complaining of a severe headache is refusing all treatment as well as transport by the EMTs. After having signed the refusal, the patient suddenly seizes and becomes unresponsive prior to EMS providers leaving the home. The EMT should: A) Contact medical direction for permission to treat B) Honor the patient's wishes and leave the scene C) Place the patient into the family's car for transport to the hospital D) Provide care under the guideline of implied consent

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: 17-5 19 Copyright © 2018 Pearson Education, Inc. 71) A paramedic administers a medication to decrease the effect of the parasympathetic nervous system on the heart. In response to this treatment, the EMT would expect which vital sign change? A) Increase in respirations B) Decrease in heart rate C) Decreased blood pressure D) Increase in heart rate

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: 17-2 78) The EMT understands the ECG when he makes which of these statements about the waveform? A) "The ECG shows how well the heart is oxygenating blood." B) "An ECG indicates the amount of blood in the heart." C) "The ECG can be used to determine how well the heart is pumping blood." D) "An ECG represents the electrical activity of the heart."

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: 13-10 5 Copyright © 2018 Pearson Education, Inc. 16) Which of these statements made by another EMT, regarding chest pain and acute coronary syndrome, is correct? A) "If the chest pain started during activity, it is most likely cardiac. If the pain started while the patient was at rest, it is most likely not cardiac." B) "If the patient's chest pain does not go away with nitroglycerin treatment, the EMT should assume that the medication is expired and ineffective." C) "If the patient experiences chest pain that radiates into the left arm, it is most likely a heart attack. If the pain radiates anywhere else, it is most likely not cardiac in origin." D) "Some patients experiencing acute coronary syndrome do not have actual chest pain; rather, they experience a sensation of discomfort or pressure."

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: 17-8 11 Copyright © 2018 Pearson Education, Inc. 39) The EMT shows that she understands the difference between classic angina and an acute myocardial infarction (MI) when she states: A) "Classic angina occurs when the heart rate becomes too fast; an acute MI is the result of coronary artery disease." B) "Classic angina is not accompanied by other symptoms like shortness of breath; the chest pain with an acute MI is." C) "The pain in an acute MI is typically described as stabbing; the pain with classic angina is more pressure-like." D) "An acute myocardial infarction results in the death of cardiac tissue; classic angina does not."

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: 17-17 87) A 71-year-old male patient with a cardiac history and lower abdominal and back pain has called 911 for help. On scene, you detect a large pulsatile mass in his abdomen. With the exception of skin that is diaphoretic, the primary assessment indicates no life threats to the airway, breathing, or circulation. The patient has a history of hypertension, high cholesterol, and diabetes, and is allergic to sulfa-based medications. Vital signs are pulse, 92/min; respirations, 20 breaths/min; blood pressure, 130/66 mmHg; and SpO2, 95% on room air. Which of these statements made by the patient would make you intervene immediately? A) "Since I am not having chest pain, I am not going to take my nitroglycerin." B) "I am going to check my blood sugar with my own glucometer." C) "I am going to leave my home oxygen on 2 liters since it seems to have helped my breathing." D) "I am going to take my daily aspirin since I did not take it this morning."

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: 17-13 22 Copyright © 2018 Pearson Education, Inc. 85) An elderly patient with diabetes who experiences a silent MI will most likely: A) Be on continuous home oxygen B) Experience chest pain but deny that anything is wrong C) Be taking pain medications that mask the heart pain D) Not be awakened by a heart attack as he sleeps

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: 3-10 55) A plaintiff is suing an EMT in civil court for alleged improper care and resultant injury. In this situation, which is true? A) The government is the lead agency that is prosecuting the EMT B) The EMT is facing a very serious criminal charge C) If found guilty, the EMT will face jail time or probation D) If the suit is successful, the plaintiff will most likely be awarded money

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: 3-3 53) You have been asked to review a legal case in which a patient intentionally overdosed on heroin and then died after EMS responders arrived. Those responders did not have a bag-valve mask to ventilate the nonbreathing patient, so the patient was not ventilated until a second EMS unit arrived. The evidence indicates that the EMT and paramedics both signed their morning equipment check indicating that they had inspected the ambulance and had all the necessary equipment to do their job. In this case, you would realize: A) The EMT and paramedics can seek protection under the Good Samaritan law B) The EMT and paramedics will most likely be charged with contributory negligence C) The EMT and paramedics are not responsible because the patient intentionally overdosed D) The EMT and paramedics were negligent in caring for the patient

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: 18-6 69) Which past medical condition identified during the SAMPLE history could be a metabolic cause of an altered mental status in an elderly male patient? A) Brain abscess B) Brain tumor C) Hemorrhagic stroke D) Kidney failure

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: 18-3 11 Copyright © 2018 Pearson Education, Inc. 41) A middle-aged male patient collapsed while shopping and now responds to verbal stimuli with confused speech. The primary assessment indicates no immediate life-threatening conditions. His pulse is 96, respirations 16 breaths/min, blood pressure 158/88 mmHg, SpO2 98% on room air, and blood glucose level 79 mg/dL. The patient is carrying a vial of nitroglycerin in his jacket pocket. What should you do next after determining the patient priority status? A) Administer oral glucose B) Provide oxygen via nasal cannula at 2 lpm C) Administer sublingual nitroglycerin D) Perform a secondary assessment

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: 18-7 4) While you are teaching a public awareness class about stroke, a participant asks you if all patients with stroke are paralyzed on one side of their bodies. Your reply would be: A) "Yes. Both the arm and the leg must be paralyzed for the health professional to recognize a stroke." B) "No. Some patients suffering stroke will show no signs or symptoms, but all still must be evaluated." C) "Yes. To be diagnosed with a stroke, the arm and/or the leg must be very weak and paralyzed." D) "No. Some stroke patients may have only slight weakness to one side of their bodies."

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: 18-12 8 Copyright © 2018 Pearson Education, Inc. 28) Which of these is a good description of an ischemic stroke? A) Rupture of an artery within the brain B) Blood accumulation within the brain tissue C) Simultaneous occurrence of stroke and heart attack D) Obstructive blood clot inside a blood vessel within the brain

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: 18-3 42) You are obtaining the past medical history from the family of an elderly patient with an altered mental status who suffered sudden onset of right-side weakness. Which of these statements made by the patient's family member should you recognize as increasing the patient's risk of stroke? A) "She takes an aspirin every morning." B) "Her blood pressure runs low." C) "She has a history of migraines." D) "She has an irregular heartbeat."

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: 18-12 6 Copyright © 2018 Pearson Education, Inc. 21) You have been called for a 63-year-old woman with slurred speech and right-arm weakness. On arrival, the patient informs you that the slurred speech and weakness have resolved. Since your assessment reveals no deficits, the patient insists on signing a refusal of treatment form. Which of these statements should you make prior to having her sign the form? A) "It would be best to start taking one baby aspirin every day; this will decrease the chance of this happening again." B) "Sometimes seizures present this way; call your doctor in the morning to schedule an appointment." C) "If this happens again, wait 10 minutes to see if you are okay. If the symptoms persist, call 911." D) "You really need to be evaluated in the hospital. You are at significant risk for a future stroke, which may be debilitating or even fatal."

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: 18-11 65) A patient is alert and oriented, with a blood pressure of 228/110 mmHg, a heart rate of 82 beats/min, respirations of 20 breaths/min and adequate, and a pulse oximeter reading of 96% on room air. The patient complains of a bad headache that started suddenly. The patient has equal grips and good lower leg function. The blood glucose is 68 mg/dL, and pupils are reactive, although the patient has trouble maintaining a horizontal gaze when asked to do so. He has a history of seizures, hypertension, and atrial fibrillation. Given these assessment findings, which one meets a criterion for the MEND stroke screening tool that suggests the patient may be experiencing a stroke? A) Sudden onset of a bad headache B) Hypertensive blood pressure C) History of seizures and atrial fibrillation D) Horizontal gaze abnormality

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: 18-12 63) Which of these statements indicates that the EMT understands the appropriate use of supplemental oxygen when caring for a patient with stroke? A) "In the short time that we provide care to a patient with stroke, the benefits of highconcentration oxygen outweigh the risks." B) "If positive pressure ventilation is required, it should be given with room air and not supplemental oxygen." C) "Since stroke decreases oxygen delivery to the brain, high-concentration oxygen should always be geared toward achieving an SpO2 as near to 100% as possible." D) "Oxygen should be administered at a minimal amount, just enough to get the SpO2 at or greater than 94%."

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: 19-6 8 Copyright © 2018 Pearson Education, Inc. 28) While taking an EMT class, you come across a test question that asks you to define the pathophysiology of a seizure. Which answer would you select? A) "A seizure occurs when the heart beats irregularly, causing a decreased amount of oxygenrich blood to reach the brain." B) "All seizures are caused by epilepsy, which describes a problem somewhere in the body." C) "A seizure condition describes a muscle problem that causes the arms and legs to jerk." D) "A seizure occurs when there is a massive and uncoordinated electrical discharge in the brain."

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: 19-4 17) As you approach a female patient, she appears unresponsive, with her arms and legs jerking violently. On the prehospital care report, you would document that the patient was found in which phase of a generalized seizure? A) Tonic B) Absence C) Syncopal D) Clonic

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: 19-5 55) A complex partial (psychomotor) seizure can easily be mistaken for: A) An asthma exacerbation B) A left-sided stroke C) An absence (petit mal) seizure D) Alcohol intoxication

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: 20-11 4) Which of these most accurately describes insulin? A) Pill that must be taken by patients with diabetes B) Hormone that breaks food into simple sugars C) Drug that increases the sugar in the blood D) Hormone that enables glucose to move into the cells

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: 20-5 60) The insulin level in a patient with undiagnosed diabetes is elevated, and the cellular receptors for the insulin are not sensitive (to the insulin). You would anticipate which finding when caring for this patient? A) Peripheral edema from retained fluid B) A low blood sugar reading on the glucometer C) Slowed respirations and heart rate D) Elevated blood sugar levels

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: 20-9 38) Which of these statements made by an EMT indicates a correct understanding of glucose in the human body? A) "Once ingested, glucose is broken down into carbohydrates and used for energy." B) "All cells in the body require glucose for energy and cannot use anything else." C) "Glucose is transformed into fats, which the cells of the body use for energy." D) "The cells of the brain cannot store glucose, and are uniquely sensitive to low glucose levels."

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: 20-11 48) When providing information about diabetes to a group of Emergency Medical Responders, you would tell them that it is a disease: A) In which the body cannot turn carbohydrates into sugar B) In which the patient's blood sugar will suddenly drop C) That always requires insulin to be injected into the body D) In which the pancreas fails to produce the proper amount of insulin

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: 20-1 14) A patient with diabetes who took insulin earlier is found unresponsive with a blood glucose level of 29 mg/dL. Which piece of information provided by family gives the best explanation for the patient's altered mental status? A) "He ate pancakes with syrup after taking his insulin." B) "His blood sugar normally goes up after eating." C) "He took only half of his required dose of insulin this morning." D) "He didn't eat breakfast or lunch today because his belly hurt."

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: 20-7 63) A patient with diabetes is exhibiting rapid and deep respirations. As a knowledgeable EMT, you would expect this patient to have: A) hypoglycemia. B) hypoxia. C) fever and tachycardia. D) elevated blood glucose.

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: 20-8 35) You are reviewing prehospital care reports and notice that a patient with low blood sugar and no contraindications to oral glucose did not receive the medication. You recognize that this inaction placed the patient at risk for which condition? A) Liver damage B) Infection C) Heart failure D) Brain damage

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: 21-3 54) You are providing a continuing education session for your EMS department regarding anaphylaxis, as you have just returned from a national conference at which current issues related to this pathology were discussed. During your session, one of your fellow EMS providers asks you how the body can "suddenly" become allergic to something. What is your best response? A) "The body's white blood cells are uniquely sensitive to certain allergens, and when they are exposed to these allergens for the first time, the body will develop an allergic reaction." B) "It is actually not true that someone 'suddenly' becomes allergic to something. Research shows the person was always allergic to it, but incorrectly assumed he was exposed once before." C) "After a repeat exposure, the newly formed antigens of the body will attack the red blood cells, causing them to die, as well as causing airway closure and bronchoconstriction." D) "After exposure to a new antigen, the body will create antibodies to fight it; these antibodies can be the root cause of the anaphylactic response later."

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: 21-7 39) A patient informs you that he found out he is allergic to certain molds and was prescribed an epinephrine auto-injector. He asks you how the epinephrine will help him the next time he is exposed to mold. Your response would be: A) "It will quickly destroy the allergen in the mold." B) "It will provide antibodies to your body and give you temporary immunity." C) "It will reverse the reaction by mimicking the parasympathetic nervous system in your body." D) "It will cause the blood vessels to constrict and your airway structures to relax so that they reopen."

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: 22-15 22 Copyright © 2018 Pearson Education, Inc. 75) When performing a "talk down," which of these statements would appropriately be included? A) "Can you tell me how many rats there are and what their colors are?" B) "Do you see what happens when you take these drugs?" C) "Please ignore the rats and tell me exactly what you took." D) "You are seeing rats because of the drug; this will not last forever."

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: 22-14 61) This is the third day that a patient is in withdrawal from alcohol. If called to care for this patient, the EMT would recognize the need for: A) Restraints B) Positive pressure ventilation C) Warm blankets D) Seizure precautions

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: 23-7 31) Your medical director is providing an in-service program on abdominal pain. He notes that there are several different categories of pain and asks if anyone can describe visceral pain. Which response made by the EMT would be correct? A) "Visceral pain is typically described as 'sharp' and occurs when a hollow organ has become infected." B) "The exact site of visceral pain is easily located by the patient and is typically associated with nausea and vomiting." C) "Visceral pain occurs when the peritoneum lining the abdomen becomes infected and causes a rapid increase in body temperature." D) "A patient with visceral pain typically describes the pain as 'aching' and has a hard time identifying its exact location."

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: 23-6 46) You have been called for a 31-year-old male patient who experienced sudden left lower quadrant pain while lifting and moving a friend's couch to an upstairs bedroom. The EMT would recognize this history as suggestive of which type of abdominal pathology? A) Cholecystitis B) Appendicitis C) Aortic aneurysm D) Hernia

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: 23-7 85) On scene, a 45-year-old female patient tells you that her current abdominal pain felt similar to a previous small bowel obstruction, so she called for EMS much earlier than the first episode. During your assessment, which signs or symptoms would agree with her assessment? A) Nausea and diarrhea for two days B) Upper abdominal pain with deep inspiration C) Decreased heart rate and blood pressure D) Prominent and high-pitched bowl sounds

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: 23-6 29 Copyright © 2018 Pearson Education, Inc. 113) A patient with hemophilia fell backward onto his right hip and now complains of pain to that area. The primary assessment reveals no life-threatening conditions. Vital signs are pulse, 112; respirations, 18 mmHg; blood pressure, 102/84 mmHg; and SpO2, 99%. During transport, which of these findings would be of greatest concern? A) Increasing bruising and pain to the right hip becomes evident B) SpO2 reading dips to 95% for a few minutes C) Hematoma formation on the right hip that is palpable D) Heart rate increases to and is sustained at more than 130 beats/min

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: 4-9 14) Which patient who refuses treatment should still be transported to the hospital? A) 16-year-old female who lives in her parents' house and has a child B) An alert and oriented 57-year-old male who is having chest pain and is diaphoretic C) A homeless man in his 50s who is dirty and disheveled and has a body-wide rash D) A 29-year-old female who attempted to cut her wrists earlier during a failed suicide attempt, but now changes her story and states it was an accident

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: 1-6 37) As a supervisor with an emergency ambulance service, which situation regarding a potential employee would you recognize as falling under the Americans with Disabilities Act (ADA), and as case in which you would make reasonable accommodations? A) An EMT who has requested help with a drug and alcohol problem B) Applicant who cannot pass the EMT certification exam because he is dyslexic C) A blind patient who wants to become an EMT, but has not taken a class yet D) A dispatcher with a prosthetic leg who requires parking next to the building entrance

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: 5-13 35) Over the next three days, your ambulance service will be getting new and improved mobile radios. As an EMT with knowledge of communication equipment, you realize that: A) The new radios will allow combined radio and cell phone use B) New portable radios will be issued to the field crews C) The new radios will rebroadcast transmissions at a higher power D) New radios will be installed in all of the ambulances

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: 5-8 11 Copyright © 2018 Pearson Education, Inc. 41) Currently, there is a debate within your organization regarding the use of codes in your medical communications and radio traffic. As you are in favor of using plain English and doing away with codes, a strong argument to justify this position would be: A) Codes increase the amount of air time needed to relay information B) The code system can be made public, allowing others to hear confidential information C) The use of codes does not allow the EMT to practice his or her medical terminology D) Some medical information can be too complex for a simple code system

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: 4-7 41) Consider the following narrative from a patient care report: "pt. restrained passenger involved in 2 car MVC; c/o left lower leg pain rated 2/10; LOC A/O to person, place, time, and event; BBS clear; abd. Soft with tenderness LLQ; hx of NIDDM with am glucose level of 133 mg/dL." Which of these interpretations is most accurate? A) The patient's abdomen appears uninjured B) The patient is being tested for diabetes C) The patient is confused following the accident D) The patient's lungs sounds are clear and equal bilaterally

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