EMT Practice Test Questions

dosage of nitroglycerin:

0.4 mg

fist size hemotoma causes how much blood loss?

10% blood loss

abdomen loss with 1 inch distention:

1000-2000 mL

Femur Blood Loss:

1500 mL

what ratio should 2 person cpr on a child be done at?

15:2

dosage of aspirin:

162-324 mg; 81 mg each baby aspriin

flail chest:

2 or more ribs broken loose in 2 places; paradoxical movement; split

If a patient is unresponsive with a pulse you:

2 quick rescue breaths then breaths 10-12 every minute

dosage of albuterol in neb form:

2.5 mg/ml

Pelvic blood loss:

2000 mL

what is the correct treatment for someone undergoing aphyxial cardiac arrest?

5 cycles of CPR prior to retrieving the AED or emergency response system

What is the rate of CPR in breaths and compressions:

6 breaths and 110 compressions in a minute

how many bones are in the cervical spine?

7

what is the normal heart rate for a child

70-110 beats per minute

what is a normal systolic blood pressure for a child?

80-110

hypoglycemia:

BGL <50; insulin shot; rapid progression

differences in geriatric patient:

BP drops sooner; decreased cough reflex; hypertensive patients may have normal BP during shock

most common vertebrae injuries for elderly:

C1 and C2

treatment for bronchitis:

CPAP

what is contraindicated in a pnemothorax:

CPAP; you must use a bvm

What is considered bradycardic for an adult?

Heart rate less than 60

kussmaul sign:

JDV during inhalation and returns to normal during exhalation; indicates severely increased pressure in chest or around the heart

cardiognic pulmonary edema:

LEFT sided heart failure; decreased blood flow increased pressure in pulmonary capillaries; fluid leaks into alveoli

what is whooping cough:

UPPER airway infection; highly contagious; starts as cold can progress to pneumonia

ecchymosis is:

a bruise; deoxygenated blood in the tissue

s/s of peritonitis:

abdominal pain; lack of appitite, fever and chills; markle test/heel jar test

inspiration:

active; pressure drops, air is sucked in

What is another name for a heart attack?

acute myocardial infarction

respiratory distress:

adequate tidal volume but difficulty breathing

rescue breathing guidelines:

adult: 1 breath every 5-6 seconds; child: 1 breath every 3-5 seconds

pneumothorax:

air between pleural linings; lungs cant fully inflate leading to a collapsed lung

side effects of oral glucose:

airway obstruciton

what causes pancreatis:

alcohol, gall stones, infection

AVPU stands for what?

alert, verbal, pain, unconciousness

what type of chemical burn is worse, acid or alkali?

alkali is worse

contraindications of aspirin:

allergy; patient with bleeding ulcers/internal bleeding

complex partial:

altered mental status; awake but in daze and unaware

indications for oral glucose:

altered mental status; diabetes history; ability to swallow

contraindications for activated charcoal:

altered mental status; swallowed acids or alkalis

a graph used in hemiodilis is:

an artificial connection between a vein and an artery

thoracic aortic aneurysm/dissection:

aneuryms: occurs when weakened section of aortic wall begins to dilate; pulsating mass dissection: sharp tearing pain; felt in back flank or arm; NO aspirin

pediatric assessment triangle:

appearance: overall mental status; work of breathing: circulation to skin

what are the 5 steps to stop internal bleeding?

assess for shock, splint PRN, monitor Vital signs, rapid transport

common conditions where wheezing is present:

asthma, emphysema, chronic bronchitis, COPD

4 phases of a seizure:

aura; tonic; clonic; postictial

what regulatory system regulates peristalsis:

autonomic

subdural hematoma:

below the dura mater; usually from slowly expanding venous bleed; slowly develops over hours to days

epidural hematoma:

blood "pocket"; above the dura mater, usually from a rapidly expanding arterial bleed

what is an ischemic stroke?

blood flow being cut off from part of the brain

hemothorax:

blood in chest; bleeding in pleural space forming a pocket of blood at bases of lung; decreased lung expansion

hematemisis signs:

blood in vomit

grand mal seizures (primary):

both hemishperes of the brain; lasts only a few minues; loss of conciousness

hematochezia signs:

bright red blood in feces; indicates a bleed in the lower GI tract

crackles/rales:

bubbly osund during inhalation; fluid surrounding or filling the bronchioles/alveoli; base of lungs exhibit first

atherosclerosis:

buildup of fat and cholesterol;

what is congestive heart failure

bulidup of fluid in the body resulting from the pump failure of the heart

s/s of ulcer:

burning pain; LUQ; hematemis; hematochezia; melena

indication of nitroglycerin

cardiac chest pain

s/s of angia pectoris:

cardiac chest pain; radiating; cool clammy anxiety, diaphroesis; treat with nitro

tension headaches:

caused by contraction of muscles of neck/scalp; most common; radiates to neck/shoulders

DKA (type 1) hyperglycemia:

cells burn fat for energy as glucose collects in blood; fruity breath; dehydration; 3 p's; kussmaul respiration

decreased CO2, effect in intracranial pressure

cerebral vessels constrict; decreasing blood flow

increased CO2 affect in intracranial pressure

cerebral vessels dilate;Increased blood flow

what are the three things always present in a pulmonary embolism:

chest pain, dyspnea, tachypnea

wernicke korsakoff sydnrome:

chronic brain sydnrome resulting from toxic effect of alchol ;paralysis of the eys, dementia, hypothermia; eventual coma

thrombus:

clot forms and blocks off circulation

what type of breathing is present in bronchitis:

coarse rhonchi; wheezes, scattered rales

subcutaneous emphysema:

collection of air in the subcutaneous layers

epiglottis:

common in pediatrics; inflammation of the UPPER airway

what is the difference between compensatory and decompensatory stages of shock?

compensatory: normal blood pressure decompensatory: Systemic blood pressure decreases and altered mental status

ischemic chest pain

constant; not changing with movement or palpation; indication of myociaridal ischemia; causes referred pain bc heart has no sensory nerves

what type of breathing is found in pneumonia:

crackles wheezing rhonchi

s/s of CHF:

crackles, rales, rhonchi in airway; high blood pressure; altered mental status; wants to sit upright;

s/s of acute coronary syndromes:

crushing, pressure, squeezing, radiate ot arm, shoulder back; constant; pale cool skin; nausea, dizziness, synocpe; abnormla heart beats; shortness of breath

Melena signs:

dark red blood in feces; indicates a bleed in the upper respiratory tract

head trauma level 2 signs/symptoms:

decerebrate posturing; extension of upper extremities; torso and legs; pupils mid sized and fixed; central neurogenic hyperventilation

head trauma level 1 signs/symptoms:

decorticate posturing; pupils mid sized and reactive; cheyne-stokes breathing

s/s of depressants:

decrease hr, bp, rr; depress mental status; cool clammy and pale bc poor perfusion from hypotension

pulsus paradoxus:

decrease in pulse and blood pressure when inhalation occurs

s/s of a pneumothorax:

decreased lung sounds on one side; respiratory distress; maybe bubbling chest wound

HHNS (type 2) hyperglycemia:

dehyrdation; some insulin is being produced so some blucose is getting to cells therefore there is no large ketone buildup; NO kussmaul's respirations or fruity breath

what is emphysema

destruction of alveolar walls which reduce gas exchange

non cardiogenic pulmonary edema:

destruction of capillary beds; inflammation, alveolar/capillary walls destroyed; fluid moves in and around alvelli

s/s of stimulant drugs:

dilated pupils; elevated heart rate; agitation/excitation; unresponsiveness to pn

what are the 5 steps to stop external bleeding?

direct pressure, tourniquet, pressure bandage, shock treatment (oxygen, elevation, blanket), rapid transport

what are the 4 forces acting on a bullet?

drag, profile, cavitation, fragmentation

s/s of epiglottis

dyspnea; fever; sore throat; cyanosis

appendicitis s/s

early:dull pain at umbilicus; later: RLQ at mcburney point; positive markle test

increasing ICP causes:

edema, ischemia, hemmorage

thoracic contusions (bruising)

either bruise to lung; or bruise to heart; AMI like chest pain, arrhythmias and disturbances

seizures are caused by:

electrical overload of the brain

coupe/contra coupe:

entire brain shifts forward hitting frontal bone and snapping veins/arteries; anterior and posterior bleeds

When do you change roles during CPR?

every two minutes

acute subdural hematoma:

expands rapidly due to size of vessel; develops in a few hours

syncope:

fainting; usually occurs when a person is standing; place supine

s/s of hyperventilation syndrome

fatigue nervous dizzy; calcium levels decrease so mucles in hands and feet cramp

s/s of pneumonia:

fever, cough, dyspnea, tachypnea; tachycardia; localized chest pain; shallow respirations; altered mental status

head trauma level 3 signs/symptoms:

flaccid, no reaction to pain, pupils fixed and dilated

what is the postion of comfort for respiratory emergencys?

flowlers

what is the only way out of the skull?

foramen magnum

hyperglycemia:

glocose builds up in blood because cannot enter cells fast enough; BGL 200-500 mg/dL;

what increases sugar levels:

glucagen and epinephrine

s/s of abdominal aortic aneurysm

gradual onset; "tearing sensation"; pulsating mass; cool/cyanotic legs and feet;

clustur headaches

have vascular origin; excruciating pain on one side; drooping eyelids

respiratory failure in pedis:

head bobbing, see saw breathing; core cyanosis; loss of muscle tone; bradycardia; absent breath sounds; hypotention

up and over crashes injur:

head, neck, chest, abdomen

what is a silent MI

heart attack; common in women, elderly, diabetics; no chest pain; but yes shortnes of breath, nasuea, lightheadedness and weakness

What is considered tachycardic for an adult?

heart rate more than 100

tension pneumothorax:

hearts pumping ability is diminished; great vessels are bent and blood flow is hindered

preeclampsia signs

high blood pressure; diabetes; blurred vision, headaches, edema

wheezing:

high pitched whistling; constriction of bronchioles; LOWER airway; treat with albuterol

conscious patient order:

history, secondary assessment, vital signs

s/s of hypoglycemia:

hunger, weakness, salivation, dilated pupils; tachycardia

indications for epinephrine:

hypertension; alterned mentation, breathing problems

what happens if a patient has preeclampsia?

hypertensive; extremely high blood pressure and swelling in extremeties; susceptible to seizures

s/s of cyanide poisoning:

hypoxia at a cellular level; confusion; agitation; burning in mouth; dyspnea; bitter almonds?

hypoxia vs hypoxemia:

hypoxia is decreaesd oxygen in tissues/cells; hypoxemia: decreased oxygne in blood stream

When is nitroglycerin not advised to be administered?

if the systolic blood pressure is less than 100

sebecuous glands are found:

in the dermis layer

side effects of epinephrine:

increased heart rate, pale skin, dizziness, chest pain, headache, nausea, vommiting, anxiousness, excitiability

what does beta 1 receptors do?

increases HR/contractility

action of oral glucose:

increases blood sugar and brain sugar levels

When cells are deprived of oxygen and die they are called?

infarcted cells

what is pneumonia:

infection of lungs where theres fluid or pus in the alveoli; poor gas exchange

cholecystitis:

inflammation of the gallbladder; Fat, fourty, fertile, farty, female

peritonitis:

inflammation of the peritoneum from blood/pus and bacteria that leaked into the cavity;

what is bronchitis:

inflammation, swelling , thickening of bronchioles, recurrent infections;

myocardial ischemia:

insufficient fuels getting to heart cells; causes irritation

what hormone is produced by the pancreas:

insulin

what lowers sugar levels?

insulin

thirst is an indicator of what?

internal bleeding

what is asthma:

irritatants/allergens causing bronchospasm; swelling of inner airways

what does placing a folded towel underneath a childs shoulders do?

it aids in aligning the childs airway

What is the function of the carotid artery?

it carries blood from the heart to the head

what does DKA cause?

it causes frequent urination in an attempt to rid the body of excess acid buildup

Where does blood flow after it leaves the left ventricle?

it flows to the aortic arch

what does a sphygmonometer measure?

it measures blood pressure

What does diastolic blood pressure refer to?

it refers to the pressure of the vessels during the relaxation phase; bottom of the blood pressure

down and under crash injury:

knees, femurs, hips, pelvis, spine

what is the Don Juan Syndrome?

landing feet first; bilateral heel fractures; ankle fractures; distal tibia/fibula fractures; knee dislocations; femur fractures, hip injuries, spine compression fractures

absence seizure:

loss of awareness characterized by a blank stare; mistaken for daydreaming

What happens when someone has a pericardial tamponade?

low blood pressure; muffled heart sound; weak pulse due to the hearts struggles to pump

if an object is impaled what do you do?

manually secure; control bleeding and stabilize object

actions of epinephrine:

mimics response of sympathetic nervous system; constricts blood vessels to improve blood pressure; relaxes smooth muscles to improve breathing; stimulates heartbeat; reverses swelling and hives

conditions that must be met before administering nitroglycerin:

minimum systolic of 9ommhg; heart rate should be between 50-100; max of 3

position of comfort for anphylyactic shock

modified trendelenburg

abdominal eviscerations:

moist, sterile, fiber free occlusive dressing; treat for shock

becks triad:

narrowing pulse pressure; JVD, muffled heart sounds; pulsus pardoxus

What medication is Erectile Dysfunction medications a contraindication?

nitroglycerin

What does nitroglycerin do?

nitroglycerin dilates the vessels to reduce the hearts preload

type 1 diabetes:

no significant isulin production; requires doses of insulin; DKA ->hyperglycemic condition

type 2 diabetes

non insulin dependent (adult onset);

contraindications of albuterol:

not responsive enough to use; precautuions when chest pain; hr>150

treatments for closed head injury

o2, ppv 12-16 bpm; capnography, monitor LOC, maybe reverse trendelenburg, c-spine precautions

what is a pulmonary embolism:

obstruction of blood flow in the pulmonary arteries leading to hypoxia; blood cannot get to the lungs

how do you treat a chest impalement?

occlusive dressing on 3 sides

how do you treat a neck injury?

occlusive dressing on 4 sides; consider c collar

what do you do if an internal organ is exposed?

occlusive dressing x4; flex hips/knees if no spinal injury

secondary seizure:

occur as a result of "insult" to the body

vascular headaches:

occur bc of dilation or distention of vessels or inflamation in the cranium

Are open ended or close ended questions better to ask?

open ended questions; it avoids the yes/no answer

ulcer:

open wound/sore in the GI tract; breakdown of protective lining may lead to bleeding/perforation

what do you focus on during secondary assessments of the abdomen?

pain, rigidity, medical devices, distentions, scars

what is pulmonary edema:

patient commonly has cardiac disypfuction there are two types; cardiogenic and non cardiogenic

inidactions of Asprin:

patient having chest pain; may keep vessels that deliver blood to the heart from completely shutting off; suggestive of a heart attack

what is hyperventilation syndrom

patient is really excited and breaths faster and deeper

PASG indications:

pelvic fracture, HYPOtension,

pericardial tamponade:

pericardium does not stretch; bleeding between sac and heart muscle reduces the hearts pumping/filling ability; becks triad

what does right sided heart failure lead to:

perifpehral edema; JVD; liver enlargement; respiratory distress

how do you place a patient that is pregnant:

place the patient on the left side; this prevents uterus compression

common conditions where rhonchi is present:

pneumonia; aspiration; chronic bronchitis, emphysema

indications for activated charcoal:

poison ingested by mouth within two hours time

treatment for crackles rales:

ppv/bvm/cpap

compartment syndrome:

pressure in space around the capillaries exceeds the pressure in needed to perfuse the tissues; blood flow is cut off and cells are hypoxic; extremity may feel hard and pulses may be normal

s/s of bronchitis:

productive cough; overweight, JVD; peripheral edema; clubbing nails

status seizure

prolonged seizure that lasts greater than ten minutes; hypoxia is a threat;

what is cystic fibrosis:

pulmonary disfunction as well as changes in mucus secreting glands that block airway;

what does left sided heart failure lead to

pulmonary edema

PASG contraindications:

pulmonary edema (absolute); penetrating thoracic, eviseration, pregnancy, impaled abdomen

common conditions where crackles/rales are present:

pulmonary edema, pneumonia, CHF

basilar skull fracture signs/symptoms:

raccoon eyes; bruising behind ears; blood and CSF from ears/nose

s/s of a heart attack:

radiating chest discomfort; anxiety; dyspnea; sense of impending doom; diaphresis; vommiting; rapid and irregular pulse; JDV; edema

exhalation:

relaxed; pressure rises and air is forced out

reassessment consists of:

repeat primary survey, check vital signs , review chief complaint, check interventions

what is the most common reason for cardiac arrest in children?

respiratory arrest

apnea:

respiratory arrest; no longer breathing

s/s of a tension pneumothorax:

respiratory distress; dropping bp; jdv, tracheial deviation is a late sign; 3 side occlusive dressing

respiratory distress in pedis:

retractions are an early sign; grunting; see-saw breathing, increased accessory muscle use

reperfusion:

return of blood to an area that was once ischemic; increased o2 increases number of free radicals which lead to cell death; use nasal cannula 2lmp

the five "rights"

right patient, right medication, right dose, right time, right route of administration

what side of heart failure does pulmonary embolism lead to?

right sided heart failure

pneumothorax

rupter of protion of lung where air enteres the pleural cavity;

hemmorhagic:

rupture of an artery that causes bleeding in the brain

aneurysm:

ruptured blood vessel leading to massive hemmorage

s/s of cholecystitis:

ruq pain/tenderness; radiates to right shoulder; onset after a fatty meel

indications for albuterol:

s/s of dyspnea with bronchoconstriction, wheezing

dilantin and tegral are used to treat what?

seizures

abruptio placentae:

separation of the placentae from the uterine wall; can result from traumatic injury; administer oxygen 100%

dyspnea

shortness of breath

What type of heart attack is extremely common in elderly?

silent heart attack

capillary bleed:

slow, even flow; dark to intermediate red

What is the parasympathetic system responsible for?

slowing the heart rate and intestinal activity

what are the actions of nitroglycerin

smooth muscle relaxation, reduces cardiac workload, dilates coronary arteries, and dilates systemic arteries

rhonchi:

snoring/rattling; thick mucuous secretion; sound changes when cough and move

embolism:

something floats into and clogs the cerebral circulation

what are three things to check if suspicious of a stroke?

speech, facial droop, arm drift

arterial bleed:

spurting, pulsating flow; bright red

venus bleed:

steady slow flow; dark red

what type fo breathing is found in epiglottis:

stridor

s/s of pneumothorax:

sudden SOB; sharp stabbing pain; decreased breath sounds on ONE side; subcutaneous empheysema

s/s of asthma

sudden dyyspnea, cough, wheezing, tachypnea, tachycardia, use of assessory muscles, feever, pulsus paradoxus,

s/s of pulmonary embolism:

sudden unexplained dyspnea; localized stabbing sharp chest pain; tachynea; tachycardia; syncope; cool moist skin; anxiety cyanosis; crackles

contraindications of nitroglycerin

systolic lower than 90; cannot take with erectile dysfunciton medications; allergy

s/s of pulmonary edema

tachycardia; anxiety; tripod; crackles, cyanosis, JVD

angia pectoris:

temporary interruption of fuel; "chest pain"

thrombophillia:

tendency to develop blood clots

what does the term lumen refer to in EMS?

the diameter of a tube

What is pericardial tamponade?

the heart is impeded by fluid in the pericardium

what delivers blood to the right atrium?

the superior and inferior vena cava

s/s of cystic fibrosis:

thick mucus when coughing; gastrointestional complaints; ab pain; malnutrition; malaise; reoccuring cough

What is arteriosclerosis?

thickening of arterial walls

s/s of emphysema:

thin barrel chest; nonproductive cough; pursed lips; pink complexion; tachypnea, tachycardia; tripod position

respiratory failure:

tidal volume and/or breakthing rate inadequate

transverse divides the body:

top and bottom

TIA

transient ischemic attack; same s/s as a stroke patient but can recover completely in 24 hours; not purminant

What is TIA

transient ischemic attack; this is where vessels in the brain are blocked for a few minutes

stages of alcohol withdrawl:

tremors; hallucinagens; seizures; delerium tremors (high felever, severe confusion, tachycardia)

contraindications for oral glucose:

unconcsious; inability to swallow

two types of frontal impact is:

up and over or down and under

s/s of pancreatis:

upper quad pain; pain that radiates to the back; mild jaundice

what does alpha 1 receptors do?

vasoconstricts/shunts blood

what does nitroglycerin do?

vasodilator; drops your preload to help the heart pump; reduces workload; drops blood pressure

neurogenic shock:

warm, red, dry skin and maybe low BP; caused by injury to thoracic or above; decreased pulse

what is an AAA?

weakened ballooned enlarged area of the wall of the ab. aorta;

what type of breathing is found in asthma:

wheezing

what type of breathing is present in emphysema:

wheezing and rhonchi

what is the paper bag effect?

when a victim takes a deep breath before impact and the air trapped in the lungs is compressed; may cause a pneumothorax

ischemic shock:

when cerebral artery is blocked by clot or foreign matter; CAN recieve fibriniolytic

simple partial:

will remain concious;

fibrile

young age; due to rapid temperature increase