EMT Test #3
What type of muscles control the size of the bronchioles in the lungs?
Smooth muscle
After applying direct pressure to open fractures of a radius and ulna bleeding is still severe. Which of the following would be the BEST next option for bleeding control?
Splint the extremity (???)
A patient has an automatic implanted cardiac defibrillator. During your secondary assessment the patient loses consciousness, is apneic and pulseless. Which of the following is the most appropriate action to take?
Start CPR and attach an AED (???)
A 45-year-old is found supine on the floor with pinpoint pupils, shallow respirations and vomitus In and around the mouth. What treatment should be implemented next?
Suction
You hear an unresponsive patient gurgling. What is your next action?
Suction the airway
The "fight or flight" response involved which nervous system and which hormone?
Sympathetic nervous system and epinephrine
Which of the following is the MOST common cause of seizures in infants and children?
Fever
A three-year-old patient presents with a high fever, headache, stiff neck, rash on his abdomen and sensitivity to light. What standard precautions should you take for this patient?
Gown, eye protection and gloves
Which of the options below most commonly complicates pediatric airway management?
Head size
Which of the following is NOT a common cause of shock in infants and children?
Heart failure
Which of the following would you determine as a result of your reassessment?
His pulse oximeter reading has dropped to 78%.
Which of the following is NOT an acceptable method or adjunct in restraining a patient?
Hog-typing the patient
A patient presents with a stab would to the lower left chest and a minor amount of external bleeding. There does not appear to be any bubbling or air movement from the wound. Which of the following is the next appropriate step?
Secure the airway
Which of the following BEST describes an appropriate sequence for the patient in pulseless VT?
Shock, 2 minutes of CPR, analyze (???)
The point at which the trachea divides into the two mainstem bronchi is called the
carina
Police escorts of ambulances driving at emergency status are typically discouraged because:
drivers who pull over for the police officer often pull back in front of the ambulance
You have performed a head tilt-chin life maneuver on a 12-month-old boy and are attempting to ventilate him with a bag-valve mask. You are experiencing a lot of resistance with each breath and the chest is barely rising. Prior to attempting ventilations again, you should:
ease the bead forward a little (???)
During your assessment of a 36 week pregnant woman you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You should next:
time her contractions
With the exception of __________, most abdominal organs are not able to sense tearing sensations.
Aorta
Artificial ventilations for a 5-year-old child should be provided at a rate of _____ per minute
12 to 20
Your patient fell out of a tree while putting the roof on a tree house. A 15-foot ladder is required to enter the tree house and there is enough room for an adult to stand up inside. Your patient should be transported to:
A trauma center
Which of the following BEST describes a mobile radio?
A two-way radio that is mounted in a vehicle
What stage of labor is a patient in if the baby is already half-way out of the birth canal upon your arrival?
2nd stage
A 14-year-old female complains of difficulty breathing and vertigo. You note she has hives on her chest and abdomen. After completing the primary assessment, what is the most important element of your SAMPLE history?
A (Allergies)
For which of the following patients would a focused physical exam be appropriate?
A 28-year-old man complaining of a rash on his legs
Why do major internal abdominal injuries require oxygen to maintain internal perfusion?
A lack of circulating volume decreases the oxygen and CO2 transport capability (???)
Which of the following situations will most likely NOT require additional resources at the scene?
A patient with emphysema who is on oxygen therapy at home
A hare traction splint may be used on which of the following musculoskeletal injuries?
A possible closed fracture to the femur (???)
Which of the following is a side of the pediatric assessment triangle?
Appearance
Your patient is a 65-year-old male with a history of COPD. He is sitting up and complaining of a severe shortness of breath. You should:
Apply a non-breather bask giving 15 pm of oxygen (???)
How should maternal bleeding be controlled after delivery of the baby?
Apply direct pressure with a sanitary napkin, Elevate the patient's legs, Massage the fundus (All of the Above)
Your patient is an 80-year-old male complaining of lower back pain that radiates through to the abdomen. He describes the pain as "tearing" in nature. He is pale, diaphoretic and anxious and has a bp of 80/60, pulse of 112, and respiratory rate of 20. Which of the following conditions is MOST likely?
Abdominal aortic aneurysm
A 23-year old female is sitting on a park bench. She states that she has been running for the past 30 minutes and all of a sudden she cant catch her breath. She states that this has never happened before and she usually runs 5 miles a day. Your assessment reveals that she is flushed, her pulse is fast and weak, her respirations are fast and she is wheezing and she has hives on her arms an chest. She is most likely suffering from which of the following?
Anaphylaxis
Which of the following injuries requires the use of an occlusive dressing?
An open wound to the chest
A 52-year-old male has been hit in the head with the bucket of a crane. The patient is unresponsive, has respirations of 8 bpm, shallow and irregular, a radial pulse of 60 strong and regular, bp of 168/92 and the right pupil appears to be blown. The patient should be managed by an airway adjunct (if accepted) and:
Administer oxygen 12L/min via non-rebreather (???)
A 27-year-old female who is 9 months pregnant asks you to wait before helping her to the cot. She feels the need to use the bathroom. Which of the following is the BEST course of action?
Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible
Which of the following statements BEST describes the exchange of gas in the alveoli?
Air moves into the alveoli, blood is transported by the pulmonary capillaries and diffusion occurs (???)
A five-year-old girl was struck by a car and is now unresponsive to verbal stimuli with obvious retractions and nasal flaring on inspiration. The airway is patent, breathing is fast and shallow and the carotid pulse is weak and slow. Which of the following is the next appropriate treatment?
Apply oxygen via non-rebreather
A bedridden special-needs patient needs to be transported to the hospital. The patient is supported in bed with a number of extremely large cushions. When you try to move her she yells out. Which one of the following is the next appropriate step to take?
Ask the caregiver how a move is normally done
You arrive at the college dorm and find a 21-year-old patient lying supine on the floor, unresponsive. The patient is guppy breathing at 5 times a minute, has a strong radial pulse at 11 bpm and has emesis on himself. Friends state they went out to dinner and a party. They returned to change clothes for another party and he never came out of his dorm room. Your partner suctions the patient, inserts an oropharyngeal airway and ventilates the patient with a bag-valve mask with high-concentration oxygen. You listen to lung sounds and there are coarse rhonchi bilaterally. What condition do you suspect?
Aspiration
An asthma patient reposnds only to painful stimuli and is making very weak resopiratory effort. Which of the following should you do net?
Assist the patient's ventilations with a bag-value mask device and supplemental oxygen
A male in his mid-60s is awake but he does not seem to acknowledge your presence. He is perspiring profusely, has cyanosis of his ears and lips and has rapid, shallow, respirations. Which of the following should you do first?
Assist ventilations with a bag-valve mask and supplemental oxygen
A 6 -month old male is choking. The child has retractions of his intercostal muscles and is grayish in color. Which of the following is the BEST intervention for this patient?
Back slaps and chest thrusts
A 3-year-old child is in severe respiratory distress. She is cyanotic and responds only to painful stimuli. The child had complained of a sore throat earlier and has had a fever since early in the morning. Which of the following is the BEST course of action?
Begin gentle ventilations with a bag-valve mask and supplemental oxygen
Which of the following would change a trauma patient's category from "stable" to "unstable"
Bilateral femur fracture
While transporting a patient to the hospital, the EMT notes that patient's jugular veins are flat (non-distended). Which of these is most likely the cause of this finding?
Blood loss (???)
The muscle tissue of the heart most directly recieves its blood supply from the:
Coronary arteries
Normally, respiratory drive is triggered by changing levels of:
Carbon Dioxide
Which of the following should be preformed during rapid physical exam/rapid trauma assessment?
Confirm breath sounds, Check the extremities for signs of injury, Palpate the abdomen (All of the Above)
You respond to the scene of a 56-year-old obese female complaining of respiratory distress. She states she has "heart problems", suffers from high bp and takes a "water pill". She is afebrile and has coarse crackles bilaterally. What is most likely the cause of her respiratory distress?
Congestive heart failure
Which of the following is a desired action of epinephrine delivered by auto-injector?
Constriction of blood vessels
An injury caused by heavy pressure to the tissues, such as when an extremity is trapped under a fallen tree, that results in damage to muscle cells and the accumulation of waste products in the tissue is called a(n):
Crush injury
The mother of an ill 20-month old tells you that the baby's diaper has been dry for hours. She adds that the baby has had very poor oral intake for the past two days. Of the following, which is most likely the patient's problem?
Dehydration (shock)
Assessing blood pressure on a patient with an AV shunt, fistula, or graft could lead to which of the following?
Damage to the AV shunt, fistula, or graft requiring surgery
Bleeding should initially be controlled with which of the following techniques?
Direct pressure
The EMT's obligation to provide care to a patient as a formal or ethical responsibility is known as which of the following?
Duty to Act
At a MVC you smell gasoline upon entering the car. What type of move should be used to move your unresponsive patient ?
Emergency Move
A 3-year-old is in respiratory distress. He is leaning forward in the tripod position and is drooling profusely. What condition do you suspect?
Epiglottis
You are the first arriving responder on the scene of a major explosion. This is no doubt a MCI, what should you next implement NIMS/ICS?
Establish command
What are the components of the Glasgow Coma Scale?
Eye-opening, motor response, and verbal response
Which of the following is NOT a general rule of splinting?
In order to avoid loss of use of a limb, it is important to splint before moving, even if the patient is unstable.
You are on scene with several agencies both local and federal. In order to operate in an effective manner, all agencies should follow the:
Incident Command System (???)
Which of the following is NOT a normal change in elderly patients?
Increased metabolism
The spouse of a 72-year-old female tells you his wife took a number of oxycodone pills to try to kill herself. He tells you he cannot locate the pill bottle but knows they were definitely oxycodone. The patient denies taking the pills but presents with a slightly lethargic mental status. You should:
Initiate immediate transport of this patient
A two-year-old has fallen out of her crib and landed on a small chair. She complains of severe pain in her "belly". Her vital sings are pulse 140, respirations 30, bp 80/62. After completing the primary and secondary assessments you should:
Initiate rapid transport
Which of the following is the correct method of suctioning?
Insert the catheter or tip to the desired depth prior to applying suction
Which of the following is the beneficial action of nitroglycerin in some cardiac emergencies?
It dilates blood vessels throughout the body
Damage to what structure in the neck can cause airway occlusion and death to the patient?
Larynx (???)
You are dispatched to a female with altered mental status. A man, who smells of alcohol, says that she is his wife and that he doesn't know what happened. "I just found her this way!" The husband is behaving suspiciously, appears to be paranoid, and is pacing erratically around the room. What would be the safest course of action?
Leave the house and call for law enforcement
Which chamber of the heart is the strongest, most muscular part of the heart and is primarily responsible for pumping oxygenated blood to the rest of the body?
Left ventricle
Which of the following connects bone to bone?
Ligaments
Pain in the upper abdomen is most likely linked to what organ?
Liver and spleen
Which of the following changes commonly occur in the cardiovascular system during anaphylaxis
Low blood pressure due to vasodilation
You are called to an assault on a homeless male. Dried blood from the trauma is visible around the patient's mouth and nose. During your assessment, you note the patient has a productive cough. The patient says, "Don't worry, I'm not contagious, I've had this cough for a year." Describe the best approach regarding respiratory isolation.
Mask yourself and the patient
What source will provide first aid information about hazardous materials for employees at a work site?
Material Safety Data Sheet
What of the following has the ultimate responsibility for the patient care aspects of an EMS system?
Medical Director
Arrange the following signs and symptoms for shock in the order that they will appear:
Mental status, Pale, nausea, respirations, pulse, dropping bp (1,4,3,6,5,2) (???)
Using "START" Triage, what are the assessment parameters that are used to determine patient placement into treatment sectors
Mental status, blood pressure, and respiratory rate (???)
An 11-year-old male has fallen from a tree onto the rails of a fence. He complains of abdominal pain, but is ambulatory and otherwise uninjured. His vital signs are pulse 118, respirations 24, bp 110.74. You should suspect:
Minor injuries and vital signs related to fear (???)
A 21-year-old female is having a convulsion upon your arrival. Which of the following should you do first?
Move furniture and other objects away from the patient to prevent injury
Which of the following agencies is responsible for establishing EMS system assessment programs?
National Highway Traffic Safety Administration (NHTSA)
Which of the following is a common sign and symptom in poisoning of all types?
Nausea and vomiting
What form of shock would be suspected from cervical spine injury?
Neurogenic shock
Occlusive dressings must be carried on an ambulance to treat which of the following injuries?
Open pneumothorax
A 17-year-old male is lying on the ground. He is unresponsive and cyanotic. He is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first?
Open the patient's airway using a manual maneuver
Snoring respirations on a unresponsive male should be addressed by?
Opening the airway with a jaw-thrust maneuver
A 64-year-old male present with sub-sternal chest pain. His vital signs are bp 88/68, pulse 80, respiratory rate 20, and oxygen saturation 92% on room air. The patient is not allergic to any medications, is prescribed nitroglycerin and is not on any ED medications. What medications should you administer?
Oxygen and aspirin
You approach an unresponsive patient, you can see his chest rise and fall normally, but his skin appears pale. You feel his wrist and feel a rapid pulse with cool skin. What should you do next?
Perform a rapid assessment
An 18-year-old male driver of a vehicle that struck a tree. He is conscious an complaining of neck pain. The passenger is obviously dead. You have performed your primary assessment. Which of the following is the next step?
Perform a rapid trauma assessment
An unresponsive patient is breathing four times a minute and has a strong radial pulse. Your partner suctions the patient, inserts an oropharyngeal airway and ventilates the patient with a bag-value mask with high-concentration oxygen. What is your next course of action?
Perform a rapid trauma assessment
What determinatives did the Centers for Disease Control and Prevention release in order to guide the most injured patients into trauma centers?
Physiological determinants, anatomic criteria, and mechanism of injury
Heroin over dose would result in what type of pupil exam results?
Pinpoint
Signs that identify the hazardous material contained within a transport vehicle are called:
Placards
A 44-year-old male with a history of diabetes is unresponsive. He has a respiratory rate of 12 bpm with snoring respirations, pulse of 112 bpm and is pale and sweaty. Which of the following should you do to treat this patient?
Place the patient in the recovery position, administer oxygen and monitor his airway status (???)
A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in short, shallow respirations, pulse ox is 93% on room air. the best approach regarding supplemental oxygen is to:
Place the patient on a non-rebreather mask
Which of the following is the correct procedure for immobilizing a patient who is 34 weeks pregnant?
Place the patient on her left side of the backboard (???)
What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients
Placenta
Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness?
Placing the head and heck in a neutral position; placing a folded towel under the back of the head if necessary
A 45-year-old nonsmoker male with a history of asthma is in respiratory distress. You find him lying supine on the couch. The patient is lethargic, but can answer all of your questions appropriately. He is diaphoretic, and complains of being cold, coughing and having difficulty breathing for the past 3 days. His vital signs are bp of 110/70, pulse of 116, respiratory rate of 24, pulse ox of 93& and a temp of 102.6 degrees. You hear rhonchi in the left lobes and he is coughing up yellow-tinged sputum. What condition do you suspect?
Pneumonia
After your physical exam of a pregnant woman you determine the baby is crowning. You should next:
Prepare to deliver the baby on-scene (???)
Why does tension pneumothorax lead to shock?
Pressure built up in the pleural space compresses the heart
Using START triage guidelines, a patient who is not breathing but begins breathing when the airway is open is a _______________ patient
Priority 2 (Yellow)
As you approach an intersection with lights and sirens on, you approach cautiously, come to a complete stop at the intersection, ensure all other drivers can see you, and slowly ease your way through the intersection. These actions describe your abilities to:
Proceed with due regard for the safety of all drivers on the road
What is the primary effect of a prescribed inhaler?
Relaxation of the bronchioles
All of the following are signs of adequate breathing and circulation in the newborn EXCEPT:
Relaxation of the extremities
During your assessment of a man on a cold evening you determine that the patient is not acting appropriate and is wearing wet clothing. Which o the following is the most appropriate treatment for this patient?
Remove all of the patient's wet clothing, keep the patient dry and wrap in blankets
While ventilating a 27-year-old with blunt chest trauma you note resistance with an absence o fright chest wall movement. Which of the following is MOST likely?
Tension pneumothorax
Two EMT's respond to the scene of a syneopal episode. They evaluate a 50-year-old male patient who passed out and cut his upper lip. The EMT's examine the patient and his vital signs are normal. The EMTs talk the patient out of an expensive ambulance ride and suggest he will save money by driving himself to the urgent care clinic for stitches for his lip rather than waiting all night in the ER department as a non-emergent patient. The patient signs the EMS refusal form. The patient decides to see his own doctor the next morning but he dies at his house from sudden cardiac arrest an hour later. Which of the following statements is true?
The EMT's are negligent because there was proximal causation
What is the cause of jugular vein distention?
The heart is not pumping effectively
A 68-year-old male patient experiencing ACS with no relief after NTN and aspirin is asking to be transported to his cardiologist's hospital, which is 45 minutes away. Your nearest facility is 5 minutes away, a Level 3 trauma Center is 10 minutes away and a hospital with cardiac catheterization capabilities is 15 minutes away. Which hospital is the best destination?
The hospital the patient requests (???)
You notice that your patient's respiratory rate has dropped from 32 to 10 and her oxygen has dropped to 81%. Those findings most likely indicate:
The need for positive pressure ventilations (???)
You are the first to arrive at the scene of a MVC. The driver of a tractor-trailer is walking around and complains of neck pain. The driver of a car is conscious, but cannot exit the vehicle because the door is stuck and the steering wheel is displaced onto his lap. The passenger of the car is sitting upright in the passenger seat, is unconscious and has radial pulses. Access to the passenger in the car is not obstructed. A fourth patient, who was also a passenger in the car is found about ten feet away and responds to commands appropriately. Based on your triage of the patients which of the following should be transported first?
The passenger in the car's front seat
You have arrived on the scene of a call for a possible stroke. The patient is no longer showing any signs of stroke. Which of the following has most likely occurred?
The patient has suffered a transient ischemic attack (TIA)
You notice paradoxical motion to a patient's chest on inspiration and expiration. What is the most likely injury present?
The patient may have a flail chest
Which is the next structure that a drop of blood would pass through after passing through the right atrium?
The pulmonary artery (???)
A patient has a traumatic amputation of the right arm. Upon your arrival the stump of the arm is bleeding profusely. Following direct pressure at the site and application of trauma dressings the bleeding is still severe. What would be the next step you should take in attempting to limit the bleeding?
Tourniquet (???)
A 6-year-old male is unconscious after a MVC. His airway is patent but he is breathing very rapidly. His respiratory rate is 58 an you notice he is slightly cyanotic. In this case, the most important reason to initiate positive pressure ventilations is to:
Treat apnea
If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done?
Try to slip the cord over the baby's head
A patient is agitated, anxious and refuses to have a non-rebreather mask applied. Which of the following is the best option for oxygen administration?
Use a nasal cannula instead
Which of the following cardiac dysrhythmias cannot produce a pulse?
Ventricular Fibrillation
Rough handling of a patient with severe hypothermia may result in which of the following?
Ventricular fibrillation (???)
You are dispatched for an "electrical surgery". Your initial exam reveals a conscious person, breathing adequately. Vital signs are normal and there are no obvious signs of burns. What is the next step?
White on the scene, rapidly do a complete assessment, provide oxygen, provide care for potential spine injuries and transport as soon as possible after the exam
The chemical that produces edema and narrowing of the airways during hypersensitivity reactions is called:
histamine
An 81-year-old COPD complains of three days of shortness of breath. She is altered mental status and you notice cyanosis in her fingernails and lips. The most appropriate oxygen delivery method for this patient would be a:
non-rebreather at 12 lpm
You are transporting a two year old after he has drowned. Which of the following is most concerning for the patient?
the becoming child hypothermic