Questions answered wrong from on practice exams

You and your partner Gertrude arrive on scene to find two men who have been in a fist fight and have been handcuffed by police. You have been asked to treat both men. While Gertrude is treating one man for facial lacerations and a contusion on the head, the man begins to have a seizure. What would you do?

Make sure your patient was in equal or more advanced care and then assist Gertrude with airway management

The protrusion of cartilage from the anterior neck area is known as?

thyroid cartilage

How much blood loss is considered serious in an adult patient?

1000cc

When using the rule of palm to determine the extent of the burn, each palm is considered what percentage of the body surface?

A: 1% (for infants, children, and adults)

Your patient is a 33 year old female who fell off the back of a motorcycle going approximately 20 MPH. Her respirations are irregular at 8 a minute. An OPA has been inserted and ventilations are being assisted with a BVM and 100% O2 at a rate and tidal volume of________________________. C-Spine precautions have been taken and she is packaged and moved to the ambulance where she stops breathing and there is no palpable pulse. CPR is started and the lead paramedic does a rapid sequence intubation. The BVM is attached to the ET tube and ventilations are restarted at a rate of ______________________________________________.

A: 10 to 12 breaths per minute. Tidal volume of just enough air to give adequate chest rise. / 8 to 10 breaths per minute without pauses in compressions.

Dispatch reports a jet ski collision on a local lake. The reporting party says that the two guys are in the water floating face down and one of their buddies just jumped off the boat to help them. When you arrive on scene the boat has just brought the two unconscious men to shore and CPR and rescue breathing are in progress. The first man has a pulse but is not breathing. The second man does not have a pulse and is apneic. What ventilation rate will you use for the first man? What about the second man?

A: 10-12 ventilations per minute for the first man and 6 ventilations per minute and 100 compressions for the second man (The AHA guidelines specify that an adult who is apneic, but has a pulse, should have rescue breathing performed on them at a rate of 10-12 ventilations per minute. (mouth to mask or BVM ventilations). An adult who is pulseless and apneic should have CPR performed on him/her at a rate of 30 compressions to 2 ventilations. This ratio creates a ventilation rate of approximately 6 ventilations per minute with at least 100 compressions.)

Which of the following are the correct dose and route for oral glucose?

A: 15g buccal (The correct dose and route for oral glucose is 15g. Oral glucose comes in a tube containing a gel with 15 grams of dextrose. The proper route of administration is buccal, or between the teeth and gums. )

You arrived to find your patient pulseless and apneic. What is their GCS?

A: 3 (Even though they are pulseless and apneic, your patient would receive one point in each of the three categories for a total of 3.)

You arrive on scene and find a 20 year old female with burns to her entire back, chest, and both arms. Using the Rule of nines, approximately what percent of her body has been burned?

A: 45% (Using the Rule of nines would indicate that approximately 45% of her body has been affected by the burns (entire back 18% + chest 9% + both arms 18% = 45%). The abdomen was not affected so it is only 9% for the chest instead of 18% for the entire abdomen and chest.)

You are dispatched to a possible stroke victim. You arrive to find an elderly man laying face down on the floor. He has Decerebrate Posturing, is making moaning sounds, and his eyes do not respond to verbal or painful stimuli, what is this man's GCS?

A: 5 (Decerebrate Posturing is the same as Abnormal Extension-2, he only moans and makes sounds-2, and his eyes do not respond to any stimulus-1.)

You arrive on scene to find a 78 year old man who is sitting in a chair and staring off into space. His breathing is labored and you can hear wet lung sounds. You get no response when you try to get his name. Your requests for him to move his toes go without response. He winces and withdraws slightly when his chest is rubbed. What is this patients GCS?

A: 9 (No verbal response gets him a 1, withdrawal from pain gets him 4 points, and his eyes being open on their own gets him 4, for a total of 9.)

You and your partner Lola arrive on scene to a multiple patient emergency. Which of the following patients would you and Lola consider a priority patient?

A: A 45 year old female with a blood pressure of 169/92 (A blood pressure of 169/92 would be considered a priority patient. Contractions that are 12 minutes apart, a simple fracture, and wasp stings in and of themselves are secondary to the blood pressure.)

A person suffering from an allergic reaction will likely have ______________.

A: A low blood pressure and a high pulse rate (Allergic reactions generally lower the BP through dilation of the vessels and speed up the pulse rate.)

Signs and symptoms exhibited by a patient with chronic kidney failure may include all of the following except:

A: Agitation Signs and symptoms a patient with chronic kidney failure may exhibit include: altered level of consciousness, seizures, coma, lethargy, nausea, headaches, cramps, and edema.

Compartment syndrome may likely occur in which incident?

A: All of the above (All of the above have the potential for compartment syndrome to occur. Compartment syndrome causes an increase in pressure in the muscle compartment thus causing nerve damage and decreased blood flow.)

Which of the following is likely to cause syncope?

A: All of the above (Metabolic emergency, hypovolemia, cardio. emergency)

During anaphylaxis the tissues of the respiratory system __________.

A: Swell (Allergic reaction may cause the permeability of the vessels to change, allowing fluids to leak into the surrounding tissues of the lungs.)

Your patient is an 86 year old woman who states she is feeling "funny and light headed." As you are talking with her she becomes unresponsive and apneic. What should you immediately do?

A: Assess her pulse (You would immediately want to assess her pulse to see if she has gone into cardiac arrest and to know if CPR needs to be started. 2010 AHA guidelines place a priority on CAB instead of ABC as in the past. If the patient had a pulse, you would immediately begin to provide ventilatory support. If the patient were pulseless you would start compressions and then provide 2 ventilations after the first 30 compressions.)

A two year old boy was pulled from a house fire and handed to you. His weak shallow breathing necessitates assisted ventilations. You put him on high flow oxygen assisted with a BVM at approximately 18 breaths per minute. After 10 minutes of transport, the child's pulse is 50 bpm. What should you do next?

A: Begin chest compressions (A child that is not perfusing well despite assisted ventilations with high flow oxygen and who has a pulse rate below 60 beats per minute, should have chest compressions initiated by the rescuer.)

With regard to blood pressure, which of the following statements is true?

A: Blood pressure has a direct affect on the perfusion of the body's tissues ( Blood pressure has a direct affect on the body's tissues, as without proper pressure the perfusion / oxygenation of the tissues is inadequate. Blood pressure is measured from the pressure in the arteries not the right ventricle. It is equal to cardiac output, TIMES peripheral vascular resistance. Blood pressure, although an important sign, is not taken during the initial assessment.)

Dispatch has reported a possible heart attack and bystanders are doing CPR. A 46-year-old woman was out mowing her lawn when neighbors saw her fall straight to the ground. You arrive to find two people doing what appears to be effective CPR. According to the AHA, What should you do after taking BSI precautions?

A: Briefly question rescuers about arrest events - Turn on AED - Attach AED to patient (According to the AHA: Answer 1 is incorrect because you should turn the AED on first, which will include the prompt to attach the pads. Answer 3 is incorrect because you would want to have the rescuers stop CPR prior to making a pulse check. Answer 4 is incorrect because it recommends shock regardless of analysis.)

The functions of the respiratory system include all of the following except:

A: Bronchiole/venous gas exchange (The functions of the respiratory system include: ventilation, respiration, alveolar/capillary gas exchange, and buffer.)

You are on scene of an ice skating accident where your patient has completely dislocated her knee. She has no distal pulses and her leg is pale. She is in extreme pain, so you should?

A: Call medical control immediately for stabilization instructions (With no distal pulses you will need to contact medical control on how to proceed unless manipulation is within your local scope of practice. Splinting the extremity may be called for but transporting low priority would be inappropriate.)

What is one of the most common causes of stroke in young people?

A: Cocaine ( Cocaine has become an all too common cause of stroke in young people today. It is caused by the effects of cocaine on the blood vessels by causing them to constrict. This in turn causes a decrease of blow flow through the cerebral arteries in the brain.)

The National Incident Management System (NIMS) includes a componant referred to as "Interoperability". This componant is concerned with:

A: Communication between EMS, fire and law enforcement during an MCI.

Injury may occur to the internal organs after a traumatic impact. These are termed _______________ injuries.

A: Deceleration (When an internal organ such as the brain is injured as a result of the skull stopping abruptly and the brain coming into contact from a high rate of speed. The injury is termed deceleration.)

You have a conscious patient who is having problems breathing. As a precautionary measure, you insert an OPA. This will likely result in the?

A: Demonstration of the patient's gag reflex

Generally, the thickest layer of skin tissue is the?

A: Dermis

Side effects of Epinephrine on a patient may include all of the following except:

A: Dialates the bronchioles (Side effects of Epinephrine on a patient may include: Increased pulse rate and B/P, anxiety, and cardiac arrhythmias. Bronchodilation is a desired effect of Epinephrine. Epinephrine is used in anaphylaxis to reverse the vasodilator and bronchoconstriction. Remember side effects are unintended consequences of medication uses.)

Of the following, where shouldn't attention be focused during secondary assessment of the chest?

A: Distention (During secondary assessment of the chest, attention should be focused on: Pain, equal rise and fall, guarding, breath sounds, retractions, scars, medication patches, and medical devices. Distension is usually associated with the abdomen, not the chest.)

A victim of a front end collision would likely suffer from what mechanisms of injury?

A: Down and under / up and over (Down and under / up and over are typical paths that the body takes during a front end collision.)

A fierce winter storm has left hundreds of people stranded along a stretch of highway for a few days. You have been dispatched with the National Guard to help care for anyone suffering from exposure. As you prepare your equipment what things should you carry extra of and why?

A: Drinking water; Dehydration is a very likely problem (While warming methods and glucose are good, drinking water is probably the most important. This is due to the fact that cold weather decreases our thirst mechanism and so we don't drink. However, a lot of moisture is lost during the respiratory cycle in cold air. This is compounded by not feeling thirsty, and a person becomes dehydrate)

A call comes in for a 61 yr old female with an altered LOC. When you arrive, the patient's sister tells you that the patient had a stroke about a year ago, but she knows of no other health problems. During your initial assessment, you find her eyes open and looking around. She is speaking to you, but saying inappropriate words. She will not obey your commands to "raise your arm please ma'am" and she moves her arm toward her chest when you give her a light sternal rub. What is this woman's GCS and what should you do after administering oxygen?

A: GCS of 12 / Package the patient for transport (The woman's eyes are open spontaneously so she gets a 4. She is speaking inappropriate words and this gets her a 3. You know she will not obey commands, but will localize pain which gets her a 5, which nets her a GCS of 12. Given the history and the altered LOC, immediate transport is the next best thing to do.)

What would you do during delivery if the baby is crowning but the amniotic sac is not broken?

A: Gently tear the sac exposing the baby's head (Only if the baby is crowning without the amniotic sac breaking should you help it break. It does not require inserting your fingers into the vagina.)

With regard to the abdomen the word distended means?

A: Harder than normal (A belly is distended if is bulging out in any way.)

You are on scene with a 52 year old male who is unresponsive. The family tells you that he is diabetic. What would be a reason not to give this patient D-50?

A: He could be suffering from a stroke. (Administration of D-50 to a patient who has experienced a cerebral vascular attack (stroke) could exacerbate the problem. Always check blood glucose levels prior to administering any form of dextrose.)

Assessment findings that indicate seizure include all of the following except:

A: Hemiplegia (Assessment findings that indicate seizure include: Spasms, muscle contractions; tongue biting, increased secretions; sweating; cyanosis; unconscious gradually increasing level of consciousness; shaking or tremors with no loss of consciousness; incontinence; and amnesia of event. Hemiplegia is usually associated with TIA and CVA not seizures. Todd's paralysis may occur following seizure, but the paralysis usually affects the body part exhibiting tremors and spontaneously resolves.)

You and your partner Amy arrive on scene to find a woman with hives over much of her body. She is wheezing and complaining of difficulty breathing. Her husband says she was stung by a hornet and has no prior history of allergies. What would be the best course of action?

A: High flow O2 and rapid transportation if the patient appears to be going into anaphylaxis.

You and your partner Gustof arrive on scene to a reported fall. You find a woman in her 70's in the bathtub. Her caretaker says she found her like this after phoning for 2 days and not getting an answer. Your patient is alert and lucid. She tells you that she did not fall, but instead was just unable to get out of the bathtub unassisted. There is no water in the bathtub, but there is feces. Her left side shows some bruising and her left shoulder is notably tender to touch. She has good PMS in her limbs and reports no pain in her back and neck as she sits up. She says, she has only been in the bathtub for a couple of hours. The caretaker, suggests it has been considerably longer. Which of the following would be the most appropriate concerns?

A: Hypothermia, dehydration (e elderly are particularly susceptible to hypothermia and can become hypothermic in a short time in conditions and temperatures where a younger person would be fine. Dehydration is also a very good possibility with the discrepancy in the length of time that she has been in the bathtub.)

Your patient is a 75 year old male who may have had a stroke. He is unconscious and breathing with snoring respirations. After performing a head tilt chin lift maneuver, the snoring is still present. What is your best course of action?

A: Insert a nasopharyngeal, measured from the nostril to the earlobe (he snoring is likely caused by the tongue falling back against the pharynx. The snoring may be eliminated by inserting a properly measured nasopharyngeal. If the head tilt did not help open the airway, the jaw thrust is even less likely to be effective. Snoring respirations are not usually caused by secretions in the mouth.)

Your 57 year old patient was a chain smoker for 35 years and is pursing his lips during exhalation. How does this action assist the patients respiratory effort?

A: It created backpressure on the collapsed alveoli (Breathing with pursed lips is a sign that a chronic obstructive pulmonary disease (COPD) patient is trying to keep the alveoli open with backpressure on their lungs.)

A man has called 911 and reported that his wife has just given birth to a baby girl at home. The delivery went normally, except during the delivery of the placenta the woman began to bleed heavily. What would be the best choice of action when you arrive on scene?

A: Massage the patient's uterus (Massaging the uterus may help to stop the bleeding during this emergency. The placenta should deliver normally, and you would not put a compression dressing on the vagina. Giving high flow O2 and rapid transport would be appropriate, however, it would not be done until addressing the life threat of the bleeding.)

Which of the following is not an enteral route of drug administration?

A: Nasal (nteral routes of administration include oral (PO), orogastric (OG), nasogastric (NG), sublingual (SL), buccal, and rectal.)

Which best describes white matter?

A: Nerve pathways that conduct messages of the brain

When a person is suffering an allergic reaction to a bee sting, the vessels _________.

A: Open up (The dilation of the vessels causes a drop in blood pressure or hypotension.)

All of the following are types of Intracranial Hematoma except:

A: Parietal (An Intracranial Hematoma is the rupture of blood vessels between the brain and the skull. Types of intracranial hematoma include: epidural (between the dura mater and the skull), subdural (between brain and dura matter), intracerebral (inside brain), and subarachnoid (beneath the arachnoid membrane and the brain).

Which of the following is a high priority condition?

A: Severe pain (Uncomplicated childbirth is not a high priority condition. Severe pain anywhere is high priority.)

The skin of a person with hypoglycemia is likely to be____________.

A: Sweaty (Patients with hypoglycemia are likely to be sweaty, clammy, pale, and or cold.)

You and your partner Larry are dispatched for a call to a man with severe stomach pain. When you arrive on scene you find him lying on the floor of the kitchen in the fetal position. There is vomit on his face and he says he is going to throw up again. He denies falling and says the only thing wrong is that his stomach is killing him. Assessing his abdomen you find it to be very tender to the touch and he moans when you palpate his stomach. He is also breathing very fast at 30 a minute. What other signs and symptoms might you find with this patient?

A: Tachycardia - hypotension - fever (The patient is not likely to have crepitus, having no pain and denying that they fell. A person with broken ribs is unlikely to be breathing fast and deep and if a person has been vomiting copious amounts it is likely they would be in metabolic alkalosis rather than acidosis.)

Which is an indication for the use of the non-rebreather mask?

A: The patient shows signs of hypoxia (The non-rebreather mask is the ideal mask for patients who are showing signs of hypoxia. A non-rebreather mask with 15 LPM of O2 and a tight fitting mask seal can deliver high concentrations of oxygen. Studies show between 60%-90% concentrations of oxygen are delivered with a non-rebreather mask.)

Your patient is a 78 year old male who is complaining of chest pain and shortness of breath. Which of the following assessment questions would be the most appropriate to ask him?

A: What does the pain feel like? (Open ended assessment questions will reveal more information than closed ended. This means that descriptive answers received from open ended questions will likely be better than closed ended "yes or no" questions or questions that make a patient choose between 2 or more choices.)

During secondary assessment, all of the following are aspects of monitoring the pulse that should be addressed except:

A: feel (During secondary assessment, all of the following are aspects of monitoring the pulse that should be addressed: Rate, rhythm, regularity (adjust timing for irregularity), strength, and location.)

You arrive on scene with your partner Mark to find your patient, a 68 year old man who is unconscious and has a pulse of 140. He is cyanotic around his mouth and down his neck and appears to be breathing very shallow at 6 per minute. Your actions would include?

Ventilation with a BVM with attached O2 at 15 lpm

You are evaluating the patient's current state with an oscilloscope. What area are you assessing?

cardiac conduction

The left side of the heart ________________________ and ________________________.

receives pulmonary circulation, drives systemic circulation