Quiz 4

42. Structural protection afforded to a motorcycle rider during a crash comes from: A) protective gear worn by the rider. B) the main frame of the motorcycle. C) side foot pedals and the handlebars. D) the handlebars and large engine block.

A) protective gear worn by the rider.

51. The MOST significant fall occurs from a height greater than: A) 10 feet. B) 15 feet. C) 1.5 times the patient's height. D) 2 times the patient's height.

B) 15 feet.

47. A CQI program should primarily focus on: A) modifying protocols as needed. B) improving patient care delivery. C) identifying incompetent medics. D) reviewing all patient care reports.

B) improving patient care delivery.

20. The main purpose of continuing education is to: A) facilitate networking of EMS personnel. B) recall material that was learned previously. C) allow EMS personnel to function at a higher level. D) remain current with the latest treatment guidelines.

D) remain current with the latest treatment guidelines.

26. The third phase of a motor vehicle accident involves: A) crush injuries to the body. B) impact by another vehicle. C) deceleration of internal organs. D) injuries caused by flying debris.

C) deceleration of internal organs.

47. The second impact that occurs when an adult pedestrian is struck by a motor vehicle would MOST likely result in injuries to the: A) head and neck. B) hips and knees. C) pelvis and chest. D) lower extremities.

C) pelvis and chest.

2. The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy. A) kinetic, potential B) barometric, kinetic C) potential, kinetic D) chemical, potential

C) potential, kinetic

25. In order to provide the best possible patient care, the paramedic must: A) disregard negative judgments made by the patient. B) project a sympathetic demeanor toward all patients. C) appear competent, even if he or she feels incompetent. D) establish and maintain credibility and instill confidence.

D) establish and maintain credibility and instill confidence.

44. Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the: A) cervical spine. B) chest and abdomen. C) wrists and forearms. D) femurs and tibias.

D) femurs and tibias.

60. When using a group of subjects who range in age from 30 to 40 years, 35 years of age would considered the: A) mode. B) mean. C) median. D) midpoint.

D) midpoint.

2. In the United States, mobile intensive care units (MICUs) initially were staffed by: A) physicians. B) registered nurses. C) funeral home directors. D) nonphysician providers.

D) nonphysician providers.

30. The initial point of bodily impact when an unrestrained passenger takes the "down and under" pathway during a frontal collision is the: A) knees. B) pelvis. C) femurs. D) abdomen.

A) knees.

59. Which of the following statements regarding exit wounds is correct? A) Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body. B) Compared to entrance wounds, exit wounds are generally much smaller and typically have regular edges. C) Despite fragmentation of the projectile, there is usually only one exit wound for each round that is fired. D) With low-velocity gunshot wounds, the exit wound is always a mirror image of the entrance wound.

A) Exit wounds occur when the projectile's energy is not entirely dissipated along its trajectory through the body.

64. Which of the following organs is LEAST susceptible to pressure changes caused by an explosion? A) Liver B) Lungs C) Tympanic membrane D) Gastrointestinal tract

A) Liver

37. Which of the following is NOT a benefit of a properly worn seat belt? A) Minimal risk of whiplash injuries after a rear-end collision B) Prevention of partial or complete ejection from the vehicle C) Prevention of occupants from violently contacting each other D) Distribution of deceleration energy over a greater surface area

A) Minimal risk of whiplash injuries after a rear-end collision

43. A properly worn motorcycle helmet will: A) not protect the cervical spine. B) eliminate the risk of head trauma. C) decrease the risk of a spinal injury. D) minimize the trauma caused by secondary impacts.

A) not protect the cervical spine.

57. Which of the following general statements regarding gunshot wounds is correct? A) The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes. B) Injuries from a shotgun blast are most devastating when the distance between the gun and the target is less than 100 yards. C) Wounds to lower extremities that are not associated with a fracture or neurovascular compromise are always explored surgically. D) Tissue of high elasticity, such as muscle, is less able to tolerate temporary cavitation than tissue of low elasticity, such as the liver.

A) The most important factor for the seriousness of a gunshot wound is the type of tissue through which the projectile passes.

53. Which of the following factors is the LEAST influential in the severity of a stab wound? A) The size of the attacker B) The anatomic area involved C) The length of the knife blade D) The angle of penetration

A) The size of the attacker

48. Unlike adults, children who are struck by a motor vehicle are MORE likely to: A) be run over by the vehicle as they are propelled to the ground. B) experience injuries to the lower extremities from the initial impact. C) be propelled onto the hood of the vehicle during the second impact. D) turn away from the oncoming vehicle, resulting in posterior trauma.

A) be run over by the vehicle as they are propelled to the ground.

50. When a person falls from a significant height and lands on his or her feet, axial loading results in: A) compression or burst fractures to the lumbar spine. B) shearing injuries to the liver, spleen, and aorta. C) crushing injuries to the heels and hip dislocations. D) disc injuries to the lower cervical and upper thoracic spine.

A) compression or burst fractures to the lumbar spine.

32. During a frontal collision, MOST pneumothoraces occur when: A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact. B) the diaphragm rapidly ascends into the chest cavity during impact, causing an increase in intrathoracic pressure. C) the chest strikes the steering wheel, which fractures one or more ribs and causes a perforation injury to one of the lungs. D) the patient is ejected through the windshield, and his or her chest collides with a secondary object outside the vehicle.

A) the patient takes a deep breath just before impact and the lungs rapidly decompress at the time of impact.

39. All of the following statements regarding front air bags are correct, EXCEPT: A) Small children riding in the front seat can be killed when the air bag deploys. B) Air bags will provide protection from both initial and secondary impacts. C) Without the use of a seat belt, front air bags are insufficient in preventing ejection. D) Front air bags will not activate in side impacts or impacts to the front quarter panel.

B) Air bags will provide protection from both initial and secondary impacts.

61. Which of the following statements regarding primary blast injuries is correct? A) Primary blast injuries are typically the most obvious injuries. B) Primary blast injuries are the most easily overlooked. C) Primary blast injuries are the result of flying glass or shrapnel. D) Primary blast injuries are due entirely to intense heat.

B) Primary blast injuries are the most easily overlooked.

46. When an adult pedestrian is struck by a motor vehicle, lateral and posterior injuries are most common because: A) the patient is thrust onto the hood of the vehicle. B) adults tend to turn to the side or away from the impact. C) the patient is thrown and lands on his or her side or back. D) the initial impact by the bumper spins the patient to the side.

B) adults tend to turn to the side or away from the impact.

45. After a motorcyclist is ejected from his or her motorcycle, secondary collisions: A) most commonly involve a stationary object. B) cause an unpredictable combination of blunt injuries. C) typically cause bilateral fractures of the femurs and tibias. D) result in less severe injuries if the rider is wearing leather.

B) cause an unpredictable combination of blunt injuries.

55. If a person survives the initial trauma from a shotgun wound at close range: A) nervous system damage is likely due to the internal dispersal of the pellets. B) contaminants that were driven into the wound can cause a severe infection. C) he or she typically dies within 24 hours secondary to liver or renal failure. D) it is likely that only soft tissue was injured and major organs were spared.

B) contaminants that were driven into the wound can cause a severe infection.

35. Following a rotational impact, the MOST severely injured patient(s. will likely be found at the point of: A) least deceleration. B) greatest deceleration. C) secondary impact. D) greatest acceleration.

B) greatest deceleration.

40. Common air bag-related injuries include: A) spinal fractures. B) minor skin burns. C) hyperflexion injuries. D) abdominal abrasions.

B) minor skin burns.

27. If the windshield of a wrecked vehicle is cracked or broken: A) you should assume that the driver has a severe intracerebral hemorrhage. B) the front seat occupant has a cervical spine injury until proven otherwise. C) the rear seat passenger was likely thrust from the seat into the windshield. D) it is likely that the vehicle was traveling at least 55 mph at the time of impact.

B) the front seat occupant has a cervical spine injury until proven otherwise.

29. The forces applied to the driver during a frontal vehicle collision will differ based on all of the following factors, EXCEPT: A) objects inside the vehicle. B) the physical size of the patient. C) the design of the motor vehicle. D) safety features of the motor vehicle.

B) the physical size of the patient.

34. The severity of hyperextension injuries to the neck following a rear-end collision depends MOSTLY on: A) the proper use of seat belts. B) the position of the headrest. C) proper deployment of the air bags. D) whether the driver tenses up.

B) the position of the headrest.

36. Which of the following statements regarding rollover motor vehicle crashes is correct? A) Injuries to the passengers are usually not serious if seat belts are worn properly. B) Ejection of the patient from the vehicle increases the chance of death by 5 times. C) Unrestrained passengers are struck with each change in direction the car makes. D) The restrained occupant's head and neck usually remain stationary during a rollover.

C) Unrestrained passengers are struck with each change in direction the car makes.

41. Lap belts that are worn alone and too high by a pregnant woman: A) usually do not injure the fetus because the uterus is a highly muscular organ. B) will provide adequate protection for the uterus if the air bag properly deploys. C) allow enough forward flexion and subsequent compression to rupture the uterus. D) will provide equal distribution of forces and prevent forward flexion of the mother.

C) allow enough forward flexion and subsequent compression to rupture the uterus.

63. The shock wave velocity from an explosion is slower and its duration is longer if a person is: A) closer to the explosion. B) standing behind a solid object. C) farther from the explosion. D) standing beside a solid object.

C) farther from the explosion.

56. Compared to a handgun, a rifle: A) is less accurate. B) fires a single projectile. C) fires at a higher velocity. D) has less powerful ammunition.

C) fires at a higher velocity.

52. Unlike blunt trauma, penetrating trauma: A) is especially common during the primary blast injury following an explosion. B) often causes damage to a large body surface area, even from a single projectile. C) involves a disruption of the skin and underlying tissues in a small, focused area. D) is usually more fatal because of the severe external bleeding that accompanies it.

C) involves a disruption of the skin and underlying tissues in a small, focused area.

62. The peak magnitude of the pressure wave experienced by a person: A) causes secondary and tertiary injuries as a result of the explosion. B) will cause less severe trauma if the person is standing beside a solid object. C) lessens as the person is farther away from the center of the explosion. D) causes more severe trauma if the person is in an open area during the explosion.

C) lessens as the person is farther away from the center of the explosion.

31. When a patient takes the "up and over" pathway during a head-on collision: A) the head takes a higher trajectory, striking the windshield and causing stretching injuries to the neck. B) secondary injuries as the patient is ejected are often less severe than the primary injuries. C) the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx. D) injuries to the parietal aspect of the skull are common as the head strikes the side window.

C) the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.

38. What type of injuries will MOST likely occur if a passenger is wearing his or her lap belt above the pelvic bone during a frontal impact? A) Pelvic and lumbar spine B) Femur and thoracic spine C) Kidney and thoracic spine D) Abdominal and lumbar spine

D) Abdominal and lumbar spine

58. Which of the following characteristics of an entry wound indicates that the weapon was fired at close range? A) Abrasions around the wound B) Indentation of cutaneous tissues C) Severe bleeding from the wound D) Tattoo marks from powder burns

D) Tattoo marks from powder burns

65. A vagus nerve-mediated form of cardiogenic shock without compensatory vasoconstriction that may be seen following a blast injury would MOST likely present with: A) syncope and hypertension. B) hypertension and bradycardia. C) hypotension and tachycardia. D) bradycardia and hypotension.

D) bradycardia and hypotension.

49. According to the Waddell triad, the second impact from a motor vehicle occurs when the: A) head strikes the ground, resulting in skull and facial fractures. B) car's bumper strikes the pelvis and femurs instead of the knees. C) child is run over by the car as he or she is propelled to the ground. D) chest and abdomen strike the grille or low on the hood of the car.

D) chest and abdomen strike the grille or low on the hood of the car.

60. During an explosion, secondary blast injuries occur when: A) hollow organs rupture due to the pressure wave. B) the patient is thrown against a stationary object. C) the patient sustains severe burns from the intense heat. D) the patient is struck by flying debris, such as shrapnel.

D) the patient is struck by flying debris, such as shrapnel.

28. The MOST reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is: A) deformity to the driver's brake pedal. B) severe damage to the front rims of the tires. C) a trail of debris leading to the site of impact. D) the presence of tire skid marks at the scene.

D) the presence of tire skid marks at the scene.

33. During a lateral impact collision: A) the far-side occupant, even if properly restrained, experiences double the amount of force as the driver. B) the patient's head moves away from the object causing the impact, resulting in stretching injuries. C) properly worn seat belts protect the passenger from pelvic trauma at the time of impact. D) trauma to the upper extremities depends on the spatial orientation of the arms upon impact.

D) trauma to the upper extremities depends on the spatial orientation of the arms upon impact.

54. Compared to stab wounds to the posterior part of the body, stab wounds to the anterior part of the body are generally: A) downward. B) single. C) multiple. D) upward.

D) upward.

24. Unlike deceleration injuries, crush and compression injuries occur: A) at the time of impact. B) before impact occurs. C) after the initial impact. D) from penetrating mechanisms.

A) at the time of impact.

18. The greatest amount of kinetic energy would be created if a ____-pound driver struck a tree while traveling at ____ mph. A) 140, 50 B) 160, 30 C) 150, 40 D) 170, 30

A) 140, 50

4. Which of the following is NOT a critical point addressed by the "White Paper" written in 1966 that was entitled "Accidental Death and Disability: The Neglected Disease of Modern Society"? A) Ensuring that paramedics responded to every call B) Participating in community-based prevention efforts C) Allocating adequate resources for medical direction D) Developing and pursuing a national EMS research agenda

A) Ensuring that paramedics responded to every call

8. Which of the following is one of the 10 system elements developed by the National Highway Traffic Safety Administration (NHTSA) in an effort to sustain EMS systems? A) Medical direction B) Fully enhanced 9-1-1 C) Paramedic supervisors D) Continued federal funding

A) Medical direction

45. Which of the following statements regarding protocols is correct? A) Protocols are usually developed in conjunction with national standards. B) A well-written protocol should address every possible patient condition. C) Most protocols reflect the personal opinion of the EMS medical director. D) Protocols are orders, and the responder cannot deviate from them under any circumstances.

A) Protocols are usually developed in conjunction with national standards.

8. Which of the following mechanisms of injury poses the LEAST threat for significant injury? A) Rear-end collision with restrained driver B) Death of an occupant in the same vehicle C) Motorcycle crash at greater than 20 mph D) Vehicular intrusion of greater than 12 inches

A) Rear-end collision with restrained driver

14. Which of the following is NOT a factor when considering transport of a trauma patient via helicopter? A) The need for definitive airway management B) Distance from the scene to the landing zone C) Time it will take the aircraft to reach the scene D) Type of terrain on which the helicopter will land

A) The need for definitive airway management

9. Which of the following injuries would MOST likely require transport to a Level I trauma center? A) Two or more proximal long bone fractures B) Superficial burns to an entire lower extremity C) Lateral neck pain following a motor vehicle crash D) Penetrating injury that is distal to the elbow or knee

A) Two or more proximal long bone fractures

72. Before you are able to clean your uniform after taking care of a patient at a major motor vehicle crash, your unit, which is the only one available, is dispatched to a residence for a patient with chest pain. Though not bloody, your uniform is noticeably dirty and you are still sweating from the previous call. Which of the following statements regarding this scenario is MOST correct? A) You should maintain a professional attitude and care for the patient to the best of your ability. B) The patient will likely be offended by your appearance, but you should not be concerned with this. C) Assess the patient and provide needed care after explaining to the patient why your uniform is dirty. D) It would be wise to remain in the ambulance as your partner performs a primary patient assessment.

A) You should maintain a professional attitude and care for the patient to the best of your ability.

29. As an advocate for your patient, you must: A) act in the patient's best interest and remain respectful of his or her wishes and beliefs.. B) allow your personal feelings to affect the quality of care that you provide to your patients. C) treat all patients the same, regardless of differences in lifestyle, culture, and personal values. D) keep suspicions of abuse or neglect to yourself if the patient fears retribution from the abuser.

A) act in the patient's best interest and remain respectful of his or her wishes and beliefs..

67. A patient has requested to be transported to a specific hospital; however, the hospital does not have the proper resources to meet the patient's needs. You should: A) determine if there is a more appropriate medical facility within a reasonable distance. B) advise the patient that his or her hospital of choice is a poorly equipped medical facility. C) remember that the hospital can always transfer the patient to a more appropriate facility. D) contact medical control and request permission to transport the patient to his or her choice hospital.

A) determine if there is a more appropriate medical facility within a reasonable distance.

59. The qualitative method of gathering data for a research project: A) does not use numerical information and is the least accurate. B) uses variables such as mean, median, and mode for data gathering. C) is highly accurate in gathering reliable data for the research project. D) assigns numerical values to the data and is a highly reliable method.

A) does not use numerical information and is the least accurate.

66. You are dispatched to a residence at 3:00 AM for a 39-year-old man with signs of a common cold. When caring for this patient, you should: A) educate the patient and tactfully discuss why a cold is not an emergency. B) realize that this clearly is not a call to which you should have been dispatched. C) advise the patient that this is not an emergency and obtain a signed refusal. D) tell the patient to schedule an appointment with his physician the next day.

A) educate the patient and tactfully discuss why a cold is not an emergency.

51. EMS protocol development, training methodologies, and equipment use decisions are based mainly on: A) evidence. B) experience. C) personal opinion. D) public preference.

A) evidence.

73. While caring for an elderly man with abdominal pain, you are very open with the patient and answer his questions honestly. These actions will MOST likely show the patient that you: A) have integrity. B) are competent. C) are empathetic. D) are self-motivated.

A) have integrity.

26. Openness, honesty, and truthfulness are attributes that demonstrate: A) integrity. B) empathy. C) sympathy. D) advocacy

A) integrity.

16. A paramedic who is licensed in a particular state: A) is required to function under the guidance of a licensed physician. B) has complete autonomy and can function as an independent provider. C) must obtain more continuing education hours than a certified paramedic. D) is authorized to function as medical control for EMTs and advanced EMTs.

A) is required to function under the guidance of a licensed physician.

50. Possible stress points in the day-to-day operations of the EMS system that would likely be identified by a comprehensive CQI program include all of the following, EXCEPT: A) personal finance issues. B) receiving facility issues. C) medical direction issues. D) education and training issues.

A) personal finance issues.

3. Knowledge of kinetics can help the paramedic: A) predict injury patterns found in a patient. B) determine which organs have been injured. C) quantify how much blood a patient has lost. D) differentiate between medical and trauma patients.

A) predict injury patterns found in a patient.

31. When responding to an emergency scene, it is MOST important to: A) proceed in a manner that is timely and safe. B) moderately exceed the speed limit when possible. C) stay at least 10' behind any cars in front of you. D) use your siren to move heavy traffic out of the way.

A) proceed in a manner that is timely and safe

38. When educating citizens who live in an area where EMS response times will be lengthy, the MOST important skill to teach them is: A) rescue breathing and chest compressions. B) maintenance of a patient's body temperature. C) initial management of a patient with a seizure. D) manually stabilizing an injured person's neck.

A) rescue breathing and chest compressions.

23. During abrupt deceleration: A) shearing or rupturing of internal organs can occur. B) the neck commonly sustains hyperextension injuries. C) the skull provides excellent protection for the brain. D) supporting structures of the aorta keep it attached.

A) shearing or rupturing of internal organs can occur.

44. Specific functions that the paramedic should perform prior to contacting medical control are called: A) standing orders. B) online protocols. C) physician directives. D) predefined standards.

A) standing orders.

21. It is important to become involved in a national or state EMS organization, such as the National Association of EMTs (NAEMT) or the National Association of State EMS Directors (NASEMSD), because: A) such organizations have an impact on the future direction of EMS. B) these organizations offer continuing education for all EMS providers. C) membership in a professional organization is a tax-deductible expense. D) such organizations promote unique EMS training standards for each state.

A) such organizations have an impact on the future direction of EMS.

11. If the receiving facility does not have adequate resources to take care of your patient, you should next determine whether: A) there is an appropriate facility within a reasonable distance. B) an emergency physician should be dispatched to the scene. C) transport of the patient by ambulance is absolutely necessary. D) a BLS ambulance can transport the patient to a distant hospital.

A) there is an appropriate facility within a reasonable distance.

58. When research participants are advised of all the aspects of the project, the research project is said to be: A) unblinded. B) retrospective. C) cross-sectional. D) double-blinded.

A) unblinded.

36. When you transfer care of your patient to the hospital staff, it is MOST important to: A) use discretion and protect the patient's privacy. B) give a brief report and quickly return to service. C) only give your hand-off report to a staff physician. D) always obtain a signature from the receiving nurse.

A) use discretion and protect the patient's privacy.

70. You and your team are attempting to resuscitate a 50-year-old woman in a traumatic cardiac arrest. Your team consists of two EMTs and an AEMT. Which of the following tasks would be MOST appropriate to assign to the AEMT? A) Chest compressions B) IV therapy and fluid boluses C) Cardiac drug administration D) Emotional support for the family

B) IV therapy and fluid boluses

15. Which of the following statements regarding the EMT is correct? A) Manual defibrillation is a skill that all EMTs are required to learn and perform. B) In some states, EMTs are trained in advanced airway management and IV therapy. C) There are far more certified paramedics in the United States than there are EMTs. D) EMTs are licensed and can provide basic life support without medical direction.

B) In some states, EMTs are trained in advanced airway management and IV therapy.

49. Which of the following statements regarding peer review is correct? A) The EMS administrator is the ideal person to conduct the review. B) Peer review is not a tool to demean or belittle a fellow paramedic. C) It is preferable to use the same people to conduct all peer reviews. D) Review findings should be shared with others to facilitate learning.

B) Peer review is not a tool to demean or belittle a fellow paramedic.

41. Which of the following is NOT a typical function of the EMS medical director? A) Interfacing between EMS systems and other agencies B) Responding to an emergency scene with the paramedics C) Participating in the hiring process of new EMS personnel D) Developing protocols in cooperation with other EMS experts

B) Responding to an emergency scene with the paramedics

10. Which of the following statements regarding the EMS system is correct? A) The paramedic is usually the public's first contact with the EMS system. B) The paramedic is a public servant who often responds to non-emergency calls. C) The public's perception of an emergency is often the same as the paramedic's. D) Dispatch information is usually an accurate depiction of what really happened.

B) The paramedic is a public servant who often responds to non-emergency calls.

3. The entity that was created in 1966 and that provides authority and financial support for the development of basic and advanced life support programs is the: A) National Association of EMTs. B) United States Department of Transportation. C) National Highway Safety Department. D) Centers for Disease Control and Prevention.

B) United States Department of Transportation.

4. The primary determinants of the extent of trauma a patient sustains are the: A) type of object that strikes a patient and the part of the body that sustains the most impact. B) amount of energy in the object and the mechanism by which the object is delivered to the body. C) size of the object that strikes the body and any secondary injuries that occur if the patient falls. D) physical size of the patient and the part of the body that sustains direct impact from an object.

B) amount of energy in the object and the mechanism by which the object is delivered to the body.

12. At a minimum, a Level II trauma center should: A) have an in-house neurosurgeon 24 hours a day. B) be able to initiate definitive care for all injured patients. C) have access to an emergency physician within 20 minutes. D) provide total care for every aspect of a patient's injuries.

B) be able to initiate definitive care for all injured patients.

1. Mobile army surgical hospitals (M*A*S*H) saved thousands of soldiers' lives during the Korean war by: A) performing surgery within 30 minutes of the injury. B) bringing the hospital facilities closer to the battlefield. C) deploying combat medics to retrieve wounded soldiers. D) using helicopters to airlift casualties to the United States.

B) bringing the hospital facilities closer to the battlefield.

54. Research that is based on observation only, without an attempt to alter or change an event, is called ______________ research. A) prospective B) descriptive C) experimental D) retrospective

B) descriptive

63. In order to link research and evidence to patient care, one must: A) conduct research at least every 10 years and then perform a retrospective analysis of the data. B) ensure that the quality of the evidence is sufficient to justify changing patient care protocols. C) recognize that evidence is less reliable than scientific data that produce sound statistics. D) understand that only level 1 evidence can be used to justify changing patient care protocols.

B) ensure that the quality of the evidence is sufficient to justify changing patient care protocols.

17. Compared to an EMT, an AEMT: A) can administer a variety of emergency medications. B) has a more advanced knowledge of pathophysiology. C) is trained and authorized to perform manual defibrillation. D) can legally transfer patient care to a provider of lesser training.

B) has a more advanced knowledge of pathophysiology.

61. When gathering data for a research project that involves subjects in various age groups, standard deviation outlines: A) how close the scores in each set will be to the median. B) how much the scores in each set will differ from the mean. C) the most frequent age of the subject or subjects being used. D) the average age of the subjects used in the research project.

B) how much the scores in each set will differ from the mean.

17. An object increases its kinetic energy more by: A) decreasing its speed than by increasing its mass. B) increasing its velocity than by increasing its mass. C) decreasing its velocity than by decreasing its mass. D) increasing its mass than by increasing its velocity.

B) increasing its velocity than by increasing its mass.

33. You should prioritize the needs of your patient based on the: A) distance from the scene to the closest medical facility. B) injury or illness that requires the most urgent treatment. C) patient's interpretation of the seriousness of the situation. D) patient's age and the results of his or her initial vital signs.

B) injury or illness that requires the most urgent treatment.

68. While you and your partner are en route to the scene of a patient in cardiac arrest, you should expect the emergency medical dispatcher to: A) obtain your permission to give simple medical directions to the caller. B) instruct the caller on how to perform CPR until you arrive at the scene. C) advise you of the patient's medical history so you can be better prepared. D) tell the caller to place the patient in the recovery position and then reassess.

B) instruct the caller on how to perform CPR until you arrive at the scene.

39. When educating the public regarding your EMS system, you should do all of the following, EXCEPT: A) research the needs of your community. B) liken your job to EMS-related TV shows. C) advocate the importance of injury prevention. D) ensure that citizens know how to access EMS.

B) liken your job to EMS-related TV shows.

16. The "platinum 10 minutes" refers to the: A) maximum amount of time to extricate a patient. B) maximum time spent at a scene for a trauma patient. C) amount of time before decompensated shock occurs. D) amount of time taken to perform a rapid assessment.

B) maximum time spent at a scene for a trauma patient.

24. A paramedic is considered a health care professional, and as such should: A) demand respect from others who are in the EMS profession. B) meet societal expectations whether he or she is on or off duty. C) obtain more than the required amount of continuing education. D) maintain higher standards than other health care professionals.

B) meet societal expectations whether he or she is on or off duty.

62. Prior to conducting a research project in which people will be used as subjects, it is MOST important to: A) ensure that all the subjects are fully briefed on the perceived outcome. B) obtain consent from the subjects and ensure their safety and well-being. C) select subjects who are nonbiased and have no knowledge of the project. D) randomly select the subjects using the alternative time sampling method.

B) obtain consent from the subjects and ensure their safety and well-being.

71. You are moving from one state to another and plan to continue your career in EMS. The state to which you are moving will MOST likely require that you: A) become a registered paramedic with the National Registry of EMTs. B) obtain state certification and maintain adequate continuing education. C) show proof that you have worked as a paramedic for at least 10 years. D) repeat an entire paramedic training program and take a state examination.

B) obtain state certification and maintain adequate continuing education.

75. You arrive at a convenience store to find a middle-aged male in cardiac arrest. Your protocols provide for standing orders in this type of scenario. This means that you should: A) contact medical control before providing advanced-level care. B) perform certain interventions prior to contacting medical control. C) begin CPR and then contact medical control for further direction. D) pronounce the patient dead if there is no response after 10 minutes.

B) perform certain interventions prior to contacting medical control.

42. The MAIN benefit to online medical control is that it: A) affords the paramedic better protection against a lawsuit. B) provides an immediate and specific patient care resource. C) allows the physician and paramedic to develop a rapport. D) facilitates a faster transport to the emergency department.

B) provides an immediate and specific patient care resource.

34. When faced with a situation that is not addressed in your EMS system's protocols, you should: A) contact the nurse at the receiving facility. B) radio your medical director to obtain orders. C) proceed with basic life support and transport. D) let experience guide further care of the patient.

B) radio your medical director to obtain orders.

28. If a paramedic is self-motivated, he or she should NOT: A) continuously educate himself or herself. B) require maximum supervision at work. C) possess an internal drive for excellence. D) be able to accept constructive feedback.

B) require maximum supervision at work

7. According to the American College of Surgeons, an injured patient should be transported to a Level I trauma center if his or her: A) heart rate is greater than 100 beats/min. B) systolic blood pressure is less than 90 mm Hg. C) respiratory rate is less than 14 breaths/min. D) Glasgow Coma Scale score is less than 15.

B) systolic blood pressure is less than 90 mm Hg.

22. Penetrating trauma occurs when: A) internal organs are lacerated and bleed profusely. B) tissues are penetrated by single or multiple objects. C) blunt force trauma causes explosive open injuries. D) a fractured rib perforates the parenchyma of a lung.

B) tissues are penetrated by single or multiple objects.

1. The acute physiologic and structural change that occurs in a patient's body when an external source of energy dissipates faster than the body's ability to sustain and dissipate it is called: A) injury. B) trauma. C) deceleration. D) kinematics.

B) trauma.

22. Performing the functions of a paramedic prior to licensure is: A) immoral. B) unlawful. C) unethical. D) permissible.

B) unlawful.

9. The EMS network begins: A) by educating dispatchers. B) with citizen involvement. C) when an injury has occurred. D) when paramedics are notified.

B) with citizen involvement.

37. When returning your unit to service following a call, the responsibility of ensuring that the unit is restocked and ready for another call rests with: A) the paramedic in charge. B) the medic who was driving. C) everyone on the EMS team. D) the shift captain or supervisor.

C) everyone on the EMS team.

55. A scientific approach to research in which a researcher controls, manipulates, and then measures one or more variables to ascertain how manipulating the variables affects the subjects is called ______________ research. A) prospective B) qualitative C) experimental D) nonexperimental

C) experimental

5. The first EMT textbook, Emergency Care and Transportation of the Sick and Injured, was published in 1971 by the: A) National Association of EMS Educators (NAEMSE). B) American College of Emergency Physicians (ACEP). C) American Academy of Orthopaedic Surgeons (AAOS). D) American Association of Critical Care Nurses (AACN).

C) American Academy of Orthopaedic Surgeons (AAOS).

5. Which of the following general statements regarding trauma is correct? A) Bullet impact is less if the energy in the bullet is applied to a small area. B) The position of the patient at the time of the event is considered to be an internal factor. C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma. D) Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period.

C) Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma.

13. What instructions or guidance would an emergency medical dispatcher MOST likely provide to a caller? A) How to properly use a bag-mask device B) How to obtain a blood pressure by palpation C) How to control bleeding and perform CPR D) How to administer prescribed antihypertensives

C) How to control bleeding and perform CPR

7. Which of the following was NOT a required component identified by the Emergency Medical Services System Act of 1973? A) EMS research B) Mutual aid agreements C) National EMS certification D) Integration of health services

C) National EMS certification

65. Which of the following is NOT a typical question to answer when evaluating and interpreting research? A) Is your conclusion based on the data? B) Did you account for all confounding variables? C) Will the research study be published in a notable journal? D) Was the study approved and conducted in an ethical fashion?

C) Will the research study be published in a notable journal?

27. Being empathetic toward a patient means that you: A) reassure the patient of your competence. B) know exactly how the patient feels. C) acknowledge the patient's feelings. D) feel a sense of sorrow for the patient.

C) acknowledge the patient's feelings.

25. The MOST common site of deceleration injury in the chest is the: A) heart. B) esophagus. C) aorta. D) vena cava.

C) aorta.

57. The LEAST preferable and reliable method of selecting people to participate in a research study is: A) random sampling. B) systematic sampling. C) convenience sampling. D) alternative time sampling.

C) convenience sampling.

20. Sudden deceleration of a motor vehicle that is traveling at 60 mph: A) typically generates forces of up to 10 to 20 g. B) initially causes whiplash injuries to the patient's neck. C) dissipates tremendous forces and causes major injuries. D) causes the driver's body to stop moving at the same time.

C) dissipates tremendous forces and causes major injuries.

19. The law of conservation of energy states that: A) kinetic energy can be converted only to thermal or chemical energy. B) the force that an object can exert is the product of its mass multiplied by its acceleration. C) energy can be neither created nor destroyed; it can only change form. D) a body at rest will remain at rest unless acted upon by an outside force.

C) energy can be neither created nor destroyed; it can only change form.

11. A specific attribute of a Level I trauma center is that it: A) is involved in an injury prevention program. B) can initiate definitive care for all injured patients. C) has 24-hour in-house coverage by general surgeons. D) has rapid access to an off-site anesthesiologist.

C) has 24-hour in-house coverage by general surgeons.

53. The first part of EMS research is to: A) obtain medical director authorization. B) determine if there is adequate funding. C) identify a specific problem or question. D) determine the style of research to be used.

C) identify a specific problem or question.

18. A major recommendation made by the 2009 EMS Education Standards for paramedic training was the: A) removal of endotracheal intubation from the minimum core content of the training program. B) addition of 750 hours of clinical and field training above and beyond classroom education. C) inclusion of a college-level anatomy and physiology course as part of the training program. D) prerequisite that all paramedic students possess a minimum of an associate's degree.

C) inclusion of a college-level anatomy and physiology course as part of the training program.

32. After ensuring your own personal safety, your next priority should be to: A) ensure the safety of your patient. B) proceed quickly with patient care. C) make sure that your partner is safe. D) provide safety for any bystanders.

C) make sure that your partner is safe.

14. If an emergency medical responder is appropriately trained and competent, he or she should be able to: A) detect signs of patient deterioration, obtain baseline vital signs, and give IV fluids to maintain adequate perfusion. B) perform lifesaving interventions and transport the patient after paramedics have performed a detailed physical exam. C) recognize the seriousness of a patient's condition, provide basic life support care, and relay information to the paramedic. D) develop a field diagnosis of the patient's problem, perform limited advanced airway techniques, and update responding paramedics.

C) recognize the seriousness of a patient's condition, provide basic life support care, and relay information to the paramedic.

23. Records of your education, state or local credentials, and recertification are held by a recognized agency through a process called: A) licensure. B) reciprocity.. C) registration. D) certification.

C) registration.

48. Peer review can be a good learning experience if: A) the EMS system's medical director and administrative staff take part in the process. B) the person or persons conducting the review have at least 10 years of EMS experience. C) those conducting the review have good guidelines to follow and the person being evaluated keeps an open mind. D) the information gained from the review is shared with other personnel within the EMS system.

C) those conducting the review have good guidelines to follow and the person being evaluated keeps an open mind.

43. A protocol is MOST accurately defined as a(n): A) nationally accepted standard of care. B) verbal order given by the medical director. C) treatment plan for a specific illness or injury. D) agreement between the paramedic and physician.

C) treatment plan for a specific illness or injury.

13. If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury: A) by ground to the Level I trauma center. B) to the closest hospital for stabilization. C) via air transport to the Level I trauma center. D) by ground to the Level II trauma center.

C) via air transport to the Level I trauma center.

69. Upon arriving at the scene of a motorcycle crash, you are approached by an EMR. What is the MOST important information the EMR should provide to you? A) The patient's vital signs and the presence of any underlying medical conditions B) How the crash occurred and approximately when he or she first arrived at the scene C) His or her perception of the criticality of the patient's condition and suspicion for internal bleeding D) Initial scene and patient assessment findings and any basic care that was provided to the patient

D) Initial scene and patient assessment findings and any basic care that was provided to the patient

6. Which of the following will be of MOST benefit in helping the paramedic predict the type of injuries that a patient experienced? A) Index of suspicion B) Past medical history C) Age of the patient D) Mechanism of injury

D) Mechanism of injury

21. Which of the following injury mechanisms would MOST likely result in blunt trauma? A) Small-caliber gunshot wound B) Explosion involving shards of glass C) Falling from a tree onto a fence D) The pressure wave caused by a blast

D) The pressure wave caused by a blast

15. When summoning an air transport service to transport a critically injured patient, it is MOST important to: A) determine the flight crew's credentials. B) ensure that the fire department is present. C) predetermine the destination facility. D) activate the service as soon as possible.

D) activate the service as soon as possible.

64. An unblinded research study is one in which: A) some of the participants are aware of all aspects of the project. B) nobody is aware of any of the aspects of the research project. C) only the principal researcher is aware of all aspects of the project. D) all research participants are advised of all aspects of the project.

D) all research participants are advised of all aspects of the project.

46. The main goal of any CQI program is to: A) promptly correct any problems once they are identified. B) identify and remove paramedics who are not competent. C) revamp protocols based on the current standards of care. D) assess for ongoing improvement before a problem arises.

D) assess for ongoing improvement before a problem arises.

74. Prior to transporting a 66-year-old woman with chest pain to the hospital, she expresses the need to retrieve her bible and say a prayer. You should: A) advise the patient that a minister will talk with her at the hospital. B) tactfully explain to the patient that her condition will not allow it. C) leave the room if your religious beliefs are not consistent with hers. D) be respectful of the patient's wishes and give her the time she needs.

D) be respectful of the patient's wishes and give her the time she needs.

40. A major distinction between a paramedic and an EMT is that the paramedic: A) is more likely to be sued for negligence. B) is held to a higher professional standard. C) can function independently of a physician. D) carries out advanced pharmacologic skills.

D) carries out advanced pharmacologic skills.

56. Research that is based on a group of individuals at one point in time is called ______________ research. A) descriptive B) prospective C) retrospective D) cross-sectional

D) cross-sectional

12. Common actions performed by the dispatcher after receiving an emergency call include all of the following, EXCEPT: A) receiving and entering all data regarding the call. B) relaying information to the appropriate resources. C) interpreting the information provided by the caller. D) determining if an ambulance should be dispatched.

D) determining if an ambulance should be dispatched.

52. The main purpose of research in EMS is to determine: A) if EMS is eligible for federal funding. B) the easiest approach to treating a patient. C) if local EMS protocols should be amended. D) whether treatment is effective or ineffective.

D) whether treatment is effective or ineffective.

6. Dr. Eugene Nagel advanced emergency medical treatment in 1969 by: A) training paramedics to administer certain medications directly through the chest wall and into the left ventricle. B) developing and implementing closed-chest cardiac massage (CPR) in order to pump blood in a patient without a pulse. C) implementing the "golden hour," which dramatically increased survival rates of patients who experienced severe trauma. D) developing a telemetry system that enabled fire fighters to transmit a patient's electrocardiogram to the physician at the hospital.

D) developing a telemetry system that enabled fire fighters to transmit a patient's electrocardiogram to the physician at the hospital.

10. If the mechanism of injury does not appear to be significant, you should consider transporting an injured patient to a Level I trauma center if he or she: A) is older than 45 years of age. B) takes any kind of medication. C) is emotionally upset or angry. D) has a known bleeding disorder.

D) has a known bleeding disorder.

35. When deciding which medical facility is most appropriate for your patient's needs, it is MOST important to: A) consider the distance from the scene to the hospital. B) ask the patient where his or her physician is located. C) be knowledgeable of the major streets and highways. D) know the capabilities of all the hospitals in your area.

D) know the capabilities of all the hospitals in your area.

19. The 2009 National EMS Education Standards: A) clearly state that all paramedic training programs must be at least 1,200 hours in length. B) require inclusion of a college-level pathophysiology course within the paramedic program. C) mandate that the paramedic designation must be achieved through an associate degree program. D) outline the minimum knowledge base that the paramedic must possess in order to function in the field.

D) outline the minimum knowledge base that the paramedic must possess in order to function in the field.

30. All of the following are examples of injury prevention, EXCEPT: A) demonstrating the proper use of a bicycle helmet. B) instructing a person on how to wear a seat belt properly. C) informing a patient of a loose rug at the top of the stairs. D) teaching rescue breathing and CPR to a group of citizens.

D) teaching rescue breathing and CPR to a group of citizens.