Block 2

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours

Which of the following is an appropriate dose of activated charcoal for a 20kg child?

20g

At a flow rate of 6 l/min, a nasal cannula can deliver an approximate oxygen concentration of up to:

44%

If a baby is born at 7.52, the second Apgar score should be calculated at :

7.57

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of:

8

With a good mask to face seal and an oxygen flow rate of 15 l/min, the nonrebreathing mask is capable of delivering up to % inspired oxygen.

90%

Which of the following patients is in decompensated shock?

A 20 year old female with absent radial pulses and dilated pupils

In which of the following patient would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway?

A 37- year old female who is found unconscious in her bed

Characteristic anatomic features of Down syndrome include:

A round head with a flat occiput

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular, and his pulse is slow and weak. His daughter tells you that he fell the day before but refused to allow her call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be most suspicious that this patient is experiencing:

A subdural hematoma

A 56 year old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:

Acute myocardial infarction

A 66 year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours duration. Her blood pressure is 140/90 mm Hg. her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not haver prescribed nitroglycerin, but her husband does. You should

Administer oxygen give her 324 mg of aspirin, and and heart her further

A 51 year old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breath/min and regular. You Should:

Administer oxygen via a nonrebreathing mask

A 23 year old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has agonal gasps, and has copious bloody secretions in his mouth. How should you manage his airway?

Alternate oropharyngeal suctioning and ventilation with a bag-mask device

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

Ask the patient if she has developed a suicidal plan

Law enforcement has summoned you to a nightclub, where a 22year old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

Assist ventilations, perform a rapid exam, and prepare for immediate transport

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 mins . You should:

Begin CPR apply the AED, and deliver a stock if it is indicated

General guidelines for managing a patient with a behavioral emergency include:

Being prepared to spend extra time with the patient

Alkalosis is a condition that occurs when:

Blood acidity is reduced by excessive breathing

Which of the following is not a component of the Apgar scorer?

Body size

Cerebral palsy is a condition that results from damage or injury to the:

Brain

A man was found unresponsive in his bed at home> There is no evidence of injury, and the patient's medical history is not known. The patient's face is cherry red, yet the pulse oximeter reads 98%. Which of the following would MOST likely explain this?

Carbon monoxide poisoning

Which of the following injuries would MOST likely cause obstructive shock?

Cardiac temponade

You are treating a middle - aged man with chest discomfort. He has a history of three previous heart attacks and takes nitroglycerin as needed for chest pain. you have standing orders to administer aspirin to patients with suspected cardiac-related chest pain or discomfort. While your partner is preparing to give oxygen to the patient. you should:

Confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin and document the time and dose given

Esophageal varices MOST commonly occur in patients who:

Consume a lot of alcohol

Which of the following is an indication of imminent birth?

Crowning of the baby's head

Which of the following signs is commonly observed is patients with right-sided heart failure?

Dependent edema

A 30 year old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his recusal of transport?

He is currently not prescribed any medications

The purpose of the GEMS diamond is to:

Helps EMS personnel remember what is different about elderly patients

You are dispatched to a residence for a 66 year old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:

Imitate CPR and attach an AED as soon as possible

Cardiogenic shock may result from all of the following EXCEPT:

Increased preload

You respond to the residence of a 70 year old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious but appears confused. His blood pressure is 98/54 mm Hg. his pulse rate is 120 beats/min and irregular, and his respirations are 24 breath/min and labored. You should:

Leave him in a sitting position, keep him warms, and prepare for immediate transport

A 29 year old pregnant women has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardia. This EMT should suspect:

Mallory- Weiss tear

To reverse the effects of a narcotic overdose you should administer:

Narcan

A 60 year old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient?

Oxygen via nonrebreathing mask and a focused secondary assessment

A 67 year old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes:

Placing her in an upright position

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accu8rately describes:

Psychogenic shock

Which of the following statements regarding pulse oximetry is correct?

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood

A 19 year old female is found unconscious by her roommate. Yours primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should:

Remove the airway and be prepared to suction her oropharynx

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old women. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her side. You should:

Repeat the arm drift test, but move the patient's arms into position yourself

A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation?

Request a police officer to accompany you in the ambulance

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

Shortness of breath and a blood pressure of 76/56 mm Hg

Which of the following clinical signs would necessitate the administration of naloxone (Narcan) in a suspected narcotic overdose?

Slow respirations

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He is unable to cough and becomes cyanotic around the lips. You should:

Stand behind him and administer abdominal thrusts

A 67 year old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:

Stop the ambulance, begin CPR, and attach the AED as soon as possible

Which of the following statements regarding the hypoxic drive is correct?

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels

A 58 year old male presents with confusion, right sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?

a small clot in a cerebral artery cause temporary symptoms

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

administering blow by oxygen and transporting the child with her mother

A normal level of consciousness in an infant or child is characterized by:

age-appropriate behavior, good muscle tone, and good eye contact

A 60 year old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardia. The EMT should suspect:

aortic aneurysm

The components of the pediatric assessment triangle (PAT) are:

appearance, work of breathing, and skin circulation

You respond to a residence for patient with a severe led injury following an accident with a chainsaw. When you arrive, you find the patient, a 44 year old male, lying supine in the backyard. He has a partial amputation of his right, lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:

apply direct pressure to the wound

After ensuring his or her own safety, the EMT's next priority when caring for a patient with a behavioral emergency is to:

assess the patient's response to his or her environment

A 62 year old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen, if needed, and contacting medical control, you should:

assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:

assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center

The third stage of labor begins when the :

baby is expelled from the vagina

You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control?

begin transport to the hospital and closely monitor her condition while en route

When assessing a patient with signs and symptoms of shock, it is important to remember that:

blood pressure may be the last measurable factor to change in shock

The inferior vena cave returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the :

brain

The primary waste product of aerobic metabolism is :

carbon dioxide

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tub?

check the mechanical ventilator for malfunction

A 19 year old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. You should:

contact medical control and administer oral glucose

A conscious and alert 29 year old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40 F(5c). On exam, you hear bilateral expiratory wheezing . After providing supplemental oxygen, you should:

determine if she has been prescribed a beta-agonist inhaler

You are dispatched to a residence for a 40 years old female who fainted. Upon your arrival, the patients is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:

determine if she was injured when she fainted

You are dispatched to a skilled nursing care facility for an 80 year old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should:

determine the patient's baseline mental status

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should:

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing

EMTs are dispatched to a residence for an 80 year old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular, and she conscious and alert. The EMTs should suspect that the patient:

experienced a vasovagal response

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:

external respiration

When assessing the heart rate of a 6 month old infant, you should palpate the brachial pulse or pulse

femoral

You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient's potential for violence?

his large body size

A 2-month-old infant was found unresponsive in his crib by his mother. When you arrive, you determine that the infant is apneic and pulseless. His skin is pale and cold and his arms are stiff. You should:

inform the child's mother that her son is deceased

You are dispatched to an apartment complex where a 21 year old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:

insert a nasopharyngeal airway and begin assisted ventilation

The leading cause of maternal death during the first trimester of pregnancy is:

internal bleeding caused by a ruptured ectopic pregnancy

A mucosal atomizer device (MAD) is used to deliver certain medications via the :

intranasal route

The stooped posture of some older people, which gives them a humpback appearance, is called

kyphosis

Talking about an elderly patient in front of him or her to other members of the family:

might cause the patient to think that he or she has no say in making decisions

In contrast to abruptio placentas, placenta previa:

might present without significant abdominal pain

You unit is dispatched to a county jail for intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be most concerned that this patient:

might vomit and aspirate

An acute myocardial infarction (AMI) occurs when:

myocardial tissue dies secondary to an absence of oxygen.

EMTs respond to a known heroin abuser who is unresponsive. If they give naloxone (Narcan) to this patient, the EMTs should recall that:

naloxone administration could seizures in this patient

When preparing to obtain a 12-lead EGG, the V1 and V2 electrodes should be placed

on either side of the sternum

After using the pediatric assessment triangle (PAT) to form your general impression of a sick or injured child, you should:

perform a hands on assessment of the ABCs

A 2 year old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You Should:

perform abdominal thrusts

A 71 year old male is semiconscious following a sudden, severe headache. There is vomitus on his face, and his respirations are slow and shallow. The EMT must immediately:

perform oropharyngeal suctioning

Autism is defined as a:

pervasive developmental disorder characterized by impairment of social interaction

A 59n year old male presents with severe vomiting and diarrhea of 3 days duration. He is confused and diaphoretic, and his radial pulses are absent . His blood pressure is 78/50 mm Hg. After applying supplement oxygen, you should:

prepare for immediate transport

A 29 year old presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:

provide ventilatory support

Immediately after physically restraining a violent patient, the EMT should:

reassess the patient's airway and breathing

You are caring for a 68 year old man with sudden onset of left-0sided paralysis and slurred speech. His airway is patient, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include:

recovery position and transport

You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:

remain in a safe place and request law enforcement

Bruising to the --- is least suggestive of child abuse

shins

On contrast to the sympathetic nervous system, the parasympathetic nervous system:

slows the heart and respiratory rates

Solid abdominal organs include the :

spleen, kidneys, and pancreas

You are dispatched to a local elementary school for an injured child. As you approach the child , you note that he is lying at the base of the monkey bars. He is unresponsive, and there are no signs of breathing, You should:

stabilize his head and check for a pulse

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should:

start at the lower lung fields and determine at which level you start hearing clear breath sounds

When determining the frequency of contractions, you should time the contractions from the:

start of one to the start of the nexts6t

Proper technique for suctioning the oropharynx of an adult patient includes:

suctioning while with drawing the catheter from the oropharynx

In which position should you restrain a physically uncooperative patient?

supine

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

the injury might have been preceded by a medical condition

In contrast to a living will, a " do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest